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Suicidal thoughts and behaviors (STB) and emergency department (ED) utilization are prevalent in autistic youth. The current study surveyed clinicians in a pediatric psychiatric ED to examine differences in attitudes on suicide-related care for autistic and non-autistic patient populations. While clinicians rated addressing STB in ASD as important and adaptations to care as necessary, less than half identified ASD as a suicide risk factor and confidence ratings were significantly lower for autistic patients. Previous ASD training predicted confidence and accounted for approximately 25% of the variance in confidence scores. Findings highlight the urgency to develop and disseminate ED clinician training, and address the lack of validated assessment tools, adapted suicide prevention practices, and evidence-based treatments for STB in autistic youth.

Background Few treatment options for alcohol use disorders (AUDs) exist and more are critically needed. Here, we assessed whether trace amine associated receptor 1 (TAAR1), a modulator of brain monoamine systems, is involved in the behavioral and reinforcement-related effects of ethanol and whether it could potentially serve as a therapeutic target. Methods Wild-type (WT) and TAAR1 knockout (KO) mice (75% C57J/BL6 and 25% 129S1/Sv background) were compared in tests of ethanol consumption (two-bottle choice [TBC]), motor impairment (loss of righting reflex, [LORR], locomotor activity) and ethanol clearance (blood ethanol level [BEL]). Results As compared with WT mice, KO mice displayed (1) significantly greater preference for and consumption of ethanol in a TBC paradigm (3%–11% vol/vol escalating over 10 weeks), with no significant difference observed in TBC with sucrose (1%–3%); (2) significantly greater sedative-like effects of acute ethanol (2.0 or 2.5 g/kg, intraperitoneal [i.p.]) manifested as LORR observed at a lower dose and for longer time, with similar BELs and rates of ethanol clearance; and (3) lower cumulative locomotor activity over 60 minutes in response to an acute ethanol challenge (1.0–2.5 g/kg, i.p.). Conclusions The present findings are the first to implicate TAAR1 in the behavioral and reinforcement-related effects of ethanol and raise the question of whether specific drugs that target TAAR1 could potentially reduce alcohol consumption in humans with AUDs.

Rationale Methods for establishing robust long-term self-administration of intravenous (i.v.) nicotine, the primary psychoactive agent in tobacco, are not well-established in laboratory animals. Objective Here, we examine the use of a fading procedure to establish robust and consistent i.v. nicotine self-administration under second-order schedule conditions in squirrel monkeys. Methods First, self-administration behavior was developed in two groups of male squirrel monkeys using a second-order fixed-interval 5-min schedule with fixed-ratio 5 units (FI 5-min (FR5: S)). Comparable performances were maintained by i.v. cocaine (0.032 mg/kg/injection (inj); group A, n  = 3) and the combination of food delivery (20–30 % condensed milk) and 0.01 mg/kg/inj i.v. nicotine (group B, n  = 3). Subsequently, the concentration of condensed milk was gradually reduced to zero in the second group and self-administration behavior was maintained by i.v. nicotine alone. Next, self-administration of a range of doses of i.v. nicotine (0.001–0.032 mg/kg/inj) and, in additional experiments, the minor tobacco alkaloid anatabine (0.01–0.18 mg/kg/inj) was studied in both groups. Results Results show that nicotine and anatabine had reinforcing effects in both groups. However, optimal doses of nicotine and anatabine maintained significantly higher rates of i.v. self-administration behavior in subjects trained with the fading procedure than in subjects provided with a history of cocaine-maintained responding. Conclusion These results illustrate conditions under which robust i.v. nicotine self-administration can be established in squirrel monkeys and the influence of prior experimental history in the expression of reinforcing effects of nicotine and anatabine.

Cultural competency is a cornerstone of patient-centered health care. Religious doctrines may define appropriate consumption or use of certain animals and forbid use of others. Many medications contain ingredients that are animal-derived; these medications may be unacceptable to individual patients within the context of their religious beliefs and lifestyle choices. Knowledge of animal-derived medications as a component of cultural competency can facilitate a dialogue that shifts focus from the group to the individual, away from cultural competency toward cultural humility, and away from a paternalistic provider/patient dynamic toward one of partnership. To explore how animal-derived drug components may impact medication selection and acceptability from the perspective of patients, physicians, and religious leaders as evidenced by studies that explore the question via survey or questionnaire. A secondary objective is to use the context of animal-derived drug products as a component of cultural competency to build a framework supporting the development of cultural humility. A systematic search was performed in the PubMed, CINAHL, Cochrane, and ProQuest databases using combinations of the following terms: \"medication selection,\" \"medication,\" \"adherence,\" \"pharmaceutical preparations,\" \"religion and medicine,\" \"religion,\" \"animal,\" \"dietary,\" \"porcine,\" and \"bovine.\" Studies that reported using surveys or questionnaires to examine patient, physician, or religious leader perspective on animal-derived medications published in English between 1990 and 2020 were included. Review articles, opinion pieces, case reports, surveys of persons other than patients, religious leaders, or physicians, and studies published in languages other than English were excluded. Three authors independently reviewed articles to extract information pertaining to perspectives on animal-based medication ingredients. Eight studies meeting the described criteria were found that queried beliefs or knowledge of patients, religious leaders, or physicians regarding medications and medical products of biologic origin. Those studies are described in full in this review. Knowledge of animal-derived ingredients may help open conversations with patients around spiritual history and cultural competency, particularly for those patients belonging to religious sects with doctrines that define appropriate use of human- or animal-derived products. Further formal study is needed to explore more fully the extent to which religious beliefs may impact selection of animal- or human-derived medications. Guidelines developed from this knowledge may aid in identifying individual patients with whom the discussion may be particularly relevant. More studies are needed to quantify and qualify beliefs regarding animal-derived medication constituents.

In 2015 the United Nations adopted the 2030 Agenda for Sustainable Development (United Nations General Assembly [UNGA] 2015b), a very ambitious agenda, with 17 Sustainable Development Goals (SDGs) and 169 associated targets. Among them were goals and targets that directly touched upon peacebuilding, through the promotion of peaceful societies, the reduction of violence, and access to justice. As the SDGs were being adopted and nations began to implement them in 2016, the United Nations Secretary-General proposed the UN Plan of Action (PoA) to Prevent Violent Extremism with 48 recommendations for national actors in seven priority areas (UNGA 2015a). This briefing provides an overview of the overlapping elements of the two agendas for the development practitioner tasked with delivering the SDGs and the UN PoA. It concludes with political considerations for implementation, security and development overlaps, and the importance of monitoring reforms if development interventions are intended to contribute to peace and a reduction in violent extremism.

My creative thesis is a personal collection of Maternal Poetry for publication. The thesis is a collection of fifty-four poems titled, “Pieces of Me Returned: Maternal Poetry.” My poetry uses narrative form to express my experiences as a daughter, mother, childbirth educator and doula. My poetry is influenced by feminist reader response to Adrienne Rich’s book, Of Woman Born: Motherhood as Experience and Institution. I also chose maternal poets such as Adrienne Rich, Sharon Olds, bell hooks and Audre Lorde to aid in developing a maternal/feminist voice for my poetry. My thesis is divided into three sections, A Woman Becomes A Mother, The Doula’s Diary, and Family Heirloom: Memories We Hold. The first section, “A Woman Becomes A Mother,” explores my own experience with motherhood and the physicality of how identity changes after pregnancy and birth. The poetry seeks to challenge the cultural expectations of woman as mothers. The second section, “The Doula’s Diary,” uses persona to develop a personal voice for each narrative poem. I interviewed several of my birth doula clients to explore the dichotomies of pregnancy, birth and motherhood based on their experiences. I also discussed the physicality of my own birth. The poetry in this section questions the traditional mindset that birth is terrifying, dangerous or painful but can be empowering, beautiful and gentle. In the last section, “Family Heirloom: The Memories We Hold,” I explore the roles and labels connected to parenting. My poetry in this section allows me to observe the wide variety of challenges in which a person faces as a daughter, mother or wife. My poetry discusses the progressively changing roles of parents by observing and discussing birth in several generations within my own family. Lastly, I wish my overall collection of poetry to tell the untold stories of motherhood through poetry.

Background Few treatment options for alcohol use disorders (AUDs) exist and more are critically needed. Here, we assessed whether trace amine associated receptor 1 (TAAR1), a modulator of brain monoamine systems, is involved in the behavioral and reinforcement-related effects of ethanol and whether it could potentially serve as a therapeutic target. Methods Wild-type (WT) and TAAR1 knockout (KO) mice (75% C57J/BL6 and 25% 129S1/Sv background) were compared in tests of ethanol consumption (two-bottle choice [TBC]), motor impairment (loss of righting reflex, [LORR], locomotor activity) and ethanol clearance (blood ethanol level [BEL]). Results As compared with WT mice, KO mice displayed (1) significantly greater preference for and consumption of ethanol in a TBC paradigm (3%–11% vol/vol escalating over 10 weeks), with no significant difference observed in TBC with sucrose (1%–3%); (2) significantly greater sedative-like effects of acute ethanol (2.0 or 2.5 g/kg, intraperitoneal [i.p.]) manifested as LORR observed at a lower dose and for longer time, with similar BELs and rates of ethanol clearance; and (3) lower cumulative locomotor activity over 60 minutes in response to an acute ethanol challenge (1.0–2.5 g/kg, i.p.). Conclusions The present findings are the first to implicate TAAR1 in the behavioral and reinforcement-related effects of ethanol and raise the question of whether specific drugs that target TAAR1 could potentially reduce alcohol consumption in humans with AUDs.

Viruses that infect bacteria (phages) can influence bacterial community dynamics, bacterial genome evolution and ecosystem biogeochemistry. These influences differ depending on whether phages establish lytic, chronic or lysogenic infections. Although the first two produce virion progeny, with lytic infections resulting in cell destruction, phages undergoing lysogenic infections replicate with cells without producing virions. The impacts of lysogeny are numerous and well-studied at the cellular level, but ecosystem-level consequences remain underexplored compared to those of lytic infections. Here, we review lysogeny from molecular mechanisms to ecological patterns to emerging approaches of investigation. Our goal is to highlight both its diversity and importance in complex communities. Altogether, using a combined viral ecology toolkit that is applied across broad model systems and environments will help us understand more of the diverse lifestyles and ecological impacts of lysogens in nature.

Down syndrome (DS), the genetic condition caused by trisomy 21, is characterized by variable cognitive impairment, immune dysregulation, dysmorphogenesis and increased prevalence of diverse co-occurring conditions. The mechanisms by which trisomy 21 causes these effects remain largely unknown. We demonstrate that triplication of the interferon receptor ( IFNR ) gene cluster on chromosome 21 is necessary for multiple phenotypes in a mouse model of DS. Whole-blood transcriptome analysis demonstrated that IFNR overexpression associates with chronic interferon hyperactivity and inflammation in people with DS. To define the contribution of this locus to DS phenotypes, we used genome editing to correct its copy number in a mouse model of DS, which normalized antiviral responses, prevented heart malformations, ameliorated developmental delays, improved cognition and attenuated craniofacial anomalies. Triplication of the Ifnr locus modulates hallmarks of DS in mice, suggesting that trisomy 21 elicits an interferonopathy potentially amenable to therapeutic intervention. A mouse model of Down syndrome (DS) highlights the importance of triplication of the IFNR gene cluster for a variety of DS-associated traits. Copy number correction resulted in amelioration of multiple phenotypes associated with the condition.

DETAILS FOR THIS REVIEW Study Population: 15 studies conducted in Asia, Europe, and North America with a total of 2,348 women with normogonadotropic anovulation or polycystic ovary syndrome (PCOS) and clomiphene resistance or failure Efficacy End Points: Live birth rate per woman; clinical pregnancy rate per woman Harm End Points: Rates of multiple pregnancy, miscarriage, ectopic pregnancy, and ovarian hyperstimulation syndrome per woman THE NUMBERS Benefits 1 in 11: increased live birth rate per woman 1 in 8: increased clinical pregnancy rate per woman Harms 1 in 25: miscarriages per woman Narrative: In women with PCOS who are trying to conceive, clomiphene has often been used as a first-line agent to induce ovulation.1,2 Clomiphene induces or restores ovulation in approximately 75% of women, but only approximately one-half of those women conceive after 6 months of treatment.3,4 The Cochrane review discussed here identified 15 studies, with 2,348 participants, examining gonadotropins for ovulation stimulation. There was little to no difference in ectopic pregnancy rates between gonadotropins and clomiphene (very low-certainty evidence), and no cases of ovarian hyperstimulation syndrome were reported in the study.5 The systematic review and meta-analysis showed that there may be little to no difference in rates of live birth, multiple pregnancies per woman, clinical pregnancy, or miscarriage between purified urinary-derived gonadotropins and recombinant FSH, human menopausal gonadotropin and urinary FSH, and highly purified urinary FSH and purified urinary FSH (low to very low-certainty evidence). In the study that compared gonadotropins with continued clomiphene citrate, participants were randomized to either intrauterine insemination or intercourse in an effort to control for this potential confounding factor.6 The most recent American College of Obstetricians and Gynecologists practice guideline for PCOS recommends clomiphene as the first-line agent for ovulation induction, with gonadotropins as a second-line consideration.16 Conclusion: We have assigned a color recommendation of yellow (unclear benefits) due to low-certainty evidence for several outcomes, primarily stemming from low power and potential bias.