Pathological cardiac hypertrophy is a major risk factor for heart failure and is characterized by transcriptional and metabolic remodeling. Although chromatin accessibility is closely associated with transcriptional regulation, how accessibility changes relate to gene-expression and functional changes during hypertrophic stress remains incompletely understood.

Integrated ATAC-seq and RNA-seq analyses were performed in control and AngII-treated cardiomyocytes, followed by pathway enrichment and mitochondrial gene annotation. Candidate genes were validated in transverse aortic constriction (TAC)-induced hypertrophic mouse hearts and AngII-treated cardiomyocytes, and Car5b was examined using siRNA-mediated knockdown. KEGG pathway enrichment of genes identified by the AngII ATAC-seq/RNA-seq integration was used to nominate pathways for follow-up. PI3K and AKT phosphorylation was evaluated by Western blotting, mitochondrial membrane potential by JC-1 staining, and intracellular reactive oxygen species (ROS) by DCFH-DA/MitoTracker fluorescence staining.

AngII stimulation was associated with widespread chromatin-accessibility remodeling and extensive transcriptional reprogramming. Integrated analysis identified 155 genes with overlapping changes in chromatin accessibility and gene expression; this concordance was interpreted as an association and not as evidence of direct epigenetic regulation. Integration with mitochondrial gene annotation prioritized Car5b, Noct, and Agpat4 as candidate genes. Car5b was consistently upregulated at the mRNA and protein levels in hypertrophic hearts and cardiomyocytes. Car5b knockdown attenuated AngII-induced hypertrophic marker expression and cardiomyocyte enlargement. KEGG pathway enrichment analysis of the 155 genes identified by integrated ATAC-seq and RNA-seq analysis of AngII-treated primary cardiomyocytes revealed the PI3K/AKT signaling pathway as one of the enriched pathways. AngII increased PI3K and AKT phosphorylation, whereas Car5b knockdown was associated with lower phosphorylation levels. Car5b knockdown was also associated with improved mitochondrial membrane potential and reduced intracellular ROS accumulation.

These findings identify Car5b as a mitochondria-related candidate associated with AngII-induced cardiomyocyte hypertrophy. Car5b knockdown attenuated hypertrophic readouts and coincided with reduced PI3K/AKT phosphorylation, improved mitochondrial membrane potential, and lower ROS. The present experiments do not establish the causal sequence among Car5b, PI3K/AKT signaling, and mitochondrial dysfunction, and concordant ATAC-seq/RNA-seq changes do not by themselves demonstrate direct epigenetic regulation. Car5b therefore warrants further mechanistic investigation as a potential modulator of pathological cardiac remodeling.

To examine the psychosocial impact of this disease on recovered individuals and frontline health workers (FHWs) following the 2024 MVD outbreak in Rwanda.

a cross-sectional survey.

Kigali, the capital city of Rwanda, had two treatment centres during the outbreak of the MVD disease from 24 September to 24 October 2024.

All 51 recovered individuals from MVD and 98 FHWs who met the eligibility criteria were involved in the study.Depression was measured using the Patient Health Questionnaire (PHQ-9), anxiety with the Generalised Anxiety Disorder (GAD-7) scale and post-traumatic stress disorder using the PTSD Checklist for DSM-5 (PCL-5). Perceived stigma was measured using the adapted Ebola stigma and discrimination questionnaire and the Multidimensional Scale of Perceived Social Support Scale (MPSS) to assess social support. Wilcoxon rank-sum and Kruskal-Wallis tests examined differences in depression, anxiety and PTSD by sex and profession. Spearman correlation assessed relationships between variables.

115 participants, including 29 recovered people and 86 FHWs. 11.8% of FHWs had moderate to severe depression and 20.7% of recovered people had mild to moderate depression. Moderate to severe anxiety was exhibited by 9.4% of FHWs, and mild anxiety was reported by 17.2% of recovered people. 9.3% of FHWs and one recovered individual had a total PCL score above 33 (PTSD). Among recovered people, there was a significant negative correlation between anxiety and social support (r=-0.36, p value=0.05) and a significant difference in PTSD symptom levels between sexes (p value=0.01). Among FHWs, MVD-related stigma was positively correlated with PTSD symptoms (r=+0.23, p value=0.05). Symptoms of depression (β coef.=-0.19, 95% CI -0.32, -0.05) and anxiety (β coef.=-0.16, 95% CI -0.26, -0.06) decreased with age. Married FHWs had lower levels of depression (β coef.=-2.72, 95% CI -4.96, -0.49) and anxiety (β coef.=-2.35, 95% CI -4.07, -0.62) compared with single individuals.

Six months post-containment of the MVD outbreak in Rwanda, many FHWs were still experiencing depression, anxiety and PTSD. Contextualised and culturally adapted mental health and psychosocial support interventions are highly recommended for integration into infectious disease response plans.

To identify and map health-related services and interventions that support Armed Forces transitioning to veteran status, and to synthesise evidence on their potential effectiveness.

Scoping review.

Medline (Ovid), Embase (Ovid), APA PsycInfo (Ovid), Cochrane (Wiley), Web of Science (Clarivate), ASSIA (ProQuest) and PTSD Pubs (Proquest), citation chasing and web searches.

Armed Forces members, veterans, family members and service providers from the UK, Europe, Canada, Australia or New Zealand.

Health-related services and interventions intended to support military to civilian transition.

Health and wellbeing outcomes (eg, mental health symptoms, quality of life), broader transition-related outcomes (eg, employment, housing, social connection), acceptability, barriers and facilitators to intervention or service engagement.

Tabulation and narrative synthesis (using thematic analysis for qualitative studies).

Thirty-four unique studies were included, reporting data on 10 040 veterans and transitioning service personnel. Twenty-two distinct interventions were identified and grouped into five categories: (1) art-based, (2) sport or outdoor-based, (3) peer- or group-based, (4) employment, skills or education training and (5) digital technology interventions. Most evidence originated from the UK, with additional studies from Canada, Australia, New Zealand and Israel. While no critical appraisal of study quality was performed within this review, quantitative evaluations suggested benefits for mental health, wellbeing and reintegration outcomes for some intervention types; however, evidence was heterogeneous and variable in outcome measurement. Qualitative evidence highlighted value in social connection, identity and purpose, and identified barriers related to awareness, access, acceptability and the need for tailored provision.

A diverse range of services and interventions are available to support transition to civilian life, but the strength and consistency of the evidence varied considerably, meaning findings should be interpreted as identifying potentially valuable approaches rather than established best practices. Future research should prioritise robust evaluation designs, consistent outcome reporting and attention to implementation and equity. Service planners may benefit from improved signposting and better integration across health, social care and third-sector pathways to support veterans during transition.

Zenodo record 17630661.

In this study, the trajectories of depressive symptoms and the role of resilience were examined during the transition to high school. A five-wave longitudinal survey, with 1-month intervals, was conducted during the first semester of Grade 10 among 639 Chinese students (M_age = 15.88; SD = 0.63; 52.2% females) from four high schools. Latent growth modelling was employed to analyse the data. Results indicated that a quadratic growth model adequately fit the data, showing a quadratic trajectory characterised by an initial rapid increase in depressive symptoms followed by gradual deceleration. Sex significantly predicted initial symptom levels, with females reporting higher symptoms than males, but did not predict rates of change. Higher resilience was associated with lower initial depressive symptoms and a decelerated trajectory over time. These findings suggest that resilience could be a valuable target for depressive symptom prevention and intervention programmes during the transition to high school.

Hospital-based violence intervention programs (HVIPs) aim to interrupt cycles of violence and support recovery among youth exposed to interpersonal violence. However, HVIP evaluations often rely on deficit-oriented outcomes (i.e., reinjury, mortality, criminal justice system involvement) that may not reflect priorities of youth and families.

To determine youth and parent perspectives on patient-centered outcomes, needs, and priorities following violent injury.

Focus groups were conducted with youth and parents connected to community-based organizations (CBOs) collaborating with a pediatric HVIP. Focus group participants were engaged as community proxies for HVIP participants given their affiliation with CBOs serving violence-affected communities and their relevant experiences with violence and/or service systems. Focus groups explored definitions of health and success, barriers to healing, and priorities for recovery. Transcripts were analyzed using thematic analysis and consensus-based coding.

Three focus groups were conducted with a total of 17 participants (12 youth, 5 parents). Five major themes emerged: (1) holistic definitions of health and success; (2) emotional communication and processing during recovery following violent injury; (3) systemic and structural barriers to recovery; (4) social circles as key determinants in healing; (5) the role of trust in recovery. Regarding patient-centered outcome priorities, youth emphasized goal-planning, mental health and social needs, while parents highlighted mental health, mentorship, and repeat injury.

Youth and parents prioritize outcomes that extend beyond traditional HVIP metrics. Incorporating patient-centered outcomes into program evaluation may better capture meaningful recovery and improve trauma-informed design of HVIPs.

Gender-based violence is a pervasive public health and human rights problem that disproportionately affects women in Africa, resulting in profound physical, psychological, and social consequences. Despite these impacts, many survivors do not seek formal help due to stigma, fear, and limited access to resources. This study aimed to estimate the pooled prevalence of help-seeking behavior and identify its determinants among gender-based violence survivor women in Africa.

A systematic review and meta-analysis were conducted following standard methodological guidelines, using studies identified from African Journals Online, PubMed/MEDLINE, PsycINFO, EMBASE, and Google Scholar. Data were extracted and analyzed using a random-effects model to estimate the pooled prevalence and associated factors. Statistical heterogeneity and publication bias were assessed using funnel plots and Egger's regression test.

Thirteen studies involving 31,061 women were included. The pooled prevalence of help-seeking behavior among women who experienced gender-based violence in Africa was 33.86% (95% CI: 28.23, 39.49). Help-seeking behavior was significantly more likely among women with access to fuel sources (aOR = 2.26; 95% CI: 1.54, 3.32), women from rich households (aOR = 2.57; 95% CI: 1.12, 5.90), and women with independent land ownership (aOR = 1.85; 95% CI: 1.30, 2.64).

Only one-third of women survivors of gender-based violence in Africa reported help-seeking behavior, highlighting a substantial unmet need for support services. Economic empowerment and access to productive resources, including land ownership and household assets, play a critical role in enabling help-seeking behavior. Interventions aimed at improving women's economic independence and access to essential resources should be integrated into gender-based violence prevention and response strategies across African settings.

Interoception - the perception and interpretation of internal bodily signals - is increasingly recognized as a transdiagnostic mechanism underlying emotion regulation and psychopathology. Although many psychiatric interventions implicitly or explicitly target interoceptive processes, there is limited clarity regarding how interoception is defined, measured, and applied in mental healthcare, as well as how effective interoception-focused interventions are across psychiatric populations.

A systematic scoping review was conducted of peer-reviewed studies published up to September 1, 2025, using Scopus, PsycINFO, and Web of Science. Studies were included if they evaluated interventions targeting interoception or related constructs in individuals with psychiatric disorders. Studies focusing on emotional awareness, emotion regulation, or alexithymia were excluded. Data were synthesized to map definitions, measurements, intervention types, effectiveness, and reported benefits and barriers.

Forty-seven studies were included (37 quantitative; 13 qualitative/mixed). There was substantial heterogeneity in conceptualization and measurement, with most studies focusing on interoceptive awareness using self-report measures, particularly the Multidimensional Assessment of Interoceptive Awareness (MAIA). Interventions included mindfulness-based approaches, body-oriented therapies, structured protocols, and technology-supported methods. Of 37 (quasi-)experimental studies, 34 reported significant improvements in interoceptive outcomes. Qualitative findings highlighted benefits such as improved body awareness and emotion regulation, alongside barriers including skepticism, difficulty engaging with bodily focus, and feelings of being overwhelmed.

Interoception-focused interventions show consistent positive effects across psychiatric populations and represent a promising avenue for clinical practice. However, variability in definitions and measurement currently limits translation into standardized care. Future research should prioritize clearer conceptualization, multi-method assessment strategies, and greater attention to individual differences to support more personalized and effective interoception-based treatments.

With an aging population, physical frailty has become a significant public health issue. In Chile, few longitudinal studies comprehensively identify its predictors.

To determine sociodemographic, mental health, loneliness, and clinical variables that predict physical frailty in older adults over 12 months.

A prospective cohort study was conducted. 394 individuals between 60 and 80 years of age from Greater Santiago and the Province of Concepción participated, selected through a stratified cluster sampling design. Physical frailty was assessed using the FRIED scale as the outcome variable. The predictor variables considered were sociodemographic characteristics, perceived social support (MSPSS), social participation, depressive (PHQ-9) and anxiety (GAI) symptoms, cognitive functioning (MoCA), perceived loneliness (ULS-3), self-reported chronic conditions, and body mass index. Data collection occurred at baseline (2021) and after 12 months (2022). Logistic regression analysis was performed with the R statistical software.

The baseline prevalence of physical frailty was 22.7%. Compared with robust and pre-frail individuals at baseline, frail older adults had a lower education level and lower social participation, higher depressive and anxiety symptoms, higher perceived loneliness, lower cognitive functioning, and a higher prevalence of multimorbidity (p<0.05). Overall, the predictor variables for incident physical frailty at the one-year follow-up were age, perceived social support, depressive and anxiety symptoms, cognitive functioning, the presence of hypertension, vascular disease, and body mass index (p=0.040), explaining 28% of the variance.

These findings demonstrate that the development of physical frailty is influenced by sociodemographic, mental health, loneliness, and clinical factors, emphasizing that it should be viewed as a multidimensional phenomenon rather than solely a physical condition.

Multiple sclerosis (MS) is a chronic disease of the central nervous system that mainly affects young adults. In addition to physical symptoms, MS has a significant impact on mental health and quality of life. In Chile, there is little information on these aspects.

To characterize mental health and quality of life among individuals with MS in Chile using a mixed methodological approach.

A two-phase study was conducted. In the quantitative, cross-sectional and descriptive phase, 24 people with MS participated (87.5% women; mean age 36.9 years). The Modified Fatigue Impact Scale (MFIS), the Beck II Depression Inventory (BDI-II), the Rosenberg Self-Esteem Scale (RSES), and the Multiple Sclerosis Quality of Life-54 (MSQOL-54) questionnaire were applied. In the qualitative phase, semi-structured interviews were conducted with eight open-ended questions to explore emotional experiences, support networks, and coping strategies. Descriptive statistical analysis and thematic analysis of personal accounts were conducted, integrating the results.

The MSQOL-54 showed similar scores in physical health (57.0±17.4) and mental health (57.5±22.5), with greater impact on energy and health perception. The MFIS averaged 45.9 (SD=17.6), with physical and cognitive fatigue predominating. The BDI-II showed moderate-severe depressive symptoms (mean 21.6±12.1) and the RSES medium-low self-esteem (18.0±5.2). Negative correlations between depression and quality of life and positive correlations between self-esteem and quality of life were identified. The qualitative analysis revealed categories related to self-control, emotional containment, awareness of emotions, social skills, tolerance to frustration, identity, and support networks. The absence of networks correlated with greater emotional vulnerability.

This study shows fatigue, depression, and low self-esteem are key factors that affect the quality of life of people with MS in Chile. Interdisciplinary interventions that integrate physical, psychological, and social aspects are required to improve the well-being of this population.

In 2023, approximately 23,000 persons died of homicide and 49,000 persons died of suicide in the United States, according to the National Vital Statistics System. This report summarizes data from CDC's National Violent Death Reporting System (NVDRS) on violent deaths and suicides that occurred in the 50 states, the District of Columbia, and Puerto Rico in 2023.

2023.

NVDRS collects data from death certificates, coroner and medical examiner records, and law enforcement reports. This report includes data collected from all 50 states, the District of Columbia, and Puerto Rico. Forty-seven states had statewide data, three additional states had data from counties representing a subset of their population (31 California counties, representing 74.1% of its population; 38 Florida counties, representing 59.3% of its population; and 13 Texas counties, representing 62.9% of its population), and the District of Columbia and Puerto Rico had jurisdiction-wide data. NVDRS collates information for each death and links deaths that are related (e.g., multiple homicides, homicide followed by suicide, or multiple suicides) into a single incident.

For 2023, NVDRS collected information on 70,133 fatal incidents involving 72,093 deaths. The deaths recorded in NVDRS accounted for 91.6% of all homicides, legal intervention deaths, suicides, unintentional firearm injury deaths, and deaths of undetermined intent in the United States in 2023. In addition, information was collected for 671 fatal incidents involving 730 deaths in Puerto Rico. Data for Puerto Rico were analyzed separately.Of the 72,093 deaths that occurred in the 50 states and the District of Columbia, the majority (62.4%) were suicides, followed by homicides (28.5%), deaths of undetermined intent that might be due to violence (6.9%), legal intervention deaths (1.5%) (i.e., deaths caused by law enforcement and other persons with legal authority to use deadly force acting in the line of duty, excluding legal executions), and unintentional firearm injury deaths (<1.0%). Of the 730 deaths reported for Puerto Rico, 66.4% were homicides and 32.9% were suicides.Demographic patterns and circumstances varied by manner of death. In the 50 states and the District of Columbia, the suicide rate was higher for males than for females (23.5 versus 6.1 per 100,000 population). The suicide rate for males was highest for those aged ≥85 years (53.0), whereas for females, the suicide rate was highest for those aged 45-54 years (8.8). In addition, non-Hispanic American Indian or Alaska Native (AI/AN) persons had the highest suicide rates among all racial and ethnic groups (22.7). Among both males and females, the most common method of injury for suicide was a firearm. Among all suicide decedents for whom circumstances were known, suicide was most often preceded by an intimate partner, mental health, or physical health problem or by a recent or impending crisis.The homicide rate was also higher for males (10.8 per 100,000 population) than for females (2.7). Among all homicide victims, the homicide rate was highest among adults aged 20-24 years (14.1) compared with other age groups. Non-Hispanic Black or African American (Black) males experienced the highest homicide rate of any racial or ethnic group (50.6). Among all homicide victims, the most common method of injury was a firearm. When the relationship between a homicide victim and a suspect was known, the suspect was most frequently an acquaintance or friend for male victims and a current or former intimate partner for female victims. When circumstances were known, homicide was most often precipitated by an argument or conflict, occurred in conjunction with another crime, or, for female victims, was related to intimate partner violence. Nearly all victims of legal intervention deaths were male (95.6%) and the legal intervention death rate was highest among men aged 30-34 years. The legal intervention death rate was highest among AI/AN males, followed by Black males. A firearm was used in most legal intervention deaths. When circumstances were known, the most frequently reported circumstances for legal intervention deaths were the victim's reported use of a weapon, the victim being previously known to authorities, or that the victim reportedly had mental health or substance use problems.Other manners of death included unintentional firearm injury deaths and deaths of undetermined intent. Unintentional firearm injury deaths occurred most frequently among males, non-Hispanic White (White) persons, and persons aged 15-19 years. When circumstances were known, these deaths most frequently occurred while the shooter was playing with a firearm and most often were precipitated by a person unintentionally pulling the trigger. The rate of deaths of undetermined intent was highest among males, particularly among AI/AN and Black males, and among adults aged 35-44 years. Poisoning was the most common method of injury in deaths of undetermined intent, often involving opioids (67% positive among decedents tested).In Puerto Rico, the homicide rate was twice as high as the suicide rate and was 10.7 times higher for males than for females. Firearms were the most common method of injury in homicides. When the relationship between the homicide victim and suspect was known, the suspect was most frequently an acquaintance or friend for male victims and a current or former intimate partner for female victims. Among male homicide victims in Puerto Rico when circumstances were known, the most common precipitating circumstances were drug involvement and the victim previously being known to authorities, whereas among female victims, the most common homicide circumstance was intimate partner violence. The suicide rate in Puerto Rico was also higher for males than for females. The most common suicide method was hanging, strangulation, or suffocation. Depressed mood or currently diagnosed mental health problem were frequent circumstances reported for both male and female suicide decedents.

This report summarizes NVDRS data on violent deaths and suicides that occurred in 2023. The suicide rate was highest among AI/AN and White males, whereas the homicide rate was highest among Black males. Intimate partner violence precipitated a large proportion of homicides of females. Mental health and substance use problems, previous awareness of the victim by authorities, intimate partner problems, interpersonal conflicts, and acute life stressors were the primary precipitating circumstances for multiple types of deaths examined.

The injury-related deaths described in this report are preventable, and data can guide public health action. NVDRS data are used to monitor the occurrence of these fatal injuries and assist public health agencies in developing, implementing, and evaluating programs, policies, and practices to reduce and prevent deaths. Violent death reporting system data are helping states identify disproportionately affected groups and implement targeted prevention strategies, including youth suicide-focused analyses in Maryland and veteran suicide-focused initiatives in Michigan and Connecticut that guided statewide partnerships, crisis line outreach, and mental health service expansion.