ObjectiveThis study aims to investigate the correlation between trace element concentrations, 25-hydroxyvitamin D [25(OH)D] levels, and the severity of tic disorders (TD) in children from the Hubei region. Additionally, it seeks to explore the interrelationships among these monitored indicators to provide a reference for the clinical diagnosis and treatment of pediatric TD.MethodsA retrospective review was conducted on the medical records of 237 children diagnosed with TD (TD group) and 137 healthy controls, admitted to the Department of Neurology at Hubei Maternal and Child Health Care Hospital. The TD group was further divided into mild and moderate-to-severe subgroups based on the Yale Global Tic Severity Scale scores. General clinical data were collected, and serum trace element levels were measured using inductively coupled plasma mass spectrometry (ICP-MS), while serum 25(OH)D levels were quantified via liquid chromatography–tandem mass spectrometry (LC–MS/MS). Group comparisons, Spearman correlation analysis, and univariate/multivariate logistic regression analyses were performed.ResultsThe findings indicated that serum 25(OH)D levels were significantly lower in children with TD compared to controls (p < 0.001). Logistic regression analysis demonstrated that 25(OH)D was an independent protective factor against tic disorders.(p < 0.001). Compared to the control group, children with TD exhibited significantly lower levels of calcium and copper (p < 0.001), along with higher levels of iron and cadmium (p < 0.01). These differences were more pronounced in the subgroup of children older than 6 years. An age-stratified subgroup analysis revealed no significant differences in any other indicators except for cadmium between the TD and control groups among children aged 6 years or younger (p > 0.05). Spearman correlation analysis demonstrated that within the TD group, 25(OH)D levels had the most significant correlations with calcium and copper (p < 0.001). No statistically significant differences were observed in the levels of the 10 trace elements or 25(OH)D between the mild and moderate-to-severe TD subgroups (p > 0.05).ConclusionChildren with Tic Disorders in Hubei Province demonstrate a distinctive alteration in their micronutrient profile, primarily characterized by a deficiency in 25(OH)D, alongside reduced levels of calcium and copper, and elevated levels of iron and cadmium. This association is particularly pronounced in male children over the age of six. While 25(OH)D deficiency is identified as an independent risk factor for TD, its concentration does not significantly correlate with the severity of the disorder.
Markers of neuroinflammation in the CSF of patients with difficult to treat psychiatric disease
IntroductionThe immune system is recognized as participating in the pathophysiology of psychiatric disease and there is renewed interest in identifying biomarkers of this immune activation. MethodsWe measured serum and cerebral spinal fluid (CSF) autoantibodies with other routine and novel markers of neuroinflammation, including CSF cytokines in patients with atypical psychiatric presentations of both psychotic and mood disorders (n=35). Their markers were compared with cohorts of non-inflammatory neurological disease (NIND) controls (n=18), patients with central nervous system (CNS) viral infection (n=22) and autoimmune encephalitis (AE; n=40). ResultsThe most common autoantibody detected in the serum of patients with psychiatric disease were anti-nuclear antibodies followed by thyroid autoantibodies. Few atypical psychiatric patients had abnormal conventional CSF markers of neuroinflammation (pleocytosis, oligoclonal bands, abnormal CSF IgG: albumin ratio). Further analysis of CSF revealed elevation of ITAC/CXCL11 in the psychiatric cohort. TARC/CCL17 was lower in the psychiatric cohort compared to other groups in a random-effects multinomial model, despite no significant differences on univariate analysis. When the values of CSF cytokines were examined in individual patients, six patients (17%) had at least one CSF cytokine greater than four standard deviations above the mean of the NIND cohort group. Extensive serological evaluation revised the diagnoses of six (17%) of our psychiatric group, and these patients’ showed improvement with immunosuppression. ConclusionOur results suggest a subset of people with atypical psychiatric disease may have a predominant immune contribution. This highlights the need for reevaluation and further consideration of differential diagnosis where patient presentations are not clinically typical, do not respond to conventional psychotropic treatment, or if other risk factors for autoimmunity are present.
Excessive Internet use and depressive symptom levels in adolescents with depressive disorders: chain mediation of social anxiety and sleep quality
BackgroundAdolescents with depressive disorders are at elevated risk for adverse mental health outcomes, and excessive Internet use has been increasingly linked to greater symptom severity. Therefore, this study aimed to examine the chain mediating roles of social anxiety and sleep quality in the association between excessive Internet use and depressive symptoms among adolescents with depressive disorders.MethodsA cross-sectional design was used. A total of 266 Chinese adolescents with clinically diagnosed depressive disorders (M = 15.79 years, SD = 1.85; 71.4% female) were assessed using the Internet Addiction Test, Zung Self-Rating Depression Scale, Social Anxiety Scale for Children, and Pittsburgh Sleep Quality Index. Correlation analyses and bootstrapping methods were conducted using SPSS and the PROCESS macro to examine the chain mediating effects of social anxiety and sleep quality.ResultsThe total indirect effect of excessive Internet use on depressive symptoms accounted for 65.66% of the total effect. Specifically, the indirect effects via social anxiety and sleep quality accounted for 24.10% and 26.51% of the total effect, respectively. In addition, the chain mediating effect of social anxiety and sleep quality was significant, accounting for 14.76% of the total effect.ConclusionExcessive Internet use was positively associated with more severe depressive symptoms among adolescents with depressive disorders, both directly and indirectly through the chain mediating effects of social anxiety and sleep quality. These findings highlight potential targets for preventing and intervening in excessive Internet use among this population.
When the market asks no price: AI chatbot interaction as psychic market disruption
The rapid adoption of AI chatbots for emotional support and quasi-therapeutic interaction raises questions that existing clinical and regulatory frameworks are not equipped to address. This Perspective applies the psychic arbitrage framework—which reconceptualizes defense mechanisms as energy-conversion operations on internal psychic markets—to analyze the specific transactional distortions produced by chatbot interaction. The framework identifies four dysfunctions: liquidity illusion (apparent emotional processing without genuine containment), market-making blockage (narcissistic reflection replacing transformative engagement), closure of arbitrage circuits (path-dependent externalization displacing autonomous elaboration), and repertoire degradation (progressive intolerance of costly but productive transactions). The article proposes that chatbots trained via Reinforcement Learning from Human Feedback (RLHF) produce a functional analogue of the Dark Triad profile—narcissistic mirroring, Machiavellian retention, and psychopathic detachment—as systematic architectural output regularities, not personality attribution. Preliminary converging evidence from mechanistic interpretability, formal reward-learning analysis, clinical reports, and user behavior studies is broadly consistent with these predictions but does not yet demonstrate direct long-term causal effects. The framework offers clinicians a transactional vocabulary for assessing AI-related risk and generates falsifiable predictions for future research.
Distinct sleep-disordered breathing phenotypes in elderly patients with depressive disorder: links to hypoxemia severity and inflammatory burden
ObjectiveTo identify sleep-disordered breathing phenotypes in older adults with depressive disorder and obstructive sleep apnea-hypopnea syndrome (OSAHS) and to evaluate their associations with systemic inflammation.MethodsElderly patients with depressive disorder and OSAHS were consecutively enrolled from January to December 2025. A Gower distance matrix was constructed and phenotypes were derived using partitioning around medoids (PAM; k-medoids), with k selected based on silhouette, elbow criteria, and clinical interpretability. Blood samples were collected the morning after PSG to measure serum high-sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6), interleukin-1β (IL-1β), and tumor necrosis factor-α (TNF-α).ResultsAmong 198 participants, k = 2 was selected based on internal validity metrics (silhouette and elbow) and clinical interpretability. Compared with the lower-hypoxia/less-severe OSAHS phenotype (Cluster 1, n = 92), the high-hypoxia/severe OSAHS phenotype (Cluster 2, n = 106) had higher BMI, HAMD-17, and ESS, and more severe AHI/ODI/TS90 with a lower LSaO2. The high-hypoxia/severe OSAHS phenotype also showed higher hs-CRP, IL-6, IL-1β, TNF-α, WBC, neutrophils, and NLR. The inflammatory burden score was higher in the high-hypoxia/severe OSAHS phenotype (β = 1.10 SD unadjusted; β = 1.67 SD adjusted for age, sex, BMI, comorbidity, smoking, drinking, education, and MoCA; β = 1.45 SD further adjusted for HAMD-17 and ESS; all P < 0.001). In men (n = 135), PAM clustering similarly identified two phenotypes differentiated mainly by AHI/ODI, with selective elevations in IL-1β and neutrophil counts.ConclusionsThe high-hypoxia/severe OSAHS phenotype in older adults with depressive disorder is independently associated with a higher systemic inflammatory burden.
Adverse childhood experiences and non-suicidal self-injury in adolescents: the roles of depressive symptoms and teacher care
BackgroundNon-suicidal self-injury (NSSI) has become an increasingly prominent mental health problem during adolescence and often co-occurs with depressive symptoms, anxiety, personality-related difficulties, and experiences of childhood trauma, forming a complex psychosocial risk structure. From a risk and protective factor perspective, the present study examined the associations among adverse childhood experiences (ACEs), depressive symptoms, perceived teacher care, and NSSI among Chinese adolescents.MethodsThe participants were 2,221 junior high school students from three schools in China. Data were collected using the Childhood Trauma Questionnaire, the Adolescent Non-Suicidal Self-Injury Questionnaire, a depression scale, and a teacher care scale.ResultsAdverse childhood experiences and depressive symptoms were significantly positively associated with NSSI, whereas perceived teacher care was significantly negatively associated with NSSI. Higher levels of ACE exposure and more severe depressive symptoms were associated with higher levels of NSSI, while higher levels of teacher care were associated with lower levels of NSSI. Moreover, among adolescents reporting higher levels of perceived teacher care, the positive associations between ACEs and NSSI and between depressive symptoms and NSSI were attenuated, suggesting that teacher care, as an external support resource in the school context, may play an important protective role.ConclusionsAdverse childhood experiences and depressive symptoms are important risk factors for adolescent NSSI, whereas teacher care plays a significant protective role in the school context. School-based prevention and intervention efforts should prioritize adolescents with high levels of ACE exposure and pronounced depressive symptoms, while strengthening teacher care to enhance protective resources. Future research should further explore how specific dimensions and timing of ACEs, trajectories of depressive symptoms, and multiple sources of social support jointly influence the development and maintenance of NSSI in adolescents.
Digital twins of ex vivo human lungs enable accurate and personalized evaluation of therapeutic efficacy
Nature Biotechnology, Published online: 04 May 2026; doi:10.1038/s41587-026-03121-4
A comprehensive ‘digital twin’ of a human organ has been built.
An international and independent scientific foundation for AI governance
Nature Medicine, Published online: 04 May 2026; doi:10.1038/s41591-026-04375-w
An international and independent scientific foundation for AI governance
Depressive Symptoms Are Associated with Altered Development of Amygdala-Ventrolateral Prefrontal Connectivity During Implicit Emotion Regulation Across Adolescence
Adolescence is characterized by extensive development in neural circuits that support emotion processing and regulation, and by increased risk for depression. While altered frontolimbic functioning during emotion processing has been implicated in youth with depression relative to healthy controls, the directions of the associations have been inconsistent.
Phasing out animal research prematurely will maintain gender inequities in medicine
Nature Neuroscience, Published online: 04 May 2026; doi:10.1038/s41593-026-02309-w
Decades of male bias in animal research have left female biology critically understudied. Prematurely phasing out animal research would lock this inequity into future biomedicine, disproportionately harming women.