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Background Childhood adversity and trauma are prevalent risk factors for the development of mental health conditions. This two-part paper describes the conceptual basis and pilot implementation of a tiered model of pediatric population mental health, highlighting the local socioecological context in which it was developed and the trauma-informed approach used. Methods Using retrospective record review of three datasets from the primary and secondary care pediatric clinics of a large academic medical center, which were harmonized to cover the study period from July 1, 2023 to June 30, 2024, we conducted descriptive analyses of patients across three levels: pediatric primary care ( n  = 9535), an integrated primary care program, which embeds mental health clinicians in primary care ( n  = 267), and family-centered trauma-informed psychotherapies in secondary care ( n  = 63), designed to address emotion dysregulation in pre-adolescent children. Demographics and lifetime history of trauma and adversity (assessed with a comprehensive 19-item list coded based on standardized screeners) were assessed through electronic medical records. Results Relative to the pediatric primary care population, more patients in the integrated primary care program and trauma-informed psychotherapies identified as White. Using our 19-item assessment, the lifetime prevalence of adversity or trauma was nearly universal among patients in the integrated primary care (94.4%) and trauma-informed psychotherapy (98.4%) programs. However, the lifetime prevalence of childhood adversities differed significantly across the two programs (integrated primary care: 76.8%; trauma-informed psychotherapy: 98.4%) when we assessed prevalence based only on the 10-item Adverse Childhood Experiences Questionnaire (Felitti VJ, Anda RF, Nordenberg D, Williamson DF, Spitz AM, Edwards V, Koss MP, Marks JS, Am J Prev Med 14:245–58, 1998). There was a higher prevalence of family and parent-related adversities in the trauma-informed psychotherapy program. Conclusions Findings support the need for trauma-informed, population mental health approaches in pediatric care. Developmentally tailored, family-centered, transdiagnostic screening and interventions are essential. Study findings, including gaps in programmatic fiscal sustainability, suggest avenues for policy reform to support and scale trauma-informed programs like ours. Programs seeking to implement trauma-informed approaches should leverage implementation and participatory research to ensure effectiveness and equitable accessibility for patients of diverse identities.

We recently reported that a chimeric peptide (GEP44) targeting the glucagon-like peptide-1 receptor (GLP-1R) and neuropeptide Y1- and Y2- receptors decreased body weight (BW), energy intake, and core temperature in diet-induced obese (DIO) male and female mice. In the current study, we tested the hypothesis that the strong reduction in body weight in response to GEP44 is partially related to the stimulation of energy expenditure (EE). To test this, rats were maintained on a high fat diet (HFD) for at least 4 months to elicit DIO prior to undergoing a sequential 2-day vehicle period, 2-day GEP44 (50 nmol/kg) period, and a minimum 2-day washout period, and detailed measures of energy homeostasis. GEP44 (50 nmol/kg) reduced EE (indirect calorimetry), respiratory exchange ratio (RER), core temperature, activity, energy intake, and BW in male and female rats. As in our previous study in mice, GEP44 reduced BW in male and female HFD-fed rats by 3.8 ± 0.2% and 2.3 ± 0.4%, respectively. These effects appear to be mediated by increased lipid oxidation and reductions in energy intake as GEP44 reduced RER and cumulative energy intake in male and female HFD-fed rats. The strong reduction in body weight in response to GEP44 is related to a robust reduction in energy intake, but not to the stimulation of EE. The paradoxical finding that GEP44 reduced EE might be secondary to a reduction in diet-induced thermogenesis or might indicate an important mechanism to limit the overall efficacy of GEP44 to prevent further weight loss.

The objective of this study was to compare the nutritional composition and the neutral detergent fiber (NDF) degradation kinetics of brown midrib (BMR) and non-BMR genotypes within and across warm-season annual grasses. Four commercial varieties (two non-BMR and two BMR) of corn, sorghum, and pearl millet were planted in plots. Forage samples were incubated in the rumen of three rumen-cannulated cows for 0, 3, 6, 12, 24, 48, 96, and 240 h. On an NDF basis, all forage types showed lower acid detergent lignin (ADL) concentrations for BMR genotypes, but the magnitude of the difference differed among forage types. The concentration of undegraded NDF (uNDF; NDF basis) differed among forage types and between genotypes. Corn had the least, pearl millet had the intermediate, and sorghum had the greatest concentration of uNDF. Non-BMR genotypes had greater concentrations of uNDF than BMR genotypes. No interaction existed between forage type and genotype for the concentration of uNDF. In conclusion, although BMR forages may show lower ADL concentrations in the cell wall and greater NDF degradability than non-BMR forages of the same forage type, BMR forages do not always have the least ADL concentration or the greatest NDF degradability when comparing different forage types.

ObjectivesTo describe (1) the proportion of deaths that were in recently hospitalised children and (2) causes of mortality among deceased children aged 0–59 months with preceding hospitalisations who enrolled in a mortality surveillance programme.DesignDescriptive study using prospectively collected data.SettingEight Child Health and Mortality Prevention Surveillance (CHAMPS) community and healthcare sites in sub-Saharan Africa and South Asia.ParticipantsDeaths among children aged 0–59 months enrolled in CHAMPS 2016–2023.InterventionsNone.Primary and secondary outcome measuresDeaths with antecedent hospitalisations within 180 days of death. Causes of death determined by expert panels who reviewed clinical data and histopathologic and microbiologic results from postmortem minimally invasive tissue sampling.ResultsCHAMPS enrolled 8548 deaths; we excluded 3688 neonates who died before discharge or ≤24 hours of birth and 482 with unclear information on antecedent hospitalisations. Out of the 4378 remaining deaths, 16.7% (95% CI 15.7% to 17.9%) were deaths that occurred within 180 days of a hospitalisation (n=733/4378). Of these, 55.7% (95% CI 52.0% to 59.3%) occurred outside healthcare facilities. Among included deaths with minimally invasive tissue sampling completed (n=337), lower respiratory tract infections (41.2%, 95% CI 36.0% to 46.7%), sepsis (39.8%, 95% CI 34.5% to 45.2%) and undernutrition (n=92, 27.3%, 95% CI 22.7% to 32.4%) were most common causes of death among cases with antecedent hospitalisations. The greatest proportion of deaths with antecedent hospital admissions occurred among cases aged 1–11 months (48.0%, 95% CI 44.4% to 51.7%), compared with those aged 0–1 months (21.7%, 95% CI 18.8% to 24.9%) and those aged 1–5 years (30.3%, 95% CI 27.0% to 33.8%). Moreover, the greatest proportion of deaths with antecedent hospital admissions occurred among infants/children with weight-for-age Z-score of <−3 (62.5%, 95% CI 56.5% to 68.0%) compared with those with weight-for-age Z-score of ≥−3 (37.5%, 95% CI 32.0% to 43.5%).ConclusionsWe observed a high proportion of deaths with antecedent hospitalisations within 180 days among young children across eight sites in sub-Saharan Africa and Asia. Among those deaths, children aged 1–11 months and undernourished infants were over-represented, suggesting early follow-up as a potential point to focus targeted support and future research.

Abstract Background and objectives One Paleopathology is a novel concept in Paleopathology that extends the One Health paradigm into the past. A workshop at the University of Durham, UK, was held prior to the 2024 International Society for Evolution, Medicine, and Public Health (ISEMPH) meeting, firstly to define and expand the concept of One Paleopathology and secondly to generate transdisciplinary research and outreach under this framework. This article presents a logic model to evaluate how effectively the workshop met its goals. Methodology Two surveys were conducted, one immediately following the workshop and at the 1-year mark. These surveys assess the direct outputs from the workshop—tangible research and outreach products—as well as changes in participants’ attitudes toward One Paleopathology and the degree to which transdisciplinarity was incorporated into resulting projects. Results Both the outputs (direct products of the workshop activities) and outcomes (changes in knowledge or attitude because of the activities) of the workshop suggest that the goals are being met. The first goal, to define and expand the concept of One Paleopathology, was met, with participants expressing strong acceptance of the framework. The second goal—generating transdisciplinary research—is reflected in eight ongoing projects initiated at the workshop. Conclusions and implications The workshop structure and outcomes assessment presented here evaluate an initial effort in effecting conceptual change in the social sciences. Participants were enthusiastic about One Paleopathology, and over the following year new collaborations and research agendas aligned with the concept emerged. Importantly, participants reported integrating transdisciplinarity into their long-term research, indicating that the workshop had a sustained impact. Lay Summary This article describes the creation, content, and results of a One Paleopathology workshop held at the University of Durham (UK) in August 2024, prior to the annual meeting of the International Society of Evolutionary Medicine and Public Health (ISEMPH). The workshop goals included extending today’s One Health paradigm to include the past, fostering an appreciation of planetary health—past and present— and forging transdisciplinary relationships to address complex health challenges today. After the workshop, two participant surveys measured the effectiveness of the workshop in meeting these goals. The surveys suggest that researchers have sustained interest in this concept and will continue to extend their health-related research to reflect the integration of humans, animals, and the environment.

We recently reported that a chimeric peptide (GEP44) targeting the glucagon-like peptide-1 receptor (GLP-1R) and neuropeptide Y1- and Y2- receptors decreased body weight (BW), energy intake and core temperature in diet-induced obese (DIO) male and female mice. In the current study, we tested the hypothesis that the strong reduction of body weight in response to GEP44 is partially related to the stimulation of energy expenditure (EE). To test this, rats were maintained on a HFD for at least 4 months to elicit DIO prior to undergoing a sequential 2-day vehicle period, 2-day GEP44 (50 nmol/kg) period and a minimum 2-day washout period and detailed measures of energy homeostasis. GEP44 (50 nmol/kg) reduced EE (indirect calorimetry), respiratory exchange ratio (RER), core temperature, activity, energy intake and BW in male and female rats. As in our previous study in mice, GEP44 reduced BW in male and female HFD-fed rats by 3.8 ± 0.2% and 2.3 ± 0.4%, respectively. These effects appear to be mediated by increased lipid oxidation and reductions of energy intake as GEP44 reduced RER and cumulative energy intake in male and female HFD-fed rats. The strong reduction of body weight in response to GEP44 is related to a robust reduction of energy intake, but not to stimulation of EE. The paradoxical finding that GEP44 reduced EE might be secondary to a reduction of diet-induced thermogenesis or might indicate an important mechanism to limit the overall efficacy of GEP44 to prevent further weight loss.

We recently reported that a chimeric peptide (GEP44) targeting the glucagon-like peptide-1 receptor (GLP-1R) and neuropeptide Y1- and Y2-receptors decreased body weight (BW), energy intake and core temperature in diet-induced obese (DIO) male and female mice. Given that GEP44 was found to reduce core temperature (surrogate measure of energy expenditure (EE)) in DIO mice, we hypothesized that GEP44 would reduce EE in male and female high fat diet (HFD)-fed rats. To test this, rats were maintained on a HFD for at least 4 months to elicit DIO prior to undergoing a sequential 2-day vehicle period, 2-day GEP44 (50 nmol/kg) period and a minimum 2-day washout period and detailed measures of energy homeostasis. GEP44 (50 nmol/kg) reduced EE (indirect calorimetry), respiratory exchange ratio (RER), core temperature, activity, energy intake and BW in male and female rats. As in our previous study in mice, GEP44 reduced BW in male and female HFD-fed rats by 3.8 ± 0.2% and 2.3 ± 0.4%, respectively. These effects appear to be mediated by increased lipid oxidation and reductions of energy intake as GEP44 reduced RER and cumulative energy intake in male and female HFD-fed rats. The strong reduction of body weight in response to GEP44 is related to a robust reduction of energy intake, but not to stimulation of EE. The paradoxical finding that GEP44 reduced EE might be secondary to a reduction of diet-induced thermogenesis or might indicate an important mechanism to limit the overall efficacy of GEP44 to prevent further weight loss.