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The in vitro differentiation of pluripotent stem cells into human intestinal organoids (HIOs) has served as a powerful means for creating complex three-dimensional intestinal structures. Owing to their diverse cell populations, transplantation into an animal host is supported with this system and allows the temporal formation of fully laminated structures, including crypt-villus architecture and smooth muscle layers that resemble native human intestine. Although the endpoint of HIO engraftment has been well described, here we aim to elucidate the developmental stages of HIO engraftment and establish whether it parallels fetal human intestinal development. We analyzed a time course of transplanted HIOs histologically at 2, 4, 6 and 8 weeks post-transplantation, and demonstrated that HIO maturation closely resembles key stages of fetal human intestinal development. We also utilized single-nuclear RNA sequencing to determine and track the emergence of distinct cell populations over time, and validated our transcriptomic data through in situ protein expression. These observations suggest that transplanted HIOs do indeed recapitulate early intestinal development, solidifying their value as a human intestinal model system.

Since the inception of the viral #MeToo Movement in 2017, news coverage of sexual assault incidents and related public discourse have become much more prevalent on social media platforms. While this hashtag activism has prompted important social discourse, little is known about how exposure to this type of trauma-related content affects survivors of sexual violence navigating these online spaces. To explore this phenomenon, we conducted in-depth, semi-structured interviews with young adult women survivors of sexual assault who regularly use social media (e.g., Facebook and Twitter). Participants were asked to reflect on sexual assault–related content (i.e., news stories and related public discourse) which they have observed on social media platforms. Thematic analysis of the qualitative data found survivors described (1) negative changes to their mental health and relationships in the face of these exposures, (2) certain types of content (e.g., rape culture narratives) which were particularly distressing to them, (3) how they coped with distress tied to this exposure, and (4) recommendations for clinicians on how to help survivors navigate social media in a healthier way. The present study is a first step toward understanding the impact of online social movements on trauma survivors and provides concrete clinical recommendations for therapists working with sexual assault survivors in this unique post-#MeToo context.

Background and aimsThe intestinal stem cell niche is exquisitely sensitive to changes in diet, with high fat diet, caloric restriction, and fasting resulting in altered crypt metabolism and intestinal stem cell function. Unlike cells on the villus, cells in the crypt are not immediately exposed to the dynamically changing contents of the lumen. We hypothesized that enteroendocrine cells (EECs), which sense environmental cues and in response release hormones and metabolites, are essential for relaying the nutrient status of the animal to cells deep in the crypt.MethodsWe used the tamoxifen-inducible VillinCreERT2 mouse model to deplete EECs (Neurog3fl/fl) from adult intestinal epithelium and we generated human intestinal organoids from wild-type and NEUROG3-null human pluripotent stem cells. We used indirect calorimetry, 1H-NMR metabolomics, mitochondrial live imaging, and the Seahorse bioanalyzer to assess metabolism. Intestinal stem cell activity was measured by proliferation and enteroid-forming capacity. Transcriptional changes were assessed using 10X Genomics single-cell sequencing.ResultsLoss of EECs resulted in increased energy expenditure in mice, an abundance of active mitochondria, and a shift of crypt metabolism to fatty acid oxidation. Crypts from mouse and human intestinal organoids lacking EECs displayed increased intestinal stem cell activity and failed to activate phospho-S6 ribosomal protein, a marker for activity of the master metabolic regulator mammalian target of rapamycin (mTOR). These phenotypes were similar to those observed when wild-type mice were deprived of nutrients.ConclusionsDeletion of EECs recapitulated a fasting phenotype despite normal levels of ingested nutrients. These data suggest that EECs are required to relay nutritional information to the stem cell niche and are essential regulators of intestinal metabolism.

We sought to explore the type and function of support networks of transmasculine and nonbinary young adults (TNBYA) during their chosen name transition. We conducted 12 in-depth, semi-structured qu...

The phenomenon of “slutpages,” tied to high schools, fraternities, and the military, used to post, share, and comment on nude and semi-nude images of women, has emerged in mass media. To our knowledge, this is the first study to empirically investigate slutpage use behaviors including: visiting slutpages, posting nude images/videos online without consent, and using a vault app to store/share nude images. We conducted a survey of undergraduate college students attending a large Midwestern university in the U.S., with 1867 respondents (36.4% cis/transgender men, 63.6% cisgender women; 18–24 years old M = 20.39) to determine who is engaging in slutpage use behaviors. Our results showed that younger participants and men were more likely to engage in slutpage use behaviors than older participants and women, especially if they participated in Greek Life or played a team sport for their university. Men in a fraternity or on a team sport visited slutpages and posted nude images/video online without consent more frequently than men outside these groups, or women in general. Drinking alcohol and using pornography more frequently were also associated with slutpage use behaviors. This study provides a new understanding of slutpages as a social form of image-based sexual abuse and informs researchers, educators, and policy makers to expand their inquiry into online sexual experiences and exploitation to include this phenomenon.

Long-term impacts of diet have been well studied; however, the immediate response of the intestinal epithelium to a change in nutrients remains poorly understood. We use physiological metrics and single-cell transcriptomics to interrogate the intestinal epithelial cell response to a high-fat diet (HFD). Within 1 day of HFD exposure, mice exhibit altered whole-body physiology and increased intestinal epithelial proliferation. Single-cell transcriptional analysis on day 1 reveals a cell-stress response in intestinal crypts and a shift toward fatty acid metabolism. By 3 days of HFD, computational trajectory analysis suggests an emergence of progenitors, with a transcriptional profile shifting from secretory populations toward enterocytes. Furthermore, enterocytes upregulate lipid absorption genes and show increased lipid absorption in vivo over 7 days of HFD. These findings demonstrate the rapid intestinal epithelial response to a dietary change and help illustrate the essential ability of animals to adapt to shifting nutritional environments.

Introduction Sexual violence, particularly in the context of drinking, is prevalent on college campuses. This study tested a brief intervention to prevent sexual violence among students receiving care from college health centers. Study design This study was a two-arm, unblinded cluster RCT. Setting/participants On 28 campuses with health/counseling centers (1:1 randomization allocation; 12 intervention and 16 control), from September 2015 to March 2018, a total of 2,291 students seeking care at college health centers completed surveys before the appointment, immediately after, 4 months later, and 12 months later. Intervention Intervention college health center staff received training on delivering sexual violence education to all students seeking care. Control sites provided information about drinking responsibly. Main outcome measures The primary outcome was students’ change in recognition of sexual violence. Additional outcomes included sexual violence disclosure and use of services among students with a history of sexual violence at baseline. Generalized linear mixed models accounting for campus-level clustering assessed intervention effects. Data were analyzed from September 2018 to June 2019. Results Half (55%) of students seeking care at college health centers reported any history of sexual violence exposure. No between-group differences in primary (β=0.001, 95% CI= −0.04, 0.04) or secondary outcomes emerged between intervention and control students. Post-hoc analyses adjusting for the intensity of intervention delivery (intensity-adjusted) revealed an increase in self-efficacy to use harm reduction strategies (β=0.09, 95% CI=0.01, 0.18) among intervention participants. Among those who reported sexual violence at baseline, intervention students had increased odds of disclosing violence during the visit (AOR=4.47, 95% CI=2.25, 8.89) in intensity-adjusted analyses compared with control. No between-group differences emerged for remaining outcomes. Conclusions Sexual violence exposure is high among students seeking care in college health centers. A brief provider-delivered sexual violence intervention, when implemented with fidelity, was associated with improved self-efficacy to use harm reduction and increased disclosure of sexual violence during clinical encounters but no increased use of services. More interventions that are stronger in intensity are needed to connect students to sexual violence services. Trial registration This study is registered at www.clinicaltrials.gov NCT02355470.

Objectives. To assess differences by gender of sexual partner in the association between sexual assault and alcohol use among women seeking care in college health centers. Methods. This longitudinal study comprised 1578 women aged 18 to 24 years visiting 28 college health centers in Pennsylvania and West Virginia from 2015 to 2018. We used multilevel logistic regression and negative binomial regression, testing for interactions of gender of sexual partners, sexual assault, and prevalence and frequency of alcohol use and binge drinking. Results. Sexual assault was reported by 87.3% of women who had sex with women or with women and men (WSWM), 68.2% of women who had sex with men only (WSM), and 47.5% of women with no penetrative sexual partners. The relative associations between sexual assault and alcohol outcomes were smaller for WSWM (prevalence: odds ratios from 0.04 to 0.06; frequency: incidence rate ratios [IRRs] from 0.24 to 0.43) and larger for women who had no penetrative sexual partners (IRRs from 1.55 to 2.63), compared with WSM. Conclusions. Alcohol use patterns among women who have experienced sexual assault differ by gender of sexual partners.

Background & Aims Shiga toxin (Stx)-producing Escherichia coli (eg, O157:H7) infection produces bloody diarrhea, while Stx inhibits protein synthesis and causes the life-threatening systemic complication of hemolytic uremic syndrome. The murine intestinal tract is resistant to O157:H7 and Stx, and human cells in culture fail to model the complex tissue responses to intestinal injury. We used genetically identical, human stem cell–derived intestinal tissues of varying complexity to study Stx toxicity in vitro and in vivo. Methods In vitro susceptibility to apical or basolateral exposure to Stx was assessed using human intestinal organoids (HIOs) derived from embryonic stem cells, or enteroids derived from multipotent intestinal stem cells. HIOs contain a lumen, with a single layer of differentiated epithelium surrounded by mesenchymal cells. Enteroids only contain epithelium. In vivo susceptibility was assessed using HIOs, with or without an enteric nervous system, transplanted into mice. Results Stx induced necrosis and apoptotic death in both epithelial and mesenchymal cells. Responses that require protein synthesis (cellular proliferation and wound repair) also were observed. Epithelial barrier function was maintained even after epithelial cell death was seen, and apical to basolateral translocation of Stx was seen. Tissue cross-talk, in which mesenchymal cell damage caused epithelial cell damage, was observed. Stx induced mesenchymal expression of the epithelial marker E-cadherin, the initial step in mesenchymal–epithelial transition. In vivo responses of HIO transplants injected with Stx mirrored those seen in vitro. Conclusions Intestinal tissue responses to protein synthesis inhibition by Stx are complex. Organoid models allow for an unprecedented examination of human tissue responses to a deadly toxin., Graphical abstract

SummaryWhile the systemic impacts of overnutrition are well-known to cause obesity and metabolic syndrome over the course of months, the immediate adaptive response of the intestinal epithelium to dietary changes remains poorly understood. Here we used physiological metrics and single cell analyses to interrogate the adaptive response of intestinal epithelial cells when moved to a high fat diet (HFD). Within 1 day of HFD exposure, mice exhibited altered feeding behavior, an increase in energy expenditure and an increase in intestinal epithelial proliferation. Single cell transcriptional analysis demonstrated several acute cellular changes on day 1, including a cell-stress response in intestinal crypts, de-granularization of Paneth cells, and a shift towards fatty acid cellular metabolism. By 3 days of HFD, there was an emergence of uncommitted progenitors with a transcriptional profile indicative of a shift from secretory populations and towards an absorptive fate. In enterocytes, genes regulating lipid transport and absorption increased over the first 3 days which paralleled a functional increase in lipid absorption in vivo over the course of 7 days on HFD. These findings demonstrate that intestinal epithelial cell populations respond rapidly to changes in diet through initial changes in cellular function followed by a shift in cellular composition.

Prevalence of sexual assault remains high on American college campuses, and sexual consent education is lacking within school-based sexual health education programming. Much empirical research has aimed to reduce sexual violence through a deeper understanding of college students’ perceptions of sexual consent. However, researchers have not yet examined the impact of broader social discourse, such as that initiated by the #MeToo movement, on emerging adults’ conceptualizations of sexual consent. Gendered focus groups were conducted with 34 college students at a large midwestern university in spring of 2019. Qualitative analyses using a phenomenological framework revealed a developmental process of consent education shaped by socialized sexual scripts and public discourse of the #MeToo movement. Four distinct themes emerged: (1) Introductions to Consent in Childhood, (2) Lack of Sexual Consent Education in Adolescence, (3) The Nuanced College Context, and (4) Consent in the Era of #MeToo. Findings reveal that consent is introduced in childhood, outside the context of sexuality, but is generally not revisited within the context of sexual consent by parents or educators during adolescence, leaving media messaging and socialized sexual scripts to serve as guides for sexual consent. This lack of sexual consent education in adolescence then leaves emerging adults unprepared for nuanced sexual experiences in the college context and unable to critically engage with public discourse surrounding consent such as the #MeToo movement, which has caused both fearful and positive outcomes. Findings support the need for earlier and more comprehensive education about sexual consent in childhood and adolescence and the need for college sexual assault prevention programs to include further instruction on navigating ambiguous sexual consent experiences.

Rape myth acceptance (RMA) is commonly targeted in anti-rape activism (e.g., the #MeToo Movement) and prevention work due to its association with perpetration, risk of victimization, survivor outcomes, and injustices in the criminal legal system. The 22-item updated Illinois Rape Myth Acceptance (uIRMA) scale is a widely used, reliable measure for assessing this construct; however, it has primarily been validated within samples of U.S. college students. To assess the factor structure and reliability of this measure for community samples of adult women, we analyzed uIRMA data from 356 U.S. women (age 25–35) collected via CloudResearch’s MTurk toolkit. Confirmatory factor analysis demonstrated high internal reliability for the overall scale (α = .92) and supported a five-factor structure (subscales: She Asked For It, He Didn’t Mean To, He Didn’t Mean To [Intoxication], It Wasn’t Really Rape, She Lied) with good model fit. The rape myth ‘‘He Didn’t Mean To’’ was most highly endorsed in the overall sample, while ‘‘It Wasn’t Really Rape’’ was endorsed the least. Analyses of RMA and participant characteristics demonstrated that women identifying as politically conservative, religious (predominantly Christian), or heterosexual endorsed rape myth constructs at significantly higher rates. Education level, social media use, and victimization history yielded mixed findings across RMA subscales, while age, race/ethnicity, income level, and regional location showed no associations with RMA. Findings suggest the uIRMA is an appropriate measure of RMA in community samples of adult women; however, the field would benefit from more consistent administration of the scale (i.e., 19-item vs. 22-item version; directionality of Likert-type scale) to allow for comparability across time and samples. Rape prevention work should target ideological adherence to patriarchal and other oppressive belief systems which may represent a common underlying factor across groups of women showing higher endorsement of RMA.

Circadian rhythms regulate diverse aspects of gastrointestinal physiology ranging from the composition of microbiota to motility. However, development of the intestinal circadian clock and detailed mechanisms regulating circadian physiology of the intestine remain largely unknown. In this report, we show that both pluripotent stem cell‐derived human intestinal organoids engrafted into mice and patient‐derived human intestinal enteroids possess circadian rhythms and demonstrate circadian phase‐dependent necrotic cell death responses to Clostridium difficile toxin B (TcdB). Intriguingly, mouse and human enteroids demonstrate anti‐phasic necrotic cell death responses to TcdB. RNA‐Seq analysis shows that ~3–10% of the detectable transcripts are rhythmically expressed in mouse and human enteroids. Remarkably, we observe anti‐phasic gene expression of Rac1, a small GTPase directly inactivated by TcdB, between mouse and human enteroids, and disruption of Rac1 abolishes clock‐dependent necrotic cell death responses. Our findings uncover robust functions of circadian rhythms regulating clock‐controlled genes in both mouse and human enteroids governing organism‐specific, circadian phase‐dependent necrotic cell death responses, and lay a foundation for human organ‐ and disease‐specific investigation of clock functions using human organoids for translational applications., Mouse and human 3D in vitro models show tissue maturation to determine species‐specific circadian rhytms in the intestine.

Two patients with homozygous mutations in PDX1 presented with pancreatic agenesis, chronic diarrhea, and poor weight gain, the causes of which were not identified through routine clinical testing. We aimed to perform a deep analysis of the stomach and intestine using organoids derived from induced pluripotent stem cells from PDX1Gastric fundic, antral, and duodenal organoids were generated using induced pluripotent stem cell lines from a PDX1Patient-derived PDX1These patients will now be monitored for the progression of metaplasia and gastrointestinal complications that might be related to the reduced gastric and intestinal endocrine cells. This study demonstrates the utility of organoids in diagnosing uncovered pathologies.

Personality-linked psychological factors including distress tolerance and delay discounting have been shown to underlie both Alcohol Use and Major Depressive Disorders. Although these disorders commonly co-occur, especially among individuals seeking in-patient treatment, no study has examined the association between distress tolerance, delay discounting and dual diagnoses. This project evaluated these relations in a sample of 79 low-income adults receiving in-patient substance use treatment. It was hypothesized that individuals with low levels of distress tolerance and elevated discounting would be more likely to report co-occurring disorders. Utilizing structural equation modeling, we found that the interaction between distress tolerance and delay discounting was associated with co-occurring Alcohol Use and Major Depressive Disorders in the expected direction. Findings suggest these constructs could be used for targeting prevention efforts for vulnerable individuals as well as refining current interventions to improve treatment outcomes.

SummaryTwo patients with mutations in PDX1 presented with pancreatic agenesis, chronic diarrhea and poor weight gain, the causes of which were not identified through routine clinical testing. We generated patient derived organoids as a novel diagnostic strategy and observed that PDX1188delC/188delC antral organoids convert to an intestinal phenotype, while intestinal organoids undergo gastric metaplasia with significant reduction in enteroendocrine cells. This prompted a re-examination of gastric and intestinal biopsies from both PDX1188delC/188delC patients, which recapitulated organoid phenotypes. Antral biopsies had increased parietal cells and lacked G-cells suggesting loss of antral identity. These patients will now be monitored for the progression of metaplasia. This study demonstrates the utility of organoids for patient diagnoses and treatment.

Bystander interventions have been highlighted as promising strategies to reduce sexual violence and sexual harassment, yet their effectiveness for sexual minority youth remains largely unexamined in high schools’ populations. This rigorous cluster randomized control trial addresses this gap by evaluating intervention effectiveness among sexual majority and minority students known be to at increased risk of sexual violence. Kentucky high schools were randomized to intervention or control conditions. In intervention schools, educators provided school-wide Green Dot presentations (phase 1) and intensive bystander training to student popular opinion leaders (phase 2). Each spring from 2010 to 2014, students attending 26 high schools completed anonymous surveys about violence acceptance and violent events. An analytic sample of 74,836 surveys with no missing data over the 5 years was available. Sexual violence acceptance scores declined significantly over time in intervention versus control schools among all but sexual minority males. This intervention was also associated with reductions in both perpetration and victimization of sexual violence, sexual harassment, and physical dating violence among sexual majority yet not sexual minority youth. Both sexual minority and majority youth experienced reductions in stalking victimization and perpetration associated with the intervention. In this large cluster randomized controlled trial, the bystander intervention appears to work best to reduce violence for sexual majority youth. Bystander programs may benefit from explicitly engaging sexual minority youth in intervention efforts or adapting intervention programs to include attitudes that shape the experience of sexual minority high school youth (e.g., homophobic teasing, homonegativity).

We explored patterns of intimate partner violence (IPV) victimization at the relationship level within a socioeconomically diverse sample of young women who had experienced IPV. We recruited from a university, a 2-year college, and high-risk community settings. Drawing on life course theory and utilizing the life history calendar, we conducted retrospective interviews with 148 young women aged 18–24 about partner victimization (physical IPV, coercive control, and sexual IPV) within each relationship, beginning with their first (up to four relationships; 388 total). We assessed patterns of IPV across participants’ relationship histories: rates of the three IPV types and co-occurrence, by setting and relationship number; relationship length in association with the number of IPV types; and transitions into and out of abusive relationships. Coercive control was the most common IPV type across Relationships 1–4 (46–58% of relationships), followed by physical IPV (42–54%) and sexual IPV (29–34%); the most common co-occurrence patterns were physical IPV plus coercive control and all three IPV types combined. Relationships lasted 15–24 months on average, and relationship length was positively associated with the number of IPV types. Transitions were heterogeneous, with systematic, positive change in physical IPV from Relationships 1 to 2; setting was not associated with transition patterns. In the future, researchers should explore a relationship-level approach; prevention and intervention efforts should integrate sexual assault and partner violence, begin early, and target all youth. Additional online materials for this article are available on PWQ’s website at http://journals.sagepub.com/doi/suppl/10.1177/0361684318795880 .

Study Objective To examine the effect of childhood trauma and family history of psychiatric illness on weight loss trajectories of obese, female adolescents with polycystic ovary syndrome (PCOS). Design Prospective study. Setting PCOS and adolescent medicine outpatient clinics. Participants Participants were, on average, 15.8 years of age, 80% Caucasian (39/49 participants), and had a body mass index of 36.8 ± 8.8. Interventions Healthy Bodies, Healthy Minds is an evidence-based one-on-one intervention consisting of 4 weekly sessions, 4 biweekly sessions, and 3 monthly booster sessions. Each session was 45-60 minutes long with 15-30 minutes of physical activity with a lifestyle coach. Main Outcome Measures Paired sample t tests were used to assess group differences in pre- and post-treatment weight between participants reporting childhood trauma and body mass index-matched controls not endorsing trauma. One-way analysis of variance was performed to assess the influence of childhood trauma on weight loss between the 2 groups. Results Adolescents without a family history of psychiatric illness lost more weight (mean, −1.28 kg; SD, 6.89) than those who had a family history of psychiatric illness (mean, −0.64 kg; SD, 4.7) from baseline to booster session completion (6 months). However, results of independent t tests did not reveal statistically significant group differences in weight loss from baseline to booster session completion (t21 = 0.51; P = .6). Conclusion Obese adolescents with PCOS who have experienced childhood trauma can lose weight and acquire its health benefits when enrolled in an intervention addressing weight, mood, and sleep. Family history of psychiatric illness emerged as a potential predictor of lesser weight loss.

Introduction Sexual violence (SV) on college campuses is common, especially alcohol-related SV. This is a 2-arm cluster randomized controlled trial to test a brief intervention to reduce risk for alcohol-related sexual violence (SV) among students receiving care from college health centers (CHCs). Intervention CHC staff are trained to deliver universal SV education to all students seeking care, to facilitate patient and provider comfort in discussing SV and related abusive experiences (including the role of alcohol). Control sites provide participants with information about drinking responsibly. Methods Across 28 participating campuses (12 randomized to intervention and 16 to control), 2292 students seeking care at CHCs complete surveys prior to their appointment (baseline), immediately after (exit), 4 months later (T2) and one year later (T3). The primary outcome is change in recognition of SV and sexual risk. Among those reporting SV exposure at baseline, changes in SV victimization, disclosure, and use of SV services are additional outcomes. Intervention effects will be assessed using generalized linear mixed models that account for clustering of repeated observations both within CHCs and within students. Results Slightly more than half of the participating colleges have undergraduate enrollment of ≥ 3000 students; two-thirds are public and almost half are urban. Among participants there were relatively more Asian (10 v 1%) and Black/African American (13 v 7%) and fewer White (58 v 74%) participants in the intervention compared to control. Conclusions This study will offer the first formal assessment for SV prevention in the CHC setting. Clinical Trials #: NCT02355470

Current in vitro approaches and animal models have critical limitations for modeling human gastrointestinal diseases because they may not properly represent multicellular human primary tissues. Therefore, there is a need for model platforms that recapitulate human in vivo development, physiology, and disease processes to validate new therapeutics. One of the major steps toward this goal was the generation of three-dimensional (3D) human gastric organoids (hGOs) via the directed differentiation of human pluripotent stem cells (hPSCs). The normal functions and diseases of the stomach occur in the luminal epithelium, however accessing the epithelium on the inside of organoids is challenging. We sought to develop a bioengineered platform to introduce luminal flow through hGOs to better model in vivo gastric functions. Here, we report an innovative microfluidic imaging platform housing hGOs with peristaltic luminal flow in vitro. This human stomach-on-a-chip allows robust, long-term, 3D growth of hGOs with the capacity for luminal delivery via a peristaltic pump. Organoids were cannulated and medium containing fluorescent dextran was delivered through the lumen using a peristaltic pump. This system also allowed us to rhythmically introduce stretch and contraction to the organoid, reminiscent of gastric motility. Our platform has the potential for long-term delivery of nutrients or pharmacological agents into the gastric lumen in vitro for the study of human gastric physiology, disease modeling, and drug screening, among other possibilities.

Pluripotent stem cell (PSC)-derived organoids are miniature, three-dimensional human tissues generated by the application of developmental biological principles to PSCs in vitro. The approach to generate organoids uses a combination of directed differentiation, morphogenetic processes, and the intrinsically driven self-assembly of cells that mimics organogenesis in the developing embryo. The resulting organoids have remarkable cell type complexity, architecture and function similar to their in vivo counterparts. In the past five years, human PSC-derived organoids with components of all three germ layers have been generated, resulting in the establishment of a new human model system. Here, and in the accompanying poster, we provide an overview of how principles of developmental biology have been essential for generating human organoids in vitro, and how organoids are now being used as a primary research tool to investigate human developmental biology.

CONTEXT: Despite multiple calls for clinic-based services to identify and support women victimized by partner violence, screening remains uncommon in family planning clinics. Furthermore, traditional screening, based on disclosure of violence, may miss women who fear reporting their experiences. Strategies that are sensitive to the signs, symptoms and impact of trauma require exploration. METHODS: In 2011, as part of a cluster randomized controlled trial, staff at 11 Pennsylvania family planning clinics were trained to offer a trauma-informed intervention addressing intimate partner violence and reproductive coercion to all women seeking care, regardless of exposure to violence. The intervention sought to educate women about available resources and harm reduction strategies. In 2013, at the conclusion of the trial, 18 providers, five administrators and 49 patients completed semistructured interviews exploring acceptability of the intervention and barriers to implementation. Consensus and open coding strategies were used to analyze the data. RESULTS: Providers reported that the intervention increased their confidence in discussing intimate partner violence and reproductive coercion. They noted that asking patients to share the educational information with other women facilitated the conversation. Barriers to implementation included lack of time and not having routine reminders to offer the intervention. Patients described how receiving the intervention gave them important information, made them feel supported and less isolated, and empowered them to help others. CONCLUSIONS: A universal intervention may be acceptable to providers and patients. However, successful implementation in family planning settings may require attention to system-level factors that providers view as barriers.Copyright © 2017 by the Guttmacher Institute. Language: en

The phenomenon of "slutpages," tied to high schools, fraternities, and the military, used to post, share, and comment on nude and semi-nude images of women, has emerged in mass media. To our knowledge, this is the first study to empirically investigate slutpage use behaviors including: visiting slutpages, posting nude images/videos online without consent, and using a vault app to store/share nude images. We conducted a survey of undergraduate college students attending a large Midwestern university in the U.S., with 1867 respondents (36.4% cis/transgender men, 63.6% cisgender women; 18-24 years old M = 20.39) to determine who is engaging in slutpage use behaviors. Our results showed that younger participants and men were more likely to engage in slutpage use behaviors than older participants and women, especially if they participated in Greek Life or played a team sport for their university. Men in a fraternity or on a team sport visited slutpages and posted nude images/video online without consent more frequently than men outside these groups, or women in general. Drinking alcohol and using pornography more frequently were also associated with slutpage use behaviors. This study provides a new understanding of slutpages as a social form of image-based sexual abuse and informs researchers, educators, and policy makers to expand their inquiry into online sexual experiences and exploitation to include this phenomenon.

Sexual violence is a devastating trauma with long-lasting effects on survivors’ health and well-being. Despite the substantial impacts of the last 25 years of research, the prevalence of sexual violence has remained stable. It will be necessary to reconceptualize our work, challenging our theories, methods, and strategies for dissemination and implementation moving forward. We outline an intersectional, community-engaged approach for sexual violence research to center the stories of survivors who face systemic oppression and inequity. Finally, we suggest applications of this approach for justice, healing, and prevention to inform our collective work to end sexual violence.

Reproductive coercion and female relationship abuse are prevalent and associated with poor sexual health; health care providers should assess for harmful partner behaviors among all patients who are adolescents or young women., OBJECTIVE: To investigate demographic differences and evaluate how reproductive coercion and relationship abuse influences young females' care-seeking and sexual health behaviors. METHODS: We conducted a secondary analysis of cross-sectional baseline survey data from sexually active female students (aged 14–19 years) who sought care from school health centers. Outcomes included recent (previous 3 months) reproductive coercion, physical or sexual adolescent relationship abuse, and nonpartner sexual violence victimization. Cluster-adjusted χ2 tests compared demographics and generalized linear mixed models estimated associations among reproductive coercion, adolescent relationship abuse (physical and sexual abuse in romantic relationships), and care-seeking and sexual health behaviors. RESULTS: Of 550 sexually active high school females, 12% reported recent reproductive coercion and 17% reported physical or sexual adolescent relationship abuse, with no significant demographic differences. Prevalence of recent nonpartner sexual violence was 17%. There were no observed significant differences in care-seeking behaviors among those with recent reproductive coercion compared with those without. Physical or sexual adolescent relationship abuse was associated with increased odds of seeking testing or treatment for sexually transmitted infections (adjusted odds ratio [aOR] 2.08, 95% CI 1.05–4.13). Females exposed to both adolescent relationship abuse and reproductive coercion had higher odds of having a partner who was 5 or more years older (aOR 4.66, 95% CI 1.51–14.4), having two or more recent sexual partners (aOR 3.86, 95% CI 1.57–9.48), and using hormonal contraception only (aOR 3.77, 95% CI 1.09–13.1 vs hormonal methods with condoms). CONCLUSION: Almost one in eight females experienced recent reproductive coercion. We did not observe significant demographic differences in reproductive coercion. Partner age and number of sexual partners may elevate risk for abusive relationships. Relationship abuse is prevalent among high school students seeking care, with no clear pattern for case identification. By failing to identify factors associated with harmful partner behaviors, our results support universal assessment for reproductive coercion and relationship abuse among high school–aged adolescents, involving education, resources, and harm-reduction counseling to all patients. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov, NCT01678378.

Enteroendocrine cells (EECs) in the intestine regulate many aspects of whole-body physiology and metabolism. EECs sense luminal and circulating nutrients and respond by secreting hormones that act on multiple organs and organ systems, such as the brain, gallbladder, and pancreas, to control satiety, digestion, and glucose homeostasis. In addition, EECs act locally, on enteric neurons, endothelial cells, and the gastrointestinal epithelium, to facilitate digestion and absorption of nutrients. Many recent reports raise the possibility that EECs and the enteric nervous system may coordinate to regulate gastrointestinal functions. Loss of all EECs results in chronic malabsorptive diarrhea, placing EECs in a central role regulating nutrient absorption in the gut. Because there is increasing evidence that EECs can directly modulate the efficiency of nutrient absorption, it is possible that EECs are master regulators of a feed-forward loop connecting appetite, digestion, metabolism, and abnormally augmented nutrient absorption that perpetuates metabolic disease. This review focuses on the roles that specific EEC hormones play on glucose, peptide, and lipid absorption within the intestine.

In recent years, researchers and clinicians around the world have been taken aback by the high prevalence of relationship violence, particularly among school-age children as young as 12. Many have also documented the close relationship between prejudice and discrimination on the basis of gender identity, sexual orientation and racial identity, and young people’s experiences of dating violence. In this chapter, we begin by visiting the issue of dating violence in young people around the world and why it merits such careful study. We review scientific evidence and discuss the unique and salient role that prejudicial and discriminatory experiences of gender and sexual minorities, particularly when intersecting with minority racial and disability standings, play in the development and ongoing experiences of relationship violence in childhood and well into adulthood. We will further review existing knowledge on the risk factors which add to minority youths’ existing vulnerabilities, as well as protective factors which may facilitate resilience.

Background The current study is the first to explore the prevalence of reproductive coercion among adolescent women currently or previously involved in the U.S. foster care system. Reproductive coercion (RC), a form of intimate partner violence (IPV) involving exertion of power over a partner by controlling their reproductive health and decision making, is a significant public health concern. Existing research on RC has primarily been conducted in either healthcare settings or on college campuses. Foster youth are disproportionately impacted by both adolescent pregnancy and interpersonal violence. RC may contribute to this elevated risk. Methods We conducted a cross-sectional survey in 2015 and 2016 of adolescent women (n = 136), ages 16–24 years old, seeking services from youth-serving agencies affiliated with a child welfare system in Pennsylvania, United States. Participants completed measures assessing RC, experiences of physical and sexual violence, sexual behaviors, and pregnancy. We used multivariable logistic regression to assess associations between RC and study outcomes. Results The sample was predominantly African American (67.4%) and largely identified as something other than heterosexual (46.6%). Nearly one-third of the sample (30.1%) reported a history of RC, with the most common being male partners telling them not to use birth control. High rates of IPV (62.1%), lifetime pregnancy (43.4%), and unwanted pregnancy (30.9%) were also reported. RC was associated with significantly higher odds of IPV (Adjusted Odds Ratio (AOR) = 4.22, 95% Confidence Interval (CI): 1.60, 11.13), multi-perpetrator rape (AOR 3.56, 95% CI: 1.04, 12.24), pregnancy (AOR = 5.39, 95% CI: 2.14, 13.60), and unintended pregnancy (AOR 5.39, 95% CI: 2.04, 14.25). Young women reporting RC also had elevated odds for using alcohol or drugs before sex (AOR = 4.34, 95% CI: 1.72, 10.97) and having sex with a male partner 5 years or more older (AOR = 7.32, 95% CI: 2.84, 18.87). No significant differences emerged between RC and sociodemographic characteristics. Implications These data suggest women involved in the U.S. foster care system, particularly women of color and/or LGBTQ + identified who comprised the majority of participants in the current study, may be at an increased risk for experiencing RC and other forms of IPV associated with adolescent pregnancy. In addition to efforts to prevent IPV and sexual violence, assessment for RC, healthy relationships education, and access to sexual and reproductive health care may mitigate these risks and improve outcomes for these young women.

Our study sought to assess whether parental monitoring and their associations with health behaviors differed for heterosexual girls compared to sexual minority girls (girls who identified as lesbian or bisexual, endorsed same-sex attraction, or had same-sex romantic or sexualpartners). We analyzed three components of parental monitoring—adolescent disclosure, parental solicitation, and parental knowledge—between heterosexual and sexual minority girls.We also tested if the associations between these three constructs and adolescent relationship abuse, suicidality, heavy drinking, binge drinking, anxiety symptoms, and depressive symptoms were different for heterosexual girls compared to sexual minority girls. Sexual minority girls were less likely to disclose accurately to their parents their location and activities and perceived their parents asked less and knew less about their location and activities than did heterosexual girls. Heterosexual girls who reported higher levels of adolescent disclosure were less likely than were sexual minority girls to report suicidality and anxiety symptoms. Additionally, heterosexual girls who reported higher levels of parental knowledge were also less likely than were sexual minority girls to report anxiety and depressive symptoms. These findings suggest that parental monitoring may not be as protective forsexual minority girls as it is for heterosexual girls.

Objective We assessed the effectiveness of a provider-delivered intervention targeting reproductive coercion, an important factor in unintended pregnancy. Study Design We randomized 25 family planning clinics (17 clusters) to deliver an education/counseling intervention or usual care. Reproductive coercion and partner violence victimization at 1 year follow-up were primary outcomes. Unintended pregnancy, recognition of sexual and reproductive coercion, self-efficacy to use and use of harm reduction behaviors to reduce victimization and contraception nonuse, and knowledge and use of partner violence resources were secondary outcomes. Analyses included all available data using an intention-to-treat approach. Results Among 4009 females ages 16 to 29 years seeking care, 3687 completed a baseline survey prior to clinic visit from October 2011 to November 2012; 3017 provided data at 12–20weeks post-baseline (T2) and 2926 at 12months post-baseline (T3) (79% retention). Intervention effects were not significant for reproductive coercion [adjusted risk ratio (ARR) 1.50 (95% confidence interval 0.95–2.35)] or partner violence [ARR 1.07 (0.84–1.38)]. Intervention participants reported improved knowledge of partner violence resources [ARR 4.25 (3.29–5.50)] and self-efficacy to enact harm reduction behaviors [adjusted mean difference 0.06 (0.02–0.10)]. In time point-specific models which included moderating effects of exposure to reproductive coercion at baseline, a higher reproductive coercion score at baseline was associated with a decrease in reproductive coercion 1 year later (T3). Use and sharing of the domestic violence hotline number also increased. Conclusion This brief clinic intervention did not reduce partner violence victimization. The intervention enhanced two outcomes that may increase safety for women, specifically awareness of partner violence resources and self-efficacy to enact harm reduction behaviors. It also appeared to reduce reproductive coercion among women experiencing multiple forms of such abuse.

The goal of the current study was to identify risk factors that predict sexual intimate partner violence (IPV) victimization across young women’s relationship histories, within a socioeconomically diverse sample recruited from a university, a 2-year college, and community organizations serving low-income young women. We interviewed 148 young women aged 18 to 24 years about partner victimization (physical IPV, coercive control, and sexual IPV) within each of their relationships (up to four relationships, beginning with their first; 388 in total). We used the life history calendar to structure the interviews and obtain detailed information about each relationship, including age difference between participants and their partners, and relationship length. We used multilevel modeling to examine primary caregiver highest grade completed (an indicator of socioeconomic status [SES]), participant age, age difference, relationship length, setting, and physical IPV/coercive control as predictors of sexual IPV during their first relationship and across Relationships 1 to 4. Sexual IPV during participants’ first relationship was inversely associated with SES and age, and positively associated with physical IPV/coercive control; 2-year college and community participants reported lower rates of sexual IPV during the first relationship, compared with university participants. The trajectory of sexual IPV across Relationships 1 to 4 declined among university participants and increased among 2-year college participants; age difference and physical IPV/coercive control positively covaried with sexual IPV across Relationships 1 to 4. Low SES, young age, large age difference, and the presence of physical IPV and coercive control may be risk factors for sexual IPV victimization within adolescent relationships. Sexual violence prevention and intervention approaches should incorporate these risk factors, and be designed to reach an increasingly socioeconomically diverse population across a variety of settings, to be effective.

The present study assessed how individuals used the #NotOkay hashtag on Twitter to respond to Donald Trump’s comments about grabbing women by their genitals. We analyzed 652 tweets which included commentary about the hashtag. Three main themes emerged: (a) users’ acknowledgment and condemnation of rape culture, (b) Donald Trump and the national state of sexual assault, and (c) engaging men and boys to end violence against women. Our findings emphasize that powerful political leaders can be salient symbols of rape culture, and Twitter is used as a public platform to organize and challenge problematic social discourse and call for action/change.

Summary Human organoid systems recapitulate in vivo organ architecture yet fail to capture complex pathologies such as inflammation and fibrosis. Here, using 11 different healthy and diseased pluripotent stem cell lines, we developed a reproducible method to derive multi-cellular human liver organoids composed of hepatocyte-, stellate-, and Kupffer-like cells that exhibit transcriptomic resemblance to in vivo-derived tissues. Under free fatty acid treatment, organoids, but not reaggregated cocultured spheroids, recapitulated key features of steatohepatitis, including steatosis, inflammation, and fibrosis phenotypes in a successive manner. Interestingly, an organoid-level biophysical readout with atomic force microscopy demonstrated that organoid stiffening reflects the fibrosis severity. Furthermore, organoids from patients with genetic dysfunction of lysosomal acid lipase phenocopied severe steatohepatitis, rescued by FXR agonism-mediated reactive oxygen species suppression. The presented key methodology and preliminary results offer a new approach for studying a personalized basis for inflammation and fibrosis in humans, thus facilitating the discovery of effective treatments.

Teen dating violence and sexual violence are severe public health problems. Abusive behaviors within the context of dating or romantic relationships are associated with adverse health outcomes. Promoting positive bystander intervention and increasing knowledge of abusive behaviors are promising strategies for preventing dating and sexual violence. Coaching Boys Into Men (CBIM) is an evidence-based, athletic coach-delivered dating violence prevention program that has been shown to increase positive bystander behaviors and reduce abuse perpetration among high school male athletes. Identifying specific barriers and facilitators based on the coaches' experiences with program delivery combined with the coaches' and athletes' program perceptions may help optimize future CBIM implementation and sustainability. Semi-structured interviews with coaches (n = 36) explored the implementers' perspectives on strategies that worked well and potential barriers to program implementation. Ten focus groups with male athletes (n = 39) assessed their experiences with CBIM and the suitability of having their coaches deliver this program. Coaches described using the CBIM training cards and integrating program delivery during practice. Athletes reported coaches routinely delivering the CBIM program and adding their own personal stories or examples to the discussions. Key facilitators to program implementation include support from the violence prevention advocate, the ease of integrating CBIM into the sports season, and using the program materials. Barriers to implementation included finding sufficient time for the program, dynamics of delivering sensitive program content, and participant constraints. Coaches and athletes alike found the program feasible and acceptable to implement within the sports setting. Both coaches and athletes offered insights on the implementation and the feasibility and acceptability of CBIM within school-based athletic programs. These experiences by implementers and recipients alike can inform future dissemination and implementation efforts of CBIM. Further, by pinpointing where and how coaches were successful in implementing the program and what resonated with athletes, can help better understand how CBIM is effective in promoting athletes to stop violence against women and girls. Coach and athlete reflections on CBIM implementation provide insights for optimizing future program delivery and dissemination.

Background Unintended pregnancy (UIP) is a persistent public health concern in the United States disproportionately experienced by racial/ethnic minorities and women of low socioeconomic status. UIP often occurs with experiences of reproductive coercion (RC) and intimate partner violence (IPV). The purpose of the study was to qualitatively describe and compare contexts for UIP risk between low-income Black and White women with histories of IPV/RC. Study Design Semistructured interviews were conducted with low-income Black and White women with histories of IPV or RC, ages 18 to 29 years, recruited from family planning clinics in Pittsburgh, Pennsylvania. Results Interviews with 10 non-Hispanic Black women and 34 non-Hispanic White women (N = 44) were included in the analysis. Differences between White and Black women emerged regarding IPV/RC experiences, gender roles in intimate relationships, and trauma histories, including childhood adversity. Fatal threats and IPV related to childbearing were most influential among White women. Among Black women, pregnancy was greatly influenced by RC related to impending incarceration, subfertility, and condom nonuse, and decisions about contraception were often dependent on the male. Sexual abuse, including childhood sexual assault, in the context of sexual/reproductive health was more prominent among White women. Childhood experiences of neglect impacted pregnancy intention and love-seeking behaviors among Black women. Conclusions Racial differences exist in experiences of IPV/RC with regard to UIP even among women with similar economic resources and health care access. These findings provide much-needed context to the persistent racial/ethnic disparities in UIP and illustrate influences beyond differential access to care and socioeconomic status.

Public intimate partner violence (IPV) discourse emphasizes physical violence. In May 2016, the Twitter hashtag #MaybeHeDoesntHitYou generated a public conversation about abuse beyond physical IPV. Because of the often-disconnect between IPV research and what survivors struggle to name as abuse in their daily lives, we sought to understand how IPV discourse was unfolding as a result of the #MaybeHeDoesntHitYou hashtag.NCapture was used to collect publically available Twitter data containing the hashtag "#MaybeHeDoesntHitYou" from May 10, 2016 to May 17, 2016. Using the Duluth Power and Control Wheel (a range of tactics used by abusers to control and harm their partners) and the Women's Experience with Battering (WEB) framework (emotional and behavioral responses to being abused), we analyzed 1,229 original content tweets using qualitative content analysis.All dimensions of the Power and Control Wheel and five of six dimensions of the WEB framework were expressed via #MaybeHeDoesntHitYou; users did not express yearning for intimacy with their abusive partners. Users described one form of IPV not currently represented within the Power and Control Wheel-reproductive coercion (e.g., "#MaybeHeDoesntHitYou but he refuses to use condoms and forces you not to use contraception so you try to do it behind his back"). Two additional themes emerged; users challenged the gender pronoun of the hashtag, highlighting that abuse may happen with partners of all genders, and users provided social support for others (e.g., "#MaybeHeDoesntHitYou is real. Bruises and scars aren't the only measure of abuse! If this is you, help is there…").Results from our study underscore the potential for social media platforms to be powerful agents for engaging public dialogue about the realities of IPV, as well as a space for seeking and providing social support about this critical women's health issue.

Sexual assault is a prevalent public health problem that differentially impacts sexual and gender minority (SGM) populations compared with their heterosexual and cisgender counterparts. In this chapter, we define sexual minorities considering both sexual orientation identity (e.g., lesbian, gay, bisexual, pansexual, asexual) and sexual behavior (those who have same-sex sexual partners). Gender minorities are defined as people whose gender identity does not align with their sex designation at birth (i.e., transgender, genderqueer, not on the binary). SGM populations often experience ongoing discrimination because of their sexual orientation and gender identity, which fuels violence perpetration against them and hinders disclosure of violence victimization. Survivors of sexual assault regardless of sexual orientation or gender identity may experience numerous poor mental health outcomes, including depression, anxiety, posttraumatic stress disorder, substance use, nonsuicidal self-injury, suicidal ideation, and suicide attempts ( Bonomi, Anderson, Rivara, & Thompson, 2007 ; Campbell, Dworkin, & Cabral, 2009 ; Clements-Nolle, Marx, & Katz, 2006 ; Hequembourg, Bimbi, & Parsons, 2011 ; Ratner et al., 2003 ; Temple, Weston, Rodriguez, & Marshall, 2007 ; Tomasula, Anderson, Littleton, & Riley-Tillman, 2012 ; Turchik, 2012 ). Sexual assault also carries significant sexual and reproductive health impacts; survivors are more likely to engage in risky sexual behavior (e.g., inconsistent condom use, multiple sex partners) and experience pain with sexual intercourse, decreased sexual pleasure, sexually transmitted infections, and unintended pregnancy ( Fuentes, 2008 ; Golding, 1996 ; Hequembourg et al., 2011 ; Noll, Trickett, & Putnam, 2003 ; Turchik, 2012 ). Given the deleterious impacts of sexual assault and unique vulnerabilities faced by SGM populations, we review the research on the prevalence of sexual assault among sexual and gender minorities, discuss risk and protective factors for sexual assault related to sexual orientation and gender identity, and highlight gaps in the sexual violence prevention and intervention field for SGM populations.