Making HIV Prevention Programming Count: Identifying Predictors of Success in a Parent-Based HIV Prevention Program for Youth

Predictors of change in the number of sexual topics parents discussed and responsiveness during sex communication with their preadolescent after participating in a five-session sexual risk reduction intervention for parents were examined. Data were from 339 African American parents of preadolescents enrolled in the intervention arm of a randomized-controlled trial of the Parents’ Matter! Program (PMP). Four categories of predictors of success were examined: time and resource constraints, personal characteristics, the parent-child relationship, and parent perceptions of child readiness for sex communication. There were only sporadic associations between success and time and resource constraints for either outcome. Parent perception of child readiness for sex communication was positively associated with discussions of sex topics (b = 1.11, confidence interval [CI]: 0.24-1.97) and parental responsiveness (b = .68, CI: 0.22-1.15). Although parents face time and resource constraints, most attended at least four sessions, and demographics such as income had limited effects on program success

Enhancing HIV Communication between Parents and Children: Efficacy of the Parents Matter!

We examine efficacy of the Parents Matter! Program (PMP), a program to teach African-American parents of preadolescents sexual communication and HIV-prevention skills, through a multicenter, randomized control trial. A total of 1115 parent-child participants were randomized to one of three intervention arms (enhanced, brief, control). Percentages and 95% confidence intervals compare parents’ perception of child readiness to learn about sexual issues, communication effectiveness, and dyad concordance from baseline to 12 months postintervention. Wilcoxon rank sum tests compare the changes in scores measuring communication content in HIV/ AIDS, abstinence, and condom use. Compared to control, parents in the enhanced arm increased perception of child readiness to learn about sex (16% vs. 29%; p \u3c .001), and a greater proportion of parent-child dyads reported concordant responses on communication topics: HIV/AIDS (15%, 95% CI = 8-21%; p \u3c .001), abstinence (13%, 95% CI = 7-20%; p \u3c .001), condoms (15%, 95% CI = 9-22%; p \u3c .001). Increases in communication scores in HIV/AIDS, abstinence, and condom use were greater in the enhanced arm than control (p \u3c 0.01). We conclude that the enhanced PMP can help parents educate children about HIV and prepare children to avoid sexual risk

HIV testing for pregnant women: A rights-based analysis of national policies

Ethical and human rights concerns have been expressed regarding the global shift in policies on HIV testing of pregnant women. The main purpose of this research was to conduct a policy analysis using a human rights-based approach of national policies for HIV testing of pregnant women. We collected HIV testing policies from 19 countries including: Cambodia, China, Guyana, Haiti, India, Jamaica, Kenya, Moldova, Papua New Guinea, Russian Federation, South Africa, Sudan, Swaziland, Tanzania, Ukraine, United States, Uzbekistan, Zambia and Zimbabwe. We analysed the HIV testing policies using a standardised framework that focused on government obligations to respect, protect and fulfil. Our results highlight the need for more attention to issues of pregnant women's autonomy in consenting to HIV testing, confidentiality in antenatal care settings and provision of counselling and care services. We conclude with a discussion about potential implications of the current testing policies and provide recommendations for ways that HIV testing policies can more effectively uphold the human rights of pregnant women

Motor network dynamic resting state fMRI connectivity of neurotypical children in regions affected by cerebral palsy

BackgroundNormative childhood motor network resting-state fMRI effective connectivity is undefined, yet necessary for translatable dynamic resting-state-network-informed evaluation in pediatric cerebral palsy.MethodsCross-spectral dynamic causal modeling of resting-state-fMRI was investigated in 50 neurotypically developing 5- to 13-year-old children. Fully connected six-node network models per hemisphere included primary motor cortex, striatum, subthalamic nucleus, globus pallidus internus, thalamus, and contralateral cerebellum. Parametric Empirical Bayes with exhaustive Bayesian model reduction and Bayesian modeling averaging informed the model; Purdue Pegboard Test scores of hand motor behavior were the covariate at the group level to determine the effective-connectivity-functional behavior relationship.ResultsAlthough both hemispheres exhibited similar effective connectivity of motor cortico-basal ganglia-cerebellar networks, magnitudes were slightly greater on the right, except for left-sided connections of the striatum which were more numerous and of opposite polarity. Inter-nodal motor network effective connectivity remained consistent and robust across subjects. Age had a greater impact on connections to the contralateral cerebellum, bilaterally. Motor behavior, however, affected different connections in each hemisphere, exerting a more prominent effect on the left modulatory connections to the subthalamic nucleus, contralateral cerebellum, primary motor cortex, and thalamus.DiscussionThis study revealed a consistent pattern of directed resting-state effective connectivity in healthy children aged 5–13 years within the motor network, encompassing cortical, subcortical, and cerebellar regions, correlated with motor skill proficiency. Both hemispheres exhibited similar effective connectivity within motor cortico-basal ganglia-cerebellar networks reflecting inter-nodal signal direction predicted by other modalities, mainly differing from task-dependent studies due to network differences at rest. Notably, age-related changes were more pronounced in connections to the contralateral cerebellum. Conversely, motor behavior distinctly impacted connections in each hemisphere, emphasizing its role in modulating left sided connections to the subthalamic nucleus, contralateral cerebellum, primary motor cortex, and thalamus. Motor network effective connectivity was correlated with motor behavior, validating its physiological significance. This study is the first to evaluate a normative effective connectivity model for the pediatric motor network using resting-state functional MRI correlating with behavior and serves as a foundation for identifying abnormal findings and optimizing targeted interventions like deep brain stimulation, potentially influencing future therapeutic approaches for children with movement disorders

Use of term reference infants in assessing the developmental outcome of extremely preterm infants: lessons learned in a multicenter study.

OBJECTIVE: Extremely preterm (EP) impairment rates are likely underestimated using the Bayley III norm-based thresholds scores and may be better assessed relative to concurrent healthy term reference (TR) infants born in the same hospital. STUDY DESIGN: Blinded, certified examiners in the Neonatal Research Network (NRN) evaluated EP survivors and a sample of healthy TR infants recruited near the 2-year assessment age. RESULTS: We assessed 1452 EP infants and 183 TR infants. TR-based thresholds showed higher overall EP impairment than Bayley norm-based thresholds (O.R. = 1.86; [95% CI 1.56-2.23], especially for severe impairment (36% vs. 24%; p ≤ 0.001). Difficulty recruiting TR patients at 2 years extended the study by 14 months and affected their demographics. CONCLUSION: Impairment rates among EP infants appear to be substantially underestimated from Bayley III norms. These rates may be best assessed by comparison with healthy term infants followed with minimal attrition from birth in the same centers

Analysis of the effects of exposure to acute hypoxia on oxidative lesions and tumour progression in a transgenic mouse breast cancer model

<p>Abstract</p> <p>Background</p> <p>Tumour hypoxia is known to be a poor prognostic indicator, predictive of increased risk of metastatic disease and reduced survival. Genomic instability has been proposed as one of the potential mechanisms for hypoxic tumour progression. Both of these features are commonly found in many cancer types, but their relationship and association with tumour progression has not been examined in the same model.</p> <p>Methods</p> <p>To address this issue, we determined the effects of 6 week <it>in vivo </it>acute hypoxic exposure on the levels of mutagenic lipid peroxidation product, malondialdehyde, and 8-oxo-7,8-dihydro-2'-deoxyguanosine DNA (8-oxo-dG) lesions in the transgenic polyomavirus middle T (PyMT) breast cancer mouse model.</p> <p>Results</p> <p>We observed significantly increased plasma lipid peroxidation and 8-oxo-dG lesion levels in the hypoxia-exposed mice. Consumption of malondialdehyde also induced a significant increase in the PyMT tumour DNA lesion levels, however, these increases did not translate into enhanced tumour progression. We further showed that the <it>in vivo </it>exposure to acute hypoxia induced accumulation of F4/80 positive tumour-associated macrophages (TAMs), demonstrating a relationship between hypoxia and macrophages in an experimental model.</p> <p>Conclusion</p> <p>These data suggest that although exposure to acute hypoxia causes an increase in 8-oxo-dG lesions and TAMs in the PyMT tumours, these increases do not translate into significant changes in tumour progression at the primary or metastatic levels in this strong viral oncogene-driven breast cancer model.</p

Consensus guidelines for the use and interpretation of angiogenesis assays

The formation of new blood vessels, or angiogenesis, is a complex process that plays important roles in growth and development, tissue and organ regeneration, as well as numerous pathological conditions. Angiogenesis undergoes multiple discrete steps that can be individually evaluated and quantified by a large number of bioassays. These independent assessments hold advantages but also have limitations. This article describes in vivo, ex vivo, and in vitro bioassays that are available for the evaluation of angiogenesis and highlights critical aspects that are relevant for their execution and proper interpretation. As such, this collaborative work is the first edition of consensus guidelines on angiogenesis bioassays to serve for current and future reference

Erwachsenen Aufmerksamkeitsdefizit-/Hyperaktivitätsstörung: Untersuchung der Neurophysiologischen Modelle

Introduction. Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by symptoms of inattention, impulsivity, and hyperactivity that are observed across the lifespan. Deviant electroencephalographic (EEG) patterns of activity have been repeatedly observed in children with ADHD during resting-state conditions. However, the research in adult populations is limited and several neurophysiological models investigated in children with ADHD have not been examined in adults. Thus, the primary aim of this thesis was to investigate neurophysiological models of ADHD in an adult population, as well as to explore the relation between resting-state brain oscillations and core ADHD behaviors. The neurophysiological models investigated in this thesis were quantitative EEG (QEEG) using fixed frequency bands and individualized frequency bands based on individual alpha peak frequency (iAPF), phenotype classification, and vigilance classification. Methods. Continuous 21-channel EEG was acquired from 48 adult participants with DSM-IV defined ADHD and 48 age and sex matched healthy control participants. To investigate QEEG differences between populations the EEG was Fourier transformed and pooled into nine regions by averaging the power at several electrode sites. For each frequency band (delta, theta, alpha, beta, theta/alpha, and theta/beta power), power analysis (absolute and relative power), and condition (eyes-closed and eyes-open), a mixed ANOVA was used to examine the effects of region and group using fixed and individualized frequency bands. To investigate the EEG phenotype model, EEG files were individually reviewed and hand scored for the presence or absence of identifiable EEG patterns including frontal slowing, low iAPF, high iAPF, beta spindling, frontal alpha, persistent eyes-open alpha, temporal alpha, and paroxysmal activity. A Pearson’s chi-squared test was used to investigate the relationship between group (ADHD, Control) and phenotype (present, absent) in a series of 2x2 cross-tabulation tables. To investigate the EEG vigilance model, eyes-closed EEG vigilance stages (O, A1, A2, A3, B1, and B2/3+) were classified using the latest version of Vigilance Algorithm Leipzig (VIGALL) macro. Differences in the amounts of vigilance stages and stage transitions in ADHD and control participants were tested using a Mann-Whitney U-test. Correlations were calculated between ADHD behavioral measures, QEEG data, and classification sub-groups. Results. Compared to control participants, the ADHD group presented with significantly enhanced relative theta, absolute beta, theta/alpha power, and attenuated relative alpha during the eyes-closed condition, as well as significantly enhanced absolute and relative theta and attenuated relative alpha during the eyes-open condition when using fixed-frequency bands for the QEEG analysis. Despite non-significant differences in iAPF values between groups, QEEG differences were influenced using individualized frequency bands. Consequently, the ADHD group presented with significantly attenuated relative alpha and relative beta during the eyes-closed condition, as well as significantly enhanced absolute and relative theta, theta/alpha power, and attenuated relative alpha during the eyes-open condition. EEG phenotype classification revealed a significantly greater prevalence of the frontal slow and high iAPF subtypes in the ADHD group compared to the control group. EEG vigilance classification revealed that ADHD participants spent more time in lower vigilance stages (B2/3) than control participants did (ADHD = 21.2%, Control = 14.2%). No consistent relationship was found between resting-state brain oscillations and ADHD behaviors, with the exception of a weak positive correlation between iAPF and inattention. Discussion. The present investigation confirmed and extended many of the findings reported in children with ADHD in an adult ADHD population; namely enhanced theta and attenuated alpha activity. Theta and alpha power abnormalities were further evidenced by an increased prevalence of ADHD individuals with the frontal slow (theta) and high iAPF phenotypes (alpha) and lower vigilance stage dominance (theta/alpha). The results support the hypothesis that imbalances or deviations within septal-hippocampal circuits and thalamocotical loops may lead to the disturbances of theta and alpha activity, expression of ADHD subtypes, and neurobiological deficits linked to the dopaminergic system, altered reinforcement mechanisms, and changes in vigilance and arousal. Further, these findings may account for discrepant QEEG findings within ADHD research, as EEG activity in ADHD appears to be mediated by iAPF values. Future research should investigate the role of iAPF in ADHD, as well as determine whether these neurophysiological models are reliable discriminants of ADHD or predictive of treatment response.Einführung. Die Aufmerksamkeitsdefizit-/ Hyperaktivitätsstörung (ADHS) ist eine neurobiologisch verursachte Entwicklungsstörung. Symptome der Unaufmerksamkeit, Impulsivität und Hyperaktivität werden bei Kindern und auch bei Erwachsenen beobachtet. Im Ruhe-Elektroenzephalogramm (EEG) wurden wiederholt abweichende Aktivitätsmuster bei Kindern mit einer ADHS beobachtet. ADHS bei Erwachsenen ist bisher nur wenig untersucht und neurophysiologische Modelle der ADHS wurden bisher nur für Kinder entwickelt. Daher ist das Hauptziel der vorliegenden Arbeit, die neurophysiologischen Modelle der ADHS an Erwachsenen zu überprüfen. Außerdem soll die Beziehung zwischen den Oszillationen des Gehirns im Ruhezustand und den Hauptsymptomen der ADHS untersucht werden. Im Einzelnen wurden folgende Modelle in dieser Arbeit untersucht: Abweichungen im quantitativen EEG (QEEG), wobei feste und individuelle Frequenzbänder anhand von individueller Alpha-Peak Frequenz (iAPF) betrachtet werden, die Phänotypen-Klassifikation und die Vigilanz-Klassifikation. Methode. Achtundvierzig Erwachsene mit einer DSM-IV ADHS Diagnose und 48 in Alter und Geschlecht gematchte, gesunde Probanden wurden mit einem 21-Kanal EEG gemessen. Für die Untersuchung etwaiger Unterschiede zwischen den Probanden mit und ohne ADHS wurde das EEG Fourier transformiert und in neun Regionen aufgeteilt, indem das durchschnittliche Powerspektrum von mehreren Elektrodenpositionen gebildet wurde. Die Effekte von Region und Gruppe wurden mit Hilfe von Varianzanalysen einmal für feste und einmal für individualisierte Frequenzbänder bestimmt (Delta, Theta, Alpha, Beta, Theta/Alpha und Theta/Beta Power absolute und relative Power) jeweils für die Bedingungen (Augen offen (A-O) und Augen geschlossen(A-G). Für die Untersuchung des EEG Phänotypen-Models wurden die EEG-Daten für jeden Probanden einzeln überprüft. Es wurde per visueller Inspektion geprüft, ob folgende EEG-Muster vorhanden waren: frontale Verlangsamung, niedrige iAPF, hohe iAPF, Beta-Spindeln, frontales Alpha, fehlender Alpha- Block bei geöffneten Augen, temporales Alpha und paroxysmale Aktivität. Ein Pearson’s Chi-Quadrat Test wurde mit 2x2 Kreuztabellen berechnet, um die Beziehung zwischen der Gruppe und dem Phänotyp zu untersuchen. Um das EEG Vigilanz-Model zu untersuchen, wurden die EEG-Vigilanzstadien bei geschlossenen Augen (O, A1, A2, A3, B1 und B2/3+) mit der neuesten Version des Vigilanz Algorithmus Leipzig (VIGALL) Macro klassifiziert. Die Unterschiede in der Menge der Vigilanz-Stadien und den Übergängen in die verschiedenen Stadien, wurde mit dem Mann-Whitney U-test analysiert. Korrelationen wurden zwischen den Symptomen, den QEEG-Daten und den Klassifikationssubtypen berechnet. Ergebnisse. Im Vergleich zu den Probanden der Kontrollgruppe zeigte die ADHS-Gruppe in der QEEG-Analyse mit festen Frequenzbändern signifikant größere Anteile im relativen Theta, absoluten Beta und in der Theta/Alpha Power sowie ein verringertes relatives Alpha während der A-G Bedingung. In der A-O Bedingung war Theta absolut und relativ stärker, sowie Alpha relativ geringer ausgeprägt. Obwohl in den iAPF-Werten keine signifikanten Gruppenunterschiede gefunden wurden, ergab sich ein anderes Bild als bei der Betrachtung der festen Frequenzbänder. Die ADHS-Gruppe zeigte signifikant weniger relatives Alpha und weniger relatives Beta in der A-G Bedingung. Außerdem zeigten sich in der A-O Bedingung signifikante Erhöhungen im absoluten und relativen Theta und in der Theta/Alpha Power sowie eine Verringerung des relativen Alpha. Die EEG-Phänotypen-Klassifikation ergab in der ADHS-Gruppe eine signifikant häufigere Prävalenz der frontalen Verlangsamung und des Subtypus mit hoher iAPF. Die EEG Vigilanz-Klassifikation zeigte, dass die ADHS Gruppe mehr Zeit in niedrigeren Vigilanzstadien (B2/3) verbrachte als die Kontrollgruppe (ADHS = 21.2%, Kontrollen = 14.2%). Bis auf eine schwache positive Korrelation zwischen der iAPF und Unaufmerksamkeit, fanden sich keine konsistenten Beziehungen zwischen den Oszillationen im Ruhezustand des Gehirns und den Symptomen. Diskussion. Die hiervorliegende Arbeit bestätigt und erweitert viele Befunde aus der ADHS-Forschung an Kindern für Erwachsene, vor allem die erhöhte Theta- und niedrigere Alpha-Aktivität. Diese Befunde werden auch durch die erhöhte Prävalenz der Phänotypen frontale Verlangsamung und hohe iAPF, sowie der Dominanz der niedrigeren Vigilanzstadien in der ADHS Gruppe bestätigt. Die Ergebnisse unterstützen die Hypothese, wonach ein Ungleichgewicht oder Abweichungen in den septo-hippokampalen Verbindungen und den thalamisch-kortikalen Schleifen zu einer Störung von Theta- und Alpha-Aktivität, dem Auftreten von ADHS-Subtypen und neurobiologischen Defiziten führen, welche mit dem dopaminergen System, veränderten Verstärkungsmechanismen und Veränderungen in der Vigilanz und Erregung verbunden sind. Ferner können die Ergebnisse dazu beitragen, widersprüchliche Befunde zu der Aktivität einzelner Frequenzbänder zu klären, da der iAPF-Wert anscheinend die EEG-Aktivität anders darstellt. Zukünftig sollte die iAPF bei einer QEEG-Betrachtung stärker berücksichtigt werden. Außerdem sollte untersucht werden, welchen Beitrag die neurophysiologischen Modelle zur Diagnose und Vorhersage des Therapieerfolgs bei ADHS leisten können