Substance Use Severity Predicts Suicidal Ideation in Early Adult Emergency Department Patients: The Role of Family Support

Alcohol and drug abuse are strong predictors of suicide. While screening methods have proven effective at identifying and treating substance abuse in non-treatment-seeking users (e.g., screening and brief intervention [SBI]), less attention has been given to the co-occurrence of suicidality among this population, including its correlates and etiology. The current study addresses this gap by presenting data from early adult emergency department (ED) patients (mean age = 27; N = 505), screened for substance abuse and suicidal ideation. Prevalence of past year ideation was high (15%). Results demonstrated a significant and positive indirect effect of cocaine use severity on likelihood of suicidal ideation, mediated through family support. The implications for SBI practices in the ED and suicide etiology among non-treatment-seeking substance abusers are discussed

Preventing HIV in Adolescents Affected by Maternal HIV Infection: The Ms. Now! Program

Young people in the United States, particularly African American youth, are at heightened risk for HIV infection. One proven prevention strategy is to enhance family processes through a group-based behavioral intervention. Such interventions have garnered considerable evidence for their effectiveness. Moreover, they have become increasingly culturally-informed in order to engage specific vulnerable populations and more effectively address their unique risk factors. A group overlooked by these efforts is adolescent children of mothers living with HIV (MLH). The current study therefore investigated the structured adaptation of an evidence-based HIV prevention intervention for this population. Two main phases of the study were completed. First, 15 MLH and 13 children of MLH (aged 10 to 15 years-old) were queried through focus groups and individual interviews, respectively. This formative work revealed needed modifications to intervention content, format, and delivery, and guided the selection of measures used to evaluate the intervention. For feedback on the newly adapted intervention, a community advisory board (CAB), consisting of MLH, their adolescent children, individuals working with MLH, and program staff familiar with the original evidence-based intervention (total CAB members = 11), was convened. In the second phase of the study, 12 MLH-child dyads were recruited to participate in the intervention for the purposes of examining the feasibility, defined in terms of its preliminary efficacy and acceptability. As hypothesized, the newly formed Ms. Now (Moms Stopping it Now!) intervention improved protective family processes, including parent-child relationship quality and parental monitoring. Attendance at all sessions was high, and participants had excellent engagement scores. They also rated the Ms. Now program as highly satisfactory. Clinical and prevention implications are explored, and observations are made about the process of adaptation. Finally, recommendations for a larger-scale pilot test of the intervention are offered

Diabetes Insipidus in Mice with a Mutation in Aquaporin-2

Congenital nephrogenic diabetes insipidus (NDI) is a disease characterized by failure of the kidney to concentrate urine in response to vasopressin. Human kindreds with nephrogenic diabetes insipidus have been found to harbor mutations in the vasopressin receptor 2 (Avpr2) gene or the vasopressin-sensitive water channel aquaporin-2 (Aqp2) gene. Development of a treatment is rendered difficult due to the lack of a viable animal model. Through forward genetic screening of ethylnitrosourea-mutagenized mice, we report the identification and characterization of a mouse model of NDI, with an F204V mutation in the Aqp2 gene. Unlike previously attempted murine models of NDI, our mice survive to adulthood and more exactly recapitulate the human disorder. Previous in vitro experiments using renal cell lines suggest recessive Aqp2 mutations result in improper trafficking of the mutant water pore. Using these animals, we have directly proven this hypothesis of improper AQP2 translocation as the molecular defect in nephrogenic diabetes insipidus in the intact organism. Additionally, using a renal cell line we show that the mutated protein, AQP2-F204V, is retained in the endoplasmic reticulum and that this abnormal localization can be rescued by wild-type protein. This novel mouse model allows for further mechanistic studies as well as testing of pharmacological and gene therapies for NDI

Genetic and environmental influences on affiliation with deviant peers during adolescence and early adulthood

Adolescence and early adulthood is a time when peer groups become increasingly influential in the lives of young people. Youth exposed to deviant peers risk susceptibility to externalizing behaviors and related psychopathology. In addition to environmental correlates of deviant peer affiliation, a growing body of evidence suggests that affiliation with deviant peers is heritable. This study examined the magnitude of genetic and environmental influences on affiliation with deviant peers, changes in the relative importance of these factors, and which of these factors contribute to the stability of affiliation across this critical developmental period using a longitudinal twin study design that assessed same-sex twins (485 monozygotic pairs, 271 dizygotic pairs) at three discrete ages-15-, 18-, and 21-years-old. Biometric models revealed that genetic influences increased with age. New genetic influences appeared during late adolescence, and no new genetic influences emerged by age 21. Environmental influences shared by sibling pairs decreased with age, while the proportion of nonshared environmental effects unique to each individual remained relatively stable over the course of development. Shared environmental influences were largely age-overlapping whereas nonshared environmental influences were largely age-specific. In summary, this study found variance in affiliation with deviant peers is explained by shared and nonshared environment effects as well as by genetic influences (46% by age 21), supporting the role of genetically influenced selection factors. The shared environment was almost exclusively responsible for the stability in late adolescence, while genetic influences were primarily responsible for stability in early adulthood

Kinesins relocalize the chromosomal passenger complex to the midzone for spindle disassembly.

Mitotic spindle disassembly after chromosome separation is as important as spindle assembly, yet the molecular mechanisms for spindle disassembly are unclear. In this study, we investigated how the chromosomal passenger complex (CPC), which contains the Aurora B kinase Ipl1, swiftly concentrates at the spindle midzone in late anaphase, and we researched the role of this dramatic relocalization during spindle disassembly. We showed that the kinesins Kip1 and Kip3 are essential for CPC relocalization. In cells lacking Kip1 and Kip3, spindle disassembly is severely delayed until after contraction of the cytokinetic ring. Purified Kip1 and Kip3 interact directly with the CPC and recruit it to microtubules in vitro, and single-molecule experiments showed that the CPC diffuses dynamically on microtubules but that diffusion stops when the CPC encounters a Kip1 molecule. We propose that Kip1 and Kip3 trap the CPC at the spindle midzone in late anaphase to ensure timely spindle disassembly

Hyperoxemia and excess oxygen use in early acute respiratory distress syndrome : Insights from the LUNG SAFE study

Publisher Copyright: © 2020 The Author(s). Copyright: Copyright 2020 Elsevier B.V., All rights reserved.Background: Concerns exist regarding the prevalence and impact of unnecessary oxygen use in patients with acute respiratory distress syndrome (ARDS). We examined this issue in patients with ARDS enrolled in the Large observational study to UNderstand the Global impact of Severe Acute respiratory FailurE (LUNG SAFE) study. Methods: In this secondary analysis of the LUNG SAFE study, we wished to determine the prevalence and the outcomes associated with hyperoxemia on day 1, sustained hyperoxemia, and excessive oxygen use in patients with early ARDS. Patients who fulfilled criteria of ARDS on day 1 and day 2 of acute hypoxemic respiratory failure were categorized based on the presence of hyperoxemia (PaO2 > 100 mmHg) on day 1, sustained (i.e., present on day 1 and day 2) hyperoxemia, or excessive oxygen use (FIO2 ≥ 0.60 during hyperoxemia). Results: Of 2005 patients that met the inclusion criteria, 131 (6.5%) were hypoxemic (PaO2 < 55 mmHg), 607 (30%) had hyperoxemia on day 1, and 250 (12%) had sustained hyperoxemia. Excess FIO2 use occurred in 400 (66%) out of 607 patients with hyperoxemia. Excess FIO2 use decreased from day 1 to day 2 of ARDS, with most hyperoxemic patients on day 2 receiving relatively low FIO2. Multivariate analyses found no independent relationship between day 1 hyperoxemia, sustained hyperoxemia, or excess FIO2 use and adverse clinical outcomes. Mortality was 42% in patients with excess FIO2 use, compared to 39% in a propensity-matched sample of normoxemic (PaO2 55-100 mmHg) patients (P = 0.47). Conclusions: Hyperoxemia and excess oxygen use are both prevalent in early ARDS but are most often non-sustained. No relationship was found between hyperoxemia or excessive oxygen use and patient outcome in this cohort. Trial registration: LUNG-SAFE is registered with ClinicalTrials.gov, NCT02010073publishersversionPeer reviewe

Depressive symptoms, illicit drug use and HIV/STI risk among sexual minority young adults

This study examined the interaction of depressive symptoms and drug use on HIV/STI risk among sexual minority young adults. Analyses tested the interactive effect of depressive symptoms and drug use on unprotected sex. Among drug users, more depressive symptoms were associated with higher rates of unprotected sex with a male partner (for both male and female participants), but this was nonsignificant for nonusers. Interventions with these groups should incorporate content on depression and drug use to reduce HIV/STI risk. Prevention efforts also should not neglect the vulnerability of young women that have sex with women and/or identify as nonheterosexual