Emergency department presentations for deliberate self-harm and suicidal ideation in 25-39 years olds following agency-notified child maltreatment: results from the Childhood Adversity and Lifetime Morbidity (CALM) study.

AIMS: To compare prospective reports of child maltreatment (CM) with emergency department (ED) presentations for deliberate self-harm (DSH) and suicidal ideation in individuals aged between 25 and 39 years old. METHODS: Linked records between the Mater-University of Queensland Study of Pregnancy birth cohort and Queensland administrative health data were used, which included notifications to child protection agencies for CM. ED presentations for individuals aged between 25 and 39 years of age for suicidal ideation, suicidal behaviour or poisoning by paracetamol or psychotropic medications where the intention was unclear were examined using logistic regression analyses. RESULTS: A total of 609 (10.1%) individuals were the subject of one or more CM notifications for neglect or physical, sexual or emotional abuse before the age of 15 years. Of these, 250 (4.1%) presented at least once to ED for DSH and/or suicidal ideation between 25 and 39 years of age. In adjusted analysis, any notification of CM was associated with significantly increased odds of presenting to ED for these reasons (aOR = 2.80; 95% CI = 2.04-3.84). In sensitivity analyses, any notification of CM increased the odds of the combined outcome of DSH and suicidal ideation by 275% (aOR = 2.75; 95% CI = 1.96-4.06) and increased the odds of DSH alone by 269% (aOR = 2.69; 95% CI = 1.65-4.41). CONCLUSIONS: All CM types (including emotional abuse and neglect) were associated with ED presentations for DSH and suicidal ideation in individuals between 25 and 39 years of age. These findings have important implications for the prevention of DSH, suicidal ideation and other health outcomes. They also underscore the importance of trauma-informed care in ED for all individuals presenting with DSH and suicidal ideation.

A structural study of PrCrO3 under extreme conditions: a comparison with the effects of doping.

The nuclear and magnetic structure of [Formula: see text] has been investigated using neutron and X-ray powder diffraction as a function of pressure and temperature. The orthorhombic symmetry (space group [Formula: see text]) remains stable up to the highest temperature (1500 K) and pressure (approx. [Formula: see text]) considered. There is a crossover in the magnitude of the a- and b-lattice parameters at approximately 1135 K, caused by competing effects of octahedral tilting and distortion. The material is antiferromagnetic ([Formula: see text] K) with [Formula: see text] symmetry, with a maximum moment of [Formula: see text] on the [Formula: see text] sites aligned along the direction of the [Formula: see text]-axis. The application of pressure shows an abnormal softening in the unit-cell volume, which is suggestive of a continuous approach to a second-order phase transition. Raman spectroscopy measurements at ambient temperature were collected as a function of pressure up to approximately [Formula: see text] GPa, with discontinuous mode behaviour further suggesting the existence of a transition above 7 GPa. The measured structural changes in [Formula: see text] are compared extensively in the wider context of other lanthanide orthochromites, and the comparative effects of A- and B-site substitution on the polyhedral tilts and distortion are discussed. This article is part of the theme issue 'Exploring the length scales, timescales and chemistry of challenging materials (Part 1)'.

Development, women-centricity and psychometric properties of maternity patient-reported outcome measures (PROMs): A systematic review.

BACKGROUND: Measuring maternity care outcomes based on what women value is critical to promoting woman-centred maternity care. Patient-reported outcome measures (PROMs) are instruments that enable service users to assess healthcare service and system performance. AIM: To identify and critically appraise the risk of bias, woman-centricity (content validity) and psychometric properties of maternity PROMs published in the scientific literature. METHODS: MEDLINE, CINAHL Plus, PsycINFO and Embase were systematically searched for relevant records between 01/01/2010 and 07/10/2021. Included articles underwent risk of bias, content validity and psychometric properties assessments in line with COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) guidance. PROM results were summarised according to language subgroups and an overall recommendation for use was determined. FINDINGS: Forty-four studies reported on the development and psychometric evaluation of 9 maternity PROMs, grouped into 32 language subgroups. Risk of bias assessments for the PROM development and content validity showed inadequate or doubtful methodological quality. Internal consistency reliability, hypothesis testing (for construct validity), structural validity and test-retest reliability varied markedly in sufficiency and evidence quality. No PROMs received a level 'A' recommendation, required for real-world use. CONCLUSION: Maternity PROMs identified in this systematic review had poor quality evidence for their measurement properties and lacked sufficient content validity, indicating a lack of woman-centricity in instrument development. Future research should prioritise women's voices in deciding what is relevant, comprehensive and comprehensible to measure, as this will impact overall validity and reliability and facilitate real-world use.

Sialic acid blockade in dendritic cells enhances CD8+ T cell responses by facilitating high-avidity interactions.

Sialic acids are negatively charged carbohydrates that cap the glycans of glycoproteins and glycolipids. Sialic acids are involved in various biological processes including cell-cell adhesion and immune recognition. In dendritic cells (DCs), the major antigen-presenting cells of the immune system, sialic acids emerge as important regulators of maturation and interaction with other lymphocytes including T cells. Many aspects of how sialic acids regulate DC functions are not well understood and tools and model systems to address these are limited. Here, we have established cultures of murine bone marrow-derived DCs (BMDCs) that lack sialic acid expression using a sialic acid-blocking mimetic Ac53FaxNeu5Ac. Ac53FaxNeu5Ac treatment potentiated BMDC activation via toll-like receptor (TLR) stimulation without affecting differentiation and viability. Sialic acid blockade further increased the capacity of BMDCs to induce antigen-specific CD8+ T cell proliferation. Transcriptome-wide gene expression analysis revealed that sialic acid mimetic treatment of BMDCs induces differential expression of genes involved in T cell activation, cell-adhesion, and cell-cell interactions. Subsequent cell clustering assays and single cell avidity measurements demonstrated that BMDCs with reduced sialylation form higher avidity interactions with CD8+ T cells. This increased avidity was detectable in the absence of antigens, but was especially pronounced in antigen-dependent interactions. Together, our data show that sialic acid blockade in BMDCs ameliorates maturation and enhances both cognate T cell receptor-MHC-dependent and independent T cell interactions that allow for more robust CD8+ T cell responses.

Generation of αCD11b-CpG antibody conjugates for the targeted stimulation of myeloid cells.

CpG oligonucleotides are short single-stranded synthetic DNA molecules. Upon binding to Toll-like receptor 9 (TLR9), CpG activates immune cells in humans and mice. This results in robust Th1 type immunity potentially resulting in clearance of pathogens, reduction of allergy and anti-tumor immunity. However, the effectiveness of CpG as an adjuvant depends on its administration route, with only strong effects seen when CpG is administered locally. As local administration is not always feasible, we generated conjugates to specifically deliver CpG to myeloid cells often abundantly present in tumors. For this we coupled CpG (3'-Thiol-modified phosphorothioate (PTO) CpG-ODN1826 type B (5'-tccatgacgttcctgacgtt-3')) to monoclonal antibodies (mAbs) directed against the myeloid cell marker CD11b using maleimide-thiol coupling. The CD11b-CpG mAb (αCD11b-CpG) conjugates contained about four CpG molecules/conjugate and displayed binding and internalization characteristics similar to unconjugated CD11b mAbs (αCD11b). The αCD11b-CpG conjugates readily induced maturation of murine dendritic cells (DCs) in a TLR9-dependent manner in vitro. Following intravenous injection, αCD11b-CpG conjugates efficiently targeted CD11b+ immune cells in the blood, lymph nodes and spleen. Finally, injection of αCD11b-CpG conjugates, but not untargeted conjugates, induced maturation of CD11b+ cell subsets in vivo. In conclusion, conjugating CpG to αCD11b enabled specific targeting and activation of myeloid cells in vivo.

Topography dependence of the metamagnetic phase transition in FeRh thin films.

The equiatomic alloy FeRh is of great scientific and technological interest due its highly unusual first-order antiferromagnetic (AF) to ferromagnetic (FM) phase transition. Here we report an exploration of the interplay between topography and phase evolution with a comprehensive magnetic force microscopy study of nominal 50 nm thick FeRh thin films and subtractively patterned wires of width 0.2 µm-2 µm. In continuous films where the surface morphology had not been optimised for smoothness, the topographical variation was observed to dominate the distribution of the magnetic transition temperatures and dictates the nucleation and growth of the magnetic phases. This observation was repeated for patterned elements, where the effects of surface morphology were more significant than those of spatial confinement. These results have clear implications for future studies of low-dimensional FeRh films, as surface topography must be considered when analysing and comparing the transition behaviour of FeRh thin films.

Surviving drought: a framework for understanding animal responses to small rain events in the arid zone.

Large rain events drive dramatic resource pulses and the complex pulse-reserve dynamics of arid ecosystems change between high-rain years and drought. However, arid-zone animal responses to short-term changes in climate are unknown, particularly smaller rain events that briefly interrupt longer-term drought. Using arthropods as model animals, we determined the effects of a small rain event on arthropod abundance in western New South Wales, Australia during a longer-term shift toward drought. Arthropod abundance decreased over 2 yr, but captures of 10 out of 15 ordinal taxa increased dramatically after the small rain event (<40 mm). The magnitude of increases ranged from 10.4 million% (collembolans) to 81% (spiders). After 3 months, most taxa returned to prerain abundance. However, small soil-dwelling beetles, mites, spiders, and collembolans retained high abundances despite the onset of winter temperatures and lack of subsequent rain. As predicted by pulse-reserve models, most arid-zone arthropod populations declined during drought. However, small rain events may play a role in buffering some taxa from declines during longer-term drought or other xenobiotic influences. We outline the framework for a new model of animal responses to environmental conditions in the arid zone, as some species clearly benefit from rain inputs that do not dramatically influence primary productivity.

A systems genomics approach identifies SIGLEC15 as a susceptibility factor in recurrent vulvovaginal candidiasis.

Candida vaginitis is a frequent clinical diagnosis with up to 8% of women experiencing recurrent vulvovaginal candidiasis (RVVC) globally. RVVC is characterized by at least three episodes per year. Most patients with RVVC lack known risk factors, suggesting a role for genetic risk factors in this condition. Through integration of genomic approaches and immunological studies in two independent cohorts of patients with RVVC and healthy individuals, we identified genes and cellular processes that contribute to the pathogenesis of RVVC, including cellular morphogenesis and metabolism, and cellular adhesion. We further identified SIGLEC15, a lectin expressed by various immune cells that binds sialic acid-containing structures, as a candidate gene involved in RVVC susceptibility. Candida stimulation induced SIGLEC15 expression in human peripheral blood mononuclear cells (PBMCs) and a polymorphism in the SIGLEC15 gene that was associated with RVVC in the patient cohorts led to an altered cytokine profile after PBMC stimulation. The same polymorphism led to an increase in IL1B and NLRP3 expression after Candida stimulation in HeLa cells in vitro. Last, Siglec15 expression was induced by Candida at the vaginal surface of mice, where in vivo silencing of Siglec15 led to an increase in the fungal burden. Siglec15 silencing was additionally accompanied by an increase in polymorphonuclear leukocytes during the course of infection. Identification of these pathways and cellular processes contributes to a better understanding of RVVC and may open new therapeutic avenues.

Plio-Pleistocene diversification and biogeographic barriers in southern Australia reflected in the phylogeography of a widespread and common lizard species.

Palaeoclimatic events and biogeographical processes since the mid-Tertiary have played an important role in shaping the evolution and distribution of Australian fauna. However, their impacts on fauna in southern and arid zone regions of Australia are not well understood. Here we investigate the phylogeography of an Australian scincid lizard, Tiliqua rugosa, across southern Australia using mitochondrial DNA (mtDNA) and 11 nuclear DNA markers (nuDNA), including nine anonymous nuclear loci. Phylogenetic analyses revealed three major mtDNA lineages within T. rugosa, geographically localised north and south of the Murray River in southern Australia, and west of the Nullarbor Plain. Molecular variance and population analyses of both mtDNA and nuDNA haplotypes revealed significant variation among the three populations, although potential introgression of nuDNA markers was also detected for the Northern and Southern population. Coalescent times for major mtDNA lineages coincide with an aridification phase, which commenced after the early Pliocene and increased in intensity during the Late Pliocene-Pleistocene. Species distribution modelling and a phylogeographic diffusion model suggest that the range of T. rugosa may have contracted during the Last Glacial Maximum and the locations of optimal habitat appear to coincide with the geographic origin of several distinct mtDNA lineages. Overall, our analyses suggest that Plio-Pleistocene climatic changes and biogeographic barriers associated with the Nullarbor Plain and Murray River have played a key role in shaping the present-day distribution of genetic diversity in T. rugosa and many additional ground-dwelling animals distributed across southern Australia.

Indicaciones de estudio urodinámico / Indications of urodynamic study

The basic objective of urodynamics is to reproduce the patient's symptoms while evaluating the lower urinary tract directly, with objective quantification of parameters, correlating the symptoms with the findings of the test. Traditionally, it is used: a) to diagnose lower urinary tract dysfunction, quantify its severity and determine the most significant abnormality, b) to predict the consequences of lower urinary tract dysfunction on the upper urinary tract, c) to predict the results of therapeutic interventions and possible complications and d) to investigate the causes of treatment failures. In this article we will refer to the indications of urodynamics taking into account the recommendations of the main international urological societies: 1) in women with urinary incontinence, with emphasis on those who have stress urinary incontinence and who will undergo surgery, 2) in men with non-neurogenic lower urinary tract symptoms suggestive of benign prostatic hyperplasia, and 3) in patients with neurologic involvement of the lower urinary tract ("neurogenic bladder"), considering the classification of neurological disorders according to the risk over the upper urinary tract. (AU)

Ostwald's rule of stages and metastable transitions in the hydrogen-water system at high pressure.

Although the hydrogenous analogue of the D2-D2O system has been well explored in the regimes above 1 GPa, and below 0.2 GPa, there have been very few studies in the region between these pressures. The recent discovery in the range 0.5-0.7 GPa of a new phase, C0, that possesses a new clathrate structure with a new H2O network, along with the proposal of another structure stable at similar conditions, has prompted further studies of the hydrogen water system in this intermediate pressure region. Here, we report the results of neutron-diffraction experiments that observed transitions from metastable to stable structures in the D2-D2O system around 0.2-0.3 GPa between 130 K and 280 K. These metastable structures were observed in the stability region of the sII hydrogen hydrate clathrate and computational studies of their relative enthalpies suggest that transition sequence observed is in line with Ostwald's 'Rule of Stages'.

Registered nurses' provision of end-of-life care to hospitalised adults: A mixed studies review.

OBJECTIVES: To describe, critically appraise and synthesise research regarding nurses' perceptions of their knowledge, skills or experiences in providing end-of-life care to hospitalised adults to help inform both future educational and practice initiatives. DESIGN: Mixed studies review. DATA SOURCES: MEDLINE, CINAHL, Cochrane Library, Web of Science and SCOPUS databases were searched for the years 2004-June 2018, along with journal hand-searching and reference list searching. REVIEW METHODS: Two independent reviewers screened the titles and abstracts of studies. Data extraction and quality assessment using the Mixed Methods Appraisal Tool was conducted independently by two reviewers. Disagreements were adjudicated by a third reviewer. Study findings were synthesised thematically. RESULTS: Nineteen studies met the inclusion criteria. Of them, ten were quantitative, eight qualitative and one mixed-method. All but one quantitative study were conducted in the United States and all but one used some form of survey. The qualitative studies were conducted in a variety of countries and all but one used some form of interview for data collection. Five themes were identified including nurse as a protecting provider, nurse as an advocate, nurse as a reflective practitioner, obstacles to providing quality end-of-life care and aids to providing quality end-of-life care. CONCLUSIONS: Registered Nurses have aligned their end-of-life care with practice with the profession's expectations and are enacting a patient centred approach to their practice. They rely on reflective practices and on the support of others to overcome organisational, educational and emotional the challenges they to providing quality end-of-life care.

Selection outweighs drift at a fine scale: Lack of MHC differentiation within a family living lizard across geographically close but disconnected rocky outcrops.

The highly polymorphic genes of the major histocompatibility complex (MHC) are involved in disease resistance, mate choice and kin recognition. Therefore, they are widely used markers for investigating adaptive variation. Although selection is the key driver, gene flow and genetic drift also influence adaptive genetic variation, sometimes in opposing ways and with consequences for adaptive potential. To further understand the processes that generate MHC variation, it is helpful to compare variation at the MHC with that at neutral genetic loci. Differences in MHC and neutral genetic variation are useful for inferring the relative influence of selection, gene flow and drift on MHC variation. To date, such investigations have usually been undertaken at a broad spatial scale. Yet, evolutionary and ecological processes can occur at a fine spatial scale, particularly in small or fragmented populations. We investigated spatial patterns of MHC variation among three geographically close, naturally discrete, sampling sites of Egernia stokesii, an Australian lizard. The MHC of E. stokesii has recently been characterized, and there is evidence for historical selection on the MHC. We found E. stokesii MHC weakly differentiated among sites compared to microsatellites, suggesting selection, acting similarly at each site, has outweighed any effects of low gene flow or of genetic drift on E. stokesii MHC variation. Our findings demonstrate the strength of selection in shaping patterns of MHC variation or consistency at a fine spatial scale.

Can you detect early dementia from an email? A proof of principle study of daily computer use to detect cognitive and functional decline.

OBJECTIVE: To determine whether multiple computer use behaviours can distinguish between cognitively healthy older adults and those in the early stages of cognitive decline, and to investigate whether these behaviours are associated with cognitive and functional ability. METHODS: Older adults with cognitive impairment (n = 20) and healthy controls (n = 24) completed assessments of cognitive and functional abilities and a series of semi-directed computer tasks. Computer use behaviours were captured passively using bespoke software. RESULTS: The profile of computer use behaviours was significantly different in cognitively impaired compared with cognitively healthy control participants including more frequent pauses, slower typing, and a higher proportion of mouse clicks. These behaviours were significantly associated with performance on cognitive and functional assessments, in particular, those related to memory. CONCLUSION: Unobtrusively capturing computer use behaviours offers the potential for early detection of neurodegeneration in non-clinical settings, which could enable timely interventions to ultimately improve long-term outcomes.

A novel role of the corticotrophin-releasing hormone regulating peptide, teneurin C-terminal associated peptide 1, on glucose uptake into the brain.

Teneurin C-terminal associated peptide (TCAP) is an ancient paracrine signalling agent that evolved via lateral gene transfer from prokaryotes into an early metazoan ancestor. Although it bears structural similarity to corticotrophin-releasing hormone (CRH), it inhibits the in vivo actions of CRH. The TCAPs are highly expressed in neurones, where they induce rapid cytoskeletal rearrangement and are neuroprotective. Because these processes are highly energy-dependent, this suggests that TCAP has the potential to regulate glucose uptake because glucose is the primary energy substrate in brain, and neurones require a steady supply to meet the high metabolic demands of neuronal communication. Therefore, the objective of the present study was to assess the effect of TCAP-mediated glucose uptake in the brain and in neuronal cell models. TCAP-mediated 18 F-deoxyglucose (FDG) uptake into brain tissue was assessed in male wild-type Wistar rats by functional positron emission tomography. TCAP-1 increased FDG uptake by over 40% into cortical regions of the brain, demonstrating that TCAP-1 can significantly enhance glucose supply. Importantly, a single nanomolar injection of TCAP-1 increased brain glucose after 3 days and decreased blood glucose after 1 week. This is corroborated by a decreased serum concentration of insulin and an increased serum concentration of glucagon. In immortalised hypothalamic neurones, TCAP-1 increased ATP production and enhanced glucose uptake by increasing glucose transporter recruitment to the plasma membrane likely via AKT and mitogen-activated protein kinase/ERK phosphorylation events. Taken together, these data demonstrate that TCAP-1 increases glucose metabolism in neurones, and may represent a peptide signalling agent that regulated glucose uptake before insulin and related peptides.

Magnetic and structural changes in LaCo0.9Mn0.1O3 at high pressure.

The structural and magnetic properties of LaCo0.9Mn0.1O3 have been studied as a function of pressure by neutron powder diffraction and DC magnetometry. The material is confirmed to exhibit rhombohedral R [Formula: see text] c symmetry between ambient pressure and 6 GPa. We have determined the bulk modulus B 0 of the sample using a second-order Birch-Murnaghan equation of state which yielded: B 0 = 140(9) GPa and V [Formula: see text]. We report a non-linear increase of the Curie temperature T C from an ambient pressure value of 224.7 K to ∼236 K at a pressure of 4 GPa. Finally, we confirm the glassy-like nature of the magnetism in LaCo0.9Mn0.1O3, which is maintained throughout the pressure range explored.

Genes and Group Membership Predict Gidgee Skink (Egernia stokesii) Reproductive Pairs.

Due to their role in mate choice, disease resistance and kin recognition, genes of the major histocompatibility complex (MHC) are good candidates for investigating genetic-based mate choice. MHC-based mate choice is context dependent and influenced by many factors including social structure. Social structure diversity makes the Egernia group of lizards suitable for comparative studies of MHC-based mate choice. We investigated mate choice in the gidgee skink (Egernia stokesii), a lizard that exhibits high levels of social group and spatial stability. Group membership was incorporated into tests of the good genes as heterozygosity and compatible genes hypotheses for adaptive (MHC) and neutral (microsatellite) genetic diversity (n = 47 individuals genotyped). Females were more likely to pair with a male with higher MHC diversity and with whom they had a lower degree of microsatellite relatedness. Males were more likely to pair with a female with higher microsatellite heterozygosity and with whom they shared a lower proportion of MHC alleles. Lizards were more likely to mate with an individual from within, rather than outside, their social group, which confirmed earlier findings for this species and indicated mate choice had already largely occurred prior to either social group formation or acceptance of an individual into an existing group. Thus, a combination of genes and group membership, rather than group membership alone, predicted mate choice in this species. This work will contribute to an enhanced understanding of squamate group formation and a deeper understanding of the evolution of sociality within all vertebrates.