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The stiffness of adherent mammalian cells is regulated by the elasticity of substrates due to mechanotransduction via integrin-based focal adhesions. Dictyostelium discoideum is an ameboid protozoan model organism that does not carry genes for classical integrin and can adhere to substrates without forming focal adhesions. It also has a life cycle that naturally includes both single-cellular and multicellular life forms. In this article, we report the measurements of the elastic modulus of single cells on varied substrate stiffnesses and the elastic modulus of the multicellular “slug” using atomic force microscopy (AFM) as a microindenter/force transducer. The results show that the elastic modulus of the Dictyostelium cell is regulated by the stiffness of the substrate and its surrounding cells, which is similar to the mechanotransduction behavior of mammalian cells.

IntroductionAutism is a lifelong neurodevelopmental condition diagnosed on the basis of differences in social communication, interaction and repetitive behaviours, including sensory sensitivities. Autistic individuals without intellectual disabilities often face barriers to positive adult outcomes and are at high risk for poor health, including mental health issues, which could be mitigated by improving well-being. Young people should receive support to increase their well-being during the transition to adulthood, when social and family support often reduces. This is the protocol for a feasibility randomised controlled trial (RCT) of an online peer-group intervention, ‘Understanding You, Discovering You’ (UYDY). Objectives included assessing recruitment and retention rates, acceptability of procedures, characterising usual care, assessing the acceptability of UYDY and care as usual (CAU) and calculating outcome measure variances for a full trial.Methods and analysisThis two-arm parallel feasibility RCT includes a nested qualitative evaluation. Seventy participants aged 16–25 years old with a clinical autism diagnosis will be randomised on a 1:1 basis to UYDY or CAU. Exclusion criteria include risk of harm to self or others, receipt of postdiagnostic support in the past 12 months, and literacy levels such that the written session materials are not accessible. UYDY, a 6-week online peer-group intervention, will cover topics such as understanding autism, problem-solving and accessing services, and is facilitated by an autistic person and social care professionals. The main outcomes from the feasibility trial will be collecting data on (1) recruitment and retention rates; (2) the acceptability of randomisation and outcome measurement procedures; (3) CAU accessed by participants; (4) acceptability of the interventions; (5) clinical outcome measure variances (see below). See the Statistical methods section below for how this will be assessed in the current study. Clinical outcomes will be measured at baseline, and 8, 16 and 24 weeks post-randomisation. The primary clinical outcome is well-being, assessed using the Warwick Edinburgh Mental Wellbeing Scale. Secondary clinical outcomes include autism social identification, quality of life, social support and loneliness. Adverse events will be monitored and reported. Carer impact will also be measured. Participants will be recruited from England and Wales via charities and NHS services. Qualitative interviews will be conducted to explore the acceptability of trial participation including randomisation and the interventions.Ethics and disseminationEthical approval has been obtained from the HRA and NHS REC (23/WA/0113). Informed consent will be collected from all participants (see online supplemental material for an example consent form). Results will inform the design of a full RCT and will be disseminated through peer-reviewed journals, conferences, and stakeholder events.Trial registration number ISRCTN10513626.

Background There is emerging evidence to suggest gender diverse people are overrepresented in avoidant/restrictive food intake disorder (ARFID) samples. However, the mechanisms underlying elevated risk for ARFID in this group are currently unknown. Gender diversity and neurodivergence commonly co-occur, with elevated sensory sensitivities reported to be a shared experience common across autism, attention deficit hyperactivity disorder (ADHD), and ARFID. We aimed to examine the unique contribution of sensory sensitivities, including hypo- and hyper-sensitivity, in predicting ARFID symptoms in gender diverse adults, whilst controlling for autistic and ADHD traits. Methods Gender diverse adults ( N  = 182; 142 assigned female at birth; M age = 28.6 years) in the UK participated in an online survey. We examined correlations between their self-reported ARFID symptoms, sensory sensitivities, autistic traits (not including sensory sensitivities), and ADHD traits whilst controlling for weight and shape concerns. We then used hierarchical multiple regression to investigate the unique contribution of sensory sensitivities to ARFID symptoms whilst controlling for the other neurodivergent traits. Results In our gender diverse sample, higher levels of ARFID symptoms were associated with higher levels of sensory sensitivities, autistic traits, and ADHD traits, after controlling for weight and shape concerns. Furthermore, sensory sensitivities, specifically hyper-sensitivity, uniquely predicted levels of ARFID symptoms once we accounted for autistic and ADHD traits. Conclusions When considering neurodivergence, sensory hyper-sensitivities may be particularly relevant to ARFID symptomatology in gender diverse adults. Future research should explore associations between ARFID presentations and sensory sensitivities in large samples of gender diverse adults, to enable separate analyses by gender identity. Plain english summary Gender diverse people, whose gender identity does not align with their sex assigned at birth, are at increased risk for eating disorders such as avoidant/restrictive food intake disorder (ARFID). Sensory sensitivities, autism and attention deficit hyperactivity disorder (ADHD) may increase a person’s risk of developing ARFID. Gender diverse people commonly report co-occurring autistic and ADHD traits, making it challenging to determine whether ARFID symptoms are linked to the autistic and ADHD traits they report, or whether ARFID symptoms are specifically associated with sensory sensitivities. We asked 182 gender diverse adults to complete an online questionnaire about their levels of ARFID symptoms, autistic traits, ADHD traits, and sensory sensitivities. We found gender diverse people with higher levels of ARFID symptoms also reported higher levels of autistic traits, ADHD traits, and sensory sensitivities. When we accounted for autistic and ADHD traits in our gender diverse sample, sensory hyper-sensitivity (i.e., an over-response to sensory information) had the strongest association with ARFID symptoms. Our findings suggest sensory sensitivities may be important to the development of ARFID symptoms in gender diverse people, over and above the influence of autistic and ADHD traits.

IntroductionDepression is three to four times more prevalent in autistic people and is related to reduced quality of life. There is a need for empirically supported psychological interventions for depression specifically adapted to meet the needs of autistic adults. ADEPT-2 aims to establish the clinical and cost-effectiveness of an adapted low-intensity psychological intervention (guided self-help) for depression in autistic adults.Methods and analysisA two parallel-group multicentre pragmatic randomised controlled trial investigating the effectiveness of GSH for depression in autistic adults. Participants (n=248) aged ≥18 years with a clinical diagnosis of autism currently experiencing depression will be randomised to GSH or treatment as usual (TAU). GSH is a low-intensity psychological intervention based on the principles of behavioural activation adapted for autism. GSH comprises informational materials for nine individual sessions facilitated online by a GSH coach who has received training and supervision in delivering the intervention. The primary outcome will be Beck Depression Inventory-II depression scores at 16 weeks post randomisation with follow-up measures at 32 and 52 weeks. Additional measures of anxiety, patient-rated global improvement, quality of life, work and social adjustment, positive and negative affect will be measured 16 and 52 weeks post randomisation. The primary health economic analysis will assess the cost-effectiveness of GSH compared with TAU over 52 weeks, from a societal perspective including the National Health Service, personal social services, personal expenses, voluntary services and productivity. An embedded qualitative study will explore the acceptability, experiences and adherence of participants and therapists to treatment principles.Ethics and disseminationThis trial has been approved by the East of England - Essex Research Ethics Committee on 10 June 2022 (REC Reference number: 22/EE/0091). The findings of the research will be submitted for publication in peer-reviewed journals and disseminated in an appropriate format to trial participants and the wider public.Trial registration number ISRCTN17547011.

Edward Gibbon laid the fall of the Roman Empire at Christianity's door, suggesting that 'pusillanimous youth preferred the penance of the monastic to the dangers of a military life ... whole legions were buried in these religious sanctuaries'. This surprising 2007 study suggests that, far from seeing Christianity as the cause of the fall of the Roman Empire, we should understand the Christianisation of the household as a central Roman survival strategy. By establishing new 'ground rules' for marriage and family life, the Roman Christians of the last century of the Western empire found a way to re-invent the Roman family as a social institution to weather the political, military, and social upheaval of two centuries of invasion and civil war. In doing so, these men and women - both clergy and lay - found themselves changing both what it meant to be Roman, and what it meant to be Christian.

Forensic patients with psychosis often engage in violent behaviour. There has been significant progress in understanding risk factors for violence, but identification of causal mechanisms of violence is limited. To develop a testable psychological framework explaining violence in psychosis - grounded in patient experience - to guide targeted treatment development. We conducted in-depth interviews with 20 patients with psychosis using forensic psychiatric services across three regions in England. Interviews were analysed using reflexive thematic analysis. People with lived experience contributed to the analysis. Analysis of interviews identified several psychological processes involved in the occurrence of violence. Violence was the dominant response mode to difficulties that was both habitual and underpinned by rules that engaged and justified an attack. Violence was triggered by a trio of sensitivities to other people: sensitivity to physical threat, from which violence protected; sensitivity to social disrespect, by which violence increased status; and sensitivity to unfairness, by which violence delivered revenge. Violence was an attempt to regulate difficult internal states: intense emotions were released through aggression and violence was an attempt to escape being overwhelmed by voices, visions or paranoia. There were different patterns of emphasis across these processes when explaining an individual participant's offending behaviour. The seven-factor model of violence derived from our analysis of patient accounts highlights multiple modifiable psychological processes that can plausibly lead to violence. The model can guide the research and development of targeted treatments to reduce violence by individuals with psychosis.

G ender dysphoria is distress in relation to incongruence between an individual’s gender and sex assigned at birth. Gender clinics offer support for gender dysphoria, and there is a higher prevalence of autism in young people attending such clinics than in the general population. We aimed to investigate the lived experiences of autistic young people who have experienced gender dysphoria, and their parents, using a multi-perspectival IPA design. Young autistic people aged 13–17 years ( n  = 15), and their parents ( n  = 16), completed in-depth interviews about the young person’s experience of gender dysphoria. We analysed each individual transcript to generate individual themes, and for each of the dyads, developed themes which acknowledged the similarities and differences in parent–child perspectives. The first superordinate theme was coping with distress which had two subordinate themes; understanding difficult feelings and focus on alleviating distress with external support . This theme described how young people were overwhelmed by negative feelings which they came to understand as being about gender incongruence and looked to alleviate these feelings through a gender transition. The second superordinate theme was working out who I am which had two subordinate themes: the centrality of different identities and needs and thinking about gender. This theme described how young people and their parents focused on different needs; while young people more often focused on their gender-related needs, parents focused on autism-related needs. We conclude that young people and parents may have different perspectives and priorities when it comes to meeting the needs of autistic young people who experience gender dysphoria.

It has long been acknowledged that although the reign of Constantine (d. 337 c.e.) brought new prosperity to the Christian churches, it was also an age of ever-escalating division. This essay suggests that recent scholarship on populism can help us to understand the role of conflict in Constantinian Christianity. Structured conflict, we suggest, had a recognized value as a tool for cultivating the loyalty of a following. The creation of factional loyalty, rather than spiritual unity, seems to have been the aim of the fourth-century Christian bishops and clergy. Yet it is less clear whether this goal was shared by the emperor himself.

This systematic review investigated how studies have measured gender dysphoria (GD) in autistic samples and the impact of using different measures on study results. The literature search identified 339 relevant papers, with 12 of them meeting the inclusion criteria. Results showed that seven different measures of GD characteristics have been used with autistic samples and that the studies consistently reported a greater number of GD characteristics and a greater severity of GD in autistic compared to non-autistic samples. Methodological common practices were found in recruiting participants from clinical settings rather than the general population, having more autistic males than females in the samples, for studies being conducted in Europe, North America, and Oceania, and using single-item measures of GD for samples of autistic children. Issues were identified with study designs and measures of GD, suggesting a need for a more standardized multi-item self-report measure of GD for use in clinical and non-clinical samples across different ages and cultures.