Factors associated with neurofeedback and mindfulness-based combination therapy for patients with substance use disorder: A multicenter study

Background and objectives Substance use disorder (SUD) has become a major concern in public health globally, and there is an urgent need to develop an integrated psychosocial intervention. The aims of the current study are to test the efficacy of the integrated treatment with neurofeedback and mindfulness-based therapy for SUD and identify the predictors of the efficacy. Methods This study included 110 participants with SUD into the analysis. Outcome of measures includes demographic characteristics, severity of dependence, quality of life, symptoms of depression, and anxiety. Independent t test is used to estimate the change of scores at baseline and three months follow-up. Generalized estimating equations are applied to analyze the effect of predictors on the scores of dependence severity over time by controlling for the effects of demographic characteristics. Results A total of 22 (20 %) participants were comorbid with major mental disorder (MMD). The decrement of the severity in dependence, anxiety, and depression after treatment are identified. Improved scores of qualities of life in generic, psychological, social, and environmental domains are also noticed. After controlling for the effects of demographic characteristics, the predictors of poorer outcome are comorbid with MMD, lower quality of life, and higher level of depression and anxiety. Conclusion The present study implicates the efficacy of integrated therapy. Early identification of predictors is beneficial for healthcare workers to improve the treatment efficacy. (AU)

Factors impeding switching from methadone to buprenorphine in heroin users receiving methadone maintenance therapy - A naturalistic cohort study.

INTRODUCTION: Switching from methadone to buprenorphine/naloxone remains a challenge for heroin users receiving methadone maintenance treatment (MMT). The present study aimed to investigate the predictors for failed switching from methadone to buprenorphine/naloxone among patients receiving MMT. METHODS: This 5-year retrospective study included 168 individuals (138 males and 30 females) with opioid dependence who attempted to switch from methadone to buprenorphine/naloxone at our MMT clinics in Taiwan. We excluded patients with psychiatric comorbidity and other substance use disorders except nicotine. A univariate Cox proportional hazards regression model (Cox model) was used to estimate the potential factors of subsequent failed switching, followed by a multivariate Cox model to identify significant predictors after adjusting for other covariates. RESULTS: Seventy of the 168 participants (41.7%) failed switching from methadone to buprenorphine/naloxone. After forward selection in the Cox hazard regression model, a greater average dose of methadone (HR = 1.02; P = 0.01), greater maximal maintenance dose of MMT (HR = 1.02; P < 0.001), greater average dose of buprenorphine (HR = 1.10; P = 0.021), and lower average attendance rate during the three months before switching (HR = 0.09; P = 0.002) were significantly associated with failed switching. CONCLUSIONS: This study with limited participants showed that dose of methadone, dose of buprenorphine, and attendance rates were significantly associated with failed switching. Clinicians should discuss with their patients about tapering the dose of methadone and improving their attendance if they want to switch from methadone to buprenorphine. Further studies are necessary to verify whether our findings generalize to other populations.

Preparation, characterization and antibacterial applications of carboxymethyl chitosan/CuO nanocomposite hydrogels.

In this study, a series of antibacterial carboxymethyl chitosan/CuO nanocomposites were prepared by treating the carboxymethyl chitosan (CMCh) hydrogel with copper (II) chloride (CuCl2) solution followed by the oxidation of copper ions in the presence of sodium hydroxide. The resulting nanocomposite hydrogels were characterized by using FTIR, XRD and SEM techniques. The SEM micrographs revealed the uniform distribution of CuO nanoparticles in the hydrogel matrix with the size ranging from 20nm to 50nm, while XRD patterns confirmed the formation of monoclinic crystalline structures of CuO nanoparticles. The swelling behavior of the nanocomposite hydrogels were studied at a varied pH range. CMCh/CuO nanocomposite hydrogels showed rather higher swelling as compared to pure CMCh hydrogel. The antibacterial properties of the nanocomposite hydrogels were studied against Staphylococcus aureus and Escherichia coli. The results showed excellent antibacterial behavior of the nanocomposite hydrogels. Therefore, the developed CMCh/CuO nanocomposite hydrogels might be used effectively in numerous biomedical fields.

Synthesis and characterization of antibacterial carboxymethyl Chitosan/ZnO nanocomposite hydrogels.

The antibacterial carboxymethyl chitosan/ZnO nanocomposite hydrogels were successfully prepared via in situ formation of ZnO nanorods in the crosslinked carboxymethyl chitosan (CMCh) matrix, by treating the CMCh hydrogel matrix with zinc nitrate solution followed by the oxidation of zinc ions with alkaline solution. The resulting CMCh/ZnO hydrogels were characterized by using FTIR spectroscopy, X-ray diffractormetry and scanning electron microscopy (SEM). SEM micrographs revealed the formation of ZnO nanorods in the hydrogel matrix with the size ranging from 190nm to 600nm. The swelling behavior of the prepared nanocomposite hydrogels was also investigated in different pH solutions. The CMCh/ZnO nanocomposite hydrogel showed rather higher swelling behavior in different pH solutions in comparison with neat CMCh hydrogel. Furthermore, the antibacterial activity of CMCh/ZnO hydrogel was studied against Escherichia coli and Staphylococcus aureus by CFU assay. The results demonstrated an excellent antibacterial activity of the nanocomposite hydrogel. Therefore, the developed CMCh/ZnO nanocomposite hydrogel can be used effectively in biomedical field.