Search Results (3,600)

Background/Objectives: Attention Deficit Hyperactivity Disorder (ADHD) is one of the most common neurodevelopmental disorders in childhood and it tends to remain during adulthood. It not only affects cognitive abilities and behavior but also often presents emotional disturbances and alterations in the perceived quality of life. These symptoms are primarily related to dysfunctions in the ventromedial and dorsolateral prefrontal network. The main objective was to evaluate the feasibility and explore the initial outcomes of an integrated protocol combining neuropsychological treatment and transcranial direct current stimulation (tDCS). Methods: This study presents a single-case experimental A-B design of a 21-year-old woman, diagnosed with predominantly inattentive ADHD, treated at the University Psychology Clinic of Loyola Andalucía University. The treatment was carried out twice a week for 5 weeks (10 sessions in total), with 20 min of anodal tDCS at F3 and cathodal tDCS at F4 (2 mA), while digital neurorehabilitation exercises and psychotherapeutic support were provided. Results: An overall significant improvement was observed in cognitive functions (p = 0.008), with clinically significant gains in cognitive flexibility, visual working memory, and planning. Mixed results were found in inhibition, with improvement in interference control but no change in response inhibition. No significant changes were observed in sustained attention, auditory working memory, or processing speed. In terms of emotional state, an overall improvement was noted (p = 0.046), particularly in depression symptoms and perceived quality of life related to physical and psychological health. However, no significant changes were observed in anxiety symptoms or in areas related to the environment and social relationships. These findings reflect pilot-level evidence of clinical change within a feasibility framework. Conclusions: The combined treatment was found to be safe and feasible, showing promising preliminary improvements in cognitive and emotional domains. As a single-case study, these results serve as hypothesis-generating evidence for future controlled trials. Full article

Suicidal behavior among adolescents and young adults represents a growing public health concern due to its high prevalence and its negative impact on psychological well-being. The aim of this study was to examine the associations between emotional regulation, attachment styles, cyberviolence, and suicidal ideation among Chilean university students. A descriptive cross-sectional design was employed with a sample of 1083 participants, using the Suicidal Ideation Frequency Inventory, the Close Relationship Experience Questionnaire (ECR-R), the Spanish Modified Version of the Trait Meta-Mood Scale (TMMS-24) and the Cyber Dating Violence Instrument for Teens (CyDAV-T). Bivariate analyses and binary logistic regression were conducted to identify significant predictors of suicidal ideation. The results revealed a high prevalence of suicidal ideation, particularly among women (19.06%; p < 0.001). Difficulties in emotion regulation were strongly associated with a higher likelihood of suicidal ideation (p < 0.001), whereas adequate (p < 0.001) or excellent (p < 0.01) regulation functioned as a significant protective factor. In addition, a disorganized attachment style was identified as a risk factor (p < 0.05), especially among women (p < 0.01). In conclusion, emotion regulation emerges as a key protective factor against suicidal ideation, underscoring the importance of implementing socioemotional training programs within university settings. Full article

The concept of ‘developmental hemostasis’ from birth to infancy and onwards to childhood and adulthood was introduced in the 1980s and is used to indicate the fundamental discrepancies of hemostatic mechanism between children and adults. The underlying differentiations are more pronounced in term and even more in preterm neonates. Hemostatic alterations tend to improve throughout childhood and adolescence but still imply a great example of the basic concept that children do not simply represent small adults. Many neonatal coagulation disorders lead to severe morbidities, such as intraventricular hemorrhage and intracerebral infarct, with critical consequences on long-term neurodevelopmental outcome. As the limits of viability have decreased and many preterm and severely affected neonates survive and grow up, a broad understanding of hemorrhagic and thrombotic complications in neonates is very important, in order to provide prompt identification and treatment. Coagulation abnormalities are usually induced by specific pathophysiologic disorders, and neonatal sepsis is a significant trigger of hemostatic derangement. Despite the initial protective role of coagulation activation during the early stages of sepsis, ultimately hemostatic abnormalities exert a substantial impact on clinical outcome and prognosis. This review explores developmental aspects of coagulation, particularly in relation to neonatal sepsis. Full article

Major depressive disorder (MDD) is a highly prevalent psychiatric illness for which rapid-acting antidepressants such as ketamine provide only transient benefit. Because κ-opioid receptor (KOR) signaling contributes to stress-related dysphoria and impaired neuroplasticity, we examined whether KOR antagonism could prolong ketamine’s antidepressant-like effects in a mouse model of adolescent chronic unpredictable stress (CUS). Male C57BL/6J mice (n = 10 per group for behavioral analyses) were exposed to CUS during adolescence and developed persistent depression-like behavior in adulthood. Mice with depressive-like behavior received a single injection of ketamine, the selective KOR antagonist norbinaltorphimine (nBNI), or their combination. Behavioral testing showed that all treatments reduced immobility in the tail suspension test (TST) 24 h post-administration; however, only the combined ketamine/nBNI treatment maintained antidepressant-like effects one week post-treatment. Molecular analyses (n = 4–8 per group) were conducted at this single time point, one week post-treatment, to characterize region-specific signaling states in the prefrontal cortex, hippocampus, and striatum, focusing on ERK, AKT, JNK, mTOR, and BDNF pathways. These molecular findings represent correlates of sustained behavioral effects rather than evidence of causal mechanisms. Together, the data indicate that concurrent KOR antagonism is associated with prolonged antidepressant response to ketamine in stress-exposed male mice and with distinct region-dependent signaling profiles at one week post-treatment. Further studies are needed to establish mechanistic causality and confirm the possible applicability of these findings. Full article

Social capital has been well established to have beneficial effects on a variety of behavioral, developmental, and health outcomes across the life course. In particular, social capital has been proven to be a protective factor benefiting health, particularly among young people. However, we know little about whether or how social capital might provide a protective effect against a very specific mental health challenge of young and mid-adult life: experiencing postpartum depression. Using linear regression models and restricted-use data from the National Study of Adolescent to Adult Health (five waves conducted beginning in 1995 when respondents were in grades 7–12 and following them into adulthood) on women who gave birth during early adulthood, and controlling for a variety of demographic factors (such as race, parental and partner social capital, SES), we aim to understand potential associations between social capital derived from families and romantic partners and postpartum depression symptomology. Our findings suggest the need for approaches that help pregnant women build and maintain key social connections and resources with fathers and partners. Full article

Background: Young adulthood represents a critical period for the emergence of early metabolic disturbances, potentially influenced by dietary shifts toward convenience and ultra-processed foods. However, evidence linking dietary patterns and cooking practices with objective metabolic biomarkers in Romanian university students remains limited. Methods: This cross-sectional study included 693 students aged 18–24 years at the Victor Babeș University of Medicine and Pharmacy, Romania (June–July 2025). Dietary habits, food preferences, and cooking practices were assessed using a structured online questionnaire, while anthropometric and biochemical data were obtained from university health records. The primary outcome was glycated hemoglobin (HbA1c), a marker of average blood glucose levels over the previous 2–3 months. Prediabetes was defined as HbA1c 5.7–6.4%. Dietary patterns were identified using k-means clustering based on fast-food consumption frequency, main meal of the day, fruit and vegetable intake frequency, and predominant cooking method. Multivariable regression models assessed associations between dietary variables and glycemic or lipid outcomes. Results: Prediabetes prevalence was 21.1% (diabetes: 1.4%). Three dietary patterns were identified: health-conscious (prediabetes 15.4%), mixed (20.0%), and fast-food oriented (27.3%; χ² p = 0.003). Fast-food consumption frequency was independently associated with higher prediabetes risk (OR = 1.78 per category; 95% CI 1.38–2.30; p < 0.001) and higher HbA1c levels (β = 0.147; p < 0.001), while fruit and vegetable intake showed an inverse association with HbA1c (β = −0.109; p < 0.001). A dose–response relationship was observed between fast-food frequency and both HbA1c and prediabetes prevalence (p-trend < 0.001). An interaction between high-temperature cooking methods and frequent fast-food consumption was observed for HbA1c (p = 0.023). BMI and sex were the strongest predictors of lipid outcomes, although fast-food intake was associated with higher triglyceride levels (p = 0.034). Conclusions: Among Romanian university students, dietary patterns characterized by frequent fast-food consumption were associated with higher HbA1c levels and greater prediabetes prevalence. A high-temperature cooking method was associated with higher glycemic levels when combined with frequent fast-food intake. These findings suggest that early dietary behaviors during university years may be relevant for metabolic risk profiles in young adults. Full article

Background/Objectives: Young adulthood is a critical developmental period during which lifestyle behaviors may shape intrinsic brain network dynamics that support cognition. This pilot longitudinal intervention study examined whether variability in physical activity and sedentary behavior during an 8-week exercise and/or cognitive intervention protocol was associated with changes in intrinsic brain dynamics and cognitive and mood outcomes in undergraduate young adults. Methods: Participants (n = 32) completed resting-state functional magnetic resonance imaging (rs-fMRI) at baseline (T1) and post-intervention (T2). Dynamic functional network connectivity (dFNC) was estimated from 53 intrinsic connectivity networks derived using spatially constrained independent component analysis (ICA). Ten recurring dynamic connectivity states were identified and individualized using constrained dynamic double functional independent primitives (c-ddFIPs). State occupancy and dynamic convergence and divergence metrics were computed to characterize network flexibility. Results: Greater moderate-to-vigorous physical activity was modestly but consistently associated with increased occupancy of integrative higher-order states, particularly States 6 and 7, and reduced occupancy of more segregated configurations. More physically active individuals also demonstrated greater divergence between integrative and low-engagement states, whereas greater sedentary time corresponded to increased similarity among segregated configurations. Working memory performance showed parallel associations with more integrative and better-differentiated dynamic patterns. Conclusions: These findings suggest that dynamic functional network reconfiguration may represent a neurobiological mechanism linking lifestyle behaviors and cognitive health in young adulthood. Furthermore, they highlight the translational promise of engagement-driven, low-burden programs for college-aged young adults, showing that even modest variability in habitual physical activity corresponds to greater engagement and differentiation of integrative connectivity states linked to executive and broader cognitive functions. Full article

Background/Objectives: Morning erections provide an intercourse-independent indicator of nocturnal erectile physiology. We aimed to examine whether body mass index (BMI) and muscle strength are associated with morning-erection frequency in apparently healthy Japanese male university students. Methods: This cross-sectional study analyzed 125 men with complete data (170 assessed; 45 excluded). Handgrip and back muscle strength were measured using dynamometry; BMI was calculated from height and weight. Morning-erection frequency was assessed using a single 6-category item and was dichotomized as low vs. high. Univariable and multivariable logistic regression models were fitted. Exploratory principal component analysis (PCA) and k-means clustering (k = 2, silhouette-supported) were performed. Results: Seventy-four participants (59.2%) were classified as low frequency. Back muscle strength was associated with high frequency (univariable odds ratio [OR] 1.61; 95% confidence interval [CI] 1.07–2.42; and p = 0.021) and remained significant after adjustment for BMI and handgrip strength (OR 1.88; 95% CI 1.02–3.47; and p = 0.045), whereas BMI and handgrip strength were not significant. Clustering identified two clusters (n = 41 and n = 84); Cluster 2 (higher BMI/strength) had a higher proportion of high morning-erection frequency (48% vs. 27%). Conclusions: In apparently healthy young men, greater back muscle strength was independently associated with higher self-reported morning-erection frequency. In this cohort, 59.2% reported infrequent morning erections, suggesting potential relevance even in early adulthood. Given the exploratory clustering, the single-item outcome, and likely residual confounding, these findings are hypothesis-generating and warrant longitudinal validation. Full article

Lower urinary tract dysfunction (LUTD) is a multifactorial disease process that encompasses diverse symptoms ranging from issues with storage and sensation to impaired emptying of the bladder. Furthermore, symptoms tend to worsen with age and other comorbidities and in men can also be influenced by changes to the prostate, making diagnosis and treatment difficult to manage. Environmental factors are thought to contribute to disease risk. In mice, previous work has found that developmental exposure to polychlorinated biphenyls (PCBs) is capable of altering voiding function in offspring. However, the effects of PCB exposure in adulthood instead of development are not well known. Whether changes in voiding are a consequence of early or later life exposures remains an important area of study, as environmental chemicals and exposures can occur across the lifespan and can be mitigated. Here, we test whether PCB exposure in adulthood alters voiding or prostate morphology in male mice. C57Bl/6J adult male mice were exposed to the human-relevant MARBLES PCB mixture (0, 0.1, 1, and 6 mg/kg/d) orally daily for two months. Lower urinary tract function was then assessed through urodynamic testing including void spot assay, uroflowmetry, and anesthetized cystometry. Prostate lobes were collected for histology. The only change to voiding function was a reduction in void duration in the 6 versus 1 mg/kg/d PCB group but not to the vehicle control. Prostate, seminal vesicle, and testes wet weights were unchanged. However, PCB exposure reduced the number of Ki67-positive proliferating cells in the anterior and ventral prostate lobes only at the 1 mg/kg/d dose, with no change to caspase 3-positive cells or smooth muscle thickness. Together, these data indicate that 2-month exposure to PCBs in adult mice has little impact on voiding but is a sufficient exposure to produce changes in cell proliferation in the prostate. The mechanistic impacts of these changes remains to be investigated but could help better understand individual risk for LUTD. Full article

Background and Clinical Significance: Subvalvular aortic stenosis (SAS) is the second most common form of aortic stenosis after valvular disease and predominantly affects male patients. It is frequently associated with other congenital cardiac anomalies, such as ventricular septal defect, and is rarely diagnosed during infancy. Instead, SAS typically manifests during childhood or adulthood as a progressive left ventricular outflow tract obstruction, leading to left ventricular hypertrophy and, in many cases, aortic regurgitation. Case Presentation: The first patient was a 61-year-old man presenting with progressive dyspnea, in whom echocardiography revealed severe subaortic stenosis and computed tomography demonstrated aneurysmal dilatation of the ascending aorta. Intraoperatively, the aortic valve was found to be dystrophic with mixed stenotic and regurgitant disease; therefore, subaortic membrane resection, mechanical aortic valve replacement, and ascending aortic replacement with a synthetic graft were performed. The second patient was a 31-year-old man with exertional dyspnea and a discrete subaortic membrane associated with mild ascending aortic dilatation. Surgical treatment consisted of complete membrane resection and aortic valve repair, while the ascending aorta was preserved. Both patients had an uneventful postoperative course and were discharged on the fourth postoperative day. At 3-month follow-up, both were asymptomatic, in normal sinus rhythm, and demonstrated satisfactory echocardiographic findings without residual left ventricular outflow tract obstruction. Conclusions: Surgical intervention remains the definitive treatment for subvalvular aortic stenosis when clinically indicated. Concomitant cardiac or aortic pathology should be addressed during the same procedure to optimize outcomes. When performed with meticulous technique and appropriate patient selection, surgical correction is associated with excellent early recovery and favorable mid-term results, although long-term follow-up remains essential due to the risk of recurrence. Full article

Vitamin D is a pleiotropic secosteroid with endocrine and intracrine actions that influence key phases of allogeneic hematopoietic stem cell transplantation. Epithelial barriers, antigen-presenting cells and effector lymphocytes express the vitamin D receptor and enzymes required for local activation, allowing circulating 25-hydroxyvitamin D to be converted into its active form and modulate immune interactions. During the peri-transplant period, sunlight deprivation, reduced intake, mucosal injury, cholestasis and corticosteroid exposure markedly reduce vitamin D levels at a time when antigen presentation and immune reconstitution occur. This review integrates mechanistic immunology with clinical observations and interventional data to outline strategies that prevent severe deficiency. It summarizes epidemiology before and after transplantation, associations with acute and chronic graft-versus-host disease, relapse, engraftment, infections, bone health and survival, and evaluates dosing approaches including pre-conditioning loading and reassessment at day thirty with escalation if needed. Absorption-savvy formulations such as oral thin-film and intramuscular cholecalciferol are considered when gastrointestinal function is compromised. Given the high prevalence of deficiency, biological plausibility, safety and low cost, a structured approach that includes screening, repletion and monitoring to achieve concentrations of at least thirty nanograms per milliliter by day thirty represents a pragmatic and low-risk component of supportive care pending definitive evidence. Full article

Background: Cardiovascular risk factors may emerge early in life and track into adulthood. Local data from inland and socioeconomically vulnerable regions remain limited. This study aimed to describe cardiovascular risk indicators in school-aged children from inland Portugal, focusing on body mass index (BMI), blood pressure (BP), and physical activity patterns. Methods: A cross-sectional school-based screening study was conducted in 101 children and adolescents aged 10–15 years. Anthropometric measurements and BP were obtained using standardized procedures. BMI categories were classified according to age- and sex-specific WHO references. BP was classified using European pediatric percentiles. Because measurements were obtained during a single visit, results were interpreted as elevated BP at screening. Associations between variables were explored using chi-square or Fisher’s exact tests and Spearman’s correlation. Results: The prevalence of underweight, normal weight, and overweight/obesity was 25.7%, 67.3%, and 6.9%, respectively. Overall, 24.8% of participants presented elevated BP at screening. The BMI category was significantly associated with BP classification (p = 0.003), and BMI correlated positively with systolic BP (ρ = 0.32; p = 0.001). Most children reported only school-based physical education. Conclusions: This school-based screening suggests a high proportion of elevated BP measurements and an unexpectedly high prevalence of underweight children, indicating the coexistence of different nutritional vulnerabilities. Findings should be interpreted cautiously due to the small, single-school sample and single-occasion BP assessment but support the importance of early cardiovascular risk monitoring in vulnerable settings. Full article

Background: In contemporary societies, the pursuit of performance and the experience of urgency emerge as dominant forces shaping individual lives. In this context, delaying behaviors assume particular significance, especially for university students, who are immersed in environments that seem to prioritize speed and efficiency as the main routes to adulthood. The pressure to be flawless and fast, coupled with uncertainty about the future, calls for reflection on procrastination, its impact on psychological well-being, and the role of educational institutions. This study explored university students’ opinions and experiences regarding academic procrastination. Methods: Ten focus groups were conducted with 89 students enrolled in a Bachelor’s degree program. All focus groups were recorded and transcribed verbatim. The corpus was analyzed using Thematic Analysis of Elementary Contexts and Reflexive Thematic Analysis. Results: The former, a cluster-based thematic procedure, identified seven clusters capturing both the organizational aspects of university life and the experience of being a student in contemporary society. The secondary thematic analysis further explored these dimensions, emphasizing themes such as social pressure and concerns about the future. Conclusions: Findings suggest that understanding the dynamics underlying procrastination can inform university policies attuned to young adults’ developmental needs and well-being. Full article

Background: Moyamoya disease (MMD) is a rare, progressive cerebrovascular arteriopathy characterized by stenosis and occlusion of the distal internal carotid arteries with the development of compensatory collateral networks. In children, MMD is a major cause of ischemic stroke; however, neurological morbidity frequently extends beyond cerebrovascular events to include epilepsy, headache, cognitive impairment, and psychiatric manifestations. Data regarding the long-term evolution of these complications in Caucasian pediatric patients remains limited. Case Report: We present the longitudinal case of a Caucasian female diagnosed with advanced MMD after an ischemic stroke at the age of 7 years, followed by indirect surgical revascularization (encephalo-duro-arterio-synangiosis) and chronic antiplatelet therapy. Four years later, she developed recurrent focal aware sensory–motor seizures associated with chronic post-ischemic cortical injury. Despite stable vascular imaging and absence of recurrent infarction, the patient experienced persistent neurological sequelae, including residual spastic hemiparesis, episodic tension-type headaches, and evolving neuropsychological complications. Cognitive assessment initially suggested mild neurocognitive impairment, with subsequent improvement during adolescence. In late follow-up, prominent anxiety symptoms emerged, and psychiatric evaluation confirmed panic disorder requiring psychological and pharmacological support. The patient remained neurologically stable into adulthood under continued multidisciplinary care. This case illustrates the broad spectrum of neurological and psychiatric complications that may accompany pediatric MMD, even in the absence of new ischemic events. The accompanying literature review emphasizes that epilepsy, headache, cognitive dysfunction, and psychiatric disorders represent clinically significant components of the long-term disease burden in children with MMD. Conclusions: Pediatric moyamoya disease should be regarded not only as a cause of childhood stroke, but also as a chronic condition with long-term epileptic, cognitive, and psychiatric sequelae that may evolve independently of recurrent ischemic injury. By providing longitudinal follow-up from childhood into adulthood in a Caucasian patient, this report underscores the importance of integrating neuropsychological and psychiatric surveillance into standard care pathways, alongside vascular and surgical management, to better address the full spectrum of morbidity and improve quality of life. Full article

Background/Objectives: Attention-deficit/hyperactivity disorder (ADHD) frequently persists into adulthood and is characterized by heterogeneous clinical presentations influenced by gender, demographic and psychosocial factors. Although gender-related differences in adult ADHD have been reported, individuals residing in rural settings remain underrepresented in empirical research. Guided by Gender-Based Analysis Plus (GBA+) framework, this study examined gender differences and psychosocial correlates of ADHD subtypes among adults in a rural Canadian population. Methods: A cross-sectional study was conducted using de-identified medical record data collected between February 2021 and January 2024 from a rural outpatient clinic in Northern British Columbia, Canada. The sample comprised 660 adults aged 19 years and older with a documented ADHD diagnosis. The combined presentation was the most common (67.0%), followed by the inattentive presentation (30.3%), while the hyperactive/impulsive presentation was rare (2.7%). In bivariate analyses, ADHD presentation was not significantly associated with gender, age group, employment status, or marital status. Prescribed ADHD medication differed across presentations (χ² (1) = 12.36, p < 0.001), with a higher proportion of individuals with the inattentive presentation reporting pharmacological treatment. In the pooled logistic regression model, prescribed ADHD medication was the only variable independently associated with presentation (OR = 0.54, 95% CI 0.38–0.77, p = 0.001). In gender-stratified models, this association remained evident among women, whereas no stable inferential conclusions could be drawn for men or gender-diverse participants. Conclusions: Within a GBA+ perspective, the findings suggest that gender may shape recognition and entry into care, rather than the clinical subtype identified at assessment, underscoring the need for a comprehensive assessment in rural clinical practice. Full article