In the revised DSM-5, Somatic Symptom Disorder (SSD) no longer requires medically unexplained symptoms and instead focuses on psychobehavioral positive criteria, applicable regardless of the underlying cause. Evidence on the frequency and characteristics of SSD among medically hospitalized inpatients remains scarce. We therefore investigated SSD frequency and age- and gender-associated characteristics in this population.

This cross-sectional analysis used baseline data from SomPsyNet, an intervention targeting SOMatic hospital inpatients to prevent PSYchosocial distress through a care NETwork. SSD was assessed using the Somatic Symptom Scale-8 (SSS-8) and the Somatic Symptom Disorder-B Criteria Scale (SSD-12), applying DSM-5-aligned and established cut-offs. Criteria were operationalized as A) somatic symptom burden (SSS-8 sum score ≥ 9 or per item≥3), B) symptom-related distress (SSD-12 ≥ 23), and C) proxies for symptom persistence. Associations with age were examined using robust regression.

Among 3109 inpatients enrolled between June 2020 and December 2022, 20.6 % (SSS-8 sum score ≥ 9) to 21.9 % (SSS-8 per item≥3) met all three SSD criteria. Among the 25.5 % of patients positive for Criterion B (SSD-12 ≥ 23), Criteria A and C were frequently also met. No female predominance in symptom-related distress was observed. Younger patients reported higher somatic symptom burden and symptom-related distress (SSS-8: B = -0.04, t = -7.51; SSD-12: B = -0.05, t = -5.11).

Symptoms consistent with DSM-5 SSD criteria were common among medically hospitalized inpatients. These findings underscore the frequency of SSD-related distress in this setting, highlight age- and gender-related differences in symptom presentation, and emphasize the need for further research to clarify its clinical implications.

While links between depression and cancer risk are well documented, specific depressive symptoms involved remain unclear, as does the presence of associations between cognitive function and cancer risk. To address these gaps, we assessed associations of cognitive function levels and depressive symptoms with cancer occurrence among middle-aged and older Chinese adults.

This prospective cohort study utilized 2011 to 2020 data from the CHARLS, a population-based nationwide survey from China. Adults aged 45 years or older with cognitive function and depressive symptom data and no baseline cancer diagnosis were included for analysis. Global cognitive function scores were calculated for executive function and episodic memory performance using an adapted version of the Telephone Interview for Cognitive Status. Depressive symptoms were assessed using the CESD-10. Risk of events was reported based on adjusted HRs and 95 % CIs for cancer incidence, using a Cox proportional hazards regression model.

Of 16,518 cancer-free adults (mean [SD] age: 56.5 [8.9] years) assessed at baseline, 244 new cancer cases were diagnosed (mean [SD] age: 57.6 [8.9] years) during a median follow-up period of 9 years (IQR, 7-9 years). A lower level of executive function (adjusted HR [95 %CI], 0.69 [0.52-0.92]) and higher somatic retardation levels (adjusted HR [95 %CI], 1.34 [1.00-1.79]) were associated with higher subsequent risk of cancer incidence, after controlling for the impact of demographic characteristics, health-related lifestyle factors and medical conditions.

In this longitudinal cohort study, lower initial levels of executive function and higher somatic retardation depressive symptom levels predicted higher subsequent cancer incidence.

Obesity rates have surged in recent years, particularly in developing countries, yet key drivers remain inadequately understood. We identify short videos as a novel and significant determinant of obesity. We use China Family Panel Studies (CFPS) microdata in China to examine the causal relationship between short videos and obesity by the fixed effect panel regression model. Our findings show that short videos increase BMI by 0.12 and the probability of obesity by 2.2 %, resulting in an additional CNY of 7.52 billion one year in healthcare costs nationwide. It can explain about 27 % of the growth in China's obese population from 2020 to 2022, suggesting that it has become a major new driver of obesity. Further analysis reveals that short videos are addictive, displacing time for physical exercise, and we find no evidence supporting their positive impact on exercise by information channel. Other potential mechanisms, including mental health, sleep quality, and health-related habits, are found to be insignificant. Heterogeneity analysis indicates that men, individuals with lower education levels, those aged over 35, and urban residents are more likely to experience negative effects from short video addiction. This study contributes to the literature by highlighting short video platforms as emerging digital determinants of obesity, providing new perspectives for health policy and digital media regulation.

Invasive pulmonary aspergillosis (IPA) is a life-threatening fungal infection traditionally associated with severely immunocompromised hosts, particularly those with hematologic malignancies. However, its epidemiological profile has shifted in recent years, with a rising incidence among critically ill patients in intensive care units (ICUs), many of whom lack classical risk factors. This change is driven by increased use of corticosteroids and immunomodulatory therapies, the growing prevalence of chronic lung disease, and severe viral pneumonias such as influenza and COVID-19. In these patients, airway epithelial injury, immune dysregulation, and mechanical ventilation facilitate fungal invasion even in the absence of profound immunosuppression. Corticosteroids play a central role in IPA pathogenesis. While they limit hyperinflammation, they simultaneously impair fungal clearance by suppressing NF-κB signaling, downregulating TNF-α production, and promoting IL-10 secretion, resulting in a Th2-skewed immune profile. Neutrophil recruitment persists but becomes dysregulated, contributing to tissue injury rather than effective pathogen elimination. Corticosteroids may also directly enhance Aspergillus growth, further compounding risk. Diagnosis of IPA in ICU patients remain challenging because radiological hallmarks such as the halo sign are uncommon, and distinguishing colonization from invasive disease is difficult. Serum and bronchoalveolar lavage galactomannan, β-D-glucan assays, and PCR can improve early detection, but no single test is definitive in this heterogeneous population. As much as possible, high-quality lower respiratory tract samples should be obtained. Furthermore, effective treatment requires not only timely diagnosis, but also careful selection of antifungal taking into consideration pharmacologic challenges of ICU patients and pharmacodynamics of antifungals. Recognition of high-risk patients such as those receiving corticosteroids, those with chronic lung disease, severe viral pneumonia, or requiring invasive ventilation is critical to improve outcomes. Mortality in this group can exceed that of neutropenic patients, underscoring the need for heightened clinical suspicion and timely antifungal therapy. A deeper understanding of the immunopathogenesis of IPA in non-neutropenic patients, particularly the dual effects of corticosteroids on inflammation and host defense, may inform risk stratification and guide earlier intervention. Enhanced surveillance, prompt diagnostic workup, and judicious use of immunomodulatory therapy represent key strategies to mitigate the rising burden of this devastating infection in ICU settings.

With annual global plastic production exceeding 400 million tons, nanoscale polystyrene particles (nPS) have become a major health concern due to their bioaccumulation capacity and ability to cross biological barriers. Surface-charged nPS variants (cationic, anionic, and neutral) show distinct biodistribution patterns, yet the mechanisms underlying their systemic damage remain incompletely understood. This study aimed to investigate the systemic injury mechanisms of nPS with different surface charges.

Mice were exposed to fluorescently labeled cationic (amino-modified), anionic (carboxyl-modified), and neutral nPS via drinking water (25 mg/mL) for 3 weeks. Tissue distribution was analyzed using fluorescence microscopy; pathological changes were assessed via hematoxylin-eosin (HE) staining; metabolic perturbations were detected by metabolomic profiling. Mechanistic investigations were performed using metabolomics, flow cytometry, and molecular assays in AML12 hepatocytes and vascular endothelial cells.

Fluorescence microscopy showed neutral nPS accumulated in the vascular endothelium of the stomach, intestine, and lung via passive diffusion, while cationic/anionic nPS penetrated hepatic sinusoids through charge-mediated interactions. HE staining revealed severe liver injury, with no significant abnormalities in other tissues. Metabolomic profiling indicated disrupted hepatic amino acid and lipid metabolism, depleted antioxidants (e.g., vitamin E and glutathione), and induced oxidative stress (evidenced by elevated hydroxy fatty acids). In hepatocytes, nPS-induced endoplasmic reticulum (ER) stress triggered excessive reactive oxygen species (ROS) production, inhibiting SLC7A11-mediated cystine uptake and glutathione synthesis, leading to disulfide stress (β-actin disulfide mispairing) and ferroptosis (GPX4 inactivation and iron accumulation). In contrast, neutral nPS induced endothelial cell senescence via phagolysosome dysfunction, causing lysosomal membrane permeabilization and β-galactosidase release.

This study identifies a "charge-specific injury" paradigm: charged nPS induce hepatocyte ferroptosis via an ER stress-disulfide stress cascade, while neutral nPS trigger endothelial senescence through phagocytic dysfunction. These findings provide critical insights for the biosafety assessment of nanoplastics and identify potential targets for preventing plastic pollution-related liver diseases.

Assessing usability and satisfaction is vital to ensure the efficiency and optimal use of mobile health (mHealth) applications. Nevertheless, existing questionnaires revolve around computerized systems and lack validation for evaluating mHealth applications. We aimed to develop and validate a tri-language questionnaire to assess usability and satisfaction of mobile health applications (USHA). This study consisted of three phases: item development, translation, and validation. During the item development phase, a preliminary English version of the USHA questionnaire that comprised Likert-scale and demographic items was designed. Subsequently, forward-backward translation was performed to produce Malay and Chinese versions. Content validation was conducted with eight experts, followed by face validation with five diabetes mellitus patients. Reliability testing was conducted through test-retest analysis among diabetes mellitus patients. The initial tri-language USHA questionnaire consisted of 18 Likert-scale items and 8 demographic items. Following expert validation, five Likert-scale items and one demographic item were eliminated for lack of relevance, importance, or clarity, while four Likert-scale items were rephrased. During face validation, additional one demographic item was removed. The finalized questionnaire demonstrated high reliability, with a Cronbach's alpha of 0.956 and an intraclass correlation coefficient of 0.845. Consequently, the tri-language USHA questionnaire consisted of 13 Likert-scale items and six demographic items, is a valid and reliable instrument that enhances accessibility and enables assessment of the usability and satisfaction of interactive mHealth applications, especially for diabetes mellitus care across a broad range of users.

Recognizing metabolic heterogeneity in gestational diabetes mellitus (GDM) and body mass index (BMI)-linked phenotypes, we evaluated whether combining hemoglobin A1c (HbA1c, reflecting fasting glycaemia) and 1,5-anhydroglucitol (1,5-AG, reflecting post-load glucose excursions) improves early prediction and whether performance differs by BMI.

In this multicenter retrospective study, pregnant women who had 1,5-AG and HbA1c measured before 20 weeks of gestation at two tertiary centers in Japan were included. Spearman's correlation was used to assess associations between glycemic markers and glucose levels. Predictive performance for GDM was evaluated using ROC analysis, and stratified analyses were conducted by pre-pregnancy BMI.

Among 191 participants, 45 (24.1%) developed GDM: 35.1 ± 4.9 years, pre-pregnancy BMI 22.9 ± 4.3 kg/m², and sampling at 14.3 [IQR 14.0-14.7] weeks. HbA1c correlated with fasting glucose (r = 0.35) while 1,5-AG correlated inversely with 2-h glucose (r =  - 0.39). They themselves were not significantly correlated (r =  - 0.13). As single predictors, performance depended on BMI: in ≥ 25.0 kg/m², HbA1c outperformed 1,5-AG (AUC 0.776 vs 0.618); in BMI < 25.0 kg/m², 1,5-AG outperformed HbA1c (AUC 0.704 vs 0.640). In both BMI strata, the dual-marker model was superior (AUC 0.833 and 0.803, respectively) and provided more balanced sensitivity, accuracy, and F1. Pre-pregnancy BMI correlated positively with fasting plasma glucose (r = 0.47) but not with 1-h or 2-h glucose (r = 0.20 and r = 0.16, respectively), supporting BMI-related metabolic variation.

Combining 1,5-AG and HbA1c enhances early prediction of GDM by capturing complementary glycemic abnormalities linked to BMI-specific metabolic phenotypes.

This retrospective case series describes seven diabetic cats treated with velagliflozin that were considered non-ideal candidates for this therapy. These more complicated diabetic feline cases were referred to the Small Animal Department, Ghent University. Sole inclusion criterion for this case series was treatment with velagliflozin (Senvelgo; Boehringer Ingelheim) after diagnosis of diabetes mellitus. Data on signalment, medical history, clinical findings, diagnostics, treatment, response and outcomes were available for all cats. The initial consultation for all cats took place between March 2024 and May 2025. Current literature on the use of sodium-glucose cotransporter-2 inhibitors in feline patients remains limited, with most studies involving highly selected populations with strict exclusion criteria. This case series describes the use of velagliflozin in non-ideal candidates for SGLT2 inhibitor therapy, aiming to support clinicians managing such cases and to provide usefull information for future studies. In these non-ideal cases, the use of velagliflozin may be considered off-label; its administration should comply with local ethical and legal regulations, with informed client consent obtained. Consultation with a veterinary specialist is recommended when clinical experience is limited. This case series includes diabetic cats with suspected and/or confirmed comorbidities that complicate diabetes management, such as hypersomatotropism and chronic kidney disease. In addition, it reports on the concurrent use of other treatments, including cabergoline and insulin. The potential interaction and possible synergistic effects of these combined therapies represent an area of interest for future research. To ensure optimal glycemic control and enable individualized dosing, four of the presented cases were closely monitored using continuous glucose monitoring. Furthermore, the availability of ketone concentrations in both urine and/or blood provided valuable insight into the metabolic changes associated with this new treatment. The role of ketone monitoring in predicting treatment response and identifying potential adverse effects represents another important area for future research.

This study aimed to evaluate the added benefits of a structured nutritional intervention combined with dapagliflozin in patients with DN.

In this prospective, randomized, open-label trial, 108 patients with DN were assigned to a control group (CG, conventional care), a treatment group (TG, CG + dapagliflozin 10 mg/day), or an observation group (OG, TG + Mediterranean diet and oral nutritional supplements). Key outcomes included glycaemic control (FBG, PBG, HbA1c), renal function (BUN, sCr, UACR, eGFR), nutritional status (albumin, ferritin, SGA), inflammation (CRP, TNF-α, IL-6), safety and quality of life (SF-36), assessed at baseline, 3 and 6 months.

Both TG and OG showed significant improvements over CG in glycaemic control and renal parameters (P<0.05). The OG demonstrated superior outcomes compared to TG: greater reductions in HbA1c (-1.5% vs. -0.9%), FBG, PBG and UACR (-48% vs. -35%) (all P<0.05). Nutritional markers (albumin, ferritin) and SF-36 scores improved significantly more in the OG. Inflammatory markers decreased in both treatment groups, with a trend favoring OG. Adverse event rates did not differ significantly among groups.

Adjunctive nutritional intervention significantly enhances the glycaemic, renal, nutritional and quality-of-life benefits of dapagliflozin in patients with DN, offering a promising integrated therapeutic strategy.

Despite the established role of anti-vascular endothelial growth factor (anti-VEGF) agents as first-line therapy for diabetic macular edema (DME), their therapeutic effect may be incomplete or unsustained in a proportion of patients.

This study aimed to evaluate the efficacy and safety of intravitreal conbercept (IVC) combined with traditional Chinese medicine (TCM) for the treatment of DME.

A systematic search was conducted in PubMed, EMBASE, Web of Science, the Cochrane Library, Scopus, and CNKI from database inception to June 2025. Eligible randomized controlled trials (RCTs) comparing IVC combined with TCM versus IVC monotherapy were included.

A total of 14 studies involving 979 patients met the inclusion criteria. Compared with IVC monotherapy, IVC combined with TCM resulted in a greater reduction in central macular thickness (CMT) and significantly improved best-corrected visual acuity (BCVA) at both 3 and 6 months. However, no significant difference in BCVA was observed at 1 month (MD = -0.03; 95% CI -0.08 to 0.03; p = 0.34). The combination therapy was also associated with a significantly lower ineffectiveness rate (RR = 0.32; 95% CI 0.22-0.47; p < 0.05) and fewer adverse events (AEs) (RR = 0.67; 95% CI 0.45-1.00; p < 0.05).

IVC combined with TCM may provide additional therapeutic benefits for patients with DME without increasing safety risks. Nevertheless, high-quality, large-scale, multicenter RCTs are still required to further confirm these findings.