Early onset stage III diabetic nephropathy in a child with Prader-Willi syndrome treated with dulaglutide: a case report.

Background: Prader-Willi syndrome (PWS) is a multisystem genetic disorder caused by chromosomal imprinting gene defects, with approximately 70% of cases resulting from paternal deletion of the chromosomal region 15. The main clinical features include severe infantile hypotonia, early-onset childhood obesity, hyperphagia, and underdeveloped external genitalia. As individuals with PWS age, they may exhibit irritability, social dysfunction, impaired gonadal development, and metabolic syndrome. Previous literature places the prevalence of type 2 diabetes mellitus (T2DM) in PWS at approximately 7-24%. Oxytocin is a neuropeptide secreted by the paraventricular (PVN) and supraoptic (SON) nuclei of the hypothalamus and regulates energy metabolism, which is involved in PWS. Due to age limitations, very few patients progress to diabetic nephropathy during childhood, and reports of typical diabetic nephropathy in PWS during childhood are extremely rare. Dulaglutide is a glucagon-like peptide-1 (GLP-1) receptor agonist which can be used in the treatment of T2DM. Case Description: This article reports a case of a child with PWS complicated by stage III diabetic nephropathy, providing a retrospective analysis of the diagnosis and treatment process, as well as a review of domestic and international literature, to enhance understanding of this condition. And this article provides a treatment idea for PWS patients with diabetic nephropathy. Conclusions: It is very important to enhance understanding of PWS. And we offer new diagnostic and possible therapeutic approaches for pediatric patients with diabetic nephropathy.

Carbon dioxide radical anion mediated dehalogenation kinetics and mechanisms of halogenated alkanes.

Carbon dioxide radical anion (CO2•-) recently becomes appreciated in halogenated contaminants elimination; nevertheless, its application has been restricted by insufficient mechanistic understanding. Herein, we provided a quantitative insight into the kinetics and mechanisms of CO2•- mediated dehalogenation of halogenated alkanes. A CO2•- dominated UV254/H2O2/HCOO- system has been successfully established and demonstrated for effective elimination of 7 kinds of halogenated alkanes (71.3 % to 100 % of removal). Using a laser flash photolysis technology, the second-order rate constants of CO2•- ( [Formula: see text] ) reacting with CCl4, CHCl3 and CH2Cl2 were firstly reported, to be 2.5 × 108, 6.2 × 107 and 5.8 × 106 M-1s-1, respectively. [Formula: see text] presented a significant negative correlation with the lowest unoccupied molecular orbital energy (ELUMO) of chlorinated alkanes, proving that the enhanced dehalogenation of CO2•- was attributed by direct electron transfer mechanism. A fitting model was developed accordingly for [Formula: see text] prediction. This study also demonstrated that the CO2•- mediated ARP effectively removed halogenated alkanes regardless of pH condition (6.0∼9.0) and bicarbonate concentrations. These findings are significant in advancing the scientific understanding of CO2•- mediated ARP. This reductive process a promising control strategy for halogenated contaminants, such as polyfluoroalkyl substances (PFAS) and halogenated pharmaceuticals.

The Reciprocal Relations between Parental Psychological Control and Social Anxiety and the Mediating Role of Self-Concept Clarity Among Chinese Early Adolescents.

Although parental psychological control has been well-documented as a significant predictor of social anxiety among adolescents, few studies examine how changes in parental psychological control and adolescent social anxiety are reciprocally related at the within-person level, especially in Chinese culture. This longitudinal study examined reciprocal relations between parental psychological control and social anxiety, and the potential mediating role of self-concept clarity, by disentangling between- and within-person effects. A total of 4731 students (44.9% girls; Mage = 10.91 years, SD = 0.72) participated in a four-wave longitudinal study with 6-month intervals. Results from random intercept cross-lagged panel modeling indicated that parental psychological control directly predicted social anxiety, and vice versa. Parental psychological control indirectly predicted social anxiety via self-concept clarity, and social anxiety also indirectly predicted parental psychological control via self-concept clarity. These findings reveal a vicious cycle of mutual influence between parental psychological control and adolescent social anxiety in Chinese youth, and highlight the crucial role of self-concept clarity in the interplay between parenting and adolescent social functioning.

Multifunctional Conductive Hydrogel Interface for Bioelectronic Recording and Stimulation.

The past few decades have witnessed the rapid advancement and broad applications of flexible bioelectronics, in wearable and implantable electronics, brain-computer interfaces, neural science and technology, clinical diagnosis, treatment, etc. It is noteworthy that soft and elastic conductive hydrogels, owing to their multiple similarities with biological tissues in terms of mechanics, electronics, water-rich, and biological functions, have successfully bridged the gap between rigid electronics and soft biology. Multifunctional hydrogel bioelectronics, emerging as a new generation of promising material candidates, have authentically established highly compatible and reliable, high-quality bioelectronic interfaces, particularly in bioelectronic recording and stimulation. This review summarizes the material basis and design principles involved in constructing hydrogel bioelectronic interfaces, and systematically discusses the fundamental mechanism and unique advantages in bioelectrical interfacing with the biological surface. Furthermore, an overview of the state-of-the-art manufacturing strategies for hydrogel bioelectronic interfaces with enhanced biocompatibility and integration with the biological system is presented. This review finally exemplifies the unprecedented advancement and impetus toward bioelectronic recording and stimulation, especially in implantable and integrated hydrogel bioelectronic systems, and concludes with a perspective expectation for hydrogel bioelectronics in clinical and biomedical applications.

Mussel-Inspired Self-Adhesive and Tough Hydrogels for Effectively Cooling Solar Cells and Thermoelectric Generators.

Adhesive hydrogel-based evaporative cooling, which necessitates no electricity input, holds promise for reducing energy consumption in thermal management. Herein, inspired by the surface attachment of mussel adhesive proteins via abundant dynamic covalent bonds and noncovalent interactions, we propose a facile strategy to fabricate a self-adhesive cooling hydrogel (Li-AA-TA-PAM) using a copolymer of acrylamide (AM) and acrylic acid (AA) as the primary framework. The monomers formed hydrogen bonds between their carboxyl and amide groups, while tannic acid (TA), rich in catechol groups, enhances the adhesion of the hydrogel through hydrogen bonding. The hydrogel demonstrated strong adhesion to various material surfaces, including plastic, ceramic, glass, and metal. Even under high-speed rotation, it still maintains robust adhesion. The adhesion strength of the Li-AA-TA-PAM hydrogel to aluminum foil reached an impressive value of 296.875 kPa. Interestingly, the excellent contact caused by robust adhesion accelerates heat transfer, resulting in a rapid cooling performance, which mimics the perspiration of mammals. Lithium bromide (LiBr) with hydroactively sorptive sites is introduced to enhance sorption kinetics, thereby extending the effective cooling period. Consequently, the operation temperature of commercial polycrystalline silicon solar cells was reduced by 16 °C under an illumination of 1 kW m-2, and the corresponding efficiency of energy conversion was increased by 1.14%, thereby enhancing the output properties and life span of solar cells. The strategy demonstrates the potential for refrigeration applications using viscous gels.

Are children with IgA nephropathy different from adult patients?

BACKGROUND: Previously, several studies have indicated that pediatric IgA nephropathy (IgAN) might be different from adult IgAN, and treatment strategies might be also different between pediatric IgAN and adult IgAN. METHODS: We analyzed two prospective cohorts established by pediatric and adult nephrologists, respectively. A comprehensive analysis was performed investigating the difference in clinical and pathological characteristics, treatment, and prognosis between children and adults with IgAN. RESULTS: A total of 1015 children and 1911 adults with IgAN were eligible for analysis. More frequent gross hematuria (88% vs. 20%, p < 0.0001) and higher proteinuria (1.8 vs. 1.3 g/d, p < 0.0001) were seen in children compared to adults. In comparison, the estimated glomerular filtration rate (eGFR) was lower in adults (80.4 vs. 163 ml/min/1.73 m2, p < 0.0001). Hypertension was more prevalent in adult patients. Pathologically, a higher proportion of M1 was revealed (62% vs. 39%, p < 0.0001) in children than in adults. S1 (62% vs. 28%, p < 0.0001) and T1-2 (34% vs. 8%, p < 0.0001) were more frequent in adults. Adjusted by proteinuria, eGFR, and hypertension, children were more likely to be treated with glucocorticoids than adults (87% vs. 45%, p < 0.0001). After propensity score matching, in IgAN with proteinuria > 1 g/d, children treated with steroids were 1.87 (95% CI 1.16-3.02, p = 0.01) times more likely to reach complete remission of proteinuria compared with adults treated with steroids. CONCLUSIONS: Children present significantly differently from adults with IgAN in clinical and pathological manifestations and disease progression. Steroid response might be better in children.

Mutations in the NUP93, NUP107 and NUP160 genes cause steroid-resistant nephrotic syndrome in Chinese children.

BACKGROUND: The variants of nucleoporins are extremely rare in hereditary steroid-resistant nephrotic syndrome (SRNS). Most of the patients carrying such variants progress to end stage kidney disease (ESKD) in their childhood. More clinical and genetic data from these patients are needed to characterize their genotype-phenotype relationships and elucidate the role of nucleoporins in SRNS. METHODS: Four patients of SRNS carrying biallelic variants in the NUP93, NUP107 and NUP160 genes were presented. The clinical and molecular genetic characteristics of these patients were summarized, and relevant literature was reviewed. RESULTS: All four patients in this study were female and initially presented with SRNS. The median age at the onset of the disease was 5.08 years, ranging from 1 to 10.5 years. Among the four patients, three progressed to ESKD at a median age of 7 years, ranging from 1.5 to 10.5 years, while one patient reached stage 3 chronic kidney disease (CKD3). Kidney biopsies revealed focal segmental glomerulosclerosis in three patients. Biallelic variants were detected in NUP93 in one patient, NUP107 in two patients, as well as NUP160 in one patient respectively. Among these variants, five yielded single amino acid substitutions, one led to nonsense mutation causing premature termination of NUP107 translation, one caused a single nucleotide deletion resulting in frameshift and truncation of NUP107. Furthermore, one splicing donor mutation was observed in NUP160. None of these variants had been reported previously. CONCLUSION: This report indicates that biallelic variants in NUP93, NUP107 and NUP160 can cause severe early-onset SRNS, which rapidly progresses to ESKD. Moreover, these findings expand the spectrum of phenotypes and genotypes and highlight the importance of next-generation sequencing in elucidating the molecular basis of SRNS and allowing rational treatment for affected individuals.

A tough and bioadhesive injectable hydrogel formed with maleimidyl alginate and pristine gelatin.

Injectable hydrogels have wide applications in clinical practice. However, the development of tough and bioadhesive ones based on biopolymers, along with biofriendly and robust crosslinking strategies, still represents a great challenge. Herein, we report an injectable hydrogel composed of maleimidyl alginate and pristine gelatin, for which the precursor solutions could self-crosslink via mild Michael-type addition without any catalyst or external energy upon mixing. This hydrogel is tough and bioadhesive, which can maintain intactness as well as adherence to the defect of porcine skin under fierce bending and twisting, warm water bath, and boiling water shower. Besides, it is biocompatible, bioactive and biodegradable, which could support the growth and remodeling of cells by affording an extracellular matrix-like environment. As a proof of application, we demonstrate that this hydrogel could significantly accelerate diabetic skin wound healing, thereby holding great potential in healthcare.

Intelligent, Flexible Artificial Throats with Sound Emitting, Detecting, and Recognizing Abilities.

In recent years, there has been a notable rise in the number of patients afflicted with laryngeal diseases, including cancer, trauma, and other ailments leading to voice loss. Currently, the market is witnessing a pressing demand for medical and healthcare products designed to assist individuals with voice defects, prompting the invention of the artificial throat (AT). This user-friendly device eliminates the need for complex procedures like phonation reconstruction surgery. Therefore, in this review, we will initially give a careful introduction to the intelligent AT, which can act not only as a sound sensor but also as a thin-film sound emitter. Then, the sensing principle to detect sound will be discussed carefully, including capacitive, piezoelectric, electromagnetic, and piezoresistive components employed in the realm of sound sensing. Following this, the development of thermoacoustic theory and different materials made of sound emitters will also be analyzed. After that, various algorithms utilized by the intelligent AT for speech pattern recognition will be reviewed, including some classical algorithms and neural network algorithms. Finally, the outlook, challenge, and conclusion of the intelligent AT will be stated. The intelligent AT presents clear advantages for patients with voice impairments, demonstrating significant social values.

Longitudinal relations between teacher support and academic achievement among Chinese children: Disentangling between­ and within-student associations.

This study investigated the longitudinal associations between teacher support (i.e., emotional and instrumental support) and academic (i.e., math) achievement at the between-student and within-student levels using random intercept cross-lagged panel models (RI-CLPMs). Data were collected from 694 elementary school students in China (44.9% girls; Mage = 10.53 years, SD = 0.70) over four waves across 2 school years. Results from the RI-CLPMs supported that higher academic achievement was significantly associated with higher teacher emotional and instrumental support at the between-student level. At the within-student level, the RI-CLPMs only supported the predictive effect of academic achievement on teacher instrumental support, but not emotional support. Further analysis utilizing cross-lagged panel models (CLPMs) demonstrated significant reciprocal effects between teacher emotional support and academic achievement, as well as instrumental support and academic achievement. No significant sex differences were observed in RI-CLPMs or CLPMs. The findings illustrate the importance of distinguishing the between-student and within-student associations in longitudinal relations concerning teacher support and academic achievement.

[Advances of proteostasis network and its stability maintenance mechanism].

Protein is fundamental to life, as it generates protein variants. The maintenance of a dynamic equilibrium in these protein variants, known as protein homeostasis, is crucial for cellular function. Various factors, both endogenous and exogenous, can disrupt protein homeostasis during protein synthesis. These factors include translational error, and biological functions mediated by regulatory factors, and more. When cell accumulate proteins with folding errors, it impairs protein homeostasis, leading to the development of related diseases. In response to protein folding errors, multiple monitoring mechanisms are activated to mediate pathways that sustain the dynamic equilibrium. This review highlights the complex relationships within the proteostasis network, which are influenced by a variety of factors. These insights potentially provide new directions for studying diseases caused by protein synthesis errors.

A low-voltage alternant direct current electroporation chip for ultrafast releasing the genome DNA of Helicobacter pylori bacterium.

Nucleic acid detection, as an important molecular diagnostic method, is widely used in bacterial identification, disease diagnosis. For detecting the nucleic acid of bacteria, the prerequisite is to release nucleic acids inside the bacteria. The common means to release nucleic acids is the chemical method, which involves complex processes, is time-consuming, and remains chemical inhibitors. Compared with chemical methods, electroporation as a physical method has the advantages of easy operation, short-time consumption, and chemical reagents free. However, the current works using electroporation often necessitates high-frequency or high-voltage conditions, entailing bulky power devices. Herein, we propose a low-voltage alternant direct current (LADC) electroporation chip and the corresponding miniature device for ultrafast releasing the genome DNA from Helicobacter pylori (H. pylori) for detection. We connected a micrometer-interdigital electrode in the chip with a 20 V portable battery to make the miniature device. Using this low-voltage device, our chip released genome DNA of H. pylori within only 5 ms, achieving a cell lysis rate of 99.5%. We further combined this chip with a colorimetric loop-mediated isothermal amplification assay to visually detect H. pylori within ~ 25 min at 10 CFU/µL. We detected 11 clinical samples using the chip, and the detection results were consistent with those of the clinical standard. The results indicate that the LADC electroporation chip is useful for ultrafast release of genome DNA from bacteria and is expected to promote the development of nucleic acid detection in POCT and other scenarios.

Focus on Mitochondrial Respiratory Chain: Potential Therapeutic Target for Chronic Renal Failure.

The function of the respiratory chain is closely associated with kidney function, and the dysfunction of the respiratory chain is a primary pathophysiological change in chronic kidney failure. The incidence of chronic kidney failure caused by defects in respiratory-chain-related genes has frequently been overlooked. Correcting abnormal metabolic reprogramming, rescuing the "toxic respiratory chain", and targeting the clearance of mitochondrial reactive oxygen species are potential therapies for treating chronic kidney failure. These treatments have shown promising results in slowing fibrosis and inflammation progression and improving kidney function in various animal models of chronic kidney failure and patients with chronic kidney disease (CKD). The mitochondrial respiratory chain is a key target worthy of attention in the treatment of chronic kidney failure. This review integrated research related to the mitochondrial respiratory chain and chronic kidney failure, primarily elucidating the pathological status of the mitochondrial respiratory chain in chronic kidney failure and potential therapeutic drugs. It provided new ideas for the treatment of kidney failure and promoted the development of drugs targeting the mitochondrial respiratory chain.

Multi-biomarker combination detection system for diagnosis and classification of dry eye disease by imaging of a multi-channel metasurface.

Dry eye disease (DED) is one of the most common ocular surface diseases, characterized by unstable tear film and ocular inflammation, affecting hundreds of millions of people worldwide. Currently, the clinical diagnosis of DED mainly relies on physical methods such as optical microscopy and ocular surface interferometric imaging, but classifying DED is still difficult. Here, we propose a compact and portable immune detection system based on the direct imaging of a nanophotonic metasurface with gradient geometry, for fast and ultra-sensitive detection of multiple biomarkers (i.e. Matrix metalloproteinase-9 (MMP-9), Lipocalin-1 (LCN-1), Lactoferrin (LTF)) in tears for the diagnosis and classification of DED. This centimeter-scale concentric nanophotonic metasurface, which consists of millions of unique metallic nanostructures, was fabricated through a cost-effective nanoimprint lithography (NIL) process. The immune detection system based on the antibody-modified metasurface shows favorable detection selectivity, an ultra-high sensitivity (3350 pixels/Refractive Index Unit (RIU)) and low limit of detection (LOD) (0.3 ng/mL for MMP-9, 1 ng/mL for LTF, and 0.5 ng/mL for LCN-1). Further clinical sampling and detection results demonstrated that this multi-biomarker detection system enabled accurate determination and symptom classification of DED, manifesting high correlation and consistency with clinical diagnosis results. The advantages such as low sample consumption, one-step detection, simple operation, and simultaneous detection of multiple biomarkers make the platform promising for screening and detecting a broader range of biomarker combinations in clinical practice.

A nomogram model combining ultrasound-based radiomics features and clinicopathological factors to identify germline BRCA1/2 mutation in invasive breast cancer patients.

Objective: BRCA1/2 status is a key to personalized therapy for invasive breast cancer patients. This study aimed to explore the association between ultrasound radiomics features and germline BRCA1/2 mutation in patients with invasive breast cancer. Materials and methods: In this retrospective study, 100 lesions in 92 BRCA1/2-mutated patients and 390 lesions in 357 non-BRCA1/2-mutated patients were included and randomly assigned as training and validation datasets in a ratio of 7:3. Gray-scale ultrasound images of the largest plane of the lesions were used for feature extraction. Maximum relevance minimum redundancy (mRMR) algorithm and multivariate logistic least absolute shrinkage and selection operator (LASSO) regression were used to select features. The multivariate logistic regression method was used to construct predictive models based on clinicopathological factors, radiomics features, or a combination of them. Results: In the clinical model, age at first diagnosis, family history of BRCA1/2-related malignancies, HER2 status, and Ki-67 level were found to be independent predictors for BRCA1/2 mutation. In the radiomics model, 10 significant features were selected from the 1032 radiomics features extracted from US images. The AUCs of the radiomics model were not inferior to those of the clinical model in both training dataset [0.712 (95% CI, 0.647-0.776) vs 0.768 (95% CI, 0.704-0.835); p = 0.429] and validation dataset [0.705 (95% CI, 0.597-0.808) vs 0.723 (95% CI, 0.625-0.828); p = 0.820]. The AUCs of the nomogram model combining clinical and radiomics features were 0.804 (95% CI, 0.748-0.861) in the training dataset and 0.811 (95% CI, 0.724-0.894) in the validation dataset, which were proved significantly higher than those of the clinical model alone by DeLong's test (p = 0.041; p = 0.007). To be noted, the negative predictive values (NPVs) of the nomogram model reached a favorable 0.93 in both datasets. Conclusion: This machine nomogram model combining ultrasound-based radiomics and clinical features exhibited a promising performance in identifying germline BRCA1/2 mutation in patients with invasive breast cancer and may help avoid unnecessary gene tests in clinical practice.

High-throughput microfluidic systems accelerated by artificial intelligence for biomedical applications.

High-throughput microfluidic systems are widely used in biomedical fields for tasks like disease detection, drug testing, and material discovery. Despite the great advances in automation and throughput, the large amounts of data generated by the high-throughput microfluidic systems generally outpace the abilities of manual analysis. Recently, the convergence of microfluidic systems and artificial intelligence (AI) has been promising in solving the issue by significantly accelerating the process of data analysis as well as improving the capability of intelligent decision. This review offers a comprehensive introduction on AI methods and outlines the current advances of high-throughput microfluidic systems accelerated by AI, covering biomedical detection, drug screening, and automated system control and design. Furthermore, the challenges and opportunities in this field are critically discussed as well.

Longitudinal Relation between Harsh Punishment and Psychoticism among Chinese Early Adolescents: Disentangling between­ and within­Family Effects.

This longitudinal study examined bidirectional relations between parental harsh punishment and psychoticism at the between­ and within­family levels in Chinese adolescents. There were 3,307 Chinese youth (43.6% girls, Mage = 11.30 years, SD = 0.24) who participated in a 4-wave longitudinal study, spaced 12 months apart. The results of cross-lagged panel modeling (i.e. CLPM) found the significant bidirectional relations between parental harsh punishment and psychoticism at the between-family level. However, the within-person level analysis of random intercept cross-lagged panel modeling (i.e. RI-CLPM) only revealed parental harsh punishment significantly predicted youth psychoticism, but not vice versa. Moreover, no sex differences were observed in the bidirectional relations between parental harsh punishment and psychoticism at the between- or within-family level. These results suggest parental harsh parenting could exacerbate the psychoticism trait at both the between- and within-family level, whereas the influence of young people's psychoticism on harsh parenting response from parents occurs only at the between-family level. The findings help to understand the nature of the dynamic process of change between psychoticism and harsh parenting among Chinese adolescents.

Cost-Effective Nanophotonic Metasurfaces with Spatially Gradient Structures for Ultrasensitive Imaging-Based Refractometric Sensing.

Nanophotonic metasurfaces are widely utilized in various domains, such as biomedical, healthcare, and environmental monitoring, benefiting from their unique advantages of label-free, noninvasive, and real-time response. However, nanophotonic metasurfaces usually rely on sophisticated instruments, and expensive and time-consuming fabrication processes, which severely restricts their practical applications. Herein, a spatially gradient metasurface is integrated with an imaging-based sensing scheme, waiving the requirement of spectrometers and achieving an ultrahigh imaging-based sensitivity of 3321 pixels/refractive index unit superior to that characterized using conventional compact spectrometers. The metasurface is fabricated by nanoimprint lithography using a reusable cyclic olefin copolymer template featuring millions of unique nanostructures. Under the illumination of monochromatic light, the transmittance of different nanostructures on the metasurface differs, resulting in grayscale images with varied intensity distributions. Analyzing the intensity change of the metasurface's recorded image can obtain the covering medium's refractive index. Furthermore, through theory and experimentation, the high reliability of the proposed reusable and flexible template has been verified for nanophotonic metasurface fabrication which further reduces the fabrication cost of core sensing elements. Finally, with proper optimization of the metasurface structure and imaging system, this setup is expected to be applied to many emerging areas of point-of-care, real-time, and on-site biosensing.

Modified American College of Radiology Thyroid Imaging Reporting and Data System and Modified Artificial Intelligence Thyroid Imaging Reporting and Data System for Thyroid Nodules: A Multicenter Retrospective Study.

Background: Risk stratification systems for thyroid nodules are limited by low specificity. The fine-needle aspiration (FNA) biopsy size thresholds and stratification criteria are based on evidence from the literature and expert consensus. Our aims were to investigate the optimal FNA biopsy size thresholds in the American College of Radiology (ACR) Thyroid Imaging Reporting and Data System (TI-RADS) and artificial intelligence (AI) TI-RADS and to revise the stratification criteria in AI TI-RADS. Methods: A total of 2596 thyroid nodules (in 2511 patients) on ultrasound examination with definite pathological diagnoses were retrospectively identified from January 2017 to September 2021 in 6 participating Chinese hospitals. The modified criteria for ACR TI-RADS were as follows: (1) no FNA for TR3; (2) FNA threshold for TR4 increased to 2.5 cm. The modified criteria for AI TI-RADS were as follows: (1) 6-point nodules upgraded to TR5; (2) no FNA for TR3; (3) FNA threshold for TR4 increased to 2.5 cm. The diagnostic performance and the unnecessary FNA rate (UFR) of modified versions were compared with the original ACR TI-RADS. Results: Compared with the original ACR TI-RADS, the modified ACR (mACR) TI-RADS yielded higher specificity (73% vs. 46%), accuracy (74% vs. 51%), area under the receiver operating characteristic curve (AUC; 0.80 vs. 0.70), and lower UFR (25% vs. 48%; all p < 0.001), although the sensitivity was slightly decreased (87% vs. 93%, p = 0.057). Compared with the original ACR TI-RADS, the modified AI (mAI) TI-RADS yielded higher specificity (73% vs. 46%), accuracy (75% vs. 51%), AUC (0.81 vs. 0.70), and lower UFR (24% vs. 48%; all p < 0.001), although the sensitivity tended to be slightly decreased (89% vs. 93%, p = 0.13). There was no significant difference between the mACR TI-RADS and mAI TI-RADS in the diagnostic performance and UFR (all p > 0.05). Conclusions: The revised FNA thresholds and the stratification criteria of the mACR TI-RADS and mAI TI-RADS may be associated with improvements in specificity and accuracy, without significantly sacrificing sensitivity for malignancy detection.

Maternal Childhood Maltreatment and Adolescent Internalizing Problems: The Mediating Role of Maternal Depressive Symptoms and Offspring Childhood Maltreatment.

Research has demonstrated the predictive effect of maternal childhood maltreatment on adolescent internalizing problems. However, few studies have explored the mediating mechanisms of how mothers' experiences of childhood maltreatment are transmitted to their offspring's internalizing problems over time. The present multi-informant study investigated the potential mediating effects of maternal depressive symptoms and offspring's childhood maltreatment experiences on the relation between maternal childhood maltreatment and adolescent internalizing problems. A total of 823 Chinese youth (43.4% girls; Mage = 10.26 years, SD = 0.94) and their mothers participated in a two-wave longitudinal study with one-year intervals. Mothers reported their experiences of childhood maltreatment and depressive symptoms, while youth reported their childhood maltreatment experiences and internalizing problems. Findings of path analysis indicated that maternal emotional abuse at T1 could significantly predict adolescent internalizing problems at T2, after controlling for a baseline of adolescent internalizing problems. Maternal emotional abuse, emotional neglect, and physical neglect at T1 can influence adolescent internalizing problems at T2 through maternal depressive symptoms at T1 to adolescent internalizing problems at T1. Maternal emotional abuse at T1 displayed statistically significant indirect effects on adolescent internalizing problems at T2 successively through the pathway from adolescent emotional abuse at T1 to adolescent internalizing problems at T1. The findings supported the cycle of maltreatment hypothesis. The present study highlights the intergenerational link between maternal childhood maltreatment and adolescent internalizing problems, as well as reveals the mediating mechanisms in this relation.