Myocardial Injury and Altered Gene Expression Associated With SARS-CoV-2 Infection or mRNA Vaccination.

SARS CoV-2 enters host cells via its Spike protein moiety binding to the essential cardiac enzyme angiotensin-converting enzyme (ACE) 2, followed by internalization. COVID-19 mRNA vaccines are RNA sequences that are translated into Spike protein, which follows the same ACE2-binding route as the intact virion. In model systems, isolated Spike protein can produce cell damage and altered gene expression, and myocardial injury or myocarditis can occur during COVID-19 or after mRNA vaccination. We investigated 7 COVID-19 and 6 post-mRNA vaccination patients with myocardial injury and found nearly identical alterations in gene expression that would predispose to inflammation, coagulopathy, and myocardial dysfunction.

Impact of COVID-19 among young people currently and formerly in foster care.

BACKGROUND: COVID-19 continues to have devastating impacts across the United States, causing high levels of unemployment and disconnection from work and school. Furthermore, some communities are at higher risk for adverse outcomes due to the pandemic, including transition age foster youth. Transition age foster youth report negative impacts on their employment, educational attainment, ability to meet basic needs, and their connection to work and school. OBJECTIVE: The current study examines the impact of the COVID-19 pandemic on key young adult outcomes including education, employment, financial well-being, and disconnection from work and school. METHODS: Young people from the Jim Casey Youth Opportunities Initiative complete a survey every April and October. This study focuses on a subsample of 2117 young people who completed 8004 surveys. Utilizing an interrupted time series design, we examine changes in outcomes at six time points pre-pandemic onset (April 2017-October 2019) and two timepoints post-pandemic onset (October 2020 and April 2021). RESULTS: The pandemic slowed the declining school enrollment rates but did not reverse the downward trend that started before the pandemic. The pandemic decreased the number of young people who were employed and increased the number of those who were disconnected from work and school. The pandemic increased the number of young people who reported having savings. CONCLUSION: Transition age foster youth needs access to employment and educational opportunities, which were disrupted during the COVID-19 pandemic. Additional resources are needed to ensure young people are connected to work and school.

The impacts of cytoplasmic incompatibility factor (cifA and cifB) genetic variation on phenotypes.

Wolbachia are maternally transmitted, intracellular bacteria that can often selfishly spread through arthropod populations via cytoplasmic incompatibility (CI). CI manifests as embryonic death when males expressing prophage WO genes cifA and cifB mate with uninfected females or females harboring an incompatible Wolbachia strain. Females with a compatible cifA-expressing strain rescue CI. Thus, cif-mediated CI confers a relative fitness advantage to females transmitting Wolbachia. However, whether cif sequence variation underpins incompatibilities between Wolbachia strains and variation in CI penetrance remains unknown. Here, we engineer Drosophila melanogaster to transgenically express cognate and non-cognate cif homologs and assess their CI and rescue capability. Cognate expression revealed that cifA;B native to D. melanogaster causes strong CI, and cognate cifA;B homologs from two other Drosophila-associated Wolbachia cause weak transgenic CI, including the first demonstration of phylogenetic type 2 cifA;B CI. Intriguingly, non-cognate expression of cifA and cifB alleles from different strains revealed that cifA homologs generally contribute to strong transgenic CI and interchangeable rescue despite their evolutionary divergence, and cifB genetic divergence contributes to weak or no transgenic CI. Finally, we find that a type 1 cifA can rescue CI caused by a genetically divergent type 2 cifA;B in a manner consistent with unidirectional incompatibility. By genetically dissecting individual CI functions for type 1 and 2 cifA and cifB, this work illuminates new relationships between cif genotype and CI phenotype. We discuss the relevance of these findings to CI's genetic basis, phenotypic variation patterns, and mechanism.

Ectopic Pregnancy: Diagnosis and Management.

Ectopic pregnancy occurs when a fertilized ovum implants outside of the uterine cavity. In the United States, the estimated prevalence of ectopic pregnancy is 1% to 2%, and ruptured ectopic pregnancy accounts for 2.7% of pregnancy-related deaths. Risk factors include a history of pelvic inflammatory disease, cigarette smoking, fallopian tube surgery, previous ectopic pregnancy, and infertility. Ectopic pregnancy should be considered in any patient presenting early in pregnancy with vaginal bleeding or lower abdominal pain in whom intrauterine pregnancy has not yet been established. The definitive diagnosis of ectopic pregnancy can be made with ultrasound visualization of a yolk sac and/or embryo in the adnexa. However, most ectopic pregnancies do not reach this stage. More often, patient symptoms combined with serial ultrasonography and trends in beta human chorionic gonadotropin levels are used to make the diagnosis. Pregnancy of unknown location refers to a transient state in which a pregnancy test is positive but ultrasonography shows neither intrauterine nor ectopic pregnancy. Serial beta human chorionic gonadotropin levels, serial ultrasonography, and, at times, uterine aspiration can be used to arrive at a definitive diagnosis. Treatment of diagnosed ectopic pregnancy includes medical management with intramuscular methotrexate, surgical management via salpingostomy or salpingectomy, and, in rare cases, expectant management. A patient with diagnosed ectopic pregnancy should be immediately transferred for surgery if she has peritoneal signs or hemodynamic instability, if the initial beta human chorionic gonadotropin level is high, if fetal cardiac activity is detected outside of the uterus on ultrasonography, or if there is a contraindication to medical management.

Tracking microhabitat temperature variation with iButton data loggers.

PREMISE OF THE STUDY: Fine-scale variation in temperature and soil moisture contribute to microhabitats across the landscape, affecting plant phenology, distribution, and fitness. The recent availability of compact and inexpensive temperature and humidity data loggers such as iButtons has facilitated research on microclimates. METHODS AND RESULTS: Here, we highlight the use of iButtons in three distinct settings: comparisons of empirical data to modeled climate data for rare rock ferns in the genus Asplenium in eastern North America; generation of fine-scale data to predict flowering time and vernalization responsiveness of crop wild relatives of chickpea from southeastern Anatolia; and measurements of extreme thermal variation of solar array installations in Vermont. DISCUSSION: We highlight a range of challenges with iButtons, including serious limitations of the Hygrochron function that affect their utility for measuring soil moisture, and methods for protecting them from the elements and from human interference. Finally, we provide MATLAB code to facilitate the processing of raw iButton data.

Identifying Sensitive Periods for Alcohol Use: The Roles of Timing and Chronicity of Child Physical Abuse.

BACKGROUND: Childhood maltreatment, particularly physical abuse (PA), increases the risk of alcohol use during young adulthood. Although prior research underscores the importance of examining the roles of PA-event characteristics such as timing of and chronicity of PA in initiating and maintaining alcohol use, few studies have explored the risk of developing alcohol use based on the timing and chronicity of PA. METHODS: Using a community sample of 300 young adults (ages 18 to 25), this study examined how variations in timing and chronicity of PA relate to 4 distinct drinking behaviors including drinking frequency, binge drinking, alcohol-related problems, and alcohol use disorder (AUD) in the past 12 months. We controlled for sociodemographic information, other types of maltreatment, and common risk factors for alcohol use, such as psychological distress, parental alcoholism, and peer alcohol use in all analyses. This study used person-centered and developmental-stage-based characterizations of PA timing and chronicity to explore the relationship between timing and chronicity of PA and later drinking behaviors. RESULTS: Overall, individuals who were physically abused, particularly during adolescence, and who chronically experienced PA, reported higher levels of monthly drinking frequency and more pathological drinking behaviors such as binge drinking, alcohol-related problems, and AUD. CONCLUSIONS: This study describes the specific roles of timing and chronicity of PA in understanding the increased vulnerability to alcohol use among victims of PA. Our findings suggest that PA during adolescence and chronic PA are related to problematic drinking behaviors in young adulthood.

Building Social Capital Through a Peer-Led Community Health Workshop: A Pilot with the Bhutanese Refugee Community.

Despite the high health and mental health care needs, resettled refugees often face cultural and linguistic challenges that hinder the access to appropriate and timely interventions and services. Additionally, such concepts as preventive health or mental health treatment are foreign to this population, which creates additional burdens to the refugee community that already have difficulty navigating a complex health care system in the U.S. To address multiple and complex gaps in health and mental health support for the refugee community, requested is an innovative approach that can convey culturally responsive and effective interventions for health promotion, such as peer-based health education. Few studies have been conducted on the effectiveness of peer-led community health interventions with refugee populations in the U.S. resettlement context. However, peer-led interventions have been shown to be effective when working with cultural minorities and interventions in an international context. Adopting a social capital framework, the current study conducted qualitative evaluation on the impact of a pilot peer-led community health workshop (CHW) in the Bhutanese refugee community. A hybrid thematic analysis of focus group discussion data revealed the improvement in health promotion outcomes and health practice, as well as perceived emotional health. The results also showed that the peer-led CHW provided a platform of community building and participation, while increasing a sense of community, sense of belonging and unity. The findings posit that a peer-led intervention model provides culturally responsive and effective tools for building social capital and promoting community health in the refugee community.

The association of attention deficit hyperactivity disorder with socioeconomic disadvantage: alternative explanations and evidence.

BACKGROUND: Studies throughout Northern Europe, the United States and Australia have found an association between childhood attention deficit hyperactivity disorder (ADHD) and family socioeconomic disadvantage. We report further evidence for the association and review potential causal pathways that might explain the link. METHOD: Secondary analysis of a UK birth cohort (the Millennium Cohort Study, N = 19,519) was used to model the association of ADHD with socioeconomic disadvantage and assess evidence for several potential explanatory pathways. The case definition of ADHD was a parent-report of whether ADHD had been identified by a medical doctor or health professional when children were 7 years old. RESULTS: ADHD was associated with a range of indicators of social and economic disadvantage including poverty, housing tenure, maternal education, income, lone parenthood and younger motherhood. There was no evidence to suggest childhood ADHD was a causal factor of socioeconomic disadvantage: income did not decrease for parents of children with ADHD compared to controls over the 7-year study period. No clinical bias towards labelling ADHD in low SES groups was detected. There was evidence to suggest that parent attachment/family conflict mediated the relationship between ADHD and SES. CONCLUSION: Although genetic and neurological determinants may be the primary predictors of difficulties with activity level and attention, aetiology appears to be influenced by socioeconomic situation.

Pedestrians' estimates of their own nighttime conspicuity are unaffected by severe reductions in headlight illumination.

INTRODUCTION: At night pedestrians tend to overestimate their conspicuity to oncoming drivers, but little is known about factors affecting pedestrians' conspicuity estimates. This study examines how headlamp intensity and pedestrians' clothing influence judgments of their own conspicuity. METHOD: Forty-eight undergraduate students estimated their own conspicuity on an unilluminated closed road by walking in front of a stationary vehicle to the point at which they judged that they were just recognizable to the driver. Unknown to the participants, high beam intensity was manipulated between subjects by placing neutral density filters on the headlamps. RESULTS: Estimated conspicuity distances did not significantly vary with changes in headlamp intensity even when only 3% of the illumination from the headlamps was present. PRACTICAL APPLICATIONS: These findings underscore the need to educate pedestrians about the visual challenges that drivers face at night and the need to minimize pedestrians' exposure to traffic flow at night.

Effect of colloidal particle size on adsorbed monodisperse and bidisperse monolayers.

Coating hydrogel films or microspheres by an adsorbed colloidal shell is one synthesis method for forming colloidosomes. The colloidal shell allows control of the release rate of encapsulated materials, as well as selective transport. Previous studies found that the packing density of self-assembled, adsorbed colloidal monolayers is independent of the colloidal particle size. In this paper we develop an equilibrium model that correlates the packing density of charged colloidal particles in an adsorbed shell to the particle dimensions in monodisperse and bidisperse systems. In systems where the molar concentration in solution is fixed, the increase in adsorption energy with increasing particle size leads to a monotonic increase in the monolayer packing density with particle radius. However, in systems where the mass fraction of the particles in the adsorbing solutions is fixed, increasing particle size also reduces the molar concentration of particles in solution, thereby reducing the probability of adsorption. The result is a nonmonotonic dependence of the packing density in the adsorbed layer on the particle radius. In bidisperse monolayers composed of two particle sizes, the packing density in the layer increases significantly with size asymmetry. These results may be utilized to design the properties of colloidal shells and coatings to achieve specific properties such as transport rate and selectivity.

Diffusion through colloidosome shells.

Colloidosomes are aqueous cores surrounded by a shell composed of packed colloidal particles. Recent studies suggest that these colloidal shells reduce, or even inhibit, the transport of molecular species (diffusants). However, the effect of the colloidal shell on transport is unclear: In some cases, the reduction in transport of diffusants through the shell was found to be independent of the size of the colloidal particles composing the shell. Other studies find, however, that shells composed of small colloidal particles of order 100nm or less hindered transport of diffusants more than those composed of micro-scale colloidal particles. In this paper we present a simple diffusion model that accounts for three processes that reduce diffusant transport through the shell: (i) a reduction in the penetrable volume available for transport, which also increases the tortuousity of the diffusional path, (ii) narrow pore size which may hinder transport for larger diffusants through size exclusion, and (iii) a reduction in interfacial area due to 'blocking' of the surface by the adsorbed particles. We find that the colloidal particle size does not affect the reduction in transport through the colloidal shell when the shell is a monolayer. However, in closely packed, thick layers where the thickness of the multi-layer shell is fixed, the rate of transport decreases significantly with colloidal particle dimensions. These results are in excellent agreement with previously published experimental results.

The major genetic determinants of HIV-1 control affect HLA class I peptide presentation.

Infectious and inflammatory diseases have repeatedly shown strong genetic associations within the major histocompatibility complex (MHC); however, the basis for these associations remains elusive. To define host genetic effects on the outcome of a chronic viral infection, we performed genome-wide association analysis in a multiethnic cohort of HIV-1 controllers and progressors, and we analyzed the effects of individual amino acids within the classical human leukocyte antigen (HLA) proteins. We identified >300 genome-wide significant single-nucleotide polymorphisms (SNPs) within the MHC and none elsewhere. Specific amino acids in the HLA-B peptide binding groove, as well as an independent HLA-C effect, explain the SNP associations and reconcile both protective and risk HLA alleles. These results implicate the nature of the HLA-viral peptide interaction as the major factor modulating durable control of HIV infection.

Controlling surface porosity and release from hydrogels using a colloidal particle coating.

Recent studies suggest that coating microcapsules by a shell composed of impenetrable colloidal particles (thereby forming 'colloidosomes') can be used to control surface porosity, and therefore, permeability. The voids between the particles in the coating define the size of the surface pores available for transport. However, to date, data demonstrating this selectivity has been largely qualitative. In this paper we examine, quantitatively, the effect of a surface coating (shell), composed of colloidal particles, on release from hydrogels. We find that the presence of a colloidal shell does indeed reduce the rate of transport of three model molecules: Aspirin, caffeine, and FITC-dextran with MW of approximately 3000-5000. Contrary to expectation, however, we find that for all three molecules the reduction in transport rate is largely independent of the dimensions of the particles composing the shell, despite differences that range over three orders of magnitude. In the case of the small molecules, caffeine and aspirin, the colloidal shell reduces the effective diffusion coefficient by a factor of 3. In the case of dextran, the suppression in the release rate due to the colloidal shell was much larger. These results are explained using a simple diffusion model that accounts for the volume fraction and diameter of the colloidal particles in the shell, and the size of the diffusing molecules.

Persistent low-level viremia in HIV-1 elite controllers and relationship to immunologic parameters.

BACKGROUND: Human immunodeficiency virus type 1 (HIV-1) elite controllers are able to control virus replication to levels below the limits of detection by commercial assays, but the actual level of viremia in these individuals is not well defined. Here, we quantify plasma HIV-1 RNA in elite controllers and correlate this with specific immunologic parameters. METHODS: Plasma HIV-1 RNA levels were quantified in 90 elite controllers with use of a real time reverse-transcriptase polymerase chain reaction assay with a sensitivity of 0.2 copies/mL. HIV-1-specific immune responses and longitudinal CD4(+) T cell counts were examined. RESULTS: The median plasma HIV-1 RNA level was 2 copies/mL (interquartile range, 0.2-14 copies/mL). A longitudinal analysis of 31 elite controllers demonstrated 2-5-fold fluctuations in viremia in the majority of individuals; 6 had persistent levels below 1 copy/mL. Viremia correlated directly with HIV-1-specific neutralizing antibodies and Western blot reactivity but not with CD8(+) T cell responses. Absolute CD4(+) T cell decrease was more common among individuals with detectable viremia (P = .04). CONCLUSIONS: Low-level viremia is present in the majority of elite controllers and is associated with higher HIV-1-specific antibody responses. Absolute CD4(+) T cell loss is more common among viremic individuals, suggesting that even very low-level viremia has negative consequences over time.

Genetic and immunologic heterogeneity among persons who control HIV infection in the absence of therapy.

BACKGROUND: Spontaneous control of human immunodeficiency virus (HIV) infection has been documented in a minority of HIV-infected individuals. The mechanisms behind this outcome remain largely unknown, and a better understanding of them will likely influence future vaccine strategies. METHODS: HIV-specific T cell and antibody responses as well as host genetics were examined in untreated HIV-infected patients who maintain comparatively low plasma HIV RNA levels (hereafter, controllers), including those with levels of < 50 RNA copies/mL (elite controllers, n = 64), those with levels of 50-2000 copies/mL (viremic controllers, n = 60); we also examined HIV-specific T cell and antibody responses as well as host genetics for patients with levels of >10,000 copies/mL (chronic progressors, n = 30). RESULTS: CD8+ T cells from both controller groups preferentially target Gag over other proteins in the context of diverse HLA class I alleles, whereas responses are more broadly distributed in persons with progressive infection. Elite controllers represent a distinct group of individuals who have significantly more CD4 and CD8 T cells that secrete interferon-gamma and interleukin-2 and lower levels of HIV-neutralizing antibodies. Individual responses were quite heterogeneous, and none of the parameters evaluated was uniquely associated with the ability to control viremia. CONCLUSIONS: Elite controllers are a distinct group, even when compared to persons with low level viremia, but they exhibit marked genetic and immunologic heterogeneity. Even low-level viremia among HIV controllers was associated with measurable T cell dysfunction, which has implications for current prophylactic vaccine strategies.

An inter-gender effect on ethanol drinking in rats: proximal females increase ethanol drinking in males.

Three groups of male Long-Evans hooded rats were assessed for effects of social opportunity on drinking of ethanol or water. The ethanol/female group received intermittent presentations of a sipper containing ethanol that was followed by 15 s of social interaction opportunity with a female rat. The ethanol/male group received similar training except the social interaction opportunity was with a male rat. The water/female group received training similar to the ethanol/female group except that the sipper contained water. For the ethanol groups, the concentration of ethanol [3%, 4%, 6%, 8% and 10% (vol/vol)] in the sipper was increased across sessions. With 10% ethanol in the sipper, social opportunity with females induced more drinking and ethanol intake than did social opportunity with males. Social opportunity with females induced more intake of ethanol than water. Post-session plasma samples revealed social opportunity with females induced higher corticosterone and testosterone levels than did social opportunity with males, irrespective of the sipper fluid. This study documents, for the first time, an inter-gender effect on ethanol drinking in rats.

Fathers' reflections on parenting young children with type 1 diabetes.

PURPOSE: To describe fathers' experiences in parenting and managing the care of their young children with type 1 diabetes. DESIGN AND METHODS: This qualitative descriptive study used 16 open-ended, in-depth interviews with 14 purposively selected, involved, educated, stably employed fathers of 15 children younger than 10 years old. The fathers were asked to describe their perspective of the initial diagnosis, how they learned diabetes care, their day-to-day care and parenting experiences, and what strategies they used in the day-to-day management. Data were managed using NVivo software and analyzed using principles of naturalistic inquiry and qualitative content analysis. RESULTS: The overarching theme was "From sadness to action," with six categories emerging: (1) "shock and awe" (after diagnosis), (2) quick response to the diagnosis and learning diabetes care: "suck it up and do it," (3) "staying in the loop" (practicing the skills, tasks, and responsibilities of diabetes management), (4) "partnerships in care" (tag teaming or co-parenting), (5) active participation (being actively involved in their children's day-to-day care and benefiting from participating in this care), and (6) mantra for living with diabetes: child first, diabetes second. CLINICAL IMPLICATIONS: Nurses working with children with diabetes can use the results of this study to better understand the role of fathers in the care of these children. Fathers underscored the importance of practicing diabetes care-related tasks to improve their confidence when caring for children alone. Their practical and philosophical strategies for managing their children's chronic illness have recently been incorporated into a parent mentor intervention for children newly diagnosed with type 1 diabetes.

Program self-evaluation: the evolution of an injury prevention foundation.

OBJECT: Injuries are a leading cause of morbidity and mortality in the US. The authors provide a brief discussion of a national injury prevention foundation's self-evaluation of its efforts to decrease the incidence of traumatic injuries through educational programs, legislative efforts, and community programming. METHODS: The authors performed a literature review of evaluation studies and activities of the Think First National Injury Prevention Foundation accomplished between 1986 and 2002 and summarized their findings. Suggestions generated from research studies were incorporated into the foundation's programs. Efficacy studies show that the injury prevention programs have a significant impact on knowledge, attitudes, and practice, and demonstrate the need for injury prevention to be recognized as a valuable component of the US medical system. CONCLUSIONS: After a self-evaluation, the Think First National Injury Prevention Foundation has made strides in developing a multilevel approach to injury prevention by combining education with legislative initiatives, community-wide safety programming, and a large public presence, similar to what has been accomplished with successful smoking cessation programs and seat-belt use campaigns.

Funcionamento de um serviço universitário de aconselhamento psicológico / The functioning of a university service of psychological counseling

A formação do futuro psicólogo deve incluir um treino adequado em atendimento geral de problemas de natureza psicológica, independentemente da área de especialização que o estudante venha a adotar. Relata-se uma experiência em que a situação real de Aconselhamento Psicológico é vivenciada pelos discentes durante um estágio prático. Observa-se que a conjunção do atendimento de clientes e da supervisão centrada no aluno oferece resultados satisfatórios. A situação descrita pode ser indicada para cursos similares como um tipo de solução à carência, freqüente entre nós, de recursos humanos e materiais suficientes para um treinamento ideal (AU)