Stroke is characterized by high morbidity, disability, and mortality, and has become the third leading cause of death worldwide. In China, stroke accounts for 39.9% of all cerebrovascular diseases, with young and middle-aged survivors (aged 40–60 years) comprising 33% of global stroke survivors in this age group and over 51.51% of all stroke cases in China. Despite significant improvements in treatment, 70–80% of survivors still lose the ability to live independently, and social participation declines to varying degrees. Social participation plays an important role in rehabilitation outcome indicators, which can reflect the overall recovery of survivors and is closely related to quality of life. Guided by the International Classification of Functioning, Disability and Health (ICF) framework, this review aims to examine the current status, assessment tools, and influencing factors of social participation among young and middle-aged stroke survivors, with the goal of informing future research and guiding clinical practice.
A qualitative study on the participation experience in a mental health recovery program based on WHO QualityRights in South Korea
IntroductionThe World Health Organization’s QualityRights initiative offers a practical framework for developing rights-based, person-centered, and recovery-oriented mental health systems. In Korea, the face-to-face WHO QualityRights specialized training module, Recovery practices for mental health and well-being, was culturally and clinically adapted for local use, incorporating Open Dialogue principles. This adaptation led to the development of the group-based “QualityRights Recovery Program.” This study examines the experiences and perspectives of individuals with lived experience of mental health challenges, their family caregivers, and mental health practitioners who participated in this program to inform the local implementation of recovery-oriented mental health practices.MethodsEighteen participants were recruited from two mental health facilities in Suwon, Republic of Korea. Researchers conducted semi-structured interviews and used thematic analysis to examine participants’ experiences with the 13-week QualityRights Recovery Program, which was adapted for the Korean clinical context.ResultsFour major themes emerged: (1) participation and engagement in recovery, (2) changes in communication and decision-making, (3) mutual understanding and shifts in perception, and (4) redefining recovery concepts and therapeutic aims.ConclusionParticipants’ perspectives on the QualityRights Recovery Program indicate its potential to restore the autonomy and well-being of individuals with lived experience, while also positively influencing the perspectives of their caregivers and practitioners. These findings provide guidance for expanding rights-based, recovery-oriented mental health interventions in Korea.
Protocol for a randomized trial to predict the efficacy of cognitive and behavioral interventions for symptoms of depression
IntroductionCognitive behavioral therapy (CBT) is one of the most common interventions for depression and has two key components: Cognitive Restructuring (CR) and Behavioral Activation (BA). However, no evidence-based guidelines exist to help clients and clinicians decide whether CBT would be a good first-line treatment for a given individual based on their personal characteristics, and which CBT intervention would benefit them more. We propose that specific capacities to learn from new information and experiences are prerequisites for response to CBT and that BA and CR require different learning capacities. In this study, we aim to develop predictive models of symptom change based on computationally-derived variables from behavioral tasks, in addition to clinical and demographic self-report data, to identify parameters and variables that can determine which individuals with depressive symptoms would benefit from CBT-based interventions and, ideally, which specific interventions they would benefit from more.Methods and analysisWe plan to recruit at least 1,500 adult participants who report having symptoms of depression and reside in U.S. After completing a series of questionnaires and behavioral tasks to assess their learning propensities, participants will be randomly assigned to a BA or a CR group. Using an online self-help tool, participants will then engage with designated modules according to their assigned group for five weeks. We will assess symptoms 1 week post-intervention (main end point of study) and follow up at 6, 18, and 42 weeks post-intervention. Upon enrolling and consenting into the main study, participants will be randomly assigned to either the training dataset or the held-out test dataset at a ratio of 2:1. This enables a clean separation of training and test datasets and prevent data leakage. We plan to build cross-validated predictive algorithms on the training dataset, and preregister our analysis plan before we validate our models and hypotheses in the held-out, unseen, test dataset. Enrollment of the study started 23rd January, 2024.Study protocol registrationClinicalTrials.gov, identifier (NCT06631183). The protocol follows the Standard Protocol Items: Recommendations for Interventional Trials (SPIRIT) guidelines. Numbers in brackets follow subsection numbers in the guidelines.
Empathy and alexithymia in essential tremor
BackgroundSocial cognition is increasingly recognized as part of the non-motor phenotype of essential tremor (ET). Available ET evidence suggests selective alterations in some socio-cognitive domains, whereas findings on self-reported empathy and alexithymia remain limited and inconsistent.ObjectivesThis cross-sectional study aimed to evaluate empathy and alexithymia in patients with ET compared with healthy controls (HC), and to explore their associations with global cognition and with each other.MethodsForty ET patients and 40 HC underwent the Italian versions of the Montreal Cognitive Assessment (MoCA), the short Empathy Quotient (EQ-short), and the Toronto Alexithymia Scale (TAS-20).ResultsET patients had significantly lower MoCA scores than HC (22.1 ± 4.1 vs. 25.3 ± 3.2, p<0.001), whereas no between-group differences emerged for EQ-short or TAS-20 scores. In ET, MoCA was not significantly associated with empathy or alexithymia measures. In HC, higher MoCA scores were associated with greater emotional reactivity. Exploratory bivariate analyses suggested inverse associations between social skills and alexithymia in ET, but only the adjusted ET models remained significant.ConclusionOur findings do not support a group-level deficit in self-reported empathy or alexithymia in ET. Rather, they suggest that socio-emotional functioning may be largely preserved at the group level, while the relationship between social skills and emotional self-description may differ in ET.
Sequencing peptides by reversing translation
Nature Biotechnology, Published online: 16 April 2026; doi:10.1038/s41587-026-03108-1
A new peptide sequencing approach converts amino acids into DNA sequences, which are easily read.
Diversity-generating retroelements for programmable targeted hypermutagenesis
Nature Biotechnology, Published online: 16 April 2026; doi:10.1038/s41587-026-03078-4
Diversity-generating retroelements are engineered for directed evolution in E.coli.
Trabectedin and low-dose irinotecan to target EWS::FLI1 in Ewing sarcoma: a phase 1/2 trial
Nature Medicine, Published online: 16 April 2026; doi:10.1038/s41591-026-04340-7
In this phase 1/2 trial, patients with Ewing sarcoma received trabectedin and low-dose irinotecan at concentrations known to inhibit the activity of the transcription factor EWS::FLI1, leading to encouraging clinical response rates.
Integrated epidemiological and molecular data inform the relationship between precancer and cancer states of esophageal adenocarcinoma
Nature Medicine, Published online: 16 April 2026; doi:10.1038/s41591-026-04331-8
Analyses of epidemiological, clinical and molecular data from a prospective cohort of 3,100 patients with esophageal carcinoma suggest intestinal metaplasia as a single precancer pathway preceding the disease.
Spatial and single-cell characterization of human glioblastoma tumor microenvironment reveals malignant cellular communities
Nature Neuroscience, Published online: 16 April 2026; doi:10.1038/s41593-026-02265-5
Integrating spatial and single-cell data from 100 patients, the authors define conserved cellular communities and communications in glioblastoma, revealing distinct mesenchymal-like tumor subtypes and predominant neurogliomal synapses that shape tumor progression.
Spatial, temporal and Notch determination of terminal selector expression controls neuronal cell fate in the Drosophila optic lobe
Nature Neuroscience, Published online: 16 April 2026; doi:10.1038/s41593-026-02256-6
The authors characterized the spatial origin of Drosophila medulla neurons, completing their previous characterization of the temporal and Notch origins of these neurons and allowing them to correlate patterning of progenitors and neuronal type-specific features.