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We report biochemical and structural studies on inhibiting bacterial S -adenosyl-L-homocysteine hydrolase by transition metal cations. Our results revealed diverse molecular mechanisms of enzyme inactivation. Depending on the cation, the mechanism is based on arresting the enzyme in its closed, inactive conformation, disulfide bond formation within the active site or oxidation of the intermediate form of a cofactor.

Background/objectives: Intimate partner violence (IPV) and child physical abuse frequently co-occur, yet IPV-exposed children are not routinely evaluated for abuse. Furthermore, IPV survivors often seek care for their children but not for themselves, making pediatric visits an opportunity to address IPV. We developed a trauma- and violence-informed care (TVIC)-based model that 1) evaluated IPV-exposed children and 2) linked survivor-caregivers to an IPV advocate. We aimed to assess the feasibility and acceptability of the model., Participants: Children < 3 who were reported to Child Protective Services (CPS) for exposure to IPV and their survivor-caregiver., Methods: To examine feasibility, we calculated the percentage of 1) eligible children evaluated and 2) caregivers who met with an IPV advocate during the child's visit and followed up with the advocate. To assess acceptability, we conducted qualitative interviews with 30/41 caregivers about their perceptions of the model., Results: From 7/1/20-6/30/22, 49 (22.7 %) of 216 eligible children were evaluated. Of 41 caregivers, six already were receiving IPV services; Of the remaining 35, 24 (68.6 %) met with an IPV advocate, and 22 (91.7 %) had ≥1 follow-up visit with an advocate. We identified three themes: 1) Motivations for the visit, 2) Engagement with the model, and 3) Benefits. Caregivers attended the visit due to behavioral concerns about the child and a desire to comply with CPS. Engagement occurred as medical providers established rapport and provided support without judgment. Benefits included recognizing the impact of IPV on the child and immediate linkage to advocacy services., Conclusion: A TVIC-based model is feasible and acceptable and could improve caregivers' engagement with the evaluation of IPV-exposed children for abuse and with IPV services, which have the potential to improve safety and promote well-being., Competing Interests: Conflict of interest Andrea Asnes reports that the Department of Pediatrics receives payment for her expert testimony in child abuse cases and that she receives grants from the State of Connecticut to support the Yale Child Abuse Programs. The other authors report no other financial or ethical conflicts of interest., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Background: Survivors of gun violence have significant sequelae including reinjury with a firearm and mental health disorders that often go undiagnosed and untreated. The Screening and Tool for Awareness and Relief of Trauma (START) is a targeted behavioral mental health intervention developed for patients who come from communities of color with sustained and persistent trauma., Methods: In this pilot study, we evaluate the feasibility of completing a randomized controlled trial to test the START intervention. Using a mixed methods study design, we used both quantitative and qualitative data collection to assess the START intervention and the feasibility of completing a randomized controlled trial. The purpose of this study was to estimate important study parameters that would enable a future randomized controlled trial., Results: We were able to make conclusions about several crucial domains of a behavioral intervention trial: (1) recruitment and retention-we had a high follow-up rate, but our recruitment was low (34% of eligible participants); (2) acceptability of the intervention-the addition of audiovisual resources would make the tools more accessible; (3) feasibility of the control-more appropriate for a stepped wedge cluster randomized controlled trial design; (4) intervention fidelity-there was an 81% concordance rate between the fidelity survey results and the audio recordings; (5) approximate effect size-there was a 0.4-point decrease in the PTSD Checklist-Civilian Version in the control compared with a 10.7-point decrease in the treatment group for the first month., Conclusion: While it was feasible to conduct a randomized controlled trial, our findings suggest that a stepped wedge cluster randomized controlled trial design may be the most successful trial design for the START intervention. In addition, the inclusion of a "credible messenger" to recruit participants into the study and the development of audiovisual resources for START would improve recruitment and effectiveness., Level of Evidence: Prognostic and Epidemiological; Level IV., (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)

Background: Obtaining accurate information is critical for youth's sexual and reproductive health (SRH). Youth not in foster care often learn about SRH from their biological parents. Separated from their biological parents, youth in care depend on healthcare providers and caregivers for SRH information. However, they often receive insufficient information and feel unsupported in meeting their needs for SRH information., Purpose: This study explored female African American adolescents in foster care's perspectives on effective SRH communication with caregivers to help them avoid sexual risks., Methods: A qualitative study was conducted using semi-structured interviews. We used purposive sampling to recruit 16 adolescents aged 18 to 20 years old with a history of foster care placement. The transcribed interviews underwent inductive thematic analysis. The Positive Youth Development theory underpinned this research., Results: Two prominent themes emerged: establishing a relationship and preferred communication approach. Youth reported that for caregivers to engage in effective SRH communication, they must first establish a relationship by being aware of the youth's childhood trauma, building trust, having patience, and being vulnerable. Youth also appreciated caregivers who ensured comfortability and were honest and straightforward., Discussion: Caregivers should be trained on adverse childhood experiences, trauma-informed approaches, SRH knowledge, and communication., Implications to Practice: Healthcare providers should make use of the time spent with youth and discuss SRH topics during clinical encounters. This time spent with youth may be their only chance to obtain accurate SRH information. Youth's perspectives regarding communication about SRH should be implemented in future SRH communication interventions., Competing Interests: Declaration of Competing Interest None., (Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.)