Feasibility of Bystander Administration of Public-Access Naloxone for Opioid Overdose.

OBJECTIVE: Pre-stationing naloxone, a competitive antagonist that can reverse the effects of opioid overdose, in public spaces may expedite antidote delivery. Our study aimed to determine the feasibility of bystander-assisted overdose treatment using pre-stationed naloxone. METHODS: Convenience sample of bystanders in Cambridge, Massachusetts in April 2017. Subjects assisted a simulated patient described as unconscious. Subjects interacted with simulated EMS dispatch to locate a nearby box, unlock it, and administer naloxone. RESULTS: Fifty participants completed the simulation. Median time from simulated ambulance dispatch to naloxone administration was 189 seconds, and from arrival at patient side to administration 61 seconds. All but one participant (98.0%) correctly administered naloxone. Subjects' comfort with administration and willingness to provide medical care increased from before to after the trial. Comfort in administering naloxone varied significantly with level of previous training prior to, but not following, study participation. CONCLUSIONS: Bystanders are willing and able to access pre-stationed naloxone and administer it to a simulated patient in a public space. Public access naloxone stations may be a useful tool to reduce time to naloxone administration, particularly in areas where opioid overdoses are clustered.

Effects of Cationic Proteins on Gold Nanoparticle/Aptamer Assays.

Gold nanoparticles (AuNPs) and aptamers are compelling building blocks for analytical assays with desired attributes of selectivity and sensitivity and may theoretically form the basis of instrument-free color-changing assays for any target against which a DNA aptamer has been selected. However, assays for proteins based on these components may be subject to significant interferences from the interaction of proteins with nanoparticles. We found that for three representative protein/aptamer systems-thrombin, apolipoprotein E, and platelet-derived growth factor-pH-dependent aggregation occurred, even in the absence of the aptamer, to differing extents. This effect is most pronounced when proteins display net surface charge (i.e., when pH < pI) but can even be observed at pH = pI when the protein retains regions of positive charge. These interactions of AuNPs and cationic regions on proteins may present an important limitation on the development of AuNP-based analytical assays.