Public health and safety professionals, including firefighters, police officers, and emergency medical personnel, serve as critical pillars of public safety and societal well-being. These professions require navigating environments characterized by ‘brittleness’, ‘anxiety’, ‘nonlinearity’, and ‘incomprehensibility’—conditions that lead to chronic physical and psychological stress. This stress significantly elevates the risk of mental health disorders such as post-traumatic stress disorder, anxiety disorders, mood disorders, and sleep disturbances, while also increasing the likelihood of human errors driven by cognitive lapses. Such challenges extend beyond individual health, undermining organizational efficiency and ultimately jeopardizing public safety and societal welfare. Existing mental health management systems predominantly depend on reactive interventions, which are insufficient to meet the dynamic and unpredictable demands of high-risk occupational environments. As a proactive alternative, this paper introduces the concept of ‘Mind Vital Signs,’ an innovative framework that expands the traditional concept of vital signs into the mental health domain. Mind Vital Signs integrates physiological indicators—including heart rate variability, physical activity, respiratory rates, and sleep patterns—with psychological and behavioral data such as ecological momentary assessments and life logs. By employing real-time monitoring and advanced analytics, this multidimensional system facilitates early detection of mental health risks and supports targeted and timely preventive interventions. The implementation of Mind Vital Signs not only bolsters individual resilience and organizational stability but also enhances operational efficiency and strengthens public safety and societal well-being. Future research should prioritize clinical validation and policy development to ensure the effective integration and scalability of Mind Vital Signs in high-risk occupational settings.

Public health and safety professionals, including firefighters, police officers, and emergency medical personnel, serve as critical pillars of public safety and societal well-being. These professions require navigating environments characterized by ‘brittleness’, ‘anxiety’, ‘nonlinearity’, and ‘incomprehensibility’—conditions that lead to chronic physical and psychological stress. This stress significantly elevates the risk of mental health disorders such as post-traumatic stress disorder, anxiety disorders, mood disorders, and sleep disturbances, while also increasing the likelihood of human errors driven by cognitive lapses. Such challenges extend beyond individual health, undermining organizational efficiency and ultimately jeopardizing public safety and societal welfare. Existing mental health management systems predominantly depend on reactive interventions, which are insufficient to meet the dynamic and unpredictable demands of high-risk occupational environments. As a proactive alternative, this paper introduces the concept of ‘Mind Vital Signs,’ an innovative framework that expands the traditional concept of vital signs into the mental health domain. Mind Vital Signs integrates physiological indicators—including heart rate variability, physical activity, respiratory rates, and sleep patterns—with psychological and behavioral data such as ecological momentary assessments and life logs. By employing real-time monitoring and advanced analytics, this multidimensional system facilitates early detection of mental health risks and supports targeted and timely preventive interventions. The implementation of Mind Vital Signs not only bolsters individual resilience and organizational stability but also enhances operational efficiency and strengthens public safety and societal well-being. Future research should prioritize clinical validation and policy development to ensure the effective integration and scalability of Mind Vital Signs in high-risk occupational settings.

Public health and safety professionals, including firefighters, police officers, and emergency medical personnel, serve as critical pillars of public safety and societal well-being. These professions require navigating environments characterized by ‘brittleness’, ‘anxiety’, ‘nonlinearity’, and ‘incomprehensibility’—conditions that lead to chronic physical and psychological stress. This stress significantly elevates the risk of mental health disorders such as post-traumatic stress disorder, anxiety disorders, mood disorders, and sleep disturbances, while also increasing the likelihood of human errors driven by cognitive lapses. Such challenges extend beyond individual health, undermining organizational efficiency and ultimately jeopardizing public safety and societal welfare. Existing mental health management systems predominantly depend on reactive interventions, which are insufficient to meet the dynamic and unpredictable demands of high-risk occupational environments. As a proactive alternative, this paper introduces the concept of ‘Mind Vital Signs,’ an innovative framework that expands the traditional concept of vital signs into the mental health domain. Mind Vital Signs integrates physiological indicators—including heart rate variability, physical activity, respiratory rates, and sleep patterns—with psychological and behavioral data such as ecological momentary assessments and life logs. By employing real-time monitoring and advanced analytics, this multidimensional system facilitates early detection of mental health risks and supports targeted and timely preventive interventions. The implementation of Mind Vital Signs not only bolsters individual resilience and organizational stability but also enhances operational efficiency and strengthens public safety and societal well-being. Future research should prioritize clinical validation and policy development to ensure the effective integration and scalability of Mind Vital Signs in high-risk occupational settings.

Public health and safety professionals, including firefighters, police officers, and emergency medical personnel, serve as critical pillars of public safety and societal well-being. These professions require navigating environments characterized by ‘brittleness’, ‘anxiety’, ‘nonlinearity’, and ‘incomprehensibility’—conditions that lead to chronic physical and psychological stress. This stress significantly elevates the risk of mental health disorders such as post-traumatic stress disorder, anxiety disorders, mood disorders, and sleep disturbances, while also increasing the likelihood of human errors driven by cognitive lapses. Such challenges extend beyond individual health, undermining organizational efficiency and ultimately jeopardizing public safety and societal welfare. Existing mental health management systems predominantly depend on reactive interventions, which are insufficient to meet the dynamic and unpredictable demands of high-risk occupational environments. As a proactive alternative, this paper introduces the concept of ‘Mind Vital Signs,’ an innovative framework that expands the traditional concept of vital signs into the mental health domain. Mind Vital Signs integrates physiological indicators—including heart rate variability, physical activity, respiratory rates, and sleep patterns—with psychological and behavioral data such as ecological momentary assessments and life logs. By employing real-time monitoring and advanced analytics, this multidimensional system facilitates early detection of mental health risks and supports targeted and timely preventive interventions. The implementation of Mind Vital Signs not only bolsters individual resilience and organizational stability but also enhances operational efficiency and strengthens public safety and societal well-being. Future research should prioritize clinical validation and policy development to ensure the effective integration and scalability of Mind Vital Signs in high-risk occupational settings.

Public health and safety professionals, including firefighters, police officers, and emergency medical personnel, serve as critical pillars of public safety and societal well-being. These professions require navigating environments characterized by ‘brittleness’, ‘anxiety’, ‘nonlinearity’, and ‘incomprehensibility’—conditions that lead to chronic physical and psychological stress. This stress significantly elevates the risk of mental health disorders such as post-traumatic stress disorder, anxiety disorders, mood disorders, and sleep disturbances, while also increasing the likelihood of human errors driven by cognitive lapses. Such challenges extend beyond individual health, undermining organizational efficiency and ultimately jeopardizing public safety and societal welfare. Existing mental health management systems predominantly depend on reactive interventions, which are insufficient to meet the dynamic and unpredictable demands of high-risk occupational environments. As a proactive alternative, this paper introduces the concept of ‘Mind Vital Signs,’ an innovative framework that expands the traditional concept of vital signs into the mental health domain. Mind Vital Signs integrates physiological indicators—including heart rate variability, physical activity, respiratory rates, and sleep patterns—with psychological and behavioral data such as ecological momentary assessments and life logs. By employing real-time monitoring and advanced analytics, this multidimensional system facilitates early detection of mental health risks and supports targeted and timely preventive interventions. The implementation of Mind Vital Signs not only bolsters individual resilience and organizational stability but also enhances operational efficiency and strengthens public safety and societal well-being. Future research should prioritize clinical validation and policy development to ensure the effective integration and scalability of Mind Vital Signs in high-risk occupational settings.

Anosmia, characterized by the loss of smell, is associated not only with dysfunction in the peripheral olfactory system but also with changes in several brain regions involved in olfactory processing. Specifically, the orbitofrontal cortex is recognized for its pivotal role in integrating olfactory information, engaging in bidirectional communication with the primary olfactory regions, including the olfactory cortex, amygdala, and entorhinal cortex. However, little is known about alterations in structural connections among these brain regions in patients with anosmia. In this study, highresolution T1-weighted images were obtained from participants. Utilizing the volumes of key brain regions implicated in olfactory function, we employed a structural covariance approach to investigate brain reorganization patterns in patients with anosmia (n=22) compared to healthy individuals (n=30). Our structural covariance analysis demonstrated diminished connectivity between the amygdala and entorhinal cortex, components of the primary olfactory network, in patients with anosmia compared to healthy individuals (z=-2.22, FDR-corrected p=0.039). Conversely, connectivity between the orbitofrontal cortex—a major region in the extended olfactory network—and amygdala was found to be enhanced in the anosmia group compared to healthy individuals (z=2.32, FDR-corrected p=0.039). However, the structural connections between the orbitofrontal cortex and entorhinal cortex did not differ significantly between the groups (z=0.04, FDR-corrected p=0.968). These findings suggest a potential structural reorganization, particularly of higher-order cortical regions, possibly as a compensatory effort to interpret the limited olfactory information available in individuals with olfactory loss.

Cognitive dysfunction, a significant complication of type 2 diabetes mellitus (T2DM), can potentially manifest even from the early stages of the disease. Despite evidence of global brain atrophy and related cognitive dysfunction in early-stage T2DM patients, specific regions vulnerable to these changes have not yet been identified. The study enrolled patients with T2DM of less than five years’ duration and without chronic complications (T2DM group, n=100) and demographically similar healthy controls (control group, n=50). High-resolution T1-weighted magnetic resonance imaging data were subjected to independent component analysis to identify structurally significant components indicative of morphometric networks. Within these networks, the groups’ gray matter volumes were compared, and distinctions in memory performance were assessed. In the T2DM group, the relationship between changes in gray matter volume within these networks and declines in memory performance was examined. Among the identified morphometric networks, the T2DM group exhibited reduced gray matter volumes in both the precuneus (Bonferronicorrected p=0.003) and insular-opercular (Bonferroni-corrected p=0.024) networks relative to the control group. Patients with T2DM demonstrated significantly lower memory performance than the control group (p=0.001). In the T2DM group, reductions in gray matter volume in both the precuneus (r=0.316, p=0.001) and insular-opercular (r=0.199, p=0.047) networks were correlated with diminished memory performance. Our findings indicate that structural alterations in the precuneus and insular-opercular networks, along with memory dysfunction, can manifest within the first 5 years following a diagnosis of T2DM.

Complex regional pain syndrome (CRPS) is a chronic neuropathic pain disorder. Pain catastrophizing, characterized by magnification, rumination, and helplessness, increases perceived pain intensity and mental distress in CRPS patients. As functional connectivity patterns in CRPS remain largely unknown, we aimed to investigate functional connectivity alterations in CRPS patients and their association with pain catastrophizing using a whole-brain analysis approach. Twenty-one patients with CRPS and 49 healthy controls were included in the study for clinical assessment and resting-state functional magnetic resonance imaging. Between-group differences in whole-brain functional connectivity were examined through a Network-based Statistics analysis. Associations between altered functional connectivity and the extent of pain catastrophizing were also assessed in CRPS patients. Relative to healthy controls, CRPS patients showed higher levels of functional connectivity in the bilateral somatosensory subnetworks (components 1~2), but lower functional connectivity within the prefronto-posterior cingulate (component 3), prefrontal (component 4), prefronto-parietal (component 5), and thalamo-anterior cingulate (component 6) subnetworks (p<0.05, family-wise error corrected). Higher levels of functional connectivity in components 1~2 (β=0.45, p=0.04) and lower levels of functional connectivity in components 3~6 (β=-0.49, p=0.047) were significantly correlated with higher levels of pain catastrophizing in CRPS patients. Higher functional connectivity in the somatosensory subnetworks implicating exaggerated pain perception and lower functional connectivity in the prefronto-parieto-cingulo-thalamic subnetworks indicating impaired cognitive-affective pain processing may underlie pain catastrophizing in CRPS.

The FK506 binding protein 5 (FKBP5) is a co-chaperone that regulates the activity of the glucocorticoid receptor (GR) and has been reported to mediate stress resilience. This study aimed to determine the effects of Fkbp5 deletion on acute stress-induced recognition memory impairment and hippocampal GR signaling. Wild-type and Fkbp5-knockout mice were subjected to acute uncontrollable stress induced by restraint and electrical tail shock. First, we assessed the cognitive status of mice using a novel object recognition task. Next, we measured plasma corticosterone, GR levels, and the levels of GR phosphorylation at serine 211 in the hippocampus. Wild-type mice exhibited stress-induced memory impairments, whereas Fkbp5-knockout mice did not. Plasma corticosterone and GR levels did not differ between the non-stressed wild-type and Fkbp5-knockout mice, but the levels of phosphorylated GR were lower in Fkbp5-knockout mice than in wild-type mice. Wild-type and Fkbp5-knockout mice showed increased nuclear GR levels following stress, indicating GR translocation. However, cytosolic phosphorylated GR levels were lower in the hippocampi of Fkbp5-knockout mice following stress than in those of wild-type mice. These results suggest that FKBP5 deficiency increases resilience to acute stress by altering GR signaling.

Biomarkers of suicidal behavior (SB), particularly peripheral biomarkers, may aid in the development of preventive and intervention strategies. The peripheral biomarkers of SB should be easily accessible, cost-effective, and minimally invasive. To identify peripheral biomarkers of SB, we summarized the current knowledge related to SB biomarkers with a focus on suicidal outcomes (suicidal ideation [SI], suicide risk [SR], suicide attempt [SA], and suicide death [SD]), measured site (center or periphery), and study design (cross-sectional or longitudinal). We also evaluated the central findings to validate the findings of peripheral biomarkers of SB. We found reduced peripheral interleukin (IL)-2 levels in individuals with a recent SA, higher cerebrospinal fluid (CSF) IL-6 levels in patients with a current SR and future SD, higher CSF tumor necrosis factor-α levels for current and future SRs, higher high-sensitivity C-reactive protein levels and lower peripheral total cholesterol levels for recent SAs, lower peripheral 5-HT levels for present SR, and a lower folate level for future SR and SA within 1 year. Previous studies have shown inconsistent associations of low peripheral leptin levels with SR and recent SA; therefore, further study is required. Given the multiple determinants of SB and weak associations with single biological markers, combinations of potential biological markers rather than single markers may improve the screening, diagnosis, and prediction of SB.