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Robust evidence supports the use of prolonged exposure therapy (PE) as a first-line treatment for posttraumatic stress disorder (PTSD). However, Latinos have not benefitted equally from advancements in the treatment of PTSD and continue to face barriers to receiving care. There is consensus that it is necessary to support the expansion of high-quality culturally and linguistically appropriate treatment to address disparities experienced by racial and ethnic minorities in behavioral health care. The current study was a randomized controlled trial comparing a culturally adapted PE intervention with applied relaxation (AR) among Spanish-speaking Latinos with PTSD in Puerto Rico. Eligible participants (N = 98) were randomly assigned to PE (n = 49) or AR (n = 49). Both treatments included 12-15 weekly sessions each lasting 60-90 min. The primary outcome, clinician-rated PTSD symptom severity, was assessed using the Clinician-Administered PTSD Scale for DSM-5 at baseline, posttreatment, and 3-month follow-up. Secondary outcomes were assessed using the Patient Health Questionnaire and State-Trait Anxiety Inventory. Results showed a large within-group effect of treatment on PTSD symptoms, PE: d = 1.29, 95% CI [1.12, 2.05]; AR: d = 1.38, 95% CI [1.21, 2.19]. The between-group effect on PTSD symptoms was small, d = -0.09, 95% CI [-0.48, 0.31]. Participants in both treatment conditions reported significant decreases in PTSD symptoms from baseline to follow-up; additionally, significant within-group reductions in depression and anxiety symptoms were observed. These findings underscore the potential benefit of PE and AR for the treatment of Spanish-speaking Latinos with PTSD. [ABSTRACT FROM AUTHOR]

Background: Frailty is a state of increased vulnerability to stressors, and predicts risk of adverse outcomes, such as mortality. Frailty can be defined by a frailty index (FI) using an accumulation of deficits approach. An FI comprised of 20 items derived from our previously studied test‐based frailty index (TBFI) and an additional 33 survey‐based elements sourced from the standard CGA was developed to evaluate if predictive validity of survival was improved. Methods: One hundred eighty‐nine cancer patients during acute hospitalization were consented between September 2018 and May 2019. Frailty scores were calculated, and patients were categorized into four groups: non‐frail (0–0.2), mildly frail (0.2–0.3), moderately frail (0.3–0.4), and severely frail (>0.4). Patients were followed for 1‐year to assess FI and TBFI prediction of survival. Area under the curve (AUC) statistics from ROC analyses were compared for the FI versus TBFI. Results: Increasing frailty was similarly associated with increased risk of mortality (HR, 4.5 [95% CI, 2.519–8.075] and HR, 4.1 [95%CI, 1.692–9.942]) and the likelihood of death at 6 months was about 11‐fold (odds ratio, 10.9 [95% CI, 3.97–33.24]) and 9.73‐fold (95% CI, 2.85–38.50) higher for severely frail patients compared to non‐frail patients for FI and TBFI, respectively. This association was independent of age and type of cancer. The FI and TBFI were predictive of survival for older and younger cancer patients with no significant differences between models in discriminating survival (FI AUC, 0.747 [95% CI, 0.6772–0.8157] and TBFI AUC, 0.724 [95% CI, 0.6513–0.7957]). Conclusions: The TBFI was predictive of survival, and the addition of an in‐person assessment (FI) did not greatly improve predictive validity. Increasing frailty, as measured by a TBFI, resulted in a meaningfully increased risk of mortality and may be well‐suited for screening of hospitalized cancer patients. [ABSTRACT FROM AUTHOR]

Background: For cancer patients with an unplanned hospitalization, estimating survival has been limited. We examined factors predicting survival and investigated the concept of using a deficit‐accumulation survival index (DASI) in this population. Methods: Data were abstracted from medical records of 145 patients who had an unplanned 30‐day readmission between 01/01/16 and 09/30/16. Comparison data were obtained for patients who were admitted as close in time to the date of index admission of a study patient, but who did not experience a readmission within 30 days of their discharge date. Our survival analysis compared those readmitted within 30 days versus those who were not. Scores from 23 medical record elements used in our DASI system categorized patients into low‐, moderate‐, and high‐score groups. Results: Thirty‐day readmission was strongly associated with the survival (adjusted hazard ratio [HR] 2.39; 95% confidence interval [CI], 1.46‐3.92). Patients readmitted within 30 days of discharge from index admission had a median survival of 147 days (95% CI, 85‐207) versus patients not readmitted who had not reached median survival by the end of the study (P < .0001). DASI was useful in predicting the survival; median survival time was 78 days (95% CI, 61‐131) for the high score, 318 days (95% CI, 207‐426) for the moderate score, and not reached as of 426 days (95% CI, 251 to undetermined) for the low‐score DASI group (P < .0001). Conclusions: Patients readmitted within 30 days of an unplanned hospitalization are at higher risk of mortality than those not readmitted. A novel DASI developed from clinical documentation may help to predict survival in this population. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Traumatic Stress is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Journal of Traumatic Stress is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Glyphosate-resistant weeds are an increasing problem in perennial cropping systems in the Central Valley of California, USA. To elucidate the evolutionary origins and spatial spread of resistance, we investigated the geographical distribution of glyphosate resistance and the population genetic diversity and structure of Conyza bonariensis and compared the results with previously studied C. canadensis. Thirty-five populations from orchards and vineyards across the Central Valley were sampled. Population genetic structure was assessed using microsatellite markers. Population-level resistance was assessed in glasshouse screening of plants grown from field-collected seed. Bayesian clustering and analyses of multilocus genotypes indicated multiple origins of resistance, as observed in C. canadensis. Pairwise FST analysis detected spatial spread of resistance in the south of the Central Valley, also similar to C. canadensis. The results strongly indicate that the southern valley was an environment markedly more suitable than the northern valley for resistance spread and that spread in Conyza species was driven by increased uniformity of strong selection in the southern valley, due to recent regulation on herbicides other than glyphosate. Accordingly, resistant C. canadensis individuals occurred at high frequencies only in the southern valley, but interestingly resistant C. bonariensis occurred at high frequencies throughout the valley. Expression of resistance showed varying degrees of plasticity in C. bonariensis. The lower selfing rate and substantially greater genotypic diversity in C. bonariensis, relative to C. canadensis, indicate greater evolutionary potential over shorter time periods. Interspecific hybridisation was detected, but its role in resistance evolution remains unclear. [ABSTRACT FROM AUTHOR]

This article characterizes the weed seedbank after a 12-yr rotation of cotton (Gossypium hirsutum L.)-tomato (Lycopersicon esculentum L.) under standard tillage (ST) and conservation tillage (CT) with and without cover crops in Five Points, CA, from 1999 to 2011. Treatment comparisons included standard tillage with no cover crop (STNO), standard tillage with cover crop (STCC), conservation tillage with no cover crop (CTNO), and conservation tillage with cover crop (CTCC). Weed density, by species, in each plot was assessed in 2003, 2006, and 2011. In 2011, soil cores were taken from each plot and seedlings that emerged from these cores were monitored in the greenhouse, counted by species, and the data were subjected to canonical discriminant analysis. Differences in weed densities were not consistent between CT and ST plots but they were generally greater in plots with cover crops than in those without, particularly in the CT system. The seedbank size was largest in the CTCC system. The weed seedbank community composition of this system was also distinctly different from the other systems. Shepherd's-purse (Capsella bursa-pastoris L. Medik.), black nightshade (Solanum nigrum L.), henbit (Lamium amplexicaule L.), and common chickweed (Stellaria media L. Vill.) were associated with the CTCC system. Barnyardgrass (Echinochloa crus-galli L. Beauv.) and horseweed (Conyza canadensis L. Cronq.) were associated with the CTNO system. Although differences in the aboveground weed densities were inconsistent between the tillage systems, the weed seedbank size was greater in the CT system and having a cover crop further increased the seedbank size. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Traumatic Stress is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

A new spinicaudatan (clam shrimp), Hardapestheria maxwelli gen. et sp. nov., is described from the Jurassic Kalkrand Formation of central Namibia. Specimens were collected from a sedimentary interbed within a succession of flood basalts. These are the first spinicaudatans to be described from the Jurassic of south-western Africa. The new taxon is assigned to the family Eosestheriidae based on the combination of punctae and radial ornamentation on the carapace. Ornamentation on the growth bands in H. maxwelli differs from other eosestheriid genera because the punctate ornamentation is not restricted to the dorsal region of the carapace. Instead, all growth bands include a proximal region with punctae even though the distal portion of each growth band may exhibit anastomosing lirae. Among well-documented Mesozoic spinicaudatan genera, Hardapestheria is most closely related to Carapacestheria from the contemporaneous Kirkpatrick Basalt of Antarctica and Yanjiestheria from the Early Cretaceous of China. Hardapestheria maxwelli displays sexual dimorphism, which can be definitively related to a dioecious mating system with discrete male and female individuals. Review of additional early members of the Eosestheriidae suggests that the maintenance of two discrete sexes was the ancestral state for the clade. The ability to discriminate sexual mating system type unambiguously is rare in fossils, and this new species sheds light on the relationship between environmental stability and mating system evolution. [ABSTRACT FROM AUTHOR]

Recent increases in glyphosate use in perennial crops of California, USA, are hypothesized to have led to an increase in selection and evolution of resistance to the herbicide in Conyza canadensis populations. To gain insight into the evolutionary origins and spread of resistance and to inform glyphosate resistance management strategies, we investigated the geographical distribution of glyphosate resistance in C. canadensis across and surrounding the Central Valley, its spatial relationship to groundwater protection areas (GWPA), and the genetic diversity and population structure and history using microsatellite markers. Frequencies of resistant individuals in 42 sampled populations were positively correlated with the size of GWPA within counties. Analyses of population genetic structure also supported spread of resistance in these areas. Bayesian clustering and approximate Bayesian computation (ABC) analyses revealed multiple independent origins of resistance within the Central Valley. Based on parameter estimation in the ABC analyses, resistant genotypes underwent expansion after glyphosate use began in agriculture, but many years before it was detected. Thus, diversity in weed control practices prior to herbicide regulation in GWPA probably kept resistance frequencies low. Regionally coordinated efforts to reduce seed dispersal and selection pressure are needed to manage glyphosate resistance in C. canadensis. [ABSTRACT FROM AUTHOR]

The identification of leptin as a mediator of body weight regulation provided much initial excitement for the treatment of obesity. Unfortunately, leptin monotherapy is insufficient in reversing obesity in rodents or humans. Recent findings suggest that amylin is able to restore leptin sensitivity and when used in combination with leptin enhances body weight loss in obese rodents and humans. However, as the uniqueness of this combination therapy remains unclear, we assessed whether co-administration of leptin with other weight loss-inducing hormones equally restores leptin responsiveness in diet-induced obese (DIO) mice. Accordingly, we report here the design and characterization of a series of site-specifically enhanced leptin analogs of high potency and sustained action that, when administered in combination with exendin-4 or fibroblast growth factor 21 (FGF21), restores leptin responsiveness in DIO mice after an initial body weight loss of 30%. Using either combination, body weight loss was enhanced compared with either exendin-4 or FGF21 monotherapy, and leptin alone was sufficient to maintain the reduced body weight. In contrast, leptin monotherapy proved ineffective when identical weight loss was induced by caloric restriction alone over a comparable time. Accordingly, we find that a hypothalamic counter-regulatory response to weight loss, assessed using changes in hypothalamic agouti related peptide (AgRP) levels, is triggered by caloric restriction, but blunted by treatment with exendin-4. We conclude that leptin re-sensitization requires pharmacotherapy but does not appear to be restricted to a unique signaling pathway. Our findings provide preclinical evidence that high activity, long-acting leptin analogs are additively efficacious when used in combination with other weight-lowering agents. Copyright © 2012 European Peptide Society and John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Unlike the post-Vietnam era, effective, specialized treatments for posttraumatic stress disorder (PTSD) now exist, although these treatments have not been widely available in clinical settings. The U.S. Department of Veterans Affairs (VA) is nationally disseminating 2 evidence-based psychotherapies for PTSD throughout the VA health care system. The VA has developed national initiatives to train mental health staff in the delivery of Cognitive Processing Therapy (CPT) and Prolonged Exposure therapy (PE) and has implemented a variety of strategies to promote local implementation. In this article, the authors examine VA's national CPT and PE training initiatives and report initial patient, therapist, and system-level program evaluation results. Key issues, lessons learned, and next steps for maximizing impact and sustainability are also addressed. [ABSTRACT FROM AUTHOR]

Atomic-resolution structures from small proteins have recently been deter- mined from high-quality powder diffraction patterns using a combination of stereochemical restraints and Rietveld refinement [Von Dreele (2007), J. Appl. Cryst. 40, 133-143; Margiolaki et al. (2007), J. Am. Chem. Soc. 129, 11865- 11871]. While powder diffraction data have been obtained from batch samples of small crystal-suspensions, which are exposed to X-rays for long periods of time and undergo significant radiation damage, the proof-of-concept that protein powder diffraction data from nanocrystals of a membrane protein can be obtained using a continuous microjet is shown. This flow-focusing aerojet has been developed to deliver a solution of hydrated protein nanocrystals to an X-ray beam for diffraction analysis. This method requires neither the crushing of larger polycrystalline samples nor any techniques to avoid radiation damage such as cryocooling. Apparatus to record protein powder diffraction in this manner has been commissioned, and in this paper the first powder diffraction patterns from a membrane protein, photosystem I, with crystallite sizes of less than 500 nm are presented. These preliminary patterns show the lowest-order reflections, which agree quantitatively with theoretical calculations of the powder profile. The results also serve to test our aerojet injector system, with future application to femtosecond diffraction in free-electron X-ray laser schemes, and for serial crystallography using a single-file beam of aligned hydrated molecules. [ABSTRACT FROM AUTHOR]

The resolution of X-ray diffraction microscopy is limited by the maximum dose that can be delivered prior to sample damage. In the proposed serial crystallography method, the damage problem is addressed by distributing the total dose over many identical hydrated macromolecules running continuously in a single-file train across a continuous X-ray beam, and resolution is then limited only by the available molecular and X-ray fluxes and molecular alignment. Orientation of the diffracting molecules is achieved by laser alignment. The incident X-ray fluence (energy/area) is evaluated that is required to obtain a given resolution from (i) an analytical model, giving the count rate at the maximum scattering angle for a model protein, (ii) explicit simulation of diffraction patterns for a GroEL-GroES protein complex, and (iii) the spatial frequency cut-off of the transfer function following iterative solution of the phase problem, and reconstruction of an electron density map in the projection approximation. These calculations include counting shot noise and multiple starts of the phasing algorithm. The results indicate counting time and the number of proteins needed within the beam at any instant for a given resolution and X-ray flux. An inverse fourth-power dependence of exposure time on resolution is confirmed, with important implications for all coherent X-ray imaging. It is found that multiple single-file protein beams will be needed for sub-nanometer resolution on current third-generation synchrotrons, but not on fourth-generation designs, where reconstruction of secondary protein structure at a resolution of 7 A should be possible with relatively short exposures. [ABSTRACT FROM AUTHOR]

Posttraumatic arthritis is one of the most frequent causes of disability following joint trauma. The objective of this study was to develop a model of a closed articular fracture in the mouse knee joint to quantify the temporal sequence of joint degeneration in a model of posttraumatic arthritis. Closed intraarticular fractures were created in the tibial plateau of adult mice (C57BL/6) using a computer-controlled materials testing system and a custom-built indenter tip. Tibial plateau fractures were classified and imaged over time using high-resolution digital radiography. Animals were sacrificed at 2, 4, 8, and 50 weeks following fracture, and the experimental and contralateral control limbs were harvested for histology and micro-computed tomography (microCT) analysis. By radiographic analysis, tibial plateau fractures closely resembled clinical fractures. More complex and comminuted fractures correlated to significantly higher fracture energies. Histologic analysis demonstrated progressive joint degeneration as measured by a modified Mankin scale, with fibrillation and loss of proteoglycan in the articular cartilage. Subchondral bone thickening was also observed in experimental joints. The induction of a closed intraarticular fracture of the mouse tibial plateau generated a reproducible and clinically relevant joint injury that progressed to osteoarthritis-like changes by histologic and microCT evaluations. The ability to induce joint degeneration without an osteotomy or open arthrotomy provides a valuable new model for studying the natural sequelae of posttraumatic arthritis. Notably, the use of a murine model will facilitate the use of genetically modified animals for the investigation of specific genes implicated in the pathology of posttraumatic arthritis. © 2007 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 25:578-592, 2007 [ABSTRACT FROM AUTHOR]

Since the introduction of posttraumatic stress disorder (PTSD) into the Diagnostic and Statistical Manual of Mental Disorders, Third Edition (DSM-III; American Psychiatric Association, 1980), considerable research has demonstrated the efficacy of several cognitive–behavioral therapy (CBT) programs in the treatment of chronic PTSD. Among these efficacious treatments is exposure therapy. Despite all the evidence for the efficacy of exposure therapy and other CBT programs, few therapists are trained in these treatments and few patients receive them. In this article, the authors review extant evidence on the reasons that therapists do not use these treatments and recent research on the dissemination of efficacious treatments of PTSD. [ABSTRACT FROM AUTHOR]

Epithelial–mesenchymal interactions are crucial for the proper development of many organs, including the pancreas. Within the pancreas, the ducts are thought to harbor stem/progenitor cells, and possibly to give rise to pancreatic ductal carcinoma. Little is known about the mechanism of formation of pancreatic ducts in the embryo. Pancreatic mesenchyme contains numerous soluble factors which help to sustain the growth and differentiation of exocrine and endocrine structures. Here, we report that one such morphoregulatory mesenchymal protein, epimorphin, plays an important role during pancreatic ductal proliferation and differentiation. We found that epimorphin is expressed in pancreatic mesenchyme during early stages of development, and at mesenchymal–epithelial interfaces surrounding the ducts at later stages. Strong upregulation of epimorphin expression was seen during in vitro pancreatic duct differentiation. Similarly, in vitro pancreatic duct formation was inhibited by a neutralizing antibody against epimorphin, whereas addition of recombinant epimorphin partially rescued duct formation. Together, our study demonstrates the role of epimorphin in pancreatic ductal morphogenesis. [ABSTRACT FROM AUTHOR]

The effect of the limited alignment of hydrated molecules is considered in a laser-aligned molecular beam, on diffraction patterns taken from the beam. Simulated patterns for a protein beam are inverted using the Fienup- Gerchberg-Saxton phasing algorithm, and the effect of limited alignment on the resolution of the resulting potential maps is studied. For a typical protein molecule (lysozyme) with anisotropic polarizability, it is found that up to 1 kW of continuous-wave near-infrared laser power (depending on dielectric constant), together with cooling to liquid-nitrogen temperatures, may be needed to produce sufficiently accurate alignment for direct observation of the secondary structure of proteins in the reconstructed potential or charge-density map. For a typical virus (TMV), a 50 W continuous-wave laser is adequate for subnanometre resolution at room temperature. The dependence of resolution on laser power, temperature, molecular size, shape and dielectric constant is analyzed. [ABSTRACT FROM AUTHOR]

Many studies have demonstrated the efficacy of exposure therapy in the treatment of chronic posttraumatic stress disorder (PTSD). Despite the convincing outcome literature, a concern that this treatment may exacerbate symptoms and lead to premature dropout has been voiced on the basis of a few reports. In this paper, we examined the hypothesis that treatments that include exposure will be associated with a higher dropout rate than treatments that do not include exposure. A literature search identified 25 controlled studies of cognitive–behavioral treatment for PTSD that included data on dropout. The results indicated no difference in dropout rates among exposure therapy, cognitive therapy, stress inoculation training, and EMDR. These findings are consistent with previous research about the tolerability of exposure therapy. [ABSTRACT FROM AUTHOR]

This paper provides an overview of several treatment interventions for trauma-related disturbances in adult victims of crime. Following a brief discussion of mental health service utilization among crime victims, we describe interventions for acute and chronic reactions to trauma. We present some controlled studies of psychosocial treatments for posttraumatic stress disorder (PTSD) that have gained empirical support and are recommended as first line interventions by expert consensus (E. B. Foa, J. R. T. Davidson, & A. Francis, 1999) including exposure therapy, cognitive therapy, and stress inoculation training, followed by a brief summary of selected studies examining the efficacy of pharmacological treatment for PTSD. Finally, we discuss multicultural issues, factors associated with treatment outcome, and challenges we have encountered in treating crime victims. [ABSTRACT FROM AUTHOR]

Images of randomly placed two-dimensional arrays of gold balls have been reconstructed from their soft-X-ray transmission diffraction patterns. An iterative hybrid input-output (HiO) algorithm was used to solve the phase problem for the continuous distribution of diffuse X-ray scattering. Knowledge of the approximate size of the clusters was required. The images compare well with scanning electron microscope (SEM) images of the same sample. The use of micrometre-sized silicon nitride window supports is suggested, and absorption filters have been used to allow collection of low spatial frequencies often obscured by a beam stop. This method of phasing diffuse scattering may have application to scattering from individual inorganic nanostructures or single macromolecules. [ABSTRACT FROM AUTHOR]

The article presents a case study depicting the treatment of a male patient presenting with symptoms resembling post-traumatic stress disorder (PTSD), particularly commenting on the use of prolonged exposure (PE). It addresses the patient's comorbid issues of substance abuse as a coping mechanism, the lasting psychological impact of sexual abuse, and emotionally processing traumatic events.

This article responds to the commentary on Elizabeth A. Hembree's and Edna B. Foa's review of interventions for trauma-related disturbances in adult trauma victims. According to this article, the author of the commentary took umbrage with the summary of research on the efficacy of eye movement desensitization and reprocessing for the treatment of trauma-related symptoms. This article reaffirms the conclusion that has been made by Hembree and Foa originally offered in their review, that assertions about an important role for eye movements or any other laterally alternating stimuli on treatment outcome have not been supported by extant research. [ABSTRACT FROM AUTHOR]