Factors associated with treatment acceptance and compliance among incarcerated male sex offenders.

The files of sex offenders who had been offered treatment at a medium-security state prison were divided into three groups: treatment refusal (n = 59), treatment noncompliance (n = 61), and treatment compliance (n = 36). Demographic, offense-related, clinical, and psychological assessment data were collected. Significant differences were found between groups on years to parole eligibility; plea; relation to victim; childhood sexual victimization; and Minnesota Multiphasic Personality Inventory-2 Variable Response Inconsistency (VRIN), Lie (L), and Masculinity-Femininity (Mf) scale scores. Logistic regression analyses revealed that significant predictors of treatment refusal include increased time until parole eligibility and lower VRIN and Mf scores (vs. noncompliant) as well as no history of childhood sexual victimization and higher L scores (vs. compliant). Having entered a not-guilty plea was the only significant predictor of noncompliance among those who initially accepted treatment. These findings are discussed in relation to previous studies of sex offender treatment compliance and directions for future research.

Single dose vaccination with AS03-adjuvanted H5N1 vaccines in a randomized trial induces strong and broad immune responsiveness to booster vaccination in adults.

Priming a population with a pre-pandemic vaccine is being considered to maximize the response upon subsequent vaccination with a true pandemic vaccine more closely matched to the causative pandemic strain. The present study explored this prime-boost concept by evaluating different primary schedules with the pre-pandemic A/Vietnam/1194/2004(NIBRG-14) vaccine, containing 3.75 microg of HA, followed by a 6-month booster with a vaccine formulated with 3.75 microg HA of either the same strain or with A/Indonesia/05/2005(IBCDC-RG2), a heterologous strain from a different clade. In this multicentre, open, randomized study (NCT00430521) we measured immune responses in four groups (N = 48-60) of adults aged 18-60 years who received a single booster administration of either A/Indonesia/05/2005 or A/Vietnam/1194/2004 vaccine 6 months after a 1- or 2-dose (given 21 days apart) primary vaccination with A/Vietnam/1194/2004. All prime-boost schedules assessed induced early (7 days post-booster) humoral responses that met regulatory acceptance criteria. Two doses of A/Vietnam/1194/2004 given 6 months apart achieved equivalent homologous seroprotection after the second vaccination (89.6%), when compared to two doses given 21 days apart (92.7-93.2%). Remarkably, two doses of A/Vietnam/1194/2004 given 6 months apart induced a higher cross-reactive seroprotection against A/Indonesia/05/2005 (83.3%) when compared to two doses given 21 days apart (41.5-54.5%). A 6-month A/Indonesia/05/2005 booster dose after one primary dose of A/Vietnam/1194/2004 vaccine induced 92.5% seroprotection against A/Indonesia/05/2005 and 98.1% against A/Vietnam/1194/2004. Since a single booster 6 months after one primary dose of AS03-adjuvanted vaccine induces strong and rapid seroprotective immune response against both homologous and heterologous H5N1 strains, these results might have important implications for public health strategy aiming to organize vaccination campaigns with pre-pandemic vaccines.

Nur77 as a survival factor in tumor necrosis factor signaling.

The immediate-early gene Nur77, which encodes an orphan nuclear receptor, is rapidly induced by various stress stimuli, including tumor necrosis factor (TNF). Nur77 has been implicated in mediating apoptosis, particularly in T cells and tumor cells. We report here that Nur77 can play a role in antagonizing apoptosis in TNF signaling. Nur77 expression is strongly induced by TNF. Interestingly, unlike most antiapoptotic molecules, this induced expression of Nur77 is largely independent of NF-kappa B. Ectopic expression of Nur77 can protect wild-type, TRAF2-/-, and RelA-/- cells from apoptosis induced by TNF, whereas expression of a dominant-negative form of Nur77 (DN-Nur77) accelerates TNF-mediated cell death in the mutant cells. In mouse embryonic fibroblasts, Nur77 remains in the nucleus in response to TNF and is not translocated to the mitochondria, where it was reported to mediate apoptosis. Our results suggest that Nur77 is a survival effector protein in the context of TNF-mediated signaling.

IL-1 receptor-associated kinase 4 is essential for IL-18-mediated NK and Th1 cell responses.

IL-18 is an important cytokine for both innate and adaptive immunity. NK T cells and Th1 cells depend on IL-18 for their divergent functions. The IL-18R, IL-1R, and mammalian Toll-like receptors (TLRs) share homologous intracellular domains known as the TLR/IL-1R/plant R domain. Previously, we reported that IL-1R-associated kinase (IRAK)-4 plays a critical role in IL-1R and TLR signaling cascades and is essential for the innate immune response. Because TLR/IL-1R/plant R-containing receptors mediate signal transduction in a similar fashion, we investigated the role of IRAK-4 in IL-18R signaling. In this study, we show that IL-18-induced responses such as NK cell activity, Th1 IFN-gamma production, and Th1 cell proliferation are severely impaired in IRAK-4-deficient mice. IRAK-4(-/-) Th1 cells also do not exhibit NF-kappaB activation or IkappaB degradation in response to IL-18. Moreover, AP-1 activation which is triggered by c-Jun N-terminal kinase activation is also completely inhibited in IRAK-4(-/-) Th1 cells. These results suggest that IRAK-4 is an essential component of the IL-18 signaling cascade.