Building a statewide network of MOUD expertise using tiered ECHO® mentoring opportunities.

BACKGROUND: Expanding access to workforce training for opioid use disorder (OUD) treatment continues to be a priority. This study explored the use of tiered mentoring opportunities within an ECHO® model to expand treatment capacity and develop a statewide network of medications for OUD (MOUD) expertise. ECHO® engages participants in a virtual community to learn best practices through case-based learning and interactions with experts. METHODS: We studied two incentivized Illinois MOUD ECHO® training programs by examining aggregate demographic and prescribing data across eight training cohorts (n = 199 participants). Participants (n = 51) in the last two cohorts were evaluated with expanded pre- and post-training surveys. Qualitative interviews were completed with a subset (n = 13) to examine effects observed in the survey data. RESULTS: For the whole group, we found a geographic expansion of the participants' prescribing capacity that reached into rural and other underserved areas in Illinois. Participants in the last two cohorts reported both increased self-efficacy for OUD treatment and increased connectedness to the addiction treatment community in Illinois. Participants who progressed through the tiered mentorship roles were found to exhibit stepwise increases in reported self-efficacy and connectedness measures. CONCLUSION: An incentivized ECHO® program yielded substantive outcomes in terms of increased prescribing capacity across the state. The use of tiered mentoring opportunities enabled participants to develop MOUD expertise and support novice providers in a growing statewide network. There is potential to train professionals to a high level of expertise when the ECHO® model is combined with a mentorship pathway.

Field application of activated carbon amendment for in-situ stabilization of polychlorinated biphenyls in marine sediment.

We report results on the first field-scale application of activated carbon (AC) amendment to contaminated sediment for in-situ stabilization of polychlorinated biphenyls (PCBs). The test was performed on a tidal mud flat at South Basin, adjacent to the former Hunters Point Naval Shipyard, San Francisco Bay, CA. The major goals of the field study were to (1) assess scale up of the AC mixing technology using two available, large-scale devices, (2) validate the effectiveness of the AC amendment at the field scale, and (3) identify possible adverse effects of the remediation technology. Also, the test allowed comparison among monitoring tools, evaluation of longer-term effectiveness of AC amendment, and identification of field-related factors that confound the performance of in-situ biological assessments. Following background pretreatment measurements, we successfully incorporated AC into sediment to a nominal 30 cm depth during a single mixing event, as confirmed by total organic carbon and black carbon contents in the designated test plots. The measured AC dose averaged 2.0-3.2 wt% and varied depending on sampling locations and mixing equipment. AC amendment did not impact sediment resuspension or PCB release into the water column over the treatment plots, nor adversely impactthe existing macro benthic community composition, richness, or diversity. The PCB bioaccumulation in marine clams was reduced when exposed to sediment treated with 2% AC in comparison to the control plot Field-deployed semi permeable membrane devices and polyethylene devices showed about 50% reduction in PCB uptake in AC-treated sediment and similar reduction in estimated pore-water PCB concentration. This reduction was evident even after 13-month post-treatment with then 7 months of continuous exposure, indicating AC treatment efficacy was retained for an extended period. Aqueous equilibrium PCB concentrations and PCB desorption showed an AC-dose response. Field-exposed AC after 18 months retained a strong stabilization capability to reduce aqueous equilibrium PCB concentrations by about 90%, which also supports the long-term effectiveness of AC in the field. Additional mixing during or after AC deployment, increasing AC dose, reducing AC-particle size, and sequential deployment of AC dose will likely improve AC-sediment contact and overall effectiveness. The reductions in PCB availability observed with slow mass transfer under field conditions calls for predictive models to assess the long-term trends in pore-water PCB concentrations and the benefits of alternative in-situ AC application and mixing strategies.

Field methods for amending marine sediment with activated carbon and assessing treatment effectiveness.

Previous laboratory studies have shown reductions in PCB bioavailability for sediments amended with activated carbon (AC). Here we report results on a preliminary pilot-scale study to assess challenges in scaling-up for field deployment and monitoring. The goals of the preliminary pilot-scale study at Hunters Point Shipyard (San Francisco, USA) were to (1) test the capabilities of a large-scale mixing device for incorporating AC into sediment, (2) develop and evaluate our field assessment techniques, and (3) compare reductions in PCB bioavailability found in the laboratory with well-mixed systems to those observed in the field with one-time-mixed systems. In this study we successfully used a large-scale device to mix 500kg of AC into a 34.4m(2) plot to a depth of 1ft, a depth that includes the majority of the biologically active zone. Our results indicate that after 7 months of AC-sediment contact in the field, the 28-day PCB bioaccumulation for the bent-nosed clam, Macoma nasuta, field-deployed to this AC-amended sediment was approximately half of the bioaccumulation resulting from exposure to untreated sediment. Similar PCB bioaccumulation reductions were found in laboratory bioassays conducted on both the bivalve, M. nasuta and the estuarine amphipod, Leptocheirus plumulosus, using sediment collected from the treated and untreated field plots one year after the AC amendment occurred. To further understand the long-term effectiveness of AC as an in situ treatment strategy for PCB-contaminated sediments under field conditions, a 3-year comprehensive study is currently underway at Hunters Point that will compare the effectiveness of two large-scale mixing devices and include both unmixed and mixed-only control plots.

Microporous porphyrin solids.

Metalloporphyrins are exceedingly useful building blocks for the design and synthesis of molecularly based solids. The use of hydrogen bonding or metal ion coordination provides a wide range of framework solids. Using various polyfunctionalized porphyrins, we have created porous solids that are thermally robust and that retain their internal porosity upon loss of solvates. Their pore dimensions are comparable to zeolites, and they show shape and size selectivity in sorption of guest molecules and in epoxidation of alkenes.

A robust microporous zinc porphyrin framework solid.

A robust microporous zinc(II) metalloporphyrin framework solid has been synthesized. The proposed structural model developed from X-ray single crystal data has an interpenetrated three-dimensional framework of zinc trans-biscarboxylate tetraarylporphyrins whose carboxylates coordinate the six edges of tetrahedral Zn(4)O(6+) clusters, maintaining a charge-neutral framework. This cubic framework has 74% free volume and 4 x 7 A pores. N(2) adsorption gives a type I isotherm with a surface area of 800 m(2)/g, which is greater than that of a typical zeolite. Experimental evidence indicates that the interpenetrated frameworks of the evacuated solid remain intact and retain a microporous structure. This is a versatile framework system: alteration of the metal in the porphyrin may create a catalytically active solid, and modification of the 10-, 20-substituents of the porphyrin can provide control over both the polarity and the size of the pores.