Sensitivity of Medicaid Claims Data for Identifying Opioid Use Disorder in Patients Admitted to 6 New York City Public Hospitals.

OBJECTIVES: Behavioral health diagnoses are frequently underreported in administrative health data. For a pragmatic trial of a hospital addiction consult program, we sought to determine the sensitivity of Medicaid claims data for identifying patients with opioid use disorder (OUD). METHODS: A structured review of electronic health record (EHR) data was conducted to identify patients with OUD in 6 New York City public hospitals. Cases selected for review were adults admitted to medical/surgical inpatient units who received methadone or sublingual buprenorphine in the hospital. For cases with OUD based on EHR review, we searched for the hospitalization in Medicaid claims data and examined International Classification of Diseases, Tenth Revision discharge diagnosis codes to identify opioid diagnoses (OUD, opioid poisoning, or opioid-related adverse events). Sensitivity of Medicaid claims data for capturing OUD hospitalizations was calculated using EHR review findings as the reference standard measure. RESULTS: Among 552 cases with OUD based on EHR review, 465 (84.2%) were found in the Medicaid claims data, of which 418 (89.9%) had an opioid discharge diagnosis. Opioid diagnoses were the primary diagnosis in 49 cases (11.7%), whereas in the remainder, they were secondary diagnoses. CONCLUSION: In this sample of hospitalized patients receiving OUD medications, Medicaid claims seem to have good sensitivity for capturing opioid diagnoses. Although the sensitivity of claims data may vary, it can potentially be a valuable source of information about OUD patients.

Experiences of stigma among individuals in recovery from opioid use disorder in a rural setting: A qualitative analysis.

INTRODUCTION: Stigma is a barrier to accessing treatment and support services for individuals with substance use disorder. Stigma is negatively associated with completion of treatment for substance use disorder and management of recovery. OBJECTIVE: To learn from individuals in recovery from opioid use disorder in a largely rural area about how their personal experiences of stigma affected their ability to enter into treatment and stay in recovery. METHODS: We conducted ten focus group sessions with established cohorts of individuals in recovery who met regularly as part of recovery programs in central Maine, including two cohorts of postpartum women. Focus groups included 58 participants (33 women and 25 men, age > 18). We conducted a content analysis of focus group transcripts. RESULTS: Study participants identified hospitals, government agencies, and pharmacies as the primary locations where they had stigmatizing experiences. Participants identified pharmacists and pharmacy technicians as the most frequent perpetrators of stigma. Participants identified fear and secrecy as pathways through which stigma negatively affected their recovery. CONCLUSION: Anti-stigma training programs and related efforts conducted in rural areas may benefit from including pharmacists and pharmacy technicians in training activities, and from considering hospital, government agency, and pharmacy settings as venues for anti-stigma interventions.

Efficient quenching of TGA-capped CdTe quantum dot emission by a surface-coordinated europium(III) cyclen complex.

Extremely efficient quenching of the excited state of aqueous CdTe quantum dots (QDs) by photoinduced electron transfer to a europium cyclen complex is facilitated by surface coordination to the thioglycolic acid capping ligand. The quenching dynamics are elucidated using steady-state emission and picosecond transient absorption.

Magnetic core-shell nanoparticles for drug delivery by nebulization.

BACKGROUND: Aerosolized therapeutics hold great potential for effective treatment of various diseases including lung cancer. In this context, there is an urgent need to develop novel nanocarriers suitable for drug delivery by nebulization. To address this need, we synthesized and characterized a biocompatible drug delivery vehicle following surface coating of Fe3O4 magnetic nanoparticles (MNPs) with a polymer poly(lactic-co-glycolic acid) (PLGA). The polymeric shell of these engineered nanoparticles was loaded with a potential anti-cancer drug quercetin and their suitability for targeting lung cancer cells via nebulization was evaluated. RESULTS: Average particle size of the developed MNPs and PLGA-MNPs as measured by electron microscopy was 9.6 and 53.2 nm, whereas their hydrodynamic swelling as determined using dynamic light scattering was 54.3 nm and 293.4 nm respectively. Utilizing a series of standardized biological tests incorporating a cell-based automated image acquisition and analysis procedure in combination with real-time impedance sensing, we confirmed that the developed MNP-based nanocarrier system was biocompatible, as no cytotoxicity was observed when up to 100 µg/ml PLGA-MNP was applied to the cultured human lung epithelial cells. Moreover, the PLGA-MNP preparation was well-tolerated in vivo in mice when applied intranasally as measured by glutathione and IL-6 secretion assays after 1, 4, or 7 days post-treatment. To imitate aerosol formation for drug delivery to the lungs, we applied quercitin loaded PLGA-MNPs to the human lung carcinoma cell line A549 following a single round of nebulization. The drug-loaded PLGA-MNPs significantly reduced the number of viable A549 cells, which was comparable when applied either by nebulization or by direct pipetting. CONCLUSION: We have developed a magnetic core-shell nanoparticle-based nanocarrier system and evaluated the feasibility of its drug delivery capability via aerosol administration. This study has implications for targeted delivery of therapeutics and poorly soluble medicinal compounds via inhalation route.

Photophysical studies of CdTe quantum dots in the presence of a zinc cationic porphyrin.

The photophysical properties of 2.3 nm thioglycolic acid (TGA) coated CdTe quantum dots (QDs) prepared by a reflux method have been studied in the presence of cationic meso-tetrakis(4-N-methylpyridyl) zinc porphyrin (ZnTMPyP4). Addition of the CdTe QDs to the porphyrin in H(2)O results in a marked red-shift and hypochromism in the porphyrin absorption spectrum, indicative of a non-covalent binding interaction with the QD surface. Only low equivalents of the quantum dot were required for complete quenching of the porphyrin fluorescence revealing that one quantum dot may quench more than one porphyrin. Similarly addition of porphyrin to the quantum dot provided evidence for very efficient quenching of the CdTe photoluminescence, suggesting the formation of CdTe-porphyrin aggregates. Definitive evidence for such aggregates was gathered using small angle X-ray spectroscopy (SAXS). Ultrafast transient absorption data are consistent with very rapid photoinduced electron transfer (1.3 ps) and the resultant formation of a long-lived porphyrin species.

Structure and antibacterial activity of the silver(I) complex of 2-aminophenoxazine-3-one.

The crystal structure and antibacterial activity of the first metal complex of 2-aminophenoxazine-3-one is reported. We describe the silver(i) complex of this important biological molecule and show that the binding mode is through the phenoxazine ring nitrogen. A new synthetic route to 2-aminophenoxazine-3-one is also reported.