Experiences, Perceived Challenges, and Support Systems of Early College High School Students

In this qualitative study, the prior experiences, perceived challenges, and support systems of 17 Grade 12 Hispanic students at an early college high school were explored using the framework of social capital theory. Utilizing Moustakas’s phenomenological design, data were collected using focus group and individuals interviews. Several themes emerged and were related to the conceptual framework of social capital, such as the school environment, support from family and teachers, and the students’ identify and values. Understanding the experiences of the Grade 12 students can provide valuable information for high school and college administrators in an ECHS setting

Assessment of the cardiac safety and pharmacokinetics of a short course, twice daily dose of orally-administered mifepristone in healthy male subjects

Background: Mifepristone is approved to control hyperglycemia in adults with endogenousCushing’s syndrome and is described as a mildly QTc prolonging drug, based on a TQT study.The aim of the present study was to assess the effect of mifepristone on the QTc interval at plasmamifepristone concentrations exceeding those observed in the TQT study.Methods: Twenty healthy, male volunteers were given three doses of 1200 mg mifepristoneevery 12 h with a high-fat meal in a randomized, placebo-controlled 2-period crossover study.Holter ECG recordings were made on Day 1 and 2.Results: Eighteen subjects completed the study. Mean peak plasma mifepristone concentrationswere 4.01 μg/mL (CV: 31%) on the fi rst dose and 5.77 μg/mL (CV: 29%) on the thirddose. Mifepristone did not have a meaningful QTc effect. The placebo-corrected, change-from--baseline QTcF (ΔΔQTcF) was between –1.6 and 0.7 ms on the fi rst dose (upper bound of 90%CI 3.8 ms) and the largest ΔΔQTcF on the third dose was 4.9 ms (upper bound of 90% CI: 8.4 ms).Concentration effect modeling showed a slightly negative slope of –0.01 ms/ng/mL.Conclusions: Mifepristone did not cause a clinically meaningful QTc prolongation in healthyvolunteers at plasma concent rations of mifepristone and its main metabolites that clearlyexceeded those seen in a previous TQT study

Exile Vol. XI No. 2

FICTION Don\u27t Break Bread with Strangers by Thomas Getz 5-12 Story by Kathy Swiger 17-20 The Last of the Flag Pole Sitters 25-29 POETRY Muttering: A Letter by Gretchen Schenk 14-15 Poem by Jane Pearson 20 Marina in March by Karen Combs 21 of the pope too slow in recovery by Bill C. West Jr. 22 Poem by Jim Nichols 23 Poem by Judy Strange 23 Haiku by Bonnie Bishop 29 ART Pen and Ink by Dan Thaxton 4 Linocut by Richard Machlan 13 Etching by Lynne Wiley 16 Woodcut by Lela Giles 22 Charcoal by Carol Kubie 2

Evaluation and Support Mechanisms of an Emerging University-wide Global Health Training Program

Background: Global health education is in high demand in the United States, across the continuum of learning, and field experiences are an essential part of this education. However, evaluations of these programs are limited. Objectives: The aim of this study was to evaluate a field placement program at Johns Hopkins University, in Baltimore, Maryland, to understand how to better support student training overseas and faculty mentorship. Methods: We used qualitative and quantitative methods to gather data from program reporting requirements (152 student surveys and 46 experiential narrative essays), followed by 17 semistructured interviews, and 2 focus groups. Data were analyzed through manual coding and a socioecological model served as an analytical and a synthesizing framework. Findings: A series of factors influence the participants' experience in overseas placements spanning across 4 aggregate levels, from individual to societal, including opportunity for professional advancement, independence, loneliness and illness, mentorship quality, funding, institutional partnership building, opportunity for public health contribution, and for development of cultural competency. Faculty and students thought that the program was beneficial to the learning experience, particularly for its contribution to experiential knowledge of a low- and middle-income country setting and for developing cross-cultural relationships. Communication and scope of work were 2 areas in which students and faculty members often had different expectations and many students emerged having cultivated different skills than they or their mentor initially expected. Students found the experience useful for both their academic and professional careers and faculty members saw mentorship, one of their professional responsibilities, emerge. Conclusions: Many socioecological factors influence an overseas field experience, which in turn produces important effects on students' career choices, and faculty members appreciate the opportunity to serve as mentors. The most vital support mechanisms suggested for faculty and students included available funding, clear preparation, and communication facilitation across the experiential continuum

Building Blocks of Global Health Mentorship: Motivation, Expectations, and Institutional Support

Background: Global health education and training experiences are in high demand. Mentorship plays an important role in successful training, but academic institutions often lack formalized mentorship support. This study aimed to evaluate perceptions of global health mentorship across disciplines at Johns Hopkins University and to understand how to better support faculty mentorship for global health training. Methods: This is a retrospective study that used qualitative methods to assess the perceptions of students who participated in the Johns Hopkins Center for Global Health (CGH) field placement program from 2011–2013 and CGH faculty who may have served as their mentors. Qualitative data was gathered through 30 individual in-depth interviews and 4 focus groups capturing both faculty and student perspectives. Data were analyzed inductively until thematic saturation was reached; a theoretical model, which we call the “building blocks of global health mentorship” model, emerged to serve as an analytical and synthesizing framework. Findings: A series of factors influenced global health mentorship from an individual to institutional level, including motivation, expectation alignment, finances, time, and knowledge. Both students and faculty reported the importance of motivation and aligned expectations to the mentorship experience and, more broadly, the overseas experience. Mentorship relationships were identified by students and faculty as either a catalyst or a hindrance to the training experience from both a personal and a professional point of view. Many faculty mentioned insufficient institutional support and financial resources, which negatively influenced their capacity to serve as mentors. Conclusions: Many factors, ranging from individual to institutional, influence mentorship for both faculty and students, which in turn influence international experiences. The underlying role of institutional support emerged as a highly salient influencing factor. Global health programs should harness the faculty and students’ motivations and expectations, as well as provide better support to faculty serving as mentors

HIV Infection Linked to Injection Use of Oxymorphone in Indiana, 2014-2015

BACKGROUND: In January 2015, a total of 11 new diagnoses of human immunodeficiency virus (HIV) infection were reported in a small community in Indiana. We investigated the extent and cause of the outbreak and implemented control measures. METHODS: We identified an outbreak-related case as laboratory-confirmed HIV infection newly diagnosed after October 1, 2014, in a person who either resided in Scott County, Indiana, or was named by another case patient as a syringe-sharing or sexual partner. HIV polymerase (pol) sequences from case patients were phylogenetically analyzed, and potential risk factors associated with HIV infection were ascertained. RESULTS: From November 18, 2014, to November 1, 2015, HIV infection was diagnosed in 181 case patients. Most of these patients (87.8%) reported having injected the extended-release formulation of the prescription opioid oxymorphone, and 92.3% were coinfected with hepatitis C virus. Among 159 case patients who had an HIV type 1 pol gene sequence, 157 (98.7%) had sequences that were highly related, as determined by phylogenetic analyses. Contact tracing investigations led to the identification of 536 persons who were named as contacts of case patients; 468 of these contacts (87.3%) were located, assessed for risk, tested for HIV, and, if infected, linked to care. The number of times a contact was named as a syringe-sharing partner by a case patient was significantly associated with the risk of HIV infection (adjusted risk ratio for each time named, 1.9; P<0.001). In response to this outbreak, a public health emergency was declared on March 26, 2015, and a syringe-service program in Indiana was established for the first time. CONCLUSIONS: Injection-drug use of extended-release oxymorphone within a network of persons who inject drugs in Indiana led to the introduction and rapid transmission of HIV. (Funded by the state government of Indiana and others.)

Knockdown of Amyloid Precursor Protein in Zebrafish Causes Defects in Motor Axon Outgrowth

Amyloid precursor protein (APP) plays a pivotal role in Alzheimer’s disease (AD) pathogenesis, but its normal physiological functions are less clear. Combined deletion of the APP and APP-like protein 2 (APLP2) genes in mice results in post-natal lethality, suggesting that APP performs an essential, if redundant, function during embryogenesis. We previously showed that injection of antisense morpholino to reduce APP levels in zebrafish embryos caused convergent-extension defects. Here we report that a reduction in APP levels causes defective axonal outgrowth of facial branchiomotor and spinal motor neurons, which involves disorganized axonal cytoskeletal elements. The defective outgrowth is caused in a cell-autonomous manner and both extracellular and intracellular domains of human APP are required to rescue the defective phenotype. Interestingly, wild-type human APP rescues the defective phenotype but APPswe mutation, which causes familial AD, does not. Our results show that the zebrafish model provides a powerful system to delineate APP functions in vivo and to study the biological effects of APP mutations

Population-specific coding variant underlies genome-wide association with adiponectin level

Adiponectin is a protein hormone that can affect major metabolic processes including glucose regulation and fat metabolism. Our previous genome-wide association (GWA) study of circulating plasma adiponectin levels in Filipino women from the Cebu Longitudinal Health and Nutrition Survey (CLHNS) detected a 100 kb two-SNP haplotype at KNG1–ADIPOQ associated with reduced adiponectin (frequency = 0.050, P = 1.8 × 10−25). Subsequent genotyping of CLHNS young adult offspring detected an uncommon variant [minor allele frequency (MAF) = 0.025] located ∼800 kb from ADIPOQ that showed strong association with lower adiponectin levels (P = 2.7 × 10−15, n = 1695) and tagged a subset of KNG1–ADIPOQ haplotype carriers with even lower adiponectin levels. Sequencing of the ADIPOQ-coding region detected variant R221S (MAF = 0.015, P = 2.9 × 10−69), which explained 17.1% of the variance in adiponectin levels and largely accounted for the initial GWA signal in Filipinos. R221S was not present in 12 514 Europeans with previously sequenced exons. To explore the mechanism of this substitution, we re-measured adiponectin level in 20 R221S offspring carriers and 20 non-carriers using two alternative antibodies and determined that the presence of R221S resulted in artificially low quantification of adiponectin level using the original immunoassay. These data provide an example of an uncommon variant responsible for a GWA signal and demonstrate that genetic associations with phenotypes measured by antibody-based quantification methods can be affected by uncommon coding SNPs residing in the antibody target region

Selenium status is positively associated with bone mineral density in healthy aging European men

Objective It is still a matter of debate if subtle changes in selenium (Se) status affect thyroid function tests (TFTs) and bone mineral density (BMD). This is particularly relevant for the elderly, whose nutritional status is more vulnerable. Design and Methods We investigated Se status in a cohort of 387 healthy elderly men (median age 77 yrs; inter quartile range 75-80 yrs) in relation to TFTs and BMD. Se status was determined by measuring both plasma selenoprotein P (SePP) and Se. Results The overall Se status in our population was low normal with only 0.5% (2/387) of subjects meeting the criteria for Se deficiency. SePP and Se levels were not associated with thyroid stimulating hormone (TSH), free thyroxine (FT4), thyroxine (T4), triiodothyronine (T3) or reverse triiodothyronine (rT3) levels. The T3/T4 and T3/rT3 ratios, reflecting peripheral metabolism of thyroid hormone, were not associated with Se status either. SePP and Se were positively associated with total BMD and femoral trochanter BMD. Se, but not SePP, was positively associated with femoral neck and ward's BMD. Multivariate linear analyses showed that these associations remain statistically significant in a model including TSH, FT4, body mass index, physical performance score, age, smoking, diabetes mellitus and number of medication use. Conclusion Our study demonstrates that Se status, within the normal European marginally supplied range, is positively associated with BMD in healthy aging men, independent of thyroid function. Thyroid function tests appear unaffected by Se status in this population

The Number of X Chromosomes Causes Sex Differences in Adiposity in Mice

Sexual dimorphism in body weight, fat distribution, and metabolic disease has been attributed largely to differential effects of male and female gonadal hormones. Here, we report that the number of X chromosomes within cells also contributes to these sex differences. We employed a unique mouse model, known as the “four core genotypes,” to distinguish between effects of gonadal sex (testes or ovaries) and sex chromosomes (XX or XY). With this model, we produced gonadal male and female mice carrying XX or XY sex chromosome complements. Mice were gonadectomized to remove the acute effects of gonadal hormones and to uncover effects of sex chromosome complement on obesity. Mice with XX sex chromosomes (relative to XY), regardless of their type of gonad, had up to 2-fold increased adiposity and greater food intake during daylight hours, when mice are normally inactive. Mice with two X chromosomes also had accelerated weight gain on a high fat diet and developed fatty liver and elevated lipid and insulin levels. Further genetic studies with mice carrying XO and XXY chromosome complements revealed that the differences between XX and XY mice are attributable to dosage of the X chromosome, rather than effects of the Y chromosome. A subset of genes that escape X chromosome inactivation exhibited higher expression levels in adipose tissue and liver of XX compared to XY mice, and may contribute to the sex differences in obesity. Overall, our study is the first to identify sex chromosome complement, a factor distinguishing all male and female cells, as a cause of sex differences in obesity and metabolism