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Background: Treatment resistant depression (TRD) is a subset of major depressive disorder (MDD) in which symptoms do not respond to front line therapies. In older adults, the assessment and treatment of TRD is complicated by psychosocial risk factors unique to this population, as well as a relative paucity of research., Methods: Narrative review aimed at (1) defining TRLLD for clinical practice and research; (2) describing psychosocial risk factors; (3) reviewing psychological and non-pharmacological treatments; (4) discussing the role of clinical phenotyping for personalized treatment; and (5) outlining research priorities., Results: Our definition of TRLLD centers on response to medication and neuromodulation in primary depressive disorders. Psychosocial risk factors include trauma and early life adversity, chronic physical illness, social isolation, personality, and barriers to care. Promising non-pharmacological treatments include cognitive training, psychotherapy, and lifestyle interventions. The utility of clinical phenotyping is highlighted by studies examining the impact of comorbidities, symptom dimensions (e.g., apathy), and structural/functional brain changes., Limitations: There is a relative paucity of TRLLD research. This limits the scope of empirical data from which to derive reliable patterns and complicates efforts to evaluate the literature quantitatively., Conclusions: TRLLD is a complex disorder that demands further investigation given our aging population. While this review highlights the promising breadth of TRLLD research to date, more research is needed to help elucidate, for example, the optimal timing for implementing risk mitigation strategies, the value of collaborative care approaches, specific treatment components associated with more robust response, and phenotyping to help inform treatment decisions., Competing Interests: Declaration of competing interest Regan E. Patrick, PhD: Partial salary support from NIH/NIA, Rogers Family Foundation, and Biogen, Inc. Rebecca A. Dickinson, BSc, BA: No disclosures or conflicts. Melanie T. Gentry, MD: No disclosures or conflicts. Joseph U. Kim, PhD: No disclosures or conflicts. Lauren E. Oberlin, PhD: No disclosures or conflicts. Soohyun Park, PhD: Grant support from Pope-Hintz Fellowship (Hintz Family Foundation) and Alzheimer's Association Research Fellowship. Jessica L. Principe, MD, MS: No disclosures or conflicts. Antonio L. Teixeira, MD, PhD: No disclosures or conflicts. Sara L. Weisenbach, PhD: NIH grant support as PI (R01MH116033); ADHD Expert Consortium Member for Qbtech., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Emotion regulation (ER), or the ability to modulate the experience and expression of emotion, is critical to adaptive functioning and is a key feature of mood disorders. At the same time, normal aging is associated with changes in ER, though the interaction of aging with the presence of a mood disorder are unclear. Here, we review what is known about ER and its underlying neural mechanisms in late life mood disorders, specifically late life depression and bipolar disorder. We also review behavioral and neuromodulation therapies that seek to reduce negative affect and improve positive affect. We conclude with recommendations for future research into the nature and mechanisms of ER and interventions targeting ER in older adults with mood disorders., Competing Interests: CONFLICTS OF INTEREST The authors declare that they have no conflicts of interest.

Background: Patient clinical collateral information is critical for providing psychiatric and psychotherapeutic care. With the shift to primarily virtual care triggered by the COVID-19 pandemic, psychotherapists may have received less clinical information than they did when they were providing in-person care. This study assesses whether the shift to virtual care had an impact on therapists' use of patients' electronic and social media to augment clinical information that may inform psychotherapy., Methods: In 2018, we conducted a survey of a cohort of psychotherapists affiliated with McLean Hospital. We then reapproached the same cohort of providers for the current study, gathering survey responses from August 10, 2020, to September 1, 2020, for this analysis. We asked clinicians whether they viewed patients' electronic and social media in the context of their psychotherapeutic relationship, what they viewed, how much they viewed it, and their attitudes about doing so., Results: Of the 99 respondents, 64 (64.6%) had viewed at least 1 patient's social media and 8 (8.1%) had viewed a patient's electronic media. Of those who reported viewing patients' media, 70 (97.2%) indicated they believed this information helped them provide more effective treatment. Compared with the 2018 prepandemic data, there were significantly more clinicians with>10 years of experience reporting media use in therapy. There was also a significant increase during the pandemic in the viewing of media of adult patients and a trend toward an increase in viewing of media of older adult patients., Conclusions: Review of patients' electronic and social media in therapy became more common among clinicians at a large psychiatric teaching hospital during the COVID-19 pandemic. These findings support continuing research about how reviewing patients' media can inform and improve clinical care., Competing Interests: K.J.R. has performed scientific consultation for Bioxcel, Bionomics, Acer, Takeda, and Jazz Pharma and serves on Scientific Advisory Boards for Sage and the Brain Research Foundation; he has received sponsored research support from Takeda, Brainsway, and Alto Neuroscience. None of this work is related to the current study. I.V.V. receives current research support from the National Institute on Aging, the National Institute of Mental Health, the Once Upon a Time Foundation, and the Harvard Dean’s Initiative on Aging. K.J.R. was previously an investigator of the Howard Hughes Medical Institute and receives current research support from the National Institutes of Health, the National Institute of Mental Health, and the Once Upon a Time Foundation. The remaining authors declare no conflicts of interest., (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)

During pathogenic infections, bacterial cells experience environmental stress conditions, including low oxygen and thermal stress. Bacterial cells proliferate during infection and divide by a mechanism characterized by the assembly of a large cytoskeletal structure at the division site called the Z-ring. The major protein constituting the Z-ring is FtsZ, a tubulin homolog and GTPase that utilizes the nucleotide to assemble into dynamic polymers. In Escherichia coli , many cell division proteins interact with FtsZ and modulate Z-ring assembly, while others direct cell wall insertion and peptidoglycan remodeling. Here, we show that ZapE, an ATPase that accumulates during late constriction, directly interacts with FtsZ and phospholipids in vitro . In the presence of adenosine triphosphate (ATP), ZapE induces bundling of GTP-induced FtsZ polymers; however, ZapE also binds FtsZ in the absence of GTP. The ZapE mutant protein ZapE(K84A), which is defective for ATP hydrolysis, also interacts with FtsZ and induces FtsZ filament bundling. In vivo , cultures of zapE deletion cells contain a low percentage of filamentous cells, suggesting that they have a modest division defect; however, they are able to grow when exposed to stress, such as high temperature and limited oxygen. When combined with the chromosomal deletion of minC , which encodes an FtsZ disassembly factor, Δ zapE Δ minC cells experience growth delays that slow proliferation at high temperature and prevent recovery. This synthetic slow growth phenotype after exposure to stress suggests that ZapE may function to ensure proliferation during and after stress, and this is exacerbated when cells are also deleted for minC. Expression of either ZapE or ZapE(K84A) complements the aberrant growth phenotypes in vivo suggesting that the division-associated role of ZapE does not require ZapE ATP hydrolysis. These results support that ZapE is a stress-regulated cell division protein that interacts directly with FtsZ and phospholipids, promoting growth and division after exposure to environmental stress., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 DiBiasio, Dickinson, Trebino, Ferreira, Morrison and Camberg.)

Automated walk-over weighing systems can be used to monitor liveweights of cattle. Minimal literature exists to describe agreement between automated and static scales, and no known studies describe repeatability when used for daily measurements of dairy cows. This study establishes the repeatability of an automated walk-over cattle-weighing system, and agreement with static electronic scales, when used in a commercial dairy herd to weigh lactating cows. Forty-six lactating dairy cows from a seasonal calving, pasture-based dairy herd in southwest Victoria, Australia, were weighed once using a set of static scales and repeatedly using an automated walk-over weighing system at the exit of a rotary dairy. Substantial agreement was observed between the automated and static scales when assessed using Lin's concordance correlation coefficient. Weights measured by the automated walkover scales were within 5% of those measured by the static scales in 96% of weighings. Bland and Altman's 95% limits of agreement were -23.3 to 43.6 kg, a range of 66.9 kg. The 95% repeatability coefficient for automated weighings was 46.3 kg. Removal of a single outlier from the data set increased Lin's concordance coefficient, narrowed Bland and Altman's 95% limits of agreement to a range of 32.5 kg, and reduced the 95% repeatability coefficient to 18.7 kg. Cow misbehavior during walk-over weighing accounted for many of the larger weight discrepancies. The automated walk-over weighing system showed substantial agreement with the static scales when assessed using Lin's concordance correlation coefficient. This contrasted with limited agreement when assessed using Bland and Altman's method, largely due to poor repeatability. This suggests the automated weighing system is inadequate for detecting small liveweight differences in individual cows based on comparisons of single weights. Misbehaviors and other factors can result in the recording of spurious values on walk-over scales. Excluding outlier weights and comparing means of 7 consecutive daily weights may improve agreement sufficiently to allow meaningful assessment of small short-term changes in automated weights in individuals and groups of cows., (Copyright © 2013 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.)

To surmount the economic pressures of managed care, specialists are pursuing various initiatives designed to increase revenues and market share that may put them into competition with healthcare systems. Systems contemplating collaboration with specialists to gain their loyalty may first consider employing a strategy involving physician gain sharing. It should be understood, however, that there are legal hurdles to be overcome in developing gain sharing, that there are different gain-sharing models to be used, and that there are limitations as well as benefits to such an initiative. These limitations require healthcare systems to consider other, more durable specialist integration strategies. The balance of power between a healthcare system and specialists will affect the success of whatever integration strategy is employed.