Esherishia coli (E. coli) and Salmonella species (spp.) pose serious public health threats because of their ability to contaminate poultry products and spread through farm environments. This study assessed the prevalence, antimicrobial resistance, and virulence gene profiles of E. coli and Salmonella spp.

A cross-sectional study was conducted, involving the random collection of 400 samples from broilers, drinker's water, feedstuff, broiler litter, and poultry workers in broiler farms. Furthermore, a structural questionnaire was administered to poultry workers to identify potential risk factors and assess the public health implications associated with pathogen transmission. The antimicrobial and anti-virulence activities of melanin against E. coli and Salmonella enteritidis (S. enteritidis) were also assessed.

E. coli and Salmonella spp. were frequently isolated from broiler farms, with a predominance of. E. coli serotype O111:H2 (25.64%) and S. enteritidis strains (30.4%) among the total examined samples. Multivariate analysis revealed that poultry workers, who had symptoms worsened after starting farm work and those did not use of personal protective equipment (PPE) were strongly associated with E. coli positivity. E. coli isolates exhibited full resistance to ampicillin (AMP) and tetracycline (TET), whereas Salmonella spp. isolates showed full resistance to AMP. Most of the examined E. coli isolates (71.8%) and the Salmonella spp. isolates (60.9%) were multidrug resistant (MDR) strains. In addition, 28.2% of E. coli isolates and 30.4% of Salmonella spp. isolates were -XDR. The stx1, stx2, and hylA virulence genes were respectively detected in 69.2%, 69.2%, and 74.4% of the examined E. coli isolates, whereas the sopB and hilA virulence genes were identified in all Salmonella spp. isolates. One-way repeated-measures analysis of variance (ANOVA) showed that natural melanin treatment significantly reduced the expression of virulence genes in both E. coli and S. enteritidis isolates.

The predominance of E. coli serotypes O111 and S. enteritidis highlights the need for improved hygiene practices and zoonotic diseases awareness to limit pathogen transmission in poultry farms. The detection of MDR and XDR strains e emphasizes the consequences of antimicrobial misuse and its implications for public health. Melanin has potential antimicrobial and anti-virulence activities against E. coli and S. enteritidis.

The intersection of digitalization and population aging has positioned internet use and cognitive function among older adults as a salient public health concern. However, existing research has predominantly treated internet use as a binary variable, failing to adequately uncover the heterogeneous effects of usage behaviors. Moreover, the moderating role of living arrangement has received insufficient attention.

This study analyzed two-wave panel data from the China Longitudinal Aging Social Survey (CLASS) in 2018 and 2020, comprising 6,800 older adults aged 65 and above, yielding 13,600 person-wave observations. Cognitive function was assessed using the Mini-Mental State Examination (MMSE), encompassing orientation, memory, and calculation. Internet use was operationalized as a four-dimensional construct, including internet adoption, use intensity, device operation proficiency, and function types. Two-way fixed effects models were employed to estimate the associations between multidimensional internet use and cognitive function, and to test the moderating role of living arrangement.

Internet adoption exerted a protective effect on overall cognitive function. Among continuous users, use intensity and instrumental us promoted cognitive improvement, whereas device operation proficiency was negatively associated with cognitive function. These effects exhibited significant heterogeneity across cognitive subdomains, including orientation, memory, and calculation. Living arrangement moderated the association only at the level of internet adoption; specifically, co-residence with children attenuated the protective effect of internet adoption.

Internet use exerts multidimensional and heterogeneous effects on cognitive function among older adults, moderated by living arrangement. These findings provide theoretical guidance for stratified digital intervention design.

Collaboration is a foundational characteristic of ethical mental healthcare. However, inpatient mental healthcare often fails to espouse the practices and principles that would establish meaningful collaborative care, with coercion and restrictive practices an ongoing aspect of consumers' lived experience. This qualitative descriptive study aimed to understand consumers' perspectives of collaboration with clinicians in the inpatient mental health setting. One-on-one semi-structured interviews were conducted with 12 people who have experienced involuntary inpatient mental healthcare; data were analysed by thematic analysis. The participants of this study valued collaborative inpatient mental healthcare. However, they reported that their own perspectives were not sufficiently sought or considered. Clinicians' default scepticism compounded participants' experiences of inconsideration. In contrast, genuinely caring interpersonal relationships with clinicians were valued, establishing a sense of safety and collaboration. The failure to establish collaboration requires systemic reform and the resolution of micro-cultures that disenfranchise the perspectives of people receiving inpatient mental healthcare. Notably, the participants of this study reported that interpersonal relationships with clinicians facilitated meaningful collaboration. Collaboration relies on the presence of strong interpersonal care; the culture, policy and structures of inpatient mental healthcare must be oriented to be interpersonal.

Knee pain affects 22.9% of individuals aged 40 years and over globally and is associated with body function, activity, environmental, and personal factors described in the International Classification of Functioning, Disability and Health (ICF) model. Most prior studies examined isolated risk factors using conventional regression.

This study aimed to examine self-reported knee pain in community-dwelling older adults by combining machine learning and partial-correlation network analysis with smartphone-based physical performance measurement.

This cross-sectional study included 852 adults aged 60 years and older. Baseline assessment of 38 variables across 7 ICF-aligned domains was reduced to 21 predictors using prespecified, rule-based criteria (events per variable=14.95). Walking speed, sit-to-stand, gait knee flexion, and gait asymmetry were measured using a validated vision-based smartphone app. Missing data were addressed by multiple imputation (m=5) with Rubin rules. Six algorithms (logistic regression with elastic-net penalty as baseline, k-nearest neighbors, random forest, Extreme Gradient Boosting, Light Gradient Boosting Machine, and support vector machine) were trained using nested 5×5 cross-validation, and the best model was interpreted using Shapley Additive Explanations and partial dependence plots. Partial-correlation network analysis examined the 10 top-ranked features and the knee-pain node, with bootstrap stability assessment and a sensitivity analysis excluding EuroQol 5-Dimension (EQ-5D) Pain/Discomfort.

Knee pain prevalence was 36.9% (314/852). Pooled area under the receiver operating characteristic curve values ranged from 0.692 to 0.723, with random forest highest (area under the receiver operating characteristic curve=0.723, 95% CI 0.689-0.757). The top Shapley Additive Explanations features were EQ-5D Pain/Discomfort, EQ-5D Utility, and house estate. In the 11-node network, only EQ-5D Pain/Discomfort (partial correlation=0.260) and house estate (0.158) had direct edges with knee pain. Sit-to-stand showed the highest strength centrality (0.679) without a direct edge, acting as a hub linking body function, body structure, mental health, and activity variables. Shapley Additive Explanations importance and network strength were weakly correlated (ρ=0.018). The sensitivity analysis preserved the pattern (best area under the receiver operating characteristic curve=0.724).

Knee pain in older adults was associated with variables spanning 7 ICF domains, with EQ-5D Pain/Discomfort and housing environment (lower-income rental estate residence) as direct correlates and sit-to-stand as a network hub. Combining machine learning and partial-correlation network analysis may inform multidisciplinary biopsychosocial assessment, pending confirmation in prospective and externally validated studies.

Schizophrenia is a chronic psychiatric disorder associated with significantly elevated mortality. While antipsychotics are the cornerstone of treatment, their long-term effects on survival remain uncertain, particularly in non-Western populations. We aimed to assess the real-world association between antipsychotic treatment patterns and all-cause mortality among adults with schizophrenia in China.

This population-based cohort study included 435,816 adults from the Community Schizophrenia Registry System of Guangdong Province, China. Patients were classified into four groups: antipsychotic monotherapy, polytherapy, non-antipsychotic treatment and non-drug treatment. Cox proportional hazards models were used to estimate adjusted hazard ratios (aHRs) for mortality.

Over a median follow-up of 7.2 years, 73,527 deaths (16.9%) occurred. Antipsychotic polytherapy (57.6%) was the most common regimen, followed by monotherapy (27.6%). Compared with the non-drug group, mortality risks were significantly lower for polytherapy (aHR: 0.18; 95% CI: 0.18-0.19), monotherapy (aHR: 0.24; 95% CI: 0.24-0.25) and non-antipsychotic treatment (aHR: 0.22; 95% CI: 0.21-0.23). Both first- and second-generation antipsychotics showed comparable mortality benefits. While most polytherapy regimens performed similarly to or better than monotherapy, combinations like risperidone-sulpiride were associated with higher mortality. Subgroup analyses showed stronger benefits in women, younger individuals, rural residents and those with less severe illness.

Antipsychotic treatment is associated with significantly reduced mortality among patients with schizophrenia in China, with effects varying by patient characteristics and drug regimen.

Neurodevelopmental disorder traits are associated with a range of psychosocial difficulties, yet the longitudinal processes linking these traits to mental health remain insufficiently explored. This study examined developmental associations among autism spectrum disorder (ASD) traits, attention-deficit/hyperactivity disorder (ADHD) traits, social maladjustment, and mental health from childhood through adolescence.

Longitudinal data were drawn from 9,619 students across 11 grade cohorts in mainstream classrooms. Cross-lagged structural equation modeling was used to estimate independent longitudinal associations among ASD traits, ADHD traits, social maladjustment, and mental health, while controlling for confounding factors. ASD and ADHD traits were modeled simultaneously to clarify their unique developmental patterns.

ASD traits were consistently associated with later internalizing problems and peer difficulties. ADHD traits were associated with later internalizing and externalizing problems, as well as academic challenges and strained teacher-parent relationships. These associations differed by trait type, suggesting distinct developmental pathways. Several bidirectional associations also emerged: poorer mental health was associated with subsequent social maladjustment, which was subsequently linked to persistent developmental difficulties.

The findings indicate that social maladjustment is involved in the longitudinal associations between developmental disorder traits and mental health and may shape developmental trajectories. These results highlight the need for comprehensive support approaches that consider peer relationships, learning environments, and family-school relationships.

To understand the experience of fatigue and cognitive impairment in adults with symptomatic primary sclerosing cholangitis (PSC) as an essential first step towards developing PSC-specific symptom measures.

Purposeful sampling was used to identify 17 symptomatic adults from the PSC Symptom Assessment Project who met general trial eligibility criteria for in-depth concept elicitation interviews focused on key PSC symptoms. Of these, twelve were interviewed in-depth about fatigue and eleven about cognitive impairment. Interviews were conducted virtually, audio-recorded, transcribed and analysed. The Theory of Unpleasant Symptoms guided the development of a PSC symptom conceptual framework.

Participants were on average 42 years old, 57% male, 71% White and 57% had inflammatory bowel disease. Half experienced fatigue and cognitive impairment daily, while others described varying frequencies of these symptoms. Most participants described fatigue getting progressively worse throughout the day, often requiring naps. Fatigue interfered with domestic duties, job responsibilities and family/social activities. Fatigue impacted mental health with frustration, sadness and guilt. Participants with cognitive impairment reported it ranged from mild to severe, with some unable to live independently or maintain employment. Working memory, verbal fluency, attention and processing speed were impacted. Fatigue and cognitive impairment frequently co-occurred but could occur separately.

PSC-related fatigue and cognitive impairment impact daily, work-related, emotional and social functioning in symptomatic adults. These qualitative findings inform the customization of PSC-specific fatigue and cognitive function measures with strong content validity that is necessary for use in PSC research and clinical trials.

Amyotrophic Lateral Sclerosis (ALS) is a rapidly progressive, fatal neurodegenerative disease. Patients with ALS are at increased risk of developing depressive symptoms. A clearer understanding of the associations between depressive symptoms, disease progression, health-related quality of life and perceived social support is needed to advance intervention-oriented research and improve psychosocial care in ALS.

In a multicenter cross-sectional study, patients with ALS were asked to complete patient-reported outcomes (PROs) to evaluate depressive symptoms (ALS-Depression-Inventory, ADI-12), health-related quality of life (ALS-Assessment-Questionnaire, ALSAQ-5/ALSAQ-40), physical functioning (ALS-Functional Rating Scale-Extension, ALSFRS-EX) and perceived social support (Multidimensional Scale of Perceived Social Support, MSPSS). To evaluate associations between demographic/clinical variables and PROs, we performed Pearson's, Spearman's, and partial correlation analyses. In addition, a multiple regression was run to identify predictors of depressive symptoms. Comparisons of patient groups were performed with chi-squared tests for categorical variables and Student t-tests or one-way analysis of variance (ANOVA) for continuous variables, followed by post-hoc tests.

Out of the 150 patients examined, 60% reported depressive symptoms, with half of them exhibiting clinically relevant depressive symptoms. Depressive symptoms were significantly associated with disease progression (r = .466, p < .001), various aspects of health-related quality of life (mobility: r = .394, activities of daily living: r = .268 and emotional well-being: r = .793, all p < .001), the MSPSS sum score (partial r = -.234, p  = .007), and the ALSFRS-EX sum score (r = -.352, p < .001). Patients with depressive symptoms reported significantly more physical impairments (p = .002) and less perceived social support by their families (p = .016) and friends (p < .001) compared to patients without depressive symptoms.

Depressive symptoms are prevalent in patients with ALS and are closely associated with faster disease progression, reduced physical functioning, poorer health-related quality of life, and lower perceived social support. Further studies, particularly using qualitative methods, are needed to elucidate protective factors, clarify psychosocial mechanisms, and support the conceptualization of specialized and integrated psychosocial care for patients with ALS in Germany.

Major depressive disorder (MDD) is characterized by depressed mood, anhedonia, and loss of energy, which can be accompanied by associated symptoms and co-morbidities. Psychiatric scales such as the Montgomery Åsberg Depression Rating Scale (MADRS) must account for the complex nature of depression.

The MADRS total score change between baseline and week 8 was the primary outcome measure in a randomized, double-blind clinical trial investigating the antidepressant efficacy of 8 weeks' treatment with silexan compared to sertraline and placebo in patients with mild or moderate MDD. We report on a pre-planned, exploratory analysis of the individual MADRS items. Treatment effects were assessed using analyses of covariance with baseline adjustment, based on an estimand strategy.

498 subjects (silexan 170, sertraline 171, placebo 157) were treated and analyzed. After 8 weeks, silexan was superior to placebo for 5 out of the 9 MADRS items analyzed ('apparent sadness', 'reported sadness', 'reduced appetite', 'concentration difficulties', 'lassitude'; p<0.05) and showed clinically important adjusted mean value differences >0.2 points for 7 out of the 9 items. Item-level results for silexan and sertraline were mainly comparable.

Silexan had a strong over-all antidepressant effect, with the most pronounced improvements affecting the cardinal symptoms of depression.

EudraCT2020-000688-22 first entered on 12/08/2020.

Neuropsychiatric presentations are common across neurological and mental health services but they are often inadequately covered by core clinical psychology and clinical neuropsychology training. Consequently, we aimed to identify components for a neuropsychiatry curriculum for clinical psychologists using a Delphi process. We completed a three-round e-Delphi study with 19 experts (clinical psychologists, neuropsychologists, psychiatrists, neurologists, individuals with lived experience of neuropsychiatric disorders). Round 1 collected ratings on 80 syllabus items derived from textbook reviews, conference topics and a scoping review of neuropsychiatry syllabuses. Items failing to reach consensus were refined, and new topics added via free-text suggestions. Rounds 2 and 3 repeated rating and thematic analysis, culminating in a consensus meeting where items were classified as core or supplementary. Consensus thresholds were set at mean ≥2.0, mean distance from the mean ≤0.2 and ≥75% agreement for final decisions. The process yielded 40 core and 38 supplementary syllabus items. Core topics include autoimmune and neuroinflammatory disorders, delirium, functional neurological disorders, neuropsychiatric sequelae of epilepsy, stroke, traumatic brain injury, dementia and multidisciplinary working, among others. Supplementary items covered background knowledge of less frequent but still prevalent disorders as well as competencies in interpreting clinical data alongside conceptual and historical issues. The final component list reflects both clinical competencies and emerging areas of practice, emphasising assessment, formulation, psychological interventions, cultural considerations and medicolegal aspects. The e-Delphi-derived curriculum provides a framework for neuropsychiatric competencies for postgraduate psychology training with modification needed for application in diverse health care settings.