Pigmentary and Other Dermatologic Manifestations of Minocycline: a reminder of adverse effects

The applications of the tetracycline class of antibiotics extends beyond their antimicrobial activity to anti-inflammatory, immunosuppressive and neuroprotective applications making it a commonly used class of medication. Minocycline, a second generation tetracycline, has inherent characteristics that improve absorption and distribution. These benefits promote even more wide spread use. This familiarity of usage breeds prescriptive complacency toward the dermatologic complications including hyperpigmentation. The following case explores these adverse manifestations of Minocycline use

Managing Vendor Relationships

Libraries and vendors are all too often trapped in the paradigm of swapping content and services for dollars. Pivoting from this transactional model, this preconference panel of one moderator and five speakers explored the following questions: How can librarians and vendors work together to develop better products and services? What can impede these relationships? What are best practices for collaborating effectively and ethically? How can everyone build, negotiate, and sustain these relationships for mutual benefit? And when conflict inevitably arises, how do we deal with it? This preconference featured perspectives from two vendors, three libraries, and one consortium, based in the United States. Each speaker shared stories illustrating principles and practices of good and bad relationship management. Subsequently the speakers facilitated group discussions and answered questions, including several questions that attendees shared in advance. Successfully managing relationships among libraries and vendors is vital because these relationships enable and sustain collaborations, aid negotiations, and mitigate discord

Using 2D and 3D pluripotent stem cell models to study neurotropic viruses

Understanding the impact of viral pathogens on the human central nervous system (CNS) has been challenging due to the lack of viable human CNS models for controlled experiments to determine the causal factors underlying pathogenesis. Human embryonic stem cells (ESCs) and, more recently, cellular reprogramming of adult somatic cells to generate human induced pluripotent stem cells (iPSCs) provide opportunities for directed differentiation to neural cells that can be used to evaluate the impact of known and emerging viruses on neural cell types. Pluripotent stem cells (PSCs) can be induced to neural lineages in either two- (2D) or three-dimensional (3D) cultures, each bearing distinct advantages and limitations for modeling viral pathogenesis and evaluating effective therapeutics. Here we review the current state of technology in stem cell-based modeling of the CNS and how these models can be used to determine viral tropism and identify cellular phenotypes to investigate virus-host interactions and facilitate drug screening. We focus on several viruses (e.g., human immunodeficiency virus (HIV), herpes simplex virus (HSV), Zika virus (ZIKV), human cytomegalovirus (HCMV), SARS-CoV-2, West Nile virus (WNV)) to illustrate key advantages, as well as challenges, of PSC-based models. We also discuss how human PSC-based models can be used to evaluate the safety and efficacy of therapeutic drugs by generating data that are complementary to existing preclinical models. Ultimately, these efforts could facilitate the movement towards personalized medicine and provide patients and physicians with an additional source of information to consider when evaluating available treatment strategies

Executive Summary of Survey Among Temporarily Homeless Families

Executive Summary of Survey Project Among Temporarily Homeless Families The agency we were assigned is a non-profit organization centered around providing housing and resources for houseless families in the Seattle region. The agency consists of five housing locations along with additional day centers. The housing locations are Burien, Northshore, The Regrade, Bellevue, and the Family Diversion Center. They all offer family housing services, healthcare, education, and employment. The goal of our project was to gather information from guests on the healthcare services that they have utilized. It was also used to gather requests for additional services at each site to improve quality of care. With the information collected, the health services at the agency will be improved and provide additional awareness to better meet the guests\u27 specific needs. Background The families within the agency are described as two-parent families (pregnant or with children), single parents of all genders (pregnant or with children), extended families, and families with pets. The guest population varies from people coming from Seattle to those who have arrived from across the world, resulting in a variety of languages spoken at each site. These factors also provide a truly diverse population, each culture being accompanied by their own specific needs. In 2021, 76% of the families served identified as Black, Indigenous, or People of Color (Mary’s Place, 2021). Out of all the guests at the agency, 40% of these families considered themselves African American or of African Descent. The agency commits to “create a workplace and service structure that advances equity, diversity, and inclusion as a priority” (p.7). In 2021, the agency served 592 families, had 138,644 overnight stays, served 415,932 meals, served 1,204 children and 592 families, and had 100+ women visit the day center on average each day. Across the multiple locations, the organization commits to address barriers such as social determinants of health, and empower parents to build family stability, secure housing, and prepare for employment. Some of the healthcare services offered are dental, optical, mental health services, pediatric healthcare, and substance use aid. The agency also offers housing, assistance, and support to families with children with life threatening illnesses within their Popsicle Program (Mary’s Place, n.d.). The organization’s Housing Services and Housing Specialist utilize a problem-solving approach along with light flexible funding to support their guests in finding permanent housing. Often, these families have a challenging time finding housing due to the Americans with Disabilities Act (ADA), size of the unit or family, language barriers, or other barriers. In 2021, the agency helped 549 families find permanent housing (Mary’s Place, 2021). A main priority among the guests and the organization is employment. The agency has partnered with 35+ different companies to provide a variety of employment options for the guests (Mary’s Place, n.d.). In addition, the Employer Engagement team offers training for specific careers, readiness skills, access to referrals, and preparations for long-term employment (Mary’s Place, n.d.). To accompany employment services, the organization also values education and encourages to maintain education for families by providing program resources for enhanced learning, language classes, GED classes, region-based school systems, and tutoring services (Mary’s Place, n.d.). These resources are provided for guests and for houseless families not currently sheltered (Mary’s Place, n.d.). Activities and Methods The foundation of our project was centered around the agency’s willingness to improve guest utilization of health services through survey conduction. We began our project by conducting a windshield survey of each shelter site. By doing this, we were able to get a sense of the community and understand the conditions that affect the health of the population. Moving forward, we collected data about the physical environment, social, economics, and services available (Rector, 2021). Using these observations, we developed a nursing diagnosis for the population. The nursing diagnosis is readiness for enhanced knowledge related to guest utilization of agency’s health services. The agency requested that we facilitate a previously designed survey, created by preceding SPU nursing students. Next, we researched the best method of conducting a high-quality survey in an ethical manner. An emphasis was placed on the importance of voluntary participation; therefore, we did not directly ask guests to fill out the surveys in order to avoid skewing data (Kelley et al., 2003). Our literature review revealed several different approaches to how to best conduct the surveys. We used incentives like baked goods and coloring pages for a greater participation outcome. We took into consideration the population of families at the agency and included an activity for children to do while parents took the surveys. We offered surveys to the guests to complete and made them aware of our intentions with the results (Kelley et al., 2003). We addressed the language barrier by using site-provided interpreter services. Our team conducted surveys at each agency location twice and input the data in an Excel document. We created graphs to display the data to the organization. Outcomes/Limitations We succeeded in collecting data from guests regarding the services they are utilizing and their additional needs from the organization. Visiting each site twice provided a greater opportunity to collect surveys resulting in more data. The results consisted of anonymous, voluntary responses which we compiled and analyzed. Since participation was voluntary, the results were limited based on how many guests decided to engage in the survey. We attempted to address this limitation by visiting each site twice to collect the most data possible for each location and offering incentives to encourage participation. Another limitation we came across was a language barrier between us and some of the guests. This was addressed by having nine translations of the survey available to expand participation. We also utilized interpreter phone services when needed to communicate with guests. Conclusion Overall, the project’s purpose was to conduct surveys at the agency locations and gather information about health services being used and current health concerns to improve care quality. We accomplished the organization’s goal by implementing the surveys amongst the guests. By doing this, we hope to have achieved the desired outcomes of increasing awareness of resources by guests, accessibility of resources, and guest satisfaction. With our project, the health services team can set annual goals for guests and the organization. We encourage the continuation of survey use within the agency. References Abdelazeem, B., Abbas, K.S., Amin, M.A., El-Shahat, N.A., Malik, B., Kalantary, A., & Eltobgy, M. (2022) The effectiveness of incentives for research participation: A systematic review and meta-analysis of randomized controlled trials. PLoS ONE, 17(4): e0267534. https://doi.org/10.1371/journal.pone.0267534 Kelley, K., Clark, B., Brown, V., & Sitzia, J. (2003). Good practice in the conduct and reporting of survey research. International Journal for Quality in Health Care, 15(3), 261-266. https://doi.org/10.1093/intqhc/mzg031 Orcher, L. T. (2007). Conducting a survey: Technique for a term project, (1st ed.). Routledge. https://doi.org/10.4324/9781315267937 Rector, C., & Stanley, M. J. (2021). Lippincott CoursePoint Enhanced for Rector\u27s Community and Public Health Nursing. Wolters Kluwer. vbk://9781975178284 Who we serve. (n.d.). Mary’s Place. Retrieved February 22, 2023, from https://www.marysplaceseattle.org/who-we-serve 2021 gratitude report. (2021). Mary’s Place. https://static1.squarespace.com/static/5b8989d231d4df1bccd7bcc7/t/6282aaeac941950e930ace53/1652730603879/2021+Gratitude+Report.pd

Mexican American Adolescents’ Gender Role Attitude Development: The Role of Adolescents’ Gender and Nativity and Parents’ Gender Role Attitudes

Gender development has long term implications for education and career endeavors and family formation behaviors, but we know very little about the role of sociocultural factors in developmental and individual differences. In this study, we investigated one domain of gender development, gender role attitudes, in Mexican American adolescents (N = 246; 51% female), using four phases of longitudinal data across eight years. Data were collected when adolescents averaged 12.51 years (SD = 0.58), 14.64 years (SD = 0.59), 17.72 years (SD = 0.57), and 19.60 years of age (SD = 0.66). Mothers’ and fathers’ gender role attitudes also were assessed in Phases 1, 3, and 4. Findings revealed that gender attitude development varied as a function of the interaction between adolescents’ nativity and gender. Among Mexico-born adolescents, females exhibited significant declines in traditional attitudes from early to late adolescence, but males’ attitudes were stable over time. U.S.-born females and males, in contrast, did not differ in their gender attitude trajectories. Examining the links between mothers’, fathers’, and adolescents’ gender role attitudes revealed within-person associations between mothers’ and adolescents’ gender role attitudes: on occasions when mothers reported more traditional attitudes relative to their own cross-time average, adolescents also reported more traditional attitudes than usual. In addition, fathers’ more traditional gender role attitudes were associated with daughters’, but not sons’, more traditional gender role attitudes at the between-person level. The discussion focuses on the interpretation of Mexican American adolescents’ gender role attitude development from a cultural ecological perspective

Mexican American Adolescents’ Gender Role Attitude Development: The Role of Adolescents’ Gender and Nativity and Parents’ Gender Role Attitudes

Gender development has long term implications for education and career endeavors and family formation behaviors, but we know very little about the role of sociocultural factors in developmental and individual differences. In this study, we investigated one domain of gender development, gender role attitudes, in Mexican American adolescents (N = 246; 51% female), using four phases of longitudinal data across eight years. Data were collected when adolescents averaged 12.51 years (SD = 0.58), 14.64 years (SD = 0.59), 17.72 years (SD = 0.57), and 19.60 years of age (SD = 0.66). Mothers’ and fathers’ gender role attitudes also were assessed in Phases 1, 3, and 4. Findings revealed that gender attitude development varied as a function of the interaction between adolescents’ nativity and gender. Among Mexico-born adolescents, females exhibited significant declines in traditional attitudes from early to late adolescence, but males’ attitudes were stable over time. U.S.-born females and males, in contrast, did not differ in their gender attitude trajectories. Examining the links between mothers’, fathers’, and adolescents’ gender role attitudes revealed within-person associations between mothers’ and adolescents’ gender role attitudes: on occasions when mothers reported more traditional attitudes relative to their own cross-time average, adolescents also reported more traditional attitudes than usual. In addition, fathers’ more traditional gender role attitudes were associated with daughters’, but not sons’, more traditional gender role attitudes at the between-person level. The discussion focuses on the interpretation of Mexican American adolescents’ gender role attitude development from a cultural ecological perspective

Commensal Microbes and Hair Follicle Morphogenesis Coordinately Drive Treg Migration into Neonatal Skin

Regulatory T cells (Tregs) are required to establish immune tolerance to commensal microbes. Tregs accumulate abruptly in the skin during a defined window of postnatal tissue development. However, the mechanisms mediating Treg migration to neonatal skin are unknown. Here we show that hair follicle (HF) development facilitates the accumulation of Tregs in neonatal skin and that upon skin entry these cells localize to HFs, a primary reservoir for skin commensals. Further, germ-free neonates had reduced skin Tregs indicating that commensal microbes augment Treg accumulation. We identified Ccl20 as a HF-derived, microbiota-dependent chemokine and found its receptor, Ccr6, to be preferentially expressed by Tregs in neonatal skin. The Ccl20-Ccr6 pathway mediated Treg migration in vitro and in vivo. Thus, HF morphogenesis, commensal microbe colonization, and local chemokine production work in concert to recruit Tregs into neonatal skin, thereby establishing this tissue Treg niche early in life

Efficacy of Sofosbuvir, Velpatasvir, and GS-9857 in Patients With Hepatitis C Virus Genotype 2, 3, 4, or 6 Infections in an Open-Label, Phase 2 Trial

Background & Aims Studies are needed to determine the optimal regimen for patients with chronic hepatitis C virus (HCV) genotype 2, 3, 4, or 6 infections whose prior course of antiviral therapy has failed, and the feasibility of shortening treatment duration. We performed a phase 2 study to determine the efficacy and safety of the combination of the nucleotide polymerase inhibitor sofosbuvir, the NS5A inhibitor velpatasvir, and the NS3/4A protease inhibitor GS-9857 in these patients. Methods We performed a multicenter, open-label trial at 32 sites in the United States and 2 sites in New Zealand from March 3, 2015 to April 27, 2015. Our study included 128 treatment-naïve and treatment-experienced patients (1 with HCV genotype 1b; 33 with HCV genotype 2; 74 with HCV genotype 3; 17 with genotype HCV 4; and 3 with HCV genotype 6), with or without compensated cirrhosis. All patients received sofosbuvir-velpatasvir (400 mg/100 mg fixed-dose combination tablet) and GS-9857 (100 mg) once daily for 6–12 weeks. The primary end point was sustained virologic response 12 weeks after treatment (SVR12). Results After 6 weeks of treatment, SVR12s were achieved by 88% of treatment-naïve patients without cirrhosis (29 of 33; 95% confidence interval, 72%–97%). After 8 weeks of treatment, SVR12s were achieved by 93% of treatment-naïve patients with cirrhosis (28 of 30; 95% CI, 78%–99%). After 12 weeks of treatment, SVR12s were achieved by all treatment-experienced patients without cirrhosis (36 of 36; 95% CI, 90%–100%) and 97% of treatment-experienced patients with cirrhosis (28 of 29; 95% CI, 82%–100%). The most common adverse events were headache, diarrhea, fatigue, and nausea. Three patients (1%) discontinued treatment due to adverse events. Conclusions In a phase 2 open-label trial, we found sofosbuvir-velpatasvir plus GS-9857 (8 weeks in treatment-naïve patients or 12 weeks in treatment-experienced patients) to be safe and effective for patients with HCV genotype 2, 3, 4, or 6 infections, with or without compensated cirrhosis

Genome-wide association study identifies 30 loci associated with bipolar disorder.

Bipolar disorder is a highly heritable psychiatric disorder. We performed a genome-wide association study (GWAS) including 20,352 cases and 31,358 controls of European descent, with follow-up analysis of 822 variants with P < 1 × 10-4 in an additional 9,412 cases and 137,760 controls. Eight of the 19 variants that were genome-wide significant (P < 5 × 10-8) in the discovery GWAS were not genome-wide significant in the combined analysis, consistent with small effect sizes and limited power but also with genetic heterogeneity. In the combined analysis, 30 loci were genome-wide significant, including 20 newly identified loci. The significant loci contain genes encoding ion channels, neurotransmitter transporters and synaptic components. Pathway analysis revealed nine significantly enriched gene sets, including regulation of insulin secretion and endocannabinoid signaling. Bipolar I disorder is strongly genetically correlated with schizophrenia, driven by psychosis, whereas bipolar II disorder is more strongly correlated with major depressive disorder. These findings address key clinical questions and provide potential biological mechanisms for bipolar disorder