Given substantial comorbidity among, and considerable heterogeneity within, psychiatric diagnoses, researchers have suggested alternative systems for classifying psychopathology. The Hierarchical Taxonomy of Psychopathology (HiTOP) is a recently proposed framework for understanding mental disorders based on how symptoms and diagnoses tend to cluster across individuals. While the model is grounded in existing research and supported by recent meta-analytic evidence, its structure has not yet been directly tested using large, representative clinical datasets. In this study, we used electronic health record (EHR) data to examine the overall organization of mental disorders as proposed by HiTOP, with the goal of informing future research on biological and environmental risk factors as well as important life outcomes.

Data were drawn from the All of Us Research Program, a landmark nationwide US biobank initiative designed to advance population-scale health research, and included participants’ psychiatric diagnoses and sociodemographic correlates as documented in their EHRs. A total of 127,963 participants and 39 primary diagnoses were identified. We analyzed patterns of co-occurrence among psychiatric diagnoses to identify broader psychopathology dimensions, assess the overall structure of mental disorders, and clarify the placement of conditions that have been inconsistently categorized in past research. Several competing dimensional models were compared based on their statistical fit and complementary assessments of factor strength, specificity, and reproducibility.

A model identifying six broad and correlated dimensions – Fear, Distress, Externalizing, Substance Use, Thought Problems, and Neurodevelopmental Disorders – provided the best fit to the data. This structure was highly consistent across analyses and showed strong split-half replicability and meaningful associations with relevant clinical and demographic characteristics.

These findings support a 6-factor model of psychopathology that broadly resembles major dimensions in the HiTOP framework. By addressing key gaps in the literature, this study advances our understanding of the structure and correlates of mental disorders. The results offer a foundation for more nuanced investigations into the etiology, progression, and treatment of mental health conditions.

In South Africa, community health workers (CHWs) provide home-based care and health promotion for patients with chronic conditions like hypertension. However, their views on patients’ poor blood pressure control remain unclear. Understanding CHWs’ perspectives could inform future community-level strategies for improving blood pressure management.

To explore CHWs’ experiences about factors contributing to uncontrolled hypertension among adults living in a South African District.

A qualitative exploratory design, based on 22 face-to-face, semi-structured interviews with CHW. Data was transcribed and analysed manually using thematic analysis.

Four themes emerged: (1) adequate knowledge about blood pressure and hypertension. However, lack of comprehension about the physiological concept of blood pressure and hypertension, (2) interventions used for hypertension control were contextualized and very simple, (3) contextual barriers to hypertension control included financial, personal, systemic, medication as well as cultural and traditional factors, (4) strategies to improve hypertension control included improved team work, awareness creation, holistic healthcare, improved access to clinic facilities, system-related improvements and patient initiatives.

Community health workers (CHWs) demonstrated sufficient knowledge of hypertension, highlighting the need to strengthen and standardize their training, supervision, and support. Their patient advice was practical and context-specific. To address barriers and stigma around hypertension, CHWs should lead awareness campaigns and engage in community-based exercise and support groups, with help from rehabilitation teams. Collaborating with local police and community leaders to address violence, alcohol, and crime, along with initiatives like community gardens, multidisciplinary teamwork, and more frequent home visits, could further improve hypertension control.

The benefit of endovascular treatment (EVT) in acute ischemic strokes (AIS) due to medium vessel occlusion (MeVO) remains unclear, as recent randomized controlled trials (RCTs) have shown neutral results. This meta-analysis examines the pooled efficacy and safety of EVT in MeVO.

A systematic review and meta-analysis of two RCTs (DISTAL and ESCAPE-MeVO) involving 1073 participants was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. The primary outcome was the risk ratios (RR) of excellent functional outcome, defined as modified Rankin score (mRS) 0–1 at 90 days. Secondary outcomes included mRS 0–2 and symptomatic intracranial hemorrhage (sICH).

The RR implied no significant difference between the two treatment arms; for the primary efficacy outcome, RR (mRS 0–1) was 0.95 (95% CI: 0.81–1.10; I2 = 0%), and for the secondary efficacy outcome, RR (mRS 0–2) was 0.98 (95% CI: 0.88–0.09; I2 = 10%). The EVT + best medical treatment (BMT) arm demonstrated a higher risk of sICH (RR: 2.39, 95% CI: 1.26–4.53; I2 = 0%) and serious adverse events (SAE) (RR: 1.32, 95% CI: 1.11–1.56; I2 = 0%), while mortality at 90 days (RR: 1.29, 95% CI: 0.94–1.76; I2 = 16%) showed no significant difference.

Our study showed that, in patients with AIS due to MeVO, EVT did not lead to better outcomes at 90 days when compared to BMT and was associated with a higher risk of sICH and SAEs compared to usual care, and this result was confirmed in a trial sequential analysis.

The study protocol was registered with the International Prospective Register of Systematic Reviews under the registration identification number CRD420250653970.

To evaluate the evidence for superior laryngeal nerve block in neurogenic cough and outline practical considerations for clinical use.

A systematic review was conducted in May 2024, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Eligible studies reported validated cough-specific quality-of-life outcomes and safety data.

Nine studies (1 randomised trial, 8 case series; n = 490) were included. All studies reported subjective improvement: eight conducted statistical testing and seven showed significant benefit, with the Leicester Cough Questionnaire exceeding the minimal clinically important difference and the Cough Severity Index showing reductions post treatment. Patients received an average of 2 to 3 injections, with follow-up of up to 22 months. Adverse effects were mild and transient. Neuromodulator use and behavioural therapy were inconsistently reported.

Superior laryngeal nerve block appears safe and effective as a short-term intervention, with long-term efficacy remaining uncertain. This review highlights procedural gaps and introduces a structured pathway to guide patient selection, injection and follow up. Robust multicentred trials and consensus guidelines are needed to define long-term benefit and standardise practice.

To evaluate the incidence of hospital-onset bacteremia and fungemia (HOB) among solid organ malignancy (SOM), hematologic malignancy (HM), and hematopoietic cell transplant (HCT) therapy patients at a large cancer care center.

A single-center, observational, retrospective analysis was conducted for hospitalizations between January 1, 2018, and September 30, 2024, to identify patients with a first positive blood culture on or after day four of hospitalization. Hospitalizations were grouped into three categories: SOM, HM with HCT, and HM without HCT. The primary objective was to study the incidence of HOB. Secondary objectives: identification of risk factors for HOB events and pathogens associated with HOB events.

In 45,896 admissions, 1,470 HOB events were identified (incidence: 3.2%). The incidence of HOB was highest in the HM/HCT cohort (3.8%), followed by HM without HCT (2.3%) and SOM (0.9%). Risk factors of HOB identified included HM (OR 1.49), hospitalization within the past 90 days (OR 1.50), length of stay greater than or equal to 30 days (OR 6.74), intensive care unit (ICU) admission (OR 4.06), development of a CAUTI during admission (OR 23.23), or presence of a central line (OR 51.61). The most common pathogens were Escherichia coli (20.1%), coagulase-negative Staphylococci (19.0%), and Viridians streptococci (11.3%).

This study highlights the high incidence of HOB among cancer and HCT patients. The risk factors and differential rates of HOB in subpopulations of this demographic may help to inform targeted infection prevention efforts in cancer centers.

Fine particulate matter (PM2.5) exposure and unfavourable lifestyle are both significant risk factors for mental health disorders, yet their combined effects on adolescent depression and anxiety remain poorly understood. This study aims to determine whether PM2.5 exposure and lifestyle are independently associated with adolescent depression and anxiety, and whether there are joint effects between these factors on mental health outcomes.

In this cross-sectional study, 19852 participants were analysed. PM2.5 concentrations were obtained from the ChinaHighAirPollutants (CHAP) dataset. Lifestyle factors were assessed through self-reported questionnaires, and a healthy lifestyle score was developed based on eight lifestyle risk factors. Depression and anxiety were assessed using the PHQ-9 and GAD-7 scales. Restricted cubic spline analysed dose–response relationships between PM2.5 exposure and mental health outcomes. The independent and joint effects were assessed using logistic regression models. Both multiplicative and additive interactions (relative excess risk due to interaction, RERI) were examined. Multiple classification approaches were incorporated to ensure robust results.

The study included 19852 participants with a mean age of 15.16 years (SD 1.60), comprising 9886 (49.8%) males and 9966 (50.2%) females. Depression and anxiety were identified in 3845 (19.37%) and 3230 (16.27%) participants, respectively. PM2.5 exposure showed a linear dose-response relationship with depression and anxiety. Joint effects analysis at the 75th percentile of PM2.5 with a lifestyle risk score of 4 revealed the strongest associations, with adjusted odds ratios of 4.49 (95% CI: 3.79–5.33) for depression, 4.01 (95% CI: 3.36–4.78) for anxiety and 4.24 (95% CI: 3.52–5.10) for their comorbidity. Simultaneously, significant additive interactions (RERI > 0) between high levels of PM2.5 exposure and unfavourable lifestyle factors were detected, suggesting synergistic effects on mental health outcomes. Subgroup and sensitivity analyses confirmed the robustness of these findings.

High PM2.5 exposure and unfavourable lifestyle factors demonstrated significant independent and joint effects on depression and anxiety among adolescents. These findings highlight that implementing stringent air pollution control measures, combined with promoting healthy lifestyle practices, may be crucial for protecting adolescent mental health.