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Black women in the United States are faced with unrelenting chronic stressors that are often driven by racism and oppression and that result in mental health inequities. Similar to common U.S. societal views of Black women, ideological values about Black women's lives also permeate psychiatry and neuroscience research to prevent likely impactful research that fully examines the role of social power structures in the biological embedding of racism. This article's overall aim is to highlight the most urgent areas to address in mental health inequities utilizing a Black feminist lens that include 1) culturally grounded and contextually relevant considerations for the biological embedding of racism on mental health outcomes for Black women across the lifespan and 2) intersectional frameworks that address mental health inequities ingrained in multiple marginalization. We conclude with a call to action informed by Black feminist thought for the field of neuroscience to make a concerted effort to address mental health inequities among Black women and other disenfranchised groups from a frame of compassion, cultural humility, and a continuous pursuit of social justice.

Published data demonstrate that management of uncomplicated pediatric appendicitis with antibiotics-alone is safe and frequently successful. Randomized controlled trials (RCT) comparing antibiotics-alone to appendectomy are lacking, alongside insight into drivers of failure. We sought to validate the antibiotics-alone approach and identify barriers to success using an RCT design.Patients aged 6-17 years with uncomplicated appendicitis were randomized to appendectomy or intravenous piperacillin/tazobactam for 24-48 h followed by 10 days of oral ciprofloxacin/metronidazole. Enrollment required symptoms48 h, WBC18, appendiceal diameter11 mm, and radiographic absence of perforation. Lack of clinical improvement or persistently elevated WBC resulted in appendectomy. Primary outcomes were 1-year success rate of antibiotics-alone and quality-of-life measures.Among 39 children enrolled over 31 months, 20 were randomized to antibiotics-alone and 19 to surgery. At 1 year, 6 nonoperative patients underwent appendectomy (70% success). Four cases were not true antibiotic failures but instead reflected "pragmatic" challenges to executing nonoperative algorithms. Only 2 cases represented recurrent/refractory appendicitis, suggesting a 90% adjusted 1-year success rate. Parental PedsQL™ scores were similar between treatment cohorts (91.3 vs 90.2, P = 0.32). Children treated with antibiotics-alone had faster return to activity (2.0 vs 12 days, P = 0.001) and fewer parental missed work days (0.0 vs 2.5, P = 0.03).These data corroborate findings from non-randomized studies suggesting 70-90% of uncomplicated pediatric appendicitis can be treated with antibiotics-alone, with fewer disability days. Failures appear multifactorial, often reflecting practical hurdles and not antibiotic limitations. As surgeons consider nonoperative protocols for uncomplicated appendicitis, these data further inform the variability of treatment success.1; randomized controlled trial.

Inflammatory cytokine storm is a known cause for acute respiratory distress syndrome. In this study, we have investigated the role of IFN-γ in lethal lung inflammation using a mouse model of postinfluenza methicillin-resistant Staphylococcus aureus (MRSA) pneumonia. To mimic the clinical scenario, animals were treated with antibiotics for effective bacterial control following MRSA superinfection. However, antibiotic therapy alone is not sufficient to improve survival of wild-type animals in this lethal acute respiratory distress syndrome model. In contrast, antibiotics induce effective protection in mice deficient in IFN-γ response. Mechanistically, we show that rather than inhibiting bacterial clearance, IFN-γ promotes proinflammatory cytokine response to cause lethal lung damage. Neutralization of IFN-γ after influenza prevents hyperproduction of TNF-α, and thereby protects against inflammatory lung damage and animal mortality. Taken together, the current study demonstrates that influenza-induced IFN-γ drives a stepwise propagation of inflammatory cytokine response, which ultimately results in fatal lung damage during secondary MRSA pneumonia, despite of antibiotic therapy.

Racial discrimination can lead to psychosocial problems for Black adolescents, including internalization (e.g., depression) and externalization (e.g., conduct problems). Black parents (N = 186; M(age) = 42.9) of adolescents (ages 10–18) were assessed to investigate how parental worries and racial socialization competency (i.e., confidence, skills, and stress) contribute to the association between parental discrimination experiences and their adolescents’ psychosocial problems. Mediation analyses indicated that the total direct models with discrimination, worries, and problems had good fit, and that the addition of worry mediated the discrimination-problems association. Furthermore, racial socialization competency moderated the association between worry and problems, wherein greater competency was associated with less impact of worry on problems. Findings illuminate potential intervention targets for buffering discrimination’s influence on adolescents’ psychosocial functioning.

Organic micropollutants (OMPs) have been widely detected in the aqueous environment and their effect on the environment and human health has been studied. The removal of OMPs from effluents of a co...

Black families are significantly less likely to receive evidence-based trauma treatment services; however, little is known about factors impacting engagement, particularly at Children’s Advocacy Centers (CACs). The goal of this study is to better understand barriers and facilitators of service utilization for Black caregivers of CAC referred youth. Participants ( n = 15) were randomly selected Black maternal caregivers (ages 26–42) recruited from a pool of individuals who were referred to receive CAC services. Black maternal caregivers reported barriers to accessing services at CACs including a lack of assistance and information in the referral and onboarding process, transportation issues, childcare, employment hours, system mistrust, stigma associated with the service system, and outside stressors such as stressors related to parenting. Maternal caregivers also shared suggestions for improving services at CACs including increasing the length, breadth, and clarity of investigations conducted by child protection services and law enforcement (LE) agencies, providing case management services, and having more diverse staff and discussing racial stressors. We conclude by identifying specific barriers to the initiation and engagement in services for Black families, and we provide suggestions for CACs seeking to improve engagement of Black families referred for trauma-related mental health services.

An increasing number of studies performing correlative drug screens on patient-derived organoids (PDO) are revealing enormous potential for these models in predicting patient response to therapy. Despite this, their future use in a clinical setting is hindered by intrinsic limitations of PDO models, namely low success rates in establishing growing cell cultures from tumor tissue samples and long return times for drug response data that fall outside timescales of clinical actionability. To address these limitations, we leveraged technological advances in emulsion-based microfluidics and droplet generators to develop MicroOrganoSpheres (MOS) - microscale environments containing tumorspheres that retain structural, cellular, and genetic properties of an individual patient’s diseased tissue. Here, we focused on generating MOS from breast cancer tissue biopsies and resections across different subtypes of breast cancer. We established over 30 unique patients’ breast MOS samples at an average of 80% success, with the majority of these samples being hormone receptor positive (ER+/PR+) - the most clinically lethal and challenging subtype to establish. We evaluated MOS dose-responses across several first line standard of care chemotherapies for breast cancer. For this, we created a semi-automated workflow paired with high-content imaging for quantifying dose responses and tracking longitudinal cell dynamics during dosing. We generated dose response data for MOS samples, being able to move from primary tissue samples to MOS to drug dosing data within a clinically relevant timescale of 2-3 weeks. We conclude that our platform demonstrates the feasibility of 1) efficiently establishing MOS from breast cancer patient tumor samples from different subtypes and 2) performing drug dosing studies on these samples with improved turnaround times that enable clinical actionability for the patient. Together, these findings provide a foundation for evaluating this technology as a diagnostic tool in future clinical settings. Citation Format: David M. Graham, Gabrielle Rupprecht, Eric D. Bankaitis, Jeremy M. Force, Wylie Watlington, Steven W. Metzger, Xiling Shen, David Hsu. A novel and rapid patient-derived organoid breast cancer platform for precision medicine [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 192.

Approximately one-third of college students engage in heavy episodic drinking. Although White students drink more than Black students, White individuals are more likely to mature out of heavy drinking, whereas Black individuals drink more as they age and experience disproportionate alcohol-related consequences. Compared to their White counterparts, limited research has examined factors associated with alcohol use among Black college students. Descriptive drinking norms based on the typical college student are strong predictors of college student drinking, but previous research found that this association was weaker for Black college students. Therefore, the current study is a preliminary examination of perceived drinking norms (descriptive) and approval (injunctive) based on race for Black college students. Further, we explored likelihood of excessive drinking around other Black students. The current study included survey responses of 192 Black college students from a large southeastern US university. Results indicated that university and race-specific descriptive norms, but not university and race-specific injunctive norms, were associated with more drinks per week. These findings suggest that descriptive norms with Black students at the participant's university as the normative reference group are associated with alcohol use among Black students. Further, greater likelihood of drinking excessively around peers who share the same racial identity may impact alcohol consumption for this population. Current prevention programs for college student drinking are tailored by gender rather than race; however, preliminary findings from the current study suggests that tailoring by race may be an effective way to prevent alcohol misuse among Black college students.

This study examines two equity-elaborated social and emotional learning (SEL) competencies among Black adolescents: coping responses to race-related stress at school (self-management) and racial identity (self-awareness), and their relation to school adjustment (school belonging, school valuing, cognitive strategy use). The sample included 151 Black high school students ( Mage = 16.42; 52% female) from the southeastern United States. Hierarchical regression analyses revealed that racial centrality moderated the relationships between active coping and school valuing and active coping and cognitive strategy use. Findings support the value of using an equity-elaborated lens to understand the role of SEL competencies for Black youth’s school adjustment.

The mental health status of Black youth is a complex interplay of resilience in the face of risk. Basic and applied research on cultural considerations for Black youth and their families has prolif...

This preliminary investigation explored associations between African American students’ perceptions of racial fairness, dimensions of school engagement (behavioral, emotional, cognitive) and school...

Recently, research has reported that the rates of suicide among Black children between the ages of 5 to 12-years-old are increasing as they are now more likely to commit suicide than White children. Yet, there are very few, if any, frameworks being used by researchers to explain the risks of suicide among Black children. Suicide research has overwhelmingly been focused on White youth thus leaving a critical gap in suicide research. This conceptual paper provides an integrated framework using the Interpersonal-Psychological Theory of Suicide and Intersectionality theory, as a guide for researchers, clinicians, and practitioners to incorporate culturally appropriate techniques in their work as a way to prevent suicide among Black children. This framework highlights racial discrimination, mental health, socioeconomic status, and sexual/gender minority status to be the most preeminent, yet understudied factors leading to suicide risk among Black children in the United States. Reprinted with permission of SAGE Publications; Opara et al. J Black Stud (51:611–631), copyright 2020.

African American youth are more likely than their peers from other racial and ethnic groups to experience interpersonal traumas and traumatic racist and discriminatory encounters. Unfortunately, evidence-based trauma treatments have been less effective among these youth likely due to these treatments not being culturally tailored to address both interpersonal and racial trauma. In this article, we utilize the racial encounter coping appraisal and socialization theory to propose suggestions for adapting trauma-focused cognitive behavioral therapy—an evidence-based trauma treatment for children and adolescents—to include racial socialization or the process of transmitting culture, attitudes, and values to help youth overcome stressors associated with ethnic minority status. We conclude by discussing implications for the research and clinical community to best promote healing from both interpersonal and racial trauma for African American youth.

Batch adsorbers were designed for the adsorption of the fabric dyes Basic Violet 16 (BV16) and Reactive Red 195 (RR195) on locally available low-cost natural adsorbents of Persian bentonite, vermicompost and Persian charred dolomite. The adsorption isotherm data were in agreement with the Langmuir isotherm model (R2 > 99%). Results showed that with increasing the adsorption capacity of bentonite for BV16 from 434.78 to 833.33 mg/g due to the presence of the anionic dye, the amount of the adsorbent decreases by 50%. The adsorption capacity of vermicompost for the cationic dye was obtained 16 mg/g in single dye solution and of charred dolomite for the anionic dye was almost 7 mg/g in both dye systems. Based on the extended Langmuir model, the maximum adsorption capacity of natural bentonite for BV16 and of charred dolomite for RR195 were concluded 821.63 mg/g and 7.03 mg/g, respectively, which the capacities are almost the same in single and binary systems. The adsorption capacity and removal efficiency of Persian bentonite from contaminated water are comparable with that of activated carbon. Compared to activated carbon bentonite and the other natural adsorbents used in this study are less expensive and do not require a separate activation or pre-treatment step. Cost for 90% removal of dye from 100 m3 groundwater using 1 kg the studied adsorbents of vermicompost, charred dolomite and bentonite was calculated 0.06, 0.05 and 0.04 euro, respectively, in both single and binary systems.

Increased reports in public schools and depictions on social media signify racial harassment is quite prevalent in the lives of black students in the United States. However, the degree to which research has focused on the specific forms of racial harassment in school and its emotional effects remain understudied. This phenomenological study explored the retrospective accounts of racial harassment in the public-school experiences of a sample of older black youth and the emotional consequences of such encounters. Findings from the participants indicate the most prevalent form of racial harassment occurred in the form of subtle assaults and racial slights, followed by verbal and physical assaults. Participants were also more likely to express anger and sadness in their accounts of racial harassment. Discussion focuses on how racial harassment has adverse emotional consequences and the need for interventions that address racial healing, bias reduction, and emotional regulation for adults and students in school.

Background The SIS Wound Matrix (SISWM) has been shown to improve healing of chronic ulcers over standard of care. In this study, we tested the hypothesis that chronic venous ulcers responsive to treatment with SISWM would more closely mimic an acute wound state as opposed to unresponsive ulcers. Methods Serum and wound exudate were collected at baseline and then weekly for up to 12 weeks from 12 patients receiving multiple applications of the SISWM. Levels of matrix metalloproteinases (MMP-1, MMP-2, MMP-3, MMP-9, and MMP-12), pro-inflammatory cytokines (IL-1β, TNF-α, IL-8), and transforming growth factor beta (TGF-β1) were evaluated. A variety of Th1/Th2 cytokines were also assayed, as were systemic anti-SIS and anti-α-gal antibody titers. Results Seven of the 12 patients eventually healed their wounds. Results showed significant decreases in MMP-1, MMP-2, MMP-3, MMP-9, TNF-α and IL-8, and significant increases in TGF-β1 in wounds responding to treatment with the SISWM versus wounds that did not respond to treatment. None of the 12 patients formed a measurable serum antibody response to the SISWM. Conclusions These data show that SISWM does not lead to immune system recognition or sensitization to the matrix and that wounds that went on to heal following treatment were characterized by a more acute wound state. The study confirms that the wound environment is important to healing and that turning a wound toward an acute biochemical state is key to the healing process.

Given the heightened national attention to negative race-related issues and the subsequent community solution-oriented outcry (e.g., Black Lives Matter movement), it is crucial to address healing from racial discrimination for Black Americans. Clinical and community psychologists have responded by developing and implementing programs that focus on racial socialization and psychological wellness, particularly given disproportionate issues with utilization, access, and the provision of quality services within urban and predominantly Black communities. The aim of this article is to describe 2 applied programs (Engaging, Managing, and Bonding through Race and Family Learning Villages), which seek to address and heal racial stress through crucial proximal systems—families and schools—and to highlight participant reactions. These programs offer solutions through strengths-based and participatory approaches which draw from Black Americans’ own protective mechanisms related to improved mental health. We conclude with a discussion on practice, assessments, and models specific to racial stress for researchers, practitioners, and consumers of mental health services.

SignificanceThe regulation of functional immune cell plasticity is poorly understood. Host environmental cues are critical, but the possible influence of pathogen-derived virulence factors has not been described. We have used reverse-engineered influenza A viruses that differ in PB1-F2 activity to analyze influenza in mice in the presence or absence of host interferon (IFN)-γ. In the absence of functional PB1-F2 and IFN-γ, lung ILC2s initiated robust IL-5 responses following viral challenge, which led to improved tissue integrity and survival. Conversely, functional PB1-F2 suppressed IL-5+ILC2 responses and induced a dominant IL-13+CD8 T cell response regardless of host IFN-γ. These findings demonstrate the critical interplay between the viral virulence factors and host cytokines in regulating protective pulmonary immunity during influenza virus infection.

Background: Understanding the mechanisms by which evidence-based interventions (EBIs) for mental health are naturally diffused among youth in low-and middle-income countries—particularly those with histories of violence and civil unrest—can illuminate which intervention elements are most transferrable and inform scale-up decisions that support youth adjustment. This study explored the diffusion of an evidence-based mental health intervention—the Youth Readiness Intervention (YRI)—among peer networks of Sierra Leonean youth (aged 18–30) who participated in a trial of the intervention as integrated into youth entrepreneurship programs. Methods: Trained research assistants recruited index participants who had completed the YRI integrated within entrepreneurship training (N = 165) and control index participants (N = 165). Index participants nominated three of their closest peers. Nominated peers were recruited and enrolled in the current study (N = 289). A sub-sample of index participants and peers participated in dyadic interviews (N = 11) and focus group discussions (N = 16). Multivariate regression analysis compared YRI knowledge levels among YRI participants’ peers relative to control participants’ peers. Results: Qualitative findings supported the diffusion of several YRI skills and components across peer networks (i.e., progressive muscle relaxation and diaphragmatic breathing). Quantitative findings indicated that YRI knowledge was significantly higher for YRI participants’ peers (β = 0.02, p < 0.00) compared to control participants’ peers. Conclusion: Findings suggest that diffusion of evidence-based intervention components can occur naturally among peers in post-conflict LMIC settings. Developing tools to promote the diffusion of the most transferrable EBI components across peer networks could help maximize the benefits of mental health interventions for youth adjustment and resilience in post-conflict settings.

Interleukin-33 (IL-33) is a multifunctional cytokine that mediates type 2-dominated immune responses. In contrast, the role of IL-33 during viral vaccination, which often aims to induce type 1 immunity, has not been fully investigated. Here, we examined the effects of IL-33 on influenza vaccine responses. We found that intranasal coadministration of IL-33 with an inactivated influenza virus vaccine increases vaccine efficacy against influenza virus infection, not only with the homologous strain but also with heterologous strains, including the 2009 H1N1 influenza virus pandemic strain. Cross-protection was dependent on group 2 innate lymphoid cells (ILC2s), as the beneficial effect of IL-33 on vaccine efficacy was abrogated in ILC2-deficient C57BL/6 Il7r(Cre/+) Rora(fl/fl) mice. Furthermore, mechanistic studies revealed that IL-33-activated ILC2s potentiate vaccine efficacy by enhancing mucosal humoral immunity, particularly IgA responses, potentially in a Th2 cytokine-dependent manner. Our results demonstrate that IL-33-mediated activation of ILC2s is a critical early event that is important for the induction of mucosal humoral immunity, which in turn is responsible for cross-strain protection against influenza. Thus, we reveal a previously unrecognized role for the IL-33–ILC2 axis in establishing broadly protective and long-lasting humoral mucosal immunity against influenza, knowledge that may help in the development of a universal influenza vaccine. IMPORTANCE Current influenza vaccines, although capable of protecting against predicted viruses/strains included in the vaccine, are inept at providing cross-protection against emerging/novel strains. Thus, we are in critical need of a universal vaccine that can protect against a wide range of influenza viruses. Our novel findings show that a mucosal vaccination strategy involving the activation of lung ILC2s is highly effective in eliciting cross-protective humoral immunity in the lungs. This suggests that the biology of lung ILC2s can be exploited to increase the cross-reactivity of commercially available influenza subunit vaccines.

Highly sensitive nucleic acid amplification tests (NAATs) designed to detect SARS-CoV-2 RNA are the standard of care for the diagnosis of COVID-19. However, the accuracy of these methods for the quantitation of active virus rather than non-infectious RNA fragments that can persist for extended periods of time has been unclear. This issue is particularly relevant for congregate care patients who are unable to return to their home residence until fully negative by NAATs. We tested paired samples from individual patients for the presence of virus at both early and later stages of disease. Culture of nasopharyngeal swab samples for 10 days in Vero E6 cells revealed active virus in only 4 out of 14 (28.6%) patients. The ability to isolate viral plaque-forming units (PFU) correlated with viral RNA loads of >6.79 log genomic copies/ml and only occurred in samples collected from patients early after symptom onset and before development of antibody. Culture in Vero E6 cells lacking the STAT1-dependent interferon signaling pathway increased the numbers of viral PFU detected but did not affect the incidence of positive cultures. We conclude that culturable virus is correlated with SARS-CoV-2 NAATs detection only during early symptom onset and with high viral titers/low antibody titers in non-immunosuppressed patients.

The potential of a mixed sorbent consisting of vermicompost and Persian charred dolomite for simultaneous adsorption of Basic Violet 16 (BV16) and Reactive Red 195 (RR195) was investigated. First-order derivative spectrophotometry was used for simultaneous analysis of the two dyes. In single dye experiments, the maximum adsorption capacity of vermicompost for BV16 was found to be 16 mg g−1 and the adsorption capacity of charred dolomite for RR195 was 7.3 mg g−1. Anionic RR195 was not noticeably adsorbed by vermicompost (negative surface charge) and cationic BV16 not by charred dolomite (positive surface charge) but adsorbed by the oppositely charged adsorbents which indicates a selective electrostatic adsorption mechanism. In binary dye solution, BV16 adsorption onto charred dolomite was increased in the presence of RR195 (synergistic effect), yet RR195 adsorption on charred dolomite was not influenced by BV16. An antagonistic effect of RR195 was concluded for BV16 adsorption onto vermicompost. The adsorption equilibrium data for both adsorbents fitted more acceptable to the Langmuir isotherm model than to the Freundlich model in single and binary solutions, but other than the adsorption of BV16 on vermicompost in binary solution which followed the Freundlich model. More than 50% of the removal efficiencies determined for both dyes onto the mixed sorbents were >70% which highlights that the mixed sorbent investigated is highly efficacious for the simultaneous removal of cationic and anionic dyes from contaminated groundwater. Eight cycles reusing vermicompost with 1 N NaOH for regeneration demonstrates the practicability and economic advantage of this natural biosorbent.

The current examines how African American residential fathers’ communicative support and parental knowledge influence adolescents’ substance use across a 3-year period. Additionally, this study examines whether these associations vary for African American boys and girls. Participants were 665 African American adolescents (M = 13.1 years of age; 49% female) from the National Longitudinal Study of Youth-1997. All adolescents resided with their fathers or father figures. Individual and parallel process growth curve analyses examined how communicative support and parental knowledge were associated with initial levels and rate of change in African American adolescents’ substance use. Although African American girls exhibited higher initial levels of substance use, there was greater growth in boys’ substance use over time. Analyses indicated that residential fathers’ parental knowledge was associated with substance use over time for both girls and boys. Findings also revealed that demographic factors more strongly predicted father–daughter relational characteristics. Our study highlights how African American residential fathers’ parenting practices influence adolescent substance use. Further, this investigation suggests that gender and demographic variation in relation to African American girls’ and boys’ substance use is highly nuanced. Implications for prevention are discussed.

African American youth are disproportionately represented among trauma-exposed youth; yet, they are significantly less likely to access and complete mental health services. Research suggests that barriers to accessing and engaging in trauma-focused treatment include both logistical factors and engagement factors. This multiple case study sought to illustrate the initial feasibility and acceptability of delivering culturally tailored, trauma-focused cognitive behavioral therapy (TF-CBT) via telehealth in a school setting with three African American youth presenting with multiple barriers to accessing treatment. Barriers to treatment, telehealth modifications, and cultural tailoring are described for each participant. The UCLA Posttraumatic Stress Disorder Reaction Index (UCLA PTSD-RI) was completed at pretreatment and posttreatment. Results demonstrated significant decreases in symptoms of posttraumatic stress, as evidenced by a reduction in total UCLA PTSD-RI scores to nonclinical levels for all participants at posttreatment (UCLA scores posttreatment = 8-12). In addition, at posttreatment no participants met diagnostic criteria for PTSD or adjustment disorder. This multiple case study provides preliminary support for school-based, culturally tailored TF-CBT delivered via telehealth with African American youth.

Previous research on renters’ experiences in the Housing Choice Voucher (HCV) program is robust, but much of it has been conducted in the context of mobility interventions providing added resources...

Prolonged detection of SARS-CoV-2 viral RNA has been observed in hospitalized congregate care patients following resolution of clinical symptoms. It is unknown whether patients with persistent PCR positivity pose a risk for COVID-19 transmission. The purpose of this study was to examine the results of serial PCR testing, viral load, and viral culture in patients awaiting discharge prior to a negative PCR test. We sampled 14 patients who were admitted from skilled nursing and/or rehabilitation facilities to a large academic medical center, had clinical signs and symptoms of COVID-19, and had multiple PCR-positive tests separated by at least 14 days. PCR-positive nasopharyngeal swabs were obtained from each patient for viral load quantification and viral culture. The mean age of patients was 72.5 years (55 – 92), with a mean peak SOFA score of 5.6 (1 – 11). Patients were hospitalized for a mean of 37.0 days (25 – 60). RNA was detected by PCR for a mean of 32.9 days (19 – 47). Mean viral load for the first PCR-positive nasopharyngeal swab collected at our hospital was 5.81 genomic copies/mL (2.12 – 9.72). Viral load decreased significantly with days from clinical symptom onset (R = -0.69, 95% CI, -0.80 – -0.55). Four out of 28 samples grew active virus via culture, with no active virus isolates after 2 days of symptom onset. Our viral culture data suggests that persistent PCR positivity may not correlate with infectivity, which has important implications for COVID-19 infection control precautions among older congregate care patients.

Many ethnic minority groups experience higher rates of posttraumatic stress disorder (PTSD) compared to their European American counterparts. One explanation for this is the differential experience of racism, which can itself be traumatic. This article aims to provide a theoretical basis for the tra