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Background: Many patients treated using hemodialysis remain anemic despite exogenous erythropoietin therapy, suggesting that the anemia experienced by these patients is multifactorial in cause. Iron deficiency, infection, inflammation, and malnutrition have been implicated in this process. Additionally, secondary hyperparathyroidism has been associated with anemia in adults, but few data exist about this topic in children.Study Design: Cross-sectional retrospective.Setting& Participants: Children treated in hemodialysis centers (N = 588) within the Centers for Medicare & Medicaid Services' 2002 Clinical Performance Measures Project.Predictor: Intact parathyroid hormone (iPTH) levels assessed in October, November, and December 2001 and categorized as quintiles.Outcomes& Measurements: Achievement of serum hemoglobin level > or = 11 g/dL was assessed using Poisson regression adjusting for sex, age, race, dialysis vintage, vascular access type, single-pool Kt/V, serum albumin level, normalized protein catabolic rate, calcium-phosphorus product, and erythropoietin alfa dose.Results: Using the second quintile (iPTH, 103-224 pg/mL) as the reference quintile, there was no association between iPTH quintile and achievement of the hemoglobin goal: quintile 1 prevalence ratio, 1.0 (95% CI, 0.9-1.2); quintile 3, 0.95 (95% CI, 0.8-1.1); quintile 4, 0.99 (95% CI, 0.8-1.2); and quintile 5, 0.97 (95% CI, 0.8-1.1). Only serum albumin level >/= 3.5 g/dL (bromocresol green assay method) or > or = 3.2 g/dL (bromocresol purple assay method) was significantly associated with meeting the hemoglobin goal: 1.4 (95% CI, 1.2-1.6).Limitations: The simultaneous collection of iPTH and hemoglobin limits causal inference. Iron stores and iron therapy are potential confounders not accounted for in this study.Conclusions: In the largest study of this topic in children, no association was found between iPTH level and achievement of a hemoglobin level > or = 11 g/dL. Serum albumin level was associated strongly with achievement of the hemoglobin goal. [ABSTRACT FROM AUTHOR]

Development in any domain is often characterized by increasingly abstract representations. Recent evidence in the domain of shape recognition provides one example; between 18 and 24 months children appear to build increasingly abstract representations of object shape [Smith, L. B. (2003). Learning to recognize objects. Psychological Science, 14, 244-250]. Abstraction is in part simplification because it requires the removal of irrelevant information. At the same time, part of generalization is ignoring irrelevant differences. The resulting prediction is this: simplification may enable generalization. Four experiments asked whether simple training instances could shortcut the process of abstraction and directly promote appropriate generalization. Toddlers were taught novel object categories with either simple or complex training exemplars. We found that children who learned with simple objects were able to generalize according to shape similarity, typically relevant for early object categories, better than those who learned with complex objects. Abstraction is the product of learning; using simplified - already abstracted instances - can short-cut that learning, leading to robust generalization. [ABSTRACT FROM AUTHOR]

Two experiments examined the relation between early object name learning and the ability to represent objects by their abstract shapes. In Experiment 1, two-year-old children with productive vocabularies in the bottom 20th percentile--'late talkers'--were compared with (1) same-age children with larger vocabularies, and (2) younger children matched for productive vocabulary, on their ability to recognize named common objects. Object categories were represented two ways: by lifelike, perceptually rich toys, and by grey caricatures of those objects' abstract shapes. All 3 groups recognized lifelike objects equally well. Both typically-developing control groups were better than late talkers at recognizing shape caricatures of objects whose names they knew. In Experiment 2, late talkers and age-matched controls identified named objects represented by lifelike toys and by duplicates of those toys covered in grey textured paint. Age-matched controls knew more of the object names overall, but both they and the late talkers performed equally well on both kinds of test objects. Thus, late talkers had some difficulty in Experiment 1 recognizing objects from abstract shape cues, but no difficulty in Experiment 2 when the shape cues were realistic. The findings imply a relation between the growth of productive vocabulary and the emergence of the ability to represent object categories by abstract shape. [ABSTRACT FROM AUTHOR]

Previous research has focused on evaluating the nouns and verbs in parents' input through type/token ratios. This research offers an additional means of evaluating parent speech by first examining the frequencies of individual nouns, verbs and descriptors and second examining the learning task presented to children. Study 1 examines 25 transcripts from the CHILDES database of English-speaking parents' speech to children at five developmental levels ranging from 0; 11 to 2; 11 in age. Study 2 examines 50 transcripts from the CHILDES database of Mandarin-speaking caregivers' speech to children ranging from 1; 9 to 2; 3 in age. The results suggest that the patterns of frequency for individual nouns and individual verbs are different, but that the frequency patterns for nouns and the frequency patterns for verbs are similar in English and Mandarin. Further, this research suggests that in both languages the nouns in parents' input are similarly organized: the most frequent nouns spoken to children tend to name solid objects that share a similar shape. In contrast verbs' meanings in both languages tend to include more variable conceptual relations. [ABSTRACT FROM AUTHOR]

Ten children with specific language impairment and 10 children with normal language development were asked to describe objects so that a listener could select them. Each trial targeted two out of a group of three toys. The targeted objects were identical or were similar in size or color. Children in the two groups did not differ in referential success, although children in both groups found the size items more difficult. Content analysis of the messages did reveal differences in the referential strategies used most frequently. Children with specific language impairment were more likely to mention the attributes of each object separately, rather than to describe the characteristics common to a pair of objects. Children in both groups talked about separate objects more often when talking about size than about color or object type. Use of this strategy could indicate the effects of attentional capacity on children's solutions to communication tasks. [ABSTRACT FROM AUTHOR]

Mindfulness catalyzes health behavior change. Yet, interoception is dysregulated in depression, potentially impairing behavioral activation. We examined the mediating role of interoceptive appreciation, as measured by how much one trusts and listens to internal bodily signals, on behavior change. Primary care patients with depression, anxiety, or stress disorders related to chronic illness were randomized to Mindfulness Training for Primary Care (MTPC) using the Mindful Behavior Change curriculum or a low-dose mindfulness comparator. Participants (N = 274) completed the Multidimensional Assessment of Interoceptive Awareness (MAIA) at 0 and 8 weeks. At week 7, participants chose a health behavior action plan. During weeks 8-10, participants reported their action plan initiation (API) level. We investigated the effect of MTPC on API level (MTPC-API), the mediating role of interoceptive appreciation (Body Listening [MAIA-BL] + Trusting [MAIA-T]), and baseline depression severity as a moderator. MTPC had a significant direct effect on API. Interoceptive appreciation (MAIA-BL + MAIA-T) had a significant indirect effect on API (CI=0.15-0.56). Without depression (n = 76), MAIA-BL partially mediated MTPC-API (CI=0.02-0.87). With moderate-to-severe depression (n = 132), MAIA-T partially mediated MTPC-API (CI=0.01-0.85). Interoceptive appreciation helps people listen to motivating bodily signals. In depression, regaining body trust may be an important step on a mindful path towards change., Competing Interests: Declaration of competing interest The authors have no financial conflicts of interest to declare., (Copyright © 2024. Published by Elsevier B.V.)

This article introduces the Journal of Speech, Language, and Hearing Research Special Issue: Selected Papers From the 2022 Apraxia Kids Research Symposium. The field of childhood apraxia of speech (CAS) has developed significantly in the past 15 years, with key improvements in understanding of basic biology including genetics, neuroscience, and computational modelling; development of diagnostic tools and methods; diversity of evidence-based interventions with increasingly rigorous experimental designs; and understanding of impacts beyond impairment-level measures. Papers in this special issue not only review and synthesize the some of the substantial progress to date but also present novel findings addressing critical research gaps and adding to the overall body of knowledge. A second aim of this prologue is to report the current research needs in CAS, which arose from symposium discussions involving researchers, clinicians, and Apraxia Kids community members (including parents of children with CAS). Four primary areas of need emerged from discussions at the symposium. These were: (a) What questions should we ask? (b) Who should be in the research? (c) How do we conduct the research? and (d) How do we move from research to practice? Across themes, symposium attendees emphasized the need for CAS research to better account for the diversity of people with CAS and improve the timeliness of implementation of high-level evidence-based practice across the lifespan. It is our goal that the articles and prologue discussion in this special issue provide an appreciation of advancements in CAS research and an updated view of the most pressing needs for future research.

Given the proven benefits of screening to reduce diabetic ketoacidosis (DKA) likelihood at the time of stage 3 type 1 diabetes diagnosis, and emerging availability of therapy to delay disease progression, type 1 diabetes screening programmes are being increasingly emphasised. Once broadly implemented, screening initiatives will identify significant numbers of islet autoantibody-positive (IAb + ) children and adults who are at risk of (confirmed single IAb + ) or living with (multiple IAb + ) early-stage (stage 1 and stage 2) type 1 diabetes. These individuals will need monitoring for disease progression; much of this care will happen in non-specialised settings. To inform this monitoring, JDRF in conjunction with international experts and societies developed consensus guidance. Broad advice from this guidance includes the following: (1) partnerships should be fostered between endocrinologists and primary-care providers to care for people who are IAb + ; (2) when people who are IAb + are initially identified there is a need for confirmation using a second sample; (3) single IAb + individuals are at lower risk of progression than multiple IAb + individuals; (4) individuals with early-stage type 1 diabetes should have periodic medical monitoring, including regular assessments of glucose levels, regular education about symptoms of diabetes and DKA, and psychosocial support; (5) interested people with stage 2 type 1 diabetes should be offered trial participation or approved therapies; and (6) all health professionals involved in monitoring and care of individuals with type 1 diabetes have a responsibility to provide education. The guidance also emphasises significant unmet needs for further research on early-stage type 1 diabetes to increase the rigour of future recommendations and inform clinical care., (© 2024. American Diabetes Association and European Association for the Study of Diabetes.)

Producing recognizable words is a difficult motor task; a one-syllable word can require the coordination of over 80 muscles. Thus, it is not surprising that the development of word productions in infancy lags considerably behind receptive language and is a known limiting factor in language development. A large literature has focused on the vocal apparatus, its articulators, and language development. There has been limited study of the relations between non-speech motor skills and the quality of early speech productions. Here we present evidence that the spontaneous vocalizations of 9- to 24-month-old infants recruit extraneous, synergistic co-activations of hand and head movements and that the temporal precision of the co-activation of vocal and extraneous muscle groups tightens with age and improved recognizability of speech. These results implicate an interaction between the muscle groups that produce speech and other body movements and provide new empirical pathways for understanding the role of motor development in language acquisition. RESEARCH HIGHLIGHTS: The spontaneous vocalizations of 9- to 24-month-old infants recruit extraneous, synergistic co-activations of hand and head movements. The temporal precision of these hand and head movements during vocal production tighten with age and improved speech recognition. These results implicate an interaction between the muscle groups producing speech with other body movements. These results provide new empirical pathways for understanding the role of motor development in language acquisition., (© 2024 The Authors. Developmental Science published by John Wiley & Sons Ltd.)

Background and Objectives: Asthma is a common, potentially serious childhood chronic condition that disproportionately afflicts Black children. Hospitalizations and emergency department (ED) visits for asthma can often be prevented. Nearly half of children with asthma are covered by Medicaid, which should facilitate access to care to manage and treat symptoms. We provide new evidence on racial disparities in asthma hospitalizations and ED visits among Medicaid-enrolled children., Methods: We used comprehensive Medicaid claims data from the Transformed Medicaid Statistical Information System. Our study population included 279 985 Medicaid-enrolled children with diagnosed asthma. We identified asthma hospitalizations and ED visits occurring in 2019. We estimated differences in the odds of asthma hospitalizations and ED visits for non-Hispanic Black versus non-Hispanic white children, adjusting for sex, age, Medicaid eligibility group, Medicaid plan type, state, and rurality., Results: In 2019, among Black children with asthma, 1.2% had an asthma hospitalization and 8.0% had an asthma ED visit compared with 0.5% and 3.4% of white children with a hospitalization and ED visit, respectively. After adjusting for other characteristics, the rates for Black children were more than twice the rates for white children (hospitalization adjusted odds ratio 2.45, 95% confidence interval 2.23-2.69; ED adjusted odds ratio 2.42; 95% confidence interval 2.33-2.51)., Conclusions: There are stark racial disparities in asthma hospitalizations and ED visits among Medicaid-enrolled children with asthma. To diminish these disparities, it will be important to implement solutions that address poor quality care, discriminatory treatment in health care settings, and the structural factors that disproportionately expose Black children to asthma triggers and access barriers., (Copyright © 2024 by the American Academy of Pediatrics.)

Context.—: Syphilis, a reemerging disease caused by the spirochete Treponema pallidum, is becoming more frequent in surgical pathology and hematopathology practices. Hematopathologists typically receive lymph node biopsies from patients with syphilis who have localized or diffuse lymphadenopathy. Occasionally, syphilis infection in the aerodigestive tract can show a prominent lymphoplasmacytic infiltrate and mimic lymphoma. Besides the varying and occasional atypical morphology, the fact that clinical suspicion tends to be low or absent when histologic evaluation is requested adds to the importance of making this diagnosis., Objective.—: To summarize histologic features of syphilitic lymphadenitis and syphilis lesions in the aerodigestive tract, and to review differential diagnosis and potential diagnostic pitfalls., Data Sources.—: Literature review via PubMed search., Conclusions.—: Characteristic histologic findings in syphilitic lymphadenitis include thickened capsule with plasma cell-rich inflammatory infiltrate, reactive follicular and paracortical hyperplasia with prominent lymphoplasmacytic infiltrate, and vasculitis. Lymph nodes, however, can show a number of other nonspecific histologic features, which frequently makes the diagnosis quite challenging. In the aerodigestive tract, syphilis is characterized by plasma cell-rich infiltrates. Immunohistochemistry for T pallidum is the preferred method for detecting spirochetes; however, this immunohistochemical stain shows cross-reactivity with other treponemal and commensal spirochetes. Differential diagnosis of syphilis in lymph nodes and the aerodigestive tract is broad and includes reactive, infectious, and neoplastic entities. Pathologists should be aware of the histologic features of syphilis and keep this challenging entity in the differential diagnosis., (© 2024 College of American Pathologists.)

The development of sparse edge coding in the mammalian visual cortex depends on early visual experience. In humans, there are multiple indicators that the statistics of early visual experiences has unique properties that may support these developments. However, there are no direct measures of the edge statistics of infant daily-life experience. Using head-mounted cameras to capture egocentric images of young infants and adults in the home, we found infant images to have distinct edge statistics relative to adults. For infants, scenes with sparse edge patterns-few edges and few orientations-dominate. The findings implicate biased early input at the scale of daily life that is likely specific to the early months after birth and provide insights into the quality, amount, and timing of the visual experiences during the foundational developmental period for human vision.

Competing Interests: The authors have no relevant financial interest in the products or companies described in this article.

Traditionally, the exogenous control of gaze by external saliencies and the endogenous control of gaze by knowledge and context have been viewed as competing systems, with late infancy seen as a period of strengthening top-down control over the vagaries of the input. Here we found that one-year-old infants control sustained attention through head movements that increase the visibility of the attended object. Freely moving one-year-old infants (n = 45) wore head-mounted eye trackers and head motion sensors while exploring sets of toys of the same physical size. The visual size of the objects, a well-documented salience, varied naturally with the infant's moment-to-moment posture and head movements. Sustained attention to an object was characterized by the tight control of head movements that created and then stabilized a visual size advantage for the attended object for sustained attention. The findings show collaboration between exogenous and endogenous attentional systems and suggest new hypotheses about the development of sustained visual attention., (© 2023 The Authors. Developmental Science published by John Wiley & Sons Ltd.)

Our objective was to assess changes in preventive services use before and during the COVID-19 pandemic. We obtained secondary survey data from the National Health Interview Survey for 2019 and 2021. We examined, six preventive services among all adults. Descriptive and multivariate analyses assessed changes in preventive service use among adults and by race/ethnicity for 2019 and 2021 (drawing from an unweighted sample of 60 843 weighted to be 386.2 million across both years). We used Ordinary least squares estimation to conduct a difference-in-differences analysis that assessed changes in service use for non-white racial/ethnic groups relative to changes for white non-Hispanic adults between 2019 and 2021. We found preventive services use declined overall for each screening service assessed. Asian adults experienced the largest declines relative to white adults for "well visit within the last year" (-7.45 percentage points (pp) relative to white adults), "blood pressure screening within the last year" (-7.85 pp), and "mammograms within the last year" (-12.3 pp). While adults in other racial/ethnic groups did not experience significant declines in preventive services use relative to white adults between 2019 and 2021, pre-existing disparities remained for Hispanic and American Indian/Alaska Native (AIAN) adults compared to white adults. In conclusion, preventive service use declined in the first years of the COVID-19 public health emergency, and existing disparities in access for Hispanic and AIAN adults continued. Future research should investigate barriers Asian adults may face in obtaining access to preventive services after the conclusion of the public health emergency and federal pandemic-related protections., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Research on infant and toddler reaching has shown evidence for motor planning after the initiation of the reaching action. However, the reach action sequence does not begin after the initiation of a reach but rather includes the initial visual fixations onto the target object occurring before the reach. We developed a paradigm that synchronizes head-mounted eye-tracking and motion capture to determine whether the latency between the first visual fixation on a target object and the first reaching movement toward the object predicts subsequent reaching behavior in toddlers. In a corpus of over one hundred reach sequences produced by 17 toddlers, we found that longer fixation-reach latencies during the pre-reach phase predicted slower reaches. If the slowness of an executed reach indicates reach difficulty, then the duration of pre-reach planning would be correlated with reach difficulty. However, no relation was found with pre-reach planning duration when reach difficulty was measured by usual factors and independent of reach duration. The findings raise important questions about the measurement of reach difficulty, models of motor control, and possible developmental changes in the relations between pre-planning and continuously unfolding motor plans throughout an action sequence., (© 2023 The Authors. Infancy published by Wiley Periodicals LLC on behalf of International Congress of Infant Studies.)

Objective: To develop a reliable and valid short form of the State Anxiety Subscale of the State-Trait Anxiety Inventory for Children (STAI-CH) in the Environmental Determinants of Diabetes in the Young (TEDDY) study., Methods: A Development Sample of 842 10-year-old TEDDY children completed the STAI-CH State Subscale about their type 1 diabetes (T1D) risk. The best 6 items (three anxiety-present and three anxiety-absent) for use in a short form (SAI-CH-6) were identified via item-total correlations. SAI-CH-6 reliability was examined in a Validation Sample (n = 257) of children who completed the full 20-item STAI-CH State Subscale and then again in an Application Sample (n = 2,710) who completed only the SAI-CH-6. Expected associations between the children's SAI-CH-6 scores and country of residence, sex, T1D family history, accuracy of T1D risk perception, worry about getting T1D, and their parents' anxiety scores were examined., Results: The SAI-CH-6 was reliable (α = 0.81-0.87) and highly correlated with the full 20-item STAI-CH State Subscale (Development Sample: r = 0.94; Validation Sample: r = 0.92). SAI-CH-6 scores detected significant differences in state anxiety symptoms associated with T1D risk by country, T1D family history, accuracy of T1D risk perception, and worry about getting T1D and were correlated with the child's parent's anxiety., Conclusion: The SAI-CH-6 appears useful for assessing children's state anxiety symptoms when burden and time limitations prohibit the use of the STAI-CH. The utility of the SAI-CH-6 in older children with and without chronic conditions needs to be assessed., (© The Author(s) 2023. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Global salinization of freshwaters is adversely affecting biotic communities and ecosystem processes. We reviewed six decades (1960-2020) of literature published on animal responses to increased salinities across different taxonomic and ecological contexts and identified knowledge gaps. From 585 journal articles, we characterized 5924 responses of mollusks, crustaceans, zooplankton, non-arthropod invertebrates (NAI), insects, fishes, and amphibians to salinization. Insects and fishes were the most studied taxa; Na + and Cl - were the most studied ions - . Collectively, concentrations of the ions examined typically spanned five orders of magnitude. Species' invasiveness was a key motivation for studying mollusks, crustaceans, and fishes; threats of urbanization and road salts were key motivations for studying NAI, zooplankton, and amphibians. Laboratory studies were more common than field studies for most taxa. Focal life stages in laboratory studies varied widely but juveniles and adults were represented similarly in field studies. Studies of mollusks, NAI, and crustacean focused on adults; studies of zooplankton, insects, fishes, and amphibians focused on juveniles. Organismal- and population-level responses measuring solute uptake, internal chemistry, body condition, or ion concentrations predominated laboratory studies; population- and assemblage-level responses measuring abundance, spatial distribution, or assemblage composition predominated field studies. Negative responses to salinization predominated but positive and unimodal responses were apparent across all taxa and organizational levels. Key topics for further research include a) salinity responses by more taxa, b) responses to especially toxic ions (i.e., potassium, bicarbonate, sulfate, magnesium), c) mechanisms causing positive and unimodal responses, d) traits underpinning responses, e) effects transcending organizational levels, f) ion-specific response thresholds, and g) interactions between salinity and other stressors. Our review suggests inter-taxa variation in sensitivity to salinization reflects occurrence of certain biological traits, including gill-breathing, semi-permeable skin, multiple life stages, and limited mobility. We propose a traits-based framework to predict salinization sensitivity from shared traits. This evolutionary approach could inform management aimed at preventing or reducing adverse impacts of freshwater salinization., Competing Interests: Declaration of competing interest The authors declare there are no competing or conflicts of interest., (Copyright © 2023 The Author(s). Published by Elsevier B.V. All rights reserved.)

Objective: To examine the proportion of healthcare visits are delivered by nurse practitioners and physician assistants versus physicians and how this has changed over time and by clinical setting, diagnosis, and patient demographics., Design: Cross-sectional time series study., Setting: National data from the traditional Medicare insurance program in the USA., Participants: Of people using Medicare (ie, those older than 65 years, permanently disabled, and people with end stage renal disease), a 20% random sample was taken., Main Outcome Measures: The proportion of physician, nurse practitioner, and physician assistant visits in the outpatient and skilled nursing facility settings delivered by physicians, nurse practitioners, and physician assistants, and how this proportion varies by type of visit and diagnosis., Results: From 1 January 2013 to 31 December 2019, 276 million visits were included in the sample. The proportion of all visits delivered by nurse practitioners and physician assistants in a year increased from 14.0% (95% confidence interval 14.0% to 14.0%) to 25.6% (25.6% to 25.6%). In 2019, the proportion of visits delivered by a nurse practitioner or physician assistant varied across conditions, ranging from 13.2% for eye disorders and 20.4% for hypertension to 36.7% for anxiety disorders and 41.5% for respiratory infections. Among all patients with at least one visit in 2019, 41.9% had one or more nurse practitioner or physician assistant visits. Compared with patients who had no visits from a nurse practitioner or physician assistant, the likelihood of receiving any care was greatest among patients who were lower income (2.9% greater), rural residents (19.7%), and disabled (5.6%)., Conclusion: The proportion of visits delivered by nurse practitioners and physician assistants in the USA is increasing rapidly and now accounts for a quarter of all healthcare visits., Competing Interests: Competing interests: All authors have completed the ICMJE uniform disclosure form at www.icmje.org/disclosure-of-interest/ and declare: no support from any organisation for the submitted work; no financial relationships with any organizations that might have an interest in the submitted work in the previous three; no other relationships or activities that could appear to have influenced the submitted work., (© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

An efficient synthesis of cyclohexenes has been achieved from easily accessible tetrahydropyrans via a tandem 1,5-hydride shift-aldol condensation. We discovered that readily available aluminium reagents, e.g. Al 2 O 3 or Al(O t Bu) 3 are essential for this process, promoting the 1,5-hydride shift with complete regio- and enantiospecificity (in stark contrast to results obtained under basic conditions). The mild conditions, coupled with multiple methods available to access the tetrahydropyran starting materials makes this a versatile method with exceptional functional group tolerance. A wide range of cyclohexenes (>40 examples) have been prepared, many in enantiopure form, showing our ability to selectively install a substituent at each position around the newly forged cyclohexene ring. Experimental and computational studies revealed that aluminium serves a dual role in facilitating the hydride shift, activating both the alkoxide nucleophile and the electrophilic carbonyl group., (© 2023 The Authors. Angewandte Chemie International Edition published by Wiley-VCH GmbH.)

Sertoli cells support the development of sperm and the function of various somatic cells in the interstitium between the tubules. Sertoli cells regulate the function of the testicular vasculature and the development and function of the Leydig cells that produce testosterone for fertility and virility. However, the Sertoli cell-derived factors that regulate these cells are largely unknown. To define potential mechanisms by which Sertoli cells could support testicular somatic cell function, we aimed to identify Sertoli cell-enriched proteins in the testicular interstitial fluid (TIF) between the tubules. We previously resolved the proteome of TIF in mice and humans and have shown it to be a rich source of seminiferous tubule-derived proteins. In the current study, we designed bioinformatic strategies to interrogate relevant proteomic and genomic datasets to identify Sertoli cell-enriched proteins in mouse and human TIF. We analysed proteins in mouse TIF that were significantly reduced after one week of acute Sertoli cell ablation in vivo and validated which of these are likely to arise primarily from Sertoli cells based on relevant mouse testis RNASeq datasets. We used a different, but complementary, approach to identify Sertoli cell-enriched proteins in human TIF, taking advantage of high-quality human testis genomic, proteomic and immunohistochemical datasets. We identified a total of 47 and 40 Sertoli cell-enriched proteins in mouse and human TIF, respectively, including 15 proteins that are conserved in both species. Proteins with potential roles in angiogenesis, the regulation of Leydig cells or steroidogenesis, and immune cell regulation were identified. The data suggests that some of these proteins are secreted, but that Sertoli cells also deposit specific proteins into TIF via the release of extracellular vesicles. In conclusion, we have identified novel Sertoli cell-enriched proteins in TIF that are candidates for regulating somatic cell-cell communication and testis function., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 O’Donnell et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: Efforts to prevent the spread of the coronavirus led to dramatic reductions in nonemergency medical care services during the first several months of the COVID-19 pandemic. Delayed or missed screenings can lead to more advanced stage cancer diagnoses with potentially worse health outcomes and exacerbate preexisting racial and ethnic disparities. The objective of this analysis was to examine how the pandemic affected rates of breast and colorectal cancer screenings by race and ethnicity., Methods: We analyzed panels of providers that placed orders in 2019-2020 for mammogram and colonoscopy cancer screenings using electronic health record (EHR) data. We used a difference-in-differences design to examine the extent to which changes in provider-level mammogram and colonoscopy orders declined over the first year of the pandemic and whether these changes differed across race and ethnicity groups., Results: We found considerable declines in both types of screenings from March through May 2020, relative to the same months in 2019, for all racial and ethnic groups. Some rebound in screenings occurred in June through December 2020, particularly among White and Black patients; however, use among other groups was still lower than expected., Conclusions: This research suggests that many patients experienced missed or delayed screenings during the first few months of the pandemic, which could lead to detrimental health outcomes. Our findings also underscore the importance of having high-quality data on race and ethnicity to document and understand racial and ethnic disparities in access to care., (© 2023 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.)

Introduction: Vaccine hesitancy is a global health threat undermining control of many vaccine-preventable diseases. Patient-level education has largely been ineffective in reducing vaccine concerns and increasing vaccine uptake. We built and evaluated a personalized vaccine risk communication website called LetsTalkShots in English, Spanish and French (Canadian) for vaccines across the lifespan. LetsTalkShots tailors lived experiences, credible sources and informational animations to disseminate the right message from the right messenger to the right person, applying a broad range of behavioral theories., Methods: We used mixed-methods research to test our animation and some aspects of credible sources and personal narratives. We conducted 67 discussion groups ( n = 325 persons), stratified by race/ethnicity (African American, Hispanic, and White people) and population (e.g., parents, pregnant women, adolescents, younger adults, and older adults). Using a large Ipsos survey among English-speaking respondents ( n = 2,272), we tested animations aligned with vaccine concerns and specific to population (e.g., parents of children, parents of adolescents, younger adults, older adults)., Results: Discussion groups provided robust feedback specific to each animation as well as areas for improvements across animations. Most respondents indicated that the information presented was interesting (85.5%), clear (96.0%), helpful (87.0%), and trustworthy (82.2%)., Discussion: Tailored vaccine risk communication can assist decision makers as they consider vaccination for themselves, their families, and their communities. LetsTalkShots presents a model for personalized communication in other areas of medicine and public health., Competing Interests: DS has received research support from Merck and serves on advisory boards for Merck, Janssen Moderna, and Sanofi. MD has received research support from Merck. KT was employed by Bonnemaison. LB was employed by Bucci-Hepworth Health Services Inc. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Salmon, Dudley, Brewer, Shaw, Schuh, Proveaux, Jamison, Forr, Goryn, Breiman, Orenstein, Kao, Josiah Willcock, Cantu, Decea, Mowson, Tsubata, Bucci, Lawler, Watkins, Moore, Fugett, Fugal, Tovar, Gay, Cary, Vann, Smith, Kan, Mankel, Beekun, Smith, Adams, Harvey and Orton.)

High-grade B-cell lymphoma with 11q aberrations (LBL-11q) resembles Burkitt lymphoma (BL), is negative for MYC rearrangement, and harbors chromosome 11q aberrations. Rare cases of high-grade B-cell lymphoma with concurrent MYC rearrangement and 11q aberrations (HGBCL-MYC-11q) have been described. In this study, we report the clinicopathologic, cytogenetic, and molecular findings in 4 such cases. Diagnoses were made on tissue or bone marrow biopsies. Karyotype, fluorescence in situ hybridization, genomic microarray analyses, and next-generation sequencing were performed. All patients were male (median age, 39 years). Three cases were diagnosed as BL, while one was diagnosed as diffuse large B-cell lymphoma. Karyotypes (available in 2 patients) were complex. In 1 patient, copy number analysis showed gains at 1q21.1-q44 and 13q31.3 and loss of 13q34, abnormalities typically seen in BL. All of our cases showed 2 or more mutations that are recurrent in BL, including ID3, TP53, DDX3X, CCND3, FBXO1, and MYC. Two cases showed a GNA13 mutation, commonly seen in LBL-11q. Cases of HGBCL-MYC-11q display overlapping morphologic and immunophenotypic, as well as cytogenetic and molecular features between BL and LBL-11q, with a mutational landscape enriched for mutations recurrent in BL. Concurrent MYC rearrangement with 11q abnormalities is important to recognize, especially as it has implications for their classification., (Copyright © 2023 Elsevier Inc. All rights reserved.)

Objective: To examine geographic variation in preventable hospitalizations among Medicaid/CHIP-enrolled children and to test the association between preventable hospitalizations and a novel measure of racialized economic segregation, which captures residential segregation within ZIP codes based on race and income simultaneously., Data Sources: We supplement claims and enrollment data from the Transformed Medicaid Statistical Information System (T-MSIS) representing over 12 million Medicaid/CHIP enrollees in 24 states with data from the Public Health Disparities Geocoding Project measuring racialized economic segregation., Study Design: We measure preventable hospitalizations by ZIP code among children. We use logistic regression to estimate the association between ZIP code-level measures of racialized economic segregation and preventable hospitalizations, controlling for sex, age, rurality, eligibility group, managed care plan type, and state., Data Extraction Methods: We include children ages 0-17 continuously enrolled in Medicaid/CHIP throughout 2018. We use validated algorithms to identify preventable hospitalizations, which account for characteristics of the pediatric population and exclude children with certain underlying conditions., Principal Findings: Preventable hospitalizations vary substantially across ZIP codes, and a quarter of ZIP codes have rates exceeding 150 hospitalizations per 100,000 Medicaid-enrolled children per year. Preventable hospitalization rates vary significantly by level of racialized economic segregation: children living in the ZIP codes that have the highest concentration of low-income, non-Hispanic Black residents have adjusted rates of 181 per 100,000 children, compared to 110 per 100,000 for children in ZIP codes that have the highest concentration of high-income, non-Hispanic white residents (p < 0.01). This pattern is driven by asthma-related preventable hospitalizations., Conclusions: Medicaid-enrolled children's risk of preventable hospitalizations depends on where they live, and children in economically and racially segregated neighborhoods-specifically those with higher concentrations of low-income, non-Hispanic Black residents-are at particularly high risk. It will be important to identify and implement Medicaid/CHIP and other policies that increase access to high-quality preventive care and that address structural drivers of children's health inequities., (© 2022 Health Research and Educational Trust.)

Actions in the world elicit data for learning and do so in a stream of interconnected events. Here, we provide evidence on how toddlers with their parent sample information by acting on toys during exploratory play. We observed 10 min of free-flowing and unconstrained object exploration of by toddlers (mean age 21 months) and parents in a room with many available objects ( n = 32). Borrowing concepts and measures from the study of narratives, we found that the toy selections are not a string of unrelated events but exhibit a suite of what we call coherence statistics: Zipfian distributions, burstiness and a network structure. We discuss the transient memory processes that underlie the moment-to-moment toy selections that create this coherence and the role of these statistics in the development of abstract and generalizable systems of knowledge. This article is part of the theme issue 'Concepts in interaction: social engagement and inner experiences'.

Mosquitoes are responsible for the death and debilitation of millions of people every year due to the pathogens they can transmit while blood feeding. While a handful of mosquitoes, namely those in the Aedes, Anopheles, and Culex genus, are the dominant vectors, many other species belonging to different genus are also involved in various pathogen cycles. Sabethes cyaneus is one of the many poorly understood mosquito species involved in the sylvatic cycle of Yellow Fever Virus. Here, we report the expression profile differences between male and female of Sa.cyaneus salivary glands (SGs). We find that female Sa.cyaneus SGs have 165 up-regulated and 18 down-regulated genes compared to male SGs. Most of the up-regulated genes have unknown functions, however, odorant binding proteins, such as those in the D7 protein family, and mucins were among the top 30 genes. We also performed various in vitro activity assays of female SGs. In the activity analysis we found that female SG extracts inhibit coagulation by blocking factor Xa and has endonuclease activity. Knowledge about mosquitoes and their physiology are important for understanding how different species differ in their ability to feed on and transmits pathogens to humans. These results provide us with an insight into the Sabethes SG activity and gene expression that expands our understanding of mosquito salivary glands., (Copyright © 2022. Published by Elsevier Ltd.)

The data for early object name learning is often conceptualized as a problem of mapping heard names to referents. However, infants do not hear object names as discrete events but rather in extended interactions organized around goal-directed actions on objects. The present study examined the statistical structure of the nonlinguistic events that surround parent naming of objects. Parents and 12-month -old infants were left alone in a room for 10 minutes with 32 objects available for exploration. Parent and infant handling of objects and parent naming of objects were coded. The four measured statistics were from measures used in the study of coherent discourse: (1) a frequency distribution in which actions were frequently directed to a few objects and more rarely to other objects; (2) repeated returns to the high-frequency objects over the 10-minute play period; (3) clustered repetitions, continuity, of actions on objects; and (4) structured networks of transitions among objects in play that connected all the played-with objects. Parent naming was infrequent but related to the statistics of object-directed actions. The implications of the discourse-like stream of actions are discussed in terms of learning mechanisms that could support rapid learning of object names from relatively few name-object co-occurrences.

Toddlers learn words in the context of speech from adult social partners. The present studies quantitatively describe the temporal context of parent speech to toddlers about objects in individual real-world interactions. We show that at the temporal scale of a single play episode, parent talk to toddlers about individual objects is predominantly, but not always, clustered. Clustered speech is characterized by repeated references to the same object close in time, interspersed with lulls in speech about the object. Clustered temporal speech patterns mirror temporal patterns observed at longer timescales, and persisted regardless of play context. Moreover, clustered speech about individual novel objects predicted toddlers' learning of those objects' novel names. Clustered talk may be optimal for toddlers' word learning because it exploits domain-general principles of human memory and attention, principles that may have evolved precisely because of the clustered structure of natural events important to humans, including human behavior., Competing Interests: Declaration of Competing Interest None., (Copyright © 2022 Elsevier B.V. All rights reserved.)

A decrease in non-emergent procedure volume was observed during the COVID-19 pandemic to conserve protective equipment, increase hospital capacity, and limit nosocomial infection. Decreasing COVID-19 infection rates, paired with increasing hospital financial pressure and concerns for patient welfare, have prompted the development of guidelines for re-introduction of medically-necessary time-sensitive (MeNTS) procedures. Such protocols have received criticism for potentially perpetuating inequities disfavoring vulnerable populations. Limited access to testing supplies and protective equipment, coupled with higher incidence of medical comorbidities attributable to social determinants of health, disadvantages vulnerable populations in seemingly objective prioritization schema. Here, we detail both an analysis of current guidelines as well as strategies aimed at mitigating these disparities (including prioritizing essential infrastructure workers, implementing questionnaires, improving scheduling communication, tracking patients via ZIP codes and insurance status, facilitating post-operative rehabilitation, acknowledging physician bias, and favoring lottery selection over first-come, first-served). These guidelines and strategies can apply to future pandemics and even routine prioritization schema.

Androgens such as testosterone and dihydrotestosterone (DHT) are essential for male sexual development, masculinisation, and fertility. Testosterone is produced via the canonical androgen production pathway and is essential for normal masculinisation and testis function. Disruption to androgen production can result in disorders of sexual development (DSD). In the canonical pathway, 17β-hydroxysteroid dehydrogenase type 3 (HSD17B3) is viewed as a critical enzyme in the production of testosterone, performing the final conversion required. HSD17B3 deficiency in humans is associated with DSD due to low testosterone concentration during development. Individuals with HSD17B3 mutations have poorly masculinised external genitalia that can appear as ambiguous or female, whilst having internal Wolffian structures and testes. Recent studies in mice deficient in HSD17B3 have made the surprising finding that testosterone production is maintained, male mice are masculinised and remain fertile, suggesting differences between mice and human testosterone production exist. We discuss the phenotypic differences observed and the possible other pathways and enzymes that could be contributing to testosterone production and male development. The identification of alternative testosterone synthesising enzymes could inform the development of novel therapies to endogenously regulate testosterone production in individuals with testosterone deficiency.