How receiving welfare assistance could be linked to children's bullying victimization: Exploring the potential pathways.

The study proposes and tests the pathways from receiving welfare assistance to children's bullying victimization. Specifically, the study examines whether children's difficulty making friends and school disconnection mediate the association between welfare assistance receipt to children's bullying victimization. The 2019 National Survey of Children's Health dataset was used, and the sample consisted of 12,230 caregivers of adolescents, aged 12-17 years. A path model was utilized to explore the proposed pathways. Findings suggest that welfare assistance receipt was not significantly associated with children's bullying victimization. It was positively related to children's bullying victimization through the mediating roles of having difficulty making friends and school disconnection. Schools and communities need to create spaces where youth can connect with peers, which is an important part of their development.

Integrating mixed reality preparation into acute coronary syndrome simulation for nursing students: a single-group pretest-posttest study.

BACKGROUND: Timely and effective intervention within the 'golden hour'-the critical first 90 min after the symptom onset-is crucial for initiating life-saving treatment and reducing mortality in acute coronary syndrome (ACS). This highlights the need for nursing students to be proficient in ACS care, emphasizing the importance of preparatory training. This study enhanced traditional simulation methods by integrating a mixed reality (MR) preparation step, offering a more immersive learning experience. We aimed to evaluate the effectiveness of integrating MR preparation into ACS simulation education, focusing on enhancements in knowledge, self-confidence in learning, and self-efficacy in learning. Additionally, we examined performance, practice immersion, and satisfaction to comprehensively evaluate the MR application. METHODS: One-group pretest-posttest design was implemented in a convenience sample of thirty-nine senior nursing students from a university in South Korea in August 2022. We developed a simulation program integrating MR preparation into ACS simulation (IMRP-ACSS), which was validated through expert review for content validity. The students participated in the simulation program over six hours across two days, including a 40-minute individual session of MR-based simulation preparation using head-mounted displays (the HoloLens 2). Individual changes in knowledge, self-confidence in learning, and self-efficacy in learning evaluated by the survey were analyzed using paired t-tests. Additionally, group performance assessed using the checklist was analyzed. Immersion and satisfaction were measured with a tool and a 10-point Likert scale, respectively. RESULTS: Individually, participants demonstrated significantly increased knowledge (t = 11.87, p < .001), self-confidence in learning (t = 7.17, p < .001), and self-efficacy in learning (t = 4.70, p < .001) post-education. Group performance yielded a mean score of 56.43/70 ± 7.45. Groups scored higher in electrocardiogram interpretation, patient safety, and heparin administration. Participants reported a practice immersion level of 37.82/50 ± 9.13 and expressed satisfaction with the program, achieving an average score of 8.85/10 ± 1.35. CONCLUSION: Integrating MR preparation into ACS simulation enhanced nursing students' knowledge, self-confidence in learning, and self-efficacy in ACS care, providing a replicable and immersive learning experience. This method is an effective addition to nursing education, preparing students through comprehensive, technology-enhanced training.

Anti-obesity effects of Lactiplantibacillus plantarum SKO-001 in high-fat diet-induced obese mice.

PURPOSE: Previous reports showed that some probiotics provide beneficial effects on various diseases including metabolic disorders. This study aimed to investigate the anti-obesity effects of Lactiplantibacillus (L.) plantarum SKO-001 (SKO-001), a probiotic strain newly isolated from Angelica gigas. METHODS: C57BL/6J mice were fed with high-fat diet (HFD, 60% fat) for four weeks, and then different doses of SKO-001 (n = 10 each group) were orally given for 12 weeks. Following treatment, body weight, fat weight, serum parameters and adipose and liver tissues were analyzed. RESULTS: SKO-001 (2 × 1010 CFU/day, per os) reduced body weight gain after 10th week of administration, accompanied by a reduction in body fat mass of mice. In the SKO-001-fed group, increased serum adiponectin, decreased leptin, insulin, total cholesterol, low-density lipoprotein cholesterol, free fatty acids, and triglyceride levels were observed. Hematoxylin and eosin staining of various fat depots showed that increased adipocyte size caused by HFD intake was markedly reduced and correlated with reduced mRNA levels of lipogenesis genes, including sterol regulatory element-binding protein-1c, peroxisome proliferator-activated receptor gamma, and CCAAT/enhancer binding protein alpha, and increased uncoupling protein 1 levels. Similarly, SKO-001 reduced lipid accumulation, decreased the mRNA levels of lipogenic genes, and reduced α-smooth muscle actin and collagen type 1 alpha 1 levels in the liver. CONCLUSIONS: SKO-001 ameliorates obesity and related metabolic abnormalities in adipose and liver tissues, possibly via the regulation of lipid metabolism. Based on the results of the present study, SKO-001 may be applicable as an anti-obesity therapeutic or functional food.

Effects of school environment on depression among Black and White adolescents.

While the school environment is critical for adolescents' psychological development, how the school environment influences depression among different racial groups has not been fully explored. This study aims to identify the effects of the school environment (school connectedness, school climates, trouble with peers and teachers) on depressive symptoms among Black and White adolescents. It also compares how the effects of school environments differ between Black and White adolescents. This study analyzed wave 6 of the Fragile Families and Child Well-being Study, a longitudinal birth cohort study in 20 major cities across the United States. Almost three-fourth (73.39%) of the adolescents were Black, and 26.61% were White. About half (50.46%) of the adolescents were females, and the mean age of adolescents was 15.39. Multiple regression analysis showed that higher school connectedness and less frequent troubles with teachers were associated with lower depression among Black adolescents. In contrast, only school connectedness was associated with depression among White adolescents. Higher school connectedness was associated with lower depressive symptoms for both Black and White adolescents. However, the magnitude of the effects of school connectedness was found to be statistically weaker among Black adolescents. These findings suggest a need for creating a racially equitable school environment that makes every student feel more connected to their schools, especially Black students.

Bioengineering of Halobacterium sp. NRC-1 gas vesicle nanoparticles with GvpC fusion protein produced in E. coli.

Gas vesicle nanoparticles (GVNPs) are hollow, buoyant prokaryotic organelles used for cell flotation. GVNPs are encoded by a large gas vesicle protein (gvp) gene cluster in the haloarchaeon, Halobacterium sp. NRC-1, including one gene, gvpC, specifying a protein bound to the surface of the nanoparticles. Genetically engineered GVNPs in the Halobacterium sp. have been produced by fusion of foreign sequences to gvpC. To improve the versatility of the GVNP platform, we developed a method for displaying exogenously produced GvpC fusion proteins on the haloarchaeal nanoparticles. The streptococcal IgG-binding protein domain was fused at or near the C-terminus of GvpC, expressed and purified from E. coli, and shown to bind to wild-type GVNPs. The two fusion proteins, GvpC3GB and GvpC4GB, without or with a highly acidic GvpC C-terminal region, were found to be able to bind nanoparticles equally well. The GVNP-bound GvpC-IgG-binding fusion protein was also capable of binding to an enzyme-linked IgG-HRP complex which retained enzyme activity, demonstrating the hybrid system capability for display and delivery of protein complexes. This is the first report demonstrating functional binding of exogenously produced GvpC fusion proteins to wild-type haloarchaeal GVNPs which significantly expands the capability of the platform to produce bioengineered nanoparticles for biomedical applications. KEY POINTS: • Haloarchaeal gas vesicle nanoparticles (GVNPs) constitute a versatile display system. • GvpC-streptococcal IgG-binding fusion proteins expressed in E. coli bind to GVNPs. • IgG-binding proteins displayed on floating GVNPs bind and display IgG-HRP complex.

Characterization of a C-Type Lectin Domain-Containing Protein with Antibacterial Activity from Pacific Abalone (Haliotis discus hannai).

Genes that influence the growth of Pacific abalone (Haliotis discus hannai) may improve the productivity of the aquaculture industry. Previous research demonstrated that the differential expression of a gene encoding a C-type lectin domain-containing protein (CTLD) was associated with a faster growth in Pacific abalone. We analyzed this gene and identified an open reading frame that consisted of 145 amino acids. The sequence showed a significant homology to other genes that encode CTLDs in the genus Haliotis. Expression profiling analysis at different developmental stages and from various tissues showed that the gene was first expressed at approximately 50 days after fertilization (shell length of 2.47 ± 0.13 mm). In adult Pacific abalone, the gene was strongly expressed in the epipodium, gill, and mantle. Recombinant Pacific abalone CTLD purified from Escherichia coli exhibited antimicrobial activity against several Gram-positive bacteria (Bacillus subtilis, Streptococcus iniae, and Lactococcus garvieae) and Gram-negative bacteria (Vibrio alginolyticus and Vibrio harveyi). We also performed bacterial agglutination assays in the presence of Ca2+, as well as bacterial binding assays in the presence of the detergent dodecyl maltoside. Incubation with E. coli and B. subtilis cells suggested that the CTLD stimulated Ca2+-dependent bacterial agglutination. Our results suggest that this novel Pacific abalone CTLD is important for the pathogen recognition in the gastropod host defense mechanism.

Angiotensin AT1 receptor antagonism by losartan stimulates adipocyte browning via induction of apelin.

Adipocyte browning appears to be a potential therapeutic strategy to combat obesity and related metabolic disorders. Recent studies have shown that apelin, an adipokine, stimulates adipocyte browning and has negative cross-talk with angiotensin II receptor type 1 (AT1 receptor) signaling. Here, we report that losartan, a selective AT1 receptor antagonist, induces browning, as evidenced by an increase in browning marker expression, mitochondrial biogenesis, and oxygen consumption in murine adipocytes. In parallel, losartan up-regulated apelin expression, concomitant with increased phosphorylation of protein kinase B and AMP-activated protein kinase. However, the siRNA-mediated knockdown of apelin expression attenuated losartan-induced browning. Angiotensin II cotreatment also inhibited losartan-induced browning, suggesting that AT1 receptor antagonism-induced activation of apelin signaling may be responsible for adipocyte browning induced by losartan. The in vivo browning effects of losartan were confirmed using both C57BL/6J and ob/ob mice. Furthermore, in vivo apelin knockdown by adeno-associated virus carrying-apelin shRNA significantly inhibited losartan-induced adipocyte browning. In summary, these data suggested that AT1 receptor antagonism by losartan promotes the browning of white adipocytes via the induction of apelin expression. Therefore, apelin modulation may be an effective strategy for the treatment of obesity and its related metabolic disorders.

Caregiver's difficulty paying child's healthcare bills and bullying victimization of adolescents with physical disabilities.

Guided by the ecological systems perspective, the objective of the study was to examine whether caregivers' difficulty paying their child's health-care bills is associated with bullying victimization directly and indirectly through the mediating mechanisms of caregivers' frustration, adolescents' internalizing problems, and social difficulty focusing on adolescents with physical disabilities. The 2019 National Survey of Children's Health dataset, which collected data on adolescents' and caregivers' demographic characteristics and health and well-being, was used. The study sample consisted of 368 caregivers of adolescents, 12-17 years of age with physical disabilities. No direct association between caregivers' difficulty paying their child's health-care bills and bullying victimization was found. However, caregivers' frustration and adolescents' internalizing problems were shown to have an indirect association with bullying victimization, which was mediated by difficulty making friends. In addition, adolescents' difficulty making friends was positively associated with bullying victimization. Practitioners working with adolescents with physical disabilities are encouraged to foster collaborative processes across various ecological systems of the adolescent and family to address caregivers' frustration and promote positive social and emotional development of the adolescent with physical disabilities, which can decrease their risk of bullying victimization.

Heat shock protein 70 gene expression and stress response of red-spotted (Epinephelus akaara) and hybrid (E. akaara female × E. lanceolatus male) groupers to heat and cold shock exposure.

The importance of the temperature tolerance of fish is increasing due to climate change caused by global warming. This study examined the expression of the heat shock protein 70 (HSP70) gene, and plasma cortisol and glucose levels, as a stress response in red-spotted and hybrid groupers during exposure to heat and cold shock. Temperature in the tank where fishes acclimated at 20℃ was gradually increased or decreased, respectively, to examine the survival rate of fish. The result showed a higher survival rate of the hybrid than that of the red-spotted grouper upon exposure to a higher temperature. To further analyze the factors associated with temperature-associated stress, fishes were collected from different temperatures which changed from 20 to 30℃ or 10℃, respectively, and then back to 20℃. The expression levels of the gene encoding heat shock protein 70 (HSP70) were analyzed by qPCR using cDNA prepared from RNA extracted from the brain. A higher level of HSP70 transcript was detected in the hybrid during heat shock exposure. Analysis of cortisol and glucose from the blood of fish collected during the acclimation periods clearly indicated that the level of cortisol was increased upon temperature shift although a slight difference in the degrees of changes timing was slightly different between red-spotted grouper and hybrid. The results showed a correlation between the level of HSP70 and survival rate upon exposure to higher temperature shock. This study provides basic information regarding whether HSP70 expression increases the survival rate of fish subjected to rapid temperature changes.

Exploring Sex Differences in the Association between Bullying Involvement and Alcohol and Marijuana Use among U.S. Adolescents in 6th to 10th Grade.

Objectives: The aim of the current study was to examine whether different types of involvement in bullying, together with a set of social-ecological correlates, were associated with alcohol and marijuana use for female and male adolescents. Methods: This study utilized data derived from the U.S. division of the 2005-2006 Health Behavior in School-Aged Children (HBSC) study, which include 7,084 U.S. 6th-10th graders (3,353 males and 3,731 females) in public and private schools. Results: The results showed that although some forms of involvement in bullying were associated with alcohol and marijuana use, some of these associations became non-significant when the social-ecological covariates were included in the models. The final logistic regression models revealed that being a traditional bully-victim increased the risk of alcohol use for males while being a traditional bully and cyber victim increased the risk of alcohol use for females. In addition, being a cyberbully increased the risk of marijuana use for males. While parental monitoring decreased the risk, delinquent peers increased the risk of both alcohol and marijuana use for both sexes. Parent/guardian support decreased the risk of alcohol use for females. The likelihood of alcohol use and marijuana use increased with age for both sexes, while being an African American was linked with a lower risk of alcohol and marijuana use among males. Conclusions/Importance: Our findings demonstrate the importance of examining the link between bullying involvement and substance use, together with social-ecological correlates for female and male adolescents.

Robust Inertial Measurement Unit-Based Attitude Determination Kalman Filter for Kinematically Constrained Links.

The external acceleration of a fast-moving body induces uncertainty in attitude determination based on inertial measurement unit (IMU) signals and thus, frequently degrades the determination accuracy. Although previous works adopt acceleration-compensating mechanisms to deal with this problem, they cannot completely eliminate the uncertainty as they are, inherently, approaches to an underdetermined problem. This paper presents a novel constraint-augmented Kalman filter (KF) that eliminates the acceleration-induced uncertainty for a robust IMU-based attitude determination when IMU is attached to a constrained link. Particularly, this research deals with an acceleration-level kinematic constraint derived on the basis of a ball joint. Experimental results demonstrate the superiority of the proposed constrained KF over the conventional unconstrained KF: The average accuracy improved by 1.88° with a maximum of 4.18°. More importantly, whereas the accuracy of conventional KF is dependent to some extent on test acceleration conditions, that of the proposed KF is independent of these conditions. Due to the robustness of the proposed KF, it may be applied when accurate attitude estimation is needed regardless of dynamic conditions.

Effect of Strapdown Integration Order and Sampling Rate on IMU-Based Attitude Estimation Accuracy.

This paper deals with the strapdown integration of attitude estimation Kalman filter (KF) based on inertial measurement unit (IMU) signals. In many low-cost wearable IMU applications, a first-order is selected for strapdown integration, which may degrade attitude estimation performance in high-speed angular motions. The purpose of this research is to provide insights into the effect of the strapdown integration order and sampling rate on the attitude estimation accuracy for low-cost IMU applications. Experimental results showed that the effect of integration order was small when the angular velocity was low and the sampling rate was large. However, as the angular velocity increased and the sampling rate decreased, the effect of integration order increased, i.e., obviously, the third-order KF resulted in better estimations than the first-order KF. When comparing the case where both transient matrix and process noise covariance matrix are applied to the corresponding order and the case where only the transient matrix is applied to the corresponding order but the process noise covariance matrix for the first-order is still used, both cases had almost equivalent estimation accuracy. However, in terms of the calculation cost, the latter case was more economical than the former, particularly for the third-order KF (i.e., the ratio of the former to the latter is 1.22 to 1).

The Moderating Role of Attachment on the Association between Childhood Maltreatment and Adolescent Dating Violence.

Approximately twenty percent of female and ten percent of male adolescents report violence in their dating relationships and there is a significant association between dating violence in adolescence and later perpetration of intimate partner violence (IPV) in adulthood. Identification of factors associated with dating violence can inform intervention and prevention efforts. This study was designed to examine the associations of early childhood maltreatment experience and involvement in adolescent dating violence. It also aimed to identify the moderating effect of insecure attachment styles on these associations. One hundred fifty adolescent who participated in a larger longitudinal study on prenatal drug exposure participated in this study. Participants completed self-report measures of childhood maltreatment at a standard follow-up visit between the ages of 15-19 years. Approximately 18 month later, they completed questionnaires on their attachment styles and level of dating violence perpetration and victimization. Hierarchical regression modeling revealed a significant main effect for childhood abuse but not insecure attachment on perpetration and victimization of dating violence. Avoidant attachment significantly moderated the relationship between childhood abuse exposure and dating violence: For adolescents who reported an avoidant attachment style, an increase in the level of experienced childhood maltreatment predicted significantly higher increases in victimization by dating violence, compared to those did not have avoidant attachment. Results suggest adolescents with child maltreatment history and avoidant attachment styles may be at higher risk for involvement in dating violence and support intervention efforts for fostering attachment relationship to attenuate the association between early exposures to maltreatment and involvement in dating violence later.

Dim-light photoreceptor of chub mackerel Scomber japonicus and the photoresponse upon illumination with LEDs of different wavelengths.

To study the absorption characteristics of rhodopsin, a dim-light photoreceptor, in chub mackerel (Scomber japonicus) and the relationship between light wavelengths on the photoresponse, the rod opsin gene was cloned into an expression vector, pMT4. Recombinant opsin was transiently expressed in COS-1 cells and reconstituted with 11-cis-retinal. Cells containing the regenerated rhodopsin were solubilized and subjected to UV/Vis spectroscopic analysis in the dark and upon illumination. Difference spectra from the lysates indicated an absorption maximum of mackerel rhodopsin around 500 nm. Four types of light-emitting diode (LED) modules with different wavelengths (red, peak 627 nm; cyan, 505 nm; blue, 442 nm; white, 447 + 560 nm) were constructed to examine their effects on the photoresponse in chub mackerel. Behavioral responses of the mackerels, including speed and frequencies acclimated in the dark and upon LED illumination, were analyzed using an underwater acoustic camera. Compared to an average speed of 22.25 ± 1.57 cm/s of mackerel movement in the dark, speed increased to 22.97 ± 0.29, 24.66 ± 1.06, 26.28 ± 2.28, and 25.19 ± 1.91 cm/s upon exposure to red, blue, cyan, and white LEDs, respectively. There were increases of 103.48 ± 1.58, 109.37 ± 5.29, 118.48 ± 10.82, and 109.43 ± 3.92 %, respectively, in the relative speed of the fishes upon illumination with red, blue, cyan, and white LEDs compared with that in the dark (set at 100 %). Similar rate of wavelength-dependent responses was observed in a frequency analysis. These results indicate that an LED emitting a peak wavelength close to an absorption maximum of rhodopsin is more effective at eliciting a response to light.

Organ-specific distribution of gold nanoparticles by their surface functionalization.

The behavior and fate of intravenously (i.v.) injected nanoparticles (NPs) can be controlled by several physicochemical factors including size, shape and surface charge. To evaluate the role of surface charge on distribution of NPs, we used neutral-charged 15-nm-sized polyethylene glycol-coated gold nanoparticles (AuNP(PEG)) as a core NP and carboxyl or amine groups were conjugated to AuNP(PEG) to generate negative (AuNP(COOH)) or positive AuNP (AuNP(NH2)), respectively. Each type of AuNP was i.v. injected into mice (1 mg kg(-1)) and the concentration of Au was measured in different organs at 30 min, 4, 24 h, 7, 14 days, 1, 3 and 6 months post-injection. The organ distribution also showed the higher deposition rate depending on their functional groups: AuNP(PEG) for mesenteric lymph node, kidney, brain and testis; AuNP(COOH) for liver; AuNP(NH2) for spleen, lung and heart. The blood circulation time and the major excretion route were different depending on their functional groups. In conclusion, functional groups conjugated on the surface of AuNPs produce differences in blood kinetics, organ distribution and elimination pattern which can be important information for directing NPs to specific organs or improving the kinetic properties.

Differentially-Expressed Genes Associated with Faster Growth of the Pacific Abalone, Haliotis discus hannai.

The Pacific abalone Haliotis discus hannai is used for commercial aquaculture in Korea. We examined the transcriptome of Pacific abalone Haliotis discus hannai siblings using NGS technology to identify genes associated with high growth rates. Pacific abalones grown for 200 days post-fertilization were divided into small-, medium-, and large-size groups with mean weights of 0.26 ± 0.09 g, 1.43 ± 0.405 g, and 5.24 ± 1.09 g, respectively. RNA isolated from the soft tissues of each group was subjected to RNA sequencing. Approximately 1%-3% of the transcripts were differentially expressed in abalones, depending on the growth rate. RT-PCR was carried out on thirty four genes selected to confirm the relative differences in expression detected by RNA sequencing. Six differentially-expressed genes were identified as associated with faster growth of the Pacific abalone. These include five up-regulated genes (including one specific to females) encoding transcripts homologous to incilarin A, perlucin, transforming growth factor-beta-induced protein immunoglobulin-heavy chain 3 (ig-h3), vitelline envelope zona pellucida domain 4, and defensin, and one down-regulated gene encoding tomoregulin in large abalones. Most of the transcripts were expressed predominantly in the hepatopancreas. The genes identified in this study will lead to development of markers for identification of high-growth-rate abalones and female abalones.

Effect of initial salt concentrations on cell performance and distribution of internal resistance in microbial desalination cells.

Microbial desalination cells (MDCs) are modified microbial fuel cells (MFCs) that concurrently produce electricity and desalinate seawater, but adding a desalination compartment and an ion-exchange membrane may increase the internal resistance (Ri), which can limit the cell performance. However, the effects of a desalination chamber and initial NaCl concentrations on the internal resistances and the cell performances (i.e. Coulombic efficiency (CE), current and power density) of MDCs have yet to be thoroughly explored; thus, the cell performance and Ri distributions of MDCs having different initial concentrations and an MFC having no desalination chamber were compared. In the MDCs, the current and power density generation increased from 2.82 mA and 158.2 mW/m2 to 3.17 mA and 204.5 mW/m2 when the initial NaCl concentrations were increased from 5 to 30 g/L, as a consequence of the internal resistances decreasing from 2432.0 to 2328.4 Ω. And even though the MFC has a lower Ri than the MDCs, lower cell performances (current: 2.59 mA; power density: 141.6 mW/m2 and CE: 62.1%) were observed; there was no effect of improved junction potential in the MFC. Thus, in the MDCs, the higher internal resistances due to the addition of a desalination compartment can be offset by reducing the electrolyte resistance and improving the junction potential at higher NaCl concentrations.

Association between Secondhand Smoke and Allergic Diseases in Korean Adolescents: Cross-Sectional Analysis of the 2019 KYRBS.

This study aimed to determine whether secondhand smoking (SHS) in adolescents is associated with allergic diseases. Data from the 2019 Korea Youth Risk Behavior Survey were used (N = 37,848 Korean adolescents: 19,114 boys and 18,734 girls). This study assessed SHS exposure using questionnaire data, which included information, such as exposure to SHS and allergic diseases. Multiple logistic regression analysis was used to estimate the association between exposure to SHS and allergic diseases. The results showed that exposure to SHS in schools and public places, exposure for 1-3 days (OR = 1.158, 95% CI, 1.077-1.246), 4-6 days (OR = 1.308, 95% CI, 1.190-1.438), and everyday (OR = 1.306, 95% CI, 1.187-1.437), and exposure in one, two, or three places were significantly associated with allergic diseases (one OR = 1.226, 95% CI, 1.169-1.128, two OR = 1.289, 95% CI, 1.222-1.360 and three OR = 1.282, 95% CI, 1.177-1.395). The present results show that exposure to SHS occurs in various places and at various frequencies, and it is associated with allergic diseases in Korean adolescents.

Racial/ethnic differences in parenting behaviors as protective factors in adolescent internalizing problems.

The current study explores variations among racially/ethnically diverse adolescents regarding parents' role in mitigating internalizing problems. Adolescents with a higher level of parental awareness, ease of talking to parents, and parental support were less likely to show internalizing problems. Parental awareness was negatively associated with internalizing problems among Whites and Hispanics. The ease of talking to parents was significant for all groups except for American Indians/Alaska Natives. These findings can inform culturally relevant treatments.