Secondary intracranial infections are common and severe complications in patients with viral encephalitis, contributing to higher mortality, prolonged hospitalization and increased healthcare burden. Evidence on risk factors, pathogen spectrum and resistance patterns remains limited, and predictive models tailored to this population are lacking.

We conducted a single-center retrospective cohort study, including 160 consecutive patients diagnosed with viral encephalitis. Clinical, therapeutic, laboratory and microbiological data were extracted from hospital records. Independent risk factors were identified using multivariate logistic and Cox regression. Predictive performance was assessed by receiver operating characteristic analysis. Pathogen distribution and antimicrobial resistance profiles were analyzed descriptively.

During a median follow-up of 16 days, 50 patients (31.3%) developed secondary intracranial infections, corresponding to an incidence of 2.9 events per 1000 patient-days. Independent predictors included older age (adjusted OR 1.39 per 10 years, P = 0.021), comorbidities (OR 2.18, P = 0.048), corticosteroid use ≥7 days (OR 2.45, P = 0.025), ≥2 invasive procedures (OR 2.92, P = 0.007) and elevated CSF protein (OR 2.36, P = 0.037). The multivariable risk score achieved an area under the curve of 0.86 (95% CI 0.80–0.92). Pathogen analysis revealed methicillin-resistant Staphylococcus aureus (MRSA) (24.0%) and Acinetobacter baumannii (20.0%) as predominant isolates, both showing high multidrug resistance, including carbapenem resistance rates of 70% in A. baumannii.

Secondary intracranial infections occur frequently in viral encephalitis and are strongly associated with host vulnerability. The predominance of MRSA and carbapenem-resistant A. baumannii underscores the urgent need for tailored infection control and antimicrobial strategies in neurocritical care.

Our study aimed to explore risk factors for medium–giant coronary artery aneurysms in children with Kawasaki disease.

6,540 eligible children with Kawasaki disease who were diagnosed in Wuhan Children’s Hospital from January 2011 to December 2023 were retrospectively analysed. The clinical and laboratory data were compared between medium–giant group and non–medium–giant group.

A total of 6,540 patients with Kawasaki disease were included, and 162 (2.5%) developed medium–giant coronary artery aneurysms, of whom 56 (0.9%) were giant. Univariate analysis showed a statistically significant difference between the two groups in 22 variables (P< 0.05). The least absolute shrinkage and selection operator regression analysis revealed that intravenous immunoglobulin resistance, haemoglobin, platelet count, and albumin were the most significant risk factors for medium–giant coronary artery aneurysms. The result of binary logistic regression analysis showed that intravenous immunoglobulin resistance (OR = 6.474, 95%CI = 4.399 ∼ 9.528, P< 0.001), platelet count elevation (OR = 1.003, 95%CI = 1.002 ∼ 1.004, P< 0.001), and albumin reduction (OR = 0.912, 95%CI = 0.879 ∼ 0.946, P< 0.001) were independent risk factors affecting the occurrence of medium–giant coronary artery aneurysms, and the area under the curve of the regression model was 0.75, with a sensitivity of 62.3% and a specificity of 79.2%.

Intravenous immunoglobulin resistance, platelet counts elevation, and albumin levels reduction may be significant predictors of medium–giant coronary artery aneurysms and can serve as a reference for early diagnosis of medium–giant coronary artery aneurysms.

The mental health risk factors for primary healthcare workers (PHWs) following the Coronavirus Disease 2019 pandemic and the differences by urbanicity remain unclear. In this study, we aimed to identify key factors of anxiety and depression among PHWs in urban and rural settings in China.

This cross-sectional study was conducted in all 31 provinces in mainland China, between 1 May and 31 October 2022. A total of 3,769 PHWs, including family physicians, nurses, public health professionals, pharmacists, and other medical staff, were recruited from 44 urban community health service centers and 27 rural township hospitals. The Bayesian Additive Regression Tree model was employed to identify risk factors of anxiety and depression.

Among 3,769 PHWs, 1,006 (26.7%) worked in urban areas and 2,763 (73.3%) in rural areas. Occupational satisfaction significantly influenced anxiety in both urban and rural practitioners. For urban PHWs, living with family (odds ratio (OR): 0.42, 95% confidence interval (CI): 0.28–0.62) and self-rated health (fair: OR: 0.31, 95% CI: 0.23–0.42; good: OR: 0.13, 95% CI: 0.09–0.20) were key factors of anxiety. For rural PHWs, after-work exercise (rarely: OR: 0.28, 95% CI: 0.11–0.76; frequently: OR: 0.15, 95% CI: 0.05–0.44) played a critical role. Depression was associated with after-work exercise, self-rated health, and occupational satisfaction for all PHWs. Additionally, living with family (OR: 0.51, 95% CI: 0.34–0.75) and organizational support satisfaction (satisfied: OR: 0.28, 95% CI: 0.19–0.42) were significant for urban practitioners.

Risk factors such as occupational satisfaction, health, and family relations significantly influence PHW mental health in China, with notable differences by urbanicity. Tailored mental health interventions are recommended to address urban–rural disparities.

Dynamic, data-driven predictors of perioperative mortality risks in preterm/early-term neonates with CHD undergoing cardiac surgery in the first 24 months of life are limited.

To identify risk factors of mortality in the first 24 months of life for pre/early-term neonates with CHD.

Retrospective cohort study of patients <39 weeks of gestation undergoing cardiac surgery within 24 months of life from 2013–2020 at a tertiary care centre. Independent risk factors of mortality within 24 months of life were determined by multivariable Cox regression analysis.

Among the 205 neonates, 33 (16.1%) died within 24 months. Multivariable analysis revealed that high-frequency ventilation (hazard ratio = 5.15; 95% confidence interval): 2.51, 10.6; p < 0.001), extracorporeal membrane oxygenation support (hazard ratio = 5.77; 95% confidence interval: 2.67, 12.5; p < 0.001), and CHD with a palliated circulation (hazard ratio = 6.07; 95% confidence interval: 2.84, 13; p < 0.001) were significant independent risk factors of mortality at any time during the index hospitalisation or the first 24 months of life.

Identifying and re-evaluating risk factors of mortality for preterm/early-term neonates with CHD at any time during the index hospitalisation or the first 24 months of life may guide resource allocation and therapeutic interventions.

Trial registration number and date of registration: IRB P00028833 5/2/2018. Retrospectively registered.

This study aimed to estimate the prevalence of Eustachian tube dysfunction and identify associated risk factors in a consecutive cohort of children undergoing adenotonsillectomy for sleep-disordered breathing.

This was a retrospective study of children with sleep-disordered breathing admitted for adenotonsillectomy in two tertiary public hospitals in South China from January 2019 to November 2023. The prevalence of Eustachian tube dysfunction was assessed based on tympanograms. Demographic information and clinical characteristics were collected for risk factors analysis.

A total of 1,044 children aged 3 to 14 years were enrolled in the present study, 375 (35.92%) of whom had Eustachian tube dysfunction. Risk factors for Eustachian tube dysfunction included age less than or equal to six years, allergic rhinitis, sinusitis, adenoid hypertrophy and hypoxemia. No significant association was found between Eustachian tube dysfunction and gender, disease duration, tonsillar hypertrophy, obesity or obstructive sleep apnoea.

Eustachian tube dysfunction is highly prevalent in children undergoing adenotonsillectomy for sleep-disordered breathing and, therefore, warrants further attention and intervention.

Infants with CHD who undergo cardiopulmonary bypass surgery are at risk of impaired growth and neurodevelopment. However, few studies have thoroughly investigated the risk factors for growth and neurodevelopmental impairments, particularly with respect to the timing of the initial surgical intervention.

We retrospectively analysed term singleton infants with CHD who underwent cardiopulmonary bypass surgery at a Japanese tertiary centre between 2015 and 2021. Neurodevelopment was assessed at 18–22 months of age using the Kyoto Scale of Psychological Development. We compared outcomes by CHD type (univentricular [UV] vs. biventricular [BV]) and analysed risk factors for growth impairment (weight and height < tenth percentile) and neurodevelopmental impairment (developmental quotient [DQ] < 85), including birth weight, sex, the type of CHD (UV or BV), and timing of the initial cardiopulmonary bypass surgery (<28 days or ≥28 days).

Of the 108 eligible children, 29 had UV physiology and 79 had BV physiology. Both groups showed impaired growth, with significantly lower body weights in the UV group. Neurodevelopmental scores (total DQ) were significantly lower in the UV group. Neurodevelopmental impairment (total DQ < 85) was observed in 44/108 (40.7%) children, and after adjustment, UV repair was significantly associated with neurodevelopmental impairment (adjusted odds ratio [OR] 3.11, 95% confidence interval [CI] 1.27–7.65). Timing of the initial cardiopulmonary bypass surgery was not associated with outcomes.

Infants with CHD in Japan exhibit impaired growth and neurodevelopment at 18–22 months following cardiopulmonary bypass surgery, especially those with UV physiology.

Major depressive episodes (MDEs) are highly recurrent in clinical samples. However, the course of MDEs and predictors of their endurance are unclear in the general youth population.

We investigated prospective factors associated with enduring MDE (the presence of 12-month DSM-IV MDE at baseline and 1 year using the Composite International Diagnostic Interview–Screening Scales) in 1,833 participants of a 1-year epidemiological youth cohort study in Hong Kong. Multivariable logistic regression models were used to examine the influences of a range of personal and environmental factors.

At baseline, 13.7% participants had MDEs, among whom 21.1% presented enduring MDEs. More severe symptoms of post-traumatic stress disorder (adjusted odds ratio [aOR] = 5.54, confidence interval [CI] = 2.14–14.38), depression (aOR = 3.92, CI = 1.79–8.62), and generalized anxiety (aOR = 2.27, CI = 1.21–4.25) at baseline were among the strongest associated factors for enduring MDE, with trends of associations observed for psychotic-like experiences (aOR = 1.98, CI = 0.98–4.02) and eating disorder symptoms (aOR = 1.88, CI = 0.90–3.95). Among various types of stressors, only dependent stressors at follow-up showed a clear association with enduring MDE (aOR = 4.22, CI = 1.81–9.83). Those with enduring MDE showed poorer functioning and mental health-related quality of life at follow-up, with only 35.6% having sought any psychiatric/psychological help during the past year.

Detecting comorbid symptoms in those with prior MDEs and reducing the impact of dependent stressors may help reduce their long-term implications. Enhancing the accessibility and acceptability of youth-targeted mental health services would also be crucial to improve help-seeking.

Childbirth-related post-traumatic stress disorder (CB-PTSD) is an underrecognized condition with consequences for mothers and infants. This study aimed to determine risk factors for CB-PTSD symptoms across countries within a stress–diathesis framework, focusing on antenatal, birth-related, and postpartum predictors.

The INTERSECT cross-sectional survey (April 2021–January 2024) included 11,302 women at 6–12 weeks postpartum. The study was carried out across maternity services in 31 countries. Outcomes were CB-PTSD diagnosis, symptom severity, and perceived traumatic birth, assessed with the City Birth Trauma Scale. Multiple risk factors were assessed, including preexisting vulnerability, pregnancy, birth, and infant-related factors. All models were adjusted for country-level variation as a random effect.

Models explained substantial variance across all outcomes (conditional R2 = 0.53–0.58). Negative birth experience was the strongest predictor (e.g. odds ratio [OR] = 0.82, 95% confidence interval [CI] = 0.80–0.84 for diagnosis). Ongoing maternal complications predicted both CB-PTSD diagnosis and symptoms (e.g. OR = 1.61, 95% CI = 1.41–1.84), and major infant complications were associated with CB-PTSD diagnosis (OR = 1.63, 95% CI = 1.29–2.07). Reports of perceived danger to self or infant (criterion A) were linked to higher CB-PTSD symptoms and traumatic birth ratings (e.g., β =0.25, 95% CI = 0.21–0.29). Other predictors reached significance but showed small effects.

Findings support a stress–diathesis framework, showing that while pre-existing vulnerabilities contribute, birth-related stressors exert the strongest influence. Trauma-informed maternity care should prioritize these factors, with attention to women’s appraisals of birth.

An increase in mental disorders has been suggested, but the interpretation of such trends remains unclear. This study examines changes in the 12-month prevalence of anxiety and mood disorders over 12 years and evaluates whether clinical characteristics or sociodemographic, vulnerability and health-lifestyle risk factors contributed to these trends.

To assess trends in the 12-month prevalence of anxiety disorders (i.e. panic disorder, agoraphobia, social anxiety disorder or generalised anxiety disorder) and mood disorders (major depressive disorder, dysthymia or bipolar disorder) and explore whether changes in clinical profiles or risk factors influenced these trends.

Data from 11 615 respondents (mean age 43.5 years, 53.5% female) in the Netherlands Mental Health Survey and Incidence Studies (NEMESIS) were analysed, covering 2007–2009 (NEMESIS-2, n = 6646) and 2019–2022 (NEMESIS-3, n = 4969). Diagnoses were determined using the Composite International Diagnostic Interview 3.0.

The 12-month prevalence of all anxiety and mood disorders was significantly higher in 2019–2022 compared to 2007–2009, with relative increases across disorders ranging from approximately a half to more than double their previous rates. Any anxiety or mood disorder increased from 10.2 to 16.7%. Clinical profiles were equally severe in 2019–2022; rather, there was increased mental health care use, a higher number of comorbid disorders and earlier onset. Examination of 14 risk factors showed no consistent evidence of greater prevalence or increased relative impact over time.

There was a consistent rise in the 12-month prevalence of anxiety and mood disorders over 12 years. This increase was not explained by changes in risk factors or less severe disorder reporting. Instead, these findings suggest a concerning decline in public mental health, highlighting the need for effective prevention strategies, timely interventions and better mental health resource allocation to address growing clinical demands.