Early Adulthood Research Articles

Differential temporal decline of cerebral oxytocin and μ-opioid receptor density during the aging process in mice.

Aging is often associated with changes in social, sexual, emotional and pain functioning, as well as with the increased prevalence of certain psychopathologies. However, the neurodevelopmental basis underpinning these age-related changes remains to be determined. Considering the key roles of oxytocin (OTR) and μ-opioid (MOPr) receptor systems in regulating social, sexual, pain, reward and emotional processing, it seems plausible that they are also implicated in age-related behavioural alterations. Although the ontogeny of both receptors has been well characterized in rodent brains from early development till adulthood, little is known concerning the neuroadaptations occurring from middle age to old age. Therefore, we mapped the neuroadaptations in OTR and MOPr in the brains of mice at those developmental endpoints. Quantitative OTR and MOPr autoradiographic binding was carried out in the brains of male mice at 2, 6, 9, 12 and 18 months of age. A significant whole brain decline in OTR density was detected between 2 and 6months of age, with no additional decline thereafter. Interestingly, for MOPrs, the decline in density was not detected until 9months of age. Region-specific age-related decline in OTR density was concentrated in the lateral anterior olfactory nuclei (AOL) and, for MOPr, in the AOL and the nucleus accumbens for MOPr. Identifying the tipping point of these age-related variations in both receptors may assist with our understanding of the neurobiology underlining age-related changes in social, pain and emotional functioning/processing. It may also help us target interventions to specific developmental windows to abrogate certain age-related psychopathologies.

Impact of Domestic Task Involvement toward Parental Stress on Dual Earner Couples

Purpose: The prevalence of dual-earner couples in Indonesia, particularly in urban areas, has led to an increase in their roles both at work and in the family. This situation often results in inappropriate domestic task involvement, which in turn affects the stress levels of these couples. Understanding the impact of domestic task involvement on parental stress is crucial for the fields of family studies, psychology, and sociology. Method: The research included 237 respondents obtained using purposive sampling techniques, and the results were analyzed with quantitative methods with criteria for early adulthood, working married couples, having children aged at least six years, and being domiciled in Jabodetabek. Data was collected through a survey using the instruments Subject’s Involvement in Household Chores and Partner’s Involvement in Household Chores for the independent variable and Parental Stress Scale for the dependent variable. Data was analyzed using quantitative methods through multiple regression analysis to test the impact of domestic task involvement on parental stress. Result: The results show that domestic task involvement has a significantly negative impact of 3.4% on low levels of parental stress. The multiple regression test shows the calculated significance level of 0.017 < 0.05. Subject Involvement and Partner Involvement simultaneously have a negative influence on parental stress. Conclusion: The study underscores the pivotal role of collaboration between husband and wife in managing domestic tasks, which can significantly reduce parental stress. These findings not only contribute to the academic discourse but also suggest practical strategies for supporting dual-earner couples in Indonesia.

Associations between tripartite dimensions of internalizing symptoms and transition readiness in a sample of emerging adults with and without chronic physical health conditions.

Theoretical models note psychosocial functioning as a key influence on transition readiness skills (TRS) among emerging adults (EA), but little is known about the relative importance of unique vs. shared anxiety and depressive dimensions, operationalized according to Clark and Watson's (1991) tripartite model, in contributing to TRS. Moreover, although development of TRS is important for all EA, few studies have examined whether the strength of relationships between internalizing symptoms and TRS vary between EA with and without chronic physical health conditions (CHC). Given the links between suboptimal TRS and adverse health outcomes, additional research is needed. This study examined individual and additive associations between three internalizing symptom dimensions (anxious arousal, anhedonic depression, and general distress) and TRS, as well as the moderating role of CHC status. One hundred twenty-six EA completed an online survey measuring TRS and internalizing symptoms. The sample was 70.6% women, 39.7% of minoritized racial identity, and 21.2% Hispanic ethnicity. The mean participant age was 21.23 years. In two of three regression models, anhedonic depression alone was significantly related to TRS. CHC moderated the relationship between internalizing and TRS in only two of nine models. In both cases, internalizing symptoms were negatively associated with TRS for those without CHCs, but not for those with CHCs. Assessment of anhedonic depression may be particularly useful in identifying youth at risk for suboptimal TRS regardless of CHC status. Moreover, interventions such as behavioral activation to improve TRS skill attainment warrant additional investigation.

A longitudinal study of adolescent pathways differentiating suicide ideation and attempt in early adulthood.

Suicide ideation and attempt are leading risk factors for mortality in young adults. However, the adolescent risk factors distinguishing suicide ideation from attempt in young adults remain unclear. The present study aimed to examine the extent to which within-person stability and change in depressive symptoms, school difficulties, and peer victimization from ages 12 to 17 were differentially associated with later suicide ideation and attempt from ages 20 to 23. The study included 1647 participants from the Quebec Longitudinal Study of Child Development (QLSCD; 52% female). Participants reported on their depressive symptoms, school difficulties, and peer victimization at ages 12, 13, 15, and 17, and on suicide ideation and attempt at ages 20 and 23. Data were collected in the Province of Quebec, Canada, between 2010 and 2021. Results indicated that 11% (N = 121) and 8% (N = 86) reported suicide ideation and attempt, respectively, between ages 20 and 23. A random-intercept cross-lagged panel model showed that within-person increases in depressive symptoms during adolescence were related to both suicide ideation and attempt, whereas within-person increases in school difficulties and peer victimization were for the most part related to suicide attempt only. Within-person stability in depressive symptoms from ages 12 to 17 years were also related to suicide attempt, and not ideation. However, this association was only marginally significant. Findings suggest that experiencing unusual rises in school difficulties and peer victimization during adolescence, as well as depressive symptoms persisting over time, may distinguish young adults who think about suicide from those who attempt suicide.

Childhood trauma impacts internalizing problems in early adulthood: the affective implications of olfactory dysfunctions

Early detection and prevention of internalizing problems demand a thorough exploration of latent vulnerabilities before clinical symptoms emerge. Limited research attention has been paid to the influence of olfactory perception, a flexible factor intricately linked to emotional processing and external environmental factors. This study sought to examine the mediating role of olfactory function in the relationship between childhood trauma, encompassing both dimensions of child abuse and neglect, and internalizing problems. A total of 1661 individuals (801 males, Meanage = 21.67 years) participated in wave 1, with 327 participants (152 males, Meanage = 21.8 1 years) included in the follow-up wave 2 three months later. Online questionnaires, including the Childhood Trauma Questionnaire, Self-reported Olfactory Disorder Questionnaire, Beck Depression Inventory, and General Anxiety Disorder-7, were administered. Mediation tests were conducted using Mplus 8. Our findings revealed a significant mediating effect of olfactory dysfunction between childhood trauma and adult internalizing problems in wave 1 (B = 0.224, 95% CI [0.167, 0.294]). Childhood trauma heightened vulnerability to olfactory dysfunction (B = 0.721, 95% CI [0.671, 0.724]), subsequently exacerbating internalizing problems (B = 0.311, 95% CI [0.226, 0.408]). This effect persisted in longitudinal data (abuse: B = 0.686, p < 0.001; neglect: B = 0.200, p < 0.001). Regarding internalizing problems influenced by olfactory function, childhood abuse had a greater impact compared to childhood neglect (wave 1: χ2 = 56.012, p < 0.001; wave 2: χ2 = 5.156, p = 0.023). This study found that olfactory dysfunction mediated the relationship between childhood trauma and internalizing problems, contributing valuable insights into psychopathology and the early identification of symptoms related to internalizing problems.

Hand Warmer-Induced Hypoxia Accelerates Pest Control in Hermetic Storage.

Accelerating oxygen depletion during hermetic storage can minimize pest damage and preserve product quality. This study evaluated the effectiveness of hand warmers in accelerating hypoxia to control insect pests inside hermetic containers. We used one, two, or four hand warmers to deplete oxygen in a 4-gallon hermetic jar with 4 kg of cowpea and cowpea bruchids, alongside a non-hermetic control with cowpea bruchids and no hand warmers. Oxygen levels, insect mortality, egg counts, seed moisture content, and germination rates were monitored over 2, 5, or 8 days of storage. Only the four hand warmers treatment reduced oxygen levels below 1% within 12 h and maintained them for up to 168 h. The other treatments did not achieve this level. Insect mortality was higher with more hand warmers and extended storage duration, reaching 100% after 5 and 8 days with four and two hand warmers, respectively. Similarly, increased hand warmers and extended storage durations reduced egg counts and adult emergence. The treatments did not affect the moisture content or germination rates of the stored cowpea seeds. Hand warmers proved effective in accelerating hypoxia during hermetic storage, resulting in high insect mortality and reduced reproduction, without compromising grain quality.

Does growing up in a physical activity-friendly neighborhood increase the likelihood of remaining active during adolescence and early adulthood?

BackgroundThe SOPHYA-cohort-study investigated whether the objectively characterized and perceived residential neighborhood of Swiss youth predict accelerometer-measured physical activity and activity in specific domains (participation in a sports club and cycling) five years later.MethodsAt baseline in 2014, 1230 children and adolescents aged 6 to 16 years participated and wore accelerometers for 7 days. Of these children, 447 participated again in the follow-up study in 2019 and provided longitudinal accelerometer measurements. Sociodemographic factors and perceptions of the local neighbourhood were assessed by questionnaire. Specific objective environmental data (e.g. built environment or social environment) was modelled to the children’s address at baseline. Multivariate linear and logistic regression models were applied to identify short- and long-term characteristics that are associated with accelerometer-based physical activity, cycling and participation in organised sport.ResultsIf the neighborhood-score as perceived by the parents in 2014 was in the middle or lowest tertile, children were significantly less active cross-sectionally in 2014 (-41.1 (-78.0;-4.2) and -52.4 (-88.6;-16.2) counts per minute, cpm), and five years later (-52.4 (-88.6;-16.2) and 48.1 (-86.6;-9.7) cpm). In addition, they were also less likely to accumulate active minutes above the median at both measuring points compared to peers of the same age and sex. Using objective environmental data modeled around the children’s residential address, similar associations were found: In the tertile with the lowest proportion of green space children achieved less cpm in 2014, while a high main street density and a low socioeconomic environment, respectively, hindered physical activity tracking above the median longitudinally. Also for cycling and participation in a sport club, the associations with the perceived and objective environment were more pronounced in the longitudinal analyses.ConclusionThe results suggest that growing up in a physical activity friendly neighborhood increases the likelihood of remaining active during adolescence and early adulthood. Interventions should be implemented to ensure that children growing up in an unfavorable neighborhood do not fall behind at an early stage.

Mechanism of cognitive processing for acupuncture action on generalized anxiety with naturally occurring consecutive partial sleep deprivation in early adulthood: a randomized controlled study and evaluation of event-related potentials

IntroductionGeneralized anxiety disorder (GAD) is a common mental disorder that often begins in adolescence or early adulthood and is characterized by widespread and persistent anxiety. Partial sleep deprivation (PSD) is an important risk factor for GAD development and a common comorbidity. Adolescence is a period of rapid brain and nervous system development, and during this time, the occurrence of GAD can lead to neurocognitive deficits, such as impaired attention, cognitive control, and attention bias, that significantly affect cognitive function. However, relatively little research has been conducted on GAD comorbid with PSD in early adulthood compared with other psychiatric disorders. Clinical studies have demonstrated the effectiveness of acupuncture in treating GAD and sleep disorders, but the mechanism of how acupuncture modulates neurocognitive processing in patients with GAD comorbid with PSD has not been clarified.Methods/designIn this randomized clinical trial, a total of 56 participants diagnosed with GAD comorbid with naturally occurring PSD and 28 healthy controls (HCs) will be recruited. The participants diagnosed with GAD comorbid with PSD will be randomly assigned to either the acupuncture group or the sham acupuncture group at a 1:1 ratio. The primary outcome measure is the Hamilton Anxiety Rating Scale (HAMA). Secondary outcome measures are the Sleep Deprivation Index (SDI), the Self-Assessment Scale for Anxiety (SAS), the Epworth Sleepiness Scale (ESS), and the State-Trait Anxiety Inventory (STAI). Additionally, three psychological paradigms (the attentional network test, psychomotor vigilance test, and emotional face Go/No-go) and event-related potential (ERP) data. Healthy volunteers will not undergo acupuncture but will instead participate in baseline assessments for the scales, mental paradigms, and ERP data. Acupuncture and sham acupuncture interventions will be conducted for 30 min, three times a week, over a 2-week period. Evaluations will be performed at zero weeks (baseline), 1 week, and 2 weeks, with the data enumerator, outcome assessor, and participant blinded to the treatment assignment.DiscussionThis study contributes to the exploration of the effects of acupuncture on improving anxiety symptoms and cognitive functions in individuals with comorbid GAD and PSD.Trial registrationClinicalTrials.gov, ChiCTR2400082221. Registered March 25, 2024.

Physical activity during adolescence and early adulthood and breast cancer risk before age 40 years.

Breast cancer (BC) incidence is increasing in women under age 40 years, underscoring the need for research on BC risk factors for younger women. We used data from an international family cohort (n=26,348) to examine whether recreational physical activity (RPA) during adolescence and early adulthood are associated with BC risk before age 40. The cohort includes 2,502 women diagnosed with BC before age 40, including 2,408 diagnosed before study enrollment (68% within 5 years of enrollment). Women reported their average hours-per-week of moderate and strenuous RPA during adolescence (12-17 years) and early adulthood (25-34 years), which were converted to total age-adjusted metabolic equivalents-per-week and categorized into quartiles. We conducted attained age analyses until age 40 (follow-up time began at age 18) using Cox proportional hazards regression models adjusted for study center, race and ethnicity, and education. Being in the highest versus lowest quartile of RPA during adolescence and early adulthood were respectively associated with 12% [HR (95% CI): 0.88 (0.78, 0.98)] and 16% [HR (95% CI): 0.84 (0.74, 0.95) lower BC risks before age 40. Being in the highest quartile of RPA during both adolescence and early adulthood (Pearson correlation=0.52) versus neither timepoint was associated with a 22% lower risk [HR (95% CI): 0.78 (0.68, 0.89)]. Findings suggest that RPA during adolescence and early adulthood may lower BC risk before age 40. Policies promoting physical activity during adolescence and early adulthood may be important for reducing the growing burden of breast cancer in younger women.

Is there an association between psychological distress during early adulthood and later trajectories of physical activity during adulthood? Longitudinal data from two cohort studies

BackgroundOur aim was to analyse the prospective association between psychological distress during early adulthood and physical activity trajectories between early and middle adulthood.MethodsWe used data from the 1958 National Child...

Childhood exposure to air pollution, noise, and surrounding greenness and incident hypertension in early adulthood in a US nationwide cohort–the Growing Up Today Study (GUTS)

Exposure to increased air pollution, noise, and reduced surrounding greenness have been suggested as potential environmental risk factors for hypertension in adults, but limited evidence exists regarding early-life exposure, particularly from prospective studies. We investigated independent and joint associations of childhood exposure to these factors with incident hypertension in early adulthood in a US nationwide cohort. Study participants were from the Growing Up Today Study (GUTS) established in 1996 (GUTSI) and 2004 (GUTSII), who were ages 9−14 (GUTSI) or 10−17 (GUTSII) at enrollment. Incident hypertension was identified by self-report on questionnaires from 2010 to 2021. We estimated residential exposures to air pollution (from spatiotemporal models), noise, and surrounding greenness throughout childhood (10-18y). We applied Cox proportional hazards models adjusted for potential confounders to assess hazard ratios (HRs) and 95% confidence intervals (CIs) associated with each interquartile range (IQR) change in exposure. We performed a quantile g-computation to assess the joint association of simultaneous exposure to the mixture. We considered potential effect modification by sex, maternal history of hypertension, overweight/obese status at age 18, urbanicity, and neighborhood socioeconomic status. Among 17,762 participants, 1530 hypertensive cases occurred during an average follow-up of 12.8 years. HRs for all exposures were small with CIs including unity. A joint HR of 1.03 (95% CI: 0.95, 1.11) was associated with a one-quartile increase across simultaneous exposure to the environmental mixture. The joint associations were stronger among non-obese participants or participants living in less advantaged neighborhoods: HRs of 1.07 (95% CI: 0.97, 1.18) and 1.08 (95% CI: 0.98, 1.18), respectively. In conclusion, we did not identify an independent or joint association between childhood exposure to air pollution, noise, and surrounding greenness and early adulthood hypertension. However, a positive joint association was suggested among non-obese participants or those living in less advantaged neighborhoods.

Culture of safety in an adult and paediatric emergency department before and after the COVID-19 pandemic

BackgroundThe WHO recognises patient safety as a serious public health problem. The COVID-19 pandemic affected adult EDs (AEDs) and paediatric EDs (PEDs) differently. We compared the culture of safety in...

Factors Associated with Mental Health Service Use Among Children with ADHD from Adolescence to Early Adulthood.

Childhood attention-deficit/hyperactivity disorder (ADHD) is common and is associated with lifelong adverse outcomes. Little is known about factors associated with mental health service use (MHSU) among children with ADHD from adolescence to early adulthood. This retrospective cohort study aims to investigate factors associated with MHSU among children with ADHD from adolescence to early adulthood using secondary data from Waves I to III of the National Longitudinal Study of Adolescent Health (n = 554). Multivariable Poisson regression and Generalized Estimating Equation were used to estimate adjusted relative risks and 95% confidence intervals. Results indicate that factors significantly associated with MHSU from adolescence to early adulthood included race/ethnicity, a routine physical exam last year, and a history of suicidal ideation or attempt. Findings of the study extend the current understanding by identifying predictors and barriers for MHSU and inform the development of targeted intervention programs for increasing MHSU among children with ADHD.

Interspecific competition leads to more long‐winged morphs in two sympatric cricket species

Abstract Coexistence mechanisms for species competing for the same resource include resource partitioning, neutrality, microhabitat preference and trade‐off between competitive and dispersal abilities. We explored the coexistence mechanism of two species of trigonidiid crickets (Dianemobius nigrofasciatus (Orthoptera: Trigonidiidae) and Polionemobius taprobanensis (Orthoptera: Trigonidiidae)) that share the same habitat. Dianemobius nigrofasciatus is more common in areas where the ground surface is somewhat open, while P. taprobanensis is more common in more densely vegetated environments. The effects of micro‐environmental differences, similarities in competitive ability and investment in dispersal ability under interspecific competitive conditions on the coexistence of these species were examined using laboratory experiments. Both P. taprobanensis and D. nigrofasciatus performed better in vegetated environments. Although the adult emergence of D. nigrofasciatus were delayed by the presence of P. taprobanensis, the emergence rate of P. taprobanensis was not significantly affected by D. nigrofasciatus. The presence of P. taprobanensis caused a higher frequency of a long‐winged morph (macropterous) of D. nigrofasciatus. The results suggest that D. nigrofasciatus is inferior to P. taprobanensis in interspecific competition, and it, therefore, disperses (as macropterous adults) at greater rates in the presence of P. taprobanensis. Furthermore, it may be that D. nigrofasciatus has been forced to change its preferred microhabitat from vegetative habitats, which are inherently more suitable, to more open environments due to competition. These above mechanisms are thought to allow the two species to coexist in the same habitat.

A novel genetic mouse model of osteoporosis with double heterozygosity of Irx3 and Irx5 characterizes sex-dependent phenotypes in bone homeostasis

Iroquois homeobox gene 3 (Irx3) and Irx5 encode transcription factors that play crucial roles in limb development and bone formation. Previous studies using knockout mice have revealed a role of Irx3 and Irx5 in osteogenesis in young adult mice. However, whether these genes are also essential for bone homeostasis in adulthood and contribute to bone diseases remain poorly understood. Osteoporosis is a disease characterized by lower bone mineral density and disrupted bone microarchitecture, typically occurs in postmenopausal women. Here, we demonstrate that Irx3/5dHet mice with a half-reduction of Irx3 and Irx5 dosage serve as a novel model of osteoporosis. By micro-computed tomography, we found that Irx3/5dHet mice exhibited sex-dependent bone loss patterns. While male Irx3/5dHet mice progressively lost trabecular microstructures with aging, female mutants exhibited lower bone mineral density (BMD) and bone volume fraction (BV/TV) at early adulthood (9–15 weeks old) but without further loss later at 1 year of age. Bone marrow adipocytes are known to be elevated at the expenses of lower osteogenesis in osteoporotic bone marrow. Surprisingly, we found sex-dependent changes in adipogenesis at the age of skeletal maturity that bone marrow adipocytes were reduced in female Irx3/5dHet mice along with deteriorated osteogenesis, while male mice exhibited elevated adipogenesis. In summary, we reported a novel genetic model for osteoporosis-like phenotypes, highlighting sex-dependent bone mineral density and bone marrow adipocyte characteristics.

A Study of the Neurobiological Mechanisms of Non-suicidal Self-injurious Behaviour

Non-suicidal self-injury (NSSI) often occurs in adolescence and early adulthood, accompanied by an increase in the incidence and development of related diseases, making it a significant risk factor for suicide. NSSI behavior among adolescents has become a serious public health issue, threatening their physical and mental development. This article explores the identification methods, biological causes, and emotional causes of NSSI behavior and provides current applicable treatment interventions. By elaborating on the harm of NSSI behavior to adolescents, identification methods, and intervention strategies are proposed to provide a theoretical basis for monitoring and protecting adolescent health in order to improve NSSI behavior among adolescents.

Development and implementation of autoverification standardization in the adult and pediatric emergency department.

In an effort to expedite the publication of articles, AJHP is posting manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time. This project utilized the guidance of the American Society of Health-System Pharmacists (ASHP) autoverification toolkit to refine our health system's approach to autoverification and contribute to the literature regarding appropriate use of autoverification technology in a pediatric and adult emergency department (ED). This single-center quality improvement study was conducted in an academic medical center ED that has 33 pediatric beds and 77 adult beds. A team consisting of clinical pharmacy specialists in emergency medicine, medication safety and informatics personnel, operational managers, and pharmacy leadership was identified to develop and implement autoverification best practices in the ED utilizing practices outlined within the ASHP autoverification toolkit. Before implementation of best practices, defined as the "preoptimization" state, autoverification took place for most medications available in the automated dispensing cabinets (ADCs). By anchoring the autoverification rule on ADC inventory, it was challenging to optimize both inventory practices and autoverification best practices. This project focused on redesigning the autoverification rules in the electronic health record, defined as the "postoptimization" state. In the postoptimization state, autoverification in the ED was updated to better align with regulatory standards. Autoverification metrics and the percentage of orders that autoverified vs required pharmacist verification were analyzed in the preoptimization and postoptimization states. This project utilized the guidance from ASHP's autoverification toolkit to refine our health system's approach to autoverification. High-alert medications (eg, insulin, extended-release opioids, digoxin) were taken off autoverification following implementation. Optimization of autoverification rules allows more orders for high-alert medications to be reviewed by a pharmacist.

Subjective well-being in early adulthood—long-term consequences of inclusive vs. segregated education for students with special educational needs in Germany?

ABSTRACT We analysed the long-term consequences of inclusive versus segregated educational settings for students with special educational needs in the area of learning (SEN-L, formerly ‘learning disability”) in Germany. We focused on the consequences of educational settings on subjective well-being (SWB) measured as general life satisfaction five to six years after leaving a mainstream or a special school. We accounted for the selection of students into the different educational settings based on a variety of individual and socio-demographic characteristics. To this end, we conducted entropy balancing and controlled for the current status of not being in education, employment or training (NEET). Young adults who formerly attended segregated special schools reported on average slightly lower levels of life satisfaction. They were also at a much higher risk of being excluded from post-secondary education and the labour market at the age of 20 to 21. However, the differences in life satisfaction were not significant when accounting for systematic differences in individual and socio-demographic characteristics between the two groups. This finding highlights the importance of considering the selection mechanisms underlying educational settings in analyses of outcomes of students with SEN. Their current NEET status did not explain differences in life satisfaction by educational setting.

The association of resilience with HbA1c and key psychosocial factors in emerging adults with type 1 diabetes.

Emerging adults (EAs) with type 1 diabetes (T1D) have difficulty meeting glycemic targets and have a high prevalence of mental health comorbidities. Resilience, the ability to harness resources needed to sustain one's emotional and physical well-being, may be a key factor impacting poor mental health and glycemic outcomes. We aimed to (a) evaluate the association between resilience, HbA1c, and key psychosocial factors and (b) explore whether resilience moderates the relationship between psychosocial factors (depression, diabetes-related distress, anxiety) and HbA1c in EAs with T1D. EAs with T1D (N = 233) (mean age = 19.9 years (SD = 1.6), range 16.8-24.7) seen at an EA-specific diabetes clinic completed resilience, diabetes-related distress, depression, and anxiety measures and had their HbA1c level evaluated. We used linear regression models and conducted moderation analyses for the resilience factor. Resilience was strongly associated with HbA1c, depression, diabetes-related distress, and anxiety in EAs with T1D. We did not find evidence that resilience moderates the relationship between depression, anxiety, or diabetes-related distress and HbA1c. This study found that resilience is a highly relevant psychological factor associated with HbA1c and a key mental health factor for EAs with T1D. Novel interventions are needed to ameliorate high diabetes-related distress and HbA1c, and bolstering resilience may be one avenue to explore. Future research on resilience should longitudinally characterize and evaluate whether resilience may be a mechanism underlying the relationship between poor psychosocial outcomes and not meeting glycemic targets in EAs with T1D.

Early mortality in STXBP1-related disorders.

Pathogenic variants in STXBP1 cause a spectrum of disorders mainly consisting of developmental and epileptic encephalopathy (DEE), often featuring drug-resistant epilepsy. An increased mortality risk occurs in individuals with drug-resistant epilepsy and DEE, with sudden unexpected death in epilepsy (SUDEP) often the major cause of death. This study aimed to identify the rate and causes of mortality in STXBP1-related disorders. Through an international call, we analyzed data on individuals with STXBP1 pathogenic variants, who passed away from causes related to their disease. We estimated a mortality rate of 3.2% (31/966), based on the STXBP1 Foundation and the STXBP1 Global Connect registry. In total, we analyzed data on 40 individuals (23 males) harboring pathogenic STXBP1 variants, collected from different centers worldwide. They died at a median age of 13years (range: 11months-46years). The most common cause of death was SUDEP (36%), followed by pulmonary infections and respiratory complications (33%). The incidence of SUDEP peaked in mid-childhood, while non-SUDEP causes were more frequent in early childhood or adulthood (p = 0.006). In the most severe phenotypes, death was related to non-SUDEP causes (p = 0.018). We found a mortality rate in STXBP1-related disorders similar to other DEEs, with an early age at death and SUDEP as well as pulmonary infections as the main cause of death. These findings assist in prognostic evaluation and genetic counseling for the families. They help to define the mortality risk of STXBP1-related disorders and implement preventative strategies.