Barriers, Facilitators and Opportunities for HIV Status Disclosure Among Young Men Who Have Sex With Men: Qualitative Findings from the Tough Talks Intervention.

Disclosing one's HIV status can involve complex individual and interpersonal processes interacting with discriminatory societal norms and institutionalized biases. To support disclosure decision-making among young men who have sex with men (YMSM) living with HIV, we developed Tough Talks™, an mHealth intervention that uses artificially intelligent-facilitated role-playing disclosure scenarios and informational activities that build disclosure skills and self-efficacy. Qualitative interviews were conducted with 30 YMSM living with HIV (mean age 24 years, 50% Black) who were enrolled in a randomized controlled trial assessing Tough Talks™ to understand their experiences with HIV status disclosure. Interviews were recorded, transcribed, and thematically coded. Barriers to disclosure focused on fear, anxiety, stigma, and trauma. Facilitators to disclosure are described in the context of these barriers including how participants built comfort and confidence in disclosure decisions and ways the Tough Talks™ intervention helped them. Participants' narratives identified meaning-making within disclosure conversations including opportunities for educating others and advocacy. Findings revealed ongoing challenges to HIV status disclosure among YMSM and a need for clinical providers and others to support disclosure decision-making and affirm individuals' autonomy over their decisions to disclose. Considering disclosure as a process rather than discrete events could inform future intervention approaches.

Neural response to monetary and social rewards in adolescent girls and their parents.

Functional magnetic resonance imaging (fMRI) studies have indicated that the mesocorticolimbic dopamine system is heavily involved in all stages of reward processing. However, the majority of research has been conducted using monetary rewards and it is unclear to what extent other types of rewards, such as social rewards, evoke similar or different neural activation. There have also been few investigations into potential differences or similarities between reward processing in parents and offspring. The present study examined fMRI neural activation in response to monetary and social reward in a sample of 14-22-year-old adolescent girls (N = 145) and a biological parent (N = 124) and compared activation across adolescent-parent dyads (N = 82). Across all participants, both monetary and social reward elicited bilateral striatal activation, which did not differ between reward types or between adolescents and their parents. Neural activation in response to the different reward types were positively correlated in the striatum among adolescents and in the mPFC and OFC among parents. Overall, the present study suggests that both monetary and social reward elicit striatal activation regardless of age and provides evidence that neural mechanisms underlying reward processing may converge differentially among youth and adults.

Reward-Related Brain Activity Mediates the relationship between Decision-Making Deficits and Pediatric Depression Symptom Severity.

BACKGROUND: The mechanisms linking neural and behavioral indices of reduced reward sensitivity in depression, particularly in children, remain unclear. Reward positivity (RewP), a neural index of reward processing, has been consistently associated with depression. Separately, recent studies using the drift-diffusion model (DDM) on behavioral data have delineated computational indices of reward sensitivity. Therefore, the present study examined whether RewP is a neural mediator of DDM-based indices of reward processing in predicting pediatric depression across varying levels of symptom severity. METHODS: A community sample of 166 girls, aged 8 to 14 years, completed two tasks. The first was a reward guessing task from which RewP was computed using electroencephalography; the second was a probabilistic reward-based decision-making task. On this second task, DDM analysis was applied to behavioral data to quantify the efficiency of accumulating reward-related evidence (drift rate) and potential baseline bias (starting point) towards the differently rewarded choices. Depression severity was measured using the self-report Children's Depression Inventory (CDI). RESULTS: RewP was correlated with drift rate, but not starting point bias, towards the more rewarded choice. Furthermore, RewP completely mediated the association between a slower drift rate towards the more rewarded option and higher depression symptom severity. CONCLUSION: Our findings suggest that reduced neural sensitivity to reward feedback might be a neural mechanism underscoring behavioral insensitivity to reward in children and adolescents with higher depression symptom severity, offering novel insights into the relationship between neural and computational indices of reward processing in this context.

Aging alters the subchondral bone response 7 days after noninvasive traumatic joint injury in C57BL/6JN mice.

Posttraumatic osteoarthritis (PTOA) commonly develops following anterior cruciate ligament (ACL) injuries, affecting around 50% of individuals within 10-20 years. Recent studies have highlighted early changes in subchondral bone structure after ACL injury in adolescent or young adult mice, which could contribute to the development of PTOA. However, ACL injuries do not only occur early in life. Middle-aged and older patients also experience ACL injuries and PTOA, but whether the aged subchondral bone also responds rapidly to injury is unknown. This study utilized a noninvasive, single overload mouse injury model to assess subchondral bone microarchitecture, turnover, and material properties in both young adults (5 months) and early old age (22 months) female C57BL/6JN mice at 7 days after injury. Mice underwent either joint injury (i.e., produces ACL tears) or sham injury procedures on both the loaded and contralateral limbs, allowing evaluation of the impacts of injury versus loading. The subchondral bone response to ACL injury is distinct for young adult and aged mice. While 5-month mice show subchondral bone loss and increased bone resorption postinjury, 22-month mice did not show loss of bone structure and had lower bone resorption. Subchondral bone plate modulus increased with age, but not with injury. Both ages of mice showed several bone measures were altered in the contralateral limb, demonstrating the systemic skeletal response to joint injury. These data motivate further investigation to discern how osteochondral tissues differently respond to injury in aging, such that diagnostics and treatments can be refined for these demographics.

Electrocortical Reactivity During Self-Referential Processing Predicts the Development of Depression Across Adolescence.

BACKGROUND: Negative attentional biases and self-schemas have been implicated in the development of depression. Research has indicated that a larger late positive potential (LPP) to negative self-referential words is associated with depression-as well as a maternal history of depression, an indicator of risk. However, it is unclear whether the LPP to self-referential words predicts the actual development of depression. In the current study, we examined whether electrocortical reactivity during self-referential processing predicted the development of depression across adolescence. METHODS: The sample consisted of 165 8- to 14-year-old girls with no lifetime history of a depressive disorder who completed the self-referential encoding task while electroencephalography was recorded at a baseline assessment. Participants and their parent completed the Kiddie Schedule for Affective Disorders and Schizophrenia for School-Age Children at the baseline and 2-, 4-, and 6-year follow-up assessments. RESULTS: Results indicated that a larger LPP to negative self-referential words at baseline predicted an increased likelihood of developing chronic-intermittent depression (i.e., persistent and/or recurrent), but not nonchronic, single-episode depression, across adolescence. In contrast, neither self-referential encoding task recall biases nor the LPP to positive self-referential words predicted the development of either type of depression. CONCLUSIONS: The results of the current study suggest that electrocortical reactivity associated with a negative self-schema in late childhood predicts the development of a more pernicious subtype of depression across adolescence. Moreover, the current study highlights the importance of considering clinical course in the examination of biomarkers of risk for depression.

Evaluation of ChatGPT's responses to information needs and information seeking of dementia patients.

Many people in the advanced stages of dementia require full-time caregivers, most of whom are family members who provide informal (non-specialized) care. It is important to provide these caregivers with high-quality information to help them understand and manage the symptoms and behaviors of dementia patients. This study aims to evaluate ChatGPT, a chatbot built using the Generative Pre-trained Transformer (GPT) large language model, in responding to information needs and information seeking of such informal caregivers. We identified the information needs of dementia patients based on the relevant literature (22 articles were selected from 2442 retrieved articles). From this analysis, we created a list of 31 items that describe these information needs, and used them to formulate 118 relevant questions. We then asked these questions to ChatGPT and investigated its responses. In the next phase, we asked 15 informal and 15 formal dementia-patient caregivers to analyze and evaluate these ChatGPT responses, using both quantitative (questionnaire) and qualitative (interview) approaches. In the interviews conducted, informal caregivers were more positive towards the use of ChatGPT to obtain non-specialized information about dementia compared to formal caregivers. However, ChatGPT struggled to provide satisfactory responses to more specialized (clinical) inquiries. In the questionnaire study, informal caregivers gave higher ratings to ChatGPT's responsiveness on the 31 items describing information needs, giving an overall mean score of 3.77 (SD 0.98) out of 5; the mean score among formal caregivers was 3.13 (SD 0.65), indicating that formal caregivers showed less trust in ChatGPT's responses compared to informal caregivers. ChatGPT's responses to non-clinical information needs related to dementia patients were generally satisfactory at this stage. As this tool is still under heavy development, it holds promise for providing even higher-quality information in response to information needs, particularly when developed in collaboration with healthcare professionals. Thus, large language models such as ChatGPT can serve as valuable sources of information for informal caregivers, although they may not fully meet the needs of formal caregivers who seek specialized (clinical) answers. Nevertheless, even in its current state, ChatGPT was able to provide responses to some of the clinical questions related to dementia that were asked.

ChatGPT in medical libraries, possibilities and future directions: An integrative review.

BACKGROUND: The emergence of the artificial intelligence chatbot ChatGPT in November 2022 has garnered substantial attention across diverse disciplines. Despite widespread adoption in various sectors, the exploration of its application in libraries, especially within the medical domain, remains limited. AIMS/OBJECTIVES: Many areas of interest remain unexplored like ChatGPT in medical libraries and this review aims to synthesise what is currently known about it to identify gaps and stimulate further research. METHODS: Employing Cooper's integrative review method, this study involves a comprehensive analysis of existing literature on ChatGPT and its potential implementations within library contexts. RESULTS: A systematic literature search across various databases yielded 166 papers, with 30 excluded for irrelevance. After abstract reviews and methodological assessments, 136 articles were selected. Critical Appraisal Skills Programme qualitative checklist further narrowed down to 29 papers, forming the basis for the present study. The literature analysis reveals diverse applications of ChatGPT in medical libraries, including aiding users in finding relevant medical information, answering queries, providing recommendations and facilitating access to resources. Potential challenges and ethical considerations associated with ChatGPT in this context are also highlighted. CONCLUSION: Positioned as a review, our study elucidates the applications of ChatGPT in medical libraries and discusses relevant considerations. The integration of ChatGPT into medical library services holds promise for enhancing information retrieval and user experience, benefiting library users and the broader medical community.

Concussion incidence and mechanisms differ between elite females and males in Australian Football.

OBJECTIVES: To investigate the incidence and the game circumstances of concussion in the professional female (AFLW) and male (AFL) competitions of Australian Football, to identify potential targets for risk reduction. DESIGN: Retrospective cohort. METHODS: Concussion data were obtained from the AFL injury database, which included all concussions sustained by AFL (Male) players from 2015 to 18 and AFLW (Female) players from 2017 to 19. Concussions were diagnosed by experienced clinicians utilising standardised concussion assessment tools and injury definitions, as well as video review. Video footage was analysed to determine the circumstances each concussion occurred, which included the action and the contact-point of impact. RESULTS: The incidence of concussion was higher in the AFLW (Female) compared to the AFL (Male) (IRR = 2.12, 95 %CI 1.54 to 2.92). Video footage was available for 194/252 (77 %) concussions in the AFL and 35/44 (80 %) concussions in the AFLW. Male players were most frequently concussed during marking contests (28 %) with primary impact from the upper limb (22 %) or the shoulder (19 %). Conversely, being bumped (23 %) or tackled (20 %) were the main actions associated with concussion in female players, with the head (29 %) or the ground (23 %) the most common contact-points of impact. CONCLUSIONS: In elite Australian Football a higher incidence of concussion was demonstrated in female compared to male players. The mechanisms associated with concussion were also found to differ between male and female competitions, suggesting that different injury prevention interventions may be beneficial. In particular, a review of tackling and bumping skills training and education in the AFLW may reduce the risk of concussion.

Neural response to monetary and social rewards and familial risk for psychopathology in adolescent females.

BACKGROUND: Adolescence is a key developmental period for the emergence of psychopathology. Reward-related brain activity increases across adolescence and has been identified as a potential neurobiological mechanism of risk for different forms of psychopathology. The reward positivity (RewP) is an event-related potential component that indexes reward system activation and has been associated with both concurrent and family history of psychopathology. However, it is unclear whether the RewP is also associated with higher-order psychopathology subfactors and whether this relationship is present across different types of reward. METHODS: In a sample of 193 adolescent females and a biological parent, the present study examined the association between adolescent and parental psychopathology subfactors and adolescent RewP to monetary and social reward. RESULTS: Results indicated that the adolescent and parental distress subfactors were negatively associated with the adolescent domain-general RewP. The adolescent and parental positive mood subfactors were negatively associated with the adolescent domain-general and domain-specific monetary RewP, respectively. Conversely, the adolescent and parental fear/obsessions subfactors were positively associated with the adolescent domain-general RewP. The associations between parental and adolescent psychopathology subfactors and the adolescent RewP were independent of each other. CONCLUSIONS: The RewP in adolescent females is associated with both concurrent and parental psychopathology symptoms, suggesting that it indexes both severity and risk for higher-order subfactors.

Recent advances and current challenges in CAR-T cell therapy.

Rapid advancements in the field of immunotherapy have significantly improved cancer treatments. Specifically, an individualized cell-based modality which involves the removal of some of the patient's own white blood cells, including T cells, has revolutionized research in this field. This study focuses on the recent advances and current challenges of Chimeric Antigen Receptor- T (CAR-T) cell therapy and its regulations in the United States (US) and European Union (EU). Understanding the regulatory regimes of CAR-T cell therapy is critical for researchers and manufacturers as they navigate the hurdles of bringing CAR-T cell therapy to the global market. Benefits of CAR-T cell therapy include high response rates and the potential of long-term remissions in some haematological malignancies. However, the drawbacks are still evident including high costs, adverse reactions, and limited efficacy to solid tumours. CAR-T cell therapy is rapidly advancing, with 1231 clinical trials launched globally according to www.clinicalTrial.gov . The future of CAR-T cell therapy holds enormous promise but improving its safety, effectiveness, and availability are still barriers to its successful implementation.

Social feedback biases emerge during recall but not prediction and shift across the development of social anxiety.

Memory is a reconstructive process that can result in events being recalled as more positive or negative than they actually were. While positive recall biases may contribute to well-being, negative recall biases may promote internalizing symptoms, such as social anxiety. Adolescence is characterized by increased salience of peers and peak incidence of social anxiety. Symptoms often wax and wane before becoming more intractable during adulthood. Open questions remain regarding how and when biases for social feedback are expressed and how individual differences in biases may contribute to social anxiety across development. Two studies used a social feedback and cued response task to assess biases about being liked or disliked when retrieving memories vs. making predictions. Findings revealed a robust positivity bias about memories for social feedback, regardless of whether memories were true or false. Moreover, memory bias was associated with social anxiety in a developmentally sensitive way. Among adults (study 1), more severe symptoms of social anxiety were associated with a negativity bias. During the transition from adolescence to adulthood (study 2), age strengthened the positivity bias in those with less severe symptoms and strengthened the negativity bias in those with more severe symptoms. These patterns of bias were isolated to perceived memory retrieval and did not generalize to predictions about social feedback. These results provide initial support for a model by which schemas may infiltrate perceptions of memory for past, but not predictions of future, social events, shaping susceptibility for social anxiety, particularly during the transition into adulthood.

Examining Blunted Initial Response to Reward and Recent Suicidal Ideation in Children and Adolescents Using Event-Related Potentials: Failure to Conceptually Replicate Across Two Independent Samples.

A recent study by Tsypes and colleagues (2019) found that children with recent suicidal ideation had blunted neural reward processing, as measured by the reward positivity (RewP), compared to matched controls, and that this difference was driven by reduced neural responses to monetary loss, rather than to reward. Here, we aimed to conceptually replicate and extend these findings in two samples (n = 264, 27 with suicidal ideation; and n = 314, 49 with suicidal ideation at baseline) of children and adolescents (11 to 15 years and 8 to 15 years, respectively). Results from both samples showed no evidence that children and adolescents with suicidal ideation have abnormal reward or loss processing, nor that reward processing predicts suicidal ideation two years later. The results highlight the need for greater statistical power, as well as continued research examining the neural underpinnings of suicidal thoughts and behaviors.

Predicting internalizing symptoms with machine learning: identifying individuals that need care.

Objective The current project aims to identify individuals in urgent need of mental health care, using a machine learning algorithm (random forest). Comparison/contrast with conventional regression analyses is discussed. Participants: A total of 2,409 participants were recruited from an anonymous university, including undergraduate and graduate students, faculty, and staff. Methods: Answers to a COVID-19 impact survey, the Patient Health Questionnaire-9 (PHQ-9), and the Generalized Anxiety Disorder-7 (GAD-7) were collected. The total scores of PHQ-9 and GAD-7 were regressed on six composites that were created from the questionnaire items, based on their topics. A random forest was trained and validated. Results: Results indicate that the random forest model was able to make accurate, prospective predictions (R2 = .429 on average) and we review variables that were deemed predictively relevant. Conclusions: Overall, the study suggests that predictive models can be clinically useful in identifying individuals with internalizing symptoms based on daily life disruption experiences.

Draft genome sequences of two Pseudomonas strains isolated from 129I plumes at the Hanford Site.

Pseudomonas strains DVZ6 and DVZ24 were isolated from a sediment trap incubated in an 129I plume at the Hanford Site (Washington State, USA). Whole-genome sequencing of the strains revealed that both genomes are 5.77 Mb in size, with a G + C content of 64.75%.

Draft genome sequence of Enterobacter hormaechei DVZ29, an iodide-oxidizing bacterium isolated from the Hanford site.

Enterobacter hormaechei DVZ29 was isolated from a sediment trap incubated in an 129I plume at the Hanford Site (Washington State, USA). A whole genome sequencing of the strain resulted in 32 contigs and revealed that the genome is 4.90 Mb, with a G + C content of 55.61%.

Low-Dose Naltrexone Use in Postural Orthostatic Tachycardia Syndrome: A Case Series.

Introduction In recent years, low-dose naltrexone has emerged as a novel off-label therapy for many chronic conditions including postural orthostatic tachycardia syndrome (POTS), however, there is little evidence for its efficacy. Methods In this institutional review board (IRB)-approved case series, the charts of six tilt table-confirmed patients with POTS who underwent a trial of low-dose naltrexone (LDN) at our institution were reviewed. Medical history, subjective description of symptom severity, the continuation of therapy, tolerability, and scores on patient-reported outcome measures (Patient-Reported Outcomes Measurement Information System {PROMIS} Fatigue, PROMIS physical and mental health, Generalized Anxiety Disorder Assessment {GAD}-7, Patient Health Questionnaire {PHQ}-9, and Composite Autonomic Symptom Score {COMPASS}) were collected at therapy initiation and six to 12 months after the start of LDN. Results Three out of six reviewed patients reported an improvement in their POTS after the initiation of LDN. Two patients discontinued the therapy due to a lack of perceived benefit. No side effects or adverse outcomes were reported. The patient-reported outcome measures of PROMIS Fatigue, PROMIS physical and mental health, GAD-7, PHQ-9, and COMPASS showed inconsistent changes over the course of therapy, with some patients showing improvement or stability and others showing worsening. The small sample size and incomplete response rate did not allow for extensive statistical analysis. Conclusion As seen in its use in other conditions, LDN appears to have a favorable safety and side effect profile in patients with POTS but has little evidence for efficacy. Although some patients noted benefit, patient-reported outcome measures show a variable response profile. High-quality randomized controlled trials are needed to determine if the treatment is efficacious and should be used outside of a trial basis.

Complete genome sequence of Cellulomonas sp., strain ES6, a chromate-reducing bacterium isolated from chromium-contaminated subsurface sediment.

Cellulomonas sp. strain ES6 is a chromate-reducing bacterium isolated from chromium contaminated subsurface sediment. Illumina MiSeq and Oxford Nanopore sequencing were used to assemble the genome sequence which consisted of a single circular chromosome of 4.13 Mb, contained 3,960 protein encoding genes and with an overall G + C content 75.38%.

Loss of mental health support among college students during the COVID-19 pandemic.

Objective: The COVID-19 pandemic has simultaneously exacerbated mental health concerns among college students and made it more challenging for many students to access mental health support. However, little is known about the extent of mental health support loss among college students, or which students have lost support. Participants: 415 undergraduate students who reported receiving mental health support prior to the pandemic participated. Methods: Students completed an online questionnaire between March and May of 2020. Researchers examined the extent of support loss and how support loss differed by demographic and mental health variables. Methods pre-registered at https://osf.io/m83hz. Results: 62% of respondents reported loss of mental health support. Loss of support was associated with more severe depressive symptoms (p < .001), more severe anxiety symptoms (p < .001), suicidal ideation (p < .001), and sexual minority identity (p = .017). Conclusions: Loss of support was common, especially among more vulnerable students.

Design, development, implementation, and evaluation of a severe drug-drug interaction alert system in the ICU: An analysis of acceptance and override rates.

BACKGROUND AND OBJECTIVE: The override rate of Drug-Drug Interaction Alerts (DDIA) in Intensive Care Units (ICUs) is very high. Therefore, this study aimed to design, develop, implement, and evaluate a severe Drug-Drug Alert System (DDIAS) in a system of ICUs and measure the override rate of this system. METHODS: This is a cross-sectional study that details the design, development, implementation, and evaluation of a DDIAS for severe interactions into a Computerized Provider Order Entry (CPOE) system in the ICUs of Nemazee general teaching hospitals in 2021. The patients exposed to the volume of DDIAS, acceptance and overridden of DDIAS, and usability of DDIAS have been collected. The study was approved by the local Institutional Review Board (IRB) and; the ethics committee of Shiraz University of Medical Science on date: 2019-11-23 (Approval ID: IR.SUMS.REC.1398.1046). RESULTS: The knowledge base of the DDIAS contains 9,809 severe potential drug-drug interactions (pDDIs). A total of 2672 medications were prescribed in the population study. The volume and acceptance rate for the DDIAS were 81 % and 97.5 %, respectively. The override rate was 2.5 %. The mean System Usability Scale (SUS) score of the DDIAS was 75. CONCLUSION: This study demonstrates that implementing high-risk DDIAS at the point of prescribing in ICUs improves adherence to alerts. In addition, the usability of the DDIAS was reasonable. Further studies are needed to investigate the establishment of severe DDIAS and measure the prescribers' response to DDIAS on a larger scale.

COVID-19 experiences and psychopathology symptoms in college students at the onset of the pandemic.

Objective: The present study examined what specific aspects of the COVID-19 pandemic contributed to psychopathology symptoms among college students during the initial stages of the pandemic. Participants: One thousand and eighty-nine college students (Mage = 20.73, SDage = 2.93) enrolled at a university in New York participated in the study between March and May 2020. Methods: Participants completed self-report measures assessing pandemic-related experiences and psychopathology symptoms. Results: Results indicated that greater COVID-19-related life changes were uniquely associated with greater depression and post-traumatic stress symptoms. Greater concerns about school, home confinement, and basic needs were uniquely associated with greater depression symptoms. Finally, greater COVID-19 infection concerns were uniquely associated with greater generalized anxiety and post-traumatic stress symptoms. Conclusion: The present study indicates that the COVID-19 pandemic had a multifaceted impact on undergraduate students and that specific COVID-19 experiences contributed to higher rates of psychopathology symptoms.