Key bacterial vaginosis (BV)-associated bacteria implicated in biofilm formation include Gardnerella species, Prevotella bivia, and Fannyhessea vaginae. We investigated their spatial organization in the BV biofilm over time from longitudinal vaginal specimens obtained from women with incident BV (iBV) using peptide nucleic acid-fluorescence in situ hybridization (PNA-FISH). Heterosexual women with optimal vaginal microbiota self-collected vaginal specimens twice daily for 60 days or until iBV development (Nugent score 7-10 on ≥4 consecutive specimens). Women who developed iBV were matched to healthy controls by age, race, and contraceptive method. Gardnerella spp., P. bivia, and F. vaginae were quantified using PNA-FISH 2 days pre-iBV, the day of iBV, and 2 days post-iBV across five optical layers (z, z + 2, z + 4, z + 6, and z + 8 μm). Total counts of all three bacterial species were significantly higher on the day of iBV compared to 2 days pre-iBV (P = 0.011) and remained elevated 2 days post-iBV. Across most layers and time points, pooled mean Gardnerella spp. counts were significantly higher than F. vaginae counts (P ≤ 0.022-0.0003). On the day of iBV and 2 days post-iBV, pooled mean counts of Gardnerella spp. and F. vaginae progressively increased across most biofilm layers (P ≤ 0.043-0.0012). Controls had significantly lower counts of Gardnerella spp. and F. vaginae. P. bivia had low counts in all specimens. During the critical time period surrounding iBV, Gardnerella spp. are abundant throughout the developing biofilm and facilitate F. vaginae incorporation at later time points and higher biofilm layers. Additional research, including other Prevotella spp., is needed.IMPORTANCEBacterial vaginosis (BV) is the most common vaginal infection in reproductive-age women worldwide with a global prevalence of 30%. Recurrence rates can be up to 60% within 1 year of treatment. While BV is characterized as a polymicrobial biofilm infection, the exact etiology remains unknown. The BV biofilm may persist after antibiotic treatment, possibly due to incomplete eradication by current antimicrobial therapies, contributing to recurrent infection. Data are limited in evaluating the spatial formation of the BV biofilm around the time of incident BV. Providing a better understanding of this critical time period in incident BV pathogenesis is necessary to inform the development of prevention methods aimed at inhibiting biofilm formation and improving long-term treatment outcomes.

This essay aims to scientifically justify the incorporation of Michael Balint’s basic failure theory (BFT) into medical education. This theory postulates that human beings suffer a fault between their needs and what the environment provides during critical periods of development in childhood and possibly from intrauterine life. The fault can be biological, physical, psychological or social. The sooner the basic failure is compensated, the better the person’s subsequent health will be. Clinical illness, in this interpretation, is a symptom of an uncompensated basic failure. Balint proposed BFT in opposition to the theory of external agents penetrating the defenses of a basically healthy organism, which is usually taught in medical schools. BFT facilitates direct access to the person-centered clinical method, facilitates the approach through narrative-based medicine; and notably, admits compassion as a therapeutic element in the doctor-patient relationship. Conceptually, it clearly fits with salutogenic approaches such as “The natural history of health” that are emerging in medical education. The scientific foundations supporting TFB come from fields such as social genomics, sociology, and historical-cultural learning theory.

Childhood and adolescence are critical periods for the development of Executive Functions (EF), which underpin self-control, planning, and social adaptation, and are often compromised in children growing up in psychosocially vulnerable contexts. This study examined the effects of STap2Go, a fully digital, strategy-based EF training, on EF performance and self-perceived maladjustment in 36 at-risk children and adolescents compared with 32 controls. Participants completed pre- and post-intervention assessments using the Neuropsychological Assessment Battery of Executive Functions (BANFE-3) and the Multifactorial Self-Evaluative Test for Child Adaptation (TAMAI). Results showed a significant effect of training on global EF and on General Maladjustment, with improvements only in the intervention group. These findings support the inclusion of scalable, avatar-guided EF stimulation programs such as STap2Go within social inclusion pathways for youth in vulnerable situations.

Rheumatoid arthritis (RA) patients face significant psychological challenges alongside physical symptoms, necessitating a comprehensive understanding of how psychological vulnerability and adaptation patterns evolve throughout the disease course. This review examined 95 studies (2000-2025) from PubMed, Web of Science, and CNKI databases including longitudinal cohorts, randomized controlled trials, and mixed-methods research, to characterize the complex interplay between biological, psychological, and social factors affecting RA patients’ mental health. Findings revealed three distinct vulnerability trajectories (45% persistently low, 30% fluctuating improvement, 25% persistently high) and four adaptation stages, with critical intervention periods occurring 3-6 months post-diagnosis and during disease flares. Multiple factors significantly influence psychological outcomes, including gender (females showing 1.8-fold increased risk), age (younger patients experiencing 42% higher vulnerability), pain intensity, inflammatory markers, and neuroendocrine dysregulation (48% showing cortisol rhythm disruption). Early psychological intervention (within 3 months of diagnosis) demonstrated robust benefits, reducing depression incidence by 42% with effects persisting 24-36 months, while different modalities showed complementary advantages: Cognitive behavioral therapy for depression (Cohen’s d = 0.68), mindfulness for pain acceptance (38% improvement), and peer support for meaning reconstruction (25.6% increase). These findings underscore the importance of integrating routine psychological assessment into standard RA care, developing stage-appropriate interventions, and advancing research toward personalized biopsychosocial approaches that address the dynamic psychological dimensions of the disease.

Adolescence is a sensitive period for the emergence of psychopathology. During this time, physiological changes and environmental exposures jointly shape brain development and influence cognitive and personality maturation, collectively heightening vulnerability to mental disorders. However, the complexity of interactions between these factors has hindered a systems-level understanding of mental health and the causal roles of cognition and personality in psychopathology. In this study, we proposed a multifactorial causal framework integrating brain, pubertal, environmental, and behavioral factors to characterize heterogeneity in adolescent mental health trajectories at the individual level. We then investigated latent causal pathways linking cognition and personality to mental health outcomes and identified potential personalized intervention targets. Leveraging the Adolescent Brain Cognitive Development (ABCD) dataset (N = 4,501), we analyzed 165 behavioral pairs connecting cognition and personality traits to mental health symptoms. Using cross-sectional multivariate mediation and longitudinal interaction-inclusive analyses, we identified 68 behavioral pairs showing significant causal relationships, with brain and environmental exposures contributing to most pathways, while pubertal factors exhibited limited involvement. Individualized interpretive analyses further revealed 23 pairs suggesting potential interventions with response rates exceeding 50%. Among these, behavioral inhibition, negative urgency, and processing speed emerged as the most common intervention targets, whereas psychosis symptoms and attention problems were the most likely issues to improve. Overall, our study advances a comprehensive framework capturing the multifactorial and heterogeneous nature of adolescent mental health, delineates specific causal pathways from cognitive and personality traits to psychopathology, and provides a principled basis for potential individualized intervention strategies.

The landscape of trauma-focused interventions for young children has evolved significantly, though substantial gaps remain. Early childhood trauma exposure occurs during sensitive periods of brain development with potential lifelong consequences. However, these periods also present unique opportunities for intervention to redirect trajectories toward positive outcomes. Rapid neurodevelopmental changes across early childhood necessitate interventions specifically designed for evolving capacities rather than simply "scaled down" versions of adult treatments. A review focused exclusively on evidence-based interventions for young children is needed. This review represents a synthesis of the literature informed by our clinical and research expertise. We review interventions that (1) target trauma symptoms as primary outcomes, (2) were designed for children ages 0-8 years, (3) include substantive caregiver involvement, and (4) have empirical support from published randomized controlled trials or well-designed quasi-experimental studies. Our review revealed a tiered evidence base for young children, with the strongest support for interventions targeting specific age groups: Child-Parent Psychotherapy for infants and toddlers, Preschool PTSD Treatment for preschoolers, and Trauma-Focused CBT for early elementary children. Critical gaps include limited interventions for children under age 3, sparse evidence for interventions targeting noninterpersonal trauma, assessment challenges, particularly with longitudinal measurement across developmental transitions, and insufficient implementation research on disseminating interventions in community settings. By continuing to refine effective trauma interventions for our youngest children, we can alleviate immediate suffering and potentially prevent decades of associated difficulties across the lifespan. Future research priorities should include expanding the evidence base for existing interventions through well-powered trials with diverse samples, developing and testing preventive interventions delivered following potentially traumatic events, adapting established interventions for under-studied trauma types, and implementation research to support widespread adoption in real-world settings.

The preschool years are a critical period for developing fundamental movement skills (FMS), which are strongly linked to physical activity (PA). This study aimed to examine the associations between FMS and PA on weekdays and weekends among Chinese preschool children. A total of 364 preschoolers (mean age: 4.34 ± 0.74 years, 53% boys) participated. FMS were assessed using the Chinese Fundamental Movement Skills Test (CFMST), and PA was objectively measured with ActiGraph GT3X + accelerometers. Analyses were conducted separately for weekday and weekend, and PA was analyzed by intensity levels. Multilevel mixed-effects linear regression models were used to analyzed associations between FMS and PA, adjusting for age, sex, BMI and accelerometer wear time. Locomotor skills were significantly associated with higher weekday moderate-intensity PA (MPA, β = 0.29, p = 0.002), vigorous-intensity PA (VPA, β = 0.19, p = 0.004), and moderate-to-vigorous PA (MVPA, β = 0.45, p = 0.001). Object control skills were positively associated with weekday VPA (β = 0.10, p = 0.018), MVPA (β = 0.23, p = 0.050), and weekend MPA (β = 0.34, p = 0.014), MVPA (β = 0.53, p = 0.037). Stability skills were positively associated with weekday MPA (β = 0.08, p = 0.013), VPA (β = 0.05, p = 0.004), MVPA (β = 0.12, p = 0.005), weekend MPA (β = 0.10, p = 0.007), and MVPA (β = 0.15, p = 0.003). FMS were significantly associated with PA levels across both weekdays and weekends. Locomotor emerged as key determinants of weekday PA, while object control skills and stability skills were positively linked to both weekday and weekend PA. These findings highlight the importance of developing multiple dimensions of FMS to support PA participation in early childhood.

Converging evidence suggests that understanding the human brain requires more than just examining pairwise functional brain interactions. The human brain is a complex, nonlinear system, and focusing solely on linear pairwise functional connectivity often overlooks important nonlinear and higher-order interactions. Infancy is a critical period marked by significant brain development that could contribute to future learning, health, and life success. Exploring higher-order functional relationships in the brain can provide insight into brain function and development. To the best of our knowledge, there is no existing research on multiway, multiscale brain network interactions in infants. In this study, we comprehensively investigate the interactions among brain intrinsic connectivity networks (ICNs), including both pairwise (pair-FNC) and triple relationships (tri-FNC). We focused on a dataset of typically developing infants scanned during the first six months of life-a critical period for brain maturation. In total, 71 infants (aged 4-179 days) contributed 126 scans (76 from 41 males, 50 from 30 females). Our results revealed significant hierarchical, multiway, multiscale brain functional network interactions in the infant brain. These findings suggest that tri-FNC provide additional insights beyond what pairwise interactions reveal during early brain development. The tri-FNC predominantly involve the default mode, sensorimotor, visual, limbic, language, salience, and central executive domains. Notably, these triplet networks align with the classical triple network model of the human brain, which includes the default mode network, the salience network, and the central executive network. This suggests that the brain network system might already be initially established during the first six months of infancy. We also found that pair-FNC were less effective at detecting these networks. The present study suggests that exploring tri-FNC can offer additional insights beyond pair-FNC by capturing higher-order nonlinear interactions, potentially yielding more reliable biomarkers to characterize developmental trajectories.

Abstract Aim Adolescence is a critical period during which health behaviors and school participation intersect, influencing long-term health outcomes. This study examines the associations between health behaviors, mental well-being, health outcomes, and reading and writing difficulties (RWDs) among Danish adolescents. Subject and methods This cross-sectional study analyzed data from the 2017 Future Occupation of Children and Adolescents (FOCA) cohort, including 13,100 ninth-grade students across Denmark. All data except sex were self-reported. Logistic regression models estimated odds ratios (ORs), adjusted for socioeconomic status and sex. Results Poorer self-rated health (OR = 1.50; 99% confidence interval [CI] 1.25–1.80), poor mental health (OR = 1.99; 99% CI 1.57–2.52), increased smoking (OR = 1.14; 99% CI 1.02–1.28), lower life satisfaction (OR = 1.15; 99% CI 1.10–1.19), lower self-efficacy (OR = 1.08; 99% CI 1.05–1.12), higher body mass index (BMI) (OR = 1.06; 99% CI 1.04–1.08), and lower levels of leisure-time physical activity (OR = 1.05; 99% CI 1.03–1.08) were all associated with higher odds of reporting having RWDs. No associations with alcohol use were found. Socioeconomic status and sex did not substantially confound the results, except for regular drug and hash use. Conclusion RWDs and health-related outcomes appear to be associated among adolescents. Prospective studies are needed to determine whether the associations imply a causal relation that could inform the development of targeted interventions addressing both educational challenges and health risks.

Background/Objectives: Cardiac remodeling post-myocardial infarction is a critical process determining patient prognosis. Poland’s Coordinated Specialist Care program enables early cardiac rehabilitation (CSC-Infarct) during peak remodeling period. This study evaluated the safety and effectiveness of very early cardiac rehabilitation initiated during peak remodeling (mean 16.8 ± 3.4 days post- ST-elevation myocardial infarction [STEMI]) within the CSC-Infarct program. We examined outcomes following two training modalities—interval and continuous—applied according to clinical guidelines based on baseline exercise capacity. Methods: We enrolled 288 patients (135 women, 153 men, age 59.7 ± 9.8 years) after first STEMI into a 24-day rehabilitation program (5 sessions/week) within CSC-Infarct. Patients received either interval training (n = 127) or continuous training (n = 161) according to National Health Fund protocols. Hemodynamic, metabolic (metabolic equivalents [MET], maximal oxygen uptake [VO2max]), and functional parameters (6-minute walk test [6MWT]) were assessed pre- and post-rehabilitation. Results: Both groups showed significant improvement in most parameters. The continuous training group achieved higher final MET values (8.9 ± 2.5 vs. 6.5 ± 1.9; p < 0.001), VO2max (31.0 ± 8.8 vs. 22.9 ± 6.5 mL/kg/min; p < 0.001), and 6MWT distance (530.9 ± 108.9 vs. 455.6 ± 104.3 m; p < 0.001). Significant improvement in heart rate recovery (HRR), indicating autonomic balance, was observed only in the continuous training group (p = 0.026), not in the interval group (p = 0.290). Conclusions: Early rehabilitation within CSC-Infarct (mean 16.8 days post-infarction) during intensive remodeling is safe and effective. Both training modalities produced clinically significant improvements when appropriately matched to patient baseline capacity. Continuous training showed additional benefit in autonomic balance (HRR improvement), while interval training achieved substantial relative gains (+11.8% in 6MWT) in lower-capacity patients. The CSC-Infarct program provides optimal timing for rehabilitation implementation during the critical cardiac remodeling period.

Puberty is a critical transitional period in individual development marked by significant biological, psychological, and social changes. This study aims to determine the differences in anxiety levels when facing puberty between male and female adolescents. The method used is a quantitative approach with a comparative design. The research population consisted of students aged 12 to 15 years from SMPN 159 West Jakarta. A sample of 214 students was selected using stratified random sampling. Data were collected through an anxiety scale questionnaire developed by the author based on Spielberger's anxiety theory. One-way ANOVA analysis showed a significant difference in anxiety levels between male and female adolescents. Female adolescents tend to have higher anxiety levels than male adolescents. This study contributes to the understanding of developmental psychology and serves as a basis for psychological interventions in schools.

Purpose: Adolescence represents a critical period for establishing lifelong healthy dietary behaviors; however, adherence to the Mediterranean Diet (MedDiet) during this stage remains suboptimal and is affected by various factors. This study aimed to evaluate adherence to MedDiet in Turkish adolescents and investigate its associations with socioeconomic status, eating habits, and anthropometric measurements. Methods: A cross-sectional descriptive study was conducted involving 273 high school students (mean age 15.5 ± 1.1 years). Data were collected via face-to-face interviews using a structured questionnaire that encompassed sections on general information, eating habits, and the Mediterranean Diet Quality Index (KIDMED). Anthropometric data were also measured by the researchers. Statistical analyses were performed using IBM SPSS Statistics 23.0, with significance set at p

With the continuous increase in coal mining depth and intensity, the stress distribution in surrounding rock during multi-working face coordinated mining has become increasingly complex, significantly affecting the safe and efficient extraction of coal resources. This study takes the 22,214 and 22,215 working faces in Liuta Mine as the engineering background and employs FLAC3D numerical simulation to analyze the evolution of mining-induced stress and overburden fracture characteristics during coordinated mining of two adjacent faces. By establishing the stress superposition intensity index I σ and the plastic zone evolution index I P , the mechanisms of stress superposition and cumulative plastic damage in multi-working face mining were quantitatively revealed. Simulation results indicate that the stress and plastic zone in the first-mined face exhibit a symmetric distribution, with the peak abutment pressure increasing as the face advances, reaching a maximum stress concentration factor of 1.8. In contrast, the subsequent face, influenced by the adjacent goaf and the coal pillar and key stratum structure, shows significant asymmetry in both strike and dip stress distributions. The stress concentration factor on the coal pillar side reaches a maximum of 2.3, and the stress increment within 0–40 m ahead of the face is approximately 1.3–1.4 times that of the first-mined face. The multi-working face advance process demonstrates a three-stage evolution characterized by low superposition, medium superposition, and strong superposition. At an advance distance of 2,400 m, corresponding to the transition of the main key stratum from a suspended state to a fractured voussoir beam structure, the stage represents a strong superposition zone of stress and plastic deformation. In this zone, the plastic area on the coal pillar side connects with the goaf of the first-mined face, leading to a significant increase in the risk of surrounding rock instability. The study elucidates the mechanisms of stress transfer and plastic zone interconnection during coordinated multi-working face mining and identifies the strong superposition stage as a critical period for rockburst prevention and control. Accordingly, a combined strategy of differentiated support and directional pressure relief is proposed to maintain surrounding rock stability, with emphasis on monitoring the strong plastic deformation superposition zone. The findings provide a theoretical reference for mining-induced stress analysis, stability control of surrounding rock, and rockburst prevention under similar geological and mining conditions.

ABSTRACT Background Amblyopia is a leading cause of preventable visual impairment, particularly when diagnosis and treatment are delayed beyond the critical period of visual development. Aim To analyze the demographic profile, clinical types, refractive status, and response to therapy in patients diagnosed with amblyopia at a tertiary care hospital. Materials and Methods This retrospective study analyzed hospital records of amblyopic patients attending the Ophthalmology Department of Tezpur Medical College & Hospital between January 2023 and December 2025. Patients were categorized based on age, sex, subtype of amblyopia, refractive status, and treatment response. Improvement was defined as a gain of ≥2 Snellen lines in best-corrected visual acuity (BCVA). Successful treatment was defined as BCVA of 6/9 ±2 Snellen lines or equal vision in both eyes. Results A total of 108 patients (63 males, 45 females) with amblyopia were identified. The mean age was 26.5 years. Anisometropic amblyopia (46.3%) was the most common subtype, followed by iso-ametropic (23.1%) and strabismic amblyopia (18.5%). Only 46.3% of patients presented with complaints related to the amblyopic eye. Amblyopia therapy was instituted in 18 patients, of whom 11 (61.1%) achieved successful visual outcomes. Maximum improvement was observed in myopic anisometropic amblyopia, while the least improvement was seen in strabismic and stimulus deprivation amblyopia. Conclusion Late presentation and lack of awareness remain major barriers to successful amblyopia management. Early screening, timely refractive correction, and structured amblyopia therapy significantly improve visual outcomes, particularly in younger patients. Keywords: Amblyopia, Anisometropia, Strabismus, Visual deprivation, Occlusion therapy

Neuroplasticity, the brain's adaptive ability to restructure and reorganize itself, represents one of the most fascinating aspects of the developing brain. Neuroplasticity is maximal during the "first 1000 days" (conception through two years of life), presenting both unique opportunities and vulnerabilities. While neonatal neurology often focuses on the "symptomatic minority" presenting early after birth, there remains an "unrecognized majority" of children who will present with disorders later in childhood. For clinicians working with newborns and young infants, a comprehensive understanding of developmental principles provides the foundation for knowledge to optimize early intervention strategies. This review focuses on the biological basis of neuroplasticity and metaplasticity in the neonatal brain, as well as their role in neurodevelopment. We examine how the "dynamic neural exposome" (the full mix of biological and environmental influences the brain is exposed to over time) and "toxic stressor interplay" (the combined effect of multiple stressors such as pain, infection, and inflammation) influence these processes, often leading to "ontogenetic adaptations" (short-term survival-driven changes in brain wiring that may have long-term consequences). We outline mechanisms shaping early brain development, describe how early experiences and interventions influence outcomes, and emphasize prioritizing prevention over later rescue to improve neurodevelopmental outcomes. IMPACT: The article provides a high-level framework that links the brain's response to experience and injury directly to clinical implications in neonatology, expanding the focus to the "first 1000 days". The effectiveness of interventions hinges on their timing relative to developmental critical and sensitive periods, alongside the dynamic interplay between genetic and environmental influences (including the Maternal-Placental-Fetal triad) on brain development. Neuroplasticity presents both a window for recovery and adaptation, and a susceptibility to adverse experiences, emphasizing the need for evidence-based neuroprotective and neurodevelopmental care that prioritizes preventive approaches to improve long-term outcomes.

Introduction: Laryngoscopy and tracheal intubation inevitably trigger a sympathoadrenal response, manifesting as tachycardia and hypertension. While video laryngoscopy (VL) offers improved glottic visualization compared to direct laryngoscopy (DL), its efficacy in specifically attenuating this hemodynamic stress remains a subject of debate. This study investigates whether VL provides superior hemodynamic stability during the critical post-intubation period by analyzing the rate pressure product (RPP) and temporal hemodynamic interactions. Methods: In this prospective, single-blind, randomized controlled trial, 40 adult patients (ASA I-II) undergoing elective surgery were allocated to either Group VL (GlideScope, n=20) or Group DL (Macintosh, n=20). Anesthesia was strictly standardized with Fentanyl 2 mcg/kg, Propofol 2 mg/kg, and Atracurium 0.5 mg/kg. Hemodynamic parameters, including systolic blood pressure (SBP), mean arterial pressure (MAP), and heart rate (HR), were recorded at baseline (T0) and at 1 (T1), 2 (T2), and 5 (T5) minutes post-intubation. The primary analysis utilized a general linear model (Repeated Measures ANOVA) to assess Time-Group interactions, corrected for sphericity. Results: Demographics were homogeneous between groups. A significant Time-Group interaction was observed for MAP (p less than 0.001), indicating a blunted pressor response curve in the VL group. Heart Rate at 1-minute post-intubation was significantly lower in Group VL (75.45 plus or minus 11.23 bpm) compared to Group DL (90.15 plus or minus 15.22 bpm; p equals 0.001). Analysis of the rate pressure product revealed that Group DL approached ischemic thresholds, whereas Group VL maintained significantly lower myocardial workload at minutes 1 and 2 (p less than 0.01). Conclusion: Video laryngoscopy significantly attenuates the reflex tachycardia and arterial pressure surge associated with tracheal intubation compared to direct laryngoscopy. VL is recommended to minimize cardiovascular stress in susceptible surgical populations.

Introduction: Nutritional status during the critical period of 6–24 months relies heavily on appropriate Complementary Feeding (MP-ASI), a practice directly modulated by maternal health literacy. Objective: This study analyzed the correlation between maternal knowledge levels and complementary feeding patterns with the nutritional status of children aged 6–24 months in Central Lombok Regency. Method: This cross-sectional study involved 73 mothers selected via consecutive sampling in the Penujak Public Health Center area. Maternal knowledge and feeding patterns were assessed using validated questionnaires, while nutritional status (Length-for-Age) was derived from secondary data. Data were analyzed using the Spearman’s rho test. Result and Discussion: Stunting prevalence was critically high at 57.5%. Most mothers (50.7%) had 'moderate' knowledge. Bivariate analysis revealed a significant positive correlation between maternal knowledge and nutritional status (r=0.297; p=0.011). Furthermore, a moderately strong correlation was found between complementary feeding patterns and nutritional status (r=0.531; p<0.001). Conclusion: Complementary feeding practices serve as a stronger determinant of nutritional status than knowledge alone. Interventions must shift from passive education to operational strategies, such as cooking demonstrations of local menus and the reactivation of Toddler Mothers’ Classes (Kelas Ibu Balita) to improve practical feeding skills.

Adolescence is a critical period for mental health vulnerability alongside rising digital media exposure. Current evidence often fails to distinguish the distinct roles of leisure screen time (LST) quantity and addictive patterns like internet gaming disorder (IGD) on a comprehensive range of mental health outcomes. This study aimed to investigate the independent and joint associations of LST and IGD with multiple mental health conditions among Chinese adolescents. We conducted a school-based, cross-sectional survey in Sichuan Province, China. Participants were recruited by random cluster sampling from 20 public schools. The sample comprised 13,240 adolescents (6659/13,240, 50.3% girls) with a mean age of 15.4 (SD 1.6) years. LST was self-reported, and IGD was evaluated using the Internet Gaming Disorder Scale-9 Item Short Form (IGDS9-SF). Mental health outcomes included overall mental health status and 5 specific diseases: psychological distress, depression, paranoia, insomnia, and suicidal ideation, all assessed using validated scales. The prevalence of excessive LST, IGD, and any mental health disorder was 48.2% (6378/13,240; 95% CI 47.3%-49.0%), 1.4% (188/13,240; 95% CI 1.2%-1.6%), and 55.8% (7387/13,240; 95% CI 54.9%-56.7%), respectively. After adjustment, excessive LST (odds ratio [OR] 1.18, 95% CI 1.09-1.27) and IGD (OR 6.58, 95% CI 5.02-8.62) were independently associated with poor mental health. A dose-response relationship existed for LST quartiles (Q2: OR 1.15, 95% CI 1.04-1.26; Q3: OR 1.24, 95% CI 1.12-1.37; Q4: OR 1.31, 95% CI 1.18-1.46; Ptrend<.001). Excessive LST was associated with depression (OR 1.16, 95% CIs 1.05-1.29), paranoia (OR 1.22, 95% CI 1.11-1.34), and suicidal ideation (OR 1.15, 95% CI 1.04-1.28), while IGD was associated with all 5 disorders, most notably depression (OR 6.43, 95% CI 4.56-9.06) and paranoia (OR 5.77, 95% CI 4.05-8.21). IGD consistently demonstrated stronger associations than LST: psychological distress (OR 4.40, 95% CI 3.12-6.19 vs OR 1.14, 95% CI 0.98-1.33), depression (OR 6.43, 95% CI 4.56-9.06 vs OR 1.16, 95% CI 1.05-1.29), paranoia (OR 5.77, 95% CI 4.05-8.21 vs OR 1.22, 95% CI 1.11-1.34), insomnia (OR 2.90, 95% CI 2.09-4.05 vs OR 1.12, 95% CI 102-1.22), and suicidal ideation (OR 3.85, 95% CI 2.76-5.37 vs OR 1.15, 95% CI 1.04-1.28). Adolescents with both excessive LST and IGD demonstrated the highest odds of mental health disorders (OR 7.35, 95% CI 5.29-10.22). No significant interaction was found on additive or multiplicative scales. Both excessive LST and IGD are independently associated with mental health disorders in adolescents, with IGD showing a substantially stronger association. This study is distinct from prior research by simultaneously investigating both screen time quantity and addictive usage patterns, and by comprehensively assessing 5 distinct mental health outcomes. Longitudinal studies are needed to better understand the long-term effects.

Prevalence of and factors associated with anxiety among school going adolescents analysis from 59 countries.

Background and objective Childhood, adolescence, and emerging adulthood represent critical transitional periods characterized by rapid biological, psychological, and social development, each of which may distinctly influence diet–mood interactions. To date, no study has concurrently examined the association between dietary diversity and depressive symptoms across the full developmental spectrum spanning these life stages. As a result, age-specific vulnerabilities and potential windows for intervention remain poorly understood. Using a large and diverse sample of Chinese children, adolescents, and university students, this cross-sectional study aimed to explore the relationship between dietary diversity and depressive symptoms across these key developmental periods. The findings may help inform the design of targeted, developmentally appropriate nutritional strategies for depression prevention. Materials and methods In this cross-sectional investigation, a total of 11,856 Chinese college students and 1,281 children and adolescents were enrolled. All participants completed self-administered questionnaires assessing demographic characteristics, lifestyle behaviors, dietary diversity, and depressive symptoms [evaluated with the Patient Health Questionnaire-9 (PHQ-9) and the 20-item Zung Self-Rating Depression Scale (SDS)]. Multivariable logistic regression analyses were employed to examine the associations between dietary diversity and depressive symptoms, with adjustment for relevant confounding factors. Results The prevalence of depressive symptoms was 18.9% (2,245/11,856) among college students and 4.7% (60/1,281) among children and adolescents. Among college students, a significant inverse relationship was observed between dietary diversity scores and depressive symptoms. Compared to participants with a score of 0, the adjusted odds ratios decreased progressively with higher scores, ranging from OR = 0.94 (95% CI: 0.39, 2.30) for a score of 1 to OR = 0.33 (95% CI: 0.13, 0.81) for a score of 9. Similarly, among children and adolescents, higher dietary diversity was associated with markedly lower odds of depressive symptoms, with ORs declining from 0.164 (95% CI: 0.007, 3.837) for one food score to 0.026 (95% CI: 0.002, 0.390) for seven food scores, relative to the zero-score reference group. In analyses of specific food groups, college students showed significant inverse associations between depressive symptoms and consumption of vegetables (OR = 0.67, 95% CI: 0.55, 0.81), fruits (OR = 0.78, 95% CI: 0.70, 0.88), red meat (OR = 0.85, 95% CI: 0.75, 0.95), and soy products (OR = 0.89, 95% CI: 0.80, 0.99). Among children and adolescents, significant associations were observed for multiple dietary factors, with inverse associations for fruit intake ( P = 0.019) and breakfast consumption ( P &amp;lt; 0.001), and positive associations for sugar-sweetened beverages ( P = 0.025), fried foods ( P &amp;lt; 0.001), fast food ( P &amp;lt; 0.001), and processed foods ( P = 0.033). Conclusions This study establishes a significant inverse relationship between dietary diversity and depressive symptoms. The results support the integration of dietary diversity into public health recommendations and behavioral interventions. Specifically, fostering diverse and healthy eating patterns emerges as a promising, practical strategy for the prevention of depressive symptoms, underscoring the role of nutrition in mental well-being.