Larger brain volumes in the neonatal period are associated with better 2-year cognitive development in children born moderate-to-late preterm (MLP). Whether these associations persist into school age for executive function (EF) is unknown.

Children born MLP underwent brain magnetic resonance imaging (MRI) at term-equivalent age (n = 168) and EF assessment at 9 years (n = 159). Mean or median differences in EF subdomains (attentional control, cognitive flexibility, goal setting, behavioral EF) for a unit increase in brain volumes were estimated using linear regression, overall and for subgroups defined by gestational age at MRI, sex and excluding participants with developmental delay at 2 years.

There were few associations between brain volumes and EF. Small effects were found for larger total tissue (mean difference = 0.16; 95% CI = -0.04, 0.36; p = 0.11), white matter (mean difference = 0.21; 95% CI = 0.05, 0.38; p = 0.01) and subcortical gray matter (mean difference = 0.17; 95% CI = -0.01, 0.34; p = 0.06) volumes and improved goal setting. Subgroup relationships were similar.

Neonatal brain volumes in MLP children are not strongly associated with school-age EF. Imaging techniques with higher sensitivity, and other risk factors for poorer EF should be explored.

This study described the associations between neonatal brain volumes and executive function (EF) outcomes at 9 years in children born moderate-to-late preterm (MLP), a group that has been under researched compared with children born very preterm. There was limited evidence of an association between neonatal brain volumes and school-age EF outcomes in children born MLP, contrasting previous findings in very preterm children. This suggests that neonatal brain volumes alone do not effectively predict school-age EF in children born MLP, highlighting the need for more sensitive neuroimaging techniques and identification of other important predictors of long-term outcomes in this population.

As a bisphosphonate drug, zoledronic acid is widely used in the treatment of osteoporosis, hypercalcemia, Paget's disease, and solid malignant tumors. Common adverse reactions include acute-phase responses such as myalgia, fatigue, arthralgia, and fever, while psychiatric disorders have been infrequently reported. This paper presents a case of acute psychiatric disorder in an osteoporotic patient following intravenous infusion of zoledronic acid for the first time, underscoring the necessity of clinical vigilance regarding such rare adverse reactions during treatment.

MDMA is a promising adjunct to psychotherapy and has well-known abuse liability, although less than other amphetamine analogs. While the reinforcing dopamine (DA)-releasing properties of MDMA are on par with methamphetamine (METH), MDMA is a far more potent serotonin (5-HT) releaser, via the 5-HT transporter (SERT). MDMA-mediated 5-HT release in a major reward center, the nucleus accumbens (NAc), drives prosocial behaviors via 5-HT_1BR activation. We hypothesized that this prosocial mechanism contributes to the reduced reinforcing properties of MDMA compared to METH and used a platform of assays to predict the balance of prosocial and abuse-linked effects of (R)-MDMA, a novel entactogen in clinical development. NAc DA release, measured by GRAB-DA photometry in vivo, increased in proportion to MDMA (7.5 and 15 mg/kg, i.p.) and METH (2 mg/kg i.p.)-conditioned place preference (CPP). Using conditional knockouts (cKOs) for DAT and SERT, microdialysis, and photometry, we found that MDMA-released 5-HT limited MDMA-released DA through actions in the NAc, rather than at ventral tegmental area DAergic cell bodies. SERT cKO reduced the MDMA dose required for CPP three-fold. This enhanced MDMA-CPP and increased DA release were replicated by intra-NAc infusion of either a 5-HT reuptake inhibitor (escitalopram) to prevent MDMA interaction with SERT, or a 5-HT_2CR antagonist (SB242084), but not by the 5-HT_1BR antagonist NAS-181. These data support separate mechanisms for the low abuse potential versus prosocial effect of MDMA. Using this platform of assays, (R)-MDMA is predicted to have prosocial effects and low abuse potential.

Mounting evidence indicates that mindfulness-based interventions improve physical and mental health. However, whether brief mindfulness intervention supports health benefits by regulating metabolic profiles is poorly understood. To address this gap, this randomized controlled trial compared ten 1-hour sessions of integrative body-mind training (IBMT) with relaxation training (RT) in 42 participants. Untargeted metabolomics was performed on fasting serum samples to investigate the physiological effects of the interventions on metabolic profiles. After IBMT, significant increases were observed in glycine derivatives, glutamate, and tetrahexosylceramide, while multiple sulfur containing compounds decreased. In contrast, RT yielded no significant intervention effects. A direct comparison between IBMT and RT revealed significant group differences in the levels of glycine, phosphatidylcholine, phosphatidylethanolamine, phosphoglycerol, phosphatidylserine, sphingomyelin derivatives, and α-linolenic acid. Further, pathway and enrichment analyses confirmed the effects of IBMT on amino acid and lipid metabolism with significant alterations to sphingolipid, α-linolenic acid, and linoleic acid metabolism as well as histidine and pyruvate metabolism. These findings suggest that IBMT can reprogram key metabolic pathways. In conclusion, this study offers insights into how a brief mindfulness intervention modulates metabolic profiles and highlights the potential of mindfulness-based interventions to promote health through metabolic regulation. These findings may guide the development of future mindfulness-based health promotion strategies.

Early prediction of disability progression in multiple sclerosis (MS) remains challenging despite its critical importance for therapeutic decision-making. We present the first systematic evaluation of personalized federated learning (PFL) for 2-year MS disability progression prediction, leveraging multi-center real-world data from over 26,000 patients. While conventional federated learning (FL) enables privacy-aware collaborative modeling, it remains vulnerable to institutional data heterogeneity. PFL overcomes this challenge by adapting shared models to local data distributions without compromising privacy. We evaluated two personalization strategies: a novel AdaptiveDualBranchNet architecture with selective parameter sharing, and personalized fine-tuning of global models, benchmarked against centralized and client-specific approaches. Baseline FL underperformed relative to personalized methods, whereas personalization significantly improved performance, with personalized FedProx and FedAVG achieving ROC-AUC scores of 0.8398 ± 0.0019 and 0.8384 ± 0.0014, respectively. These findings establish personalization as critical for scalable, privacy-aware clinical prediction models and highlight its potential to inform earlier intervention strategies in MS and beyond.

Cognitive impairments in schizophrenia significantly impact daily functioning and quality of life, posing a major therapeutic challenge. While both cognitive training and transcranial direct current stimulation (tDCS) have shown promise in improving cognitive function, their combined effects remain underexplored. This double-blind, sham-controlled, randomized clinical trial investigated whether adaptive working memory training (aWMT) paired with anodal tDCS to the right dorsolateral prefrontal cortex (DLPFC) enhances cognitive outcomes in schizophrenia. Twenty-eight individuals with schizophrenia or schizoaffective disorder completed ten sessions of aWMT with concurrent 2 mA anodal or sham tDCS. Cognitive improvements were assessed using the Brief Assessment of Cognition in Schizophrenia (BACS) at baseline, three days after training, and at follow-ups one month, and three months later. Clinical measures evaluated psychopathology, depression, and quality of life. Anodal tDCS significantly improved working memory performance during training, with gains partially sustained at follow-ups. Short-term transfer effects with large effect sizes were observed in the BACS, although clinical symptoms and quality of life remained unaffected. While preliminary, these findings indicate that tDCS could support cognitive training outcomes in schizophrenia. Larger randomized controlled trials are needed to confirm transfer effects and determine the long-term benefits of this approach. If proven effective, integrating tDCS into cognitive remediation therapies could represent an innovative strategy to address cognitive deficits in schizophrenia.

Emotional memories require coordinated activity of the amygdala and hippocampus. Human intracranial recordings have shown that formation of aversive memories involves an amygdala theta-hippocampal gamma phase code. Yet, the mechanisms engaged during translation of aversive experiences into memories and subsequent retrieval remain unclear. Directly recording from human amygdala and hippocampus, here we show that hippocampal gamma activity increases for correctly remembered aversive scenes. Crucially, patterns of amygdala high amplitude gamma activity at encoding are reactivated in the hippocampus, but not amygdala, during both aversive encoding and retrieval. Trial-specific hippocampal gamma patterns showing highest representational similarity with amygdala activity at encoding are reactivated in the hippocampus during aversive retrieval. This reactivation process occurs against a background of gamma activity that is otherwise decorrelated between encoding and retrieval. Thus, phasic hippocampal gamma responses track the retrieval of aversive memories, with activity patterns apparently entrained by the amygdala during encoding.

Immigration is a significant determinant of mental illness among racialised newcomer youth who experience immigration challenges, including cross-cultural transitions and adaptations, social exclusion, anti-immigrant policies and the loss and reconstruction of social support networks. The development of tools to support self-care can improve the mental health and well-being of this population. In this project, we utilised the photovoice approach to explore racialised newcomers' mental health struggles and how they mitigate them. We constituted a working group comprising racialised newcomers with lived experiences of immigration-related mental health stressors to support the workbook development. The risk for mental illnesses for international students, and signs and symptoms of stress, depression and anxiety were covered. We utilised photos that depicted the immigration-related mental health stressors and mental health boosters that help mitigate these stressors. Each photo had a title and a closed caption that depicted its essence. Spaces to journal were provided as well as a list of resources for free groceries, religious organisations and thrift shops. The workbook was pilot tested with 13 participants who were racialised newcomers and experienced self-reported symptoms of mental illness since arriving in Canada. Their reported benefits of utilising the workbook include increasing mental health literacy, validating experiences, creating catharsis through journaling, incentivising them to better respond to stressors and habitually developing practices to boost their mental well-being. A workbook with psychoeducation content on mental health risks and symptoms and content that utilises data from people with experiences like the targeted population can enhance the agency of self-care through increased knowledge, validation of experiences and inculcation of hope.

Moral injury (MI) is the damage done to one's conscience or moral compass when one perpetrates, witnesses, or fails to prevent acts that transgress one's own moral beliefs. There are numerous associations between MI and various mental health outcomes, including burnout, depression, anxiety, sleep disorders, and increased job turnover. However, there has been no research or official study investigating MI in mental health nurses (MHNs) in Switzerland. This study aimed to examine and describe the spectrum and impact of MI in Swiss MHN. Demographic data and descriptions of MI in mental health nursing were collected from 19 problem-focused interviews between September and November 2023. The data were analysed descriptively and using qualitative content analysis strategies, respectively. Participants highlighted specific potentially morally injurious events (PMIEs) such as coercive measures, power plays, and sanctioning behaviour prevalent in mental health nursing. As they caused violations of moral values, with intense emotional responses ranging from anger to guilt, shame, helplessness, and powerlessness, MIs could be identified. They resulted in long-term consequences such as job changes, sleep disturbances, anxiety, panic attacks, sensory crises, and substance abuse. The results emphasise the impact of MI on the well-being and practice of MHN in Switzerland. Participants perceived MI as expressing intense emotions and dissatisfaction, challenging their moral principles in the context of their daily work. Participants confronted with MI reported increased risks for negative health outcomes. The identification of causes of MI emphasises the need for targeted interventions in the psychiatric setting.

To examine the association between perceived quality of care and the level of coercion experienced by individuals hospitalised in acute mental health units.

National cross-sectional study.

Data were collected from 255 patients admitted to 12 acute mental health units across Spain. Standardised instruments assessed perceived quality of care and levels of coercion, humiliation and fear at discharge. Multiple linear regression analyses were used to explore associations between care quality dimensions and patients' experiences.

Perceived quality of care was significantly associated with lower levels of perceived coercion and humiliation. All dimensions of care quality showed inverse associations, with the "secluded" dimension showing the strongest association. The association between care quality and perceived fear was less consistent. These findings are particularly relevant for mental health nurses, who play a central role in delivering relational care and ensuring patients' emotional safety.

Higher perceived quality of care is associated with lower levels of coercion, humiliation, and fear during hospitalisation in acute mental health settings.

For mental health nursing, these results underscore the critical role of nurses in creating therapeutic environments that reduce coercive experiences. By fostering trust, promoting patient autonomy, and ensuring emotional and physical safety, nurses can significantly influence the quality of care and patient outcomes.

The study addresses the lack of evidence on how perceived quality of care influences experiences of coercion in acute mental health settings. Better perceived care quality is linked to reduced feelings of coercion, humiliation and fear. The research has direct implications for mental health nurses, clinical educators and healthcare managers aiming to improve patient experiences and reduce coercive practices in psychiatric care.

STROBE reporting guideline.

No patient or public contribution.