Do help-seeking adolescents report more psychotic-like experiences than young adults on the 16-item version of the prodromal questionnaire (PQ-16)?

AIM: To compare psychotic-like experiences (PLEs) in adolescents and young adults referred to the Mental Health Services (MHSs). METHODS: Participants scored the 16-item Prodromal Questionnaire (PQ-16) as part of the intake procedure. Data on the Diagnostic and Statistical Manual of Mental Disorders (DSM) classification and demographic data were collected. RESULTS: The PQ-16 was completed by 13 783 respondents (mean age 24.63 years, SD = 6.09; 62.6% female). Overall, the scores on the PQ-16 were not higher for adolescents (11-17 years; m = 4.84, SD = 3.62) than for young adults (18-35 years; m = 5.47, SD = 3.85). On PQ-16 item level, adolescents reported seeing and hearing things more than adults did. Across all age groups, males scored lower on the PQ-16 than females. Specifically, adolescent males scored lower than other participants. For adolescents and young adults alike, PQ-16 scores were higher for participants with borderline personality disorder, PTSD, and mood disorder than for those with other DSM classifications. CONCLUSIONS: Although help-seeking adolescents did not score higher on the PQ-16 than help-seeking young adults, more of them reported perceptual anomalies. Irrespective of age, participants with borderline personality disorder, PTSD and mood disorder scored higher on the PQ-16 than those with other DSM classifications.

Screened Out: Ethically Managing Sunscreen Misinformation by Social Media Influencers.

Rampant social media use allows individuals and organizations to broadcast their views to scoping audiences with minimal requirements for vetting or validating shared information. We discuss the impact of disinformation transmitted via social media and use the recent example of false information broadcast concerning sunscreens recently reported in the Wall Street Journal. We also highlight the ethical consequences of social media influencers who disseminate unchecked information and the need for healthcare professionals to be involved to enhance accountability, goodwill, and truthfulness.

Correlates of viral suppression among sexual minority men and transgender women living with HIV in Mpumalanga, South Africa.

Sexual minority men (SMM) and transgender women in South Africa engage in HIV care at lower rates than other persons living with HIV and may experience population-specific barriers to HIV treatment and viral suppression (VS). As part of a pilot trial of an SMM-tailored peer navigation (PN) intervention in Ehlanzeni district, South Africa, we assessed factors associated with ART use and VS among SMM at trial enrolment. A total of 103 HIV-positive SMM and transgender women enrolled in the pilot trial. Data on clinical visits and ART adherence were self-reported. VS status was verified through laboratory analysis (<1000 copies/ml). We assessed correlates of VS at baseline using Poisson generalized linear model (GLM) with a log link function, including demographic, psychosocial, clinical, and behavioral indicators. Among participants, 52.4% reported ART use and only 42.2% of all participants had evidence of VS. Of the 49.5% who reported optimal engagement in HIV care (consistent clinic visits with pills never missed for ≥ 4 consecutive days) in the past 3-months, 56.0% were virally suppressed. In multivariable analysis, SMM were significantly more likely to be virally suppressed when they were ≥ 25 years of age (Adjusted prevalence ratio [APR] = 2.0, CI 95%:1.0-3.8); in a relationship but not living with partner, as compared to married, living together, or single (APR = 1.7, CI 95%:1.0-2.7), and optimally engaged in care (APR = 2.1, 95% CI:1.3-3.3). Findings indicate a need for targeted treatment and care support programming, especially for SMM and transgender women who are young and married/living with their partners to improve treatment outcomes among this population.

SRPK3 Is Essential for Cognitive and Ocular Development in Humans and Zebrafish, Explaining X-Linked Intellectual Disability.

OBJECTIVE: Intellectual disability is often the outcome of neurodevelopmental disorders and is characterized by significant impairments in intellectual and adaptive functioning. X-linked intellectual disability (XLID) is a subset of these disorders caused by genetic defects on the X chromosome, affecting about 2 out of 1,000 males. In syndromic form, it leads to a broad range of cognitive, behavioral, ocular, and physical disabilities. METHODS: Employing exome or genome sequencing, here we identified 4 missense variants (c.475C > G; p.H159D, c.1373C > A; p.T458N, and c.1585G > A; p.E529K, c.953C > T; p.S318L) and a putative truncating variant (c.1413_1414del; p.Y471*) in the SRPK3 gene in 9 XLID patients from 5 unrelated families. To validate SRPK3 as a novel XLID gene, we established a knockout (KO) model of the SRPK3 orthologue in zebrafish. RESULTS: The 8 patients ascertained postnatally shared common clinical features including intellectual disability, agenesis of the corpus callosum, abnormal eye movement, and ataxia. A ninth case, ascertained prenatally, had a complex structural brain phenotype. Together, these data indicate a pathological role of SRPK3 in neurodevelopmental disorders. In post-fertilization day 5 larvae (free swimming stage), KO zebrafish exhibited severe deficits in eye movement and swim bladder inflation, mimicking uncontrolled ocular movement and physical clumsiness observed in human patients. In adult KO zebrafish, cerebellar agenesis and behavioral abnormalities were observed, recapitulating human phenotypes of cerebellar atrophy and intellectual disability. INTERPRETATION: Overall, these results suggest a crucial role of SRPK3 in the pathogenesis of syndromic X-linked intellectual disability and provide new insights into brain development, cognitive and ocular dysfunction in both humans and zebrafish. ANN NEUROL 2024.

Ethics of Residency Programs and Fellowships that Electively Withdraw from the NRMP Match.

The National Resident Matching Program (NRMP), known as "The Match (TM)," facilitates the placement of medical graduates into residency and fellowship programs in the United States. Programs may opt out of TM for various reasons. The selective and intermittent withdrawal of programs from TM raises ethical concerns surrounding fairness, transparency, beneficence, autonomy, and justice for applicants. We discuss these issues, present the history behind TM, and offer suggestions to promote fairness.

Doxxing and cyberbullying in dermatology.

Doxxing, a type of cyberbullying, occurs when an individual's personal information is shared without consent and with malintent. Doxxing can be seen as a form of vigilantism, a way to hold others accountable for their actions or opinions; however, this form of justice can have catastrophic impacts on the victim, especially physicians. Since the COVID-19 pandemic, where physicians and health care providers strongly led public health advocacy efforts on social media, the frequency of doxxing and cyberbullying has increased. Diversity, equity, and inclusion (DEI) initiatives have also recently sparked controversy in dermatology and medicine, where advocates for DEI and those opposed to DEI initiatives have also been doxxed. This behavior is incredibly taxing on an individual's mental health, with substantial negative implications on a person's social, personal, and professional life. We discuss the ethical considerations of doxxing and avenues for better protecting physicians.

Relevance and ethical issues of diversity equity and inclusion programs, circa 2024-2025.

A recent resolution with approximately 100 signatories entitled "Sunsetting All Diversity, Equity, and Inclusion (DEI) Programs" administered by the American Academy of Dermatology (AAD) sparked controversial debate within the field. Despite the AAD voting against the proposal to eliminate DEI initiatives, many underrepresented medical groups wondered how to move forward and create safe spaces for everyone. We discuss the relevance of DEI programs in today's society and the ethical challenges that may arise. We conclude with actionable recommendations on how organizations can improve their current DEI strategies to ensure they are more inclusive and not perceived as discriminatory.

How variable are the classic ERP effects during sentence processing? A systematic resampling analysis of the N400 and P600 effects.

Although event-related potential (ERP) research on language processing has capitalized on key, theoretically influential components such as the N400 and P600, their measurement properties-especially the variability in their temporal and spatial parameters-have rarely been examined. The current study examined the measurement properties of the N400 and P600 effects elicited by semantic and syntactic anomalies, respectively, during sentence processing. We used a bootstrap resampling procedure to randomly draw many thousands of resamples varying in sample size and stimulus count from a larger sample of 187 participants and 40 stimulus sentences of each type per condition. Our resampling investigation focused on three issues: (a) statistical power; (b) variability in the magnitudes of the effects; and (c) variability in the temporal and spatial profiles of the effects. At the level of grand averages, the N400 and P600 effects were both robust and substantial. However, across resamples, there was a high degree of variability in effect magnitudes, onset times, and scalp distributions, which may be greater than is currently appreciated in the literature, especially for the P600 effects. These results provide a useful basis for designing future studies using these two well-established ERP components. At the same time, the results also highlight challenges that need to be addressed in future research (e.g., how best to analyze the ERP data without engaging in such questionable research practices as p-hacking).

Exploring the Effect of Specimen Size on Elastic Properties of Fused-Filament-Fabrication-Printed Polycarbonate and Thermoplastic Polyurethane.

Additive manufacturing (AM) is often used to create designs inspired by topology optimization and biological structures, yielding unique cross-sectional geometries spanning across scales. However, manufacturing defects intrinsic to AM can affect material properties, limiting the applicability of a uniform material model across diverse cross-sections. To examine this phenomenon, this paper explores the influence of specimen size and layer height on the compressive modulus of polycarbonate (PC) and thermoplastic polyurethane (TPU) specimens fabricated using fused filament fabrication (FFF). Micro-computed tomography imaging and compression testing were conducted on the printed samples. The results indicate that while variations in the modulus were statistically significant due to both layer height and size of the specimen in TPU, variations in PC were only statistically significant due to layer height. The highest elastic modulus was observed at a 0.2 mm layer height for both materials across different sizes. These findings offer valuable insights into design components for FFF, emphasizing the importance of considering mechanical property variations due to feature size, especially in TPU. Furthermore, locations with a higher probability of failure are recommended to be printed closer to the print bed, especially for TPU, because of the lower void volume fraction observed near the heated print bed.

Endoscopic Versus Traditional Thoracic Discectomy: A Multicenter Retrospective Case Series and Meta-Analysis.

BACKGROUND AND OBJECTIVES: Surgical treatment for symptomatic thoracic disc herniations (TDH) involves invasive open surgical approaches with relatively high complication rates and prolonged hospital stays. Although advantages of full endoscopic spine surgery (FESS) are well-established in lumbar disc herniations, data are limited for the endoscopic treatment of TDH despite potential benefits regarding surgical invasiveness. The aim of this study was to provide a comprehensive evaluation of potential benefits of FESS for the treatment of TDH. METHODS: PubMed, MEDLINE, EMBASE, and Scopus were systematically searched for the term "thoracic disc herniation" up to March 2023 and study quality appraised with a subsequent meta-analysis. Primary outcomes were perioperative complications, need for instrumentation, and reoperations. Simultaneously, we performed a multicenter retrospective evaluation of outcomes in patients undergoing full endoscopic thoracic discectomy. RESULTS: We identified 3190 patients from 108 studies for the traditional thoracic discectomy meta-analysis. Pooled incidence rates of complications were 25% (95% CI 0.22-0.29) for perioperative complications and 7% (95% CI 0.05-0.09) for reoperation. In this cohort, 37% (95% CI 0.26-0.49) of patients underwent instrumentation. The pooled mean for estimated blood loss for traditional approaches was 570 mL (95% CI 477.3-664.1) and 7.0 days (95% CI 5.91-8.14) for length of stay. For FESS, 41 patients from multiple institutions were retrospectively reviewed, perioperative complications were reported in 4 patients (9.7%), 4 (9.7%) required revision surgery, and 6 (14.6%) required instrumentation. Median blood loss was 5 mL (IQR 5-10), and length of stay was 0.43 days (IQR 0-1.23). CONCLUSION: The results suggest that full endoscopic thoracic discectomy is a safe and effective treatment option for patients with symptomatic TDH. When compared with open surgical approaches, FESS dramatically diminishes invasiveness, the rate of complications, and need for prolonged hospitalizations. Full endoscopic spine surgery has the capacity to alter the standard of care for TDH treatment toward an elective outpatient surgery.

Ultrastructural changes in chronic inflammatory enteropathies-a comparison between dogs and humans.

Chronic inflammatory enteropathies (CIEs) are an important group of diseases in dogs and involve complex pathogenetic aspects. Endoscopy and histopathology are vital for documenting the disease but are less useful for subclassifying CIEs and predicting the response to treatment. However, healing of the mucosal disease process (deep remission) and ultrastructural evaluation of the mucosa have received little attention in canine CIE. Given that canine CIE shares many similarities with inflammatory bowel diseases (IBDs) in human patients-and presents a good spontaneous disease model for human IBD-this perspective article evaluates the literature on ultrastructural lesions in canine CIE and human IBD and offers future directions for the study of ultrastructural mucosal lesions in canine CIE. Such lesions might have a higher sensitivity of detection than structural changes revealed upon light microscopy and may even precede or remain after the resolution of the clinical signs and histologic lesions.