Community member perspectives on adapting the cascade of care for opioid use disorder for a tribal nation in the United States.

BACKGROUND AND AIMS: The Opioid Use Disorder (OUD) Cascade of Care is a public health model that has been used to measure population-level OUD risk, treatment engagement, retention, service and outcome indicators. However, no studies have examined its relevance for American Indian and Alaska Native (AI/AN) communities. Thus, we aimed to understand (1) the utility of existing stages and (2) the relative 'fit' of the OUD Cascade of Care from a tribal perspective. DESIGN, SETTING, PARTICIPANTS AND MEASUREMENTS: Qualitative analysis of in-depth interviews with 20 individuals who were knowledgeable regarding the treatment of OUD in an Anishinaabe tribal setting in Minnesota, USA. Community member roles included clinicians, peer support specialists and cultural practitioners, among others. Thematic analysis was used to analyze the data. FINDINGS: Participants identified the key transition points of prevention, assessment, inpatient/outpatient pathways and recovery as relevant to their community. They re-imagined an Aanji'bide (Changing our Paths) model of opioid recovery and change that was non-linear; included developmental stage and individual pathways; and demonstrated resilience through connection to culture/spirituality, community and others. CONCLUSIONS: Community members living/working in a rural tribal nation in Minnesota, USA identified non-linearity and cultural connection as key elements to include in an Anishinaabe-centered model of opioid recovery and change.

Longevity and reliability of chronic unit recordings using the Utah, intracortical multi-electrode arrays.

Objective.Microelectrode arrays are standard tools for conducting chronic electrophysiological experiments, allowing researchers to simultaneously record from large numbers of neurons. Specifically, Utah electrode arrays (UEAs) have been utilized by scientists in many species, including rodents, rhesus macaques, marmosets, and human participants. The field of clinical human brain-computer interfaces currently relies on the UEA as a number of research groups have clearance from the United States Federal Drug Administration (FDA) for this device through the investigational device exemption pathway. Despite its widespread usage in systems neuroscience, few studies have comprehensively evaluated the reliability and signal quality of the Utah array over long periods of time in a large dataset.Approach.We collected and analyzed over 6000 recorded datasets from various cortical areas spanning almost nine years of experiments, totaling 17 rhesus macaques (Macaca mulatta) and 2 human subjects, and 55 separate microelectrode Utah arrays. The scale of this dataset allowed us to evaluate the average life of these arrays, based primarily on the signal-to-noise ratio of each electrode over time.Main results.Using implants in primary motor, premotor, prefrontal, and somatosensory cortices, we found that the average lifespan of available recordings from UEAs was 622 days, although we provide several examples of these UEAs lasting over 1000 days and one up to 9 years; human implants were also shown to last longer than non-human primate implants. We also found that electrode length did not affect longevity and quality, but iridium oxide metallization on the electrode tip exhibited superior yield as compared to platinum metallization.Significance.Understanding longevity and reliability of microelectrode array recordings allows researchers to set expectations and plan experiments accordingly and maximize the amount of high-quality data gathered. Our results suggest that one can expect chronic unit recordings to last at least two years, with the possibility for arrays to last the better part of a decade.