Social deprivation is associated with worse functional recovery and social participation after stroke. Home-based, individualized rehabilitation provided by Community Stroke Rehabilitation Teams (CSRTs) improves these outcomes. This study aimed to show that CSRTs offered an effective specific rehabilitation for socially deprived patients.

This was a retrospective study conducted in real-care conditions. Social deprivation was assessed by the Evaluation de la Précarité et des Inégalités de santé dans les Centres d’Examens de Santé score. The outcome questionnaires included the Frenchay Activity Index (FAI) and the EuroQol-5Dimension. We compared these outcomes between deprived and non-deprived (ND) populations. Rehabilitation of the deprived population was assessed by comparing interventions across both groups.

We included 198 deprived patients and 140 ND patients. Deprived patients were more often women (p = 0.027), more likely to live alone at home (p = 0.01), and were referred later to a CSRT, despite having greater activity limitations at baseline (p < 0.001). They also had a lower FAI at baseline (13.2 vs. 16.6; p = 0.007). Although their FAI improved over time (+2.4 ± 5.5; p < 0.001), the improvement was modest and insufficient to close the gap with the ND group (15.7 vs. 20.7; p < 0.001). Regarding program characteristics, the deprived population received input from a greater number of healthcare professionals (2.7 ± 1.2 vs 2.4 ± 1.3; p = 0.017) and more often from the intervention “Health professional relationship” (34.2% vs 15.6%; p = 0.005).

These findings highlight the intersectionality of stroke-related challenges and the critical need to design post-stroke rehabilitation strategies that are more equitable and responsive to gender and social determinants of health.

The distinction between passive and active suicidal ideation (SI) and their underlying etiologies remains poorly understood. The Interpersonal Theory of Suicide implicates guilt, loneliness, and hopelessness in these SI subtypes, but there is minimal work testing these relationships in real time, capturing clinically meaningful fluctuations in SI. We conducted the first ecological momentary assessment (EMA) study to distinguish between passive and active SI in adolescents, and the first study to evaluate moment-to-moment etiological factors and mediators of passive and active SI in this age group.

Participants (N = 104) were adolescent psychiatric inpatients (Mage = 15.1; 72.12% female). They completed an EMA protocol including measures of guilt, loneliness, hopelessness, and passive and active SI for four weeks post-discharge. Multilevel modeling was used to evaluate guilt and loneliness, respectively, as predictors of prospective passive and active SI, respectively. We also evaluated whether hopelessness mediated the interaction between guilt and loneliness in predicting future SI. Hopelessness was also evaluated as a mediator between passive and active SI.

Guilt predicted prospective passive and active SI, respectively, whereas loneliness only predicted prospective passive SI. The interaction between guilt and loneliness did not predict active SI, and hopelessness did not mediate the association between guilt and active SI. Passive SI prospectively predicted active SI, but hopelessness did not mediate this association.

Findings suggest that passive and active SI may share overlap but also differences in their etiologies. Their relationship with etiological factors and mediators may differ as a function of temporal scale.

Depression among middle-aged and older adults is a critical public health priority. Clarifying the dynamic evolution of depression is essential for establishing prevention and intervention strategies; however, relevant research is limited. The aim of this study was to elucidate the transition patterns underlying different depressive symptoms (DS) states.

Data from the China Health and Retirement Longitudinal Study were utilised in this study, which included participants aged ≥45 years with multiple DS assessments via the Center for Epidemiological Studies Depression Scale. Multi-state Markov models were employed to estimate transition probabilities and intensities between DS states, the total length of stay and mean sojourn time in each state and the hazard ratios (HRs) of factors.

Among 19,991 participants (average follow-up: 7.3 years), the 10-year cumulative probabilities of transition from non-DS to depressive states increased by 19.4% in males and 31.8% in females. Mild DS was the most unstable state, with the highest transition intensities (males: 1.029; females: 0.970) and shortest sojourn time (males: 0.959 years; females: 1.022 years). Sex and age strongly influenced depressive state transitions. Compared to participants without chronic disease, those with ≥3 chronic diseases had a higher risk of developing mild DS (HR = 1.685, 95% Confidence Interval [CI]: 1.530–1.856) and transitioning to death from both the non-DS (HR = 2.905, 95% CI: 2.293–3.681) and severe-DS (HR = 3.429, 95% CI: 1.290–9.112) states, but a lower likelihood of recovery from mild DS (HR = 0.821, 95% CI: 0.749–0.900) and severe DS (HR = 0.730, 95% CI: 0.630–0.847). Compared to no participation in social activities, frequent participation was associated with a lower risk of progression to the mild-DS state (HR = 0.851, 95% CI: 0.785–0.920) and a greater likelihood of recovery from severe DS (HR = 1.169, 95% CI: 1.034–1.322). Being underweight was associated with an increased risk of mild-DS onset (HR = 1.338, 95% CI: 1.129–1.587) and transitioning to death from both the non-DS and mild-DS states, compared with individuals of normal weight.

Our study revealed a continuous population shift towards depressive states and identified the mild-DS state as a critical intervention state owing to its instability. In addition to sex and age, modifiable factors, including chronic disease conditions, social activity participation and weight status, significantly influenced DS-state transitions, offering actionable insights for precision prevention strategies.

To extend the current understanding of executive function (EF) deficits in youth with neurofibromatosis type 1 by investigating the impact of cognitive load on performance compared to typically developing children.

In this prospective multicenter study, 42 children with neurofibromatosis type 1 (NF1) (ages 7–18) completed neuropsychological assessments of intellect and executive functioning. Age- and sex-matched controls (n = 42) were drawn from the normative database for the tasks of executive control (TEC). Multivariate and supplementary univariate analyses examined group differences and task effects (inhibitory control and working memory demand). Associations between TEC performance and parent-reported executive dysfunction (BRIEF) were also explored.

Both groups showed reduced accuracy and speed with increased inhibitory demand and made fewer errors with increased working memory demand. However, children with NF1 were significantly less accurate and consistent across tasks, particularly under higher cognitive load, while controls improved or maintained performance. Significant group × cognitive load interactions were observed, and laboratory-based deficits in NF1 were associated with parent-reported executive dysfunction.

Children with NF1 experience unique and multidimensional decrements in EF performance in response to increased cognitive load, unlike typically developing peers. These deficits appear to be clinically relevant. Targeting working memory and inhibitory control may reduce susceptibility to cognitive overload and improve outcomes for children with NF1.

One of the challenges of psychological research is obtaining a sample representative of the general population. One largely overlooked participant characteristic is sub-clinical levels of psychiatric symptoms.

A series of studies were conducted to assess (i) whether typical psychology study participants had more psychiatric symptoms than the general population, (ii) whether there are sub-groups defined by psychiatric symptoms within the no-diagnosis, no-medication participant pool, and (iii) whether sub-clinical levels of psychiatric symptoms have an effect on standard behavioral tasks. Five UK national datasets (N > 10,000) were compared to data from psychology study participants (Study 1: n = 872; Study 2: n = 43,094; Study 3: n = 267).

Psychology study participants showed significantly higher levels of anxiety and depression and lower well-being, according to four commonly used mental health measures (GHQ-12, PHQ-8, WEMWBS, and WHO-5). Five sub-groups within the psychology study participant group were identified based on symptom levels, ranging from none to significant psychiatric symptoms. These groupings predicted performance on tests of executive function, including the Stroop task and the n-back task, as well as measures of intelligence.

This study demonstrates that standard psychology participant pools are unrepresentative and suggests that a failure to account for psychiatric symptoms when recruiting for any psychological study is likely to negatively impact the reproducibility and generalizability of psychological science.

Building collapses, debris removal, new construction, and increased stove use for heating have elevated air pollution in regions affected by the February 6, 2023, Kahramanmaraş earthquake. This study examines the relationship between carbon monoxide (CO) poisoning and air pollution in these areas 1 year after the disaster.

A retrospective analysis of 151 patients from 10 hospitals in 8 cities was conducted, including data on demographics, clinical symptoms, sources of CO exposure, vital signs, laboratory findings, air pollution levels, and outcomes.

Indoor stove use was the primary source of CO exposure. The average Air Quality Index (AQI) was 55 (IQR 44-56), and particulate matter (PM2.5) levels averaged 17.5 μg/m3 (IQR 10-27), exceeding EPA (Environmental Protection Agency) thresholds. AQI levels post-earthquake were significantly higher than pre-earthquake in Kahramanmaraş (AQI1 = 48.5 [IQR 48-55], AQI2 = 55 [IQR 55-80]; P = 0.007), Hatay (AQI1 = 40.5 ± 13.7, AQI2 = 56 [IQR 51-60.5]; P <0.001), and Gaziantep (AQI1 = 44 [IQR 41-56], AQI2 = 55 [IQR 54-55.5]; P = 0.014). Leukocytosis (P = 0.004) and myocardial injury (P <0.001) in CO poisoning cases varied significantly across provinces.

In conclusion, elevated AQI and PM2.5 levels likely worsened myocardial injury in CO poisoning cases due to combined outdoor and indoor pollution effects. These findings emphasize the need for air quality monitoring and mitigation in disaster regions.

To develop an evaluative framework for assessing the emergency response capabilities of higher education institutions to major emerging infectious diseases, enabling institutions to identify preparedness gaps and prioritize improvements across the outbreak lifecycle.

The Haddon Matrix was used as the foundation for the framework. A Delphi study with a Likert scale was conducted, followed by the Analytic Hierarchy Process (AHP) to determine the importance of the indicators.

A consensus was reached on the evaluation system, comprising 3 primary indicators: prevention and preparedness, response and handling, and recovery and rehabilitation. These indicators were further divided into 11 secondary and 34 tertiary indicators. Expert authority coefficients were 0.82 and 0.80, and Kendall’s coefficients were 0.32 and 0.161 (P < 0.001). AHP highlighted prevention and preparedness as the highest-priority domain (weight = 0.426), followed by recovery and rehabilitation (0.326). High-priority items included safety knowledge dissemination, emergency command systems, primary prevention, and timely warning and monitoring.

Integrating the Haddon matrix, Delphi consensus, and AHP, this study delivers a validated, prioritized framework to assess universities’ MEID response capability across phases. External validity beyond Shanghai remains to be established; cross-regional applicability should be empirically tested through multi-site validation, broader stakeholder representation, and evaluation of technology-enabled components, particularly in resource-limited settings.