Adolescent social anxiety is associated with diminished discrimination of anticipated threat and safety in the bed nucleus of the stria terminalis.

Social anxiety-which typically emerges in adolescence-lies on a continuum and, when extreme, can be devastating. Socially anxious individuals are prone to heightened fear, anxiety, and the avoidance of contexts associated with potential social scrutiny. Yet most neuroimaging research has focused on acute social threat. Much less attention has been devoted to understanding the neural systems recruited during the uncertain anticipation of potential encounters with social threat. Here we used a novel fMRI paradigm to probe the neural circuitry engaged during the anticipation and acute presentation of threatening faces and voices in a racially diverse sample of 66 adolescents selectively recruited to encompass a range of social anxiety and enriched for clinically significant levels of distress and impairment. Results demonstrated that adolescents with more severe social anxiety symptoms experience heightened distress when anticipating encounters with social threat, and reduced discrimination of uncertain social threat and safety in the bed nucleus of the stria terminalis (BST), a key division of the central extended amygdala (EAc). Although the EAc-including the BST and central nucleus of the amygdala-was robustly engaged by the acute presentation of threatening faces and voices, the degree of EAc engagement was unrelated to the severity of social anxiety. Together, these observations provide a neurobiologically grounded framework for conceptualizing adolescent social anxiety and set the stage for the kinds of prospective-longitudinal and mechanistic research that will be necessary to determine causation and, ultimately, to develop improved interventions for this often-debilitating illness.

Advancing equity in access to school mental health through multiple informant decision-making.

There has been a substantial increase in the number of students with mental health needs, yet significant discrepancies exist in access to timely intervention. Traditional gatekeeping to intervention has been the provenance of single information sources. Multi-informant decision-making is a promising mechanism to improve equitable access. However, critical advancements are necessary to improve decision-making relating to (a) who is identified, (b) what type of need is determined, (c) the type of intervention necessary, and (d) where or under what circumstances to implement the intervention. We review critical components of effective mental health decision-making, contributors to inequities in school mental health services, and offer future directions for research and practice to increase equitable student outcomes.

The General Psychopathology 'p' Factor in Adolescence: Multi-Informant Assessment and Computerized Adaptive Testing.

Accumulating evidence supports the presence of a general psychopathology dimension, the p factor ('p'). Despite growing interest in the p factor, questions remain about how p is assessed. Although multi-informant assessment of psychopathology is commonplace in clinical research and practice with children and adolescents, almost no research has taken a multi-informant approach to studying youth p or has examined the degree of concordance between parent and youth reports. Further, estimating p requires assessment of a large number of symptoms, resulting in high reporter burden that may not be feasible in many clinical and research settings. In the present study, we used bifactor multidimensional item response theory models to estimate parent- and adolescent-reported p in a large community sample of youth (11-17 years) and parents (N = 5,060 dyads). We examined agreement between parent and youth p scores and associations with assessor-rated youth global functioning. We also applied computerized adaptive testing (CAT) simulations to parent and youth reports to determine whether adaptive testing substantially alters agreement on p or associations with youth global functioning. Parent-youth agreement on p was moderate (r =.44) and both reports were negatively associated with youth global functioning. Notably, 7 out of 10 of the highest loading items were common across reporters. CAT reduced the average number of items administered by 57%. Agreement between CAT-derived p scores was similar to the full form (r =.40) and CAT scores were negatively correlated with youth functioning. These novel results highlight the promise and potential clinical utility of a multi-informant p factor approach.

Links between parental monitoring and parent-adolescent conflict: A multimodal test of bidirectional relations.

During adolescence, youth increase in both independence and conflict with parents. Parents vary in how much they know about their adolescents' whereabouts and activities and how they acquire this information (i.e., the sources of what parents know). We probed how parental knowledge of adolescents' whereabouts and activities-and their information sources-relates to (a) domains of parent-adolescent conflict (fighting about, or having different beliefs about, daily life topics) and (b) parent and adolescent attachment-related behavior during a conflict discussion task. Using the Actor-Partner Interdependence Model, we tested links between parental knowledge and its sources and conflict processes. Eighty-seven adolescents (Mage = 15.18; 55% female) and parents completed surveys about parental knowledge and its sources (i.e., parental solicitation of adolescents' activities, adolescent disclosure to parents about their activities) and separate interviews on conflict domains. A subset of parent-adolescent dyads (n = 65) interacted for 5 min about an adolescent-identified conflict topic. Different beliefs about daily life topics related to parental knowledge: parents' reports of greater different beliefs about daily life topics predicted less knowledge of adolescents' activities/whereabouts, solicitation, and disclosure, for both parent and adolescent reports of these domains. For adolescents, greater different beliefs related to less solicitation and disclosure. Only adolescent reports of parental knowledge, solicitation, and disclosure predicted attachment-related behaviors both dyad members displayed during the conflict discussion task. Findings reveal links between parental knowledge of adolescents' activities and conflict processes and demonstrate dyadic interdependence between parental knowledge of adolescents' activities and conflict processes. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Safety strategies and harm reduction for methamphetamine users in the era of fentanyl contamination: A qualitative analysis.

INTRODUCTION: In the United States, methamphetamine use is increasing and the context of its use has changed, with reports of illicitly manufactured fentanyl being mixed with methamphetamine (either deliberately or inadvertently). We explore risk-mitigating actions taken by people who use drugs to protect their health when using methamphetamine in that context. METHODS: We conducted qualitative interviews with 48 adults (18+) who used methamphetamine in the past three months at two sites in Nevada, USA and two sites in New Mexico, USA. Interviews were recorded, transcribed, and analyzed using thematic analysis. RESULTS: Respondents described two rationales for employing harm reduction strategies. First, to prevent harm from methamphetamine containing illicit fentanyl, and second, to maintain their general wellbeing while using methamphetamine. Regarding methamphetamine containing illicit fentanyl, our findings highlight how respondents employ primary strategies like buying from trusted sources and secondary strategies such as spotting and selective use of harm reduction tools (i.e., fentanyl test strips) to reduce risks. To maintain their general wellbeing, participants reduced their use of methamphetamine as reasonably as possible, and used other substances like marijuana and alcohol alongside methamphetamine to counter the unwanted side effects of methamphetamine (i.e., hallucinations and paranoia). Use of these harm reduction strategies varied within situational and social contexts, and respondents usually developed these strategies based on their lived experiences. CONCLUSION: Our findings uniquely demonstrate that people who use methamphetamine prioritize community driven, trust-based strategies within their social networks to mitigate risks in a fentanyl-contaminated drug environment. Additionally, our results indicate that harm reduction behaviors are influenced by multilevel risk environments, which include social, physical, economic, and political factors. Overall, these results highlight the potential for targeted interventions at the network level, which are responsive to complexities and shifts in drug market dynamics- such as illicit fentanyl in methamphetamine.

Enabling white color tunability in complex 3D-printed composites by using lead-free self-trapped exciton 2D perovskite/carbon quantum dot inks.

The generation of stable white light emission using lead-free perovskites remains a huge challenge in the development of future display and lighting technologies, due to fast material deterioration and the decrease of the color quality. In this work, we report a combination of diverse types of 2D A2SnX4 (A = bulky cation, X = Br, I) perovskites exhibiting self-trapped exciton (STE) emission and blue luminescent carbon quantum dots (CQDs), with the purpose of generating A2SnX4/CQD inks with a broadband emission in the visible region and a tunable white light color. By varying the concentration of the 2D perovskite, the white emission of the mixtures is modulated to cool, neutral, and warm tonalities, with a PL quantum yield up to 45%. From the combinations, the PEA2SnI4/CQD-based ink shows the longest stability, due to suitable surface ligand passivation provided by the capping ligands covering the CQDs, compensating the defect sites in the perovskite. Then, by incorporating the PEA2SnI4/CQDs inks into an acrylate polymer matrix, the quenching of the PL component from the perovskite was restrained, being stable for >400 h under ambient conditions and at a relative humidity of ∼50%, and allowing the preparation of complex 3D-printed composites with stable white emission tonalities. This contribution offers an application of STE-based Sn-perovskites to facilitate the future fabrication of lead-free white-light optoelectronic devices.

Impact of alternative splicing on Arabidopsis proteome.

Alternative splicing is an important regulatory process in eukaryotes. In plants, the major form of alternative splicing is intron retention. Despite its importance, the global impact of AS on the Arabidopsis proteome has not been investigated. In this study, we address this gap by performing a comprehensive integrated analysis of how changes in AS can affect the Arabidopsis proteome using mutants that disrupt ACINUS and PININ, two evolutionarily conserved alternative splicing factors. We used tandem mass tagging (TMT) with real-time search MS3 (RTS-SPS-MS3) coupled with extensive sample fractionations to achieve very high coverage and accurate protein quantification. We then integrated our proteomic data with transcriptomic data to assess how transcript changes and increased intron retention (IIR) affect the proteome. For differentially expressed transcripts, we have observed a weak to moderate correlation between transcript changes and protein changes. Our studies revealed that some IIRs have no effect on either transcript or protein levels, while some IIRs can significantly affect protein levels. Surprisingly, we found that IIRs have a much smaller effect on increasing protein diversity. Notably, the increased intron retention events detected in the double mutant are also detected in the WT under various biotic or abiotic stresses. We further investigated the characteristics of the retained introns. Our extensive proteomic data help to guide the phenotypic analysis and reveal that collective protein changes contribute to the observed phenotypes of the increased anthocyanin, pale green, reduced growth, and short root observed in the acinus pnn double mutant. Overall, our study provides insight into the intricate regulatory mechanism of intron retention and its impact on protein abundance in plants.

SECRET AGENT O-GlcNAcylates Hundreds of Proteins Involved in Diverse Cellular Processes in Arabidopsis.

O-GlcNAcylation is a critical post-translational modification of proteins observed in both plants and animals and plays a key role in growth and development. While considerable knowledge exists about over 3000 substrates in animals, our understanding of this modification in plants remains limited. Unlike animals, plants possess two putative homologs: SECRET AGENT (SEC) and SPINDLY, with SPINDLY also exhibiting O-fucosylation activity. To investigate the role of SEC as a major O-GlcNAc transferase in plants, we utilized lectin-weak affinity chromatography enrichment and stable isotope labeling in Arabidopsis labeling, quantifying at both MS1 and MS2 levels. Our findings reveal a significant reduction in O-GlcNAc levels in the sec mutant, indicating the critical role of SEC in mediating O-GlcNAcylation. Through a comprehensive approach, combining higher-energy collision dissociation and electron-transfer high-energy collision dissociation fragmentation with substantial fractionations, we expanded our GlcNAc profiling, identifying 436 O-GlcNAc targets, including 227 new targets. The targets span diverse cellular processes, suggesting broad regulatory functions of O-GlcNAcylation. The expanded targets also enabled exploration of crosstalk between O-GlcNAcylation and O-fucosylation. We also examined electron-transfer high-energy collision dissociation fragmentation for site assignment. This report advances our understanding of O-GlcNAcylation in plants, facilitating further research in this field.

Bivalent fears of evaluation: A developmentally-informed, multi-informant, and multi-modal examination of associations with safety behaviors.

Fears of negative (FNE) and positive (FPE) evaluation and safety behaviors feature prominently in cognitive-behavioral models of social anxiety. However, we have a poor understanding of their associations, particularly given evidence that they both vary in form and function. This study aimed to identify the factor structure of safety behaviors and explore their differential associations with FNE and FPE. We addressed these aims across samples that varied in developmental stage, informant, and assessment modality. We collected self-reported data from college students (n = 349; Mage = 19.42) and adolescent-parent dyads (n = 134; Mage_adolescents = 14.49, Mage_parents = 45.01); parents also completed an ecologically-valid evaluation task. We confirmed a two-factor structure of safety behaviors (i.e., avoidance and impression management) that fit the data well for college students, adolescents, and parents' self-report, but not for parents' report about adolescents. Associations between avoidance and impression management and FNE/FPE were significant within-informants but not between-informants. For parents, in-the-moment arousal following receipt of negative, but not positive, feedback was associated with avoidance and impression management. Findings have implications for integrated measurement of FNE, FPE, and safety behaviors, as well as treatments that target social anxiety through each of these domains.

Workflow enhancement of TurboID-mediated proximity labeling for SPY signaling network mapping.

TurboID-based proximity labeling coupled to mass spectrometry (PL-MS) has emerged as a powerful tool for mapping protein-protein interactions in both plant and animal systems. Despite advances in sensitivity, PL-MS studies can still suffer from false negatives, especially when dealing with low abundance bait proteins and their transient interactors. Protein-level enrichment for biotinylated proteins is well developed and popular, but direct detection of biotinylated proteins by peptide-level enrichment and the difference in results between direct and indirect detection remain underexplored. To address this gap, we compared and improved enrichment and data analysis methods using TurboID fused to SPY, a low-abundance O-fucose transferase, using an AAL-enriched SPY target library for cross-referencing. Our results showed that MyOne and M280 streptavidin beads significantly outperformed antibody beads for peptide-level enrichment, with M280 performing best. In addition, while a biotin concentration ≤ 50 µM is recommended for protein-level enrichment in plants, higher biotin concentrations can be used for peptide-level enrichment, allowing us to improve detection and data quality. FragPipe's MSFragger protein identification and quantification software outperformed Maxquant and Protein Prospector for SPY interactome enrichment due to its superior detection of biotinylated peptides. Our improved washing protocols for protein-level enrichment mitigated bead collapse issues, improving data quality, and reducing experimental time. We found that the two enrichment methods provided complementary results and identified a total of 160 SPY-TurboID-enriched interactors, including 60 previously identified in the AAL-enriched SPY target list and 100 additional novel interactors. SILIA quantitative proteomics comparing WT and spy-4 mutants showed that SPY affects the protein levels of some of the identified interactors, such as nucleoporin proteins. We expect that our improvement will extend beyond TurboID to benefit other PL systems and hold promise for broader applications in biological research.

Next-generation mapping of the salicylic acid signaling hub and transcriptional cascade.

For over 60 years, salicylic acid (SA) has been known as a plant immune signal required for both basal and systemic acquired resistance (SAR). SA activates these immune responses by reprogramming up to 20% of the transcriptome through the function of NPR1. However, components in the NPR1-signaling hub, which appears as nuclear condensates, and the NPR1- signaling cascade remained elusive due to difficulties in studying transcriptional cofactors whose chromatin associations are often indirect and transient. To overcome this challenge, we applied TurboID to divulge the NPR1-proxiome, which detected almost all known NPR1-interactors as well as new components of transcription-related complexes. Testing of new components showed that chromatin remodeling and histone demethylation contribute to SA-induced resistance. Globally, NPR1-proxiome shares a striking similarity to GBPL3-proxiome involved in SA synthesis, except associated transcription factors (TFs), suggesting that common regulatory modules are recruited to reprogram specific transcriptomes by transcriptional cofactors, like NPR1, through binding to unique TFs. Stepwise greenCUT&RUN analyses showed that, upon SA-induction, NPR1 initiates the transcriptional cascade primarily through association with TGA TFs to induce expression of secondary TFs, predominantly WRKYs. WRKY54 and WRKY70 then play a major role in inducing immune-output genes without interacting with NPR1 at the chromatin. Moreover, a loss of NPR1 condensate formation decreases its chromatin-association and transcriptional activity, indicating the importance of condensates in organizing the NPR1- signaling hub and initiating the transcriptional cascade. This study demonstrates how combinatorial applications of TurboID and stepwise greenCUT&RUN transcend traditional genetic methods to globally map signaling hubs and transcriptional cascades.

A nuclear configuration interaction approach to study nuclear spin effects: an application to ortho- and para-3 He2 @C60.

We introduce a non-orthogonal configuration interaction approach to investigate nuclear quantum effects on energies and densities of confined fermionic nuclei. The Hamiltonian employed draws parallels between confined systems and many-electron atoms, where effective non-Coulombic potentials represent the interactions of the trapped particles. One advantage of this method is its generality, as it offers the potential to study the nuclear quantum effects of various confined species affected by effective isotropic or anisotropic potentials. As a first application, we analyze the quantum states of two 3 He atoms encapsulated in C60 . At the Hartree-Fock level, we observe the breaking of spin and spatial symmetries. To ensure wavefunctions with the correct symmetries, we mix the broken-symmetry Hartree-Fock states within the non-orthogonal configuration interaction expansion. Our proposed approach predicts singly and triply degenerate ground states for the singlet (para-3 He2 @C60 ) and triplet (ortho-3 He2 @C60 ) nuclear spin configurations, respectively. The ortho-3 He2 @C60 ground state is 5.69 cm-1 higher in energy than the para-3 He2 @C60 ground state. The nuclear densities obtained for these states exhibit the icosahedral symmetry of the C60 embedding potential. Importantly, our calculated energies for the lowest 85 states are in close agreement with perturbation theory results based on a harmonic oscillator plus rigid rotor model of 3 He2 @C60 .

Uncovering the proximal proteome of CTR1 through TurboID-mediated proximity labeling.

Protein-protein interactions play a crucial role in driving cellular processes and enabling appropriate physiological responses in organisms. The plant hormone ethylene signaling pathway is complex and regulated by the spatiotemporal regulation of its signaling molecules. Constitutive Triple Response 1 (CTR1), a key negative regulator of the pathway, regulates the function of Ethylene-Insensitive 2 (EIN2), a positive regulator of ethylene signaling, at the endoplasmic reticulum (ER) through phosphorylation. Our recent study revealed that CTR1 can also translocate from the ER to the nucleus in response to ethylene and positively regulate ethylene responses by stabilizing EIN3. To gain further insights into the role of CTR1 in plants, we used TurboID-based proximity labeling and mass spectrometry to identify the proximal proteomes of CTR1 in Nicotiana benthamiana. The identified proximal proteins include known ethylene signaling components, as well as proteins involved in diverse cellular processes such as mitochondrial respiration, mRNA metabolism, and organelle biogenesis. Our study demonstrates the feasibility of proximity labeling using the N. benthamiana transient expression system and identifies the potential interactors of CTR1 in vivo, uncovering the potential roles of CTR1 in a wide range of cellular processes.

A Perovskite Photovoltaic Mini-Module-CsPbBr3 Photoelectrochemical Cell Tandem Device for Solar-Driven Degradation of Organic Compounds.

Recently, halide perovskites have been widely explored for high-efficiency photocatalysis or photoelectrochemical (PEC) cells. Here, in order to make an efficient photoanode electrode for the degradation of pollutants, concretely 2-mercaptobenzothiazole (MBT), nanoscale cesium lead bromide (CsPbBr3) perovskite was directly formed on the surface of mesoporous titanium dioxide (meso-TiO2) film using a two-step spin-coating process. This photoelectrode recorded a photocurrent of up to 3.02 ± 0.03 mA/cm2 under standard AM 1.5G (100 mW/cm2) illumination through an optimization process such as introducing a thin aluminum oxide (Al2O3) coating layer. Furthermore, to supply high voltage for efficient oxidation of MBT without an external bias, we developed a new photovoltaic/PEC tandem system using a methylammonium lead iodide (MAPbI3) based mini-module consisting of three solar cells interconnected in series and confirmed its successful operation. This approach looks very promising due to its applicability to various PEC reactions.

Impact of core-shell perovskite nanocrystals for LED applications: successes, challenges, and prospects.

Perovskite nanocrystals (PeNCs) synthesized by colloidal solution methods are an outstanding case of study due to their remarkable optical features, different from their bulk counterpart, such as a tuneable band gap and narrower photoluminescence emission, altered by the size and shape. However, the stability of these systems needs to be improved to consolidate their application in optoelectronic devices. Improved PeNC quality is associated with a less defective structure, as it affects negatively the photoluminescence quantum yield (PLQY), due to the essential, but at the same time labile interaction between the colloidal capping ligands and the perovskite core. In this sense, it would be extremely effective to obtain an alternative method to stabilize the PeNC phases and passivate the surface, in order to improve both stability and optical properties. This objective can be reached exploiting the structural benefits of the interaction between the perovskite and other organic or inorganic materials with a compatible structure and optical properties and limiting the optical drawbacks. This perspective contemplates different combinations of core/shell PeNCs and the critical steps during the synthesis, including drawbacks and challenges based on their optical properties. Additionally, it provides insights for future light emitting diode (LED) applications and advanced characterization. Finally, the existing challenges and opportunities for core/shell PeNCs are discussed.

Prediction of habitat complexity using a trait-based approach on coral reefs in Guam.

Scleractinian corals are primary contributors to the structural complexity of coral reef ecosystems. The structure derived from their carbonate skeletons underpins the biodiversity and myriad of ecosystem services provided by coral reefs. This study used a trait-based approach to provide new insights into the relationships between habitat complexity and coral morphology. Three-Dimensional (3D) photogrammetry techniques were used to survey 208 study plots on the island of Guam, from which structural complexity metrics were derived and physical traits of corals were quantified. Three traits at the individual colony level (e.g., morphology, size, and genera) and two site-level environmental characteristics (e.g., wave exposure and substratum-habitat type) were examined. Standard taxonomy-based metrics were also included at the reef-plot level (e.g., coral abundance, richness, and diversity). Different traits disproportionately contributed to 3D metrics of habitat complexity. Larger colonies with a columnar morphology have the highest contribution to surface complexity, slope, and vector ruggedness measure, whereas branching and encrusting columnar colonies have the highest contribution to planform and profile curvature. These results highlight the importance of considering colony morphology and size in addition to conventional taxonomic metrics for the understanding and monitoring reef structural complexity. The approach presented here provides a framework for studies in other locations to predict the trajectory of reefs under changing environmental conditions.

Optimizing Quantum Control Pulses with Gaussian Process Priors: The Spectral Way.

This study presents the Gaussian Process Prior Optimization for Pulse Shaping (GPPOPS) methodology, a novel approach to pulse shaping engineering. Its main objective is to efficiently identify laser pulse shapes that can achieve a desired task encoded in a cost function while being experimentally implementable. The AlH+ molecule was utilized as a test case to find pulse shapes that maximized vibronic transitions. The results demonstrate that optimal pulses can be readily implemented using current laser technology and that their control capabilities can withstand noise. The study emphasizes the benefits of constructing a surrogate approach to the control landscape during the optimization process. This approach is expected to be versatile, efficient and readily implementable in the laboratory. Its demonstrated robustness to noise sets it apart from other numerical pulse shaping engineering methods. By reducing the required experimental labor, this method has the potential to facilitate breakthroughs in quantum engineering.

Mechanistic Insight into the Internalization, Distribution, and Autophagy Process of Manganese Nanoparticles in Capsicum annuum L.: Evidence from Orthogonal Microscopic Analysis.

Orthogonal techniques were used to track manganese nanoparticles (MnNPs) in Capsicum annuum L. leaf tissue and cell compartments and subsequently to explain the mechanism of uptake, translocation, and cellular interaction. C. annuum L was cultivated and foliarly exposed to MnNPs (100 mg/L, 50 mL/per leaf) before analysis by using scanning electron microscopy coupled with energy-dispersive X-ray spectroscopy (SEM-EDS) as well as dark-field hyperspectral and two-photon microscopy. We visualized the internalization of MnNP aggregates from the leaf surface and observed particle accumulation in the leaf cuticle and epidermis as well as spongy mesophyll and guard cells. These techniques enabled a description of how MnNPs cross different plant tissues as well as selectively accumulate and translocate in specific cells. We also imaged abundant fluorescent vesicles and vacuoles containing MnNPs, indicating likely induction of autophagy processes in C. annuum L., which is the bio-response upon storing or transforming the particles. These findings highlight the importance of utilizing orthogonal techniques to characterize nanoscale material fate and distribution with complex biological matrices and demonstrate that such an approach offers a significant mechanistic understanding that can inform both risk assessment and efforts aimed at applying nanotechnology to agriculture.

Characteristics of patients with chronic kidney disease and Type 2 diabetes initiating finerenone in the USA: a multi-database, cross-sectional study.

Aim: Finerenone is safe and efficacious for treating patients with chronic kidney disease (CKD) and Type 2 diabetes (T2D). Evidence on the use of finerenone in clinical practice is lacking. Objective: To describe demographic and clinical characteristics of early adopters of finerenone in the United States, according to sodium-glucose cotransporter 2 inhibitor (SGLT2i) use and urine albumin-creatinine ratio (UACR) levels. Methods: Multi-database, observational, cross-sectional study, using data from two US databases (Optum Claims and Optum EHR). Three cohorts were included: finerenone initiators with prior CKD-T2D, finerenone initiators with prior CKD-T2D and concomitant SGLT2i use, finerenone initiators with prior CKD-T2D stratified according to UACR. Results: In total, 1015 patients were included, 353 from Optum Claims and 662 from Optum EHR. Mean age was 72.0 and 68.4 years in Optum claims and EHR, respectively. Median eGFR was 44 and 44 ml/min/1.73 m2; and median UACR was 132 (28-698)/365 (74-1185.4) mg/g, in Optum Claims and EHR, respectively. 70.5/70.4% were taking renin-angiotensin system inhibitors, 42.5/53.3% SGLT2i. Overall, 9.0/6.3% of patients had baseline UACR <30 mg/g, 15.0/20.2% had UACR 30-300 mg/g, and 14.4/27.6% had UACR >300 mg/g. Conclusion: Current management of patients with CKD-T2D reflects use of finerenone independently from background therapies and clinical characteristics, suggesting implementation of therapeutic strategies based on different modes of action.

Parent-youth convergence (and divergence) in reports about pediatric quality of life.

PURPOSE: Researchers and service providers typically assess pediatric Health-Related Quality of Life (HRQOL) by collecting independent reports from parents and youth. An emerging body of work indicates that patterns of parent-youth reports yield information germane to understanding youth outcomes. We identified patterns of HRQOL among youth and their parents seeking mental health treatment and examined links between agreement patterns and mental and physical health functioning. METHODS: Participants included 227 youth (mean age = 14.40 years, SD = 2.42; 63% female) and parent dyads presenting at a mood disorders clinic between 2013 and 2020. We assessed HRQOL using parallel youth and parent forms of the Pediatric Quality of Life Inventory Generic Core Scales. We also assessed youth clinical correlates of depression, suicidal ideation, and impairment, as well as health information via electronic health record (e.g., psychotropic medication usage, BMI). RESULTS: Latent class analysis showed three parent-youth reporting patterns: Low-Low (LL), High-High (HH), and Parent Low-Youth High (PL-YH). Relative to youth in the HH group, youth in the LL and PL-YH groups reported significantly greater depressive symptoms and had higher rates of suicidal ideation and psychotropic medication use. In addition, youth in the LL group reported significantly greater levels of impairment. CONCLUSIONS: Parent-youth patterns of HRQOL reporting can reveal clinically meaningful information and indicate poorer functioning for certain groups (LL, PL-YH) of youth. These findings have implications for improving accuracy of risk assessments that leverage HRQOL data.