Perineuronal nets (PNNs) in the primary visual cortex (V1) are specialized extracellular matrix structures that form predominantly on parvalbumin+ GABAergic neurons, marking the closure of visual critical period plasticity. More recently, PNNs are used to characterize deficits in critical period plasticity in mouse models for neurodevelopmental disorders such as Rett syndrome, Fragile X syndrome, and CDKL5 deficiency disorder. Within the mouse V1, studies typically focus on the expression and function of PNNs within the binocular zone, though PNNs are expressed in other subregions of the V1. The expression and role of these PNNs in other subregions are unknown. Here, we performed a systematic whole V1 characterization of PNN expression using Wisteria floribunda agglutinin (WFA) staining, with hemisphere-, subregion-, and anatomical axes- specificity, using a null male mouse model for CDKL5 deficiency disorder during the visual critical period. Patients with CDKL5 deficiency disorder often exhibit cerebral cortical visual impairment, though the underlying mechanisms are unclear. Compared to wild-type controls, Cdkl5-null males show regional-specific changes in WFA expression; specifically, decreased all-PNNs in V1M and increased high-intensity PNNs in V1B at P30, and increased WFA pixel intensities in all three V1 subregions at P15, suggesting precocious altered PNN expression in the Cdkl5-null V1. In both genotypes, the binocular zone has significantly higher density of PNNs at both ages, compared to the monocular zone and the rostral V1. These results lay the groundwork to probe the roles for PNNs beyond the binocular zone and cumulatively suggest that, during visual critical period, subregion-specific variations in PNN expression may lead to functional consequences within the Cdkl5-null cortex.
Perceived stress and mental health in perimenopausal women: a serial mediation study of psychological distress and social support
BackgroundThe perimenopausal phase is associated with a significantly higher prevalence of mental health disorders in women, with stress perception emerging as a pivotal risk factor. However, the psychological and social mechanisms through which stress perception influences women’s mental health during this period remain to be fully elucidated. This study aims to use a stress process model to examine how social support mediates the link between stress perception and psychological symptom severity during perimenopause.MethodsA cross-sectional survey design was used, and 549 Chinese perimenopausal women were surveyed through face-to-face questionnaires. The survey employed the Chinese Perceived Stress Scale, Kessler Psychological Distress Scale, Perceived Social Support Scale, and Psychological symptom severity (BSRS-5) to evaluate participants’ psychological symptom severity. The researchers used SPSS 26.0 for related analyses, PROCESS macro software for regression analyses, and applied the Bootstrap method to assess mediating effects.ResultsThe findings of the study indicate that perceived stress, psychological distress, and psychological symptom severity (BSRS-5) are significantly and positively correlated, and perceived social support is significantly and negatively correlated with these variables (P < 0.01). The study reveals that perceived stress significantly increases psychological symptom severity scores(BSRS-5) (effect size=0.493, 59.60%) after adjusting for confounding variables. Additionally, psychological distress and perceived social support independently mediate this relationship (effect sizes=0.204, 24.67% and 0.101, 12.21%, respectively). Additionally, perceived stress indirectly affects psychological symptom severity(BSRS-5) through the chain-mediated mediating pathway of “psychological distress → perceived social support” (effect size = 0.030, percentage = 3.62%).ConclusionStress can directly increase psychological symptom severity in perimenopausal women and indirect effects can be observed through mediating factors such as psychological distress, perceived social support, and the chain-mediated relationship between these two elements. Thus, reducing symptom severity is essential for improving mental health. The study indicates that enhancing the mental health of this group requires a multifaceted approach. This approach should focus on the alleviation of psychological distress and the promotion of social support systems. This will effectively disrupt the cycle of stress and psychological distress.
The many manifestations of magical thinking: a systematic review
Magical thinking (MT) involves beliefs that thoughts or actions can influence events in unrealistic ways. While MT is integral to obsessive compulsive disorder, and reflected in the cognitive features of schizophrenia, it is observable across the general population in various forms. Given its prevalence and potential relevance to a range of psychiatric conditions, understanding more about what may predispose an individual to MT, and how it may in some cases culminate in psychological distress or dysfunction would be helpful. This paper reports a systematic review of studies investigating MT, encompassing both magical ideation and thought-action fusion specifically, across the disciplines of psychiatry and psychology, to shed further light on the likely predisposing factors and behavioural consequences of MT, its potential neurobiological underpinnings, and role in psychiatric symptomatology. After exclusions, 191 studies were identified that explored MT in association with a diverse array of secondary topics, from gambling compulsions to childhood trauma, within both clinical and non-clinical samples, across a range of cultural contexts. On an intra-individual level, MT demonstrates numerous cognitive and emotional correlates, and on a societal level it may influence both social custom and religious tradition. A synthesis of the available evidence uncovers unexplored relationships with social cognition and mental health, and future research investigating its emerging relationships with stress, mood and social connection, may uncover functions beyond those exhibited by a simple marker of psychopathology.
Sleep quality and its associated factors among women of reproductive age in Ethiopia: a systematic review and meta-analysis
BackgroundQuality sleep is vital for women’s health during reproductive years, affecting both physical and mental well-being. In Ethiopia, socio-economic and cultural factors worsen sleep issues, but data on this demographic are scarce. This systematic review and meta-analysis assesses the prevalence of poor sleep quality among Ethiopian women and identifies contributing factors, aiming to inform interventions and policies to improve sleep health in low-resource settings.MethodThis systematic review followed PRISMA guidelines and searched PubMed, Scopus, and Web of Science for observational studies. We included studies utilizing the Pittsburgh Sleep Quality Index (PSQI), as it is the most widely validated tool for assessing subjective sleep quality across diverse populations. Reviewers independently screened articles using Rayyan and assessed study quality with the Joanna Briggs Institute tools. Data were analyzed using Stata version 17. To account for potential clinical and methodological variability across studies, a random-effects model was employed to pool results, with heterogeneity assessed using statistics and the Cochrane’s Q test. Publication bias and sensitivity analyses were also performed.ResultNine studies involving 4,376 women of reproductive age (15–49 years) in Ethiopia were included. The pooled prevalence of poor sleep quality was 49.17% (95% CI: 35.29, 63.08). Significant predictors of poor sleep quality included intimate partner violence (OR: 3.24), depression (OR: 3.37), unplanned pregnancy (OR: 2.71), multigravidity (OR: 2.61), and substance use (OR: 2.24).ConclusionA systematic review indicates that nearly half of Ethiopian women of reproductive age experience poor sleep quality. Key factors include unplanned pregnancies, substance use history, intimate partner violence, previous depression, stress, being in the third trimester, and comorbidities; these need urgent attention and the implementation of screening and preventive measures. Future research should focus on effective interventions to improve sleep quality in these populations.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/, identifier CRD42023455867.
Group-based psychosocial interventions reduce internalized stigma in psychiatric disorders: ISMI-focused systematic review
BackgroundInternalized stigma negatively impacts recovery outcomes, quality of life, and self-concept among individuals with psychiatric diagnoses. Group-based psychosocial interventions have been proposed as effective stigma-reduction strategies, but their impact across diverse populations remains under-evaluated.ObjectiveThis systematic review synthesizes global evidence on the effectiveness of group-based interventions in reducing internalized stigma in adult psychiatric populations, with a focus on studies using the Internalized Stigma of Mental Illness (ISMI) scale.MethodsFollowing PRISMA 2020 guidelines, we searched PubMed, PsycINFO and Web of Science, and additionally screened full-text platforms (SpringerLink, ScienceDirect, SAGE Journals, and Wiley Online Library), for studies published between 2003 and 2025. Inclusion criteria required adult psychiatric populations, group-based interventions, and internalized stigma as a primary outcome. Study selection, risk of bias assessment, and data extraction were performed independently by two reviewers (US and GOC).ResultsTen studies [n= 1,088], across five countries, met inclusion criteria, including randomized controlled trials and pre-post designs. Most studies reported significant reductions in ISMI scores post-intervention, particularly in the domains of stereotype endorsement and social withdrawal. Culturally adapted interventions in China, Poland, and Spain demonstrated feasibility and impact, though subscale reliability varied regionally.ConclusionGroup-based psychosocial interventions may help reduce internalized stigma in psychiatric populations within an ISMI-based evidence base. The ISMI scale is, to this day, among the most frequently used instrument, though cultural adaptation of subscales such as stigma resistance remains a concern.
Detecting bipolarity using the Lebanese Arabic hypomania checklist (HCL-32): validation of shortened HCL versions
IntroductionDue to the under diagnosis of bipolar disorder, screening instruments such as the hypomania checklist 32 items (HCL-32) is used to differentiate between Bipolar Disorder (BD) and Major Depressive Disorder (MDD). However due to its lengthy format, efforts were done to validate a shorter alternative without compromising its ability to differentiate between BD and MDD. We aimed to shorten the HCL-32 and assess the screening performance of the three Lebanese Arabic abbreviated HCL versions (HCL-20, -16, and -8) relative to the full HCL-32 in a sample of clinically diagnosed patients with BD and MDD in Lebanon.MethodsIn a sample of 760 patients (BD-I=29, BD-II=142, MDD=589) clinically diagnosed with BD and MDD, the screening performance of the three Lebanese Arabic abbreviated HCL versions (HCL-20, -16, and -8) as well as the full HCL-32, was assessed, looking at the reliability, sensitivity, and specificity.ResultsAll the shortened HCL versions showed strong reliability (a=0.78-0.90.) They also demonstrated good screening ability (AUC=0.8520- 0.8835) in differentiating BD from MDD. For the sensitivities across the shortened versions, they were consistently higher in BD-II vs MDD compared to BD-I vs MDD across all scales showing that the shortened versions have the ability to detect BD-II cases much more effectively.DiscussionThis study is the first to validate the shortened HCL versions in an Arabic speaking population. The HCL- 16 appears to be the most optimal shortened scale for distinguishing between BD versus MDD. However, these findings should be interpreted in light of the study’s limitations including the use of retrospective data collection and item interdependence of the HCL-32.
Novel antivenoms bite back
Nature Biotechnology, Published online: 20 May 2026; doi:10.1038/s41587-026-03157-6
New approaches to antivenoms for snakebite lean on cutting-edge techniques, but can they successfully be brought to market?
Directed evolution of small RNA-stabilizing motifs that improve prime-editing efficiency
Nature Biotechnology, Published online: 20 May 2026; doi:10.1038/s41587-026-03123-2
Prime editing is improved with engineered RNA-stabilizing motifs.
An AI framework for multi-disease detection via retinal imaging
Nature Medicine, Published online: 20 May 2026; doi:10.1038/s41591-026-04424-4
Using large-scale retinal images from community and tertiary hospitals, we developed Reti-Pioneer, a quality-aware, multi-task framework for multi-disease detection. Diverse external validation confirmed its generalizability. Furthermore, a prospective silent trial and clinical pilot study demonstrated its time efficiency, real-world feasibility, and potential for integration into clinical workflows.
Unintended consequences of legacy oversight in digital medicine
Nature Medicine, Published online: 20 May 2026; doi:10.1038/s41591-026-04417-3
Unintended consequences of legacy oversight in digital medicine