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AIM: We examined associations among injury severity, white matter structural connectivity within functionally defined brain networks and psychosocial/adaptive outcomes in children with traumatic brain injury (TBI). METHOD: Participants included 58 youths (39 male) with complicated-mild TBI (cmTBI; n = 12, age = 12.6 ± 2.0), moderate/severe TBI (msTBI; n = 16, age = 11.4 ± 2.9) and a comparison group with orthopedic injury (OI; n = 24, age = 11.7 ± 2.1), at least 1 year post-injury. Participants underwent diffusion tensor imaging and parents rated children's behavioral and adaptive function on the CBCL and ABAS-3, respectively. Probabilistic tractography quantified streamline density. Group differences were analyzed for structural connectivity and behavioral outcomes. RESULTS: Groups differed in structural connectivity within regions of the default mode and central executive networks (ps < .05, FDR corrected). The msTBI group displayed decreased connectivity relative to cmTBI and OI, whereas the cmTBI group displayed increased connectivity relative to msTBI and OI. Similar patterns emerged in several behavioral domains. Ordinary least squares path analyses showed that structural connectivity mediated the relationship between injury severity and multiple parent-reported outcomes for msTBI. INTERPRETATION: White matter structural connectivity may explain unique variance in long-term psychosocial and adaptive outcome in children with TBI, particularly in cases of moderate-to-severe injury.

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To investigate the relationship of predisposing, enabling, need, and immigration-related factors to tele-mental health services utilization among California adults, we conducted a secondary analysis of two waves of the California Health Interview Survey (CHIS) collected between 2015 and 2018 (N = 78,345). A series of logistic regression models were conducted to examine correlates and predictors to tele-mental health services use. Approximately 1.3% reported the use of tele-mental health services. Overall, health insurance status, severe psychological distress, perceived need for mental health services, and identifying as Asian, remained strong predictors for tele-mental health service use. When accounting for all factors, we found that being a non-citizen was associated with lower odds of tele-mental health service use (AOR = 0.47, CI = 0.26, 0.87, p < 0.05). These findings suggest that citizenship, resources to access, and perceived need for mental health care collectively are the most significant factors driving the use of tele-mental health services. There is a need to address inequitable access to tele-mental health services among immigrants who do not qualify for healthcare coverage due to citizenship status.

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[This corrects the article on p. 3394 in vol. 15, PMID: 38855702.].

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OBJECTIVES: The purpose of this study was to define current practices related to beta-lactam/beta-lactamase inhibitor (BL/BLI) dose descriptions in hospitals that provide care for pediatric patients and to identify perceived implications of standardizing BL/BLI dose communication and ordering to a total drug-based strategy. METHODS: A 27-item electronic survey was distributed via 4 pediatric pharmacy and infectious diseases listservs. Survey questions pertained to hospital demographics, dosing communication practices, BL/BLI ordering and labeling practices, obstacles to safe BL/BLI use, and the effects of potential standardization to a total drug communication strategy. SPSS was used for quantitative analysis and MAXQDA was used for qualitative analysis. RESULTS: A total of 140 unique survey responses were analyzed after exclusion of incomplete responses and reconciliation of multiple responses from the same institution. Overall, 56.2% of institutions order BL/BLIs by BL component for pediatric patients, and 22% of institutions order by BL component for adult patients. Approximately half (51.8%) of respondents felt that standardizing to total drug would have a negative effect at their institution; perception of potential effect varied based on the institution's ordering strategy. CONCLUSION: Communication and ordering of BL/BLIs is inconsistent across institutions and between pediatric and adult patients. In the short term, the perception is that standardization would compound institutional challenges.

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Prostate cancer (PCa) screening has evolved beyond PSA and digital rectal exam to include multiparametric prostate MRI (mpMRI). Incorporating this advanced imaging tool has further limited the well-established problem of overdiagnosis, aiding in the identification of higher grade, clinically significant cancers. For this reason, mpMRI has become an important part of the diagnostic pathway and is recommended across guidelines in biopsy naïve patients or for patients with prior negative biopsy. This contemporary review evaluates the most recent literature on the role of mpMRI in the screening and diagnosis of prostate cancer. Barriers to utilization of mpMRI still exist including variable access, high cost, and requisite expertise, encouraging evaluation of novel techniques such as biparametric MRI. Future screening and diagnostic practice patterns will undoubtedly evolve as our understanding of novel biomarkers and artificial intelligence improves.

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Transgender/non-binary (TNB) adolescents are at increased risk for mental health concerns, and caregiver awareness is important to facilitate access to care. Yet, limited research has examined caregiver awareness of TNB mental health. Thus, we examined (1) the prevalence of internalizing symptoms (depression, generalized anxiety, separation anxiety, social anxiety) among TNB adolescents and (2) associations between adolescent and caregiver reports of adolescent mental health symptoms. TNB adolescents (N = 75) aged 12-18 and a caregiver were recruited from a multidisciplinary gender clinic in Ohio. Adolescents self-reported their mental health symptoms via the CDI and SCARED. Caregivers reported their perceptions of the adolescent's mental health symptoms via the CASI-5. Descriptive statistics assessed participant characteristics, adolescent self-reported mental health symptoms, and caregiver proxy reports of adolescent mental health symptoms. Pearson's correlations and scatterplots were used to compare adolescent and caregiver reports and McNemar tests assessed if the differences were statistically significant. Most TNB adolescents reported elevated symptoms of depression (59%), generalized anxiety (75%), separation anxiety (52%), and social anxiety (78%). Caregiver and adolescent reports were significantly correlated for depression (r = .36, p = .002), separation anxiety (r = .39, p < .001), and social anxiety (r = .47, p < .001). Caregiver and adolescent reports of generalized anxiety were not significantly correlated (r = .21, p = .08). McNemar tests were significant (all p < .001), such that adolescents' reports met clinical cutoffs far more than their caregivers' reports. CONCLUSIONS: Though adolescent and caregiver reports were low to moderately correlated, youth reports were consistently higher, suggesting the importance of interventions to increase caregiver understanding of TNB adolescent mental health. WHAT IS KNOWN: • Transgender/non-binary adolescents are at high risk for mental health concerns and caregivers are essential to coordinate care. WHAT IS NEW: • This study expands the diagnostic mental health sub-categories examined in transgender/non-binary adolescents, noting elevated symptoms of separation and social anxiety. • Transgender/non-binary adolescents reported more symptoms of depression, generalized anxiety, separation anxiety, and social anxiety than caregivers.

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Starch accumulation in plant tissues provides an important carbon source at night and for regrowth after periods of dormancy and in times of stress. Both ɑ- and ß-amylases (AMYs and BAMs, respectively) catalyze starch hydrolysis, but their functional roles are unclear. Moreover, the presence of catalytically inactive amylases that show starch excess phenotypes when deleted presents an interesting series of questions on how starch degradation is regulated. Plants lacking one of these catalytically inactive ß-amylases, BAM9, were shown to have enhanced starch accumulation when combined with mutations in BAM1 and BAM3, the primary starch degrading BAMs in response to stress and at night, respectively. Importantly, BAM9 has been reported to be transcriptionally induced by stress through activation of SnRK1. Using yeast two-hybrid experiments, we identified the plastid-localized AMY3 as a potential interaction partner for BAM9. We found that BAM9 interacted with AMY3 in vitro and that BAM9 enhances AMY3 activity 3-fold. Modeling of the AMY3-BAM9 complex revealed a previously undescribed N-terminal structural feature in AMY3 that we call the alpha-alpha hairpin that could serve as a potential interaction site. Additionally, AMY3 lacking the alpha-alpha hairpin is unaffected by BAM9. Structural analysis of AMY3 showed that it can form a homodimer in solution and that BAM9 appears to replace one of the AMY3 monomers to form a heterodimer. Collectively these data suggest that BAM9 is a pseudoamylase that activates AMY3 in response to cellular stress, possibly facilitating starch degradation to provide an additional energy source for stress recovery.

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Objective: The coronavirus disease-2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), has had a profound global impact on individual health and well-being in adults and children. While most fully recover from COVID-19, a relatively large subgroup continues to experience persistent physical, cognitive, and emotional/behavioral symptoms beyond the initial infection period. The World Health Organization has termed this phenomenon "Post-COVID-19 Condition" (PCC), better known as "Long COVID." Due to the cognitive and psychosocial symptoms, neuropsychologists often assess and recommend treatment for individuals with Long COVID. However, guidance for neuropsychologists' involvement in clinical care, policy-making, and research has not yet been developed. The authors of this manuscript convened to address this critical gap and develop guidance for clinical neuropsychologists working with patients presenting with Long COVID. Method: Authors include pediatric and adult neuropsychologists with expertise in Long COVID and behavioral health. All authors have been engaged in clinical and research efforts examining the impact of COVID-19. Authors summarized the literature-to-date pertinent to the neuropsychiatric sequelae of Long COVID and developed guidance for neuropsychologists working with individuals with Long COVID. Conclusions: Research findings regarding neuropsychiatric symptoms associated with Long COVID are mixed and limited by methodological differences. As they practice and conduct research, neuropsychologists should remain mindful of the evolving and tenuous nature of the literature.

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The COVID-19 pandemic has exposed and exacerbated the persistent racial and ethnic health disparities in the United States. The pandemic has also had profound spillover effects on other aspects of health and wellbeing, such as mental health, chronic diseases, education, and income, for marginalized groups. In this article, we provide a thorough analysis of the pandemic's impact on racial and ethnic health disproportionalities, highlighting the multifaceted and interrelated factors that contribute to these inequities. We also argue for a renewed focus on health equity in healthcare policy and practice, emphasizing the need for systemic changes that address both the immediate and long-term consequences of these imbalances. We propose a framework for achieving health equity that involves creating equitable systems, care, and outcomes for all individuals, regardless of their race or ethnicity.

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Deficits in memory performance have been linked to a wide range of neurological and neuropsychiatric conditions. While many studies have assessed the memory impacts of individual conditions, this study considers a broader perspective by evaluating how memory recall is differentially associated with nine common neuropsychiatric conditions using data drawn from 55 international studies, aggregating 15,883 unique participants aged 15-90. The effects of dementia, mild cognitive impairment, Parkinson's disease, traumatic brain injury, stroke, depression, attention-deficit/hyperactivity disorder (ADHD), schizophrenia, and bipolar disorder on immediate, short-, and long-delay verbal learning and memory (VLM) scores were estimated relative to matched healthy individuals. Random forest models identified age, years of education, and site as important VLM covariates. A Bayesian harmonization approach was used to isolate and remove site effects. Regression estimated the adjusted association of each clinical group with VLM scores. Memory deficits were strongly associated with dementia and schizophrenia (p < 0.001), while neither depression nor ADHD showed consistent associations with VLM scores (p > 0.05). Differences associated with clinical conditions were larger for longer delayed recall duration items. By comparing VLM across clinical conditions, this study provides a foundation for enhanced diagnostic precision and offers new insights into disease management of comorbid disorders.

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The COVID-19 pandemic had an impact on socialization across all age groups but older adults experienced additional challenges. The purpose of this study was to explore older adults' perceptions and experiences of using technology to support social interactions during the COVID-19 pandemic. We used a qualitative interpretive descriptive approach to understand community dwelling older adults' perceptions of their experiences. We analyzed data using an interpretive thematic analysis approach. Forty-one older adults (median age 74yrs) participated in in-depth interviews exploring experiences of using technology to support their social interaction during the pandemic. Participants discussed the transition towards virtual means of socialization during the pandemic, perceptions of using technology for social interaction, and challenges to adapting to virtual connection. We discuss our findings and the implications for how we introduce technology to older adults.

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This scoping review assesses evidence regarding nurse involvement in health information technology (health IT) design, focusing on the method(s), frequency, capacity, and levels of involvement. The JBI methodology for scoping reviews was used to search seven multidisciplinary databases, yielding 2948 articles. After screening, 98 articles were included for data abstraction. Textual data summary is ongoing. Preliminary findings highlight that nurses are often involved in the late stages of health IT design, with less frequency in the early and pre-programming design phases. Most studies used a user-centered design approach to elicit nurses' views about health IT tools after the tools had been developed, with nearly half being point of care nurses. Increasing nurse involvement in health IT design may help to improve nurses' perceptions of health IT that nurses use.

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The pandemic caused a rapid shift to reliance on technology to meet basic daily needs related to both health and social interaction. As social isolation is known to be a major contributing factor to physiologic decline and psychological morbidity amongst older adults, we sought to study this shift, and conducted a multi-method study including; (1) a cross-sectional telephone survey and in-depth interviews with community dwelling older adults; and (2) interviews with community organizations supporting technology use for older adults. Quantitative data were analysed using descriptive, inferential statistics; qualitative data were analyzed using thematic analysis. Over 800 older adults completed surveys; 41 completed interviews. 26 community organizations shared their perceptions of supporting the rapid shift to virtual technology. Our results emphasize that social pressure plays a core role in adoption of new technology skills. These results are critical to appraise as reliance on digital technologies continues and look to support older adults.

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Cancer self-management interventions improve symptom management and confidence, but few interventions target the complex needs of older adults with cancer and multi-morbidities. Despite growing evidence of digital health tools in cancer care, many such tools have not been co-designed with older adults to ensure that they are tailored to their specific needs. The objective of the study was to design a self-and symptom-management app to support older adults with cancer and multi-morbidities. Utilizing a user-centered design thinking framework, we recruited 2 caregivers and 18 older adults with lived experiences of cancer to design a medium-fidelity app prototype. Participants highlighted the importance of tracking functions to make sense of the information about their symptoms, clear displays, and reminders to mitigate concerns related to polypharmacy. This app will create a 'home base' for symprtom management and support for older adults with cancer and multi-morbidities.

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INTRODUCTION: It is unclear how young adults who do not use tobacco perceive FDA-authorized e-cigarettes for market entry. This study explored the perceptions and use interests of FDA-authorized e-cigarettes among this population to inform policy decision-making. METHODS: We conducted in-depth interviews with young adults in the US, aged 18-29 years, who do not use tobacco (n=25). Participants viewed images of FDA-authorized e-cigarettes and discussed their perceptions and interest in using these products. We used reflexive thematic analysis to analyze interview data. RESULTS: Many participants stated that they were not interested in using FDA-authorized e-cigarettes because they had little interest in using e-cigarettes in general. Additionally, almost all participants found the tobacco flavor and product design of these products unappealing, which further added to their disinterest. Most reported high trust in the FDA and its authorization process for e-cigarette market entry and considered FDA-authorized e-cigarettes safe to use. Most considered FDA-authorized products less harmful than other (unauthorized) e-cigarettes they saw in daily life but were not more interested in using the authorized products. When given the hypothetical scenario where FDA-authorized products come with a variety of fruit and candy flavors, most participants still expressed little interest in using them, mainly due to the high perceived harm from using any e-cigarette products. CONCLUSIONS: Although non-tobacco-using young adults in our study reported low interest in using FDA-authorized e-cigarettes for market entry and e-cigarettes in general, the FDA is recommended to continue to evaluate the impact of flavorings and packages on e-cigarette product appeal to reduce e-cigarette use among young people. The FDA should also examine strategies to effectively communicate the purpose of FDA authorization to the public and emphasize that it does not mean these products are 'approved' or safer than unauthorized products.

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Irritable bowel syndrome (IBS), a disorder of gut-brain interaction, is often comorbid with somatic pain and psychological disorders. Dysregulated signaling of brain-derived neurotrophic factor (BDNF) and its receptor, tropomyosin-related kinase B (TrkB), has been implicated in somatic-psychological symptoms in individuals with IBS. We investigated the association of 10 single-nucleotide polymorphisms (SNPs) in the regulatory 3' untranslated region of neurotrophic receptor tyrosine kinase-2 (NTRK2) kinase domain-deficient truncated isoform (TrkB.T1) and BDNF Val66Met SNP with somatic and psychological symptoms and quality-of-life (QoL) in a cohort from the United States (IBS, n = 464; healthy controls, n = 156). We found that the homozygous recessive genotype (G/G) of rs2013566 in individuals with IBS is associated with worsened somatic symptoms, including headache, back pain, joint pain, muscle pain, and somatization as well as diminished sleep quality, energy level, and overall QoL. Validation using United Kingdom BioBank data confirmed the association of rs2013566 with an increased likelihood of headache. Several SNPs (rs1627784, rs1624327, and rs1147198) showed significant associations with muscle pain in our U.S. cohort. These 4 SNPs are predominantly located in H3K4Me1-enriched regions, suggesting their enhancer and/or transcription regulation potential. Our findings suggest that genetic variation within the 3' untranslated region region of the TrkB.T1 isoform may contribute to comorbid conditions in individuals with IBS, resulting in a spectrum of somatic and psychological symptoms impacting their QoL. These findings advance our understanding of the genetic interaction between BDNF/TrkB pathways and somatic-psychological symptoms in IBS, highlighting the importance of further exploring this interaction for potential clinical applications. PERSPECTIVE: This study aims to understand the genetic effects on IBS-related symptoms across somatic, psychological, and quality-of-life (QoL) domains, validated by United Kingdom BioBank data. The rs2013566 homozygous recessive genotype correlates with worsened somatic symptoms and reduced QoL, emphasizing its clinical significance.

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Infection management in solid organ transplantation poses unique challenges, with a diverse array of potential pathogens and associated antimicrobial therapies. With limited high-quality randomized clinical trials to direct optimal care, therapeutic "myths" may propagate and contribute to suboptimal or excessive antimicrobial use. We discuss 6 therapeutic myths with particular relevance to solid organ transplantation and provide recommendations for infectious diseases clinicians involved in the care of this high-risk population.