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ObjectivesTo evaluate the prevalence of weight discrimination (the perception of being treated unfairly based on weight) and its sociodemographic associations among early adolescents aged 10 to 13 in the United States.MethodsWe analyzed cross-sectional data from the Adolescent Brain Cognitive Development (ABCD) Study in Year Two (2018-2020). Multivariable logistic regression analyses were conducted, with perceived weight discrimination as the dependent variable and age, sex, sexual orientation, race and ethnicity, body mass index (BMI) category, household income, and highest parental education level as adjusted independent variables. Interaction with BMI category and weight discrimination by sex, sexual orientation, race and ethnicity, and household income was tested for.ResultsIn our analytical sample (N = 7129), we found that 5.46 % of early adolescents reported experiencing weight discrimination. Adolescents with BMI percentile ≥95th (adjusted odds ratio [AOR], 6.41; 95 % confidence interval [CI], 4.71-8.70),

Purpose: Ambidexterity increases an organisation's capability to successfully navigate dynamic and uncertain environments. While leaders are expected to model flexible learning and practices throughout the organisation, little is known about the leader characteristics and contextual factors that underpin ambidexterity. This study aims to explore whether paradoxical thinking, integrator behaviours and managerial role and level influence the likelihood of leaders exhibiting ambidexterity. Design/methodology/approach: This study relied on a self-report questionnaire completed by 152 managers of a large, public health-care organisation in New Zealand. A k-means cluster analysis of the data was conducted to identify leader ambidexterity clusters, and the hypothesised effects were tested with multinomial logistic regressions. Findings: Health-care managers favoured exploitation and moderate ambidexterity. Higher levels of integrator behaviours (i.e. reflective learning and context responsiveness) were found among leaders who showed high ambidexterity. Context responsiveness was the sole significant predictor distinguishing between high ambidexterity and other ambidexterity profiles. No statistically significant differences in ambidexterity cluster membership were found between clinical and non-clinical roles and across managerial levels. Research limitations/implications: While our study relied on a cross-sectional self-reported design, the findings underscore the importance of learning behaviours and context responsiveness to ambidexterity. This study discusses avenues for future research and leadership development towards improved organisational learning systems and practices. Originality/value: To the best of the authors' knowledge, this study is one of the first to test the contribution of paradoxical thinking and integrator behaviours to health-care leader ambidexterity and to examine differences in ambidexterity profiles across managerial levels and roles. The factor analysis suggests that integrator behaviours represent two distinct constructs: reflective learning and context responsiveness.

Patients with SCN8A epileptic encephalopathy exhibit a range of clinical features, including multiple seizure types, movement disorders, and behavioral abnormalities, such as developmental delay, mild-to-severe intellectual disability, and autism. Recently, the de novo heterozygous SCN8A R1620L mutation was identified in an individual with autism, intellectual disability, and behavioral seizures without accompanying electrographic seizure activity. To date, the effects of SCN8A mutations that are primarily associated with behavioral abnormalities have not been studied in a mouse model. To better understand the phenotypic and functional consequences of the R1620L mutation, we used CRISPR/Cas9 technology to generate mice expressing the corresponding SCN8A amino acid substitution. Homozygous mutants exhibit tremors and a maximum lifespan of 22 days, while heterozygous mutants (RL/+) exhibit autistic-like behaviors, such as hyperactivity and learning and social deficits, increased seizure susceptibility, and spontaneous seizures. Current clamp analyses revealed a reduced threshold for firing action potentials in heterozygous CA3 pyramidal neurons and reduced firing frequency, suggesting that the R1620L mutation has both gain- and loss-of-function effects. In vivo calcium imaging using miniscopes in freely moving RL/+ mutants showed hyperexcitability of cortical excitatory neurons that is likely to increase seizure susceptibility. Finally, we found that oxcarbazepine and Huperzine A, a sodium channel blocker and reversible acetylcholinesterase inhibitor, respectively, were capable of conferring robust protection against induced seizures in RL/+ mutants. This mouse line will provide the opportunity to better understand the range of clinical phenotypes associated with SCN8A mutations and to develop new therapeutic approaches.

Report _Case Presentation _Photo Vignette _Letter Authors declare that the contents of this article are their own original unpublished findings. Title: Primary cutaneous perivascular epithelioid cell tumors: two cases and a review of the literature Authors: Jennifer Wong1 DO, Jason Mammino2 DO, Jennifer Seyffert3 DO, Kristen Schmits4 MD, Etan Marks4 MD, Daniel Rivlin3 MD Affiliations: 1Department of Dermatology, LECOM- Larkin Community Hospital, Miami, Florida, USA, 2Department of Dermatology, KCUMB - Advanced Dermatology and Cosmetic Surgery, Orlando, Florida, USA, 3Department of Dermatology, LECOM- Skin and Cancer Associates, Miami Beach, Florida, USA, 4Department of Dermatopathology Advanced Dermatology and Cosmetic Surgery Pathology Laboratory, Delray Beach, Florida, USA Corresponding Author: Jennifer Seyffert DO, 4308 Alton Road, Suite 510, Miami Beach, FL 33140, Tel: 305-674-8865, Fax: 305-674-1459, Email: jseyf12@gmail.com Abstract: Perivascular epithelioid cell tumors, also known as PEComas, are mesenchymal neoplasms which uncommonly originate within the skin, with only 23 cases documented within the literature. These rare neoplasms classically display epithelioid cells composed of granular or clear cytoplasm arranged in sheets, nests, or cords. Their immunoreactivity for melanocytic and smooth muscle markers makes these tumors distinct and unique.[1] We herein present two cases of primary cutaneous PEComas that clinically mimic other common cutaneous neoplasms and illustrate the necessity for clinical-pathologic correlation. A literature review is also presented to compare the different clinical and histological presentations of cutaneous PEComas.

Healthcare for transgender and gender-diverse (TGD) patients is evolving. With 1.6 million people in the United States identifying as transgender, clinicians have significant opportunity to learn, build trust, and offer thoughtful preventive and therapeutic care. Gender-affirming care starts by using chosen names and pronouns and creating welcoming environments. Medical and surgical care for TGD persons is endorsed by multiple medical societies and is associated with reduced symptoms of dysphoria and improved quality of life. Barriers accessing this care include a lack of provider knowledge and availability, socioeconomic factors, discrimination, ongoing anti-LGBTQ+ legislation, and mistreatment from the medical system. Complications of gender-affirming surgical procedures are uncommon when performed by qualified and well-trained surgeons, though often patients must travel significant distances to attain surgical care, limiting postoperative follow-up. Complications of non-medical-grade procedures, such as fillers, are common and can present many years after the initial procedure. With respect to sexual wellness, social and biomedical interventions addressing disproportionate effects of human immunodeficiency virus and sexually transmitted infections on TGD people show promise in clinical trials. Further education for providers and patients, advocacy for affirming spaces and policies promoting evidence-based care, and building trust are crucial for holistic care of TGD patients. [ABSTRACT FROM AUTHOR]

Background and Aims Although non-optimum ambient temperature is a major non-traditional risk factor for acute myocardial infarction, there is no prior knowledge on whether non-optimum ambient temperature could differentially affect myocardial infarction with obstructive coronary artery disease (MI-CAD) and myocardial infarction with non-obstructive coronary arteries (MINOCA). Methods Using the Chinese Cardiovascular Association database-Chest Pain Center Registry, a nationwide, time-stratified, case-crossover investigation was conducted from 2015 to 2021. Meteorological data were obtained from an established satellite-based model, and daily exposures were assigned according to the onset of myocardial infarction in each patient. A conditional logistic regression model combined with distributed lag non-linear models (10 days) was used to estimate the exposure–response relationships. Results A total of 83 784 MINOCA patients and 918 730 MI-CAD patients were included. The risk of MINOCA and MI-CAD associated with low temperature occurred at lag 2 day and lasted to 1 week. Extremely low temperature was associated with a substantially greater odds ratio (OR) of MINOCA [OR 1.58, 95% confidence interval (CI) 1.31–1.90] than MI-CAD (unmatched: OR 1.32, 95% CI 1.23–1.43; equally matched by age and sex: OR 1.25, 95% CI 1.04–1.50), compared with the corresponding reference temperatures (30°C, 35°C, and 30°C). Stronger associations were observed for patients who were aged ≥65 years, female, or resided in the south. There was no significant difference for the impacts of high temperature on MINOCA and MI-CAD. Conclusions This nationwide study highlights the particular susceptibility of MINOCA patients to ambient low temperature compared with that of MI-CAD patients. [ABSTRACT FROM AUTHOR]

The Wraparound approach aims to prevent and interrupt gang activity by "wrapping" youth with individualized supports to increase prosocial connections and reduce the risks for gang involvement. The current study examines 38 interviews with program staff and external stakeholders to assess implementation strengths and challenges of a Wraparound program in British Columbia, Canada. Thematic analysis resulted in seven strengths-related themes concerning program structure, team, and youth engagement strategies, and seven challenge-related themes regarding youth interactions, resources, and communication. Findings highlight the benefits of an individualized approach, with consideration of enhanced communication and outreach strategies, resource allocation, and case manager training. [ABSTRACT FROM AUTHOR]

The scores from student evaluation forms are often used to construct assessments about the quality and effectiveness of course instruction. These assessments, in turn, can have serious professional impacts on instructors with respect to future course assignments, grants, promotion and hiring decisions. Previous research suggests that scores from student evaluations can be significantly predicted by factors other than teaching quality, in particular, the gender of teaching staff. However, most existing research is challenged by logistical constraints of separating gender from teaching quality in face-to-face courses. The goal of the current study was to examine gender-neutrality in students' assessments of teaching assistants, by manipulating perceived teaching assistant gender for an online course. Using a mixed methods approach across nine semesters in which teaching assistants posed as both male and female, findings from 232 students suggest mixed evidence concerning gender bias in evaluations of teaching assistant performance. Highlights include no significant differences for the overall mean performance scores between the perceived male versus perceived female subgroups; individual item analysis suggests that students were more likely to rate the perceived male teaching assistant as having high expectations and the course as having a more challenging workload. Limitations and directions for future research are discussed.

Prostate carcinoma is the most common non-dermatological malignancy in men and only second to lung cancer as the leading cause of cancer related deaths in America. Moreover, metastasis to the skin is even more uncommon following apparently successful treatment of a preexisting prostate cancer. We present an 87-year-old man previously diagnosed with prostate cancer treated with brachytherapy, who presented with a metastatic prostate adenocarcinoma of the scalp mimicking a basal cell carcinoma. Herein, we present a patient with an NKX 3.1 positive cutaneous metastatic prostate carcinoma identified through NKX3.1 stain rather than the typical PSA/PSAP stain.