Cardiac fibrosis is a central pathological feature of many cardiovascular diseases and contributes to progressive myocardial remodeling and heart failure. Among the diverse cellular sources of activated fibroblasts, endothelial cells have emerged as a significant contributor through endothelial-to-mesenchymal transition (EndMT). During EndMT, endothelial cells lose their endothelial characteristics and acquire mesenchymal phenotypes, resulting in increased extracellular matrix deposition and tissue stiffening. Multiple pathological stimuli, including inflammatory signaling, oxidative stress, and metabolic dysregulation, activate intracellular signaling pathways that drive EndMT. In addition to these molecular mechanisms, recent studies highlight the importance of intercellular communication mediated by extracellular vesicles, particularly exosomes carrying microRNAs (miRNAs), in regulating cardiac fibrosis. Exosomal miRNAs released from endothelial cells, cardiomyocytes, and fibroblasts can modulate fibrotic signaling networks and influence EndMT progression. This review summarizes the pathological signaling pathways governing EndMT in cardiac fibrosis and discusses the emerging roles of exosomal miRNA-mediated crosstalk in cardiac remodeling. Understanding these integrated mechanisms may provide new insights into therapeutic strategies targeting cardiac fibrosis.

To evaluate whether cochlear implantation reduces listening-related fatigue in children with unilateral hearing loss.

Prospective within-subjects crossover study.

Three academic medical centers specializing in pediatric cochlear implantation.

Fatigue was assessed using the Vanderbilt Fatigue Scale and PedsQL™ 3.0 Multidimensional Fatigue Scale. Parent- and child-reported versions were completed after consecutive days of baseline cochlear implant use and following a three-day discontinuation during a holiday break. Paired t-tests compared conditions (P <0.05). Univariable regressions examined associations with age, sex, and deafness duration. Intraclass correlation coefficients assessed parent-child agreement.

Of 69 eligible patients, 37 responded; 18 declined due to reluctance to discontinue CI use. Nineteen children (mean age 8.6 y, 26.3% male, mean deafness duration 3.4 y) completed the study. Parent-reported fatigue significantly worsened after implant non-use in mental (P=0.01) and physical domains (P=0.04) on the Vanderbilt scale, and in cognitive fatigue (P=0.03) on the PedsQL. Child-reported scores trended toward greater fatigue during non-use, though not statistically significant. Younger age and male sex were associated with higher fatigue in parent reports. Intraclass correlation coefficients indicated moderate to good parent-child agreement.

Cochlear implantation alleviates listening-related fatigue in children with unilateral hearing loss, particularly in cognitive and physical domains as perceived by parents. Fatigue represents a clinically meaningful, non-audiological outcome in candidacy assessment and postoperative evaluation.

This cross-sectional two-step study aimed to investigate the prevalence of eating disorder (ED) symptoms and associated mental health difficulties among elite athletes and an age-and sex matched comparison group.

National team athletes were recruited through national sport federations, while participants in the comparison group were recruited via social media. A total of 408 participants (athletes n = 256; comparison group n = 152) (72.1% female), completed an anonymous online survey comprising validated psychometric measures of ED symptoms, exercise addiction, depression and psychological flexibility. Participants who screened positive for ED symptoms and providing contact details were invited to undergo a clinical assessment using the ED Examination Interview (EDE 17.0D).

Overall, 25.0% (n = 102) reported ED symptoms, with a higher prevalence in the comparison group than among athletes (37.5% vs. 17.6%, p < 0.001). Interviews were completed by 78.0% (n = 18) of athletes and 47.0% (n = 16) of comparison group participants who screened positive for ED symptoms, confirming an ED diagnosis in all but one athlete. Furthermore, 18.6% (n = 76) reported clinically relevant symptoms of depression, and 22.8% (n = 93) of exercise addiction. Associations were observed between ED symptoms and symptoms of exercise addiction, depression, and psychological inflexibility in the total sample, among athletes and in the comparison group.

ED symptoms were common among athletes and the comparison group and were associated with depressive symptoms, problematic exercise behaviour, and psychological inflexibility. To safeguard athlete health and optimise performance, national sports organisations should implement systematic preventive strategies, promote early identification, establish clear referral pathways, and ensure access to coordinated multidisciplinary care.

Progressive multiple sclerosis (MS) is usually associated with progressive asymmetrical motor impairment. A single critical demyelinating lesion anatomically associated with motor impairment was seen in > 20% of patients with progressive MS. The assessment of critical lesion-associated progressive MS requires understanding their clinical course, how prior inflammatory relapse location and their first MRI appearance relates to progressive motor impairment.

To determine: (1) clinical course and prior relapse location and (2) interval between first MRI critical lesion evidence and progressive motor impairment in patients with progressive MS with a single critical lesion.

Prospective, consecutively accrued patients with progressive MS were seen at a tertiary MS clinic (July 1, 2021-June 30, 2022). Patients with one critical lesion anatomically associated with progressive motor impairment were included. Patients with two or more tandem critical lesions along the same corticospinal tract or too extensive demyelinating lesion burden to determine the association between motor impairment and one critical lesion were excluded. A location-related relapse (LRR) was defined as a prior acute inflammatory demyelinating event at the same CNS site subsequently identified with critical lesion-associated motor progression. Clinical course was progressive from onset [primary progressive MS (PPMS)] or relapse-onset [secondary progressive MS (SPMS)] with SPMS dichotomized to those with or without LRR. MRIs were reviewed determining the earliest MRI critical lesion appearance and duration between this and the onset of progressive motor impairment.

53 of 266 (20%) patients with progressive MS had a single critical lesion associated with motor progression. Clinical course was SPMS in 36/53 (68%) and PPMS in 17/53 (32%). SPMS critical lesion onset was LRR-associated in 26/36 (72%). Critical lesion was first MRI-evident a median of 2.2 years before the onset of motor progression in SPMS (IQR -1.7 to 4.6) and -4.5 years (IQR -10.6 to -2.5) in PPMS with negative values indicating first MRI evidence came after motor progression onset.

In people with a single critical lesion-associated motor progression, this typically presents as SPMS and often follows an LRR. This emphasizes the anatomic association between initial lesion-associated inflammatory presentation and subsequent motor progression.

During adolescence, sleep disturbances and emotionally driven eating patterns frequently coexist, potentially sharing underlying psychological mechanisms. However, their specific relationship in this population has not been fully clarified. This study explored the association between emotional eating and different sleep-related difficulties among Spanish adolescents. A cross-sectional analysis was conducted with 837 participants between 12 and 17 years old from the Eating Healthy and Daily Life Activities (EHDLA) study. Sleep-related difficulties were evaluated using the bedtime issues, excessive daytime sleepiness, night awakenings, regularity/duration of sleep, and snoring (BEARS) screening tool, while emotional eating was measured with the Emotional Eating Scale adapted for children and adolescents. Adjusted logistic regression models were used to evaluate the associations. Greater emotional eating was associated with higher likelihood of certain sleep-related disturbances, particularly those occurring at bedtime (odds ratio [OR] = 1.01; 95% confidence interval [CI] 1.00-1.02; p = 0.033) and snoring (OR = 1.02; 95% CI 1.00-1.03; p = 0.012). Among emotional dimensions, anger and anxiety showed the strongest associations with the presence of at least one sleep-related issue.

 Emotional eating appears to be selectively linked to specific sleep disturbances in adolescents, with emotional regulation processes, especially those related to anger and anxiety, playing a potentially relevant role. These findings highlight the importance of considering both behavioral and emotional factors when addressing sleep health in this age group.

• Sleep-related problems are highly prevalent during adolescence and are associated with adverse physical and mental health outcomes. Emotional eating is also a common maladaptive behavior during this developmental period and has been linked to negative emotional states and unhealthy dietary patterns. • Previous research has suggested a potential relationship between sleep disturbances and unhealthy eating behaviors, although evidence in adolescents remains limited and has focused mainly on overall dietary habits rather than emotional eating.

• Emotional eating was selectively associated with specific sleep-related problems, particularly bedtime difficulties and snoring, in a large sample of Spanish adolescents, with anger and anxiety showing the strongest associations. • These findings suggest that emotional regulation may represent an important mechanism linking eating behaviors and sleep disturbances during adolescence, supporting the development of integrated behavioral interventions in this population.

Waste management presents a major environmental and public health challenge, creating an urgent need for strategies that convert discarded materials into higher-value products. Waste-derived nanoparticles (WDNPs) have gained increasing attention because they integrate waste valorization with the production of functional nanomaterials for environmental, biomedical, agricultural, packaging, sensing, catalytic and energy-related applications. This review critically evaluates WDNP synthesis from five major waste streams, including agricultural residues, animal-derived waste, plastic waste, electronic waste and industrial by-products. Across these categories, precursor composition strongly influences nanoparticle size, morphology, surface chemistry, stability and functional performance, making feedstock selection and processing conditions central to reproducible production. Evidence from recent studies indicates that WDNPs have broad functional potential across environmental remediation, biomedical delivery, antimicrobial systems, sustainable packaging, agriculture, energy storage and catalysis. However, translation beyond laboratory-scale studies remains limited by feedstock variability, limited reproducibility, complex purification requirements, potential toxicity, insufficient standardization and limited pilot-scale validation. By comparing synthesis approaches, application outcomes and translational barriers across waste categories, this review provides a critical overview of the opportunities and limitations of WDNPs and identifies the key requirements for their responsible development within a circular-economy framework.

Children with dyslexia are at elevated risk of depression and anxiety. The transition from primary to secondary school may be particularly challenging given increased educational demands. Past research indicates school-connectedness may be a protective factor across this transition. We tested longitudinal relationships between dyslexia, school-connectedness, depression, and anxiety over the secondary school transition. Children (N = 208, M_age = 12.16, 58% girls, 61 with dyslexia) and their caregivers (95% mothers) completed standardised measures of school-connectedness, depression, and anxiety in Year 6, and again in Year 7 after the transition to secondary school. Mediation models tested direct and indirect effects of dyslexia on Year 7 depression and anxiety through domains of school-connectedness (whole school, peer, friend, and teacher). After adjusting for Year 6 depression, anxiety, and gender, there were no significant direct effects of dyslexia on depression or anxiety in Year 7. However, dyslexia was indirectly associated with both depression and anxiety via school- and peer-connectedness. These findings support the role of school-connectedness in supporting mental health, and suggest peer-connectedness might be an important protective factor post-transition to secondary school. Future studies should explore further change across adolescence and mental health promotion targeting school- and peer-connectedness among children with dyslexia.

Global geopolitical tensions are quickly increasing the threat of significant transboundary radiological emergencies. The past nuclear and radiological disasters have highlighted critical deficiencies, yet the international healthcare system is still inadequately equipped for extensive nuclear and radiological crises. Our analysis of contemporary vulnerabilities, focusing on ongoing near-miss scenarios at the Zaporizhzhia Nuclear Power Plant and persistent systemic gaps in low- and middle-income countries (LMICs). The primary gap is the misalignment between global policy frameworks and frontline clinical preparedness. We suggest enhancing healthcare education, incorporating mental health into emergency preparedness strategies, strengthening early warning systems and transboundary radiological emergency response, and improving the availability of medical countermeasures. A standardized strategy is essential to enhance resilience in the face of future nuclear and radiological emergencies.

Aging affects all organ systems, yet no standard method exists to quantify urological age. Renal function, prostate health, sexual function, fertility, and bladder control are central to men's health span, but their relationship with mental health and chronological aging remains poorly defined. The aim of this study was to develop the Urological Age and Longevity (UAL) framework, a consensus-driven composite index that quantifies urological biological age in men and explores its potential for guiding personalized strategies for healthy aging.

The UAL model was constructed through a three-phase process combining literature evidence and expert consensus. First, a multidisciplinary group systematically reviewed aging and urology indices to identify relevant longevity domains. Second, the preliminary framework underwent content validation using qualitative and quantitative feedback from an expert panel. Third, each parameter was organized into consensus-defined risk tiers to create a personalized UAL score.

Ten domains central to urological aging, including functional measures, biochemical markers, hormonal profile, sexual functions, systemic correlates, mental health, environmental exposures, lifestyle habits, surgical history, and family history, were identified and validated. Each parameter was assigned consensus-defined tiers, generating a structured 0 to 20 scoring system that estimates urological biological age and supports individualized risk profiling.

The UAL framework is the first organ-specific biological age model in urology. It enables assessment of genitourinary aging using routine clinical and lifestyle data, offering opportunities for targeted, modifiable interventions. Prospective validation studies are now warranted to confirm its predictive and clinical utility.

The psychological impact of disasters extends beyond directly exposed populations to those indirectly affected through close social networks. Sex is a critical factor of post-trauma outcomes, yet its role in shaping the mental health of indirectly exposed individuals remains underexplored.

This study investigates sex-based disparities in psychosocial distress among a cohort remotely exposed to a major earthquake.

Approximately 3 months after the 2023 Kahramanmaras earthquakes, 129 Turkish medical students with indirect exposure (e.g. via affected relatives or close social circles) took part in this cross-sectional study, completing a structured anxiety survey and a self-report form. The self-report form assessed academic stress, health behaviors (smoking, alcohol use, exercise, and nutrition status), and lifestyle factors.

After Bonferroni correction, no variable remained statistically significant. However, using the Benjamini-Hochberg false discovery rate procedure, peer bullying was associated with sex (χ²(3) = 13.581, p_FDR = .046, Cramer's V = 0.324). All other chi-square tests were nonsignificant under both correction methods.

After rigorous correction, sex differences were largely attenuated. Peer bullying showed a possible association under FDR, but not under Bonferroni, suggesting the need for larger confirmatory studies.