We present a 69-year-old female patient who initially manifested with depression and anhedonia, initially misdiagnosed as primary psychiatric illness. She subsequently developed progressive gait instability and cognitive decline. After comprehensive clinical and laboratory evaluation, she was finally diagnosed with multiple sclerosis (MS) complicated by neuropsychiatric systemic lupus erythematosus (NPSLE). Brain magnetic resonance imaging (MRI) revealed multifocal white matter lesions consistent with demyelination. Serologic testing demonstrated positivity for antinuclear antibody (ANA), anti-double-stranded DNA (dsDNA), anti-SS-A/Ro, anti-histone, anti-nucleosome, and anti-centromere antibodies. Cerebrospinal fluid (CSF) examination confirmed intrathecal synthesis of immunoglobulin G (IgG), as evidenced by CSF-restricted oligoclonal bands (OCBs). Serum myelin oligodendrocyte glycoprotein immunoglobulin G (MOG-IgG) was positive at a titer of 1:32, whereas aquaporin-4 (AQP4) antibodies were negative. Based on the clinical manifestations, laboratory results and disease progression, the final diagnosis was established as coexisting MS and NPSLE. The patient achieved clinical improvement after treatment with glucocorticoids and hydroxychloroquine. This case highlights the diagnostic challenges posed by overlapping autoimmune central nervous system (CNS) disorders and underscores the importance of longitudinal assessment in differentiating MS from MOG-IgG-associated disorder (MOGAD) and NPSLE.

China's rapid transition into a super-aged society is accelerating demand for advanced wearable healthcare sensors tailored for long-term, low-burden monitoring. While numerous reviews discuss demographic and policy contexts, fewer highlight the latest wearable sensor research emerging from Chinese laboratories and companies. This Mini Review summarizes representative advances published in the last five years across three major application areas-chronic metabolic disease management, neurodegenerative disease monitoring, and cardiovascular risk mitigation-focusing on sensor design, sampling media, data integration, and clinical relevance. Rather than examining demographic trends or general market growth, we emphasize technological breakthroughs such as non-invasive glucose-sensing microneedle patches, CKD-oriented urine/breath analyzers, multimodal gait-EEG neurodegenerative platforms, and bioresorbable cardiovascular implants that reflect China's emphasis on long-term, low-burden, and telemedicine-ready care. By concentrating on these China-originated devices and research prototypes, this review aims to provide a concise update on emerging concepts and highlight how these technologies reflect localized priorities-such as non-invasive sampling and family-assisted tele-care-while shaping future global trends.

Randomized controlled trials with lung volume reduction surgery (LVRS) or endobronchial valves (EBVs) have shown clinically significant benefits for specific patients with emphysema.

What is the impact of a comprehensive lung volume reduction (LVR) program, with both LVRS and EBVs as treatment options, on patient selection and short- and long-term outcomes in real life?

This study summarizes the results of a prospective comprehensive LVR program in tertiary care, based on 5-year inclusions and follow-up over 1 to 3 years.

A total of 429 cases were discussed at a multidisciplinary emphysema board; of these, 131 (30%) were referred for LVRS, 73 (17%) were referred for EBV, 25 (6%) were referred for lung transplantation, and 200 (47%) were referred for usual care. A total of 38 (52%) of the EBV interventions were followed by a second to fourth intervention, including LVRS in 25 (34%). For LVRS first, 72 (55%) and 37 (38%) of patients had a single 1-stage bilateral or unilateral LVRS procedure, and 22 (17%) had a staged procedure. Clinically significant improvements between baseline and follow-up visits were obtained on all outcome dimensions in all LVRS and EBV groups for most of the visits. Responder rates varied between 50% and 80% at 3 months to 1 year and slowly declined in the second year. Transplant-free survival over 2.5 years, adjusted for age and BODE Index at baseline, was significantly better for the EBV intervention (hazard ratio, 0.14; 95% CI, 0.04-0.44) and borderline significant for LVRS (hazard ratio, 0.7; 95% CI, 0.45-1.2) compared with the nonintervention group.

LVR programs should cover both surgical and bronchoscopic interventions to maximize eligibility and to improve outcome and prognosis of highly symptomatic patients with severe emphysema.

Ischemic stroke (IS) is a cerebrovascular disease with high mortality and disability rates, currently lacking effective therapeutic targets. The STING inhibitor SN-011 shows potential in IS treatment, but its mechanism of action remains unclear. This study aims to explore the key molecular mechanisms of SN-011 in treating IS through bioinformatics approaches. IS transcriptome datasets were analyzed to identify differentially expressed genes. Mendelian randomization using brain eQTL and IS-GWAS data identified genes with causal relationships to IS. Single-cell transcriptome, pseudo-time trajectory, intercellular communication, and transcription factor regulatory network analyzes were performed. Molecular docking and DARTS-WB assay validated SN-011 binding to transcription factors. Transcriptomic analysis identified 77 intersecting genes. Mendelian randomization revealed ADGRE5 as a protective gene for IS (OR < 1), significantly downregulated in venous endothelial cells (vECs) during disease progression. Cell communication analysis showed ADGRE5-high vECs interact with immune, glial, and stromal cells via LAMININ (Lamb2-CD44, Lamb2-Itga6+Itgb1, Lamb2-Dag1 pair) and JAM signaling pathways. Transcription factor analysis identified JUNB as a negative regulator of ADGRE5. Molecular docking (-6.8 kcal/mol) combined with an in vitro DARTS-WB assay confirmed the interaction between SN-011 and JUNB. In OGD-induced endothelial cell injury models, SN-011 suppressed JUNB expression, restored ADGRE5 expression inhibited by JUNB overexpression, reversed the downregulation of LAMB2 and CD44, and reduced the expression of the pro-inflammatory cytokines IL-6 and IL-1β. Notably, blockade of LAMB2 largely abolished these protective effects, indicating that the anti-inflammatory and endothelial-protective activities of SN-011 are mediated, at least in part, through restoration of the LAMB2-CD44 signaling axis. ADGRE5 downregulation in vECs may impair vascular repair by disrupting LAMININ-mediated intercellular communication. SN-011 may exert neuroprotective effects by targeting JUNB to upregulate ADGRE5 expression and restore the vEC-centered cellular communication network, providing a theoretical basis for SN-011 as a potential IS therapeutic.

Based on findings from human atherosclerotic arteries and mouse arterial injury models, where ZHX2 expression is significantly downregulated, this study identifies ZHX2 as a critical inhibitor of pathological vascular remodeling. Functionally, local adenoviral overexpression of ZHX2 in vivo attenuates neointima formation in a mouse carotid artery ligation model, while in vitro experiments demonstrate that ZHX2 impedes the proliferation and migration of primary Vascular Smooth Muscle Cells (VSMCs). Mechanistically, integrated RNA-seq and ChIP-seq analyses reveal that ZHX2 transcriptionally regulates GADD45G, directly binding to its promoter and activating its transcription. The essential role of this pathway is confirmed by the finding that knockdown of GADD45G counteracts the inhibitory effects of ZHX2 overexpression on VSMC proliferation, migration, and neointima formation. Consequently, the ZHX2/GADD45G signaling axis is highlighted as a potential regulatory pathway in injury-associated neointimal remodeling.

Ubiquitin C-terminal hydrolase L1 (UCHL1) is a highly conserved deubiquitinating enzyme that has transitioned from being viewed as a "brain-specific" protein to a global regulator of cellular proteostasis and signal transduction. As a key component of the ubiquitin-proteasome system (UPS), UCHL1 maintains the intracellular free ubiquitin pool through its C-terminal hydrolase activity, while also exhibiting atypical ligase-like functions and acting as a molecular scaffold for signaling complexes. Beyond its classical role in neurons, increasing evidence suggests that UCHL1 participates in diverse pathological conditions including neurodegeneration, cancer, cardiovascular and metabolic diseases, as well as musculoskeletal disorders. Through regulation of protein turnover, oxidative stress, inflammatory signaling, and cell survival, UCHL1 emerges as a context-dependent regulator with dual protective and pathogenic roles. This review explores the sophisticated multi-level regulation of UCHL1, ranging from transcriptional control to epigenetic silencing and posttranslational modifications, summarizes the recent research progress of UCHL1 in various systems, and elaborates on its mechanism of action in various conditions, including neurological and musculoskeletal disorders.

Introduction Autistic people are particularly at risk of experiencing forms of violence, ostracism or discrimination, which lead to social exclusion in the course of their lives. However, very little research has addressed social exclusion from its subjective dimensions (e.g. attitudes, opinions, social representations and self-perception) and the relational contexts in which these experiences take shape and affect well-being and mental health. This article presents the results of qualitative research conducted with young autistic adults in Quebec who took part in asynchronous online discussion groups. It aims to identify the forms of social exclusion shared by the participants to better understand the relational contexts in which these experiences take place. Method Four asynchronous online focus groups were conducted with 23 autistic adults living in Quebec and aged 19 to 31 (average: 24). They all have received a professional diagnosis of autism. For nearly 3 weeks, open-ended questions were asked on a specific topic. A qualitative analysis using open coding was conducted. Results: The results show 4 main sources of exclusion mentioned by the participants: microaggressions, discrimination, victimization and constraints on self-determination. Social exclusion takes place in a variety of relational contexts, in which the entourage and formal services are sometimes seen as supports, sometimes as sources of vulnerability. Strategies of concealment, self-exclusion and camouflage appear to be ways of preventing exclusion, to the detriment of well-being. Discussion Five avenues for improvement in clinical and reception practices in general services are identified: 1. Develop service delivery practices in general and specialized services that are sensitive to the characteristics and needs of autistic people; 2. Adopt a trauma-informed approach and promote environments that support recovery; 3. Improve the flexibility of services and intervention methods in response to the needs expressed by autistic people; 4. Continue awareness-raising efforts to promote greater social acceptance of autism and neurodiversity in schools and the workplace; 5. Establish cross-sectoral collaborations between the education, employment, health, and social services sectors, involving user groups and advocacy organizations, to contribute to the development of truly inclusive practices.

Background/Originality Collaboration between patient partners (PPs), clinicians, and researchers is rapidly expanding in mental health care and research. This participatory approach, integrating patient experiential knowledge with scientific expertise is progressively transforming research paradigms with significant positive impacts. Patient engagement promotes adhesion to research projects, facilitates knowledge transfer, and contributes to reducing the stigma associated with mental illness. In addition, it helps advance therapeutic targets and interventions that better address patients' real-world needs. Neuromodulation is an emerging field with the potential to overcome many limitations of our current mental health systems. Its therapeutic efficacy has been demonstrated for various psychiatric conditions, yet it remains largely unknown to the public and inaccessible to many patients who could benefit from these otherwise promising interventions. The involvement of PPs in neuromodulation research and its impacts, currently undocumented in the scientific literature, would offer new and necessary perspectives on these challenges and warrants further investigation. Objective This article explores the roles and impacts of PP engagement in mental health research involving neuromodulation, with a focus on the specific issues that affect its implementation. We also examine the perspectives of both the PP and the researchers currently collaborating on TENTADIS, a project investigating home-based transcranial direct current stimulation (tDCS) for individuals suffering from borderline personality disorder. Through an examination of the literature and experiential reflections, this paper identifies various roles that the patient partner can fill in the co-construction of neuromodulation research and the important effects of such partnerships. Method/Expected Results This perspective article is based on a reflective analysis of co-construction experiences within the TENTADIS project, integrated with current literature on neuromodulation research and participatory approaches in mental health. Expected Impacts (Discussion) Within the TENTADIS research project, the PP actively participates in protocol development, contributing experiential knowledge that highlights practical constraints, participant expectations, and patient needs, thus enriching project design. Expected outcomes include advances in understanding both clinical and patient-related issues associated with neuromodulation, and identification of the specific contributions PPs can make in this field. This collaboration illustrates how co-construction can reduce barriers to access, improve intervention acceptability, and accelerate the implementation of neuromodulation in mental health services.

Objectives In the era of artificial intelligence, our understanding of mental health challenges depends heavily on our ability to generate and analyze large-scale datasets. Accordingly, the Data Valorization Axis of the Québec Mental Health Alliance (ASMQ) was established in 2024 to create a comprehensive repository of open mental health data and metadata in Québec. This initiative's mandate is to facilitate the indexing and discoverability of data and metadata collected in Québec, notably at the 3 main mental-health research centers of the Fonds de recherche du Québec: the Centre de recherche de l'Institut universitaire en santé mentale de Montréal (CR-IUSMM), the Centre de recherche CERVO and the Centre de recherche Douglas. Methods To build the Alliance repository, researchers and clinicians at ASMQ affiliated institutions were directly invited to index the datasets available in their laboratories. Nine databases were identified, and some are currently accessible via online-sharing platforms: Neurobagel, Maelstrom, and the Atlas of Longitudinal Datasets. Here, we present a description of the data contained in the various databases. Results To date, the data and metadata of 11,570 participants (26% psychosis and schizophrenia, 21% personality disorder, 19% mood disorder, 12% substance use, 10% bipolar disorder, 9% anxiety disorder) across 8 biobanks and datasets have been shared online through the Alliance repository. The biobank metadata includes various demographic (e.g. age, sex, gender, level of education), medical (e.g. psychiatric and physical diagnoses, medication use), psychosocial (e.g. social functioning, quality of life, depressive symptoms), anthropometric (e.g. height, weight), metabolic, behavioral (e.g. sleep, consumption of non-food products), cognitive (e.g. performance on neurophysiological tests), and medical-imaging data. Additionally, general information on governance and procedures for accessing and contributing new data to the repository is provided. Impact The Québec Mental Health Alliance repository enhances the visibility and accessibility of mental-health data in Québec, facilitating the sharing and dissemination of domain-specific data and metadata. The repository also aims to facilitate the harmonization of access procedures and experimental protocols. By advancing open science in Québec, the Alliance repository can catalyze scientific breakthroughs that rely on the analysis of large-scale datasets. This initiative could eventually be extended to other health institutions across Québec.