This review provides an overview of literature addressing progressive massive fibrosis (PMF) from September 2009 to the present. Advances are described in understanding its pathophysiology, ...epidemiology of the occurrence of PMF and related conditions, the impact of PMF on pulmonary function, advances in imaging of PMF, and factors affecting progression of pneumoconiosis in dust-exposed workers to PMF. Basic advances in understanding the etiology of PMF are impeded by the lack of a well-accepted animal model for human PMF. Recent studies evaluating lung tissue samples and epidemiologic investigations support an important role for the silica component of coal mine dust in causing coal workers' pneumoconiosis and PMF in contemporary coal miners in the United States and for silica in causing silicosis and PMF in artificial stone workers throughout the world. Development of PMF is associated with substantial decline in pulmonary function relative to no disease or small opacity pneumoconiosis. In recent reports, computed tomography has had greater sensitivity for detecting PMF than chest x-ray. Magnetic resonance imaging shows promise in differentiating between PMF and lung cancer. Although PMF develops in dust-exposed workers without previously identified small opacity pneumoconiosis, the presence of small opacity pneumoconiosis increases the risk for progression to PMF, as does heavier dust exposure. Recent literature does not document any effective new treatments for PMF and new therapies to prevent and treat PMF are an important need.
Transdiagnostic processes confer risk for multiple types of psychopathology and explain the co-occurrence of different disorders. For this reason, transdiagnostic processes provide ideal targets for ...early intervention and treatment. Childhood trauma exposure is associated with elevated risk for virtually all commonly occurring forms of psychopathology. We articulate a transdiagnostic model of the developmental mechanisms that explain the strong links between childhood trauma and psychopathology as well as protective factors that promote resilience against multiple forms of psychopathology.
We present a model of transdiagnostic mechanisms spanning three broad domains: social information processing, emotional processing, and accelerated biological aging. Changes in social information processing that prioritize threat-related information-such as heightened perceptual sensitivity to threat, misclassification of negative and neutral emotions as anger, and attention biases towards threat-related cues-have been consistently observed in children who have experienced trauma. Patterns of emotional processing common in children exposed to trauma include elevated emotional reactivity to threat-related stimuli, low emotional awareness, and difficulties with emotional learning and emotion regulation. More recently, a pattern of accelerated aging across multiple biological metrics, including pubertal development and cellular aging, has been found in trauma-exposed children. Although these changes in social information processing, emotional responding, and the pace of biological aging reflect developmental adaptations that may promote safety and provide other benefits for children raised in dangerous environments, they have been consistently associated with the emergence of multiple forms of internalizing and externalizing psychopathology and explain the link between childhood trauma exposure and transdiagnostic psychopathology. Children with higher levels of social support, particularly from caregivers, are less likely to develop psychopathology following trauma exposure. Caregiver buffering of threat-related processing may be one mechanism explaining this protective effect.
Childhood trauma exposure is a powerful transdiagnostic risk factor associated with elevated risk for multiple forms of psychopathology across development. Changes in threat-related social and emotional processing and accelerated biological aging serve as transdiagnostic mechanisms linking childhood trauma with psychopathology. These transdiagnostic mechanisms represent critical targets for early interventions aimed at preventing the emergence of psychopathology in children who have experienced trauma.
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DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Autonomic nervous system (ANS) activity is a core and central component of emotion and motivated action. The myriad social and cognitive challenges faced by humans require flexible modulation of ANS ...activity for different contexts. In this study, simultaneous activity of the parasympathetic and sympathetic nervous system was measured using respiratory sinus arrhythmia (RSA) and pre-ejection period (PEP), respectively. Samples combined four previous studies (N = 325, 63% female, aged 15–55) in which RSA and PEP were collected continuously during a resting baseline and an acute stressor, the Trier Social Stress Task. The concurrent relation between RSA and PEP responses was modelled in order to determine the extent to which SNS and PNS activity is correlated across the task within and between participants, and whether this correlation was moderated by age, race, sex, or baseline RSA and PEP. Overall, RSA and PEP were reciprocally coupled. However, recovery from a stressor was characterized by coactivation. Individuals also vary in the extent to which their SNS and PNS are reciprocally coupled; women, younger adults, and individuals with higher baseline RSA showed more reciprocal coupling than men, older adults, and those with lower baseline RSA, respectively, reflecting greater coordination of physiological responding in the former groups.
•Correlated activity of the sympathetic and parasympathetic nervous systems was measured during the Trier Social Stress Task.•Changes in respiratory sinus arrhythmia (RSA) and pre-ejection period (PEP) indicated reciprocal activity, overall.•Recovery from a stressor was characterized by coactivation.•Correlations of RSA and PEP were stronger in females than males, and among older adults and those with higher baseline RSA.
Cardiac healing following acute myocardial infarction (MI) involves the mobilization and activation of immune cells, including macrophages. In the early phase after MI, macrophages adopt a ...proinflammatory phenotype, while polarizing toward a reparative one in the late stage. Although metabolic reprogramming has been observed during this transition, the mechanistic links to macrophage differentiation are still poorly understood. In this issue of the JCI, Cai, Zhao and colleagues demonstrate that mitochondrial function in macrophages governed the resolution of inflammation and tissue repair by modulating the phagocytic removal of apoptotic cells (so-called efferocytosis) as well as myofibroblast activation. These findings provide important mechanistic insights into the potential relevance of metabolic modulation of macrophage functions following MI, which might lead to alternative therapeutic strategies for MI.
Macrostructural characteristics, such as cost of living and state-level anti-poverty programs relate to the magnitude of socioeconomic disparities in brain development and mental health. In this ...study we leveraged data from the Adolescent Brain and Cognitive Development (ABCD) study from 10,633 9-11 year old youth (5115 female) across 17 states. Lower income was associated with smaller hippocampal volume and higher internalizing psychopathology. These associations were stronger in states with higher cost of living. However, in high cost of living states that provide more generous cash benefits for low-income families, socioeconomic disparities in hippocampal volume were reduced by 34%, such that the association of family income with hippocampal volume resembled that in the lowest cost of living states. We observed similar patterns for internalizing psychopathology. State-level anti-poverty programs and cost of living may be confounded with other factors related to neurodevelopment and mental health. However, the patterns were robust to controls for numerous state-level social, economic, and political characteristics. These findings suggest that state-level macrostructural characteristics, including the generosity of anti-poverty policies, are potentially relevant for addressing the relationship of low income with brain development and mental health.
AbstractBackgroundChildhood adversity is strongly linked to negative mental health outcomes, including depression and anxiety. Leveraging cognitive neuroscience to identify mechanisms that contribute ...to resilience in children with a history of maltreatment may provide viable intervention targets for the treatment or prevention of psychopathology. We present a conceptual model of a potential neurobiological mechanism of resilience to depression and anxiety following childhood adversity. Specifically, we argue that neural circuits underlying the cognitive control of emotion may promote resilience, wherein a child’s ability to recruit the frontoparietal control network to modulate amygdala reactivity to negative emotional cues—such as during cognitive reappraisal—buffers risk for internalizing symptoms following exposure to adversity. MethodsWe provide preliminary support for this model of resilience in a longitudinal sample of 151 participants 8 to 17 years of age with ( n = 79) and without ( n = 72) a history of childhood maltreatment who completed a cognitive reappraisal task while undergoing functional magnetic resonance imaging. ResultsAmong maltreated youths, those who were better able to recruit prefrontal control regions and modulate amygdala reactivity during reappraisal exhibited lower risk for depression over time. By contrast, no association was observed between neural functioning during reappraisal and depression among youths without a history of maltreatment. ConclusionsThese preliminary findings support the hypothesis that children who are better able to regulate emotion through recruitment of the frontoparietal network exhibit greater resilience to depression following childhood maltreatment. Interventions targeting cognitive reappraisal and other cognitive emotion regulation strategies may have potential for reducing vulnerability to depression among children exposed to adversity.
Childhood maltreatment is associated with increased risk for most forms of psychopathology. We examine emotion dysregulation as a transdiagnostic mechanism linking maltreatment with general ...psychopathology. A sample of 262 children and adolescents participated; 162 (61.8%) experienced abuse or exposure to domestic violence. We assessed four emotion regulation processes (cognitive reappraisal, attention bias to threat, expressive suppression, and rumination) and emotional reactivity. Psychopathology symptoms were assessed concurrently and at a 2-year longitudinal follow-up. A general psychopathology factor (p factor), representing co-occurrence of psychopathology symptoms across multiple internalizing and externalizing domains, was estimated using confirmatory factor analysis. Maltreatment was associated with heightened emotional reactivity and greater use of expressive suppression and rumination. The association of maltreatment with attention bias varied across development, with maltreated children exhibiting a bias toward threat and adolescents a bias away from threat. Greater emotional reactivity and engagement in rumination mediated the longitudinal association between maltreatment and increased general psychopathology over time. Emotion dysregulation following childhood maltreatment occurs at multiple stages of the emotion generation process, in some cases varies across development, and serves as a transdiagnostic mechanism linking child maltreatment with general psychopathology.
Competitiveness and cooperativeness are important predictors of social and learning outcomes at school. Drawing on evidence suggesting that contexts with high income inequality foster an ethos of ...competitiveness and inhibit cooperativeness in the economic environment, we examine whether income inequality is also associated with more competitiveness and less cooperativeness in the academic environment. We conducted four preregistered studies to test this idea. In Study 1, analysis of the OECD PISA 2018 data set (≈500,000 15-year-old students from 75 countries) revealed that students from economically unequal countries perceive their schoolmates as more competitive and less cooperative. In Study 2a and 2b, analysis of the PISA 2003 (250,000+ students from 38 countries) and PISA 2000 (75,000+ students from 32 countries) data sets revealed that students from unequal countries are themselves more competitive and, surprisingly, also more cooperative. Follow-up analyses resolved this apparent paradox, showing that students from unequal countries are oriented toward instrumental rather than intrinsic cooperativeness (i.e., using cooperation as a strategic tool to achieve academic success rather than for the enjoyment of the activity itself). Study 3 offers a conceptual experimental replication (≈850 young adults imagining going back to school) and indicates that induced income inequality (a) increases perceived competitiveness, (b) decreases perceived cooperativeness, (c) prompts an orientation toward competitiveness, and (d) prompts an orientation toward instrumental rather than intrinsic cooperativeness. Results are discussed in relation to the multidisciplinary literatures on the psychology of income inequality, the selective function of school systems, coopetition, self-determination, and cooperative learning.
Educational Impact and Implications StatementIndividuals residing in places with high income inequality have been shown to compete more fiercely for status and cooperate less. In this research, we examine whether this phenomenon also applies to students at school. Analyses of three OECD PISA data sets (≈850,000 students from a total of 75+ countries observed in 2018, 2003, and 2000) show that 15-year-old students from economically unequal countries (a) perceive their schoolmates as more competitive and less cooperative and (b) are more competitive and more strategically cooperative (i.e., they use cooperation as a tool to achieve academic success). An experiment manipulating income inequality (≈850 young adults) led to the same conclusions. Taken together, our results suggest that income inequality fosters an ethos of competitiveness among the workforce of tomorrow.
Workforce shortages, late referrals, and palliative care program resource constraints present significant barriers to meeting the needs of hospitalized patients facing serious illnesses. The Center ...to Advance Palliative Care convened a consensus panel to select criteria by which patients at high risk for unmet palliative care needs can be identified in advance for a palliative care screening assessment. The consensus panel developed primary and secondary criteria for two checklists-one to use for screening at the time of admission and one for daily patient rounds. The consensus panel believes that by implementing a checklist approach to screening patients for unmet palliative care needs, combined with educational initiatives and other system-change work, hospital staff engaged in day-to-day patient care can identify a majority of such needs, reserving specialty palliative care services for more complex problems.
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