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Physical activity has been found to alter sleep architecture, but these effects have been studied predominantly in the laboratory and the generalizability of these findings to naturalistic environments and longer time intervals, as well as their psychological effects, have not been evaluated. Recent technological advancements in wearable devices have made it possible to capture detailed measures of sleep outside the lab, including timing of specific sleep stages. In the current study, we utilized photoplethysmography coupled with accelerometers and smartphone ambulatory assessment to collect daily measurements of sleep, physical activity and mood in a sample of N = 82 over multi-month data collection intervals. We found a robust inverse relationship between sedentary behavior and physical activity and sleep architecture: both low-intensity and moderate-to-vigorous physical activity were associated with increased NREM sleep and decreased REM sleep, as well as a longer REM latency, while higher levels of sedentary behavior showed the opposite pattern. A decreased REM/NREM ratio and increased REM latency were in turn associated with improved wellbeing, including increased energy, reduced stress and enhanced perceived restfulness of sleep. Our results suggest that physical activity and sleep account for unique variance in a person's mood, suggesting that these effects are at least partially independent. [ABSTRACT FROM AUTHOR]

Staff of the ambulatory infusion clinic at a Magnetdesignated academic medical center observed the rates of adverse venous events, including infiltration and extravasation. An evidence-based quality improvement project was developed to standardize venous access assessment using the Modified Adult Difficult IV Access Scale in conjunction with competency validation for safe administration of vesicant chemotherapy agents according to practice standards. Postimplementation data revealed a 79% reduction in adverse venous events. [ABSTRACT FROM AUTHOR]

Abstract Objective: To examine providers’ perceptions of integrated care prior to the merger of a university’s student health center and counseling services. Participants: Seventeen providers across student health services (n = 9) and counseling (n = 8) agreed to participate in the qualitative study. Method: Semi-structured individual interviews that focused on the perceived benefits and challenges of the merger were conducted in December 2019. Following the interviews, a thematic analysis was completed. Results: The perceived benefits noted by providers centered on the ability of an interdisciplinary team to improve the coordination of, access to, and quality of care delivered to students. However, more anticipated challenges were reported by providers (e.g., differences in training and care protocols, losing one’s autonomy as a provider). Conclusions: This qualitative study provides a more in-depth analysis of providers’ perceptions of integrated care prior to implementation in a university setting and may have implications for model adoption. [ABSTRACT FROM AUTHOR]

Objective: Given the substantial demands of cancer caregiving, practical and psychometrically sound tools to evaluate distress among cancer caregivers are needed. CancerSupportSourceTM‐Caregiver is a distress screening, referral, and support program designed to identify the unmet needs of cancer caregivers and link caregivers to desired resources and support. This study refined and finalized the CancerSupportSource‐Caregiver screening measure and examined its psychometric properties. Methods: Using an analytic sample of 400 caregivers to people with cancer, we first performed item reduction by assessing exploratory factor analysis, external/internal item quality, and judging theoretical and practical implications of items. Confirmatory factor analysis along with reliability and validity analyses were then conducted to corroborate dimensionality and psychometric properties of the final measure. Nonparametric receiver operating characteristic curve analyses determined scoring thresholds for depression and anxiety risk subscales. Results: Scale refinement resulted in an 18‐item measure plus one screening item assessing tobacco and substance use. Items represented five domains of caregiver concerns: emotional well‐being, patient well‐being, caregiving tasks, finances, and healthy lifestyle. Our analyses showed strong internal consistency and test‐retest reliability, a replicable factor structure, and adequate convergent, discriminant, and known groups validity. Sensitivity of 2‐item depression and 2‐item anxiety risk subscales were 0.95 and 0.87, respectively. Conclusions: CancerSupportSource‐Caregiver is a reliable and valid multidimensional measure of caregiver distress that also screens for risk for clinically significant depression and anxiety. It can be implemented within a distress screening, referral, and follow‐up program to rapidly assess caregivers' unmet needs and enhance caregiver well‐being across the care continuum. [ABSTRACT FROM AUTHOR]

Background: Caregivers are rarely assessed for caregiving-related strain. This study explored the psychometric properties of the caregiving-related physical, emotional, and financial strain questions in the National Alliance for Caregiving's (NAC) survey and a new total score (NAC-3). Methods: Comparisons were made to existing caregiver quality of life, distress, and burden instruments through an online, cross-sectional survey of U.S. adult cancer caregivers. Results: Findings from 299 caregivers showed that the NAC-3 was moderately to strongly associated with each of the comparison instruments. Similar concepts were also shown to be more strongly correlated (except physical health construct) and dissimilar concepts items had weaker correlations. Conclusion: Findings suggest that the total score and individual items are psychometrically sound for use as compared to established caregiving-related instruments. The total score and items provide a concise option, potentially beneficial for clinical use, and can be compared to nationally representative samples of caregivers through NAC's surveys. [ABSTRACT FROM AUTHOR]

This essay focuses on contemporary author Lyudmila Ulitskaya’s novel The Kukotsky Case, which has received little attention from Anglophone scholars. The novel, first published in Russian in 2001 and then in English translation in 2016, centers the ethics of women’s health and medical care in the Soviet Union, from the Stalinist period through the collapse. The complex nexus of questions regarding the (im)per - missible in reproductive health and maternity forms the major narrative arc. Using a conceptual framework from the modern Medical Humanities, which emphasize writing and storytelling as valuable tools that can facilitate healing, I explore how The Kukotsky Case innovates writing the pregnant body in the Russian literary canon. In contrast to her male predecessors (Dostoevsky, Tolstoy, Chekhov), whose descriptions of childbearing and mothering have dominated the Russian literary tradition, Ulitskaya merges her own professional background in genetics with her creative powers as a writer so that experiencers of pregnancy can better access and appreciate their own metamorphosis. [ABSTRACT FROM AUTHOR]

Background: The sharp rise in opioid use disorder (OUD) among women coupled with disproportionally high rates of unintended pregnancy have led to a four-fold increase in the number of pregnant women with OUD in the United States over the past decade. Supporting intentional family planning can have multiple health benefits and reduce harms related to OUD but requires a comprehensive understanding of women's perspectives of preventing unintended pregnancies. The purpose of this study was to comprehensively evaluate the knowledge, attitudes and experiences as they relate to seeking contraception, particularly LARCs, among women with active or recovered opioid misuse. Methods: In-depth interviews and focus group discussions with 36 women with current or past opioid misuse were recorded and transcribed. Transcripts were coded by ≥ 2 investigators. Themes related to contraceptive care seeking were identified and contextualized within the Health Belief Model. Results: Our analysis revealed seven interwoven themes that describe individual level factors associated with contraceptive care seeking in women with current or past opioid misuse: relationship with drugs, reproductive experiences and self-perceptions, sexual partner dynamics, access, awareness of options, healthcare attitudes/experiences, and perceptions of contraception efficacy/ side effects. Overall, perceived susceptibility and severity to unintended pregnancy varied, but most women perceived high benefits of contraception, particularly LARC. However, perceived barriers were too high for most to obtain desired contraception to support family planning intentions. Conclusions: The individual-level factors identified should inform the design of integrated services to promote patient-centered contraceptive counseling as a form of harm reduction. Interventions should reduce barriers to contraceptive access, particularly LARCs, and establish counseling strategies that use open, non-judgmental communication, acknowledge the continuum of reproductive needs, explore perceived susceptibility to pregnancy, and utilize peer educators. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To compare serum cardiac troponin I (cTnI) concentrations between sea otters with and without cardiomyopathy and describe 2 cases of cardiomyopathy with different etiologies. ANIMALS: 25 free-ranging southern sea otters (Enhydra lutris nereis) with (n = 14; cases) and without (11; controls) cardiomyopathy and 17 healthy managed southern sea otters from aquariums or rehabilitation centers (controls). PROCEDURES: Serum cTnI concentration was measured in live sea otters. Histopathologic and gross necropsy findings were used to classify cardiomyopathy status in free-ranging otters; physical examination and echocardiography were used to assess health status of managed otters. Two otters received extensive medical evaluations under managed care, including diagnostic imaging, serial cTnI concentration measurement, and necropsy. RESULTS: A significant difference in cTnI concentrations was observed between cases and both control groups, with median values of 0.279 ng/mL for cases and < 0.006 ng/mL for free-ranging and managed controls. A cutoff value of = 0.037 ng/mL yielded respective sensitivity and specificity estimates for detection of cardiomyopathy of 64.3% and 90.9% for free-ranging cases versus free-ranging controls and 64.3% and 94.1% for free-ranging cases versus managed controls. CONCLUSIONS AND CLINICAL RELEVANCE: Cardiomyopathy is a common cause of sea otter death that has been associated with domoic acid exposure and protozoal infection. Antemortem diagnostic tests are needed to identify cardiac damage. Results suggested that serum cTnI concentration has promise as a biomarker for detection of cardiomyopathy in sea otters. Serial cTnI concentration measurements and diagnostic imaging are recommended to improve heart disease diagnosis in managed care settings. [ABSTRACT FROM AUTHOR]

Purpose: Cancer caregiving is shown to be a burdensome experience in typical times. The purpose of this study was to describe cancer caregivers' emotional, physical, and financial strain during the COVID-19 pandemic and compared to preCOVID-19, and explore racial and ethnic variations in caregiver strain. Methods: We conducted a cross-sectional online survey using Lucid, LLC, incorporating quotas for race, ethnicity, gender and age. Caregivers had to be adults living in the USA and currently providing unpaid care to an adult cancer patient (i.e., during COVID-19) and prior to the pandemic. We assessed the caregivers' emotional, physical, and financial strain and asked them to compare to preCOVID-19 caregiving. Analyses included descriptive and linear regression adjusting for sociodemographic and caregiving-related variables. Results: A total of 285 caregivers met eligibility, and most were nonHispanic white (72.3%) and female (59.6%). Based on a scale of "1: Much lower" to "5: Much higher", the financial, physical and emotional strain/stress experienced by caregivers compared to preCOVID-19 was, on average, 3.52 (SD: 0.82; range: 1–5) for financial strain, 3.61 (SD: 0.86; range: 1–5) for physical strain, and 3.88 (SD: 0.89; range: 1–5) for emotional stress. NonHispanic black caregivers were significantly more likely than nonHispanic white caregivers to indicate that caregiving-related financial strain was higher than preCOVID-19. Moreover, Hispanic caregivers compared to nonHispanic white caregivers reported caregiving-related emotional stress was higher than preCOVID-19. Conclusion: These findings suggest a need to be attentive to racial and ethnic variations in emotional and financial strain and provide targeted support in clinical care and via public policy during a public health crisis. [ABSTRACT FROM AUTHOR]

Attention-deficit/hyperactivity disorder (ADHD) and anxiety disorders are highly prevalent diagnoses in adult populations. Although there are substantial qualitative differences between these two diagnoses, both are characterized by impairments in executive functioning (EF) -- the cognitive processes necessary for completing day-to-day tasks. Recent decades have seen an influx in research on the nature and consequences of such impairments; however, the resulting evidence is mixed. Although some studies suggest deficits are constrained to individual -- but unagreed upon -- EF domains, very few have investigated the unique EF profiles of ADHD and anxiety in adult populations. Further, despite the high comorbidity of ADHD and anxiety, there are many outstanding questions about the impact of co-morbid diagnoses on an individual's EF strengths and weaknesses. The current pilot study investigated the association between EF task performance and symptoms of both anxiety and ADHD in a non-clinical sample of adults, using computerized EF tasks and self-report symptom questionnaires. Results showed that when controlling for potential confounds, higher ADHD symptoms were associated with poorer accuracy on a set shifting task, and higher anxiety symptoms were associated with slower responses on an inhibitory control task. This study provides preliminary evidence for unique EF impairments associated with ADHD symptoms versus anxiety symptoms and warrants further investigation in both clinical and non-clinical samples. [ABSTRACT FROM AUTHOR]

It is a critical commonplace that the young Chekhov owed a substantial debt to the French author Emile Zola, who was famous throughout European letters, many would say notorious, for his forthright, oftentimes graphic depictions of sexuality and the human body. However, this commonplace is a shallow one: most parallels between Chekhov and Zola in contemporary criticism are made in passing and a full‐length study on the two authors has yet to be undertaken. In this connection, my article explores how those very features found in Zola that so infuriated critics of his day, including his graphic sexuality, his love of raw detail, and his oftentimes haphazard blend of in vogue scientific theories and imaginative literature, shaped Chekhov's own work. More specifically, I focus on Chekhov's relationship to one of Zola's most intriguing scandals, the publication of his novel Therese Raquin. In his scandalous introduction to this work, Zola laid out his Naturalist method of writing imaginative literature. In his view, an author must be a "surgeon" who performs analysis on his characters, in particular his female characters, in the same way a doctor does an autopsy on a corpse. My article examines the implications such an artistic orientation had for the young Anton Chekhov, who as both a professional physician and a professional artist, responded particularly to Zola's dual self‐posturing and its resulting implications for describing complex female characters in Russian literature. [ABSTRACT FROM AUTHOR]

Highlights • Two manure application methods were compared for loss of P species and TS. • Shallow-disk manure injection caused more dilution of DP and TP than broadcasting. • Shallow-disk injection reduced soluble P availability more than broadcasting. • Broadcasting and shallow-disk injection led to similar transport dynamics for TS. • Large subsurface flow volumes were found to act as a primary diluter of P. Abstract Eutrophication and sedimentation are pervasive challenges in many agricultural watersheds. Recent research has promoted shallow-disk manure injection as a means of mitigating phosphorus (P) losses in runoff while maintaining the water quality benefits of no-till, such as reduced particulate P and sediment losses. However, the precision and accuracy of field studies seeking to quantify the effectiveness of shallow-disk injection as a P mitigation strategy are substantially constrained by hydrologic variability across spatial and temporal scales. In this study, overland and subsurface flow from twelve plots in central Pennsylvania (PA) were measured and sampled for all P constituents and total solids (TS) from January 2013 to May 2017. We regressed loads of total P (TP), dissolved P (DP), particulate P (PP), and TS against flow depths to evaluate how P and TS losses changed with increasing flow. The results revealed dilution of all P constituents and near-chemostatic behavior (little change in concentration with change in flow) for TS for both application methods. Shallow-disk injection was found to be more effective than broadcasting in promoting dilution of DP, and to a lesser extent, TP. In contrast, the broadcast plots showed stronger dilution patterns than did the injection plots for PP, and there was no difference between application methods for TS. Variability among plots within each manure application practice was largely dependent on relative contributions of overland and subsurface flow due to increased dilution of P by subsurface flow. Overall, shallow-disk injection appears to be an effective practice to reduce DP and TP losses without negating the erosion-reducing benefits of no-till. [ABSTRACT FROM AUTHOR]

Numerous studies have documented a gender gap in political knowledge. Men score higher than women on quiz-style survey questions testing knowledge of national-level electoral politics and the “rules of the game.” Structural, situational, and psychological factors have been examined as possible explanations, but a residual gap remains after they are controlled. Two broad explanations have been advanced in the literature. First, women’s differential propensity to respond “don’t know” depresses their scores when correct answers to knowledge questions are tallied. Second, political knowledge questions typically focus on national-level electoral politics and the rules of the game, a focus that privileges men. This article joins these two broad explanations. Using a statewide survey of Ohio voters, it provides clear evidence that the residual gender gap in political knowledge is an artifact of measurement. Both the don’t know response and a focus on national-level politics and the rules of the game favor men. [ABSTRACT FROM AUTHOR]

Invasive Burmese pythons (Python bivittatus Kuhl, 1820) have introduced a lung parasite, Raillietiella orientalis, (Hett, 1915) from the python’s native range in Southeast Asia to its introduced range in Florida, where parasite spillover from pythons to two families and eight genera of native snakes has occurred. Because these novel host species present a diversity of ecological and morphological traits, and because these parasites attach to their hosts with hooks located on their cephalothorax, we predicted that R. orientalis would exhibit substantial, host-associated phenotypic plasticity in cephalothorax shape. Indeed, geometric morphometric analyses of 39 parasites from five host species revealed significant variation among host taxa in R. orientalis cephalothorax shape. We observed differences associated with host ecology, where parasites from semi-aquatic and aquatic snakes exhibited the greatest morphological similarity. Morphological analyses of R. orientalis recovered from invasive pythons, native pit vipers, and terrestrial snakes each revealed distinct shapes. Our results suggest R. orientalis can exhibit significant differences in morphology based upon host species infected, and this plasticity may facilitate infection with this non-native parasite in a wide array of novel squamate host species. [ABSTRACT FROM AUTHOR]

Study Question: Does a man (patient 1) with a previously described deficiency in principle cation channel of sperm (CatSper) function have a mutation in the CatSper-epsilon (CATSPERE) and/or CatSper-zeta (CATSPERZ) gene?Summary Answer: Patient 1 has a homozygous in-frame 6-bp deletion in exon 18 (c.2393_2398delCTATGG, rs761237686) of CATSPERE.What Is Known Already: CatSper is the principal calcium channel of mammalian spermatozoa. Spermatozoa from patient 1 had a specific loss of CatSper function and were unable to fertilize at IVF. Loss of CatSper function could not be attributed to genetic abnormalities in coding regions of seven CatSper subunits. Two additional subunits (CatSper-epsilon (CATPSERE) and CatSper-zeta (CATSPERZ)) were recently identified, and are now proposed to contribute to the formation of the mature channel complex.Study Design, Size, Duration: This was a basic medical research study analysing genomic data from a single patient (patient 1) for defects in CATSPERE and CATSPERZ.Participants/materials, Setting, Methods: The original exome sequencing data for patient 1 were analysed for mutations in CATSPERE and CATSPERZ. Sanger sequencing was conducted to confirm the presence of a rare variant.Main Results and the Role Of Chance: Patient 1 is homozygous for an in-frame 6-bp deletion in exon 18 (c.2393_2398delCTATGG, rs761237686) of CATSPERE that is predicted to be highly deleterious.Limitations, Reasons For Caution: The nature of the molecular deficit caused by the rs761237686 variant and whether it is exclusively responsible for the loss of CatSper function remain to be elucidated.Wider Implications Of the Findings: Population genetics are available for a significant number of predicted deleterious variants of CatSper subunits. The consequence of homozygous and compound heterozygous forms on sperm fertilization potential could be significant. Selective targeting of CatSper subunit expression maybe a feasible strategy for the development of novel contraceptives.Study Funding/competing Interest(s): This study was funded by project grants from the MRC (MR/K013343/1 and MR/012492/1), Chief Scientist Office/NHS research Scotland. This work was also supported by NIH R01GM111802, Pew Biomedical Scholars Award 00028642 and Packer Wentz Endowment Will to P.V.L. C.L.R.B is the editor-in-chief of Molecular Human Reproduction, has received lecturing fees from Merck and Ferring, and is on the Scientific Advisory Panel for Ohana BioSciences. C.L.R.B was chair of the World Health Organization Expert Synthesis Group on Diagnosis of Male infertility (2012-2016). [ABSTRACT FROM AUTHOR]

Both preclinical and clinical evidence suggests that the endogenous opioid system is involved in responses to stress. For example, in animal models opioid agonists reduce isolation distress whereas opioid antagonists increase isolation distress. We recently reported that the mixed mu agonist and kappa antagonist buprenorphine dampened responses to acute psychosocial stress in humans. Now we extend this to study the effects of a pure mu-opioid agonist, hydromorphone, and a non-opioid analgesic, acetaminophen, on response to social stress. We compared the effect of hydromorphone (2 and 4 mg), acetaminophen (1000 mg) to a placebo using a between subject design. Healthy adult volunteers were randomly assigned to receive placebo ( N  = 13), 2 mg hydromorphone ( N  = 12), 4 mg hydromorphone (N = 12), or 1000 mg acetaminophen (paracetamol; N = 13) under double-blind conditions before undergoing a stress task or a control task on two separate sessions. The stress task, consisting of a standardized speaking task and the non-stressful control task were presented in counterbalanced order. Dependent measures included mood ratings, subjective appraisal of the stress (or no-stress) task, salivary cortisol, pupil diameter, heart rate, and blood pressure. The stress task produced its expected increase in heart rate, blood pressure, salivary cortisol, pupil diameter, and subjective ratings of anxiety and negative mood. Hydromorphone dose-dependently dampened cortisol responses to stress, and decreased ratings of how “challenging” participants found the task. Acetaminophen did not affect physiological responses, but, like hydromorphone, decreased ratings of how “challenging” the task was. The hydromorphone results support the idea that the mu-opioid system is involved in physiological responses to acute stress in humans, in line with results from preclinical studies. The non-opioid analgesic acetaminophen did not dampen physiological responses, but did reduce some components of psychological stress. It remains to be determined how both opioid and non-opioid systems mediate the complex physiological and psychological responses to social stress. [ABSTRACT FROM AUTHOR]

Identification of the origin of parasites of nonindigenous species (NIS) can be complex. NIS may introduce parasites from their native range and acquire parasites from within their invaded range. Determination of whether parasites are non-native or native can be complicated when parasite genera occur within both the NIS' native range and its introduced range. We explored potential for spillover and spillback of lung parasites infecting Burmese pythons (Python bivittatus) in their invasive range (Florida). We collected 498 indigenous snakes of 26 species and 805 Burmese pythons during 2004-2016 and examined them for lung parasites. We used morphology to identify three genera of pentastome parasites, Raillietiella, a cosmopolitan form, and Porocephalus and Kiricephalus, both New World forms. We sequenced these parasites at one mitochondrial and one nuclear locus and showed that each genus is represented by a single species, R. orientalis, P. crotali, and K. coarctatus. Pythons are host to R. orientalis and P. crotali, but not K. coarctatus; native snakes are host to all three species. Sequence data show that pythons introduced R. orientalis to North America, where this parasite now infects native snakes. Additionally, our data suggest that pythons are competent hosts to P. crotali, a widespread parasite native to North and South America that was previously hypothesized to infect only viperid snakes. Our results indicate invasive Burmese pythons have affected parasite-host dynamics of native snakes in ways that are consistent with parasite spillover and demonstrate the potential for indirect effects during invasions. Additionally, we show that pythons have acquired a parasite native to their introduced range, which is the initial condition necessary for parasite spillback. [ABSTRACT FROM AUTHOR]

В статье рассматривается сравнительно малоизученная повесть Чехова «Именины». Повесть была написана в 1888 году, когда Чехов сам признался в том, что он был под гипнозом Толстого. Многие ученые сводят влияние Толстого на рассказы и повести Чехова этих лет к имитации толстовства. Они, однако, упускают из виду то, что уже в конце 1880-х, Чехов начал полемизировать с Толстым, особенно с тем, как последний описывал беременность и роды в своем романе «Анна Каренина». Статья доказывает, что Чехов, вводя аллюзии к «Анне Карениной», изображает совершенно другой портрет роженицы. На взгляд Толстого, деторождение должно символизировать небесный зов, который соединяет всех матерей в святое сообщество. В отличие от старшего автора, Чехов подчеркивает парадоксальность беременности и родов для молодой женщины. В творчестве Чехова, беременность и роды одновременно являются страшными и сенсуалистическими; они служат для матери источником связи с миром—через ее нерожденного ребенка—и одновременно отделяют ее от всех остальных. [ABSTRACT FROM AUTHOR]

Rationale: ±3,4-Methylenedioxymethamphetamine (MDMA, 'ecstasy') is a stimulant-psychedelic drug with unique social effects. It may dampen reactivity to negative social stimuli such as social threat and rejection. Perhaps because of these effects, MDMA has shown promise as a treatment for post-traumatic stress disorder (PTSD). However, the effect of single doses of MDMA on responses to an acute psychosocial stressor has not been tested. Objectives: In this study, we sought to test the effects of MDMA on responses to stress in healthy adults using a public speaking task. We hypothesized that the drug would reduce responses to the stressful task. Methods: Volunteers ( N = 39) were randomly assigned to receive placebo ( N = 13), 0.5 mg/kg MDMA ( N = 13), or 1.0 mg/kg MDMA ( N = 13) during a stress and a no-stress session. Dependent measures included subjective reports of drug effects and emotional responses to the task, as well as salivary cortisol, heart rate, and blood pressure. Results: The stress task produced its expected increase in physiological responses (cortisol, heart rate) and subjective ratings of stress in all three groups, and MDMA produced its expected subjective and physiological effects. MDMA alone increased ratings of subjective stress, heart rate, and saliva cortisol concentrations, but contrary to our hypothesis, it did not moderate responses to the Trier Social Stress Test. Conclusions: Despite its efficacy in PTSD and anxiety, MDMA did not reduce either the subjective or objective responses to stress in this controlled study. The conditions under which MDMA relieves responses to negative events or memories remain to be determined. [ABSTRACT FROM AUTHOR]

The calcium channel of sperm (CatSper) is essential for sperm hyperactivated motility and fertility. The steroid hormone progesterone activates CatSper of human sperm via binding to the serine hydrolase ABHD2. However, steroid specificity of ABHD2 has not been evaluated. Here, we explored whether steroid hormones to which human spermatozoa are exposed in the male and female genital tract influence CatSper activation via modulation of ABHD2. The results show that testosterone, estrogen, and hydrocortisone did not alter basal CatSper currents, whereas the neurosteroid pregnenolone sulfate exerted similar effects as progesterone, likely binding to the same site. However, physiological concentrations of testosterone and hydrocortisone inhibited CatSper activation by progesterone. Additionally, testosterone antagonized the effect of pregnenolone sulfate. We have also explored whether steroid-like molecules, such as the plant triterpenoids pristimerin and lupeol, affect sperm fertility. Interestingly, both compounds competed with progesterone and pregnenolone sulfate and significantly reduced CatSper activation by either steroid. Furthermore, pristimerin and lupeol considerably diminished hyperactivation of capacitated spermatozoa. These results indicate that (i) pregnenolone sulfate together with progesterone are the main steroids that activate CatSper and (ii) pristimerin and lupeol can act as contraceptive compounds by averting sperm hyperactivation, thus preventing fertilization. [ABSTRACT FROM AUTHOR]

Becoming a Responsible Teen (BART) is a community-based, HIV risk reduction curriculum shown to increase safer sex behaviors among African American adolescents. However, BART does not address common barriers to sexual health care access, which may limit program efficacy. We used a community-engaged adaptation process to maximize program relevance and health outcomes by incorporating a broad ecological perspective. Adolescent and staff advisory boards at a community-based organization recommended modifications (e.g., delete references to Kwanzaa, update language, localize incentives) and supported inclusion of critical on-site health services, such as sexually transmitted infection testing and condom provision. We conducted a trial of adapted BART (one session/week for 8 weeks) with 36 adolescents at two community organizations (mean age = 15.5 years, 52% female; 61% reported previous sexual intercourse). Most received on-site sexually transmitted infection testing (61%) and condoms (70%). Adolescents demonstrated significant improvements in self-efficacy for safer sexual practices (p < .02), AIDS risk knowledge (p < .001), condom knowledge (p < .001), and condom attitudes (p < .04). Adolescents and staff were satisfied with the revised curriculum and found on-site services acceptable. Based on improvements in constructs influencing behavior and the successful delivery of services essential for optimal health, future studies to assess efficacy and sustainability of the adapted curriculum appear warranted. [ABSTRACT FROM AUTHOR]

±3,4-Methylenedioxymethamphetamine (MDMA) is a popular recreational drug that enhances sociability and feelings of closeness with others. These "prosocial" effects appear to motivate the recreational use of MDMA and may also form the basis of its potential as an adjunct to psychotherapy. However, the extent to which MDMA differs from prototypic stimulant drugs, such as dextroamphetamine, methamphetamine, and methylphenidate, in either its behavioral effects or mechanisms of action, is not fully known. The purpose of this review is to evaluate human laboratory findings of the social effects of MDMA compared to other stimulants, ranging from simple subjective ratings of sociability to more complex elements of social processing and behavior. We also review the neurochemical mechanisms by which these drugs may impact sociability. Together, the findings reviewed here lay the groundwork for better understanding the socially enhancing effects of MDMA that distinguish it from other stimulant drugs, especially as these effects relate to the reinforcing and potentially therapeutic effects of the drug. [ABSTRACT FROM AUTHOR]

Four species of ticks known to parasitize humans (Amblyomma americanum (lone star tick), Dermacentor variabilis (American dog tick), Amblyomma maculatum (Gulf Coast tick), and Ixodes scapularis (black-legged tick)) were collected at Joint Base Langley-Eustis, Fort Eustis, Virginia during 2009. These ticks were tested individually (adults and nymphs) and in pools of 15 (larvae) for pathogens of public health importance within the genera: Rickettsia, Borrelia, and Ehrlichia, by quantitative real-time polymerase chain reaction (qPCR) assays and, where appropriate, multilocus sequence typing (MLST). Of the 340 A americanum ticks tested, a minimum of 65 (19%), 4 (1%), 4 (1%), and one (<1%) were positive for Rickettsia amblyommii, B lonestari, E ewingii and E chaffeensis, respectively. One of 2 (50%) A maculatum ticks collected was found to be positive for R parkeri by MLST and qPCR analyses. All 33 D variabilis ticks were negative for evidence of rickettsial infections. Likewise, no pathogenic organisms were detected from the single Ixodes scapularis tick collected. Pathogenic rickettsiae and ehrlichiae are likely emerging and cause under-recognized diseases, which threaten people who live, work, train, or otherwise engage in outdoor activities at, or in the vicinity of, Fort Eustis, Virginia. [ABSTRACT FROM AUTHOR]

Steroids regulate cell proliferation, tissue development, and cell signaling via two pathways: a nuclear receptor mechanism and genome-independent signaling. Sperm activation, egg maturation, and steroid-induced anesthesia are executed via the latter pathway, the key components of which remain unknown. Here, we present characterization of the human sperm progesterone receptor that is conveyed by the orphan enzyme α/β hydrolase domain-containing protein 2 (ABHD2). We show that ABHD2 is highly expressed in spermatozoa, binds progesterone, and acts as a progesterone-dependent lipid hydrolase by depleting the endocannabinoid 2-arachidonoylglycerol (2AG) from plasma membrane. The 2AG inhibits the sperm calcium channel (CatSper), and its removal leads to calcium influx via CatSper and ensures sperm activation. This study reveals that progesterone-activated endocannabinoid depletion by ABHD2 is a general mechanism by which progesterone exerts its genome-independent action and primes sperm for fertilization. [ABSTRACT FROM AUTHOR]

The evaluation for children with bruising may be affected by the specialty to which they are referred. We conducted a 3-year retrospective review of subjects referred for bruising to Child Abuse Pediatrics (CAP) or Pediatric Hematology to identify characteristics associated with referral to each specialty and to compare the diagnostic evaluations and diagnoses based on specialty. Of 369 subjects, 275 were referred to CAP and 94 to Hematology. Clinical exam findings were similar in both groups. Hematology referrals were significantly more likely to have laboratory evaluations. Among those referred to CAP, 9.5% had head computed tomography scans and 27.3% had skeletal surveys. No children referred to Hematology had these imaging studies performed. Hematology never diagnosed child physical abuse, and CAP never diagnosed bleeding disorders. Pediatric hematologists and CAPs perform different evaluations and reach different diagnostic conclusions for similar patients with bruising. Further investigation of these practice patterns is warranted. [ABSTRACT FROM AUTHOR]

Background Cow's milk intake has been inconsistently associated with islet autoimmunity ( IA) and type 1 diabetes ( T1D) development. Genetic and environmental factors may modify the effect of cow's milk on IA and T1D risk. Methods The Diabetes Autoimmunity Study in the Young ( DAISY) follows children at increased T1D risk of IA (presence of autoantibodies to insulin, GAD65, or IA-2 twice in succession) and T1D development. We examined 1835 DAISY children with data on cow's milk intake: 143 developed IA, 40 subsequently developed T1D. Cow's milk protein and lactose intake were calculated from prospectively collected parent- and self-reported food frequency questionnaires ( FFQ). High risk HLA-DR genotype: HLA-DR3/4, DQB1*0302; low/moderate risk: all other genotypes. We examined interactions between cow's milk intake, age at cow's milk introduction, and HLA-DR genotype in IA and T1D development. Interaction models contained the base terms (e.g., cow's milk protein and HLA-DR genotype) and an interaction term (e.g., cow's milk protein* HLA-DR genotype). Results In survival models adjusted for total calories, FFQ type, T1D family history, and ethnicity, greater cow's milk protein intake was associated with increased IA risk in children with low/moderate risk HLA-DR genotypes [hazard ratio ( HR): 1.41, 95% confidence interval ( CI): 1.08-1.84], but not in children with high risk HLA-DR genotypes. Cow's milk protein intake was associated with progression to T1D ( HR: 1.59, CI: 1.13-2.25) in children with IA. Conclusions Greater cow's milk intake may increase risk of IA and progression to T1D. Early in the T1D disease process, cow's milk intake may be more influential in children with low/moderate genetic T1D risk. [ABSTRACT FROM AUTHOR]

Objective: The objective was to test the discriminatory power of a 25-item distress screening tool for use among cancer survivors. We used a measure of item discrimination to determine which items perform better than others at identifying those at greatest risk of distress. Methods: A total of 251 members (90 % female, median age 57 years) of a community-based cancer support organization completed a web-based distress screening tool. Participants were asked to rate each of 25 items according to the question 'Today, how concerned are you about...?' using a five-point Likert scale (0 not at all to 4 very seriously concerned). An overall distress score was calculated as the sum of items rated at or above two for somewhat concerned. Participants were categorized as high scorers (≥13, n = 59) and low scorers (≤4, n = 60). The item discrimination index (IDI) was calculated for each item as the percentage difference in concerned (somewhat or greater) responses between high and low scorers. Results: Items with the greatest discriminatory power (IDI ≥0.8) were as follows: changes or disruptions in work, school or home life; feeling sad or depressed; feeling too tired to do the things you need or want to do; worrying about the future and what lies ahead; and feeling nervous or afraid. Conversely, items with the lowest IDI included considering taking your own life; eating and nutrition; tobacco or substance use; and transportation to treatment and appointments. Conclusion: The results highlight, among 25 items of a community-based distress screening tool, items with the greatest discriminatory power to identify cancer survivors with psychosocial distress. Results suggest targeted screening items to identify those most at risk for distress and priority areas for support services. [ABSTRACT FROM AUTHOR]

We examined comparative skin permeability by measuring cutaneous water loss and epidermal lipid content of two sympatric snake congeners, the Southern Copperhead ( Agkistrodon contortrix) and the Western Cottonmouth ( A. piscivorus). Samples of shed epidermis from each snake species were taken to first investigate species-specific differences. Shed samples from multiple regions along the dorsal and ventral integument were then used to examine potential variation in skin permeability and lipid content among different regions along the body for each species. Rates of cutaneous water loss were significantly higher for A. piscivorus. In addition, cutaneous water loss rates of A. piscivorus differed among region (i.e., anterior, mid, and posterior) and surface (i.e., dorsal and ventral) with the highest rates of cutaneous water loss from the mid-dorsum. Lipid content did not differ between species. However, lipid content varied between the dorsal and ventral surfaces of both species, with greater lipid content on the dorsal surface. Our results support a species-specific difference in cutaneous water loss between A. contortrix and A. piscivorus and may reflect species-specific adaptations to their differences in microhabitat preference. [ABSTRACT FROM AUTHOR]

Objective: A high proportion of individuals convicted of driving under the influence (DUI) are repeat offenders. Efforts have sought to identify specific factors underlying DUI recidivism. Of particular interest is the role that alcohol-related cognitions might play in the development and escalation of alcohol use. The present study investigated the degree to which preoccupation with, and attentional bias to, alcohol are heightened among repeat DUI offenders. Method: Three groups of participants (recidivist DUI offenders, first-time offenders, and controls; n = 20 per group) performed a visual probe task to measure attentional bias and completed questionnaires regarding their cognitive and emotional preoccupation with alcohol and drinking habits. Results: Recidivist offenders displayed a significantly heightened alcohol attentional bias and reported greater preoccupation with alcohol compared with both first-time offenders and controls. By contrast, none of the groups differed with regard to the self-reported quantity and frequency of their consumption. Conclusions: Factors reflecting preoccupation with alcohol have utility for differentiating recidivist offenders from both first-time offenders and nonoffenders. These findings highlight the value of moving beyond self-reported assessments of drinking patterns toward assessing specific cognitive and behavioral characteristics that can improve our understanding, assessment, and treatment of the problem of DUI recidivism. [ABSTRACT FROM AUTHOR]

Alcohol is well-known for impairing impulse control as well as its disruptive effects on other aspects of behavioral functioning, such as motor control. Time-course analyses during a single dose show rapid development of acute tolerance to impairment of motor coordination, reaction time, and levels of subjective intoxication, but no acute tolerance to impairment of the ability to inhibit responses. Evidence for a possible lag in tolerance development to the impairing effects of alcohol on inhibitory control suggests that, as drinkers' blood alcohol concentration (BAC) declines, they might exhibit prolonged impulsivity despite having an unimpaired ability to initiate action. The present study extended the time-course analysis to examine the recovery of inhibitory control under a dose of alcohol as drinkers' BAC descended from a peak of 80mg/100ml to a zero level. Twenty-four healthy adults were tested following 0.65g/kg alcohol and a placebo in a counterbalanced order. They performed a cued go/no-go task that measured response inhibition. They also performed tasks that assessed reaction time, motor coordination, and completed ratings of their subjective levels of intoxication. Alcohol initially impaired inhibitory control, response time, and motor coordination and increased subjective ratings of intoxication. However, acute tolerance to the impairing effects of alcohol was observed for measures of response time, motor coordination, and ratings of intoxication and these measures returned to sober (i.e., placebo) levels by the time BAC fell to near zero. By contrast, impairment of inhibitory control showed no acute tolerance and remained impaired even when drinkers' BAC returned to near zero. Taken together, these results indicate that the disinhibiting effects of alcohol are present even when the impairing effects of alcohol on other aspects of behavior have diminished under the dose. These findings could provide a greater understanding of impulsive behaviors during the descending limb of intoxication. [ABSTRACT FROM AUTHOR]

While the human papillomavirus (HPV) vaccine has potential to protect against the majority of HPV-associated cancers, vaccination rates in the United States remain low. Racial/ethnic and economic disparities exist for HPV vaccination completion rates. We conducted a mixed-methods study using the theory of planned behavior framework to explore attitudes and beliefs about HPV vaccination among urban, economically disadvantaged adolescents. Fifty adolescents aged 14-18 years were recruited from community-based organizations to complete a written survey and participate in a focus group. The mean age was 15.5 ± 1.3 years; 98 % were African American or mixed race; 64 % were female; 52 % reported previous sexual intercourse; 40 % reported receipt of ≥1 HPV vaccine dose. The knowledge deficit about the HPV vaccine was profound and seemed slightly greater among males. Mothers, fathers and grandmothers were mentioned as important referents for HPV vaccination, but peers and romantic partners were not. Common barriers to vaccination were lack of awareness, anticipated side effects (i.e., pain), and concerns about vaccine safety. Characteristics associated with ≥1 vaccine dose were: having heard of the HPV vaccine versus not (65 vs. 20 %, p = 0.002) and agreeing with the statement 'Most people I know would think HPV vaccine is good for your health' versus not (67 vs. 27 %, p = 0.007). Our work indicates a profound lack of awareness about HPV vaccination as well as the important influence of parents among urban, economically-disadvantaged youth. Awareness of these attitudes and beliefs can assist providers and health officials by informing specific interventions to increase vaccine uptake. [ABSTRACT FROM AUTHOR]

Haemonchus populations were collected from cattle from mid-western and eastern Southern US (four and six populations, respectively) to determine the relative prevalence of Haemonchus contortus and Haemonchus placei and the frequency of the three isotype-1 β-tubulin polymorphisms associated with benzimidazole resistance. A minimum of 32 individual adult worms were genotyped at position 24 of the rDNA ITS-2 for each population to determine species identity (296 worms in total). One population from Georgia was identified as 100% H. contortus with the remaining nine populations identified as 100% H. placei. For the H. contortus population, 29 out of 32 worms carried the P200Y (TAC) isotype-1 β-tubulin and 2 out of 32 worms carried the P167Y (TAC) benzimidazole resistance associated polymorphisms respectively. For H. placei, six out of the nine populations contained the P200Y (TAC) isotype-1 β-tubulin benzimidazole resistance associated polymorphism at low frequency (between 1.6% and 9.4%) with no resistance associated polymorphisms being identified at the P198 and P167 codons. This is the first report of the P200Y (TAC) isotype-1 β-tubulin benzimidazole resistance associated polymorphism in H. placei. The presence of this mutation in multiple independent H. placei populations indicates the risk of resistance emerging in this parasite should benzimidazoles be intensively used for parasite control in US cattle. [ABSTRACT FROM AUTHOR]