BackgroundItaly’s community-based mental health model, grounded in Law 180, has long been regarded as a global example of rights-oriented psychiatric reform. However, recent years have witnessed a crisis in the national health system, marked by chronic and progressively accumulating underfunding, workforce shortages, and organizational strain, rather than a single acute disruption. This s/tudy compares two samples of informal caregivers of individuals receiving mental health care in Sardinia (2024 vs. 2025) to explore differences in their perceptions of service quality, organizational well-being, and respect for human rights.MethodsA cross-sectional design was used to compare independent caregiver samples (2024: n = 100; 2025: n = 74). Participants completed the Well-Being at Work and Respect for Human Rights Questionnaire (WWRR), which assesses satisfaction with care, perceptions of organizational quality, and respect for users’ and staff’s rights. Data were analyzed with ANOVA and chi-square tests.ResultsCaregivers in 2025 reported significantly higher satisfaction than those in 2024 regarding the quality of services (p = 0.007), organizational aspects (p = 0.007), and respect for the human rights of both users (p < 0.001) and staff (p = 0.037). No differences emerged in perceived user satisfaction or resource adequacy, with both cohorts expressing persistent concern about staffing and infrastructure. The perceived need for additional nurses, doctors, and support staff increased in 2025, which may indicate growing awareness of workforce fragility.ConclusionsThese differences in satisfaction should be interpreted within a context of prolonged systemic strain, which may foster adaptive or resilience-based perceptions among informal caregivers. Despite ongoing structural difficulties, informal caregivers maintain high confidence in Italy’s community mental health services and perceive them as respectful of human rights. However, their increasing concern about resource shortages highlights the urgent need for investment to preserve the ethical and organizational strengths of the Italian model.
Hyponatremia in patients with severe anorexia nervosa was associated with more severe and longer duration of disease
IntroductionSeveral mechanisms are thought to contribute to hyponatremia in patients with anorexia nervosa (AN). The aims of this descriptive, cross-sectional study among patients admitted to a specialized somatic unit for eating disorders (ED) were to determine the frequency of hyponatremia and to compare medical findings between patients with normonatremia and hyponatremia.MethodsThis retrospective, descriptive cross-sectional study included patients admitted to the unit between December 2016 and October 2021. Demographic, medical history, and clinical data were extracted from medical records. Patients were categorized according to plasma sodium concentration (<135 mmol/L vs. ≥135 mmol/L).ResultsAmong 131 patients, 17 (13%) had hyponatremia at admission. Hyponatremia was associated with lower BMI, lower nadir BMI, longer disease duration, and an adverse biochemical profile (lower albumin, higher creatinine, higher platelet counts, and higher bicarbonate levels). Thirteen patients (10%) were deceased at follow-up; hyponatremia was associated with mortality in unadjusted analysis (OR 8.03, 95% CI 2.29–28.16) but not after multivariable adjustment.DiscussionThe study found that 13% of patients admitted to a specialized somatic unit for ED had hyponatremia, which clustered with indicators of more severe and longstanding AN (lower BMI, lower nadir BMI, longer disease duration). Hyponatremia was associated with mortality in unadjusted analyses, but this association was attenuated after adjustment for age and illness severity. Despite the established potential of purging to induce hyponatremia, our findings suggest that, in this severely ill inpatient population, overall illness severity and chronic medical deterioration may be more important determinants of both hyponatremia and mortality risk than purging per se.
Metacognitive model of suicidality: a study of Iranian inpatients
BackgroundThe metacognitive model of suicidality proposes that positive metacognitions about suicide activate suicide-specific rumination, which in turn leads to the activation of negative metacognitions about suicide and an escalating aggravation of suicidal ideation/behavior. Initial studies support the model assumptions. However, investigations in highly burdened inpatient samples as well as studies in non-Western samples are missing by now.MethodsA total of 209 Iranian psychiatric inpatients (56.9% female; age M = 31.14, SD = 11.04) took part in a cross-sectional assessment. Self-report measures to assess suicidal ideation/behavior, depressive symptoms, suicide-specific rumination, and metacognitions about suicide were used.ResultsPositive metacognitions about suicide were associated with suicide-specific rumination. Suicide-specific rumination was associated with negative metacognitions about suicide. Suicidal thoughts were positively and positive metacognitions about suicide were negatively associated with lifetime suicide attempts.ConclusionThe results support assumptions of the metacognitive model of suicidality and underscore the importance of metacognitions about suicide and suicide-specific rumination in understanding the suicidal process.
Editorial: Enhancing the social skills and social competence for children and adolescents with autism spectrum disorder
Sleep-related problems among patients with rheumatoid arthritis in the World Health Organization Eastern Mediterranean region: a systematic review and meta-analysis
BackgroundSleep-related problems are common among patients with rheumatoid arthritis (RA) and contribute substantially to disease burden and reduced quality of life. Evidence from the World Health Organization Eastern Mediterranean Region (WHO EMRO) remains fragmented, with variability in reported prevalence, sleep constructs assessed, and associated risk factors. This study aimed to systematically review and meta-analyze the prevalence and correlates of sleep-related problems among adults with RA in WHO EMRO countries.MethodsA systematic search of PubMed, Scopus, Web of Science, Embase, CINAHL, and Google Scholar was conducted to identify observational studies reporting sleep-related outcomes among adults (≥18 years) with RA in WHO EMRO countries from inception to 27 July 2025. Study screening, data extraction, and quality appraisal using Joanna Briggs Institute (JBI) checklists were conducted primarily by a single author, with methodological oversight and consultation from senior collaborators. Eligible studies reported prevalence or sufficient data to calculate prevalence of specific sleep-related constructs, including subjective sleep quality, insomnia symptoms, daytime sleepiness, or obstructive sleep apnea. Random-effects meta-analysis (DerSimonian-Laird) was used to pool prevalence estimates and odds ratios (ORs) for associated risk factors. Heterogeneity was assessed using the I² statistic and Cochran’s Q test. Subgroup analyses were conducted by sleep construct, assessment method, and country. Publication bias was evaluated using funnel plots, Egger’s test, and Begg’s test, with cautious interpretation due to the small number of studies.ResultsTen studies met inclusion criteria for qualitative synthesis, and six studies (n = 2,315 participants) were included in the quantitative meta-analysis. The pooled prevalence of sleep-related problems was 60.9% (95% CI: 56.5%–65.2%), with substantial heterogeneity (I² = 88%, p < 0.001), reflecting differences in sleep constructs and assessment methods. Subgroup analyses yielded pooled prevalence estimates of 58% for insomnia symptoms, 65% for obstructive sleep apnea-related measures, and 61% for poor subjective sleep quality (PSQI above cut-off), with no statistically significant differences between subgroups. Among associated factors, depression showed the strongest association with sleep-related problems (OR = 2.65; 95% CI: 1.87–3.75), followed by pain (OR = 2.18; 95% CI: 1.68–2.84), fatigue (OR = 1.91; 95% CI: 1.45–2.52), female gender (OR = 1.67; 95% CI: 1.25–2.23), and older age (OR = 1.42; 95% CI: 1.12–1.80). Heterogeneity for risk factor analyses ranged from low to moderate. Publication bias assessments did not indicate statistically significant small-study effects but were underpowered.ConclusionSleep-related problems—assessed using heterogeneous subjective and objective measures—are highly prevalent among patients with RA in WHO EMRO countries with available data. Given substantial clinical and methodological heterogeneity and the limited number of contributing countries, findings should be interpreted as reflecting overall sleep-related burden rather than the prevalence of a single clinical disorder. Routine screening, multidisciplinary management, and culturally adapted interventions are recommended. Future large-scale, longitudinal studies using standardized diagnostic criteria across a broader range of WHO EMRO countries are needed to strengthen the evidence base.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO/view/CRD420251109906, identifier CRD420251109906.
Pathogenic germline variants identify elevated cancer risk in pediatric patients referred for genetic testing
Nature Medicine, Published online: 29 May 2026; doi:10.1038/s41591-026-04451-1
Through large-scale genomic analysis, we show that pathogenic germline variants in pediatric cancer-predisposition genes are associated with increased subsequent tumor risk, highlighting their value for counseling and surveillance.
Mapping the genetic diversity of Indigenous Americans
Nature Medicine, Published online: 29 May 2026; doi:10.1038/d41591-026-00028-0
A comprehensive analysis of Indigenous American genomes charts an evolutionary history shaped by unique geographic and cultural environments, climate shifts, and colonization, and reveals natural selection of genes involved in immunity, metabolism and reproduction.
An unexpected molecular explanation for how tau aggregation begins in Alzheimer’s disease
Nature Neuroscience, Published online: 29 May 2026; doi:10.1038/s41593-026-02298-w
Disruption of a neuronal-specific protein degradation system, the plasma membrane-bound neuroproteasome, triggers the conversion of endogenous tau into aggregates that mirror those seen in patients with Alzheimer’s disease (AD). Aging and APOE4 — the largest risk factors for AD — induce neuroproteasome loss, which provides a potential mechanistic basis for sporadic AD.
Neuroproteasomes regulate endogenous tau paired helical filament formation in an APOE genotype- and age-dependent manner
Nature Neuroscience, Published online: 29 May 2026; doi:10.1038/s41593-026-02297-x
A cellular explanation for how tau aggregates into fibrils in Alzheimer’s disease has been elusive. This paper identifies the failure of ‘neuroproteasomes’ as sufficient to convert tau into paired helical filaments, a process regulated by ApoE and aging.
The Download: unlocking lithium and controlling Ebola
This is today’s edition of The Download, our weekday newsletter that provides a daily dose of what’s going on in the world of technology.
How a new extraction process could unlock the world’s lithium
A new method for extracting lithium could cut costs and emissions from one of the world’s most important materials for EVs and energy storage.
The technique uses a weak acid to dissolve silicate minerals. That frees not only the lithium but also other useful materials, including alumina and silica.
“At scale, we believe this will be the lowest-cost way of sourcing lithium in the world,” says Yet-Ming Chiang, an MIT professor who co-authored a study of the process published yesterday in Science.
Startup Rock Zero is already working to commercialize the research. Read the full story on a new way to unlock the world’s lithium.
—Casey Crownhart
The deadly Ebola outbreak is proving difficult to control
The alert was raised on May 5. Four health-care workers in the Democratic Republic of the Congo had died from an unknown illness within four days. Tests in Kinshasa revealed the culprit: the Bundibugyo virus, one of the causes of Ebola.
A couple of weeks ago, an outbreak of hantavirus erupted aboard a cruise ship. Three people died, but the outbreak was kept under control. The picture for Ebola is bleaker for several reasons, including the disease itself, the available treatments, and the local environment.
Find out why the outbreak is causing alarm.
—Jessica Hamzelou
This story is from The Spark, our weekly newsletter giving you the inside track on all things biotech. Sign up to receive it in your inbox every Thursday.
How the Pope’s Magnifica Humanitas offers a template for individuals to meet the AI moment
——Father Séamus Finn, a leader in faith-based and socially responsible investing with the Oblates of Mary Immaculate, and Sister Susan Francois, assistant congregation leader and treasurer of the Sisters of St. Joseph of Peace
Pope Leo XIV’s new encyclical on artificial intelligence includes a statement that warrants serious attention from technologists and policymakers: “Technology is never neutral.”
Magnifica Humanitas is a call to act with courage and solidarity as AI transforms human life, framing the choice ahead as one between the Tower of Babel and the rebuilding of our common humanity. It warns that corporations alone cannot set the direction of such a transformation.
With governments slow to regulate AI, institutional investors are stepping into the gap. Here’s how they can build a better future.
The must-reads
I’ve combed the internet to find you today’s most fun/important/scary/fascinating stories about technology.
1 Anthropic is now valued higher than OpenAI
It hit a $965 billion valuation after a new funding round. (AP News)
+ Claude demand has driven annualized revenue to $47 billion. (WSJ $)
+ The funding round may be Anthropic’s last before an IPO. (TechCrunch)
+ What even is the AI bubble? (MIT Technology Review)
2 A Blue Origin rocket has exploded in a setback to NASA’s Moon plans
New Glenn burst into flames during testing on a Florida launchpad. (CNBC)
+ Blue Origin is heavily involved in NASA’s Moon base plans. (The Verge)
+ It also wants to compete with Elon Musk’s SpaceX. (Reuters $)
3 Adversaries are tracking US troop locations via mobile phone data
The Pentagon has long ignored warnings of this exact threat. (Reuters $)
+ The targeting uses commercially available location data. (Wired $)
+ LLMs could supercharge mass surveillance. (MIT Technology Review)
4 Anthropic plans a broad rollout of Mythos AI in the coming weeks
Despite concerns over its cybersecurity capabilities. (CNET)
+ Claude Opus 4.8 is now out, with a promise to be more honest. (The Verge)
5 Grok oversaw a crime spree in an AI safety test
Models were tasked with governing a simulated society. (Fortune)
+ Grok committed 180 crimes, while Claude ruled with restraint. (Gizmodo)
6 Amazon has scrapped an AI leaderboard after worker gaming
Employees were artificially inflating usage scores. (FT $)
+ We can build better AI benchmarks. (MIT Technology Review)
7 Political spending by AI and crypto groups is shifting elections
They’ve pushed their preferred candidates closer to power. (Axios)
8 China’s tech boom is fueling a new wave of industrial tourism
Visitors are touring AI labs and EV factories. (Rest of World)
9 Alibaba’s MuleRun aims to replicate the OpenClaw craze
The AI agent platform is positioned as a safer alternative. (SCMP)
10 Mysterious changes have emerged in the Sun’s magnetic field
They could reshape space weather forecasts. (404 Media)
Quote of the day
“What Peter Thiel is doing is terrible. His settling in Argentina is even worse.”
—Elisa Lilita Carrió, an Argentine politician, writes on X that Peter Thiel’s relocation to her country has angered her even more than his leadership of Palantir.
One More Thing
NASA, ESA, CSA, STSCI, WEBB ERO PRODUCTION TEAM
How the James Webb Space Telescope broke the universe
When the James Webb Space Telescope began full operations in 2022, astronomers were in awe of the flood of data that arrived.
“Every hour we were looking at a galaxy or an exoplanet or star formation,” says NASA scientist Heidi Hammel. “It was like a firehose.”
Since then, JWST has delivered nonstop discoveries, from distant galaxies to new planetary atmospheres. “We’re cracking open an entirely new window on the universe,” says Hammel.
Discover how JWST has transformed astronomy.
—Jonathan O’Callaghan
We can still have nice things
A place for comfort, fun, and distraction to brighten up your day. (Got any ideas? Drop me a line.)
+ Kubrick fans will love this Lego recreation of Dr Strangelove.
+ Here’s a fascinating explanation of why seven landlocked countries have navies.
+ This mesmerizing 4K remaster of a super typhoon turns weather data into cinematic art.
+ Go inside the genius of Queen with this track-by-track breakdown of “Bohemian Rhapsody.”