Increased risk of fourteen mental disorders in people with dissociative experiences: A nationwide population-based retrospective cohort study.

Therapist memory for treatment contents: Implications for patient outcomes.

Factors associated with dysphagia among community-dwelling Palestinian older adults.

Major Depressive Disorder (MDD) is common and burdensome. Repetitive Transcranial Magnetic Stimulation (rTMS) is recommended for individuals who do not respond to first-line treatments. Coach-supported digital mental health programs are scalable strategies for delivering therapeutic content. This randomized controlled trial tested whether digital mental health programs bolster rTMS for MDD. N=36 depressed adults completed a six-week course of rTMS. Of this group, n=18 were randomized to digital cognitive behavioral therapy (iCBT with Coaching), and n=18 were randomized to digital narrative stories of hope (iNarratives with Coaching). Multilevel models tested group differences in treatment outcomes over time. Principal outcomes focused on the Hamilton Rating Scale for Depression. Exploratory analyses compared outcomes versus a Benchmarking Sample of N=29 patients who received rTMS without coaching. There was a main effect of time (p<.001), indicating an overall reduction in depression symptoms during the trial. Contrary to hypotheses, there was no Group x Time interaction (p=.662), and groups did not differ on clinical response rates (p=.654). Secondary analyses found that the iNarratives group showed greater improvement in positive emotion and functional impairment, whereas the iCBT group showed less dropout from the coaching intervention. Exploratory analyses found a Group x Time interaction (p=.039), potentially suggesting that participants in iCBT or iNarratives showed steeper symptom reduction versus the Benchmarking Sample. The coach-supported iCBT and iNarratives approaches are comparable as adjuncts to rTMS for depression and may yield lower depression scores versus rTMS alone. iNarratives effects appeared specific to increases in positive emotions and decreases in functional impairment.

Ischemic cardiomyopathy ranks as a principal cause of death and incapacity worldwide. Myocardial ischemia‑reperfusion injury (MIRI) caused by percutaneous coronary intervention is a major threat in the treatment of ischemic cardiomyopathy. Although lactylation (Kla) is extensively implicated in numerous pathological processes, its role and specific effects in MIRI remain unclear. Lactylation proteomics was used to identify proteins with different modifications during ischemia‑reperfusion injury. Co‑immunoprecipitation experiments were utilized to detect isocitrate dehydrogenase 2 (IDH2) lactylation levels. Immuno-fluorescence staining was applied to confirm intracellular lactylation levels. TUNEL, DHE and MitoSOX staining were used to measure oxidative damage in cells and tissues. An oxygen consumption rate experiment and the ATP assay were conducted to determine mitochondrial function. Western blots were utilized to detect changes in proteins related to mitochondrial functional homeostasis and downstream signal alterations. Excessive lactate accumulation was observed in MIRI model mice. This accumulation exacerbated the decline in cardiac function and the damage to cardiomyocytes in mice after MIRI. The lactylation of IDH2 in mitochondria was found to play a regulatory role in mitochondrial dysfunction and MIRI. Regarding the mechanism, it was verified that high IDH2 K275 lactylation caused a reduction in its enzymatic activity and decreased the production of α‑ketoglutarate in the tricarboxylic acid cycle. Consequently, the activation of the AMPK pathway was inhibited, and mitochondrial damage and functional impairment were aggravated. It was also found that SIRT3 regulated and prevented IDH2 lactylation. The results of the present study indicated that IDH2 lactylation, which is elevated due to lactate accumulation and negatively regulated by SIRT3, contributes to the exacerbation of MIRI by regulating the functional homeostasis of mitochondria. This discovery offers a new therapeutic concept and target for MIRI prevention.

Oxidative stress biomarkers in assisted reproductive technologies: From follicular redox biology to clinical translation.

Functional and psychosocial outcomes of simultaneous condylectomy and bimaxillary orthognathic surgery for unilateral condylar hyperplasia: Retrospective study.

Schizophrenia and autism share neurobiological mechanisms and overlapping clinical features, often resulting in the emergence of autistic traits in early stages of psychosis. The PANSS Autism Severity Score (PAUSS) provides a rapid measure of autistic features within the standard PANSS assessment. We aimed to determine the prevalence of autistic features in first-episode psychosis (FEP), characterise their clinical, cognitive, and functional profile, and examine their impact on 2-year outcomes. A total of 328 FEP patients were included from the PEPs multicentre cohort, followed for 2 years. Autistic features were rated using PAUSS (cut-off ≥ 30), yielding autistic (n = 38) and non-autistic (n = 290) groups. Sociodemographic, clinical, cognitive, and functional variables were analysed. Longitudinal analyses examined symptomatic remission rates and trajectories of psychopathology and functioning using logistic regression and mixed-model ANOVA. The autistic group represented 11.6% of the sample. At baseline, they exhibited lower birth weight, greater medication side effects, higher general psychopathology and depressive severity, and poorer global functioning. Cognitively, they showed significant deficits in working memory, social cognition, and cognitive reserve compared to the non-autistic group. Over 2 years, this group was 3.6 times less likely to achieve symptomatic remission and consistently exhibited higher symptom severity and lower functioning across all follow-ups. Autistic features in FEP identify a subgroup with a possible distinct profile of neurodevelopmental markers, greater cognitive and functional impairments, and poorer clinical outcomes. Early identification may guide more personalised interventions, although further research is needed to refine PAUSS specificity and develop targeted, tailored treatments.

Early development and SGLT2 inhibitor-mediated reversal of coronary microvascular dysfunction in an isoprenaline-induced murine HFpEF model: Insights from multimodal in vivo imaging.

Introduction: Schizophrenia is a complex mental health disorder characterised by variable treatment responses. Previous research has explored factors influencing patient experiences; however, the understanding of how modifiable and non-modifiable factors relate to treatment effectiveness remains limited and, at times, inconsistent. Aim: To explore how the sociodemographic and clinical factors influence illness severity, treatment outcomes, and functional adjustment in work and social domains in patients with Schizophrenia. Materials and Methods: The present cross-sectional observational study was conducted at Sree Balaji Medical College and Hospital, Chennai, India, from July 2022 to July 2023, on 74 schizophrenia patients with at least six months of follow-up. The study assessed sociodemographic factors, treatment adherence, and illness severity in relation to therapeutic outcomes and social adaptation. Data were analysed using Epi Info software version 7, applying Mann-Whitney, Chi-square, and Wilcoxon signed-rank tests, with a significance level set at p &lt;0.05. Results: The current study included individuals diagnosed with schizophrenia spectrum disorders (mean age: 36.1 years), with balanced gender distribution. Most participants were unemployed (71.6%) and married (59.5%). A significant reduction in illness severity was observed post-intervention (p &lt;0.001). Demographic variables such as age, sex, and marital status showed no significant differences; however, marked and severe illness was associated with lower treatment efficacy (p&lt;0.001) and poor resilience (p=0.001). Treatment response assessed via effectiveness index and global improvement categories. Treatment effectiveness was significantly associated with factors such as employment status (p=0.028), illness severity (p&lt;0.001), age of illness onset (p=0.021), Higher Mental Function (HMF) (p=0.002), insight (p=0.007), resilience (p=0.019), and antipsychotic dose (p=0.041). Global improvement was significantly associated with factors such as employment status (p=0.012), illness severity (p&lt;0.001), age of illness onset (p=0.035), HMF (p=0.003), insight (p=0.037), resilience (p&lt;0.001), and treatment adherence (p=0.023). Individuals with milder illness, better insight, preserved HMF, higher resilience scores, and active treatment adherence showed more favourable outcomes. Functional impairment was significantly greater among those with inadequate treatment response and higher illness severity, particularly affecting work, home management, leisure, and interpersonal relationships (p&lt;0.001). Despite overall improvement, a subset of patients continued to experience residual functional limitations, highlighting the link between treatment effectiveness and real-world functioning. Conclusion: According to the present study results, higher resilience, good insight, employment and strong family support are the key factors associated with better outcomes. The study also supports the role of early intervention, sustained treatment engagement and a recovery oriented approach for better clinical and psychosocial care.

Subthreshold depressive symptoms significantly hinder functional recovery in bipolar disorder (BD). While most studies use a global score to assess the impact of these symptoms on functioning, this study examines which specific subthreshold depressive symptoms mostly impede functional recovery in patients with BD in remission. The sample comprised a total of 413 patients with BD. Subthreshold depressive symptoms were assessed using the 17-item Hamilton Depression Rating Scale (HAM-D), and psychosocial functioning was measured with the Functioning Assessment Short Test (FAST). Bivariate analyses were performed to identify items from the HAM-D as well as other clinical and demographic variables associated with functional impairment. Multivariate linear regression analyses were conducted including the variables that demonstrated significant associations in the bivariate analyses. The linear regression model for the FAST total score demonstrated that "psychomotor retardation" (item 8) had the strongest association on psychosocial functioning (β=6,9; p<0,001), followed by "feelings of guilt" (item 2) (β=5,75; p<0,001) "work and activities" (item 7) (β=5,38; p<0,001) and "somatic anxiety" (item 11) (β=3,45; p<0,001). Other significant clinical variables included antipsychotic use, older age, fewer years of education and male sex. This model explained 39,6% of the variance in the FAST total score (R2=0,396; Adjusted R2=0,375; F(399,13)=20,04; p<0,001). Specific subthreshold symptoms, including psychomotor retardation, apathy, guilt and somatic anxiety significantly influence psychosocial functioning. These findings highlight the importance of specifically targeting these symptoms to achieve functional recovery, even when patients are clinically stable.

Problematic social media usage (PUSM) has become a growing public health issue, with adolescents being particularly vulnerable. The absence of a standardized diagnostic tool has hindered consistent clinical identification and research advancement. To address this gap, the present study systematically evaluated the applicability of the DSM-5 Internet gaming disorder (IGD) criteria for diagnosing PUSM. A total of 405 participants were recruited and divided into five groups: PUSM, gaming disorder (GD), regular social media users (RSMU), regular gamers (RG), and healthy controls (HC). In this study, patients were evaluated using both ICD-11 and DSM-5. The ICD-11 criteria served as an external criterion, providing a benchmark for the validity testing of the DSM-5 framework. The DSM-5 IGD criteria demonstrated excellent diagnostic accuracy (>80%) for both PUSM and GD, except "deception". The ICD-11 and DSM-5 criteria exhibited high consistency, though the ICD-11 criteria adopted a stricter diagnostic threshold. No significant differences were observed between the PUSM and GD groups in terms of symptom profiles, functional impairment, or clinical severity. This study provides empirical support for adopting the DSM-5 IGD diagnostic criteria as a standardized clinical tool for assessing PUSM. However, the "deception" criterion requires further validation due to its weak diagnostic performance. The findings further confirm the conceptual and symptomatic homogeneity between PUSM and IGD, supporting their classification within a unified behavioral addiction framework.

Recent advances in immunoregulatory biomaterials for tendon healing: From immune remodeling to functional regeneration.

Integrated psychosocial, sleep, and nutritional support improves postoperative recovery, immune modulation, and survival after curative resection for low rectal cancer: A randomized controlled trial.

While the National Health Service (NHS) in the United Kingdom (UK) is increasing provisions for psychological interventions in primary care for patients with long-term conditions (LTCs), there is limited knowledge of effective implementation. This study reports on outcomes of an open pilot trial implementing the Accessible Depression and Anxiety Psychological Therapies for Long Term Conditions (ADAPT-LTC) programme in Scottish primary care services. This study entails a pragmatic, real-world implementation evaluation of ADAPT-LTC in primary care using data collected from routine outcome monitoring. Analysis focused on implementation (feasibility, suitability), service (clinical outcomes) and client (care experiences and satisfaction) outcomes. Rates of recovery, reliable improvement, reliable recovery and reliable deterioration were used as indicators of clinical outcomes. Approximately half of referred patients progressed to treatment. Patient engagement in treatment was split into groups of patients who attended few treatment sessions (approximately <4 sessions) or patients who accessed 6-8 sessions or more. Among patients who participated in treatment, CBT was associated with large pre- to post-treatment effects in reducing depression, anxiety, and functional impairment, with 35%-40% of patients no longer meeting criteria for psychiatric diagnosis and 60% reporting clinically reliable improvements. Patients reported positive care experiences and satisfaction. Delivering brief psychological intervention in primary care was effective for most patients with LTCs. However, a subgroup of patients did not start treatment or struggled to attend treatment suggesting the programme may not be suitable for all patients. Methods for enhancing engagement and implementation of ADAPT-LTC are discussed.

Stereo-encephalography-guided multi-lead deep brain stimulation for treatment-refractory obsessive compulsive disorder - Study design and individualized surgical targeting approach.

Excision-cryosurgery of auricular keloids associated with active follow-up: A retrospective study of 61 patients.

A cohesive sense of self depends on intact autobiographical memory, both of which are impaired in dissociative disorders. Maladaptive daydreaming (MD), a recently proposed dissociative condition, involves excessive immersion in fantastical inner worlds, often at the expense of real-life engagement, leading to distress and functional impairment. The present study aimed to examine whether maladaptive daydreamers' persistent focus on imagined events and an idealized self, alongside reduced attention to real experiences, may create confusion, impair memory, and ultimately disrupt self-coherence. N = 191 adults (88 with MD, 74% female, Mage = 28.92, SDage = 10.86; 103 controls, 75% female, Mage = 30.06, SDage = 10.90) completed objective memory tasks (Autobiographical memory test; Reality monitoring test), and questionnaires (Dissociative experiences scale, childhood trauma questionnaire, maladaptive daydreaming scale, self-concept clarity, and a newly developed confabulation experiences questionnaire). As predicted, autobiographical memory in MD was impaired (MD = 6.48 [2.93], Control = 7.46[2.65], t (189) = -2.41, p < .05, d = -.35), more confabulation experiences were reported (MD = 16.63[12.69], Control = 11.94[10.23], t (189) = 2.78, p < .01, d = .40) and self-concept was less coherent (MD = 29.14[8.60], Control = 35.89[10.18], t (189) = -4.87, p < .001, d = -.71). Memory deficits mediated the MD-self-concept relationship, but only through commission, rather than omission, errors. In sum, compulsive-immersive daydreaming is related to forgetting and confabulation, which may disrupt one's sense of identity. These findings support the view of MD as a dissociative condition marked by a fragmented self-concept.

Childhood victimization has lifelong adverse consequences including lower well-being and functional impairments in adulthood. Nonetheless, some victimized individuals appear to fare well, although it remains unclear whether they flourish (i.e., experience overall well-being and optimal functioning). We used data from the nationally representative Environmental Risk (E-Risk) Longitudinal Twin Study, which followed 2,232 children born in 1994-1995 across England and Wales to 18 years of age (93% retention, N = 2,066). Victimization was prospectively assessed between ages 5-12 years, capturing exposure to severe physical abuse, sexual abuse, emotional abuse and neglect, physical neglect, peer bullying, and domestic violence. Flourishing was assessed at age 18 across four domains: social well-being, education and cognition, physical health, and mental well-being. Over a third of the 558 victimized children flourished on at least one measure within all four domains at age 18, with the highest flourishing rates found for perceptions of social support, social status, and sleep quality. Experiencing two or more types of victimization was associated with lower flourishing for perceived social status (adjusted odds ratio [adj.OR] = 0.45, 95% confidence interval [CI] = 0.28, 0.73, p = .001) and faster biological aging (adj.OR = 0.57, 95% CI = 0.35, 0.93, p = .024) compared to single victimization exposure. Victimized girls were more likely to flourish in their educational attainment than boys (adj.OR = 1.61, 95% CI = 1.02, 2.55, p = .042). A substantial proportion of victimized children flourished across multiple domains in early adulthood. Identifying enabling factors could inform promotive interventions.

Exploring plantar aponeurosis disorders: beyond the classics.