Prevalence and risk factors of depression in U.S. adults post mass shootings: evidence from population-based surveys of multiple communities.

OBJECTIVES: Mass violence incidents (MVIs) involving firearms, commonly referred to as "mass shootings" have become increasingly frequent in the United States. These shootings often result in immediate casualties and have far-reaching psychological impacts on survivors, witnesses, and the broader community. This study aimed to assess the prevalence and risk factors of depression within affected communities. STUDY DESIGN: Population-based cross-sectional study. METHODS: Data were collected from six communities affected by MVIs involving firearms that occurred between 2015 and 2020. Participants were randomly selected through address-based sampling, and depression was assessed using Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition) diagnostic-level major depressive episode (MDE). RESULTS: Overall, the MDE prevalence was 17·2% since the MVI, 15·4% in the past year, and 8·2% in the past month. Significant risk factors for MDE since MVIs include high exposure to the incident (adjusted relative risk [aRR] = 1·32, 95% confidence interval [CI]: 19-1·60), being aged 18-29 years (aRR = 2·52, 95% CI: 1·61-3·95), being a woman (aRR = 1·58, 95% CI: 1·27-1·96), having low social support (aRR = 1·80, 95% CI: 1·46-2·22), and experiencing past sexual or physical trauma (aRR = 2·20, 1·52-3·19). CONCLUSION: Our study reveals a high burden of depression within communities affected by MVIs involving firearm use. Persons with high exposure to the MVIs and certain demographic groups had greater risks for MDE. These findings highlight the long-term mental health burden in communities affected by MVIs and underscore the necessity of providing mental health services in its aftermath.

Adverse childhood experiences among early care and education teachers: Prevalence and associations with observed quality of classroom social and emotional climate.

This study examines the prevalence of self-reported adverse childhood experiences (ACEs) among a sample of 349 early care and education teachers. Seventy-three percent of the sample reported experiencing at least one ACE and 22% reported experiencing 4 or more ACEs. Live observational assessments of the quality of the social and emotional climate in teacher's classrooms were conducted for a subsample of 58 teachers. Within this subsample, reporting a higher number of ACEs was associated with facilitating a lower quality social and emotional classroom climate. Individual ACEs were also examined. Teachers who reported experiencing incarceration of a family member, physical abuse, or emotional abuse were observed to facilitate a lower quality social and emotional classroom climate. This study provides preliminary insight into the prevalence of ACEs among members of the early care and education workforce. Further, it extends previous work examining the multi-generational impacts of ACEs within families by showing that ACEs may influence the care that is provided to children in childcare settings.

Examining Stressors and Available Parenting Resources for Opioid-Using Mothers: Qualitative Findings from an Inpatient Substance Use Treatment Program.

Given the alarming opioid epidemic, high prevalence of parents involved in substance use treatment programs for opioid use disorder, and critical role that parenting stress plays on opioid use and relapse, the current study examines stressors experienced by mothers enrolled in substance use treatment. Specifically, interviews were conducted with mothers with opioid use disorder (OUD) enrolled in an inpatient substance use treatment program, to identify common themes and develop recommendations related to interventions targeting common stressors among this population. A significant number of parent-related, substance use-related, and other stressors were present prior to and during substance use treatment; with more stressors reported during treatment than prior to treatment. Mothers with OUD reported that they would be interested in receiving parenting services, but that relevant parenting resources were not offered during substance use treatment.

A subset of Cowdria ruminantium genes important for immune recognition and protection.

Cowdria ruminantium causes the tick-borne rickettsial disease of heartwater, which is devastating to livestock production in sub-Saharan Africa. Current diagnosis and control methods are inadequate. We have identified and sequenced a subset of genes encoding recombinant antigens recognized by antibody and peripheral blood mononuclear cells from immune ruminants. The identified genes include many with significant similarity to those of Rickettsia prowazekii, genes predicted to encode different outer membrane proteins and lipoproteins and a gene containing an unusual tandem repeat structure. Evidence is presented for immune protection by recombinant antigens in a mouse model of C. ruminantium infection. These data identify new recombinant antigens for evaluation in vaccines and diagnostic tests to control heartwater.

An SNP map of human chromosome 22.

The human genome sequence will provide a reference for measuring DNA sequence variation in human populations. Sequence variants are responsible for the genetic component of individuality, including complex characteristics such as disease susceptibility and drug response. Most sequence variants are single nucleotide polymorphisms (SNPs), where two alternate bases occur at one position. Comparison of any two genomes reveals around 1 SNP per kilobase. A sufficiently dense map of SNPs would allow the detection of sequence variants responsible for particular characteristics on the basis that they are associated with a specific SNP allele. Here we have evaluated large-scale sequencing approaches to obtaining SNPs, and have constructed a map of 2,730 SNPs on human chromosome 22. Most of the SNPs are within 25 kilobases of a transcribed exon, and are valuable for association studies. We have scaled up the process, detecting over 65,000 SNPs in the genome as part of The SNP Consortium programme, which is on target to build a map of 1 SNP every 5 kilobases that is integrated with the human genome sequence and that is freely available in the public domain.

Binding of pi-acceptor ligands to (triamine)iron(II) complexes.

A series of (Me3TACN)FeII derivatives with soft coligands have been investigated, where Me3TACN is N,N',N"-trimethyl-1,4,7-triazacyclononane. Treatment of Me3TACN with FeCl2 afforded a compound with the empirical formula (Me3TACN)FeCl2 (1). Compound 1, which is a versatile precursor reagent, was shown by single-crystal X-ray diffraction to be the salt [(Me3TACN)2Fe2Cl3][(Me3TACN)FeCl3], containing isolated [(Me3TACN)2Fe2Cl3]+ and [(Me3TACN)FeCl3]- subunits. Treatment of 1 with NaBPh4 gave the known [(Me3TACN)2Fe2Cl3]BPh4, while the addition of Me3TACN to FeCl4(2-) gave [(Me3TACN)FeCl3]-. Oxygenation of 1 afforded [(Me3TACN)FeCl2]2(mu-O), which was shown crystallographically to be centrosymmetric with a pair of distorted octahedral Fe centers. The Fe-N bond trans to the Fe-O bond is elongated by 02 A relative to the other Fe-N distances. Solutions of 1 and thiolates absorb CO to give [(Me3TACN)Fe(SPh)(CO)2]BPh4 and (Me3TACN)Fe(S2C2H4)(CO) (nu CO = 1896 cm-1). Treatment of 1 with excess CN- afforded [(Me3TACN)Fe(CN)3]-, isolated as its PPh4+ salt 5. Crystallographic and spectroscopic studies show that 5 is low spin with a C3v structure; its Fe-N distances contracted by 023 A relative to those in [(Me3TACN)FeCl3]-. Aqueous solutions of 1 bind CO upon the addition of CN- to produce (Me3TACN)Fe(CN)2(CO) (6) Analogous to 6 is (Me3TACN)Fe(CN)2(CNMe), prepared by methylation of 5. The metastable dicarbonyl [(Me3TACN)FeI(CO)2]I was prepared by treatment of FeI2(CO)4 with Me3TACN and was crystallographically characterized as its BPh4- salt. Values of E1/2 for [(Me3TACN)FeCl3]-, 5, and 6 are -0409, -0640, and 0533 V vs Fc/Fc+, respectively.

Investigation of the potential use of immunosuppressive agent gliotoxin in organ transplantation.

Gliotoxin is an immunosuppressive secondary metabolite produced by several pathogenic fungi. It has previously been shown to prevent graft-versus-host disease in transplantation of allogeneic mouse bone marrow and to reduce the immunogenicity of human fetal pancreas. We here report on the effect of gliotoxin on the prevention of rejection of allografts in two distinct models. Bathing mouse thyroid tissue in gliotoxin solution for 16 hr prolonged graft survival following transplantation into allogeneic recipients. In contrast the perfusion of rat kidneys with gliotoxin followed by 1 hr of incubation before orthotopic transplantation had little success with preventing allograft rejection. This disparity is most likely due to the incubation in the renal model not allowing sufficient time for the elimination of antigen presenting cells in the donor organ. However, the success with the thyroid grafts demonstrates the potential of gliotoxin as an immunomodulating agent in organ transplantation and warrants further investigation in other systems.

Vulvar manifestations of sexually transmitted diseases.

On the vulva, the appearance of sexually transmitted diseases (STD) is modified for several reasons. Recognition of the special characteristics of vulvar epithelium facilitates diagnosis of both sexually transmitted diseases and vulvar dermatoses that may be mistaken for STDs. The first section will review examination techniques and anatomic considerations. The second section will describe distinctive manifestations of vulvar herpes, human papillomavirus (HPV), molluscum contagiosum, scabies, and syphilis. The final section will provide differential diagnoses for primary and secondary vulvar lesions including erythema, papules, plaques, pustules, bullae, erosions, and ulcers.

HLA typing in polymorphous light eruption.

Human leukocyte antigen typing of 41 white patients with polymorphous light eruption (limited concept) showed no significant differences when compared with the typing of 51 white control subjects. We previously found that actinic prurigo, an idiopathic photodermatosis particularly associated with Amerindians, has a positive association with antigens A24 and Cw4 and a negative association with A3. We suggest, on the basis of both laboratory and clinical findings, that polymorphous light eruption (limited concept) and actinic prurigo are two different and distinct diseases.

Treatment of actinic prurigo with intermittent short-course topical 0.05% clobetasol 17-propionate. A preliminary report.

Actinic prurigo is a chronic familial photodermatosis that occurs mostly in Amerindians. Eight patients with actinic prurigo were given intermittent 3- to 14-day courses of topical 0.05% clobetasol 17-propionate cream or ointment in 1988 and 1989. Seven out of eight patients cleared or markedly improved. All of the patients had been resistant previously to milder topical corticosteroids. There have been no side effects. This therapy offers an effective alternative to systemic corticosteroids, oral psoralen with long-wave UV radiation in the A range, or thalidomide.

Electrocardiographic values from clinically normal, anesthetized ferrets (Mustela putorius furo).

Electrocardiograms were recorded from 25 clinically normal male ferrets anesthetized with ketamine and xylazine and from 7 ferrets anesthetized with ketamine alone. Ferrets anesthetized with ketamine alone had excessive salivation, open eyes, muscle tremors, muscle twitching, paddling motions, attempts to stand, and an unstable ECG baseline. Because ketamine/xylazine combination resulted in induction and good muscle relaxation, the ECG had little interference resulting from muscular movement.

Prevention of graft-versus-host disease by treatment of bone marrow with gliotoxin in fully allogeneic chimeras and their cytotoxic T cell repertoire.

Gliotoxin, a secondary fungal metabolite, at nanomolar concentrations, irreversibly inhibits murine T cell proliferation to mitogen. Treatment of allogeneic spleen cells with gliotoxin allows their transfer into sublethally irradiated recipients without inducing a GVH reaction. Gliotoxin treatment of bone marrow allows the establishment of fully allogenic bone marrow chimeras free of GVH disease. The cytotoxic T cell repertoire against influenza virus in these animals is restricted to both host- and donor-type MHC. However, their immune competence is severely compromised by their lack of host MHC-type stimulator cells.

Oral acanthosis nigricans: report of a case and comparison of oral and cutaneous pathology.

Malignant acanthosis nigricans is usually associated with adenocarcinomas of the digestive tract. The lesions of acanthosis nigricans commonly run a parallel course to the associated malignancy, producing hyperpigmented, roughened plaques on the skin and, sometimes, verruca-like papules on the oral mucosa. The clinical differences between cutaneous and oral acanthosis nigricans are mirrored by the marked differences in the histopathology. Because oral acanthosis nigricans is uncommon, recognizing histologic features may be difficult. The oral lesions have a true acanthosis and epithelial papillary hyperplasia while the cutaneous forms show slight irregular acanthosis that alternates with areas of epidermal atrophy and dermal papillomatosis.

Enhancement of murine thyroid allograft survival after 16 to 20 hours' organ culture.

Fully allogeneic thyroid organs cultured 16-20 hr in Hanks' balanced salt solution (HBSS) were transplanted to mice under the kidney capsule. Organ cultures maintained in 5% CO2 and air or in 100% nitrogen atmosphere in HBSS survived beyond the normal period required for graft rejection, in contrast to those maintained in room air or thyroids cultured in Eagle's minimum essential medium. Rejection of HBSS-cultured allogeneic thyroids can be induced by the injection of donor peritoneal exudate cells into the recipient 2 days after transplant. Lymphoid stimulator cells cultured overnight in HBSS, but not in (Eagle's) minimum essential medium in 5% CO2 and air, failed to induce alloreactive cytotoxic T cells in mixed lymphocyte cultures in vitro. The data suggest that short-term organ culture in a chemically simpler and nutritionally deficient medium in a low-oxygen environment enhances allograft survival. This is in contrast to the presently held theory, in which high-oxygen concentration is believed responsible for enhancement of allograft survival. This procedure should prove helpful in further determination of the factors involved in homograft rejection.