Bruxism, a centrally mediated masticatory muscle activity, is highly prevalent in children with autism spectrum disorder (ASD), a population where research remains limited despite the condition's impact on sleep and quality of life. This study aimed to investigate the frequency of sleep and awake bruxism in children with ASD and analyze their associations with sleep indicators and caregiver mental health. This cross-sectional study included 146 participants (4-18 years old) divided into two groups: 73 with an ASD diagnosis and 73 without ASD. Data were collected from questionnaires administered to caregivers (sociodemographic data, Sleep Disturbance Scale for Children [SDSC], and Depression, Anxiety, Stress Scale [DASS-21]) and from children's clinical oral examinations. Clinically based sleep bruxism was more frequent in children with ASD, while awake bruxism predominated in the neurotypical group. Caregivers, mostly women, reported significantly higher levels of anxiety and depression in the ASD group (p < 0.05). In the ASD group, higher frequencies of sleep bruxism were observed among children with sleep-onset and maintenance difficulties and among those whose caregivers did not report depressive symptoms; however, these associations did not remain statistically significant after Bonferroni correction for multiple comparisons. The findings suggest that children with ASD have a higher frequency of sleep disturbances and medication use. The association between sleep bruxism and sleep difficulties in the ASD group suggests the preponderance of neurophysiological/sleep regulation mechanisms. Moreover, caregivers face significant socioeconomic impact and psychological distress.

Studies on schizophrenia-associated rare copy number variants (CNVs) have predominantly focused on people of European (EUR) ancestry. Here we present a rare CNV study of schizophrenia in East Asian (EAS) populations, comprising 20,903 cases and 23,258 controls. We observed a significantly elevated genome-wide rare CNV burden in EAS cases compared with controls. Cross-population comparisons showed largely consistent rare CNV effects on schizophrenia risk. In the EAS sample, we identified nine genome-wide-significant schizophrenia-associated rare CNV loci. Meta-analysis with EUR data yielded 14 significant loci, including 8 that reached genome-wide significance for the first time. Genes within these 14 loci were significantly less tolerant to loss-of-function variants than genes in other CNV loci. The new rare CNVs associated with schizophrenia in EAS populations showed higher carrier frequencies in EAS than in EUR populations (0.38% versus 0.0017%). Overall, this study underscores the importance of increasing population diversity to fully capture the genetic underpinnings of schizophrenia.

Adolescent athletes encounter compounded academic and competitive pressures that may elevate psychological distress and affect physiological recovery. Yoga, a structured mind-body practice integrating physical postures, breathing regulation, and meditative practices, represents a potentially accessible strategy for supporting psychological well-being and selected physiological indices in youth sport contexts. To evaluate the effects of an eight-week structured yoga intervention on psychological distress, mental well-being, and physiological regulation in competitive teenage athletes. Eighty-eight district-level teenage athletes (male: 52, female: 36; mean age 15.8 ± 1.4 years) were randomly allocated to a yoga intervention group (n = 44) or a wait-list control group (n = 44). The intervention comprised daily 60-min sessions (six days/week) of asana, pranayama, and dhyana over eight weeks. Psychological outcomes were assessed using the Depression Anxiety Stress Scales-21 (DASS-21) and the Mental Health Inventory-56 (MHI-56). Physiological outcomes included resting heart rate (HR), peripheral oxygen saturation (SpO₂), body temperature, and body mass index (BMI). Analysis of covariance (ANCOVA), with baseline values as covariates, and mixed-effects models were employed. The yoga group demonstrated significantly greater reductions across all DASS-21 subscales relative to controls: depression (F (1,86) = 7.46, p = 0.008, Hedges' g = 0.62), anxiety (F (1,86) = 6.12, p = 0.015, g = 0.56), and stress (F (1,86) = 5.84, p = 0.018, g = 0.55). Mental well-being improved significantly (F (1,86) = 9.03, p = 0.004, g = 0.65). Physiological outcomes showed significant reductions in resting HR (g = 0.58) and BMI (g = 0.42), alongside increased SpO₂ (g = 0.61); body temperature was unchanged. An eight-week multicomponent yoga programme was associated with moderate-to-large improvements in psychological health and favourable changes in selected physiological outcome among adolescent athletes. These findings support structured yoga as a potentially useful adjunct within youth sport training environments; however, the physiological measures employed do not permit conclusions regarding specific autonomic mechanisms.

Despite major advances with sodium-glucose cotransporter 2 (SGLT2) inhibitors and glucagon-like peptide-1 (GLP-1) receptor agonists, progressive tubulointerstitial injury remains a major determinant of renal function decline in diabetic kidney disease (DKD), and the molecular regulators of ferroptotic tubular injury remain incompletely defined. Serum/glucocorticoid-regulated kinase 2 (SGK2), predominantly expressed in renal proximal tubular cells, reportedly regulates ferroptosis in prostate cancer; however, its precise role in DKD remains underexplored. Therefore, this study aimed to investigate the role of SGK2 in tubular ferroptosis in DKD.

We identified SGK2 as a ferroptosis-related gene through integrated transcriptomic analyses, which was significantly downregulated in renal tubular cells from patients with DKD and diabetic mice. Functional experiments demonstrated that SGK2 overexpression suppressed lipid peroxidation and ferroptosis, thereby alleviating tubular injury, inflammation, and fibrosis. Mechanistically, SGK2 promoted the association of acyl-CoA synthetase long-chain family member 4 (ACSL4) with the E3 ubiquitin ligase neural precursor cell expressed developmentally downregulated 4-like (NEDD4L) and enhanced K48-linked ubiquitination and proteasomal degradation of ACSL4.

This study identified SGK2 as a novel negative regulator of ferroptosis in patients with DKD. We found that SGK2 suppresses ferroptosis by promoting NEDD4L-mediated ubiquitination and proteasomal degradation of ACSL4, thereby limiting lipid peroxidation and protecting the renal tubules. The SGK2-ACSL4 axis offers new insights into the molecular regulation of tubular ferroptosis.

SGK2 suppresses tubular ferroptosis in DKD through NEDD4L-dependent K48-linked ubiquitination and proteasomal degradation of ACSL4. These findings suggest that SGK2 is a potential regulatory target in DKD and provide a basis for further studies on its role in disease progression. Antioxid. Redox Signal. 00, 000-000.

Intentional poisoning is a major public health challenge requiring rapid emergency intervention. This study aimed to identify demographic, psychiatric, and toxicological factors associated with intentional poisoning among patients presenting to a hospital emergency department.

We conducted a retrospective cross-sectional analysis of 658 poisoning cases recorded in a hospital emergency department poisoning registry in Ilam, Iran (March 2022-March 2023), with linked medical-record data reviewed after the index encounter. The primary outcome was a final binary classification of intentional versus unintentional poisoning. Categorical associations were examined using Pearson chi-square tests or Fisher exact tests as appropriate. A multivariable logistic regression model included five prespecified clinical/psychiatric variables and estimated adjusted odds ratios (aORs) with 95% confidence intervals (CIs). Analyses used Stata version 11.0 (α = 0.05, two-sided).

Of 658 patients, 367 (55.8%) were classified as intentional poisoning and 291 (44.2%) as unintentional. Intentional poisoning was more frequent among women than men (194/279, 69.5% vs. 173/379, 45.6%; p < 0.001) and among urban than rural residents (295/476, 62.0% vs. 72/182, 39.6%; p < 0.001). In the multivariable clinical model, previous suicide attempt showed the strongest association with intentional poisoning (aOR 4.69, 95% CI 2.55-8.61, p < 0.001), and psychiatric disorder history remained associated (aOR 1.78, 95% CI 1.02-3.12, p = 0.043); current psychiatric disorder did not remain independently associated after mutual adjustment (aOR 0.91, 95% CI 0.59-1.40, p = 0.669). Among specific agents, high intentional-use proportions were observed for aluminum phosphide (17/18, 94.4%), antibiotics (13/15, 86.7%), and acetaminophen (35/43, 81.4%).

Intentional poisoning was associated with distinct demographic patterns and psychiatric vulnerability, particularly a history of previous suicide attempts. These findings support systematic mental health assessment in emergency poisoning care and prevention strategies focused on patients with established self-harm history and access to highly lethal agents.

Childhood overweight and obesity are increasing worldwide, yet their population-level associations with a broad range of non-communicable diseases (NCDs) among children aged 5-9 years remain insufficiently characterized. This study examined the country-level associations between overweight/obesity and NCDs prevalence and explored whether these association patterns differed by sex.

This ecological study included 2022 national-level data from 174 countries. The prevalence of NCDs among children aged 5-9 years was obtained from the Global Burden of Disease (GBD), while overweight and obesity prevalence estimates were obtained from the World Health Organization Global Health Observatory (GHO). We utilized Spearman's correlation analysis to assess correlations and Random Forest to explore predictive importance, while generating forest plots and importance summary plots as independent visualization tools for the results.

Significant global disparities in childhood overweight/obesity existed, with high prevalence in the Americas/Europe and low in Africa/Southeast Asia. Both were significantly positively correlated with multiple NCDs (p < 0.05). For overweight and obesity, the strongest correlations were with neoplastic disease, digestive and urinary system disease, neurological and psychiatric disease, as well as cardiovascular disease. After Benjamini-Hochberg false discovery rate (FDR) correction, multiple positive associations remained significant in the overall and boys' analyses, including associations with skin-related diseases among boys, whereas no positive associations remained significant among girls.

This study provides epidemiological evidence on robust positive associations between childhood overweight/obesity and a broad spectrum of NCDs. Governments and global health systems should implement preventive measures against childhood weight abnormalities.

Elderly patients with dyslipidemia are at higher risk of medication adverse effects and poor health outcomes due to polypharmacy. This study assesses polypharmacy status and its associated risk factors in elderly populations with dyslipidemia.

This cross-sectional population-based study analyzed data of elderly population (aged ≥ 60 years) from national Iranian Multicenter Osteoporosis Study (IMOS-2021). Polypharmacy and dyslipidemia were defined as ≥ 5 medications, and presence of any lipid abnormality or current use of lipid-lowering medications, respectively. Hypercholesterolemia was considered as total cholesterol ≥ 200 mg/dL, low High-Density Lipoprotein-Cholesterol as < 40 mg/dL in male, and < 50 mg/dL in female, high Low-Density Lipoprotein- Cholesterol as ≥ 130 mg/dL, and hypertriglyceridemia as triglyceride ≥ 150 mg/dL in accordance with NCEP ATPIII guideline. Multivariable logistic regression models were used to assess the associations and reported the results as adjusted odds ratios (AORs) and 95% confidence intervals (CIs).

Among the 558 patients evaluated (mean age of 67 years), 55% were female, and 20.8% (95% CI: 17.2-24.9) were exposed to polypharmacy, which was more common in females than males (22.4% vs. 18.8%). The multivariable analysis identified higher AOR of polypharmacy in individuals with hypertension (AOR 2.3; 95%CI: 1.2-4.4), diabetes (2.8; 1.64-4.8), cardiovascular disease (3.2; 1.8-5.7), and urban residents (2.2; 1.2-4.0), whereas better self-rated health was protective (0.6; 0.4-0.9).

Our findings highlight the clinical complexity of this group and need for systematic medication review. Healthcare professionals should be trained about the potential negative effects of unnecessary prescriptions on health status of elderly populations with dyslipidemia.

Risk stratification and therapeutic decision-making in acute pulmonary embolism (PE) remain challenging, particularly in patients with apparent hemodynamic stability after an initially unstable presentation. We present the case of a 61-year-old woman with a history of type 2 diabetes mellitus, hypertension, and obesity who presented with sudden-onset dyspnea and chest pain accompanied by initial hemodynamic instability and elevated lactate levels. Computed tomography pulmonary angiography confirmed bilateral PE. Although the patient subsequently achieved hemodynamic stabilization, transthoracic echocardiography demonstrated severe right ventricular dysfunction, McConnell's sign, a right heart thrombus in transit, and right ventricle-pulmonary artery uncoupling with a tricuspid annular plane systolic excursion (TAPSE)/pulmonary artery systolic pressure (PASP) ratio of 0.19. Given these findings, systemic thrombolysis was performed, resulting in clinical and echocardiographic improvement without major bleeding complications. This case highlights the limitations of hemodynamic stability as the sole criterion for risk assessment in acute PE. The presence of a right heart thrombus in transit and right ventricle-pulmonary artery uncoupling may identify patients at increased risk of deterioration despite the absence of persistent shock. Integrating clinical and echocardiographic findings may improve the recognition of concealed high-risk features and support individualized therapeutic decision-making in acute PE.

Olanzapine is a widely prescribed second-generation antipsychotic. We report the case of an 81-year-old woman with hypertension, type 2 diabetes mellitus, osteoporosis, and long-term olanzapine use who presented with progressive dyspnea, orthopnea, paroxysmal nocturnal dyspnea, lower extremity edema, and palpitations. Transthoracic echocardiography demonstrated four-chamber dilation, global left ventricular hypokinesis, and a reduced left ventricular ejection fraction (LVEF) of 30-35%. Coronary angiography revealed normal coronary arteries. After initiation of guideline-directed medical therapy for heart failure and discontinuation of olanzapine because of suspected drug-associated cardiomyopathy, the patient clinically stabilized. At outpatient follow-up, transthoracic echocardiography demonstrated partial recovery of left ventricular systolic function, with the LVEF improving to 40.77%. This case emphasizes the necessity of considering medication-associated cardiomyopathy in the differential diagnosis of new-onset nonischemic heart failure, particularly in patients receiving long-term antipsychotic therapy. Early recognition of cardiotoxicity and withdrawal of the offending agent may improve clinical outcomes.