This article describes the case of a 68-year-old woman presenting with acute dizziness and double vision, diagnosed with wall-eyed bilateral internuclear ophthalmoplegia (WEBINO). She experienced unprovoked, nonpositional dizziness, and binocular double vision that improved with eye closure. Neurological examination showed right eye exotropia, left eye hypertropia, mild right eyelid ptosis, and impaired extraocular movements, especially in elevation and adduction. Diagnostic tests including blood work and cerebrospinal fluid analysis were largely normal, but brain magnetic resonance imagingindicated symmetric diffusion-weighted imaging brightening in the bilateral midbrain, suggesting an acute infarction. WEBINO, a rare neuro-ophthalmological disorder often linked to brainstem strokes or demyelinating diseases, is characterized by bilateral medial rectus weakness due to lesions in the medial longitudinal fasciculus. The case underscores the importance of thorough clinical and radiological evaluation in diagnosing atypical presentations of neuro-ophthalmological disorders, with management focused on treating the underlying cause and providing symptomatic relief for diplopia.

Takotsubo cardiomyopathy (TCM), also known as stress cardiomyopathy, affects 0.02% of hospitalized patients and is primarily triggered by emotional stressors, although unusual medical situations have also been documented. We report the case of a 36-year-old female patient who presented with symptoms of infection (oropharyngeal pain and diarrhea) 10 days before admission. Upon arrival at the emergency department, she exhibited progressive weakness, lower cranial nerve involvement, and areflexia, necessitating invasive mechanical ventilation support. Diagnostic evaluation revealed sinus tachycardia and atrial fibrillation, leading to a diagnosis of Guillain-Barré syndrome (GBS) with associated cardiovascular dysautonomia. Echocardiography demonstrated apical hypokinesia of the left ventricle, consistent with TCM. Furthermore, her thyroid profile indicated hyperthyroidism, fulfilling the criteria for a thyroid storm. Treatment comprised intravenous human immunoglobulin, methimazole, and propranolol. We present the first documented case of TCM attributed to dysautonomia resulting from GBS and thyroid storm.

Physical activity (PA) is a widely accepted non-pharmacological therapy for patients with Alzheimer's disease (AD). Existing studies have demonstrated that PA can improve cognitive function in AD patients. However, few of the meta-analyses conducted to date have included participants with a confirmed AD diagnosis that meets standardized diagnostic criteria, nor have they systematically evaluated the interactions between different intervention parameters. The aim of this study was therefore to investigate the effects of PA on cognitive function improvement in AD patients, and how different intervention parameters may influence the effect sizes.

Two investigators independently conducted systematic searches in four international databases (PubMed, Web of Science, Embase, and Cochrane Library) and two Chinese databases (China National Knowledge Infrastructure [CNKI] and VIP Database [VIP]) while adhering to PRISMA guidelines. The search was limited to randomized clinical trials (RCTs) and covered each database from its inception to March 31, 2025. The methodological quality of included studies was assessed using criteria from the Cochrane Handbook 5.1.0. All analyses were performed using Stata 15.0.

The meta-analysis included 13 RCTs with a total of 813 AD patients. PA significantly improved Mini-Mental State Examination (MMSE) scores in AD patients (Weighted Mean Difference [WMD] = 1.79, 95% CI: 1.03 to 2.55, p < 0.001). Subgroup analyses showed that interventions with moderate intensity (WMD = 2.12), a single session duration of 30 min (WMD = 2.15), a frequency of >3 times per week (WMD = 3.03), a total weekly intervention time of >120 min (WMD = 2.10), and a total intervention duration of >12 weeks (WMD = 1.95) significantly improved MMSE scores. Meta-regression analysis revealed that intervention frequency (p < 0.001) and total intervention duration (p = 0.002) were significantly correlated with improved cognitive function, while the intervention intensity (p < 0.001) and single session duration (p = 0.002) showed negative correlations.

Our findings suggest that PA interventions can improve MMSE scores and enhance cognitive function in AD patients. We recommend that PA interventions for AD patients consist of moderate-intensity, a single session duration of 30 min, a frequency of >3 times per week, a total weekly intervention time of >120 min, and a total intervention duration of >12 weeks. The PROSPERO Registration: CRD420250631766. https://www.crd.york.ac.uk/PROSPERO/view/CRD420250631766.

Background and Objective: Previous studies have shown that experience of racial discrimination is associated with increased mental health problems, especially stress. Using a cluster analytical procedure, the current study aimed to examine stress characteristics related to racial discrimination in individuals from diverse racial identities.Method: In total, 4220 participants completed the questionnaires assessing stress, resilience, everyday racial discrimination, and experience of major racial discrimination. K-means cluster analysis was performed to cluster participants' features regarding stress, resilience, everyday racial discrimination, and major racial discrimination. To determine the optimal number of clusters, the gap statistic was employed. Extracted clusters were then compared across racial groups using chi-square tests.Results: Cluster analysis revealed a three-cluster solution, including 'low stress', 'stress cluster with high racial discrimination', and 'stress cluster with low racial discrimination' clusters. Concerning the race-differences, Black (32.57%) and Indigenous (33.63%) participants had higher membership in the stress cluster with high racial discrimination compared to other racialized groups. Regarding the stress cluster with low racial discrimination, a higher membership was observed among Arab participants (30.82%) and those with other racial identities (30.40%) compared to other racialized groups.Conclusions: The findings demonstrate a type of stress characterized by high levels of racial discrimination and accompanying psychosocial burdens. Implications for intervention, prevention, and future research are discussed in the paper.

Body weight misperception is increasingly prevalent among adolescents, yet the association between weight misperception and academic performances is unclear. This study aims to examine the association among weight misperception and academic performances among Chinese adolescents and estimate the mediating effect of loneliness on this association.

This repeated cross-sectional study uses data of adolescents aged 13-19 years, collected from the Ningbo Youth Risk Behavior Surveys from 2007 to 2022. Data of anthropometric, demographic, weight perception, mood, and academic performance information were collected via self-reported questionnaires. Multivariate logit regression is used to investigate the association between weight misperception and academic performance. A generalized structural equation model is used to assess the mediating effect of loneliness on this association.

The sample sizes for each wave were 921, 909, 1,555, and 2,690. Adolescents with overestimation of body weight were significantly associated with higher odds of having poor academic performances for both girls (OR: 1.23, 95% CI: 1.03-1.46) and boys (OR: 1.45, 95% CI: 1.18-1.77). Specifically, body weight overestimation was significantly associated with higher odds of loneliness for girls (OR: 1.28, 95% CI: 1.05-1.56) and boys (OR: 1.40, 95% CI: 1.11-1.75), while loneliness was significantly associated with poorer academic performances for girls (OR: 1.34, 95% CI: 1.05-1.71) and boys (OR: 1.31, 95% CI: 1.09-1.59). Loneliness played a mediating role in the association between overestimation of body weight and poor academic performances, with indirect effects of 58.19 and 55.85% for girls (OR: 1.69, 95% CI: 1.14-2.24) and boys (OR: 1.81, 95% CI: 1.28-2.34), respectively.

Overestimation of body weight is associated with poorer academic performances in Chinese adolescents, mediated by loneliness. This finding suggests that family and school-based health education and psychological interventions, such as education on body image, targeted mental health consulting, mutual aid networks, fostering inclusive classroom, and family-school collaboration, should be encouraged to the well-being of adolescents.

Using AI-powered mobile applications for mental health screening can help reduce maternal mental health disparities among Black mothers who are pregnant or parenting in the United States. A maternal health education question and answer mobile application chatbot has the potential to intervene in the maternal depression cascade, specifically screening. Extant research demonstrates the usability of mobile applications addressing mental health. However, limited scholarship explores the intersection between AI-powered mobile application chatbots and maternal mental health. This study uses a multimethod analysis to evaluate the usability of an AI-powered mobile application to address maternal mental health among Black women. Data sources, including mobile application engagement, mental health disorder scales, and secondary qualitative analysis from focus group discussions (n = 5), will be assessed through a multimethod approach. The study team previously collected data across the United States for this clinical intervention in 2022. Findings indicate that the mobile application demonstrated promise in the application's usability to screen for maternal health depression indicators. This was achieved using the mobile application's intent classification functionality that classified users' questions that contained targeted search terms (e.g., postpartum depression) or specific inquiries about mental health and appropriate follow-up from the study team to provide mental health resources. Critical interconnected themes were assessed and reflected high confidence, acceptance, and usability of the mobile application in addressing maternal mental health inquiries. Findings contribute to evidence about the usability of AI-powered mobile applications informed by Black mothers in appropriate screening for maternal depression indicators and inquiries. This study provides insight into closing the gap in maternal health disparities in depression outcomes for Black mothers.Trial Registration: ClinicalTrials.gov NCT06053515; https://clinicaltrials.gov/study/NCT06053515.

In rural Thailand, caregiving for bedridden older adults often emphasizes physical support, while their emotional and psychological needs remain unmet. The Five Love Languages framework offers a positive psychology-based approach to enhancing emotional care. This study aimed to explore the lived experiences of Thai children and to use the Five Love Languages framework to promote the emotional well-being of bedridden older adults in a rural Thai community.

A phenomenological study using Colaizzi's method was conducted on eleven children (aged 11-12) who were purposively recruited. Data were collected and analyzed from April to May 2025 through semi-structured interviews until conceptual richness was achieved. All transcripts were then manually analyzed using Colaizzi's seven-step process.

Three overarching themes with eight subthemes emerged: 1) Awakening emotional sensitivity in caregiving- transitioning from task-based care to emotionally responsive care; (2) Reconstructing social bonds-strengthening intergenerational connections and reduced isolation; and (3) Personal growth and reciprocity-developing empathy, leadership, and civic responsibility.

Applying the Five Love Languages framework enabled children to foster intergenerational bonds that enhanced the emotional well-being of older adults and supported children's personal growth. Nurse-led programs can sustain intergenerational caregiving in rural communities.

Managing stress carries significant implications for the mental wellbeing, academic achievements, career advancement, and overall life satisfaction of medical students. However, the coping mechanisms for stress management are diverse. The current systematic review examines the proposals and consequences of stress management for students in medical education, acknowledging the array of challenges inherent to their academic journey.

A search was conducted from 2013 to 2023 (September) across databases such as PubMed, Web of Science, and Scopus to retrieve articles on "Medical students," "Coping mechanisms," and "Stress management". The English-language articles were the only ones considered in the study. The articles that discussed coping mechanisms, such as resilience training, mindfulness-based stress reduction (MBSR) programs, and/or wellness and self-care workshops, were included in the study. This review was not prospectively registered in PROSPERO; however, PRISMA 2020 guidelines were followed throughout.

Nine articles were included in the study based on the inclusion and exclusion criteria. Among 2,334 medical students, 11%, 72.7%, and 16.3% reported low, moderate, and high stress levels, respectively. The selected nine articles aimed to address these far-reaching effects of stress management strategies. The stress management programs encompass creating robust mental health support systems within institutions, incorporating anxiety management education into regular coursework, offering workshops that teach practical techniques for handling emotional turmoil effectively, and fostering an environment where discussing one's challenges is encouraged rather than stigmatized. Such programs encourage students to seek expert guidance when needed, undertake systematic investigations to tailor interventions to changing needs and circumstances, and emphasize the importance of balancing work responsibilities, academic commitments, and personal life.

By implementing these suggestions within their framework, institutions can more effectively prepare their medical learners to overcome educational challenges and cultivate empathetic, resilient professionals skilled in delivering healthcare services.

To identify factors distinguishing frail from pre-frail status in community-dwelling older adults and construct a risk prediction model with logistic regression as the primary method to identify independent risk factors, and a neural network as a supplementary approach to explore complex relationships.

The FRAIL Frailty Screening Scale was used to screen adults aged 65 and above meeting inclusion criteria for pre-frailty and frailty. A cross-sectional survey collected basic information and disease status, while scales assessed nutritional risk, sarcopenia, and activities of daily living (ADL), alongside physical measurements. Binary logistic regression was used as the primary method to identify factors associated with frailty status. A multi-layer perceptron neural network was employed secondarily to explore complex, non-linear associative patterns.

Of 1,451 participants, 46.0% were pre-frailty, and 54.0% were frail. Age, education level, smoking status, number of chronic diseases, SNAQ nutritional risk, SARC-F sarcopenia, and ADL disability were independent associated with frailty status, with SARC-F sarcopenia showing the strongest association with frailty status. The neural network model identified SARC-F sarcopenia (100.0%), waist circumference (67.0%), and age (62.8%) as the most influential factors.

Our findings identify several factors strongly associated with frailty status in a cross-sectional sample. While these factors represent potential targets for intervention, future longitudinal studies are needed to confirm their predictive value for frailty progression. The logistic regression model provides clinically interpretable factors associated with frailty (e.g., SARC-F sarcopenia, ADL disability, nutritional risk). The neural network analysis corroborated the paramount importance of sarcopenia and highlighted additional non-linear associations. Community decisions should be primarily based on the interpretable outputs of the logistic regression model. Given the cross-sectional design, these findings represent associations at a single time point.

Unhealthy diets are major contributors to the global burden of non-communicable diseases, particularly cardiovascular disease and metabolic syndrome, where dietary fat quality plays a critical role. Among dietary fats, linoleic acid (LA)-the predominant omega-6 polyunsaturated fatty acid-has been at the center of a long-standing and evolving controversy. Initially promoted for its cholesterol-lowering properties, LA later became the focus of debate due to hypotheses suggesting pro-inflammatory and oxidative effects, which led to conflicting interpretations of its metabolic impact and inconsistent dietary guidelines over time. This review traces the origins and progression of this controversy, examining how shifts in biochemical understanding, experimental design, and population dietary patterns have shaped current perspectives on LA and cardiometabolic health. By integrating evidence from biochemical, preclinical, and human studies, we clarify the mechanistic and clinical bases underlying LA's actions and re-evaluate its role in lipid metabolism, inflammation, and glucose regulation. Overall, most human evidence supports beneficial associations between LA exposure and cardiometabolic outcomes, though heterogeneity across studies underscores the relevance of dietary context, genetic background, and metabolic status. Understanding how the controversy emerged and evolved is essential to refine current recommendations for dietary fat and disease prevention.