Life Stages Research Articles

Impact of physical and sexual abuse on risk of hospitalisations for physical and mental illnesses: insights from two large prospective cohort studies

Physical abuse can lead to severe health consequences that extend beyond immediate harm. We explored the associations of physical abuse experienced during childhood and adulthood with a wide range of adult health conditions requiring hospital treatment. We utilised data from a sub-cohort of 157,366 UK Biobank participants (46.4% of the baseline population; age range 45-81; 89,101 women) and repeated analyses in an independent population of 85,929 adults from the Finnish Public Sector (FPS) study (age range 17-78; 68,544 women). Participants in both cohorts reported instances of physical and sexual abuse at study baseline. Follow-up included 77 common health conditions ascertained from linkage data to national hospital and mortality registries. Mean follow-up duration was 4.6 years (SD 0.14) in UK Biobank and 10.6 years (4.3) in FPS. Physical and sexual abuse was associated with 22 mental and physical health conditions. After multivariable adjustments, participants who experienced abuse during both early and later stages of life had a 2.12- (95% confidence interval 1.39-3.23) to 3.37-fold (1.52-7.45) increased risk of mental and behavioural disorders, a 1.46 (1.20-1.79) to 1.83 (1.05-3.20) times increased risk of metabolic, haematologic, and respiratory diseases, and a 1.24 (1.07-1.45) times higher risk of inflammatory diseases compared with non-exposed participants. The absolute risk difference between these groups was greatest for metabolic and haematologic conditions (rate 381 and risk difference 160 per 100,000 person-years). Frailty, comorbidities, and competing risk of death did not modify these associations, but the possibility of bias or residual confounding cannot be excluded. Repeated exposure to physical and sexual abuse amplifies the risk of hospitalisations from mental disorders and physical diseases spanning diverse organ systems. Addressing this issue may necessitate multifaceted strategies, including shifts in societal norms, legal measures, and increased healthcare provision for affected individuals and their families. Wellcome Trust, UK Medical Research Council, U.S. National Institute on Aging, Academy of Finland.

"Too young to have this kind of diagnosis": A qualitative exploration of younger adults' experiences of colorectal cancer diagnosis.

Colorectal cancer (CRC) incidence is rising among adults under the age of 50 (early- or young-onset CRC). This population is more likely to have advanced-stage disease at diagnosis, suggesting their diagnostic pathway may be prolonged. To better understand factors influencing this pathway, this study explored patients' experiences of decision-making during a diagnosis of young-onset CRC. Semi-structured interviews were conducted with 17 participants with young-onset CRC diagnosed in 2021-2022 in Victoria, Australia. Interviews were conducted online or by phone an average 7months (range 1-13) after diagnosis. Analysis was approached from a critical realist perspective, with themes developed inductively using reflexive thematic analysis. Five themes were identified: Shifting Perception of Urgency, Multidimensional Perception of Role, Making the Most of Resources, Stage of Life, and COVID Adds Complexity. Participants' decision-making evolved over the diagnostic period. As participants perceived urgency to act, they took on a more active role in decision-making, utilising personal resources to access timely care. Their decisions were shaped by stage-of-life considerations, including employment and caring for a young family, with the COVID-19 pandemic adding "…a whole other layer of complexity" to the process. Younger adults with CRC make decisions in the context of unique considerations, adapting to reduce time to diagnosis, with decisions complicated by the COVID-19 pandemic. Greater support from health care providers/systems in the diagnostic period may improve timeliness of CRC diagnosis and outcomes in younger adults.

In utero exposure to maternal diabetes exacerbates dietary sodium intake-induced endothelial dysfunction by activating cyclooxygenase 2-derived prostanoids.

Prenatal exposure to maternal diabetes has been recognized as a significant cardiovascular risk factor, increasing the susceptibility to the emergence of conditions such as high blood pressure, atherosclerosis, and heart disease in later stages of life. However, it is unclear if offspring exposed to diabetes in utero have worse vascular outcomes on a high-salt (HS) diet. To test the hypothesis that in utero exposure to maternal diabetes predisposes to HS-induced vascular dysfunction, we treated adult male wild-type offspring (DM_Exp, 6 mo old) of diabetic Ins2+/C96Y mice (Akita mice) with HS (8% sodium chloride, 10 days) and analyzed endothelial function via wire myograph and cyclooxygenase (COX)-derived prostanoids pathway by ELISA, quantitative PCR, and immunochemistry. On a regular diet, DM_Exp mice did not manifest any vascular dysfunction, remodeling, or inflammation. However, HS increased aortic contractility to phenylephrine and induced endothelial dysfunction (analyzed by acetylcholine-induced endothelium-dependent relaxation), vascular hydrogen peroxide production, COX2 expression, and prostaglandin E2 (PGE2) overproduction. Interestingly, ex vivo antioxidant treatment (tempol) or COX1/2 (indomethacin) or COX2 (NS398) inhibitors improved or reverted the endothelial dysfunction in DM_Exp mice fed a HS diet. Finally, DM_Exp mice fed with HS exhibited greater circulating cytokines and chemokines accompanied by vascular inflammation. In summary, our findings indicate that prenatal exposure to maternal diabetes predisposes to HS-induced vascular dysfunction, primarily through the induction of oxidative stress and the generation of COX2-derived PGE2. This supports the concept that in utero exposure to maternal diabetes is a cardiovascular risk factor in adulthood.NEW & NOTEWORTHY Using a unique mouse model of prenatal exposure to maternal type 1 diabetes, our study demonstrates the novel observation that prenatal exposure to maternal diabetes results in a predisposition to high-salt (HS) dietary-induced vascular dysfunction and inflammation in adulthood. Mechanistically, we demonstrated that in utero exposure to maternal diabetes and HS intake induces vascular oxidative stress, cyclooxygenase-derived prostaglandin E2, and inflammation.

Inheriting housing inequality: Parental homeownership and place of origin as key factors for homeownership in Japanese metropolitan areas

The term “housing ladder” refers to the phenomenon of people moving from one housing type to another according to changing demands of different life stages. This phenomenon is observed in many countries and is known as the Jutaku Sugoroku Paradigm in the Japanese context. This study aims to clarify whether adult children's access to homeownership might be affected by their parents' homeownership and their place of origin. Questionnaire Data from a survey across Japan's two largest metropolitan areas, Tokyo and Osaka, were analyzed by combining crosstabulations and a binomial logit model. The results revealed that individuals are more likely to attain homeownership if they come from a metropolitan area and if their home of origin is an owner-occupied house. These findings suggest that housing inequality is being passed on to the next generation by parents' homeownership status and residential location. Japanese housing policies that promote private ownership of housing may reinforce these inequalities. The study concludes that Japan experiences the same intergenerational transmission of housing inequality due to homeownership as other countries, whereas place of origin was an additional factor for homeownership in the Japanese context.

The lethal and sublethal impacts of two tire rubber-derived chemicals on Brook trout (Salvelinus fontinalis) fry and fingerlings

Recent toxicity studies of stormwater runoff implicated N-(1,3-dimethylbutyl)-N'-phenyl-p-phenylenediamine-quinone (6PPD-quinone) as the contaminant responsible for the mass mortality of coho salmon (Oncorhynchus kisutch). In the wake of this discovery, 6PPD-quinone has been measured in waterways around urban centers, along with other tire wear leachates like hexamethoxymethylmelamine (HMMM). The limited data available for 6PPD-quinone have shown toxicity can vary depending on the species. In this study we compared the acute toxicity of 6PPD-quinone and HMMM to Brook trout (Salvelinus fontinalis) fry and fingerlings. Our results show that fry are ∼3 times more sensitive to 6PPD-quinone than fingerlings. Exposure to HMMM ≤ 6.6 mg/L had no impact on fry survival. These results highlight the importance of conducting toxicity tests on multiple life stages of fish species, and that relying on fingerling life stages for species-based risk assessment may underestimate the impacts of exposure. 6PPD-quinone also had many sublethal effects on Brook trout fingerlings, such as increased interlamellar cell mass (ILCM) size, hematocrit, blood glucose, total CO2, and decreased blood sodium and chloride concentrations. Linear relationships between ILCM size and select blood parameters support the conclusion that 6PPD-quinone toxicity is an outcome of osmorespiratory challenges imposed by gill impairment.

The effect of forest structural complexity on tick-borne pathogens in questing ticks and small mammals

Forest management is increasingly focused on enhancing structural complexity. An increase in structural complexity is assumed to increase the abundance and diversity of fauna, including vertebrates. This faunal assemblage serves, in turn, as host community for a suite of vectors and their pathogens, so that structural complexity may cascade through a network of interactions in forest ecosystems. Here we use a network of 19 forest plots representing a gradient of structural complexity and dominant tree species (oak, beech, poplar) to test two hypotheses on the effect of structural complexity on the prevalence of tick-borne pathogens. Our first hypothesis is that tick densities will increase with increasing structural complexity, assuming that each life stage has higher chances of finding a suitable host. The second hypothesis is that the pathogen prevalence in ticks and small mammals decreases (cf. dilution hypothesis) or increases (cf. amplification hypothesis) with increasing structural complexity. These expectations are tested through a community-level analysis, looking at twelve pathogens: seven genospecies of Borrelia (B. afzelii, B. bavariensis, B. garinii, B. burgdorferi sensu stricto, B. spielmanii, B. valaisiana and B. miyamotoi), Babesia s.s., Babesia microti, Anaplasma phagocytophilum, Rickettsia helvetica and Spiroplasma ixodetes. We found that more structurally complex forests have a higher density of questing nymphs (in June and July, during the peak of nymph activity). We did not find a clear change in pathogen prevalence with increasing structural complexity in ticks, wood mice and bank vole; the effect was different for the different pathogens and between the different dominant tree species. No clear co-occurrence patterns of pathogens were found. The density of infected nymphs and thus the disease risk is higher in more complex forests. A potential solution is to focus on decreasing the human-tick interactions in forests instead of trying to decrease the number of questing ticks.

SOCIOECONOMIC DEPRIVATION, HEALTH AND ACCESS TO HEALTHCARE AMONG MILLENNIALS

This study estimates and decomposes components of different measures of inequality in health and healthcare use among millennial adolescents, a sizeable cohort of individuals at a critical stage of life. Administrative data from the UK Hospital Episode Statistics are linked to Next Steps, a survey collecting information about millennials born between 1989 and 1990, providing a uniquely comprehensive source of health and socioeconomic variables. Socioeconomic inequalities in psychological distress, long-term illness and the use of emergency and outpatient hospital care are measured using a corrected concentration index. Shapley-Shorrocks decomposition techniques are employed to measure the relative contributions of childhood socioeconomic circumstances to adolescents’ health and healthcare inequality of opportunity. Results show that income-related deprivation contributes to significant inequalities in mental and physical health among adolescents aged between 15 and 17 years old. There are also pro-rich inequalities in the use of specific outpatient hospital services (e.g., orthodontic and mental healthcare), while pro-poor disparities are found in the use of emergency care services. Regional and parental circumstances are leading factors in influencing inequality of opportunity in the use of hospital care among adolescents. These findings shed light on the main drivers of health inequalities during an important stage of human development and have potentially important implications on human capital formation across the life-cycle.

Dynamic impact of delivery modes on gut microbiota in preterm infants hospitalized during the initial 4 weeks of life

Preterm infants face a high risk of various complications, and their gut microbiota plays a pivotal role in health. Delivery modes have been reported to affect the development of gut microbiota in term infants, but its impact on preterm infants remains unclear. Here, we collected fecal samples from 30 preterm infants at five-time points within the first four weeks of life. Employing 16S rRNA sequencing, principal coordinates analysis, the analysis of similarities and Wilcoxon rank-sum test, we examined the top dominant phyla and genera, the temporal changes in specific taxa abundance, and their relationship with delivery modes, such as Escherichia-Shigella and Enterococcus based on vaginal delivery and Pluralibacter related to cesarean section. Moreover, we identified particular bacteria, such as Taonella, Patulibacter, and others, whose proportions fluctuated among preterm infants born via different delivery modes at varying time points, as well as the microbiota types and functions. These results indicated the influence of delivery mode on the composition and function of the preterm infant gut microbiota. Importantly, these effects are time-dependent during the early stages of life. These insights shed light on the pivotal role of delivery mode in shaping the gut microbiota of preterm infants and have significant clinical implications for their care and management.

Developmental toxicity and potential mechanisms exposed to polystyrene microplastics and polybrominated diphenyl ethers during early life stages of fat greenling (Hexagrammos otakii)

The occurrence of microplastics (MPs) in aquatic ecosystems and their ability to absorb hydrophobic pollutants, such as persistent organic pollutants (POPs), is currently a significant concern. MPs, which are the main breakdown product of plastics, have been frequently detected in the environment, posing serious threats to organisms’ health. One particular pollutant, 2,2′,4,4′-tetrabromodiphenyl ether (BDE-47), is a dominant congener of PBDEs and is highly toxic to organisms. However, there is limited knowledge regarding the exposure of marine fishes to PBDEs through MPs and their combined toxic effects. In this study, the embryo toxicity of Hexagrammos otakii was conducted to investigate the combined effects of MPs and BDE-47. The results showed that MPs and BDE-47 co-exposure had detrimental effects on embryonic development, such as reduced hatchability, increased mortality, decreased heart rate, and body malformation. Moreover, the combined toxicity of these substances appeared more pronounced harmful effects compared to exposure to BDE-47 alone. Histopathological examination revealed that co-exposure can cause greater damage to hatching glands and yolk. The enrichment of Kyoto Encyclopedia of Genes and Genomes (KEGG) pathways included phagosome, metabolism of xenobiotics by cytochrome P450, TCA cycle, and Wnt signaling pathway, which are closely related to embryonic growth. BDE-47 and MPs may activate the Wnt signaling pathway to affect the normal development of embryos. Our results suggest that MPs and BDE-47 exposure may cause growth disorders in the early life stages of H.otakii, leading to abnormal embryonic development. All these results will contribute to the further study of the ecological risk assessment and toxicity of MPs and organic pollutant mixtures in marine fish.

Monitoring and predicting the presence and abundance of juvenile Atlantic salmon in tributaries according to habitat characteristics using environmental DNA

AbstractConservation of the Atlantic salmon Salmo salar requires to monitor the spatial distribution and abundance of juveniles at a local scale in tributaries. However, tributaries are rarely accounted for in monitoring programs despite their importance for juvenile life stages. This is mainly because inventories of young salmon populations in tributaries can be technically challenging with traditional methods, as the number of tributaries in a watershed can be important and their access limited compared to the main stem. In this study, we tested the use of environmental DNA (eDNA) to quantify the abundance of juvenile Atlantic salmon in tributaries. We successfully detected eDNA of juvenile Atlantic salmon in 19 tributaries of three main rivers of the Gaspé Peninsula (Québec, Canada) using quantitative real‐time PCR analyses. By comparing the eDNA approach with electrofishing surveys conducted in parallel to water sampling, we found that eDNA concentrations positively correlated with juvenile abundance, total biomass, and body surface area. The use of the allometrically scaled mass (ASM) instead of abundance improved the correlation. Furthermore, we demonstrated that the levels of eDNA molecules detected for juvenile Atlantic salmon were also correlated with water temperature and canopy cover measured in each tributary. Finally, we tested if eDNA concentrations measured in a tributary could be used as a reliable indicator of juvenile abundance or biomass in that tributary. We found that our models slightly better predicted juvenile biomass than juvenile abundance. The use of ASM did not improve model prediction, suggesting that further refinement would be required in the future. Our method will facilitate the implementation of conservation practices appropriate to the ecology of juvenile Atlantic salmon in tributaries.

Land use change and coastal water darkening drive synchronous dynamics in phytoplankton and fish phenology on centennial timescales

AbstractAt high latitudes, the suitable window for timing reproductive events is particularly narrow, promoting tight synchrony between trophic levels. Climate change may disrupt this synchrony due to diverging responses to temperature between, for example, the early life stages of higher trophic levels and their food resources. Evidence for this is equivocal, and the role of compensatory mechanisms is poorly understood. Here, we show how a combination of ocean warming and coastal water darkening drive long‐term changes in phytoplankton spring bloom timing in Lofoten Norway, and how spawning time of Northeast Arctic cod responds in synchrony. Spring bloom timing was derived from hydrographical observations dating back to 1936, while cod spawning time was estimated from weekly fisheries catch and roe landing data since 1877. Our results suggest that land use change and freshwater run‐off causing coastal water darkening has gradually delayed the spring bloom up to the late 1980s after which ocean warming has caused it to advance. The cod appear to track phytoplankton dynamics by timing gonadal development and spawning to maximize overlap between offspring hatch date and predicted resource availability. This finding emphasises the importance of land–ocean coupling for coastal ecosystem functioning, and the potential for fish to adapt through phenotypic plasticity.

A 3D organoid platform that supports liver-stage P.falciparum infection can be used to identify intrahepatic antimalarial drugs

Malaria, a major public health burden, is caused by Plasmodium spp parasites that first replicate in the human liver to establish infection before spreading to erythrocytes. Liver-stage malaria research has remained challenging due to the lack of a clinically relevant and scalable in vitro model of the human liver. Here, we demonstrate that organoids derived from intrahepatic ductal cells differentiated into a hepatocyte-like fate can support the infection and intrahepatic maturation of Plasmodium falciparum. The P.falciparum exoerythrocytic forms observed expressed both early and late-stage parasitic proteins and decreased in frequency in response to treatment with both known and putative antimalarial drugs that target intrahepatic P.falciparum. The P.falciparum-infected human liver organoids thus provide a platform not only for fundamental studies that characterise intrahepatic parasite-host interaction but can also serve as a powerful translational tool in pre-erythrocytic vaccine development and to identify new antimalarial drugs that target the liver stage infection.

Nutritional Status, Dietary Intake, and Nutrition-Related Interventions Among Older Adults With Type 1 Diabetes: A Systematic Review and Call for More Evidence Toward Clinical Guidelines.

There is an emerging population of older adults (≥65 years) living with type 1 diabetes. Optimizing health through nutrition during this life stage is challenged by multiple and ongoing changes in diabetes management, comorbidities, and lifestyle factors. There is a need to understand nutritional status, dietary intake, and nutrition-related interventions that may maximize well-being throughout the life span in type 1 diabetes, in addition to nutrition recommendations from clinical guidelines and consensus reports. Three reviewers used Cochrane guidelines to screen original research (January 1993-2023) and guidelines (2012-2023) in two databases (MEDLINE and CENTRAL) to characterize nutrition evidence in this population. We found limited original research explicitly focused on nutrition and diet in adults ≥65 years of age with type 1 diabetes (six experimental studies, five observational studies) and meta-analyses/reviews (one scoping review), since in the majority of analyses individuals ≥65 years of age were combined with those age ≥18 years, with diverse diabetes durations, and also individuals with type 1 and type 2 diabetes were combined. Further, existing clinical guidelines (n = 10) lacked specificity and evidence to guide clinical practice and self-management behaviors in this population. From a scientific perspective, little is known about nutrition and diet among older adults with type 1 diabetes, including baseline nutrition status, dietary intake and eating behaviors, and the impact of nutrition interventions on key clinical and patient-oriented outcomes. This likely reflects the population's recent emergence and unique considerations. Addressing these gaps is foundational to developing evidence-based nutrition practices and guidelines for older adults living with type 1 diabetes.

The Role of Insecure Attachment in Emotional Disorders: From Children to the Elderly

Certain emotional disorders pose a significant societal concern due to their association with recurring suicidal tendencies and behaviors. Beyond the ongoing debate surrounding genetic and personality factors, this paper underscores the importance of considering attachment in the context of emotional disorders. Through a comprehensive review of literature in the fields of social and clinical psychology, this paper explores the connection between insecure attachment and emotional disorders. The exploration encompasses a concise historical overview and categozrization of attachment, followed by an in-depth analysis of the role of insecure attachment in emotional disorders across the lifespan, from childhood to old age. Additionally, potential mediator and moderator mechanisms are discussed. Notably, emotional regulation emerges as a predominant mediator during various life stages, serving this role in both childhood and adulthood, while self-esteem is identified as a sole mediating factor during adolescence. By elucidating the detrimental impacts of insecure attachment, this article emphasizes the crucial need to understand attachment dynamics throughout the human lifespan. Future research endeavors may focus on promoting heightened awareness among parents regarding the significance of sensitive early family interactions and encouraging individuals to identify and cultivate secure attachment figures.

Managing patients with eating disorders: a qualitative study in primary care.

General Practitioners (GPs) play a key role in the diagnosis and management of eating disorders (EDs). To explore GPs' experiences of managing patients with eating disorders (EDs). A qualitative study utilising remote semi-structured interviews. Fourteen GPs were interviewed about their experiences of supporting patients with EDs. The interviews were recorded, transcribed and analysed using thematic analysis. The analysis described four themes: i) 'Continuity of care' addressing the GPs relationship with patients and family, patients transitions across life stages and geographical areas and patient non-attendance; ii) 'The role of guidance' focusing on guidelines and protocols, referrals and specialist professionals as points of contact; iii) 'Structural barriers' including waiting times, lack of resources, referral criteria and relationships between services; iv) 'Confidence and skills' reflecting professional and personal experience in EDs, previous training and training needs. Transcending these themes was the notion of the 'Limits to the care' GPs can provide due to professional boundaries and the emotional impact of managing patients with EDs. This study found that whilst GPs want to help patients with EDs many limits remain to the care they can provide due to both internal and external factors. Funding is required for training and accessible specialist ED support and greater clarity is needed regarding referral processes if ED management in Primary Care is to be optimised.

LONG-TERM LENDING FOR PUBLIC-PRIVATE PARTNERSHIP PROJECTS: OPPORTUNITIES AND PROSPECTS

The article is devoted to the topical issues of long-term lending to public-private partnership projects in the context of a permanent shortage of budget funds and the financial instability of business entities. The purpose of the study is to highlight the problems of attracting long-term credit resources by partners in the process of implementing joint projects and to outline areas for their solution. To achieve this goal, general scientific research methods and analytical data from the State Statistics Service of Ukraine and the National Bank of Ukraine were used.The article reveals the main problems in the development of the debt financial instruments market, which make partnership projects between the state and business unattractive for investors. It is argued that the possibility of providing long-term loans depends not only on the actions of the bank, but also on the monetary policy of the NBU, which should ensure the introduction of preferential reserve requirements for banks, the provision of irrevocable deposits, the NBU's approval to refinance banks for the implementation of PPP projects, and the introduction of preferential lending by banks to PPP projects. The authors emphasize the priority importance of the state policy on the development of programs for the availability of long-term loans in the process of implementing partnership projects. Given the underdevelopment of financial instruments for public-private partnerships, the author substantiates the need to use innovative instruments – credit derivatives, the effectiveness of which is confirmed by international experience. The article offers a list of the most effective financial instruments that should be used at each stage of the project life cycle.It is concluded that the recommendations provided will ensure that the partners attract the necessary amount of financial resources in the process of long-term project implementation and will allow them to obtain a synergistic effect from such cooperation.

IoT-based Pregnant Mother Contraction Monitoring System Design

Pregnancy is an important stage in a woman's life that requires special monitoring and care to ensure the well-being of both mother and fetus. The presence of uterine contractions is an im-portant indicator of imminent labour, and prompt monitoring is essential to spot difficulties and ensure a safe delivery. This study aims to track contractions in pregnant women to improve pre-natal and labour care. Real-time monitoring, recording and analysis of uterine contractions. This research is a type of RD research with the ADDIE model (Analysis, Design, Development, Implementation, and Evaluation. The result of this tool is that it can precisely track contraction activity and send information to the IoT network. Through an easy-to-use mobile app, this in-formation can be accessed by medical staff caring for pregnant women and pregnant women themselves. To provide continuous monitoring, provide early notification of alarming changes, and facilitate rapid medical response, this monitoring system utilizes IoT technology. This can ease the burden on medical institutions, lower the possibility of difficulties during labour, and provide a sense of security for pregnant women. As an innovative and effective tool, the Inter-net of Things-based Maternal Contraction Monitoring System is anticipated to improve prenatal and delivery healthcare, reduce maternal and infant mortality, and monitor contractions in preg-nant women. The healthcare of pregnant women around the world could be significantly im-proved with the successful implementation of this approach.

An extensive investigation into the bioactive component of breast milk, lactation, and clinical application of Galactagogues: A review

Nowadays, people are becoming more and more conscious of the link between nutrition, diet, and health. This bond is established from birth. In addition to being thought of as the finest nutrition for a newborn to preserve its physical and nutritional well-being, breastfeeding is usually seen as the best choice for a baby during the early stages of life. The American College of Obstetricians and Gynecologists (ACOG) advises breastfeeding exclusively for six months, after which the mother and child may decide to continue nursing in addition to introducing supplemental meals for the remainder of the baby's first year or beyond. Since breast milk includes a variety of bioactive ingredients, including proteins, vitamins, nucleotides, oligosaccharides, immunoglobulin, and some minerals, it is often regarded as the major nutritional supply for babies. A crucial opportunity for intervention to improve breastfeeding success is when inadequate supply of breast milk is often identified as the primary reason for early breastfeeding cessation. When non-drug breastfeeding support approaches fail to improve a persistently poor milk production, mothers frequently turn to drugs called galactagogues for assistance. Galactagogues function by interfering with the complex hormonal balance that controls breastfeeding, specifically with regard to prolactin and oxytocin. The available data about the effectiveness and safety of pharmacological treatments for lactation insufficiency is assessed in this narrative review. The majority of research has focused on the use of domperidone, and studies have indicated that there are modest short-term improvements for breast milk production. While there is less evidence supporting metoclopramide safety and efficacy than there is for domperidone, metoclopramide functions similarly to domperidone, thus in the event that domperidone is ineffective, it may be a good alternative for therapy. Lack of information on alternative medicines, such as metformin, oxytocin, prolactin, and herbal remedies, renders their clinical usage unreasonable. The study points out important gaps in the data and makes recommendations for possible future research topics related to galactagogues' impact on nursing.

The southernmost member of the Simulium venustum species group (Diptera: Simuliidae) in the Old World: a new species from the Rif Mountains of Morocco

The polytene chromosomes, larva, pupa, and male are described for the black fly Simulium chaouikaidi n. sp., a member of the Simulium venustum group from Morocco. Chromosomally, this new species is one fixed inversion removed from the standard banding sequence for the subgenus Simulium and has microscopically undifferentiated sex chromosomes and minimal autosomal polymorphism. It is homosequential with two other species in the S. venustum species group: S. bergi Rubtsov and S. paramorsitans Rubtsov. Structurally, each known life stage of the new species is distinct from that of all other simuliids in North Africa. This new species is the southernmost member of the S. venustum group in the Old World and is apparently endemic to the Rif Mountains. Its restricted distribution includes Bou Hachem Natural Park where its habitat is afforded some protection.

Lethal combination for seedlings: extreme heat drives mortality of drought-exposed high-elevation pine seedlings.

Hotter drought- and biotically-driven tree mortality are expected to increase with climate change in much of the western United States, and species persistence will depend upon ongoing establishment under novel conditions or migration to track ecological niche requirements. High-elevation tree species may be particularly vulnerable to increasing water stress as snowpack declines, increasing the potential for adult mortality and simultaneous regeneration failures. Seedling survival will be determined by ecophysiological limitations in response to changing water availability and temperature. We exposed seedlings from populations of Pinus longaeva, Pinus flexilis, and Pinus albicaulis to severe drought and concurrent temperature stress in common gardens testing timing of drought onset under two different temperature regimes. We monitored seedling functional traits, physiological function, and survival. The combined stressors of water limitation and extreme heat led to conservative water use strategies and declines in physiological function, with these joint stressors ultimately exceeding species' tolerances and leading to complete episodic mortality across all species. Growing conditions were the primary determinant of seedling trait expression, with seedlings exhibiting more drought-resistant traits such as lower specific leaf area in the hottest, driest treatment conditions. Water stress-induced stomatal closure was also widely apparent. Under adequate soil moisture, seedlings endured prolonged exposure to high air and surface temperatures, suggesting broad margins for survival. The critical interaction between soil moisture and temperature suggests that rising temperatures will exacerbate growing season moisture stress. Our results highlight the importance of local conditions over population- and species-level influences in shaping strategies for stress tolerance and resistance to desiccation at this early life stage. By quantifying some of the physiological consequences of drought and heat that lead to seedling mortality, we can better understand the future effects of global change on the composition and distribution of high-elevation conifer forests.