<![CDATA[Authoritarian governments are detrimental to mental health. Let’s explore a historic case.]]>
‘Postcode lottery’ in robotic surgery access for patients, data shows
NHS patients in England are facing a “postcode lottery” in access to robotic-assisted surgery, analysis by RCS England shows.
Reduced bilateral auditory cortex activation during pure-tone perception in pediatric HIV
IntroductionChildren with perinatally acquired HIV (CPHIV) are at increased risk of neurodevelopmental difficulties, including hearing-related impairments, despite early initiation of antiretroviral therapy (ART). Previous studies have reported a higher prevalence of hearing loss in CPHIV compared with uninfected children; however, the contribution of the central auditory system to these auditory differences remains unclear. Understanding central auditory processing in CPHIV is important, as even subtle auditory difficulties during childhood can negatively affect speech and language development, academic performance, and quality of life.MethodsFunctional MRI was used to examine neural responses to auditory stimulation in 108 11-year-old children (60 CPHIV and 48 children without HIV). During scanning, participants listened to pure tones at low (500 Hz), middle (1,500 Hz), and high (4,000 Hz) frequencies.ResultsCPHIV demonstrated modestly elevated hearing thresholds (reflecting poorer hearing sensitivity) at several frequencies; however, the prevalence of clinically defined hearing loss did not differ between groups. Across all children, pure-tone stimulation elicited robust bilateral activation of the auditory cortices, with both the spatial extent and magnitude of activation decreasing as tone frequency increased. Relative to controls, CPHIV exhibited significantly reduced bilateral auditory cortex responses across frequencies. These group differences persisted after accounting for sex and handedness and after excluding children with hearing loss. Associations between hearing thresholds and auditory cortex activation were generally weak, except at 4,000 Hz in CPHIV, where poorer hearing was associated with stronger auditory cortex activation, consistent with a compensatory neural response.DiscussionDespite largely normal peripheral hearing, CPHIV receiving ART exhibited reduced bilateral auditory cortex responses during pure-tone processing. These findings suggest that alterations within the central auditory system may contribute to auditory vulnerability in CPHIV.
A narrative review on oxytocin at the intersection of sleep, stress, and social behavior
Sleep, stress regulation, and circadian rhythms form an interdependent network that shapes cognition, emotion, and social behavior. Disruption of any component can amplify stress sensitivity and impair emotional regulation, leading to neurobehavioral instability. This review discusses evidence from human and animal studies to illustrate how oxytocin (OT) may function at multiple brain regions to modulate sleep regulation, stress physiology, and social interaction. We discuss mechanisms by which sleep deficiency heightens hypothalamic–pituitary–adrenal (HPA) axis activity and stress-related behavioral reactivity and impulsivity, and how OT signaling is thought to counteract these effects by reducing HPA output and stress-induced behavioral responses. Furthermore, converging evidence from preclinical and emerging human studies suggests that OT release may contribute to non-rapid eye movement (NREM) and rapid eye movement (REM) sleep stability potentially via modulation of hippocampal-amygdalar circuits and thalamocortical network activity, including sleep spindle-related dynamics, thereby enhancing emotional processing and social memory. Social isolation, a potent stressor, reduces OT signaling and disrupts sleep–wake dynamics, suggesting a mechanistic link between positive social interaction and sleep maintenance. Collectively, we propose OT as a key neuromodulatory regulator at the intersection of sleep, stress resilience, and social behavior, providing new insights into the neuroendocrine pathways that underlie adaptive emotional regulation and identifying potential therapeutic targets for stress-related sleep disturbances.
The role of sensory experience in the maturation of prefrontal cortical circuits
Sensory input during early life is crucial for brain circuitry to be appropriately wired and refined. Foundational studies in the past century established that early sensory input was required for the appropriate development of primary sensory areas. Further investigation in the beginning of the 21st century extended this idea by suggesting that early sensory inputs may also impact remodeling of associative cortical regions. While many of the early studies promoting this idea were based on correlational observations, more causal studies followed soon after. It quickly became clear that sensory experience is a driver for shaping associative regions, including those that do not necessarily receive direct sensory input, such as the prefrontal cortex (PFC). The PFC is a region critical for sensory integration as well as for goal-directed, flexible behavior across species. Importantly, the PFC is a late developing structure, where the integration of diverse types of information, such as sensory information, during early life can elicit alterations in the underlying developing neural circuitry. These sensory inputs can interact with genetically-encoded biological programs to shape the maturation of PFC circuitry. In this review, we will highlight the studies supporting this model and delve further into how sensory experience during early life can impact different biological mechanisms to shape developing PFC circuitry.
Analysis of characteristics of hospitalized patients with chronic insomnia: a single-center retrospective study
ObjectiveInsomnia is a prevalent health issue within the general population. Nonetheless, there is a paucity of research specifically addressing chronic insomnia among hospitalized patients. Consequently, the objective of this study is to investigate chronic insomnia in adult inpatients.MethodsA retrospective analysis was conducted on hospitalized patients at Fengjie County People’s Hospital in Chongqing from January 2022 to June 2025. The study included patients aged 18 to 100 years, with comprehensive documentation of their demographic information, laboratory test results, and insomnia treatment details. Patients with incomplete data or those under 18 years of age were excluded from the study. The analysis focused on the age distribution, gender ratio, and BMI distribution of the patients, as well as the prevalence of primary diagnostic categories and the distribution characteristics of fasting blood glucose levels and dyslipidemia.ResultsThe study included a total of 871 patients, with a male representation of 39.6%. The mean body mass index (BMI) was 23.1 ± 3.7 kg/m², and the mean age was 64.1 ± 13.9 years. The predominant sources of disease were identified as infectious diseases, cardiovascular diseases, neurological disorders, tumors, and musculoskeletal conditions. A significant proportion of patients presented with elevated fasting blood glucose levels and dyslipidemia.ConclusionChronic insomnia in hospitalized patients predominantly affects elderly women. Chronic insomnia in hospitalized patients predominantly affects elderly women, who primarily present with infectious diseases, cardiovascular conditions, neurological disorders, tumors, and musculoskeletal issues. These patients often exhibit dyslipidemia and elevated fasting blood glucose levels, necessitating clinical attention.
Effect of a nursing-based information–motivation–behavioral model on older patients with type 2 diabetes mellitus
BackgroundOlder patients with type 2 diabetes mellitus (T2DM) frequently encounter challenges, including a diminished capacity for self-management, a high prevalence of negative emotions, and cognitive decline and physiological changes attributable to long-term disease burden, leading to compromised glycemic control and impaired quality of life. Traditional diabetes nursing interventions often lack systematic strategies to address the psychological and cognitive needs specific to this patient population. The Information-Motivation-Behavioral Skills (IMB) model is a theoretical framework designed to promote health behavioral changes; however, research investigating its specific application in regulating psychological state and managing cognitive function in older patients with T2DM remains limited.AimTo investigate the effectiveness of a nursing intervention based on the IMB model in older patients with T2DM.MethodsData from 86 older patients with T2DM were divided into 2 groups: intervention (structured IMB model-based nursing + routine care [n = 43]); and control (conventional T2DM care [n = 43]). Psychological state (Self-Rating Anxiety and Depression Scales [SAS, SDS]), cognitive function (Mini-Mental State Examination [MMSE] and Montreal Cognitive Assessment [MoCA]), glycemic control (fasting blood glucose [FBG], 2 h postprandial blood glucose [2hPBG], and glycated hemoglobin A1c [HbA1c]), and satisfaction with nursing were compared between the 2 groups before and after a three-month intervention.ResultsSAS and SDS scores significantly decreased in both groups after intervention, with a more pronounced reduction in the intervention group (P < 0.05). MMSE and MoCA scores improved in both groups, with significantly higher scores in the intervention group (P < 0.05). Glycemic control (FBG, 2hPBG, and HbA1c) improved substantially in the intervention group (P < 0.05). Satisfaction with nursing among the intervention group (95.35%) was significantly greater than that in the control group (79.07%) (P < 0.05).ConclusionThe IMB model-based nursing intervention alleviates anxiety and depression, improves cognitive function, enhances glycemic control, and increases satisfaction with nursing in older patients with T2DM, thus meriting broader clinical implementation.
Number of children and maternal mental health in the context of China’s fertility policy transition: the moderating effect of employment status and the mediating effect of family environment
BackgroundHaving more children may be detrimental to maternal mental health during China’s ongoing fertility policy transition. However, under what circumstances and how number of children could be associated with maternal mental health remains understudied in China. This study examined the association between number of children and maternal anxiety and depressive symptoms among mothers of middle school students in Shanghai, China. It also explored the moderating effect of maternal employment status and the mediating effect of family environment.MethodsMothers of students from 7 middle schools in Shanghai were surveyed. In total, 4,215 valid questionnaires were obtained. The survey included sociodemographic information, the Generalized Anxiety Disorder Scale (GAD-7), the Center for Epidemiologic Studies Depression Scale (CES-D), and the Chinese version of the Family Environment Scale (FES-CV). Multiple linear regression analysis was performed to examine the association between number of children and maternal anxiety/depressive symptoms. Model 1 and Model 4 of SPSS PROCESS were then employed to examine the moderating effect of employment status and the mediating effect of family environment.ResultsThe rates of clinically significant anxiety and depressive symptoms among mothers were 13.6% and 17.6%, respectively. The moderating effect of maternal employment status was significant. Among unemployed mothers, number of children was positively associated with both maternal anxiety and depressive symptoms, whereas among employed mothers, number of children was not associated with maternal anxiety or depression. Among unemployed mothers, family environment mediated the association between number of children and maternal anxiety/depressive symptoms through the pathways of family conflict and organization. Among employed mothers, family environment suppressed the association between number of children and maternal anxiety/depressive symptoms through the pathways of family conflict, intellectual-cultural orientation, organization, control, and independence.ConclusionOur findings suggest that number of children per se is not necessarily associated with worsened maternal mental health. Instead, the potential changes in employment participation and family environment that accompany having more children may be more relevant. Therefore, stakeholders, clinicians, and researchers should therefore focus on these aspects when addressing maternal mental health.
Iron dyshomeostasis in neuropsychiatric disorders
Iron is an indispensable element for the normal physiological function of the brain. In terms of neuronal metabolism, iron is involved in multiple critical biological processes such as oxygen transport, energy metabolism, DNA synthesis, neurotransmitter synthesis and myelin formation. Maintaining brain iron homeostasis is crucial for neurodevelopment and function. Iron dyshomeostasis has been associated with the onset and progression of various neuropsychiatric disorders, including Parkinson’s disease, Alzheimer’s disease, depression, schizophrenia, attention deficit hyperactivity disorder, and autism spectrum disorder. In neurodegenerative diseases such as Parkinson’s disease and Alzheimer’s disease, abnormally elevated iron levels can be detected in specific brain regions, including the basal ganglia and the prefrontal cortex. These changes are often accompanied by pathological processes such as oxidative stress, neuroinflammation, and pathological protein aggregation. Therefore, brain iron metabolism is an important entry point for understanding the pathophysiological process of neuropsychiatric disorders. Mechanistically, iron overload induces oxidative damage through the Fenton reaction, exacerbating mitochondrial dysfunction and abnormal protein aggregation. The effects of iron deficiency vary across different diseases; its impact on myelination and neurotransmitter synthesis may increase the risk of neurodevelopmental disorders such as attention deficit hyperactivity disorder (ADHD), while its effects on immune activation and energy metabolism may contribute to the development of mental disorders such as depression. This article systematically reviews the current research progress of the role of cerebral iron metabolism in neuropsychiatric diseases. It focuses on the mechanisms underlying iron homeostasis imbalances in neurodegenerative and psychiatric diseases. Building on this foundation, the article analyzes the therapeutic targets and clinical significance of iron metabolism-related interventions and outlines future research directions in this field.
Coping under pressure: police-specific stressors and mental health in Catalonia police forces
IntroductionPolice officers are exposed to elevated psychological risks due to both operational and organizational stressors. Additionally, police officers tend to resort to avoidant coping strategies, which exacerbate poor mental health outcomes, such as burnout and PTSD.MethodsThis study aims to examine clinical symptoms (stress, anxiety, depression), coping styles, and perceived stressors among police forces from Catalonia, Spain. A total of 741 officers completed an online survey comprising DASS-21, PSQ-Op, PSQ-Org, Brief COPE and brief open-ended questions. ResultsOverall, both operational and organizational stressors were significant predictors of clinical symptoms, with the latter revealing a more pronounced impact. Avoidant coping emerged as the strongest risk factor for distress, while problem-focused coping emerged as a possible protective factor, especially against depression. Both gender and years of service influenced coping strategies: i) female officers reported higher use of adaptive coping, while male officers scored higher in avoidant coping; and ii) more experienced officers reported lower anxiety symptoms but also lower use of active coping strategies. DiscussionThese findings underscore the importance of addressing both organizational culture and individual-level factors in promoting psychological resilience, while considering gender and career stage to support sustainable mental health within police forces.