Coronary artery disease (CAD) is a leading cause of mortality and morbidity globally, with its elevated rates of disability and death posing a significant public health concern. Vitamin D is a crucial bioactive compound involved in numerous physiological processes and has garnered considerable interest due to its potential health benefits. The association between vitamin D and CAD has been a prominent focus of scholarly investigation. However, there remains considerable debate regarding whether vitamin D confers protective effects against CAD, and the underlying mechanisms by which vitamin D influences CAD remain inadequately understood. Mendelian randomization analysis was performed using large-scale genome-wide association study data to examine the causal relationship between serum 25-hydroxyvitamin D (25(OH)D) levels and CAD. Plasma proteomics data were subsequently employed for mediation analysis, followed by enrichment analysis to identify intermediary metabolic or signaling pathways through which serum 25(OH)D may mediate the onset and progression of CAD. The Mendelian randomization analysis indicated that higher serum 25(OH)D levels were associated with a reduced risk of CAD (odds ratio [95% confidence interval]: 0.799 [0.643-0.993], P = .043). No evidence of pleiotropy (P = .949) or heterogeneity (P = .630) was observed in the results. The protein-mediated analysis identified 19 plasma proteins, including Serine/threonine-protein kinase TBK1, membrane associating domain domain-containing protein 2, and interleukin-17D, as key mediators through which reduced vitamin D levels contribute to the development of CAD. The mediation effects ranged from 4.85 to 34.49%. Following the identification of these 19 mediating proteins, 59 intermediary pathways were further pinpointed through which serum vitamin D influences CAD risk. Increased levels of 25(OH)D may reduce the risk of CAD. Further, plasma proteomics-mediated analyses have uncovered potential mechanisms through which 25(OH)D influences the development of CAD, offering a detailed framework for understanding the relationship between vitamin D deficiency and CAD progression. This provides novel evidence to support the recommendation of appropriate vitamin D supplementation as part of lifestyle guidance for CAD patients.

The application of immersive technologies, particularly virtual reality, has expanded rapidly across health care domains, including mental health, rehabilitation, and education. These technologies enable the creation of controlled, interactive, and ecologically valid environments that can support therapeutic interventions, skill development, and behavioral assessment. Within forensic mental health services (FMHS) and prison settings, where individuals often present with complex psychological needs in restrictive and highly regulated environments, immersive technologies offer potential advantages such as safe simulation of real-world scenarios, enhanced engagement, and personalized intervention delivery. However, despite increasing interest, the evidence base remains fragmented, and questions persist regarding effectiveness, ethical implications, and feasibility of implementation in secure and resource-constrained contexts.

Interest in immersive technologies in FMHS and prison settings is growing, yet their role remains unclear. This scoping review mapped current uses, highlighted opportunities, and identified key gaps and considerations for future implementation.

A scoping review of English-language publications (2010-2025) was conducted using the Scopus, PubMed, and CINAHL databases. Data extraction followed the Joanna Briggs Institute framework, and thematic analysis explored benefits, drawbacks, and implementation barriers.

Thirty sources were identified. Primary research focused mainly on virtual reality for therapy, skill training, education, and assessment. There was evidence suggesting benefits such as increased engagement, emotional regulation, skill acquisition, autonomy, and improved clinician-patient dialogue. However, the studies were small, heterogeneous, and inconsistently reported, with limited long-term follow-up. Implementation barriers included institutional, ethical, and technical constraints and limited personalization and end user involvement. Co-design and participatory approaches surfaced as key enablers of acceptability, relevance, and safe use.

The existing evidence base is preliminary and exploratory but indicates that immersive technologies may have potential value in FMHS and prison contexts. Current findings should be interpreted cautiously because studies are small, heterogeneous, and rarely include long-term follow-up. More robust evidence, careful implementation, and meaningful end user input are needed to support safe, relevant, ethical, and effective use. The emphasis on coproduction and guidance for safe, user-centered implementation is a novel contribution.

Post-traumatic stress disorder (PTSD) is maintained by dysfunctional trauma-related appraisals. Cognitive Bias Modification for Appraisals (CBM-APP) aims to train more functional trauma-related appraisals and has been shown to reduce PTSD symptoms. However, little is known about how this training affects the interrelations among symptoms and cognitive appraisals.

In this secondary analysis of a randomized controlled trial involving 77 adult patients diagnosed with PTSD (CBM-APP: n = 37; control training: n = 40), we applied repeated cross-sectional network analysis to examine changes in the structure and centrality of associations among PTSD symptom clusters (re-experiencing, avoidance, negative cognition and mood, hyperarousal, assessed with the PTSD Checklist for DSM-5) and trauma-related cognitive measures, all assessed at both pre- and post-training. To capture multiple levels of cognitive processing, we included responses during a scenario task (reflective, idiosyncratic, spontaneous appraisals) and the Implicit Association Test (automatic self-associations). Four cross-sectional Gaussian Graphical Models were estimated for the training and control group and both timepoints (pre-/post-training × CBM-APP vs. control group).

While overall network connectivity did not differ significantly across networks, descriptive patterns indicated that Alterations in Cognition and Mood emerged as the most central node in both groups at post-training assessment. Further, in the CBM-APP group, the centrality of implicit trauma-related associations decreased pre- to post-training, suggesting potential weaker associations of automatic negative self-associations with symptom activation.

Given the small sample and moderate network stability, findings are preliminary but suggest that CBM-APP may influence the relational structure of PTSD symptoms and cognitions.

The 1p36 deletion syndrome is a subtelomeric deletion syndrome characterized by developmental delay, epilepsy, and distinctive facial features. The diagnostic rate has improved with advances in genetic testing, including chromosomal microarray analysis. However, little is known about the psychosocial impact of a child's diagnosis on parents. This study aimed to explore the psychosocial experiences related to parenting among parents of children with 1p36 deletion syndrome.

The questionnaire survey was conducted among parents of children with 1p36 deletion syndrome, through the Japanese family association related to the syndrome. The questionnaire included items on the characteristics of parents and their children, information sources for 1p36 deletion syndrome, and complications and issues related to this syndrome. Parental mental health was assessed using measures of psychological distress and subjective well-being, with affiliate stigma examined as a key factor associated with mental health outcomes, along with other psychological variables including parental strain and self-esteem.

Thirty-nine parents (mean age: 43.1 years) responded to the questionnaire. The mean age of the child at diagnosis was 1.9 years. Most parents obtained information from the internet, and information from medical and genetic specialists was limited. Parental challenges in medical and welfare aspects were diverse and varied by the child's developmental stage. Exploratory path analysis suggested that the association between affiliate stigma and mental health may be mediated by parental strain and self-esteem. Furthermore, affiliate stigma was significantly higher in parents of children with 1p36 deletion syndrome than in those with Down syndrome.

Parents of children with 1p36 deletion syndrome experience limited access to information from medical and genetic specialists, diverse medical and welfare challenges across developmental stages, and potentially high levels of affiliate stigma. These findings suggest the need for psychosocial support that considers the potential impact of affiliate stigma and is tailored to the evolving challenges experienced across the child's developmental stages.

Total knee arthroplasty (TKA) is an effective surgical treatment for advanced knee osteoarthritis (KOA). However, the classification of postoperative symptom clusters and their impact on quality of life (QoL) remain underexplored. This study aims to categorize symptom clusters in KOA patients after TKA using latent class analysis (LCA) and to analyze the relationship between symptom clusters and QoL. Standardized questionnaires were used to assess postoperative symptoms, including pain, swelling, anxiety, depression, and sleep disorders. LCA was employed to classify patients into high-symptom (C1), low-symptom (C2), and high-swelling (C3) groups. Multivariate unordered multinomial logistic regression was applied to analyze the association between symptom clusters and clinical variables. Differences in SF-12 health survey total scores and dimensional scores among symptom clusters were also compared. A total of 365 KOA patients who underwent TKA were analyzed (from 389 valid respondents; valid response rate 93.8%). LCA identified 3 distinct symptom clusters: C1 (high-symptom group, n = 59; 16.2%), C2 (low-symptom group, n = 186; 51.0%), and C3 (high-swelling group, n = 120; 32.9%). Key factors differentiating the high-symptom group from the low-symptom group included BMI, first joint surgery, and swelling severity (P < .05). On the SF-12, the total score of C1 (50.38 ± 12.96) was significantly lower than that of C2 (56.63 ± 9.56, P = .003) and C3 (57.42 ± 10.85, P = .004). The mental dimension score was significantly lower in C1 (55.22 ± 13.72) than in C2 (63.17 ± 11.33, P < .001) and C3 (63.61 ± 12.23, P < .001). Postoperative symptom cluster classification is an effective tool for assessing the symptom profile of KOA patients after TKA. Significant differences in QoL were found across symptom clusters, with the high-symptom and high-swelling groups showing lower quality of life, particularly in mental health. This study provides data support for individualized management of postoperative symptoms in KOA patients, highlighting the importance of comprehensive symptom assessment in postoperative care.

As Alzheimer's disease (AD) care shifts to institutions, differences between psychiatric hospitals and nursing homes remain unclear. We compared AD patients and professional caregivers across these settings and explored institution-specific links between caregiver burden, mental health, and sleep quality. A cross-sectional study (January to November 2024) enrolled 121 AD patients and 123 caregivers from 2 psychiatric hospitals and 2 nursing homes in Shanghai. Assessments used standardized scales. Analyses included nonparametric tests, χ2 tests, Spearman correlations, and stepwise regression. Post hoc power was adequate for moderate-to-large effects. AD patients in psychiatric hospitals are more severe, and caregivers face greater burden and psychological risk. Tailored, institution-specific mental health interventions are needed. Psychiatric hospital patients had poorer cognition and greater functional dependence (P < .001). Hospital caregivers reported higher burden, depression, anxiety, and worse sleep in specific domains (P < .05; effect sizes r = 0.18-0.47). Burden correlated positively with depression, anxiety, and poor sleep (r = 0.397-0.458). In the total sample, anxiety and poor sleep predicted burden (adjusted R2 = 0.285). In psychiatric hospitals, sleep quality was the dominant predictor (β = 0.483). In nursing homes, anxiety and workload predicted burden (adjusted R2 = 0.418); sleep quality was a negative predictor (β = -0.222), likely from floor effects and adaptive coping.

Despite the mental health benefits of physical activity, the specific dose-response relationship between objectively measured physical fitness (especially cardiorespiratory fitness and lung capacity) and anxiety in youth is unclear. The purpose of this study is to explore the association between these indicators in Chinese college students. A cross-sectional analysis of 3878 undergraduate students was conducted. Anxiety was assessed using the generalized anxiety disorder 7-item scale (a score of ≥10 was positive). Objective measurement of cardiopulmonary function, muscle strength, flexibility and vital capacity, and according to national standards, excellent, good, pass, fail 4 grades. After controlling for demographics and health behaviors, adjusted odds ratios (aOR) and 95% confidence intervals (CIs) for anxiety were calculated by multivariate logistic regression and analyzed graphically. The prevalence of anxiety was 24.9%. Cardiopulmonary function and muscle strength showed a clear negative dose-response relationship: compared with the excellent grade, the failing grade had the highest cardiopulmonary function related anxiety ratio (aOR = 2.15, 95% CI: 1.50-3.08), followed by muscle strength (aOR = 1.75, 95% CI: 1.18-2.60). There was a significant nonlinear association between spirometry and anxiety, with only a significantly higher risk of passing grade (aOR = 1.85, 95% CI: 1.35-2.53). Comprehensive effect analysis showed that students who failed both heart, lung and muscle had the highest risk. Among the behavioral factors, poor sleep quality (aOR = 2.85) and frequent staying up late (aOR = 1.65) were most strongly associated with anxiety. This study demonstrates a significant negative dose-response association between higher levels of cardiorespiratory fitness and muscle strength and lower odds of anxiety in college students, while vital capacity shows a complex nonlinear relationship. Improving these physical fitness components may be a feasible strategy associated with lower anxiety risk, although causality cannot be inferred from the cross-sectional design.

The health-related quality of life (HRQoL) for hemodialysis (HD) patients is typically lower than that of kidney transplant patients. Considering that HRQoL is significant for the treatment and well-being of HD patients, this study aimed to evaluate HRQoL among patients undergoing HD in Saudi Arabia. This is a cross-sectional study that was conducted at Dr Sulaiman Al-Habib Hospital in Riyadh, Saudi Arabia, between June and October 2025. Multivariable logistic regression analysis was performed to examine factors associated with physical and mental health outcomes. This study included 93 HD patients. Males had significantly higher PCS (65.72 ± 29.44) and MCS (72.01 ± 23.70) compared to females (PCS: 45.31 ± 29.75; MCS: 56.17 ± 27.18; P < .001). Educational level significantly differed with MCS (P = .02), with high school graduates and postgraduate degree holders having higher MCS scores. Employment status was also differed in both PCS (P < .001) and MCS (P = .02). Higher itching in the past 24 hours was associated with lower odds of both PCS (adjusted odds ratio (aOR) = 0.76, 95% confidence intervals [CI]: 0.61-0.96, P = .018) and MCS (aOR = 0.64, 95% CI: 0.48-0.85, P = .002). for mental health, being Saudi national (aOR = 0.05, 95% CI: 0.00-0.98, P = .048), having a high school education (aOR = 17.74, 95% CI: 1.99-158.18, P = .010), being a student (aOR = 0.01, 95% CI: 0.00-0.55, P = .024), spending 1 to 5 years (aOR = 0.18, 95% CI: 0.03-1.00, P = .050), were all associated with higher MCS scores. The current study revealed that males had significantly higher PCS and MCS than females. Hence, considering these findings is essential to developing efficacious targeted interventions to improve HRQoL among patients on HD, particularly those with lower PCS and/or MCS scores. Further studies are required to explain differences in PCS and/or MCS scores among certain patients' demographic groups.

The peripartum period presents a critical window for identifying and addressing maternal mental health concerns. However, existing screening tools often face linguistic and cultural barriers when applied in diverse populations especially of LMIC's (low and middle income countries). This validation study aimed to translate and validate an ultra brief, simple, binary-scoring, novel mental health screening tool into Hindi language, evaluating its psychometric properties and cultural relevance among Hindi-speaking women. The scale developed in 2019, includes symptoms of depressed mood, anxiety symptoms and suicidal ideation, which is possibly more feasible and acceptable for use by non-specialist health workers in busy, low-resource primary care settings. However, a Hindi translated, validated version of the scale is not yet available for use among Indian population.

As specified by the World Health organisation, the translation process involved forward and backward translations, expert panel reviews, and pilot testing to ensure linguistic equivalence and cultural appropriateness. Subsequently, the translated tool underwent psychometric validation, including exploratory factor analyses, assessment of reliability and concurrent validity against established screening tool (Edinburgh Postnatal Depression rating scale) in the said population. The study recruited a diverse sample of 194 peripartum women seeking antenatal and postnatal care and treatment from a tertiary care healthcare setting, ensuring representation across socio-demographic variables.

The findings of this study underscore the successful translation and validation of an ultra-brief peripartum mental health screening tool for common mental health disorders into Hindi language, demonstrating its reliability, validity, and clinical relevance among Hindi-speaking women. Face validation and pilot testing confirmed comprehensibility and feasibility for use by non specialist health workers. Clinical relevance of the tool was assessed through psychometric evaluation metrics, including internal consistency (Cronbach's α = 0.80; P < 0.001), cross language concordance (ICC ≥ 0.7), test retest reliability (ICC = 0.952; P < 0.00), factor structure, content validity (CVI = 0.911), and concurrent validity (Pearson's correlation coefficient 0.67 in ANC/ 0.71in PNC; P < 0.05), thus providing a valuable instrument for identifying peripartum mental health concerns within this population.

Findings elucidated the reliability, validity, and clinical utility of the translated screening tool in screening for peripartum common mental health disorders among Hindi-speaking women, thereby facilitating timely identification and support for maternal mental health concerns.

Predicting cognitive decline from brain MRI is a central question in neuroscience. Hippocampal volume (HV) is a key cognitive biomarker, and normative models can be augmented with multimodal information. Here we augment normative models with genetic information and show improvements in cognitive decline prediction across multiple experimental setups.

We improve normative models for HV by integrating multi-threshold polygenic scores (PGS) with demographic and imaging data using Gaussian Process Regression (GPR). Models were trained on 23,997 participants from UK Biobank (UKBB) and validated on 3,000 out-of-sample participants from the Alzheimer's Disease Neuroimaging Initiative (ADNI) and the European Prevention of Alzheimer's Disease (EPAD) cohorts.

Our genetically-informed models significantly strengthened associations across six experimental designs and 13 key neurocognitive measures, including Mini-Mental State Examination (MMSE), Clinical Dementia Rating (CDR), and Alzheimer's Disease Assessment Scale (ADAS), while enhancing prediction of future cognitive decline.

Together, these findings underscore the promise of integrating multi-threshold PGS with neuroimaging-based predictive models to improve prognostication and early intervention strategies for neurodegenerative diseases.