Myelodysplastic syndromes (MDS) are a heterogeneous group of disorders caused by abnormalities at the hematopoietic stem cell level and are associated with ineffective hematopoiesis, peripheral cytopenias, and a propensity for leukemic transformation. Recent research elucidates the key mechanisms and roles of ribosomal proteins (RPs), microRNAs (miRNAs), extracellular vesicles (EVs), and long non-coding RNAs (lncRNAs) in the pathophysiology of MDS. Mutations or altered expression of RP genes lead to ribosomal stress and activation of p53, resulting in impaired erythropoiesis and apoptosis of hematopoietic progenitors. Dysregulation of miRNAs modulates gene expression programs that are essential for hematopoietic differentiation and apoptosis. Moreover, EV-associated miRNAs mediate multiple processes, including intercellular communication and regulation of the bone marrow (BM) microenvironment, thereby contributing to DNA damage and clonal evolution. EV-associated miR-10a and miR-15a have been reported to induce DNA damage in HSCs. LncRNAs have emerged as promising tools for cancer diagnosis and prognostic biomarkers. They play critical roles in regulating malignant cell proliferation, apoptosis, and epigenetic modifications. This overview highlights the molecular complexity of MDS pathogenesis, offering insights to support stratified diagnosis and the development of targeted therapies.

Combat-related stress is associated with autonomic nervous system (ANS) dysregulation-sympathetic predominance, reduced vagal tone, and decreased heart rate variability (HRV)-linked to increased cardiovascular risk. Non-pharmacological interventions targeting autonomic regulation show promise, but controlled studies in combat-exposed populations remain limited. We assessed whether adding a structured breathing-meditation protocol, the Technique of Mental Relaxation (TMR), to standard rehabilitation is associated with changes in HRV and electrocardiogram (ECG)-derived indices of autonomic regulation in Ukrainian servicemen.

A controlled, non-randomized study screened 84 male servicemen; 77 were allocated to a TMR group (n = 37; TMR plus standard treatment) or a control group (n = 40; standard treatment alone). Paired baseline and post-treatment 5-min supine recordings, obtained over a 14-day rehabilitation period, were available for 74 participants (TMR n = 35, control n = 39); a civilian reference group (n = 89) provided baseline comparison. Primary HRV outcomes were SDNN, RMSSD, the Baevsky Stress Index, and heart rate; ECG analysis added repolarization intervals, with Hedges' g.

At baseline, both military groups showed impaired autonomic regulation versus civilians (all p < 0.0001). After intervention, the TMR group improved (SDNN 23→30 ms, p < 0.001; RMSSD 12→19 ms, p < 0.001; Stress Index 422→253, p < 0.001), whereas controls deteriorated; post-treatment between-group differences were significant for all primary outcomes (p ≤ 0.008).

Heart-rate-adjusted analyses attenuated part of this difference, the Stress Index remaining most robust. Given the non-randomized design, these findings warrant caution and support randomized trials, with HRV as an objective monitoring tool.

Research on autism in Latin America has grown substantially over the past two decades; however, evidence regarding the experiences of autistic people and their families remains fragmented across countries and disciplines. This narrative review aimed to synthesize the available evidence on the experiences of autistic people and their families while navigating health, education, and social protection systems across Latin America. A literature search was conducted in PubMed for studies published between January 2000 and July 2026. The search combined the terms "autism spectrum disorder," "autism," and "autistic" with the names and demonyms of all countries in Latin America and the Caribbean, as well as the regional terms Latin America and Central America. Studies addressing pathways to autism identification, access to health services, socioeconomic inequalities, family experiences, educational inclusion, professional training, and current regional challenges were included. A total of 75 studies met the inclusion criteria and were synthesized narratively. Across the region, families consistently recognized developmental differences during the first years of life; however, pathways to autism identification were frequently prolonged by fragmented health systems, shortages of trained professionals, and limited access to specialized services. Socioeconomic and geographic inequalities further restricted access to assessment, supports, and ongoing services. Families played a central role in coordinating care, navigating complex systems, and advocating for the rights of autistic people. Educational inclusion remained limited by insufficient resources, inadequate teacher preparation, and inconsistent implementation of inclusive policies. The available evidence was concentrated in a small number of countries, highlighting important gaps in regional knowledge. Overall, autistic people and their families continue to encounter substantial barriers while navigating health, education, and social protection systems across Latin America. Strengthening early identification, expanding professional training, improving intersectoral coordination, and increasing research capacity across underrepresented countries are essential priorities for advancing equitable, coordinated, and inclusive supports throughout the region.

Climate change poses severe health risks to people with severe and persistent mental illness (SPMI), particularly from extreme heat events. People living with schizophrenia had three-fold higher mortality during the 2021 heat dome event in British Columbia. Multiple factors increase vulnerability, including thermoregulation impairment from neuroleptic medications and neurobiological changes, cognitive symptoms affecting risk comprehension, social isolation, comorbid physical conditions, housing instability, and barriers to accessing cooling resources due to stigma and poverty.

This pilot quality improvement study addressed knowledge gaps among frontline mental health providers in Ontario, Canada. We delivered 20-minute educational presentations to 26 mental health teams, including Assertive Community Treatment (ACT) Teams, Flexible ACT, and Intensive Case Management teams. Pre- and post-surveys assessed knowledge, attitudes, and skills among 102 participants (primarily nurses, social workers, and community mental health workers). We provided practical resources including air conditioner funding application templates, resource lists, and visual reminder stickers for clients.

Post-intervention surveys from 44 participants demonstrated increased knowledge of heat-related risks, improved confidence in recognizing heat exhaustion and heat stroke symptoms, and enhanced comfort in prevention and intervention strategies. Participants identified needs for visual aids and systemic solutions like maximum indoor temperature bylaws.

While clinician education is necessary, systemic interventions, client-focused education co-created with peers, community health checks, and universal protections are essential to protect the most vulnerable. Future work must include people with lived experience in program design and pursue policy-level advocacy for comprehensive climate adaptation. Extreme heat poses an increased risk of morbidity and mortality to people living with SPMI. Psychiatrists and mental health service teams must be better prepared to protect people from the health consequences of extreme heat.

We evaluated associations between implementation of Florida Senate Bill 1718 and self-reported physical and mental health among Hispanic and non-Hispanic Black adults, and examined whether these associations differed by cancer survivorship.

Using 2022-2024 Behavioral Risk Factor Surveillance System data, Hispanic and non-Hispanic Black adults in Florida were compared with those in Southern control states; cancer survivors were propensity-matched 1:2 to adults without cancer. Survey-weighted difference-in-differences and triple-difference models estimated changes in self-reported poor physical and mental health days. Parallel pre-policy trends were assessed using event-study models on an extended 2020-2024 panel, and p values for state-comparative models were obtained using a wild cluster bootstrap.

Among 5991 respondents, the Florida-versus-control increase in poor physical health days among cancer survivors alone was imprecisely estimated (difference-in-differences, 4.97 days; 95% CI, -0.59 to 10.52; bootstrap p = 0.137). In the survey-weighted analysis, implementation of SB 1718 was associated with a differential increase of 7.09 physically unhealthy days per month among cancer survivors relative to adults without cancer (triple difference, 95% CI, 3.63-10.54). However, this estimate was substantially attenuated and no longer statistically significant in the unweighted analysis (1.34 days; 95% CI, -0.19 to 2.87). The estimate also varied when the largest survey weights were excluded or winsorized and was based on small Florida cancer-survivor samples. No robust differential association was identified for mentally unhealthy days.

Although the survey-weighted analysis suggested an increase in physically unhealthy days among cancer survivors following implementation of Florida SB 1718, the magnitude and statistical significance of this estimate were not robust to the weighting specification. Small Florida cancer-survivor samples, unequal survey weights, and limited compositional comparability between Florida and the control states preclude a definitive conclusion regarding the policy's association with self-reported health.

University students represent a dynamic and diverse population, navigating a critical period of personal growth, academic challenges, and engaging with a wide variety of new people. However, they often face significant mental health challenges, including anxiety, depressive, and insomnia symptoms, which are exacerbated by academic pressures, financial stress, and poor dietary habits. Hence, this research sought to examine the prevalence of mental health issues among university students in Bangladesh and explore potential links between these issues and financial prioritization and nutrition.

This cross-sectional survey was carried out among 450 students attending Noakhali Science and Technology University (NSTU), Bangladesh using a structured questionnaire. Anxiety, depressive, and insomnia symptoms were assessed using the Generalized Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire-9 (PHQ-9), and Athens Insomnia Scale-8 (AIS-8), respectively. Nutritional behavior was assessed using the Health Promoting Lifestyle Profile-II (HPLP-II) nutrition subscale, and financial priority was evaluated using a culturally adapted version of the Castellanos and Holcomb financial prioritization instrument. Multivariable linear regression was used to examine the associations between financial priority and mental health outcomes, whereas multivariable logistic regression was used to assess the associations between nutrition and mental health outcomes.

The prevalence of anxiety, depressive, and insomnia symptoms was 78.9%, 90.4%, and 63.6%, respectively, Anxiety, depressive, and insomnia symptoms were significantly interconnected, with positive associations between anxiety and depressive symptoms (β = 0.154, p < 0.001), anxiety and insomnia symptoms (β = 0.183, p < 0.001), and depressive and insomnia symptoms (β = 0.192, p < 0.001). Most students prioritized spending on food (84.4%) and clothing (71.3%). In multivariable linear regression analyses, prioritizing food was associated with lower anxiety (b = -2.153, p < 0.001), depressive (b = -1.743, p = 0.018), and insomnia (b = -3.519, p < 0.001) symptom scores. Conversely, prioritizing smoking was associated with increased mental health issues (p < 0.001). In multivariable logistic regression analyses, good nutrition was associated with reduced odds of anxiety (adjusted odds ratio [AOR]: 0.501, p = 0.012) and depressive (AOR: 0.425, p = 0.025) symptoms, but higher odds of insomnia symptoms (AOR: 2.03, p = 0.002).

These findings highlight the intricate relationships between financial priorities, nutrition, and psychological well-being among Bangladeshi university students, emphasizing the need for importance of developing targeted interventions and support systems.

People supporting individuals with psychotic disorders play a vital role in community-based mental health care but often face their own health and wellbeing challenges and limited access to support. Digital interventions, including online courses, may help address these unmet needs.

This study explored participants' experiences of the Caring for People with Psychosis and Schizophrenia MOOC, using the Kirkpatrick Evaluation Model, a widely applied framework for evaluating educational programmes.

Individual semi-structured interviews were conducted online with participants who accessed the course. Interviews were audio-recorded, transcribed verbatim, and analysed using reflexive thematic analysis. Findings were then mapped onto the four levels of the Kirkpatrick model to explore learner reactions, knowledge gains, behavioural change, and wider impacts of the MOOC.

Nine participants (six carers and three non-carers) were interviewed, and five key themes were identified. Learners described enrolling during periods of emotional difficulty and uncertainty and found the course validating, informative, and connecting (reaction). They reported greater understanding of psychosis, caregiving strategies, and self-care approaches (learning), which increased their sense of confidence. Many carers applied this knowledge in their daily routines, communication, and relationships (behaviour), reportedly improving perceived wellbeing for themselves and their relatives (impact). The MOOC's flexible and multimodal design supported meaningful engagement alongside other responsibilities.

Preliminary evidence from this model of online training suggests that a globally accessible MOOC can connect learners, enhance understanding, and build confidence in caregiving for psychosis. Subjective reports indicate the potential of MOOCs to address learners' informational and emotional needs through flexible, supportive online education.

Amid the escalating global mental health crisis among children and adolescents, low self-esteem has been recognized as a pivotal risk factor for the onset of psychological difficulties. Developing interventions that are both cost-effective and widely accessible to enhance self-esteem carries substantial public health significance. The present study aims to systematically evaluate the effects of various forms of physical activity on self-esteem in typically developing children and adolescents, and to establish a comparative ranking of their effectiveness.

Following the PRISMA 2020 guidelines, randomized controlled trials (RCTs) were systematically retrieved from PubMed, the Cochrane Library, Embase, and Web of Science from database inception to March 31, 2026. The Cochrane Risk of Bias 2 (RoB2) tool was used to assess the risk of bias. A network meta-analysis was conducted to integrate both direct and indirect evidence, with standardized mean differences (SMD) and corresponding 95% confidence intervals (CI) calculated. The surface under the cumulative ranking curve (SUCRA) was applied to rank the relative effectiveness of interventions.

A total of 17 RCTs were ultimately included. The network meta-analysis indicated that resistance exercise showed the highest probability of being the most effective intervention for improving self-esteem (SUCRA = 97.8%), and was significantly superior to multimodal exercise, stretching exercise, and no intervention; while its advantages over aerobic exercise and mind-body exercise did not reach statistical significance. Funnel plot revealed no significant asymmetry (low publication bias). Combined with good consistency and low study bias, our findings are robust.

Resistance exercise, aerobic exercise, mind-body exercise, multimodal exercise, and stretching exercise were all effective in enhancing self-esteem among typically developing children and adolescents, with resistance exercise showing the highest probability of being the most effective. These findings suggest that resistance exercise may serve as the preferred physical activity intervention to promote self-esteem in school, family, and community settings based on current evidence.

https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD420261364418, PROSPERO (CRD420261364418).

Platform-based on-demand food delivery has expanded rapidly in China, reshaping delivery work through strict deadlines, piece-rate pay, algorithmic management, long working hours, and intensive road exposure. These conditions may increase occupational injuries and broader health risks among food delivery riders.

This narrative review synthesizes evidence on occupational injuries and health risks among food delivery riders in China and identifies potential mechanisms and prevention strategies.

We searched PubMed, Web of Science Core Collection, and CNKI for Chinese- and English-language literature published from January 1, 2015 to March 31, 2026. Search concepts included food delivery riders, platform work, occupational injuries, road traffic injuries, musculoskeletal disorders, fatigue, sleep, mental health, algorithmic management, and occupational health protection. Titles, abstracts, and full texts were screened for relevance, and 47 eligible sources were included.

Existing evidence indicates that riders face interrelated risks, including road traffic injuries, work-related musculoskeletal disorders, fatigue, sleep disturbance, occupational stress, anxiety and depressive symptoms, and chronic risks related to irregular eating and limited health management. Risky riding should be understood not only as an individual behavior, but also as a response to delivery deadlines, income pressure, algorithmic control, fatigue, road conditions, and inadequate protection. Key gaps include the predominance of cross-sectional studies, limited longitudinal and intervention evidence, insufficient subgroup analyses of full-time, crowdsourced, and part-time riders, and heavy reliance on self-reported exposure measures.

Occupational injuries and health risks among food delivery riders should be viewed as occupational and public health issues embedded in platform-based work organization. Prevention should move beyond individual safety education and post-accident compensation to include upstream governance of algorithms, delivery deadlines and working hours, fatigue and sleep management, traffic and ergonomic protection, accessible occupational health services, privacy-preserving monitoring, and multi-stakeholder support. Longitudinal and intervention studies are needed to clarify causal pathways and evaluate prevention strategies.

Bipolar disorder (BD) carries a substantial global health burden. While pharmacological treatments effectively achieve clinical remission, functional and personal recovery often remain suboptimal. Although formal art therapy has been explored in psychiatry, the role of daily, organic artistic practice as a lived mechanism for personal recovery in BD is underexplored. This study aimed to analyze how artistic practice influences the personal recovery process from the perspective of outpatients with BD.

A qualitative study with a phenomenological design was conducted at the outpatient clinic of the Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz (INPRFM) in Mexico City. A non-probabilistic, purposive sample of typical cases technique was utilized to recruit adult outpatients with BD type I who were in syndromal recovery (euthymia) and actively engaged in artistic practices. Data were collected through semi-structured interviews and analyzed using thematic analysis based on the personal recovery model. Methodological rigor was ensured by adhering to the Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines.

Nine participants (seven women and two men) were included until information saturation was reached. Artistic practice functioned as a multifaceted catalyst for personal recovery. Core themes identified included the redefinition of personal identity and the mitigation of self-stigma, the cultivation of hope, and the discovery of new life meanings. Additionally, artistic engagement fostered a profound sense of responsibility toward self-management and treatment adherence, while simultaneously promoting spiritual, cognitive, and social connectedness.

Daily artistic practice extends beyond mere symptom management, acting as a vital component of personal recovery in BD. Recognizing and integrating patients' artistic interests into clinical discussions may enhance therapeutic alliances, combat internalized stigma, and promote holistic well-being in this population.