Schizotypy refers to personality traits linked to an increased risk for schizophrenia-spectrum disorders (SSD). The Schizotypal Personality Questionnaire-Brief Revised (SPQ-BR) is a widely used 32-item self-report measure, but its psychometric properties in German-speaking populations are unexplored. This study comprised 738 individuals, including 33 with SSD, and 148 with other mental disorders. Participants (mean age: 38 years, 77% female) completed an online survey that included the German version of the SPQ-BR (SPQ-BR-G) and additional measures to assess convergent and discriminant validity. Reliability, latent factor structure, and validity were assessed. The SPQ-BR-G demonstrated excellent internal consistency (α = 0.91), good convergent validity (r = 0.52-0.58), and discriminant validity (r < 0.50) for the cognitive-perceptual and disorganized factors. Confirmatory factor analysis supported three- and four-factor solutions, while a single-factor model demonstrated poor fit. Subjective well-being was negatively associated with the SPQ-BR-G, after adjusting for sex, age, and education. Compared to the survey sample, SSD patients scored significantly higher on all factor levels and most items (p < 0.05), with 35% ranking in the top SPQ-BR-G decile. In SSD patients, moderate to high correlations were observed between the negative (r = 0.86, p < 0.001) and positive (r = 0.53, p < 0.05) dimensions of the Positive and Negative Syndrome Scale and the SPQ-BR-G. The SPQ-BR-G shows robust psychometric properties, supporting its use in schizotypy research. Its validation enhances cross-cultural comparisons and may aid in early risk and biological risk factor identification for SSD.

Excessive dietary salt intake remains a major public health concern in Japan and worldwide, contributing to noncommunicable diseases, including hypertension and cardiovascular disease. Although national health promotion strategies in Japan have emphasized behavioral change through nutrition education and awareness campaigns to achieve population-level salt-reduction targets, average intake continues to exceed recommended levels. This suggests that the food environment needs structural modifications through multisectoral collaboration to increase the nutritional quality of consumer foods and the availability of healthier options. Voluntary reformulation by the food industry is a key component of these efforts. To support voluntary reformulation, we developed a practical guide for setting salt-reduction targets and planning feasible reformulation strategies, informed by consultation with registered dietitians working in national and local governments, reviews of guidance documents and voluntary corporate initiatives in other high-income countries, and feedback from Japanese food companies on the draft guide. This guide promotes target setting aligned with the Specific, Measurable, Achievable, Relevant, and Time-bound (SMART) framework for goal-setting and outlines methodological options for product scope, nutrient focus (salt alone, or salt and other nutrients such as fat and sugar), metrics, sodium criteria, and implementation timelines. The guide also addresses organizational structures and collaboration with external stakeholders. Business incentives are highlighted, including opportunities for product innovation, contributions to environmental, social, and governance performance, and the building of consumer trust. By providing a structured and adaptable framework, the guide aims to foster coordinated industry engagement in salt reduction to prevent hypertension and cardiovascular disease. This mini review presents a guide to help Japanese food companies set voluntary salt-reduction targets and plan feasible product reformulation strategies. It integrates international guidance, registered dietitians' and companies' feedback, and the SMART framework to help translate policy goals into actionable objectives, promoting consistent salt reduction across the food industry.

Human T-cell Lymphotropic virus type 1 (HTLV-1) is a retrovirus that infected 10-20 million of individuals worldwide. HTLV-1 infection is associated with the development of various diseases, including HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP) and adult T-cell leukemia/lymphoma (ATLL). HAM/TSP is a chronic progressive neuroinflammatory disease characterized by motor impairment, spasticity, and other neurological manifestations. This narrative review provides a comprehensive overview of HAM/TSP following HTLV-1 infection. We discussed the virology and epidemiology of HTLV-1, transmission modes, and risk factors for infection. Furthermore, we delved into the pathogenesis of HAM/TSP disease, exploring the role of neuroimmunology and immune dysregulation. Viral proteins and host genetic factors that influence disease progression are also examined. Diagnostic approaches, including laboratory tests and imaging techniques, are discussed, along with available treatment options and immunomodulatory therapies. Additionally, we highlighted the history of HAM/TSP disease and provide insights into the global distribution and epidemiology. Finally, the current status and challenges of HTLV-1 vaccine development are addressed. This narrative review aims to enhance understanding of HAM/TSP disease following HTLV-1 infection, shedding light on key aspects of their etiology, diagnosis, and management, while emphasizing the need for continued research and public health interventions.

The WHO Package of Essential Non-communicable Diseases Interventions (WHO PEN) provides a core set of measures to prevent, detect and manage non-communicable diseases (NCDs) in low-resource settings. Many countries have adopted WHO PEN to strengthen primary healthcare, yet there is limited consolidated evidence on what components have been implemented and how WHO PEN has been implemented across different contexts. Understanding both the 'what' (disease modules, intervention activities, tools) and the 'how' (strategies, approaches, target populations and contextual factors) is crucial to assess the short-term to medium-term effects on health system readiness, provider performance, patient outcomes and long-term population health impact.This protocol outlines a systematic review that will be updated as new evidence emerges and additional countries adopt or adapt WHO PEN. It represents the first systematic review focused on the implementation of the multifaceted interventions under WHO PEN. Findings will support efforts to sustain and scale up NCD interventions at the primary healthcare level and inform future updates of WHO PEN and related WHO guidance.

We will search PubMed, Web of Science, Cochrane Library and Google Scholar for studies published up to June 2025, supplemented by grey literature and reference checking.The review will follow the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols guidelines. Given the complexity, the review will be conducted in two stages. Stage 1 consists of an overview of review, mapping of existing review and evidence and guiding deeper inquiry of stage 2. Stage 2 will conduct a mixed-methods systematic review of the primary studies, forming the main output of this protocol.

Ethics approval is not required. The protocol and findings will be disseminated through peer-reviewed publications, webinars and conferences.

CRD420251064835.

This study aimed to assess HPV vaccination coverage and cervical cancer screening participation among Iranian females under 46 years old, comparing Iran's situation to he Cervical Cancer Elimination Initiative (CCEI) targets.

This nationally and sub-nationally representative cross-sectional study analyzed data from the STEPS 2021 survey. Female participants aged 18-45 years without missing data on HPV vaccination or cervical cancer screening were included. Categorical data were presented as weighted percentages with 95% confidence intervals (95% CI). Logistic regression assessed associations between demographic and female cancer screening variables with the outcomes.

A total of 8,158 females were included. Only 0.85% (95% CI: 0.69-1.02) of women received the HPV vaccine, while cervical cancer screening participation was 39.4% (95% CI: 38.21-40.6). No significant differences in HPV vaccination coverage were observed across age groups. However, screening rates were significantly higher in older women, rising from 27.99% (18-35 years) to 54.07% (36-45 years). HPV vaccination was not significantly associated with demographic variables. In contrast, cervical cancer screening participation was higher among unemployed women (40.58%), married women (49.6%), and those in the highest wealth quintile (42.47% compared to 28.29% in the lowest quintile).

HPV vaccination coverage in Iran is critically low, falling far short of the CCEI target of 90%. Cervical cancer screening participation is comparatively better but still lags approximately 30% behind the target. Strategic interventions are critical to bridge the gap between Iran's current status and the CCEI targets.

Evidence on the association between family history and atherosclerotic cardiovascular disease (ASCVD) across age groups remains limited.

This study aimed to evaluate the relations of family history of ASCVD (FHA) with incident ASCVD and its predictive value across age groups in China-PAR (Prediction for Atherosclerotic Cardiovascular Disease Risk in China) and UK Biobank.

A total of 117,640 Chinese and 457,781 UK adults were included from 2 population-based cohorts, with family history assured by face-to-face interviews with standardized questionnaires.

During median follow-ups of 6.0 (Q1-Q3: 5.7-11.4) years (China-PAR) and 11.8 (Q1-Q3: 11.0-12.5) years (UK Biobank), 4,681 and 26,913 ASCVD cases occurred. Generally, FHA was consistently associated with higher ASCVD risk, but the association weakened with age (P_interaction < 0.001). The strongest effect was in adults <45 years, with HRs of 1.48 (95% CI: 1.11-1.96) in China-PAR and 1.47 (95% CI: 1.23-1.76) in UK Biobank, which was transformed to 6.75 and 5.33 years ASCVD-free years lost at the index of 20 years, and this gap decreased to 3.40 and 1.42 years at the index of 80 years, respectively. Notably, sibling history conferred greater risk than parental history (P_{heterogeneity} < 0.001).

In both populations, FHA is a key indicator for identifying high ASCVD risk, especially in younger individuals, with a stronger impact driven by sibling history. These findings highlight the importance of tailoring recommendations for identifying high-risk individuals based on family history, with consideration of different age groups.

Cardiovascular diseases (CVDs) account for a large and increasing health burden worldwide, as shown in the Global Burden of Disease Study 2021. However, there has been no comprehensive assessment of CVDs in Asia, which bears the largest population globally.

This study sought to evaluate the burden of CVD in Asia from 1990 to 2021.

Mortality, prevalence, and disability-adjusted life years (DALYs) along with their age-standardized rates (ASRs) per 100,000 population from 1990 to 2021 were used to measure the CVDs burden. Further subanalyses were conducted based on age group and sex.

In 2021, CVDs caused an estimated 11.9 million deaths (95% uncertainty interval [UI]: 10.9-12.9 million deaths), 340.4 million prevalent cases (95% UI: 315.1-366.9 million prevalent cases), and 270.4 million DALYs (95% UI: 251.6-290.2 million DALYs). Although the ASR of prevalence slightly increased from 1990 to 2021 with a percentage change of 5.7% (95% UI: 3.9%-8.1%), the ASRs of death and DALYs were significantly decreased, with percentage changes of -28.2% (95% UI: -42.2% to -12.5%) and -37.8% (95% UI: -50.5% to -24.3%), respectively. The Asian burden of CVDs was higher in males and the elderly. The primary contributors to DALYs across Asia were ischemic heart disease, stroke, and hypertensive heart disease.

Burden of CVDs in Asia remains substantial. Certain populations, including males and the elderly, experienced a heavier burden of CVDs.

Autonomous motivation, grounded in self-determination theory, is important for sustaining diabetes self-care behaviors. Although mobile health interventions, gamification, and peer support are increasingly used to enhance motivation in diabetes care, evidence on how motivation evolves over time remains limited. Specifically, it is unclear whether motivational change follows a linear pattern or a nonlinear trajectory, such as an initial increase followed by a subsequent decline. Clarifying these temporal patterns is critical for informing the design of adaptive diabetes self-care interventions.

The objective of this study was to characterize the 1-year developmental trajectory of autonomous motivation following the real-world introduction of a commercially available team-based gamification app.

This prospective, single-arm longitudinal study involved adults with diabetes (predominantly type 2) recruited from outpatient clinics in Japan. Participants were instructed to use a team-based gamification app designed to promote desirable habits through peer support and social comparison for at least 7 days. The primary outcome, autonomous motivation, was assessed using the Treatment Self-Regulation Questionnaire-Autonomous Motivation subscale (TSRQ-AM; score range 7-49) at baseline, 6 weeks, 6 months, and 1 year. Secondary measures included hemoglobin A_1c (HbA_1c), body weight, triglycerides, and psychological scales (eg, Self-Efficacy Scale for Diabetes Self-Care, Summary of Diabetes Self-Care Activities, Problem Areas in Diabetes scale, and World Health Organization-Five Well-Being Index). To analyze the trajectory, we used linear mixed-effects models with random intercepts for participants. The final model included fixed effects for time (as both linear and quadratic terms), age, sex, employment status, family structure, baseline BMI, and baseline HbA_1c.

Of 32 consenting participants, 29 (90.6%) were included in the primary analysis; clinical data at 1 year were available for 26 (81.3%) participants. In exploratory analyses, mean TSRQ-AM scores increased from baseline (37.4, SD 7.9) to 6 months (39.5, SD 7.4; Cohen d=0.47). Over the 1-year period, body weight decreased significantly (b=-0.39; P=.01), whereas HbA_1c (P=.40) and triglycerides (P=.14) showed no significant changes. The TSRQ-AM score showed a significant nonlinear change over time. A model including a quadratic time term fit significantly better than a linear-only model (χ²₁=4.1; P=.04), with a significant quadratic effect (b=-7.26; P=.045), indicating an inverted U-shaped trajectory peaking at 6 months. Higher baseline BMI was associated with lower TSRQ-AM scores (b=-1.00; P=.001).

This formative study provides preliminary evidence of a nonlinear, 1-year trajectory of autonomous motivation following the introduction of a team-based app. The observed curvilinear pattern suggests that autonomous motivation during the intervention may peak at around 6 months, underscoring the importance of adaptive intervention designs to maintain engagement over time. The accompanying reduction in body weight suggests potential physiological relevance that warrants further investigation in controlled studies.

UMIN Clinical Trials Registry UMIN000044874; https://tinyurl.com/59bzb68k.

Diabetic dyslipidemia (DD), characterized by a classical triad of abnormal lipid profiles among the diabetic population, presents a major public health concern in South Africa, particularly among Black South Africans. The increasing prevalence of DD significantly contributes to the development of atherosclerotic cardiovascular disease. With the incidence of diabetes rising from 4.5% in 2010 to 12.7% in 2021, urgent preventive measures and effective treatments are crucial to tackle the risk of premature mortality.

This systematic review and meta-analysis protocol aims to examine the existing literature on DD, providing an understanding of its prevalence and associated predictors among the diabetic population in South Africa, with the intention of informing more effective clinical and public health interventions.

The protocol is registered in PROSPERO (International Prospective Register of Systematic Reviews) and will adhere to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The available literature on DD will be systematically searched in common scholarly databases and reviewed accordingly. All published and unpublished studies conducted in South Africa prior to 2024 and written in English will be included. Two members (MN and FA) of the review team will independently screen the studies identified through the database search and assess risk of bias using the revised JBI critical appraisal tools. The review will integrate both quantitative and qualitative data synthesis. Results from both qualitative and quantitative data synthesis will be presented through forest plots, subgroup forest plots, and summary tables, which will present findings on pooled prevalence, odds ratios for predictors, heterogeneity statistics, and sensitivity analyses.

The protocol was finalized in January 2025. The literature search was conducted between October 2024 and March 2025. Title and abstract screening began in April 2025, and full-text review was completed by July 2025, with data extraction scheduled for completion by September 2025. The completion of statistical analyses is expected by October 2025. We anticipate submission of the completed systematic review and meta-analysis for publication in December 2025.

The findings of the study protocol will inform the design of targeted interventions and policies aimed at advancing the management of DD and subsequently reducing the increased risk of atherosclerotic cardiovascular disease among the diabetic population.

Micronutrient deficiencies are common in type 2 diabetics (T2D), promoting the occurrence of anxiety-depressive disorders.

The objectives of this study were to evaluate the micronutrient status of patients with type 2 diabetes (T2D), screen them for anxiety-depressive disorders, and investigate associations between these disorders and micronutrient intake.

This was a descriptive cross-sectional study involving 115 type 2 diabetics. They underwent a dietary survey and completed the Hospital Anxiety and Depression Scale (HAD) and Dopamine/Norepinephrine/Serotonin (DNS) questionnaires assessing anxiety-depressive disorders.

Deficiencies in the intake of vitamins (A, E, C, B) and minerals (magnesium, copper, iron, zinc) were noted. Negative and significant associations were found between depression scores and the intake of vitamin B1 (p=0.01) and vitamin B6 (p=0.024). Similarly, negative and significant associations were found between anxiety scores and the intake of vitamin B6 (p=0.049), vitamin B9 (p=0.019), and vitamin B12 (p=0.01). Referring to the DNS score, we found negative associations between the dopamine score and the intake of vitamin B9 (p=0.002), magnesium (p=0.003), and copper (p=0.007) ; between the norepinephrine score and the intake of vitamin C (p=0.046), vitamin B6 (p<0.001), magnesium (p=0.024), and zinc (p=0.009); and between the serotonin score and the intake of vitamin B12 (p=0.001), magnesium (p=0.027), and zinc (p=0.047). Conclusion : micronutrient deficiencies can exacerbate pre-existing anxiety and depressive disorders in type 2 diabetics. Systematic nutritional education is recommended, emphasizing a balanced and varied diet rich in vitamins and minerals.