Central nervous system stimulants like methamphetamines and cocaine are known to increase the risk of intracranial haemorrhage (ICH) in adults. However, the effects of prenatal methamphetamine exposure on neonatal cerebrovascular outcomes remain underexplored despite its growing prevalence.

To assess whether prenatal methamphetamine exposure increases offspring ICH risk versus unexposed pregnancies, and to compare findings with 3,4-methylenedioxymethamphetamine (MDMA)/opioid exposures, including stratification by gestational age.

This nationwide, population-based cohort study in Taiwan included pregnancies resulting in live births between 2004 and 2018, and followed offspring through 31 December 2019 to examine the association between prenatal exposure to methamphetamines, MDMA or opioids and incident ICH in offspring. The cohort included 53 455 pairs of pregnant women and their first offspring, with 10 691 exposed to illicit drugs and 42 764 matched controls. Cox proportional hazards models estimated adjusted hazard ratios (aHRs), accounting for maternal age, comorbidities, socioeconomic status and other confounders.

Prenatal methamphetamine exposure was associated with a higher risk of ICH in offspring compared with unexposed controls (0.4 v. 0.2%, aHR = 1.72, 95% CI 1.06–2.79). This elevated risk persisted among those exclusively exposed to methamphetamines (aHR = 1.82, 95% CI 1.04–3.29). No statistically significant association was observed for MDMA (0.2 v. 0.2%; aHR = 1.58, 95% CI 0.64–3.93; p = 0.324) or illicit opioids (0.4 v. 0.2%; aHR = 1.43, 95% CI 0.81–2.53; p = 0.214). Stratified analyses showed methamphetamine exposure increased ICH risk among full-term infants (aHR = 4.30, 95% CI 2.08–8.88), with no statistically significant association observed in preterm infants (aHR = 1.00, 95% CI 0.52–1.93).

Prenatal methamphetamine exposure was associated with a higher risk of offspring ICH, particularly among full-term infants. These findings support the importance of efforts to reduce methamphetamine use during pregnancy.

Prior observational studies have reported conflicting results regarding whether antidepressant treatment reduces long-term dementia risk, likely due to confounding by indication and reverse causation. We aimed to investigate the association between baseline antidepressant use and incident dementia, incorporating cognitive and neuroimaging outcomes.

We conducted a prospective cohort study using UK Biobank participants free of dementia at baseline. Antidepressant use was self-reported at baseline (2006–2010). Incident dementia was identified through linked electronic health records until December 19, 2022. Cox proportional hazards models estimated hazard ratios (HRs) for all-cause dementia, Alzheimer’s disease (AD), and vascular dementia (VD), adjusting for sociodemographic, lifestyle, health-related, antidepressant indication factors, and co-medication of other anticholinergics. In subsamples, cognitive performance (n = 57,330) and structural brain imaging (n = 42,276) were examined as intermediate outcomes.

Among 461,464 participants, 33,721 (7.3%) reported baseline antidepressant use. Over a mean follow-up of 13.4 years, 7,922 (1.7%) developed incident dementia. Baseline antidepressant use was associated with higher risks of all-cause dementia (adjusted HR: 1.47, 95% CI 1.36–1.60), AD (1.53, 1.36–1.73), and VD (1.44, 1.23–1.70). Users performed worse on fluid intelligence and prospective memory tasks and showed lower total and gray matter volume, regional reductions in the hippocampal gray matter and basal nucleus, and greater white matter hyperintensity volume.

Baseline antidepressant use was linked to a higher risk of dementia, poorer cognitive performance, and adverse brain structural changes. These findings underscore the importance of judicious prescribing, regular cognitive monitoring, and consideration of non-pharmacological approaches in clinical care.

To evaluate the impact of the COVID-19 pandemic on physical growth, nutritional intake and immune function in children aged 12–24 months.

A cross-sectional analysis was conducted utilising data from the National Health and Nutrition Examination Survey (NHANES). Pre-pandemic (2017–2018) and pandemic (2021–2023) cohorts were compared.

Nationally representative data from the United States.

Children aged 12–24 months (pre-pandemic: n 3 904 863; pandemic: n 3 496 904).

No significant differences were observed in physical growth (weight, length and BMI) or macronutrient intake between cohorts. Pandemic-born children had lower vitamin A (437·0 v. 540·0 mcg/d, P = 0·006) and B12 (2·7 v. 3·4 mcg/d, P = 0·009) intake but higher vitamin C intake (87·0 v. 62·8 mg/d, P < 0·001). Inflammatory markers (neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio and systemic immune-inflammation index) showed minor age- and sex-specific variations but remained within normal ranges. Environmental toxin exposure (cadmium and mercury) was significantly reduced during the pandemic.

The COVID-19 pandemic did not substantially alter growth, nutrition or immune function in infants and toddlers, though micronutrient intakes and toxin exposure shifted. Long-term monitoring is warranted.

The high comorbidity between mental and cardiovascular diseases is widely recognized, but the underlying mechanisms are not yet well understood. We investigated the familial coaggregation and shared genetic loading between these diseases.

Using claims data from Taiwan’s universal health insurance program, we identified cohorts of 4,513,509 individuals with parental information and 3,330,181 with full-sibling information born between 1970 and 1999, and followed up until 2020. Genotyping was available for 106,796 unrelated participants from the Taiwan Biobank. Multiple logistic regression models were used to estimate the association of parental history, full-sibling history, and polygenic risk scores (PRSs) for severe mental illnesses (schizophrenia, bipolar disorder, major depressive disorder [MDD]) with the risk of myocardial infarction, stroke, peripheral arterial disease (PAD), and heart failure.

Individuals with a parental history of schizophrenia, bipolar disorder, or MDD were more likely to have stroke and PAD. Coaggregation in full-siblings was observed for MDD with myocardial infarction and heart failure, bipolar disorders with stroke, and schizophrenia with PAD. The PAD risk increased with more relatives affected by MDD; the magnitude of association was larger when both parents were affected than when either parent was affected, and when there were two affected siblings than in those with only one. MDD PRS was positively associated with the risk of myocardial infarction and PAD.

This study revealed familial coaggregation between mental and cardiovascular diseases, and shared polygenic liability of MDD with cardiovascular diseases. Our findings suggest the potential benefit of family-based integrated screening and preventive strategies.

The relationship between frailty, self-efficacy, and advance care planning (ACP) remains unclear in Asia. This study examined how frailty status relates to decisional self-efficacy, ACP engagement, and advance directive completion among older adults receiving home healthcare in Taiwan.

A cross-sectional analysis was conducted using baseline data from a nationwide cohort in Taiwan. Participants (N = 358) were categorized by Clinical Frailty Scale (CFS): mildly frail (CFS 4–5, n = 60), moderately frail (CFS 6, n = 83), severely frail (CFS 7, n = 147), and very severely frail (CFS 8–9, n = 68). ACP engagement and decision-making self-efficacy were assessed using Likert scales.

Patients with greater frailty had lower odds of high decisional self-efficacy (CFS: 8–9: odds ratio [OR] = 0.38, 95% confidence interval [CI] = 0.14–1.07) but higher odds of ACP engagement (CFS: 6: OR = 3.38, 95% CI = 1.40–8.17; CFS: 7: OR = 2.52, 95% CI = 1.08–5.89) compared with mildly frail individuals. However, this increase did not extend linearly to the very severely frail group. Advance directive completion remained low across all frailty levels (4.8–10.0%) and was not significantly associated with frailty status.

Frailty was associated with lower decisional self-efficacy but higher readiness for ACP, revealing a divergence between perceived confidence and planning motivation. Despite greater engagement, advance directive completion remained low. Stage-sensitive, values-based approaches may help bridge the gap between intention and documentation across the frailty spectrum.

Lifestyle changes and unhealthy eating habits have led to a sharp rise in obesity rates worldwide. Obesity is closely associated with a range of complications, including cognitive impairment and dementia. Accumulating evidence indicates that obesity negatively affects cognitive function and may increase the risk of neurodegenerative diseases. Conversely, cognitive dysfunction may further contribute to the development and progression of obesity. With growing attention in this field, obesity-related cognitive impairment has emerged as an important research focus at the intersection of metabolic and neurological disorders.

This article reviews the potential mechanisms underlying obesity-related cognitive impairment and summarizes emerging therapeutic strategies.

The development and progression of obesity-related cognitive impairment involve multiple mechanisms, including insulin resistance, systemic and central inflammation, immune dysregulation, microcirculatory alterations and changes in neurotransmitters and synaptic plasticity. Recent studies have focused on the adipose tissue-brain axis and the microbiota–gut–brain axis, in particular, the targeted effects of extracellular vesicles released from adipose tissue and microbiota on the brain.

This article systematically reviews the mechanisms underlying obesity-related cognitive impairment and presents novel therapeutic strategies.

To explore barriers and facilitators experienced by Australian organizational stakeholders in implementing COVID-19 vaccine rollout for health professional students.

A qualitative study using semi-structured interviews with organizational stakeholders, including senior health department staff, university clinical placement coordinators, and clinical educators across Australia from November 21 to December 20, 2022, via ZOOM. An inductive and then deductive thematic analysis was conducted, guided by the Theoretical Domains Framework.

Nineteen participants were interviewed. Five key domains were generated: environmental context and resources, attention, decision-making, and goals, professional role and identity, emotion, and optimism. Barriers included top-down communication, inconsistent messaging, and limited vaccine access, leading to negative emotions. Enablers included teamwork, adaptability, and optimism.

The findings offer insights into operational challenges and support during the vaccine rollout. These lessons should inform strategies to overcome similar barriers in future large-scale health interventions or emergency responses.

Research has reported that prehospital time and distance play a crucial role in determining patient outcomes such as mortality or injury severity. This study aimed to investigate the association of prehospital time with traffic injury severity.

This study employed a retrospective analysis of data from January 1, 2016, to December 31, 2022, focusing on 5,022 traffic crash patients admitted to a Level-I trauma center and transported by EMS in Taiwan. The variables included were EMS prehospital time (response, on-scene, and transport times), patient demographics (age and gender), crash time, and injury severity score (ISS). Patients with ISSs ≥ 9 were classified as sustaining killed or serious injuries (KSIs). Chi-square tests identified risk factors, and logistic regression models estimated the adjusted odds ratio for KSI.

The results revealed that an increased minute of prehospital time was associated with an increase in the risk of KSI by 2%. A response time over 4 minutes raised the KSI risk by 80%, while on-scene and transport times of 7 minutes or more increased the risk by 98% and 87%, respectively. Total prehospital time exceeding 21 minutes led to a 97% higher KSI risk. Logistic regression models revealed that crashes between 00:00 and 5:00 had a 70% higher KSI risk, with elderly individuals at midnight facing a fivefold greater risk than other age groups.

Study findings support the notion that enhancing EMS efficiency may provide crucial clues for improving trauma care programs. In addition, strategic deployment of emergency personnel during high-risk early morning hours can be beneficial in dealing with serious traffic accident injuries.

Comprehensive Emergency Management (CEM) and Hazard Vulnerability Analysis (HVA) are vital topics in disaster management, particularly for hospital emergency preparedness training. Traditionally, these topics are taught through lectures, which rely heavily on the instructor’s ability, potentially limiting effectiveness. This study introduces a serious game approach as an alternative method and compares its effectiveness with lectures in fostering engagement and knowledge gain.

Participants, all hospital staff, were divided into two groups. The Lecture (L) group received a traditional lecture from an expert in hospital emergency management, while the Game (G) group engaged in a board game, “Hospital Hazard,” designed by the researchers to teach CEM and HVA concepts. Participants completed surveys before and after the sessions. The pre-survey assessed interest in learning CEM and HVA and willingness to engage in hospital CEM/HVA activities, using a 5-point Likert scale (1=very low, 5=very high). The post-survey reassessed these metrics and evaluated session enjoyment, willingness to recommend, perceived educational effectiveness, and knowledge gain, also on a 5-point scale (1=very poor, 5=very good).

The L group included 60 participants, and the G group had 109. Both groups showed significant improvement in interest and willingness after the sessions (Interest: L 3.65 → 4.08, G 3.76 → 4.30; p<0.05; Willingness: L 3.67 → 4.07, G 3.83 → 4.30; p<0.05). The G group rated the game significantly higher in terms of enjoyment, willingness to recommend, and effectiveness as a learning tool (G:L = 4.73:4.33, 4.67:4.33, 4.68:4.47, respectively; all p<0.05), with no significant difference in knowledge gain between groups (G:L = 4.46:4.40; p=0.53).

The serious game approach matched expert lectures in boosting interest, willingness, and knowledge gain among hospital staff. It outperformed lectures in enjoyment, recommendation willingness, and perceived effectiveness as a learning tool. Thoughtfully designed serious games are promising tools for teaching CEM and HVA in hospital settings.