Parent-child relationship quality buffers the association between mothers' adverse childhood experiences and physiological synchrony.

Background: Family environment plays a critical role in shaping stress response systems. Concordance between mothers' and children's physiological states, specifically their Respiratory Sinus Arrhythmia (RSA), reflects dyadic co-regulation. Negative or weakened RSA synchrony during interactions is linked to various psychosocial risks, but existing research has focused on risks in the mother or child as opposed to the dyad.

Delirium detection in the emergency department: A diagnostic accuracy meta-analysis of history, physical examination, laboratory tests, and screening instruments.

Introduction: Geriatric emergency department (ED) guidelines emphasize timely identification of delirium. This article updates previous diagnostic accuracy systematic reviews of history, physical examination, laboratory testing, and ED screening instruments for the diagnosis of delirium as well as test-treatment thresholds for ED delirium screening.

Methods: We conducted a systematic review to quantify the diagnostic accuracy of approaches to identify delirium.

Osteoporosis Screening Disparities among Ethnic and Racial Minorities: A Systematic Review.

Background: Osteoporosis is a preventable disease that is simple and cost-effective to screen based on clinical practice guidelines, yet many patients go undiagnosed and untreated leading to increased burden of the disease. Specifically, racial and ethnic minorities have lower rates of dual energy absorptiometry (DXA) screening. Inadequate screening may lead to an increased risk of fracture, higher health care costs, and increased morbidity and mortality disproportionately experienced by racial-ethnic minority populations.

Risk Factors for Pediatric Asthma Readmissions: A Systematic Review.

Objective: To systematically review the literature on pediatric asthma readmission risk factors.

Study Design: We searched PubMed/MEDLINE, CINAHL, Scopus, PsycINFO, and Cochrane Central Register of Controlled Trials for published articles (through November 2019) on pediatric asthma readmission risk factors. Two authors independently screened titles and abstracts and consensus was reached on disagreements.

A novel, low fidelity simulator for laryngotracheal reconstruction.

Introduction: Open airway reconstruction is a highly specialized skill. Simulation affords the opportunity to practice surgical skills in a low stakes environment which is particularly important for a high acuity, low frequency operation. Although animal models have been described, these present ethical and financial barriers, and therefore are not ideal to expose residents to airway reconstruction techniques.

Teaching a tracheotomy handoff tool to pediatric first responders.

Introduction: The Critical Airway Risk Evaluation (CARE) system is an airway classification system we designed to improve handoffs between caregivers by describing the risk of a patient's airway above the tracheotomy tube, and therefore the correct resuscitation maneuvers in the event of an airway emergency. It is designed to quickly communicate 3 categories: 1-easily intubatable; 2-intubatable with specialized techniques or equipment; or 3-not intubatable. We have demonstrated previously that the system is easily taught to and used by pediatric otolaryngologists.

Cutaneous sign of abuse: Kids are not just little people.

Skin injury is the most common form of child physical abuse. Although the pattern and visual appearance of skin injury and the treatment needed for the injury is similar in children and adults, characteristics of infant and childhood skin may complicate the diagnosis of injury. A good understanding of normal developmental presentation of accidental injury from infancy to adulthood, locations for injury that should trigger consideration of abuse, and cutaneous mimics of abuse across the lifespan are critical to the identification of suspected abuse.

A pilot randomized clinical trial testing integrated 12-Step facilitation (iTSF) treatment for adolescent substance use disorder.

Background And Aims: The integration of 12-Step philosophy and practices is common in adolescent substance use disorder (SUD) treatment programs, particularly in North America. However, although numerous experimental studies have tested 12-Step facilitation (TSF) treatments among adults, no studies have tested TSF-specific treatments for adolescents. We tested the efficacy of a novel integrated TSF.

Exploiting endogenous fibrocartilage stem cells to regenerate cartilage and repair joint injury.

Tissue regeneration using stem cell-based transplantation faces many hurdles. Alternatively, therapeutically exploiting endogenous stem cells to regenerate injured or diseased tissue may circumvent these challenges. Here we show resident fibrocartilage stem cells (FCSCs) can be used to regenerate and repair cartilage.

Psychological conditions in adults with diabetes.

Type 1 (T1D) and Type 2 diabetes (T2D) represent a demanding set of biopsychosocial challenges for patients and their families, whether the age of disease onset occurs in childhood, adolescence, or adulthood. Psychological conditions, defined as syndromes, disorders, and diabetes-specific psychological issues affect a larger proportion of individuals with T1D and T2D compared to the general population. In this review, we summarize the prevalence, impact and psychological treatments associated with the primary categories of psychological conditions that affect adults with T1D and T2D: depressive symptoms and syndromes, anxiety disorders, eating behaviors and disorders and serious mental illness.

Cutaneous infectious diseases: Kids are not just little people.

The changes in immune response that occur with age play a significant role in disease presentation and patient management. Evolution of the innate and adaptive immune systems throughout life, influenced partly by hormonal changes associated with puberty, plays a role in the differences between pediatric and adult response to disease. We review a series of manifestations of dermatologic infectious diseases spanning bacterial, viral, and fungal origins that can be seen in both pediatric and adult age groups and highlight similarities and differences in presentation and disease course.

Caregiver insightfulness and young children's violence exposure: testing a relational model of risk and resilience.

This study employed a relational post-traumatic stress frame to explore the co-contribution of young children's exposure to violence and caregiver insightfulness on child behavioral outcomes in a high-risk, non-referred sample of caregivers and preschoolers (n = 64; mean age 3.83 years, SD = .77).

Yet another function of p53--the switch that determines whether radiation-induced autophagy will be cytoprotective or nonprotective: implications for autophagy inhibition as a therapeutic strategy.

The influence of autophagy inhibition on radiation sensitivity was studied in human breast, head and neck, and non-small cell lung cancer cell lines, in cell lines that were either wild type or mutant/null in p53, and in cells where p53 was inducible or silenced. Whereas ionizing radiation promoted autophagy in all tumor cell lines studied, pharmacological inhibition of autophagy and/or genetic silencing of autophagy genes failed to influence sensitivity to radiation in p53 mutant Hs578t breast tumor cells, HN6 head and neck tumor cells, and H358 non-small cell lung cancer cells. The requirement for functional p53 in the promotion of cytoprotective autophagy by radiation was confirmed by the observation that radiation-induced autophagy was nonprotective in p53 null H1299 cells but was converted to the cytoprotective form with induction of p53.

Association of gene variants of the renin-angiotensin system with accelerated hippocampal volume loss and cognitive decline in old age.

Objective: Genetic factors confer risk for neuropsychiatric phenotypes, but the polygenic etiology of these phenotypes makes identification of genetic culprits challenging. An approach to this challenge is to examine the effects of genetic variation on relevant endophenotypes, such as hippocampal volume loss. A smaller hippocampus is associated with gene variants of the renin-angiotensin system (RAS), a system implicated in vascular disease.

Self-organization of domain structures by DNA-loop-extruding enzymes.

The long chromosomal DNAs of cells are organized into loop domains much larger in size than individual DNA-binding enzymes, presenting the question of how formation of such structures is controlled. We present a model for generation of defined chromosomal loops, based on molecular machines consisting of two coupled and oppositely directed motile elements which extrude loops from the double helix along which they translocate, while excluding one another sterically. If these machines do not dissociate from DNA (infinite processivity), a disordered, exponential steady-state distribution of small loops is obtained.

Sildenafil preserves intracorporeal smooth muscle after radical retropubic prostatectomy.

Purpose: Early use of vasoactive agents has been shown to rehabilitate erectile function after nerve sparing radical retropubic prostatectomy (RRP). The loss of intracorporeal smooth muscle (SM) and an increase in intracorporeal fibrosis have been demonstrated in vasculogenic impotence and implicated in permanent post-RRP erectile dysfunction. We assessed the effect of sildenafil on SM content after RRP.

Growth factors. Their biology and promise in dermatologic diseases and tissue repair.

In the last few years, the field of peptide growth factors has exploded with new knowledge and potential therapeutic applications. We review some of these important aspects of growth factors with regard to the field of dermatology.