Objective: While school belonging and campus climate are critical to student well-being, the nuanced interplay between internal feelings of connection and external perceptions of the institutional environment remains underexplored. Participants: The analytic sample included 1,245 college students aged 18-29 years. Methods: Latent profile analysis (LPA) was conducted to identify subgroups based on school belonging and perceived campus climate. Results: This study identified three distinct latent profiles of college students based on their experiences of school belonging and perceived school climate: high belonging & high climate, moderate belonging & moderate climate, and moderate belonging & low climate. Further analysis examined how these profiles differ across mental health outcomes and self-injurious thoughts and behaviors. Conclusion: These findings suggest that mental health risks are non-linearly distributed across campus environments. Administrators must prioritize systemic, macro-level climate improvements and implement refined clinical screening to proactively identify and support hidden vulnerabilities within the "invisible middle."

To assess the longitudinal association between the onset of child death and psychosocial outcomes among adults aged 40 years and older in South Africa between 2015 and 2022.

Data were drawn from three waves of the HAALSI study. Child death was modelled as a time-varying indicator capturing the onset of child death between survey waves. Fixed-effects regression models estimated within-person changes in psychosocial outcomes following bereavement.

The pooled analytic sample included 9,494 person-wave observations from adults aged 40 years and older across the 2015, 2019, and 2022 survey waves. Of these, 3,935 observations were among parents with a history of child loss and 5,559 among parents without such a history. During follow-up, 432 participants experienced the onset of child death. Adjusted fixed-effects analyses showed that the onset of child death was associated with increased depressive symptoms, poorer sleep quality, more PTSD symptoms, poorer self-rated health, reduced cognitive functioning, and marginally lower life satisfaction. No significant sex differences were observed.

The onset of child death was associated with worsening psychological, sleep, physical health, and cognitive outcomes among adults aged 40 years and older, highlighting the need for routine screening and targeted bereavement support.

Findings support the development of feasible, community-led bereavement support in rural South Africa, with primary healthcare and community health workers helping to identify adults experiencing persistent distress and facilitating appropriate support or referral.

Australia implemented the Online Safety Amendment (Social Media Minimum Age) Act 2024 (Cth; SMMA) on 10 December 2025. This policy represents a world-first social media age-restriction, which requires age-restricted social media platforms to take reasonable steps to prevent Australians under the age of 16 from creating or keeping an account. Preliminary estimates suggest that approximately 1 194 000 young people should be affected by the deactivation of accounts. As the SMMA is enacted, we are collecting data to examine the outcomes for young people, parents and families. This study protocol paper serves as a summary of the methodological design for the evaluation of the implementation and outcomes of the SMMA, including (a) young people's adherence, and the SMMA's impact on (b) their digital practices; (c) their physical, psychological and social well-being; (d) their families and (e) community attitudes and dynamics. Adherence refers to a participant's experience of account removal/deactivation and any attempts to bypass or circumvent those restrictions. The term is used solely for brevity, and we acknowledge that children and parents are not subject to legal obligations under the SMMA.

To evaluate the impact of the SMMA implementation, a mixed-methods approach is being undertaken, involving 4121 young people aged 10 to 16 years and their parents or caregivers. Data collection involves five-wave longitudinal parent-child surveys, opt-in passive smartphone tracking, administrative linked and non-linked health and educational data, qualitative interviews and focus groups. We will conduct descriptive analyses examining frequencies, average values, percentages, factor analysis and reliability of scales for each survey wave. Various analytical approaches (eg, logistic regressions, multi-level modelling, random-intercept cross-lagged panel model) may be used to understand both between-person and within-person changes pre- and post-implementation of the SMMA. For causal inference analyses, we will employ targeted maximum likelihood estimation (TMLE) as our primary strategy to evaluate the effect of young people's adherence to the SMMA on key outcomes, such as psychosocial well-being and distress. Qualitative data will be analysed using a combination of thematic analysis and structured coding approaches. This will include iterative analysis of open-ended survey responses and in-depth qualitative data from interviews, focus groups and related tasks to identify key themes, patterns and lived experiences.

The study received ethical approval from the Australian Institute of Family Studies (AIFS) Human Research Ethics Committee (application approval number 2025/06) and complies with the National Statement on Ethical Conduct in Human Research and the Australian Institute of Aboriginal and Torres Strait Islander Studies (AIATSIS) Code of Ethics for Aboriginal and Torres Strait Islander Research. All participants provided informed consent at the beginning of the baseline survey and in each subsequent wave. Only parents and young people who provided their consent were eligible to take part in the study. Findings from this evaluation will inform national policy oversight and implementation in Australia, contribute empirical evidence to international debates and inform other countries considering similar age-based regulation of social media. Results will be disseminated through public-facing reports, peer-reviewed publications and stakeholder engagement activities to support evidence-informed decision-making in digital safety regulation in Australia and internationally.

Microbial tryptophan metabolites regulate cognitive function, but their role in vascular cognitive impairment (VCI) induced by chronic cerebral hypoperfusion (CCH) remains poorly understood. In the CCH cohort, we observed gut microbiota dysbiosis and reduced levels of microbial tryptophan metabolites, including indole-3-lactic acid (ILA), in cognitively impaired CCH patients, with these metabolites serving as protective factors. In mice with bilateral carotid artery stenosis, gut microbiota dysbiosis and ILA reduction preceded cognitive decline and were accompanied by astrocytic aryl hydrocarbon receptor (AHR) inactivation, aquaporin-4 (AQP4) depolarization, and glymphatic dysfunction. Fecal microbiota transplantation (FMT) reconstituted the gut microbiota and salvaged cognition. The cognitive improvement following FMT depended on the restoration of the glymphatic system. Tryptophan supplementation increased cerebral ILA concentrations, activated astrocytic AHR, and polarized AQP4, thereby rescuing glymphatic function and enabling cognitive recovery. Notably, ILA supplementation alone was sufficient to restore AQP4 polarization and cognitive function. Mechanistically, we identified dioxin-responsive elements within the promoters of the AQP4 polarization-associated genes alpha-syntrophin (Snta1) and dystroglycan 1 (Dag1). ILA supplementation activated AHR in astrocytes and upregulated the expression of these genes, whereas AHR-specific antagonist pretreatment inhibited the upregulation of Snta1 and Dag1 induced by ILA. These findings demonstrate an ILA-AHR-AQP4 axis linking microbial tryptophan metabolism to the glymphatic system, which is important for cognitive restoration and indicates a novel therapeutic insight for VCI associated with CCH. Given the exploratory nature of the clinical cohorts, the findings warrant validation in larger independent cohorts. (Trial registration: ClinicalTrials. gov. ID number: NCT04688138).

The sodium-glucose cotransporter-2 (SGLT-2) inhibitor empagliflozin has been reported to exert significant neuroprotective effects on neurobehavioral deficits; however, its effects on chemotherapy-induced neuroplastic changes have not yet been investigated. The present study investigates the behavioral changes and hippocampal cellular responses through which empagliflozin exerts antidepressant effects against chemotherapy-induced pathological alterations. We employed a mouse model of depression induced by oral administration of the chemotherapeutic agent sorafenib for 28 days. Sorafenib-induced cardiotoxicity was assessed using immunohistochemistry. Behavioral changes were evaluated using the forced swim test (FST), tail suspension test (TST), sucrose preference test (SPT), female urine sniffing test (FUST), and open field test (OFT). Synaptic transmission and long-term potentiation (LTP) at hippocampal Schaffer collateral-CA1 synapses were measured using extracellular field recordings. Oral administration of sorafenib induced macrophage infiltration and apoptosis in mouse hearts, whereas co-treatment with empagliflozin prevented these effects. In addition to cardiotoxicity, sorafenib also elicited depression-like behaviors, as evidenced by increased immobility time in the FST and TST, reduced sucrose preference in the SPT, decreased sniffing time in the FUST, and reduced time spent in the central zone during the OFT. Moreover, these neurological impairments were accompanied by a reduced input-output curve and diminished magnitude of LTP at hippocampal Schaffer collateral-CA1 synapses. Co-treatment with empagliflozin effectively prevented these neurological and cellular changes. Inhibition of sodium-glucose cotransporter-2 prevents sorafenib-induced depression-like behaviors and suppresses the decline in synaptic transmission and LTP in the hippocampus, thereby contributing to the antidepressant effects of empagliflozin.

Sleep disturbances are common in chronic pain populations and often assessed with actigraphy, which estimates sleep indirectly from movement. Frequent nocturnal movement or extended periods of motionless wakefulness may decrease the accuracy of movement-based sleep detection in this population. Wearable electroencephalography (EEG) offers an alternative to actigraphy by directly capturing neurophysiological sleep signals in home settings. We conducted a 7-day home-based study in adults with chronic musculoskeletal pain (n=21; 71% female; 76% White), where participants wore a wrist actigraph and EEG headband and completed sleep diaries. Limits of agreement (LoA) were assessed using Bland-Altman analyses. Relative to wearable EEG, actigraphy showed substantial disagreement for all sleep variables with proportional bias: TST (mean bias=1.79 min; LoA=-122.02 to 125.60 min), sleep efficiency (mean bias= -0.90%; LoA=-22.01 to 20.20%), wake after sleep onset (mean bias=22.86 min; LoA=-75.23 to 120.95 min), and awakenings (mean bias=-5.70 events; LoA=-31.87 to 20.47 events). Epoch-by-epoch analyses demonstrated high sensitivity (92.8%) but low specificity (49.7%), with agreement of 87.6% and Cohen's κ = 0.42, and revealed substantial within- and between-person variability. Wide LoA, proportional bias, and weak epoch-level agreement suggest that actigraphy should be interpreted cautiously when used as a surrogate for neurophysiologic sleep assessment in chronic pain. PERSPECTIVE: This 7-day home-based study highlights the need for context-sensitive sleep assessment in chronic pain: movement-based actigraphy may be useful in some settings but may be a poor surrogate for wearable EEG when accurate wakefulness, sleep fragmentation, or night-to-night variability estimates are needed.

Co-occurring depressive and anxiety symptoms in adolescents are associated with functional impairment. However, few studies have examined how family functioning, peer problems, emotion dysregulation, and mental health knowledge relate to the severity profiles of these symptoms.

A total of 3981 adolescents completed the PHQ-9, GAD-7, DERS-16, APGAR, SDQ peer-problems subscale, and a mental health knowledge questionnaire. Latent profile analysis identified symptom severity profiles. R3STEP and BCH procedures, adjusted for school-level clustering, examined predictors and distal outcomes. Multi-group analyses tested cross-sectional indirect associations through emotion dysregulation.

Three severity profiles of co-occurring depressive and anxiety symptoms were identified (entropy = 0.945): low/no (64.48%), moderate (29.29%), and severe (6.23%). The severe profile showed the lowest family functioning and mental health knowledge, more peer problems than the low/no profile, and the greatest emotion dysregulation. Family functioning showed negative indirect associations with depressive and anxiety symptoms through emotion dysregulation in the low/no and moderate profiles (all p < 0.001), and with depressive symptoms only in the severe profile (B = -0.148, p = 0.018). Peer problems showed significant indirect associations in the low/no profile for both outcomes (p = 0.003) and in the severe profile for depressive symptoms only (B = 0.196, p = 0.005), but not in the moderate profile.

Emotion dysregulation was consistently involved in the cross-sectional indirect associations between family and peer factors and depressive and anxiety symptoms. These findings provide preliminary evidence for emotion-regulation-focused, stratified interventions for adolescents in Huangpu District, Shanghai, pending longitudinal confirmation.

Quality of life (QoL) varies substantially among individuals with obsessive-compulsive disorder (OCD), but the clinical and contextual factors most strongly associated with QoL remain unclear. A better understanding of these factors may improve assessment, treatment planning, and service organization.

3152 adults with lifetime OCD completed a validated measure of QoL along with clinical and sociodemographic measures. A 22-feature expert-informed model, based on prior scientific and clinical knowledge, was compared with data-driven models using recursive feature elimination and gradient-boosted trees. Model performance was evaluated using 5-fold cross-validation.

Data-driven models modestly outperformed the expert-informed model (RMSE 7.23 vs. 7.56; R² 0.55 vs. 0.51). Although several predictors overlapped, machine-derived models identified predictors not selected by experts, including subjective social rank, anhedonia, and inequality-adjusted national human development. Across models, depression severity, subjective social rank, and anxiety severity were the strongest predictors of QoL. Reduced data-driven models using 12-18 features retained comparable predictive performance and significantly outperformed the expert model.

Expert knowledge captured much of the variance in QoL in OCD, but data-driven approaches improved predictive accuracy and identified novel factors. QoL was most strongly predicted by depression severity, anxiety severity, and social context rather than OCD severity alone, suggesting that clinical assessment and treatment planning should routinely consider broader affective and psychosocial difficulties alongside OCD symptoms.

This mixed-methods study analyzed burnout in healthcare and social care professionals working with children and adolescents.

Participants (n = 101) were chosen using snowball sampling; these worked in mental health, pediatric medicine, or social care institutions. Online questionnaires were distributed and 8 participants were chosen for interviews through purposive sampling.

Burnout decreased with age (p =.01), while doctors reported the highest burnout (M = 44.39). Pediatric medicine professionals reported significantly higher burnout (M = 43.54); social care institution professionals reported the lowest (M = 37.46). Exhaustion correlated with disengagement (p <.001). Qualitative results identified contributors for burnout, including clinical pressures and systemic challenges. Peer support, supervision, and multidisciplinary approaches were considered protective.

Findings inform service developers to implement burnout reduction strategies, improving retention rates and the overall working experience.

Poor sleep quality is a prevalent issue linked to higher procrastination, which not only impairs academic and work functioning but also adversely affects mental and physical health. However, the psychological and neural basis underlying this association remain unclear. In this study, 1163 participants were initially assessed with self-report measures of sleep quality, procrastination, anxiety, and self-control and resting-state fMRI to examine the behavioral and neural correlates of the association between sleep quality and procrastination. After questionnaire and MRI quality control, 1079 participants were included in the final analyses. Elastic net regression revealed distinct functional connectivity patterns centered on the default mode network and prefrontal control regions, including the dorsolateral prefrontal cortex, medial prefrontal cortex, and anterior cingulate cortex, which significantly predicted poorer sleep quality. Furthermore, parallel mediation analyses indicated that anxiety and self-control statistically mediated the association between sleep quality and procrastination, and that composite brain network strength also showed an indirect association with procrastination involving these same behavioral pathways. Integrating these behavioral and neuroimaging findings, our results indicate that poor sleep quality is associated with atypical patterns of connectivity within prefrontal and default mode systems, which may be consistent with the proposed role of diminished psychological resources in emotion regulation and executive control. Guided by the conservation of resources model, this multi-level framework provides an integrated perspective on the psychological and neural basis of the relationship between sleep quality and procrastination, thereby providing potentially relevant directions for future intervention research.