Pathological iron accumulation is a common pathophysiological hallmark across multiple neurodegenerative diseases (NDDs), motivating the need for accurate, non-invasive quantification methods. Quantitative susceptibility mapping (QSM) is an advanced magnetic resonance imaging (MRI) technique that enables in vivo measurement of tissue magnetic susceptibility (χ), providing a sensitive proxy for iron content. This umbrella review systematically evaluates the diagnostic accuracy, clinical correlations, and distinct iron distribution patterns of QSM in major NDDs, such as Parkinson's disease (PD), Alzheimer's disease (AD), amyotrophic lateral sclerosis (ALS), and atypical Parkinsonism. We included 15 (13/15 were rated Low or Critically Low on AMSTAR 2) systematic reviews and meta-analyses (through July 15, 2026); however, the findings should be interpreted cautiously because of heterogeneity and the low methodological quality. A Corrected Covered Area (CCA) analysis demonstrated only slight overlap of primary studies across the included reviews (CCA = 5.42%). Collectively, the evidence indicates that QSM provides comparable or higher diagnostic sensitivity and reliability than conventional R2* and SWI techniques, particularly for deep gray matter structures. The findings support significant iron overload in the substantia nigra, particularly in the pars compacta, as a robust biomarker for PD that correlates with motor severity and disease duration. Furthermore, regional iron profiling in the basal ganglia is critical for differential diagnosis; specifically, elevated χ in the putamen and globus pallidus effectively distinguishes multiple system atrophy and progressive supranuclear palsy from idiopathic PD. Distinctively, AD and ALS exhibit specific χ alterations in the thalamus, motor cortex, and hippocampus, reflecting divergent iron-related pathophysiological mechanisms, which correlate with cognitive impairment and upper motor neuron signs. Overall, QSM shows diagnostic promise and offers mechanistic insights into iron-related neurodegenerative processes.

Sleep problems such as prolonged night waking and difficulty falling asleep are common in infants. Sleep problems can affect development and put parents at risk of sleep deprivation, potentially leading to stress and burnout. It is therefore important to identify sleep problems early to facilitate targeted intervention and support. The Brief Infant Sleep Questionnaire (BISQ) developed by Sadeh (2004) is a widely used tool to identify and describe sleep behavior. However, a validated German translation is still missing. The main aim was to validate the German version of the BISQ by evaluating whether it captures age-related changes in sleep behavior whether it can distinguish between infants with and without sleep problems similarly to the original version.

We validated the German version of the BISQ by secondary analyses including N = 562 infants aged 6 to 24 months from seven independent samples and examined relations to infant development. Caregivers completed the German version of the BISQ. Additionally, parents in a subset of samples completed the Ages and Stages Questionnaires to assess developmental progress. To validate the BISQ against an objective measure, infants in three of the samples wore an actiwatch for a single night.

Results showed age-related changes in sleep measures as assessed by the BISQ. Significant moderate correlations emerged between caregiver-reported night sleep duration and night wakings and one night of actigraphy. Additionally, BISQ sleep measures differed between infants whose parents reported a sleep problem and those who did not. The infant's sleep location (in own vs. shared bed) was a significant predictor of BISQ measures. Infants who slept alone in a separate room had more favorable sleep measures than infants who slept in the parent's room or the parent's bed. Daytime sleep duration and the time taken to fall asleep at night were positively associated with gross motor development, whereas nocturnal sleep duration was negatively associated.

Our findings suggest that the German BISQ is a valid, quick-to-administer instrument for assessing infant sleep.

Patient aggression is a pervasive challenge in global mental healthcare. Although de-escalation is a cornerstone of non-coercive care, a significant theory-practice gap persists. This is often attributed to a research focus on fragmented techniques rather than on de-escalation as a continuous, relational process embedded in clinical practice. This gap is particularly pronounced in China's unique socio-cultural context, characterized by high-context communication and pronounced hierarchical power dynamics, which directly shape trust-building and authority navigation during de-escalation.

This study aimed to bridge this gap by exploring the lived experiences of psychiatric nurses in China, reconceptualizing de-escalation, and generating an integrated practice framework.

A qualitative descriptive study with interpretive thematic analysis was conducted using semi-structured, in-depth interviews with thirty registered psychiatric nurses from multiple tertiary hospitals across China. Data were analyzed using reflexive thematic analysis.

The analysis yielded a novel four-phase process model: pre-emptive prevention ('building a defensive levee'), an in-the-moment operational trilogy ('Stabilise, Connect, Resolve'), and post-intervention consolidation ('achieving a therapeutic closed-loop'), all sustained by an organizational ecosystem. The model repositions effective de-escalation not as an isolated skill but as a multidimensional outcome of relational, cognitive, and systemic factors. The model's novelty lies in its integration of discrete skills into a temporal, phase-based process, emphasizing the cyclical nature of relational work and the foundational role of the organizational ecosystem. Thus, it moves beyond a 'technocratic' training focus on fragmented skills in isolation. The core operational trilogy ("Stabilise, Connect, Resolve") provides a cognitive-behavioral framework for in-the-moment clinical reasoning.

This study provides a robust, experience-based framework that addresses the theory-practice gap by capturing de-escalation as a complex, continuous process. The findings underscore the necessity of moving beyond technocratic training towards systemic, relationship-centered support, offering a critical foundation for safer and more therapeutic mental healthcare environments.

Mineralizing angiopathy is a rare cause of arterial ischemic stroke in early childhood, typically characterized by basal ganglia infarction following minor head trauma and lenticulostriate calcifications. The underlying pathophysiology and risk factors remain poorly understood, although perinatal and postnatal brain injuries have been proposed as potential contributors.

We report three infants (aged 14 to 38 months) who developed basal ganglia infarction after minor head trauma. Clinical presentation, neuroimaging findings, treatment, and follow-up data were retrospectively reviewed.

Brain computed tomography demonstrated lenticulostriate calcifications in all three patients, supporting the diagnosis of mineralizing angiopathy. All children received acetylsalicylic acid (3 to 4 mg/kg/day). During follow-up, no patient experienced recurrent stroke. Neurological outcome was generally favorable, although one child had persistent language delay.

Mineralizing angiopathy should be considered in young children presenting with basal ganglia infarction after minor head trauma. Recognition of its characteristic neuroimaging features may facilitate diagnosis and help avoid unnecessary investigations. Although the prognosis is generally favorable, the pathophysiology and causal role of mineralizing angiopathy remain uncertain, warranting further studies.

Emotional and physical demands of caregiving can affect nutritional intake, particularly of vitamin B9 (folate), which is important in the functioning of the nervous and skeletal systems. Non-caregivers studies in Puerto Rico, a folate-fortified region since 1998, have reported low consumption of folic acid (folate added to foods or taken as a diet supplement) consumption among women, which can potentially affect individuals' subjective mental/physical health well-being. Serum folate levels are a widely used, low-cost, modifiable marker of recent folate status, yet a relationship between serum folate levels and mental/physical health among informal caregivers of patients with chronic diseases in Puerto Rico has not been established. The latter study can be especially vital, as it may allow us to contribute to the initial understanding of caregivers' mental/physical health phenotypes.

To evaluate cross-sectional relationships between serum folate levels and subjective mental health and physical health in informal caregivers of patients with chronic diseases in Puerto Rico.

An observational cross-sectional study from July 2024 to May 2025 was conducted with 69 caregivers. Participants provided blood samples for serum folate levels and answered the PROMIS-10 questionnaire. Descriptive statistics, independent samples t-tests, and multiple regression models were conducted.

The sample included 69 participants. In regression analyses, higher folate levels were significantly associated with higher mental health in both unadjusted and fully adjusted models. Folate levels were also positively associated with physical health in unadjusted and partially adjusted models; however, this association was attenuated and no longer statistically substantial after further adjustment for perceived stress.

Findings suggest that low serum folate levels are a risk factor to consider while assessing the physical/mental health of informal caregivers, with future studies aimed at validating the findings in a larger cohort and with future clinical applications such as screening for folate deficiency, dietary counseling, and supplementation programs to address and mitigate these specific health risks.

To examine associations between social drivers of health and veteran-level reach of STRIDE, a supervised walking program implemented in the Veterans Health Administration (VA).

We included 2527 patients across 5 facilities. We tested whether housing insecurity, rurality, race, and neighborhood deprivation were associated with reach, defined as any STRIDE walk during hospitalization.

We used the first 6 months of postimplementation data from a stepped-wedge implementation trial.

During the implementation period, 197 veterans (7.8%) received at least 1 STRIDE walk. In unadjusted models, patients residing rurally (vs. urban) and those who were White, non-Hispanic/Latino (NH) (vs. Black NH) were significantly more likely to receive ≥1 STRIDE walk. Unadjusted models showed large site differences in STRIDE reach, ranging from 3% to 26% probability by site. Reach differences coincided somewhat with facility-level racial composition: the lowest reach was observed at a site with a majority of Black NH admitted patients, whereas the highest reach was found at a site with a majority of White NH patients. In adjusted models, patient-level rurality remained associated with greater reach (probability 9% for rural veterans vs. 6% for urban veterans), but race was no longer associated (probability 6% among White NH veterans vs. 7% among Black NH veterans).

Patient-level rurality was consistently positively associated with implementation outcomes. Patient-level race was associated with implementation outcomes in unadjusted but not adjusted models. Secondary analyses in implementation trials may help assess how social drivers of health are associated with implementation outcomes.

In the phase 3 randomized controlled trial (RCT; NCT03355209) of fenfluramine in Lennox-Gastaut syndrome (LGS), patients in fenfluramine treatment groups (0.2 mg/kg/day, 0.7 mg/kg/day) experienced greater reduction from baseline in frequency of seizures associated with a fall versus placebo, which was sustained in the open-label extension (OLE) study (NCT03355209). In this post hoc analysis, trajectories of fenfluramine effectiveness and safety, along with dose changes over time, are described for patients with LGS randomized to placebo in RCT who switched to fenfluramine in OLE (PBO-FFA) and those who received fenfluramine in both RCT/OLE (FFA-FFA). Among patients who completed 12 months in OLE (N = 151), numerical improvements in effectiveness outcomes were seen in the PBO-FFA group (n = 59) after initiating fenfluramine and were similar to those in the FFA-FFA group (n = 92). Regression to the mean was not observed in the PBO-FFA group, suggesting that changes were due to fenfluramine. Incidence of the most commonly reported treatment-emergent adverse events increased in the PBO-FFA group after fenfluramine initiation but decreased in the FFA-FFA group in OLE. These data demonstrate rapid improvement in seizure frequency and global functioning in both groups with continued clinical improvement as the mean fenfluramine dose was increased. These results confirm that sustained fenfluramine treatment is effective and tolerable. PLAIN LANGUAGE SUMMARY: This study assessed the change over time in the number of seizures, overall improvement, and side effects in patients with LGS receiving placebo (no active medicine) or fenfluramine in a 14-week study; all patients later received fenfluramine in the extension study. Overall, the number of seizures (associated with a fall) decreased once patients initially receiving placebo changed to fenfluramine (optimal effect around Month 4 while receiving a higher dose), but as expected, common side effects were reported more frequently once patients began fenfluramine treatment. Patients, parents, and doctors should be aware of this time course to allow fenfluramine enough time to work.

Despite extensive research on HIV-associated neurocognitive disorders (HAND), interest in cognitive rehabilitation has emerged only within the past 15 years. HAND are characterised by mild-to-moderate impairments in multiple cognitive domains: attention, episodic memory and executive functions. In the context of HAND, the prevalence of episodic memory disorders is high, ranging from 40% to 65% across studies. This scoping review aims to identify available evidence of rehabilitation programmes targeting episodic memory disorders associated with HIV and to examine their characteristics and theoretical foundations. The initial search included rehabilitation programmes, but this yielded only three eligible clinical trials. Therefore, we expanded our inclusion criteria to encompass experimental studies of potential rehabilitation techniques aimed at improving episodic memory. The search results included 610 records, and 27 full-text articles were assessed for eligibility, of which 10 studies were included: 3 clinical trials and 7 experimental studies. The clinical trials all targeted multiple cognitive functions, episodic memory included. Two trials used a computer-based training approach, while one combined stimulation and compensatory techniques. Two trials demonstrated a significant effect on memory test scores post-intervention compared with the control group, but none showed an impact on quality of life, mental health or a transfer to memory functioning in daily life. The seven experimental cognitive studies demonstrated benefits for episodic memory (retrospective and prospective) using various memory techniques: retrieval practice, self-generated encoding and external aids. This scoping review underscores the need to advance clinical research and rehabilitation practices targeting episodic memory impairment in HAND.

Depression is a highly prevalent mental disorder, with current medications often limited by delayed onset and insufficient efficacy, underscoring the urgent need to explore novel therapeutic strategies. Urolithin B (UB), a natural ellagitannin-derived metabolite, exhibits anti-inflammatory and antioxidant activities in neuroinflammation, yet its role in depression remains unclear.

The present research aimed to uncover possible effects of UB on depressive-like behavior and hippocampal neuronal damage in a rat model of depression and to preliminarily elucidate its underlying molecular mechanisms.

A rat model of depression was created using the chronic unpredictable mild stress (CUMS) paradigm, after which UB intervention was applied. To evaluate depressive-like behaviors, several behavioral tests were conducted, including sucrose preference test, forced swim test, tail suspension test, and open field test. Hippocampal pathological changes and related factor expression were evaluated using histopathology, immunofluorescence, and ELISA. Potential targets were screened via single-cell RNA sequencing (scRNA-seq) data obtained from the GEO database. Subsequently, the function of the identified target gene was validated through in vitro knockdown/overexpression experiments and an in vivo rescue experiment.

UB significantly ameliorated depressive-like behaviors in CUMS rats and alleviated hippocampal neuronal damage, synaptic loss, and neuroinflammation. scRNA-seq analysis revealed a significant upregulation of SLP2 expression in hippocampal neurons (HNs) from the treated group, along with the enrichment of mitophagy-related pathways. Functional experiments confirmed that SLP2 regulates the PINK1/Parkin pathway, promotes mitophagy, and maintains neuronal energy homeostasis. Conversely, knockdown of SLP2 reversed the antidepressant and neuroprotective effects of UB.

UB alleviates CUMS-induced depressive-like behavior and hippocampal neuronal damage by upregulating SLP2 and regulating the PINK1/Parkin-mediated mitophagy pathway. This study presents a new potential target and theoretical basis for developing natural compound-based therapies for depression.

The 2021 expansion of the Child Tax Credit provided advance monthly cash transfers to most US households with children. Although prior evaluations documented overall improvements in household well-being, less is known about variation by household structure. This study examined policy-period changes in parental mental health and material hardship among female-headed households. Using data from 1.3 million respondents to the Census Bureau's Household Pulse Survey (2020-25) and an intersectional framework, we applied difference-in-differences and multilevel models to estimate changes in parental mental health and material hardship before, during, and after expanded Child Tax Credit implementation. Non-female-headed households showed improvements in depression, anxiety, and housing insecurity, whereas female-headed households, particularly those with low incomes and Black, Hispanic, and Asian households, showed smaller or no comparable gains. Food insecurity did not improve across groups. Intersectional analyses showed that the highest burdens and smallest improvements were concentrated among low-income, female-headed households across racial and ethnic groups. Findings suggest that the expanded Child Tax Credit did not fully close baseline disparities, underscoring the importance of household structure and intersecting social positions in policy design and evaluation.