Lifetime Acts of Violence Assessment (LAVA) predictors of laboratory aggression.

While self-report data warrants interpretive caution in applied settings, these indices serve an important role in exploratory research. The Lifetime Assessment of Violent Acts (LAVA) inventory is a brief, reliable, face-valid questionnaire for estimating the frequency, triggers, and consequences (including injuries to others) of prior acts of aggression. The LAVA also identifies the situational contexts in which prior violence was triggered and provides a basis for risk classifications based on past reactive, intimate partner, alcohol-related, and/or weapon-related violence. Scores on the LAVA indices have been linked to a range of developmental and maladjustment indicators. Associations were found between lab-provoked (Taylor Aggression Paradigm) responding and both dimensional and risk classification scores in this sample (N = 92) of college men. Participants "competed" with a fictional opponent using electric shock as a retaliatory measure for perceived provocation. The total LAVA dimensional score predicted mean shock intensity ( d = .87), baseline responding ( d = 0.90), and past sexual aggression ( d = 1.01). Shock intensities in response to high provocation were predicted ( M d = 0.57) by all but one LAVA index. Participants who reported inflicting one or more injuries on another showed more intense escalations of aggression ( d = 0.46) in response to provocation than normative counterparts. Prior injuries to another ( RR = 2.71), reactive acts of aggression ( RR = 3.73), or intimate-partner violence ( RR = 4.19) elevated the risk of one or more prior acts of self-reported sexual aggression. The limitations and potential value of self-report data were discussed in regard to aggression research.

Childhood Sexual Abuse and Lifetime Aggression.

This study of college undergraduates (N = 873) examined three hypotheses regarding associations between childhood sexual abuse and lifetime aggression: 1) childhood sexual abuse was expected to account for unshared variance in the lifetime aggression indicators after controlling for the potential effects of parental physical abuse, sibling physical abuse, exposure to intimate partner violence, peer bullying, and respondent age; 2) childhood sexual abuse associations were expected to be relatively stronger among the women than the men; 3) childhood sexual abuse links to lifetime aggression were expected to vary as a function of age of victimization (adolescent < childhood < dual-age victims). Aggression histories varied widely with over 20% reporting prior injuries inflicted on others (3.2% > five injuries). Sexual abuse links to aggression tended to be stronger (p < .001) for the women than the men, and rates of aggression were higher when sexual abuse recurred across both childhood and adolescence. Partial support was found for all three hypotheses.

Differentiating corporal punishment from physical abuse in the prediction of lifetime aggression.

Corporal punishment and parental physical abuse often co-occur during upbringing, making it difficult to differentiate their selective impacts on psychological functioning. Associations between corporal punishment and a number of lifetime aggression indicators were examined in this study after efforts to control the potential influence of various forms of co-occurring maltreatment (parental physical abuse, childhood sexual abuse, sibling abuse, peer bullying, and observed parental violence). College students (N = 1,136) provided retrospective self-reports regarding their history of aggression and levels of exposure to childhood corporal punishment and maltreatment experiences. Analyses focused on three hypotheses: 1) The odds of experiencing childhood physical abuse would be higher among respondents reporting frequent corporal punishment during upbringing; 2) Corporal punishment scores would predict the criterion aggression indices after control of variance associated with childhood maltreatment; 3) Aggression scores would be higher among respondents classified in the moderate and elevated corporal punishment risk groups. Strong support was found for the first hypothesis since the odds of childhood physical abuse recollections were higher (OR = 65.3) among respondents who experienced frequent (>60 total disciplinary acts) corporal punishment during upbringing. Partial support was found for the second and third hypotheses. Dimensional and categorical corporal punishment scores were associated significantly with half of the criterion measures. These findings support efforts to dissuade reliance on corporal punishment to manage child behavior.

Failure mode and effects analysis: A community practice perspective.

PURPOSE: To report our early experiences with failure mode and effects analysis (FMEA) in a community practice setting. METHODS: The FMEA facilitator received extensive training at the AAPM Summer School. Early efforts focused on department education and emphasized the need for process evaluation in the context of high profile radiation therapy accidents. A multidisciplinary team was assembled with representation from each of the major department disciplines. Stereotactic radiosurgery (SRS) was identified as the most appropriate treatment technique for the first FMEA evaluation, as it is largely self-contained and has the potential to produce high impact failure modes. Process mapping was completed using breakout sessions, and then compiled into a simple electronic format. Weekly sessions were used to complete the FMEA evaluation. Risk priority number (RPN) values > 100 or severity scores of 9 or 10 were considered high risk. The overall time commitment was also tracked. RESULTS: The final SRS process map contained 15 major process steps and 183 subprocess steps. Splitting the process map into individual assignments was a successful strategy for our group. The process map was designed to contain enough detail such that another radiation oncology team would be able to perform our procedures. Continuous facilitator involvement helped maintain consistent scoring during FMEA. Practice changes were made responding to the highest RPN scores, and new resulting RPN scores were below our high-risk threshold. The estimated person-hour equivalent for project completion was 258 hr. CONCLUSIONS: This report provides important details on the initial steps we took to complete our first FMEA, providing guidance for community practices seeking to incorporate this process into their quality assurance (QA) program. Determining the feasibility of implementing complex QA processes into different practice settings will take on increasing significance as the field of radiation oncology transitions into the new TG-100 QA paradigm.

Psychometric Properties of the Lifetime Assessment of Violent Acts.

The Lifetime Assessment of Violent Acts (LAVA) inventory provides estimates of the frequency, triggers, and consequences (including injuries to others) of historic acts of aggression. The LAVA also identifies the situational contexts in which prior violence was triggered and allows classifications based on past reactive, intimate partner, alcoholrelated, and/or weapon-related violence. Normative and psychometric data were provided from a college (N = 1,133) and general population (N = 545) sample. Around 15% of the general population sample recalled inflicting 5 or more injuries on others at some time in the past. LAVA scores were significantly higher for women than men (d = .45), and respondents from the general population were more aggressive than those in the college sample (d = .41). The potential benefits, applications, and limitations of this retrospective self-report inventory are discussed.

DNA vaccination by intradermal electroporation induces long-lasting immune responses in rhesus macaques.

BACKGROUND: A desirable HIV vaccine should induce protective long-lasting humoral and cellular immune responses. METHODS: Macaques were immunized by env DNA, selected from a panel of recently transmitted SIVmac251 Env using intradermal electroporation as vaccine delivery method and magnitude, breadth and longevity of humoral and cellular immune responses. RESULTS: The macaques developed high, long-lasting humoral immune responses with neutralizing capacity against homologous and heterologous Env. The avidity of the antibody responses was also preserved over 1-year follow-up. Analysis of cellular immune responses demonstrated induction of Env-specific memory T cells harboring granzyme B, albeit their overall levels were low. Similar to the humoral responses, the cellular immunity was persistent over the ~1-year follow-up. CONCLUSION: These data show that vaccination by this intradermal DNA delivery regimen is able to induce potent and durable immune responses in macaques.

Safety and tolerability of the Easy Vax™ clinical epidermal electroporation system in healthy adults.

DNA vaccines are cost-effective and versatile, though intracellular delivery has been challenging in humans. Alternative delivery modalities such as electroporation have demonstrated improved immune responses, but are painful. In this single-center, double-blind, medical device trial, we evaluated the safety and tolerability of Easy Vax™ dermal electroporation system, alone (without DNA) in healthy adults. Three randomized protocol doses were administered to 10 subjects (80% white, 60% female, mean age: 32.1 years) in each of two areas (total of six doses). Two subjects complained of shooting pain, burning and/or tingling when doses were administered to the forearm region, but not the lateral deltoid regions. Subsequent doses for the remaining eight subjects were restricted to the deltoid regions only. Tolerability pain scores never exceeded 3 of 10 in the 11-Point Pain Rating scale, and 12 of 100 in the Visual Analog Scale (VAS), and lower in follow-up evaluations (P < 0.0001), with no significant difference between the three dosing protocols. Electrical properties of the skin, measured automatically by the device, showed no correlation between pain intensity and skin conductance. In conclusion, the Easy Vax™ electroporation device is safe and well tolerated when administered over the lateral deltoid skin regions in healthy volunteers.

Boys Round Here: The Relationship Between Masculine Honor Ideology, Aggressive Behavior, Race, and Regional Affiliation.

Masculine honor ideology (MHI) refers to a set of beliefs that dictate men must respond aggressively to threat or insult to maintain their ideal masculine reputation. The current study demonstrates the robust relationship between MHI and lifetime aggression outcomes in a national sample of men from the United States. It also details the regional prevalence of MHI and compares these rates across races and regions of the country. Participants included 896 adult United States men (Mage = 35.86, SD = 1.22) recruited on Amazon's Mechanical Turk. It was expected that the odds of endorsing past aggressive behavior and lifetime maladjustment would be increased by stronger adherence to MHI. This hypothesis was supported, and individuals who reported greater MHI adherence also had higher rates of lifetime aggression and maladjustment. Contrary to expectations, White, non-Hispanic men endorsed lower rates of MHI than did other men. Black men adhered more strongly to MHI than White and Hispanic men. It was also expected that men in the Southern and Western United States would endorse greater MHI in comparison to men in the Northeast United States. The hypothesis was only partially supported for White, non-Hispanic men, and it was associated with participant birthplace and their father's birthplace. There were no regional differences in MHI adherence related to the participants' mother's birthplace or where participants lived at survey completion. These findings suggest that MHI may spread more uniformly than prior research suggests and that MHI may have more nuanced cultural considerations that deserve continued empirical investigation.

A combination of intradermal jet-injection and electroporation overcomes in vivo dose restriction of DNA vaccines.

BACKGROUND: The use of optimized delivery devices has been shown to enhance the potency of DNA vaccines. However, further optimization of DNA vaccine delivery is needed for this vaccine modality to ultimately be efficacious in humans. METHODS: Herein we evaluated antigen expression and immunogenicity after intradermal delivery of different doses of DNA vaccines by needle or by the Biojector jet-injection device, with or without the addition of electroporation (EP). RESULTS: Neither needle injection augmented by EP nor Biojector alone could induce higher magnitudes of immune responses after immunizations with a high dose of DNA. After division of a defined DNA dose into multiple skin sites, the humoral response was particularly enhanced by Biojector while cellular responses were particularly enhanced by EP. Furthermore, a close correlation between in vivo antigen expression and cell-mediated as well as humoral immune responses was observed. CONCLUSIONS: These results show that two optimized DNA vaccine delivery devices can act together to overcome dose restrictions of plasmid DNA vaccines.

PID-5 Trait Indicators of Emotional Instability and Childhood Adversity Antecedents.

Personality traits provide natural mechanisms through which childhood maltreatment may translate into psychiatric symptomatology. The PID-5 has provided a DSM-supported exemplar for canvassing traits that may contribute to the developmental trajectories of many personality and mood disorders. This general population survey (N = 2,430) examined associations between adverse childhood experiences (ACE questionnaire) and selected PID-5 trait indicators of emotional well-being (Depressivity, Anxiousness, and Emotional Lability). These associations were contrasted with others derived from traditional dimensional measures of childhood maltreatment. ACE counts and all six of the dimensional maltreatment indicators were linked to the three trait scores. Family emotional abuse and ACE counts provided equally strong correlates of Depressivity and Anxiousness. ACE counts and childhood sexual abuse were especially strong in their associations with all three traits. Graded relationships were found in these trait-adversity relationships with polyvictimized respondents generating the highest personality maladjustment. The odds of a trait score elevation (>1 SD) were raised substantially (two to five fold) by singular adversity exposures, and the co-occurrence of only two different forms of adversity maximized odds of extreme trait expression. These results contribute to an evidentiary base suggesting steeper developmental trajectories for personality maladjustment among maltreated youth.

Implications of COVID-19 to Stroke Medicine: An Epidemiological and Pathophysiological Perspective.

The neurological complications of Coronavirus 2019 (COVID-19) including stroke have been documented in the recent literature. COVID-19-related inflammation is suggested to contribute to both a hypercoagulable state and haemorrhagic transformation, including in younger individuals. COVID-19 is associated with a heightened risk of ischaemic stroke. Haemorrhagic stroke in COVID-19 patients is associated with increased morbidity and mortality. Cerebral venous sinus thrombosis (CVST) accounts for <1% of stroke cases in the general population but has come to heightened public attention due to the increased risk associated with adenoviral COVID-19 vaccines. However, recent evidence suggests the prevalence of stroke is less in vaccinated individuals than in unvaccinated COVID-19 patients. This review evaluates the current evidence of COVID-19-related ischaemic and haemorrhagic stroke, with a focus on current epidemiology and inflammatory-linked pathophysiology in the field of vascular neurology and stroke medicine.

The Role of Children's PTSD Symptomatology in Non-Offending Caregivers' Secondary Traumatic Stress Symptomatology Following Disclosures of Sexual or Physical Abuse.

This research examined factors influencing levels of secondary traumatic stress (STS) in non-offending caregivers (NOCs) of children with histories of sexual or physical abuse. These factors included the nature of the abuse, NOCs' relationships with the initiators of the abuse, children's ages and genders, NOCs' trauma histories, and the elapsed time between children's disclosures of abuse and their trauma assessments. As a secondary objective, this research examined the interactions between children's self-reports of their own posttraumatic stress disorder (PTSD) symptomatology, NOCs' estimates of their children's PTSD symptomatology, and NOCs' self-reports of their own STS symptomatology. Participants from a clinical sample (N = 300, children = 150, NOCs = 150; child age M = 9.89, SD = 4.08; NOC age M = 37.87, SD = 9.23) completed structured intake interviews, the PTSD Checklist for the DSM-5 (PCL-5) and the Child PTSD Symptom Scale (CPSS; Child-Report and NOC-Report). Analytic strategies included point-biserial correlation coefficient calculations, linear regression analyses, and Analyses of Covariance (ANCOVAs). NOCs' levels of STS were impacted by their relationships with the initiators of the abuse and their own trauma histories. NOCs' self-reported STS symptomatology mirrored their estimates of their children's PTSD symptomatology. The discrepancy scores between children's self-reports of their PTSD symptomatology and NOCs' estimates of children's PTSD symptomatology were impacted by children's ages and genders. Clinical practitioners should note the importance of examining children's PTSD symptomatology and NOCs' STS symptomatology concurrently when making recommendations for trauma-informed evidence-based treatments.

Childhood adversity links to self-reported mood, anxiety, and stress-related disorders.

BACKGROUND: Child abuse has been identified within the DSM-5 as a putative etiologic risk for over two dozen psychiatric disorders. METHODS: This study examined associations between self-reported diagnostic histories of six Mood, Anxiety and Stress-Related Disorders and childhood adversities measured using dichotomous ACE (Adverse Childhood Experiences) counts and dimensional indices of child abuse. RESULTS: Adversity odds ratio were all significant (p < .001) and averaged as follows: sexual abuse, ORM = 3.16; emotional abuse, ORM = 2.62; physical abuse, ORM = 2.41; maternal battering, ORM = 2.15. An effort was made to differentiate between additive and interactive adversity risks. While significant adversity interactions were found, they tended to be modest in effect sizes and scope. The combination of sexual, physical and emotional abuse was associated with a maximal odds ratio and prevalence for Major Depression (OR = 5.13, 70.8%). The large impacts of unitary adversities limited the potential for large interactive effects. LIMITATIONS: The cross-sectional analysis relied on retrospective self-reports that may not generalize fully to respondents differing in ethnicity, religion, sexual orientation, or other factors. CONCLUSIONS: Childhood adversity in four different forms was associated with higher prevalence rates for six different mood and anxiety disorders. Childhood sexual and emotional abuse appeared to account for unshared variance in all of these lifetime diagnoses. Significant high risk adversity combinations were found for Major Depression (sexual/physical/ emotional), Post-Traumatic Stress Disorder (sexual/physical & physical/maternal battering), and Generalized Anxiety Disorder (physical/emotion/maternal battering).

Optimization of skin electroporation in mice to increase tolerability of DNA vaccine delivery to patients.

Electroporation has, during the last years, proven to be a very successful delivery method for DNA vaccines and has now reached clinical evaluation. Although intramuscular electroporation is practical in animal models, intradermal electroporation might be more suitable for clinical administration. Skin is the most accessible organ of the body and has professional antigen-presenting cells in large amounts; thus, skin is an ideal target for DNA vaccine delivery. Moreover, intradermal electroporation has clear clinical benefits such as improved safety and tolerability. This article describes improvements for effective and tolerable DNA delivery to skin. The time of pulse delivery has been shortened by 90% and even pulse programs of 240-ms total duration generate robust immune responses. We show that a single vaccination using an optimized gene delivery generates (i) high and consistent protein expression in vivo, (ii) cytotoxic antigen-specific T cells expressing both IFNgamma and CD107a (lysosomal-associated membrane protein 1). Furthermore, application of a topical anesthetic cream prior to vaccination does not affect the number or function of the antigen-specific T cells induced. This suggests that local anesthesia can be used to further decrease the sensation of pulse delivery in patients.

Distrustful, Conventional, Entitled, and Dysregulated: PID-5 Personality Facets Predict Hostile Masculinity and Sexual Violence in Community Men.

Psychopathy and narcissism are known predictors of sexual violence, but they are broad personality constructs with limited utility in intervention and prevention efforts. The Personality Inventory for DSM-5 (PID-5) assesses 25 specific personality facets residing in five higher order domains. The goal of this research was to test the PID-5 in a sexual aggression model, which also included hostile masculinity, juvenile delinquency, and five sexual assault indices. A nationwide sample of adult men (N = 512) completed the online survey. Hostile masculinity and juvenile delinquency were expected to have direct paths to sexual violence in a structural equation model. Hostile masculinity was also hypothesized as a mediator between sexual violence and PID-5 facets related to narcissism and psychopathy. These hypotheses were largely supported. Overall, 29.5% of men reported perpetrating sexual violence at least once, and 24.2% reported multiple assaults. In the sexually violent sample, 45.7% endorsed completed rape as their most severe act. PID-5 Suspiciousness, Cognitive and Perceptual Dysregulation, Grandiosity, and a lack of Eccentricity emerged as indirect predictors of sexual violence. These PID-5 facets were mediated by hostile masculinity, which had a reliable path to sexual violence. Juvenile delinquency had a direct and indirect path to sexual assault. The model accounted for 48% of the variance in latent sexual violence, and the five sexual violence index R2s ranged from .53 to .82. This research adds specificity to sexual violence models by demonstrating the underlying maladaptive personality trait structures associated with sexual assault. It also provides a more precise personality profile for clinical use and prevention programs.

Idiopathic Granulomatous Mastitis Presenting in a Patient With Hypothyroidism and Recent Hospitalization for Myxedema Coma: A Rare Case Report and Review of Literature.

Idiopathic granulomatous mastitis (IGM) is a rare, benign inflammatory disorder of the breast. Clinical features may include painful breasts, erythema, subcutaneous nodules, and ulcerative lesions. It can mimic various other breast pathologies, and it is a diagnosis of exclusion after infection, malignancy, and other inflammatory conditions have been ruled out. In this article, we present a case of IGM developing in a 40-year-old female 3 months after hospitalization for myxedema coma. A contrast-enhanced magnetic resonance imaging of the breasts showed bilateral edema, and a biopsy was negative for malignancy or infection. She was started on prednisone and had noticeable improvement of ulcerations within several weeks. IGM is a rare condition that requires a multimodal treatment approach. Often recalcitrant disease is encountered and requires surgical intervention, immunosuppression, and antimicrobial therapy. The diagnosis should be entertained in patients with bilateral breast inflammation to avoid unnecessary surgical resection early on.

Differential executive functioning in young adulthood as a function of experienced child abuse.

INTRODUCTION: Previous research has shown cognitive dysfunction in adults with a history of child abuse. The purpose of the present study was to measure differences that exist in executive functioning skills between individuals who have been abused as children versus those without the history of childhood abuse. METHODS: The present study recruited 43 students from the University of North Dakota (33 women) between ages 18 and 23 years of age. The participants were administered several prescreening measures, including a measure of physical child abuse, emotional child abuse, and sexual child abuse. Based on responses to these measures, participants were grouped into a no-child-abuse group, a mild-child-abuse group, or a moderate-to-severe child abuse group. All participants were administered measures of executive functioning that included the Wisconsin Card Sorting Task, the Operation Span Task, and the Connors Continuous Performance Task with a simultaneous recording of electroencephalographic activity using a wireless 9 channel EEG system. RESULTS: There was a statistically significant main effect of child abuse group (no child abuse vs. moderate-to-high child abuse) for the EEG-derived probability of cognitive workload during the OSPAN. Beta bandwidths for individuals in the drug abuse group, which served as a covariate, were also found to be significantly attenuated during the Connors CPT. CONCLUSION: Individuals that have been abused as children must use significantly more mental effort to complete executive functioning tasks as compared to their non-abused counterparts. Increased neurological effort could be used to explain poor decision-making skills that are common within the population.

Accelerating Physics-Based Simulations Using End-to-End Neural Network Proxies: An Application in Oil Reservoir Modeling.

We develop a proxy model based on deep learning methods to accelerate the simulations of oil reservoirs-by three orders of magnitude-compared to industry-strength physics-based PDE solvers. This paper describes a new architectural approach to this task modeling a simulator as an end-to-end black box, accompanied by a thorough experimental evaluation on a publicly available reservoir model. We demonstrate that in a practical setting a speedup of more than 2000X can be achieved with an average sequence error of about 10% relative to the simulator. The task involves varying well locations and varying geological realizations. The end-to-end proxy model is contrasted with several baselines, including upscaling, and is shown to outperform these by two orders of magnitude. We believe the outcomes presented here are extremely promising and offer a valuable benchmark for continuing research in oil field development optimization. Due to its domain-agnostic architecture, the presented approach can be extended to many applications beyond the field of oil and gas exploration.

Revisiting the link between childhood sexual abuse and adult sexual aggression.

BACKGROUND: Childhood maltreatment poses a risk factor for adult sexual aggression among men. OBJECTIVE: Efforts were made to examine links between childhood sexual abuse (CSA) and sexual aggression after controlling variance associated with other forms of abuse. PARTICIPANTS AND SETTING: This sample was comprised of men (n = 489) who completed a national survey regarding their history of possible abuse and/or sexual aggression. METHODS: Maltreatment indices included CSA, parental and sibling physical abuse, exposure to domestic violence, peer bullying, and family emotional abuse. Self-report indicators of sexual frotteurism, coercion and rape were provided by the Sexual Experiences Survey-Short Form Perpetration. RESULTS: CSA links with the criterion indicators were relatively stronger (r = 0.36, d = 0.65, p <  .001) than those found for non-sexual forms of abuse. CSA accounted for unshared variance in sexual aggression with these effects magnified by the addition of parental physical abuse (d = 2.1) or exposure to domestic violence (d = 2.2). The relative risks of prior acts of rape were elevated by CSA (RR = 4.39, p <  .001), parental physical abuse (RR = 3.85, p < 0.001), exposure to domestic violence (RR = 3.81, p <  .001), or sibling physical abuse (RR = 2.56, p = 0.007). These risks of completed rape were higher as well among respondents polyvictimized by two (RR = 4.92, p <  .001) or more (RR = 8.94, p < 0.001) forms of abuse. CONCLUSIONS: Multiple forms of child maltreatment, particularly CSA, were strongly associated with adult sexual aggression in this sample of men from the general population.

DNA vaccination for prostate cancer.

DNA-based cancer vaccines have been used successfully in mice to induce cytotoxic T lymphocytes (CTLs) specific for prostate antigens. Translation of a prostate-specific antigen (PSA) DNA vaccine into a phase I clinical trial demonstrated that PSA-specific immune responses could be induced but at a significantly lower level compared with those in mice. To enhance the efficacy of DNA vaccination against prostate cancer, we have explored and optimized intradermal electroporation as an effective way of delivering a PSA DNA vaccine. The results demonstrated that intradermal DNA vaccination using low amounts of DNA, followed by two sets of electrical pulses of different length and voltage, effectively induced PSA-specific T cells. Here we describe in detail how to perform intradermal DNA electroporation to induce high gene expression in skin and, more important, how to induce and analyze PSA-specific T cell responses.