Agitation after traumatic brain injury: a review of current and future concepts in diagnosis and management.

OBJECTIVES: Agitation and aggression are common following traumatic brain injury. The challenges related to these disorders affect all stages of recovery, from the acute hospital to the community setting. The aim of this literature review is to provide an updated overview of the current state of post-traumatic agitation research. METHODS: We performed a PubMed literature review which included recent confirmatory and novel research as well as classic and historical studies to integrate past and future concepts. RESULTS: Areas explored include the personal and societal effects of post-traumatic agitation, methods for defining and diagnosing several neurobehavioral disorders, and pathophysiology and management of agitation and aggression. Target areas for future study are identified and discussed. DISCUSSION: While much progress has been made in understanding post-traumatic agitation, there remain several key areas that require further elucidation to support the care and treatment for people with traumatic brain injury.

Comparative Toxicity of Aquatic Per- and Polyfluoroalkyl Substance Exposure in Three Species of Amphibians.

Per- and polyfluoroalkyl substances (PFAS) are contaminants of concern due to their widespread occurrence in the environment, persistence, and potential to elicit a range of negative health effects. Per- and polyfluoroalkyl substances are regularly detected in surface waters, but their effects on many aquatic organisms are still poorly understood. Species with thyroid-dependent development, like amphibians, can be especially susceptible to PFAS effects on thyroid hormone regulation. We examined sublethal effects of aquatic exposure to four commonly detected PFAS on larval northern leopard frogs (Rana [Lithobates] pipiens), American toads (Anaxyrus americanus), and eastern tiger salamanders (Ambystoma tigrinum). Animals were exposed for 30 days (frogs and salamanders) or until metamorphosis (toads) to 10, 100, or 1000 µg/L of perfluorooctane sulfonate (PFOS), perfluorooctanoic acid (PFOA), perfluorohexane sulfonate (PFHxS), or 6:2 fluorotelomer sulfonate (6:2 FTS). We determined that chronic exposure to common PFAS can negatively affect amphibian body condition and development at concentrations as low as 10 µg/L. These effects were highly species dependent, with species having prolonged larval development (frogs and salamanders) being more sensitive to PFAS than more rapidly developing species (toads). Our results demonstrate that some species could experience sublethal effects at sites with surface waters highly affected by PFAS. Our results also indicate that evaluating PFAS toxicity using a single species may not be sufficient for accurate amphibian risk assessment. Future studies are needed to determine whether these differences in susceptibility can be predicted from species' life histories and whether more commonly occurring environmental levels of PFAS could affect amphibians. Environ Toxicol Chem 2022;41:1407-1415. © 2022 The Authors. Environmental Toxicology and Chemistry published by Wiley Periodicals LLC on behalf of SETAC.

Lurasidone an Effective Alternative for the Treatment of Irritability Associated With Autism Spectrum Disorder.

The key objective to demonstrate the use of Lurasidone in children or adolescents with autism spectrum disorders (ASD) and add further insights into its use in clinical practice with youth. We present four cases treated in the inpatient settings with unique challenges and their treatment course to address the unique clinical practice challenges. There is a dearth of psychopharmacologic options to treat irritability and affective symptoms in children and/or adolescents with autism spectrum disorders. Although recent research has yielded mixed results, there is still a not clear consensus on its effectiveness. Based on our experience, we found Lurasidone was an effective alternative due to its unique psychopharmacologic profile. It was well tolerated without any side effects, and its efficacy was more observed at higher doses.

In vitro and in silico modeling of perfluoroalkyl substances mixture toxicity in an amphibian fibroblast cell line.

Poly and perfluoroalkyl substances (PFAS) are a large group of emerging organic pollutants that can persist in the environment and bioaccumulate in biota. They are found in complex mixtures, and although the exact number of PFAS is unknown, it has been estimated to be in the thousands. The objective of this study was two-fold. First, we examined the cytotoxicity of PFAS singly and in binary mixtures using an amphibian fibroblast cell line. Second, we used this experimental data to develop quantitative structure-activity relationship (QSAR) models for single and binary mixtures. We tested the cytotoxicity of four common PFAS: perfluorooctane sulfonate (PFOS); perfluorooctanoic acid (PFOA); perfluorohexane sulfonate (PFHxS); and perfluorohexanoic acid (PFHxA). PFOS was the most toxic and PFHxA the least cytotoxic. Binary mixtures allowed for the construction of isobolograms to test for additivity, synergism, or antagonism. Using this data, QSAR modeling was used for predicting the toxicity of 24 single and 1380 binary mixtures (theoretically generated). Overall, our experimental and modeling results showed that mixtures were approximately additive, with the exception of PFOS and PFOA, which were found to be weakly synergistic. This data shows that certain mixtures of PFAS may have increased toxicity potential above what the simple sum of PFAS concentrations would suggest. More studies are needed that test the toxicity of PFAS mixtures.

What Crisis? Management Researchers' Experiences with and Views of Scholarly Misconduct.

This research presents the results of a survey regarding scientific misconduct and questionable research practices elicited from a sample of 1215 management researchers. We find that misconduct (research that was either fabricated or falsified) is not encountered often by reviewers nor editors. Yet, there is a strong prevalence of misrepresentations (method inadequacy, omission or withholding of contradictory results, dropping of unsupported hypotheses). When it comes to potential methodological improvements, those that are skeptical about the empirical body of work being published see merit in replication studies. Yet, a sizeable majority of editors and authors eschew open data policies, which points to hidden costs and limited incentives for data sharing in management research.

The Changing Nonlinear Relationship between Income and Terrorism.

This article reinvestigates the relationship between real per capita gross domestic product (GDP) and terrorism. We devise a terrorism Lorenz curve to show that domestic and transnational terrorist attacks are each more concentrated in middle-income countries, thereby suggesting a nonlinear income-terrorism relationship. Moreover, this point of concentration shifted to lower income countries after the rising influence of the religious fundamentalist and nationalist/separatist terrorists in the early 1990s. For transnational terrorist attacks, this shift characterized not only the attack venue but also the perpetrators' nationality. The article then uses nonlinear smooth transition regressions to establish the relationship between real per capita GDP and terrorism for eight alternative terrorism samples, accounting for venue, perpetrators' nationality, terrorism type, and the period. Our nonlinear estimates are shown to be favored over estimates using linear or quadratic income determinants of terrorism. These nonlinear estimates are robust to additional controls.