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The increased use of next-generation sequencing has expanded our understanding of the involvement and prevalence of mosaicism in genetic disorders. We describe a total of eleven cases: nine in which mosaic variants detected by genome sequencing (GS) and/or targeted gene panels (TGPs) were considered to be causative for the proband's phenotype, and two of apparent parental mosaicism. Variants were identified in the following genes: PHACTR1, SCN8A, KCNT1, CDKL5, NEXMIF, CUX1, TSC2, GABRB2, and SMARCB1. In addition, we identified one large duplication including three genes, UBE3A, GABRB3, and MAGEL2, and one large deletion including deletion of ARFGAP1, EEF1A2, CHRNA4, and KCNQ2. All patients were enrolled in the NYCKidSeq study, a research program studying the communication of genomic information in clinical care, as well as the clinical utility and diagnostic yield of GS for children with suspected genetic disorders in diverse populations in New York City. We observed variability in the correlation between reported variant allele fraction and the severity of the patient's phenotype, although we were not able to determine the mosaicism percentage in clinically relevant tissue(s). Although our study was not sufficiently powered to assess differences in mosaicism detection between the two testing modalities, we saw a trend toward better detection by GS as compared with TGP testing. This case series supports the importance of mosaicism in childhood-onset genetic conditions and informs guidelines for laboratory and clinical interpretation of mosaic variants detected by GS.

Purpose: This systematic review provides a comprehensive summary of the diagnostic accuracy of English language sample analysis (LSA) measures for the identification of developmental language disorder. Method: An electronic database search was conducted to identify English publications reporting empirical data on the diagnostic accuracy of English LSA measures for children aged 3 years or older. Results: Twenty-eight studies were reviewed. Studies included between 18 and 676 participants ranging in age from 3;0 to 13;6 (years;months). Analyzed measures targeted multiple linguistic domains, and diagnostic accuracy ranged from less than 25% to greater than 90%. Morphosyntax measures achieved the highest accuracy, especially in combination with length measures, and at least one acceptable measure was identified for each 1-year age band up to 10 years old. Conclusion: Several LSA measures or combinations of measures are clinically useful for the identification of developmental language disorder, although more research is needed to replicate findings using rigorous methods and to explore measures that are informative for adolescents and across diverse varieties of English. Supplemental Material: https://doi.org/10.23641/asha.21183247

El libro MANUAL DE LAS EMERGENCIAS MÉDICAS VOLUMEN 1, aborda una amplia gama de temas relevantes en el ámbito de la urgencia médica, presentando un índice estructurado y completo. Cada capítulo se enfoca en diferentes aspectos relacionados con la atención médica de emergencia, brindando conocimientos valiosos para profesionales de la salud y estudiantes. Desde la organización de los servicios de urgencias hasta el manejo de condiciones específicas como el trauma abdominal cerrado, las convulsiones en pacientes pediátricos y la fibrilación auricular, el libro abarca una amplia variedad de situaciones clínicas de importancia. Además, se examinan aspectos fundamentales como la interpretación del electrocardiograma, la atención inicial al paciente con trauma grave y la evaluación y manejo de urgencias hipertensivas. Con un enfoque práctico y fundamentado en la evidencia, cada capítulo presenta información detallada, pautas de diagnóstico y tratamiento, y referencias bibliográficas para un estudio más profundo. Esta obra se convierte en una herramienta invaluable para aquellos involucrados en la atención de emergencias médicas, brindando una visión integral y actualizada de los aspectos clave en este campo en constante evolución., Una producción de CECOMED - Centro de Educación Continua Médica.

Las interacciones ecológicas que ocurren en los diferentes ecosistemas permiten un flujo de energía y nutrientes. Pueden ser intraespecíficas o interespecíficas y categorizarse en mutualismos, cuando las especies involucradas se ven beneficiadas; o en antagonismos, cuando existen efectos negativos derivados de su interacción. Existen plantas parásitas con capacidad de establecerse sobre otras plantas para nutrirse y desarrollarse, como los muérdagos, que son un grupo de plantas que tienen un impacto negativo en las especies forestales y arbolado urbano, ya que pueden afectar su desarrollo. A pesar de lo anterior, también puede beneficiar a otros organismos como aves o mamíferos al proveerles alimento, refugio o sitios de anidación. El presente trabajo describe casos y características de estas interacciones.

Antecedentes y Objetivos: El dosel de las selvas húmedas alberga una gran diversidad de plantas epífitas y hormigas arborícolas. Estos grupos biológicos suelen ser estudiados individualmente sin considerar sus interacciones, pero pueden establecer mutualismos complejos y especializados como los jardines de hormigas, los cuales son un ensamble particular de angiospermas epífitas cultivadas por hormigas. El objetivo de este trabajo fue presentar el primer listado comentado y los mapas de distribución de las epífitas y una especie de hormiga que se asocian en jardines de hormigas reportados en el sureste de México.Métodos: Se recopilaron registros de ocurrencia de las especies de angiospermas epífitas y hormigas en la literatura especializada, registros de herbario y fotografías disponibles en bases de datos en línea nacionales e internacionales, así como observaciones en campo. Resultados clave: Un total de ocho especies de epífitas pertenecientes a seis familias de angiospermas y la hormiga Azteca gnava, fueron documentados en el sureste de México (de Veracruz a Quintana Roo), siendo los límites entre los estados de Tabasco y Chiapas en donde se concentra la mayor diversidad. Epidendrum flexuosum fue la especie más representativa de los jardines de hormigas en el sureste de México.Conclusiones: Los jardines de hormigas son sistemas complejos y su estudio en México es incipiente, por lo que se espera que este trabajo incentive tanto el estudio como la conservación de las especies del dosel y sus mutualismos.

Purpose: Our proof-of-concept study tested the feasibility of virtual testing using child assessments that were originally validated for in-person testing only. Method: Ten adult–child dyads were assigned to complete both in-person and virtual tests of language, cognition, and narratives. Child participants fell between the ages of 4 and 8 years; adult participants were speech-language clinicians or researchers with experience in administering child assessments. Half of child participants were Spanish–English bilinguals, and half were monolingual English speakers. Results: Results showed similar performance across in-person and virtual modalities on all assessments. Recommendations for adapting, administering, and scoring virtual measures with linguistically diverse children are discussed. Conclusions: Although additional research on virtual assessment is needed, our results open opportunities for appropriate remote assessment, particularly for bilingual children, who may not have in-person access to speech-language pathology services.

This study aims to assess the COVID-19 partial lockdown influence on air quality in the Metropolitan Region Rio de Janeiro (MRRJ). Criteria pollutants (CO, SO2, O3, and NO2) sampled at four sites under vehicular and industrial influences were investigated, between March 1st to April 12th, 2019 and 2020. Results showed that the partial lockdown affected pollutant levels through emission sources reduction. High decreased concentrations were observed for SO2, NO2, and CO; while an increase in the ozone concentration was recorded. Pollutant time variation evaluations helped to understand the trend and sources in the different periods. Este estudo tem como objetivo avaliar a influência do lockdown parcial da COVID-19 na qualidade do ar na Região Metropolitana do Rio de Janeiro (RMRJ). Poluentes de critérios (CO, SO2, O3 e NO2) amostrados em quatro locais sob influências veiculares e industriais foram investigados, entre 1º de março e 12 de abril de 2019 e 2020. Os resultados mostraram que o bloqueio parcial afetou os níveis de poluentes por meio da redução das fontes de emissão. Reduções nas concentrações de SO2, NO2 e CO foram registradas; enquanto um aumento na concentração de ozônio foi observado. As avaliações da variação temporal dos poluentes ajudaram a entender a tendência e as fontes nos diferentes períodos.

In the downtown area of Rio de Janeiro, Brazil, an urban mobility plan was implemented between 2011 and 2016 due to 2014 FIFA World Cup and the 2016 Olympic Games. This study aimed to evaluate the environmental benefits achieved by this urban mobility plan by comparing two periods: 2013 (before the megaevents) and 2017 (after the megaevents). Energy consumption and emissions from buses were estimated, and regulated pollutants (O3, CO, PM10, and PM2.5) were monitored. According to the calculations, NOx was the most emitted pollutant (60%). A 25% reduction levels for all pollutants was observed in 2017 compared to 2013. The reorganization of traffic shortened the bus routes, resulting in less fuel consumption (8%) and emissions. The annual mean concentrations of air pollutants (PM10, PM2.5, and CO) also decreased, thereby improving air quality. However, the levels of O3 increased, possibly owing to the reduction of NOx levels., No centro da cidade do Rio de Janeiro, Brasil, foi implementado um plano de mobilidade urbana entre 2011 e 2016 devido à Copa do Mundo FIFA 2014 e aos Jogos Olímpicos 2016. Este estudo teve como objetivo avaliar os benefícios ambientais alcançados por este plano de mobilidade urbana comparando dois períodos: 2013 (antes dos megaeventos) e 2017 (depois dos megaeventos). O consumo de energia e as emissões dos ônibus foram estimados e os poluentes regulamentados (O3, CO, PM10 e PM2,5) foram monitorados. De acordo com os cálculos, o NOx foi o poluente mais emitido (60%). Observou-se em 2017 uma redução de 25% de todos os poluentes em relação a 2013. A reorganização do tráfego encurtou as rotas de ônibus, resultando em menor consumo de combustível (8%) e emissões. As concentrações médias anuais de poluentes atmosféricos (PM10, PM2,5 e CO) também diminuíram, melhorando assim a qualidade do ar. No entanto, os níveis de O3 aumentaram, possivelmente devido à redução dos níveis de NOx.

The sharing economy concept has been recognized as a social and economic phenomenon. It is presented as a path to sustainability and disruptive business models, especially regarding urban mobility. Thus, according to the Web of Sciestate of the artforms, this study aims to establish state of the art in scientific production on service management in the shared economy company UBER. Therefore, a systematic literature review was used as a research method and analysis of a textual corpus of 36 scientific articles. For the corpus selection, we used the search string (“shar* economy” AND uber AND service). We applied the filters of document type: article and language: English, and the analysis of the journals’ reputation. The software HistCite, VOSViewer, Iramuteq, Gephi, Scimat and the online tool map chart were used for map chart analysis. As a result, it is possible to verify the research elite on the subject, leading journals, the annual and geographic distribution of the corpus, and clusters of words, in addition to elaborating a typology centered on the main themes addressed by the articles in the corpus, called “Consumer experience”, “Organizational behavior”, “Management” and “Information technology”, all under the aegis of the “Knowledge management” and “Smart Industry” scope.

PurposeUse of genomic sequencing is increasing at a pace that requires technological solutions to effectively meet the needs of a growing patient population. We developed GUÍA, a web-based application, to enhance the delivery of genomic results and related clinical information to patients and families.MethodsGUÍA development occurred in 5 phases: formative research, content development, user interface design, stakeholder/community member input, and web application development. Development was informed by qualitative research involving parents (N=22) whose children underwent genomic testing. Participants enrolled in the NYCKidSeq pilot study (N=18) completed structured feedback interviews post-result disclosure using GUÍA. Genetic specialists, researchers, patients, and community stakeholders provided their perspectives on GUÍA’s design to ensure technical, cultural, and literacy appropriateness.ResultsNYCKidSeq participants responded positively to the use of GUÍA to deliver their children’s results. All participants (N=10) with previous experience with genetic testing felt GUÍA improved result disclosure, and 17 (94%) participants said the content was clear.ConclusionsGUÍA communicates complex genomic information in an understandable and personalized manner. Initial piloting demonstrated GUÍA’s utility for families enrolled NYCKidSeq pilot study. Findings from the NYCKidSeq clinical trial will provide insight into GUÍA’s effectiveness in communicating results among diverse, multilingual populations.

In this prospective study, we examined the link between positive family relationships during childhood and adolescence and health and happiness three decades later in middle adulthood. We also investigated the stability of positive family relationships into adulthood as one possible pathway underlying this long-term association. Data were from the Fullerton Longitudinal Study (FLS) an ongoing investigation in the United States initiated in 1979 when children were aged 1 year with the most recent data collected in 2017. A cross-informant methodology was employed in which mothers and children independently completed the Positive Family Relationships (PFR) scale annually when children were of ages 9-17 years. When study children reached age 38, they reported on their current PFR, global health, and comprehensive happiness. Structural equation models revealed that children's perceptions of the family during childhood and adolescence predicted both their health and happiness at age 38. Mothers' perspectives of PFR predicted greater adult children's health, but did not predict their happiness. Associations were independent of family socioeconomic status, gender, intelligence, and extraversion. Moreover, while controlling for behavior problems (proxy for health) and happiness at age 17, both children's and mothers' early PFR related to PFR at 38 years, which in turn, predicted increased health and happiness at age 38, thus providing evidence for a pathway underlying this long-term connection. Our prospective findings revealed that families in which members get along well and support each other during the childhood and adolescent years furnish a foundation for positive family relationships in adulthood, which are associated with greater health and happiness. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

É irrefutável que existe uma lacuna no que tange às informações acerca do Programa de Educação Tutorial (PET) em todo o país. Frente a isso, o grupo PET Mentor Aprendiz, que atua na Universidade Federal de Pernambuco (UFPE), criou um recenseamento para agregar conhecimento e explorar os programas a nível nacional. O trabalho consiste em apresentar uma pesquisa censitária de integrantes ativos dos PETs no Brasil, tendo em vista a atualização de informações insuficientes existentes no Ministério da Educação (MEC). Dessa forma, é possível ampliar a visão do impacto gerado pelo PET na vida dos estudantes nas Instituições de Ensino Superior (IES) em todo o país e salientar como o programa é capaz de proporcionar experiências teóricas e práticas sob o princípio da indissociabilidade que contribuem para o campo acadêmico e profissional. A avaliação no final do questionário reúne o ponto de vista de cada envolvido nos grupos PETs em todo o Brasil.

Risk variants in the apolipoprotein L1 (APOL1 [OMIM 603743]) gene on chromosome 22 are common in individuals of West African ancestry and confer increased risk of kidney failure for people with African ancestry and hypertension. Whether disclosing APOL1 genetic testing results to patients of African ancestry and their clinicians affects blood pressure, kidney disease screening, or patient behaviors is unknown.To determine the effects of testing and disclosing APOL1 genetic results to patients of African ancestry with hypertension and their clinicians.This pragmatic randomized clinical trial randomly assigned 2050 adults of African ancestry with hypertension and without existing chronic kidney disease in 2 US health care systems from November 1, 2014, through November 28, 2016; the final date of follow-up was January 16, 2018. Patients were randomly assigned to undergo immediate (intervention) or delayed (waiting list control group) APOL1 testing in a 7:1 ratio. Statistical analysis was performed from May 1, 2018, to July 31, 2020.Patients randomly assigned to the intervention group received APOL1 genetic testing results from trained staff; their clinicians received results through clinical decision support in electronic health records. Waiting list control patients received the results after their 12-month follow-up visit.Coprimary outcomes were the change in 3-month systolic blood pressure and 12-month urine kidney disease screening comparing intervention patients with high-risk APOL1 genotypes and those with low-risk APOL1 genotypes. Secondary outcomes compared these outcomes between intervention group patients with high-risk APOL1 genotypes and controls. Exploratory analyses included psychobehavioral factors.Among 2050 randomly assigned patients (1360 women [66%]; mean [SD] age, 53 [10] years), the baseline mean (SD) systolic blood pressure was significantly higher in patients with high-risk APOL1 genotypes vs those with low-risk APOL1 genotypes and controls (137 [21] vs 134 [19] vs 133 [19] mm Hg; P = .003 for high-risk vs low-risk APOL1 genotypes; P = .001 for high-risk APOL1 genotypes vs controls). At 3 months, the mean (SD) change in systolic blood pressure was significantly greater in patients with high-risk APOL1 genotypes vs those with low-risk APOL1 genotypes (6 [18] vs 3 [18] mm Hg; P = .004) and controls (6 [18] vs 3 [19] mm Hg; P = .01). At 12 months, there was a 12% increase in urine kidney disease testing among patients with high-risk APOL1 genotypes (from 39 of 234 [17%] to 68 of 234 [29%]) vs a 6% increase among those with low-risk APOL1 genotypes (from 278 of 1561 [18%] to 377 of 1561 [24%]; P = .10) and a 7% increase among controls (from 33 of 255 [13%] to 50 of 255 [20%]; P = .01). In response to testing, patients with high-risk APOL1 genotypes reported more changes in lifestyle (a subjective measure that included better dietary and exercise habits; 129 of 218 [59%] vs 547 of 1468 [37%]; P .001) and increased blood pressure medication use (21 of 218 [10%] vs 68 of 1468 [5%]; P = .005) vs those with low-risk APOL1 genotypes; 1631 of 1686 (97%) declared they would get tested again.In this randomized clinical trial, disclosing APOL1 genetic testing results to patients of African ancestry with hypertension and their clinicians was associated with a greater reduction in systolic blood pressure, increased kidney disease screening, and positive self-reported behavior changes in those with high-risk genotypes.ClinicalTrials.gov Identifier: NCT02234063.

PURPOSE: There is a critical need for genomic medicine research that reflects and benefits socioeconomically and ancestrally diverse populations. Disparities in research populations persist, however, highlighting that traditional study designs and materials may be insufficient or inaccessible to all groups. New approaches can be gained through collaborations with patient/community stakeholders. Although some benefits of stakeholder engagement are recognized, routine incorporation into design and implementation of genomics research has yet to be realized. METHODS: The NIH-funded Clinical Sequencing Evidence-Generating Research (CSER) consortium required stakeholder engagement as a dedicated project component. Each CSER project planned and carried out stakeholder engagement activities with differing goals and expected outcomes. Examples were curated from each project to highlight engagement strategies and outcomes throughout the research lifecycle from development through dissemination. RESULTS: Projects tailored strategies to individual study needs, logistical constraints, and other challenges. Lessons learned include starting early with engagement efforts across project stakeholder groups and planned flexibility to enable adaptations throughout the project lifecycle. CONCLUSION: Each CSER project utilized more than one approach to engage with relevant stakeholders, resulting in numerous adaptations and tremendous value-added throughout the full research lifecycle. Incorporation of community stakeholder insight improves the outcomes and relevance of genomic medicine research.

Introduction: Hypoxic-ischemic encephalopathy(HIE) is a major cause of morbidity, mortality, and severe neurodevelopmental disability in term neonates. The development of a treatment strategy that could provide neuroprotection is still required. We have shown that agonism of endothelin B(ETB) receptors mediated through sovateltide provides neuroprotection and enhances neurovascular remodeling in several neuropathological conditions. Hypothesis: We hypothesize that administering sovateltide alone or as an adjuvant therapy with hypothermia could provide neuroprotection by reducing oxidative stress and promoting cell survival post-HIE brain injury. Methods: Sprague-Dawley male and female rat pups were grouped separately and were divided into 5 different subgroups (1) Control; (2) HIE+Vehicle; (3) HIE+Hypothermia; (4) HIE+sovateltide; and (5) HIE+sovateltide+hypothermia. HIE was induced by ligating the right carotid artery on a postnatal day (PND) 7, followed by hypoxia for 120 min and hypothermia (32-34°C) for 5 h. On PND 7, sovateltide (5 μg/kg, ICV) was injected after hypoxic-ischemic injury. Pups were euthanized on PND 10. Brains were isolated, and ETB receptors, VEGF, NGF, cell death and oxidative stress makers - malondialdehyde (MDA), glutathione (GSH), and superoxide dismutase (SOD) were assessed. Results: Animals receiving sovateltide showed a significant (p Conclusion: Sovateltide alone or as an adjunct to hypothermia exerts neuroprotective effects in HIE-induced brain injury in rat pups, suggesting sovateltide could be a potential therapeutic agent for neonatal HIE.

Aim: To increase Spanish speakers' representation in genomics research, accessible study materials on genetic topics must be made available in Spanish. Materials & methods: The Clinical Sequencing Evidence-Generating Research consortium is evaluating genome sequencing for underserved populations. All sites needed Spanish translation of recruitment materials, surveys and return of results. Results: We describe our process for translating site-specific materials, as well as shared measures across sites, to inform future efforts to engage Spanish speakers in research. Conclusion: In translating and adapting study materials for roughly 1000 Spanish speakers across the USA, and harmonizing translated measures across diverse sites, we overcame numerous challenges. Translation should be performed by professionals. Studies must allocate sufficient time, effort and budget to translate and adapt participant materials.

Therapeutic hypothermia with modest results is the only treatment currently available for neonatal Hypoxic ischemic encephalopathy (HIE). Endothelin B (ETB) receptors in the brain are shown to have neural restorative capacity. ETB receptors agonist sovateltide alone or as an adjuvant therapy may enhance neurovascular remodeling in HIE. Sprague-Dawley rat pups were grouped based on treatments into (1) Control; (2) HIE + Vehicle; (3) HIE + Hypothermia; (4) HIE + sovateltide; and (5) HIE + sovateltide + hypothermia. HIE was induced on postnatal day (PND) 7, followed by sovateltide (5 µg/kg) intracerebroventricular injection and/or hypothermia. On PND 10, brains were analyzed for the expression of vascular endothelial growth factor (VEGF), nerve growth factor (NGF), ETB receptors, oxidative stress and cellular damage markers. Vehicle-treated animals had high oxidative stress level as indicated by an increase in lipid peroxidation factor, malondialdehyde, and decreased antioxidants, reduced glutathione and superoxide dismutase, compared to control. These effects were reversed in sovateltide alone (p

This study investigated bidirectional associations between observed parent-youth coalitions-wherein one parent and a child align themselves against the other parent-and family hostilities as they evolved in real-time during triadic family conflict discussions. Participants were 102 families with an adolescent child (50% girls, MEn este estudio se investigaron las asociaciones bidireccionales entre las alianzas observadas entre padres y adolescentes -en las cuales un padre y un hijo se alinean contra el otro padre- y las hostilidades familiares a medida que se desarrollaban en tiempo real durante discusiones triádicas por conflictos familiares. Los participantes fueron 102 familias con un hijo adolescente (el 50% niñas, edad promedio = 15.3 años, desviación típica = 0.8). Utilizando modelos multinivel con tiempo de retardo, evaluamos las influencias inmediatas y temporales de la hostilidad (dentro de las relaciones conyugales y de las relaciones entre madre y adolescente y padre y adolescente) en las alianzas entre padres y adolescentes y viceversa. Guiados por las teorías de sensibilización, también investigamos si los antecedentes de agresión conyugal moderaron estas asociaciones. Los resultados indicaron varias asociaciones simultáneas que respaldaron la interconexión de las alianzas intergeneracionales y los intercambios agresivos y críticos dentro de las relaciones de varias familias. Además, los efectos asociados con el tiempo demostraron que la hostilidad dentro del área conyugal y de padres y adolescentes precedió a alianzas posteriores, y también que las alianzas precedieron a la hostilidad, particularmente en el área de padres y adolescentes. Los resultados también demostraron que la agresión conyugal modera las asociaciones temporales entre la hostilidad conyugal de los padres y las alianzas entre los padres y los jóvenes. Estos patrones destacan las asociaciones dinámicas entre las hostilidades y las alianzas, las maneras en la que dichos patrones se desbordan entre los subsistemas familiares, y cómo estas dos influencias insidiosas en las interacciones de los padres con sus hijos adolescentes pueden reforzarse mutuamente. Este estudio sirve como base para los esfuerzos de intervención, ya que identifica los patrones y las secuencias de las hostilidades familiares que rodean a las alianzas entre los padres y los adolescentes durante la adolescencia.

The complexity of genomic medicine can be streamlined by implementing some form of clinical decision support (CDS) to guide clinicians in how to use and interpret personalized data, however, it is not yet clear which strategies are best suited for this purpose. In this study, we used implementation science to identify common strategies for applying provider-based CDS interventions across six genomic medicine clinical research projects funded by an NIH consortium. Each project’s strategies were elicited via a structured survey derived from a typology of implementation strategies, the Expert Recommendations for Implementing Change (ERIC), and follow-up interviews guided by both implementation strategy reporting criteria and a planning framework, RE-AIM, to obtain more detail about implementation strategies and desired outcomes. We found that, on average, the three pharmacogenomics implementation projects used more strategies than the disease-focused projects. Overall, projects had four implementation strategies in common, however, operationalization of each differed in accordance with each study’s implementation outcomes. These four common strategies may be important for precision medicine program implementation, and pharmacogenomics may require more integration into clinical care. Understanding how and why these strategies were successfully employed could be useful for others implementing genomic or precision medicine programs in different contexts.

The error-related negativity (ERN), a well-established neural marker of anxiety, reflects enhanced attention to internal threat signals. While attention to threat plays a crucial role in the development and maintenance of anxiety, it is unclear how attentional control influences the ERN-anxiety association. To address this, 37 youths (M(age) = 10.89 years) completed self-report measures of attentional control and anxiety symptoms. To obtain ERN amplitude, youth completed a flanker task while simultaneous EEG was collected. Attentional control, specifically attentional shifting rather than focusing, moderated the relation between ERN amplitude and anxiety. Youth who displayed smaller neural responses to making an error and higher ability to shift attention experienced lower levels of anxiety, relative to those who exhibited larger neural responses to making an error or lower attention-shifting ability. These findings highlight that response magnitude to internal threat and ability to flexibly shift attention may jointly contribute to anxiety in youth.