Strategies to support substance use disorder care transitions from acute-care to community-based settings: a scoping review and typology.

BACKGROUND: Acute-care interventions that identify patients with substance use disorders (SUDs), initiate treatment, and link patients to community-based services, have proliferated in recent years. Yet, much is unknown about the specific strategies being used to support continuity of care from emergency department (ED) or inpatient hospital settings to community-based SUD treatment. In this scoping review, we synthesize the existing literature on patient transition interventions, and form an initial typology of reported strategies. METHODS: We searched Pubmed, Embase, CINAHL and PsychINFO for peer-reviewed articles published between 2000 and 2021 that studied interventions linking patients with SUD from ED or inpatient hospital settings to community-based SUD services. Eligible articles measured at least one post-discharge treatment outcome and included a description of the strategy used to promote linkage to community care. Detailed information was extracted on the components of the transition strategies and a thematic coding process was used to categorize strategies into a typology based on shared characteristics. Facilitators and barriers to transitions of care were synthesized using the Consolidated Framework for Implementation Research. RESULTS: Forty-five articles met inclusion criteria. 62% included ED interventions and 44% inpatient interventions. The majority focused on patients with opioid (71%) or alcohol (31%) use disorder. The transition strategies reported across studies were heterogeneous and often not well described. An initial typology of ten transition strategies, including five pre- and five post-discharge transition strategies is proposed. The most common strategy was scheduling an appointment with a community-based treatment provider prior to discharge. A range of facilitators and barriers were described, which can inform efforts to improve hospital-to-community transitions of care. CONCLUSIONS: Strategies to support transitions from acute-care to community-based SUD services, although critical for ensuring continuity of care, vary greatly across interventions and are inconsistently measured and described. More research is needed to classify SUD care transition strategies, understand their components, and explore which lead to the best patient outcomes.

Strategies to support substance use disorder care transitions from acute-care to community-based settings: A Scoping review and typology.

Background: Acute-care interventions that identify patients with substance use disorders (SUDs), initiate treatment, and link patients to community-based services, have proliferated in recent years. Yet, much is unknown about the specific strategies being used to support continuity of care from emergency department (ED) or inpatient hospital settings to community-based SUD treatment. In this scoping review, we synthesize the existing literature on patient transition interventions, and form an initial typology of reported strategies. Methods: We searched Pubmed, Embase, CINAHL and PsychINFO for peer-reviewed articles published between 2000-2021 that studied interventions linking SUD patients from ED or inpatient hospital settings to community-based SUD services. Eligible articles measured at least one post-discharge treatment outcome and included a description of the strategy used to promote linkage to community care. Detailed information was extracted on the components of the transition strategies and a thematic coding process was used to categorize strategies into a typology based on shared characteristics. Facilitators and barriers to transitions of care were synthesized using the Consolidated Framework for Implementation Research. Results: Forty-five articles met inclusion criteria. 62% included ED interventions and 44% inpatient interventions. The majority focused on patients with opioid (71%) followed by alcohol (31%) use disorder. The transition strategies reported across studies were heterogeneous and often not well described. An initial typology of ten transition strategies, including five pre- and five post-discharge transition strategies is proposed. The most common strategy was scheduling an appointment with a community-based treatment provider prior to discharge. A range of facilitators and barriers were described, which can inform efforts to improve hospital-to-community transitions of care. Conclusions: Strategies to support transitions from acute-care to community-based SUD services, although critical for ensuring continuity of care, vary greatly across interventions and are inconsistently measured and described. More research is needed to classify SUD care transition strategies, understand their components, and explore which lead to the best patient outcomes.

Rice GA3ox1 modulates pollen starch granule accumulation and pollen wall development.

The rice GA biosynthetic gene OsGA3ox1 has been proposed to regulate pollen development through the gametophytic manner, but cellular characterization of its mutant pollen is lacking. In this study, three heterozygotic biallelic variants, "-3/-19", "-3/-2" and "-3/-10", each containing one null and one 3bp-deletion allele, were obtained by the CRISPR/Cas9 technique for the functional study of OsGA3ox1. The three homozygotes, "-19/-19", "-2/-2" and "-10/-10", derived from heterozygotic variants, did not affect the development of most vegetative and floral organs but showed a significant reduction in seed-setting rate and in pollen viability. Anatomic characterizations of these mutated osga3ox1 pollens revealed defects in starch granule accumulation and pollen wall development. Additional molecular characterization suggests that abnormal pollen development in the osga3ox1 mutants might be linked to the regulation of transcription factors OsGAMYB, OsTDR and OsbHLH142 during late pollen development. In brief, the rice GA3ox1 is a crucial gene that modulates pollen starch granule accumulation and pollen wall development at the gametophytic phase.

[Diagnosis of cervical intraepithelial neoplasia by visual inspection with acetic acid among Chinese women: a meta-analysis].

OBJECTIVE: To evaluate the performance of visual inspection with acetic acid (VIA) in preliminary screening of cervical cancer and its precancerous lesions among Chinese women by meta-analysis of diagnosis. METHODS: Pubmed, Cochrane, Wanfang, CNKI and Weipu databases were employed to search for citations using the MeSH terms as "acetic acid", "cervical intraepithelial neoplasia", and "cervical cancer" both in Chinese and English. Additional relevant references cited in retrieval articles were also searched.40 pieces of research paper related with screening of cervical cancer and precancerous lesions of cervical cancer in Chinese women by VIA were collected. Bivariate random effects model was adopted using SAS 8.02. RESULTS: Twenty-two studies including 23 330 cases were finally selected in the analysis, among which 19 studies were reported in Chinese and the other 3 in English. These studies were reported from 2004 to 2010 and the age-range of subjects was between 15 and 81 years old. Stratified analysis of diagnosis threshold showed that the pooled diagnostic odds ratio (DOR) of VIA for CIN1+ (4.11, 95%CI: 3.20 - 5.04) was similar to that for CIN2+ (4.45, 95%CI: 3.73 - 5.15). Either CIN1+ or CIN2+, the DOR in younger women (≤ 40 year) (4.22, 95%CI: 3.29 - 5.16; 4.53, 95%CI: 3.46 - 5.47) was also similar to it in older women (> 40 year) (3.66, 95%CI: 2.27 - 5.37; 4.26, 95%CI: 3.32 - 5.26). There was no difference in the screening performance between county-level doctors (DOR = 4.62, 95%CI: 3.13 - 5.93) and municipal-level doctors (DOR = 4.48, 95%CI: 3.71 - 5.16). CONCLUSION: The screening performances of VIA were relatively consistent among different lesion grades and aging groups of Chinese women. After professional training, there was no difference in performance between county-level hospitals and municipal-level hospitals.

Relationship of sleep duration and annual changes in sleep duration with the incidence of gastrointestinal cancers: a prospective cohort study.

BACKGROUND: Prospective analyses have yet to identify a consistent relationship between sleep duration and the incidence of gastrointestinal (GI) cancers. The effect of changes in sleep duration on GI cancer incidence has scarcely been studied. Therefore, we aimed to examine the association between baseline sleep duration and annual changes in sleep duration and GI cancer risk in a large population-based cohort study. METHODS: A total of 123,495 participants with baseline information and 83,511 participants with annual changes in sleep duration information were prospectively observed from 2006 to 2015 for cancer incidence. Cox proportional-hazards models were used to calculate hazard ratios (HRs) and their confidence intervals (CIs) for GI cancers according to sleep duration and annual changes in sleep duration. RESULTS: In baseline sleep duration analyses, short sleep duration (≤5 h) was significantly associated with a lower risk of GI cancer in females (HR: 0.31, 95% CI: 0.10-0.90), and a linear relationship between baseline sleep duration and GI cancer was observed (P = 0.010), especially in males and in the >50-year-old group. In the annual changes in sleep duration analyses, with stable category (0 to -15 min/year) as the control group, decreased sleep duration (≤-15 min/year) was significantly associated with the development of GI cancer (HR: 1.29; 95% CI: 1.04-1.61), especially in the >50-year-old group (HR: 1.32; 95% CI: 1.01-1.71), and increased sleep duration (>0 min/year) was significantly associated with GI cancer in females (HR: 2.89; 95% CI: 1.14-7.30). CONCLUSIONS: Both sleep duration and annual changes in sleep duration were associated with the incidence of GI cancer.

A Printed and Flexible NO2 Sensor Based on a Solid Polymer Electrolyte.

Solid polymer electrolyte (SPE) is an important part of printed electrochemical gas sensors and are of value to electrochemical sensors. Here, a new type of SPE was prepared by dissolving a poly-vinylidene fluoride (PVDF) matrix in a 1-methyl-2-pyrrolidone (NMP) to immobilize 1-ethyl-3-methylimidazolium tetrafluoroborate ([EMIM] [BF4]), which was then used in a new electrochemical amperometric nitrogen dioxide sensor. The SPE was coated on a single electrode and attached to the electrode to construct a simple two-layer structure. Nitrogen dioxide in the air was reduced on the working electrode at a bias voltage of -500 V. We controlled the components and process parameters separately for control experiments. The results show that the SPE based on [EMIM] [BF4], NMP, and PVDF coated on the electrode at a thickness of 1.25 mm with a 1:1:4 weight ratio under heat treatment conditions of 80°C for 2 min has the best sensitivity. The FTIR and XPS results indicated that SPE is prepared via physical miscibility. The SEM and XRD results showed that the sensitivity of the sensor is strongly dependent on the interconnected pore structure in SPE, and the pore structure is related to the synthesis ratio, morphology, and heat treatment mode of SPE. Moreover, the sensor sensitivity has a certain relationship with SPE conductivity. The reaction principle and cycle performance of the sensor were also studied.

Diversity-oriented synthesis of chromenopyrrolidines from azomethine ylides and 2-hydroxybenzylidene indandiones via base-controlled regiodivergent (3+2) cycloaddition.

An organobase-directed, regiodivergent 1,3-dipolar cycloaddition of azomethine ylides and 2-hydoxybenzylidene indandiones is reported. The scarcely explored reversal of the nucleophilic site in azomethine ylides has been exploited for their regiodivergent (3+2) cycloaddition, which subsequently resulted in two different cascade processes to generate functionally distinct chromenopyrrolidines in a diversity oriented manner.

Utilizing Cancer - Functional Gene Set - Compound Networks to Identify Putative Drugs for Breast Cancer.

AIM AND OBJECTIVE: The number of anticancer drugs available currently is limited, and some of them have low treatment response rates. Moreover, developing a new drug for cancer therapy is labor intensive and sometimes cost prohibitive. Therefore, "repositioning" of known cancer treatment compounds can speed up the development time and potentially increase the response rate of cancer therapy. This study proposes a systems biology method for identifying new compound candidates for cancer treatment in two separate procedures. MATERIALS AND METHODS: First, a "gene set-compound" network was constructed by conducting gene set enrichment analysis on the expression profile of responses to a compound. Second, survival analyses were applied to gene expression profiles derived from four breast cancer patient cohorts to identify gene sets that are associated with cancer survival. A "cancer-functional gene set- compound" network was constructed, and candidate anticancer compounds were identified. Through the use of breast cancer as an example, 162 breast cancer survival-associated gene sets and 172 putative compounds were obtained. RESULTS: We demonstrated how to utilize the clinical relevance of previous studies through gene sets and then connect it to candidate compounds by using gene expression data from the Connectivity Map. Specifically, we chose a gene set derived from a stem cell study to demonstrate its association with breast cancer prognosis and discussed six new compounds that can increase the expression of the gene set after the treatment. CONCLUSION: Our method can effectively identify compounds with a potential to be "repositioned" for cancer treatment according to their active mechanisms and their association with patients' survival time.

High Spicy Food Intake and Risk of Cancer: A Meta-analysis of Case-control Studies.

BACKGROUND:: Studies on the association between spicy food intake and cancer risk have reported inconsistent results. We quantitatively assessed this association by conducting a meta-analysis based on evidence from case-control studies. METHODS:: PubMed, EMBASE, and the Cochrane Library were searched for eligible publications. Combined odds ratios (OR s) with their 95% confidence interval (CI) were calculated using a random- or fixed-effects model. The methodological quality of the included articles was assessed using the Newcastle-Ottawa scale (NOS). All data were analyzed using STATA 11.0 software (version 11.0; StataCorp., College Station, TX, USA). Subgroup analyses were also performed with stratification by region, sex, number of cases, cancer subtype, source of the control group, and NOS score. RESULTS:: A total 39 studies from 28 articles fulfilled the inclusion criteria for the meta-analysis (7884 patients with cancer and 10,142 controls). Comparison of the highest versus lowest exposure category in each study revealed a significant OR of 1.76 (95% CI = 1.35-2.29) in spite of significant heterogeneity (P < 0.001). In the subgroup analyses, this positive correlation was still found for gastric cancer, different regions, different numbers of cases, different sources of the control group, and high-quality articles (NOS score of ≥ 7). However, no statistically significant association was observed for women, esophageal cancer, gallbladder cancer, or low-quality articles (NOS score of <7). No evidence of publication bias was found. CONCLUSIONS:: Evidence from case-control studies suggested that a higher level of spicy food intake may be associated with an increased incidence of cancer despite significant heterogeneity. More studies are warranted to clarify our understanding of the association between high spicy food intake and the risk of cancer.

Impact of body mass index on complications following pancreatectomy: Ten-year experience at National Cancer Center in China.

AIM: To examine the impact of body mass index (BMI) on outcomes following pancreatic resection in the Chinese population. METHODS: A retrospective cohort study using prospectively collected data was conducted at the Cancer Hospital of the Chinese Academy of Medical Sciences, China National Cancer Center. Individuals who underwent pancreatic resection between January 2004 and December 2013 were identified and included in the study. Persons were classified as having a normal weight if their BMI was < 24 kg/m(2) and overweight/obese if their BMI was ≥ 24 kg/m(2) as defined by the International Life Sciences Institute Focal Point in China. A χ(2) test (for categorical variables) or a t test (for continuous variables) was used to examine the differences in patients' characteristics between normal weight and overweight/obese groups. Multiple logistic regression models were used to assess the associations of postoperative complications, operative difficulty, length of hospital stay, and cost with BMI, adjusting for age, sex, and type of surgery procedures. RESULTS: A total of 362 consecutive patients with data available for BMI calculation underwent pancreatic resection for benign or malignant disease from January 1, 2004 to December 31, 2013. Of the 362 patients, 156 were overweight or obese and 206 were of normal weight. One or more postoperative complications occurred in 35.4% of the patients following pancreatic resection. Among patients who were overweight or obese, 42.9% experienced one or more complications, significantly higher than normal weight (29.6%) individuals (P = 0.0086). Compared with individuals who had normal weight, those with a BMI ≥ 24.0 kg/m(2) had higher delayed gastric emptying (19.9% vs 5.8%, P < 0.0001) and bile leak (7.7% vs 1.9%, P = 0.0068). There were no significant differences seen in pancreatic fistula, gastrointestinal hemorrhage, reoperation, readmission, or other complications. BMI did not show a significant association with intraoperative blood loss, operative time, length of hospital stay, or cost. CONCLUSION: Higher BMI increases the risk for postoperative complications after pancreatectomy in the Chinese population. The findings require replication in future studies with larger sample sizes.

[Estimates and prediction on incidence, mortality and prevalence of lung cancer in China in 2008].

OBJECTIVE: To estimate the incidence, mortality and 5-year prevalence rates of lung cancer in China, in 2008. METHODS: Data from 36 cancer registries and the Third National Death Survey in China (2004-2005) was used to estimate the incidence, mortality and 5-year prevalence rates of lung cancer in China in 2008. Mathematical models were used to predict the lung cancer incidence and mortality rates in the next 20 years. RESULTS: In 2008, the incidence of lung cancer was 522,050 (18.5%) with the incidence rate as 33.5/100,000, which ranked the first among all the cancers. Mortality of lung cancer in China was 452,813 (23.1%) with the mortality rate as 28.7/100,000, which also ranked the first among all the cancers. The 5-year prevalence rate of lung cancer in China was 487,815 (10.6%) with the proportion as 45.6/100,000, which ranked fourth among all the cancers. Lung cancer happened more frequently among people older than 45 years, particularly in males. Our data on prediction showed that the incidence and mortality of lung cancer in China would gradually increase in the next 20 years. CONCLUSION: Lung cancer was the leading cause for both incidence and mortality of all cancers in China and both kept increasing. The key population fell in those older than 45 years, particularly males, that should be under special prevention and control for lung cancer.

[Estimation and prediction on cancer related incidence and mortality in China, 2008].

OBJECTIVE: To estimate the incidence and mortality rates of cancers in China in 2008. METHODS: Data from 36 cancer registry sites in China and from the Third National Death Survey in China (2004 - 2005) were used to estimate the incidence and mortality of cancer in China in 2008 by using mathematical models. Prediction on cancer incidence and mortality in the next 20 years was carried out. RESULTS: According to the age-standardized incidence rates, the top cancer sites were lung, stomach, liver, breast, oesophageal, colorectal, corpus uterine, cervical, leukemia and brain tumor. According to the age-standardized mortality rates, the top cancers in China were lung cancer, liver cancer, stomach cancer, oesophageal cancer, colorectal cancer, breast cancer, cervical cancer, leukemia, brain tumor and corpus uterine cancer. Cancer happened more frequently among people older than 40 years, particularly among males. Data related to prediction showed that the incidence and mortality of cancer in China would gradually increase in the next 20 years. CONCLUSION: Both incidence and mortality of cancers in China had been increasing, with the most common cancers appeared to be lung, breast and digestive tract cancers, in China. People older than 40 years should be under specific care to receive prevention and care on cancer, with males in particular.