Previous research has demonstrated that individuals' levels of self-esteem strongly influence how they regulate and protect their self-esteem. However, it remains unclear to what extent these regulatory strategies are shaped by trainable psychological processes such as decentering and self-compassion.

Two studies were conducted to investigate the role of decentering and self-compassion in self-esteem regulation. Study 1 (n = 230) examined whether decentering and self-compassion mediate the relationship between trait self-esteem and self-esteem regulation strategies. In addition, differences between experienced meditators and non-meditators in self-esteem, decentering, self-compassion, self-affirmation and self-protection were explored. Study 2 (n = 66) employed a randomized controlled design to test the feasibility and preliminary short-term effects of two brief guided audio meditations intended to enhance decentering and self-compassion.

In Study 1, multiple regression analyses revealed that decentering was associated with higher self-affirmation, while self-compassion was linked to lower self-protection. Conditional process path analysis further showed that self-esteem was positively associated with both decentering and self-compassion and had a significant indirect effect on self-protection via self-compassion. Moreover, compared to non-meditators, meditators reported higher levels of self-esteem, decentering, and self-compassion. In Study 2, both brief audio-based interventions led to increases in self-compassion and decentering relative to the control condition, with the decentering intervention showing the strongest effects on post-intervention outcomes.

The findings indicate that decentering and self-compassion can be modifiable through brief meditative practices and may play an important role in the regulation of self-esteem. Enhancing these processes may represent a promising target for psychological interventions aimed at improving self-esteem regulation and resilience in individuals vulnerable to mental health problems.

Prescription errors remain a significant challenge to medication safety in hospital settings. Forced Interception (FI) systems, which automatically flag and block potentially problematic prescriptions, serve as critical safeguards against adverse drug events. However, the specific characteristics and underlying causes of intercepted prescriptions, particularly in Chinese hospital contexts, require further investigation to inform targeted quality improvement strategies. This study aimed to analyze the characteristics and interception reasons of FI prescriptions in a hospital setting, with the goal of identifying patterns that could guide system upgrades, clinical training, and policy interventions.

This study conducted a retrospective analysis of FI prescriptions intercepted by the hospital's electronic prescribing system. Prescriptions were analyzed for interception reasons, drug categories, specific medications, and prescribing department patterns. Data were collected and categorized to identify the most frequent issues and drug types involved in forced interceptions.

A total of FI prescriptions were analyzed. The most common interception reasons were "Treatment duration exceeded" (54.89%) and "Exceeding Dosage" (28.11%), together accounting for the majority of interceptions. Traditional Chinese medicine and central nervous system drugs were the most frequently intercepted drug categories. The top three intercepted medications were Duloxetine Hydrochloride Enteric Capsules (3.63%), Atorvastatin Calcium Tablets (3.11%), and Tandospirone Citrate Capsules (2.81%). Departmental analysis revealed distinct prescribing patterns: the cardiology department showed high interceptions for hyperlipidemia-related drugs, while the mental health department had numerous interceptions for long-term antidepressant and anxiolytic prescriptions.

The study suggests that targeted interventions, including upgrading electronic prescribing systems, department-specific training, and forming special review panels, are necessary to reduce prescription errors and improve medication safety. Future work should focus on multicenter studies and, as a longer-term direction, explore the potential of artificial intelligence for dynamic risk prediction to enhance the continuous optimization of medical quality.

Geriatric depression is frequently complicated by cognitive impairment, which is linked to impaired self-care ability, elevated dementia and suicide risks, and heavier disease burden. Its pathogenesis involves metabolic disorders, vascular injury, neurodegenerative changes, and clinical factors. Nutritional status, social support, and lifestyle remain unclear in older patients with depression. This study aims to determine the prevalence of cognitive impairment and identify factors associated with cognitive impairment in hospitalized older adults with depression.

A cross-sectional study was conducted at a tertiary psychiatric hospital in China from February 2021 to March 2025. A total of 196 older patients diagnosed with depression were recruited using consecutive sampling. Cognitive impairment was evaluated using the Mini Mental State Examination (MMSE). Data collection included a general information questionnaire, Mini Nutritional Assessment Short Form (MNA-SF), Brief Psychiatric Rating Scale (BPRS), Geriatric Depression Scale (GDS), Social Support Rating Scale (SSRS), and Activities of Daily Living (ADL). Multivariable logistic regression was used to identify factors associated with cognitive impairment.

The sample was composed of 70.9% female participants, with a mean age of 69.24 ± 5.84 years. A total of 45.4% participants had cognitive impairment. The multivariable logistic regression analysis showed that better nutritional status (MNA-SF: OR = 0.223, p = 0.010) and higher ADL score (OR = 0.975, p = 0.021) were negatively associated with cognitive impairment, while higher BPRS score (OR = 1.049, p = 0.020) was positively associated with cognitive impairment.

Cognitive impairment is prevalent in hospitalized older adults with depression. Poor nutrition, low self-care ability, and severity psychiatric symptoms are associated with a higher likelihood of cognitive impairment. Targeted intervention strategies should be developed to address these factors.

How paternity leave relates to postpartum adjustment remains unclear.

We examined associations of paternity leave group [no leave, short (<1 month), or long (≥1 month)] with mothers' parenting adaptation and depressive symptoms at 3 months postpartum in a theory-guided SEM including mothers' reports of fathers' childcare and housework involvement and perceived coparenting quality.

This cross-sectional survey included 555 mothers (primipara, n = 330; multipara, n = 225). Participants completed questionnaires assessing fathers' involvement using the Child Care Activities and Housework Scale, coparenting quality using the Coparenting Relationship Scale, parenting resilience and adaptation using the Comprehensive Scale for Parenting Resilience and Adaptation, and depressive symptoms using the Center for Epidemiologic Studies Depression Scale. Parity-stratified SEM estimated associations.

In primiparous families, short and long leave were associated with higher paternal involvement; long leave had stronger associations across all four domains: Interactional Activities, Concrete Childcare Activities, Mental Support, and Housework. In multiparous families, leave was associated mainly with housework and task-based childcare, but not clearly with mental support. Across parity groups, mothers' reports of fathers' mental support showed the strongest association with mothers' perceived coparenting quality [primipara: β = 0.411, 95% CI (0.285, 0.527); multipara: β = 0.490, 95% CI (0.350, 0.612)]. Better coparenting was associated with fewer perceived difficulties in environmental resources and perceived support and with lower psychological maladaptation to parenting; psychological maladaptation was positively associated with depressive symptoms in both groups [primipara: β = 0.396, 95% CI (0.178, 0.571); multipara: β = 0.301, 95% CI (0.133, 0.459)]. Because no direct paths from paternity leave to depressive symptoms were specified, total effects represented indirect associations. These associations were small and negative for both short and long leave among primiparous mothers; among multiparous mothers, only short leave showed a small negative indirect association, whereas the association for long leave was not clearly supported.

Paternity leave duration showed small indirect associations with maternal parenting adaptation and depressive symptoms through fathers' involvement and coparenting quality. The findings suggest that the potential relevance of leave may depend not only on uptake and duration but also on supportive involvement and coparenting.

Social isolation (SI), attributable to modern lifestyles and fast-growing technology, is a leading cause of depression. Selenium nanoparticles (Se-NPs) are neuroactive agents owing to their antioxidant and anti-inflammatory activities. Additionally, physical and mental activities (Ph&M) exert neuroprotective effects by optimizing the release of both neurotransmitters and growth factors. However, their neuroprotective effects against SI-induced depression are still poorly investigated.

We aim to explore the neuroprotective effect of Se-NPs, Ph&M, and their combination to guard against the harmful effects of SI-induced depression in a rat model.

Fifty Sprague Dawley rats were randomly allocated into five groups: control, SI, Ph&M, orally administered Se-NPs (0.1 mg/kg), and a combination group. Neuroprotective activity was quantitatively estimated pharmacologically, biochemically, histologically, and behaviorally.

SI caused behavioral and biochemical alteration in the rat model, decreasing neurotransmitter levels, increasing the transcription of inflammatory response genes (TLR4 and NF-κB), and consequently increasing the production of the cytokines TNF-α and IL-1β. It also activated the proinflammatory NLRP3/caspase-1 pathway. The ER stress parameters PERK, CHOP, and GRP78 were significantly elevated. Impairment of autophagy and increased neurodegeneration were detected via the decline of AMPK/SIRT-1/Beclin-1 PI3K/AKT gene expression and m-TOR overexpression. Decreased expression of TrkB and CREB mRNA and consequent decline in brain-derived neurotropic factor were recorded. SI caused a drastic drop in Wnt3a and β-catenin levels and increased GSK3β activity affecting neuroplasticity and cognitive functions. Administration of Se-NPs and/or application of Ph&M, especially their combination, provided significant protection against prior SI effects.

Se-NPs and Ph&M, especially their combination, showed promising protective effects against neuroinflammation, oxidative stress, apoptosis and subsequent alterations of test animal behaviors precipitated by SI.

The Experience Sampling Method (ESM) delivered via smartphone applications offers a scalable approach to monitoring mental health in daily life. However, its feasibility and acceptability in low- and middle-income countries remain largely unexplored. This study provides the first evaluation of the feasibility and acceptability of app-based grief monitoring among bereaved adults in Viet Nam.

Ninety-six bereaved adults completed a two-week ESM protocol involving five daily prompts assessing momentary grief experiences and contextual factors. Feasibility was evaluated through compliance rates, while acceptability was assessed using participants' ratings of perceived personal benefit, emotional reactivity, and perceived need for professional support after completing two weeks of ESM.

The overall compliance rate was 73%, indicating good feasibility. Participants reported neutral to mildly positive perceptions of personal benefit and mildly negative to neutral levels of emotional reactivity. On average, participants did not endorse a need for professional help resulting from study participation. Neither sociodemographic characteristics nor baseline grief scores were associated with compliance. Higher baseline grief intensity was significantly associated with greater perceived need for professional help, lower emotional reactivity, and lower overall acceptability.

App-based ESM is a feasible and generally acceptable method for monitoring daily grief experiences among bereaved adults in Viet Nam. Further research is needed to optimize digital grief assessment and support the broader implementation of ESM in low- and middle-income settings.

With the rapid advancement of artificial intelligence (AI), it has exerted a profound influence on the medical field. Currently, AI applications in nursing remain nascent in China. This study aimed to investigate nurses' attitudes and anxiety levels toward AI in general hospitals in western China, and to analyze the association of these psychological factors with their AI training acceptance and clinical AI tool usage behavior.

A multicenter cross-sectional design was employed. In February 2026, a questionnaire survey was conducted among 620 registered nurses in public general hospitals across western China (Sichuan, Guizhou, and Qinghai provinces). The questionnaire collected data on nurses' demographic information, whether they had received AI training and whether they had used AI tools in the workplace, as well as their responses to the General Attitudes Toward AI Scale (GAAIS) and the AI Anxiety Scale (AIAS). Participation was voluntary and anonymous. Descriptive statistics, reliability and validity testing, correlation analysis, and structural equation modeling were performed using R software (version 4.5.1).

Of 603 returned questionnaires (97.3% response rate), 591 were valid. Negative attitudes were significantly associated with lower training acceptance (β = -0.140, p = 0.015) and lower tool usage (β = -0.141, p = 0.003). Positive attitudes and AI anxiety showed no significant associations with either outcome. Older age and longer work experience were associated with higher rates of both outcomes, with work experience showing the strongest association with tool usage. No significant association was found between training acceptance and tool usage after covariate adjustment (β = 0.070, p = 0.356).

Hospital-level resources, older age, and longer work experience were the factors most strongly associated with nurses' AI training acceptance and AI tool usage, with work experience showing the strongest association with tool usage. Negative attitudes were associated with lower engagement in both outcomes, whereas positive attitudes and anxiety showed no significant independent associations. These findings suggest that institutional support, experience-based peer learning, and targeted reduction of negative perceptions may be key priorities for AI integration in nursing practice.

Aging is characterised by the progressive accumulation of advanced glycation end products (AGEs), formed through non-enzymatic glycation reactions between reducing sugars and proteins, lipids, or nucleic acids. AGEs contribute to tissue damage through irreversible protein cross-linking and receptor-mediated inflammatory signalling via the receptor for AGEs (RAGE). Elderly individuals are disproportionately affected due to cumulative oxidative stress, chronic low-grade inflammation (inflammaging), impaired renal and enzymatic clearance, and prolonged exposure to dietary AGEs. Omega-3 polyunsaturated fatty acids (PUFAs), particularly eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), may modulate these pathways through anti-inflammatory, antioxidant, and metabolic mechanisms.

To synthesise available preclinical, in vitro, and clinical evidence on the mechanistic and therapeutic relationships between omega-3 PUFA supplementation and AGE formation, accumulation, and signalling, and to evaluate the effects of omega-3 supplementation on key age-related clinical outcomes in elderly populations, including cardiometabolic health, cognitive function, mental health, functional capacity, and quality of life.

A narrative review was conducted using searches of PubMed, Scopus, and Web of Science. Eligible study designs included in vitro experiments, animal models, randomised controlled trials (RCTs), observational studies, and systematic reviews published in English. Evidence was synthesised thematically across mechanistic and clinical domains, with priority given to studies addressing AGE-related pathways and clinically relevant endpoints.

Preclinical evidence demonstrates that omega-3 PUFAs attenuate oxidative stress and inflammatory signalling, partly through RAGE axis regulation and PPARγ activation. Clinical studies report reductions in circulating AGEs, RAGE, and pentosidine following supplementation, alongside upregulation of protective scavenger receptors such as AGER1. Omega-3 supplementation has also been associated with improvements in inflammatory markers, cardiometabolic risk, cognitive function, and physical capacity in older adults. However, RCT evidence assessing tissue-level AGE accumulation using non-invasive measures such as skin autofluorescence remains limited in elderly populations.

Omega-3 PUFAs demonstrate therapeutic potential in modulating AGE-related mechanisms and improving age-associated outcomes. Well-designed RCTs targeting tissue AGE accumulation and long-term endpoints in elderly cohorts are warranted.

Living kidney donation prior to euthanasia has never previously been reported and is not incorporated into current clinical guidelines. This study aims to discuss the unique medical, procedural, psychological and ethical considerations of living donation prior to euthanasia based on 3 Dutch cases. Of the 3 candidates, 2 successfully donated without detrimental effects to physical or mental health; one was declined for medical reasons. In two cases, euthanasia has been performed; in one case donation was transformative and the request for euthanasia was withdrawn after donation. Medically, normal life-expectancy after donor nephrectomy should be presumed as euthanasia remains uncertain. Procedurally, timing can create tension between these two processes as postponing euthanasia could be harmful. Psychologically, potential exacerbation in psychopathology should be weighed against the impact of being declined for donation. Ethically, autonomy, capacity to consent and risk-benefit ratio must be rigorously assessed, especially given the degree of suffering in these cases. We conclude that living donation and euthanasia should be seen as independent processes and a euthanasia request should not be considered an absolute contra-indication for living donation. Our initial experiences underscore the need for international dialogue and policy development.

BackgroundMild behavioral impairment (MBI), characterized by later-life emergence of persistent neuropsychiatric symptoms (NPS), is an early clinical indicator of dementia risk. Global MBI has been associated with Alzheimer's disease (AD) pathology; studies have also explored MBI domains. Prior work has linked MBI-apathy to AD cerebrospinal fluid (CSF) biomarkers, but whether associations are detectable using plasma-based biomarkers such as phosphorylated tau (p-tau) is unknown. Establishing such relationships is critical, as plasma biomarkers are more accessible than CSF.ObjectiveTo explore cross-sectional and longitudinal associations between MBI-apathy and plasma p-tau₁₈₁ levels using Alzheimer's Disease Neuroimaging Initiative data.MethodsOlder adults with normal cognition or mild cognitive impairment were categorized as MBI-apathy (n = 69), non-MBI NPS (n = 112), and no-NPS (n = 215) based on Neuropsychiatric Inventory scores and symptom persistence over one year. Linear regression modelled cross-sectional associations between NPS group and plasma p-tau₁₈₁, adjusting for age, sex, education, apolipoprotein E4 status, and Mini-Mental State Examination score. Hierarchical linear mixed-effects modelling assessed associations over two and three years, including time-by-NPS group interactions.ResultsMBI-apathy was associated with significantly higher plasma p-tau₁₈₁ levels at baseline (24.05% [6.06-45.08%]; adjusted p = 0.014), and over two (26.46% [7.24-49.12%]; adjusted p = 0.012) and three years (29.28% [10.17-51.72%]; adjusted p = 0.004) compared to no-NPS. No significant associations were observed for non-MBI NPS. In sensitivity analyses, non-MBI apathy was not associated with plasma p-tau₁₈₁ at baseline (-9.96% [-32.69-20.44%]; unadjusted p = 0.478).ConclusionsMBI-apathy is associated with elevated plasma p-tau₁₈₁ cross-sectionally and longitudinally, supporting MBI-apathy as a potential proxy marker of tau pathology for early AD detection.