Aberrant Disgust Responses and Immune Reactivity in Cocaine-Dependent Men

Background: Infectious diseases are the most common and cost-intensive health complications associated with drug addiction. There is wide belief that drug-dependent individuals expose themselves more regularly to disease-related pathogens through risky behaviors such as sharing pipes and needles, thereby increasing their risk for contracting an infectious disease. However, evidence is emerging indicating that not only lifestyle but also the immunomodulatory effects of addictive drugs, such as cocaine, may account for their high infection risk. As feelings of disgust are thought to be an important psychological mechanism in avoiding the exposure to pathogens, we sought to investigate behavioral, physiological, and immune responses to disgust-evoking cues in both cocaine-dependent and healthy men. Methods: All participants (N = 61) were exposed to neutral and disgust-evoking photographs depicting food and nonfood images while response accuracy, latency, and skin conductivity were recorded. Saliva samples were collected before and after exposure to neutral and disgusting images, respectively. Attitudes toward disgust and hygiene behaviors were assessed using questionnaire measures. Results: Response times to disgust-evoking photographs were prolonged in all participants, and specifically in cocaine-dependent individuals. While viewing the disgusting images, cocaine-dependent individuals exhibited aberrant skin conductivity and increased the secretion of the salivary cytokine interleukin-6 relative to control participants. Conclusion: Our data provide evidence of a hypersensitivity to disgusting stimuli in cocaine-dependent individuals, possibly reflecting conditioned responses to noningestive sources of infection. Coupled with a lack of interoception of bodily signals, aberrant disgust responses might lead to increased infection susceptibility in affected individuals

The Association between Clinical Recognition of Depression and Unplanned Hospital Readmission among Older Adults

Purpose The likelihood of a depression diagnosis may differ based on whether the patient was seen in an inpatient or outpatient setting. Depression has been associated with an increased risk of a 30-day readmission. The purpose of this study was to determine the level of agreement (concordance) between depression diagnosis as identified by inpatient and outpatient records and examine the relationship between depression diagnostic concordance and 30-day readmission. Methods Using universal administrative claims data from South Carolina, we examined inpatient and outpatient records. The analysis was restricted to Medicaid recipients aged 55 years and older with a primary admitting diagnosis of acute myocardial infraction (AMI), chronic obstructive pulmonary disease (COPD), heart failure (HF), and pneumonia (PN) from 2013 – 2015 (n = 8,621 patients). Depression diagnostic concordance was determined by comparing secondary diagnosis codes in inpatient records and primary or secondary diagnosis codes in prior outpatient records. Diagnostic concordance was analyzed as concordant/not concordant and as a categorical variable (concordant-no depression, concordant-depression, not concordant-inpatient only, and not concordant-outpatient only). Using log-binomial regression, we modeled diagnostic concordance and 30-day readmission, while adjusting for covariates of interest in both models. Results The agreement between inpatient and outpatient data for a recorded depression diagnosis was poor. Diagnostic concordance was significantly associated with patient age, sex, race/ethnicity, and health condition. The risk of a 30-day readmission was significantly associated with an outpatient history of depression, but not for patients with depression recorded in inpatient data. Patients with not concordant-outpatient only had a 30-day readmission rate of 8.1%, adjusted relative risk, 1.42 (p = 0.001). Patients with concordant-depression had lower 30-day readmission rates, but not statistically significant. Conclusions Patients may be at a greater risk of a 30-day readmission when a history of depression was not detected during a hospitalization. Depression, particularly when it is not detected during a hospitalization, leads to a higher risk of a readmission. Diagnostic concordance between depression recorded in inpatient and outpatient settings needs improvement to ensure patients with depression receive appropriate care during and after a hospitalization. Improving diagnostic concordance for depression may reduce untimely hospital readmissions

Assessing the natural range of variability in minimally disturbed wetlands across the Rocky Mountains: the Rocky Mountain ReMAP Project

Prepared for: the U.S. Environmental Protection Agency.Includes bibliographical references (pages 35-40).In Montana, Wyoming, Colorado and Utah, extremes of mountain climate, high elevations and characteristic geology produce a large range of natural variability within ecological systems. Even under minimal human disturbance regimes, environmental gradients can result in wetlands with very low vegetation cover, low species diversity and unpredictable hydrologic shifts. Documenting the range of variability found under minimally disturbed conditions can help distinguish signal from noise when assessing more altered occurrences, and aid in the calibration of assessment metrics. The project was a collaboration between the Montana Natural Heritage Program (MTNHP), the Colorado Natural Heritage Program (CNHP) and the Wyoming Natural Diversity Database (WYNDD). It had three objectives:1) identify reference standards for four wetland ecological systems across four Rocky Mountain ecoregions; 2) assess the range of natural variability of these ecological systems; and3) produce a regionally standardized Level 1,2 and 3 method for assessing and monitoring wetland condition, including quality assurance project plans, sampling strategies, and metrics calibrated to the four different wetland ecological systems. This report summarizes our approach, activities, and conclusions

Microbial diversity in individuals and their household contacts following typical antibiotic courses.

BackgroundAntibiotics are a mainstay of treatment for bacterial infections worldwide, yet the effects of typical antibiotic prescriptions on human indigenous microbiota have not been thoroughly evaluated. We examined the effects of the two most commonly prescribed antibiotics (amoxicillin and azithromycin) in the USA to discern whether short-term antibiotic courses may have prolonged effects on human microbiota.ResultsWe sampled the feces, saliva, and skin specimens from a cohort of unrelated, cohabitating individuals over 6 months. An individual in each household was given an antibiotic, and the other a placebo to discern antibiotic impacts on microbiota, as well as determine whether antibiotic use might reshape the microbiota of each household. We observed household-specific patterns of microbiota on each body surface, which persevered despite antibiotic perturbations. While the gut microbiota within an individual became more dissimilar over time, there was no evidence that the use of antibiotics accelerated this process when compared to household members. There was a significant change in microbiota diversity in the gut and mouth in response to antibiotics, but analogous patterns were not observed on the skin. Those who received 7 days of amoxicillin generally had greater reductions in diversity compared to those who received 3 days, in contrast to those who received azithromycin.ConclusionsAs few as 3 days of treatment with the most commonly prescribed antibiotics can result in sustained reductions in microbiota diversity, which could have implications for the maintenance of human health and resilience to disease

Projected Impact of Compositional Verification on Current and Future Aviation Safety Risk

The projected impact of compositional verification research conducted by the National Aeronautic and Space Administration System-Wide Safety and Assurance Technologies on aviation safety risk was assessed. Software and compositional verification was described. Traditional verification techniques have two major problems: testing at the prototype stage where error discovery can be quite costly and the inability to test for all potential interactions leaving some errors undetected until used by the end user. Increasingly complex and nondeterministic aviation systems are becoming too large for these tools to check and verify. Compositional verification is a "divide and conquer" solution to addressing increasingly larger and more complex systems. A review of compositional verification research being conducted by academia, industry, and Government agencies is provided. Forty-four aviation safety risks in the Biennial NextGen Safety Issues Survey were identified that could be impacted by compositional verification and grouped into five categories: automation design; system complexity; software, flight control, or equipment failure or malfunction; new technology or operations; and verification and validation. One capability, 1 research action, 5 operational improvements, and 13 enablers within the Federal Aviation Administration Joint Planning and Development Office Integrated Work Plan that could be addressed by compositional verification were identified

Evaluating Children’s Advocacy Centers’ Response to Child Sexual Abuse

Children’s Advocacy Centers (CACs) play an increasingly significant role in the response to child sexual abuse and other child maltreatment in the United States. First developed in the 1980s, CACs were designed to reduce the stress on child abuse victims and families created by traditional child abuse investigation and prosecution procedures and to improve the effectiveness of the response. According to several experts (Fontana, 1984; Pence and Wilson, 1992; Whitcomb, 1992), child victims were subjected to multiple, redundant interviews about their abuse by different agencies, and were questioned by professionals who had no knowledge of children’s developmental limitations or experience working with children. Child interviews would take place in settings like police stations that would further stress already frightened children. Moreover, the response was hampered because the multiple agencies involved did not coordinate their investigations, and children’s need for services could be neglected