BackgroundSpontaneous intracerebral hemorrhage is a neurological emergency with high mortality and disability rates. Prolonged immobilization after stroke can trigger severe systemic complications. The simultaneous occurrence of crush syndrome and capillary leak syndrome in the setting of acute intracerebral hemorrhage is extremely rare and life-threatening, and no established treatment protocol exists.Case summaryA 64-year-old man with hypertension was found unconscious on his home floor. The estimated time from onset to discovery exceeded 24 h. He was diagnosed with left basal ganglia intracerebral hemorrhage of approximately 5.6 mL with intraventricular extension. On admission, he was comatose with a Glasgow Coma Scale score of 9. Systemic involvement was extensive: severe bilateral leg swelling with multiple tension bullae, acute kidney injury requiring continuous renal replacement therapy, severe rhabdomyolysis with a peak creatine kinase exceeding 50,000 U/L, hyperkalemia, with an initial arterial blood gas in the emergency department showing 6.9 mEq/L, elevated liver enzymes, and distributive shock. Admission central venous pressure was negative, strongly indicating severe hypovolemia. Chest CT already showed hypostatic pneumonia. The clinical presentation was consistent with crush syndrome from prolonged compression, which then led to secondary capillary leak syndrome. The patient underwent emergency neuroendoscopic hematoma evacuation and external ventricular drainage. Postoperatively, he developed atrial fibrillation and deep vein thrombosis. After 3 weeks of multidisciplinary intensive care, his liver and kidney function gradually improved, and the hypostatic pneumonia was controlled. He survived to discharge with a Glasgow Coma Scale score of 11, left limb muscle strength grade 3/5, and right limb muscle strength grade 0/5, and was transferred to a local hospital for continued rehabilitation. At 3-month follow-up, he was walking independently (mRS 2), with significant improvements in neurological function and quality of life.ConclusionThis case reveals a frequently overlooked but deadly clinical pathway: prolonged immobilization after intracerebral hemorrhage can lead to traumatic rhabdomyolysis, crush syndrome, and secondary capillary leak syndrome. A negative central venous pressure, a rare finding, provided supportive evidence of severe hypovolemia due to capillary leak syndrome. This clinical triad represents a unique high-risk condition that demands a shift in treatment philosophy from neurocentric care to systemic resuscitation.
Art therapy for depression: a systematic review and meta-analysis
IntroductionDepression is among the leading causes of disability globally. Therefore, exploring the various non-medical treatment options for this condition is particularly important. The aim of the review was to assess the effect of art therapy on depressive symptoms.MethodsThe foundation of this review is a pre-planned, explorative, secondary analysis of a previously published umbrella review, encompassing the databases Cochrane Library, Embase, MEDLINE, CINAHL, ERIC, American Psychological Association PsycArticles, American Psychological Association PsycInfo, PSYNDEX, the German Clinical Trials Register, and ClinicalTrials.gov. Included were all randomized trials with any patient population receiving active visual art therapy. The outcome was depressive symptoms measured by depression assessment instruments. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and conducted a bias assessment using a modified Cochrane risk of bias tool. Data was pooled using a random-effects model and visualized in forest plots. A pooled standardized mean difference (SMD) with hedges g was calculated to measure the reduction of depressive symptoms.ResultsOf 3,100 identified reports we included 26 studies. Of these, 19 studies with 997 patients were eligible for inclusion in the meta-analysis. Overall, we found a standardized mean difference of 0.53 (95% CI: 0.30 to 0.76) for depressive symptoms, favoring the intervention group. Main sources of variation were different types of control groups, methodological quality, and patient populations.ConclusionOur results suggest that art therapy is associated with improved depressive symptoms. Therefore, art therapy should be accessible as complementary treatment for patients suffering from depressive symptoms.
Sex-related molecular phenotypes in anxiety-depressive disorders: a machine learning analysis of routine blood biomarkers
BackgroundAnxiety disorders and depressive disorders are the most prevalent mental disorders worldwide. Their diagnosis has long relied on clinical symptom assessment, and objective blood−based biomarkers remain lacking. Sex is a critical risk factor for these disorders; however, sex−specific divergence in blood biochemical profiles has yet to be systematically characterized.MethodsThis retrospective study enrolled 778 patients diagnosed with anxiety−depressive state at China−Japan Friendship Hospital. Demographic data, complete blood count parameters, and blood biochemical parameters were collected. Following missing value processing and multiple imputation, Mann–Whitney U tests were applied to identify sex−differentially expressed biomarkers. A random forest classifier was constructed to evaluate the discriminative capacity of combined multi−marker panels, with model performance comprehensively assessed through receiver operating characteristic curve analysis, SHAP−based explainability analysis, and multi−classifier probability projection. Age−stratified analyses were performed with a threshold of 50 years to explore the potential modifying effect of age on sex differences.ResultsSeveral biomarkers exhibiting significant differences between males and females were identified (FDR < 0.05), among which creatinine, hemoglobin, hematocrit, red blood cell count, and uric acid demonstrated the largest effect sizes. The random forest model achieved an area under the receiver operating characteristic curve of 0.902 on the independent test set. Multi−classifier probability projection following hyperparameter tuning yielded a Silhouette coefficient of 0.464 in the two−dimensional space, with permutational multivariate analysis of variance confirming highly significant centroid differences between groups (p < 0.001). Age−stratified analysis using hemoglobin as an example revealed that levels in males were significantly higher than those in females across both age strata, with the magnitude of the sex difference attenuated in the ≥50−year group compared with the <50−year group.ConclusionsRobust sex−related signals are embedded in routine blood biochemical markers. Although complete separation is difficult to achieve under unsupervised dimensionality reduction, these signals can be efficiently integrated through ensemble learning algorithms. This study provides a molecular phenotypic basis related to sex in patients with anxiety−depressive state and underscores the importance of fully considering sex as a variable in clinical laboratory testing.
Understanding cyber grooming in children and adolescents: a scoping review of risk factors and prevention strategies
The increasing digitalization of children’s daily lives has created new opportunities for communication, education, and social interaction while simultaneously increasing exposure to online exploitation risks. Among these risks, child grooming and cyber grooming have emerged as significant psychological, social, and public health concerns. Cyber grooming extends traditional grooming processes into digital environments through the use of anonymity, persistent communication, and technological accessibility, enabling offenders to manipulate and exploit children and adolescents in online settings. This scoping review aimed to examine the existing literature on grooming and cyber grooming, focusing on psychological, social, technological, and preventive dimensions. A literature search was conducted using PubMed, Scopus, and Web of Science databases for studies published between 2000 and 2025. Relevant findings were synthesized thematically to evaluate victim and perpetrator characteristics, developmental and environmental risk factors, prevention strategies, and legal approaches. The reviewed literature indicates that adolescents with high online engagement, limited digital literacy, emotional vulnerability, and inadequate social support may be at increased risk of grooming victimization. Offenders frequently utilize emotional manipulation, secrecy, and digital communication tools to establish trust and maintain control. Current evidence further suggests that effective prevention requires multidimensional approaches integrating digital literacy education, family involvement, psychological support, platform safety measures, and legal protections. Despite growing awareness of cyber grooming, important gaps remain regarding long-term psychological outcomes, prevalence variability, and the effectiveness of intervention programs. This review highlights cyber grooming as a multifaceted developmental and psychological phenomenon shaped by the interaction of individual vulnerabilities, online environments, and offender manipulation strategies. Effective prevention therefore requires coordinated, evidence-based, and multidisciplinary child protection efforts integrating psychological, technological, educational, and legal perspectives to improve children’s safety and well-being in digital environments.
A comparison between seven scales of neuropsychological assessments for cognitive impairment screening in Chinese older population: a cross-sectional study in Chongqing, China
BackgroundThe Clinical Dementia Rating Scale (CDR), the Ascertain Dementia 8 (AD8), the Mini-Cog, the Verbal Fluency Test (VFT), the Community Screener for Dementia (CSI-D), the Rey Auditory Verbal Learning Test (RAVLT), and the Activities of Daily Living Scale (ADL) represent seven commonly employed methods for community cognitive impairment screening in China that have garnered limited attention. This study aimed to assess the discriminatory power of these seven tests when administered concurrently in a single screening to detect cognitive impairment in the absence of a gold standard.MethodsWe conducted a cross-sectional survey among 1,506 elderly people aged 60 and above in the community. The cognitive and social functions of the elderly population were evaluated by using the Seven scales. The characteristics related to demographics and health were collected through questionnaire surveys, and the correlations and consistencies of the Seven scales with cognitive impairment were analyzed respectively. Multifactor logistic regression model was used to analyze the risk factors of cognitive impairment in each scale.ResultsThe positive screening proportions for the seven scales—CDR, ADL, AD8, CSI-D, Mini-Cog, VFT, and RAVLT—were 61.1%, 33.7%, 38.0%, 37.1%, 53.7%, 39.3%, and 52.9%, respectively. Agreement on cognitive impairment risk between each pair of scales was fair-to-moderate (Kappa: 0.32–0.645, all p < 0.001). Screening results differed significantly across the seven scales by age, educational, marital status, epilepsy, cerebral infarction, brain atrophy, and depression (all P < 0.001). Notably, Screen-positive proportions for cognitive impairment rose significantly with increasing age (p < 0.001); the ≥ 80-year-old group showed the highest proportions across scales. Conversely, higher educational attainment was associated with lower risk of screening positive for cognitive impairment (p < 0.001).ConclusionsOur study identified a relatively high screening positivity proportion for cognitive impairment in Chongqing, Age, Sex, Education, Marital status, Brain atrophy, Anxiety, and Depression are risk factors for screening positivity. The identified screening positivity for cognitive impairment varied across different neuropsychological assessment methods, indicating that assessment choice should be tailored to population characteristics rather than applying a one-size-fits-all approach. Selecting the appropriate tool can improve sensitivity and reduce missed diagnoses.
Changes in depression, anxiety, and post-traumatic stress symptoms among children and adolescents exposed to adverse childhood experiences following participation in the PROACT intervention in Nairobi, Kenya
IntroductionGlobally, children and adolescents exposed to Adverse Childhood Experiences (ACEs) face an increased risk of developing mental health disorders. The prevalence of these mental disorders is further amplified by the lack of access to specialised mental health treatment especially in low resource settings. There is an urgent need for scalable mental health interventions that can effectively address the needs of these vulnerable populations. Non-specialist-delivered interventions, such as PROACT (Psychoeducation, Relaxation, Problem-solving, Activation, and Cognitive Coping Therapy), represent a promising scalable approach that could help bridge the existing mental health treatment gap in low-resource settings.ObjectivesThis study aimed to assess changes in depression, anxiety, and post-traumatic stress symptoms among children and adolescents exposed to adverse childhood experiences following participation in the PROACT intervention delivered by trained social workers in Nairobi, Kenya.MethodologyMixed-methods pre-post study design was employed. Twenty purposively selected sites across Nairobi County each contributed one social worker (N = 20), who received training to deliver the intervention. A total of 40 children participated and received 4–6 PROACT sessions. Quantitative data were analysed using STATA version 17. Paired t-tests were used to compare baseline and endline scores, while mixed-effects linear regression models with participant ID as a random effect were fitted to estimate changes in outcomes over time and account for repeated measures. Statistically significant improvements were observed across all mental health outcomes. Mean anxiety scores decreased from 6.2 at baseline to 2.7 at endline (mean difference: −3.5; 95% CI: −4.7 to −2.2; p < 0.001), while mean depression scores decreased from 6.4 to 2.9 (mean difference: −3.6; 95% CI: −4.9 to −2.3; p < 0.001). Mean PTSD scores decreased from 16.7 (95% CI: 12.8–20.5) at baseline to 7.3 (95% CI: 4.4–10.1) at endline (mean difference: −9.4; 95% CI: −14.6 to −9.3; p < 0.001). Mixed-effects linear regression analyses corroborated these findings, demonstrating significant reductions in PTSD (β = −9.44), anxiety (β = −3.48), and depression (β = −3.59) symptoms (all p < 0.001).ConclusionThe PROACT intervention was feasible and acceptable when delivered by social workers in Nairobi primary healthcare facilities and was associated with improvements in mental health outcomes among children and adolescents. These findings highlight the potential of task-sharing approaches to expand access to mental healthcare in low- and middle-income countries (LMICs) and warrant further evaluation in controlled studies.
Povorcitinib for hidradenitis suppurativa: the randomized, double-blind, placebo-controlled STOP-HS1 and STOP-HS2 phase 3 trials
Nature Medicine, Published online: 23 July 2026; doi:10.1038/s41591-026-04534-z
In a pair of pivotal phase 3, placebo-controlled, randomized clinical trials, the oral JAK1 inhibitor povorcitinib significantly reduced abscesses and inflammatory nodules in patients with moderate to severe hidradenitis suppurativa.
Focal astrocyte loss reveals nuclear translocation during lesion repopulation
Nature Neuroscience, Published online: 23 July 2026; doi:10.1038/s41593-026-02354-5
Herwerth et al. demonstrate that, after focal astrocyte loss in the adult brain, perilesional astrocytes undergo extensive remodeling, proliferation and nuclear translocation to repopulate the depleted tissue without forming a glial scar.
Replay of procedural memory is independent of the hippocampus
Nature Neuroscience, Published online: 23 July 2026; doi:10.1038/s41593-026-02362-5
Thompson, Rollik and colleagues show that, during sleep, the brain replays procedural memories in the striatum independently of the hippocampus. Replay content was shaped by prior reward and error outcomes and predicted next-day motor performance improvements.
Samsung Proposes Offer to Acquire Swiss CDMO Specializing in Peptides
Samsung Biologics made an all-cash public tender offer of approximately $1.8 billion to acquire Switzerland-based PolyPeptide Group, a CDMO specializing in peptide-based active pharmaceutical ingredients (APIs).
Samsung views the deal as expanding its capabilities beyond antibodies and ADCs to include peptide therapeutics, particularly in obesity and diabetes, including GLP-1 therapies, while advancing innovation across high-growth areas such as oncology and other emerging indications. The transaction brings together Samsung Biologics’ global manufacturing scale with PolyPeptide’s specialized peptide expertise to create a differentiated, end-to-end multi-modality CDMO platform, notes a Samsung spokesperson.
PolyPeptide operates an integrated development-to-commercial model with growth focused on a modular, automation approach which, the company points out, gives it the flexibility to adapt quickly to changing market demand.
The planned acquisition extends beyond adding capacity in that it also lays the foundation for Samsung Biologics’ next phase of growth, supported by a strong pipeline of active peptide projects that includes a deep late-stage portfolio, notes a Samsung official. PolyPeptide operates global sites across Sweden, Belgium, France, the U.S., India, together with a corporate office in Switzerland and a separate Innovation Center in Strasbourg, France, with capabilities in R&D, development, and commercial manufacturing.
Upon completion of the transaction, Samsung will bring together PolyPeptide’s experienced team and specialized peptide expertise with Samsung’s scientific and manufacturing strengths and global operations, says John Rim, chairman of the board of directors and CEO of Samsung Biologics.
“This acquisition reinforces our long-term growth strategy by not only broadening our service portfolio with modality expansion into peptides including GLP-1, but by also boosting our geographic reach and proximity further within the U.S., Europe, and India,” continues Rim.
“After a comprehensive review of strategic options, the Board is convinced that Samsung Biologics’ offer is compelling for our shareholders, delivering an attractive cash price and immediate, certain value today,” adds Peter Wilden, chairman of the board of directors of PolyPeptide. “At the same time, it represents a transformational opportunity to accelerate our strategic ambitions at a scale we could not reach alone.”
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