Search Results (1,983)

The postnatal period involves significant emotional and relational shifts that can challenge early mother–infant interactions, particularly under conditions of psychosocial vulnerability (e.g., maternal anxiety/depression) or infant-related risk (e.g., preterm birth). Maternal mentalization, operationalized as Parental Reflective Functioning (PRF), is a key protective factor for sensitive caregiving and dyadic regulation. Objectives: This protocol describes a multicenter, open-label, single-arm feasibility study evaluating a brief, fully online, mentalization-based video-feedback intervention (VFI-RF). The study is designed to assess the feasibility and acceptability of the intervention, rather than its efficacy. We aim to recruit 48 mothers, 24 in each of two risk groups, through socio-health services and neonatal intensive care units. Risk Group 1 will include mothers with clinically significant depressive and/or anxiety symptoms, defined as EPDS > 9 and/or GAD-7 ≥ 10, whereas Risk Group 2 will include mothers of preterm infants, defined as infants born before 37 weeks of gestation. Methods: The intervention consists of 8 + 2 synchronous online sessions over approximately 5 months. Mothers record brief everyday caregiving interactions (~5 min) to review with a trained clinician, focusing on the infant’s internal states and reflective meaning-making. Assessments occur at baseline (T0, infant age ~3 months), post-intervention (T1, ~8 months), and follow-up (T2, ~12 months). Primary feasibility outcomes include recruitment/referral metrics, uptake, retention, assessment completion, missing data, and participant-reported acceptability. Secondary exploratory clinical outcomes include maternal PRF, symptoms, parenting stress, social support, and mother–infant attachment, evaluated via validated self-report questionnaires. Results: The study is designed to evaluate referral and recruitment patterns, intervention uptake, and participant retention, as well as the acceptability and suitability of study procedures and outcome measures for a future controlled trial. Preliminary trajectories of change in maternal reflective functioning and early relational indicators will be examined descriptively and exploratorily. Conclusions: Findings will inform the feasibility and refinement of a brief online mentalization-based video-feedback intervention to support at-risk mother–infant dyads during the first postnatal year. Trial registration: Registered on Open Science Framework, osf.io/6g9ja, date of registration 4th March 2026. Full article

Background/Objectives: Social isolation is a significant risk factor for child maltreatment. However, few studies have examined this relationship across multiple ecological levels, including neighborhood, family, and individual factors. This cross-sectional study operationalized social isolation using social cohesion, social support, and loneliness, and aimed to examine how their inter-relationships influence child maltreatment among Japanese mothers. Methods: Data were collected through an anonymous online survey of 330 Japanese mothers of children aged under six years, conducted April–May 2025. Structural equation modeling was employed in a two-step analytic approach. First, a confirmatory factor analysis was conducted to establish construct validity. Second, the hypothesized structural model was tested to examine the proposed pathways among social cohesion, social support, loneliness, parenting stress, and child maltreatment. Analyses were conducted using weighted least squares with mean and variance adjustment estimation. Results: Higher social cohesion was indirectly associated with reduced child maltreatment via two pathways. First, higher social cohesion was associated with lower loneliness, reduced parenting stress, and decreased child maltreatment (β = −0.063, p < 0.001). Second, higher social cohesion was associated with greater social support, reduced loneliness, lower parenting stress, and decreased child maltreatment (β = −0.043, p < 0.001). Conclusions: These findings highlight that enhancing neighborhood connectedness and alleviating maternal loneliness are key changes that may help to prevent child maltreatment. Full article

Childhood trauma is adversely linked to a spectrum of physical and neurobehavioral disorders, further facilitating the intergenerational transmission of familial trauma. This review systematically elaborates on the profound impacts of childhood trauma on both survivors and their descendants. It provides an in-depth analysis of the complex mechanisms underlying this intergenerational transmission, and innovatively proposes an Environmental-Psychological-Physiological-Molecular (EPPM) multilevel cross-generational interaction model. This model encompasses behavioral transmission of negative parenting, neural encoding of traumatic stress, intergenerational neurophysiological basis, biological permeation of the intrauterine environment, and mechanisms of epigenetic remodeling. This provides a scientific basis for deepening our understanding of the long-term consequences of trauma, promoting the development of early intervention strategies from an interdisciplinary perspective, and breaking the intergenerational cycle of trauma. Full article

The scientific literature was reviewed to systematically identify and characterize validated scales measuring homophobia, lesbophobia, biphobia, and transphobia, as well as the biopsychosocial consequences derived from these attitudes in sexual and gender minority (SGM) populations. The search was conducted in the WOS, Scopus, and Medline databases, limited to studies published between January 2015 and January 2024. This review was registered in the International Prospective Register of Systematic Reviews, and its quality was evaluated using the Effective Public Health Practice Project instrument. The criteria of the PRISMA declaration for systematic reviews were applied. Among the 78 articles initially selected, 9 met the established eligibility criteria. In these 9 articles, 13 validated scales were identified, covering attitudes toward sexual and gender minorities, internalised stigma, minority stress and resilience, parental acceptance, and experiences of bullying and cyberbullying in SGM populations. The findings reveal substantial fragmentation in the available measurement landscape, with most instruments lacking cross-cultural validation, measurement invariance testing, and construct coverage beyond Western, English- or Spanish-speaking contexts. These results should be interpreted with caution given the limited number of included studies and the absence of meta-analytic quantification. This review proposes the development of a novel intermodular measurement system as a priority research agenda and identifies key implications for specialized psychiatric and clinical practice, public health surveillance, and future research. Full article

This exploratory cross-sectional study examined whether pandemic-related family well-being responses differed across North Carolina’s 2021 county economic tiers among 178 Black parents. Survey responses were linked to county tier and included reported stress, emotional symptoms, food hardship, self-rated health, sleep change, work and parenting disruption, and parent–child interaction items. Primary analyses used the Kruskal–Wallis and chi-square tests; within-tier correlations and tier-stratified linear probability models were used for supplementary and descriptive purposes. Respondents across all tiers reported pandemic-related burdens, but most cross-tier comparisons were not statistically significant. One food-hardship item (p = 0.050) and one parent–child interaction item (p = 0.042) met the nominal 0.05 threshold, while one emotional symptom item approached significance (p = 0.074); these isolated findings did not form a consistent cross-domain pattern. The findings indicate that the county-tier classification was useful for organizing place-based comparisons but did not consistently differentiate response patterns in this sample. Larger, longitudinal studies using neighborhood- and household-level measures are needed before tier-specific or causal conclusions can be drawn. Full article

Background/Objectives: Parents of children with Attention Deficit Hyperactivity Disorder (ADHD) present high levels of stress. This population may benefit from Mindfulness-based interventions (MBI) to reduce their stress. This systematic review assesses current literature about the efficacy of MBI for managing stress and stress-related outcomes among those parents. Methods: Studies published up to September 2025 were systematically searched in PubMed, Cochrane Library, Web of Science, and Scopus, and complemented with citation tracking. Both randomized and non-randomized studies were included, provided they quantitatively evaluated parenting stress. Bias assessment was performed using Cochrane ROB-2 and ROBINS-I tools and GRADE analysis was performed. A qualitative synthesis is presented due to the substantial heterogeneity among studies. Results: Nineteen studies including nine Randomized Control Trials (RCTs) and ten non-RCTs met the inclusion criteria. Eight studies used an MBI for parents only, ten studies had a parallel intervention for the child/adolescent, and one study used an MBI for parents and teachers. Overall, the studies showed statistically significant stress reduction, either immediately after the end of the MBI (five RCTs and three non-RCTs) and mostly maintained at follow-up or presenting a delayed therapeutic effect which was only evident at the follow-up analysis (one RCT and four non-RCTs). However, some studies reported only mixed findings or no significant differences (three RCTs and two non-RCTs), and one non-RCT reported worsening of stress. Stress-related outcomes varied among different studies. Conclusions: MBI may have a significant role in reducing the stress of parents of children with ADHD and may improve stress-related outcomes, such as quality of life, psychological well-being, and parenting over-reactivity. Further studies with longer follow-up periods and lower risk of bias are necessary to clarify possible effects of MBI in stress reduction in parents with ADHD. Full article

Background/Objectives: Family-centered care (FCC) in neonatal intensive care units (NICUs) can improve infant and family outcomes. Inconsistencies in outcome reporting across FCC trials limits the comparability of findings. Aim: To develop a core outcome set (COS) for evaluating FCC interventions in neonatal intensive care settings. Methods: A list of outcomes was generated through systematic reviews and stakeholder focus groups. A three-round eDelphi study with stakeholders was conducted, followed by an expert consensus meeting. Results: The reviews and focus groups identified 72 outcomes for round 1. Sixty-three healthcare professionals (HCP), 37 parents and five ex-NICU patients completed round 1, with 12 new outcomes suggested. In round 2, 54 HCP, 28 parents and four ex-NICU patients scored 84 outcomes, resulting in the exclusion of 12 low-importance outcomes. In round 3, 45 HCP, 28 parents, and two ex-NICU patients scored the remaining 72 outcomes. Overall, 71% of participants completed all three rounds. Round 3 yielded 48 outcomes that met the predefined consensus criteria and were taken forward to the expert consensus meeting. The final 10 COS outcomes included six outcomes related to parents, namely, bonding with their infant, participation in care, parental readiness for discharge, stress, shared decision-making, and parental knowledge of the infant’s care and treatment, and four outcomes related to infants, namely, infant pain and stress, growth, nosocomial infection, and length of NICU stays. Conclusions: A COS for FCC research and practice in neonatal intensive care settings has been established. Implementation of this COS may improve reporting consistency and strengthen evidence synthesis across FCC trails, thereby better informing care delivery in clinical practice. Full article

Background/Objectives: Parental stress during neonatal intensive care unit (NICU) admission affects parental well-being, bonding, and neonatal outcomes. Reliable assessment requires instruments adapted to the linguistic and cultural context of each population. This study aimed to adapt the Parental Stressor Scale: NICU (PSS:NICU) for use in Spain and evaluate its psychometric properties. Methods: The adaptation comprised forward translation, back-translation, expert review, pilot testing with cognitive debriefing (n = 15), and psychometric evaluation. The adapted scale was administered to 160 parents (80 mothers, 80 fathers) of NICU-admitted neonates; 159 cases were retained for analysis. Internal consistency was assessed with Cronbach’s alpha. Exploratory factor analysis (EFA; maximum likelihood, Promax rotation) with parallel analysis examined the factor structure. Confirmatory factor analysis (CFA) tested the original four-factor model, and a second-order model with five first-order factors was subsequently evaluated. Results: Internal consistency was excellent (total α = 0.968; subscales α = 0.866–0.961). Parallel analysis supported a five-factor EFA solution over a four-factor solution. CFA of the original four-factor model yielded poor fit (CFI = 0.755, TLI = 0.737, RMSEA = 0.125). A second-order model with five first-order factors and one general stress factor improved fit (CFI = 0.819, RMSEA = 0.107), though indices remained below conventional thresholds. Standardised factor loadings were moderate to high (0.57–0.96). Conclusions: The Spanish PSS:NICU demonstrates excellent reliability and provides preliminary evidence supporting its use for research and clinical assessment. The original four-factor structure was not replicated; the data suggest a five-factor organisation with evidence of a higher-order stress construct. Structural validity requires confirmation in larger, independent samples. Full article

Accelerating eutrophication of aquatic ecosystems worldwide has increased concern regarding cyanotoxin exposure as an emerging environmental and public health issue, with Microcystin-LR (MC-LR) among the most extensively studied congeners due to its widespread occurrence and high toxicity. Evidence from experimental animal and cellular studies indicates that MC-LR elicits pronounced toxic impacts on both the male and female reproductive systems. In males, MC-LR induces overt testicular injury, compromises the structural and functional integrity of the blood–testis barrier, and triggers severe disorders in reproductive hormone synthesis and secretion. In females, it precipitates ovarian dysfunction, impedes normal follicular maturation and development, and induces distinct embryotoxic effects. The underlying pathogenic mechanisms involve the synergistic interplay of multiple signaling pathways, primarily including oxidative stress induction, aberrant apoptosis activation, endocrine disruption, and epigenetic modifications. Of particular significance, emerging evidence suggests that parental exposure to MC-LR may induce intergenerational or potentially transgenerational reproductive effects through epigenetic modifications in germ cells, impairing fertility and developmental outcomes in subsequent offspring and thus posing a sustained, long-term threat to population-level health. This review systematically delineates the reproductive toxicity profiles and underlying molecular mechanisms of MC-LR, evaluates its transgenerational health hazards, and aims to furnish robust scientific evidence for the formulation of targeted environmental health policies and risk management strategies. Full article

Using the Hierarchical Taxonomy of Psychopathology (HiTOP) as our framework, the current study examines how 13 common psychological disorders can be grouped into different spectra in two groups of adolescents: a community sample (N = 951), and a clinic-referred sample (N = 173). Scores for the disorders were obtained using the parent version of the Child and Adolescent PsychProfiler. Taken together, the findings across the two samples for factor structure, reliability, and discriminant and concurrent validity indicate the most support for a three-factor CFA oblique model with primary factors for neurodevelopment disorders (that include Specific Learning Disorder, Autism Spectrum Disorder, Language Disorder, and Speech Sound Disorder), internalizing disorder problems (that include Generalized Anxiety Disorder, Persistent Depressive Disorder, Separation Anxiety Disorder, Obsessive–Compulsive Disorder, Posttraumatic Stress Disorder, Anorexia Nervosa, and Bulimia Nervosa), and externalizing disorder problems [(that include Attention Deficit/Hyperactivity Disorder (ADHD), and Oppositional Defiant Disorder/Conduct Disorder (ODD/CD)], with a covariance for the error variance for Anorexia Nervosa and Bulimia Nervosa. Additionally, the analysis for Sample 2 supports the concurrent validity of the factors in this model. A modification of this model, with ADHD cross-loading on the neurodevelopment disorders factor, did not produce an admissible solution. The findings indicate support for a neurodevelopmental spectrum in the HiTOP model, with ADHD and ODD/CD showing stronger statistical association with the externalizing factor than with the neurodevelopmental factor in the models tested. This finding pertains to dimensional structure and does not invalidate the neurodevelopmental classification of ADHD in DSM-5-TR. Full article

Background: Parental burnout results from chronic stress related to the parental role and reflects a persistent imbalance between parenting demands and available psychological resources, negatively affecting parental well-being and parent–child relationships. This study examined the associations between parental burnout, parenting attitudes, and psychological resilience within the parental adaptation of the job demands–resources model, with particular attention to the potential mediating role of parenting styles in the relationship between resilience and parental burnout, while controlling for sociodemographic factors. Methods: A cross-sectional design was applied with 447 Hungarian parents who completed an anonymous online questionnaire including the Parental Burnout Assessment, the Parenting Styles and Dimensions Questionnaire, and the 10-item Connor–Davidson Resilience Scale. Data were analyzed using nonparametric correlations, group comparisons, multiple linear regression models with bootstrap estimation, and mediation analyses. Results: Resilience showed negative associations with all dimensions of parental burnout. Authoritarian and permissive parenting styles were positively associated with burnout, whereas authoritative parenting style showed negative associations. In multivariate analyses, authoritative parenting attitudes and fulfillment of the ideal parental role emerged as protective factors, while authoritarian parenting style functioned as a significant risk factor. Mediation analyses further indicated that the association between resilience and parental burnout may partly operate through parenting styles, particularly across the dimensions of emotional exhaustion, contrast, and emotional distancing. Conclusions: Parental burnout appears to be a dynamic psychological process shaped by the interaction of internal resources and parenting functioning, underscoring the importance of resource-oriented approaches in prevention and intervention. Full article

Polycyclic aromatic hydrocarbons (PAHs) represent a major class of ubiquitous environmental pollutants, posing significant risks to ecosystems and human health due to their persistence, toxicity, and potential for bioaccumulation. This review provides a comprehensive synthesis of current scientific knowledge on PAHs, integrating insights from chemical kinetics, environmental fate, and toxicological mechanisms. The fundamental structural chemistry of PAHs and its direct influence on their physicochemical properties and environmental properties are discussed. The major anthropogenic and natural sources of PAHs are detailed, alongside the chemical kinetics behind their formation during incomplete combustion and their transformation in environmental media. Unlike previous reviews that address PAH sources, remediation, or health effects as separate topics, this review uniquely traces the mechanistic continuum from molecular formation kinetics through physicochemical partitioning and environmental transport to toxicological endpoints, providing a causally linked framework for understanding how structural properties ultimately determine biological outcomes. A central focus is placed on the environmental fate and transport of PAHs across atmospheric, aquatic, and terrestrial compartments, highlighting processes such as gas–particle partitioning, sediment accumulation, and long-range transport. The review further elucidates the complex toxicological pathways of PAHs, including metabolic activation to reactive intermediates, DNA adduct formation, oxidative stress, and their roles in carcinogenesis and other systemic health effects. The analysis reveals strong scientific consensus on the carcinogenic mechanism of parent PAHs via CYP450-mediated metabolic activation to diol-epoxide intermediates while identifying critical areas of uncertainty: the current regulatory framework based on 16 priority PAHs underestimates total carcinogenic risk by a factor of 2–5, mixture toxicology remains poorly characterized, and dose–response relationships for non-cancer endpoints (cardiovascular, neurodevelopmental, immunotoxic) lack the quantitative data needed for robust risk assessment. Finally, human exposure pathways and health risk characterization approaches are discussed, highlighting the need for cumulative, mixture-based assessment frameworks. Full article

The utilization of sugarcane molasses as a low-cost carbon source for riboflavin production is hindered by the reactive oxygen species (ROS) stress induced by its complex components, which suppresses microbial metabolism. To address this, we employed adaptive laboratory evolution (ALE) under progressively increasing stress to develop a sugarcane molasses-tolerant and high-yielding Ashbya gossypii. The adapted strain achieved a riboflavin titer of 298.39 ± 2.01 mg/L, representing a 99.4% increase over the parental strain (149.66 ± 4.97 mg/L), accompanied by a 96% increase in biomass (dry cell weight). Notably, the specific riboflavin production per unit biomass showed no significant difference between the two strains, indicating that the improved total yield was primarily driven by enhanced biomass accumulation. Transcriptomic analysis revealed the molecular basis for this enhanced biomass accumulation—the elevated expression of antioxidant enzymes (SOD1, PRDX5) mitigated ROS levels to support cellular growth, while the coordinated upregulation of the pentose phosphate pathway (E2.2.1.1) and purine metabolism genes (PPAT, ADE5, PFAS, ADSL) enhanced the supply of biosynthetic precursors, ribulose-5-phosphate (Ru5P) and GTP, for nucleotide biosynthesis and cell proliferation. These metabolic adjustments collectively enabled the adapted strain to achieve robust growth under sugarcane molasses stress, thereby driving the overall increase in riboflavin production. This study elucidates the molecular mechanism underlying ALE-improved riboflavin production and provides a promising strategy for its industrial fermentation using sugarcane molasses. Full article

Glycine betaine transport systems are widely exploited by bacteria to survive osmotic stress and represent potential entry routes for antimicrobial delivery. Here, we investigate the bactericidal glycine betaine analog Tox-GB and its uptake, intracellular fate, and antimicrobial activity in Escherichia coli K-12 under osmotic stress. We show that the xenobiotic enters cells via a hierarchical uptake route involving the osmotically regulated compatible solute transporters ProU and ProP, ABC- and MFS-type transporters, respectively. ProU functions as the primary high-affinity transporter at low concentrations, whereas ProP provides a secondary uptake route at somewhat higher substrate levels. Loss of either transporter confers partial resistance, while simultaneous inactivation of both systems causes full resistance, underscoring their functional redundancy and the robustness of Tox-GB import. Intracellularly, Tox-GB undergoes oxygen-dependent degradation, yielding 4-nitrobenzaldehyde and dimethylglycine. While 4-nitrobenzaldehyde contributes to toxicity under aerobic conditions, Tox-GB remains bactericidal under anaerobic conditions, indicating additional oxygen-independent mechanisms involving either the parent compound or unidentified metabolites. These findings suggest a complex intracellular fate and multifactorial mode of action. Despite initial promise as a Trojan horse antimicrobial strategy, the use of Tox-GB for practical applications faces key limitations. Resistance readily emerges via transporter inactivation, and intrinsic resistance occurs in species lacking appropriate compatible solute uptake systems. Structural constraints in glycine betaine transporters further restrict design flexibility. Osmotic regulation limits activity to specific niches, and potential host toxicity stemming from reactive metabolites raises safety concerns. Collectively, these findings highlight the mechanistic complexity and translational challenges faced by glycine betaine–derived xenobiotics as antimicrobial agents. Full article

Type 2 diabetes mellitus (T2DM) is a major driver of chronic kidney disease and cardiovascular morbidity worldwide. Extracellular vesicles (EVs), particularly exosomes, carry microRNAs (miRNAs) that reflect the pathophysiological state of their parent cells and represent promising non-invasive biomarkers. This review comprehensively examines the diagnostic and mechanistic roles of EV-derived miRNAs in diabetic nephropathy (DN) and cardiovascular diseases (CVDs) associated with T2DM. A PRISMA-guided literature search of PubMed, Scopus, Web of Science, and Embase identified 847 articles published between January 2020 and June 2026, of which 156 studies met the inclusion criteria. Several urinary exosomal miRNAs demonstrated significant diagnostic performance for DN, including miR-4534 (AUC = 0.786), miR-136-5p (sensitivity 72.2%, specificity 78.4%), and miR-142-3p. A meta-analysis of circulating miRNAs in diabetic kidney disease reported a pooled AUC of 0.79. In the cardiovascular setting, exosomal miR-155-5p (AUC = 0.901), miR-15a-3p (AUC = 0.874), and a four-miRNA panel (miR-433-3p/let-7b/miR-30-5p/miR-122-5p; AUC = 0.833) demonstrated strong diagnostic performance for ischemic heart disease and carotid atherosclerosis in T2DM. Mechanistically, key EV-associated miRNAs, including miR-21, miR-192, and the anti-fibrotic miR-29 family, participate in fibrosis, inflammation, oxidative stress, endothelial dysfunction, and cardiac remodeling pathways. EV-derived miRNAs therefore represent highly promising non-invasive biomarkers for the early diagnosis and monitoring of diabetic renal and cardiovascular complications. However, clinical translation requires standardized EV isolation and miRNA detection protocols, together with validation in large multicenter prospective cohorts. This review highlights the considerable diagnostic and translational potential of EV-derived miRNAs for precision medicine and liquid biopsy applications in T2DM complications. Full article