Background and Objectives: Internet gaming disorder (IGD) is a growing public health concern, especially among adolescents. However, most IGD studies are cross-sectional, leaving its developmental course poorly understood. This study examined IGD trajectories, their predictors, and their long-term mental health outcomes among Chinese adolescents. Methods: A cohort of 16,833 adolescent gamers (mean age = 13.40, 46.56% girls) was recruited from 76 middle schools in Zigong City through cluster sampling. Assessments were conducted in November 2020 (T1), November 2021 (T2), and November 2022 (T3). IGD was measured using the Internet Gaming Disorder Scale–Short Form (IGDS9-SF). Demographic, gaming, environmental, and psychological factors (e.g., depression, anxiety, sleep problems, suicidal ideation, conduct problems, hyperactivity, resilience, mental wellbeing, prosocial behavior) were also assessed. Growth mixture modeling (GMM) identified IGD trajectories, and logistic regression evaluated predictors and mental health outcomes at T3. Results: GMM identified four IGD trajectories: High-Risk Decreasing (4.5%), Moderate-Risk Stable (19.5%), Moderate-Risk Increasing (3.0%), and Low-Risk Stable (73.0%). Age, gaming time, anxiety, sleep problems, conduct problems, hyperactivity/inattention, and low prosocial behavior predicted worsening IGD symptoms. At T3, the Moderate-Risk Increasing group had significantly higher risks for adverse mental health outcomes compared to the Low-Risk Stable group, whereas the High-Risk Decreasing group showed no significant or minimal differences in most domains from the Low-Risk Stable group after adjusting for baseline characteristics. Discussion and Conclusions: These findings underscore the heterogeneous nature of IGD development and highlight the need for long-term monitoring and tailored interventions to mitigate adverse mental health outcomes in at-risk adolescents.

Chronic insomnia disorder (CID) is associated with verbal fluency deficits linked to abnormal prefrontal activation. This multichannel functional near-infrared spectroscopy (fNIRS) study compared prefrontal hemodynamic responses and functional connectivity during verbal fluency tasks (VFT) in 81 CID patients versus 100 healthy controls (HC). Cortical activation patterns and interregional connectivity were analyzed using general linear modeling and correlation matrices. CID patients exhibited significantly reduced bilateral prefrontal activation (p < 0.01), particularly in the left inferior frontal gyrus (IFG), middle frontal gyrus (MFG), and superior frontal gyrus (SFG), alongside 32–45% weaker functional connectivity compared to HC. Activation in left IFG correlated negatively with sleep latency (r=-0.32) and positively with sleep duration (r = 0.28), while right SFG activation positively associated with sleep efficiency (r = 0.31) in CID patients. Receiver operating characteristic analysis demonstrated that activation in the left superior frontal gyrus (SFG_L) alone provided fair to good discriminative capacity (AUC = 0.79). Crucially, following constructive reviewer feedback, we found that a multivariate model integrating all six prefrontal ROIs achieved a higher AUC of 0.84. Most impressively, a combined model that further incorporated behavioral performance and clinical scale scores yielded excellent discrimination (AUC = 0.91). This underscores a critical finding: while fNIRS-derived prefrontal activation is a powerful biomarker in its own right, its true clinical potential is unlocked when integrated into a multi-modal framework that captures the cognitive and affective dimensions of the disorder. These results strongly suggest that such an integrated approach, rather than relying on any single metric, is the most promising path for developing objective diagnostic aids for CID.

Background: This study of 87,302 Chinese adolescents aimed to test: (1) the association of psychotic-like experiences (PLEs) with sleep disturbance and three different subtypes of problematic technology use (PTU), including problematic social media use (PSMU), problematic smartphone use (PSU), and internet gaming disorder (IGD); and (2) whether sleep disturbance mediated the relationship between PTU and PLEs. Method: 16-item Prodromal Questionnaire, Smartphone-Application Based Addiction Scale, the Bergen Social Media Addiction Scale, the Internet Gaming Disorder Scale-Short Form, Pittsburgh Sleep Quality Index, and Strength and Difficulties Questionnaires were employed. Results: (1) The prevalence of clinically relevant PLEs, IGD, PSMU, PSU, and sleep disturbance was 18.1%, 2.4%, 1.5%, 17.2%, and 26%, respectively. (2) PSU, PSMU, and IGD displayed comparable levels of association with PLEs (r = 0.37–0.41) and sleep disturbance (r = 0.42–0.47); (3) Sleep disturbance acted as a partial mediator between PTU and PLEs, mediating 51.8% of the effect of PSU, 49.2% of the effect of PSMU, and 44.1% of the effects of the IGD on PLEs. Conclusion: PTUs are closely associated with sleep disturbance and PLEs. The results call for formal assessments for sleep disturbance and PLEs among adolescents with PTU. Furthermore, targeting sleep disturbance holds great promise for the prevention and treatment of PLEs among adolescents, particularly those with PTUs.

Wound management remains a significant clinical challenge due to bacterial infection, oxidative stress, and inflammation. To address these issues, we developed a multifunctional hydrogel, NO-GM/Fle@FD, by combining gelatin methacryloyl (GelMA), Pluronic F127 diacrylate (F127DA), the nitric oxide (NO) donor S-nitrosoglutathione (GSNO), and the antibiotic fleroxacin (Fle). The hydrogel allows rapid photopolymerization under 405 nm light, forming a robust network with controlled NO release and localized antibiotic delivery. In infected murine wound model, NO-GM/Fle@FD accelerated wound closure through three mechanisms: (1) infection suppression via fleroxacin-mediated bactericidal activity, (2) ROS scavenging to reduce oxidative damage, and (3) inflammatory modulation through sustained NO release. Histological analysis revealed complete re-epithelialization by day 10, reduced inflammation, and enhanced collagen deposition in the NO-GM/Fle@FD group. Immunofluorescence showed decreased IL-1β (pro-inflammatory) and increased IL-10 (anti-inflammatory), confirming the hydrogel’s ability to resolve inflammation and counteract oxidative stress. This study demonstrates that NO-GM/Fle@FD effectively targets the infection-oxidative stress-inflammation triad, providing a promising therapeutic solution for treating infectious wounds, diabetic ulcers, burns, and other chronic complex wounds.

BACKGROUND This meta-analysis aimed to identify risk factors for suicide attempts (SA) in patients with depression to inform clinical practice. MATERIAL AND METHODS We searched multiple databases up to January 1, 2025, including MEDLINE and Embase. Case-control and cohort studies reporting risk factors for SA in patients with depression were included. Study quality was assessed using the Newcastle-Ottawa Scale (NOS), and meta-analyses were performed using Rev Man 5.4 software. Results are expressed as odds ratios (OR) and 95% confidence intervals (CI). Heterogeneity was assessed using I² and P values, and publication bias was evaluated using funnel plots and Egger's test. The registration information was deposited in the International Register of Systematic Reviews and Meta-Analyses (PROSPERO) trial registry (CRD420251061401; Retrospective registration). RESULTS Out of a total of 3792 records, 22 case-control studies were included. The overall heterogeneity (I2) ranged from 0% to 91.9%. Significant risk factors for SA included suicidal ideation (OR=4.98, 95% CI 3.21-7.22), previous hospitalizations (OR=1.38, 95% CI 1.18-1.61), family history of suicide (OR=2.59, 95% CI 1.89-3.57), psychotic symptoms (OR=2.77, 95% CI 1.98-3.88), frequent depressive episodes (OR=2.58, 95% CI 1.58-4.22), self-blame (OR=2.43, 95% CI 1.78-3.31), negative life events (OR=3.77, 95% CI 2.85-5.51), and delusion (OR=3.14, 95% CI 1.99-4.96). Publication bias was detected for family history of suicide and suicidal ideation, but OR values remained significant after correction. CONCLUSIONS Our findings highlight the need for comprehensive risk assessments and targeted interventions in clinical practice to prevent suicide attempts in patients with depression. Future research should explore the mechanisms and interactions of these risk factors to refine prevention strategies.