Preliminary Validation of Two Brief Measures of Masculine and Feminine Honor Endorsement.

Researchers have developed numerous individual differences measures to assess people's endorsement of honor ideology (i.e., beliefs regarding the importance of honor and reputation) with most ranging from 12-36 items in length. Despite having great utility, the length of these measures magnifies the costs associated with survey research, especially in research contexts that use large, representative samples (e.g., health surveys). The present study aimed to develop and validate single-item measures that assess participants' agreement with gender-specific honor prototypes, as well as short-form versions of the honor ideology for manhood (HIM) and honor ideology for womanhood (HIW) scales. An initial sample of participants (N = 879) completed single-item honor prototype measures, a battery of previously validated honor measures (including the HIM and HIW), and measures of constructs previously shown to be related to the dynamics of honor (e.g., aggression, firearm ownership). A second sample of participants (N = 100) completed the new measures, as well as an abbreviated battery of honor measures, to examine test-retest reliability. Results indicated that the new, brief measures were strongly correlated with both the original HIM and HIW as well as several other established honor measures. Moreover, the associations between these new measures and honor-related outcomes were nearly identical to those found with the original HIM and HIW. Our new measures also demonstrated acceptable test-retest reliability, despite being single-item scales. Overall, the present work provides preliminary support for several brief measures of honor endorsement that researchers can use when longer scales are not feasible.

Survey of public attitudes towards imminent death donation in the United States.

Imminent death donation (IDD) is described as living organ donation prior to a planned withdrawal of life-sustaining care in an imminently dying patient. Although IDD was ethically justified by United Network for Organ Sharing, the concept remains controversial due to presumed lack of public support. The aim of this study was to evaluate the public's attitudes towards IDD. A cross-sectional survey was conducted of US adults age >18 years (n = 2644). The survey included a case scenario of a patient with a devastating brain injury. Responses were assessed on a 5-point Likert scale. Results showed that 68% - 74% of participants agreed or strongly agreed with IDD when posed as a general question and in relation to the case scenario. Participants were concerned about "recovery after a devastating brain injury" (34%), and that "doctors would not try as hard to save a patient's life" (33%). Only 9% of participants would be less likely to trust the organ donation process. In conclusion, our study demonstrates strong public support for IDD in the case of a patient with a devastating brain injury. Notably, participants were not largely concerned with losing trust in the organ donation process. These results justify policy change towards imminent death donation.

Analytical evaluation of the clonoSEQ Assay for establishing measurable (minimal) residual disease in acute lymphoblastic leukemia, chronic lymphocytic leukemia, and multiple myeloma.

BACKGROUND: The clonoSEQ® Assay (Adaptive Biotechnologies Corporation, Seattle, USA) identifies and tracks unique disease-associated immunoglobulin (Ig) sequences by next-generation sequencing of IgH, IgK, and IgL rearrangements and IgH-BCL1/2 translocations in malignant B cells. Here, we describe studies to validate the analytical performance of the assay using patient samples and cell lines. METHODS: Sensitivity and specificity were established by defining the limit of detection (LoD), limit of quantitation (LoQ) and limit of blank (LoB) in genomic DNA (gDNA) from 66 patients with multiple myeloma (MM), acute lymphoblastic leukemia (ALL), or chronic lymphocytic leukemia (CLL), and three cell lines. Healthy donor gDNA was used as a diluent to contrive samples with specific DNA masses and malignant-cell frequencies. Precision was validated using a range of samples contrived from patient gDNA, healthy donor gDNA, and 9 cell lines to generate measurable residual disease (MRD) frequencies spanning clinically relevant thresholds. Linearity was determined using samples contrived from cell line gDNA spiked into healthy gDNA to generate 11 MRD frequencies for each DNA input, then confirmed using clinical samples. Quantitation accuracy was assessed by (1) comparing clonoSEQ and multiparametric flow cytometry (mpFC) measurements of ALL and MM cell lines diluted in healthy mononuclear cells, and (2) analyzing precision study data for bias between clonoSEQ MRD results in diluted gDNA and those expected from mpFC based on original, undiluted samples. Repeatability of nucleotide base calls was assessed via the assay's ability to recover malignant clonotype sequences across several replicates, process features, and MRD levels. RESULTS: LoD and LoQ were estimated at 1.903 cells and 2.390 malignant cells, respectively. LoB was zero in healthy donor gDNA. Precision ranged from 18% CV (coefficient of variation) at higher DNA inputs to 68% CV near the LoD. Variance component analysis showed MRD results were robust, with expected laboratory process variations contributing ≤3% CV. Linearity and accuracy were demonstrated for each disease across orders of magnitude of clonal frequencies. Nucleotide sequence error rates were extremely low. CONCLUSIONS: These studies validate the analytical performance of the clonoSEQ Assay and demonstrate its potential as a highly sensitive diagnostic tool for selected lymphoid malignancies.

Gender, status, and psychiatric labels.

We examine a key modified labeling theory proposition-that a psychiatric label increases vulnerability to competence-based criticism and rejection-within task- and collectively oriented dyads comprised of same-sex individuals with equivalent education. Drawing on empirical work that approximates these conditions, we expect the proposition to hold only among men. We also expect education, operationalized with college class standing, to moderate the effects of gender by reducing men's and increasing women's criticism and rejection. But, we also expect the effect of education to weaken when men work with a psychiatric patient. As predicted, men reject suggestions from teammates with a psychiatric history more frequently than they reject suggestions from other teammates, while women's resistance to influence is unaffected by their teammate's psychiatric status. Men also rate psychiatric patient teammates as less powerful but no lower in status than other teammates, while women's teammate assessments are unaffected by their teammate's psychiatric status. Also as predicted, education reduces men's resistance to influence when their teammate has no psychiatric history. Education also increases men's ratings of their teammate's power, as predicted, but has no effect on women's resistance to influence or teammate ratings. We discuss the implications of these findings for the modified labeling theory of mental illness and status characteristics theory.

Veteran suicide rates mirror, but do not account for, elevated suicide rates among the general population in US cultures of honor.

INTRODUCTION: Veteran total and firearm suicide rates are higher compared to the general population. Among the general population, total and firearm suicide rates are higher in US states deemed cultures of honor compared to non-honor states, likely because honor states have higher firearm ownership rates and fewer firearm laws. Considering that veterans tend to live in states with fewer firearm laws and that veteran population rates predict both statewide total and firearm suicide rates, it is possible that the elevated suicide rates seen in honor states in part due to those states having a greater presence of veterans compared to non-honor states. METHOD: Publicly available databases were used to obtain total and firearm suicide rates (per 100 k) for veterans and non-veterans, as well as our covariates (e.g., rurality). RESULTS: Veteran population proportions were higher in honor states than non-honor states. Veteran and non-veteran total and firearm suicide rates were higher in honor states compared to non-honor states. Statewide differences in all four suicide rates were indirectly explained by honor states having higher firearm ownership than non-honor states. CONCLUSIONS: These findings add to a growing body of literature showing that enacting firearm regulations may be a viable public health approach for preventing suicide.

A patient-centered nurse-supported primary care-based collaborative care program to treat opioid use disorder and depression: Design and protocol for the MI-CARE randomized controlled trial.

BACKGROUND: Opioid use disorder (OUD) contributes to rising morbidity and mortality. Life-saving OUD treatments can be provided in primary care but most patients with OUD don't receive treatment. Comorbid depression and other conditions complicate OUD management, especially in primary care. The MI-CARE trial is a pragmatic randomized encouragement (Zelen) trial testing whether offering collaborative care (CC) to patients with OUD and clinically-significant depressive symptoms increases OUD medication treatment with buprenorphine and improves depression outcomes compared to usual care. METHODS: Adult primary care patients with OUD and depressive symptoms (n ≥ 800) from two statewide health systems: Kaiser Permanente Washington and Indiana University Health are identified with computer algorithms from electronic Health record (EHR) data and automatically enrolled. A random sub-sample (50%) of eligible patients is offered the MI-CARE intervention: a 12-month nurse-driven CC intervention that includes motivational interviewing and behavioral activation. The remaining 50% of the study cohort comprise the usual care comparison group and is never contacted. The primary outcome is days of buprenorphine treatment provided during the intervention period. The powered secondary outcome is change in Patient Health Questionnaire (PHQ)-9 depression scores. Both outcomes are obtained from secondary electronic healthcare sources and compared in "intent-to-treat" analyses. CONCLUSION: MI-CARE addresses the need for rigorous encouragement trials to evaluate benefits of offering CC to generalizable samples of patients with OUD and mental health conditions identified from EHRs, as they would be in practice, and comparing outcomes to usual primary care. We describe the design and implementation of the trial, currently underway. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT05122676. Clinical trial registration date: November 17, 2021.

Self-Serving Bias or Simply Serving the Self? Evidence for a Dimensional Approach to Narcissism.

Previous research has suggested that narcissism can be conceptualized as a multidimensional construct consisting of the related, but unique, dimensions of grandiosity and entitlement. The current studies examined the divergent associations of grandiosity and entitlement with respect to different types of self-serving strategies. In Study 1, we found that narcissistic grandiosity, but not entitlement, was positively associated with a self-enhancing strategy of unrealistic optimism. This association was not mediated by self-esteem. In Study 2, narcissistic entitlement, but not grandiosity, was predictive of unethical decision-making, an interpersonal self-promotional strategy that advances the self at the expense of others. Together, both studies support a model of narcissism consisting of a relatively intrapersonal dimension of grandiosity and a relatively interpersonal dimension of entitlement.

An A643V amino acid substitution in Upc2p contributes to azole resistance in well-characterized clinical isolates of Candida albicans.

The Candida albicans Upc2p transcription factor regulates ERG11, encoding the target of azole drugs. Gain-of-function mutations that contribute to resistance were recently identified in a series of sequential clinical isolates (N. Dunkel, T. T. Liu, K. S. Barker, R. Homayouni, J. Morschhauser, and P. D. Rogers, Eukaryot. Cell 7:1180-1190, 2008). In the present study, UPC2 was sequenced from a matched set of 17 isolates. An A643V substitution was present in all of the isolates in the series that overexpressed ERG11. Azole susceptibility, ergosterol levels, and expression of ERG genes were elevated in the A643V clinical isolates and in reconstructed strains.

The UPC2 promoter in Candida albicans contains two cis-acting elements that bind directly to Upc2p, resulting in transcriptional autoregulation.

In Candida albicans, ergosterol biosynthetic genes, including ERG11, which encodes the target of azole antifungal drugs, are regulated by the transcriptional regulator Upc2p. To initially characterize the promoter of the UPC2 gene, 5' rapid amplification of cDNA ends was used to identify two transcriptional initiation sites upstream of the ATG codon. The regions within the UPC2 promoter required for azole regulation of the UPC2 promoter were then identified using nested deletions fused to a luciferase reporter which were tested for azole inducibility in wild-type (WT) and upc2Delta/upc2Delta strains. Two distinct regions important for azole induction were identified: a Upc2p-dependent region (UDR) between bp -450 and -350 upstream of the ATG codon and a Upc2p-independent region (UIR) between bp -350 and -250 upstream of the ATG codon. Within the UDR, loss or mutation of the sterol response element (SRE), so named because of homology to the Saccharomyces cerevisiae Upc2p binding site, resulted in a decrease in both basal and induced expression in the WT strain but did not affect azole inducibility in the upc2Delta/upc2Delta deletion strain. Gel shift analyses using the DNA binding domain of Upc2p confirmed binding of the protein to two SRE-related sequences within the UPC2 promoter, with strongest binding to the UDR SRE. Detailed gel shift analyses of the UDR SRE shows that Upc2p binds to a bipartite element within the UPC2 promoter, including the previously identified SRE and a new, adjacent element, the short direct repeat (SDR), with partial homology to the SRE.

Factors contributing to honor-endorsing men's suicide capability: Firearm ownership, practical capability, and exposure to painful and provocative events.

OBJECTIVE: White men in U.S. cultures of honor die by suicide at greater rates than other demographic groups. This finding has been attributed to factors such as the prevalence and use of firearms in men's suicide in honor states, as well as motivational risk factors (e.g., thwarted belongingness). Other features of honor cultures (e.g., physical aggression, risk-taking behaviors) suggest that honor-endorsing men may frequently experience painful and provocative events (PPEs), which, in turn, may facilitate practical capability for suicide. The present work tested this hypothesis and honor ideology's relationship to firearm ownership and storage practices. METHOD: In two samples of mostly White U.S. men-one undergraduate sample (N = 472, Mage  = 19.76) and one middle- to older adult sample (N = 419, Mage  = 65.17)-we assessed honor ideology endorsement, PPEs, practical capability for suicide, and firearm-related outcomes. RESULTS: Honor endorsement was greater among firearm owners (particularly self-protective owners), but it was unrelated to storage practices. Honor endorsement was positively associated with PPEs and practical capability. Additionally, the relationship between honor ideology and practical capability was indirectly explained by PPE exposure. CONCLUSIONS: Results highlight multiple avenues-PPEs, practical capability for suicide, (self-protective) firearm ownership-by which masculine honor norms may place men at risk for suicide.

Assessment of primary care practitioners' attitudes and interest in pharmacogenomic testing.

Aims: Identify the attitudes and interests of primary care providers (PCPs) in applying clinical pharmacogenomics (PGx) test results. Materials & methods: A questionnaire was designed and then disseminated to PCPs across the MedStar Health System. Results: Ninety of 312 (29%) PCPs responded and were included in analyses. Seventy-six (84%) had heard of PGx and 12 (13%) previously ordered PGx testing. Most, 68 (76%), believed PGx can improve care; however, a minority, 23 (26%), reported confidence in using PGx in prescribing decisions. Sixty-four (70%) wanted a pharmacist consultation. PCPs desired PGx for antidepressants (75%), proton pump inhibitors (72%) and other medications. Conclusion: Most PCPs felt unprepared to interpret PGx results and desired pharmacist consultations. These data can inform future PGx implementations with PCPs.

Pharmacogenetics in Practice: Estimating the Clinical Actionability of Pharmacogenetic Testing in Perioperative and Ambulatory Settings.

Most literature describing pharmacogenetic implementations are within academic medical centers and use single-gene tests. Our objective was to describe the results and lessons learned from a multisite pharmacogenetic pilot that utilized panel-based testing in academic and nonacademic settings. This was a retrospective analysis of 667 patients from a pilot in 4 perioperative and 5 outpatient cardiology clinics. Recommendations related to 12 genes and 65 drugs were classified as actionable or not actionable. They were ascertained from Clinical Pharmacogenetics Implementation Consortium (CPIC) guidelines and US Food and Drug Administration (FDA) labeling. Patients displayed a high prevalence of actionable results (88%, 99%) and use of medications (28%, 46%) with FDA or CPIC recommendations, respectively. Sixteen percent of patients had an actionable result for a current medication per CPIC compared with 5% per FDA labeling. A systematic approach by a health system may be beneficial given the quantity and diversity of patients affected.

School violence and the culture of honor.

We investigated the hypothesis that a sociocultural variable known as the culture of honor would be uniquely predictive of school-violence indicators. Controlling for demographic characteristics associated in previous studies with violent crime among adults, we found that high-school students in culture-of-honor states were significantly more likely than high-school students in non-culture-of-honor states to report having brought a weapon to school in the past month. Using data aggregated over a 20-year period, we also found that culture-of-honor states had more than twice as many school shootings per capita as non-culture-of-honor states. The data revealed important differences between school violence and general patterns of homicide and are consistent with the view that many acts of school violence reflect retaliatory aggression springing from intensely experienced social-identity threats.

On the meaning and measure of narcissism.

For three decades, social-personality research on overt narcissism has relied almost exclusively on the Narcissistic Personality Inventory (NPI). However, the NPI suffers from a host of psychometric and validity concerns that make composite NPI scores (summed across its subscales) difficult to interpret. The present studies propose that narcissistic characteristics tend to fall under two general clusters: grandiosity and entitlement. The studies show that measures of grandiosity and entitlement interact to predict scores on the NPI, controlling for gender, self-esteem, and basic personality (Study 1), but also that grandiosity and entitlement function independently with respect to mental health (Study 2) and ethical misconduct (Study 3). Together, these results challenge the view of overt narcissism as a unidimensional construct and underscore the importance of distinguishing between grandiose and entitled aspects of the narcissistic self-concept.

Taking up offenses: secondhand forgiveness and group identification.

When a person or group is mistreated, those not directly harmed by the transgression might still experience antipathy toward offenders, leading to secondhand forgiveness dynamics similar to those experienced by firsthand victims. Three studies examine the role of social identification in secondhand forgiveness. Study 1 shows that the effects of apologies on secondhand victims are moderated by level of identification with the wronged group. Study 2 shows that identification with the United States was associated with less forgiveness and greater blame and desire for retribution directed at the 9/11 terrorists, and these associations were primarily mediated by anger. Finally, Study 3 shows that participants whose assimilation needs were primed were less forgiving toward the perpetrators of an assault on ingroup members than participants whose differentiation needs were primed, an effect that was mediated by empathy for the victims.

Culture, Masculine Honor, and Violence Toward Women.

Prior research has connected the cultural ideology of honor to intrasexual violence between men and to attitudes supporting intersexual aggression in response to perceived honor violations by female romantic partners. We extend this research to show that honor ideology is also associated with an increased likelihood of men actually engaging in violent and sexually coercive behaviors toward women. Extending previous research on honor-based schemas and scripts linked to relationship violence, comparisons between honor states and non-honor states in the United States show that official rape and domestic homicide rates by White male perpetrators (Study 1) and experiences of rape and violence in relationships anonymously reported by White female teenagers (Study 2) were higher in honor states, controlling for a variety of potential confounds. These results extend prior laboratory research on honor-based schemas and scripts into the realm of extreme, real-world behaviors.

The difference isn't black and white: stereotype threat and the race gap on Raven's Advanced Progressive Matrices.

This study addresses recent criticisms aimed at the interpretation of stereotype threat research and methodological weaknesses of previous studies that have examined race differences on Raven's Advanced Progressive Matrices (APM). African American and White undergraduates completed the APM under three conditions. In two threat conditions, participants received either standard APM instructions (standard threat) or were told that the APM was an IQ test (high threat). In a low threat condition, participants were told that the APM was a set of puzzles and that the researchers wanted their opinions of them. Results supported the stereotype threat interpretation of race differences in cognitive ability test scores. Although African American participants underperformed Whites under both standard and high threat instructions, they performed just as well as Whites did under low threat instructions.

Screening for bacterial-fungal associations in a south-eastern US salt marsh using pre-established fungal monocultures.

Both bacteria and fungi play critical roles in decomposition processes in many natural environments, yet only rarely have they been studied as an integrated community. We examined whether physical associations exist between individual bacterial and fungal species that co-occur on decaying smooth cordgrass, Spartina alterniflora, in a south-eastern US salt marsh. Fungal-pervaded decaying Spartina was used as "bait" for potential bacterial associates. The bundles (infiltrated with one of three dominant fungal members of the decomposer assemblage, or an autoclaved control) were placed in a salt marsh and collected biweekly for 6 weeks during the first experiment (late summer 2002), and weekly for 3 weeks during the second experiment (early summer 2003). Terminal-restriction fragment length polymorphism (T-RFLP) analysis of 16S rRNA genes was used to track colonization by bacterial taxa in association with the established fungal species. T-RFLP analysis of 18S-to-28S internal transcribed spacer (ITS) regions was used to monitor changes in fungal communities once bundles had been placed in the field. Results from both years were nearly identical, and showed that invasion by fungi other than the bait species was slow, resulting in a virtual fungal monoculture for several weeks into the experiments. Surprisingly, bacterial communities were unaffected by the identity of the fungal bait. Regardless of the fungal species, and even in the absence of prior fungal colonization, bacterial 16S rRNA profiles were remarkably similar. These results suggest that few species-specific associations, either positive or negative, exist between bacterial and fungal members of the Spartina decomposer community during initial colonization.

Measuring individual differences in the tendency to forgive: construct validity and links with depression.

Four studies examine the construct validity of the Tendency to Forgive Scale (TTF), a brief measure of dispositional forgiveness. Study 1 showed that romantic partners' ratings of targets converged with targets' self-ratings, and Study 2 demonstrated that higher scores on the TTF were associated with lower offense accessibility. Study 3 examined the TTF's relation to self-reported depression symptoms, both independent of and interacting with attitudes toward forgiveness and dispositional vengeance. Lower TTF scores were associated with higher degrees of depression, especially for individuals with positive attitudes toward forgiveness or those low in dispositional vengeance, although neither of these latter variables displayed significant zero-order relations with depression. Finally, Study 4 examined relations between the TTF, dispositional empathy, another recent measure of dispositional forgiveness, and the dimensions of the Big Five, providing both convergent and discriminant validity evidence for the TTF.

Naming patterns reveal cultural values: patronyms, matronyms, and the U.S. culture of honor.

Four studies examined the hypothesis that honor norms would be associated with a pronounced use of patronyms, but not matronyms, for naming children. Study 1 shows that men who endorse honor values expressed a stronger desire to use patronyms (but not matronyms) for future children, an association that was mediated by patriarchal attitudes. Study 2 presents an indirect method for assessing state patronym and matronym levels. As expected, patronym scores were significantly higher in honor states and were associated with a wide range of variables linked previously to honor-related dynamics. Study 3a shows that following the terrorist attacks of 9/11, patronyms increased in honor states, but not in non-honor states. Likewise, priming men with a fictitious terrorist attack (Study 3b) increased the association between honor ideology and patronym preferences. Together, these studies reveal a subtle social signal that reflects the masculine values of an honor culture.