Effective stress regulation is essential for emotional health, whereas maladaptive stress responses contribute to neuropsychiatric disorders such as depression and post-traumatic stress disorder. Because neuron–microglia interactions are increasingly recognized as key modulators of neuroplasticity under physiological conditions, stress-related microglial dysregulation may contribute to aberrant neuronal responses implicated in mental health disorders. This exploratory study examined region-specific microglial morphometric responses to acute intense stress, chronic restraint stress, and social defeat stress (SDS) in the amygdala and habenula, focusing on the BLA, CeA, LHb, and MHb. Microglial morphology was assessed using animal-level morphometric comparisons and exploratory cluster-based profiling. Acute stress was associated with limited animal-level morphometric differences, while exploratory cluster distributions suggested subregion-dependent shifts, particularly in the CeA and LHb. Chronic stress was associated with larger soma-related parameters in the BLA and CeA, together with a descriptive redistribution toward large-soma/low-process profiles in both amygdalar subregions. In the habenula, chronic stress induced selective MHb morphometric changes, while cluster profiles remained comparatively constrained. SDS was associated with the most pronounced remodelling in the amygdala, including increased soma-related measures, reduced circularity/solidity in the CeA, altered spatial organization, and a strong redistribution toward large-soma/ high-process profile. SDS also shifted LHb cluster profiles, whereas the MHb showed comparatively limited sensitivity. Overall, these exploratory findings suggest that different stressors are associated with region- and subregion-dependent microglial remodelling, with the amygdala showing greater stress-related plasticity than the habenula. These patterns support further investigation of microglial morphological adaptation as a potential contributor to stress-related psychopathology.
The rapid digitalisation of design education has fundamentally altered how students collaborate; however, the cognitive and neurophysiological dynamics underlying online creative co-creation remain poorly understood. To address this, we conducted an exploratory pilot study (N = 11 dyads) employing a multimodal paradigm that integrated behavioural protocol analysis with fNIRS hyperscanning. Specifically, this study examined the effects of collaborative modality (face-to-face versus online via Zoom) and interactional behaviours between design students on neural coupling, utilising Phase Locking Value (PLV) to quantify inter-brain synchrony (IBS). The results revealed an inversion between observable behaviour and underlying neural synchrony. In face-to-face settings, dyads spent the majority of their time communicating verbally, yet their highest levels of IBS were associated with sketching. Conversely, although participants sketched significantly more often in the online environment, the neural coupling previously associated with sketching collapsed. Instead, verbal communication emerged as the primary correlate of enhanced IBS in the digital space. These initial findings indicate that online collaborative dyads may rely more heavily on explicit verbal channels to maintain cognitive alignment. Crucially, because generative “Solution Space” activities inherently demand the visual externalisation of ideas, this disruption of sketching-associated neural coupling raises the theoretical hypothesis that remote environments may leave students more susceptible to misaligned mental models or design fixation during the solution exploration phases. It also highlights a critical avenue for future outcome-based research.
OBJECTIVE:This study was conducted to determine the effects of peer counseling on breastfeeding outcomes. MATERIALS AND METHODS:In this systematic review and meta-analysis study, PubMed, Web of Science, EBSCOhost, Google Scholar, and YÖK Thesis Center databases were searched. The literature search was conducted between January 2025 and February 2026, and no restrictions were applied regarding the year of publication during the search process. Data were combined using meta-analysis and narrative synthesis methods. FINDINGS:A total of 7 studies involving 684 women were included in this systematic review and meta-analysis. The analysis results showed that peer counseling had a statistically significant effect on improving breastfeeding outcomes in mothers (standardized mean difference: -0.951; 95% CI: -1.358 to -0.545; Z = -4.585; p = 0.000; I2 = 83.59). CONCLUSION:The findings indicate that peer counseling interventions may improve breastfeeding outcomes. These findings support the integration of peer counseling into breastfeeding support programs and may inform clinical practice and future breastfeeding promotion strategies.
Collaborative problem solving plays a central role in children’s cognitive and social development, yet how neural activity relates to real-time peer coordination remains poorly understood. Using functional near-infrared spectroscopy (fNIRS) hyperscanning, we simultaneously recorded brain activity from 15 dyads of school-aged children during a naturalistic Tangram puzzle task, including rest, solo problem-solving, observation, and collaboration. We examined task-related neural activation and inter-brain connectivity (IBC) to assess how interpersonal neural dynamics relate to task context and behavior. No prespecified region-of-interest activation effect survived correction for multiple comparisons. At the exploratory channel level, a posterior-parietal channel showed a positive HbO response during collaboration relative to baseline. The global IBC did not differ significantly across experimental conditions, indicating that inter-brain synchrony was not determined solely by collaboration or social presence. Nevertheless, an exploratory association between global HbO coupling during Duo and total manual activity showed a relevant magnitude (Spearman rho = 0.581), a bootstrap 95
Dietary patterns covary with cognitive performance during adolescence, but the structural brain features associated with this covariance remain incompletely characterized. To identify structural brain correlates of cognition-aligned dietary patterns in adolescents while addressing adiposity, ethnicity adjustment, family relatedness, and multiple testing. We analyzed 3,308 adolescents from ABCD Release 5.1. Ten food-group measures were summarized by five dietary principal components (PCs). We constructed sample-derived, cognition-aligned dietary scores (PolyIQ) and used repeated five-fold family-level cross-fitting so that each participant’s score was calculated using cognition-derived weights estimated without that participant or members of the same family. The original PCs provided an outcome-independent benchmark. Primary models adjusted for age, sex, pubertal stage, socioeconomic status, income-to-needs ratio, sleep, and age- and sex-standardized BMI; ethnicity was excluded from primary models and added in sensitivity analyses. Brain–cognition models and family-cluster bootstrap indirect-effect models examined fractional anisotropy (FA), cortical thickness, surface area, and regional volume. All pre-specified indirect-effect models, including nonsignificant results, were retained. Cross-fitted dietary scores were associated with crystallized cognition (β = 0.099, SE = 0.018, P < 0.001) and fluid cognition (β = 0.064, SE = 0.015, P < 0.001); the five original dietary PCs were jointly associated with both domains. Brain–cognition associations in the bilateral fornix and hippocampal cingulum remained after BMI adjustment. In the all-ROI analysis, indirect associations through right and left fornix FA survived false-discovery-rate correction for both crystallized cognition (right: 0.0067, 95
Auditory Verbal Hallucinations (AVH) are not exclusive to schizophrenia but also occur in other psychiatric disorders, including Borderline Personality Disorder (BPD). While AVH in SZ has been extensively studied, their neurobiological underpinnings in BPD remain poorly understood. Preliminary evidence suggests structural anomalies in auditory regions among BPD patients experiencing AVH, indicating potential neuroanatomical vulnerabilities. This study examined structural brain differences in female BPD patients with (BPD-AVH n = 20) and without (BPD-nAVH n = 27) a lifetime history of AVH, as well as healthy controls (HC, n = 30), using high-resolution structural MRI. Cortical thickness (CTh), gyrification (CG), and gray matter volume (GMV) were assessed in frontotemporal regions implicated in auditory and speech processing, including the inferior frontal gyrus and superior, middle, and transverse temporal gyri. Region-of-interest (ROI) analyses were performed via CAT12, with supplementary segmentation of Heschl’s gyrus using the TASH toolbox. Group comparisons were conducted using SPM12. Compared to both HC and BPD-nAVH, BPD-AVH patients showed significantly reduced CG in the right transverse temporal gyrus (rTTG), a region encompassing early auditory cortex. No significant group differences emerged in other ROI analyses, for GMV, CG or CTh. Reduced gyrification in the rTTG suggests aberrant cortical folding in early auditory regions among BPD patients with AVH. This may reflect disrupted neurodevelopmental processes that impair auditory signal encoding and internal vs. external sound source discrimination. These findings highlight the role of primary auditory cortex abnormalities in AVH and support transdiagnostic models emphasizing early sensory processing deficits.
BACKGROUND:While pasteurized donor human milk (PDHM) is increasingly available to hospitalized infants, PDHM use in the outpatient setting has limited precedent. This research describes one mother's experience with acquiring and using PDHM in the outpatient setting for an infant with complex care needs.Case Selection and Methods:We reviewed a list of infants receiving PDHM in the outpatient setting from a regional milk bank and sub-selected potential infant cases to profile based on recency of PDHM receipt and diversity of circumstances surrounding PDHM use and need. The mother of one infant responded to our request for an interview. A telephone interview was conducted with the mother, and the infant's medical records were reviewed. CASE PRESENTATION:Following birth, the selected infant was diagnosed with genetic anomalies associated with a high palate, small jaw, feeding intolerance, and respiratory dysfunction. Although the mother produced enough milk to meet her infant's needs during hospitalization, her supply declined rapidly following the infant's transfer to a pediatric step-down facility and her return to work. Trials of commercial infant formula were not tolerated by the infant, mainly due to the aforementioned diagnosis. After learning about PDHM from her own research, the mother engaged in 4 months of letter writing and telephone calls with staff at the milk bank, her employment-based health insurer, and Medicaid. PDHM was eventually covered by Medicaid for 10 months, which included 3 coverage renewals. The infant progressed well medically and developmentally on an all-human milk diet, including PDHM and direct breastfeeding, until she was 20 months old, at which point they began to self-wean. CONCLUSION:This case illustrates that PDHM may still be medically necessary in the outpatient setting and that pediatric care coordination/case management and discharge planning should include assistance with outpatient PDHM cost coverage.
BACKGROUND:Inpatient lactation support is essential for establishing breastfeeding, yet disparities in support and feeding outcomes persist across racial and ethnic groups. The objective of this project was to evaluate the frequency and duration of inpatient lactation nurse visits and determine whether support intensity aligned with parental feeding goals through the lens of racial and ethnic demographics. METHODS:This retrospective analysis reviewed electronic health record data from 633 mother-infant dyads (≥37 weeks, rooming-in level care) discharged from a postpartum unit at a U.S. Magnet-designated academic medical center between September and December 2024. Nurse-documented data were extracted from the medical record for the number of visits with a lactation nurse and the estimated duration of bedside support, recorded as categorical time ranges. Total bedside time was calculated using the midpoints of documented time ranges. RESULTS:The sample was 69.7% White, 11.7% Black, and 8.4% Hispanic. The mean number of lactation nurse visits was 3.46 (standard deviation [SD] = 1.52), with a mean total bedside time of 64 minutes. Support intensity was similar across racial and ethnic groups. However, significant differences emerged when results were sorted by feeding goals. Dyads who initially intended to exclusively breastfeed but utilized formula supplementation received the highest support intensity, averaging 3.97 visits (SD = 1.63) and 79 minutes of bedside time. Comparatively, those who met their exclusive breastfeeding goal received 3.33 visits and an average of 64 minutes with lactation. CONCLUSIONS:Inpatient lactation support was distributed equally by racial and ethnic groups but varied significantly based on clinical acuity and adjustments in feeding plans. The increased support provided to families struggling to meet exclusivity goals reflects a responsive, acuity-based model of care. Specialized lactation support remains a vital clinical intervention for bridging the gap between parental intentions and inpatient feeding outcomes.
BACKGROUND:There is a well-described need for a more coordinated, systems-based approach to breastfeeding care delivery in the United States. Although several Breastfeeding and Lactation Medicine (BFLM) Divisions, Centers, and Institutes (D/C/Is) exist within U.S. health systems, they remain poorly described. We aimed to describe the U.S. national landscape of BFLM D/C/Is and the clinical and nonclinical activities they conduct. METHODS:We present a secondary analysis of cross-sectional survey data collected from U.S. BFLM prescribing clinicians from November 2024 to February 2025. Participants were recruited from conferences, professional listservs, and social media groups relevant to BFLM clinicians. If they reported working under a BFLM D/C/I, additional questions assessed clinical infrastructure and non-clinical activities of their D/C/I. Descriptive summaries were completed. RESULTS:Of 138 participants in our final sample, 20 (15%) from 10 states worked under a BFLM D/C/I and thus were included in this secondary analysis. Participants were physicians (n = 14, 70.0%), midwives (2, 10.0%), and nurse practitioners (4, 20.0%) with an average of 10.5 (standard deviation 8.6) years of BFLM experience. Most (70.0%) held positions as directors. D/C/Is had existed for an average of 7.2 years and delivered outpatient (95.0%), electronic (45.0%, i.e., "e-consult"), and inpatient (35.0%) clinical consultation services for an average of 7.9, 2.1, and 5.6 years, respectively. Most provided evidence-based staff education (95.0%), oversaw system lactation services and policies (75.0%), and conducted quality improvement and research (65.0%). CONCLUSION:Our national description of BFLM D/C/Is can inform future research and expansion of BFLM infrastructure in U.S. health systems.
Axon-carrying dendrites, AcDs, have been reported in hippocampus to be privileged dendrites which can directly feed synaptic inputs into an axonal output bypassing the soma and escaping somatic inhibition. In non-primate neocortex, 15–20
Associations between patterns of brain connectivity and brain structural features have transdiagnostic relevance to psychopathology. There is considerable evidence for disruptions to the hippocampus and temporoparietal brain systems in psychotic disorders. The present study examines structure–function relationships—specifically, the relation of hippocampal volume with patterns of temporoparietal effective connectivity—in youth at clinical high-risk for psychosis (CHR-P) and healthy controls (HCs). Participants at CHR-P and HCs completed clinical symptom measures and magnetic resonance imaging at baseline (n = 388, 42.5
Response inhibition, or the ability to suppress “pre-potent” behavioral responses, is subserved by both motor and inhibitory control processes and linked to the anterior mid-cingulate cortex (aMCC). We utilized an adapted Go/No-Go paradigm combined with proton functional magnetic resonance spectroscopy (1H fMRS) of the dACC to investigate differences in glutamate level between an All-Go (non-selective motor responding) and Go/No-Go (selective motor responding) condition, both compared to a no-response condition. This allowed disambiguation of the excitatory neurochemistry underlying motor vs. inhibitory control processes. 1H fMRS (midline dACC; 4.1 cm3) was acquired in 15 participants at 3T during non-selective (response to 100
BACKGROUND:In 2020, ∼13.4 million newborns were born preterm worldwide, with 65% occurring in sub-Saharan Africa and Southern Asia. In Ethiopia, fewer than 10% of eligible newborns received Kangaroo Mother Care (KMC) in 2021, despite WHO endorsement. This study evaluated effective early KMC (EeKMC) coverage and associated factors in northwest Ethiopia. METHODS:A facility-based cross-sectional study with a convergent parallel mixed-methods design was conducted from October 2024 to November 2025. Quantitative data were extracted from existing hospital records (secondary data) for 713 low-birth-weight neonates (<2,000 g). EeKMC was defined as ≥8 hours of skin-to-skin contact combined with exclusive breastfeeding within 24 hours of birth. Qualitative data were collected through in-depth interviews (n = 14) and observations to identify barriers and facilitators. Bivariate and multivariate logistic regression were used for quantitative analysis; thematic analysis was used for qualitative data. RESULTS:Of the 713 newborns, only 4.6% (33/713; 95% confidence interval [CI]: 3.2-6.4%) received EeKMC, whereas 55.5% (396/713) were exclusively breastfed within 24 hours. Newborns in incubators were less likely to receive EeKMC (adjusted odds ratio = 0.07; 95% CI: 0.015-0.34). Barriers included inadequate infrastructure, skill gaps, and cultural norms, while facilitators involved quality improvement initiatives and maternal willingness. CONCLUSION:EeKMC coverage is critically low at 4.6%, with incubator use identified as a significant barrier. Qualitative findings revealed barriers, including inadequate infrastructure, skill gaps among health care workers, cultural norms, and maternal fears. The cross-sectional design limits causal interpretation of the identified associations. Comprehensive interventions addressing health care infrastructure, provider training, family engagement, and cultural acceptance are urgently needed.
BACKGROUND:Breastfeeding is widely recognized as the optimal method of infant feeding and provides substantial biological, psychological, and relational benefits for the mother-infant dyad. However, the transition from breastfeeding to weaning remains insufficiently explored, particularly regarding mothers' psychological readiness to discontinue breastfeeding and the internal conflicts associated with the maternal role. Maternal ambivalence, defined as the coexistence of affection and burden in the maternal experience, may complicate the weaning process, especially in sociocultural contexts where breastfeeding is strongly associated with ideals of good motherhood. This study aimed to examine the relationship between maternal ambivalence and mothers' readiness to discontinue breastfeeding in Türkiye. METHODS:This descriptive and correlational study was conducted between July and October 2025 using an online survey distributed to mothers residing in Erzurum and across Türkiye who had a child aged 18 months or older. Data were collected using a Sociodemographic and Obstetric Information Form, the Maternal Readiness to Discontinue Breastfeeding Scale, and the Maternal Ambivalence Scale. Readiness was evaluated across four dimensions: maternal readiness, infant readiness, process management, and environmental readiness. Data were analyzed using IBM SPSS 22.0 with descriptive statistics, Kolmogorov-Smirnov tests, independent samples t tests, analysis of variance with Tukey post hoc comparisons, and correlation analyses. RESULTS:Mothers' readiness to discontinue breastfeeding was most strongly associated with maternal intention and perceived infant readiness, which showed a strong positive correlation (r = 0.644, p < 0.001). Process management demonstrated a moderate association with total readiness (r = 0.479), while maternal emotional readiness showed a weak but significant relationship (r = 0.215). Maternal ambivalence was not significantly correlated with any readiness dimension (p > 0.05). Sociodemographic and obstetric variables had minimal influence on readiness scores. CONCLUSIONS:Readiness to discontinue breastfeeding is a multidimensional process primarily shaped by maternal intention and perceived infant readiness, while maternal ambivalence operates as an independent psychological construct. These findings highlight the need for psychologically informed and culturally sensitive weaning support.
OBJECTIVE:The postpartum period is critical for maintaining breastfeeding and developing maternal attachment. Stress and emotional difficulties may adversely affect breastfeeding self-efficacy and maternal bonding. This study examined the effects of progressive relaxation exercises (PRE) on breastfeeding self-efficacy, breastfeeding attitudes, and maternal attachment. METHODS:This randomized controlled experimental study was conducted at Uşak Dikilitaş Family Health Center between May and November 2022. Using non-probability sampling, 114 postpartum breastfeeding mothers were recruited and randomly assigned to PRE, relaxation background music (RBM), and control groups. The PRE group performed relaxation exercises three times weekly for 4 weeks, while the RBM group listened to relaxation music with the same frequency and duration. The control group received routine postpartum care. Data were collected using the Personal Information Form, Breastfeeding Self-Efficacy Scale-Short Form, Maternal Attachment Inventory, Breastfeeding Classification Form, and Intervention Satisfaction Assessment Form. Analyses included one-way analysis of variance (ANOVA) and repeated measures ANOVA. RESULTS:Baseline characteristics were similar across groups. Breastfeeding self-efficacy scores increased significantly in the PRE and RBM groups. At the second follow-up, scores were 63.57 ± 0.82 (PRE), 48.81 ± 1.43 (RBM), and 47.36 ± 1.69 (control) (F = 42.782; p < 0.001). At the third follow-up, scores were 67.63 ± 0.60, 51.05 ± 1.51, and 47.81 ± 1.92, respectively (F = 53.289; p < 0.001). Maternal attachment scores were highest in the PRE group (101.57 ± 0.82, 97.89 ± 1.40, and 94.28 ± 1.72; p < 0.001). CONCLUSION:PRE improved breastfeeding self-efficacy and maternal attachment, suggesting that this practical intervention may enhance postpartum care.
INTRODUCTION:Donor human milk (DHM) is an alternative to formula for supplementation of breastfed newborns and has been associated with higher in-hospital exclusive breast milk feeding rates. Its use has increased substantially, most recently among term newborns, yet there is scarce data to describe patient characteristics and volumes administered. We aimed to characterize DHM utilization in our level 1 nursery. METHODS:We conducted a retrospective cross-sectional study of newborns discharged in 2022 from the level 1 nursery. Variables included sex, gestational age, birth weight, delivery type, hypoglycemia diagnosis, DHM volume, and length of stay. DHM use was compared across preferred language, race, ethnicity, and payer type using chi-square testing. RESULTS:A total of 10,432 discharges were reviewed-those transferred to Neonatal Intensive Care Unit (NICU) or another unit were excluded. Of 9,074 newborns receiving level 1 care, 1,094 (12.1%) received DHM. Newborns born between 35 and 37 weeks gestation, delivered by cesarean section, or diagnosed with hypoglycemia or small for gestational age were more likely to receive DHM (p < 0.05). DHM was also more common among newborns whose birth parent preferred the English language, identified as White or non-Hispanic, or had non-Medicaid insurance (p < 0.05). 6,552.6 ounces were consumed, with a total median of 3.9 ounces per newborn (dose range 2-50 mL). CONCLUSIONS:DHM use in the level 1 nursery varied by clinical and sociodemographic factors, revealing inequities. In addition, some doses exceeded recommended supplemental volumes. Future efforts should focus on ensuring equitable access to DHM, standardized dosing and discontinuation guidelines, and evaluation of impacts on exclusive breastfeeding rates.
This review synthesizes current evidence on the psychological and neurological benefits of physical activity, with emphasis on mental health, Parkinson’s disease (PD), and Alzheimer’s disease (AD). Physical inactivity is increasingly recognized as a modifiable risk factor that may exacerbate neuroinflammatory and metabolic dysfunctions associated with these conditions. Structured exercise has been shown to activate muscle–brain signaling pathways, including neurotrophic factors (BDNF, IGF-1, VEGF), immune modulation (IL-6, IL-10), metabolic regulators (PGC-1α, SIRT1), and peripheral mediators such as myokines and gut-brain axis components. For mental health, exercise is associated with reductions in depressive, anxiety, and stress-related symptoms, potentially through HPA-axis recalibration, neurotransmitter remodeling (serotonin, dopamine), and enhanced endocannabinoid signaling. These changes are supported by fMRI and EEG studies showing improved prefrontal–limbic connectivity and cognitive resilience. In PD, exercise interventions are linked to improvements in motor control, balance, and mood, likely mediated by dopaminergic integrity, neurotrophic support, and anti-inflammatory effects, with multimodal programs (aerobic, resistance, and dance-based) often demonstrating superior outcomes. In AD, mid-life physical activity has been associated with reduced dementia risk in epidemiological studies; proposed mechanisms include enhanced amyloid/tau clearance, glymphatic function, and synaptic adaptation, with some RCTs reporting hippocampal volume preservation and improved network connectivity. Shared mechanisms across conditions include neurotrophic upregulation and anti-inflammatory effects, whereas distinct pathways involve dopaminergic circuit remodeling in PD and glymphatic facilitation in AD. Clinical translation through FITT principles (frequency, intensity, time, type) requires personalized prescriptions, strong adherence strategies, and multidisciplinary integration. Despite methodological heterogeneity and limitations in the existing trials, structured physical activity emerges as a scalable, non-pharmacological intervention with potential for prevention, symptom management, and neuroprotection. Larger, well-designed studies are needed to optimize its application and clarify long-term disease-modifying effects.
