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Although cannabis was legalized in Canada in 2018 and is one of the most used substances in Canada, few studies have examined how individuals with different patterns of cannabis use differ in their attempts to decrease or abstain from cannabis. The current study examined how groups of cannabis users, which were formed on the basis of demographic characteristics, substance use patterns, mental health symptoms, and self-reported quality of life differed on their experiences with cannabis cessation. A sample of 147 Canadian adult participants who had attempted to decrease or quit cannabis were recruited from the community (n = 84, 57.14%) and crowdsourcing (n = 63, 42.86%). Four profiles of cannabis users emerged using a Latent Profile Analysis: low-risk (n = 62, 42.18%), rapidly escalating high-risk (n = 40, 27.21%), long-term high severity (n = 35, 23.81%), and long-term lower severity (n = 10, 6.80%). Individuals in the rapidly escalating profile had attempted to decrease their cannabis use more times compared to other profiles. More participants in the long-term high severity group found their use stayed the same or got worse after their last cessation attempt, compared to the low-risk group where more individuals indicated their use stopped. The results of the current study indicate that cannabis users differ in their attempts at reducing or ceasing cannabis use and that they may benefit from different intensity of cannabis interventions. [ABSTRACT FROM AUTHOR]

Children of parents with emotion regulation (ER) difficulties may be at heightened risk for internalizing and externalizing problems, and maternal invalidation may explain this association. The current study used a cross-informant design to test the indirect effect of clinician-rated maternal ER difficulties on teacher-reported internalizing and externalizing problems through maternal invalidation. This risk pathway was tested in two groups of preschoolers: children of mothers with ER difficulties and children of mothers without ER difficulties (healthy controls; HC). Participants were 85 mothers (Mage =33.30 years; 36% racial/ethnic minoritized status) and their children (Mage =4234 months; 47% racial/ethnic minoritized status). Maternal ER difficulties had a significant indirect effect on child internalizing problems and externalizing problems, specifically aggressive behavior, through maternal invalidation. Specifically, mothers with ER difficulties reported more maternal invalidation, and their children exhibited more internalizing problems and aggressive behavior in a preschool/daycare setting, pointing to multiple avenues for prevention and intervention. [ABSTRACT FROM AUTHOR]

Expectancy theory supports alcohol expectancies, or the expected effects of drinking, as an important factor in alcohol use behaviors. Recent research supports that alcohol expectancies fluctuate daily, but scant research has examined specific types of expectancies and their associations with alcohol use at the daily level. Consequently, the present study examined (1) the daily association between select expectancies (i.e. sociability, tension reduction, liquid courage) and likelihood of drinking, and (2) whether daily expectancies predict alcohol use outcomes (i.e. alcohol-related problems, heavy drinking) on drinking days. Participants (N = 221; 79.2% women) were primarily White (48.4%) and Black (29.7%) university students. Participants completed daily measures of expectancies, alcohol use, and alcohol-related problems each day for 14 days. Results from multilevel models revealed daily sociability as the only expectancy subscale linked with increased odds of drinking. Daily expectancies did not predict heavy drinking or alcohol-related problems on drinking days. At the between-person level, average levels of sociability and tension reduction expectancies were associated with a greater likelihood of engaging in heavy drinking and experiencing a problem. Findings highlight that fluctuations in sociability expectancies may be proximally linked to likelihood of alcohol use, which may inform just-in-time intervention efforts targeting alcohol expectancies. [ABSTRACT FROM AUTHOR]

Species range shifts due to changing ocean conditions are occurring around the world. As species move, they build new interaction networks as they shift from or into new ecological communities. Typically, species ranges are modeled individually, but biotic interactions have been shown to be important to creating more realistic modeling outputs for species. To understand the importance of consumer interactions in Eastern Pacific kelp forest species distributions, we used a Maxent framework to model a key foundation species, giant kelp (Macrocystis pyrifera), and a dominant herbivore, purple sea urchins (Strongylocentrotus purpuratus). With neither species having previously been modeled in the Eastern Pacific, we found evidence for M. pyrifera expansion in the northern section of its range, with no projected contraction at the southern range edge. Despite its known co-occurrence with M. pyrifera, models of S. purpuratus showed a non-concurrent southern range contraction and a co-occurring northern range expansion. While the co-occurring shifts may lead to increased spatial competition for suitable substrate, this non-concurrent contraction could result in community wide impacts such as herbivore release, tropicalization, or ecosystem restructuring. [ABSTRACT FROM AUTHOR]

Creating Compassion is an empathy-focused creative arts curriculum designed to provide short-term, low-cost, high-quality social–emotional learning (SEL) to communities and settings with limited resources. The present study sought to determine whether Creating Compassion was effective for increasing displays of prosocial behaviors and broad SEL skills for early elementary school students (n = 9) through a multiple baseline single-case design, as empathy has previously been posited as a core factor in global social–emotional skill development. Results from this study confirmed the hypothesis that Creating Compassion would increase observed prosocial behaviors with moderate effectiveness for children in first, second, and third grades, including those with identified social–emotional skill deficits. Participant scores on a pre/post assessment of global SEL competence also increased after intervention. Ultimately, findings from this study suggest the Creating Compassion intervention might be used by school psychologists and other group interventionists to expose their school communities to arts programming and engage them in a fun and creative approach to accessible early SEL intervention. Impact Statement This paper presents results from a combined arts and empathy training intervention, Creating Compassion. As an empathy-focused intervention, implementation of Creating Compassion led to increases in displays of prosocial behavior with moderate effectiveness. Increases in participants' levels of overall SEL skill competence were also observed. Results from this study support the provision of a high-quality, low-cost, arts-based SEL program to benefit Low-Income and Economically Marginalized (LIEM) communities within educational settings. [ABSTRACT FROM AUTHOR]

A significant number of pregnancies occur at advanced maternal age (>35 yr), which is a risk factor for pregnancy complications. Healthy pregnancies require massive hemodynamic adaptations, including an increased blood volume and cardiac output. There is growing evidence that these cardiovascular adaptations are impaired with age, however, little is known about maternal cardiac function with advanced age. We hypothesized that cardiac adaptations to pregnancy are impaired with advanced maternal age. Younger (4 mo; ~early reproductive maturity in humans) and aged (9 mo; ~35 yr in humans) pregnant Sprague-Dawley rats were assessed and compared with age-matched nonpregnant controls. Two-dimensional echocardiographic images were obtained (ultrasound biomicroscopy; under anesthesia) on gestational day 19 (term = 22 days) and compared with age-matched nonpregnant rats (n = 7-9/group). Left ventricular structure and function were assessed using short-axis images and transmitral Doppler signals. During systole, left ventricular anterior wall thickness increased with age in the nonpregnant rats, but there was no age-related difference between the pregnant groups. There were no significant pregnancy-associated differences in left ventricular wall thickness. Calculated left ventricular mass increased with age in nonpregnant rats and increased with pregnancy only in young rats. Compared with young pregnant rats, the aortic ejection time of aged pregnant rats was greater and Tei index was lower. Overall, the greater aortic ejection time and lower Tei index with age in pregnant rats suggest mildly altered cardiac adaptations to pregnancy with advanced maternal age, which may contribute to adverse outcomes in advanced maternal age pregnancies. NEW & NOTEWORTHY We demonstrated that even before the age of reproductive senescence, rats show signs of age-related alterations in cardiac structure that suggests increased cardiac work. Our data also demonstrate, using an in vivo echocardiographic approach, that advanced maternal age in a rat model is associated with altered cardiac function and structure relative to younger pregnant controls. [ABSTRACT FROM AUTHOR]

Empirical inquiry has demonstrated the benefits of autonomy-supportive parenting practices and harms of parental psychological control for youth development and wellbeing, though specific sources of variation in use of these practices remains unclear. Individual differences in parenting practices may be related to physiological stress reactivity; more importantly, the coordination of stress responses across multiple physiological systems within the autonomic nervous system (ANS) may account for differences in parenting practices. Guided by the autonomic space model of ANS functioning, this study investigates the role of mothers' physiological stress response in relation to autonomy-supportive and controlling parenting practices. Sixty-eight mothers (Mage = 40.88, SD = 6.97) of young adolescents watched their children participate in a stressful laboratory-based public speaking task. Changes from baseline in mothers' skin conductance level (SCL reactivity) and respiratory sinus arrhythmia (RSA reactivity) were calculated. Youth reported perceptions of mothers' promotion of volitional functioning, promotion of independence, and psychological control. Physiological measures interacted such that mothers who experienced higher SCL reactivity engaged in more youth-reported psychological control when RSA scores showed little to no change from baseline to stressful task, but less psychological control when RSA scores decreased from baseline to challenge. Thus, this asynchronous pattern of ANS activity was associated with a parenting practice that typically inhibits developmentally appropriate autonomy among young adolescents, suggesting that mothers' parenting behaviors are associated with the coordinated physiological stress response of the two ANS systems. Highlights: Mothers' parasympathetic and sympathetic nervous system activity assessed while children participated in a stressful task. Uncoordinated activity of two physiological branches was associated with controlling parenting practices. Reactivity amongst multiple physiological branches should be tested to understand variation in parenting practices. [ABSTRACT FROM AUTHOR]

The study aims to analyze marriage expectations among sexual minority youth in the United States. The possibility of marriage for same-sex couples is recent in the United States. As same-sex couples used to be excluded from getting married, LGB adults have expressed concerns about the institution of marriage and have been less likely than their heterosexual peers to consider it for themselves. However, research is lacking when considering marriage expectations and attitudes regarding marriage among LGBTQ youth. We use wave 2 of the SOGI-Q Health Study, a community sample of 542 LGBTQ youth aged 15–21 collected in 2013, a time prior to federal marriage equality. We assessed measured marriage expectations, both to a same-sex partner and to a different-sex partner, as well as attitudes regarding marriage. Results indicated that gay and lesbian youth were more likely than queer and bisexual youth to expect to get married to a same-sex partner. Individual factors (e.g., higher levels of disclosure to family members) and structural factors (e.g., knowing a married same-sex couple), were associated with higher marriage expectations to a same-sex partner. Religiosity was associated with higher expectations of marriage to a different-sex partner. Sexual identity, religiosity, disclosure, and knowing married same-sex couples were significantly associated with LGBTQ youths' expectations to marry a same-sex and/or different-sex partner, as well as their attitudes about marriage more broadly. Attitudes and expectations regarding marriage among sexual minority youth have implications for their future couple and family formation, which are broadly associated with well-being across the adult lifespan. [ABSTRACT FROM AUTHOR]

Background and Objectives: According to the acquired preparedness model, personality traits, such as impulsivity, may influence the learning process, contributing to heightened expectations surrounding risky behaviors (i.e., alcohol use, sexual risk‐taking). As bisexual women demonstrate heightened risk for hazardous alcohol‐ and sex‐related behaviors, the present study examined a sequential pathway, whereby the relation between impulsivity and sexual risk‐taking is mediated through sex‐related alcohol expectancies and alcohol use. Methods: Data were collected from 225 self‐identified cisgender, bisexual women between the ages of 18 and 30 years (M = 22.77, SD = 3.45), who participated in an online survey. Participants reported on impulsivity, sex‐related alcohol expectancies, alcohol use, and experiences of sexual risk‐taking. Results: Results revealed that sex‐related alcohol expectancies and alcohol use sequentially mediated the relation between impulsivity and sexual risk‐taking. Thus, greater impulsivity was related to greater sexual risk‐taking through heightened sex‐related alcohol expectancies and elevated alcohol use. Discussion and Conclusions: Findings from this study highlight mechanisms associated with risky drinking and sexual behaviors among this at‐risk population. Such information could aid the development of more efficacious prevention and intervention programs aimed at reducing consequences associated with alcohol use and sexual risk‐taking among bisexual women. Scientific Significance: Bisexual women are at heightened risk for alcohol‐related problems, including sexual risk‐taking. Findings from the current study identify impulsivity and sex‐related alcohol expectancies as independent and integrative predictors of such risky behaviors. Incorporation of these constructs may aid in the development of more efficacious clinical methods aimed at bettering health outcomes among bisexual women. [ABSTRACT FROM AUTHOR]

Objective Pregnancy-related infective endocarditis (IE) caries a high risk of morbidity and mortality. With increasing intravenous drug abuse (IVDA) amid the opioid epidemic, the risk factor profile may be shifting. In this case series, we aimed to describe risk factors and outcomes for peripartum IE in a contemporary cohort. Study Design We identified patients with IE diagnosed during pregnancy or up to 6 weeks' postpartum from 2015 through 2018 at a single tertiary care center. We abstracted detailed medical history and clinical outcome measures from the electronic medical record. The diagnosis of IE was supported by the modified Duke Criteria. Results Nine patients had peripartum IE: eight (89%) with a history of IVDA, one with an indwelling central venous catheter (11%), and one with prior IE (11%). None had preexisting congenital or valvular heart disease. Six (67%) had comorbid hepatitis C. Eight cases (89%) had gram-positive cocci with vegetations involving the tricuspid valve (56%) and both mitral and tricuspid valves (22%). Major complications included shock (33%), mechanical ventilation (44%), septic emboli (67%), and noncardiac abscesses (33%). Two patients underwent valve surgery, and there were two cases of postpartum maternal mortality (22%), one from septic shock and one from intracerebral hemorrhage. While four patients (44%) delivered preterm (average gestational age 35 weeks), most delivered vaginally (89%) with only one requiring an emergent caesarean section. There was no fetal mortality, although three newborns (43%) required admission to the neonatal intensive care unit. Two patients were initiated on medication-assisted treatment for opioid use disorder. Consultants included infectious disease, cardiology, cardiac surgery, maternal-fetal medicine, and psychiatry. Conclusion These findings confirm that IVDA is a growing risk factor for pregnancy-related IE. Peripartum IE carries a high risk of complications, including maternal mortality, and warrants management with a multidisciplinary care team at a tertiary center. Key Points Intravenous drug use was the most common risk factor for IE in pregnancy. IE in pregnancy carries a high morbidity and mortality with complications including septic emboli, septic shock, and need for mechanical ventilation. A multidisciplinary team approach can assure the best possible maternal and fetal outcomes. [ABSTRACT FROM AUTHOR]

Understanding how competition varies with environmental stress is critical to anticipating species and community responses to rapid environmental change. While the stress‐gradient hypothesis predicts the strength of competition to decrease with increasing stress, our understanding of how competition varies with stress is limited by a lack of mechanistic understanding of how resource‐use traits underlying competitive dynamics respond to stress. Here, we use duckweeds in the Lemna species complex to measure how phenotypic and genetic variation in R* (a resource acquisition trait representing the minimum resource requirement for positive population growth) varies with high‐temperature stress to better understand how stress alters competitive ability for essential resources. We found that heat stress increased the R* of Lemna plants for nitrogen acquisition. Because lower R* values predict dominance in competitive dynamics where resources are limiting, this indicates that under stressful, high temperatures, plants could experience reduced competitive ability due to the higher resources required to sustain positive population growth rates. We found minimal genetic variation in R* across 11 local genotypes within the Lemna species complex, indicating that selection on resource acquisition strategies for essential resources such as nitrogen may be constrained in nature. The expression of genetic variation in R* for nitrogen was further reduced under heat stress, suggesting that the response to selection for R* could be particularly constrained under high‐temperature stress. Contrary to predictions drawn from the gleaner–opportunist trade‐off, we did not find evidence for a trade‐off in resource acquisition strategies under benign conditions or high‐temperature stress. Plants with lower R* (i.e. higher growth rates under lower nitrogen levels) were not constrained to have lower growth rates under higher nitrogen levels, possibly because the chosen genotypes have not diverged across resource acquisition strategies or because Lemna spp. has escaped this constraint. Importantly, our work indicates that high‐temperature stress could increase sensitivity to competition through an increased requirement for resources while reducing the evolutionary potential for Lemna species to respond to selection for resource traits. This study acts as a key step to understanding the mechanistic traits behind competitive dynamics in resource‐limited and stressful environments. Read the free Plain Language Summary for this article on the Journal blog. [ABSTRACT FROM AUTHOR]

A series of four-coordinate zinc(II) complexes is presented in which the amido vs. imino character of a ligated nitrogen donor correlates to the luminescence intensity. DFT analysis points to a distinct mechanism for this trend wherein emission can be switched on by restricting non-radiative decay pathways through the resonance-induced delocalization of amido ligand lone-pairs. [ABSTRACT FROM AUTHOR]

The Star Trek franchise's depiction of artificial intelligence (AI) and affiliated technologies—namely, supercomputers, androids, and holograms—evokes common themes and motifs from the myths of the ancient Mediterranean. This article analyzes the mythological underpinnings of Star Trek's historical treatment and approach to AI, from The Original Series to The Next Generation and up through the newest additions to the canon, Short Treks, and Picard. AI in Star Trek, like Data, the Doctor, and Zora, expresses qualities associated with divinity: superhuman strength, intelligence, and agelessness. These very qualities distinguish them from humans and bar them from considerations of personhood. Like the Greek gods of myth, AI can present as immortal, which fundamentally distinguishes it from mortal humans, as seen in the tensions between gods and humans in Homer's Odyssey and the Homeric Hymns. The ancient tension between mortal and immortal is manifested in the combative relationship between organic creator and artificial creation, a common sci-fi trope, that can lead to a cycle of fear and hostility evocative of the divine generational warfare in Hesiod's Theogony. The artificial–organic tension resonates with the contemporary audience's conflicted experiences with evolving technologies and problematizes the show's presentation of the evolution of humanity into a posthuman existence. Just as mythology is used to consider humanity relative to the divine, narratives about AI are fertile ground to analyze what it means to be human and establish parameters for what is decidedly not human. [ABSTRACT FROM AUTHOR]

As most academic libraries closed in March 2020 to help slow the spread of COVID-19, practitioners started working from home for the first time. After observing impacts on their own work, the authors sought to study the broader effects of remote work on practitioners' professional and personal life by conducting a longitudinal study between July 2020 and June 2021. The authors identified successful and unsuccessful practices and, based on this data, developed recommendations for how employers can support their employees as whole persons to ensure more productive professional performance and healthier personal lives. [ABSTRACT FROM AUTHOR]

Understanding the processes that underlie the development of population genetic structure is central to the study of evolution. Patterns of genetic structure, in turn, can reveal signatures of isolation by distance (IBD), barriers to gene flow, or even the genesis of speciation. However, it is unclear how severe range restriction might impact the processes that dominate the development of genetic structure. In narrow endemic species, is population structure likely to be adaptive in nature, or rather the result of genetic drift? In this study, we investigated patterns of genetic diversity and structure in the narrow endemic Hayden's ringlet butterfly. Specifically, we asked to what degree genetic structure in the Hayden's ringlet can be explained by IBD, isolation by resistance (IBR) (in the form of geographic or ecological barriers to migration between populations), and isolation by environment (in the form of differences in host plant availability and preference). We employed a genotyping‐by‐sequencing (GBS) approach coupled with host preference assays, Bayesian modelling, and population genomic analyses to answer these questions. Our results suggest that despite their restricted range, levels of genetic diversity in the Hayden's ringlet are comparable to those seen in more widespread butterfly species. Hayden's ringlets showed a strong preference for feeding on grasses relative to sedges, but neither larval preference nor potential host availability at sampling sites correlated with genetic structure. We conclude that geography, in the form of IBR and simple IBD, was the major driver of contemporary patterns of differentiation in this narrow endemic species. [ABSTRACT FROM AUTHOR]

Theories of student engagement for dropout and school completion are proposed to begin as early as age five. Student engagement in elementary-age students has been linked to school completion, post-secondary education, and achievement. However, there is little research examining patterns and profiles of student engagement in this population. In an effort to provide more individualized support and intervention, work in the field of student engagement has begun to examine profiles of student engagement and disengagement or disaffection. This study explored the identification of distinguishable groups based on student engagement in a sample of third-grade students and those groups' associations with demographic and outcome variables. Consistent with findings of research with older students, four distinct profiles of student engagement were found for males and females: Engaged, Cognitively/Affectively Disengaged, Behaviorally Disengaged, Disaffected. An additional class characterized by high absences was found for males. Demographic characteristics were associated with cluster attributes for males (Free or Reduced Lunch, special education, English Learner, and race-ethnicity) and female (El status). Cluster affiliation was significantly associated with seventh grade Math and Language Arts grades for both males and females and absences for males. Implications and future directions for research are discussed. The findings from the current study indicate there are discernible classes of student engagement and disengagement that can be identified as early as the third grade. These results may aid in the early identification of those at risk for dropping out of school and more effectively link students to targeted early interventions. [ABSTRACT FROM AUTHOR]

Inactivated influenza A virus (IAV) vaccines help reduce clinical disease in suckling piglets, although endemic infections still exist. The objective of this study was to evaluate the detection of IAV in suckling and nursery piglets from IAV-vaccinated sows from farms with endemic IAV infections. Eight nasal swab collections were obtained from 135 two-week-old suckling piglets from four farms every other week from March to September 2013. Oral fluid samples were collected from the same group of nursery piglets. IAV RNA was detected in 1.64% and 31.01% of individual nasal swabs and oral fluids, respectively. H1N2 was detected most often, with sporadic detection of H1N1 and H3N2. Whole-genome sequences of IAV isolated from suckling piglets revealed an H1 hemagglutinin (HA) from the 1B.2.2.2 clade and N2 neuraminidase (NA) from the 2002A clade. The internal gene constellation of the endemic H1N2 was TTTTPT with a pandemic lineage matrix. The HA gene had 97.59% and 97.52% nucleotide and amino acid identities, respectively, to the H1 1B.2.2.2 used in the farm-specific vaccine. A similar H1 1B.2.2.2 was detected in the downstream nursery. These data demonstrate the low frequency of IAV detection in suckling piglets and downstream nurseries from farms with endemic infections in spite of using farm-specific IAV vaccines in sows. [ABSTRACT FROM AUTHOR]

Background Emergency department (ED) clinicians are more frequently providing care, including end-of-life care, to older people. Objectives To estimate the need for ED end-of-life care for people aged ≥65 years, describe characteristics of those dying within 48 hours of ED presentation and compare those dying in ED with those dying elsewhere. Methods We conducted a retrospective cohort study analysing data from 177 hospitals in Australia and New Zealand. Data on older people presenting to ED from January to December 2018, and those who died within 48 hours of ED presentation, were analysed using simple descriptive statistics and univariate logistic regression. Results From participating hospitals in Australia or New Zealand, 10,921 deaths in older people occurred. The 48-hour mortality rate was 6.43 per 1,000 ED presentations (95% confidence interval: 6.31–6.56). Just over a quarter (n = 3,067, 28.1%) died in ED. About one-quarter of the cohort (n = 2,887, 26.4%) was triaged into less urgent triage categories. Factors with an increased risk of dying in ED included age 65–74 years, ambulance arrival, most urgent triage categories, principal diagnosis of circulatory system disorder, and not identifying as an Aboriginal or Torres Strait Islander person. Of the 7,677 older people admitted, half (n = 3,836, 50.0%) had an encounter for palliative care prior to, or during, this presentation. Conclusions Our findings provide insight into the challenges of recognising the dying older patient and differentiating those appropriate for end-of-life care. We support recommendations for national advanced care planning registers and suggest a review of triage systems with an older person-focused lens. [ABSTRACT FROM AUTHOR]

Introduction: Glucagon-like peptide 1 receptor agonists (GLP-1) elicit substantial reductions in glycemia and body weight in people with type 2 diabetes (T2D) and obesity, but existing data suggest the therapy must be continued indefinitely to maintain clinical improvements. Given the high cost and poor real-world persistence of GLP-1, an effective therapy that enables deprescription with sustained clinical improvements would be beneficial. Thus, the purpose of this real-world study was to assess the effect of GLP-1 deprescription on glycemia and body weight following co-therapy with carbohydrate restricted nutrition therapy (CRNT) supported via telemedicine in a continuous remote care model. Methods: A retrospective, propensity score matched cohort study among patients with T2D at a telemedicine clinic was conducted. Patients in whom GLP-1 were deprescribed (DeRx; n = 154) were matched 1:1 with patients in whom GLP-1 were continued (Rx). HbA1c and body weight at enrollment in clinic (pre-CRNT), at date of deprescription or index date (derx/ID), and at 6 and 12 months (m) post-derx/ID were utilized in this study. Results: No regression in weight was observed following deprescription with > 70% maintaining ≥ 5% weight loss 12 m post-derx/ID. HbA1c rose 6 m and 12 m post-derx/ID in both DeRx and Rx cohorts, but most patients maintained HbA1c < 6.5%. HbA1c and body weight measured 6 m and 12 m following derx/ID did not significantly differ between cohorts and were improved at derx/ID and at follow-up intervals compared to pre-CRNT. Conclusion: These results demonstrate the potential for an alternate therapy, such as CRNT supported via telemedicine, to enable maintenance of weight loss and glycemia below therapeutic targets following discontinuation of GLP-1 therapy. [ABSTRACT FROM AUTHOR]

Theory of mind (ToM) has been argued to be a multidimensional construct, with ToM inferences depending on distinct processes across affective and cognitive ToM tasks and across first-order cognitive and second-order cognitive ToM tasks. Behavioural evidence for a multidimensional account has primarily depended on dissociations identified via analysis of variance, a statistical approach insufficient for assessing dimensionality. Instead, state-trace analysis (STA) is a more appropriate statistical technique to uncover dimensionality. The current study first applied STA to two summary datasets that had previously identified key dissociations between cognitive and affective ToM; these reanalyses did not support a multidimensional account of ToM. Next, STA was applied to a more detailed dataset to reveal whether ToM is based on multiple processes in a sample of 115 older adults aged 60–85 years (M = 68.5, SD = 5.92, 61.7% female) with higher or lower emotion perception ability. Participants made ToM judgements about different social exchanges (e.g., sarcasm or lying). STA results supported a multidimensional account of ToM across first-order cognitive, second-order cognitive, and affective ToM subdomains. These results lay a more rigorous foundation for subsequent studies to further examine the dimensionality of ToM and to apply formal modelling, progressing the field's understanding and measurement of the cognitive processes driving ToM judgements. [ABSTRACT FROM AUTHOR]

Highly pathogenic avian influenza (HPAI) viruses have potential to cross species barriers and cause pandemics. Since 2022, HPAI A(H5N1) belonging to the goose/Guangdong 2.3.4.4b hemagglutinin phylogenetic clade have infected poultry, wild birds, and mammals across North America. Continued circulation in birds and infection of multiple mammalian species with strains possessing adaptation mutations increase the risk for infection and subsequent reassortment with influenza A viruses endemic in swine. We assessed the susceptibility of swine to avian and mammalian HPAI H5N1 clade 2.3.4.4b strains using a pathogenesis and transmission model. All strains replicated in the lung of pigs and caused lesions consistent with influenza A infection. However, viral replication in the nasal cavity and transmission was only observed with mammalian isolates. Mammalian adaptation and reassortment may increase the risk for incursion and transmission of HPAI viruses in feral, backyard, or commercial swine. [ABSTRACT FROM AUTHOR]

Obsessive-compulsive disorder (OCD), a highly prevalent and debilitating disorder, is incompletely understood in terms of underpinning behavioural, psychological, and neural mechanisms. This is attributable to high symptomatic heterogeneity; cardinal features comprise obsessions and compulsions, including clinical subcategories. While obsessive and intrusive thoughts are arguably unique to humans, dysfunctional behaviours analogous to those seen in clinical OCD have been examined in nonhuman animals. Genetic, ethological, pharmacological, and neurobehavioural approaches all contribute to understanding the emergence and persistence of compulsive behaviour. One behaviour of particular interest is maladaptive checking, whereby human patients excessively perform checking rituals despite these serving no purpose. Dysfunctional and excessive checking is the most common symptom associated with OCD and can be readily operationalised in rodents. This review considers animal models of OCD, the neural circuitries associated with impairments in habit-based and goal-directed behaviour, and how these may link to the compulsions observed in OCD. We further review the Observing Response Task (ORT), an appetitive instrumental learning procedure that distinguishes between functional and dysfunctional checking, with translational application in humans and rodents. By shedding light on the psychological and neural bases of compulsive-like checking, the ORT has potential to offer translational insights into the underlying mechanisms of OCD, in addition to being a platform for testing psychological and neurochemical treatment approaches. [ABSTRACT FROM AUTHOR]

Over the past decade, the United States military has taken an interest in addressing soldiers' spiritual fitness and readiness to help improve their mental health and resiliency. Similar efforts have not been applied within the Reserve Officers' Training Corps (ROTC) population despite the mental health challenges these college students experience. To examine spiritual readiness, spiritual fitness, and depressive symptoms in ROTC cadets. Cross-sectional study. Web-based survey. We recruited ROTC cadets from 1 large southeastern university (n = 91 of 315, 28.9% response rate). The ROTC cadets (age = 21 ± 3 years; men = 68, 74.7%; women = 22, 24.2%; missing = 1, 1.1%) were mainly classified as juniors (n = 30, 33.0%) and in Army ROTC (ROTC branch: Army = 69, Air Force = 20, Navy = 2). The survey contained 3 validated instruments used to assess spiritual fitness (the Spiritual Fitness Inventory [SFI]), spiritual readiness (Spiritual Wellbeing Scale [SWBS]), and mental health via depressive symptoms (Patient Health Questionnaire [PHQ-9]). Results were analyzed using descriptive statistics and nonparametric Mann-Whitney U tests to compare belief in God or gods with the dependent measures. A Pearson correlation was calculated to assess the relationship between the SWBS score and PHQ-9 data. In total, 85.7% (n = 78/91) of ROTC cadets stated that they believed in God or gods. Overall, the cadets were considered to have average spiritual fitness (mean = 75.04 ± 14.89) and moderate spiritual well-being (mean = 90.46 ± 18.09). The average PHQ-9 score was 4.22 ± 5.25. Individuals who believed in God or gods had higher spiritual readiness (believer = 94.44 ± 16.10, nonbeliever = 67.00 ± 9.35; P ≤.01). No statistically significant differences were noted for symptoms of depression (believer = 3.38 ± 4.90, nonbeliever = 6.60 ± 6.90; P =.143) or spiritual fitness (believer = 76.12 ± 14.78, nonbeliever = 64.40 ± 12.68; P =.054) in ROTC cadets based on belief status. Overall, the ROTC cadets had moderate to average spiritual fitness and readiness, with typical depressive symptoms scores. Spiritual readiness was different for those who believed in God or gods, and existential well-being was significantly correlated with depressive symptoms. [ABSTRACT FROM AUTHOR]

A study published in the International Journal of Primatology compared the population of mantled howler monkeys at La Selva Research Station in Costa Rica in 1992 and 2022. The researchers conducted a follow-up census using acoustic triangulation and found that the number of howler monkey groups had increased from 15 in 1992 to 25 in 2022. This suggests a population growth and recovery from the effects of a yellow fever epidemic in the 1950s. The study highlights the importance of long-term protection and increasing connectivity for sustaining and bolstering primate populations. [Extracted from the article]

The widespread conflation between having a sexual interest in children and engaging in sexually abusive behavior contributes significantly to elevated levels of stigma targeted at people living with a sexual interest in children. Stigmatization and societal punitiveness surrounding people living with these interests can impact their well-being, obstruct help-seeking, and potentially increase risk of offending behavior. Recent quantitative research employing stigma intervention strategies has produced encouraging results in reducing stigmatizing attitudes toward this population. The current study sought to expand on quantitative research findings to explore qualitatively the facilitators and barriers to understanding and accepting people living with sexual interest in children. Thirty participants were interviewed following completion of an online stigma intervention study. Participants were asked about their attitudinal responses to the earlier study and how personal and professional experiences contributed to shaping their attitudes surrounding people living with a sexual interest in children. Reflexive inductive thematic analysis was used to explore what factors promote understanding and what factors act as barriers to understanding people with sexual interest in children. The significance of experiences which challenged the dominant social narrative was identified across several themes which facilitated understanding and acceptance of people who have a sexual interest in children. Themes which reflected barriers to understanding included difficulty comprehending alternate narratives, parental concern, and reinforcement of current stereotypes. Implications for developing stigma-reduction interventions and future research are discussed. [ABSTRACT FROM AUTHOR]

The Self-Concept Clarity Scale (SCCS) is a 12-item self-report measure that assesses self-concept clarity (SCC). Previous research has identified a relationship between lower SCC and higher levels of social anxiety. As a measure of positive psychological well-being, the SCCS can be used as a tool to examine and monitor SCC in populations with social anxiety disorder (SAD) who appear to be susceptible to inconsistent or unstable self-concept. However, the scale has yet to be validated with a SAD sample. A confirmatory factor analysis (CFA) was conducted on the SCCS data of sample of 87 individuals who met criteria for a diagnosis of SAD (M = 20.15, SD = 3.55; 83% female) and the reliability, convergent validity and norm scores of the SCCS with a SAD were also investigated. Results of the CFA supported a unidimensional factor structure. The SCCS was found to have good internal consistency (Cronbach's α =.80) and SCCS scores were found to correlate with measures of psychological distress and social fears, however, no correlation was found with measures of social anxiety behaviours. Also, overall results found that the SAD sample scored lower on SCC than other clinical samples in previous literature. These findings suggest that the SCCS is a psychometrically sound measure with unidimensional factor structure and demonstrated reliability and validity with a SAD sample, although additional research is warranted to replicate and extend the results of the current research. What is already known about this topic: The SCCS is a valid and reliable measure of self-concept clarity (SCC) with unidimensional factor structure, developed by Campbell et al. (1996). The SCCS has been used to identify that individuals with social anxiety symptomology demonstrate lower SCC. To the authors' knowledge, previous literature has not yet used the SCCS to measure SCC in a SAD clinical sample. What the current research adds: The findings of the original development paper and recent validations of the SCCS were supported by the current study – i.e., unidimensional factor structure and sound psychometric properties were demonstrated. Lower SCC was associated with social worry and cognitive distress. No association was found with behavioural symptoms of SAD. The SCCS demonstrated clinical utility as a measure that can be used to assist with treatment planning and formulation, and to address a client's beliefs about the self and their identity. [ABSTRACT FROM AUTHOR]

Multigroup latent profile analysis examined whether patterns of alcohol, cannabis, and tobacco use varied between college student and nonstudent young adults (N = 745), and profiles were characterized by alcohol- and drug-related problems, psychological distress, and perceived stress. Findings supported three profiles (high use across substances, primarily high tobacco use, and low use across substances) among students. Students in the high use group, relative to other groups, experienced the highest number of problems and psychological distress. Among nonstudents, two profiles emerged (high use across substances and primarily high tobacco use), and noncollege participants in the high use group experienced the highest problems, psychological distress, and perceived stress. Students, compared to nonstudents, reported more variability in their substance use profiles, as a low substance use group was not observed among nonstudents. Prevention and intervention efforts should target nonstudents, which could aid in reducing negative health outcomes based on disparities in education. [ABSTRACT FROM AUTHOR]

Objective Background Method Results Conclusion This article calls on family scholars to take seriously how families are invested and divested in maintaining and reproducing cisnormativity.Families can be a prime institution for the reproduction of cisnormativity. For transgender and nonbinary family members, families' investment in cisnormativity can generate ambiguous and toxic familial relations. Yet, family studies have not developed an adequate framework to examine how and why cisnormativity operates within families.The authors engage with empirical and theoretical work on gender, intersectionality, and families to examine how cisnormativity operates within family dynamics and processes. This article also focuses on work about trans people and families to capture how cisnormative processes within families affect trans people's familial relations.The authors advance a trans family systems framework to show how families' cisgender investments and divestments shape familial processes. The concept of cisnormative compliance is introduced to capture the beliefs and practices of obedience established by family members for the purpose of reproducing cisnormativity. Family studies can move forward in studying these cisnormative processes through documenting how gender accountability shapes family dynamics, implementing new methods, furthering an intersectional analysis, and exploring complexities of space and place.To reimagine gender and families, family scholars need to study and foreground how cisnormativity shapes family dynamics and processes. [ABSTRACT FROM AUTHOR]

Involvement in honors programs provides students an opportunity to grow academically, connect with like-minded peers, and reap tangible and intangible benefits. Understanding the motivations driving this involvement is a crucial task for honors program administrators and faculty alike as different motivations may influence how students engage and succeed in their honors pursuits. This study analyzes student motivating factors, organizing them into a five-factor framework that highlights different motivational groupings, including a non-intentional factor. While past studies have relied on student characteristics and survey information to understand honors program involvement, this study takes a qualitative approach, drawing on focus groups with current and incoming honors students to delve into the various motivations that honors students indicated as compelling for their participation in an honors program at a private mid-size liberal arts institution. The findings provide insight into key motivations which may inform efforts to increase the diversity of and involvement in honors programs. These eleven motivations are grouped into instrumental factors, personal factors, nudges, relationships, and accidental, with the majority of students noting more than one motivation for their involvement in the honors program. [ABSTRACT FROM AUTHOR]

Background: Within the pediatric population, a positive self-concept is associated with better academic achievement. Children with chronic kidney disease (CKD) are at risk for lower quality of life and academic underachievement. Little is known about self-concept among children with CKD and how self-concept influences academic achievement. The objectives of the present study were to (1) describe patient-reported self-concept among children with CKD and (2) evaluate the relationship between self-concept and academic performance. Methods: This cross-sectional study included 23 children, aged 6–16 years, with mild to moderate CKD (cause of disease due to congenital anomalies of the kidney and urinary tract) and 26 age-matched comparators. Participants completed the Self-Description Questionnaire (SDQ) and the Wide Range Achievement Test (WRAT-4). Linear regression models were used to evaluate self-concept as a predictor of academic achievement in the CKD cohort. Results: Self-concept ratings were comparable between children with CKD and non-CKD comparators; however, academic achievement trended lower for the CKD patients on measures of arithmetic (estimate = − 0.278, 95% confidence interval (CI) [− 0.530: − 0.026], t(45) = − 1.99, p = 0.053). All of the SDQ domains predicted WRAT-4 arithmetic performance, such that higher scores on the SDQ were associated with higher scores in mathematics. Kidney function did not have an effect on the relationship between self-concept and academic achievement. Conclusions: Despite the presence of a chronic disease, children with CKD endorse a positive self-concept. Positive self-concept may predict academic success in this population. [ABSTRACT FROM AUTHOR]

This article provides an overview of vestibular disease in horses, explaining the anatomy of the vestibular system and discussing the clinical signs and common causes of the disease. It emphasizes the importance of diagnostic tests in reaching a diagnosis. The article titled "Ethics Statement" by Sarah F. Colmer and Amy L. Johnson discusses the absence of an ethics statement in a clinical commentary and explains the purpose and importance of an ethics statement in research articles. [Extracted from the article]

Models of range expansion have independently explored fitness consequences of life history trait evolution and increased rates of genetic drift—or "allele surfing"—during spatial spread, but no previous model has examined the interactions between these two processes. Here, using spatially explicit simulations, we explore an ecologically complex range expansion scenario that combines density-dependent selection with allele surfing to asses the genetic and fitness consequences of density-dependent selection on the evolution of life history traits. We demonstrate that density-dependent selection on the range edge acts differently depending on the life history trait and can either diminish or enhance allele surfing. Specifically, we show that selection at the range edge is always weaker at sites affecting competitive ability (K -selected traits) than at sites affecting birth rate (r -selected traits). We then link differences in the frequency of deleterious mutations to differences in the efficacy of selection and rate of mutation accumulation across distinct life history traits. Finally, we demonstrate that the observed fitness consequences of allele surfing depend on the population density in which expansion load is measured. Our work highlights the complex relationship between ecology and expressed genetic load, which will be important to consider when interpreting both experimental and field studies of range expansion. [ABSTRACT FROM AUTHOR]

This article provides an overview of the spawning and larval development of Colossendeis megalonyx, a large sea spider found in Antarctica. The researchers observed the unique reproductive behavior of this species, where male parents care for the offspring. They collected eggs and observed the slow development of embryos, leading to the hatching of larvae. The study also suggests that the larvae of C. megalonyx have limited potential for long-distance dispersal and that the family Colossendeidae as a whole are nonbrooders. The researchers highlight the importance of field and laboratory observations for understanding the biology and natural history of sea spiders. [Extracted from the article]

Solid abdominal organ transplantation is fraught with variable rates of rejection and graft versus host disease (GVHD). We sought to determine the safety and efficacy of an advanced extracellular vesicle (EV) investigational product (IP) derived from mesenchymal stem cells (MSC) in the transplant patient population. Seven separate emergency investigational new drug (eNIDs) were filed with the Food and Drug Administration (FDA) for the emergency treatment of rejection of an isolated intestinal graft (n = 2), liver allograft graft (n = 2), modified multivisceral graft (n = 3), and GVHD in isolated intestinal transplant patients (n = 2). Fifteen milliliters of IP was administered intravenously on Day 0, 2, 4, and this treatment cycle was repeated up to four times in each patient depending on the treatment protocol allowed by the FDA. Safety (adverse event reporting) and efficacy (clinical status, serologies, and histopathology) were evaluated. There were no adverse events related to IP. All patients had improvement in clinical symptoms within 24 h, improved serologic laboratory evaluation, improved pulmonary symptoms and dermatologic manifestations of GVHD, and complete histologic resolution of graft inflammation/rejection within 7 days of IP administration. Systemic use of a MSC-derived EV IP was successful in achieving histological clearance of intestinal, liver, and multivisceral graft inflammation, and skin and pulmonary manifestations of GVHD. [ABSTRACT FROM AUTHOR]

Rapid evolution in colonising populations can alter our ability to predict future range expansions. Recent theory suggests that the dynamics of replicate range expansions are less variable, and hence more predictable, with increased selection at the expanding range front. Here, we test whether selection from environmental gradients across space produces more consistent range expansion speeds, using the experimental evolution of replicate duckweed populations colonising landscapes with and without a temperature gradient. We found that the range expansion across a temperature gradient was slower on average, with range‐front populations displaying higher population densities, and genetic signatures and trait changes consistent with directional selection. Despite this, we found that with a spatial gradient range expansion speed became more variable and less consistent among replicates over time. Our results therefore challenge current theory, highlighting that chance can still shape the genetic response to selection to influence our ability to predict range expansion speeds. [ABSTRACT FROM AUTHOR]

Comprehensive sexuality education (CSE) has been shown to have a wide range of positive impacts for K-12 students. Despite its demonstrated benefits, many K-12 students in the USA do not receive CSE. Because of this, college may be an opportune time to teach this information. However, little is known about the impact of CSE in institutions of higher education. To synthesise knowledge about the impacts of college-level sexual health courses in the USA, a review of the topic was conducted. A review searching Ebscohost, ProQuest, PubMed, and Google Scholar was undertaken. Following the search, a second coder reviewed the articles to confirm eligibility. 13 articles, published between 2001 and 2020, met the inclusion criteria and were included in the review. A wide range of outcomes were reported. These included increased health promoting behaviours, less homophobic and judgemental attitudes around sexuality, improved communication and relationships, and increased understanding of sexual violence. College sexual health courses have high potential efficacy to provide CSE and fill gaps in US students' sexual health knowledge. Future research should corroborate the existing outcomes using randomisation and more diverse samples, and examine whether these courses are effective in preventing sexual assault. [ABSTRACT FROM AUTHOR]

The national context of deportation threat, defined as the federal government's approach to deportation and/or deportation's salience to the US public, fluctuated between 2011 and 2018. US Latinos across citizenship statuses may have experienced growing psychological distress associated with these changes, given their disproportionate personal or proximal vulnerabilities to deportation. Drawing on 8 y of public- and restricted-access data from the National Health Interview Survey (2011 to 2018), this article examines trends in psychological distress among Latinos who are US-born citizens, naturalized citizens, and noncitizens. It then seeks to explain these trends by considering two theoretical pathways through which the national context of deportation threat could distress Latinos: 1) through discrete dramatic societal events that independently signal a change to the country's approach to deportation and/or that render deportation temporarily more salient to the public or 2) through more gradual changes to the country's everyday institutional (i.e., quotidian efforts to detain and deport noncitizens) and social (i.e., deportation's ongoing salience to a concerned public) environment of deportation threat. We find that, though both pathways matter to some degree, there is more consistent evidence that the gradual changes are associated with Latino US citizens and noncitizens' overall experiences of psychological distress. The article highlights how, even absent observable spillover effects of dramatic societal events bearing on deportation threat, the institutional and social environment in which they occur implicates Latinos' well-being. [ABSTRACT FROM AUTHOR]

Eating disorders (EDs) are serious, deadly disorders that emerge in adolescence and early adulthood. Further, reported incidences of EDs are increasing worldwide. As such, accessible, affordable, and effective early intervention and prevention efforts are critical. The Body Project is a well-established ED prevention program with demonstrated success at reducing ED symptom severity and the risk of onset of EDs in young females. However, it has not yet been formally evaluated in an Australian population, nor have the benefits of the treatment for young people of all genders been thoroughly investigated. This protocol paper outlines the design for a study which aims to investigate the outcomes and feasibility of the Body Project as a brief ED prevention program within an Australian youth mental health service: headspace Camperdown. This pragmatic trial will compare outcomes between a Body Project treatment group and a Treatment-as-usual control group. Primary outcomes include body image concerns, ED symptomatology and general psychological distress, measured pre- and post-treatment, and at one-month follow-up. All young people attending headspace Camperdown for care are eligible for participation in the trial. The Body Project program is comprised of four group-based 1.5 h sessions run over 4 consecutive weeks. Overall, a trial of the Body Project as an ED prevention program is warranted to investigate the outcomes of the intervention in this sample and will provide valuable information about the feasibility for widespread implementation of the treatment as part of a stepped-care approach to intervention for EDs at youth mental health service locations across Australia. ANZCTR Trial Registration Number: ACTRN12623000695606 (registered 29 June 2023). [ABSTRACT FROM AUTHOR]

Irritability is a transdiagnostic indicator of child and adolescent internalizing and externalizing problems that is measurable from early life. The objective of this systematic review was to determine the strength of the association between irritability measured from 0 to 5 years and later internalizing and externalizing problems, to identify mediators and moderators of these relationships, and to explore whether the strength of the association varied according to irritability operationalization. Relevant studies published in peer-reviewed, English-language journals between the years 2000 and 2021 were sought from EMBASE, PsycINFO, MEDLINE, CINAHL, and ERIC. We synthesized studies that included a measure of irritability within the first 5 years of life and reported associations with later internalizing and/or externalizing problems. Methodological quality was assessed using the JBI-SUMARI Critical Appraisal Checklist. Of 29,818 identified studies, 98 met inclusion criteria, with a total number of 932,229 participants. Meta-analysis was conducted on 70 studies (n = 831,913). Small, pooled associations were observed between infant irritability (0-12 months) and later internalizing (r = 0.14, 95% CI = 0.09, 0.20) and externalizing symptoms (r = 0.16, 95% CI = 0.11, 0.21) symptoms. For toddler/preschool irritability (13-60 months), small-to-moderate pooled associations were observed for internalizing (r = 0.21, 95% CI = 0.14, 0.28) and externalizing (r = 0.24, 95% CI = 0.18, 0.29) symptoms. These associations were not moderated by the lag between irritability and outcome assessment, although the strength of the associations varied according to irritability operationalization. Early irritability is a consistent transdiagnostic predictor of internalizing and externalizing symptoms in childhood and adolescence. More work is required to understand how to accurately characterize irritability across this developmental period, and to understand mechanisms underlying the relationship between early irritability and later mental health problems. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented racial and/or ethnic groups in science. One or more of the authors of this paper self-identifies as living with a disability. We actively worked to promote sex and gender balance in our author group. We actively worked to promote inclusion of historically underrepresented racial and/or ethnic groups in science in our author group. Early irritability as a transdiagnostic neurodevelopmental vulnerability to early onset mental health problems: A systematic review; https://www.crd.york.ac.uk/prospero/ ; CRD42020214658. [ABSTRACT FROM AUTHOR]

Data from the National Survey of Children's Health 2016–2019 was used to examine the co-occurrence of autism and ADHD and the impact on anxiety and depression among adolescents age 12–17. Rates of anxiety and depression were up to ten-fold the prevalence of adolescents not diagnosed with autism or ADHD. Over half of autistic females (57%) and nearly half of autistic males (49%) are also diagnosed with ADHD. Autistic females with ADHD had the highest co-occurrence of anxiety at 72% followed by autistic males with ADHD at 69%. The prevalence of depression was highest among autistic adolescents with ADHD yet was consistent across genders (male/female) at 38–39%. Adolescents diagnosed with autism and/or ADHD are at heightened risk for anxiety and depression. [ABSTRACT FROM AUTHOR]

Background: The purpose of this study was determined whether cognitive impairment is associated with time taken to complete the electronic rapid fitness assessment (eRFA). We hypothesized that taking more time to complete the eRFA will indicate worsened cognitive function. Methods: We retrospectively identified patients who presented to the Memorial Sloan Kettering Cancer Center Geriatrics Service for preoperative evaluation and completed the eRFA as a part of their preoperative assessment from February 2015 to December 2020. Cognitive function was assessed using the Mini‐Cog©, which is a screening test for cognitive function status. Patients in this study underwent elective surgery and had a hospital length of stay ≥1 day. Time to complete the eRFA was automatically recorded by a web‐based tool; assistance with eRFA completion was self‐reported by the patient. In total, 2599 patients were included, of which 2387 had available Mini‐Cog© scores. Results: Overall, 50% of surveys were completed without assistance, 37% were completed with assistance, and 13% were completed by somebody else; Mini‐Cog© scores were lower, corresponding to worsened cognitive function status, in patients requiring assistance (median score respectively, 5 vs. 4 vs. 3; p‐value <0.0001; rates of cognitive impairment 7.5%, 22%, and 38%). Among patients who completed the questionnaire independently, greater cognitive impairment was associated with longer time to complete the eRFA (change in score per 5 min = −0.09; 95% CI −0.14, −0.03; p = 0.002). Conclusions: We found evidence that requirement for assistance in completing web‐based questionnaires, and time taken to complete a questionnaire, predict which patients benefit from more comprehensive cognitive function assessments. Future studies should further validate this finding in a more diverse population and establish optimal clinical pathways. [ABSTRACT FROM AUTHOR]

Dendrites are tree-like structures with tiny spines specialized to receive excitatory synaptic transmission. Spino-dendritic plasticity, driven by neural activity, underlies the maintenance of neuronal connections crucial for proper circuit function. Abnormalities in dendritic morphology are frequently seen in epilepsy. However, the exact etiology or functional implications are not yet known. Therefore, to better comprehend the structure-function significance of this dendritic pathology in epilepsy, it is necessary to identify the common spino-dendritic disturbances present in both human and experimental models. Here, we describe the dendritic and spine structural profiles found across human refractory epilepsy as well as in animal models of developmental, acquired, and genetic epilepsies. [ABSTRACT FROM AUTHOR]

Background Out-of-pocket (OOP) costs can be substantial financial burdens for patients and may even cause patients to delay or forgo necessary medical procedures. Although overall healthcare costs are rising in the United States, recent trends in patient OOP costs for foot and ankle orthopaedic surgical procedures have not been reported. Fully understanding patient OOP costs for common orthopaedic surgical procedures, such as those performed on the foot and ankle, might help patients and professionals make informed decisions regarding treatment options and demonstrate to policymakers the growing unaffordability of these procedures. Questions/purposes (1) How do OOP costs for common outpatient foot and ankle surgical procedures for commercially insured patients compare between elective and trauma surgical procedures? (2) How do these OOP costs compare between patients enrolled in various insurance plan types? (3) How do these OOP costs compare between surgical procedures performed in hospital-based outpatient departments and ambulatory surgical centers (ASCs)? (4) How have these OOP costs changed over time? Methods This was a retrospective, comparative study drawn from a large, longitudinally maintained database. Data on adult patients who underwent elective or trauma outpatient foot or ankle surgical procedures between 2010 and 2020 were extracted using the MarketScan Database, which contains well-delineated cost variables for all patient claims, which are particularly advantageous for assessing OOP costs. Of the 1,031,279 patient encounters initially identified, 41% (427,879) met the inclusion criteria. Demographic, procedural, and financial data were recorded. The median patient age was 50 years (IQR 39 to 57); 65% were women, and more than half of patients were enrolled in preferred provider organization insurance plans. Approximately 75% of surgical procedures were classified as elective (rather than trauma), and 69% of procedures were performed in hospital-based outpatient departments (rather than ASCs). The primary outcome was OOP costs incurred by the patient, which were defined as the sum of the deductible, coinsurance, and copayment paid for each episode of care. Monetary data were adjusted to 2020 USD. A general linear regression, the Kruskal-Wallis test, and the Wilcoxon-Mann-Whitney test were used for analysis, as appropriate. Alpha was set at 0.05. Results For foot and ankle indications, trauma surgical procedures generated higher median OOP costs than elective procedures (USD 942 [IQR USD 150 to 2052] versus USD 568 [IQR USD 51 to 1426], difference of medians USD 374; p < 0.001). Of the insurance plans studied, high-deductible health plans had the highest median OOP costs. OOP costs were lower for procedures performed in ASCs than in hospital-based outpatient departments (USD 645 [IQR USD 114 to 1447] versus USD 681 [IQR USD 64 to 1683], difference of medians USD 36; p < 0.001). This trend was driven by higher coinsurance for hospital-based outpatient departments than for ASCs (USD 391 [IQR USD 0 to 1136] versus USD 337 [IQR USD 0 to 797], difference of medians USD 54; p < 0.001). The median OOP costs for common outpatient foot and ankle surgical procedures increased by 102%, from USD 450 in 2010 to USD 907 in 2020. Conclusion Rapidly increasing OOP costs of common foot and ankle orthopaedic surgical procedures warrant a thorough investigation of potential cost-saving strategies and initiatives to enhance healthcare affordability for patients. In particular, measures should be taken to reduce underuse of necessary care for patients enrolled in highdeductible health plans, such as shorter-term deductible timespans and placing additional regulations on the implementation of these plans. Moreover, policymakers and physicians could consider finding ways to increase the proportion of procedures performed at ASCs for procedure types that have been shown to be equally safe and effective as in hospital-based outpatient departments. Future studies should extend this analysis to publicly insured patients and further investigate the health and financial effects of highdeductible health plans and ASCs, respectively. Level of Evidence Level III, economic and decision analysis. [ABSTRACT FROM AUTHOR]

Objectives: To describe the characteristics of, and care provided to, older people who died within 48 h of ED presentation. Methods: A descriptive retrospective cohort study of people 65 years and older presenting to two EDs in Queensland, Australia, between April 2018 and March 2019. Data from electronic medical records were collected and analysed. Results: Two hundred and ninety‐five older people who died within 48 h of ED presentation were included. Nearly all arrived by ambulance (92%, n = 272) and 36% (n = 106) were from aged care facilities. Three‐quarters (75%, n = 222) were triaged into the most urgent triage categories (i.e. Australasian Triage Scale; ATS 1/2). Fewer than half were previously independent with mobility (38%, n = 111) and activities of daily living (43%, n = 128). Sixty‐one per cent (n = 181) had a pre‐existing healthcare directive. Twenty‐two per cent (n = 66) died in ED, most commonly due to pneumonia, intracerebral haemorrhage, cardiac arrest and/or sepsis. Over half had one or more ED visits (52%, n = 154) and/or hospital admissions (52%, n = 152) 6 months prior. Conclusions: Identification of patients at end‐of‐life (EoL) is not always straightforward; consider recent reduction in independence and recent ED visits/hospital admissions. System‐based strategies that span pre‐hospital, ED and in‐patient care are recommended to facilitate EoL pathway implementation and care continuity. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To compare postoperative urinary retention rates in the early postoperative period between home and office catheter removal. Secondary outcomes included pain, difficulty, satisfaction, likelihood to use again, and health care utilization. METHODS: We conducted a nonblinded, randomized controlled, noninferiority trial of women undergoing surgery for stress incontinence and prolapse from March 2021 to June 2022. Exclusion criteria were preoperative voiding dysfunction (need for self-catheterization or postvoid residual [PVR] greater than 150 mL), urethral bulking, and need for prolonged postoperative catheterization. Participants discharged with indwelling catheters because of an initial failed void trial were randomized 1:1 to home compared with office removal on postoperative day 3-4. For home removal, participants were instructed to remove the catheter at 7 am and to drink two glasses of water. If they had difficulty voiding 5 hours after catheter removal, they came to the office for a void trial. For office removal, participants returned for a backfill void trial with PVR assessment. Our primary outcome was rate of early postoperative urinary retention, defined as confirmed retention (PVR greater than half the voided volume) after catheter removal. Secondary outcomes were assessed at a 2-week call. Health care utilization (telephone calls and office visits) related to catheter issues was also assessed. At 80% power and a=0.05, we needed 100 participants (50/group) to detect a noninferiority margin of 11%. RESULTS: Among 117 participants, the home (n=59) and office (n=58) removal groups were similar in mean age (60 years vs 61 years), mean body mass index (29 vs 30), pelvic organ prolapse quantification system stage 3 or 4, and proportion who underwent hysterectomy or apical suspension. Sling procedures were more common in the office group (45.8% vs 77.6%). For our primary outcome, the rate of early postoperative retention was 11.9% in the home group and 22.4% in the office group (P=.13). Our predetermined noninferiority margin was greater than the upper bound of our 95% CI;thus, we conclude non-inferiority of home removal. For secondary outcomes, the home removal group was more likely to report "no pain" (P=.02) and "very likely" to use this method again (P=.004). There were no differences in difficulty or satisfaction between groups. Number of nursing calls was not different (P=.66);however, number of office visits was higher in the office group (median 0 [interquartile range 0-1] vs 1 [1-1], PC001). CONCLUSION: Postoperative urinary catheter removal by the patient at home was noninferior to office removal when early urinary retention rates were compared. Participants in the home removal group had fewer office visits and reported low pain, low difficulty, and high satisfaction. [ABSTRACT FROM AUTHOR]

Aim Design Methods Results Conclusion Implications for the Profession Impact Patient or Public Contribution To address: What are the experiences of 2SLGBTQQIA+ parents using parenting supports and services to meet their children's early childhood development needs (<5 years of age)?Whittemore and Knafl's (2005) integrative review methodology.Electronic databases were searched from 2000 to October 14, 2022 for empirical studies or reviews addressing the research question. The title and abstract of 12,158 articles were screened for inclusion in the review by two independent researchers; 175 of these articles underwent full‐text review. Studies selected were critically appraised using a Joanna Briggs Institute Critical Appraisal tool. Relevant key findings were extracted from each study and entered into N‐VIVO‐12. Thematic content analysis was employed and PRISMA guidelines were adhered to.A total of 18 articles (15 qualitative and three multi‐method studies) met the inclusion criteria and were selected for the review. Seven themes were revealed from analysis of the studies: (1) 2SLGBTQQIA+ Status kept a secret; (2) Forced to come out; (3) Heteronormative messaging; (4) Feeling excluded; (5) Stigmatised; (6) Parents act as educators; and (7) Positive experiences.This integrative review provides nurses with insight into the experiences of 2SLGBTQQIA+ parents using health care services for their young child.This article highlights what changes nurses need to make to their practice to ensure appropriate, inclusive care for clients of diverse sexual and gender identities and their families.Health care providers, especially nurses, have an opportunity to improve the experiences of these families and positively impact their health and well‐being. Additionally, there is a need for research with the 2SLGBTQQIA+ parent community and the use of rigorous methodological techniques, including clearly linking participants' gender and sexual identities with study findings, to improve our understanding of 2SLGBTQQIA+ parent experiences.Although there was no direct patient contribution to the work since it was an integrative review of the literature, indirectly patient contributions are incorporated from the original research results of studies incorporated into this review. [ABSTRACT FROM AUTHOR]

In active galactic nuclei, the relationship between UV and X-ray luminosity is well studied (often characterised by αox) but often with heterogeneous samples. We have parametrized the intrinsic distribution of X-ray luminosity, L X, for the optically selected sample of SDSS quasars in the Stripe 82 and XXL fields across redshifts 0.5–3.5. We make use of the available XMM observations and a custom pipeline to produce Bayesian sensitivity curves that are used to derive the intrinsic X-ray distribution in a hierarchical Bayesian framework. We find that the X-ray luminosity distribution is well described by a Gaussian function in log10  L X space with a mean that is dependent on the monochromatic 2500 Å UV luminosity, L 2500. We also observe some redshift dependence of the distribution. The mean of the L X distribution increases with redshift while the width decreases. This weak but significant redshift dependence leads to L 2500– L X and L 2500–αox relations that evolve with redshift, and we produce a redshift- and L 2500-dependent αox equation. Neither black hole mass nor Eddington ratio appear to be potential drivers of the redshift evolution. [ABSTRACT FROM AUTHOR]

Background: Poor mental health is associated with obesity, but existing studies are either cross-sectional or have long time periods between measurements of mental health and weight. It is, therefore, unclear how small fluctuations in mental wellbeing within individuals predict bodyweight over short time periods, e.g. within the next month. Studying this could identify modifiable determinants of weight changes and highlight opportunities for early intervention. Methods: 2,133 UK adults from a population-based cohort completed monthly mental health and weight measurements using a mobile app over a period of 6–9 months. We used random intercept regression models to examine longitudinal associations of depressive symptoms, anxiety symptoms and stress with subsequent weight. In sub-group analyses, we included interaction terms of mental health variables with baseline characteristics. Mental health variables were split into "between-individual" measurements (= the participant's median score across all timepoints) and "within-individual" measurements (at each timepoint, the difference between the participant's current score and their median). Results: Within-individual variation in depressive symptoms predicted subsequent weight (0.045kg per unit of depressive symptom severity, 95% CI 0.021–0.069). We found evidence of a moderation effect of baseline BMI on the association between within-individual fluctuation in depressive symptoms and subsequent weight: The association was only apparent in those with overweight/obesity, and it was stronger in those with obesity than those with overweight (BMI<25kg/m2: 0.011kg per unit of depressive symptom severity [95% CI -0.017 to 0.039]; BMI 25–29.9kg/m2: 0.052kg per unit of depressive symptom severity [95%CI 0.010–0.094kg]; BMI≥30kg/m2: 0.071kg per unit of depressive symptom severity [95%CI 0.013–0.129kg]). We found no evidence for other interactions, associations of stress and anxiety with weight, or for a reverse direction of association. Conclusion: In this exploratory study, individuals with overweight or obesity were more vulnerable to weight gain following higher-than-usual (for that individual) depressive symptoms than individuals with a BMI<25kg/m2. [ABSTRACT FROM AUTHOR]

AbstractObjectiveParticipantsMethodResultsConclusionsExamine differences over time in use of complementary health approaches (CHA) and dietary supplements among college students.Two samples of undergraduate students (Sample 1, N = 370; Sample 2, N = 482) from a midsized Midwestern university.Using stratified random sampling, at two time points (spring 2008, spring 2019), students were surveyed. Frequency of CHA and supplement use in the past year were assessed and compared across the two time periods.Of the CHAs compared, 53% had changed in frequency of use with only the practice of yoga significantly increasing. As for supplements, 78% changed in their frequency of use with the rate of melatonin being the only significant increase.Although the reported use of many CHAs and supplements appeared to change in the time period between assessments, findings suggest that students still report using several CHA practices and, to a lesser extent, supplements. [ABSTRACT FROM AUTHOR]