This study explored the function and molecular mechanism of long non-coding ribonucleic acid taurine up-regulated gene 1 (TUG1) in children with ventricular septal defect (VSD).

To establish an in vivo VSD model, 10 pregnant mice were administered valproic acid via intraperitoneal injection (VSD group, n = 10). Another 10 pregnant mice were used as the control group and administered 0.9% sodium chloride solution via intraperitoneal injection. Subsequently, the cardiac function and cardiac tissue histopathological characteristics in both groups were evaluated. TUG1, miR-222-3p, and hypoxia-inducible factor 1-alpha subunit inhibitor (HIF1AN) expression levels in cardiac tissues were tested. P19 cells were chosen to simulate VSD in vitro model, and the cell progression was tested. P19 cells were induced to differentiate into cardiomyocytes with dimethyl sulfoxide, and test of the shape and beating frequency of cardiomyocytes was conducted. Left ventricular fractional shortening, ejection fraction, and systolic and diastolic thickness of the cardiac anterior wall were significantly reduced in VSD fetal mice. VSD formation, aortic overlay, and dysplasia were observed.

TUG1 and HIF1AN were upregulated, and miR-222-3p was downregulated in VSD mice. Silencing TUG1 or HIF1AN or elevating miR-222-3p facilitated P19 cell progression and differentiation, whereas lowering miR-222-3p did the opposite. TUG1 was a molecular sponge of miR-222-3p, which targeted HIF1AN. Elevating HIF1AN reversed the impacts of silencing TUG1 or elevating miR-222-3p on P19 cells.

The findings of this study could offer a new insight into the molecular basis of VSD and lay the groundwork for new diagnostic techniques.

Smoking prevalence is disproportionately high among individuals with mental disorders, who also show reduced cessation success, suggesting that current cessation interventions may not fully address their specific needs. A barrier to smoking cessation is the fear that quitting may worsen mental health, yet little is known about how individuals with mental disorders experience guideline-conform cessation treatments, which may address such concerns.

This qualitative study explored the perspectives of smoking individuals with comorbid mental disorders who participated in a standardized, manual-based, cognitive behavioral smoking cessation program to identify targets for optimizing guideline-conform interventions for this population, spanning treatment engagement, perceived challenges, and facilitators within this context.

Semistructured interviews were conducted with 11 participants representing diverse cessation trajectories (sustained abstinence, relapse, and no quit attempt) 6 months after treatment completion. Data were analyzed using reflexive thematic analysis.

Three overarching themes were identified. First, participants described smoking cessation as a multidimensional, processual experience extending beyond behavioral change to encompass psychological and social dimensions, characterized by nonlinearity, adaptive meaning-making, and improvements in self-efficacy despite transient strain during early abstinence. Second, smoking was experienced as a functionally embedded practice serving affective, habitual, and social functions, with motivation emerging as dynamic and relationally sustained rather than stable. Third, treatment engagement was shaped by motivational states and contextual circumstances, with participants offering favorable evaluations of the structured intervention alongside recommendations for greater individualization and flexibility. Notably, mental health-related concerns about cessation largely persisted despite predominantly positive or neutral mental health outcomes, a pattern consistent with cognitive immunization processes.

Guideline-conform smoking cessation treatment appears feasible and largely well-received by individuals with comorbid mental disorders. The findings highlight the need for targeted psychoeducation to address persistent misconceptions about the mental health risks of cessation, as well as individualized, context-sensitive treatment adaptations, including greater flexibility in session structure, motivational support beyond the active treatment phase, and explicit attention to the social and functional embeddedness of smoking, to improve cessation outcomes in this high-risk population.

IntroductionThe mental health gender gap is well established, but there is limited understanding of why girls and young women consistently report higher rates of common mental health conditions. The emergence of online misogyny has garnered attention in recent years, highlighted in cultural debate surrounding extremist influencers and the 'manosphere'. Understanding the mental health impacts of online misogyny on girls, young women and gender-diverse people is essential given the growing prevalence of gender-based harm in digital spaces.ObjectivesTo establish whether exposure to online misogyny is longitudinally associated with mental health outcomes in girls, young women and gender-diverse people.DesignSystematic review with narrative synthesis.Data sources and methodsWe searched PsycINFO, Web of Science, PubMed and Europe PMC (4^th September 2025). Eligible studies were longitudinal and assessed mental health outcomes in participants aged 11-25 following exposure to online misogyny. Findings were synthesised narratively. Risk of bias was assessed using the Newcastle-Ottawa Scale.ResultsSix studies were included (total N=7,379), reflecting a small and methodologically diverse body of longitudinal research that provides preliminary support of prospective associations between online pornography exposure or cyber-sexual harassment and mental health outcomes among adolescent and young adult women. We did not identify any studies focused on gender-diverse people.ConclusionGiven the scale of exposure to online misogyny globally, there is an urgent need for longitudinal, mechanism-focused research that treats online misogyny as a social determinant of mental health. Future studies should explore the impact of non-targeted, pervasive or incidental exposure to misogynistic content, such as the 'manosphere', given its prevalence among girls and young women. Such work is essential to inform gender-sensitive clinical guidance, targeted prevention efforts, and platform regulation aimed at reducing psychological harm.RegistrationThis review was preregistered on the PROSPERO database (CRD420251125049).

To examine the prevalence of Adverse Childhood Experiences (ACEs) and psychological distress among nursing students and assess the influence of attitudes, subjective norms, and perceived behavioral control on help-seeking intentions.

Nursing students (N = 258), who were 89.1% female, and aged 21-66 years.

A cross-sectional design was conducted using a convenience sample from four U.S. institutions.

Approximately 24.4% of participants reported four or more ACEs, while 11.6% reported psychological distress. Attitudes, subjective norms, and perceived behavioral control significantly predicted intentions to seek mental health services (p < .001). ACEs moderated the association between subjective norms and intentions, while psychological distress moderated the relationship between attitudes and intentions.

The findings suggest that trauma-related experiences and psychological distress are important factors associated with nursing students' mental health help-seeking intentions. By using more trauma-informed approaches, college-based mental health services may help reduce barriers to help-seeking among nursing students.

There is limited knowledge of the relationship between gestational age and physical activity assessed by accelerometers in population-based cohort studies. We examined how gestational age predicts physical activity among adolescents and adults. Data from 12 896 participants (13-52 years) with physical activity assessed by two tri-axial accelerometers for seven days in the population-based Trøndelag Health Study (HUNT Study) were linked to the Medical Birth Registry of Norway. Metabolic equivalent of task (MET) min/day and min/day in total, moderate to vigorous, and light physical activity were calculated. Effects of gestational age (in weeks) and birth weight (in grams) on physical activity were modelled using fractional polynomials and linear regression. Gestational age predicted MET min/day in light physical activity (B = 1.53, 95% CI: 0.02 to 3.07) in the total sample, especially among females (B = 2.14, 95% CI: 0.33 to 3.93), and in total physical activity among adolescents (B = 2.44, 95% CI: 0.16 to 4.88). Gestational age predicted min/day in total physical activity in the total sample (B = 0.99, 95% CI: 0.07 to 1.90), among females (B = 1.25, 95% CI: 0.11 to 2.40) and adolescents (B = 1.06, 95% CI: 0.02 to 2.12). There were no non-linear or linear effects of birth weight on physical activity. Shorter gestation predicted less physical activity in the total sample, among females, and in adolescents. The associations with total physical activity are by and large consistent with previous observations that individuals born preterm with very low birth weight have lower rates of physical activity.

Nurses working in primary health centres have limited access to palliative care education.

To evaluate the effectiveness of an online palliative care learning programme for primary health centre nurses in Indonesia.

A randomised controlled trial with a parallel design was conducted at four time points (pre-post, 4 and 8 weeks). The intervention group received online modules, videos and five group meetings; the control group received only e-modules. Double-blinded randomisation with consecutive sampling was used.

A total of 61 primary health centre nurses participated (intervention=34; control=27) from Java, Bali, Sumatra, Kalimantan and Sulawesi. The control group had higher knowledge scores at 8 weeks. Perceived difficulty was significantly lower in the intervention group immediately post-intervention, with no significant group differences in reported practice perceptions.

The SPARK programme reduced perceived difficulty and supported reported practice among primary health centre nurses, offering a promising online education model for similar health systems.

Depression represents a critical concern for public mental health. This study examines time trends in the prevalence of elevated depressive symptoms throughout Europe and investigates socioeconomic differences. Data were derived from the European Social Survey waves of 2006, 2012, 2014, and 2023 (15 countries; N = 106 814). Prevalence of elevated depressive symptoms was assessed using the 8-item Center for Epidemiological Studies Depression Scale. Analyses were stratified by age, gender, education, income, occupation, limitation, and European region. Multilevel logistic regression models were used to analyze trends. Findings revealed substantial reductions over time in the prevalence of elevated depressive symptoms among older adults, smaller reductions in middle-aged individuals, and constant trends among the younger population. Considerable variations in depression trends were observed across most sociodemographic subgroups. Particularly beneficial trends were found in Eastern European middle-aged and older adults. Conversely, increasing trends among younger adults were mostly evidenced for Northern Europe, with similar patterns suggested for younger individuals with higher education and income. Additionally, those with limitations maintained an extremely high prevalence of elevated depressive symptoms over time, especially among younger individuals. Thus, while generally favorable trends were observed in older and middle-aged adults, increases in the prevalence of elevated depressive symptoms were found for parts of the younger population in Europe. Differential trends across sociodemographic groups were particularly present in terms of education, limitation, and geographic region. The findings highlight the necessity for targeted public health interventions addressing vulnerable groups. Further analyses are needed to identify intermediary determinants explaining these patterns.

Background: Slowing the progression of dementia and maintaining mental and social health and well-being are important aspects of health and healthcare for people living with dementia (PLwD). Relationships with family caregivers and unique caregiver insights are also important aspects of the health and well-being of PLwD. Methods: A group-based gaming system was developed to promote health and well-being for PLwD through movement, cognitive exercises, and social interaction. Included were family caregivers of clients living with mild- or moderate-stage impairment in an adult day center selected for the gaming intervention. Prior to implementing the intervention, three separate focus groups were conducted with 21 caregivers of PLwD, divided into each of the three focus groups based on their availability, to explore what it is like to care for someone living with dementia, their loved ones' mood, and their questions or concerns regarding the gaming intervention. Responses were thematically analyzed. Results: In total, 21 caregivers participated in the focus groups. Six themes were identified: mutuality and strategies for coping with varying emotions; new challenges and successes with connecting and relating; multidimensional challenges with adjusting to decline, help-seeking, and providing care; community, social support, and resilience; technology and community resources as tools to ease caregiving burdens, and interest in digital gaming for PLwD. Conclusions: Our results suggest that group-based digital gaming interventions may be useful to both caregivers and PLwD, by offering meaningful opportunities for social engagement.

Background: Due to the rise in Alzheimer disease (AD) and AD-related dementias (AD/ADRD) in an aging population, millions of caregivers will be at risk for physical and mental health decline. As those they care for already have physical and cognitive impairment, it is crucial that caregivers maintain health-promoting behaviors. Because regular physical activity (PA) prevents functional loss and improves physical health and well-being, understanding how to help caregivers adopt and sustain PA despite unique time, caregiving, and self-efficacy barriers is a pressing public-health priority. Existing health-promoting interventions among dementia caregivers, including PA, have demonstrated limited success. To overcome the fragmentation and slow synthesis of behavioral science evidence, the Human Behavior-Change Project advocates theoretical grounding, systematic mapping of intervention components (e.g., behavior change techniques [BCTs]) using standardized taxonomies, and explicit specification of mechanisms of behavior change (MoBCs). Objective: To examine the limited success of health-promotion interventions among dementia caregivers we aimed to conduct a narrative review to synthesize evidence from interventions that evaluated PA in dementia caregivers across three domains: (1) use of behavioral theory to inform intervention design, (2) specification of BCTs, and (3) identification and measurement of MoBCs. Methods: Two scientific databases were searched to identify representative studies and reviews, using key terms including "physical activity", "intervention", "dementia", and "caregiver" from inception to July 2025. Results: Seven primary intervention trials and six reviews were selected for inclusion. Gaps across the domains were identified to inform priority areas for future research. Conclusions: There is a need to develop tailored, theory-driven PA interventions that target empirically supported BCTs and MoBCs to improve dementia caregivers' health and well-being.

Diabetes-related hypoglycemia contributes substantially to increased morbidity, mortality, health-care utilization, and reduced quality of life. Older adults with diabetes represent a heterogeneous group of patients who need individualized blood glucose targets to avoid hypoglycemia. Since the elderly present with varying degrees of functional and cognitive status and individualized health needs, their management varies among individuals. Complicating this, the hypoglycemia risk in older adults treated with insulin also varies due to aging, renal dysfunction, cognitive impairment, and other comorbidities. The challenge for healthcare providers is in considering all aspects of care in order to avoid hypoglycemia in elderly individuals. In this review, we introduce a Patient and Function Centric Approach to the assessment and management of hypoglycemia in older adults. This holistic framework extends beyond blood glucose values to systematically evaluate the other domains of patients' health that influence hypoglycemia risk, including biochemical, medication, timing, autonomic, cognitive, mood, renal, pancreatic, hepatic, social, and physical function. The management of hypoglycemia in older adults should also include strategies to address both fear of hypoglycemia and hypoglycemia unawareness. In addition to physical limitations, the psychosocial barriers to self-care in older individuals with hypoglycemia are also of paramount importance. Using tools that measure diabetes burden, diabetes distress, and fear of hypoglycemia provides valuable insights into patient wellbeing. The use of newer anti-hyperglycemic medications, sensor-augmented insulin pump therapy, intranasal glucagon, and continuous glucose monitoring (CGM) has significantly contributed to reduced hypoglycemia incidence in individuals with diabetes. Overall, successful management requires a collaborative approach that empowers patients, respects their individual needs and preferences and helps them face the challenges associated with diabetes management with confidence rather than fear or anxiety. Adopting a patient- and function-centric approach to hypoglycemia management allows clinicians to move beyond a one-size-fits-all model and adopt individualized glycemic targets that improve overall diabetes control and mental well-being.