Stroke severity may affect the benefits and safety of antiplatelet therapies. We aimed to investigate whether the efficacy and safety of indobufen versus aspirin were affected by stroke severity.

We compared the efficacy and safety of indobufen versus aspirin in patients with NIHSS scores of 4-6, 7-9, and 10-18. The primary efficacy outcome was new stroke (ischemic or hemorrhagic) within 90 days, and the primary safety outcome was moderate or severe bleeding within 90 days. The non-inferiority criteria were set at 1.25 for the upper bounds of the 95% CI of the HR for indobufen versus aspirin based on the statistical analysis of the primary clinical trial.

In total, 3921 patients presented with NIHSS scores of 4-6, 998 patients presented with NIHSS scores of 7-9, and 515 patients presented with NIHSS scores of 10-18. The risk of the primary outcome among patients with NIHSS scores of 4-6 was higher in indobufen group than that in aspirin group (HR, 1.62; 95% CI, 1.26 to 2.08). However, indobufen was non-inferior to aspirin in patients with NIHSS scores of 7-9 (HR, 0.66; 95% CI, 0.38 to 1.15; non-inferiority P = 0.01) and NIHSS scores of 10-18 (HR, 0.49; 95% CI, 0.23 to 1.05; non-inferiority P = 0.008), with a significant statistical interaction (P = 0.001). Moderate or severe bleeding risk differences between treatments did not vary with stroke severity.

This exploratory analysis indicates that the benefit of indobufen in reducing new strokes within 3 months may vary across stroke severity. The potential non-inferiority of indobufen relative to aspirin in patients with NIHSS scores of ≥ 7, with no significant difference in safety, requires further study.

This study explored the impact of childhood hunger experiences on depressive symptoms in Chinese older adults, as well as the mediating roles of physical health and life satisfaction.

The data was sourced from three waves of surveys conducted by the China Social Tracking Survey in 2016, 2018, and 2020. Use OLS model and KHB method for regression analysis and mediation analysis.

The results showed that childhood hunger experiences significantly increase depressive symptom scores and reduce mental health levels. In addition, physical health and life satisfaction partially mediated the relationship between childhood hunger experiences and depressive symptoms in older adults, and the effect was significant.

The findings of this research emphasize the negative impact of childhood hunger experiences on the mental health outcomes of older adults, with physical health and life satisfaction being important mediating pathways.

Clinicians may wish to consider the impact of adverse childhood experiences on depressive symptoms in older adults; Healthcare providers or policymakers may want to consider how to reduce the negative impact of adverse childhood experiences, such as cultivating psychological resilience; Clinicians may wish to consider how to preserve the physical health of older adults and improve their life satisfaction.

Mental health problems are elevated in adolescents with ADHD and/or autism. Emotion regulation deficits (ERD) have been hypothesised as a key driver of such difficulties. The Regulating Emotions - Strengthening Adolescent Resilience (RE-STAR) programme is examining an alternative pathway from neurodivergence to mental health problems, mediated by elevated emotional burden (EB) resulting from the interplay of increased exposure and an unusually intense emotional reaction to commonly upsetting events (CUEs). We present the development and application of the My Emotions in School Inventory (MESI), a self-report questionnaire co-produced with neurodivergent young people, focusing on EB in schools - a setting thought to be of particular significance in this regard.

The MESI, containing 25 school-related CUEs rated on their frequency and the intensity of negative emotions they induce, was completed by secondary school students meeting symptom cut-offs on clinically validated scales of ADHD (n = 100), autism (n = 104), ADHD + autism (n = 79) and neurotypical students (n = 452). Psychometric properties were examined. The ability of the MESI to discriminate adolescents with ADHD and/or autism from neurotypical adolescents, and to predict depression and anxiety, independently of ERD, was explored.

Adolescents in the ADHD and/or autism groups experienced higher CUE frequency and intensity of reaction than their neurotypical peers. Overall levels of EB, most robustly indexed by 24 MESI CUEs, were higher in the three neurodivergent groups, though they did not differ from each other. EB in the autism and ADHD groups was generated by distinctly different CUEs. EB and ERD each contributed independently to the prediction of higher depression or anxiety.

Our findings illustrate the potential value of the MESI as an instrument to measure the contribution of EB alongside ERD in relation to adolescent mental health risks in ADHD and/or autism. Future studies need to investigate its role longitudinally.

Traditional epidemiologic studies suggest that autoimmune neurologic diseases may be associated with mental disorders (MDs). We used Mendelian randomization (MR) studies to explore the causal relationship between autoimmune neurologic diseases and MDs from the genetic perspective.

In our study, autoimmune neurologic diseases include multiple sclerosis (MS), neuromyelitis optica (NMO), and myasthenia gravis (MG); MDs include anxiety, major depressive disorder (MDD), attention deficit/hyperactivity disorder (ADHD), schizophrenia, and bipolar affective disorder (BIP). A two-sample MR approach was used to explore causal relationships. The inverse variance weighted (IVW) method was the primary method for MR analysis. In addition, we included all MG datasets for meta-analysis after MR analysis with ADHD.

Regarding the causal effects of MDs on autoimmune neurologic diseases, our analyses revealed a causal relationship between genetically predicted ADHD and MG (OR 2.250; 95% CI 1.267-3.998; p = 0.006), and no potential genetic causal relationships were found between the other diseases. However, according to the MR‒Egger analysis, there was no indication of directional pleiotropy. For the causal effects of autoimmune neurologic diseases on MDs, no potential genetic causal relationships were identified between any of the diseases. We performed a meta-analysis for MG and ADHD, there was no significant genetic causal relationship between ADHD and MG (OR 1.30 (95% CI 0.95-1.79); p = 0.10).

This study revealed that there was no genetic mechanism linking autoimmune neurologic diseases and MDs to each other. These findings provide a foundation for the prevention and treatment of comorbid conditions in clinical research.

The human cortex exhibits remarkable morphometric similarity between regions; however, the form and extent of lifespan network remodeling remain unknown. Here, we show the spatiotemporal maturation of morphometric brain networks, using multimodal neuroimaging data from 33,937 healthy participants aged 0-80 years. Global architecture matures from birth to early adulthood through enhanced modularity and small worldness. Early development features cytoarchitecturally distinct remodeling: sensory cortices exhibit increased morphometric differentiation, paralimbic cortices show increased morphometric similarity, and association cortices retain stable hub roles. Morphology-function coupling peaks in early adolescence and then decreases, supporting protracted functional maturation. These growth patterns of morphometric networks are correlated with gene expression related to synaptic signaling, neurodevelopment, and metabolism. Normative models based on morphometric networks identify person-specific, connectivity-phenotypic deviations in 1,202 patients with brain disorders. These data provide a blueprint for elucidating the principle of cortical network reconfiguration and a benchmark for quantifying interindividual network variations.

Anti-myelin-associated glycoprotein (MAG) demyelinating neuropathy is a clinically heterogeneous slowly progressive large fiber sensorimotor polyneuropathy. Management of anti-MAG neuropathy is challenging, and a small subset of anti-MAG neuropathy patients have been previously reported to deteriorate after rituximab therapy, perhaps triggered by an upsurge in autoantibody release secondary to B lymphocyte lysis. We report a patient with this complication that responded to IVIg therapy.

Case description and serial electrophysiological studies.

Serial electrophysiological studies confirmed subacute demyelination in our patient with anti-MAG neuropathy treated with rituximab followed by improvement following IVIg.

The use of IVIG therapy can be considered in cases where rituximab leads to clinical and electrophysiological worsening of anti-MAG neuropathy.

There's a general lack of knowledge about autism attributes in early psychosis, although little initial evidence showed that having autistic features contributes to poorer recovery over time. The main aim of this examination was to compare sociodemographic and clinical variables between FEP patients with or without autistic characteristics treated within an "Early Intervention in Psychosis" (EIP) service both at entry and across 2 years of follow-up. We also examined the longitudinal course of autism severity levels in FEP to investigate whether they truly represented trait-like attributes.

FEP participants completed the AQ-spectrum Questionnaire (AQ), the Positive And Negative Syndrome Scale (PANSS), and the Global Assessment of Functioning (GAF) at baseline and over time. Inter-group comparisons were examined using Chi-Squared or Mann-Whitney test, Kaplan-Meyer survival analysis, mixed-design ANOVA, and binary logistic regression. AQ score longitudinal stability was explored using Wilcoxon test for repeated measures and Spearman correlation coefficient.

132 subjects were recruited (28 [21.20 %] scored above the AQ cut-off score of≥26). At presentation, they showed younger age and higher severity in psychopathology (especially negative symptoms). Across the follow-up, the AQ+ subsample had lower incidence rates of service disengagement, PANSS symptomatic remission, and GAF functional remission. AQ scores showed longitudinal stability over time.

The AQ represents a valid instrument to assess "trait-like" autistic features in FEP subjects. Specifically, it captures a distinct FEP subgroup characterized by more severe clinical presentation, poorer clinical and functional outcomes, and specific therapeutic needs.

Women with endometriosis report higher anxiety and depression levels compared with the general population. While numerous studies focused on chronic pain, few have investigated broader potential correlates of mental well-being in patients with endometriosis. This cross-sectional study aimed to highlight the factors associated with higher anxiety and depression symptoms in women with endometriosis.

We conducted a cross-sectional analysis among 2394 participants of the ComPaRe-Endometriosis e-cohort. Symptoms of anxiety and depression were assessed via GAD-7 and PHQ-9 scales at baseline. We used polytomous logistic regression modeling to explore the factors associated with anxiety and depression symptoms severity after adjustment for age, body mass index (BMI), number of comorbidities, diagnostic delay, and age at first symptoms.

Overall, 32 % and 45 % of participants had moderate-to-severe anxiety and depression symptoms respectively. Factors positively associated with higher anxiety/depression symptom severity included lower education, poor sleep quality, reduced quality of life, severity of pelvic/abdominal pain, number of comorbidities, higher BMI, number of medical consultations to diagnosis, and use of complementary medicine. In contrast, older age, a financial situation perceived as comfortable, lack of pain treatment or less frequent transvaginal ultrasound follow-ups were associated with lower anxiety and depression symptoms.

This study identified several sociodemographic and medical factors associated with higher severity of anxiety and depression symptoms in women with endometriosis. If confirmed in future studies, these results could guide preventive strategies, enhance healthcare provider training, and optimize treatments for improved patient-centered care.

The period following discharge from psychiatric hospitalization is associated with high suicide risk. This study sought to determine the rate and associated risk factors of individuals who die by suicide after discharge in Ontario, Canada.

This retrospective case-control study, spanning from 2006-2018, utilized Ontario data to compare individuals who died by suicide within 7, 30, and 90 days of discharge with controls. Clinical, demographic, and healthcare utilization factors were compared. A Cox proportional hazards model was utilized to determine factors independently associated with suicide.

Across 615,067 psychiatric discharges, there were 320, 771, and 1325 suicide deaths within a 7-, 30-, and 90-day period respectively. These deaths correspond to a suicide rate of 2713, 1525, and 882 deaths per 100,000 person-years and 0.52, 1.25, and 2.15 suicides per 1000 discharged individuals. Cases were more likely to be male, aged 45-54, involve unplanned discharge and a history of suicidal behaviour, and admitted for mood or adjustment disorders. Rural residence, income, medical comorbidity, alcohol, substance use disorder, and psychotic illness were not significantly associated with suicide. Healthcare service utilization did not differ significantly.

The suicide rate is highest immediately following discharge and remains elevated above that of the general Canadian population throughout the 90 days afterward. Risk factors identified include mood disorders, male sex, middle age, shorter length of stay, and unplanned discharge - consistent with previous work. Individuals with unplanned discharges and shorter lengths of stay may be good candidates for closer follow-up to mitigate risk.