Psychiatry is a distinct medical specialty that integrates biological, psychological, and social sciences to diagnose, treat, and prevent psychiatric disorders. Despite major advances in neuroscience, pharmacological treatments, psychotherapy, and service delivery, psychiatry often remains insufficiently recognized within the broader mental health discourse. Public awareness efforts have largely focused on mental health in general, while psychiatry as a medical discipline has received comparatively limited visibility. This has contributed to ambiguity regarding its identity and role within modern medicine. Many medical specialties have dedicated international observance days that strengthen professional identity, public awareness, and advocacy. In contrast, psychiatry currently lacks a dedicated global day of recognition. We therefore propose the establishment of a World Psychiatry Day, to be observed annually on February 20, the birth anniversary of Johann Christian Reil (1759-1813), the physician who coined the term Psychiatrie in 1808 and advocated for psychiatry as a distinct branch of medicine. The proposed observance would reinforce psychiatry's status as a core medical specialty, promote integration of psychiatric care with general healthcare, reduce stigma, strengthen advocacy and policy engagement, encourage research and innovation, and highlight the global burden of psychiatric disorders. Ultimately, World Psychiatry Day could enhance the visibility of psychiatry within medicine and reaffirm its indispensable role in improving health and wellbeing worldwide.

Paediatric hypertension is a significant health problem, with elevated childhood blood pressure (BP) linked to adult hypertension and increased cardiovascular risk. Existing reference guidelines from the American Academy of Pediatrics (AAP) may not be appropriate for Indian children, emphasising the need to develop region-specific normative data.

(1) To derive population-specific BP percentiles for children from urban Bengaluru, aged 6-16 years, compare these to the AAP reference guidelines; (2) to estimate and compare the proportion of hypertension identified using the derived percentiles versus AAP reference guidelines and (3) to examine the association of elevated BP with lipid profiles.

Cross-sectional observational study.

Urban school-based setting in Bangalore, India.

Apparently healthy school-going children (n=9051), aged 6-16 years were included. Children with known chronic illnesses or conditions affecting BP were excluded.

None.

Sex-specific, age-specific and height-specific systolic BP (SBP) and diastolic BP (DBP); proportion of BP categories (normal, elevated, hypertensive) using AAP reference guidelines and the study-derived percentiles with Centers for Disease Control and Prevention (CDC) and Indian Academy of Pediatrics (IAP) height centiles; proportion of abnormal lipid profiles.

The study-derived SBP and DBP percentiles increased steadily with age in both sexes, differing from the percentiles of AAP reference guidelines. Using AAP reference guidelines, 14.1% of children had elevated BP and 23.9% had hypertension, compared with 6.9% and 8.1%, using study-derived percentiles. Proportion of hypertension estimated from the derived BP percentiles using CDC and IAP height centiles were similar (p=0.178). Elevated BP was significantly associated with a higher proportion of abnormal total cholesterol (8.6% vs 3.2%, p=0.027) and higher low-density lipoprotein-cholesterol levels, predominantly among girls.

The study developed updated age-sex and height-specific BP percentiles for Indian children. Findings indicate that elevated BP may coexist with adverse lipid profiles, suggesting early clustering of cardiometabolic risk factors in this population.

Various models have been developed for predicting the risk of type 2 diabetes. This study was designed to compare the performance of international and population-specific models in an Iranian population. This cross-sectional analysis examined data from 10,663 participants aged 40-70 years from the Kharameh cohort. The performance of five type 2 diabetes risk prediction models-FINDRISC, ADA, AUSDRISK, the American risk score, and a new logistic regression model was compared using statistical metrics (sensitivity, specificity, AUC) and Decision Curve Analysis to assess clinical utility. As glucose metabolism status worsened from normal to diabetes, mean age, body mass index, waist circumference, and blood pressure increased significantly. The American model showed the highest discriminative ability (AUC = 0.79) and provided the greatest standardized net benefit. The FINDRISC model showed acceptable performance (AUC = 0.72). The ADA and AUSDRISK models performed weaker (AUC = 0.64 and 0.68, respectively). The new logistic model, with an AUC of 0.71, demonstrated high sensitivity (0.82) but low specificity (0.52), making it primarily suitable for high-sensitivity initial screening. The American risk score was the most effective tool, while the lab-free FINDRISC model served as a practical alternative for primary care screening at lower risk thresholds.

Few prospective, population-based studies investigated the effect of hypertension on kidney stones. This prospective study was conducted to assess the effect of hypertension on the incidence of kidney stones in an Iranian population, using follow-up data from the Rafsanjan Cohort Study (RCS). Data from the Rafsanjan Cohort Study (RCS), which is part of the larger Prospective Epidemiological Research Studies in Iran (PERSIAN), were utilized. In the baseline phase of this study, 10,000 adults, 35 to 70 years old, were invited using the cluster sampling method. Of these, 7,453 individuals who did not report a history of kidney stone as well as related diseases at the baseline and also had a complete medical questionnaire, were included in our study. All participants were interviewed by expert interviewers and previously validated questionnaires were completed. Data were analyzed in SPSS (ver 21) and appropriate statistical tests were used to compare groups. The mean age of the participants was 49.50 ± 9.36 years, and the majority of them were female (55.8%). 23.1% of the participants had a history of hypertension. In the group of people with the history of higher mean diastolic pressure, the incidence of kidney stone disease was statistically higher than that among the other group. Furthermore, the incidence of kidney stones was highest among untreated hypertensive individuals (6.9%), followed by treated hypertensive individuals (4.2%), and lowest in non-hypertensive individuals (3.5%). The results showed that untreated hypertensive respondents had a 1.985 times higher risk of kidney stones compared to respondents with normal blood pressure. We concluded that hypertension could significantly increases the odds of kidney stone formation.

Unsustainable dietary patterns contribute substantially to climate change, biodiversity loss, and the growing global burden of non-communicable diseases. University years represent a critical transitional period during which lifelong eating behaviors are shaped. Understanding whether positive attitudes toward healthy eating are associated with sustainable dietary behaviors may inform integrated public health strategies targeting both health and environmental outcomes. This study examined the relationship between healthy eating attitudes and sustainable nutrition behaviors among Turkish university students and explored associated demographic factors.

A cross-sectional study was conducted between December 2023 and October 2024 among 610 university students aged 18-26 years. Data were collected using structured self-report questionnaires. Healthy eating attitudes were assessed using the Attitude Scale for Healthy Nutrition (ASHN), and sustainable dietary behaviors were measured using the Behaviors Scale Towards Sustainable Nutrition (BSSN). Non-parametric tests, Spearman correlation analysis, confirmatory factor analysis, and structural equation modelling (SEM) were performed.

Participants demonstrated generally high levels of healthy eating attitudes. A weak but statistically significant positive correlation was observed between overall healthy eating attitudes and sustainable dietary behaviors (r = 0.182, p < 0.001). SEM indicated that healthy eating attitudes were positively associated with sustainable nutrition behaviors (β = 0.542, p < 0.001). Non-smokers and female students exhibited significantly higher sustainable nutrition behavior scores compared to smokers and male students (p < 0.05).

Healthy eating attitudes were positively associated with sustainable dietary behaviors among university students. Although the strength of the association was modest, the findings suggest that health-oriented attitudes may support environmentally responsible dietary practices. Public health interventions that integrate sustainability principles into university-based nutrition education and campus food policies may represent a promising strategy to advance both human and environmental health. Longitudinal studies are needed to clarify causal pathways.

Diabetic foot ulcer (DFU) is a severe complication of diabetes, characterized by chronic inflammation and impaired healing. Although cellular and immunosenescence are associated with chronic wounds, the specific cell types, regulatory mechanisms, and pathological consequences within the DFU microenvironment remain poorly defined. We conducted an integrative multi-omics analysis combining bulk and single-cell RNA sequencing data from human DFU and control tissues. The novel macrophage senescence score (MSS) was constructed by integrating aging-related genome-wide association studies signals with DFU-specific transcriptional signatures. Machine learning was used to identify key regulators. Functional validation was conducted in high glucose-stimulated human macrophages in vitro. Our single-cell atlas revealed macrophages as the most prominently senescent stromal cell population in DFUs. These senescent macrophages exhibited a distinct pro-inflammatory senescence-associated secretory phenotype (SASP) and engaged in aberrant intercellular communication, notably enhancing the C-X-C motif chemokine ligand 8 (CXCL8) - atypical chemokine receptor 1 (ACKR1) signaling axis to endothelial cells. We developed and validated a disease-relevant MSS, which demonstrated superior predictive value for DFU. Mechanistically, the transcription factor runt-related transcription factor 1 (RUNX1) was identified as the top feature. Functional assays established that RUNX1, upregulated under diabetic conditions, and is associated with promoted P53 acetylation. This study establishes macrophage senescence as a central pathological mechanism in DFU, propelled by the RUNX1-P53 acetylation axis. We define its role in disrupting the wound microenvironment through aberrant SASP and cell crosstalk. The findings provide a novel predictive tool MSS and a precise molecular target with implications for prognostication and therapy.

Metabolic syndrome (MetS) is a risk factor for stroke, cardiovascular disease, and type 2 diabetes mellitus, with a global prevalence ranging from 12.5% to 31.4%. This ten-year prospective cohort study conducted in Shiraz, Iran, aimed to provide clinical evidence on the dynamics of MetS over time. Adults selected via multistage random cluster sampling were followed in 2014, 2019, and 2024. MetS was defined using ATP III and IDF criteria, and participants were categorized into unchanged, regressed, and progressed subgroups. Demographic, socioeconomic, anthropometric, medical, and paramedical characteristics were recorded. Nutritional status and physical activity were assessed using validated Persian versions of the FFQ-80 and IPAQ-7, respectively. Fatty liver was diagnosed by ultrasonography. Differences in quantitative variables (Δ) were calculated between phases. Longitudinal associations were examined using generalized estimating equations (GEE), and cross-sectional associations were assessed via univariable, binary logistic, and ordinal logistic regression analyses in SPSS version 24. The study followed 296 adults with a mean age of 42.4 ± 11.9 years and a female-to-male ratio of 1.2. According to IDF criteria, MetS prevalence in phases one, two, and three was 19.6%, 37.2%, and 41.2%, respectively. Using ATP III criteria, prevalence was 19.9%, 39.5%, and 33.4%, respectively. Analysis showed that negative changes in triglycerides (Δ-TG: OR = 0.99), fasting blood sugar (Δ-FBS: OR = 0.98), and diastolic blood pressure (Δ-DBP: OR = 0.97) were determinants of regression of MetS. On the other hand, positive changes in waist circumference (Δ-WC: OR = 1.07), systolic blood pressure (Δ-SBP: OR = 1.03), uric acid (OR = 1.02) and triglycerides (Δ-TG: OR = 1.01), along with negative change in HDL (Δ-HDL: OR = 0.97), were determinants of progression of this syndrome. In the third phase, female gender (OR = 6.67), low education (OR = 1.86), hyperuricemia (OR = 1.56), and increasing age (OR = 1.04) were positively correlated with MetS. In conclusion, MetS may regress or progress over time. Regression is possible by controlling diastolic blood pressure, blood glucose, and triglycerides, while uncontrolled waist circumference, systolic blood pressure, uric acid and triglycerides, along with low HDL, increase progression likelihood.

To investigate the association between attention-deficit/hyperactivity disorder (ADHD) and cardiometabolic risk profile at the time of type 2 diabetes (T2D) diagnosis and examine longitudinal changes in cardiometabolic measures following T2D diagnosis.

A nationwide cohort study using linked Swedish health registers.

Adults aged 18-65 years with a first recorded diagnosis of T2D between 1996 and 2020. ADHD, treated as a lifetime condition, was identified through diagnostic and prescription records.

The cardiometabolic risk profile, comprising nine clinical parameters and two behavioural factors, was assessed at T2D diagnosis and was tracked for up to 5 years post-diagnosis. Linear regression (β_ADHD) and Poisson regression models with robust variance (risk ratios (RRs)) compared cardiometabolic risk factors at diagnosis between individuals with and without ADHD. Generalised estimating equations (β_ADHD*t) assessed longitudinal changes in clinical parameters following the diagnosis.

Among 80 607 individuals with T2D, 1204 (1.5%) had an ADHD diagnosis. At T2D diagnosis, individuals with ADHD were younger and had statistically significantly higher body mass index (BMI) (β_ADHD: 1.93 (95% CI 1.54 to 2.32)), triglycerides (β_ADHD: 0.31 (95% CI 0.17 to 0.45)) and smoking prevalence (RR: 1.58 (95% CI 1.44 to 1.74)) compared with those without ADHD. Other cardiometabolic risk factors did not differ significantly. Over the subsequent 5 years, trajectories in cardiometabolic risk factors were broadly similar, except for a greater reduction in BMI in individuals with ADHD (β_ADHD*t: -0.26 (95% CI -0.34 to -0.17)), independent of baseline BMI and glucose-lowering medications. After inverse probability of treatment weighting, the BMI reduction was substantially reduced and not significant (β_ADHD*t: -0.05 (95% CI -0.17 to 0.07)).

Among adults with newly diagnosed T2D, those with co-occurring ADHD had broadly similar cardiometabolic profiles to those without ADHD but presented at a younger age with a modestly higher BMI, triglycerides and smoking prevalence. Individuals with ADHD also showed a slightly greater reduction in BMI over time following T2D diagnosis. Despite modest overall cardiometabolic differences, incorporating ADHD status into preventive diabetes care may help identify a younger, more vulnerable subgroup who could benefit from targeted risk factor management.

Predicting postoperative body mass index (BMI) trajectories and long-term type 2 diabetes (T2D) remission after bariatric surgery remains challenging. Existing models often rely on baseline variables only and fail to incorporate dynamic postoperative changes. This study aimed to develop and validate a multicentre machine-learning framework that predicts individualized BMI trajectories and T2D remission using routinely available preoperative data and time-dependent weight evolution.

This multicentre retrospective cohort study included adult patients who underwent Roux-en-Y gastric bypass or sleeve gastrectomy across 11 European centres (2012-2023). Variables with > 30% missing data were excluded; remaining missing values were imputed iteratively. A two-stage approach was used: a regression model predicting postoperative BMI at 3-60 months using an autoregressive design; and a classification model predicting T2D remission using baseline features and predicted BMI trajectories. Internal performance was evaluated with ten-fold and leave-one-clinic-out cross-validation; external validation used an independent cohort from Linköping, Sweden.

Of the 11 457 patients initially identified, 9652 patients with complete baseline and follow-up information were used for the analysis. The best BMI model (HistGradientBoosting) achieved a root mean square error (RMSE) of 1.11 kg/m2 (95% confidence interval 1.07 to 1.14) and a mean absolute error (MAE) of 0.62 kg/m2 across clinics; external testing showed an RMSE of 1.12 kg/m2 (95% confidence interval 1.11 to 1.12) and an MAE of 0.63 kg/m2. The T2D remission classifier (XGBoost) obtained a Macro F1 score of 0.88 (precision 0.87, recall 0.88), with an external F1 score of 0.89. Incorporating predicted BMI trajectories improved discrimination compared with baseline-only models (C-index 0.95 versus 0.93).

A two-stage machine-learning framework has high predictive performance for postoperative BMI and T2D remission up to 5 years after bariatric surgery. Dynamic incorporation of predicted weight trajectories enhances metabolic risk prediction and supports individualized counselling and postoperative management.

Gestational diabetes mellitus (GDM) is associated with substantial risks of adverse maternal and neonatal outcomes. Contemporary management approaches for GDM exhibit insufficient implementation, resulting in suboptimal glycemic control and preventable perinatal complications. The rapid evolution of mobile health technologies offers potential to enhance GDM care, yet evidence from large real-world studies remains limited.

This study aimed to evaluate the impact of a telemedicine-enhanced integrated management system on pregnancy outcomes and glycemic control in women with GDM and to explore the dose-response relationship between telemedicine engagement intensity and clinical outcomes.

In this real-world, prospective cohort study conducted at a provincial-level medical center in China, women with GDM were categorized into a standard care group and a telemedicine-enhanced group receiving the TangMama smartphone app in addition to standard care. We compared pregnancy outcomes and glycemic parameters between the 2 groups in an inverse probability of treatment weighting population based on propensity scores. Mediation analyses and dose-response analyses were additionally conducted to explore potential mechanisms and engagement effects.

A total of 4621 women with GDM were included, with 1711 in the telemedicine-enhanced group and 2910 in the standard care group. Upon inverse probability of treatment weighting analysis, the telemedicine-enhanced group demonstrated significantly lower gestational weight gain (adjusted mean difference -1.49 kg, 95% CI -1.81 to -1.17), reduced rates of excessive gestational weight gain (adjusted odds ratio [aOR] 0.61, 95% CI 0.54-0.69), cesarean section (aOR 0.80, 95% CI 0.71-0.91), hypertensive disorders in pregnancy (aOR 0.76, 95% CI 0.64-0.90), and pre-eclampsia (aOR 0.64, 95% CI 0.49-0.83). Glycemic control in the third trimester was significantly improved, with lower glycated hemoglobin A1c (HbA1c) levels (adjusted mean difference -0.05%, 95% CI -0.08 to -0.03) and higher HbA1c on-target rates. For neonatal outcomes, telemedicine-enhanced management was associated with lower rates of preterm birth (aOR 0.47, 95% CI 0.38-0.59), large-for-gestational age (aOR 0.81, 95% CI 0.69-0.96), neonatal unit admission (aOR 0.80, 95% CI 0.71-0.91), neonatal hypoglycemia (aOR 0.64, 95% CI 0.45-0.93), and neonatal hyperbilirubinemia (aOR 0.69, 95% CI 0.58-0.82). Mediation analyses identified gestational weight gain and third-trimester fasting plasma glucose as significant mediators. Higher telemedicine engagement was associated with improved glycemic control and reduced adverse outcomes in a dose-response manner.

Telemedicine-enhanced integrated management is associated with improved maternal glycemic control and substantial reductions of adverse pregnancy outcomes among women with GDM. The observed dose-response relationship between engagement intensity and outcomes underscores the importance of promoting active patient participation. These findings support the broader integration of telemedicine into routine GDM care pathways to optimize maternal and neonatal health.