College students\u27 suicidal ideation: Testing the predictions of the existential - constructivist theory of suicide

Suicide is the second leading cause of death in the college student population (Schwartz, 2006), and empirically supported theories for understanding suicide among college students are lacking (Lester, 1989; Prinstein, 2008; Rogers & Benson, 2013). Although not yet examined empirically, Rogers (2001) proposed an Existential - Constructivist Theory of Suicide (ECTS), in which existential distress and the inability to reconstruct meaning from adverse life events contribute to suicidal ideation. ECTS includes both interpersonal and intrapersonal drivers of suicidal ideation, and for this reason, may better explain suicidal ideation in college students than existing theoretical models. Existing research focuses on Joiner’s (2005) Interpersonal Theory of Suicide (ITS) which proposes that two interpersonal cognitive - affective states (i.e., perceived burdensomeness, thwarted belongingness) contribute to suicidal ideation (i.e., thoughts about death by suicide). Thus, in the present study I (a) tested the central hypotheses of the ECTS in a college student sample and (b) compared the model fit of the ECTS to the ITS to assess which statistical model best explained suicidal ideation in college students. Survey data were collected electronically from 195 college students (i.e., aged 18 – 25) attending Purdue University. Data were analyzed using SEM. The results supported the predictions of the ECTS. Specifically, existential distress was positively associated with suicidal ideation and meaning reconstruction was negatively associated with suicidal ideation. Contrary to Rogers’s (2001) original model of ECTS, but consistent with recent literature on meaning reconstruction, existential distress mediated the association between meaning reconstruction and suicidal ideation. Although both ECTS and ITS demonstrated adequate model fit to the data, goodness of fit statistics indicated ECTS fit the data better in this sample, overall. Results of this study provide preliminary support that meaning reconstruction may be a protective factor for suicidal ideation, which can be used to (a) refine theories of suicidal ideation and (b) develop suicide prevention and treatment programs for suicidal college students. Results should be interpreted considering limitations of this study, such as low survey response rate, homogeneity of the sample, measurement limitations, and lack of ITS replication compared to previous research

G28.17+0.05: An unusual giant HI cloud in the inner Galaxy

New 21 cm HI observations have revealed a giant HI cloud in the Galactic plane that has unusual properties. It is quite well defined, about 150 pc in diameter at a distance of 5 kpc, and contains as much as 100,000 Solar Masses of atomic hydrogen. The outer parts of the cloud appear in HI emission above the HI background, while the central regions show HI self-absorption. Models which reproduce the observations have a core with a temperature <40 K and an outer envelope as much as an order of magnitude hotter. The cold core is elongated along the Galactic plane, whereas the overall outline of the cloud is approximately spherical. The warm and cold parts of the HI cloud have a similar, and relatively large, line width of approximately 7 km/s. The cloud core is a source of weak, anomalously-excited 1720 MHz OH emission, also with a relatively large line width, which delineates the region of HI self-absorption but is slightly blue-shifted in velocity. The intensity of the 1720 MHz OH emission is correlated with N(H) derived from models of the cold core. There is 12CO emission associated with the cloud core. Most of the cloud mass is in molecules, and the total mass is > 200,000 Solar Masses. In the cold core the HI mass fraction may be 10 percent. The cloud has only a few sites of current star formation. There may be about 100 more objects like this in the inner Galaxy; every line of sight through the Galactic plane within 50 degrees of the Galactic center probably intersects at least one. We suggest that G28.17+0.05 is a cloud being observed as it enters a spiral arm and that it is in the transition from the atomic to the molecular state.Comment: 35 pages, inludes 12 figure

Birth Weight for Gestational Age Norms for a Large Cohort of Infants Born to HIV-Negative Women in Botswana Compared with Norms for U.S.-Born Black Infants

Background: Standard values for birth weight by gestational age are not available for sub-Saharan Africa, but are needed to evaluate incidence and risk factors for intrauterine growth retardation in settings where HIV, antiretrovirals, and other in utero exposures may impact birth outcomes. Methods: Birth weight data were collected from six hospitals in Botswana. Infants born to HIV-negative women between 26-44 weeks gestation were analyzed to construct birth weight for gestational age charts. These data were compared with published norms for black infants in the United States. Results: During a 29 month period from 2007-2010, birth records were reviewed in real-time from 6 hospitals and clinics in Botswana. Of these, 11,753 live infants born to HIV-negative women were included in the analysis. The median gestational age at birth was 39 weeks (1st quartile 38, 3rd quartile 40 weeks), and the median birth weight was 3100 grams (1st quartile 2800, 3rd quartile 3400 grams). We constructed estimated percentile curves for birth weight by gestational age which demonstrate increasing slope during the third trimester and leveling off beyond 40 weeks. Compared with black infants in the United States, Botswana-born infants had lower median birth weight for gestational age from weeks 37 through 42 (p < .02). Conclusions: We present birth weight for gestational age norms for Botswana, which are lower at term than norms for black infants in the United States. These findings suggest the importance of regional birth weight norms to identify and define risk factors for higher risk births. These data serve as a reference for Botswana, may apply to southern Africa, and may help to identify infants at risk for perinatal complications and inform comparisons among infants exposed to HIV and antiretrovirals in utero

Development of a Cx46 Targeting Strategy for Cancer Stem Cells

Gap-junction-mediated cell-cell communication enables tumor cells to synchronize complex processes. We previously found that glioblastoma cancer stem cells (CSCs) express higher levels of the gap junction protein Cx46 compared to non-stem tumor cells (non-CSCs) and that this was necessary and sufficient for CSC maintenance. To understand the mechanism underlying this requirement, we use point mutants to disrupt specific functions of Cx46 and find that Cx46-mediated gap-junction coupling is critical for CSCs. To develop a Cx46 targeting strategy, we screen a clinically relevant small molecule library and identify clofazimine as an inhibitor of Cx46-specific cell-cell communication. Clofazimine attenuates proliferation, self-renewal, and tumor growth and synergizes with temozolomide to induce apoptosis. Although clofazimine does not cross the blood-brain barrier, the combination of clofazimine derivatives optimized for brain penetrance with standard-of-care therapies may target glioblastoma CSCs. Furthermore, these results demonstrate the importance of targeting cell-cell communication as an anti-cancer therapy

Cancer Incidence following Expansion of HIV Treatment in Botswana

Background: The expansion of combination antiretroviral treatment (ART) in southern Africa has dramatically reduced mortality due to AIDS-related infections, but the impact of ART on cancer incidence in the region is unknown. We sought to describe trends in cancer incidence in Botswana during implementation of the first public ART program in Africa. Methods: We included 8479 incident cases from the Botswana National Cancer Registry during a period of significant ART expansion in Botswana, 2003–2008, when ART coverage increased from 7.3% to 82.3%. We fit Poisson models of age-adjusted cancer incidence and counts in the total population, and in an inverse probability weighted population with known HIV status, over time and estimated ART coverage. Findings: During this period 61.6% of cancers were diagnosed in HIV-infected individuals and 45.4% of all cancers in men and 36.4% of all cancers in women were attributable to HIV. Age-adjusted cancer incidence decreased in the HIV infected population by 8.3% per year (95% CI -14.1 to -2.1%). However, with a progressively larger and older HIV population the annual number of cancers diagnosed remained constant (0.0% annually, 95% CI -4.3 to +4.6%). In the overall population, incidence of Kaposi’s sarcoma decreased (4.6% annually, 95% CI -6.9 to -2.2), but incidence of non-Hodgkin lymphoma (+11.5% annually, 95% CI +6.3 to +17.0%) and HPV-associated cancers increased (+3.9% annually, 95% CI +1.4 to +6.5%). Age-adjusted cancer incidence among individuals without HIV increased 7.5% per year (95% CI +1.4 to +15.2%). Interpretation Expansion of ART in Botswana was associated with decreased age-specific cancer risk. However, an expanding and aging population contributed to continued high numbers of incident cancers in the HIV population. Increased capacity for early detection and treatment of HIV-associated cancer needs to be a new priority for programs in Africa

WHO 2010 Guidelines for Prevention of Mother-to-Child HIV Transmission in Zimbabwe: Modeling Clinical Outcomes in Infants and Mothers

The Zimbabwean national prevention of mother-to-child HIV transmission (PMTCT) program provided primarily single-dose nevirapine (sdNVP) from 2002-2009 and is currently replacing sdNVP with more effective antiretroviral (ARV) regimens.Published HIV and PMTCT models, with local trial and programmatic data, were used to simulate a cohort of HIV-infected, pregnant/breastfeeding women in Zimbabwe (mean age 24.0 years, mean CD4 451 cells/µL). We compared five PMTCT regimens at a fixed level of PMTCT medication uptake: 1) no antenatal ARVs (comparator); 2) sdNVP; 3) WHO 2010 guidelines using "Option A" (zidovudine during pregnancy/infant NVP during breastfeeding for women without advanced HIV disease; lifelong 3-drug antiretroviral therapy (ART) for women with advanced disease); 4) WHO "Option B" (ART during pregnancy/breastfeeding without advanced disease; lifelong ART with advanced disease); and 5) "Option B+:" lifelong ART for all pregnant/breastfeeding, HIV-infected women. Pediatric (4-6 week and 18-month infection risk, 2-year survival) and maternal (2- and 5-year survival, life expectancy from delivery) outcomes were projected.Eighteen-month pediatric infection risks ranged from 25.8% (no antenatal ARVs) to 10.9% (Options B/B+). Although maternal short-term outcomes (2- and 5-year survival) varied only slightly by regimen, maternal life expectancy was reduced after receipt of sdNVP (13.8 years) or Option B (13.9 years) compared to no antenatal ARVs (14.0 years), Option A (14.0 years), or Option B+ (14.5 years).Replacement of sdNVP with currently recommended regimens for PMTCT (WHO Options A, B, or B+) is necessary to reduce infant HIV infection risk in Zimbabwe. The planned transition to Option A may also improve both pediatric and maternal outcomes

What Will It Take to Eliminate Pediatric HIV? Reaching WHO Target Rates of Mother-to-Child HIV Transmission in Zimbabwe: A Model-Based Analysis

Using a simulation model, Andrea Ciaranello and colleagues find that the latest WHO PMTCT (prevention of mother to child transmission of HIV) guidelines plus better access to PMTCT programs, better retention of women in care, and better adherence to drugs are needed to eliminate pediatric HIV in Zimbabwe