Suicide among college students has received increased national attention over the past few decades, partly due to the publicity regarding high-profile suicide events on college campuses throughout ...the United States and its territories. Currently, suicide is identified as the second-leading cause of death in college students. Due to federal legislation such as the Garrett Lee Smith Memorial Act of 2004, many college campuses have been able to establish suicide prevention programs. This article describes how a psychiatric nurse faculty member successfully established a comprehensive suicide prevention program that was initially supported by grant funds from the Garrett Lee Smith Memorial Act.
Behavioral and personality disorders in temporal lobe epilepsy (TLE) have been a topic of interest and controversy for decades, with less attention paid to alterations in normal personality structure ...and traits. In this investigation, core personality traits (the Big 5) and their neurobiological correlates in TLE were explored using the Neuroticism Extraversion Openness-Five Factor Inventory (NEO-FFI) and structural magnetic resonance imaging (MRI) through the Epilepsy Connectome Project (ECP). NEO-FFI scores from 67 individuals with TLE (34.6 ± 9.5 years; 67% women) were compared to 31 healthy controls (32.8 ± 8.9 years; 41% women) to assess differences in the Big 5 traits (agreeableness, openness, conscientiousness, neuroticism, and extraversion). Individuals with TLE showed significantly higher neuroticism, with no significant differences on the other traits. Neural correlates of neuroticism were then determined in participants with TLE including cortical and subcortical volumes. Distributed reductions in cortical gray matter volumes were associated with increased neuroticism. Subcortically, hippocampal and amygdala volumes were negatively associated with neuroticism. These results offer insight into alterations in the Big 5 personality traits in TLE and their brain-related correlates.
•Individuals with Temporal Lobe Epilepsy (TLE) show higher levels of neuroticism in the NEO-Five Factor Inventory.•Higher neuroticism is associated with earlier age of epilepsy onset.•Distributed reductions in cortical gray matter volumes were associated with increased neuroticism in TLE.•Hippocampal and amygdala volume were negatively associated with neuroticism in TLE.
Background and Objectives
Negative consequences of tobacco use during cancer treatment are well‐documented but more in‐depth, patient‐level data are needed to understand patient beliefs about ...continued smoking (vs cessation) during gastrointestinal (GI) cancer treatment.
Methods
We conducted semi‐structured interviews with 10 patients who were active smokers being treated for GI cancers and 5 caregivers of such patients. All interviews were audio‐recorded, transcribed verbatim, and uploaded to NVivo. We consensus coded data inductively using conventional content analysis and iteratively developed our codebook. We developed data matrices to categorize the themes regarding patient perspectives on smoking as well as presumed barriers to smoking cessation during active therapy.
Results
Our interviews revealed three consistent themes: (a) Smoking cessation is not necessarily desired by many patients who have received a cancer diagnosis; (b) Failure in past quit attempts may lead to feelings of hopeless about future attempts, especially during cancer treatment; (c) Patients perceived little to no access to smoking cessation treatment at the time of their cancer diagnosis.
Conclusions
Well‐designed systemic changes that promote the positive and efficacious effects of quitting smoking during cancer treatment, and that provide barrier‐free access to such treatments may be helpful in promoting tobacco‐free behavior during cancer treatment.
Purpose
To assess tumor subtype distribution and the relative contribution of clinical and sociodemographic factors on breast cancer survival between Hispanic and non-Hispanic whites (NHWs).
Methods
...We analyzed data from the California Cancer Registry, which included 29,626 Hispanic and 99,862 NHW female invasive breast cancer cases diagnosed from 2004 to 2014. Logistic regression was used to assess ethnic differences in tumor subtype, and Cox proportional hazard modeling to assess differences in breast cancer survival.
Results
Hispanics compared to NHWs had higher odds of having triple-negative (OR = 1.29; 95% CI 1.23–1.35) and HER2-overexpressing tumors (OR = 1.19; 95% CI 1.14–1.25 HR− and OR = 1.39; 95% CI 1.31–1.48 HR+). In adjusted models, Hispanic women had a higher risk of breast cancer mortality than NHW women (mortality rate ratio MRR = 1.24; 95% CI 1.19–1.28). Clinical factors accounted for most of the mortality difference (MRR = 1.05; 95% CI 1.01–1.09); however, neighborhood socioeconomic status (SES) and health insurance together accounted for all of the mortality difference (MRR = 1.01; 95% CI 0.97–1.05).
Conclusions
Addressing SES disparities, including increasing access to health care, may be critical to overcoming poorer breast cancer outcomes in Hispanics.
Small pneumoconiotic opacities in coal miners are usually described as rounded, regular, and upper zone predominant. We aim to characterize chest radiographic patterns in New Mexico coal miners in ...comparison with other miners. Of the 330 chest radiographs reviewed, small pneumoconiotic opacities in New Mexico miners were almost always irregularly shaped, and lower lung zone predominant, consistent with diffuse dust-related pulmonary fibrosis. There was no significant difference in patterns of opacities between miners with exposure to coal mine dust exclusively, mixed coal and noncoal mine dust, and no coal dust. Our findings indicate that New Mexico coal miners demonstrate a different pattern of small pneumoconiotic opacities than the classic nodular pneumoconiosis described in the literature, predominantly from Appalachian miners. This may indicate differences in racial/ethnic characteristics or in the silica/silicate content of dust between the Appalachian and Mountain West regions.
To evaluate the temperature distribution among moderately preterm (MPT, 29-33 weeks) and extremely preterm (EPT, <29 weeks) infants upon neonatal intensive care unit (NICU) admission in 2012-2013, ...the change in admission temperature distribution for EPT infants between 2002-2003 and 2012-2013, and associations between admission temperature and mortality and morbidity for both MPT and EPT infants.
Prospectively collected data from 18 centers in the Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network were used to examine NICU admission temperature of inborn MPT and EPT infants. Associations between admission temperature and mortality and morbidity were determined by multivariable logistic regression. EPT infants from 2002-2003 and 2012-2013 were compared.
MPT and EPT cohorts consisted of 5818 and 3213 infants, respectively. The distribution of admission temperatures differed between the MPT vs EPT (P < .01), including the percentage <36.5°C (38.6% vs 40.9%), 36.5°C-37.5°C (57.3% vs 52.9%), and >37.5°C (4.2% vs 6.2%). For EPT infants in 2012-2013 compared with 2002-2003, the percentage of temperatures between 36.5°C and 37.5°C more than doubled and the percentage of temperatures >37.5°C more than tripled. Admission temperature was inversely associated with in-hospital mortality.
Low and high admission temperatures are more frequent among EPT than MPT infants. Compared with a decade earlier, fewer EPT infants experience low admission temperatures but more have elevated temperatures. In spite of a change in distribution of NICU admission temperature, an inverse association between temperature and mortality risk persists.
The rate of decline of antibody titers to influenza following infection can affect results of serological surveys, and may explain re-infection and recurrent epidemics by the same strain.
We followed ...up a cohort who seroconverted on hemagglutination inhibition (HI) antibody titers (≥ 4-fold increase) to pandemic influenza A(H1N1)pdm09 during a seroincidence study in 2009. Along with the pre-epidemic sample, and the sample from 2009 with the highest HI titer between August and October 2009 (A), two additional blood samples obtained in April 2010 and September 2010 (B and C) were assayed for antibodies to A(H1N1)pdm09 by both HI and virus microneutralization (MN) assays. We analyzed pair-wise mean-fold change in titers and the proportion with HI titers ≥ 40 and MN ≥ 160 (which correlated with a HI titer of 40 in our assays) at the 3 time-points following seroconversion.
A total of 67 participants contributed 3 samples each. From the highest HI titer in 2009 to the last sample in 2010, 2 participants showed increase in titers (by HI and MN), while 63 (94%) and 49 (73%) had reduction in HI and MN titers, respectively. Titers by both assays decreased significantly; while 70.8% and 72.3% of subjects had titers of ≥ 40 and 160 by HI and MN in 2009, these percentages decreased to 13.9% and 36.9% by September 2010. In 6 participants aged 55 years and older, the decrease was significantly greater than in those aged below 55, so that none of the elderly had HI titers ≥ 40 nor MN titers ≥ 160 by the final sample. Due to this decline in titers, only 23 (35%) of the 65 participants who seroconverted on HI in sample A were found to seroconvert between the pre-epidemic sample and sample C, compared to 53 (90%) of the 59 who seroconverted on MN on Sample A.
We observed marked reduction in titers 1 year after seroconversion by HI, and to a lesser extent by MN. Our findings have implications for re-infections, recurrent epidemics, vaccination strategies, and for cohort studies measuring infection rates by seroconversion.
ABSTRACT
We present a pilot library of synthetic NUV, U, B, V, and I photometry of star clusters with stochastically sampled IMFs and ionized gas for initial masses, Mi = 103, 104, and 105 M⊙; t = 1, ...3, 4, and 8 Myr; Z = 0.014 and Z = 0.002; and log(US) = −2 and −3. We compare the library with predictions from deterministic models and observations of isolated low-mass (<104 M⊙) star clusters with co-spatial compact H ii regions. The clusters are located in NGC 7793, one of the nearest galaxies observed as part of the HST LEGUS and Hα-LEGUS surveys. (1) For model magnitudes that only account for the stars: (a) the residual |deterministic mag - median stochastic mag| can be ≥0.5 mag, even for Mi = 105 M⊙; and (b) the largest spread in stochastic magnitudes occurs when Wolf–Rayet stars are present. (2) For Mi = 105 M⊙: (a) the median stochastic mag with gas can be >1.0 mag more luminous than the median stochastic magnitude without gas; and (b) nebular emission lines can contribute with $\gt 50{{\ \rm per\ cent}}$ and $\gt 30{{\ \rm per\ cent}}$ to the total emission in the V and I bands, respectively. (3) Age-dating OB-star clusters via deterministic tracks in the U-B versus V-I plane is highly uncertain at Z = 0.014 for Mi ∼ 103 M⊙ and Z = 0.002 for Mi ∼ 103–105 M⊙. (4) For low-mass clusters, the V-band extinction derived with stochastic models significantly depends on the value of log(US). (5) The youngest clusters tend to have higher extinction. (6) The majority of clusters have multi-peaked age PDFs. (7) Finally, we discuss the importance of characterizing the true variance in the number of stars per mass bin in nature.
Autism is a common neurodevelopmental disorder with a complex mode of inheritance. It is one of the most highly heritable of the complex disorders, although the underlying genetic factors remain ...largely unknown. Here, we report mutations in the X-chromosome PTCHD1 (patched-related) gene in seven families with autism spectrum disorder (ASD) and in three families with intellectual disability. A 167-kilobase microdeletion spanning exon 1 was found in two brothers, one with ASD and the other with a learning disability and ASD features; a 90-kilobase microdeletion spanning the entire gene was found in three males with intellectual disability in a second family. In 900 probands with ASD and 208 male probands with intellectual disability, we identified seven different missense changes (in eight male probands) that were inherited from unaffected mothers and not found in controls. Two of the ASD individuals with missense changes also carried a de novo deletion at another ASD susceptibility locus (DPYD and DPP6), suggesting complex genetic contributions. In additional males with ASD, we identified deletions in the 5' flanking region of PTCHD1 that disrupted a complex noncoding RNA and potential regulatory elements; equivalent changes were not found in male control individuals. Thus, our systematic screen of PTCHD1 and its 5' flanking regions suggests that this locus is involved in ~1% of individuals with ASD and intellectual disability.
Purpose To provide new information on adverse health outcomes (AHOs) in testicular cancer survivors (TCSs) after four cycles of etoposide and cisplatin (EPX4) or three or four cycles of bleomycin, ...etoposide, cisplatin (BEPX3/BEPX4). Methods Nine hundred fifty-two TCSs > 1 year postchemotherapy underwent physical examination and completed a questionnaire. Multinomial logistic regression estimated AHOs odds ratios (ORs) in relation to age, cumulative cisplatin and/or bleomycin dose, time since chemotherapy, sociodemographic factors, and health behaviors. Results Median age at evaluation was 37 years; median time since chemotherapy was 4.3 years. Chemotherapy consisted largely of BEPX3 (38.2%), EPX4 (30.9%), and BEPX4 (17.9%). None, one to two, three to four, or five or more AHOs were reported by 20.4%, 42.0%, 25.1%, and 12.5% of TCSs, respectively. Median number after EPX4 or BEPX3 was two (range, zero to nine and zero to 11, respectively; P > .05) and two (range, zero to 10) after BEPX4. When comparing individual AHOs for EPX4 versus BEPX3, Raynaud phenomenon (11.6% v 21.4%; P < .01), peripheral neuropathy (29.2% v 21.4%; P = .02), and obesity (25.5% v 33.0%; P = .04) differed. Larger cumulative bleomycin doses (OR, 1.44 per 90,000 IU) were significantly associated with five or more AHOs. Increasing age was a significant risk factor for one to two, three to four, or five or more AHOs versus zero AHOs (OR, 1.22, 1.50, and 1.87 per 5 years, respectively; P < .01); vigorous physical activity was protective (OR, 0.62, 0.51, and 0.41, respectively; P < .05). Significant risk factors for three to four and five or more AHOs included current (OR, 3.05 and 3.73) or former (OR, 1.61 and 1.76) smoking ( P < .05). Self-reported health was excellent/very good in 59.9% of TCSs but decreased as AHOs increased ( P < .001). Conclusion Numbers of AHOs after EPX4 or BEPX3 appear similar, with median follow-up of 4.3 years. A healthy lifestyle was associated with reduced number of AHOs.
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