Children with perinatally acquired HIV (PHIV) and those exposed to HIV but uninfected (HEU) are at increased risk for adverse cognitive and behavioral outcomes, particularly in sub-Saharan Africa. This study evaluated the efficacy of brain powered games (BPG), a mobile computerized cognitive rehabilitation intervention, on neurocognitive outcomes among children with PHIV, HEU, and HIV unexposed uninfected children (HUU) in Uganda and Malawi.

We conducted a randomized controlled trial in Uganda and Malawi enrolling 599 children aged 5 to 12 years (PHIV = 120, HEU = 239, HUU = 240). Participants were randomized to a 12-week BPG intervention or a waitlist. Neuropsychological outcomes were assessed at baseline, postintervention, and 6-month follow-up using the Kaufman Assessment Battery for Children Second Edition (KABC-II), test of variables of attention, and Cogstate. Linear mixed-effects models estimated intervention effects, separately by country.

In Uganda, children receiving BPG demonstrated higher Learning composite scores (3.34; 95% CI, 1.03-5.65), Mental Processing Index scores (2.39; 95% CI, 0.78-4.01), and Nonverbal Index scores in KABC-II (2.28; 95% CI, 0.27-4.28) immediately postintervention compared with waitlist. Cogstate Maze Learning was higher postintervention (0.02; 95% CI, 0.004-0.043) and at 6 months (0.02; 95% CI, 0.003-0.040). In Malawi, Planning scores (-2.22; 95% CI, -4.39 to -0.05) and Delayed Recall scores (-2.87; 95% CI, -5.22 to -0.51) in KABC-II were lower in the intervention arm postintervention, whereas Cogstate Identification scores were higher (-0.03; 95% CI, -0.05 to -0.004).

Mobile cognitive training produced modest, domain-specific cognitive benefits, with effects varying by context and HIV exposure status.

Depression is common in mesial temporal lobe epilepsy (mTLE), but its neuroanatomical basis-and overlap with major depressive disorder (MDD)-remains poorly defined. We investigated whether the cortical and subcortical alterations reported in MDD are also present in mTLE and leveraged the frequent occurrence of depression after epilepsy surgery to test whether such changes predate the onset of post-surgical depression.

Eighty-nine mTLE patients scheduled for anterior temporal lobectomy were classified as never depressed (NoD, n = 42), depressed before surgical evaluation (PreD, n = 23), or developing de-novo depression after surgery (PostD, n = 22). Pre-operative 3 T MRI (1 mm T1, T2, FLAIR) was processed with FreeSurfer v6.3. Six frontotemporal-limbic regions showing the largest MDD effects in ENIGMA studies-orbitofrontal cortex, rostral anterior cingulate, insula, fusiform gyrus, hippocampus, posterior cingulate-were analyzed using a latent variable model.

Depression status significantly influenced combined morphology in both hemispheres (p < 0.05). Relative to NoD, both PreD and PostD groups showed reduced cortical thickness in the orbitofrontal cortex, fusiform gyrus, insula, and rostral anterior cingulate (Cohen's d = -0.04 to -0.14). Hippocampal volume and posterior cingulate thickness did not differ between groups.

Four of the six frontotemporal regions showing the largest morphometric alterations in MDD also exhibit reduced cortical thickness in mTLE patients with past or future depression. This shared frontotemporal thinning pattern supports depression in mTLE as an expression of network pathology common to MDD, while residual regional differences may help explain the distinct phenotypic presentations of depression in these neuropsychiatric disorders. In PostD patients, these abnormalities were already present pre-operatively, consistent with a pre-existing vulnerability rather than a purely psychosocial reaction to surgery or epilepsy per se.

This study examines clinician and patient experiences and concerns regarding the use of digital technology platforms, particularly artificial intelligence (AI) chatbots, for clinical care. We conducted focus groups with clinicians and patients across two disciplines - young adult mental health and prenatal care - to explore these themes. While clinicians and patients both recognized the benefits of AI chatbots, they also noted the potential for misuse and inability to consider the clinical context among other concerns. We call for AI chatbots to provide clear, culturally sensitive communication, transparent attribution of sources, disclaimers for follow-up with health care professionals, and a form of regulation to avoid bias and misuse.

Population aging and the growing prevalence of chronic diseases pose significant challenges to the global healthcare system and highlight the relevance of issues related to the end-of-life stages. Social media is an important platform for discussing and exchanging views on these issues. This study aims to analyse public discourse on the X platform (formerly Twitter) between 2015 and 2025, based on the text content of posts (tweets) containing the hashtag #AssistedSuicide.

A retrospective analysis was conducted on 105,130 posts containing #AssistedSuicide, published by 28,314 users on X between 2015 and 2025. Data were retrieved via Fedica (20 February 2025) and processed using Python 3. The study included quantitative content analysis, sentiment analysis, geographic distribution mapping, keyword and hashtag analysis, and assessment of legislative discourse and potential amplification patterns.

Most posts (99.1%) were in English. The highest activity was observed in the United Kingdom (39.48%), the United States (29.75%), Canada (13.94%), New Zealand (6.22%), and Australia (3.80%), accounting for 93.19% of all posts. Legislative-related content represented a substantial thematic category (38.7%) and also included issues concerning vulnerable populations. Analysis of frequently occurring words and hashtags shows that the discussion on #AssistedSuicide is multifaceted, polarized, and closely linked to legislative, medical, and social issues. The discourse is characterized by high sensitivity to political events and shifts in tone during periods of legislative activity.

This study highlights the value of large-scale social media analysis for understanding public attitudes toward assisted suicide and identifying its ethical, social, and regulatory dimensions. Palliative care remains central to reducing suffering and preserving human dignity. The findings underscore the need for evidence-based policies that ensure protection of vulnerable groups, support healthcare professionals, and promote balanced end-of-life care frameworks.

Abdominal bloating and gastrointestinal discomfort are common complaints that significantly impair patients' health-related quality of life (HRQoL). Probiotic and synbiotic formulations have been proposed as supportive therapies for improving gastrointestinal symptoms and patient-reported outcomes, yet real-world data on their impact on HRQoL remain limited. Our objective was to evaluate changes in physical and mental components of HRQoL in adult patients treated with a synbiotic formulation containing Saccharomyces boulardii SB01, Lactobacillus bulgaricus LB42, Lactobacillus rhamnosus LRa05 and fructooligosaccharides (FOS) in routine clinical practice.

This prospective monocentric observational study included 50 adult patients treated with a synbiotic formulation containing Saccharomyces boulardii SB01, Lactobacillus bulgaricus LB42, Lactobacillus rhamnosus LRa05 and FOS for 15 days. Health-related quality of life was assessed using the 12-item Short Form Health Survey (SF-12) at baseline and at 30-day follow-up. Changes in SF-12 Physical Component Summary (PCS) and Mental Component Summary (MCS) scores were analyzed using Wilcoxon signed-rank tests. Clinically meaningful improvement was defined using the minimal clinically important difference (MCID). Effect sizes were calculated and correlations between changes in PCS and MCS were assessed using Spearman's rho.

The PCS scores improved significantly from baseline to follow-up (mean change +4.42, p-value= 0.003). Clinically meaningful improvement in physical HRQoL was observed in 46% of participants. In contrast, MCS scores declined significantly over the same period (mean change -9.17, p-value < 0.001) and no participants achieved MCID for mental HRQoL. Changes in physical and mental HRQoL were not significantly correlated (p-value = 0.112).

In routine clinical practice, treatment with the studied synbiotic formulation was associated with a statistically significant and clinically meaningful improvement in physical HRQoL, while mental HRQoL showed a significant decline over the short-term follow-up. These findings highlight divergent trajectories of physical and mental health outcomes and underscore the importance of multidimensional HRQoL assessment in patients with gastrointestinal disorders.

Despite advancements in sleep medicine, inadequate sleep habits among young children persist. Establishing appropriate sleep habits in early childhood is essential for supporting physical, emotional, and cognitive development. However, scalable and personalized behavioral interventions for caregivers in community settings remain scarce, particularly AI-enabled systems designed for real-world implementation.

This study evaluated adherence, perceived usefulness, and feasibility of Nenne Navi-AI among 50 caregivers recruited in Hirosaki City, Japan, through community health checkups, childcare facilities, and public advertisements. The culturally tailored application integrates supervised machine-learning models with rule-based algorithms to provide personalized guidance and ongoing support for promoting healthier sleep habits.

During the 6-month intervention, only 3 of 50 caregivers (6%) experienced continuous 3-month data-entry lapses, with no withdrawals. Significant pre-post improvements were observed in children's number of awakenings after sleep onset and subjective sleep quality ratings. Subgroup analyses suggested improvements among children with poorer baseline sleep habits (≥0.5 SD worse than the sample mean). Post-intervention assessments confirmed high caregiver acceptability, satisfaction, and reduced parenting stress.

Nenne Navi-AI demonstrates high feasibility with excellent 6-month adherence and favorable usability feedback. The system shows promise for improving early childhood sleep (night-waking), enhances caregiving experiences, reduces negative parenting emotions, and provides a scalable framework for future AI-enabled pediatric sleep interventions.

We conducted a systematic review and meta-analysis to examine the effects of mindfulness-based interventions (MBIs) on emotion regulation (ER) and emotion dysregulation (ED) in people with any mental health condition.

Following a pre-registered protocol (PROSPERO CRD42024618605), we searched multiple databases (Web of Science, PsycINFO, Embase, and PubMed) on 04/07/2025. We identified randomised-controlled trials (RCTs) in which the effects of MBIs on ER or ED were measured in people with mental health conditions established by an adequately trained healthcare professional according to the Diagnostic and Statistical Manual of Mental Disorders (from third to fifth editions) or equivalent diagnosis as per the International Classification of Diseases (ninth or 10th revisions). Pooled effect sizes (Hedge's g) were estimated using random-effect meta-analyses. Study quality was assessed using the Cochrane Risk of Bias Tool 2.

We identified 19 RCTs, with 16 in the meta-analyses (988 participants in total; 50.71% randomised to MBIs). We found that MBIs significantly improved cognitive reappraisal (k = 6, g = 0.65, 95% CI = 0.33, 0.98) and reduced overall ED (k = 9; g = -0.54; CI = -0.71, -0.36). Significant reductions in ED domains concerning goal-directedness, impulsivity, and accessing ER strategies were found. Effects for expressive suppression were nonsignificant (k = 6; g = -0.25; CI = -0.94, 0.45) with significant heterogeneity. Study quality significantly moderated both ER outcomes, though not overall ED.

MBIs show potential for improving cognitive reappraisal and reducing ED across diagnoses. However, limited evidence for younger people and self-report measurements warrant cautious interpretation.

NIHR PROSPERO 2024 CRD42024618605. https://www.crd.york.ac.uk/PROSPERO/view/CRD42024618605.

Early exposure to maternal depression can increase risk for offspring mental health problems across the lifespan. Less is known about the transdiagnostic pathways through which maternal depression influences offspring mental health risk in young adulthood. This pre-registered study tested the prospective associations of maternal depression (total exposure and instability) with offspring mental health in young adulthood and evaluated adolescent emotion dynamics as transdiagnostic mechanisms.

This study used data from the Future Families and Child Wellbeing Study (FFCWS; n = 4898). Maternal depression was assessed when children were 1, 3, 5, and 9 years old and offspring young adult depression and anxiety was assessed at age 22 with structured clinical interviews. Adolescent daily and biweekly positive and negative emotions were assessed in two Future of Families and Child Wellbeing study substudies (n range = 513-1049) when offspring were 15 years old. Informed by theory and past research, we calculated variability, instability, and inertia to assess emotion dynamics and instability to assess maternal depression dynamics. We tested study aims using logistic regression, multivariate regression, and mediation models.

Total exposure to maternal depression predicted greater odds of offspring young adult depression whereas instability in maternal depression was not directly associated with offspring mental health. Offspring biweekly emotion dynamics during adolescence significantly predicted subsequent anxiety and depression. Additionally, greater instability in maternal depression was associated with lower biweekly instability in sadness during adolescence, which was in turn associated with greater likelihood of young adult anxiety. Associations were independent of mean emotion levels and covariates.

Overall, findings highlight the importance of considering how the dynamics of mood and emotions across generations (e.g., mother, offspring) and timescales (e.g., daily, biweekly, yearly) may shape young adult psychopathology. To build from these initial findings, future studies could investigate these processes using genetically informative longitudinal designs, causal mediation analyses, and continuous measures of maternal depression.

Accurate population prevalence estimates of eating difficulties in children and young people provide essential information for the design and implementation of prevention efforts. We aimed to (I) explore the proportion of students reporting eating difficulties in a large English secondary school sample, (II) analyse factors associated with increased odds of eating difficulties and (III) estimate a weighted prevalence of eating difficulties in England.

19,797 students in school years 7-11 (aged 11-16 years) and 3037 in school years 12-13 (aged 16-19 years) from the OxWell Student Survey completed questions from the Development and Well-Being Assessment. A further 2664 had answers imputed using multiple imputation by chained equations, resulting in n = 25,498 students. The survey happened during February and March 2023. Logistic regression models estimated associations between gender, year group, ethnic group and eating difficulties. For students in Years 7-11, we estimated the prevalence of eating difficulties weighted to England's population.

The most endorsed difficulty was students thinking they were fat when others said they were very thin (47.3%; 11,277/23,837) and the least endorsed was self-induced vomiting (17.7%; 4203/23,748). Girls (aOR 3.1, 95% CI 2.9, 3.2) and gender diverse/gender non-disclosing young people (aOR 3.3, 95% CI 2.9, 3.9) had higher odds of having eating difficulties compared to boys, with increasing odds in older year groups. The weighted prevalence of eating difficulties in students in school years 7-11 was 62.5% (95% CI: 61.8, 63.3).

The findings show that eating difficulties are common in secondary school students with more than half of our sample self-reporting at least one type of eating difficulty. These data provide insight for clinical services, and the high prevalence further suggests that early intervention in community settings may have a valuable role in reducing the demand on eating disorder services.

When receiving an attention deficit hyperactivity disorder (ADHD) diagnosis, children and families/carers need clear and accurate information about the condition in a suitable format. However, many of the available resources are complex or provide content that is not evidence-based. Furthermore, there are limited studies that co-develop digital resources with and for children, particularly those with ADHD. This study describes a co-production approach with an under-represented group, children with ADHD (aged 7-11), and their families/carers, to develop an animated video that provides support and improves understanding of ADHD.

The iterative co-design process involved a series of focus groups with children and families/carers at different stages of video animation development. The views of healthcare professionals were also obtained via online questionnaires and interviews. Key themes were identified through thematic analysis before more detailed discussions of content and a review of the animation storyboard.

Eleven families (12 children, 11 parents/carers) were involved in focus groups and 23 health professionals responded to online questionnaires. The study resulted in the creation of a widely accessible evidence-based bilingual (English, Welsh) animated video for children aged 7-11, newly diagnosed with ADHD, and their families/carers. Preliminary feedback and evaluation from participants at the animation launch event showed that the animation has been well received.

This study provides background around the development of a well-received digital resource for children with ADHD. It also outlines a framework for the co-production of further resources, especially as those involved agreed that a wider range of resources is needed for children and young people with ADHD.