Empathy across three generations: From maternal and peer support in adolescence to adult parenting and child outcomes.

This study examined the development of empathic care across three generations in a sample of 184 adolescents in the United States (99 female, 85 male; 58% White, 29% African American, 8% mixed race/ethnicity, 5% other groups), followed from their family of origin at age 13 into their parenting years (through their mid-30s). Mothers' empathic support toward adolescents at age 13 predicted teens' empathy for close friends across adolescence (13-19 years). Participants' empathic support for friends in late adolescence predicted more supportive parenting behavior in adulthood, which in turn was associated with their children's empathy at age 3-8 years. Results suggest that individuals "pay forward" the empathic care they receive from parents, and that skills developed in adolescent friendships may inform later parenting.

Rethinking peer influence and risk taking: A strengths-based approach to adolescence in a new era.

The ways that psychopathology manifests in adolescence have shifted dramatically over the past twenty-five years, with rates of many externalizing behaviors declining substantially while rates of anxiety and depressive disorders have skyrocketed. This paper argues that understanding these changes requires rethinking the field's historically somewhat negative views of intense peer connections, peer influences, and adolescent risk-taking behavior. It is argued that intense peer connections are critical to development, and that peer influence and risk taking have important, often overlooked, adaptive components. The shift in observed manifestations of adolescent psychopathology over this period can be viewed at least partly in terms of a shift away from strong peer connections and toward greater risk aversion. Implications for research and intervention based on a focus on the adaptive aspects of peer influences and risk taking are discussed.

Pathways from adolescent close friendship struggles to adult negative affectivity.

This 19-year prospective study applied a social development lens to the challenge of identifying long-term predictors of adult negative affectivity. A diverse community sample of 169 individuals was repeatedly assessed from age 13 to age 32 using self-, parent-, and peer-reports. As hypothesized, lack of competence establishing and maintaining close friendships in adolescence had a substantial long-term predictive relation to negative affectivity at ages 27-32, even after accounting for prior depressive, anxious, and externalizing symptoms. Predictions also remained robust after accounting for concurrent levels of depressive symptoms, indicating that findings were not simply an artifact of previously established links between relationship quality and depressive symptoms. Predictions also emerged from poor peer relationships within young adulthood to future relative increases in negative affectivity by ages 27-32. Implications for early identification of risk as well as for potential preventive interventions are discussed.

Unique roles of adolescents' friends and fathers in predicting verbal aggression in future adult romantic relationships.

This 20-year prospective study examined verbal aggression and intense conflict within the family of origin and between adolescents and their close friends as predictors of future verbal aggression in adult romantic relationships. A diverse community sample of 154 individuals was assessed repeatedly from age 13 to 34 years using self-, parent, peer, and romantic partner reports. As hypothesized, verbal aggression in adult romantic relationships was best predicted by both paternal verbal aggression toward mothers and by intense conflict within adolescent close friendships, with each factor contributing unique variance to explaining adult romantic verbal aggression. These factors also interacted, such that paternal verbal aggression was predictive of future romantic verbal aggression only in the context of co-occurring intense conflict between an adolescent and their closest friend. Predictions remained robust even after accounting for levels of parental abusive behavior toward the adolescent, levels of physical violence between parents, and the overall quality of the adolescent's close friendship. Results indicate the critical importance of exposure to aggression and conflict within key horizontal relationships in adolescence. Implications for early identification of risk as well as for potential preventive interventions are discussed.

Mechanistic transmission modeling of COVID-19 on the Diamond Princess cruise ship demonstrates the importance of aerosol transmission.

Several lines of existing evidence support the possibility of airborne transmission of coronavirus disease 2019 (COVID-19). However, quantitative information on the relative importance of transmission pathways of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) remains limited. To evaluate the relative importance of multiple transmission routes for SARS-CoV-2, we developed a modeling framework and leveraged detailed information available from the Diamond Princess cruise ship outbreak that occurred in early 2020. We modeled 21,600 scenarios to generate a matrix of solutions across a full range of assumptions for eight unknown or uncertain epidemic and mechanistic transmission factors. A total of 132 model iterations met acceptability criteria (R2 > 0.95 for modeled vs. reported cumulative daily cases and R2 > 0 for daily cases). Analyzing only these successful model iterations quantifies the likely contributions of each defined mode of transmission. Mean estimates of the contributions of short-range, long-range, and fomite transmission modes to infected cases across the entire simulation period were 35%, 35%, and 30%, respectively. Mean estimates of the contributions of larger respiratory droplets and smaller respiratory aerosols were 41% and 59%, respectively. Our results demonstrate that aerosol inhalation was likely the dominant contributor to COVID-19 transmission among the passengers, even considering a conservative assumption of high ventilation rates and no air recirculation conditions for the cruise ship. Moreover, close-range and long-range transmission likely contributed similarly to disease progression aboard the ship, with fomite transmission playing a smaller role. The passenger quarantine also affected the importance of each mode, demonstrating the impacts of the interventions.

Gartland classification concordance of supracondylar fractures among pediatric emergency medicine physicians, radiologists, and orthopedic surgeons.

BACKGROUND: The modified Gartland classification is the most widely accepted grading method of supracondylar humeral fractures among orthopedic surgeons and is relevant to identifying fractures that may require surgery. OBJECTIVE: To assess the interobserver reliability of the modified Gartland classification among pediatric radiologists, pediatric orthopedic surgeons, and pediatric emergency medicine physicians. MATERIALS AND METHODS: Elbow radiographs for 100 children with supracondylar humeral fractures were retrospectively independently graded by two pediatric radiologists, two pediatric orthopedic surgeons, and two pediatric emergency medicine physicians using the modified Gartland classification. A third grader of the same subspecialty served as a tie-breaker as needed to reach consensus. Readers were blinded to one another and to the medical record. The modified Gartland grade documented in the medical record by the treating orthopedic provider was used as the reference standard. Interobserver agreement was assessed using kappa statistics. RESULTS: There was substantial interobserver agreement (kappa = 0.77 [95% CI, 0.69-0.85]) on consensus fracture grade between the three subspecialties. Similarly, when discriminating between Gartland type I and higher fracture grades, there was substantial interobserver agreement between specialties (kappa = 0.77 [95% CI, 0.66-0.89]). The grade assigned by pediatric radiologists differed from the reference standard on 15 occasions, pediatric emergency medicine differed on 19 occasions, and pediatric orthopedics differed on 9 occasions. CONCLUSION: The modified Gartland classification for supracondylar humeral fractures is reproducible among pediatric emergency medicine physicians, radiologists, and orthopedic surgeons.

Adolescent social learning within supportive friendships: Self-disclosure and relationship quality from adolescence to adulthood.

This study examines links between self-disclosure and relationship quality with close friends from adolescence to adulthood. A diverse community sample of adolescents (N = 184) participated in survey and observational measures annually from ages 13 through 29, along with their close friends and romantic partners. Random intercept cross-lagged panel modeling (RICLPM) was used to parse markers of within-individual change from age 13 to 18. Long-term longitudinal path models also investigated cascading associations among self-disclosure and relationship quality, on aggregate, from adolescence to adulthood. Adolescents who reported a higher-quality friendship in a given year demonstrated greater-than-expected increases in self-disclosure the following year, and an adolescent demonstrated high self-disclosure one year reported greater-than-expected increases in friendship quality the following year. Higher mean self-disclosure in adolescence predicted higher mean self-disclosure in adulthood. Results are interpreted as identifying high-quality adolescent friendships as key contexts for developing intimacy-building capacities (i.e. self-disclosure), which sets the stage for satisfying close relationships in adulthood.

Adolescent responses to paternal verbal aggression: Assessing spillover and compensatory processes using random intercept cross-lagged panel models.

INTRODUCTION: Prior research suggests several pathways through which verbal aggression manifests across adolescent relationship contexts, including spillover (continuity of aggression across different relationships) and compensation (offsetting an aggressive relationship with less aggression in other relationships). These pathways vary across timescales in ways that between-person analytic approaches are unlikely to adequately capture. The current study used random intercept cross-lagged panel modeling (RI-CLPM) to examine adolescents' spillover and compensatory responses to paternal verbal aggression. METHODS: Participants were 184 adolescents (53.2% female) from a United States community sample participating in a longitudinal study. Annually from ages 13-17, participants reported on their experiences of verbal aggression in their paternal and maternal relationships and participated in observed interactions with a close peer that were coded for aggressive behavior. RESULTS: Spillover was observed from father-adolescent to mother-adolescent and adolescent-peer contexts in analyses at the between-person level, likely capturing long-term, cumulative effects of paternal aggression. Conversely, compensation was observed in analyses at the within-person level, likely capturing medium-term (i.e., year-to-year) adaptations to paternal aggression: Adolescents who experienced more aggression from their father than expected at a specific time point were less likely to both perpetrate and experience aggression in maternal and peer relationships the following year. Several findings differed across teen gender, with compensation more likely to occur in males than females. CONCLUSIONS: These findings highlight the multiple pathways by which father-adolescent aggression may be linked to behavior in other relationships in the medium- and long-term. They also support the value of RI-CLPM in decomposing these effects.

Fathers' contributions to attachment in adolescence and adulthood: the moderating role of race, gender, income, and residential status.

Fathers play a critical yet underappreciated role in adolescent development. To examine contributions of fathers' parenting to attachment in adolescence and adulthood, this longitudinal study followed 184 adolescents from ages 13-24. At age 13, adolescents reported on their fathers' parenting behavior and were observed in a father-teen conflict task; at ages 14 and 24, they completed the Adult Attachment Interview. Adolescents who lived with their father showed higher attachment security at age 14 (Cohen's d = .72), compared to those with non-residential fathers. Fathers' positive relatedness and support for teens' psychological autonomy predicted attachment security at age 14. Fathers' physical aggression predicted attachment insecurity in adolescence, whereas fathers' verbal aggression predicted insecurity in adulthood, illuminating developmental shifts. Pathways to security were moderated by father residential status, adolescent gender, and race. Findings underscore the importance of fathers' presence, autonomy support, and non-aggression in predicting adolescents' state of mind in close relationships.

Social Media Posts from Friends during Late Adolescence as Predictors of Young Adult Physical Health.

Although an increasing body of literature has linked social experiences to physical health, research has yet to consider how specific aspects of social experiences taking place on social media during late adolescence may predict future physical health outcomes. This study thus examined qualities of social media posts received from peers at age 21 as predictors of participants' physical health (e.g., Interleukin-6 (inflammation), sleep problems, problems with physical functioning, and BMI) at age 28. Participants included 138 youth (59 men and 79 women); 57% of participants identified as White, 30% as Black/African American, and 13% as from other or mixed racial/ethnic groups. Posts from friends and participants at age 21 characterized by social ties predicted lower levels of future physical health problems, whereas socially inappropriate "faux pas" posts that deviated from peer norms by friends predicted higher levels of physical health problems at age 28. These associations were found after accounting for factors typically associated with physical health outcomes, including participants' baseline social competence, internalizing and externalizing symptoms, alcohol use, observed physical attractiveness, and history of prior hospitalizations. The results of this study suggest the importance of both achieving social integration with peers online and adhering to peer norms in the online domain as key predictors of future physical health.

Social Regulation of the Neural Threat Response Predicts Subsequent Markers of Physical Health.

OBJECTIVE: Social support has been linked to a vast range of beneficial health outcomes. However, the physiological mechanisms of social support are not well characterized. Drawing on functional magnetic resonance imaging and health-related outcome data, this study aimed to understand how neural measures of "yielding"-the reduction of brain activity during social support-moderate the link between social support and health. METHODS: We used a data set where 78 participants around the age of 24 years were exposed to the threat of shock when holding the hand of a partner. At ages 28 to 30 years, participants returned for a health visit where inflammatory activity and heart rate variability were recorded. RESULTS: Findings showed a significant interaction between dorsal anterior cingulate cortex-related yielding and perceived social support on C-reactive protein levels ( ß = -0.95, SE = 0.42, z = -2.24, p = .025, 95% confidence interval = -1.77 to -0.12). We also found a significant interaction between hypothalamus-related yielding and perceived social support on baseline heart rate variability ( ß = 0.51, SE = 0.23, z = 2.19, p = .028, 95% confidence interval = 0.05 to 0.97). CONCLUSIONS: Greater perceived social support was associated with lower C-reactive protein levels and greater baseline heart rate variability among individuals who were more likely to yield to social support in the dorsal anterior cingulate cortex and hypothalamus years earlier. The current study highlights the construct of yielding in the link between social support and physical health.

Impact of presenting stroke severity and thrombolysis on outcomes following urgent carotid interventions.

BACKGROUND: Carotid interventions are increasingly performed in select patients following acute stroke. We aimed to determine the effects of presenting stroke severity (National Institutes of Health Stroke Scale [NIHSS]) and use of systemic thrombolysis (tissue plasminogen activator [tPA]) on discharge neurological outcomes (modified Rankin scale [mRS]) after urgent carotid endarterectomy (uCEA) and urgent carotid artery stenting (uCAS). METHODS: Patients undergoing uCEA/uCAS at a tertiary Comprehensive Stroke Center (January 2015 to May 2022) were divided into two cohorts: (1) no thrombolysis (uCEA/uCAS only) and (2) use of thrombolysis before the carotid intervention (tPA + uCEA/uCAS). Outcomes were discharge mRS and 30-day complications. Regression models were used to determine an association between tPA use and presenting stroke severity (NIHSS) and discharge neurological outcomes (mRS). RESULTS: Two hundred thirty-eight patients underwent uCEA/uCAS (uCEA/uCAS only, n = 186; tPA + uCEA/uCAS, n = 52) over 7 years. In the thrombolysis cohort compared with the uCEA/uCAS only cohort, the mean presenting stroke severity was higher (NIHSS = 7.6 vs 3.8; P = .001), and more patients presented with moderate to severe strokes (57.7% vs 30.2% with NIHSS >4). The 30-day stroke, death, and myocardial infarction rates in the uCEA/uCAS only vs tPA + uCEA/uCAS were 8.1% vs 11.5% (P = .416), 0% vs 9.6% (P < .001), and 0.5% vs 1.9% (P = .39), respectively. The 30-day stroke/hemorrhagic conversion and myocardial infarction rates did not differ with tPA use; however, the difference in deaths was significantly higher in the tPA + uCEA/uCAS cohort (P < .001). There was no difference in neurological functional outcome with or without thrombolysis use (mean mRS, 2.1 vs 1.7; P = .061). For both minor strokes (NIHSS ≤4 vs NIHSS >4: relative risk, 1.58 vs 1.58, tPA vs no tPA, respectively, P = .997) and moderate strokes (NIHSS ≤10 vs NIHSS >10: relative risk, 1.94 vs 2.08, tPA vs no tPA, respectively; P = .891), the likelihood of discharge functional independence (mRS score of ≤2) was not influenced by tPA. CONCLUSIONS: Patients with a higher presenting stroke severity (NIHSS) had worse neurological functional outcomes (mRS). Patients presenting with minor and moderate strokes were more likely to have discharge neurological functional independence (mRS of ≤2), regardless of whether they received tPA or not. Overall, presenting NIHSS is predictive of discharge neurological functional autonomy and is not influenced by the use of thrombolysis.

Immune response, phenotyping and molecular graft surveillance in kidney transplant recipients following severe acute respiratory syndrome coronavirus 2 vaccination.

BACKGROUND: Understanding immunogenicity and alloimmune risk following severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination in kidney transplant recipients is imperative to understanding the correlates of protection and to inform clinical guidelines. METHODS: We studied 50 kidney transplant recipients following SARS-CoV-2 vaccination and quantified their anti-spike protein antibody, donor-derived cell-free DNA (dd-cfDNA), gene expression profiling (GEP), and alloantibody formation. RESULTS: Participants were stratified using nucleocapsid testing as either SARS-CoV-2-naïve or experienced prior to vaccination. One of 34 (3%) SARS-CoV-2 naïve participants developed anti-spike protein antibodies. In contrast, the odds ratio for the association of a prior history of SARS-CoV-2 infection with vaccine response was 18.3 (95% confidence interval 3.2, 105.0, p < 0.01). Pre- and post-vaccination levels did not change for median dd-cfDNA (0.23% vs. 0.21% respectively, p = 0.13), GEP scores (9.85 vs. 10.4 respectively, p = 0.45), calculated panel reactive antibody, de-novo donor specific antibody status, or estimated glomerular filtration rate. CONCLUSIONS: SARS-CoV-2 vaccines do not appear to trigger alloimmunity in kidney transplant recipients. The degree of vaccine immunogenicity was associated most strongly with a prior history of SARS-CoV-2 infection.

Adolescent caregiving success as a predictor of social functioning from ages 13 to 33.

Adolescent success providing satisfying support in response to a close friend's call in a caregiving task was examined as a potentially fundamental developmental competence likely to predict future social functioning, adult caregiving security, and physical health. Adolescents (86 males, 98 females; 58% White, 29% African American, 8% mixed race/ethnicity, 5% other) were followed from ages 13 to 33 (1998-2021) using multiple methods and reporters. Early caregiving success was found to predict greater self- and partner-reported caregiving security, lower negativity in adult relationships, and higher adult vagal tone. Results are interpreted as advancing our understanding beyond simply recognizing that adolescent friendships have long-term import, to now identifying specific capacities within friendships that are linked to longer-term outcomes.

Adolescent peer struggles predict accelerated epigenetic aging in midlife.

This study examined struggles to establish autonomy and relatedness with peers in adolescence and early adulthood as predictors of advanced epigenetic aging assessed at age 30. Participants (N = 154; 67 male and 87 female) were observed repeatedly, along with close friends and romantic partners, from ages 13 through 29. Observed difficulty establishing close friendships characterized by mutual autonomy and relatedness from ages 13 to 18, an interview-assessed attachment state of mind lacking autonomy and valuing of attachment at 24, and self-reported difficulties in social integration across adolescence and adulthood were all linked to greater epigenetic age at 30, after accounting for chronological age, gender, race, and income. Analyses assessing the unique and combined effects of these factors, along with lifetime history of cigarette smoking, indicated that each of these factors, except for adult social integration, contributed uniquely to explaining epigenetic age acceleration. Results are interpreted as evidence that the adolescent preoccupation with peer relationships may be highly functional given the relevance of such relationships to long-term physical outcomes.

Characterizing Emotional Support Development: From Adolescent Best Friendships to Young Adult Romantic Relationships.

This study examined development of emotional support competence within close friendships across adolescence. A sample of 184 adolescents (53% girls, 47% boys; 58% White, 29% Black, 14% other identity groups) participated in seven waves of multimethod assessments with their best friends and romantic partners from age 13 to 24. Latent change score models identified coupled predictions over time from emotional support competence to increasing friendship quality and decreasing support received from friends. Friend-rated emotional support competence in adolescence predicted supportiveness in adult romantic relationships, over and above supportiveness in adolescent romantic relationships. Teen friendships may set the stage for developing emotional support capacities that progress across time and relationships into adulthood.

Organic Fluorine as an Indicator of Per- and Polyfluoroalkyl Substances in Dust from Buildings with Healthier versus Conventional Materials.

Per- and polyfluoroalkyl substances (PFAS) are a class of thousands of persistent, organic fluorinated chemicals added to materials and products mainly to repel stains and water. PFAS have been associated with many adverse human health effects. We aimed to determine whether buildings with "healthier" materials─defined here as reportedly free of all PFAS─exhibit lower PFAS in dust. In addition to analyzing targeted PFAS with available commercial standards, we measured extractable organic fluorine (EOF) as a novel proxy that includes both known and unknown types of PFAS. We measured at least 15 targeted PFAS (n = 24), EOF (n = 24), and total fluorine (TF; n = 14) in dust collected from university common spaces and classrooms, half of which had "healthier" furniture and carpet. We observed lower PFAS contamination in buildings with "healthier" materials: "healthier" rooms had a 66% lower median summed PFAS and a 49% lower Kaplan-Meier estimated mean EOF level in dust in comparison to conventional rooms. The summed targeted PFAS were significantly correlated with EOF but accounted for up to only 9% of EOF, indicating the likely presence of unidentified PFAS. EOF levels explained less than 1% of TF in dust. We emphasize the need to use chemical class-based methods (e.g., EOF) for evaluating class-based solutions and to expand non-PFAS solutions for other building materials.

When friendships surpass parental relationships as predictors of long-term outcomes: Adolescent relationship qualities and adult psychosocial functioning.

Perceptions of adolescent-parent and adolescent-peer relationship qualities, and adolescents' attachment states of mind were examined as predictors of adult social and romantic relationship quality, depressive symptoms, and work performance. Adolescents (86 male, 98 female; 58% White, 29% African American, 8% mixed race/ethnicity, 5% other groups) were followed from age 13 to 24 via observational, self-, parent-, and close friend-reports. Adolescent close friendship quality was a significantly better predictor of adult peer and romantic outcomes, work performance, and depressive symptoms than parental reports of the parent-teen relationship; attachment security was also a strong predictor of numerous outcomes. Results are interpreted as reflecting the difficulty for parents judging parent-teen relationship quality and as reflecting the growing importance of close friendships during this period.

Indoor humidity levels and associations with reported symptoms in office buildings.

Moderate indoor relative humidity (RH) levels (i.e., 40%-60%) may minimize transmission and viability of some viruses, maximize human immune function, and minimize health risks from mold, yet uncertainties exist about typical RH levels in offices globally and about the potential independent impacts of RH levels on workers' health. To examine this, we leveraged one year of indoor RH measurements (which study participants could view in real time) in 43 office buildings in China, India, Mexico, Thailand, the United Kingdom, and the United States, and corresponding self-report symptom data from 227 office workers in a subset of 32 buildings. In the buildings in this study, 42% of measurements during 9:00 - 17:00 on weekdays were less than 40% RH and 7% exceeded 60% RH. Indoor RH levels tended to be lower in less tropical regions, in winter months, when outdoor RH or temperature was low, and late in the workday. Furthermore, we also found statistically significant evidence that higher indoor RH levels across the range of 14%-70% RH were associated with lower odds of reporting dryness or irritation of the throat and skin among females and unusual fatigue among males in models adjusted for indoor temperature, country, and day of year.