Introduction
Attention deficit hyperactivity disorder (ADHD) is associated with risk‐taking behavior, leading to accidents and unintentional injuries (summarized here as incidents). Main aim of this ...study is to determine if men and women with and without ADHD differ in the risk of mild (treated outpatient) and severe (treated inpatient) incidents across the adult lifespan (age groups: 18–29; 30–59, and ≥60 years). Secondary aim: investigate the role of comorbid mental disorders and drugs for the treatment of these comorbidities, and ADHD‐medication.
Methods
Using anonymized German claims data (N = 4,575,027), adults with ADHD diagnosis during 2016–2019 (N = 17,041) were compared with a 1:4 age and sex‐matched group without ADHD diagnosis. Regression analyses statistically tested group differences.
Results
Incidents occur in a U‐shaped form across the adult lifespan. Individuals with ADHD show the same pattern but at a substantially increased risk of both mild and severe incidents throughout the lifespan. Women without ADHD are at lower risk in young adulthood than men but at higher risk in older adulthood. Women with ADHD show the same pattern for severe incidents, but for mild incidents they have the highest risk throughout the lifespan. Co‐occurring anxiety disorder and the use of psycholeptics and ADHD‐medication decreased the incident risk.
Conclusion
We extend available knowledge which has hitherto focused on young adult males and traffic accidents. ADHD is associated with increased incidents across the adult lifespan, with distinct patterns regarding age, sex, and incident severity. An accurate diagnosis of ADHD in adulthood provides the first step towards prevention of accidents and unintentional injuries.
Attention‐deficit hyperactivity disorder (ADHD) is a developmental psychiatric disorder that affects children and adults. ADHD is one of the psychiatric disorders with the strongest genetic basis ...according to familial, twin, and single nucleotide polymorphisms (SNP)‐based epidemiological studies. In this review, we provide an update of recent insights into the genetic basis of ADHD. We discuss recent progress from genome‐wide association studies (GWAS) looking at common variants as well as rare copy number variations. New analysis of gene groups, so‐called functional ontologies, provide some insight into the gene networks afflicted, pointing to the role of neurodevelopmentally expressed gene networks. Bioinformatic methods, such as functional enrichment analysis and protein–protein network analysis, are used to highlight biological processes of likely relevance to the etiology of ADHD. Additionally, copy number variations seem to map on important pathways implicated in synaptic signaling and neurodevelopment. While some candidate gene associations of, for example, neurotransmitter receptors and signaling, have been replicated, they do not seem to explain significant variance in recent GWAS. We discuss insights from recent case–control SNP–GWAS that have presented the first whole‐genome significant SNP in ADHD.
Gender differences in career success are still an issue in society and research, and men typically earn higher incomes than women do. Building on previous theorizing and findings with the Theory of ...Gendered Organizations and the Theory of Tokenism, we used a large sample of the adult starting cohort in the German National Educational Panel Study and a multilevel approach to test how the interaction between gender and the gender ratio in occupations was associated with income. We wanted to know whether the male advantage in terms of income would be equal in magnitude across occupations (as suggested by the Theory of Gendered Organizations) or if it would vary with the gender ratio in occupations (as suggested by the Theory of Tokenism and reasoning regarding person-job fit), such that people benefit either (a) from resembling the majority of employees in a field by working in a gender-typical occupation or (b) from standing out by working in a gender-atypical occupation. Analyses supported the hypothesis that employees’ incomes may benefit if they belong to the gender minority in an occupation, but this finding applied only to women. By contrast, men did not benefit from working in a gender-atypical occupation. Thus, women earned less than men earned overall, but the gender pay gap was smaller in occupations with a higher ratio of male employees. The findings can advance the understanding of gender-related career decisions for both employers and employees.
To conduct a systematic review and meta-analysis on the relevance of low social support for the development and course of coronary heart disease (CHD).
Three electronic databases were searched ...(MEDLINE, PsycINFO/PSYNDEX, and Web of Science 2007/03). More than 1700 papers were screened in a first step. We included prospective studies assessing the impact of social support in either an initially healthy study population (etiologic studies) or in a study population with preexisting CHD (prognostic studies).
Myocardial infarction in etiologic studies; cardiovascular mortality and all-cause mortality in prognostic studies. Effects were reported as relative risk (RR) or hazard ratio (HR).
There is some evidence for an impact of low functional social support on the prevalence of CHD in etiologic studies (RR, range, 1.00-2.23). In contrast, there is no evidence of an impact of low structural social support on the prevalence of myocardial infarction in healthy populations (RR, range, 1.01-1.2). In prognostic studies, results consistently show that low functional support negatively affects cardiac and all-cause mortality (pooled RR, range, 1.59-1.71). These results were also confirmed in analyses adjusted for other risk factors for disease progression (pooled HR, 1.59). It remains unclear whether low structural social support increases mortality in patients with CHD (pooled RR, between 1.56; pooled HR, 1.12, NS).
Because the perception of social support seems important for CHD prognosis, monitoring of functional social support is indicated in patients with CHD, and interventions to increase the perception of positive social resources are warranted.
OBJECTIVES/HYPOTHESISThe purpose of this study is to elucidate factors associated with voice therapy attendance within the interdisciplinary care model.STUDY DESIGNThis was a retrospective ...review.METHODSPatients referred for voice therapy following interdisciplinary evaluation involving speech language pathology and laryngology were included. Independent variables were (1) duration between interdisciplinary voice evaluation and first voice therapy session, (2) plan of care determined at the time of evaluation, (3) mode of voice therapy delivery, and (4) stimulability for improvement during evaluation. Voice therapy attendance was measured as (1) attendance to the first voice therapy session and (2) overall voice therapy attendance.RESULTSOf 272 patients referred for voice therapy, 69.12% attended the first session, 17.28% canceled/no-showed (C/NS), and 13.6% did not schedule the first session. Of 235 patients who scheduled voice therapy, 48.94% attended all their scheduled sessions, and 51.06% C/NS at least one session. Patients with a plan of care including voice therapy + surgery were 86% less likely (risk ratio RR = 0.14, P = 0.0014) to C/NS any of their voice therapy sessions. In contrast, patients with plan of care including voice therapy + medication were more likely to C/NS at least one voice therapy session (RR = 1.27, P = 0.1419), although this finding was not significant. No other covariates had a significant impact on voice therapy initiation or overall attendance.CONCLUSIONSThis study provides further support for the positive impact of interdisciplinary evaluation on voice therapy initiation. However, once voice therapy is initiated, overall C/NS rates are persistently high, consistent with previous investigations of voice therapy dropout. Our findings suggest that plan of care determined at the time of evaluation may have an impact on voice therapy attendance.
Remote voice recording and acoustic analysis allow for comprehensive voice assessment and outcome tracking without the requirements of travel to the clinic, in-person visit, or expensive equipment. ...This paper delineates the process and considerations for implementing remote voice recording and acoustic analysis in a high-volume university voice clinic.
Clinical Focus.
Acoustic voice recordings were attempted on 108 unique patients over a 6-month period using a remote voice recording phone application. Development of the clinical process including determining normative data in which to compare acoustic results, clinician training, and clinical application is described. The treating Speech Language Pathologists (SLPs) were surveyed 2 months after implementation to assess ease of application, identify challenges and assess implementation of potential solutions.
Of 108 unique patients, 83 patients were successful in completing the process of synchronous remote acoustic voice recording in conjunction with their SLP clinician. The process of downloading the application, setting up, and obtaining voice recordings was most commonly 10-20 minutes according to the 8 SLPs surveyed. Challenges and helpful techniques were identified.
Remote acoustic voice recordings have allowed SLPs to continue to complete a comprehensive voice evaluation in a telepractice model. Given emerging knowledge about the viability of remote voice recordings, the success in obtaining acoustic data remotely, and the accessibility of a low-cost app for SLPs makes remote voice recordings a viable option to facilitate remote clinical care and research investigation.
While leptin is a well-known regulator of body fat mass, it remains unclear how circulating leptin is sensed centrally to maintain energy homeostasis. Here we show that genetic and pharmacological ...ablation of adult NG2-glia (also known as oligodendrocyte precursors), but not microglia, leads to primary leptin resistance and obesity in mice. We reveal that NG2-glia contact the dendritic processes of arcuate nucleus leptin receptor (LepR) neurons in the median eminence (ME) and that these processes degenerate upon NG2-glia elimination, which explains the consequential attenuation of these neurons’ molecular and electrical responses to leptin. Our data therefore indicate that LepR dendrites in the ME represent the principal conduits of leptin’s anorexigenic action and that NG2-glia are essential for their maintenance. Given that ME-directed X-irradiation confirmed the pharmacological and genetically mediated ablation effects on body weight, our findings provide a rationale for the known obesity risk associated with cranial radiation therapy.
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•Pharmacological and genetic ablation of NG2-glia, but not microglia, leads to obesity•NG2-glial ablation causes LepR processes in the median eminence to degenerate•Arcuate nucleus LepR neurons lose responsiveness to leptin after NG2-glia ablation•X-irradiation aimed at the median eminence is sufficient for weight gain induction
Djogo et al. show that ablation of NG2-glia, but not microglia, in the median eminence (ME) leads to selective degeneration of LepR dendrites in the arcuate nucleus, causing primary leptin resistance and obesity. These effects are reproduced with ME-directed X-irradiation, possibly explaining the obesity risk associated with cranial radiation therapy.
Cation deintercalation with soft-chemical methods provides a route to synthesize new layered compounds with emergent physical and chemical properties that are inaccessible by conventional ...high-temperature solid-state synthesis methods. One example is CrSe2, a van der Waals (vdW) material that is promising as an air-stable two-dimensional (2D) magnet. Cation deintercalation has rarely been studied mechanistically, and optimized reaction pathways to yield high-quality materials are often poorly understood. In this work, we perform a detailed study of the oxidative deintercalation process of KCrSe2. We prove for the first time using high-resolution scanning transmission electron microscopy (STEM) that even though CrSe2 indeed exists in a true vdW-layered structure, K-intercalated crystalline defects exist in the final product, even when an excess of oxidizing agent was used. We then study the kinetics of the oxidative deintercalation process, showing that it is a zeroth-order reaction with an activation energy of 0.27(6) eV, where the solid-state diffusion of K+ cations in the potassium deintercalation process is the rate-limiting step. Finally, we study the relationship between Cr–Cr distances and the change in magnetic order by tracking how the properties change as a function of varying potassium content due to deintercalation. These data suggest that it might be possible to switch between magnetic states in CrSe2 monolayers by varying its lattice parameters with methods, such as applying strain. Our study also provides a deeper understanding of the cation deintercalation process from a mechanistic perspective that will be helpful for the future development of synthetic methodology that can lead to other new layered materials.
DNA replication results in the doubling of the genome prior to cell division. This process requires the assembly of 50 or more protein factors into a replication fork. Here, we review recent ...structural and biochemical insights that start to explain how specific proteins recognize DNA replication origins, load the replicative helicase on DNA, unwind DNA, synthesize new DNA strands, and reassemble chromatin. We focus on the minichromosome maintenance (MCM2-7) proteins, which form the core of the eukaryotic replication fork, as this complex undergoes major structural rearrangements in order to engage with DNA, regulate its DNA-unwinding activity, and maintain genome stability.
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