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Abstract: Antiphospholipid antibodies (aPL) in primary or secondary antiphospholipid syndrome (APS) are a major cause for acquired thrombophilia, but specific interventions preventing autoimmune aPL development are an unmet clinical need. Although autoimmune aPL cross react with various coagulation regulatory proteins, lipid-reactive aPL, including those derived from patients with COVID-19, recognize the endolysosomal phospholipid lysobisphosphatidic acid presented by the cell surface-expressed endothelial protein C receptor. This specific recognition leads to complement-mediated activation of tissue factor (TF)-dependent proinflammatory signaling and thrombosis. Here, we show that specific inhibition of the TF coagulation initiation complex with nematode anticoagulant protein c2 (NAPc2) prevents the prothrombotic effects of aPL derived from patients with COVID-19 in mice and the aPL-induced proinflammatory and prothrombotic activation of monocytes. The induction of experimental APS is dependent on the nicotinamide adenine dinucleotide phosphate (NADPH) oxidase complex, and NAPc2 suppresses monocyte endosomal reactive oxygen species production requiring the TF cytoplasmic domain and interferon-α secretion from dendritic cells. Latent infection with murine cytomegalovirus causes TF cytoplasmic domain-dependent development of persistent aPL and circulating phospholipid-reactive B1 cells, which is prevented by short-term intervention with NAPc2 during acute viral infection. In addition, treatment of lupus prone MRL-lpr mice with NAPc2, but not with heparin, suppresses dendritic-cell activation in the spleen, aPL production and circulating phospholipid-reactive B1 cells, and attenuates lupus pathology. These data demonstrate a convergent TF-dependent mechanism of aPL development in latent viral infection and autoimmune disease and provide initial evidence that specific targeting of the TF initiation complex has therapeutic benefits beyond currently used clinical anticoagulant strategies., (© 2024 American Society of Hematology. Published by Elsevier Inc. All rights are reserved, including those for text and data mining, AI training, and similar technologies.)

Evidence-based program resources (EBPR) websites evaluate behavioral health programs, practices or policies (i.e., interventions) according to a predetermined set of research criteria and standards, usually resulting in a summary rating of the strength of an intervention's evidence base. This study is a mixed-methods analysis of the peer-reviewed academic literature relating to the influence of EBPRs on clinical practice and policy in the behavioral health field. Using an existing framework for a scoping review, we searched for research articles in PubMed, Web of Science, SCOPUS, and ProQuest that were published between January 2002 and March 2022, referenced an EBPR or multiple EBPRs, and presented data showing the influence of one or more EBPRs on behavioral health. A total of 210 articles met the inclusion criteria and were classified into five distinct categories of influence, the most important of which was showing the direct impact of one or more EBPRs on behavioral health (8.1% of articles), defined as documenting observable changes in interventions or organizations that are at least partly due to information obtained from EBPR(s). These included impacts at the state legislative and policy-making level, at the community intervention level, provider agency level, and individual practitioner level. The majority of influences identified in the study were indirect demonstrations of how EBPRs are used in various ways. However, more studies are needed to learn about the direct impact of information from EBPRs on the behavioral health field, including impact on clinician practice and treatment outcomes for consumers., (© 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Reconstruction of a large scalp defect following oncologic surgical resection is a challenging task. The defect size, location, and elasticity of the soft tissue overlying the calvarium are important factors to be considered when exploring available reconstructive options. When primary closure is not feasible with a large defect, a skin flap or graft is utilized. Skin flap is advantageous as it produces a similar color and texture as the surrounding areas, thus being the favorable method. Wounds involving exposed bone, tendon, and cartilage cannot support grafts due to poor vascularity and thus require a skin flap. One of the multi-flap closure modalities, the Orticochea flap, is an excellent choice for scalp reconstruction on large defects greater than 50 cm 2 . We present an interesting case of a patient with a large scalp defect following Mohs surgery of basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) that was successfully reconstructed with tissue expansion utilizing Orticochea flap, with the addition of an acellular dermal matrix as an adjunct in such hostile scalp reconstruction., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2022, Tran et al.)

Antiphospholipid antibodies (aPLs) cause severe autoimmune disease characterized by vascular pathologies and pregnancy complications. Here, we identify endosomal lysobisphosphatidic acid (LBPA) presented by the CD1d-like endothelial protein C receptor (EPCR) as a pathogenic cell surface antigen recognized by aPLs for induction of thrombosis and endosomal inflammatory signaling. The engagement of aPLs with EPCR-LBPA expressed on innate immune cells sustains interferon- and toll-like receptor 7-dependent B1a cell expansion and autoantibody production. Specific pharmacological interruption of EPCR-LBPA signaling attenuates major aPL-elicited pathologies and the development of autoimmunity in a mouse model of systemic lupus erythematosus. Thus, aPLs recognize a single cell surface lipid-protein receptor complex to perpetuate a self-amplifying autoimmune signaling loop dependent on the cooperation with the innate immune complement and coagulation pathways., (Copyright © 2021 The Authors, some rights reserved; exclusive licensee American Association for the Advancement of Science. No claim to original U.S. Government Works.)

Objective: To determine the prevalence and correlates of DSM-5 intermittent explosive disorder and related aggressive disorders in the United States., Methods: Community survey data (collected between 2001-2004) from the National Comorbidity Survey-Replication (NCS-R) and Adolescent Supplement (NCS-AS) involving 10,148 adolescents and 9,282 adults, respectively, were reanalyzed with recurrent aggressive behavior defined as 3 serious aggressive outbursts in any given year. In addition to prevalence, assessments of aggression severity, property damage, injury to others, intimate partner assault, utilization of guns and weapons to threaten, and treatment utilization for recurrent aggressive behavior were also assessed., Results: About 17% of adolescents and 8% of adults report a pattern of recurrent aggressive outbursts within at least 1 year. Such individuals are much more aggressive and impulsive than nonaggressive controls and are more likely to engage in intimate partner assault, carry and use guns and other weapons to threaten others, and be arrested by law enforcement. Few aggressive individuals speak with health care providers about this behavior, and fewer receive treatment for aggression., Conclusion: Recurrent aggressive behavior is common in both adolescents and adults, with clinically significant consequences to those with this pattern and to others in their environment (ie, using guns and other weapons to threaten others). While this type of behavior can be reduced though pharmacologic/psychosocial treatment intervention, the vast majority of aggressive individuals do not engage in treatment for their aggressive behavior. Screening individuals for such behavior in one's practice may do much toward identifying this problem and bringing such individuals into treatment., (© Copyright 2020 Physicians Postgraduate Press, Inc.)

The authors hypothesized that personality disorders characterized by interpersonal hypersensitivity would be associated with an elevated concentration of 8-hydroxy-2'-deoxyguanosine (8-OH-DG), the oxidized form of guanine, and a biomarker of oxidative stress burden. One hundred ninety-five male and female adults underwent semistructured diagnostic interviews, completed questionnaire measures of social cognition and emotional attribution, and had blood drawn for determination of plasma 8-OH-DG. A hierarchical linear regression model revealed that narcissistic and borderline personality disorders predicted 8-OH-DG level independently of the effects of age, gender, recent alcohol and cigarette use, current major depression, and posttraumatic stress disorder. In all subjects, 8-OH-DG level was also correlated with the number of borderline personality disorder symptoms present. Narcissistic and borderline personality disorders predicted oxidative stress burden independently of potentially confounding factors.

Rationale: Impulsive aggressive behavior is associated with reduced central function of serotonin (5-HT). Although selective serotonin reuptake inhibitors can reduce such behaviors, many with history of impulsive aggression do not respond adequately to selective serotonin reuptake inhibitors and may require treatment with a direct 5-HT agonist., Objectives: To test the hypothesis that pretreatment with the selective 5-HT2c agonist, lorcaserin, can reduce aggressive responding in impulsively aggressive individuals., Methods: Ten male and female adults were given lorcaserin (20 mg), or a matching placebo, in random order, on 2 days separated by at least 1 week. The Taylor aggression paradigm was used to assess aggressive responding, which was represented by mean shock setting administered to an opponent and by frequency of setting high and extreme shock levels to the opponent., Results: Compared with placebo, lorcaserin attenuated provoked, but not unprovoked, aggression during the Taylor aggression paradigm. This was manifest by reduction in the frequency of selecting high and extreme levels of shock against the opponent., Conclusion: Lorcaserin may possess anti-aggressive properties that could prove useful in the treatment of impulsive aggressive behavior in human subjects. These data, thus, provide a rationale for a follow-up randomized clinical trial of lorcaserin in individuals with prominent histories of impulsive aggressive behavior., (© 2019 John Wiley & Sons, Ltd.)

Individuals with DSM-5 Intermittent Explosive Disorder (IED) are often suspected of minimizing the nature of their recurrent, problematic, impulsive aggressive behavior due to the social undesirability of these behaviors. Our first study involved 400 study participants categorized as Healthy Controls (HC), Psychiatric Controls (PC) and as having IED and included the Crowne-Marlowe Social Desirability Scale (SDS), the Lie Scale from the Eysenck Personality Questionnaire-Revised (EPQ-R Lie), and the Readiness to Change (Anger) Questionnaire (RTC). IED study participants had lower SDS and lower EPQ-R Lie scores, while having higher RTC scores, compared with both HC and PC study participants. Thus, when studied in a clinical research setting, IED study participants do not provide socially desirable answers to questions and do not engaging in deceptive reporting; likely because they have recognized their need/interest in reducing their own impulsive aggressive behavior. The second study, part of a family study of 70 probands and their first-degree relatives revealed a very high positive (96.3%), but substantially lower negative (55.8%), predictive power for IED based on informant report. This suggests that, while interview of close informants can confirm the diagnosis of IED, informant interviews cannot rule out IED when such informants provide a negative report., (Copyright © 2018. Published by Elsevier B.V.)

There is ambiguity in how recurrent anger and aggression are accounted for by psychiatric nosology. One area of uncertainty is the extent to which Intermittent Explosive Disorder (IED) overlaps with and is distinct from Personality Disorder (PD). Accordingly, we conducted a study of individuals with IED and PD in order to understand the nature of comorbidity relationships seen across these two areas of psychopathology. One-thousand-five-hundred-twenty-one adults were studied (441 Healthy Controls (HC), 430 Psychiatric Controls (PC), and 650 IED subjects) and assessed for DSM-5 psychiatric disorders, life history of aggressive behavior, trait aggression, state and trait anger reactivity, and impulsivity. While nearly half of IED study participants had a comorbid PD diagnosis, nearly half with a Cluster B PD, almost as many had other personality disorders. IED predicted anger symptoms and history of aggressive behavior above and beyond a PD diagnosis. Comorbidity between IED and either Antisocial (AsPD) or Borderline (BPD) PD was associated with the highest levels of aggressive behavior. However, having IED comorbid with either AsPD and/or BPD PD was not associated with higher levels of impulsivity. Underlying personality traits related to anger, affect, and social behavior, but not identity disturbance, contribute to the shared symptom profile of IED and PD. IED is usually comorbid with PD, but does not have a unique relationship with any single PD. When comorbid with PD, a diagnosis of IED predicts more severe anger and aggression, but not necessarily increased impulsivity. These results suggest that IED and PD diagnoses retain clinical utility when made in cases meeting criteria for both., (Copyright © 2018. Published by Elsevier Ltd.)

The endocannabinoid (EC) system influences a wide variety of neurobiological processes including affect and emotionality as well as other neuropsychiatric functions. In this study we examined the relationship of circulating endocannabinoids [anandamide (AEA) and 2-arachidonoylglycerol (2-AG)] with affect and emotionality in 175 individuals with (n = 115) and without (n = 60) mood, anxiety, and/or personality disorders. Circulating AEA levels displayed a modest, though statistically significant, inverse relationship with a composite measure of affect regulation (β = - 0.264, p = 0.009), due to its relationship with affect intensity (β = - 0.225, p = 0.021) across all study participants. Neither AEA nor 2-AG level differed as a function of any syndromal/personality disorder and neither correlated significantly with state depression or state anxiety scores. These data suggest that circulating levels endocannabinoids may play a role in emotionality across individuals regardless of defined psychiatric disorder., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

Objective: To review the challenges and potential solutions in treatment options for quality migraine care in adult patients who are under or uninsured., Background: The Affordable Care Act has improved access to health care for many; however, those who are underserved continue to face treatment disparities and have inadequate access to appropriate migraine management., Methods: This manuscript is the second of a 2-part narrative review which was performed after a series of discussions within the Underserved Populations in Headache Medicine Special Interest Section meetings of the American Headache Society. Literature was reviewed for key concepts underpinning conceptual boundaries and a broad overview of the subject matter. Published guidelines, state-specific Medicaid websites, headache quality measurement sets, literature review, and expert opinion were used to tailor suggested treatment options and therapeutic strategies. In this second part of our narrative review, we explored migraine care strategies and considerations for underserved and vulnerable adult populations with migraine., Results: Although common, migraine remains untreated, particularly among those of low socioeconomic status. Low socioeconomic status may play an important role in the disease progression, prescription of hazardous medications such as opioids, outcomes, and quality of life of patients with migraine and other headache disorders. There are some evidence-based and guideline supported treatment options available at low cost that include prescription medications and supplements, though approved devices are costly. Resources available online and simple nonpharmacological strategies may be particularly useful in the underserved migraine population., Conclusions: We identified and discussed migraine treatment barriers that affect underserved populations in the US and summarized practical, cost-effective strategies to surmount them. However, more research is needed to identify the best cost-effective measures for migraine management in underserved and vulnerable patients who are uninsured or underinsured., (© 2018 American Headache Society.)

Objective: To review the scope of the problem facing individuals with migraine who are under- or uninsured. In this first of a 2-part narrative review, we will explore migraine epidemiology and the challenges that face this vulnerable population., Background: Implementation of the Affordable Care Act has improved access to health care for many individuals who were previously uninsured, but there are many, particularly those of certain demographics, who are at high risk for worse outcomes., Methods: A narrative review was performed after a series of discussions within the Underserved Populations in Headache Medicine Special Interest Section meetings of the American Headache Society. Literature was reviewed for key concepts underpinning conceptual boundaries and a broad overview of the subject matter. Published guidelines, state-specific Medicaid websites, headache quality measurement set, literature review, and expert opinion were used to tailor suggested treatment options and therapeutic strategies., Results: Migraine is common, yet remains underdiagnosed and associated with worse outcomes among those of under-represented backgrounds and those who are underinsured or uninsured. Low socioeconomics may play an important role in the disease progression, characteristics, outcome, and quality of life of patients with migraine and other headache disorders. Other barriers to optimal care include time constraints, lack of access to specialty providers, transportation, and financial limitations., Conclusion: There are many barriers and challenges that affect people with migraine who are underinsured or uninsured, particularly those of under-represented racial backgrounds and of lower socioeconomic status., (© 2018 American Headache Society.)

A computerized version of an assessment of Social-Emotional Information Processing (SEIP) using audio-video film stimuli instead of written narrative vignettes was developed for use in adult participants. This task allows for an assessment of encoding or relevant/irrelevant social-emotional information, attribution bias, and endorsement of appropriate, physically aggressive, and relationally aggressive responses to aversive social-emotional stimuli. The psychometric properties of this Video-SEIP (V-SEIP) assessment were examined in 75 healthy controls (HC) and in 75 individuals with DSM-5 Intermittent Explosive Disorder (IED) and were also compared with the original questionnaire (SEIP-Q) version of the task (HC=26; IED=26). Internal consistency, inter-rater reliability, and test-retest properties of the V-SEIP were good to excellent. In addition, IED participants displayed reduced encoding of relevant information from the film clips, elevated hostile attribution bias, elevated negative emotional response, and elevated endorsement of physically aggressive and relationally aggressive responses to the ambiguous social-emotional stimuli presented in the V-SEIP. These data indicate that the V-SEIP represents a valid and comprehensive alternative to the paper-and-pencil assessment of social-emotional information processing biases in adults., (Copyright © 2016. Published by Elsevier B.V.)

Social-emotional information processing (SEIP) was assessed in individuals with current DSM-5 Intermittent Explosive Disorder (IED: n = 100) and in healthy (n = 100) and psychiatric (n = 100) controls using a recently developed and validated self-rated questionnaire. SEIP vignettes depicted both direct aggressive and relationally aggressive scenarios of a socially ambiguous nature and were followed by questions assessing subjects' reactions and judgments about the vignettes. IED subjects differed from both healthy and psychiatric controls in all SEIP components. While hostile attribution was highly related to history of aggression, it was also directly correlated with negative emotional response. Further analysis revealed that this component, as well as response valuation and response efficiency, rather than hostile attribution, best explained history of aggressive behavior. A reformulated SEIP model, including self-reported history of childhood trauma, found that negative emotional response and response efficiency were the critical correlates for history of aggressive behavior. Psychosocial interventions of aggressive behavior in IED subjects may do well to include elements that work to reduce the emotional response to social threat and that work to restructure social cognition so that the tendency towards overt, or relationally, aggressive responding is reduced., (Copyright © 2016. Published by Elsevier Ltd.)

Background: Individuals with intermittent explosive disorder (IED) were previously found to exhibit amygdala (AMYG) hyperactivation to anger faces during functional magnetic resonance imaging (fMRI). However, acute alcohol consumption, and/or life history of alcoholism, may blunt amygdala responses to negative emotional stimuli. Thus, we examined the influence of a past history of DSM-5 Alcohol Use Disorder (AUD) on the fMRI BOLD AMYG response to anger faces in IED., Method: Forty-two IED participants, 18 with a past history of AUD (IED+AUD) and 24 without Past AUD (IED), and 32 healthy control (HC) participants, underwent fMRI scanning while viewing blocks of angry, fearful, and happy faces., Results: Compared to HC and IED+AUD participants, IED subjects exhibited greater AMYG responses to angry, but not to fear or happy, faces in the left AMYG. There were no group differences in responses to anger, fear, or happy, faces in the OFC., Conclusion: These findings suggest the possibility of a longstanding effect of AUD on AMYG response in IED to anger-related stimuli and highlight the possibility that history of AUD should be considered as an important factor in the interpretation of fMRI studies involving the AMYG response to negative emotional stimuli., (Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.)

Background: Childhood trauma is a risk factor for personality disorder. We have previously shown that childhood trauma is associated with increased central corticotrophin-releasing hormone concentration in adults with personality disorder. In the brain, the release of corticotrophin-releasing hormone can be stimulated by noradrenergic neuronal activity, raising the possibility that childhood trauma may affect the hypothalamic-pituitary adrenal (HPA) axis by altering brain noradrenergic function. In this study, we sought to test the hypothesis that childhood trauma is associated with blunted growth hormone response to the α-2 adrenergic autoreceptor agonist clonidine., Methods: All subjects provided written informed consent. Twenty personality disordered and twenty healthy controls (without personality disorder or Axis I psychopathology) underwent challenge with clonidine, while plasma Growth Hormone (GH) concentration was monitored by intravenous catheter. On a different study session, subjects completed the Childhood Trauma Questionnaire and underwent diagnostic interviews., Results: Contrary to our a priori hypothesis, childhood trauma was associated with enhanced GH response to clonidine. This positive relationship was present in the group of 40 subjects and in the subgroup 20 personality disordered subjects, but was not detected in the healthy control subjects when analyzed separately. The presence of personality disorder was unrelated to the magnitude of GH response., Discussion: Childhood trauma is positively correlated with GH response to clonidine challenge in adults with personality disorder. Enhanced rather that blunted GH response differentiates childhood trauma from previously identified negative predictors of GH response, such as anxiety or mood disorder., (Copyright © 2016 Elsevier Ltd. All rights reserved.)

We report the case of a 48-year-old man who had an unusually large submandibular gland sialolith (2.6 cm in greatest dimension), which led to sialadenitis and subsequent abscess formation. We describe the management of this patient and review the literature with emphasis on the various modalities available for diagnostic imaging.

We explore the role of DNA damage processing in the progression of cognitive decline by creating a new mouse model. The new model is a cross of a common Alzheimer's disease (AD) mouse (3xTgAD), with a mouse that is heterozygous for the critical DNA base excision repair enzyme, DNA polymerase β. A reduction of this enzyme causes neurodegeneration and aggravates the AD features of the 3xTgAD mouse, inducing neuronal dysfunction, cell death and impairing memory and synaptic plasticity. Transcriptional profiling revealed remarkable similarities in gene expression alterations in brain tissue of human AD patients and 3xTg/Polβ(+/-) mice including abnormalities suggestive of impaired cellular bioenergetics. Our findings demonstrate that a modest decrement in base excision repair capacity can render the brain more vulnerable to AD-related molecular and cellular alterations., (Published by Oxford University Press on behalf of Nucleic Acids Research 2014. This work is written by US Government employees and is in the public domain in the US.)

Background: Although not typically considered as part of the clinical phenotype of migraine, cranial autonomic symptoms, such as lacrimation or conjunctival injection, can certainly occur. Their appearance can lead to the common misdiagnosis of sinus headache in clinical practice., Case: The patient presented developed post-ganglionic sympathetic denervation at the level of the superior cervical ganglion/carotid plexus. Her subsequent partial Horner's syndrome symptoms intensified during subsequent migraine attacks indicating increasing sympathetic autonomic dysfunction. At the time of the pain, recruitment and activation of the trigeminal autonomic reflex were demonstrated by lacrimation., Conclusion: The clinical picture suggests peripheral unmasking of the underlying central trigeminal autonomic reflex that is active in migraine. Recognition of cranial autonomic symptoms in migraine is a key to confident differential diagnosis from trigeminal autonomic cephalalgias and from sinus-related headache disorders., (© 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Background: We hypothesized that SRX246, a vasopressin V1a receptor antagonist, blocks the effect of intranasally administered vasopressin on brain processing of angry Ekman faces. An interaction of intranasal and oral drug was predicted in the amygdala., Methods: Twenty-nine healthy male subjects received a baseline fMRI scan while they viewed angry faces and then were randomized to receive oral SRX246 (120 mg PO twice a day) or placebo. After an average of 7 days of treatment, they were given an acute dose of intranasal vasopressin (40 IU) or placebo and underwent a second scan. The primary outcome was BOLD activity in the amygdala in response to angry faces. Secondary analyses were focused on ROIs in a brain regions previously linked to vasopressin signaling., Results: In subjects randomized to oral placebo-intranasal vasopressin, there was a significantly diminished amygdala BOLD response from the baseline to post-drug scan compared with oral placebo-intranasal placebo subjects. RM-ANOVA of the BOLD signal changes in the amygdala revealed a significant oral drug × intranasal drug × session interaction (F (1, 25) = 4.353, p < 0.05). Follow-up tests showed that antagonism of AVPR1a with SRX246 blocked the effect of intranasal vasopressin on the neural response to angry faces. Secondary analyses revealed that SRX246 treatment was associated with significantly attenuated BOLD responses to angry faces in the right temporoparietal junction, precuneus, anterior cingulate, and putamen. Exploratory analyses revealed that the interactive and main effects of intranasal vasopressin and SRX246 were not seen for happy or neutral faces, but were detected for aversive faces (fear + anger) and at a trend level for fear faces., Conclusion: We found confirmatory evidence that SRX246 has effects on the amygdala that counter the effects of intranasal vasopressin. These effects were strongest for angry faces, but may generalize to other emotions with an aversive quality.

Background: The mechanistic model whereby serotonin affects impulsive aggression is not completely understood. The purpose of this study was to test the hypothesis that depletion of serotonin reserves by tryptophan depletion affects emotional information processing in susceptible individuals., Methods: The effect of tryptophan (vs placebo) depletion on processing of Ekman emotional faces was compared in impulsive aggressive personality disordered, male and female adults with normal controls. All subjects were free of psychotropic medications, medically healthy, nondepressed, and substance free. Additionally, subjective mood state and vital signs were monitored., Results: For emotion recognition, a significant interaction of Aggression × Drug × Sex (F(1, 31) = 7.687, P = 0.009) was found, with male normal controls but not impulsive aggressive males showing increased recognition of fear. For intensity ratings of emotional faces, a significant interaction was discovered of Drug × Group × Sex (F(1, 31) = 5.924, P = 0.021), with follow-up tests revealing that males with intermittent explosive disorder tended to increase intensity ratings of angry faces after tryptophan depletion. Additionally, tryptophan depletion was associated with increased heart rate in all subjects, and increased intensity of the subjective emotional state of "anger" in impulsive aggressive subjects., Conclusions: Individuals with clinically relevant levels of impulsive aggression may be susceptible to effects of serotonergic depletion on emotional information processing, showing a tendency to exaggerate their impression of the intensity of angry expressions and to report an angry mood state after tryptophan depletion. This may reflect heightened sensitivity to the effects of serotonergic dysregulation, and suggests that what underlies impulsive aggression is either supersensitivity to serotonergic disturbances or susceptibility to fluctuations in central serotonergic availability.

Background: Childhood trauma has been associated with elevated central corticotropin releasing hormone (CRH) drive in adults meeting general DSM-IV criteria for personality disorder. It is not clear how this may be related to pituitary or adrenal responsiveness in personality disorder. It was hypothesized that high levels of childhood trauma would be associated with blunted cortisol and adrenocorticotropin releasing hormone (ACTH) response to the combined dexamethasone(DEX)/CRH test in adults meeting general DSM-IV criteria for personality disorder., Method: 24 healthy, medication free adults with personality disorder (N=16) and a group of healthy controls (N=8) underwent semi-structured diagnostic interviews and completed the Childhood Trauma Questionnaire (CTQ). Across two separate study sessions separated by at least a week, cerebrospinal fluid (CSF) was sampled by lumbar puncture for measurement of CRH concentration (N=17), and peripheral blood cortisol and ACTH levels were measured after challenge with DEX/CRH (N=24)., Results: As hypothesized, high CTQ score was associated with a blunted cortisol and ACTH response to DEX/CRH challenge. Indices of cortisol and ACTH response (peak level and area under the curve (AUC)) to DEX/CRH were in turn significantly negatively correlated with CSF CRH concentration., Conclusion: Childhood trauma in adults with personality disorder is associated with blunted cortisol and ACTH secretion following DEX/CRH challenge. These effects are independent of depression or posttraumatic stress disorder. Previous work would suggest that blunted pituitary-adrenal response is related to elevated central CRH drive. Corroborating this, CSF CRH levels were significantly and negatively correlated with peak level and AUC of both cortisol and ACTH., (Copyright © 2011 Elsevier Ltd. All rights reserved.)

A novel anion exchange membrane adsorber is presented which shows excellent impurity removal under different buffer conductivities ranging from 2 to 2 7mS/cm. The membrane utilizes a primary amine ligand (polyallylamine) and was designed specifically to bind impurities at high salt concentrations. Studies with DNA, endotoxin, and virus spiked into buffer at varying salt conditions were done, resulting in clearance of >3, 4, and 4 LRV, respectively, with negligible change on increasing salt up to 27 mS/cm conductivities. Verification of virus removal in mAb feedstocks is also shown. The data are compared with other membrane adsorbers and a conventional resin which utilize traditional chemistries to demonstrate improved purification performance with the primary amine ligand. Additional data on scale-up of the membrane adsorber device is discussed. A stacked flat-sheet design was implemented to ensure linear scale-up of performance using bovine serum albumin (BSA) as a model. The linearly scalable device, coupled with the highly effective membrane for virus, DNA, and endotoxin removal, represents a step forward in polishing technology for the purification of monoclonal antibodies and recombinant proteins., (Copyright © 2011 Elsevier B.V. All rights reserved.)

Background: Intermittent explosive disorder (IED) is a disorder of impulsive aggression that affects as many as 7.3% of the U.S. population during some period of life. Since central serotonergic (5-HT) system dysfunction is related to impulsive aggressive behavior, pharmacologic enhancement of 5-HT activity should reduce impulsive aggressive behavior in individuals with IED., Method: A double-blind, randomized, placebo-controlled trial of the selective 5-HT uptake inhibitor fluoxetine was conducted in 100 individuals with IED (research diagnostic criteria) and current histories of impulsive aggressive behavior. The primary efficacy measure was the aggression score from the Overt Aggression Scale-Modified (OAS-M) for Outpatient Use. Secondary efficacy measures included the irritability score from the OAS-M and the Clinical Global Impressions-Improvement scale (CGI-I) score. The study took place between July 1990 and July 1999., Results: Fluoxetine treatment resulted in a sustained reduction in OAS-M aggression, and OAS-M irritability scores, apparent as early as week 2 (p < .01 for aggression and p < .001 for irritability at endpoint). Fluoxetine was also superior to placebo in the proportion of responders on the CGI-I (p < .001). Closer examination of the data revealed that full or partial remission of impulsive aggressive behaviors, as reflected by the A criteria for IED, occurred in 46% of fluoxetine-treated subjects. Fluoxetine did not exert an antidepressant or antianxiety effect, and its effects on impulsive aggression were not influenced by presence of current symptoms of depression or anxiety., Conclusion: Fluoxetine treatment has a clear antiaggressive effect in impulsive aggressive individuals with IED. However, while fluoxetine's antiaggressive effects appear robust, they lead to full or partial remission of IED in less than 50% of subjects treated with fluoxetine., (Copyright 2009 Physicians Postgraduate Press, Inc.)

Background: Uncertainty persists over the environmental effects of genetically-engineered crops that produce the insecticidal Cry proteins of Bacillus thuringiensis (Bt). We performed meta-analyses on a modified public database to synthesize current knowledge about the effects of Bt cotton, maize and potato on the abundance and interactions of arthropod non-target functional guilds., Methodology/principal Findings: We compared the abundance of predators, parasitoids, omnivores, detritivores and herbivores under scenarios in which neither, only the non-Bt crops, or both Bt and non-Bt crops received insecticide treatments. Predators were less abundant in Bt cotton compared to unsprayed non-Bt controls. As expected, fewer specialist parasitoids of the target pest occurred in Bt maize fields compared to unsprayed non-Bt controls, but no significant reduction was detected for other parasitoids. Numbers of predators and herbivores were higher in Bt crops compared to sprayed non-Bt controls, and type of insecticide influenced the magnitude of the difference. Omnivores and detritivores were more abundant in insecticide-treated controls and for the latter guild this was associated with reductions of their predators in sprayed non-Bt maize. No differences in abundance were found when both Bt and non-Bt crops were sprayed. Predator-to-prey ratios were unchanged by either Bt crops or the use of insecticides; ratios were higher in Bt maize relative to the sprayed non-Bt control., Conclusions/significance: Overall, we find no uniform effects of Bt cotton, maize and potato on the functional guilds of non-target arthropods. Use of and type of insecticides influenced the magnitude and direction of effects; insecticde effects were much larger than those of Bt crops. These meta-analyses underscore the importance of using controls not only to isolate the effects of a Bt crop per se but also to reflect the replacement of existing agricultural practices. Results will provide researchers with information to design more robust experiments and will inform the decisions of diverse stakeholders regarding the safety of transgenic insecticidal crops.

In light of the abruptness and severity of the HIV/AIDS epidemic in Asia, there has been growing concern in recent years about the HIV/AIDS risks with the steady rate of Asian and Pacific Islander (AAPI) migration to the United States. Little is known, however, about existing HIV risks among non-MSM (men who have sex with men) AAPIs. The purpose of this study was to examine self-reported HIV testing behaviors and their correlates among a sample of 604 Southeast Asians living in a U.S. urban setting. The HIV testing rate among our sample adults is 30.8%, lower than the median HIV testing rate in the U.S. adult population by state, lower than that of the general adult testing rate in the study city, and lower than that of the AAPI MSM population. A low sexually transmitted infection (STI) testing rate as a proxy for low perceived sexual risks and a dearth of HIV knowledge were associated with the low HIV testing rate. Traditional health care access measures, such as availability of medical insurance and a personal doctor, cannot explain the low HIV testing rate in this predominantly immigrant population. Culturally and linguistically appropriate HIV prevention campaigns could increase the awareness of HIV/STI risk in this AAPI population.

Asian Americans (AA) are thought to have the lowest rates of substance use. This study examined substance use prevalence among 494 urban-dwelling Southeast Asians using snowball techniques. Prevalence estimates were age-adjusted proportionate to the U.S. Asian population. Findings show beer and alcohol consumption approximated the national percentage among 25-44 year olds. U.S.-born were about three times likelier to have past month substance use. Foreign-born Vietnamese were likelier than U.S.-born to use all substances except for beer. U.S.- and foreign-born beer consumption rates were similar. Future research is needed to delineate substance use determinants and patterns in foreign and U.S.-born AA sub-groups.

This cross-sectional investigation tests the relationship between the level of self-reported childhood parental care and cerebrospinal fluid (CSF) corticotropin-releasing factor (CRF) concentration in adults with and without personality disorder (PD). Based on preclinical models of the lasting effect of post-natal parental care on central CRF function, the primary hypothesis was that childhood parental care, as reflected by the parental bonding inventory (PBI) care and involvement subscale, is inversely correlated with adult CSF CRF levels. The sample includes cerebrospinal fluid CRF samples from 19 subjects who were included in a previously published report on the relationship between CRF level and Childhood Trauma Questionnaire score. Parental bonding was measured retrospectively with the PBI in 54 medication-free male and female subjects, 37 of whom were diagnosed with a DSM-IV PD, 17 of whom were normal controls free of Axis I and II psychopathology. CSF CRF level as measured by lumbar puncture was entered into a model as the dependent variable, with the independent variables of PBI Parental Care and Involvement, diagnostic category, age, and gender. The model predicting CSF CRF level was significant, with PBI parental care and involvement negatively correlated with CSF CRF level. PD subjects with higher than median PBI parental care and involvement score had significantly lower CSF CRF levels than both normal controls and PD subjects with lower than median PBI parental care and involvement. Higher levels of self-report parental care predict lower CSF CRF levels in PD subjects, consistent with a beneficial effect of parental care on decreased stress reactivity, and consistent with previous reports in humans. The cross-sectional design of the study, however, limits causal inferences.

Objective: Whilst the 20-item Toronto Alexithymia Scale (TAS-20) was developed to measure three intercorrelated dimensions, there is some debate as to whether the scale is best served by a two- or three-factor construct. In particular, there is some doubt as to whether clinical data exhibit the third factor. This study uses data from a sample of physiotherapy (physical therapy) out-patients in the UK to validate the factorial structure of a set of models postulated in the literature, including the three-factor model hypothesized by Bagby et al. (1994)., Method: Data were collected from a sample of physiotherapy out-patients (N=242). Specialist factor analysis software (LISREL 8.54) was used to perform confirmatory factor analyses on a range of models proposed in the literature., Results: The analysis supports the three-factor model assumed by Bagby et al. (1994), as well as most of the two-factor models suggested in the literature., Conclusions: This new set of clinical data supports most of the two- and three-factor models postulated in the recent literature, including the three-factor model advocated by Bagby et al. (1994).

The model to understand sexual health among Asian American/Pacific Islander men who have sex with men first locates the dynamic process in the home country, with its prevailing cultural norms including sexual mores, shame or stigma, sexual attitudes, sexual behavior, and drug use/abuse. Second, these cultural norms are modified by the migration/immigration experience. Third, these norms, beliefs, and practices are continually influenced by the process of acculturation as these men try to adjust to life in the United States. The effects of the first two domains may vary by the degree to which a particular immigrant community remains socially and culturally insulated from the mainstream community. Conceivably, the effect of home country and migration/immigration would be less significant for those who were either very young at the time of immigration or are born in the United States.

Background: Health promotion interventions often contain several, conceptually diverse elements. As a result, it is often difficult to determine why interventions succeed or fail as well as which components should be retained or eliminated. One method to examine the effectiveness of individual intervention elements is process analysis., Methods: Kick It! is a multicomponent smoking cessation intervention developed for lower socioeconomic African Americans. The intervention includes several components, including a 24-page printed cessation manual, a staged-cessation video, a quit contract, two "Quit and Win" contests, and a single telephone booster call. Using data from a randomized intervention trial designed to test the efficacy of the Kick It! intervention, this article examines the use, impact, and interaction of the intervention's subcomponents as well as possible mediating variables related to successful quitting among intervention participants (n = 650)., Results: In univariate as well as multivariate analyses adjusting for age and stage of change, two of the five elements, watching the video and entering a Quit and Win contest, were significantly associated with 6-month point prevalence abstinence. Submitting a quit contract and receiving the booster call were significantly associated with quitting in univariate analyses, while reading the Kick It! guide was not significantly associated with quitting in either analysis., Conclusions: Despite the positive effects observed for individual elements, quitting was not significantly greater among intervention relative to comparison subjects. The primary reason for this appears to be the overall lack of intervention use. Additional research examining strategies to increase use of the Kick It! intervention components as well as the optimal sequencing and combination of components may be warranted.

The authors develop and test a culturally sensitive, low-intensity smoking cessation intervention for low-socioeconomic African Americans. African American adult smokers were randomly assigned to receive either a multicomponent smoking cessation intervention comprising a printed guide, a video, and a telephone booster call or health education materials not directly addressing tobacco use. The results of the study were mixed. Although no significant effects were observed for the entire treatment cohort, the results of post hoc analyses suggest that culturally sensitive self-help smoking cessation materials plus a single phone contact can produce short-term cessation rates similar to those reported for majority populations. This conclusion should be tempered by the low completion rate for the booster call and several design limitations of the study.

This study was undertaken to examine gender differences in the perception of social constraints against smoking and to explore the role of other sociodemographic and smoking factors that influence the perception of social pressure. Baseline data from the 20 U.S. sites in the National Cancer Institute's Community Intervention Trial for Smoking Cessation (COMMIT) were analyzed. We found that women were less likely than men to be heavy smokers and to report that smoking had affected their health, but more likely to report behavior indicating physiological addiction (timing of first cigarette). At all smoking levels, women were about twice as likely as men to report feeling pressure to quit, after adjusting for education, income, ethnic group, age, and other factors. The source of pressure, however, was different: more women report pressure from their children, whereas more men report pressure from friends and coworkers. Women were equally likely as men to make quit attempts, after adjusting for other factors, but were less likely to remain abstinent for at least 10 days. Women, regardless of education, ethnicity, and age, reported a greater tendency to ask permission before smoking in non-restricted public places. College-educated men were less likely than men without college education to smoke without asking in non-restricted places, but education did not influence whether women asked permission. For both sexes, smoking level and nicotine dependence were significant predictors of lighting up without asking in public places, after adjustment for other variables. We discuss these findings and their implications for the gender gap in smoking cessation and women's conflicting pressures to stop/continue smoking. Tobacco control efforts are discussed within the context of gender differences in social norms, roles, socialization, and communication cultures.

Background: Baseline telephone survey data from 10 COMMIT sites were submitted to statistical analyses to compare the smoking characteristics of non-Hispanic white (white), non-Hispanic black (black), Mexican-origin (Mexican), and Puerto Rican-origin (Puerto Rican) smokers., Results: White men and women were more likely to be classified as "heavy smokers" than members of other racial/ethnic groups, although black and Puerto Rican smokers were more likely than whites to increase their smoking rates on weekends. Whites were less likely to report stopping smoking in the past. White and Mexican smokers were most likely to smoke light or ultralight brands and least likely to smoke menthol cigarettes. Blacks were most likely to report smoking their first cigarette of the day within 10 min of waking., Conclusion: The differences and similarities among different groups of smokers may have important implications for understanding patterns of tobacco-related disease in smokers from different racial/ethnic and sex groups.

The purpose of this project was to develop and test culturally appropriate, low literacy, smoking cessation intervention materials designed to increase quit rates and prevent relapse postpartum for low-income African American and Hispanic women. A quasi-experimental, pretest-posttest design was used. Four Women, Infants, and Children (WIC) clinic sites in south and central Los Angeles were identified, pair-matched based on ethnic mix, and randomized to intervention (2 sites) or control status (2 sites). Participants were 18 years of age or older and either current or exsmokers (stopped smoking in the past year). The intervention group received the "Time for a Change: A Program for Healthy Moms and Babies" program including a 15-minute one-to-one counseling session and self-help guide, incorporating behavior-change strategies, booster postcard, and incentive contest. All materials were designed to match the cultural, language, and literacy needs of the target population. The smoking cessation intervention had a positive impact on both quit-smoking behavior during pregnancy and relapse prevention postpartum. Almost twice as many smokers in the intervention group (43%) reported quitting smoking at 9 months, compared to the control group (25%) (P < 0.01). At 6 weeks postpartum, 25% of the intervention baseline smokers were abstinent, compared to 12% of the control group (P < 0.01). Although no significant differences were observed for relapse during pregnancy among exsmokers at 6 weeks postpartum, a significantly higher proportion of intervention exsmokers were still abstinent (79%), compared to control exsmokers (62%) (P < 0.01). For the exsmokers, relapse prevention rates remained significant when adjusted for cotinine validated abstinence.(ABSTRACT TRUNCATED AT 250 WORDS)

This study was designed to increase smoking cessation rates, quit attempts, and cutting down among low-income African Americans using brief clinician advice in conjunction with socioculturally appropriate self-help smoking cessation/relapse prevention materials. Physicians and nurses were instructed in the National Cancer Institute's smoking intervention at inservice sessions. Smokers interviewed in a Harlem, New York clinic waiting room were recontacted 7 months later by telephone or mail (77% response). Residents receiving the intervention reported a 21% cessation rate at follow-up. An additional 27% decreased cigarette intake by at least 50%. Those reporting follow-up abstinence were significantly more likely to designate a quit date at baseline. They were also more likely to be men, employed, and have a nonsmoking partner. Smokers who decreased their cigarette intake significantly were older, employed, less nicotine-dependent (eg, delayed their wake-up cigarette), and more likely to use project materials. Physician advice had a significant impact both on patients' cutting down at least 50% and patients' watching the project video. Designation of a quit date and using project materials had a significant impact on making serious quit attempts. Results corroborate large sample, randomized, controlled trials with noninner-city physicians. We conclude that clinician smoking advice for every patient is warranted.

Objectives: This study was undertaken to explore smoking patterns and attitudes that influence smoking cessation and relapse among African Americans., Methods: Baseline data from eight Community Intervention Trial for Smoking Cessation (COMMIT) sites were analyzed., Results: Compared with Whites, African Americans who smoke less than 25 cigarettes per day were 1.6 times more likely to smoke within 10 minutes of awakening (a behavioral indicator of nicotine dependence), adjusting for education, age, and gender (OR = 1.2 for heavier smokers). African Americans reported a stronger desire to quit smoking and reported serious quit attempts in the past year. African Americans favored tobacco restrictions (they were 1.8 times more likely than Whites to view smoking as a serious community problem, 1.7 times more likely to favor restrictions on cigarette vending machines, and 2.1 times more likely to prohibit smoking in their car). African Americans were lighter/moderate, menthol smokers., Conclusions: African Americans find smoking socially unacceptable and are strongly motivated to quit, but their "wake-up" smoking may indicate high nicotine dependence, making abstinence difficult even for lighter smokers.

A total of 775 pure-strain and F1 mice were obtained from a 6 X 6 diallel mating plan. Previous factor analysis of 42 measures of emotionality identified 14 behavioral factors, ten of which were interpretable. Hayman's analysis of variance and analysis of diallel crosses were applied to each of the factors. In general, the findings indicate that the mode of inheritance for emotionality factors is polygenic and in the direction of complete dominance. However, a major point of this investigation is that the mode of inheritance of highly complex behavior such as emotionality depends on the factor in question. For example, the breakdown of dominance effects by factor was as follows: partial dominance--Motor Discharge, Food Motivation, Tunneling-2, and Activity Level (males); complete dominance--Audiogenic Reactivity, Underwater Swimming (males), and Activity Level (females); overdominance--Acrophobia, Territorial Marking (males). Additional findings include directional dominance for Underwater Swimming and Audiogenic Reactivity, and significant sex differences for eight of the 14 factors.

Children from low-income minority families participated in early childhood education programs conducted in the 1960s and 1970s by members of the Consortium for Longitudinal Studies. Data on program impact from early childhood to young adulthood revealed direct, positive effects on standardized tests, school competence, attitudes toward achievement, high school completion, and occupational attitudes. Indirect program effects were found on occupational attainment.

Factor analytic studies suggest that there are six replicable second order cognitive factors. These six factors lend themselves to being interpreted as aspects of Royce's (1964) three "ways of knowing." This view provides a unified explanation of the second and third order factors. We hypothesize that each second order factor represents either the number of cognitive schemata of a particular type that a person possesses or the quality of these schemata, and the types of schemata are linked to "ways of knowing." The division of second order factors into qualitative and quantitative aspects, with the qualitative aspects being more subject to deterioration with age, and the quantitative aspects more trainable and subject to personality influence, provides an avenue for linking cognitive abilities to the other personality traits. The theory also resolves several theoretical problems concerning cognitive abilities, including distinguishing aptitudes from achievements, measuring creativity, and determining the relationship between rote memory and intelligence.

Sixty mice from two emotionally divergent inbred strains, BALB/Alb and C57BL/10Alb, were assigned to one of three experimental groups: septal surgery, control surgery, and intact. Subsequently, all animals were administered a battery of five tasks that yielded 19 measures of emotionality. Factor scores were computed on six invariant factors obtained previously from these measures. Each factor was analyzed by an analysis of variance design with main effects for strain, sex, lesion, and days of testing. Strain and lesion main effects were found on Motor Discharge and Autonomic Balance, Strain X Lesion interaction effects on Motor Discharge and Tunneling 1, and a Lesion X Sex interaction effect on Territorial Marking. The results support the interpretation that the septum affects distinct processes modulating Autonomic Balance and Motor Discharge factors.

At follow-up in 1976, low-income children who had attended infant and preschool programs in the 1960's had significantly higher rates of meeting school requirements than did controls, as measured by lower frequency of placement in special education classes and of being retained in grade (held back).

Thirty C57BL/ALB mice, fifteen male and fifteen female, were tested for "acrophobia" via the pole test. The animals were randomly distributed into three groups of 6, 12, or 24 inch (15.24, 30.48, or 60.96 cm) high poles:. Both factor scores and individual pole measures were analyzed by 2 x 3 x 5 ANOVA, with main effects for sex, pole height, and days of testing. The results provide experimental support for the interpretation of this factor as acrophobia-that is, the greater the pole height, the higher the factor score. The reduction of factor scores over days (habituation) is interpreted as an arousal-based response.

A theoretical analysis of the structure and dynamics of human motor functioning is presented from the perspective of a general theory of individuality. Within multifactor-systems theory, the structural units of the six systems of integrative personality (i.e., sensory, motor, cognitive, affect, style, and value) are hierarchical factor structures. Integrative functioning, both within and among systems, is described via the principles of general systems and information-processing theory. Our theoretical synthesis of the structure and dynamics of human motor functioning involves conceptualizing the hierarchy of motor factors as: (a) the basic dimensions of individual differences in the motor domain, (b) classes of decomposable motor programs that specify the spatio-temporal organization of behavior, and (c) decomposable classes of processing components entailed by motor programs. Some of the implications for understanding the role of affect in motor functioning and some research suggestions were presented.

Six factors of mouse emotionality (autonomic balance, motor discharge, acrophobia, territoriality, tunneling-1, and tunneling-2) were compared across three separate studies. Each study included 19 measures from five tests of emotionality: open field, straightaway, pole, cell, and hole-in-wall. However, conditions of testing differed significantly in each study. In the first study, the measures taken were part of a large test battery. In the second study, a reduced test battery included only the 19 measures. In the third study, this reduced battery was used again, but subjects were injected with psychoactive drugs prior to testing. In addition to these changes, different genotypes were used across studies. Subjects in the first study were tested as part of a 6 × 6 diallel table. In the second and third studies, two emotionally contrasted strains (SWR and SJL) were tested. Each population was refactored by alpha factoring with varimax, followed by promax rotations. Factors obtained were compared by quantitative means using S-index and r[SUBc] coefficients of factor matching. Although support was obtained for the invariance of all six factors, the results indicate invariance as being strongest for motor discharge and acrophobia and weakest for tunneling-1 and tunneling-2 factors.