TikTok addiction has been linked to depression and anxiety, yet mechanisms underlying this relationship remain underexplored. Based on the Social Comparison and Uses and Gratifications theories, this study examined whether perceived ageism experiences mediate the relationship between TikTok addiction and depression and anxiety among Lebanese adults. The research also explores, as a theoretical possibility, whether TikTok's algorithm may be associated with greater perceived ageism experiences, which in turn would relate to psychological distress.

A cross-sectional survey was conducted among 855 participants (mean age 24.39; 76.7% females) using the TikTok Addiction Test, WHO Ageism Scale, and PHQ-4. Data were analyzed using SPSS and mediation analysis via PROCESS Macro controlling for demographic and health covariates, such as gender, education level and a history of mental health diagnosis. The mediation analysis included 735 participants with complete data for all variables entered into the model.

TikTok addiction was positively associated with psychological distress. Perceived ageism experiences partially mediated this relationship (unstandardized indirect effect: B = 0.0149, BootSE = 0.005, 95% percentile bootstrapped CI [0.0058, 0.0255]). Higher TikTok addiction symptoms were associated with greater perceived ageism experiences, which were in turn associated with higher psychological distress levels. Demographic analysis showed that females, those with lower levels of education and individuals with a history of mental health diagnosis reported higher psychological distress. Age was negatively correlated with psychological distress, showcasing higher vulnerability among younger individuals.

Findings highlight perceived ageism experiences as a small but statistically significant mediator between addictive digital media use and psychological distress. The study emphasizes the need for culturally sensitive mental health and digital literacy interventions, as they aim to support the deconstruction of idealized youthful standards, particularly with the Lebanese context where digital media serves as escapism.

Shared reading supports early child development, but parental depressive symptoms may reduce its frequency and quality. Most previous studies assumed linear relationships with small samples. This large cross-sectional study examined linear and non-linear associations between parental depressive symptoms and shared reading practices in Chinese preschoolers.

We recruited 21,366 parent-child dyads (children aged 3-6 years) from 189 kindergartens in western China. Depressive symptoms were measured with the Center for Epidemiologic Studies Depression Scale (CES-D). Shared reading was assessed using the StimQ READ subscale. Multivariable linear regression, piecewise linear regression with threshold estimation, and natural spline analysis were performed, adjusting for sociodemographic covariates.

Higher CES-D scores were linearly associated with lower total reading scores (adjusted β = -0.074 per point, 95% CI: -0.081 to -0.067). Piecewise regression identified a significant estimated breakpoint at CES-D score = 19.0 (95% CI: 11.9-26.1), below this threshold the slope was steeper (β = -0.085) than above (β = -0.051). Natural spline analysis confirmed non-linearity (P = 0.026) and located the point of maximum curvature at CES-D score = 10.9, indicating the most rapid change in slope occurred at subclinical symptom levels. The association was consistent across all subgroups (after Bonferroni correction).

Parental depressive symptoms are negatively associated with shared reading in a non-linear, breakpoint-dependent manner. Even subclinical symptoms (CES-D score≈ 11) are associated with steeper declines, while the association attenuates at higher levels (CES-D score ≈ 19). Interventions targeting parental mental health, especially at subclinical to moderate symptom levels, may help preserve high-quality home literacy environments.

Cervical clear cell carcinoma (CCC) is a rare and aggressive subtype of cervical adenocarcinoma whose molecular drivers and therapeutic vulnerabilities remain incompletely defined. As a key component of the SWI/SNF chromatin-remodeling complex, ARID1A has been recognized as a potential biomarker of therapeutic response across multiple human malignancies. Nevertheless, the molecular and clinical significance of ARID1A in CCC has not been systematically clarified. This study aimed to characterize the genomic landscape of CCC and explore whether ARID1A deficiency serves as a molecular signature that confers actionable therapeutic vulnerabilities for precision oncology.

We retrospectively collected clinicopathological data from 27 patients diagnosed with CCC at Sun Yat-sen University Cancer Center between August 2018 and May 2023. Targeted next-generation sequencing (NGS) was performed using a cancer-related panel with complete exon coverage of 312 genes and selected-region coverage of additional cancer-associated genes in tumor tissues and matched peripheral blood samples from 7 patients to identify recurrent genomic alterations and perturbed biological pathways. Functional enrichment analyses, including Gene Ontology (GO), Kyoto Encyclopedia of Genes and Genomes (KEGG), and protein-protein interaction (PPI) network analyses, were conducted to identify altered pathways and candidate hub genes. Based on the integrated genomic and network analyses, ARID1A was selected for further evaluation, and ARID1A protein expression was evaluated by immunohistochemistry in 27 CCC samples and 30 HPV-associated cervical adenocarcinoma (HPVA) samples.

The median age of enrolled patients was 47.6 years, and 74.1% of patients presented with early-stage disease (FIGO IA-IIA). With a median follow-up duration of 44.6 months, the 3- and 5-year overall survival rates were 90% and 77%, respectively. Targeted NGS identified a total of 93 somatic alterations spanning 78 genes, with recurrent alterations predominantly occurring in ARID1A, PIK3CA, SMARCA4, and JAK3. Pathway enrichment revealed significant perturbations in chromatin-remodeling, PI3K-AKT, p53, and JAK-STAT signaling pathways. PPI network analysis identified ARID1A, PIK3CA, EGFR, and CTNNB1 as core hub molecules mediating tumorigenesis. Complete loss of nuclear ARID1A expression was detected in 51.8% of CCC cases, significantly higher than the 6.0% rate detected in HPVA lesions (P < 0.001).

CCC exhibits a distinct molecular profile characterized by frequent disruption of chromatin-remodeling pathways. Enrichment analyses linked ARID1A deficiency to concurrent genomic aberrations affecting chromatin remodeling and PI3K/AKT cascades. Our findings suggest that ARID1A loss could act as a potential adjunctive diagnostic marker when interpreted together with histopathological features, HPV status, and other immunohistochemical markers, while representing a therapeutic vulnerability requiring further validation.

Primary dysmenorrhea (PD) affects a high percentage of women of reproductive age and is one of the most common causes of school and work absenteeism. It significantly reduces quality of life and impairs daily activities. Strawberry consumption has demonstrated benefits in chronic and inflammatory diseases. Therefore, the aim of this study was to evaluate the effectiveness of consuming fresh strawberries from Huelva on menstrual pain in young female university students with primary dysmenorrhea.

A randomized clinical trial was conducted including 64 participants with PD, who were randomly assigned to either the control (n = 31) or intervention group (n = 33). The intervention consisted of the daily intake of 250 g of fresh strawberries (Fragaria × ananassa, Fortuna cultivar) for 1 month. The primary outcome was pain intensity assessed using the visual analog scale (VAS). The secondary outcomes included the variables menstrual cycle length, bleeding duration, hours of sleep, absenteeism, perception of health status, State-Trait Anxiety Inventory (STAI) and mental well-being. The data were collected at baseline, at 1 month and at 2 months.

A significant decrease in maximum self-reported menstrual pain was observed at one and 2 months compared with baseline in the intervention group. Regarding menstrual cycle duration, a significant between-group difference was observed between the cycle preceding the study and the second cycle, with a greater shortening in the control group. Perceived health status was also significantly higher in the intervention group at one and 2 months compared with the control group.

These findings support the recommendation that healthcare professionals promote the consumption of polyphenol-rich foods, such as strawberries, for the relief of menstrual pain.

ClinicalTrials.gov NCT06250660 on 2024/01/26. This clinical trial was funded by the Asociación Onubense de Productores y Exportadores de Fresa, Freshuelva.

Prior research has extensively documented dependency framing in welfare discourse during the mid-to-late twentieth century, but less is known about whether this framing persists in more recent periods. This study examines U.S. newspaper discourse on social welfare during three periods marking key welfare and child welfare policy shifts: 1994-1996 (welfare reform), 2016-2018 (child welfare reform), and 2021-2023 (post-pandemic).

We randomly sampled 40 ProQuest-indexed newspaper articles from each period (120 total) addressing welfare, child welfare, unemployment insurance, or education spending. Using a mixed deductive-inductive qualitative content analysis, we examined recurring frames, their relationships, and how they were articulated across policy domains and periods. Our analysis characterizes how these frames organize meaning and share an underlying cultural logic rather than estimating their prevalence in the broader population of news coverage.

Consistent with prior research, dependency framing was common in the 1990s sample. Dependency became less prominent relative to child maltreatment framing in the later periods. The policy program under discussion also shaped which frames were most salient. Despite the declining prominence of dependency language, classic culture of poverty logics (individual pathology and family blame) persisted across periods.

Moralized narratives associated with culture of poverty theory were rearticulated in forms that increasingly centered children's endangerment. These findings demonstrate how longstanding cultural logics can persist even as their language and policy focus change, with implications for the construction of deservingness in social welfare debates.

To evaluate the association between receiving a resilience-focused program in addition to standard care and depressive symptoms and medication adherence among patients with CHB receiving antiviral therapy.

In this retrospective cohort study, 200 patients diagnosed with CHB and treated at our hospital's hepatology clinic between July 2022 and June 2025 were included. Based on historical records, 100 patients who voluntarily completed a structured 12-week resilience promotion program in addition to standard care formed the observation group, and 100 patients who received standard care only formed the control group. Primary outcomes at the 6-month follow-up were depressive symptom severity measured by the Patient Health Questionnaire-9 (PHQ-9) and medication adherence measured by the Medication Possession Ratio (MPR). Secondary outcomes included resilience (Connor-Davidson Resilience Scale-10, CD-RISC-10), virological response, alanine aminotransferase (ALT) normalization, quality of life (SF-36), adverse events, and healthcare utilization. To account for potential confounding by indication and baseline imbalances, multivariable linear, logistic, and Poisson regression models were used, with adjusted effect estimates and 95% confidence intervals reported.

At the 6-month follow-up, the observation group had lower depression scores (6.78 ± 3.45 vs. 10.23 ± 4.12), higher MPR (0.92 ± 0.08 vs. 0.78 ± 0.15), and higher resilience scores (32.45 ± 5.67 vs. 26.78 ± 6.34). Virological response (85.0% vs. 70.0%; adjusted OR 2.46, 95% CI 1.35 to 4.48) and ALT normalization (80.0% vs. 65.0%; adjusted OR 2.01, 95% CI 1.10 to 3.67) were more frequent in the observation group. SF-36 physical and mental component scores were also higher in the observation group. Adverse event incidence was similar between groups. The observation group had fewer unplanned outpatient visits (P = 0.045), and Poisson regression confirmed fewer outpatient visits in the observation group (adjusted rate ratio 0.72, 95% CI 0.56 to 0.93). However, because allocation was non-randomized, these associations may be affected by self-selection and residual confounding.

In this retrospective cohort study, receiving a resilience-focused program in addition to standard care was associated with lower depressive symptoms, better medication adherence, and more favorable virological and biochemical outcomes in patients with CHB.

Children's health and educational outcomes are interconnected, and unmet health needs affect youths' readiness to learn. Comprehensive school health (CSH) systems are designed to promote academic success and well-being for all youth. State and local health and education leaders benefit from guidance on how to build, fund, and sustain effective CSH systems to support the whole child.

In this article, we offer core areas for CSH policy development with recommendations for enhancing the quality and scale of CSH systems.

Several key policy opportunities and strategies aligned with core features of a CSH are identified, including (1) adoption of a CSH framework, (2) enhancement of cross-sector coordination and collaboration, (3) use of standardized metrics to enhance CSH system quality, (4) engagement of youth and families in system building, (5) use of innovative strategies to enhance workforce capacity and development, and (6) establishment of a strategic funding plan.

State and local health and education departments are challenged to act upon key policy opportunities to build, fund, and sustain CSH systems to promote student success, health, and well-being.

In this quasi-experimental study, we examined whether AI-assisted wushu (Chinese martial arts) routine training, delivered through camera-based immediate post-performance movement feedback, was associated with greater improvements in mental health, cognitive performance, and cardiovascular function than conventional wushu instruction among university students.

A campus-based, two-group, quasi-experimental pre-post design with non-randomized allocation by course section was conducted over 6 weeks among 298 physical education undergraduates (n = 149 per group). Outcomes included perceived stress, anxiety, psychological well-being, and emotion regulation (mental health); Stroop, digit-span, n-back, and Trail-Making Test performance and a composite executive-function index (cognitive performance); and resting heart rate, blood pressure, heart-rate variability, vital capacity, and heart-rate recovery (cardiovascular function). Post-intervention group differences were modeled with ANCOVA adjusting for baseline scores, age, sex, and BMI; associations between movement-quality gain and outcome change were examined with Pearson correlation and covariate-adjusted bootstrapped mediation, with false discovery rate correction applied.

Groups did not differ significantly at baseline (all p > 0.07). Both groups improved on every outcome (all p < 0.001), and after adjustment the AI-assisted group showed somewhat larger gains, including for perceived stress (adjusted mean difference -1.20, 95% CI - 1.74 to -0.66), psychological well-being (+1.15, 95% CI 0.39 to 1.91), n-back accuracy (+2.37, 95% CI 1.59 to 3.15), the executive-function index (+0.12, 95% CI 0.07 to 0.18), resting heart rate (-1.09 bpm, 95% CI - 1.58 to -0.60), and vital capacity (+51.6 mL, 95% CI 34.8 to 68.4; all p < 0.03, retained after FDR correction). Movement-quality gain correlated modestly with cognitive-affective but not cardiovascular improvement (r = 0.17-0.22, p < 0.01), and partially mediated group effects on emotion regulation and executive function.

These findings therefore support a multiple-pathway interpretation of the incremental AI-feedback effect rather than a single motor-skill mechanism. Given the non-randomized design, these associations are preliminary rather than definitive evidence of causal benefit; randomized, longer-term studies with appropriate active controls are needed to confirm mechanisms, durability, and generalizability.

Non-communicable diseases have become a major public health concern, with shifting trends in epidemiology among the tribal populations of India. Among them, type 2 diabetes is emerging as an epidemic, with an estimated prevalence of 19% in West Bengal. Due to inequities in health care access and utilization among tribal communities, seeking treatment for type 2 diabetes differs significantly from the general population.

This project aimed to improve the quality of diabetes screening and management services in mobile medical clinics in Nagrakata, Jalpaiguri Sadar, and Dhupguri, Jalpaiguri district, West Bengal, India, through the implementation of evidence-based recommendations.

The project used a mixed methods approach, incorporating both quantitative and qualitative data collection and analysis, to evaluate the implementation of type 2 diabetes services in mobile medical clinics. It was guided by JBI's seven-phase approach to evidence implementation, incorporating audit and feedback, and a structured framework to identify barriers, enablers, and implementation strategies.

The project recorded increased compliance with the best practice recommendations across all the settings. The quality of screening practices was improved through strategies such as the dissemination of information, education, and communication materials; strengthening risk communication between health care professionals and community members; and the inclusion of risk assessment tools.

This JBI evidence implementation project demonstrated that structured and context-specific strategies can meaningfully improve adherence to evidence-based diabetes screening practices in mobile medical clinics in underserved tribal populations. Significant improvements were observed in risk-based screening, patient education, communication of results, and use of standardized assessment tools.

https://links.lww.com/IJEBH/A706.

Nigeria's healthcare system faces several persistent structural challenges. Public-private partnerships (PPPs) have emerged as a strategy to address these gaps, although evidence on their implementation and impact remains fragmented. This scoping review mapped the implementation models, outcomes, challenges and future directions of PPPs in Nigeria's healthcare system, following the Arksey and O'Malley framework and PRISMA-ScR guidelines. Literature searches were conducted across PubMed, Scopus, Web of Science, Google Scholar and grey literature sources. Studies were screened using Rayyan, while eligibility was guided by the population-concept-context framework. Data were synthesized using descriptive and thematic analysis. Twenty-four studies were included, covering PPP applications across primary, secondary, tertiary and community healthcare systems. Identified models included service delivery, financing, infrastructure, supply chain and governance partnerships. The included evidence reported improvements in healthcare access, diagnostic capacity, immunization coverage, infrastructure development and system efficiency, particularly in tuberculosis diagnostics, radiology, dialysis and radiotherapy services. However, weak governance, poor stakeholder coordination, funding instability, affordability barriers and inequitable urban concentration of benefits persisted. Strengthening regulatory frameworks, sustainable financing, accountability and equitable access may enhance PPP implementation and enable appropriately governed PPPs to contribute to selected dimensions of healthcare access and service capacity relevant to universal health coverage in Nigeria.