The Health Consequences of Adverse Childhood Experiences: Building Resilient Communities

Studies have identified that trauma experienced as a child directly affects your health later in life. In Sonoma County, one in four children have experienced two or more Adverse Childhood Experiences (ACEs) before the age of 18. Twenty-two percent of Sonoma County adults reported experiencing four or more ACEs before the age of 18. With the high rates of ACEs in our community this fieldwork placement aimed to bring awareness and build community capacity to understand and address ACEs and foster resiliency. To raise awareness in our community we developed the ACES and Resiliency Fellowship Series, which trained 60 fellows in ACEs science and resiliency. To further extend outreach we held a presence on the national ACEs Connection networking website. This was a great resource and archive for Sonoma County to share best practices with other communities, as well as our own. To assess the impact and knowledge retention of this work, surveys were completed at all fellowship events. Future works will include potentially training another cohort of trainers, as well as engaging key stakeholders at the policy level to shift the question from “What’s wrong with you?” to “What happened to you?

IFE Final Optics and Chamber Dynamics Modeling and Experiments Final Technical Report

Our OFES-sponsored research on IFE technology originally focused on studies of grazing-incidence metal mirrors (GIMM's). After the addition of GIMM research to the High Average Power Laser (HAPL) program, our OFES-sponsored research evolved to include laser propagation studies, surface material evolution in IFE wetted-wall chambers, and magnetic intervention. In 2003, the OFES IFE Technology program was terminated. We continued to expend resources on a no-cost extension in order to complete student research projects in an orderly way and to help us explore new research directions. Those explorations led to funding in the field of extreme ultraviolet lithography, which shares many issues in common with inertial fusion chambers, and the field of radiative properties of laser-produced plasma

R A P I D C O M M U N I C AT I O N Nonclassical hydrodynamic behavior of Sn plasma irradiated with a long duration CO 2 laser pulse

Abstract It was found that the electron density scale length of Sn plasma irradiated with a long duration CO 2 laser pulse is much shorter than that predicted by the classical isothermal model. The experimentally observed small dominant region of in-band (2% bandwidth) 13.5-nm extreme ultraviolet (EUV) emission coincides with this constrained hydrodynamic behavior. The lower hydrodynamic efficiency may come from the strongly inhibited ablation mass and makes a CO 2 -laser-produced Sn plasma suitable as an EUV radiation source. When an intense laser pulse arrives at the surface of a solid material placed in a vacuum, a thin layer of the material is ablated, heated, and expands into vacuum due to the thermal gradient. Such hydrodynamic expansion of a laser-produced plasma has been studied for more than 40 years motivated by a wide range of applications, such as efficient compression of a pellet in laser fusion, X-ray lasers, laser ion acceleration, and short wavelength radiation sources For the application of laser fusion, a lot of effort has been expended to enhance hydrodynamic efficiency in order to achieve efficient compression of the fusion pellet. It has been shown that short wavelength lasers could provide higher hydrodynamic efficiency as compared with long wavelength lasers Experiments are carried out using a home-built master oscillator and power amplifier (MOPA) CO 2 laser system as the pumping laser puls

R A P I D C O M M U N I C AT I O N Nonclassical hydrodynamic behavior of Sn plasma irradiated with a long duration CO 2 laser pulse

Abstract It was found that the electron density scale length of Sn plasma irradiated with a long duration CO 2 laser pulse is much shorter than that predicted by the classical isothermal model. The experimentally observed small dominant region of in-band (2% bandwidth) 13.5-nm extreme ultraviolet (EUV) emission coincides with this constrained hydrodynamic behavior. The lower hydrodynamic efficiency may come from the strongly inhibited ablation mass and makes a CO 2 -laser-produced Sn plasma suitable as an EUV radiation source. When an intense laser pulse arrives at the surface of a solid material placed in a vacuum, a thin layer of the material is ablated, heated, and expands into vacuum due to the thermal gradient. Such hydrodynamic expansion of a laser-produced plasma has been studied for more than 40 years motivated by a wide range of applications, such as efficient compression of a pellet in laser fusion, X-ray lasers, laser ion acceleration, and short wavelength radiation sources For the application of laser fusion, a lot of effort has been expended to enhance hydrodynamic efficiency in order to achieve efficient compression of the fusion pellet. It has been shown that short wavelength lasers could provide higher hydrodynamic efficiency as compared with long wavelength lasers Experiments are carried out using a home-built master oscillator and power amplifier (MOPA) CO 2 laser system as the pumping laser puls

Developing a Questionnaire for Iranian Women's Attitude on Medical Ethics in Vaginal Childbirth

Background: Vaginal delivery is one of the challenging issues in medical ethics. It is important to use an appropriate instrument to assess medical ethics attitudes in normal delivery, but the lack of tool for this purpose is clear. Objectives: The aim of this study was to develop and validate a questionnaire for the assessment of women’s attitude on medical ethics application in normal vaginal delivery. Patients and Methods: This methodological study was carried out in Iran in 2013 - 2014. Medical ethics attitude in vaginal delivery questionnaire (MEAVDQ) was developed using the findings of a qualitative data obtained from a grounded theory research conducted on 20 women who had vaginal childbirth, in the first phase. Then, the validation criteria of this tool were tested by content and face validity in the second phase. Exploratory factor analysis was used for construct validity and reliability was also tested by Cronbach’s alpha coefficient in the third phase of this study. SPSS version 13 was used in this study. The sample size for construct validity was 250 females who had normal vaginal childbirth. Results: In the first phase of this study (tool development), by the use of four obtained categories and nine subcategories from grounded theory and literature review, three parts (98-items) of this tool were obtained (A, B and J). Part A explained the first principle of medical ethics, part B pointed to the second and third principles of medical ethics, and part J explained the fourth principle of medical ethics. After evaluating and confirming its face and content validity, 75 items remained in the questionnaire. In construct validity, by the employment of exploratory factor analysis, in parts A, B and J, 3, 7 and 3 factors were formed, respectively; and 62.8%, 64% and 51% of the total variances were explained by the obtained factors in parts A, B and J, respectively. The names of these factors in the three parts were achieved by consideration of the loading factor and medical ethics principles. The subscales of MEAVDQ showed significant reliability. In parts A, B and J, Cronbach’s alpha coefficients were 0.76, 0.72 and 0.68, respectively and for the total questionnaire, it was 0.72. The results of the test–retest were satisfactory for all the items (ICC = 0.60 - 0.95). Conclusions: The present study showed that the 59-item MEAVDQ was a valid and reliable questionnaire for the assessment of women’s attitudes toward medical ethics application in vaginal childbirth. This tool might assist specialists in making a judgment and plan appropriate for women in vaginal delivery management

Whole genome sequencing identifies a duplicated region encompassing Xq13.2q13.3 in a large Iranian family with intellectual disability

Background The X chromosome has historically been one of the most thoroughly investigated chromosomes regarding intellectual disability (ID), whose etiology is attributed to many factors including copy number variations (CNVs). Duplications of the long arm of the X chromosome have been reported in patients with ID, short stature, facial anomalies, and in many cases hypoplastic genitalia and/or behavioral abnormalities. Methods Here, we report on a large Iranian family with X‐linked ID caused by a duplication on the X chromosome identified by whole genome sequencing in combination with linkage analysis. Results Seven affected males in different branches of the family presented with ID, short stature, seizures, facial anomalies, behavioral abnormalities (aggressiveness, self‐injury, anxiety, impaired social interactions, and shyness), speech impairment, and micropenis. The duplication of the region Xq13.2q13.3, which is ~1.8 Mb in size, includes seven protein‐coding OMIM genes. Three of these genes, namely SLC16A2, RLIM, and NEXMIF, if impaired, can lead to syndromes presenting with ID. Of note, this duplicated region was located within a linkage interval with a LOD score >3. Conclusion Our report indicates that CNVs should be considered in multi‐affected families where no candidate gene defect has been identified in sequencing data analysis

Comprehensive genotype‐phenotype correlation in AP‐4 deficiency syndrome; Adding data from a large cohort of Iranian patients

Mutations in adaptor protein complex‐4 (AP‐4) genes have first been identified in 2009, causing a phenotype termed as AP‐4 deficiency syndrome. Since then several patients with overlapping phenotypes, comprised of intellectual disability (ID) and spastic tetraplegia have been reported. To delineate the genotype‐phenotype correlation of the AP‐4 deficiency syndrome, we add the data from 30 affected individuals from 12 out of 640 Iranian families with ID in whom we detected disease‐causing variants in AP‐4 complex subunits, using next‐generation sequencing. Furthermore, by comparing genotype‐phenotype findings of those affected individuals with previously reported patients, we further refine the genotype‐phenotype correlation in this syndrome. The most frequent reported clinical findings in the 101 cases consist of ID and/or global developmental delay (97%), speech disorders (92.1%), inability to walk (90.1%), spasticity (77.2%), and microcephaly (75.2%). Spastic tetraplegia has been reported in 72.3% of the investigated patients. The major brain imaging findings are abnormal corpus callosum morphology (63.4%) followed by ventriculomegaly (44.5%). Our result might suggest the AP‐4 deficiency syndrome as a major differential diagnostic for unknown hereditary neurodegenerative disorders

Mutation analysis of BRCA1 and BRCA2 genes in Iranian high risk breast cancer families

Background: Telomerase is a ribonucleoprotein enzyme that synthesises telomeres after cell division and maintains chromosomal stability leading to cellular immortalization. Telomerase has been associated with negative prognostic indicators in some studies. The present study aims to detect any association between telomerase sub-units: hTERT and hTR and the prognostic indicators including tumour's size and grade, nodal status and patient's age. Methods: Tumour samples from 46 patients with primary invasive breast cancer and 3 patients with benign tumours were collected. RT-PCR analysis was used for the detection of hTR, hTERT, and PGM1 (as a housekeeping) genes expression. Results: The expression of hTR and hTERT was found in 31(67.4%) and 38 (82.6%) samples respectively. We observed a significant association between hTR gene expression and younger age at diagnosis (p = 0.019) when comparing patients ≤ 40 years with those who are older than 40 years. None of the benign tumours expressed hTR gene. However, the expression of hTERT gene was revealed in 2 samples. No significant association between hTR and hTERT expression and tumour's grade, stage and nodal status was seen. Conclusion: The expression of hTR and hTERT seems to be independent of tumour's stage. hTR expression probably plays a greater role in mammary tumourogenesis in younger women (≤ 40 years) and this may have therapeutic implications in the context of hTR targeting strategies