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Although abortion remains legal and available to women, access to services is limited by restrictive factors such as parental consent and notification laws, mandatory delay requirements, insurance regulations/ bans, and postviability testing requirements. This study employed a hierarchical linear modeling (HLM) with all states over a six-year period 1988-2000. It found the variable parental consent statistically significant. Consistent with its focus on social justice, social workers should be aware of and informed about social policies that appear to discriminate against oppressed populations such as young women, low-income women, and women of color. [ABSTRACT FROM AUTHOR]

The authors identified the number, type, and frequency of protective behaviors that undergraduate college students who consume alcohol use to prevent alcohol-related consequences. Their hypothesis was that students who engage in more types of protective behaviors with greater frequency would be less likely to experience alcohol-related consequences. Participants consisted of a randomly selected sample of 1,355 undergraduates aged 18 years and older at a large public university. Students completed a mailed questionnaire on alcohol and health behaviors in spring 2002. The findings (after adjustment for covariates) indicated that self-protective behaviors are inversely associated with alcohol-related problems for women but not for men. The influences of gender and racial and ethnic differences are considered in relation to prevention and intervention programs aimed at reducing alcohol-related consequences on college campuses. [ABSTRACT FROM AUTHOR]

Sex differences and age-related changes in the human heart at the tissue, cell, and molecular level have been well-documented and many may be relevant for cardiovascular disease. However, how molecular programs within individual cell types vary across individuals by age and sex remains poorly characterized. To better understand this variation, we performed single-nucleus combinatorial indexing (sci) ATAC- and RNA-Seq in human heart samples from nine donors. We identify hundreds of differentially expressed genes by age and sex and find epigenetic signatures of variation in ATAC-Seq data in this discovery cohort. We then scale up our single-cell RNA-Seq analysis by combining our data with five recently published single nucleus RNA-Seq datasets of healthy adult hearts. We find variation such as metabolic alterations by sex and immune changes by age in differential expression tests, as well as alterations in abundance of cardiomyocytes by sex and neurons with age. In addition, we compare our adult-derived ATAC-Seq profiles to analogous fetal cell types to identify putative developmental-stage-specific regulatory factors. Finally, we train predictive models of cell-type-specific RNA expression levels utilizing ATAC-Seq profiles to link distal regulatory sequences to promoters, quantifying the predictive value of a simple TF-to-expression regulatory grammar and identifying cell-type-specific TFs. Our analysis represents the largest single-cell analysis of cardiac variation by age and sex to date and provides a resource for further study of healthy cardiac variation and transcriptional regulation at single-cell resolution., (© 2024. The Author(s).)

Mutations in the DMD gene lead to Duchenne muscular dystrophy (DMD), a severe neuromuscular disorder affecting young boys as they acquire motor functions. DMD is typically diagnosed at 2-4 years of age, but the absence of dystrophin has negative impacts on skeletal muscles before overt symptoms appear in patients, which poses a serious challenge in current standards of care. Here, we investigated the consequences of dystrophin deficiency during skeletal muscle development. We used single-cell transcriptome profiling to characterize the myogenic trajectory of human pluripotent stem cells and showed that DMD cells bifurcate to an alternative branch when they reach the somite stage. Dystrophin deficiency was linked to marked dysregulations of cell junction proteins involved in the cell state transitions characteristic of embryonic somitogenesis. Altogether, this work demonstrates that in vitro , dystrophin deficiency has deleterious effects on cell-cell communication during myogenic development, which should be considered in future therapeutic strategies for DMD., Competing Interests: The authors declare no competing interests., (© 2024 The Authors.)

Scedosporium spp. is a fungal species documented as the cause of infections involving the lungs, brain, and other organ systems in both immunocompetent and immunocompromised individuals. Many cases of this type of fungal infection occurring in immunocompetent patients are subsequent to traumatic injury or drowning events in or near waters containing the fungi. Infection commonly involves the lungs. Rarely, it has been shown to cause disease in the endocardium, but there is even less documentation of the fungi invading the myocardium and causing myocarditis. In this report, we present a case of disseminated Scedosporium boydii infection in a 52-year-old male patient without any known risk factors. He presented with acute onset chest pain and dyspnea accompanied by bilateral lower extremity edema. He was found to have new onset heart failure with reduced ejection fraction, and his hospital course was complicated by pneumonia, disseminated intravascular coagulation (DIC), and brain abscess formation. Multiple blood cultures failed to reveal the source of the infection. At autopsy, septated branching hyphae were identified invading both the myocardium and the cortical brain tissue. DNA sequencing revealed the fungal organisms to be Scedosporium boydii. This case reinforces the importance of autopsies in the clinical setting. It not only established the definitive diagnosis of an unexpected fungal infection, but it also helped to recognize new clinical and pathologic features of this particular fungal organism., Competing Interests: Declarations of competing interest Sean X. Zhang declares having received grants or contracts, consulting fees, and support for attending meetings and/or travel. Charles Steenbergen declared having received grants or contracts, and serving in an unpaid leadership or fiduciary role in a board, society, committee or advocacy group. Both authors wish to disclose that these were not related to this study and did not interfere in any way with the study. The other authors did not have any conflicts of interest to disclose., (Copyright © 2024 National Medical Association. Published by Elsevier Inc. All rights reserved.)

Chemical genetic screens are a powerful tool for exploring how cancer cells' response to drugs is shaped by their mutations, yet they lack a molecular view of the contribution of individual genes to the response to exposure. Here, we present sci-Plex-Gene-by-Environment (sci-Plex-GxE), a platform for combined single-cell genetic and chemical screening at scale. We highlight the advantages of large-scale, unbiased screening by defining the contribution of each of 522 human kinases to the response of glioblastoma to different drugs designed to abrogate signaling from the receptor tyrosine kinase pathway. In total, we probed 14,121 gene-by-environment combinations across 1,052,205 single-cell transcriptomes. We identify an expression signature characteristic of compensatory adaptive signaling regulated in a MEK/MAPK-dependent manner. Further analyses aimed at preventing adaptation revealed promising combination therapies, including dual MEK and CDC7/CDK9 or nuclear factor κB (NF-κB) inhibitors, as potent means of preventing transcriptional adaptation of glioblastoma to targeted therapy., Competing Interests: Declaration of interests One or more embodiments of one or more patents and patent applications filed by the University of Washington may encompass the methods, reagents, and data disclosed in this manuscript. C.T. is a SAB member, consultant, and/or co-founder of Algen Biotechnologies, Altius Therapeutics, and Scale Biosciences. J.S. is on the advisory board of Cell Genomics. J.S. is a scientific advisory board member, consultant, and/or co-founder of Cajal Neuroscience, Guardant Health, Maze Therapeutics, Camp4 Therapeutics, Phase Genomics, Adaptive Biotechnologies, Scale Biosciences, Sixth Street Capital, Pacific Biosciences, and Prime Medicine., (Copyright © 2023 The Author(s). Published by Elsevier Inc. All rights reserved.)

Embryonic development is remarkably robust, but temperature stress can degrade its ability to generate animals with invariant anatomy. Phenotypes associated with environmental stress suggest that some cell types are more sensitive to stress than others, but the basis of this sensitivity is unknown. Here, we characterize hundreds of individual zebrafish embryos under temperature stress using whole-animal single-cell RNA sequencing (RNA-seq) to identify cell types and molecular programs driving phenotypic variability. We find that temperature perturbs the normal proportions and gene expression programs of numerous cell types and also introduces asynchrony in developmental timing. The notochord is particularly sensitive to temperature, which we map to a specialized cell type: sheath cells. These cells accumulate misfolded protein at elevated temperature, leading to a cascading structural failure of the notochord and anatomic defects. Our study demonstrates that whole-animal single-cell RNA-seq can identify mechanisms for developmental robustness and pinpoint cell types that constitute key failure points., Competing Interests: Declaration of interests C.T. is a scientific advisory board (SAB) member, consultant, and/or co-founder of Algen Biotechnologies, Altius Therapeutics, and Scale Biosciences. J.S. is an SAB member, consultant, and/or co-founder of Cajal Neuroscience, Guardant Health, Maze Therapeutics, Camp4 Therapeutics, Phase Genomics, Adaptive Biotechnologies, and Scale Biosciences., (Copyright © 2023 The Author(s). Published by Elsevier Inc. All rights reserved.)

Health professions programs lack sufficient exposure to geriatric education in curricula. The Seniors Assisting in Geriatric Education (SAGE) Program exposes interprofessional (IP) teams of health professions students to older adults. To determine the impact of an interprofessional geriatric educational experience on student perceptions of team collaboration and older adults. IP teams of three or four students (n = 662) representing eight disciplines from two institutions were paired with an older adult to promote person-centered care over three semesters. Students completed two online questionnaires (pre- and post-SAGE Program, ~10 min). 136 students completed both questionnaires. Three IP collaborative practice sub-competencies under the Roles & Responsibilities and Interprofessional Communication Core Competencies increased significantly from pre- to post-SAGE Program (p ≤ 0.002). Comparison of the means for attitudes toward geriatric patients revealed statistically significant improvement in one item, Compassion ( p < .002). The SAGE Program had a positive impact on IP collaborative practice and attitudes toward older people in some, but not all, areas.

Background: This study aims to compare PTSD prevalence between seven medical specialties and to identify potential risk factors for PTSD., Methods: A cross-sectional national survey of attending physicians (n = 2216) was conducted and screened for PTSD using the Primary Care PTSD Screen. Stepwise multivariable regression analysis with backward elimination identified potential risk factors., Results: Overall prevalence of PTSD was 14% and ranged from 7% to 18% for psychiatrists and OBGYNs, respectively (p = 0.004). Six potential risk factors for PTSD included: emotional exhaustion, job dissatisfaction, lack of autonomy, working >60 h per week, poor camaraderie, and female gender (p < 0.05)., Conclusions: The prevalence of PTSD in attending physicians is more than double that of the general population. Higher risk specialties include OBGYN and general surgery. Specialty-specific interventions targeted at reducing physician burnout and improving the physician work-environment are needed to improve physician wellness and reduce PTSD., (Copyright © 2021 Elsevier Inc. All rights reserved.)

Hematopoietic stem cells (HSCs) develop from hemogenic endothelium within embryonic arterial vessels such as the aorta of the aorta-gonad-mesonephros region (AGM). To identify the signals responsible for HSC formation, here we use single cell RNA-sequencing to simultaneously analyze the transcriptional profiles of AGM-derived cells transitioning from hemogenic endothelium to HSCs, and AGM-derived endothelial cells which provide signals sufficient to support HSC maturation and self-renewal. Pseudotemporal ordering reveals dynamics of gene expression during the hemogenic endothelium to HSC transition, identifying surface receptors specifically expressed on developing HSCs. Transcriptional profiling of niche endothelial cells identifies corresponding ligands, including those signaling to Notch receptors, VLA-4 integrin, and CXCR4, which, when integrated in an engineered platform, are sufficient to support the generation of engrafting HSCs. These studies provide a transcriptional map of the signaling interactions necessary for the development of HSCs and advance the goal of engineering HSCs for therapeutic applications., (© 2022. The Author(s).)

Background: Mammalian development is associated with extensive changes in gene expression, chromatin accessibility, and nuclear structure. Here, we follow such changes associated with mouse embryonic stem cell differentiation and X inactivation by integrating, for the first time, allele-specific data from these three modalities obtained by high-throughput single-cell RNA-seq, ATAC-seq, and Hi-C., Results: Allele-specific contact decay profiles obtained by single-cell Hi-C clearly show that the inactive X chromosome has a unique profile in differentiated cells that have undergone X inactivation. Loss of this inactive X-specific structure at mitosis is followed by its reappearance during the cell cycle, suggesting a "bookmark" mechanism. Differentiation of embryonic stem cells to follow the onset of X inactivation is associated with changes in contact decay profiles that occur in parallel on both the X chromosomes and autosomes. Single-cell RNA-seq and ATAC-seq show evidence of a delay in female versus male cells, due to the presence of two active X chromosomes at early stages of differentiation. The onset of the inactive X-specific structure in single cells occurs later than gene silencing, consistent with the idea that chromatin compaction is a late event of X inactivation. Single-cell Hi-C highlights evidence of discrete changes in nuclear structure characterized by the acquisition of very long-range contacts throughout the nucleus. Novel computational approaches allow for the effective alignment of single-cell gene expression, chromatin accessibility, and 3D chromosome structure., Conclusions: Based on trajectory analyses, three distinct nuclear structure states are detected reflecting discrete and profound simultaneous changes not only to the structure of the X chromosomes, but also to that of autosomes during differentiation. Our study reveals that long-range structural changes to chromosomes appear as discrete events, unlike progressive changes in gene expression and chromatin accessibility., (© 2021. The Author(s).)

During embryogenesis, waves of hematopoietic progenitors develop from hemogenic endothelium (HE) prior to the emergence of self-renewing hematopoietic stem cells (HSCs). Although previous studies have shown that yolk-sac-derived erythromyeloid progenitors and HSCs emerge from distinct populations of HE, it remains unknown whether the earliest lymphoid-competent progenitors, multipotent progenitors, and HSCs originate from common HE. In this study, we demonstrate by clonal assays and single-cell transcriptomics that rare HE with functional HSC potential in the early murine embryo are distinct from more abundant HE with multilineage hematopoietic potential that fail to generate HSCs. Specifically, HSC-competent HE are characterized by expression of CXCR4 surface marker and by higher expression of genes tied to arterial programs regulating HSC dormancy and self-renewal. Taken together, these findings suggest a revised model of developmental hematopoiesis in which the initial populations of multipotent progenitors and HSCs arise independently from HE with distinct phenotypic and transcriptional properties., Competing Interests: Declaration of interests The authors declare no competing interests., (Copyright © 2021 The Author(s). Published by Elsevier Inc. All rights reserved.)

This paper reports the results of a multi-stage effort to develop a measure of Academic Entitlement. An empirical/rational approach was taken to develop items and reduce the item set for a final version of the Academic Entitlement Scale (AES). The measure includes seven dimensions: Accommodation, Reward for Effort, Responsibility Avoidance, Grade Haggling, Customer Orientation, Customer Service Expectations, and General Academic Entitlement. Fit, using Confirmatory Factor Analysis, for the seven-factor correlated model and a bifactor model including General AE and the six specific factors, was good. The full measure is reported along with descriptive statistics for the scale and preliminary validation evidence., Competing Interests: The authors have declared that no competing interests exist.

In recent years, macrophages have been shown to be tremendously plastic in both in vitro and in vivo settings; however, it remains unclear whether macrophages retain any persistent memory of past polarization states which may then impact their future repolarization to new states. Here, we perform deep transcriptomic profiling at high temporal resolution as macrophages are polarized with cytokines that drive them into "M1" and "M2" molecular states. We find through trajectory analysis of their global transcriptomic profiles that macrophages which are first polarized to M1 or M2 and then subsequently repolarized demonstrate little to no memory of their polarization history. We observe complete repolarization both from M1 to M2 and vice versa, and we find that macrophage transcriptional phenotypes are defined by the current cell microenvironment, rather than an amalgamation of past and present states.

Objective: To evaluate the impact of a community pharmacist-driven health coaching program on clinical outcomes from baseline to 1 year., Setting: Independent community pharmacy in western North Carolina., Practice Description: Sona Pharmacy + Clinic is an independent community pharmacy offering enhanced clinical services such as medication synchronization, adherence packaging, and free delivery. Sona Benefits offers pharmacy benefit manager (PBM) services to self-funded plans in western North Carolina., Practice Innovation: Sona Health Management Program is a disease management program offered to Sona Benefits PBM clients; the services began in October 2016., Evaluation: Change in clinical outcome measures (total number of medications, blood pressure, hemoglobin A1c, weight, low-density lipoprotein cholesterol [LDL-C], high-density lipoprotein cholesterol [HDL-C], triglycerides [TG], patient health questionnaire [PHQ-9] scores, and asthma control test [ACT] scores) were assessed for members who participated in the program for a minimum of 12 months for at least 2 of the following conditions: hypertension, hyperlipidemia, diabetes, depression, and asthma., Results: Health coaching was provided to 42 members (mean age of 55.9 years and 2.7 qualifying disease states). The mean number of medications per patient significantly decreased from 7.2 to 6.2 (P = 0.02). Systolic and diastolic blood pressures were significantly reduced from 130.8 mm Hg to 125.7 mm Hg (P = 0.04) and 76.9 mm Hg to 73.7 mm Hg (P = 0.04), respectively. Other clinical outcome measures evaluated, such as hemoglobin A1c, weight, LDL-C, HDL-C, TG, and PHQ-9 and ACT scores, were improved but did not reach significance., Conclusion: These results suggest that community pharmacists can have a positive impact on patients with multiple chronic conditions through health coaching services. This project suggests a potential model of pharmacist health coaching through pharmacist-run PBM services., (Copyright © 2020. Published by Elsevier Inc.)

To study the development of the human retina, we use single-cell RNA sequencing (RNA-seq) at key fetal stages and follow the development of the major cell types as well as populations of transitional cells. We also analyze stem cell (hPSC)-derived retinal organoids; although organoids have a very similar cellular composition at equivalent ages as the fetal retina, there are some differences in gene expression of particular cell types. Moreover, the inner retinal lamination is disrupted at more advanced stages of organoids compared with fetal retina. To determine whether the disorganization in the inner retina is due to the culture conditions, we analyze retinal development in fetal retina maintained under similar conditions. These retinospheres develop for at least 6 months, displaying better inner retinal lamination than retinal organoids. Our single-cell RNA sequencing (scRNA-seq) comparisons of fetal retina, retinal organoids, and retinospheres provide a resource for developing better in vitro models for retinal disease., Competing Interests: Declaration of Interests The authors declare no competing interests., (Copyright © 2020 The Author(s). Published by Elsevier Inc. All rights reserved.)

High-throughput chemical screens typically use coarse assays such as cell survival, limiting what can be learned about mechanisms of action, off-target effects, and heterogeneous responses. Here, we introduce "sci-Plex," which uses "nuclear hashing" to quantify global transcriptional responses to thousands of independent perturbations at single-cell resolution. As a proof of concept, we applied sci-Plex to screen three cancer cell lines exposed to 188 compounds. In total, we profiled ~650,000 single-cell transcriptomes across ~5000 independent samples in one experiment. Our results reveal substantial intercellular heterogeneity in response to specific compounds, commonalities in response to families of compounds, and insight into differential properties within families. In particular, our results with histone deacetylase inhibitors support the view that chromatin acts as an important reservoir of acetate in cancer cells., (Copyright © 2019 The Authors, some rights reserved; exclusive licensee American Association for the Advancement of Science. No claim to original U.S. Government Works.)

Over the past several decades, non-technical competencies have been given an increasing amount of emphasis in veterinary medical training. However, additional research is needed to continue understanding the role that non-technical competencies play in veterinary success and wellness. An inter-related pair of non-technical competencies that needs further empirical investigation is communication and the influence of compassion on veterinarians. This research study investigated the relationship between compassion experiences and communication styles of fourth-year veterinarians-in-training using a canonical correlation analysis. The compassion fatigue resilience (CFR) model was the theoretical framework used to conceptualize how communication behaviors may contribute to compassion fatigue and compassion satisfaction. Compassion experiences were measured using a version of the Professional Quality of Life (ProQOL) scale. Communication style was measured using the Communication Styles Inventory (CSI). Results indicated that communication style is statistically significantly related to compassion experiences ( n = 281; Function 1, R c = .552, p < .001; Function 2, R c = .369, p < .001). Compassion fatigue was found to have a statistically significant association with the communication styles of emotionality ( r = .467, p < .001), impression manipulativeness ( r = .191, p = .001), and verbal aggressiveness ( r = .239, p = .001). Results indicated support for veterinary training programs to continue adapting their curricula to include communication training and intervention programs to address communication and compassion fatigue, as well as to consider how the relationship between these two constructs may influence the wellness and success of veterinarians-in-training and veterinarians. More research is needed to understand the role of impression manipulativeness in veterinary wellness.

Objective: To evaluate the economic and clinical impact of community pharmacist-led pharmacy benefit management (PBM) services., Setting: Independent community pharmacy in western North Carolina., Practice Description: Sona Benefits is a PBM partner to self-funded plans in western North Carolina. The services provided by Sona Benefits are led by pharmacists at its affiliate company, Sona Pharmacy + Clinic., Practice Innovation: In October 2016, Sona Benefits began providing PBM services to members employed by a local continuing care retirement community., Evaluation: Economic outcome measures included change in total medical and prescription costs per member per year (PMPY) and change in cost per prescription from baseline. Change in clinical outcome measures (hemoglobin A1C, weight, blood pressure) was assessed for members who participated in 2 or more quarterly health coaching sessions., Results: Prescription costs were reduced from $1219.72 to $858.57 PMPY and medical health care costs were reduced from $5910.76 to $4290.30 PMPY from baseline. This represented a total decrease of $1981.61 PMPY in health care costs. A reduction in the average cost per prescription from $95.10 to $61.88 was observed. For patients enrolled and active in health coaching, we observed reductions in weight, hemoglobin A1C, and blood pressure. Between the initial and final health coaching visits, average weight decreased from 204.6 lb (92.8 kg) to 203.6 lb (92.4 kg), the percentage of patients at hemoglobin A1C goal increased from 47% to 53%, and percentage of patients at goal for blood pressure increased from 58% to 78%., Conclusion: Inclusion of community pharmacists in PBM service delivery produced economic benefits for plan sponsors. Preliminary clinical data suggested benefits of pharmacist-led health coaching services, but further evaluation is needed to determine the long-term impact., (Copyright © 2019 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.)

Posttraumatic stress disorder (PTSD) among trauma surgeons is three times that of the general population, and physician burnout (PBO) among surgeons is rising. Given that PTSD and PBO are both stress-based syndromes, we aim to identify the prevalence and risk factors for PTSD among trauma and nontrauma surgeons, and determine if a relationship exists. A cross-sectional survey of surgeons was conducted between September 2016 and May 2017. Respondents were screened for PTSD and PBO. Traumatic stressors were identified, and 20 potential risk factors were assessed. The respondents (n = 1026) were grouped into trauma (n = 350) and nontrauma (n = 676). Between the cohorts, there was no significant difference in prevalence of screening positive for PTSD (17% vs 15%) or PBO (30% vs 25%). A relationship was found between PTSD and PBO ( P < 0.001). The most common traumatic stressor was overwhelming work responsibilities. Potential risk factors for PTSD differed, but overlapping risk factors included hospital culture, hospital support, and salary ( P < 0.05). Our findings of an association between PTSD and PBO is concerning. Interventions to reduce rates of PTSD should target changing the existing culture of surgery, improving hospital support, and ensuring equitable pay.

In women with postpartum hemorrhage, the need to transfuse a large amount of blood products is frequent. The ABCD of massive transfusions-Assessment/Activation, Blood products, Complications, and Drugs-can help manage this complex situation. There needs to be a defined method to activate the massive transfusion protocol and a well-defined means to assess the coagulation status of the patient by either traditional laboratory tests or point of care methods such as thromboelastography. Recent data supports more aggressive use of plasma in the massively transfused patient. Obstetricians need to be vigilant in assessing compilations, especially hypothermia. Given the increased use of antithrombotic drugs in bleeding patients, one needs to consider reversal of these agents. Finally, consideration of the role of other agents such as antifibrinolytic agents in the management of the bleeding patient is important. It is important for every hospital to have a well-defined massive transfusion protocol to streamline the care of postpartum hemorrhage.

Seizures are among the most serious neurologic complications encountered in pregnancy. This review provides a foundation for the initial diagnosis, evaluation, classification, and management of seizures during pregnancy., (Copyright © 2018 Elsevier Inc. All rights reserved.)

This paper details results of a study examining administrative case data from 2010-2015 from abortion funds serving the USA and the Republic of Ireland, Northern Ireland and the Isle of Man. Driven by the available data, the researchers compared organisational characteristics, patient characteristics, procedural costs, patient resources and the ratio between patient resources and procedural costs. Independent t-tests were conducted to assess whether differences in characteristics, costs or resources were significant. The number of patients serviced by abortion funds across the two datasets increased yearly from 2010-2015. While patients in the USA had more resources, on average, to contribute to their abortion procedure, Irish, Northern Irish and Manx patients had the resources to pay for a greater percentage of their costs, on average, which was mainly attributable to the differences in gestational age of those helped by the different abortion funds. Patients across all nations were similar in terms of their marital status, average age and number of existing children. Patients across these countries face expensive procedures and a lack of resources that are bridged in part by abortion fund assistance.

The results of a study examining differences between U.S. adolescent and adult abortion fund service recipients are presented in this paper. Using existing case data from 2010 to 2015 from the National Network of Abortion Funds (N = 3,288), a secondary data analysis was conducted to determine whether or not the experiences of adolescent (n = 481) and adult abortion patients (n = 2,807) who received financial assistance to help pay for an abortion differed. Fisher's exact tests examined differences in dichotomous variables, and regression examined differences in procedural costs, patient resources and expected travel distances to obtain an abortion. Results show that a greater proportion of adolescents in this data set identified as African American, and that adolescents were more likely to report seeking an abortion due to lack of contraception, and rape, while adult patients were more likely to be seeking an abortion due to contraceptive failure and partner violence. Results are discussed using a trauma-informed framework., (© 2018 John Wiley & Sons Ltd.)

Most pediatric neck masses encountered in primary care are benign, reactive lymph nodes that originate from common pediatric viral processes. In a pediatric otolaryngology practice, more unusual pathologies are encountered, such as embryologic anomalies, vascular lesions, or neoplasms. Lesions that are larger or that have concerning features will ultimately need imaging and excisional biopsy for histopathologic confirmation of the diagnosis. A sound clinician understanding of anatomic neck spaces and common etiologies of pediatric neck masses can greatly reduce nonessential testing, cost, delay in treatment, and parental angst., (© 2017 Elsevier Inc. All rights reserved.)

Photovoice is a practical method to allow at-risk youth to express the environmental influences in their lives at school, at home, and in their community. This project emerged from an interprofessional collaboration between social work and nursing that focused on school health. The purpose was to explore the factors influencing the mental and emotional health using photographs by students in a largely Hispanic middle school. Ten students were recruited and consented but only eight completed the project. The SHOWeD method was used to assist the students to formally reflect upon their photographs. Data analysis was conducted using content analysis to identify themes presented the students' reflections. The themes were staying healthy, stress dealing with anger/frustration, maintaining friendships and communication, recognizing bullying, and planning for the future. Reflections aided students to provide rich details about how the school environment influences their mental and emotional health. The use of Photovoice is a reasonable method for at-risk youth to explore and describe their environment. Nurses, social workers, parents, and school leaders can use the new knowledge about how the school environment influences the health of students to develop tools to support a healthy school and community environment.

Researchers describe hardships experienced by abortion patients, examining administrative health cases from 2010 to 2015 in the United States. All patients received financial assistance from an abortion fund to help pay for abortion. Case data were analyzed to assess types and numbers of hardships experienced by age, race, and geographic origin. Hardships ranged from homelessness to parenting multiple children. Patients from the geographic South experienced the most hardships, followed by those from the Midwest. Hardships experienced by abortion fund patients are like those reported in other samples of abortion patients; hardships potentially cause or exacerbate trauma. Results are discussed in the context of a trauma-informed perspective.

Over-prescription of opioid pain medications and increases in heroin use have contributed to the sharp rise in opioid-related hospitalizations and overdose deaths among young adults in the United States, including pregnant women. This has imposed substantial direct and indirect costs to our nation's health care system. Effective treatment with methadone and buprenorphine is available, but significant barriers to care may restrict access for many. Improved screening tools and expanded access to treatments for substance use disorders are keys to addressing the epidemic of opioid use disorder.

The results of a secondary data analysis of 3,999 administrative cases from a national abortion fund, representing patients who received pledges for financial assistance to pay for an abortion from 2010 to 2015, are presented. Case data from the fund's national call center was analyzed to assess the impact of the fund and examine sample demographics which were compared to the demographics of national abortion patients. Procedure costs, patient resources, funding pledges, additional aid, and changes over time in financial pledges for second-trimester procedures were also examined. Results indicate that the fund sample differed from national abortion patients in that fund patients were primarily single, African American, and seeking funding for second trimester abortions. Patients were also seeking to fund expensive procedures, costing an average of over $2,000; patients were receiving over $1,000 per case in pledges and other aid; and funding pledges for second trimester procedures were increasing over time. Abortion funding assistance is essential for women who are not able to afford abortion costs, and it is particularly beneficial for patients of color and those who are younger and single. Repeal of policy banning public funding of abortion would help to eliminate financial barriers that impede abortion access.

The number of fatalities caused by tractor rollovers has decreased in recent years, but the number of fatal tractor rollover accidents with a folded-down rollover protective structure (ROPS) has increased. Operating a ROPS-equipped tractor in low overhead clearance zones is difficult and sometimes impossible. The foldable ROPS (FROPS) was designed to solve the rigid ROPS problem, but lowering and raising a conventional FROPS is a time-consuming and strenuous process. After operators fold down a FROPS to pass a low overhead clearance zone, some prefer to leave it in the folded or inoperative position, increasing the risk of a rollover fatality. The actuation forces for raising and lowering a FROPS are not well known and may be influenced by actuation speed. A completely randomized block design with two blocks, five levels of speed, and multiple replications was conducted to investigate the effect of speed on actuation torque. The blocks were two sizes of tractor FROPS. The test included five levels of speed, including two levels of static measurement and three levels of dynamic measurement. A variable-speed motor system was used to control the speed for raising and lowering the FROPS. The actuation torque is a function of the FROPS upper part shape, dimensions, material density, turning acceleration, and friction. A theoretical model was developed to predict the actuation torque based on the FROPS shape, dimensions, and material density. For one ROPS, due to friction, the dynamic actuation torque was greater for raising and less for lowering than the theoretical torque. Indicator variable regression was used to analyze the effect of speed on actuation torque. Results showed that speed had a significant (p > 0.05) effect on actuation torque. Although there were statistically significant differences between the dynamic actuation torques, these differences were relatively small and negligible compared to the differences between the static torques., (Copyright© by the American Society of Agricultural Engineers.)

Introduction: Pre-drinking is a risky, yet common activity among college students whereby they consume alcohol prior to going to an event where more alcohol may be consumed (LaBrie, Hummer, Pederson, Lac, & Chithambo, 2012). While general drinking motives have been studied extensively, attention to pre-drinking is recent, and deserves more attention. This study assessed the reliability, validity, and factor structure of the Prepartying Motivations Inventory (PMI), and identified novel motivations through a thematic analysis., Method: A sample of 276 Canadian undergraduate students completed an online survey consisting of open-ended questions, drinking and pre-drinking questions, the PMI, and a brief demographic questionnaire., Results: It was demonstrated that a four-factor model, similar to that of the initial PMI, fits well, but that improvements are made by eliminating an item related to being under the legal drinking age. Further, five new themes emerged that warrant further investigation, and possible inclusion in the current PMI., Conclusions: Findings suggest that the PMI could be refined to further understand students' motivations for pre-drinking, and might inform alcohol intervention programs on post-secondary campuses., (Copyright © 2016 Elsevier Ltd. All rights reserved.)

Simian foamy viruses (SVF) are ubiquitous in nonhuman primates (NHP). SFV can be zoonotically transmitted to humans who either work with or live commensally with NHP. We analyzed the blood of 45 Bangladeshi performing monkey owners (an ethnic group called the Bedey) for SFV infection. Surprisingly, a PCR assay failed to detect SFV infection in any of these participants. This is in contrast to our previously reported infection rate of about 5% among Bangladeshi villagers., (Copyright © 2015, American Society for Microbiology. All Rights Reserved.)

A 29-year-old male patient with a functioning pituitary macroadenoma is discussed. The pituitary mass was detected by MRI after the patient presented with sudden onset of headache, suggestive of an apoplectic event. The headache resolved with analgesic medications. Within a follow-up period of one week, the pituitary mass had spontaneously regressed to nearly half its original size without any therapy. The patient never reported any visual complaints and displayed no signs of hypopituitarism. Elevated prolactin levels were present. Seven weeks after the initial event, the pituitary mass showed continued regression on MRI. Prolactin levels remained elevated. This case provides a unique look at the rapid spontaneous regression of mass effect that may occur following apoplexy of a pituitary adenoma.

Objective: The current investigation sought to determine the pattern and magnitude of cognitive functioning deficits in persons with type 2 diabetes mellitus without dementia using meta-analysis to consolidate findings in the literature., Methods: MedLine and PsychInfo databases were searched to identify studies of cognitive functioning in persons with type 2 diabetes. Effect sizes (Cohen's d) were calculated for the differences in cognitive functioning between subjects with type 2 diabetes and controls without diabetes on classified cognitive abilities. Average d values were calculated for all cognitive abilities across studies., Results: Twenty-five studies meeting the inclusion criteria were identified. Persons with type 2 diabetes performed significantly lower than controls without diabetes (p<0.05) on all cognitive abilities evaluated, with effect sizes ranging from -0.14 to -0.37. The largest effect sizes were processing speed (with motor task demands), M -0.37 (95% CI, -0.41 to -0.32), and divided attention/shifting, M -0.36 (95% CI, -0.42 to -0.31)., Conclusions: Type 2 diabetes leads to mild to moderate deficits in all measured cognitive abilities. There was a lack of published studies investigating type 2 diabetes-associated variables; therefore, additional meta-analyses investigating the impact of these variables on cognitive functioning in type 2 diabetes could not be performed. As such, data from individual studies must be reported consistently to allow for investigation of variables that may affect the relationship between type 2 diabetes and cognitive functioning. Given the present findings, clinicians working with patients with type 2 diabetes should be alerted to the possibility of cognitive changes that could impact type 2 diabetes treatment management or require referral for neuropsychological assessment., (Copyright © 2014 Canadian Diabetes Association. Published by Elsevier Inc. All rights reserved.)

The impact of nanosecond pulsed electric fields (nsPEFs) on gene electrotransfer has not been clearly demonstrated in previous studies. This study was conducted to evaluate the influence of nsPEFs on the delivery of plasmids encoding luciferase or green fluorescent protein and subsequent expression in HACAT keratinocyte cells. Delivery was performed using millisecond electric pulses (msEPs) with or without nsPEFs. In contrast to reports in the literature, we discovered that gene expression was significantly increased up to 40-fold by applying nsPEFs to cells first followed by one msEP but not in the opposite order. We demonstrated that the effect of nsPEFs on gene transfection was time restricted. The enhancement of gene expression occurred by applying one msEP immediately after nsPEFs and reached the maximum at posttreatment 5 minutes, slightly decreased at 15 minutes and had a residual effect at 1 hour. It appears that nsPEFs play a role as an amplifier without changing the trend of gene expression kinetics due to msEPs. The effect of nsPEFs on cell viability is also dependent on the specific pulse parameters. We also determined that both calcium independent and dependent mechanisms are involved in nsPEF effects on gene electrotransfer.

This article examines the idea that believing that events occurred in the past is a non-memorial decision that reflects underlying processes that are distinct from recollecting events. Research on autobiographical memory has often focused on events that are both believed to have occurred and remembered, thus tending to overlook the distinction between autobiographical belief and recollection. Studying event representations such as false memories, believed-not-remembered events, and non-believed memories shows the influence of non-memorial processes on evaluations of occurrence. Believing that an event occurred and recollecting an event may be more strongly dissociated than previously stated. The relative independence of these constructs was examined in 2 studies. In Study 1, multiple events were cued, and then each was rated on autobiographical belief, recollection, and other memory characteristics. In Study 2, participants described a nonbelieved memory, a believed memory, and a believed-not-remembered event, and they made similar ratings. In both studies, structural equation modeling techniques revealed distinct belief and recollection latent variables. Modeling the predictors of these factors revealed a double dissociation: Perceptual, re-experiencing, and emotional features predicted recollection and not belief, whereas event plausibility strongly predicted belief and weakly predicted recollection. The results show that judgments of autobiographical belief and recollection are distinct, that each is influenced by different sources of information and processes, and that the strength of their relationship varies depending on the type of event under study. The concept of autobiographical belief is elaborated, and implications of the findings are discussed in relation to decision making about events, social influence on memory, metacognition, and recognition processes., (PsycINFO Database Record (c) 2014 APA, all rights reserved.)

Foamy viruses (FV) are complex retroviruses that naturally infect all nonhuman primates (NHP) studied to date. Zoonotic transmission of Old World NHP simian foamy viruses (SFV) has been documented, leading to nonpathogenic persistent infections. To date, there have been no reports concerning zoonotic transmission of New World monkey (NWM) SFV to humans and resulting infection. In this study, we developed a Western blot assay to detect antibodies to NWM SFV, a nested PCR assay to detect NWM SFV DNA, and a β-galactosidase-containing indicator cell line to assay replication of NWM SFV. Using these tools, we analyzed the plasma and blood of 116 primatologists, of whom 69 had reported exposures to NWM. While 8 of the primatologists tested were seropositive for SFV from a NWM, the spider monkey, none had detectable levels of viral DNA in their blood. We found that SFV isolated from three different species of NWM replicated in some, but not all, human cell lines. From our data, we conclude that while humans exposed to NWM SFV produce antibodies, there is no evidence for long-term viral persistence.

Background and Objective: Patients with limited English proficiency (LEP) are at risk for undertreated pain. The goal of this study was to examine the association between parental language proficiency, interpreted care, and postsurgical pediatric pain management., Methods: This was a retrospective matched cohort study among children <18 years of age. Children of LEP and English-proficient (EP) parents were matched according to age group, surgical procedure, and admission date. Mean number of daily pain assessments and mean daily pain scores were compared between language groups. We also compared the association between pain scores and type of medication given (opioid versus nonopioid). Within the LEP group, similar analyses compared pain assessment and treatment of children whose families received ≥ 2 professional interpretations per day versus those who received lower rates of interpretation., Results: A total of 474 children (237 LEP and 237 EP) were included in the study. Children of LEP parents had fewer pain assessments (mean: 7 [95% confidence interval: 2-13] vs 9 [95% confidence interval: 4-15]; P = .012), and higher levels of pain recorded before receiving opioid analgesics, compared with children of EP parents (P = .003). Within the LEP group, children with ≥ 2 interpretations per day had lower pain scores after medication administration (P < .05) and were more likely to receive opioids at pain levels similar to those of EP families., Conclusions: Children of LEP parents received fewer pain assessments and were less likely to receive opioid analgesics for similar levels of pain compared with children of EP parents. More frequent use of professional interpreters when assessing pain may aid in reducing the gap in pain management between LEP and EP pediatric patients.

Simian foamy viruses (SFVs) are ubiquitous in non-human primates (NHPs). As in all retroviruses, reverse transcription of SFV leads to recombination and mutation. Because more humans have been shown to be infected with SFV than with any other simian borne virus, SFV is a potentially powerful model for studying the virology and epidemiology of viruses at the human/NHP interface. In Asia, SFV is likely transmitted to humans through macaque bites and scratches that occur in the context of everyday life. We analyzed multiple proviral sequences from the SFV gag gene from both humans and macaques in order to characterize retroviral transmission at the human/NHP interface in Bangladesh. Here we report evidence that humans can be concurrently infected with multiple SFV strains, with some individuals infected by both an autochthonous SFV strain as well as a strain similar to SFV found in macaques from another geographic area. These data, combined with previous results, suggest that both human-facilitated movement of macaques leading to the introduction of non-resident strains of SFV and retroviral recombination in macaques contribute to SFV diversity among humans in Bangladesh.

Foamy viruses are complex retroviruses that have been shown to be transmitted from nonhuman primates to humans. In Bangladesh, infection with simian foamy virus (SFV) is ubiquitous among rhesus macaques, which come into contact with humans in diverse locations and contexts throughout the country. We analyzed microsatellite DNA from 126 macaques at six sites in Bangladesh in order to characterize geographic patterns of macaque population structure. We also included in this study 38 macaques owned by nomadic people who train them to perform for audiences. PCR was used to analyze a portion of the proviral gag gene from all SFV-positive macaques, and multiple clones were sequenced. Phylogenetic analysis was used to infer long-term patterns of viral transmission. Analyses of SFV gag gene sequences indicated that macaque populations from different areas harbor genetically distinct strains of SFV, suggesting that geographic features such as forest cover play a role in determining the dispersal of macaques and SFV. We also found evidence suggesting that humans traveling the region with performing macaques likely play a role in the translocation of macaques and SFV. Our studies found that individual animals can harbor more than one strain of SFV and that presence of more than one SFV strain is more common among older animals. Some macaques are infected with SFV that appears to be recombinant. These findings paint a more detailed picture of how geographic and sociocultural factors influence the spectrum of simian-borne retroviruses.