The metabolic mechanisms linking prenatal particulate matter (PM) to fetal growth remain unclear. A prospective cohort of 616 mother-fetus pairs in Guangzhou had ultrasound-based fetal growth parameters repeatedly measured from mid to late pregnancy. Fetal head circumference (HC), abdominal circumference (AC), femur length (FL), and biparietal diameter (BPD) were standardized as z-scores. Estimated fetal weight (EFW) trajectories were classified as average, slow, and rapid growth. Residential PM₁, PM_2.5, and PM₁₀ were assessed with 1 km spatiotemporal models. Multinomial logistic regression analyzed PM-EFW trajectory associations. Generalized estimating equations evaluated PM-fetal growth z-score relationships. Maternal plasma glucose and insulin levels at mid-pregnancy were examined as intermediate factors. Each 5 μg/m³ increase in PM was associated with higher odds of rapid EFW growth versus average growth (OR _PM1 = 1.56, 95% CI: 1.03, 2.37; OR _PM2.5 = 1.44, 95% CI: 1.10, 1.88; OR _PM10 = 1.28, 95% CI: 1.05, 1.56). Positive associations were also observed for BPD, HC, and AC z-scores, with PM₁ showing the numerically larger effect estimates. Maternal fasting plasma glucose and insulin resistance may partly explain the observed associations of PM exposure with rapid EFW growth and fetal growth parameters, with estimated proportions of 5.0-29.4%. This study highlights the potential risk of accelerated fetal growth associated with maternal PM exposures, and maternal glucose metabolism may represent a plausible pathway.

Background and Clinical Significance: This report investigates the complex intersection of macrostructural neuroprotection and cortical hyperexcitability during long-acting atypical antipsychotic maintenance. We present a novel clinical case demonstrating an apparent absence of detectable cerebellar vermis atrophy progression during long-acting injectable (LAI) aripiprazole maintenance, which temporally coincided with the emergence of a potential epileptogenic risk in an adolescent with bipolar disorder (BD) and cannabis use disorder. Beyond motor precision, the vermis modulates emotional-cognitive networks; deficits in these circuits impair impulse control, frequently driving comorbid substance use in youth. Case Presentation: A 16-year-old female with BD and cannabis use disorder presented with pronounced cerebellar and vermis atrophy on brain CT during an acute behavioral crisis. Following diagnostic reformulation, maintenance therapy was initiated via off-label monthly LAI aripiprazole (400 mg) alongside lithium. At 9-month follow-up, psychiatric relapses and cannabis use remitted completely. Repeat CT suggested macrostructural stability with zero apparent atrophy progression. However, during the 9th month, she abruptly developed daily generalized myoclonus. An awake electroencephalogram (EEG) revealed intense cortical hyperexcitability, documenting frequent interictal and ictal epileptiform discharges with generalized 3-4 Hz spike-wave complexes synchronized with the clinical myoclonus. Introduction of levetiracetam (500 mg BID) and cessation of adjunct methylphenidate led to complete clinical and neurophysiological remission. Conclusions: LAI aripiprazole may favorably influence the macrostructural trajectory of the cerebellum/vermis in adolescent BD, suggesting volume stabilization. However, clinicians must monitor for a drug-induced lowering of the seizure threshold, where macrostructural volume preservation coexists with microstructural electrical destabilization.

Background: Infertility is a global public health problem among males, with asthenozoospermia representing the most common cause. Since flagellar activity is vital for proper fertilization, identification of the mechanisms controlling this process is crucial. Microtubules are necessary for sperm functionality; however, their regulatory proteins in humans require further research. DCDC2C belongs to the doublecortin domain-containing family and has a role in microtubule stabilization; therefore, DCDC2C could affect the sperm flagellar structure. Objectives: The goal of the present study was to examine the presence and possible relationship between DCDC2C expression and sperm motility in asthenozoospermia. Materials and Methods: This study involved sixty men from December 2024 to December 2025. The sperm samples were processed according to the WHO criteria (6th ed.). Conventional sperm characteristics, biochemical indicators of seminal plasma, DNA fragmentation, and chromatin condensation were evaluated. Immunofluorescence staining for DCDC2C was performed, especially with respect to flagellar localization. Results: DCDC2C-positive spermatozoa were significantly more common in the normozoospermic group (78.93 ± 1.67%) than in the asthenozoospermic group (17.27 ± 2.23%; p < 0.0001). No significant differences were found for seminal biochemical markers, sperm DNA fragmentation, or chromatin condensation. Discussion: Reduced detectable distal flagellar DCDC2C immunoreactivity was associated with asthenozoospermia. Conclusions: DCDC2C protein expression is highly correlated with sperm movement, indicating that DCDC2C is a potential molecular marker for the diagnosis of asthenozoospermia.

Background/Objectives: Postpartum depressive symptoms are a major maternal mental health concern associated with adverse outcomes for mothers and infants. Although biological, psychological, and social factors have been associated with postpartum depressive symptoms, limited evidence has examined their interrelationships within a theoretically grounded framework among Thai mothers. This study aimed to test a hypothesized Stress Process Model of factors associated with postpartum depressive symptoms among Thai mothers using structural equation modeling (SEM). Methods: A cross-sectional study was conducted among 462 Thai mothers attending routine 4-6-week postnatal follow-up clinics at three tertiary hospitals in Northern Thailand. Participants were recruited using proportional allocation and consecutive sampling. Data were collected between April and June 2025 using standardized measures of postpartum depressive symptoms and standardized measures of self-perceived burden, parenting stress, social support, self-esteem, mastery, and coping, together with demographic and clinical data. Data were analyzed using descriptive statistics and SEM. Results: Using the prespecified Edinburgh Postnatal Depression Scale cutoff score of ≥11, 30.95% of participants screened positive for probable postpartum depressive symptoms. The final structural model demonstrated acceptable fit to the data (χ²/df = 2.95, RMSEA = 0.07, CFI = 0.94, TLI = 0.92, and SRMR = 0.05) and explained 65.10% of the variance in postpartum depressive symptoms. Self-perceived burden and parenting stress showed significant positive direct associations with postpartum depressive symptoms, whereas social support showed significant inverse direct and indirect associations. Perinatal complications were directly associated with postpartum depressive symptoms and indirectly associated through self-perceived burden and parenting stress. Mastery also showed a significant inverse indirect association. Conclusions: The findings support theoretically specified associations consistent with the Stress Process Model. Because all variables were assessed concurrently, the identified pathways should be interpreted as statistical associations rather than evidence of temporal ordering or causal mechanisms.

Parkinson's disease (PD) is a neurodegenerative disorder caused by the loss of dopaminergic neurons. Its symptoms affect both motor functions-such as bradykinesia, rigidity, resting tremor, and postural instability-and non-motor functions, including neuropsychiatric issues, sleep disorders, and constipation. Drawing on the literature, the following topics were developed and presented: Pathophysiology; Treatment; Neuropsychiatric and Cognitive Function; Sleep Challenges; Exercise and Movement; Striving for Wellness; and Obstacles/Paths Forward. These seven categories form the foundation of this review, which centers on four main areas related to PD: dopamine biology and pathophysiology; management of key motor and non-motor symptoms; strategies for achieving wellness; and unresolved issues in PD. The complexity of PD's clinical features is highlighted by describing patient-healthcare provider interactions, elucidating disease mechanisms, managing motor and non-motor symptoms, highlighting the benefits of exercise, emphasizing the importance of sleep, addressing mental health challenges and cognitive changes, fostering a hopeful and resilient mindset, potentially slowing disease progression, treating comorbidities, and promoting overall wellness. Although there have been tremendous advances in the basic science and clinical management of PD in recent years, PD remains incurable. Thus, we describe several roadblocks that have hindered progress in understanding PD. Only by integrating historical insights with the latest PD advances can we acquire the knowledge needed to change the disease's trajectory. Finally, this review aims to provide a meaningful summary for healthcare professionals (and students) caring for patients with PD.

Psychiatric comorbidity has been associated with worse perioperative outcomes and greater healthcare utilization after spine surgery.

This study compared complications and healthcare utilization among posterior cervical decompression and fusion (PCDF) patients with depression, psychotic disorders, or no mental-health diagnosis.

Retrospective cohort analysis of the National Inpatient Sample from 2016 to 2022.

The database was queried for elective adult PCDF encounters. Mental-health exposures were defined using Elixhauser indicators for depression and psychoses. Outcomes included medical complications, non-routine discharge, inpatient mortality, length of stay (LOS), and costs.

Chi-square and multivariate logistic regression analyses were performed. Significance was set at the P < 0.05 level.

We identified 167,480 weighted admissions: 129,205 with no mental-health diagnosis, 32,500 with depression, and 5,775 with psychotic disorders. Depression was associated with higher odds of cardiovascular complications (odds ratio [OR]: 1.20, P < 0.001), mechanical complications (OR: 1.24, P < 0.001), a composite adverse-event outcome (OR: 1.17, P < 0.001), and nonroutine discharge (OR: 1.12, P < 0.001). Psychotic disorders were associated with higher odds of mechanical complications (OR: 1.44, P = 0.002), nonroutine discharge (OR: 1.32, P < 0.001), and inpatient mortality (OR: 2.33, P = 0.043). Costs were higher with depression and highest with psychotic disorders ($39,564 vs. $40,787 vs. $42,362; P < 0.001). LOS was higher with depression and highest with psychotic disorders (4.10 vs. 4.36 vs. 4.81 days; P < 0.001).

Depression and psychotic disorders are common in PCDF and are linked to worse outcomes and higher resource use.

Clinical trials of medication for psychosis focus on symptom reduction or relapse as the primary outcome. Broader consumer definitions of recovery that emphasize quality of life, functioning, and treatment tolerability are rarely incorporated into primary trial outcomes. The aim was to co-design a Desirability of Outcome Ranking (DOOR), a novel primary outcome that integrates multiple consumer and clinician priorities in relation to antipsychotic medication trials.

Through an iterative co-design process, clinicians and consumers (young people and families with lived experience of psychosis) first rated outcomes of greatest personal and clinical importance for medication trials. The top three were quality of life, clinical symptoms, and side effects. Consumers then completed a preliminary survey, co-design focus groups, and written feedback to create the DOOR.

A final DOOR with 48 ordinal levels was created. Consumers prioritized quality of life, but only when symptoms and/or side effects remained within tolerable (mild-moderate) ranges. Levels 1-12 represented the most desirable outcomes, characterized by high/moderate quality of life with minimal-to-mild symptoms/side effects. Levels 13-24 reflected moderate/high quality of life with a mixture of symptom/side-effect outcomes. Levels 25-36 reflected low/moderate quality of life with generally lower symptoms/side effects. Levels 37-48 were least desirable, characterized by low/moderate quality of life with generally moderate/severe symptoms/side effects.

This co-designed novel DOOR integrates multiple consumer and clinician preferred constructs into a single holistic outcome. Examining its performance and interpretability in clinical trials of medication for psychosis is warranted.

Depression and anxiety are common mental disorders globally but often overlooked in low- and middle-income countries (LMICs), with limited population-level evidence on the role of household environmental conditions (HECs), especially for women. This study examined associations of HECs with depression and anxiety among women in Bangladesh.

This cross-sectional study analysed data from ever-married women in the 2022 Bangladesh Demographic and Health Survey. Depression and anxiety symptoms were measured using validated PHQ-9 and GAD-7 scales. Exposures included seven HEC indicators-housing materials, overcrowding, household air pollution (HAP), water source and treatment, sanitation, and handwashing facilities-and a cumulative HEC score. Associations were assessed using multinomial logistic regression and reported as adjusted risk ratios (aRR) with 95% confidence intervals (95% CI), adjusting for age, education, employment, place and duration of residence, etc.

Among 19,012 women, prevalence of probable depression and generalised anxiety disorder (GAD) was 5·0% and 4·4%, respectively. More than half of households had ≥3 poor HECs. Compared with women in households with ≤1 poor HEC, those with three (aRR: 1·30, 95% CI: 1·13-1·83) or ≥4 poor HECs (aRR: 1·31, 95% CI: 1·02-1·67) had higher risk of depression but not GAD. High HAP exposure was associated with both depression (aRR: 1·58, 95% CI: 1·01-2·45) and GAD (aRR: 1·61, 95% CI: 1·02-2·57). Overcrowding was associated with probable GAD (aRR: 1·32, 95% CI: 1·07-1·63), and poor sanitation with depression (aRR: 1·21, 95% CI: 1·05-1·39) only.

Poor HECs are potential contributors to depression and anxiety among Bangladeshi women. Integrating environmental improvements, particularly reducing HAP, improving sanitation, and reducing household overcrowding, into mental health prevention strategies may complement existing efforts to reduce the burden of common mental disorders in Bangladesh and other similar LMICs.

The work was supported by UKRI Medical Research Council grant (grant no: MC_UU_00032/6).

To investigate factors associated with anxiety, depressive symptoms, and cognitive impairment in individuals with hypertension.

A multicenter, large-sample cross-sectional study was conducted on 1,915 essential hypertension patients from multiple hospitals in Shandong Province (May 2022-July 2024). They were divided into four groups by Mini-Mental State Examination, Hamilton Anxiety and Depression Scales: hypertension alone (n = 1,350), with cognitive impairment (n = 191), with anxiety/depression (n = 309), and with all three conditions (n = 65). Demographics, clinical indices, lifestyle, sleep quality, and treatment information were collected. Univariate analysis, binary logistic regression, and ROC curves were used to examine these factors.

Independent risk factors for hypertension patients with anxiety/depression included waist circumference (OR=1.06), heart rate (1.02), education level, alcohol cessation (3.1), usual systolic blood pressure (1.02) and poor sleep; protective factors included age (0.94), height (0.96), occasional drinking (0.25), hypertension family history (0.15) and lower LDL-C (0.73). For hypertension patients with all three conditions, risk factors were waist circumference (1.07) and poor sleep. Lower LDL-C (0.62) was a protective factor. ROC curves showed good discriminative capacity (AUC=0.895, 0.887).

Among individuals with hypertension, comorbid anxiety, depression, and cognitive impairment are associated with poorer sleep quality and elevated waist circumference. Lower LDL-C and appropriate lipid management may have protective effects.