Omicron-induced interferon signaling prevents influenza A H1N1 and H5N1 virus infection.

Recent findings in permanent cell lines suggested that SARS-CoV-2 Omicron BA.1 induces a stronger interferon response than Delta. Here, we show that BA.1 and BA.5 but not Delta induce an antiviral state in air-liquid interface cultures of primary human bronchial epithelial cells and primary human monocytes. Both Omicron subvariants caused the production of biologically active types I (α/ß) and III (λ) interferons and protected cells from super-infection with influenza A viruses. Notably, abortive Omicron infection of monocytes was sufficient to protect monocytes from influenza A virus infection. Interestingly, while influenza-like illnesses surged during the Delta wave in England, their spread rapidly declined upon the emergence of Omicron. Mechanistically, Omicron-induced interferon signaling was mediated via double-stranded RNA recognition by MDA5, as MDA5 knockout prevented it. The JAK/STAT inhibitor baricitinib inhibited the Omicron-mediated antiviral response, suggesting it is caused by MDA5-mediated interferon production, which activates interferon receptors that then trigger JAK/STAT signaling. In conclusion, our study (1) demonstrates that only Omicron but not Delta induces a substantial interferon response in physiologically relevant models, (2) shows that Omicron infection protects cells from influenza A virus super-infection, and (3) indicates that BA.1 and BA.5 induce comparable antiviral states.

'Don't judge me 'til you walk through my shoes': A qualitative investigation of the experiences of women living with HIV.

OBJECTIVE: Women living with the human immunodeficiency virus (HIV) are less of a focus in the HIV literature, which tends to focus on the HIV experiences of men who have sex with men (MSMs). Hence, we conducted a qualitative study that examined: (a) the type of stigma and discrimination that women living with HIV experience related to their HIV status, (b) the source of this stigma and discrimination, (c) their responses related to this stigma and discrimination, and (d) the ways in which women living with HIV cope with these experiences of stigma and discrimination. DESIGN: Participants consisted of 14 self-identified women living with HIV that were recruited at a community organization in the Southern United States that provides services to individuals living with HIV. The participants ranged in age from 27 to 65 (M = 47.92, SD = 13.08). The sample primarily identified as Black (N = 12), followed by White (N = 1) and Multiracial (N = 1). Most women were cisgender (N = 13) with one woman identifying as transgender (N = 1). RESULTS: Fourteen women participated in one of two focus groups (seven in each focus group), which were audio recorded and transcribed. We identified 24 categories across five domains (Stigma and Discrimination, Source of Stigma and Discrimination, Response to Stigma and Discrimination, Coping with Stigma and Discrimination, and Support). CONCLUSIONS: This study identified that women living with HIV experience stigma and discrimination in a multitude of ways from different sources. Moreover, women with HIV responded to and coped in negative and positive ways. Multidimensional approaches including personal and community education may help alleviate the stigma and discrimination faced by women living with HIV.

Disordered eating among sex trafficking survivors: An application of objectification theory to experiences of extreme objectification.

OBJECTIVE: Substantial evidence demonstrates the physical, mental, and social health disparities experienced by sex trafficking survivors (STSs) in the United States. The limited exploration of disordered eating symptomology in STSs is a notable gap in understanding their health needs, especially considering the known link between exposure to trauma and disordered eating. One purpose of this study was to document the occurrence of disordered eating in a sample of STSs. This study also examined the unique effect of the sex trafficking experience, separate from other traumas, in explaining disordered eating directly and indirectly through mechanisms of self-objectification, including self-surveillance and body shame. METHOD: Survey data related to sex trafficking status, disordered eating, self-surveillance, body shame, and discrimination were collected from 180 nontrafficked women and 113 trafficked women. RESULTS: Findings reveal that STSs reported higher rates of disordered eating than their nontrafficked counterparts, with 74% of STSs demonstrating clinically significant disordered eating. Additionally, when controlling for general trauma and subjective socioeconomic status, trafficking status, self-surveillance, and body shame explained 56% of the variance in disordered eating. CONCLUSIONS: These results have implications for future research and clinical work with STSs, which will be instrumental in mitigating the impact of the sex trafficking epidemic plaguing women in the United States. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Nurses' Perspectives on Postpartum Pain Management.

Introduction: There is variation in postpartum opioid use by prescriber characteristics that cannot be explained by patient or birth factors. Thus, our objective was to evaluate nursing training, clinical practices, and perspectives on opioid use for postpartum pain management. Materials and Methods: In this survey study, postpartum bedside nurses at a single, large academic center were asked about training, factors influencing clinical decisions, and viewpoints regarding pain management and opioid use. Findings were summarized using descriptive analyses. Results: A total of 92 nurses completed the survey. A majority (77%) reported having received some formal training on opioid use for pain management. About a quarter (25.7%) felt their training was not adequate. Regarding clinical practices, the majority (71% and 70%, respectively) reported that "routine habit" and "patient preference" most influenced the type and amount of pain medication they administered. Finally, nurses' perspectives on pain management demonstrated a wide range of beliefs. Most nurses strongly agreed with the importance of maximizing nonopioid pain medication before opioid administration. The majority agreed that patient-reported pain score is important to consider when deciding to administer opioids. Conversely, most nurses disagreed that patients should be encouraged to endure as much pain as possible before using an opioid. Similarly, beliefs about the reliability of use of vital signs in assessing pain intensity varied widely. Conclusions: Bedside nurses rely on routine habits, patient preference, and patient-reported pain score when administering opioids for postpartum pain management. Increased training opportunities to improve consistency and standardization of opioid administration may be beneficial.

Tectonigral projections in the primate: a pathway for pre-attentive sensory input to midbrain dopaminergic neurons.

Much of the evidence linking the short-latency phasic signaling of midbrain dopaminergic neurons with reward-prediction errors used in learning and habit formation comes from recording the visual responses of monkey dopaminergic neurons. However, the information encoded by dopaminergic neuron activity is constrained by the qualities of the afferent visual signals made available to these cells. Recent evidence from rats and cats indicates the primary source of this visual input originates subcortically, via a direct tectonigral projection. The present anatomical study sought to establish whether a direct tectonigral projection is a significant feature of the primate brain. Injections of anterograde tracers into the superior colliculus of macaque monkeys labelled terminal arbors throughout the substantia nigra, with the densest terminations in the dorsal tier. Labelled boutons were found in close association (possibly indicative of synaptic contact) with ventral midbrain neurons staining positively for the dopaminergic marker tyrosine hydroxylase. Injections of retrograde tracer confined to the macaque substantia nigra retrogradely labelled small- to medium-sized neurons in the intermediate and deep layers of the superior colliculus. Together, these data indicate that a direct tectonigral projection is also a feature of the monkey brain, and therefore likely to have been conserved throughout mammalian evolution. Insofar as the superior colliculus is configured to detect unpredicted, biologically salient, sensory events, it may be safer to regard the phasic responses of midbrain dopaminergic neurons as 'sensory prediction errors' rather than 'reward prediction errors', in which case dopamine-based theories of reinforcement learning will require revision.

Vibrotactile Stimulation Based on the Fundamental Frequency Can Improve Melodic Contour Identification of Normal-Hearing Listeners With a 4-Channel Cochlear Implant Simulation.

Cochlear implant (CI) users' poor speech recognition in noise and music perception may be both due to their limited access to pitch cues such as the fundamental frequency (F0). Recent studies showed that similar to residual low-frequency acoustic hearing, vibrotactile presentation of the F0 significantly improved speech recognition in noise of CI users. The present study tested whether F0-based vibrotactile stimulation can improve melodic contour identification (MCI) of normal-hearing listeners with acoustically simulated CI processing. Each melodic contour consisted of five musical notes with one of nine contour patterns (rising, falling, or flat in each half of the contour). The F0 of the middle note was 220 or 880 Hz, and the frequency intervals between adjacent notes were 1, 3, or 5 semitones. The F0 of each note was extracted in real time and transposed to a vibration frequency centered around 110 Hz at the right forearm top. MCI was tested in five experimental conditions (with a 4- or 8-channel CI simulation alone, vibrotactile stimulation alone, and 4- or 8-channel CI simulation plus vibrotactile stimulation), each after the same amount of brief training was provided. Results showed that discrimination of vibrotactile stimuli significantly improved from chance to near perfect as the vibration frequency interval increased from 0.25 to 3 semitones. The MCI performance with vibrotactile stimulation alone was similar to that with the 4-channel CI simulation alone, but was significantly worse than that with the 8-channel CI simulation alone. Significant improvement in MCI performance with the addition of vibrotactile stimulation was only found with the 4-channel CI simulation when the middle F0 was 880 Hz and when the frequency intervals were 3 or 5 semitones. The improvement in MCI performance with than without vibrotactile stimulation was significantly correlated with the baseline MCI performance with 4-channel CI simulation alone or with the MCI performance difference between vibrotactile stimulation and 8-channel CI simulation. Therefore, when the simulated or real CI performance is relatively poor, vibrotactile stimulation based on the F0 may improve MCI with acoustic CI simulations and perhaps in real CI users as well.

Effects of therapeutic goal management (TGM) on treatment attendance and drug abstinence among men with co-occurring substance use and axis I mental disorders who are homeless: results of the Birmingham EARTH program.

PURPOSE: This study describes the implementation and impact of Therapeutic Goal Management (TGM) in a Substance Abuse and Mental Health Services Administration (SAMHSA)-sponsored demonstration project entitled Enhanced Addiction Recovery through Housing (EARTH). PARTICIPANTS: The sample included 28 male participants followed at six months who completed some treatment. Forty-three percent were Caucasian, and 57% were African American. The average age of participants was 42 years. DESIGN: The relationships between TGM goal achievement, treatment attendance, and drug abstinence outcomes were studied among EARTH program participants who were homeless and met criteria for co-occurring substance use and severe DSM-IV Axis I mental disorders. RESULTS: The results revealed an overall drug abstinence rate of 72.4% over six months and significant positive relationships between TGM goal achievement and drug abstinence (r=0.693) and TGM goal achievement and treatment attendance (r=0.843). CONCLUSIONS: This research demonstrated the relationship and potential positive impact of systematically setting, monitoring, and reinforcing personalized goals in multiple life areas on drug abstinence and treatment attendance outcomes among persons who are homeless with co-occurring substance use and other Axis I disorders in a integrated community service delivery program.

High-fidelity multiactor emergency preparedness training for patient care providers.

BACKGROUND: Providing comprehensive emergency preparedness training (EPT) for patient care providers is important to the future success of emergency preparedness operations in the United States. Disasters are rare, complex events involving many patients and environmental factors that are difficult to reproduce in a training environment. Few EPT programs possess both competency-driven goals and metrics to measure life-saving performance during a multiactor simulated disaster. METHODS: The development of an EPT curriculum for patient care providers-provided first to medical students, then to a group of experienced disaster medical providers-that recreates a simulated clinical disaster using a combination of up to 15 live actors and six high-fidelity human simulators is described. Specifically, the authors detail the Center for Health Professional Training and Emergency Response's (CHPTER's) 1-day clinical EPT course including its organization, core competency development, medical student self-evaluation, and course assessment. RESULTS: Two 1-day courses hosted by CHPTER were conducted in a university simulation center. Students who completed the course improved their overall knowledge and comfort level with EPT skills. CONCLUSIONS: The authors believe this is the first published description of a curriculum method that combines high-fidelity, multiactor scenarios to measure the life-saving performance of patient care providers utilizing a clinical disaster scenario with > 10 patients at once. A larger scale study, or preferably a multicenter trial, is needed to further study the impact of this curriculum and its potential to protect provider and patient lives.

Interactions between the Midbrain Superior Colliculus and the Basal Ganglia.

An important component of the architecture of cortico-basal ganglia connections is the parallel, re-entrant looped projections that originate and return to specific regions of the cerebral cortex. However, such loops are unlikely to have been the first evolutionary example of a closed-loop architecture involving the basal ganglia. A phylogenetically older, series of subcortical loops can be shown to link the basal ganglia with many brainstem sensorimotor structures. While the characteristics of individual components of potential subcortical re-entrant loops have been documented, the full extent to which they represent functionally segregated parallel projecting channels remains to be determined. However, for one midbrain structure, the superior colliculus (SC), anatomical evidence for closed-loop connectivity with the basal ganglia is robust, and can serve as an example against which the loop hypothesis can be evaluated for other subcortical structures. Examination of ascending projections from the SC to the thalamus suggests there may be multiple functionally segregated systems. The SC also provides afferent signals to the other principal input nuclei of the basal ganglia, the dopaminergic neurones in substantia nigra and to the subthalamic nucleus. Recent electrophysiological investigations show that the afferent signals originating in the SC carry important information concerning the onset of biologically significant events to each of the basal ganglia input nuclei. Such signals are widely regarded as crucial for the proposed functions of selection and reinforcement learning with which the basal ganglia have so often been associated.