Axis Response Research Articles

Regional gray matter volumes are not predictive of axial symptom response to subthalamic deep brain stimulation in Parkinsonian patients

IntroductionIn Parkinson’s disease (PD), axial symptom response to deep brain stimulation of the subthalamic nucleus (STN-DBS) is heterogeneous. This single-center, retrospective study aimed to assess imaging biomarkers of routine magnetic resonance imaging (MRI) to predict axial symptom response to STN-DBS, specifically by using an index of volumes of mesencephalon, pons, middle, and superior peduncle (“MR PIGD index”). MethodsWe investigated 94 PD patients pre- and three to six months postoperatively by using MDS-UPDRS III, Berg Balance Scale, Freezing of Gait Questionnaire (FOG-Q) and Ziegler Course, which were related to regional brain volumetry information using regression analysis and partial least squares correlation analysis. ResultsSTN-DBS led to significant, but heterogeneous improvement of axial PD symptoms. Neither the MR PIGD index nor other cortical brain volumes predicted the extent of the postoperative, axial symptom improvement. ConclusionsResponse to STN-DBS in PD cannot be predicted by MRI regional gray matter volumes.

Gap defect and freeze-thaw cycles effects on mechanical characteristics of concrete-filled steel tube stub columns with experimental and theoretical investigation

As concrete-filled steel tube (CFST) structures become more prevalent in engineering, their durability garners significant attention. Mechanical characteristics of concrete-filled steel tube stub columns under the combined influence of gap defect and freeze-thaw cycles is presented with experimental and theoretical investigation in the paper. Twenty-six concrete-filled steel tube stub columns were designed to study the combined effects on failure mechanisms, axial compression-strain response, strength, and ductility. The experimental results indicate that as the number of freeze-thaw cycles and gap ratio increase, the deformation of the specimen increases and the deformation time advances. The specimen's strength and ductility are decreased by the combined effect of these factors. In the most severe cases, the specimen's overall strength and ductility are reduced by 29.4 % and 44.0 %, respectively. Subsequently, a finite element numerical model is established to parametrically analyze the concrete-filled steel tube stub column. Results show that the degree of restraint in the concrete-filled steel tube significantly influences the reduction in strength and ductility of the specimens. The stronger the restraining effect, the less the degradation of strength and ductility caused by the combined impact of the two factors. Therefore, it is crucial to effectively restrain the concrete within the concrete-filled steel tube to ensure structural safety and durability.

PACAP regulates neuroendocrine and behavioral stress responses via CRF-containing neurons of the rat hypothalamic paraventricular nucleus

AbstractPituitary adenylate cyclase-activating polypeptide (PACAP) is a neuropeptide widely distributed in the brain including the hypothalamic paraventricular nucleus (PVN) implying a regulatory role in stress function. Recent evidence indicates that one of the main targets of PACAP within the PVN are corticotropin-releasing factor (CRF) neurons, which are key regulators of the hypothalamic-pituitary-adrenal (HPA) axis. However, the neural correlates that mediate PACAP effects on stress function are not fully understood. In the present study, we characterized the neuronal mechanism by which PACAP regulates neuroendocrine and behavioral stress responses in rats. We found that intracerebroventricular administration of PACAP increased the swim stress-induced c-Fos expression in distinct brain areas of the stress and anxiety circuitry including the parvocellular part of the PVN and changed behavioral stress coping during forced swimming to a more passive coping style (i.e., indicated by increased floating and reduced struggling behavior). Subsequently, PACAP administration directly into the PVN mimicked these behavioral effects and potentiated the plasma ACTH response to forced swim stress suggesting an excitatory role of PACAP on HPA stress axis reactivity. In addition, immunohistochemical analysis revealed a considerable portion of stress-activated CRF neurons in the medial parvocellular part of the PVN that co-localized PAC1 receptors suggesting that PACAP-induced effects on stress function are likely mediated directly by activation of CRF neurons in the PVN. Thus, these findings suggest that the PVN may represent one of the key areas where PACAP regulates the neuroendocrine and behavioral stress response.

Axial compressive behaviour and design of concrete-filled wire arc additively manufactured steel tubes

The axial compressive behaviour of concrete-filled wire arc additively manufactured (WAAM) steel tubular columns is investigated experimentally in this paper. Firstly, the manufacture of a series of WAAM steel plates and tubes is described. The results of tensile testing performed on coupons cut from the WAAM plates, to obtain the mechanical properties of the printed material, are summarised. 3D laser scanning was employed to generate digital models and to capture the geometric features of the WAAM steel test specimens. Concrete was then cast into the WAAM steel tubes, creating a total of nine concrete-filled steel tubular (CFST) specimens of different diameters, thicknesses and lengths that were subjected to compressive loading. The axial compressive load-deformation responses and ultimate loads of the specimens were obtained and the influence of the as-built surface undulations of the WAAM sections was assessed. Comparisons of the test results against existing structural design provisions highlight the need to consider the influence of the weakening effect of the geometric undulations that are inherent to the WAAM process on the structural response of CFST sections, in order to achieve safe-sided strength predictions.

Monosodium glutamate induces hypothalamic–pituitary–adrenal axis hyperactivation, glucocorticoid receptors down-regulation, and systemic inflammatory response in young male rats: Impact on miR-155 and miR-218

Abstract Young children are attracted to flavored foods with enhancers, particularly monosodium glutamate (MSG). Experimental studies have proven that MSG can alter the hypothalamic–pituitary–adrenal (HPA) axis response in neonates. We, therefore, investigated the modulation of microRNAs (miRNAs) by dietary MSG and its association with the stimulation of the HPA axis and inflammatory response in young male rats. One-month-old male rats were fed chow enriched with MSG (3 g/kg) for 16 weeks. Feeding MSG to rats markedly up-regulated hypothalamic miR-218, Toll-like receptors-4, and nuclear factor-kB but down-regulated miR-155 and glucocorticoid receptors (GR). In addition, it triggered a remarkable elevation in adrenocortical lipid peroxidation and depletion of antioxidants. These changes were coupled with increased plasma levels of the HPA axis hormones, comprising corticotropin-releasing hormone, adrenocorticotropic hormone, corticosterone levels, and serum pro-inflammatory cytokines. Taken together, current findings indicated that MSG caused an activation of the HPA axis, a down-regulation of GRs, and a systemic inflammatory response. These disturbances were associated with modulating hypothalamic miRNAs, encompassing miR-218 and 155.

Crushing responses of carbon/glass hybrid composite tubes under dynamic compressive loads

AbstractIn this study, the axial crushing response and energy‐absorbing mechanisms of circular composite tubes, which were reinforced by carbon fiber (C10) and carbon/glass hybrids (C3G4C3), were investigated experimentally and numerically. Both samples exhibited similar crushing responses comprising delamination and intralayer shear failure. The impact kinetic energy is primarily converted into frictional and composite damage energies. C3G4C3 had poorer crashworthiness with a mean crushing force and specific energy absorption of 313.3 kN and 58.0 kJ/kg, which are by 39.3% and 30.8% less, respectively, than those of C10. The influence of glass fiber reinforced polymers (GFRP) content (hybrid ratio) and stacking sequence on tubal crashworthiness was investigated numerically. For composite tubes with a hybrid ratio of 40%, the central distribution of GFRP (C3G4C3) achieved optimal energy absorption performance. Additionally, when GFRP layers were centralized stacked, a reduction of the hybrid ratio from 60% (G3C4G3) to 20% (GC8G) helped improve the crashworthiness of the hybrid tubes, where the mean crushing force increased by 23%.Highlights Impact responses of composite tubes reinforced by carbon fiber and carbon/glass hybrids were investigated experimentally and numerically. Carbon/glass hybrid tubes exhibited lower crashworthiness. The effects of stacking sequence and hybrid ratio on the energy absorption performance were studied.

Analytical model for RC coupling beam considering axial restraint

A novel three-dimensional distributed plasticity model element is formulated and implemented into an open-source computational platform (OpenSees) to enhance nonlinear modeling approaches for lateral force resisting systems utilizing diagonally reinforced concrete coupling beams. The model incorporates a fiber-based concrete cross-section along with truss elements to represent the diagonal reinforcement and contact elements to model reinforcing bar slip at the beam-wall interface. The model is validated using test results from five different experiments that include variations in cross-section geometries, reinforcement configurations, and boundary conditions. Notably, two test specimens shared identical attributes except for their cross-sectional shapes (with and without a slab), whereas another pair were identical except for the degree of axial restraint provided. The final specimen utilized both longitudinal and diagonal reinforcement along the length of the beam. The model accurately predicted overall shear versus chord rotation responses with errors < 5 % and axial growth responses with errors < 30 %. The proposed model provides enhanced modeling options for nonlinear analysis by enabling sensitivity studies to address the potential impacts of coupling beam axial restraint on coupling beam and coupled wall behavior.

Axial Impact Response of Carbon Fiber-Reinforced Polymer Structures in High-Speed Trains Based on Filament Winding Process.

The continuous increase in the operating speed of rail vehicles demands higher requirements for passive safety protection and lightweight design. This paper focuses on an energy-absorbing component (circular tubes) at the end of a train. Thin-walled carbon fiber-reinforced polymer (CFRP) tubes were prepared using the filament winding process. Through a combination of sled impact tests and finite element simulations, the effects of a chamfered trigger (Tube I) and embedded trigger (Tube II) on the impact response and crashworthiness of the structure were investigated. The results showed that both triggering methods led to the progressive end failure of the tubes. Tube I exhibited a mean crush force (MCF) of 891.89 kN and specific energy absorption (SEA) of 38.69 kJ/kg. In comparison, the MCF and SEA of Tube II decreased by 21.2% and 21.9%, respectively. The reason for this reduction is that the presence of the embedded trigger in Tube II restricts the expansion of the inner plies (plies 4 to 6), thereby affecting the overall energy absorption mechanism. Based on the validated finite element model, a modeling strategy study was conducted, including the failure parameters (DFAILT/DFAILC), the friction coefficient, and the interfacial strength. It was found that the prediction results are significantly influenced by modeling methods. Specifically, as the interfacial strength decreases, the tube wall is more prone to circumferential cracking or overall buckling under axial impact.

12271 Differential Impacts Of Body Composition Indices On Cortisol Response And Hpa Axis Activity

Abstract Disclosure: S.G. Gonsalves: None. A. Ross: None. M.E. Steele: None. L.N. Saligan: None. Aim: The continued interest in the influence of muscle mass and fat distribution on stress stems from its implications on preventative healthcare. Fat mass index (FMI) and fat-free mass index (FFMI) were proposed as valuable indicators of body composition beyond body mass index (BMI). This study investigated correlations of FMI and FFMI with inflammatory stress markers, hypothesizing that these body composition indices identify inflammatory stress markers more distinctly than BMI. Methods: Skeletal muscle mass was assessed by Dual-Energy X-ray Absorptiometry, HPA axis response through an adrenocorticotropic hormone (ACTH) stimulation test, and markers of inflammation and stress response (e.g., dehydroepiandrosterone, DHEA) from peripheral blood of 104 healthy individuals aged 18-71 years, 52% female, with a mean BMI of 26.3 (+4.83). Perceived stress and fatigue were captured using patient-reported outcome questionnaires before the HPA procedure. Results: ACTH correlated with FFMI at baseline (ρ=0.299, p=0.009) and 60 minutes (ρ=0.254, p=0.041). Cortisol correlated with FFMI at 15 (ρ=–0.248, p≤0.025), 30 (ρ=–0.284, p≤0.010), and 60 minutes (ρ=–0.364, p≤0.001), and with BMI at 15 (ρ=–0.228, p=0.041). FMI and BMI did not correlate with ACTH and FMI with cortisol at any timepoint. With repeated measures ANOVA, FFMI at 50th percentile had large effect on cortisol (p=0.005, partial eta=0.094) at each timepoint, higher for the under lean than those with higher FFMI, compared to BMI at the same percentile (p=0.037, partial eta=0.054). None of the indices reached significance with ACTH. FMI correlated with Erythrocyte Sedimentation Rate (ESR) (ρ=0.521), C-reactive protein (CRP, ρ=0.493, both at p≤0.001), DHEA (ρ=0.252, p=0.030), and epinephrine (ρ=–0.246, p=0.045). FFMI was not correlated with ESR and CRP. BMI correlated only with albumin (ρ = –0.412, p ≤ 0.001 and CRP (ρ=0.342, p≤0.003). Discussion: The higher correlations of inflammatory stress markers with FMI and FFMI, as compared to BMI, supports our study hypothesis. These results hint that these body composition indices may detect subtle stress-related inflammatory changes than BMI. Future research should clarify underlying mechanisms driving these associations and explore the impact of targeted interventions on these indices and subsequent changes to inflammation and stress. Presentation: 6/1/2024

Beyond Birth Control: The Neuroscience of Hormonal Contraceptives.

Hormonal contraceptives (HCs) are one of the most highly prescribed classes of drugs in the world used for both contraceptive and noncontraceptive purposes. Despite their prevalent use, the impact of HCs on the brain remains inadequately explored. This review synthesizes recent findings on the neuroscience of HCs, with a focus on human structural neuroimaging as well as translational, nonhuman animal studies investigating the cellular, molecular, and behavioral effects of HCs. Additionally, we consider data linking HCs to mood disorders and dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis and stress response as a potential mediator. The review also addresses the unique sensitivity of the adolescent brain to HCs, noting significant changes in brain structure and function when HCs are used during this developmental period. Finally, we discuss potential effects of HCs in combination with smoking-derived nicotine on outcomes of ischemic brain damage. Methodological challenges, such as the variability in HC formulations and user-specific factors, are acknowledged, emphasizing the need for precise and individualized research approaches. Overall, this review underscores the necessity for continued interdisciplinary research to elucidate the neurobiological mechanisms of HCs, aiming to optimize their use and improve women's health.

Psychobiological Stress Response Profiles in Current and Remitted Depression: A Person-Centered, Multisystem Approach

BackgroundA dysregulated stress response, including exaggerated affective reactivity and abnormal hypothalamic–pituitary–adrenal (HPA) axis responsivity, has been implicated in the etiology, maintenance and relapse of major depressive disorder (MDD). Among adolescents, discordant affective and physiological stress response profiles have been linked to negative affective outcomes and increased risk for psychopathology. Whether these findings extend to adults with varying degree of MDD risk is unclear, as are possible links to various risk factors. MethodsWe used a person-centered, multisystem approach in a sample of 119 unmedicated adults with current or remitted MDD, as well as individuals without past MDD to evaluate psychobiological stress response profiles. Multi-trajectory modeling was applied to positive affect, negative affect, and salivary cortisol (CORT) levels in response to the Maastricht Acute Stress Test. ResultsAnalyses identified four within-person profiles, one typical, Normative (n=32, 26.9%); and three atypical: CORT Hyperreactivity Affective Stability (n=17, 14.3%), CORT Hyporeactivity Affective Reactivity #1 (n=45, 37.8%), and CORT Hyporeactivity Affective Reactivity #2 (n=25, 21.0%). Validating the assumption of a Normative profile and increased risk for psychopathology in non-normative stress-response profiles, coherent associations emerged between stress response profiles and clinical status, depression severity, anhedonia, perceived stress, childhood adversity and reports of well-being, suggesting increased risk for psychopathology for individuals with a hyperreactive or discordant hyporeactive stress response profiles. ConclusionThis work advances our understanding of stress response mechanisms in MDD and underscores the potential of targeted interventions to enhance resilience and reduce psychopathology based on individual stress response profiles.

الصيغ التحليلية للاهتزازات المحورية والانحناء والقص والالتواء المقترنة لعوارض تيموشينكو ذات الصفائح المركبة الغير متماثلة

This paper presents the exact closed-form solutions for the vibration analysis of extension-bending-shear-torsion coupled responses in asymmetric laminated Timoshenko beams. The study derives four governing differential equations and corresponding boundary conditions using Hamilton’s variational principle. The formulation, based on first-order shear deformation theory (FSDT), accounts for rotary inertia, Poisson’s ratio, and extensional-flexural-torsional-shear coupling effects arising from material anisotropy. The exact solutions are obtained for various harmonic bending and twisting excitations under different boundary conditions, capturing the fully coupled axial, bending, and torsional responses. This approach offers a robust analytical method for understanding the complex dynamic behavior of laminated composite beams subjected to dynamic loads, with potential applications in aerospace, mechanical, and civil engineering structures, such as aircraft components, turbine blades, and bridges. Keywords: Closed-form solution; extension-bending-shear-torsion coupled response; harmonic excitations; asymmetric laminated beam.

Experimental study on mechanical behavior and countermeasures of mountain tunnels under strike-slip fault movement

In the seismic mountainous regions such as western China, it is usuallly inevitable to construct tunnels near active fault zones. Those fault-crossing tunnel structures can be extremely vulnerable during earthquakes. Extensive experimental studies have been conducted on the response of continuous mountain tunnels under reverse and normal fault movements, limited experimental investigations are available in the literatures on mountain tunnels with special structural measures crossing strike-slip faults. In this study, a new experimental facility for simulating the movement of strike-slip fault was developed, accounting for the spatial deformation characteristics of large active fault zones. Two groups of sandbox experiment were performed on the scaled tunnel models to investigate the evolution of ground deformation and surface rupture subjected to strike-slip fault motion and its impact on a water conveyance tunnel. The nonlinear response and damage mechanism of continuous tunnels and tunnels incorporated with specially designed articulated system were examined. The test results show that most of slip between stationary block and moving block occurred within the fault core, and significant surface ruptures are observed along the fault strike direction at the fault damage zone. The continuous tunnel undergoes significant shrinkage deformation and diagonal-shear failure near the slip surface and resulted in localized collapse of tunnel lining. The segments of articulated system tunnel suffer a significant horizontal deflection of about 5°, which results in opening and misalignment at the flexible joint. The width of the damaged zone of the articulated system tunnel is about 0.44 to 0.57 times that of the continuous tunnel. Compared to continuous tunnels, the articulated design significantly reduces the axial strain response of the tunnel lining, but increases the circumferential tensile strain at the tunnel crown and invert. It is concluded that articulated design provides an effective measure to reduce the extent of damage in mountain tunnel.

Attention to social threat predicts diurnal cortisol dynamics during the high school transition

Adolescence is a developmental period marked by significant social shifts accompanied by concurrent changes across biological, cognitive, and emotional domains. Within adolescence, the high school transition is a pivotal time for youth that is ripe with opportunities yet has the potential to disrupt functioning. An increasingly sophisticated understanding of health and developmental biology indicates that the hypothalamic-pituitary-adrenal (HPA) axis plays an important role in transducing social experiences into physiological changes that have long-term impacts on health and wellbeing. There is reason to believe that attentional biases to social threat could impact cortisol, a steroid hormone indexing activity of the HPA axis, during the high school transition. The present study examined associations between attentional biases to socially threatening stimuli, measured using the Affective Posner paradigm, and components of the diurnal cortisol rhythm among youth across the first two days of high school. Participants included 67 youth (N = 504 saliva samples) with a mean age of 12.86 years and a relatively equal split with regard to both sex assigned at birth and gender identity (54% male; 54% boys). Findings build upon and extend previous work by demonstrating that greater attentional engagement bias to socially threatening stimuli is associated with a pattern of greater diurnal HPA axis reactivity across the first two days of the high school transition, as evidenced by a steeper cortisol awakening response and a steeper diurnal cortisol slope. This work extends our understanding of the mechanisms through which stress relates to wellbeing in youth by embedding biological development in the life course. Clinically, this work has the potential to inform interventions to protect youth against the biological embedding of stress by identifying a theoretically driven, socio-contextually relevant risk factor to be attenuated – namely, attentional bias to threat.

Exploring the associations between momentary cortisol levels and psychotic-like experiences in young adults: Results from a temporal network analysis of daily-life data.

Dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis has been implicated in the development of psychosis and subthreshold psychotic symptoms commonly referred to as psychotic-like experiences (PLEs). The exact mechanisms linking the HPA axis responses with the emergence of PLEs remain unknown. The present study aimed to explore real-life associations between stress, negative affect, salivary cortisol levels (a proxy of the HPA axis activity) as well as PLEs together with their underlying cognitive biases (i.e., threat anticipation and aberrant salience). The study was based on the experience sampling method scheduled over 7 consecutive days in the sample of 77 drug-naïve, young adults (18-35 years). The saliva samples were collected with each prompt to measure cortisol levels. A temporal network analysis was used to explore the directed associations of tested variables. Altogether, 3234 data entries were analyzed. Data analysis revealed that salivary cortisol levels did not directly predict next-moment fluctuations of PLEs. However, higher salivary cortisol levels were associated with higher next-moment levels of PLEs through the effects on threat anticipation and negative affect. In turn, PLEs appeared to predict cortisol levels through the effects on negative affect and event-related stress. Negative affect and threat anticipation were the most central nodes in the network. There might be bidirectional associations between the HPA axis responses and PLEs. Threat anticipation and negative affect might be the most important mediators of these associations. Interventions targeting these mediators might hold promise for disrupting the connection between the HPA axis dysregulation and PLEs.

Crushing performance and energy absorption characteristics of aluminum/CFRP hybrid thin-walled tubes: Experimental and numerical investigations

This paper presents both experimental and numerical studies with the main purpose of exploring the crushing behavior of aluminum/CFRP hybrid thin-walled tubes under compression conditions. In particular, aluminum/CFRP tubes with 8, 10, and 12 layers of composites are considered, and the energy absorption characteristics are examined by quasi-static crushing experiments. An explicit finite element (FE) model is developed to investigate the axial crushing response and damage behavior of aluminum/CFRP tubes. Following validation against the experimental data, the developed FE model is applied to analyze the effects of number of layers and loading angles on the failure mechanism and energy absorption indexes of different tube configurations. The obtained results provide valuable insights into a practical energy absorption solution for aluminum/CFRP tubes subjected to crushing conditions, thereby contributing to the long-term development of the related industry.

Experimental investigation of quarry rock dust incorporated fly ash and slag based fiber reinforced geopolymer concrete circular columns

Manufacturing ordinary Portland cement (OPC) poses significant challenges for sustainable construction practices. OPC manufacturing emits substantial greenhouse gases into the atmosphere and demands extensive raw materials. In pursuit of greener alternatives, researchers explore geopolymer concrete (GPC), a revolutionary material that entirely replaces OPC, comprising industrial wastes/by-products activated through an alkaline solution. The study aims to investigate the feasibility of incorporating quarry rock dust (QRD) into GPC production for environmentally sustainable structural applications. Circular columns (200 mm diameter, 1000 mm length) were formulated using GPC blends with fly ash, slag (SG), and QRD as a partial SG replacement. The structural performance of these columns, with and without steel fiber reinforcement, was evaluated under varied loading conditions. Results show that QRD is a valuable ingredient in GPC for structural concrete elements, offering performance comparable to traditional OPC concrete. Furthermore, the incorporation of steel fibers significantly enhances the peak axial loads, displacement response, and overall performance of GPC columns with or without QRD. Fiber-reinforced GPC columns demonstrated approximately 8–10% higher ultimate load capacity than equivalent OPC columns. Eccentricity was found to significantly reduce ductility, but fiber reinforcement offers substantial ductility improvements (25–55%).

Ethnic Identification and Stress: Examining HPA Axis Reactivity in Response to a Discrimination Related Laboratory Stressor

Through processes of colonization, American Indians and Alaskan Natives (AI/AN) have faced continuous, ongoing efforts to diminish their unique ethnic identities. Maintaining a robust ethnic identity may shield against harms related to colonization, such as ethnic discrimination. Ethnic discrimination is a psychosocial stressor with implications for the reactivity of our main stress axis, the hypothalamic-pituitary-adrenal (HPA) axis. However, whether ethnic identification buffers against ethnic discrimination remains unclear. The current study examined the stress-buffering effects of two facets of ethnic identification – exploration and commitment – on HPA reactivity in 303 urban-dwelling AI/AN using samples of salivary cortisol collected throughout a discrimination-based stressor task. Building on the rejection-identification hypothesis and other related theories, we hypothesized that ethnic identity exploration will predict greater HPA axis reactivity and commitment will predict lesser HPA axis reactivity. Findings revealed that exploration and commitment were both positively related to stress levels, contrary to expectations that commitment would weaken the relationship between discrimination and stress. Results align with broader findings suggesting ethnic identity can intensify stress responses to discrimination. These findings contribute to a deeper understanding of discrimination-related stress and ethnic identification as they relate to ongoing health disparities and challenges experienced by AI/AN communities.

Gabapentin-Induced Adrenal Insufficiency: The Hypothalamic-Pituitary-Adrenal Axis Stress Misresponse and Risk of Infection: A Case Report and Literature Review.

This literature review, in light of the presented case report, explores the complex interplay between gabapentin (GBP), a gamma-aminobutyric acid (GABA) analog, and the hypothalamic-pituitary-adrenal (HPA) axis in patients undergoing major surgical procedures. It specifically investigates the potential impact of GBP on cortisol levels, stress responses, and infection risk, illustrated by a detailed clinical case. This review combines a comprehensive literature search with a case report of a 17-year-old male with osteosarcoma who experienced transient adrenal insufficiency and infections while receiving GBP. The case is analyzed in the context of the existing literature on GBP and the HPA axis. The findings highlight the intricate relationship between GBP use, adrenal insufficiency, and infection susceptibility. It underscores the need for further research and clinical vigilance when prescribing GBP to patients with underlying medical conditions, particularly in the context of major surgical procedures. The review underscores the need for further research and clinical vigilance when prescribing GBP, particularly in perioperative settings. In conclusion, GBP's effects on the HPA axis and immune responses are complex and multifaceted. Clinicians should exercise caution when prescribing GBP, especially for patients with underlying conditions undergoing major surgery. Further research is needed to elucidate the mechanisms of GBP's influence on cortisol levels and stress responses.

Neural and immune interactions linking early life stress and anhedonia

Early experiences of stress and adversity are associated with blunted reward sensitivity and altered reward learning. Meanwhile, anhedonia is characterized by impairments in reward processing, including motivation, effort, and pleasure. Early life stress (ELS) and anhedonia share psychological, behavioral, and neurobiological correlates, and the system-level interactions that give rise to anhedonia have yet to be fully appreciated. The proposed framework uses a multilevel, multisystem approach to aid in understanding neural-immune interactions that link ELS and anhedonia. The interactions linking anhedonia and ELS presented here include reduced reward sensitivity, alterations in hypothalamic-pituitary-adrenal (HPA) axis response, elevated inflammatory cytokines or physiological markers of stress, and blunted reward circuitry functioning along the mesocorticolimbic pathway. The clinical implications and areas for future research are also discussed. Ultimately, this research may inform the development of more specific and individualized treatments for anhedonia.