The aims of the study were twofold: 1) quantify the global burden of pSCD|MMS, and 2) estimate the number of children who warrant specialist evaluation for possible surgical revascularization.

A systematic review was conducted following PRISMA guidelines. Clinical data extracted included number of patients with pSCD, pSCD-MMS, and those who underwent surgical revascularization. Using weighted proportions and 2021 Institute for Health Metrics and Evaluation (IHME) global estimates for pSCD, for each WHO region we estimated the burden of pSCD|MMS, and the volume of pSCD|MMS patients who underwent surgical revascularization.

Of the 6,845 studies identified, 14 were included. Nine (64%) studies were from AMR, 2 (14%) studies from EMR, 1 study (7%) from EUR, 1 study (7%) from AFR, and 1 (7%) multicenter study from AMR and EUR. Of the 2045 pSCD patients between the ages of 1-21 years identified, 1.5% were diagnosed with pSCD|MMS. Of 279 pSCD|MMS patients, 49.8% underwent surgical revascularization. The projected number of pSCD|MMS cases worldwide was 36,587, equating to 18,219 potentially benefiting from surgical revascularization. Across WHO regions, the African region harbors the largest number of projected pSCD|MMS cases (32,189) including 16,030 candidates for surgical consideration. Projections should be interpreted cautiously given the limited number and geographic distribution of the available studies.

The vast majority of pSCD and pSCD|MMS burden resides in Africa, wherein SCD-related infrastructure is often limited. Sufficient capacity building for diagnostic accuracy and screening coupled with maximal medical therapy for pSCD, and robust neurosurgical infrastructure is required to improve longitudinal SCD care, mitigate neurologic complications and enhance functional outcomes. Derived from a limited body of published literature, these estimates should be considered exploratory.

Methadone is commonly associated with QT interval prolongation, which can lead to torsades de pointes. This effect has primarily been attributed to blockade of the delayed rectifier potassium current, I_Kr. However, methadone inhibits other ion currents to varying degrees. A deeper understanding of how ion currents interact to produce drug-induced QT interval prolongation may support development of strategies to mitigate risk of potentially fatal arrhythmias. Given the difficulty of isolating the contributions of specific ion currents in drugs with multiple effects, this study used cardiac electrophysiology simulations to predict current-specific effects of methadone-induced QT interval prolongation. Action potential (AP) and electrocardiogram (ECG) models based on the Tusscher-Noble-Noble-Panfilov (2004) model were built using the Cardiac Safety Simulator version 2.2. Single-cell APs were simulated using published in vitro data of methadone's effects (half-maximal inhibitory concentration and Hill coefficient) on multiple ion currents. The model was extrapolated to simulate ECGs using population parameters from a clinical study, and outputs from both models were compared to published data. A stepwise modeling approach isolated individual ion current contribution toward proarrhythmia. The final ECG model predicted heart rate-corrected QT intervals (QTc) within 1.5% of the observed data at four concentration ranges. Evaluation of individual ion currents toward QTc interval modulation suggested that I_Kr and I_K1 have a similar impact on methadone-related QTc interval prolongation. This study highlights the potential contribution of multiple ion currents to methadone's proarrhythmic effects and advances the understanding of ion current interplay underlying methadone-induced arrhythmia.

Seasonal fluctuations in mortality significantly affect population health and remain an important public health challenge, particularly in the context of climate change and population ageing. Evidence on how different causes of death shape seasonal mortality patterns remains limited. We apply a novel framework to quantify, in a systematic, transparent, and comparable manner, the absolute and relative contributions of 17 cause-of-death groups to seasonal mortality in Italy. We analyzed monthly mortality data from the Italian National Institute of Statistics, disaggregated by cause of death, sex, and 5-year age groups, 2004-19. Excess mortality for 17 major causes of death was quantified by comparing the observed age-standardized death rate (SDR) with the baseline SDR, defined as the average of the 3 months with the lowest mortality each year. Heart and respiratory diseases were the leading contributors to excess mortality, accounting for approximately 40% and 15% of the intra-annual burden, respectively. The summer months exhibited significantly smaller excess mortality. Respiratory diseases showed the highest relative impact compared to the other causes of death. While baseline mortality decreased over time, the relative intra-annual burden remained stable or increased for specific causes, indicating persistent or growing seasonal vulnerabilities. Intra-annual mortality fluctuations in Italy were mainly driven by cardiovascular and respiratory diseases and have remained stable over time despite improvements in overall mortality. These persistent patterns highlight unmet seasonal vulnerabilities and the importance of integrating cause-specific seasonality into health planning, particularly in light of ageing populations and climate change challenges.

This study examined how screen use, physical and mental health, and 3-question temporomandibular disorders (3Q-TMD) screening status relate to self-perceived academic performance among Swedish undergraduate dental and nursing students.

Ninety-one first-semester dental and nursing students completed a survey comprising sociodemographic items, estimated daily screen use by purpose, and twelve self-report instruments. Self-perceived academic performance was measured with the Academic Performance Scale (APS) and analyzed as a continuous score. Bivariate group comparisons between lower and higher self-perceived academic performance used the Mann-Whitney U test or Welch's t-test with effect sizes, and the Holm-Bonferroni procedure to control the family-wise error rate within families of outcomes. The primary analysis was a hierarchical linear regression on the continuous APS score, entering demographics, then total screen time, then purpose-specific screen use, then a psychological symptom burden composite and 3Q-TMD screening status.

Total screen time was unrelated to academic performance in every analysis. Purpose-specific screen use added 19.0% of explained variance beyond total duration (F(3,81) = 6.78, p < 0.001), whereas total duration added 2.2% beyond purpose and was not significant (F(1,81) = 2.37, p = 0.127). In the full model (R2 = 0.341, adjusted R2 = 0.266), academic screen use was positively associated with performance (β = 0.426, p < 0.001), while work-related screen use (β = -0.299, p = 0.003) and psychological symptom burden (β = -0.361, p = 0.001) were negatively associated with performance. Students reporting lower performance also reported poorer health-related quality of life in five of eight RAND-36 domains and were more likely to have a positive 3Q-TMD screening result, although the latter association did not survive adjustment for oral parafunctional behavior.

Self-perceived academic performance was associated with the purpose of screen use and with psychological symptom burden, but not with total screen-time duration.

Fear of war has emerged as a relevant psychosocial phenomenon in Europe, yet little is known about factors associated with its experiential and physiological dimensions in representative populations. This study examined sociodemographic, war-related, and psychological predictors of experiential and physiological fear of war in Germany.

Data were drawn from a nationally representative cross-sectional survey of German-speaking individuals aged 16 years and older (N = 2,530). Fear of war was assessed using the Fear of War Scale (FOWARS). Hierarchical multiple regression analyses were conducted separately for experiential and physiological fear of war, entering sociodemographic, psychological, and war-related variables in three theory-driven blocks.

Participants reported moderate levels of experiential fear of war (M = 3.54, SD = 0.99), whereas physiological fear was lower on average (M = 2.24, SD = 1.12). The final models explained 9% of the variance in experiential fear of war and 11% of the variance in physiological fear of war. War-related salience emerged as a key correlate of experiential fear, particularly when participants referred to a specific war, a global/world war, or nuclear war. In contrast, physiological fear showed clearer associations with indicators of psychological vulnerability, including childhood adversity, lower interpersonal trust, and emotion regulation variables. Overall, the findings supported differential predictor patterns across experiential and physiological fear. Women and older individuals reported higher fear levels. Sensitivity analyses using an ordinal salience variable supported the robustness of the findings.

Fear of war appears to reflect an interplay between war-related salience and individual vulnerability. Distinguishing experiential and physiological fear responses may improve understanding of psychosocial reactions to geopolitical crises and contribute to public mental health monitoring and risk communication.

The postpartum period makes mothers particularly vulnerable to mental health disorders such as postpartum depression and anxiety. Despite the high prevalence of these disorders, help-seeking for them remains critically low, leaving many women without adequate support. Therefore, the aim of this study was to examine the extent to which different factors are associated with help-seeking intentions and actual help-seeking behaviors for mental health disorders among postpartum women. We also examined how these factors differed between groups of women with symptoms of postpartum depression, postpartum anxiety, symptoms of both disorders, and women without clinical symptoms.

We used data from a cross-sectional study in Dresden, Germany, with data from N = 4,624 women collected via telephone interviews between 2021 and 2024. Multiple linear regression models were used to examine predictors of help-seeking intention (n = 4,554) in all the groups, while logistic regression models (n = 778) were used to investigate predictors of actual help-seeking behavior among women with symptoms of postpartum depression and/or anxiety.

For the different factors, results varied between help-seeking intention and actual help-seeking behavior. Negative health beliefs were found to have the most negative effect on help-seeking intention for all groups. Help-seeking intentions were lower among women with a migrant background who had symptoms of either postpartum depression or anxiety, among women with lower knowledge of services who were not clinically affected, and lower among women with symptoms of postpartum depression who had not used mental health services before. Recognition of a mental disorder was by far the most important factor associated with higher actual help-seeking behavior for all groups. Higher income and older age were factors associated with higher actual help-seeking behavior among women with symptoms of postpartum depression.

This study identified factors associated with help-seeking for postpartum depression and anxiety. The findings suggest that routine screening for postpartum depression and anxiety to address the lack of recognition of mental disorders, as well as targeted awareness campaigns to support positive health beliefs, are needed and can improve help-seeking. Tailored interventions for at-risk groups, such as low-income or migrant women, could improve postpartum mental health care.

ADHD symptoms are frequently reported in parents of children with ADHD, however, their prevalence and association with children's mental health and quality of life (QoL) remain poorly understood. This study examines parental ADHD symptoms and their associations with children's mental health and QoL in the context of a prospective longitudinal study. The sample comprised 448 mothers and 375 fathers of 456 schoolchildren from the EPINED cohort (140 ADHD, 59 subthreshold ADHD symptoms, 257 comparison group). ADHD symptom rates were higher in mothers (18.2%) than in fathers (15.9%) and were significantly more frequent among mothers of children with ADHD (24.8%) compared with mothers in the comparison group (14.7%). Maternal ADHD risk (OR = 8.15) and maternal psychological difficulties (OR = 12.15), were both associated with the persistence of children's emotional problems. Child ADHD diagnosis was associated with conduct problems (OR = 2.62) and their persistence (OR = 6.84). Additionally, maternal ADHD risk was consistently associated with poorer child QoL (β=-7.69). These findings suggest that maternal ADHD symptoms and psychological difficulties are key factors in children's emotional outcomes, highlighting the need for family-focused assessment and intervention strategies.

To explore students' experiences of engaging with an asynchronous, elective, digital mental health literacy (MHL) course adapted for delivery within UK higher education settings. Specifically, the study examined the perceived impact on MHL and acceptability. To identify recommendations for future course development.

Qualitative study using focus groups. Focus groups were audio-recorded, transcribed verbatim and analysed using Framework Analysis.

Two universities (University of Exeter and Newcastle University).

Nineteen undergraduate students predominantly studying psychology and social science subjects participated in one of five focus groups.

Four themes were identified from students' experiences of the course, including a greater understanding of mental health, greater self-awareness and understanding of others experiencing mental health difficulties. Students perceived the course as relevant, useful and accessible, and provided recommendations for future course development. Students also highlighted a need for greater guidance on responding to mental health difficulties in others, including emotional boundaries, crisis response and appropriate signposting to professional support.

Our findings suggest that MHL interventions may support greater understanding of well-being and mental ill-health, greater self-reflection and better understanding of the mental health of others within university settings. Students perceived the MHL course as relevant, acceptable and beneficial but identified uncertainty regarding how to safely respond to peers experiencing mental health difficulties. Future MHL interventions need to consider how to help students safely apply MH knowledge within their everyday interactions with peers and wider support networks.

Single mothers 'by choice' who conceive through medically assisted reproduction (MAR) are a growing and understudied group. We examined how their infants' birth outcomes compare with other family types.

Using Finnish population register data (1996-2020), we examined five birth outcomes among first-born children: low birthweight (LBW), preterm birth, small for gestational age (SGA), gestational-age-adjusted birthweight, and gestational age. We compared children of (i) single MAR mothers (n = 2230) with those of (ii) single mothers who conceived spontaneously (SC; n = 36 352); (iii) partnered MAR mothers (n = 39 350); and (iv) partnered SC mothers (n = 451 295). Regression models adjusted for maternal age, education, income, smoking, mental health, and multiplicity.

In unadjusted analyses, children of single MAR mothers (reference) had higher risks of LBW and preterm and lower gestational age than those of partnered and single SC mothers [e.g. odds ratio (OR) for LBW = 0.51; 95% confidence interval (CI) 0.44-0.60 and 0.69; 95% CI 0.59-0.81, respectively]. After adjustments, differences relative to the partnered SC group largely attenuated (e.g. OR for LBW = 1.01; 95% CI 0.85-1.21), whereas outcomes were better than those of single SC and partnered MAR mothers (e.g. OR for LBW = 1.21; 95% CI 1.01-1.45 and 1.30; 95% CI 1.08-1.55, respectively). The relative advantage in SGA and gestational-age-adjusted birthweight also remained after adjustment.

After accounting for sociodemographic characteristics and multiplicity, children of single mothers 'by choice' had birth outcomes comparable to those of partnered SC mothers and more favourable than those of single SC and partnered MAR mothers.

Prior research demonstrates associations between experiencing mental illness and school absenteeism, which leads to adverse financial and health consequences later in life. One of the starkest barriers to mental healthcare access faced by children in the United States is cost. This study aimed to examine the association between unmet need for mental healthcare and school attendance.

We analyzed 2010-2018 National Health Interview Survey data to examine the relationship between unmet need for mental healthcare due to cost and missing >4 days of school due to illness/injury in children aged 5-17. We also included measures of the abbreviated Strengths and Difficulties Questionnaire (SDQ) to account for prevalence of mental health symptomology.

Nearly half (47.73%) of children who reported unmet need for mental health care due to cost during the past 12 months missed >4 school days, compared to only 28.23% of children without unmet need for mental healthcare (p<0.001). In adjusted logistic regression models, children with unmet need for mental healthcare due to cost had 2.18 (95% CI:1.80-2.64; p<0.01) higher odds of missing >4 days of school than children whose guardians did not report unmet need for mental healthcare due to cost. Even when including the SDQ score in our models, the association between being unable to access mental healthcare and increased school absence remained (OR=1.38 (95% CI:1.13-1.69; p=0.002)).

Our study demonstrates that unmet need for mental healthcare due to cost is associated with missed school days due to illness/injury.