Vulval lichen sclerosus (LS) is a chronic inflammatory dermatosis affecting the genital skin in women. Vulval LS can cause significant symptoms, architectural changes and increased risk of squamous cell carcinoma. Effective long-term management relies on accurate diagnosis, sustained disease suppression and at least annual clinical review.

This article provides a practical framework for general practitioners to support lifelong management of vulval LS.

Key elements include patient education on self-monitoring, assessment of symptoms, recognition of clinical features and therapy adjustments. Attention should also be given to sexual function, mental health and medical comorbidities. Consistent long-term management of vulval LS improves quality of life, optimises treatment adherence and reduces negative sequalae of the condition.

Epidemiological studies suggest associations of asthma with the psychosis spectrum (psychotic experiences, bipolar disorder, schizophrenia), but the mechanisms underlying these associations remain unclear.

We examined the relationship between asthma and psychosis-related outcomes using observational cohort, polygenic score, and Mendelian randomization (MR) analyses, and assessed the possibility of shared genetic underpinnings between these traits using genetic colocalisation.

Results from a UK population-based prospective birth cohort suggest that asthma at age 7 and polygenic risk for asthma are associated with psychotic experiences in early adulthood. Results from two-sample MR analyses do not support causal relationships of genetic liability to asthma with bipolar disorder or schizophrenia. Instead, genetic correlation and colocalization analyses point to the presence of shared genetic etiology between the conditions. We identified 8 genomic regions with potentially shared causal genes between asthma and bipolar disorder or asthma and schizophrenia. Using genetically predicted mRNA expression in condition-relevant tissues (brain and lung), we identified 16 genes shared between conditions, which include FADS1, SLC4A10, BDH2, and CISD2.

Our results suggest that population-level associations of asthma with psychosis spectrum conditions could be due to shared molecular mechanisms involving fatty acid metabolism, ion channel activity, and iron homeostasis.

Functional Positron Emission Tomography (fPET) data offers novel insights into brain energy demands and molecular connectivity. Recent advances in improving temporal resolutions for this imaging technique have opened up new research possibilities. However, lower signal-to-noise ratios (SNR) inherent to short PET frames bring into question whether current realignment approaches still provide appropriate motion correction or whether additional processing steps might be required to improve correction outcomes. Thus, we aimed to evaluate the effectiveness of a standard motion correction procedure in conjunction with different SNR enhancement methods and explore potential improvements for high temporal resolution fPET with 3s dynamic frames. We investigated three techniques aimed at improving the SNR to facilitate more accurate realignment of fPET images, in comparison to conventional motion correction without any prior modifications. The methods include a deep learning technique based on the application of a conditional generative adversarial network, an exponentially weighted sliding window average and an established filtering method for denoising dynamic imaging data. Performance was compared and evaluated by correlating rigid motion parameters between approaches and with simultaneously acquired fMRI data, and by assessing magnitudes of task-induced activation. Our results indicate that none of the methods substantially improve mitigation of motion artefacts. Given the increased computational effort of the techniques, we propose that the standard motion correction procedure without prior signal modification is adequate for processing high temporal resolution fPET data of a healthy study population, exhibiting commonly observed amounts of movement. Nevertheless, future development of targeted strategies to enhance motion correction may further advance this imaging technique and applications thereof.

Adolescence is a critical developmental period during which subthreshold depression (StD) is common yet highly heterogeneous in its outcomes. Dysfunctional neural processing of reward and loss anticipation has been implicated in adolescent depression. However, it remains unclear whether these neural markers predict clinical trajectories in pre/early adolescents with StD.

Using data from the longitudinal cohort of Adolescent Brain Cognitive Development (ABCD) Study, we tracked pre/early adolescents over three years and classified them into four outcome groups: conversion to probable major depressive disorder (MDD), persistence of StD, remission of StD, and stable healthy controls (HC). Baseline functional magnetic resonance imaging (fMRI) data from the Monetary Incentive Delay (MID) task were used to quantify activation in key motivational regions during reward and loss anticipation of varying salience. Multinomial logistic regression models assessed whether baseline activation predicted later outcomes, with odds ratios (ORs) estimating the risk of MDD onset and symptom persistence.

The results showed a 6.6-fold higher risk of developing probable MDD in pre/early adolescents with StD, as compared to HC. Relative to HC, pre/early adolescents with StD showed altered activation in striatal and midbrain regions during reward anticipation. Specifically, left nucleus accumbens (NAcc) activation showed a context-dependent predictive pattern: lower activation during high-reward anticipation predicted conversion to probable MDD, whereas lower activation during loss anticipation predicted symptom remission.

Left NAcc activation may have context-dependent prognostic relevance for divergent parent-reported depressive symptom trajectories in pre/early adolescents.

To analyze concordance between pharmacist evaluators and paid actor standardized patient (SP) evaluators when grading student pharmacists' performance in a simulated mental health patient interaction.

A mental health telehealth simulation was developed for second-year student pharmacists. Performance was concurrently assessed by an SP and a pharmacist evaluator. Differences in rubric-based assessments between the two evaluator types were subsequently analyzed as paired samples using the McNemar test.

All fifty-nine enrolled students completed the simulation. There was strong agreement between SP and pharmacist evaluations for communication and professionalism metrics across the cohort. Discrepancies were observed on 8.6% of the rubric items and occurred most frequently on rubric items that required clinical judgment such as "recommended appropriate over-the-counter (OTC) options for the patient" (27% disagreement) or "no/limited use of medical jargon" (22% disagreement). Significant differences were seen with SP's reporting that the student did not complete some tasks, while the pharmacist evaluators reported the task as completed, such as "asked about duration of symptoms," and "recommended appropriate OTC/nonpharmacologic options for the patient".

This study found strong concordance between SP and pharmacist evaluators for assessing observable communication behaviors and professionalism but identified significant differences in ratings for items requiring clinical judgment.

Several studies have found mild elevations of serum neurofilament light chain (sNfL) - a marker of neuroaxonal injury - in various psychiatric disorders (PD) compared to controls. Given the documented role of neuroinflammation in PD, this study investigated the relationship between inflammatory markers and sNfL in a transdiagnostic cohort of PD.

PD data was obtained from Signature Biobank (BbS) participants aged 40-81 that presented to a psychiatric emergency department with various PDs (n = 291, M = 181, F = 110), and a control group (n = 69, M = 36, F = 33). Serum NfL was measured using SIMOA technology, inflammatory markers interleukin-6 (IL-6) and tumour necrosis factor-alpha (TNF-α) were measured using ELISA, and C-reactive protein (CRP) was measured using Atellica CH Wide range method. Linear regression models were used to test associations between sNfL and inflammatory markers while controlling for age, sex, BMI, in addition to identified statistically significant medical/lifestyle covariates of sNfL and the inflammatory markers.

In the PD transdiagnostic group, sNfL was positively associated with IL-6 (n_p² = .065, p < .001) with a medium effect size and positively associated with TNF-α (n_p² = .075, p = .002) with a medium effect size; no associations between CRP and sNfL were detected. At the subgroup levels, the associations remained statistically significant in the mood and psychotic disorders groups, and only for IL-6 in anxiety disorders group.

This study provides evidence of an association between levels of inflammation (IL-6 and TNF-α) and neuroaxonal injury (sNfL) in PD.

This study examined associations between frailty status and health-related outcomes for older adults over two years following hip-fracture surgery.

A prospective longitudinal cohort study.

Older adults (aged ≥ 60 years) who had undergone hip-fracture surgery and met inclusion criteria were recruited from a 3000-bed medical center in northern Taiwan from September 2012 to March 2019 (N = 318).

The independent variable of frailty status was assessed with a researcher-modified Clinical Frailty Scale. Baseline measures for health-related variables (pre-fracture basic activities of daily living (BADLs), physical and mental component scores for health-related quality of life (HRQoL), and number of fall incidences) were collected 1-month following hospital discharge. Follow-up assessments of frailty and health-related variables were assessed at 3- to 24-months post-discharge. Group-based trajectory modeling identified three frailty trajectory groups. Changes in frailty status associated with outcome variables were analyzed using generalized estimating equations (GEE).

Most participants were in the pre-frail trajectory group (52.6%); 33.5% were frail; 15.0% were robust. There were significant differences among trajectory groups for baseline health-related variables of pre-fracture BADLs (P < .001) and mental HRQoL (P = .01); the frail trajectory group had the poorest scores for both variables. GEE analysis indicted frailty status significantly influenced recovery of BADLs: compared with participants with a robust frailty status, BADLs were lower for those with a status of pre-frail (β = -0.675, P = .012) and frail (β = -2.349, P = .001). Physical-HRQoL scores were also lower for those who were pre-frail (β = -6.697, P < .001) and frail (β = -9.775, P < .001).

Frailty status was significantly associated with health-related outcomes following hip-fracture surgery. Assessing frailty status longitudinally could guide the development of early interventions to reduce frailty, improve recovery, enhance quality of life, and reduce falls for older adults discharged from hospital following hip-fracture surgery.

The causal role of the right inferior frontal gyrus (RIFG) in inhibitory control has previously been identified at the behavioral level using transcranial magnetic stimulation (TMS). To further explore the underlying neural mechanisms, we combined TMS with functional magnetic resonance imaging (fMRI) in bilingual language switching. Results showed reduced asymmetric switching costs in RIFG activation following continuous theta-burst stimulation (cTBS) compared to sham stimulation, while intermittent theta-burst stimulation (iTBS) caused no improvement. These findings provide neural evidence consistent with disruption of RIFG-related control, although no corresponding behavioral impairment was observed. This work is among the first studies to integrate TMS and fMRI to shed light on the neural mechanisms underlying the causal involvement of a specific brain region in bilingual language control.

The validity of inferences from 12-item Multiple Sclerosis Walking Scale (MSWS-12) scores has been established in homogeneous samples consisting largely of White people with multiple sclerosis (MS). There is evidence for differences in walking performance between Black and White people with MS, possibly explained by embodiment associated with structural racism and social determinants of health. The differences in walking performance might extend into perceptions of walking impairment as measured by the MSWS-12.

This study examined the construct validity of inferences from MSWS-12 scores as a patient-reported outcome measure (PROM) of walking impairment in Black people with MS.

The sample included 179 participants with MS who self-identified as either Black (n = 55) or White (n = 124). The participants completed the MSWS-12, Timed 25-Foot Walk (T25FW), Six-Minute Walk (6MW), Timed-Up-and-Go (TUG), Short Physical Performance Battery (SPPB), Brief International Cognitive Assessment for MS (BICAMS), Fatigue Severity Scale (FSS), Hospital Anxiety and Depression Scale (HADS), and 36-item Short-Form Survey (SF-36). The data analyses were performed using IBM SPSS.

MSWS-12 scores had strong correlations with T25FW, 6MW, TUG, SPPB in the overall sample (|r's| of .72, .75, .65, & .67, respectively), and Black (|r's| of .63, .72, .65, & .65, respectively) and White (|r's| of .77, .78, .66, & .69, respectively) samples. The correlations were weak-to-moderate between MSWS-12 with BICAMS, FSS, and HADS. There was a pattern of strong associations between MSWS-12 scores with SF-36 physical scores (|r's| of .79, .80, & .79, respectively), yet weak correlations with mental scores (|r's| of .07, .00, & .08, respectively) for the overall, Black, and White samples.

Our results provide preliminary support for the interpretation of MSWS-12 scores as a measure of walking impairment in clinical research and practice involving Black individuals with MS.

Despite important research efforts devoted to testing the effectiveness of psychological interventions for the treatment of common mental disorders in low- and middle- income countries (LMICs), a gap remains in the field of prevention. We searched multiple databases up to May 7, 2026 for randomized controlled trials (RCTs) testing task-sharing psychological interventions for preventing common mental disorders in adults living in LMICs. Prevention interventions were classified into indicated, selective and universal. Primary outcomes were the diagnosis and symptom decrease of depression, PTSD, and anxiety at post-intervention. We estimated risk ratios (RRs) and standardized mean differences (SMDs) using random effects pairways and network meta-analyses (NMA). Protocol registration: CRD42023402399. We included 81 RCTs with 10,747 participants. 41 RCTs tested indicated, 34 selective and 7 universal prevention interventions. For preventing depression, wellbeing promotion, parental psychoeducation, yoga/mindfulness, and multi-component interventions were more effective than enhanced treatment as usual (ETAU/TAU) (RR 0.25 to 0.66). In head-to-head comparisons, wellbeing promotion and psychoeducation ranked highest (Surface Under the Cumulative Ranking, SUCRA>90%). In reducing depressive symptoms, parental psychoeducation, social support, wellbeing promotion, yoga-mindfulness, cognitive behavioral therapy, multicomponent interventions were more effective than ETAU/TAU (SMDs -0.94 to -0.36). For PTSD prevention, yoga-mindfulness, parental psychoeducation, CBT, and multicomponent interventions reduced symptoms. For anxiety diagnosis and symptoms, wellbeing promotion, social support, yoga-mindfulness, multicomponent interventions, and active waiting list were the most effective interventions. Extensive evidence supports the effectiveness of task-sharing psychosocial interventions in preventing mental disorders in LMICs, with stronger evidence for indicated and selective prevention.