BACKGROUND The outcomes of patients with severe pulmonary blastomycosis requiring mechanical ventilation (MV) is not well understood in the modern era. Limited historical case series have reported 50-90% mortality in patients with Acute Respiratory Distress Syndrome (ARDS) caused by blastomycosis. The objective of this large retrospective cohort study was to describe the risk factors and outcomes of patients with severe pulmonary blastomycosis. METHODS We performed a retrospective cohort analysis utilizing the Nationwide Inpatient Sample (NIS) from 2006-2014. Patients >18 years of age with a diagnosis of blastomycosis who received mechanical ventilation were included. RESULTS There were 1,848 patients with a diagnosis of blastomycosis included in the study. Of this cohort, 219 (11.9%) patients underwent MV with a mortality rate of 39.7% compared to 2.5% in patients not requiring ventilatory support (p less then 0.01). The median time to death for patients requiring MV was 12 days (IQR 8-16). The median length of hospital stay for survivors of MV was 22 days (IQR 14-37). The rate of MV was higher for patients treated in teaching hospitals (63.4% vs 57.2%, p=0.05) and was lower for those receiving care at a rural hospital (12.3% vs 17.2%, p=0.04). In a multivariate model, female gender was associated with increased risk of mortality (OR 1.84, 95% CI 1.06-3.20, p=0.03) as was increasing patient age (10-year age increase OR 1.64, 95% CI 1.33-2.02, p less then 0.01). CONCLUSIONS In the largest published cohort of patients with blastomycosis, mortality for patients on MV is high at approximately 40%; 16-fold higher than those without MV. © The Author(s) 2020. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail journals.permissions@oup.com.Social relationships are a crucial determinant of both mental and physical health. This effect is partly due to social buffering of stress. Animal studies suggest that social buffering is mediated via the oxytocin system, while studies in humans are sparse and limited by the low ecological validity of laboratory settings. In the present study, participants (N = 326) completed smartphone questionnaires four times a day over four to five days, measuring stressors, negative affect, and social context to assess social buffering. We found that under stress, participants reported a higher need for social company. Further, the impact of prior stressful events on momentary negative affect was attenuated by the perceived pleasantness of current social company. This social buffering effect was moderated by haplotypes of the oxytocin receptor gene, based on two well-described single nucleotide polymorphisms (rs2268498, rs53576). Effects were robust when controlling for gender and age, applying different data quality criteria, and even apparent in genotype-based analyses. Our findings demonstrate that social buffering and its modulation by oxytocin system characteristics have implications for life as lived outside the laboratory. © The Author(s) 2020. Published by Oxford University Press.Insomnia is a major public health concern. Sleep restriction therapy (SRT) is an effective behavioral treatment but its delivery is impeded by a shortage of trained clinicians. https://www.selleckchem.com/products/gf109203x.html We developed a mobile app delivering SRT to individuals with insomnia. This feasibility study employed a mixed-methods design to examine the engagement, acceptability, and potential efficacy of the mobile app. Fifteen participants diagnosed with insomnia disorder used the mobile app synchronized with a wearable device for 3 weeks. Those who persisted with the study (n = 12) found the mobile app to be highly acceptable and engaging, logging on average 19 nightly sleep diary entries across the 21 day period. Significant improvements were observed for sleep measures (insomnia severity and sleep efficiency) and daytime symptoms (fatigue and sleepiness). The results suggest that a mobile app delivering SRT to individuals with insomnia is engaging, acceptable, and potentially efficacious. Further, a full-scale effectiveness study is warranted. © Society of Behavioral Medicine 2020. All rights reserved. For permissions, please e-mail journals.permissions@oup.com.One fundamental function of social norms is to promote social coordination. Moreover, greater social coordination may be called for when tight norms govern social relations with others. Hence, the sensitivity to social norm violations may be jointly modulated by relational goals and a belief that the social context is tight (vs. loose). We tested this analysis using an electrocortical marker of norm-violation detection (N400). Ninety-one young American adults were subliminally primed with either relational or neutral goals. They were then shown behaviors that were either norm-violating or normal. In the relational priming condition, the norm violation N400 increased as a function of the perceived tightness of societal norms. In the control priming condition, however, the norm violation N400 was weak regardless of perceived tightness. Thus, normative tightness was associated with increased neural processing of norm violations only when relational goals were activated. Implications for norm psychology are discussed. (Word Count 148). © The Author(s) 2020. Published by Oxford University Press.The advantages of analysis of drugs in hair samples are recognised for the long window of detection, alongside easy sampling and long stability after sample collection. Alcohol markers, ethyl glucuronide (EtG) and total fatty acid ethyl esters (FAEEs) in hair are widely used for monitoring alcohol consumption for clinical and forensic purposes. Although stability of drugs and EtG in hair samples are documented to a certain extent, stability of FAEEs in hair samples after collection has not been reported. This study covered hair samples that had been tested for FAEEs on the day of arrival at the laboratory and retested between 4 days to 80 months later. The statistical analysis of the data set reveals significant lower FAEEs levels including ethyl palmitate ester levels (EtPa) when samples were re-tested for the second time after 6 days of storage under ideal conditions. Specifically, the results suggest that when measuring total FAEEs or solely EtPa in hair samples, the elapsed time between sample collection and analysis of the sample needs to be considered when interpreting the results.