Transcranial direct current stimulation (tDCS) is a non-invasive neuromodulation technique with promising application in the treatment of neurological and psychiatric disorders. However, its effectiveness is often limited by the high inter-subject variability of the induced effects, mainly attributable to individual anatomical differences, which are not considered in the design of the stimulation protocols. Among these, structural connectivity plays a crucial role but remains often overlooked in tDCS research. Objective—This study aims to evaluate how variations in structural connectivity influence the distribution of the electric field (EF) during tDCS session. In particular, we analyse how the inclusion of white matter anisotropy affects the EF distribution and spread compared to classical isotropic models, and how the strength of connection across cortical parcels affects the EF spread. Approach—The study proposes an advancement in the computational modelling of tDCS through the integration of white matter anisotropy into finite element method (FEM) simulations. By combining advanced computational approaches, we explore the relationship between EF strength and cortical connectivity. Main results—Neglecting white matter anisotropy in electromagnetic simulations lead to a relative error in EF magnitude greater than 10% and to an orientation error of the EF vector of almost 20 degrees. The DTI-informed simulations lead to a more focalized EF distribution, moreover it was found a positive and significant (p < 0.05) correlation between EF focality and the strength of connectivity between cortical areas below P2 and P1 electrodes. Significance—These findings highlight the importance of including white matter anisotropy into tDCS simulation to prevent distortions in EF distribution and suggest the need to integrate structural connectivity information into the definition of subject-specific dose in tDCS protocols.
Causal network analysis-based assessment of gray matter alteration in post-radiotherapy nasopharyngeal carcinoma patients using 3D T1-weighted MRI
ObjectivesTo explore the temporal and causal relationships underlying brain structural changes in post-radiotherapy (RT) nasopharyngeal carcinoma (NPC) patients.MethodsA total of 38 post-radiotherapy NPC patients (33 males, 5 females; median age: 50.0 years, range: 27–63 years; median time post-RT: 17.2 months, range: 0.5–108 months) and 23 healthy controls (16 males, 7 females; median age: 37 years, range: 24–61 years) underwent T1-weighted magnetic resonance (MR) images, and their images were evaluated. The causal structural covariance network (CaSCN) analysis approach was applied to assess the causal relationships underlying radiation-induced brain structural alterations in these patients. Granger causality (GC) analysis was employed to morphometric data derived from T1-weighted MR images, which were ordered by the time elapsed post-RT.ResultsThe source-like directed associations were observed in the bilateral parahippocampal gyrus (PHG), the right gyrus rectus (REC.R), and the right caudate nucleus (CAU.R). The directed network analysis revealed that the parahippocampal gyrus (PHG), REC.R and CAU.R exhibited typical source-like characteristics, and their structural changes exerted a key regulatory effect on GM volume alterations across multiple brain regions. While the left precuneus (PCUN.L), left temporal pole: middle temporal gyrus (TPOmid.L) and the left inferior temporal gyrus (ITG.L) were typical sink-like brain region that mainly received regulatory effects from source-like brain regions, acting as major target regions of structural damage.ConclusionOver time, post-radiotherapy NPC patients exhibited progressive changes in GM volume, where the PHG.L, PHG.R, REC.R and CAU.R were core source-like brain regions. The PCUN.L, TPOmid.L, and ITG.L show distinct sink-like features, which mainly receive regulatory effects from source-like brain regions.
ASYM: multimodal depression recognition via mamba-enhanced attentive feature fusion
IntroductionDepression is a prevalent mental disorder with a severe global impact. Traditional interview-based assessments are limited by subjectivity, lengthy procedures, and unequal access to care. Although advances in AI have facilitated multimodal models for depression detection—using audiovisual data as an accessible alternative to biosignals—current approaches remain challenged by inefficient long-term temporal modeling and superficial multimodal fusion. Moreover, biosignal-based methods are constrained by high costs and narrow applicability. These challenges underscore the urgent need for optimized multimodal solutions.MethodsThis paper proposes ASYM (Attentive Synergy Mamba), a novel multimodal architecture for depression recognition, comprising three core modules: a Cross-Modal Interactive Mamba, a Multi-Scale Gated Parallel Fusion, and a Multimodal Enhanced Mamba. First, features from each modality are interactively enhanced using convolutional neural network and Bi-Mamba blocks. Cross-modal complementary information is then extracted via a cross-attention mechanism. A dual-path fusion module subsequently augments multi-scale representations and integrates cross-modal features through dynamic weighting. Finally, the feature representations are refined by a series of Bi-Mamba blocks.ResultsEvaluations on the D-Vlog and LMVD datasets using accuracy, precision, recall, and F1-score showed that ASYM achieved an accuracy of 70.91% and an F1-score of 77.13% on D-Vlog, and 74.68% accuracy with a 74.90% F1-score on LMVD. The macro-average performance across both datasets surpassed all compared mainstream methods. Ablation studies confirmed the necessity of each component, as removing any module significantly degraded performance, underscoring the efficacy and critical contribution of the proposed architecture.DiscussionWhile multimodal depression detection has improved upon single-modality approaches, issues such as computational inefficiency in long-sequence processing and inadequate fusion strategies persist. Our model addresses these limitations through multimodal interaction and multi-scale feature fusion. Future work will focus on clinical validation across diverse populations to bridge computational psychiatry and clinical practice.
Adverse childhood experiences and the risk of non-suicidal self-injury: a meta-analysis
BackgroundSystematically evaluate the association between Adverse Childhood Experiences (ACEs) and the risk of Non-suicidal Self-Injury (NSSI), thereby providing evidence-based guidance for relevant prevention and early intervention strategies.MethodsA systematic search was conducted across PubMed, Embase, Web of Science, and the Cochrane Library, from their inception to 30 November 2025, to identify observational studies reporting associations between ACEs and NSSI. Two researchers independently performed literature screening, data extraction, and quality assessment. Effect sizes were pooled using a random-effects model, with association strength expressed as odds ratios (OR) and their 95% confidence intervals (CI). Data analysis was conducted using Stata 15.ResultsA total of 13 articles included. The meta-analysis results suggest that physical abuse [OR = 2.38, 95% CI (1.36, 4.16), I2 = 99%], sexual abuse [OR = 1.88, 95% CI (1.24, 2.87), I2 = 94.9%], ACEs≥2 [OR = 3.23, 95% CI (2.62, 3.99), I2 = 89.9%], ACEs≥3 [OR = 6.13, 95% CI (4.07, 9.24), I2 = 96.9%], emotional abuse [OR = 1.65, 95% CI (1.18, 2.32), I2 = 97.9%] may increase the risk of NSSI.ConclusionIn summary, the findings of this meta-analysis suggest that exposure to adverse childhood experiences may be related to an increased likelihood of non-suicidal self-injury. Different forms of childhood adversity, including physical abuse, sexual abuse, and emotional abuse, as well as cumulative exposure to multiple ACEs, were associated with higher risks of NSSI.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/, identifier CRD42026128495.
The associations of systemic inflammation and insulin resistance-related indicators with psychopathology and BDNF in patients with chronic schizophrenia
BackgroundThe triglyceride-glucose (TyG) index and C-reactive protein-triglyceride-glucose index (CTI) are innovative indicators for assessing insulin resistance (IR) and inflammation, yet research on them in patients with schizophrenia remains limited. This study aimed to explore TyG index and CTI levels and their associations with psychopathology and brain-derived neurotrophic factor (BDNF) in patients with chronic schizophrenia (CS).MethodsThis cross-sectional study was conducted across one general hospital and two psychiatric hospitals in Anhui Province, China. Socio-demographic information and hematological parameters were collected from participants, and their psychiatric and depressive symptoms were assessed using the Positive and Negative Syndrome Scale (PANSS) and the Calgary Depression Scale for Schizophrenia (CDSS), respectively.ResultsA total of 324 patients with CS and 150 healthy controls (HCs) were enrolled in the study. Compared with HCs, patients had higher TyG index and CTI levels (all P < 0.001). Binary logistic regression analyses revealed that among patients, a high TyG index level was significantly associated with higher BDNF levels and lower negative factor scores of the PANSS, while a high CTI level was significantly associated with higher depression-hopelessness factor scores of the CDSS and lower negative factor scores of the PANSS (all P < 0.05).ConclusionPatients with CS had higher levels of TyG index and CTI, which were significantly associated with the severity of negative and depressive symptoms, as well as BDNF levels. It is suggested that the integration of the TyG index and CTI into clinical monitoring for patients with CS is necessary.
Patient safety incidents in mental health residential services: a multicenter, crosssectional, survey-based study
IntroductionWhile patient safety in general hospitals is well-researched, residential mental health services have received less attention. Psychiatric patients and staff working in such facilities face unique and complex risks. This study aims to explore and describe the frequency and characteristics of patient safety incidents (PSIs) experienced by professionals working in a cohort of Italian mental health residential services.MethodsA multicenter, cross-sectional, questionnaire-based observational study was conducted involving workers from 68 psychiatric mental health services from seven different Italian provinces. A total of 159 respondents, including both healthcare and non-healthcare professionals, took part in the study. Participants reported incidents personally experienced (FHE) or reported by colleagues (CRE) over the previous 12 months, using a taxonomy adapted from the World Health Organization’s Conceptual Framework for the International Classification for Patient Safety. Data was analyzed using descriptive statistics and zero-inflated models to identify associations between respondent characteristics and reporting behaviors.ResultsA total of 4,432 FHE and 4,807 CRE were reported. The behavior-related events were the most frequently reported, followed by incidents related to organizational or infrastructure issues, and medication errors. Secondary analyses suggested that facilities with more than ten employees had significantly higher rates of both FHE and CRE. Furthermore, residential facilities showed a higher incidence rate of CRE compared to non-residential ones, and non-healthcare workers reported witnessing fewer incidents to colleagues (28%) compared to healthcare workers. Significant variability was also observed across different provinces.ConclusionResidential mental health services experience a high incidence of PSIs, suggesting a risk profile distinct from general hospital settings. The predominance of behavior-related incidents corroborates the hypothesis that primary risks are mainly driven by relational dynamics. The findings highlight that both healthcare and non-healthcare staff are exposed to significant risks, suggesting the need of inclusive and comprehensive safety interventions. Consequently, specific training programs focused on relational risk management, de-escalation, and empathic communication are essential for all workers employed in these settings.
Evaluation of anxiety levels and stress coping methods of pregnant women after the Kahramanmaraş earthquake
ObjectiveNatural disasters can cause serious psychological pressures on women during pregnancy. How the mental health of pregnant women is affected after major disasters such as earthquakes and what coping methods come into play in this process is an important research topic. This study aimed to evaluate the anxiety levels and stress coping strategies of pregnant women who experienced the February 6, 2023 Kahramanmaraş earthquake.MethodsThis cross-sectional descriptive study was carried out within four months after the earthquake. A total of 118 pregnant women were included. Participants were grouped according to pregnancy trimester. Anxiety level was assessed with the Beck Anxiety Inventory and coping strategies with the Brief COPE Scale. Earthquake exposure data, including building damage and loss of relatives, were collected via structured survey.ResultsThe mean Beck Anxiety score was 15.9 ± 12.8. A significant difference was observed between trimesters (H = 19.09, p < 0.001), with anxiety declining from the first to the third trimester. Religious coping (ρ = 0.42, p < 0.001), acceptance (ρ = 0.36, p < 0.001), and behavioral avoidance (ρ = 0.36, p < 0.001) were positively correlated with anxiety. Positive reinterpretation and development showed a significant negative correlation with anxiety (ρ = −0.32, p < 0.001). Building damage category was not significantly associated with anxiety (p = 0.80).ConclusionAnxiety in post-earthquake pregnant women differs according to trimester, and individual coping styles are associated with anxiety levels. Within the scope of the variables measured in this study, positive reinterpretation showed the strongest negative association with anxiety. Approaches supporting cognitive flexibility should be prioritized in perinatal mental health interventions.
Plasma proteomic signature of the human menstrual cycle
Nature Medicine, Published online: 13 April 2026; doi:10.1038/s41591-026-04326-5
This Resource presents a large-scale analysis of nearly 3,000 circulating plasma proteins across the menstrual cycle in over 2,700 women from the UK Biobank, revealing distinct proteomic patterns across menstrual phases. This work sheds light on female reproductive biology and gynecological disorders, and provides a proteomic signature for accurate prediction of the menstrual cycle phase.
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STAT+: Pharmalittle: We’re reading about a pancreatic cancer pill, FDA rejecting a Replimune drug again, and more
Good morning, everyone, and welcome to another working week. We hope the weekend respite was relaxing and invigorating because that oh-too-familiar routine of meetings, deadlines, and the like has returned with a vengeance. You knew this would happen, yes? To cope, we are relying, as always, on a cuppa stimulation. Our choice today is old-fashioned vanilla. Feel free to join us. Remember, no prescription is required. Meanwhile, here are some tidbits to help you along. Best of luck accomplishing your goals today, and of course, do keep in touch. …
Metastatic pancreatic cancer patients who received a targeted pill from Revolution Medicines lived nearly twice as long as patients who received chemotherapy, a striking result in a notoriously deadly and intractable malignancy, STAT reports. Patients who took the daily pill, called daraxonrasib, lived a median of 13.2 months, compared to 6.7 months for patients who received chemotherapy. The company plans to use the data to apply for approval, although it did not say when. Revolution received a Commissioner’s National Priority Review Voucher, part of a controversial U.S. Food and Drug Administration program to review drugs in just one to two months, so the pill could be considered quickly. The pill blocks a notorious group of genes called RAS. Mutant forms of the protein are present in roughly 30% of all human cancers, including over 90% of pancreatic cancers. But nearly all efforts to curb it have failed.
The FDA — again — an experimental treatment for advanced skin cancer developed by Replimune, STAT notes. The treatment, an engineered virus designed to rev up the immune system against melanoma, has been a flashpoint in a simmering debate over shifting standards at the agency. In October, Replimune resubmitted the drug and sought accelerated approval. A spokesperson said the company added new analyses on the drug’s mechanism of action and on how patients fared relative to prior treatment with an approved immunotherapy. A rejection letter posted by the agency noted that reviewers were concerned that the effects of Replimune’s drugs couldn’t be properly teased out, because the virus is given alongside Opdivo, Bristol Myers Squibb’s approved PD-1 checkpoint inhibitor.