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Objective: The authors aimed to evaluate changes in use of government-subsidized primary mental health services, through the Medicare Benefits Schedule (MBS), by young people during the first year of the COVID-19 pandemic in Australia and whether changes were associated with age, sex, socioeconomic status, and residence in particular geographical areas., Methods: Interrupted time-series analyses were conducted by using quarterly mental health MBS service data (all young people ages 12-25 years, 2015-2020) for individual Statistical Area Level 3 areas across Australia. The data captured >22.4 million service records. Meta-analysis and meta-regression models estimated the pandemic interruption effect at the national level and delineated factors influencing these estimates., Results: Compared with expected prepandemic trends, a 6.2% (95% CI=5.3%-7.2%) increase was noted for all young people in use of MBS mental health services in 2020. Substantial differences were found between age and sex subgroups, with a higher increase among females and young people ages 18-25. A decreasing trend was observed for males ages 18-25 (3.5% reduction, 95% CI=2.5%-4.5%). The interruption effect was strongly associated with socioeconomic status. Service uptake increased in areas of high socioeconomic status, with smaller or limited uptake in areas of low socioeconomic status., Conclusions: During 2020, young people's use of primary mental health services increased overall. However, increases were inequitably distributed and relatively low, compared with increases in population-level mental health burden. Policy makers should address barriers to primary care access for young people, particularly for young males and those from socioeconomically disadvantaged backgrounds., Competing Interests: Dr. Hickie reports support for community-based projects from AstraZeneca, Eli Lily, Pfizer, Servier, and Wyeth. He is chief scientific adviser to and an equity shareholder in InnoWell Pty. Ltd. The other authors report no financial relationships with commercial interests.

Tbx20 is a member of the T-box transcription factor family expressed in the forming hearts of vertebrate and invertebrate embryos. We report here analysis of Tbx20 expression during murine cardiac development and assessment of DNA-binding and transcriptional properties of Tbx20 isoforms. Tbx20 was expressed in myocardium and endocardium, including high levels in endocardial cushions. cDNAs generated by alternative splicing encode at least four Tbx20 isoforms, and Tbx20a uniquely carried strong transactivation and transrepression domains in its C terminus. Isoforms with an intact T-box bound specifically to DNA sites resembling the consensus brachyury half site, although with less avidity compared with the related factor, Tbx5. Tbx20 physically interacted with cardiac transcription factors Nkx2-5, GATA4, and GATA5, collaborating to synergistically activate cardiac gene expression. Among cardiac GATA factors, there was preferential synergy with GATA5, implicated in endocardial differentiation. In Xenopus embryos, enforced expression of Tbx20a, but not Tbx20b, led to induction of mesodermal and endodermal lineage markers as well as cell migration, indicating that the long Tbx20a isoform uniquely bears functional domains that can alter gene expression and developmental behaviour in an in vivo context. We propose that Tbx20 plays an integrated role in the ancient myogenic program of the heart, and has been additionally coopted during evolution of vertebrates for endocardial cushion development.

Human and chinchilla listeners exhibit nonmonotonic temporal acuity for speech sounds differing in voice onset time (VOT). Characteristics of the neural discharge pattern or of the stimuli themselves that might account for the pattern of temporal acuity have not been described. Responses of chinchilla auditory-nerve fibers to syllables from an alveolar VOT continuum were measured. Peak discharge rates and peak response latencies elicited by the syllables with the shortest and longest VOTs were highly variable across groups of neurons with similar characteristic frequencies. For VOTs from the middle of the continuum, peak responses were larger, and response latencies were nearly constant across the same group of neurons. Overall, the magnitude and temporal variability of the responses of populations of primary auditory neurons varied nonmonotonically with VOT, consistent with the pattern of psychophysical temporal acuity for these syllables exhibited by humans and chinchillas. Spectral analyses suggested by the pattern of neural responses indicated that synchronous or correlated spectral cues were available over a wider bandwidth for those syllables from the middle of the continuum for which the neural representation was least variable.

Responses of chinchilla auditory-nerve fibers were measured for stimulus conditions analogous to those in which psychophysical release from masking has been observed in humans. The maskers were two equal power, narrow-band noise stimuli with different amplitude envelopes. The neurons in the sample fell into three groups that resolved the maskers' envelopes with varying degrees of accuracy. The boundaries of these groups were not sharply delineated by characteristic frequency (CF) but were dependent on the relationship between the masker level and the neurons' thresholds at the masker frequency. For the neurons that best preserved the maskers' envelope fluctuations, a neural release from masking was observed; rate-based neural masked thresholds were higher for the masker with the least fluctuating envelope. The results suggest that neural and psychophysical release from masking arises because the probe evokes larger rate changes, relative to the background response to the masker, during periods of low masker energy. Between two otherwise equivalent maskers, the one with the periods of lowest energy will produce the lower masked thresholds because rate changes are larger and more detectable.

Responses of chinchilla auditory-nerve fibers to synthesized stop consonants differing in voice onset time (VOT) were obtained. The syllables, heard as /ga/-/ka/ or /da/-/ta/, were similar to those previously used by others in psychophysical experiments with human and with chinchilla subjects. Average discharge rates of neurons tuned to the frequency region near the first formant generally increased at the onset of voicing, for VOTs longer than 20 ms. These rate increases were closely related to spectral amplitude changes associated with the onset of voicing and with the activation of the first formant; as a result, they provided accurate information about VOT. Neurons tuned to frequency regions near the second and third formants did not encode VOT in their average discharge rates. Modulations in the average rates of these neurons reflected spectral variations that were independent of VOT. The results are compared to other measurements of the peripheral encoding of speech sounds and to psychophysical observations suggesting that syllables with large variations in VOT are heard as belonging to one of only two phonemic categories.

Responses of chinchilla auditory nerve fibers to synthesized stop consonant syllables differing in voice-onset time (VOT) were obtained. The syllables, heard as /ga/-/ka/ or /da/-/ta/, were similar to those previously used by others in psychophysical experiments with human and chinchilla subjects. Synchronized discharge rates of neurons tuned to frequencies near the first formant increased at the onset of voicing for VOTs longer than 20 ms. Stimulus components near the formant or the neuron's characteristic frequency accounted for the increase. In these neurons, synchronized response changes were closely related to the same neuron's average discharge rates [D. G. Sinex and L. P. McDonald, J. Acoust. Soc. Am. 83, 1817-1827 (1988)]. Neurons tuned to frequency regions near the second and third formants usually responded to components near the second formant prior to the onset of voicing. These neurons' synchronized discharges could be captured by the first formant at the onset of voicing or with a latency of 50-60 ms, whichever was later. Since these neurons' average rate responses were unaffected by the onset of voicing, the latency of the synchronized response did provide as much additional neural cue to VOT. Overall, however, discharge synchrony did not provide as much information about VOT as was provided by the best average rate responses. The results are compared to other measurements of the peripheral encoding of speech sounds and to aspects of VOT perception.