Examination of primary aromatic amines content in polylactic acid straws and migration into food simulants using SERS with LC-MS.

Polylactic acid (PLA) straws hold eco-friendly potential; however, residual diisocyanates used to enhance the mechanical strength can generate carcinogenic primary aromatic amines (PAAs), posing health risks. Herein, we present a rapid, comprehensive strategy to detecting PAAs in 18 brands of food-grade PLA straws and assessing their migration into diverse food simulants. Surface-enhanced Raman spectroscopy was conducted to rapidly screen straws for PAAs. Subsequently, qualitative determination of migrating PAAs into various food simulants (4 % acetic acid, 10 % ethanol, 50 % ethanol) occurred at 70 °C for 2 h using liquid chromatography-mass spectrometry. Three PAAs including 4,4'-methylenedianiline, 2,4'-methylenedianiline, and 2,4-diaminotoluene were detected in all straws. Specifically, 2,4-diaminotoluene in 50 % ethanol exceeded specific migration limit of 2 µg/kg, raising safety concerns. Notably, PAAs migration to 10 % and 50 % ethanol surpassed that to 4 % acetic acid within a short 2-hour period. Moreover, PLA straws underwent varying degrees of shape changes before and after migration. Straws with poly(butylene succinate) resisted deformation compared to those without, indicating enhanced heat resistance, while poly(butyleneadipate-co-terephthalate) improved hydrolysis resistance. Importantly, swelling study unveiled swelling effect wasn't the primary factor contributing to the increased PAAs migration in ethanol food simulant, as there was no significant disparity in swelling degrees across different food simulants. FT-IR and DSC analysis revealed higher PAAs content in 50 % ethanol were due to highly concentrated polar ethanol disrupting hydrogen bonds and van der Waal forces holding PLA molecules together. Overall, minimizing contact between PLA straws and alcoholic foods is crucial to avoid potential safety risks posed by PAAs.

Adsorption of typical NDMA precursors by superfine powdered activated carbon: Critical role of particle size reduction.

Control of N-nitrosodimethylamine (NDMA) in drinking water could be achieved by removing its precursors as one practical way. Herein, superfine powdered activated carbons with a diameter of about 1 µm (SPACs) were successfully prepared by grinding powdered activated carbon (PAC, D50=24.3 µm) and applied to remove model NDMA precursors, i.e. ranitidine (RAN) and nizatidine (NIZ). Results from grain diameter experiments demonstrated that the absorption velocity increased dramatically with decreasing particle size, and the maximum increase in k2 was 26.8-folds for RAN and 33.4-folds for NIZ. Moreover, kinetic experiments explained that rapid absorption could be attributed to the acceleration of intraparticle diffusion due to the shortening of the diffusion path. Furthermore, performance comparison experiments suggested that the removal of RAN and NIZ (C0=0.5 mg/L) could reach 61.3% and 60%, respectively, within 5 min, when the dosage of SAPC-1.1 (D50=1.1 µm) was merely 5 mg/L, while PAC-24.3 could only eliminate 17.5% and 18.6%. The adsorption isotherm was well defined by Langmuir isotherm model, indicating that the adsorption of RAN/NIZ was a monolayer coverage process. The adsorption of RAN or NIZ by SAPC-1.1 and PAC-24.3 was strongly pH dependent, and high adsorption capacity could be observed under the condition of pH > pka+1. The coexistence of humic acid (HA) had no significant effect on the adsorption performance because RAN/NIZ may be coupled with HA and removed simultaneously. The coexistence of anions had little effect on the adsorption also. This study is expected to provide an alternative strategy for drinking water safety triggered by NDMA.

Mitigating harmful cyanobacterial blooms in drinking water reservoirs through in-situ sediment resuspension.

Mitigating harmful cyanobacterial blooms is a global challenge, particularly crucial for safeguarding source water. Given the limitations of current technologies for application in drinking water reservoirs, we propose an innovative strategy based on in-situ sediment resuspension (SR). This method's effectiveness in cyanobacterial control and its potential impacts on water quality were assessed through laboratory culture experiments and further validated via field applications in five drinking water reservoirs. The results revealed that SR could significantly mitigate cyanobacterial growth, evidenced by the treated sets (removal rate: 3.82×106 cells L-1d-1) compared to the control set (growth rate: 2.22×107 cells L-1d-1) according to the laboratory experiments. The underlying mechanisms identified included underwater light reduction (2.38× increase in extinction coefficient) and flocculation and entrainment of cells by resuspended particles (30 % reduction per operation). Additional contributions were noted in the reduction of bioavailable phosphate and remediation of anaerobic sediment characterized by increased redox potential. This facilitated the oxidation of iron, which in turn promoted the co-precipitation of phosphate (removal rate: 46 µg L-1d-1) and inhibited its release from the sediment. The SR operation, devoid of importing extra substances, represents a safe and economical technology for controlling harmful cyanobacteria in drinking water reservoirs.

The extent and diversity of harm from the drinking of unknown others in Australia: An analysis of data from during the COVID-19 pandemic.

INTRODUCTION: This paper aims to produce a comprehensive estimate of alcohol's harm to others (AHTO) from strangers among Australia adults in 2021. This survey was undertaken during COVID-19 and aims to compare AHTO results with those from 12 years before and identify differences across socio-demographics. METHODS: Cross-sectional data of 2574 Australian adults were collected in November 2021 via two survey modes: random digit dialling and the Life in Australia™ panel. Questions pertained to harms from the drinking of known and unknown others ('strangers') in the previous 12 months. Multivariable logistic regression is used to analyse differences in the experience of AHTO from strangers across age, gender and other socio-demographics. RESULTS: Under half of Australian adults reported experiencing AHTO from a stranger (42.2%) during the period of COVID-19. Women were at significantly higher odds of reporting harm than men. Significantly higher percentages of participants aged 18-49 reported harm than those 65 and over. Rates of experience of harm from strangers' drinking varied between different Australian regions. Adults engaging in less frequent risky drinking (less than 4 days a month) reported significantly greater experiences of harm than those not engaging in risky drinking in the past year. DISCUSSION AND CONCLUSIONS: The current study provides a national estimate of AHTO from strangers in Australia during the COVID-19 pandemic. Finding greater risk of experiencing AHTO from strangers among women than men differs from previous AHTO literature, and further research is required to determine if this is an emerging trend.

A Comparative Analysis of Drinking Water Provision and Hepatitis A Incidence in Uzbekistan in 2010-2023.

Objective This study aims to analyze the relationship between access to safe drinking water and the incidence of hepatitis A in Uzbekistan from 2010 to 2023 to inform public health strategies for disease prevention. Methods We utilized hepatitis A incidence data from the Sanitary and Epidemiological Well-Being and Public Health Authority and drinking water provision data from the Government Statistics Agency of Uzbekistan. A linear regression analysis was performed using R 4.3.2 to investigate the correlation between these variables. The study examined hepatitis A cases per 100,000 population and the percentage of households with access to safe drinking water. Results Hepatitis A incidence fluctuated significantly over the study period, with a notable spike to 162 cases per 100,000 population in 2023, despite relatively stable access to safe drinking water (ranging from 67.4% to 77% of households). The analysis revealed a complex relationship between water access and hepatitis A incidence. The linear regression coefficient was 3.89 (adjusted R-squared: 0.3021, P-value: 0.02), indicating that each growing percent of water supply is raising the incidence of hepatitis 3.89 cases of hepatitis infection. Conclusion The reverse effect of water supply percentage and the incidence of hepatitis A incidence in Uzbekistan suggests that other factors play significant roles in disease transmission. These may include sanitation practices, hygiene behaviors, and vaccination coverage. The findings emphasize the need for a multifaceted approach to hepatitis A prevention, incorporating improved water infrastructure, enhanced sanitation, public education, and comprehensive vaccination programs. Further research is needed to identify specific determinants of hepatitis A transmission in Uzbekistan to guide targeted interventions and public health policies.

Choice of alcohol over a natural reward: an experimental study in light and heavy social drinkers.

RATIONALE & OBJECTIVES: A core symptom of alcohol use disorder (AUD) is a progressively increased choice of alcohol over alternative rewards despite negative consequences. Here, we investigated choice between personalized alcohol vs. natural rewards in a laboratory setting, and compared this behavior between non-treatment-seeking heavy drinkers and light social drinkers. METHODS: 30 light social drinkers (15 men drinking < 15 drinks/week and 15 women drinking < 10 drinks/week) and 30 heavy, non-treatment-seeking drinkers (drinking more than these levels; 15 women). In the Concurrent Choice Alcohol Food (CCAF) task, participants chose between individually tailored images of alcohol and snack rewards and collected points towards the respective reward. To assess cost sensitivity, points associated to the images varied so that they favored alcohol or snack, or were equal, creating three relative point levels. RESULTS: Choice preference for alcohol was strongly correlated with Alcohol Use Disorder Identification Test (AUDIT) scores, supporting the external validity of the choice procedure. Compared to light drinkers, heavy drinkers showed increased choice preference for alcohol, as indicated by a between-group difference in points of subjective equality, a metric that quantifies the relative point level at which alcohol and snacks were equally likely to be chosen. In both groups, choice preference strongly depended on the relative point level of alcohol compared to snacks, suggesting that responding for alcohol in heavy drinkers was sensitive to costs. CONCLUSIONS: Our results replicate previous findings of a relationship between self-reported alcohol use and choice preference for alcohol. We also found that choice behavior was strongly dependent on relative cost of alcohol in both groups, although price sensitivity was lower in heavy compared to light drinkers. An increased choice preference for alcohol in heavy drinkers suggests that they attribute a higher relative reinforcing value to alcohol compared to natural rewards.

Prevalence of problem drinking in the Swedish workforce: differences between labour market industries based on gender composition and main job activity.

BACKGROUND: Identifying problem drinking patterns across industries is essential for addressing drinking problems in the workforce. Still, it is not well understood how problem drinking differs across industries and whether it is associated with industry gender composition. This study aimed to measure the prevalence of problem drinking (PPD) across Swedish industries and investigate possible associations between gender-typed industries and problem drinking. METHODS: 9,155 current workers were selected from the Swedish Longitudinal Occupational Survey of Health (SLOSH) data collected in 2020. Participants' work industries were identified through the Swedish Standard Industrial Classification (SNI) codes. Seven gender-typed industry categories were created based on gender composition and main job activity in each industry. Self-reported problem drinking was measured using a slightly modified Cut-down, Annoyed, Guilt, Eye-opener (CAGE) questionnaire and a cut-off score 2 was used to determine problem drinking. Poisson regression with robust standard errors was used to investigate the association between gender-typed industries and problem drinking. RESULTS: PPD in the workforce was 6.6%. Men (8.5%) had a higher prevalence than women (5.3%). Across industries, PPD varied from 2.3% in Water supply and waste management to 15.4% in Mining and quarrying. The highest prevalence for men was in Mining and quarrying (18.2%), whereas for women it was in Construction (11.1%). Within gender-typed industries, the highest PPD was in male-dominated Goods and Energy Production (7.7%), and the lowest was in female-dominated Health and Social Care (4.7%). In the regression analysis, both Education (aPR: 1.39, p = 0.03) and Labour-intensive Services (aPR: 1.39, p = 0.02) had higher adjusted prevalence ratios (aPR) compared with Health and Social Care. However, there was no significant difference in aPR among gender-typed industries when considering the gender composition of industries only. CONCLUSIONS: PPD in the Swedish workforce varied significantly across industries, with differences observed between men and women. Problem drinking differed between industries when categorized by gender composition and main job activity, but not when categorized by gender composition only. Future research should investigate how industry-specific psychosocial factors influence individual alcohol consumption.

Exploring the Sociodemographic Factors and Consequences related to Alcohol Consumption among Older Indigenous Community of a District in Nepal: A Qualitative Study.

INTRODUCTION: Alcoholism is a major global public health concern associated with numerous health conditions. Alcohol use has been a cultural part of several ethnic groups in Nepal. This study aimed to explore the qualitative dimension of alcohol use, its promoting factors, and consequences in Nepalese communities. METHODS: Qualitative study was conducted among 20 older adults belonging to the Magar community of Mathagadhi Rural Municipality, Lumbini Province, Nepal after acquiring ethical approval from Institutional Review Committee of CiST College (Reference number: 179/078/079). The data were analyzed using inductive thematic analysis, and themes were identified based on participants' responses to explore promoting factors for alcohol consumption along with its consequences. RESULTS: Traditional beliefs, cultural practices, and socioeconomic factors were the major contributors to alcohol misuse. Increased alcohol consumption during old age was perceived to be associated with body pain, tension, painful life events, and loneliness. CONCLUSIONS: A conflicting perception was observed, where some of the participants expressed the need to promote alcohol use as a part of their culture while some shared the view that the use of alcohol as a cultural practice should be limited. This study highlights the need for culturally appropriate interventions to address alcohol misuse among indigenous communities. Interventions should focus on addressing traditional beliefs and cultural practices that normalize alcohol consumption and the social and economic problems associated with alcohol misuse.

Applying a novel mechanistic framework for drinking water management to mitigate emerging contaminants.

A novel framework has been developed which summarizes the efficacy of treatment technologies for emerging contaminants (ECs) based on the general mitigation mechanisms of Removal, Inactivation/Degradation, and Destruction (i.e., RIDD). The RIDD framework allows for a concise critical evaluation of the efficacy of treatment processes for their mitigation potential, and provides an efficient methodology for drinking water system managers to identify knowledge gaps related to the management of ECs in water treatment with respect to current technologies available in practice. Additionally, the RIDD framework provides an understanding of the treatment processes which provide: (1) broad spectrum treatment, (2) effective mitigation for certain categories of contaminants or under certain circumstances, or (3) little or no mitigation of ECs. In the proposed format, this information is intended to assist water managers to make more informed treatment decisions. Four categories of ECs noted in recent literature as presently concerning to drinking water utilities, including both anthropogenic and microbial contaminants, were used in this study to provide examples of RIDD framework application. In many cases, broad-spectrum treatment barriers (e.g., high-pressure membranes) are expected to provide cost-effective management of a suite of ECs, which then can be compared to the costs and practicality of additional treatment barriers for individual ECs (e.g., selective ion exchange resins or tailored biological processes). Additionally, understanding the typical performance of existing treatment processes can help assist with capital planning for alternative treatment processes or upgrades, or for developing novel treatment approaches at the watershed scale such as integrated urban water management and One Water frameworks.

Earlier sexual debut as a risk factor for substance use among men who have sex with men (MSM) in Kazakhstan.

Background: Limited research have examined predictors of illicit use of drugs and binge drinking among gay, bisexual, and other men who have sex with men (MSM) in Kazakhstan and Central Asia. This study examines earlier sexual debut as a risk factor for lifetime and recent substance use behaviors among MSM in Kazakhstan. Methods: We conducted a secondary analysis of self-reported data from a NIDA-funded HIV prevention trial including 902 adult cisgender MSM in Kazakhstan who completed structured screening interviews. Logistic regression models were used to estimate associations between earlier sexual debut (ages 16 and older as the reference group) and lifetime and recent substance use, with covariance adjustment for sociodemographic characteristics. Results: The majority of MSM in our sample reported lifetime binge drinking behavior (73%) and illicit use of drugs (65%). Participants with an earlier sexual debut before 13 years old had significantly higher odds of lifetime binge drinking and any illicit use of drugs (aOR= 2.3, 95%CI: 1.2-4.5; aOR=3.0, 95%CI: 1.6-5.8). MSM who reported an earlier sexual debut between 13-15 years old had significantly higher odds of lifetime binge drinking and illicit use of any drugs (aOR=1.6, 95%CI: 1.1-2.3; aOR=1.6, 95%CI: 1.1-2.3); as well as recent binge drinking behavior (aOR=1.6, 95%CI: 1.2-2.3). Conclusion: Future research should examine pathways between earlier sexual experiences and substance use behaviors among sexually diverse populations. Earlier sexual experiences during childhood and adolescence may be relevant contextual information for interventions aimed at substance use risk prevention, treatment, and recovery among MSM populations.

Influence of tailing dust contamination in drinking water on the health status of goats in subtropical Regions.

The contamination of river systems by tailing dust remains a constraint to goat productivity in communal farming systems. A cross-sectional study was conducted to investigate how resource-limited households in subtropical regions assessed the effects of tailing dust contamination in drinking water on the health status of goats. In a study conducted in the Ba-Phalaborwa Local Municipality, 200 households from two villages were randomly selected and interviewed using a questionnaire. Forty-eight percent (n = 96) of the households were located in contaminated areas, while 52% (n = 104) were from uncontaminated areas. The study found that poor water quality, caused by tailing dust contamination, as well as a high incidence of diseases, were key factors affecting goat productivity. Water contamination was most severe during the hot and cool dry seasons. It was also noted that goats rely on freshwater as their primary source of supplemental water during dry seasons. Urine colour, oedema of the eyelids, and kid survival were indicators for assessing the health status of goats. Nominal binary logistic regression revealed that water contamination was 2.96 more likely to be reported by youth compared to elderly members. Farmers who received informal education were 37 times more likely to report contamination than those who received formal education. High kid mortality as a health status indicator was 50 times less likely to be reported in uncontaminated areas. Intervention strategies for reducing the adverse health effects of tailing dust in contaminated areas should focus primarily on the health of goats during dry seasons.

History of tobacco smoking and alcohol use can predict the effectiveness of electroconvulsive therapy in individuals with schizophrenia: A multicenter clinical trial.

BACKGROUND: Current research has found that factors such as gender, age, and family history can predict the efficacy of electroconvulsive therapy (ECT) in individuals with schizophrenia. In our clinical practice, we anecdotally observed that tobacco smokers and alcohol drinkers with schizophrenia seemed to respond more effectively to ECT than non-smokers and non-drinkers. The current study aimed to examine whether history of tobacco smoking or alcohol consumption serve as indicators for predicting therapeutic efficacy of ECT in individuals with schizophrenia. METHODS: A total of 481 individuals receiving ECT combined with antipsychotic medication (ECT + AP medication) completed a two-week (six sessions of ECT) follow-up; 106 individuals receiving only antipsychotic medication (AP medication) also completed a two-week follow-up. Smoking, alcohol consumption, and AP medication usage was recorded for these individuals. Severity of psychotic symptoms was assessed using the Positive and Negative Syndrome Scale (PANSS). RESULTS: ECT + AP medication: Compared to schizophrenic individuals without a history of smoking (non-smokers), those with a history of smoking (smokers) showed a high decrease in negative symptoms (36.96% vs 24.76%; F = 5.974, p = 0.015). While, compared to individuals without a history of alcohol consumption (non-drinkers), those with a history of alcohol consumption (drinkers) showed a high decrease in positive symptoms (48.90% vs 41.47%; F = 5.074, p = 0.025). AP medication: No differences were found in symptom reduction between smokers and non-smokers or between drinkers and non-drinkers (p > 0.05). CONCLUSIONS: Smoking history in schizophrenic individuals independently predicts better improvement in negative symptoms after ECT, while alcohol consumption history independently predicts better improvement in positive symptoms after ECT. This is a clinically significant finding.

Purification Resistance Index: A new water quality assessment method toward drinking water production.

Water quality assessment plays a significant role in ensuring the availability of clean and safe water. The Water Quality Index (WQI) model method has been developed to provide a basis for assessing water quality by integrating various water quality parameters. However, existing WQIs do not "actively" consider the difficulty of water treatment from raw water to specific water use scenarios. This study proposes a novel model framework, named as Purification Resistance Index (PRI), quantitatively evaluating not only the exceedance of pollutants but also how difficult they can be removed in the water treatment process. The framework is built based on the conventional drinking water treatment processes, with sub-indices for coagulation-sedimentation (rc), filtration (rf), disinfection (rd), and advanced treatment (ra). The model considers appropriate weights assigned to each sub-index to calculate the purification resistance, resulting in a comprehensive index for water quality evaluation. Case studies on nationwide and citywide water source reservoirs demonstrated the applicability of PRI approach. PRI breakthrough the traditional water quality risk assessment paradigm and extents to engineering region and provide useful tools for water source supervision, drinking water treatment plant planning and updating, operation control, and other purposes. Water authority, water utility and municipal design institute will all benefit. It is open for more localized practices validation and discussion.

Phosphatidylethanol as an outcome measure in treatment aimed at controlled drinking.

BACKGROUND: Phosphatidylethanol (PEth) is a specific marker of alcohol intake, used both as a screening method for hazardous use and as an outcome measure in the treatment of alcohol use disorder (AUD). However, what cut-off values to apply for hazardous use in a treatment setting is still unclear. We aimed to investigate the correlation between PEth and self-reported drinking and identify the optimal cut-off for hazardous use, for patients with AUD and a stated goal of controlled drinking. METHODS: We used data from a randomized controlled trial of two different psychological treatments aiming for controlled drinking, conducted within specialized addiction care in Stockholm, Sweden. A total of 181 patients left samples that could be included in the current analysis. Outcomes were measured at five different time points over 2 years of follow-up. PEth 16:0/18:1 values were correlated with subjective reports of recent drinking based on the Timeline Follow-Back Method. RESULTS: The correlation between PEth and self-reported alcohol intake increased significantly over time, with the weakest correlation found at baseline (Spearman's ρ = 0.42) and the strongest at the 104-week follow-up (ρ = 0.69). When used to indicate hazardous drinking according to Swedish guidelines (≥10 units per week), receiver operating characteristic analysis revealed PEth ≥ 0.22 µmol/l to be the optimal cut-off. CONCLUSIONS: PEth is a useful outcome measure that can be used to validate subjective reports of current drinking. In a treatment setting aimed at controlled drinking, the accuracy of patients' self-report measures seems to improve over time. In this context, a PEth value of ≥0.22 µmol/l is a sensitive and specific indicator of hazardous drinking.

Subcutaneous and orally self-administered high-dose carprofen shows favorable pharmacokinetic and tolerability profiles in male and female C57BL/6J mice.

Introduction: Surgical interventions in mice require appropriate pain relief to ensure animal welfare and to avoid influence of pain on research findings. Carprofen is a non-steroidal anti-inflammatory drug commonly used as an analgesic for interventions inducing mild to moderate pain in laboratory rodents. Despite its frequent use, species-specific data on pharmacokinetics (PK), side effects, and potential impact on behavioral pain indicators are limited. Methods: We determined PK and tolerability profiles of carprofen in healthy male and female C57BL/6J mice (n = 42), administered at highest recommended doses via single subcutaneous (s.c.) injection (20 mg/kg) and oral self-administration (25 mg/kg/24 h) per drinking water (d.w.) for 5 days. Plasma concentrations were measured at various time points after the start of the treatment (n = 6 per time point), and side effects were evaluated using a modified Irwin test battery, hematology, and histopathology. Additionally, potential interference with cage-side behaviors commonly used for pain assessment, such as the mouse grimace scale, wheel running, burrowing, nesting, and grooming activity, was investigated. Results: Maximum plasma concentrations of 133.4 ± 11.3 µg/ml were reached 1 h after single s.c. injection with an elimination half-life of 8.52 h. Intake from d.w. resulted in a steady state within 24 h after the start of the treatment with plasma levels of around 60 µg/ml over 5 days in both sexes. The medicated water was well-accepted, and increased d.w. intake was observed in the first 24 h after exposure (p < 0.0001). The Irwin test revealed only minor influence on tested behavior and physiological functions. However, during treatment via d.w., an increase in body temperature (p < 0.0001) was observed, as well as a reduction in voluntary wheel running activity by 49-70% in male mice. Moreover, grooming behavior was slightly affected. Hematology and histopathology were without pathological findings that could be attributed to carprofen treatment. High-dose carprofen can be considered safe and of favorable PK for both administration routes assessed in healthy C57BL/6J mice of both sexes. Further efficacy evaluation of carprofen as monoanalgesic or component of multimodal post-surgical regimens is clearly encouraged; however, the impact on behavioral markers used for pain assessment should be considered in this context.

Voluntarily stopping eating and drinking (VSED): A systematic mixed-methods review focusing on the carers' experiences.

BACKGROUND: Voluntary stopping of eating and drinking (VSED) is a way to end one's life prematurely. We synthesized the empirical data on VSED. METHODS: In this systematic mixed-methods review, we searched MEDLINE, CINAHL, PsycINFO, Google Scholar, and BELIT for English and German articles published between January 1, 2013 and November 12, 2021. We included quantitative and qualitative research examining the experiences, attitudes, and knowledge of people confronted with VSED. We inductively analyzed the data after quantitative data transformation. We assessed quality and confidence using the Mixed-Methods Appraisal Tool and GRADE-CERQual approach, respectively. This study was registered in PROSPERO (CRD42022283743). FINDINGS: We identified 22 eligible articles, comprising 16 studies. The participants were healthcare professionals and relatives, but not individuals undertaking VSED. We present here our findings on the challenges of accompanying VSED, positive experiences with VSED, and the identified needs. Support during VSED is needed at multiple levels (medical care, family relief, course planning), and the willingness to accompany VSED is very high among healthcare professionals. However, there are several problems, the most obvious being the lack of knowledge and expertise regarding VSED, placing a great burden on families and professionals. The confidence in the review findings ranged from moderate to low. INTERPRETATION: Evidence-based guidance, in-depth knowledge, and training of healthcare professionals can greatly reduce the burden and fear among individuals accompanying VSED.

Control of drinking water disinfection byproducts with a novel bromide-selective anion exchange resin: Design, mechanism, and performance.

In regions where drinking water sources containing elevated bromide levels, the formation of brominated disinfection byproducts (Br-DBPs) is enhanced, which may increase risks of cancer and birth defects. Anion exchange resin (AER) adsorption is a promising approach for reducing precursors of Br-DBPs (e.g., bromide and natural organic matter) due to its strong electrostatic force for reversible ion exchange process. However, high bromide water sources typically have high salinities, and the presence of co-existing ions (e.g., sulfate, nitrate, chloride) can significantly diminish the efficiency of conventional AERs, which use polyacrylic or polystyrene skeletons with trimethyl-ammonium functional groups. This study designed a novel AER with the polystyrene skeleton and tripentyl-ammonium functional group for the selective bromide removal, which resisted interferences from co-existing ions based on ion dehydration and ion-pairing electrostatic interactions. Column experiments with continuous high-bromide water flows demonstrated that the novel AER exhibited up to three times the operating capacity of conventional AERs, achieving reductions of 71.2 %, 44.6 %, and 67.7 % in bromide, dissolved organic carbon, and specific UV absorbance, respectively. Competitive experiments showed that the novel AER's strong sulfate interference resistance enhanced its bromide selectivity. The electrostatic interactions between AER fragments and bromide or sulfate particles were quantitatively evaluated using density functional theory calculations. Treatment with the novel AER led to reductions in total organic bromine, aliphatic Br-DBPs, and cyclic Br-DBPs by 76.7 %, 62.5 %, and 90.5 %, respectively. Notably, cytotoxicity assays using Chinese hamster ovary cells indicated a 39.7 % decrease in overall cytotoxicity of chlorinated drinking water following treatment with the novel AER.

Was receipt of any specialty alcohol treatment during the pandemic effective at reducing drinking for patients with or at risk of AUD?

INTRODUCTION: The COVID-19 pandemic changed the way healthcare providers delivered most health services, including treatment for alcohol use disorder (AUD). Specialty alcohol treatment remained available through the pandemic, and within some systems treatment use increased likely due to telehealth availability. However, the field knows little about the relationship between the pandemic's expanded access to specialty alcohol treatment and alcohol use outcomes. METHODS: The sample included 14,712 patients from Kaiser Permanente Northern California who screened positive for unhealthy alcohol use in primary care and had an AUD diagnosis or risked developing an AUD by reporting 5 or more heavy drinking days in a 3-month period between 1/1/2019 and 2/29/2020 (pre-pandemic). The study examined the receipt of any specialty alcohol treatment (including at least one outpatient, inpatient, or telehealth specialty treatment encounter, or pharmacotherapy prescription) from 3/1/2020 (pandemic start) to either the first completed follow-up alcohol screening or 6/20/2022 (study period end). The outcomes of alcohol use included changes in heavy drinking days, drinks per week, drinking days per week, and drinks per drinking day between the pre- and post-pandemic periods. RESULTS: On average patients significantly decreased alcohol use across all four alcohol use measures examined, regardless of whether they received treatment. However, those who received any treatment compared to those who did not have greater reductions in alcohol use, with an additional decrease of -3.55 heavy drinking days (95 % CI = -5.93, -1.17), -3.80 drinks per week (95 % CI = -5.18, -2.42), -0.72 drinks per drinking day (95 % CI = -1.14, -0.30), and - 1.01 drinking days per week (95 % CI = -1.30, -0.72). Treatment effects were greatest among patients who exceeded both daily and weekly limits pre-pandemic, with an additional decrease of -10.75 heavy drinking days (95 % CI = -15.28, -6.21), -12.83 drinks per week (95 % CI = -16.31, -9.35), -1.67 drinks per drinking day (95 % CI = -2.19, -1.14), and -2.02 drinking days per week (95 % CI = -2.41, -1.63). CONCLUSIONS: On average, patients decreased alcohol use during the onset of the pandemic, however, those who had any specialty alcohol treatment had significantly greater decreases, suggesting that the hybrid in-person and telehealth treatment approach was effective during the pandemic.

Drinking motives link positive and negative life events to problematic alcohol use during the COVID-19 pandemic: a longitudinal study.

PURPOSE: Stressful life events are associated with problematic drinking, and alcohol misuse has been exacerbated during the coronavirus disease 2019 (COVID-19) pandemic. While coping motives may account for this association, positive life events (PLEs) and enhancement motives are understudied. To address these gaps, we examined the associations of history of alcohol use disorder (AUD), negative life events (NLEs), and PLEs with problematic alcohol use and tested coping and enhancement motives as mediators. METHODS: The sample included baseline and follow-up data from 241 participants enrolled in the National Institute on Alcohol Abuse and Alcoholism COVID-19 Pandemic Impact on Alcohol Study. Endorsements of past year PLEs and NLEs and their associations with problematic alcohol use were examined. Among the 202 current drinkers, path analyses tested mediational pathways via coping and enhancement motives. RESULTS: The top two PLEs were change in work conditions (21.6%) and taking a vacation (20.3%). The top two NLEs were change in social activities (36.5%) and major change in recreation (26.6%). Individuals with a history of AUD and those who experienced more NLEs reported higher coping and enhancement motives, which were associated with higher problematic alcohol use. Individuals who experienced more PLEs reported lower coping motives, which was associated with lower problematic alcohol use. CONCLUSIONS: Besides coping motives, enhancement motives were also associated with pandemic problematic alcohol use. Alcohol interventions targeting reward- and relief-driven drinking patterns may be beneficial to individuals with a history of AUD and those who experienced more NLEs. More research is needed to study PLEs which may help inform the development of strength-based alcohol interventions.

Within-episode relations among simultaneous alcohol and cannabis use and continued drinking: The role of momentary subjective responses, craving, and drinking context.

BACKGROUND: Simultaneous alcohol and cannabis use is associated with riskier daily drinking. However, little research has tested momentary mechanisms through which simultaneous use predicts continued drinking during acute drinking episodes. The current study tested whether simultaneous use moments predicted within-episode increases in subjective responses, craving, and continued drinking, and whether these relations were potentiated in social versus solitary settings. METHODS: Emerging adults who co-use alcohol and cannabis (N = 85) completed 21 days of ecological momentary assessment with event-contingent reports during drinking episodes. Three-level multilevel models tested whether simultaneous (vs. alcohol-only) use moments indirectly predicted subsequent, continued drinking through subjective responses (i.e., high-arousal positive/stimulant, high-arousal negative/aggression, low-arousal positive/relaxation, low-arousal negative/impairment) and alcohol craving, and whether relations differed by social versus solitary contexts. RESULTS: Within drinking episodes, simultaneous (vs. alcohol-only) use moments were associated with increased stimulation, which was indirectly associated with continued drinking through increased alcohol craving. Additionally, the relation between simultaneous (vs. alcohol-only) use and stimulating effects was potentiated during solitary drinking moments, whereas the relation between stimulating effects and craving was potentiated during social drinking moments. However, stimulating effects were higher in social contexts across all moments. Finally, simultaneous (vs. alcohol-only) use moments were associated with increased relaxation, which was indirectly associated with a lower likelihood of continued drinking through lesser craving. CONCLUSIONS: Simultaneous use predicted both continued within-episode drinking and cessation of drinking, with acute subjective effects and craving as mechanisms, dependent upon context. Just-in-time interventions should consider targeting affect, craving, and context in event-specific interventions.