Hidradenitis suppurativa in Black and White patients - a clinical study.

OBJECTIVE: It is suggested that hidradenitis suppurativa (HS) is more prevalent and causes greater morbidity in Black patients than in White. Clinical data are however lacking. PATIENTS AND METHODS: We therefore describe HS risk factors, disease severity and clinical phenotypes in the Blacks and Whites. Patients referred for HS between 1984 and 2019 at the Johns Hopkins Hospital were identified using the Pathology Data System (PDS). Clinical and sociodemographic characteristics were extracted and the van der Zee & Jemec HS clinical phenotypes were recovered. RESULTS: A total of 278 patients were identified. Ethnically, 108 (38.8%) were White, and 170 (61.2%) Black. The following HS phenotypes were found: Regular (n=193, 69.4%), scarring folliculitis (n=40, 1.4%) frictional furuncle (11.2%), conglobata (n=9, 3.2%), syndromic (n=3, 1.1%) and ectopic (n=2, 0.7%). No statistically significant ethnic differences in clinical presentation were found. Blacks however had more severe diseases than Whites (p= 0.024 for trend). With multivariate logistic regression analysis, we found that male sex, disease duration, and smoking were independent predictors of regular HS phenotype. Major limitations are the limited number of cases studied and the lack of data regarding response to therapies. CONCLUSIONS: Demographics and phenotypical presentation of HS patients do not seem to be associated with Black ethnicity. However, there is a significant trend for Blacks to present with more Hurley stage 2 and 3 disease compared to White patients. It is speculated that ethnic differences are epiphenomena to social factors, highlighting the broader importance of ethnicity.

A Multi-Method Investigation of Parental Responses to Youth Emotion: Prospective Effects on Emotion Dysregulation and Reactive Aggression in Daily Life.

Parental responses to negative emotion, one key component of emotion socialization, may function to increase (or decrease) reactive aggression over time via indirect effects on emotion dysregulation. However, despite its transdiagnostic relevance, very little research has examined this developmental risk pathway, and no studies have done so during the volatile and vulnerable transition to adolescence. The current study uses a sample of clinically referred youth (N = 162; mean age = 12.03 years; 47% female) and their parents to examine supportive and non-supportive parental responses to negative emotion using a multi-method (questionnaire, ecological momentary assessment [EMA], observation), multi-informant approach (child-, parent-, clinician-rated). Emotion dysregulation and reactive aggression were assessed via child report during a 4-day EMA protocol completed concurrently and 9 months later. Multivariate structural equation modeling was used to examine direct and indirect paths from parental responses to emotion to daily reports of emotion dysregulation and reactive aggression. Consistent with hypotheses, parental responses to emotion predicted reactive aggression via effects on emotion dysregulation. This indirect effect was present for supportive and non-supportive parental responses to emotion, such that supportive parental responses decreased risk, and non-supportive responses increased risk. Moreover, findings indicated differential prediction by informant, and this was specific to supportive parental responses to emotion, whereby child-reported support was protective, while parent-reported support, unexpectedly, had the opposite effect. The clinical significance of integrating supportive and non-supportive parental responses to negative emotion into etiological and intervention models of reactive aggression is discussed.

Local adaptation from afar: migratory bird populations diverge in the initiation of reproductive timing while wintering in sympatry.

The initiation of reproduction in many seasonally breeding animals is controlled by photoperiod and tends to be clinal: populations at higher latitudes breed later than those at lower latitudes, often reflecting a higher photoperiodic threshold. Migratory animals presumably time reproduction to match conditions at their breeding grounds, at least in part, by cues perceived on their wintering grounds. We asked how closely related dark-eyed junco (Junco hyemalis) populations that overwinter in sympatry but breed in allopatry respond to their shared winter environment by comparing early spring indices of readiness to migrate (fat and muscle condition) and breed (baseline and elevated testosterone). We measured stable hydrogen isotopes from feathers grown the preceding year and claws grown during winter to estimate breeding and wintering latitudes, respectively. We predicted that if reproductive initiation is adapted to the emergence of resources at their respective breeding destinations, then birds migrating to higher latitudes (slate-coloured junco; J. h. hyemalis) should delay breeding as compared with those migrating to lower latitudes (pink-sided junco; J. h. mearnsi) despite a common overwinter environment. We found higher testosterone in pink-sided juncos, consistent with earlier reproductive initiation, suggesting local adaptation in reproductive phenology is achieved through differential responses to predictive environmental cues.

Editorial: Response to "ROPS Are Not Homemade".

We are writing in response to the editorial "ROPS Are Not Homemade" by W. E. Field, R. Tormoehlen, S. Ehlers, C. Cheng, A. Talbert, G. Deboy, D. Haberlin, and C. V. Schwab, which was published in the July 2019 issue of the Journal of Agricultural Safety and Health (Field et al., 2019). The editorial warns secondary school teachers and FFA advisors about the potential liability of fabricating and installing low-cost rollover protective structures (ROPS) as service learning projects for agricultural education students. The apparent intent of the editorial is to discourage teachers and advisors from carrying out such projects. We wish to present arguments as to why these are actually highly beneficial projects to undertake, and perhaps one of our best hopes for significantly reducing the number of tractor overturn injuries and fatalities by directly involving our nation's youth.

Lessons learned from the development of a hidradenitis suppurativa xenograft mouse model.

Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease originating from the pilosebaceous unit, in which patients develop painful abscesses, sinus tracts, nodules and scarring, typically in intertriginous areas. Major gaps in our understanding of HS exist, and these may be partially due to the lack of an animal model for experimental studies. We developed an HS xenograft mouse model using human HS lesions grafted onto immunocompromised mice. Although the model had its limitations, several informative lessons were learned, which may contribute to future attempts at an HS animal model.

Specimen Collection for Translational Studies in Hidradenitis Suppurativa.

Hidradenitis suppurativa (HS) is a chronic inflammatory disorder characterized by painful nodules, sinus tracts, and scars occurring predominantly in intertriginous regions. The prevalence of HS is currently 0.053-4%, with a predominance in African-American women and has been linked to low socioeconomic status. The majority of the reported literature is  retrospective, population based, epidemiologic studies. In this regard, there is a need to establish a repository of biospecimens, which represent appropriate gender and racial demographics amongst HS patients. These efforts will diminish knowledge gaps in understanding the disease pathophysiology. Hence, we sought to outline a step-by-step protocol detailing how we established our HS biobank to facilitate the formation of other HS tissue banks. Equipping researchers with carefully detailed processes for collection of HS specimens would accelerate the accumulation of well-organized human biological material. Over time, the scientific community will have access to a broad range of HS tissue biospecimens, ultimately leading to more rigorous basic and translational research. Moreover, an improved understanding of the pathophysiology is necessary for the discovery of novel therapies for this debilitating disease. We aim to provide high impact translational research methodology for cutaneous biology research and foster multidisciplinary collaboration and advancement of our understanding of cutaneous diseases.

Quality and safety of broiler meat in various chilling systems.

Chilling is a critical step in poultry processing to attain high-quality meat and to meet the USDA-Food Safety and Inspection Service temperature standards. This study was conducted to determine the effects of commercially available chilling systems on quality and safety of broiler meat. A total of 300 carcasses in 2 replications were randomly selected from a commercial processor and subjected to 3 systems: immersion chill (IC), air chill (AC), and combi in-line air chill (CIAC). Incidence of Salmonella and Campylobacter were determined on pre- and postchilled carcasses. Quality of the meat was evaluated by carcass yield, drip loss, cook loss, texture, moisture content, sensory qualities, and color (L*, a*, and b*) of boneless skinless breast fillets and skin-on drums. Shelf life of whole carcasses, breast fillets, and drums was also determined. The IC resulted in the most reduction of Salmonella (39.7%) and Campylobacter (43%) incidence due to the washing effect and presence of chlorine in the chilled water. There was no significant difference in shelf-life when comparing the chilling methods. The IC had the highest (P < 0.05) carcass yield (6.5%), followed by CIAC (+1.98.0%) and then AC (-1.10%). Drip loss, cook loss, and moisture content of breast fillets were not significantly different for all the chilling systems, but higher L* value was observed for breast fillets at 24 h postmortem treated with IC and CIAC. However, IC exhibited the lightest color and AC was darkest in the drum samples. Shear force of breast meat was significantly more tender for AC and CIAC. There were no differences in the sensory qualities of breast fillets and drums among the 3 chilling systems.

Knowing what we do not know about sexual orientation change efforts.

Comments on the original article, "Guidelines for psychological practice with lesbian, gay, and bisexual clients," by the American Psychological Association (see record 2011-19419-001). The present authors notes that the APA has provided a very helpful document for those who do clinical work with individuals experiencing same-sex attractions. Psychologists no doubt need to be familiar with the literature described in these guidelines as a part of ethical practice. However, the present authors register concern regarding how the guidelines address sexual orientation change efforts (SOCE). They focus their critique on how the guidelines portray two issues pertaining to SOCE-effectiveness and harm-and conclude with a proposal to move the discussion forward via science.

Pasteurization of chicken litter with steam and quicklime to reduce Salmonella Typhimurium.

The nursery industry pasteurizes soil with steam and quicklime to reduce plant pathogens. The mechanism of action for quicklime is the resulting exothermic reaction that occurs when the chemical interacts with water and its ability to increase pH levels. These treatments may also reduce pathogens in a commercial poultry house. In this study, a steam sterilization cart simulated conditions used by the nursery industry to treat litter inoculated with Salmonella enterica serovar Typhimurium. A homogenized sample of litter was exposed to steam for 0, 5, 30, or 120 min. Quicklime was used at concentrations of 0 (control), 2.5, 5.0, or 10.0%. All steam treatments, with or without quicklime, significantly reduced Salmonella Typhimurium colonization by at least 3 orders of magnitude. Significant reductions were also observed in the treatments with quicklime alone. Both the steam and the quicklime treatments often reduced colonization to undetectable levels, even when samples were enriched. Therefore, we demonstrated 2 novel techniques for reducing Salmonella Typhimurium in poultry litter. Soil pasteurization potentially offers an environmentally sound means of reducing the pathogens present in used poultry litter.

Clients' perceptions of how reorientation therapy and self-help can promote changes in sexual orientation.

Presented is a summary of 882 homosexual people's responses to 5 open-ended questions about sexual reorientation therapy. Of the 882 participants, 726 reported that they had received reorientation therapy from a professional therapist or a pastoral counselor. As a group, 779 (89.7%) of the participants viewed themselves as "more homosexual than heterosexual," "almost exclusively homosexual," or "exclusively homosexual" in their orientation before receiving reorientation therapy or making self-help efforts to change. The majority reported they believed sexual reorientation therapy and various forms of self-help were helpful to them, psychologically, spiritually, and sexually.

Psychological disorders among children and the parents of children undergoing cancer workup.

OBJECTIVES: This paper evaluates the association between psychological problems and cancer workup in children aged less than 20 and their parents. Assessment of the potential psychological stress in these children and their parents has been inadequately studied in the past. METHODS: A retrospective cohort study of anxiety or depression among children and the parents of children undergoing cancer workup, based on Deseret Mutual Benefit Administrators (DMBA) claims data and corresponding enrollment files for dependent children aged less than 20, from 1998 to 2002 in the United States and Canada. RESULTS: Less than 20% of cancer workups are followed by cancer diagnosis and treatment. Children with a "cancer workup only" are 89% more likely to experience anxiety/depression than are children without a cancer-related claim; that is, the rate per 100,000 person-years of anxiety/depression is 7,222 for children with a cancer workup only compared with 3,824 for children without a cancer-related claim. Mothers of children with cancer workup are 37% more likely to experience anxiety/depression. Children are significantly more likely to experience anxiety/depression if one or both of their parents experience anxiety/depression. The increased risk is influenced by whether the child experiences both cancer workup and treatment (359% higher), by cancer workup only (308% higher), and by no cancer workup or treatment (295% higher). Finally, the rate of anxiety/depression among children with cancer workup and their mothers was significantly lower in homes with more children. CONCLUSIONS: A cancer workup alone is sufficient to significantly increase the risk of anxiety/depression in children undergoing cancer workup and in their parents. The ability of a child undergoing a cancer workup to cope is influenced by the mental health of their parents. More children in the home are protective against anxiety/depression in children undergoing cancer workup and in their mothers.

Thrombolysis vs. bleeding from hemostatic sites by a prourokinase mutant compared with tissue plasminogen activator.

BACKGROUND: A single site mutant (M5) of prourokinase (proUK) was developed to make proUK less vulnerable to spontaneous activation in plasma. This was a problem that seriously compromised proUK in clinical trials, as it precluded proUK-mediated fibrinolysis at therapeutic concentrations. METHODS AND RESULTS: After completing dose-finding studies, 12 anesthetized dogs with femoral artery thrombosis were given either M5 (2.0 mg kg(-1)) or tissue plasminogen activator (t-PA) (1.4 mg kg(-1)) by i.v. infusion over 60 min (20% administered as a bolus). Two pairs of standardized injuries were inflicted at which hemostasis was completed prior to drug administration. Blood loss was quantified by measuring the hemoglobin in blood absorbed from these sites. Thrombolysis was evaluated at 90 min and was comparably effective by both activators. Rethrombosis developed in one t-PA dog. The principal difference found was that blood loss was 10-fold higher with t-PA (mean approximately 40 mL) than with M5 (mean approximately 4 mL) (P = 0.026) and occurred at more multiple sites (mean 2.7 vs. 1.2). This effect was postulated to be related to differences in the mechanism of plasminogen activation by t-PA and M5 in which the latter is promoted by degraded rather than intact (hemostatic) fibrin. In addition, two-chain M5 was efficiently inactivated by plasma C1 inactivator, an exceptional property which helped contain its non-specific proteolytic effect. CONCLUSIONS: Intravascular thrombolysis by M5 was accompanied by significantly less bleeding from hemostatic sites than by t-PA. This was attributed to the proUK paradigm of fibrinolysis being retained at therapeutic concentrations by the mutation.

A meta-analytic review of treatment of homosexuality.

This paper examined and synthesized studies of treatment of individuals identified as homosexual using meta-analytic technique. A large number of studies (146) evaluating treatment efficacy were identified, most published prior to 1975 and 14 of which met inclusion criteria and provided statistics that could be used in a meta-analysis. These 14 outcome studies were published between 1969 and 1982 and used primarily behavioral interventions. Analysis indicated that treatment for homosexuality was significantly more effective than alternative treatments or control groups for homosexuality (ES=.72), and significant differences were found across pre- to postanalysis (ES =.89). In other words, the average patient receiving treatment was better off than 79% of those in the alternative treatments or as compared to pretreatment scores on the several outcome measures. This meta-analysis of 14 studies provides empirical support for a group of 146 studies which have narratively suggested that treatment for homosexuality is effective. Variables related to treatment efficacy are examined.

A critique of Bem's "exotic becomes erotic" theory of sexual orientation development.

A critique of Bem's "Exotic Becomes Erotic" theory (1996) on the development of male homosexuality was offered. Limitations were outlined in light of relevant research findings. The authors proposed an alternative model to explain male homosexuality, i.e., reparation of early boyhood trauma, which better accounts for significant psychodynamic elements and available research. Finally, comparisons were made between specific elements of the two models.

Retrospective self-reports of changes in homosexual orientation: a consumer survey of conversion therapy clients.

We present the results of a survey of 882 dissatisfied homosexual people whom we queried about their beliefs regarding conversion therapy and the possibility of change in sexual orientation. There were 70 closed-ended questions on the survey and 5 open-ended ones. Of the 882 participants, 726 of them reported that they had received conversion therapy from a professional therapist or a pastoral counselor. Of the participants 779 or 89.7% viewed themselves as "more homosexual than heterosexual," "almost exclusively homosexual," or "exclusively homosexual" in their orientation before receiving conversion therapy or making self-help efforts to change. After receiving therapy or engaging in self-help, 305 (35.1%) of the participants continued to view their orientation in this manner. As a group, the participants reported large and statistically significant reductions in the frequency of their homosexual thoughts and fantasies that they attributed to conversion therapy or self-help. They also reported large improvements in their psychological, interpersonal, and spiritual well-being. These responses cannot, for several reasons, be generalized beyond the present sample, but the attitudes and ideas are useful in developing testable hypotheses for further research.