Patterns of Childhood Trauma and Psychological Distress among Injecting Heroin Users in China

Background: Childhood trauma has been reported as a possible cause of future substance abuse in some countries. This study reports the prevalence of childhood trauma and examines its association with psychological distress among injecting drug users from mainland China. Methodology: The study was conducted in three government-operated drug rehabilitation facilities in Shanghai, China in 2007. The Early Trauma Inventory Self Report-Short Form (ETISR-SF) was used to evaluate 4 types (general, emotional, physical and sexual) and severity of childhood trauma, and the Symptom Checklist-90-Revised (SCL-90-R) to evaluate psychological distress. Principal Findings: Among 341 injecting drug users who completed the study, about 80 % reported one or more types o

Abstract 2253: New targets of mTORC1 pathway in ER-positive cells

Abstract mTOR complex 1 (mTORC1) regulates protein translation, autophagy, and cell growth. These cellular functions are often dysregulated in cancer, therefore identification of mTORC1 targets in control of these processes is of great interest for development of targeted cancer therapies. While rapamycin shown an effect in early clinical trials, the effectiveness of rapamycin in treatment of breast cancer has been variable. Estrogen receptor (ER) ≤ mediates the proliferative effects of estrogen and represents an important clinical target in treatment of ER-positive cancers. Tamoxifen is an anti-estrogen that has become the standard agent for the treatment of ER-positive breast cancer, where it acts as an antagonist. However, resistance to tamoxifen, and other endocrine or anti-estrogen therapies develops in many cases. One mechanism by which resistance develops is through phosphorylation of ERα, allowing it to act in estrogen-independent manner. Phosphorylation of Ser118 and Ser167 is important for transcriptional activity of ERα. The regulation of these sites is complex, involving inputs from the mTOR and MAPK signaling pathways. Importantly, ERα phosphorylation correlates with resistance to tamoxifen, and is a prognostic marker for disease progression and survival. Therefore, the goal of our study is to identify new targets of mTORC1 pathway important for growth and proliferation of ER-positive cells. Thus, inhibition of downstream components of the mTORC1 pathway together in combination with anti-estrogen therapy may prove to be an effective strategy in treatment of ER-positive cancer. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 2253. doi:1538-7445.AM2012-2253</jats:p

Virtual reality or personal computer-based gynecologic pelvic exam simulation: medical student preferences

Abstract Background Gynecologic pelvic exams (GPEs) are a required proficiency for healthcare trainees, yet practice opportunities are limited. The Virtual Approach to Gynecology Project aims to supplement traditional learning with a virtual-based GPE module. This study compares trainee experiences using the immersive virtual reality (VR) version to an equivalent non-immersive personal computer (PC) simulation. Methods Five groups of 3–5 preclinical medical students were randomized to complete one version of the GPE simulation (either the PC or VR), followed by written feedback and a structured focus group. Each group then completed the other version, after which a second written feedback form was completed, and a final focus group conducted. Focus group comments were recorded, transcribed verbatim and coded. Thematic analysis was performed on coded comments and analysis of written feedback compared Likert-scale responses of VR and PC versions. Results Twenty-two individual students enrolled and were assigned to one of five groups. Focus group discussions yielded a total of 138 responses that underwent thematic analysis. VR was unanimously preferred to the PC version, scoring significantly higher Likert-scale responses on ease of use, realism, improved comfort, and confidence. The following 3 themes emerged from the thematic analysis: (1) realism and immersiveness, (2) ease of use, and (3) enjoyment. Compared to PC, VR was found to be more realistic and enjoyable, though both versions had some reported difficulty regarding use. Conclusion The immersive VR-based simulation provided a more realistic and enjoyable experience for the GPE simulation compared to the PC-based simulation and was unanimously preferred

Geospatial Social Determinants of Health Correlate with Disparities in Syphilis and Congenital Syphilis Cases in California

Syphilis and congenital syphilis (CS) are increasing in California (CA). From 2015 through 2019, for example, CA cases of early syphilis among reproductive-age females (15&ndash;44) and CS each increased by &gt;200%. Certain populations&mdash;including people experiencing homelessness, using drugs, and/or belonging to certain racial/ethnic groups&mdash;have been disproportionately impacted. We hypothesized that geospatial social determinants of health (SDH) contribute to such health inequities. To demonstrate this, we geospatially described syphilis in CA using the Healthy Places Index (HPI). The HPI is a composite index that assigns a score to each CA census tract based on eight socioeconomic characteristics associated with health (education, housing, transportation, neighborhood conditions, clean environment, and healthcare access as well as economic and social resources). We divided CA census tracts into four quartiles based on HPI scores (with the lowest quartile having the least healthy socioeconomic and environmental conditions), then used 2013&ndash;2020 CA sexually transmitted diseases surveillance data to compare overall syphilis (among adults and adolescents) and CS case counts, incidence rates (per 100,000 population or live births), and incidence rate ratios (IRRs) among these quartiles. From 2013 to 2020, across all stages of syphilis and CS, disease burden was greatest in the lowest HPI quartile and smallest in the highest quartile (8308 cases (representing 33.2% of all incidents) versus 3768 (15.1%) for primary and secondary (P&amp;S) syphilis; 5724 (31.6%) versus 2936 (16.2%) for early non-primary non-secondary (NPNS) syphilis; 11,736 (41.9%) versus 3026 (10.8%) for late/unknown duration syphilis; and 849 (61.9%) versus 57 (4.2%) for CS; all with p &lt; 0.001). Using the highest HPI quartile as a reference, the IRRs in the lowest quartile were 17 for CS, 4.5 for late/unknown duration syphilis, 2.6 for P&amp;S syphilis, and 2.3 for early NPNS syphilis. We thus observed a direct relationship between less healthy conditions (per HPI) and syphilis/CS in California, supporting our hypothesis that SDH correlate with disparities in syphilis, especially CS. HPI could inform allocation of resources to: (1) support communities most in need of assistance in preventing syphilis/CS cases and (2) reduce health disparities

Geospatial Social Determinants of Health Correlate with Disparities in Syphilis and Congenital Syphilis Cases in California

Syphilis and congenital syphilis (CS) are increasing in California (CA). From 2015 through 2019, for example, CA cases of early syphilis among reproductive-age females (15–44) and CS each increased by &gt;200%. Certain populations—including people experiencing homelessness, using drugs, and/or belonging to certain racial/ethnic groups—have been disproportionately impacted. We hypothesized that geospatial social determinants of health (SDH) contribute to such health inequities. To demonstrate this, we geospatially described syphilis in CA using the Healthy Places Index (HPI). The HPI is a composite index that assigns a score to each CA census tract based on eight socioeconomic characteristics associated with health (education, housing, transportation, neighborhood conditions, clean environment, and healthcare access as well as economic and social resources). We divided CA census tracts into four quartiles based on HPI scores (with the lowest quartile having the least healthy socioeconomic and environmental conditions), then used 2013–2020 CA sexually transmitted diseases surveillance data to compare overall syphilis (among adults and adolescents) and CS case counts, incidence rates (per 100,000 population or live births), and incidence rate ratios (IRRs) among these quartiles. From 2013 to 2020, across all stages of syphilis and CS, disease burden was greatest in the lowest HPI quartile and smallest in the highest quartile (8308 cases (representing 33.2% of all incidents) versus 3768 (15.1%) for primary and secondary (P&amp;S) syphilis; 5724 (31.6%) versus 2936 (16.2%) for early non-primary non-secondary (NPNS) syphilis; 11,736 (41.9%) versus 3026 (10.8%) for late/unknown duration syphilis; and 849 (61.9%) versus 57 (4.2%) for CS; all with p &lt; 0.001). Using the highest HPI quartile as a reference, the IRRs in the lowest quartile were 17 for CS, 4.5 for late/unknown duration syphilis, 2.6 for P&amp;S syphilis, and 2.3 for early NPNS syphilis. We thus observed a direct relationship between less healthy conditions (per HPI) and syphilis/CS in California, supporting our hypothesis that SDH correlate with disparities in syphilis, especially CS. HPI could inform allocation of resources to: (1) support communities most in need of assistance in preventing syphilis/CS cases and (2) reduce health disparities.</jats:p

X-Ray Microscopy Of Multiphase Polymeric Materials

AbstractWe have utilized the scanning transmission x-ray microscope at Brookhaven National Laboratory to acquire high energy resolution spectra of various polymers and to investigate the bulk characteristics of multiphasic polymeric materials with chemical sensitivity at a spatial resolution of about 50 nm. We present studies ranging from phase separated liquid crystalline polyesters and polyurethanes to various polymer blends. Improvements in the NEXAFS imaging and spectral acquisition protocol in the recent past provide much improved spectral fidelity and include in situ energy calibration with CO2.</jats:p

International Anal Neoplasia Society's consensus guidelines for anal cancer screening

The International Anal Neoplasia Society (IANS) developed consensus guidelines to inform anal cancer screening use among various high-risk groups. Anal cancer incidence estimates by age among risk groups provided the basis to identify risk thresholds to recommend screening. Guided by risk thresholds, screening initiation at age 35 years was recommended for men who have sex with men (MSM) and transgender women (TW) with HIV. For other people with HIV and MSM and TW not with HIV, screening initiation at age 45 years was recommended. For solid organ transplant recipients, screening initiation beginning from 10 years post-transplant was recommended. For persons with a history of vulvar precancer or cancer, screening initiation was recommended starting within 1 year of diagnosis of vulvar precancer or cancer. Persons aged >= 45 years with a history of cervical/vaginal HSIL or cancer, perianal warts, persistent (>1 year) cervical HPV16, or autoimmune conditions could be considered for screening with shared decision-making, provided there is adequate capacity to perform diagnostic procedures (high-resolution anoscopy [HRA]). Anal cytology, high-risk (hr) human papillomavirus (HPV) testing (including genotyping for HPV16), and hrHPV-cytology co-testing are different strategies currently used for anal cancer screening that show acceptable performance. Thresholds for referral for HRA or follow-up screening tests are delineated. These recommendations from IANS provide the basis to inform management of abnormal screening results, considering currently available screening tools. These guidelines provide a pivotal foundation to help generate consensus among providers and inform the introduction and implementation of risk-targeted screening for anal cancer prevention