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Although paternal age has been linked to certain psychiatric disorders, the nature of any causal relationship remains elusive. Here, we aimed to comprehensively assess the magnitude of a wide range of offsprings psychiatric risk conferred by paternal age, leveraging a pedigree inferred from covered-insurance relationship (accuracy >98%) in Taiwans single-payer compulsory insurance program. We also examined whether there is an independent role of paternal age and explored the potential effect of parental age difference. A total cohort of 7,264,788 individuals born between 1980 and 2018 were included; 5,572,232 with sibling(s) were selected for sibling-comparison analyses and 1,368,942 and 1,044,420 children with information of paternal-grandparents and maternal-grandparents, respectively, were selected for multi-generation analyses. Using inpatient/outpatient claims data (1997-2018), we identified schizophrenia, autism, bipolar disorder (BPD), attention deficit-hyperactivity disorder (ADHD), major depressive disorder (MDD), eating disorder (ED), substance use disorder (SUD), mental retardation (MR), tic disorder, obsessive-compulsive disorder (OCD), anxiety, and somatoform disorder. We identified suicides using death certificates. Logistic regression analysis was used to estimate the paternal/maternal/grand-paternal age association with psychiatric risk in the offspring. The total cohort and sibling-comparison cohort resulted in similar estimates. Paternal age had a U-shaped relationship with offsprings MDD, ED, SUD, and anxiety. A very young maternal age (25 years) was linearly associated with offsprings schizophrenia, autism, BPD, ADHD, MDD, ED, SUD, MR, OCD, anxiety, and suicide. Older grand-paternal age was linearly associated with offsprings schizophrenia, autism, ADHD, and MR. Dissimilar parental age was positively associated with offsprings ADHD, MDD, SUD, MR, anxiety, and suicide, and negatively associated with offsprings OCD. This comprehensive assessment provides solid evidence for the independent role of paternal age in psychiatric risk in the offspring and clarifies the significance of both early parenthood and delayed paternity.

Higher education institutions in the United States resorted to remote instruction after the disruption caused by the coronavirus (COVID-19) pandemic. The disjointed nature of this transition of managing the academic crisis needs to be critically engaged. By examining the experiences of global communication faculty at a midsize Midwestern university, this study attempts to reflect on the circumstances, challenges, and some unexpected outcomes of the phenomenon. Based on testimonies generated from the authors' experiences and interviews conducted with instructors, the study outlines lessons learned from the adoption of media technology and offers insights on reimagining global communication pedagogy in the post-pandemic period.

Objectives: To assess potential risk factors influencing diet outcomes after reconstruction of subtotal hypopharyngeal defects using free patch‐ or tube‐shaped anterolateral thigh (ALT) fasciocutaneous flaps. Study Design: Retrospective cohort study. Setting: First‐level referral hospital. Methods: Between January 2011 and December 2020, we studied hypopharyngeal cancer patients who underwent the reconstruction of hypopharyngeal defects using free patch‐ or tube‐shaped ALT fasciocutaneous flaps. The choice between patch‐ or tube‐shaped ALT flaps depended on the defect's nature, favoring patch‐shaped for subtotal defects and tube‐shaped for circumferential defects. A restricted diet was characterized by a history of enterostomy or endoscopic esophageal dilation treatment postreconstruction. We analyzed patients with restricted diets at 1‐ and 3‐year follow‐up visits. Results: Ninety‐eight patients were enrolled; 39 patch‐shaped flaps, and 59 tube‐shaped flaps. No significances were noted in demographics, postoperative radiotherapy (RT) or chemotherapy, rates of free flap reoperation/salvage, or complications. However, a significant difference emerged in diet outcomes at the 1‐year follow‐up (P =.005). The rate of a restricted diet was 6.08 times higher in patients with tube‐shaped flaps compared to patch‐shaped flaps (95% confidence interval [CI]: 1.95‐18.94). Stratifying based on postoperative RT revealed a 5.47 times higher rate of a restricted diet in tube‐shaped flap recipients compared to patch‐shaped flap recipients (95% CI: 1.44‐20.48). No significances were observed in 5‐year survival rates. Conclusion: Concerning postoperative RT, patch‐shaped flaps exhibited a lower incidence of a restricted diet compared to tube‐shaped flaps. Preservation of the posterior mucosa may play a crucial role in preventing RT‐induced esophageal stricture. [ABSTRACT FROM AUTHOR]