Association between Hikikomori syndrome and psychotropic medication use and misuse in Korean young adults: A population-based study.

Multidimensional apathy: A simple and inclusive clinical marker of youth mental health-A longitudinal study.

Introduction: heart-rate variability (HRV), respiratory-rate variability (RRV) and the pulse-respiration quotient (PRQ) reflect autonomic modulation, yet their relationship with university dietary habits remains understudied. Objective: to examine the association between dietary patterns and autonomic activity among university students. Methods: ninety-one young adults were classified, via factor analysis, into a healthy (PDS) or an unhealthy (PDNS) dietary pattern. From 5-min beat-to-beat (RR) and breath-to-breath (BB) recordings we extracted: high-frequency log power (HFlog), parasympathetic (PNS) and sympathetic (SNS) indices, stress index, mean RR interval (Mean RR), fractal exponents α₁ and α₂, Poincaré dispersion (SD₂), and the low- to high-frequency power ratio (LF/HF). For RRV we obtained mean breathing rate (BRmean) and BB deviation (SDBB); for PRQ we calculated mean PRQ (mPRQ). Student's t-, Mann-Whitney U-tests and Spearman correlations were applied (p ≤ 0.05). Results: fifty-three percent of participants followed the PDNS. In men, the PDS showed higher HFlog and α₁ ≈ 1. Within the PDS, lean animal products were linked to ↓SNS, ↓stress, ↓α₂ and ↑Mean RR; non-fat cereals to ↑PNS and ↓LF/HF in men; fruits-vegetables to ↓BRmean and ↑SDBB; legumes and canned fish to ↓mPRQ. In the PDNS, sugary drinks decreased PNS, HFlog and SD₂ but increased SNS in women, and raised stress and α₂ in men; fat-rich cereals elevated α₂. Conclusion: the PDS enhances vagal tone, fractal stability and cardiorespiratory synchrony, whereas the PDNS heightens sympathetic activity and lowers variability, particularly in women. These findings support early nutritional interventions that foster the PDS.

ABSTRACT Childhood maltreatment is associated with enduring emotional and cognitive outcomes. This study examines Layered Voice Analysis (LVA) as an objective method for detecting vocal biomarkers of childhood maltreatment. A quasi-experimental design was used with a sample of (N = 30) young adults. Participants were screened using the Adverse Childhood Experiences–International Questionnaire and interviewed regarding childhood experiences. Audio recordings were analysed using LVA. Participants with childhood maltreatment histories showed higher stress levels, stronger emotional involvement, strong visual imagery during recall, reduced expectation of response from the interviewer while sharing their experiences, and narrower cognitive focus. Findings indicate lasting vocal effects.

With extensive interconnections with the cerebral cortex, the cerebellum is well positioned to coordinate communication between cortical regions. Because different cerebellar subregions interconnect with distinct cortical networks, the impact of regional cerebellar activity should be network-specific. However, it is unclear whether or how cerebellar modulation impacts the functional connectivity (FC) of cerebral cortical networks. To test this, we randomly assigned adults (n = 33; 21.2 ± 3.1 years; 22 M/11 F) to undergo 20 min of 1.5 mA transcranial direct current stimulation (tDCS) targeting either the posterior midline (n = 17) or right posterolateral cerebellum (n = 16). Each participant received anodal (excitatory), cathodal (inhibitory) or sham tDCS during separate MRI sessions. We analyzed post-tDCS resting-state fMRI data to determine whether modulating different cerebellar subregions impacted resting-state FC of distinct cortical networks. Multivariate pattern analyses revealed that posterior midline tDCS primarily modulated FC in the default mode network (DMN), while posterolateral cerebellar tDCS altered FC in the frontoparietal network (FPN). Seed-based connectivity analyses confirmed that posterior midline modulation increased within-network DMN FC while decreasing FC between DMN, visual, and somatomotor networks. In contrast, posterolateral cerebellar tDCS strengthened frontoparietal and attentional network FC while decoupling FPN-DMN and FPN-visual networks. These results support the hypothesis that the cerebellum modulates corticocortical connectivity and further suggest that the posterior midline modulates the DMN, while the posterolateral cerebellum shifts the brain toward a task-ready cognitive state. These findings provide insight into how the cerebellum influences the cerebral cortex and have clinical implications for targeted interventions in neurological and psychiatric conditions.

Renewed interest in the Ross procedure, driven by compelling evidence of superior long-term outcomes, has led to increased international use. This review outlines a comprehensive framework for understanding the Ross procedure within the broader context of aortic valve replacement. Topics include procedural overview, patient selection and contraindications, diagnostic imaging, technical modifications to promote durability, clinical outcomes, postoperative management, and future directions. The Ross procedure remains the only valve replacement strategy capable of restoring life expectancy in selected young and middle-aged adults, making it an imperative option for multidisciplinary consideration.

Sexual strangulation, widely referred to as "choking," has become a prevalent sexual practice among young adults, disproportionately affecting females. Despite this high prevalence, little is known about its acute neurobehavioral effects. To evaluate the short-term impact of sexual strangulation on physical, psychological, and oculomotor functioning, and to explore participants' subjective experiences and perceptions of study participation. This randomized crossover study included 31 young adult females (18-30years) who had engaged in both choking-involved and non-choking partnered sex in the past month. Participants completed 3 visits: baseline, post-choking sex, and post-non-choking sex. Mental health assessments (Patient Health Questionnaire-9, Generalized Anxiety Disorder-7, Perceived Stress Scale) and near point of convergence (NPC) testing were administered at each visit. Mixed-effects regression models assessed outcome changes across conditions. Additionally, participants completed a post-study experience survey to express their thoughts and feelings regarding study participation. Primary outcomes were NPC distance (in centimeters) and mental health scores. Secondary outcomes included symptom self-reports following sexual choking and participants' feedback on study acceptability. NPC distance increased significantly following both choking and non-choking sex, with a greater increase post-choking (19.9% vs 8.1%, P = .007). Depression scores declined significantly only following non-choking sex (P= .038), whereas perceived stress levels decreased after both types of sex (Ps < 0.05). Anxiety scores declined only after choking-involved sex (P = .048). Notably, approximately one-third of participants reported neurological symptoms, such as head rush and blurred vision, following choking-involved sex. Most participants rated the study as acceptable and appropriate. Sexual strangulation/choking may acutely disrupt oculomotor control and attenuate typical mood-related benefits of sex. These findings support the need to assess strangulation/choking-involved sex distinctly from other sexual behaviors in clinical and research settings. This is the first randomized crossover study to examine the acute effects of sexual strangulation/choking. Strengths include a within-subject design, assessment acutely after exposure, and multimodal assessment. Limitations include a small sample size, short follow-up, and reliance on self-report data. Sexual strangulation/choking may acutely impair NPC more than non-choking sex, attenuate the typical mood-enhancing effects of sexual activity (depression), and produce unique affective outcomes (anxiety reduction). As this practice becomes increasingly mainstream, further research is urgently needed to inform health education, clinical screening, and public health responses.

Background: The rising consumption of Western-style fast food—high in carbohydrates, sugar, and fat—together with a fast-paced lifestyle, occupational stress, and physical inactivity, represents a major risk factor for fatty liver disease, which can progress to hepatitis, cirrhosis, or hepatocellular carcinoma. Evidence linking fatty liver and cholelithiasis is growing globally, yet data from Thailand and Southeast Asia remain scarce, despite both conditions being increasingly prevalent. Cholelithiasis, a common gastrointestinal disorder affecting 5–10% of the Thai population, particularly females and older adults, may also be associated with fatty liver disease. Objectives: This study investigated the correlation between cholelithiasis and fatty liver disease using ultrasonographic data from patients at Vajira Hospital, aiming to address this regional knowledge gap and inform preventive strategies. Materials and methods: A retrospective analysis was performed on 311 patients aged ≥50 years who underwent upper abdominal ultrasonography at Vajira Hospital between 2023 and 2024. Collected data included gender, age, gallstone size, and diagnostic findings. Patients were classified into two groups: 132 with cholelithiasis and 179 without. Statistical analyses included descriptive statistics (mean, SD, frequency, percentage) and inferential tests (t-test, chi-square test, and logistic regression). Results: Of the 311 patients, 162 (52.1%) had fatty liver, with a mean age of 62±8.46 years; 62.3% were female and 37.7% were male. Among these, 73 patients (45.1%) had concurrent cholelithiasis (66% female, 34% male), with a mean gallstone size of 1.09±0.53 cm. The remaining 89 patients (54.9%) had fatty liver disease without cholelithiasis (60% female, 40% male). A significant inverse association was observed between age and fatty liver disease (p=0.003), indicating that younger patients within this ≥50-year cohort were more likely to be affected. Conclusion: Cholelithiasis was not significantly associated with fatty liver disease. However, fatty liver showed a novel inverse correlation with age, with higher prevalence among younger adults within the ≥50-year cohort. This finding, which contrasts with previous reports of increasing prevalence with age, may reflect methodological factors and lifestyle influences in Thailand’s urban population. These results emphasize the need for early screening and targeted public health interventions for working-age adults, while acknowledging limitations related to study design, absence of key confounders, and restricted age range.

Human-AI collaborative systems are increasingly explored as tools for promoting mental well-being and supporting personal development. We present POCKET-MIND, a personalized digital journaling system powered by a Large Language Model (LLM) that facilitates both emotional exploration and goal pursuit through a novel Dual-Prompt Framework. Unlike traditional journaling apps that treat emotional reflection and goal tracking as separate tasks, POCKET-MIND integrates these dimensions by generating adaptive prompts that help users meaningfully connect their feelings with their personal aspirations. In a one-week exploratory study with 30 young adults, preliminary findings suggest that POCKET-MIND may support emotional articulation, self-reflection, and goal-directed behaviors. While the study had a relatively small sample size, the findings highlight the potential of Human-AI collaborative journaling for personal mental health support. This work contributes to Human-Computer Interaction (HCI) by offering early design insights into adaptive conversational systems that personalize reflective practices and foster user growth through interactive experiences.

Exchanges of interpersonal emotion regulation support between romantic couples may be especially important in older adulthood, a time when individuals tend to prioritize close relationships and emotional well-being. We examine the effects of support exchange perceptions in an adult lifespan sample of married couples. In the present study, 134 married couples (N = 268) aged 23-85 (Mage = 52.80, SD = 18.27) completed a 9-day daily diary procedure in which they reported current emotions, relationship satisfaction, and the extent to which they provided support to and received support from their partner in terms of managing emotions each day. Using actor-partner interdependence modeling and dyadic response surface analyses, we examined the effects of receiving and providing support on daily relationship satisfaction and emotional well-being, with age as a moderator. At between-person and within-person levels, providing and receiving support were generally associated with higher end-of-day relationship satisfaction and positive affect, although some associations varied by actor and partner reports. Across analyses, compared to younger adults, the well-being of older adults was more strongly linked to their partner's reported interpersonal emotion regulation. In some cases, between-person level alignment in perceptions was more strongly associated with end-of-day negative affect and positive affect among older couples than younger couples, as indicated by response surface analyses. Findings suggest that both receiving and providing interpersonal emotion regulation support are central to couples' well-being across the lifespan. This study provides preliminary evidence that partner perceptions of support exchanges may become increasingly important for well-being throughout adulthood.

Assessing the Relative Importance of Sociocontextual Determinants of Depression: A Random Forest Analysis of Young Korean Adults.

Association of Polygenic Scores for Glaucoma With Measures of Retinal Ganglion Cell Integrity in Young and Older Adults.

Young adults' sourcing and supply of opioids in a changing drug market.

Enhanced patient counselling and SMS reminder messages to improve access to community-based eye care services in Meru, Kenya: an embedded, pragmatic, individual-level, randomised, controlled, adaptive platform trial.

Trauma centers are increasingly caring for injured older adults, and a subset of these patients requires surgery for hemorrhage control. Prolonged time to surgery for hemorrhage control is associated with increased mortality. We hypothesized that older adults requiring hemorrhage control surgery have a longer time to surgery than younger adults. We analyzed Trauma Quality Improvement Program data (2017-2019) for adult patients taken directly from the emergency department to the operating room for hemorrhage control surgery. We excluded patients who were functionally dependent or had an advanced directive. Multivariable Poisson regression was used to determine the difference in time to surgery between younger adults (aged 18-64 years) and older adults (65 years and older) while controlling for potential confounders. We identified 29,406 adult patients who underwent surgery for hemorrhage control, including 2,586 older adults (8.8%). On unadjusted analysis, older adults had longer median time to surgery than younger adults (83 vs. 55 minutes, p < 0.001). On multivariable Poisson regression, controlling for patient demographics, injury mechanism, Injury Severity Score, trauma center level, and type of surgery, adjusted time to surgery was 9.4 minutes longer for older adults (95% confidence interval, 7.3-11.5; p < 0.001). Adding medical comorbidities to the model decreased the adjusted time difference to 6.2 minutes (95% confidence interval, 4.2-8.2; p < 0.001). Shock index ≥1 was less common in older adults (36% vs. 49%, p < 0.001), and the time to surgery disparity was lower among older adults with shock index ≥1 at presentation compared with those with shock index <1. Older adults have a longer time to surgery for hemorrhage control than younger adults. This difference is partially mediated by a higher burden of medical comorbidities and physiologic differences that impact the presentation of shock among older adults. Trauma centers should work to streamline decisions regarding surgical intervention for older adults in hemorrhagic shock. Therapeutic/Care Management; Level IV.

Development of a core outcome set for adolescents and young adults with cancer.

Brain dynamics and depressive symptoms in young adults: Evidence from EEG.

Studies in the past have demonstrated an association between sarcoidosis and pulmonary embolism (PE), but little is known about its impact, especially in young adults. We aim to determine the burden and impact of PE in young adults hospitalized with sarcoidosis. This study investigates the prevalence and consequences of PE in young adults aged 18-44 years hospitalized with sarcoidosis using data from the National Inpatient Sample (2016-2020) with relevant International Classification of Diseases (ICD)-10 codes. This study aims to address the primary outcomes of the burden and trends of PE and its associated impact on in-hospital mortality. Additionally, it explores secondary outcomes such as healthcare resource utilization and discharge patterns. Among 50,385 young adults (median age 37 years) hospitalized with sarcoidosis, 1120 had PE, showing a linear increase from 2% in 2016 to 2.9% (P < 0.001) in 2020. The sarcoidosis-PE+ group, predominantly in young blacks, exhibited a higher prevalence of comorbidities such as obesity, smoking, drug use, peripheral vascular disease, hypothyroidism and prior history of venous thrombus embolism. In contrast, the sarcoidosis-PE- group had a higher prevalence of diabetes (with/without chronic complication), hyperlipidemia and chronic pulmonary disease. Multivariable regression analysis adjusted for all potential sociodemographic and comorbid variables showed higher odds of all-cause mortality (odds ratio [OR]: 2.92, 95% confidence interval [CI]: 1.18-7.24, P < 0.02) in the sarcoidosis-PE+ group as compared to the sarcoidosis-PE- group. The sarcoidosis-PE+ group also had higher hospital costs and length of stay. The higher odds of in-hospital mortality with an increased length of stay and hospital cost observed in the sarcoidosis-PE+ group highlight the often underreported complications of sarcoidosis, particularly in a younger demographic. The relevance of this study stems from its potential to uncover trends that could lead to improved diagnostic and therapeutic strategies.

A systematic review of social media impact on psychological well-being among children, adolescents, and young adults in arab countries.

Objectives: Human papillomavirus (HPV) is an infectious disease transmitted sexually. It is the direct cause of cervical cancer, and it incriminates in oropharyngeal, anal, and genital cancers. Vaccination is the main control measure to exclude infection. Awareness and knowledge regarding HPV in Saudi Arabia still need improvement. Vaccination acceptance suffers from some hesitancy. This systematic review aimed to assess awareness and knowledge of HPV and HPV vaccine among young adults (18–30 years) and evaluate obstacles that prevent vaccination. Methods: According to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses principles, a systematic search strategy was constructed through PubMed, Science Direct, Google Scholar, Scopus, and Web of Science. The search involved studies published between January 2020 and June 2025. Cross-sectional and quantitative studies that evaluate HPV and HPV vaccine among young adults (18–30) in Saudi Arabia were included. After completion of data extraction, selected studies were qualified to determine the level of bias. Results: Ten studies achieved the eligibility criteria; they showed a variable degree of awareness (43–59.6%) with sample sizes ranging from 114–580 respondents. A knowledge shortage regarding high-risk genotypes of HPV, modes of transmission, and vaccination was observed among medical students and the public. Barriers toward vaccination varied between lack of awareness, ignorance about the eligibility of the age of vaccination, and issues related to culture, with a noticeably higher degree of awareness among females than among males. Conclusion: Enhancement of education programs is needed; future investigations should be directed to improve the educational campaigns to promote public awareness of HPV. The development of the medical curriculum is a necessity.