Aging doesn't just dull our memories; it destabilizes our emotions while further impairing sleep quantity and NREM sleep quality. Emotional dysregulation and anxiety symptoms in older adults accelerate their risk of cognitive decline and dementia, yet the underlying mechanisms remain largely unclear. In young adults, reductions in deep sleep, specifically the loss of slow wave activity (SWA) during non-REM sleep, impair the brain's ability to regulate anxiety overnight. This raises a testable hypothesis: Does age-related decline in SWA contribute to increased anxiety symptoms in older adults? We test this hypothesis in 61 cognitively healthy older adults (>65 y) experiencing varying levels of anxiety. Each participant underwent polysomnography-recorded sleep in the lab, followed by a structural MRI the next morning to assess atrophy in anxiety-sensitive brain regions. A subset of 24 participants was tracked longitudinally over 4 ± 2.02 years. The findings were consistent. Greater impairment in nighttime SWA predicted higher next-day anxiety in older adults, both at baseline and at follow-up. Brain imaging revealed the mechanism: atrophy in key emotion-processing regions was associated with reduced capacity to generate robust slow waves needed for overnight anxiety regulation. Critically, mediation analysis showed that impaired SWA fully accounted for the relationship between regional atrophy and disrupted overnight anxiety regulation. These findings suggest that even in the presence of age-related brain atrophy, intact SWA may preserve emotional stability by rescuing the brain's nightly emotional recalibration process, protecting mental health in aging populations.

Emerging studies have consistently shown that blood-oxygenation-level-dependent signals within white matter (WM) appear to be related to neural activity. This recognition of WM functional signal has provided a great opportunity to investigate how the brain's WM functionally evolves in youth as well as its relationship to developmental disorders. Using multimodal imaging data from 407 participants aged 8 to 22 years, we constructed the WM functional connectome (WMFC) as well as the WM structural connectome (WMSC). Our findings reveal a global three-stage reorganization process in WMFC characterized by a decreasing-increasing-decreasing pattern. Regional changes are marked by hierarchical development between primary networks and higher-order networks. In conjunction with the WMSC, we measured WM SC‒FC coupling, and found that coupling monotonically decreases with development. Treating these spatial patterns as phenotypes of WM function, we demonstrated significant regulation by neurotransmitter receptors and transcriptomic expression. Notably, WMFC significantly explained the heterogeneous regional vulnerability in neurodevelopmental disorders and outperformed the WMSC in predicting cognitive function. This study underscores the importance of investigating WM function in understanding the neural mechanisms of brain maturation and disorders.

BackgroundPsychosocial stress-particularly bullying-has been recognized as a critical determinant of mental and neurophysiological health in children. Chronic stress exposure may disrupt cortical regulatory mechanisms detectable through quantitative electroencephalography (q-EEG).ObjectiveThis study examined the correlation between perceived psychological stress, involvement in bullying, and q-EEG spectral anomalies among Indonesian school-aged children, seeking to determine if bullying-related stress generates unique neurophysiological patterns or indicates a general dysregulation of stress responses.MethodsA two-phase design was implemented. Phase I included 2781 8-13-year-olds who completed the PSS-10 and a validated bullying questionnaire. Using a Mitsar-EEG 201 equipment, Phase II selected 24 students with increased stress levels (PSS ≥ 27) for q-EEG examination. Electroencephalogram signals from 19 scalp sites were converted into z-scores using age-adjusted NeuroGuide database standards. Stress level and brain activity were correlated using Spearman's rho.ResultsThe majority of subjects (23 out of 25; 95.8%) had EEG activity above ±2 standard deviations, especially in the temporal and prefrontal areas. There was a negative correlation between stress and temporal alpha power (r = -0.43, p = 0.028) and a positive correlation between stress with enhanced prefrontal high-beta power (r = 0.47, p = 0.021). Neurophysiological alterations among bullied children closely paralleled those under non-bullying stressors such as academic overload or family conflict.ConclusionElevated stress intensity, regardless of its psychosocial origin, was associated with convergent cortical dysregulation patterns. These results suggest that q-EEG may be a viable non-invasive method for early stress-related neurophysiological dysfunction diagnosis and that pediatric populations require integrated emotional regulation therapies.

Pituitary neuroendocrine tumors (PitNETs) represent a heterogeneous group of intracranial neoplasms arising from the anterior pituitary gland. While most tumors are benign, certain subsets can display aggressive behavior marked by invasiveness, treatment resistance, and familial clustering. The current World Health Organization (WHO) classification emphasizes the role of lineage-specific transcription factors in better identifying cell types. However, this methodology is not sufficient to ensure fully accurate prediction of tumor behavior; therefore, new, more in-depth methods are required to improve diagnostic reliability and treatment decision-making.

A narrative review was carried out to evaluate the literature on PitNET classification schemas and their molecular signatures. Attention was placed on classification research and developments that impact current clinical management.

Evidence indicates improvement in the molecular classification of PitNETs, not just from lineage-specific transcription factors, but also from advances in genomic, transcriptomic, and epigenetic profiling. These newer techniques have revealed that PitNETs are driven by a complex interplay of alterations, including somatic mutations, germline predisposition genes, copy number variations, and poorly regulated signaling pathways. Each of these general findings plays a role in influencing tumor behavior, controlling lineage differentiation, and determining response to therapy. These findings indicate the need for integrating molecular characteristics with clinical data to improve risk stratification and guide personalized treatment.

Clinical data combined with molecular classification systems is redefining our understanding of PitNET behavior and improving clinical decision-making by increasing our diagnostic accuracy and advancing our knowledge of individualized patient tumor biology. Continued research and development of comprehensive predictive approaches are necessary to achieve reliable outcome prediction and improve therapeutic decision-making for all patients.

Mobile Health (mHealth) technology offers the potential to improve healthcare quality. This study aims to evaluate the effectiveness of mHealth interventions on the foot care behaviors, knowledge, and beliefs of patients with diabetes. Eleven databases were systematically searched for relevant RCTs between databases' inception and February 2025. We used Review Manager 5.4 software for meta-analysis. Subgroup analysis, publication bias tests, and sensitivity analysis were performed. The quality of the evidence was rated according to the GRADE. A total of eight studies were included in the meta-analysis. There was moderate-quality evidence that compared with other traditional foot care education, mHealth interventions can effectively enhance foot care behaviors, knowledge, and beliefs among patients with diabetes. Additionally, there was low-quality evidence that mHealth interventions can also improve patients' blood glucose levels. The findings provide preliminary reference for nurses to explore more effective auxiliary tools for patient education. However, the current evidence is of moderate and low quality, indicating that it remains necessary to focus on new evidence in the future. More high-quality RCTs are needed to explore long-term effects of mHealth interventions.

Hispanic older adults represent a rapidly growing demographic in the United States and may be disproportionately affected by cognitive impairment and depression. This study aimed to examine ethnic differences in the prevalence of cognitive impairment and depression among low-income Hispanic and non-Hispanic White older adults, and to explore the relationship between cognitive impairment and depressive symptoms within these groups.

This cross-sectional study included 157 older adults (age = 76.3 ± 6.7 years, female = 133), recruited from independent living facilities and low-income community centers in Central Florida. The sample consisted of Hispanic (n = 91) and non-Hispanic White (n = 66) older adults. Cognitive impairment was assessed using the Memory Impairment Screen, and depression was measured using the Patient Health Questionnaire-9 (PHQ-9). Chi-square tests and Mann-Whitney U tests were used to analyze group differences.

A significant difference in cognitive impairment prevalence was found between ethnic groups (χ² = 7.528, p = .006), with Hispanic participants showing higher rates. However, depression scores did not significantly differ between Hispanic and non-Hispanic White participants (U = 2930.50, p = .79), nor between those with and without cognitive impairment within each ethnic group (Hispanic: U = 839.00, p = .71; non-Hispanic White: U = 227.50, p = .93).

Cognitive impairment is more prevalent among low-income Hispanic older adults compared to their non-Hispanic White counterparts. These findings emphasize the need for culturally tailored interventions to improve cognitive health care access for older adults.

Although prior research has demonstrated enhanced striatal response when sharing rewards with close social connections, less is known about how individual differences affect ventral striatal (VS) activation and connectivity when experiencing rewards within social contexts. Given that self-reported reward sensitivity and level of substance use have been associated with differences in VS activation, we set out to investigate whether these factors would be independently associated with enhancements to neural reward responses within social contexts. In this pre-registered study, participants (N=45) underwent fMRI while playing a card guessing game in which correct or incorrect guesses resulted in monetary gains and losses that were shared evenly with either a close friend, stranger (confederate), or non-human partner. Consistent with our prior work, we found increased VS activation when sharing rewards with a socially close peer as opposed to an out-of-network stranger. As self-reported reward sensitivity increased, the difference in VS response to rewards shared with friends and strangers decreased. We also found enhanced connectivity between the VS and temporoparietal junction when sharing rewards with close friends as opposed to strangers. Finally, exploratory analyses revealed that as reward sensitivity and sub-clinical substance use increase, the difference in VS connectivity with the right fusiform face area increases as a function of social context. These findings demonstrate that responsivity to the context of close friends may be tied to individual reward sensitivity or sub-clinical substance use habits; together these factors may inform predictions of risk for future mental health disorders.

This convergent mixed method study examines the role of social support in the lives of minoritized emerging young adults with serious mental illness (YA-SMI), focusing on how they perceive and experience support from family, friends, and other sources. Data were gathered from 114 YA-SMI (ages 18-34) participating in a recovery program. Descriptive analyses revealed that 44% of participants reported family as their only source of support, while others relied on a combination of supports or reported no support. Ordinal logistic regression revealed that growing up in a household with mental illness was associated with lower odds of being in a higher support category, compared to no support. Qualitative interviews (n = 57) identified four themes: types of support, qualities of support by source, pathways to treatment, and loss. Findings suggest that YA-SMI benefit from diverse support, with non-family members providing crucial informational support. Implications for policy, practice and research are discussed.

In robot-assisted thoracoscopic (RATS) bronchial sleeve lobectomy, despite the continuous suturing (CS) technique's widespread adoption, the safety and advantages of the semi-continuous suturing (SCS) technique remain inconclusive.

Patients undergoing RATS bronchial sleeve lobectomy for central Non-Small Cell Lung Cancer (NSCLC) between January 2020 and December 2024 were retrospectively enrolled and stratified into two cohorts based on anastomotic technique: the CS group and the SCS group. Perioperative outcomes were compared between the two groups.

The SCS group (n = 18) demonstrated significantly shorter anastomotic time than the CS group (n = 14) (median 28 min [24-33] vs. 45 min [32-52]; p < 0.001), with a 21-min reduction in operative time (median 135 min [110-185] vs. 156 min [138-212]; p = 0.040). No statistically significant differences were observed in: overall complication rates (anastomosis-specific: 11.1% vs. 21.4%, p = 0.425; systemic: 22.2% vs. 42.9%, p = 0.212); 90-day mortality (0% vs. 7.1%, p = 0.467); late stenosis rate (0% vs. 7.1%, p = 0.249) or reoperation rate (5.6% vs. 14.3%, p = 0.401); postoperative recovery metrics (extubation time and hospital stay, p > 0.05).

SCS can safely reduce bronchial anastomosis time in RATS sleeve resection and is recommended as the preferred technique for optimizing operative efficiency.

Noncommunicable diseases (NCDs) are complex and chronic in nature, often requiring long-term follow-up and care, which can lead to increased healthcare costs. This study aimed to evaluate health-seeking behavior and out-of-pocket healthcare expenditures for NCDs among patients in Erbil, Iraq.

This cross-sectional study involved a convenience sample of adult patients with NCDs visiting a private internal medicine center in Erbil City. A questionnaire was used to collect data on sociodemographic characteristics, NCD characteristics, health-seeking behavior, and the average monthly cost of NCDs. Multiple quantile regression analysis was performed to examine the variables associated with the total cost.

Most participants get their NCD medicines from private pharmacies through out-of-pocket payments (96.0%). The median (IQR) cost of medications for NCDs per month was 70,000 (35,000-125,000) Iraqi Dinars (IQD), i.e., approximately US$48.3 (24.1-86.2). The median total out-of-pocket expenditures for all aspects of NCDs was 106,000 (60,000-184,500) IQD, i.e., approximately US$73.1 (41.4-126.9). Most participants indicated that out-of-pocket expenses for NCD treatment constitute an important financial burden on their households (74.4%). The total out-of-pocket expenditure for NCDs per month was statistically significantly higher among older age group (P < 0.001), those with no formal education (P = 0.002), those not working or with manual work (P = 0.003), those have more NCDs (P < 0.001), those with cardiovascular diseases (P < 0.001), those who get their medications from the private sector, those with better control of their NCDs (P = 0.002), those with complications of NCDs (P < 0.001), and those with good adherence (P = 0.001).

This study reveals the significant financial burden caused by out-of-pocket expenditures for NCD care. As most individuals with NCDs rely on private pharmacies for medication, the associated costs, particularly for those managing multiple conditions, represent a substantial challenge for households. There is a need for improved financial protection mechanisms and expanded access to affordable NCD care. Future research should examine the impact of health insurance coverage and public-sector interventions on reducing out-of-pocket expenditures and improving access to NCD care in Iraq.