BackgroundFrozen shoulder (FS), commonly known as adhesive capsulitis, is a disabling musculoskeletal condition frequently accompanied by psychological distress. This meta-analysis aimed to evaluate the association between FS and depression.MethodsFor this meta-analysis, a systematic literature search of EMBASE, PubMed, and the Cochrane Library was conducted through 2025 using the keywords "frozen shoulder", "adhesive capsulitis" and "depression." Data regarding study characteristics, participant information, and depression-related outcomes were extracted. Depressive symptoms were assessed using the Hospital Anxiety and Depression Scale (HADS). Pooled odds ratios (ORs), mean differences (MDs), and corresponding 95% confidence intervals (CIs) were calculated. Statistical heterogeneity and potential publication bias were also assessed.ResultsNine studies including 122,378 participants met the inclusion criteria. The pooled prevalence of depression among patients with FS was 25.5% (95% CI: 16.7-36.8%). Patients with FS showed significantly higher odds of depression compared with individuals without FS (OR = 2.15, 95% CI: 1.57-2.94). In addition, FS patients had significantly higher HADS-D scores (MD = 2.97, 95% CI: 0.66-5.28). Substantial heterogeneity was observed across studies, while no significant publication bias was detected.ConclusionFS is associated with an increased risk of depression. These findings emphasize the importance of incorporating psychological assessment and management into the clinical care of patients with FS to improve overall outcomes.

Primary lung adenocarcinoma is extremely rare in children, and perioperative care requires simultaneous attention to physiological recovery, family adaptation, and restoration of age-appropriate social functioning. This case report describes a 7-year-old boy with invasive pulmonary adenocarcinoma of the left lower lobe, who underwent single-port three-dimensional reconstruction-guided video-assisted thoracoscopic lung wedge resection, managed with a nurse-led perioperative pathway integrating the Family-Centered Empowerment Model (FCEM) and Enhanced Recovery After Surgery (ERAS) principles. This multidisciplinary pathway incorporated multidimensional assessment, family-partnered education, multimodal analgesia, respiratory rehabilitation, progressive mobilization, discharge preparation, and structured school reintegration planning. The patient was discharged uneventfully on postoperative day four with no perioperative complications. Longitudinal follow-up from 2021 through the most recent assessment in 2026 has confirmed no evidence of recurrence, preserved pulmonary function, successful school reintegration, reduced parental anxiety and depression, alleviated caregiver burden, and high discharge readiness. The core components of this pathway have been applied to three additional school-age thoracic tumor patients. A prospective cohort study is currently underway to further evaluate this approach. This case illustrates the operational feasibility of integrating FCEM within an ERAS-aligned perioperative nursing pathway for rare thoracic malignancies, and serves as a practice-derived case example that does not provide definitive evidence of clinical effectiveness.

Endurance runners appear to experience a higher prevalence of several mental health symptoms, including anxiety, exercise addiction, sleep disorders, and suicidal ideation. Existing evidence suggests that this pattern is multifactorial and cannot be explained by a single mechanism. In this commentary, we highlight the complex interplay among self-selection processes, sport-specific demands, and broader biopsychosocial factors that may contribute to these outcomes. We also emphasize that demographic characteristics may interact with training-related and psychological factors to shape mental health. To advance the field, we outline key priorities for future research, including longitudinal studies, clinical diagnostic assessments, investigations of pre-existing mental health conditions, and qualitative approaches to better understand athletes' lived experiences and the role of endurance running in mental health.

Aim: To synthesize evidence on the multisystem clinical burden of Rett syndrome, integrating comorbidity prevalence and concomitant medication use to inform proactive care. Materials & methods: A structured search of PubMed, Embase and Cochrane (January 2000 to July 2024), plus gray literature, identified clinical trials, observational studies, registries, and case series (n >10). Non-English articles, case reports, reviews and commentaries were excluded. Two investigators independently screened studies, extracted data and synthesized the evidence using a descriptive approach with evidence mapping. Results: Of 6253 records screened, 148 studies met inclusion criteria, spanning 24 countries and participants aged 7 months to 37 years. Neurological, musculoskeletal and developmental manifestations predominated (reported in 62.0%, 44.0% and 41.0% of studies, respectively). Epilepsy prevalence ranged from 15.0% to 91.0%, scoliosis 8.9-100% and gastrointestinal dysfunction was common, including constipation (16.4-82.8%) and gastroesophageal reflux (15.8-100.0%). Hand stereotypies were reported in 11.4% of studies, with prevalence of 70.0-100.0%. Among studies reporting developmental burden, inability to walk ranged from 19.0% to 100.0%. Additional comorbidities included sleep, oral, and endocrine disorders, among others. Antiepileptic medications contributed most to treatment burden (14.3-33.0% for monotherapy). Other commonly used medications targeted sleep (melatonin, 7.7-30.0%), gastrointestinal symptoms (proton-pump inhibitors, 37.0-61.0%) and behavioral symptoms (anti-anxiety agents, 10.0-21.4%). Conclusion: Rett syndrome imposes a substantial, lifelong multisystem burden requiring continuous surveillance. Findings highlight the importance of anticipatory, multidisciplinary care rather than symptom-driven management. Patterns of medication use, particularly for epilepsy, reflect reliance on symptom-directed therapies and highlight the need for routine medication review, careful prescribing and longitudinal monitoring to optimize outcomes.

This study examined the associations among pre-service English teachers' evaluations of teacher teaching quality, perceived school climate, academic anxiety, and learning motivation.

Virtual reality (VR) is being increasingly used as an adjunctive tool to reduce procedural pain and anxiety during various interventional procedures. Forty articles published between 2020 and 2025 were reviewed. The articles reviewed discuss the use of virtual reality to reduce procedural pain and anxiety during various interventional procedures. The results of the literature analysis show that VR can effectively direct patients' attention and reduce the subjective intensity of pain and fear during procedures across different age groups. VR has been successfully applied to interventional procedures such as vaccination, blood draws, and peripheral vein punctures in children, as well as to a wide range of interventions in obstetrics, orthopaedics, endovascular surgery, cardiology, and dentistry. The studies reviewed confirm that VR is a safe method that rarely causes adverse side effects and can be integrated into clinical practice, contributing to patient comfort, emotional well-being, and the overall satisfaction with the procedure.