Growth during pubertal induction in girls with Turner Syndrome: a retrospective cohort analysis.

CONTEXT: Patients with Turner Syndrome often present with short stature and ovarian insufficiency. The optimal method of pubertal induction to maximize adult height (AH) is unknown. OBJECTIVE: To identify variables related to pubertal induction that are associated with growth and AH. DESIGN & SETTING: Retrospective cohort analysis of patients attending a specialized Turner Syndrome clinic at a quaternary children's hospital. PATIENTS: Patients with Turner Syndrome (n=107) who attended the clinic between 2015 and 2021. Of these, 51 received estradiol for pubertal induction. MAIN OUTCOME MEASURES: Change in height standard deviation score (ΔHeightSDS) during pubertal induction, and AH. METHODS: Age at pubertal induction, bone age delay, midparental height (MPH), growth hormone treatment, and karyotype were assessed as predictors of AH and ΔHeightSDS. Associations between karyotype and comorbidities were also assessed. RESULTS: AH was predicted by MPH (0.8cm/cm, P=0.0001) and bone age delay (-1.84 cm/year, P= 0.006). ΔHeightSDS was predicted by growth hormone dose (0.09 SDS/mg/m2/week; P=0.017), bone age delay (-1.37 SDS/year; P=0.003), and age at pubertal induction (0.44 SDS/year; P=0.001). There was an interaction between bone age delay and pubertal induction age (P=0.013), with the combination of younger age at pubertal induction and a less-delayed bone age associated with a lower ΔHeightSDS. Karyotype did not influence AH or ΔHeightSDS, but did affect rates of other comorbidities. CONCLUSIONS: Decisions around timing of pubertal induction in patients with Turner Syndrome should be tailored to the individual. The current approach to estrogen supplementation needs to be refined in order to facilitate pubertal induction in a physiological manner without compromising height.

Perceptions of Anticipated Peer Support for Survivors of Sexual Violence Among Students with Minoritized Identities.

Peers' attitudes toward survivors of sexual violence can impact their willingness to disclose. Students with minoritized identities may perceive and experience their campus environments as less supportive than peers with privileged identities. The purpose of this study was to examine perceptions of anticipated peer support for sexual violence survivors, using a cross-sectional study of 2,727 students. Linear regression modeling showed significant associations between students with minoritized identities and lower scores on perceptions of anticipated peer support for survivors. There were also several important interactions between specific overlapping student identities. The findings suggest that students with minoritized identities perceive anticipated peer support less favorably than those with privileged identities.

The bystander intervention for problematic alcohol use model (BIPAUM).

Objective: The study aimed to identify phases of bystander intervention (BI) for problematic alcohol use (PAU) among college students. Participants: Twenty focus groups and nine interviews were conducted. Methods: Transcripts were thematically analyzed. Results: The phases of the Bystander Intervention for Problematic Alcohol Use Model (BIPAUM) include: (1) plan in advance, (2) notice and interpret a sign, (3) decide (i.e., assume responsibility, assess support/feasibility to intervene, and identify intervention strategy), (4) intervene, and (5) assess outcomes. Assessing outcomes loops to influence future behavior and each phase is influenced by barriers and facilitators. Conclusions: These unique phases should be considered when designing and evaluating intervention programs for PAU to meet students' needs and better reduce PAU. Future research should empirically test the BIPAUM. The results of the current study demonstrate a promising opportunity for applying BI to PAU, with the goal of reducing risky drinking among college students.

Bystander Intervention for the Prevention of Campus Sexual Violence: Opportunity, Frequency of Action, and Consequences for Confronting Those at Risk of Perpetration.

This cross-sectional study examined students' (Campus 1, n = 1,153; Campus 2, n = 1,113) experiences with four situations of direct confrontation of those at risk for sexual assault perpetration. The most reported opportunity was to confront those making false statements about sexual assault; many students reported more than one opportunity to intervene in the past year. Bystanders intervened most of the time across the four situations examined in this study. The most reported consequence of intervening was that no further harm was caused. More nuanced measures can offer practitioners further information to tailor sexual violence prevention programs.

Expansion of an Australian food composition database to estimate plant and animal intakes.

Despite evidence for favourable health outcomes associated with plant-based diets, a database containing the plant and animal content of all foods eaten is required to undertake a reliable assessment of plant-based diets within a population. This study aimed to expand an existing Australian food database to include the plant and animal content of all whole foods, beverages, multi-ingredient products and mixed dishes. Twenty-three plant- and animal-based food group classifications were first defined. The food servings per 100 g of each product were then systematically calculated using either a recipe-based approach, a food label-based approach, estimates based on similar products or online recipes. Overall, 4687 (83·5 %) foods and beverages were identified as plant or plant-containing products, and 3701 (65·9 %) were animal or animal-containing products. Results highlighted the versatility of plant and animal ingredients as they were found in various foods across many food categories, including savoury and sweet foods, as well as discretionary and core foods. For example, over 97 % of animal fat-containing foods were found in major food groups outside the AUSNUT 2011-2013 'fats and oils' group. Surprisingly, fruits, nuts and seeds were present in a greater percentage of discretionary products than in core foods and beverages. This article describes a systematic approach that is suitable for the development of other novel food databases. This database allows more accurate quantitative estimates of plant and animal intakes, which is significant for future epidemiological and clinical research aiming to investigate plant-based diets and their related health outcomes.

The presence, action, and influence of bystanders who witness sexual harassment against medical students.

PURPOSE: Sexual harassment (SH) is a widespread problem in academia, with a disproportionate impact on female medical students and those who experience marginalization via multiple systems of oppression (e.g. racism, heterosexism). Bystander intervention education is a potential approach which frames violence as a community issue where all members have a role to play in response and prevention. This study assessed the presence and influence of bystanders in SH situations for students at two medical schools. MATERIALS AND METHODS: Data came from a larger U.S. campus climate study administered online in 2019 and 2020. The sample included 584 students who responded to validated survey questions about sexual harassment experiences, bystander behavior, disclosure, perceptions of the university response to SH, and demographics. RESULTS: More than one-third of respondents experienced some form of SH by a faculty/staff member. Bystanders were present for more than half of these incidents, yet they rarely intervened. When bystanders intervened, people were more likely to disclose an incident than not. CONCLUSIONS: The results indicate that there are many missed opportunities for intervention and given the profound impact that SH has on the well-being of medical students, continued work is needed to determine effective intervention and prevention methods.[Box: see text].

Why Do Students Participate in Campus Sexual Assault Climate Surveys?

The purpose of the current study is to explore students' reasons for participating in a campus sexual assault climate survey to determine if patterns exist based on various identities and experiences. More specifically, we were interested in the most frequently reported reasons for participating, and whether they differed by key demographic variables. As part of a campus climate survey administration at two campuses, 4,020 students responded to survey questions asking why they participated in the survey (Sample 1, n = 2,937 and Sample 2, n = 1,083). To examine which demographic variables predicted reasons for taking the survey while controlling for other potential correlates, we conducted logistic regression analyses. The reasons provided by students as to why they completed the campus climate survey differed by identity characteristics, suggesting that researchers must consider the demographic makeup of their institutions when designing sampling and recruitment plans and tailoring them to their student populations. For example, while gender emerged as salient for differing reasons for participation (e.g., women more likely to participate because of the issue's importance and wanting their opinions heard more), intersectional analysis by race and gender indicates that White men (and Asian men, in Sample 1) most consistently indicated different reasons for participation, with significantly greater odds than their White and Asian women counterparts to participate for the cash incentives. This information could help improve the recruitment of representative samples for campus sexual assault surveys and therefore provide more accurate data that can be used to deliver effective intervention and prevention efforts.

A Systematic Review of Validated Measures of U.S.-Based Bystander Intervention-Related Constructs.

This review aimed to identify U.S.-based, construct-validated measures of bystander intervention. Following PRISMA-P guidelines, electronic databases were searched, and emails were solicited identifying 8,559 articles for title screening. Abstracts and full texts were double screened, resulting in 24 scales meeting inclusion criteria: (a) measured a bystander-related construct in a situation where there was a potential for actual or perceived imminent physical or emotional harm, (b) written in English, and (c) statistically validated on U.S. samples. Most scales addressed the domain of interpersonal violence (67%), with fewer relating to bias/bullying (8.2%), mental health crises (12.5%), and substance use (12.5%). Most scales (71%) assessed the "take action" step of the situational model. The modal construct represented was intent/willingness/likelihood to intervene (50%). The average number of items on a scale was 14, and most (79%) provided Likert-style response options. None of the validated scales assessing behavior first accounted for an opportunity. Sample sizes ranged from 163 to 3,397, with the modal setting from colleges. Overall, samples were young (21.8 years old), White (75%), women (64%), and heterosexual (89%). Results indicate the need to validate additional measures that capture the "interpreting the situation as problematic" step of the situational model. Scales also need to be validated using diverse samples, particularly within the mental health crisis domain. Across all domains, validated measures need to be developed that first account for an opportunity when measuring actual bystander behavior. The information gleaned can be used to assist researchers in selecting measures and guide future measure development.

Engaging Campuses in Meaningful Change Efforts to Address Relationship Violence and Sexual Misconduct: Lessons Learned From the Michigan State University Experience.

Although recent decades have been marked by tremendous strides in addressing relationship violence and sexual misconduct at institutions of higher education across the country, there still exists a range of degree and meaningfulness of these changes. A key question raised by Campbell et al. in the discussion of the model developed at Michigan State University (MSU) is how to align institutional commitment with actions, as well as engage in "meaningful" change. Three aspects of the MSU model that stand out as especially critical for other institutions to consider include working toward culture change, engaging the larger campus community, and conducting an ongoing evaluation.

Sexual violence prevalence and disclosure patterns among college undergraduates: exploring types of sexual violence and incident-specific characteristics.

Objective: Study explores the role of well-documented individual-level correlates of a range of types of sexual violence among undergraduates and examines both individual-level and incident-level correlates of disclosure patterns to formal and informal sources. Participants: The current study involves the analysis of campus climate data collected in 2018 from 2,271 undergraduate participants. Methods: Descriptive and bivariate analyses are conducted to examine correlates of sexual violence, and a logistic regression model is estimated to examine disclosure by both individual and incident-level correlates. Results: 19% of students experience at least one incident of sexual violence since coming to campus, with many reporting multiple victimizations which differs by race, gender, and sexual orientation. Significant differences found in disclosure based on gender and relationship to who committed the sexual violence. Conclusions: Overall, findings from this study highlight the importance of using a nuanced approach to examining college students' experiences of sexual violence.

Development of the Services, Policies and Programs Audit Tool to Address Campus Sexual Violence.

Evidence suggests that resources to address campus sexual violence (CSV) are inconsistently offered across institutions of higher education (IHE), and thus there is a need for campuses to continually assess their provision of resources and services to improve the climate and well-being of students. Conducting a periodical scan of resources provided is one way for IHE to assess their adherence to best practices. The current study describes the development of the Services, Policies and Programs Audit (SPPA) tool, created to help IHE evaluate their adherence with best practices related to the provision of services, policies, and programs on campus. The tool was piloted with 18 individuals from 12 different IHE across the country. Exploratory evaluation of the SPPA indicates that it may be a useful tool for self-examination of campus policies, services, and prevention and education efforts. Participants from the 12 IHE who participated in the pilot generally reported that the SPPA was helpful to their efforts. Interrater reliability results indicated that the position of the person who completes the tool impacts the scoring, with those who are more familiar with CSV services scoring higher. This aligns with other research indicating that it is important not only to have resources on campus to address CSV but also to ensure that the campus community is aware of them. The SPPA can potentially serve as one part of a larger toolkit used by IHE to assess their efforts to address CSV.

Sexual Violence Among Sorority Women: Victimization Experiences, Contexts, and Disclosure.

The purpose of this study was to examine and compare sexual violence (SV) victimization among sorority women and unaffiliated counterparts. Results showed sorority women were more likely than unaffiliated women to report experiencing some types of SV, consuming alcohol prior to victimization, and to identify their perpetrator as a hookup/casual partner. More women, regardless of affiliation, informally disclosed their victimization compared to formally reporting; many did not tell anyone because they did not think it was serious enough. The findings point to implications for harm reduction, bystander intervention, and primary prevention programming, as well as institutional policy to address SV.

College Students' Engagement in Violence Prevention Discussions with Peers.

The bystander intervention (BI) model recognizes a range of prosocial helping behaviors individuals can perform to support sexual and dating violence (S/DV) prevention efforts. Individuals can demonstrate a commitment to ending violence through proactive BI, such as participating in prevention initiatives or talking with peers about ways to keep safe, which are different than reactive BI behaviors when violence is underway. Given the anchoring of the BI model in Diffusion of Innovation Theory, which articulates the uptake of new behaviors throughout a population or community and the role of change agent aids in that process, investigating demographic, and other individual-level correlates, of proactive behaviors may help identify those students who are particularly positioned to help diffuse and normalize anti-violence behaviors. The purpose of this study was to examine (1) the occurrence of students' engagement in peer discussions about violence prevention in the past year and (2) the correlates of reporting to have those discussions among university students in a cross-sectional study implemented on two campuses in the Mid-Atlantic U.S. Results showed that the most common discussion was talking to friends about being safe in dating relationships and the least common was talking with friends about participating in violence-prevention-related activities, with 66.2% and 22.5% having done so, respectively. Women, younger students, and those reporting to know a survivor of either DV or SV were more likely to report having discussions, compared to men, older students, and those not knowing a survivor. Additional relationships were detected between other individual characteristics, knowledge about violence/victimization, and climate-related variables but differed depending on whether participants participated in the DV or SV-related survey module. Findings suggest the need for BI training initiatives to emphasize proactive engagement and peer discussions, and that gender continues to be a robust indicator of violence-prevention actions.

How Helpful Is Bystander Intervention? Perspectives of Dating and Sexual Violence Survivors.

While bystander intervention education has demonstrated promise as a strategy to reduce dating and sexual violence (DSV) on campus, little is known about whether survivors on whose behalf the interventions take place find these helpful. This paper uses qualitative, in-depth interviews with 33 DSV survivors to explore their perspectives on bystander intervention. Results indicate that while some interventions were identified as helpful, especially those that provided support to the survivor, many were not helpful enough or even harmful. Further work is needed to understand the consequences of bystander action.

Viral E protein neutralizes BET protein-mediated post-entry antagonism of SARS-CoV-2.

Inhibitors of bromodomain and extraterminal domain (BET) proteins are possible anti-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) prophylactics as they downregulate angiotensin-converting enzyme 2 (ACE2). Here we show that BET proteins should not be inactivated therapeutically because they are critical antiviral factors at the post-entry level. Depletion of BRD3 or BRD4 in cells overexpressing ACE2 exacerbates SARS-CoV-2 infection; the same is observed when cells with endogenous ACE2 expression are treated with BET inhibitors during infection and not before. Viral replication and mortality are also enhanced in BET inhibitor-treated mice overexpressing ACE2. BET inactivation suppresses interferon production induced by SARS-CoV-2, a process phenocopied by the envelope (E) protein previously identified as a possible "histone mimetic." E protein, in an acetylated form, directly binds the second bromodomain of BRD4. Our data support a model where SARS-CoV-2 E protein evolved to antagonize interferon responses via BET protein inhibition; this neutralization should not be further enhanced with BET inhibitor treatment.

Targeting transcription in heart failure via CDK7/12/13 inhibition.

Heart failure with reduced ejection fraction (HFrEF) is associated with high mortality, highlighting an urgent need for new therapeutic strategies. As stress-activated cardiac signaling cascades converge on the nucleus to drive maladaptive gene programs, interdicting pathological transcription is a conceptually attractive approach for HFrEF therapy. Here, we demonstrate that CDK7/12/13 are critical regulators of transcription activation in the heart that can be pharmacologically inhibited to improve HFrEF. CDK7/12/13 inhibition using the first-in-class inhibitor THZ1 or RNAi blocks stress-induced transcription and pathologic hypertrophy in cultured rodent cardiomyocytes. THZ1 potently attenuates adverse cardiac remodeling and HFrEF pathogenesis in mice and blocks cardinal features of disease in human iPSC-derived cardiomyocytes. THZ1 suppresses Pol II enrichment at stress-transactivated cardiac genes and inhibits a specific pathologic gene program in the failing mouse heart. These data identify CDK7/12/13 as druggable regulators of cardiac gene transactivation during disease-related stress, suggesting that HFrEF features a critical dependency on transcription that can be therapeutically exploited.

KLF15 cistromes reveal a hepatocyte pathway governing plasma corticosteroid transport and systemic inflammation.

Circulating corticosteroids orchestrate stress adaptation, including inhibition of inflammation. While pathways governing corticosteroid biosynthesis and intracellular signaling are well understood, less is known about mechanisms controlling plasma corticosteroid transport. Here, we show that hepatocyte KLF15 (Kruppel-like factor 15) controls plasma corticosteroid transport and inflammatory responses through direct transcriptional activation of Serpina6, which encodes corticosteroid-binding globulin (CBG). Klf15-deficient mice have profoundly low CBG, reduced plasma corticosteroid binding capacity, and heightened mortality during inflammatory stress. These defects are completely rescued by reconstituting CBG, supporting that KLF15 works primarily through CBG to control plasma corticosterone homeostasis. To understand transcriptional mechanisms, we generated the first KLF15 cistromes using newly engineered Klf153xFLAG mice. Unexpectedly, liver KLF15 is predominantly promoter enriched, including Serpina6, where it binds a palindromic GC-rich motif, opens chromatin, and transactivates genes with minimal associated direct gene repression. Overall, we provide critical mechanistic insight into KLF15 function and identify a hepatocyte-intrinsic transcriptional module that potently regulates systemic corticosteroid transport and inflammation.

Evaluating Efforts to Address Campus Sexual Violence: Developing a Data Ecosystem.

Sexual violence is well documented as a major problem on college campuses, and the delivery of service and programs at institutions of higher education (IHE) has proliferated over recent years. However, the implementation of these efforts has often outpaced the field's work in developing evaluation models. Many institutions depend on campus climate surveys for data to inform their efforts, yet there are multiple data points that can be accessed to provide a more holistic picture of efforts to address sexual violence on campus. The data ecosystem framework provided by Driver-Linn & Svenson (2017) offers a comprehensive approach for assessing efforts to address campus sexual violence (CSV), but implementation models are needed that connect evaluation and practice, take local context into account, and lead to changes on campus. This paper presents a case study from a multisite university to describe the process of implementing a "data ecosystem" to assess the institutions' efforts to effectively address CSV, and how the data was used by practitioners and administrators. The collaborative, utilization-driven model has provided valuable data to inform the delivery of services and programs across the university yet has limitations and requires a wide range of resources to sustain.

Help-seeking among college survivors of dating and sexual violence: a qualitative exploration of utilization of university-based victim services.

Objective: Study uses qualitative data to examine help-seeking decisions as well as the drivers and barriers to utilization of university-based victim services through the accounts of survivors. Participants: The current study involves the analysis of 33 semi-structured interviews that were conducted with dating and sexual violence (DSV) survivors at a large, Mid-Atlantic University who both did and did not utilize university-based victim services. Methods: Data were analyzed using a thematic analysis approach. Results: Analysis shows that while survivors of DSV undergo a process of help-seeking that is similar to those described in previous help-seeking models, there are additional factors that contribute to a reluctancy to seek services at a university-based victim services center in particular that must be accounted for in the literature. Conclusions: The findings from the current study underscore the importance of understanding the specific drivers and barriers to utilization of university-based victim services.

What Helps and Hinders Students' Intervening in Incidents of Dating Violence On Campus? an Exploratory Study Using Focus Groups.

Dating violence is a problem occurring on college campuses that requires unique prevention and intervention needs. Despite the widespread prevalence and pervasive impact of dating violence victimization, formal disclosure and utilization of on-campus support services for student survivors remain low and often survivors who do tell someone disclose to an informal source of support, most often a friend. Many current educational efforts on college campuses regarding dating violence, including bystander intervention programming, fail to increase students' understanding of how to safely address a situation where a peer is experiencing an abusive relationship or to provide students with information about their role as potential responders to disclosures of violence from friends. In the present exploratory study, a series of qualitative focus groups were conducted to better understand students' perspectives on dating violence on campus. Data were analyzed according to processes of thematic analysis to examine how students' understanding and knowledge of dating violence impact their decision about whether to intervene as prosocial bystanders within their social networks using focus groups. Emergent findings reveal that students undergo a multistage process of intervening that relies heavily on their existing knowledge and attitudes toward dating violence. The findings from this article are consistent with Banyard's Action Coils model. Suggestions for future research are also discussed.