OBJECTIVE: Most individuals attending detoxification clinics do not pursue subsequent treatment. Earlier research has suggested that emerging technologies like mHealth interventions could address the postdetoxification treatment gap, yet it remains unclear whether patients themselves endorse such approaches. Our study aimed to qualitatively explore perceived treatment barriers and assessed potential of mHealth among individuals who have undergone alcohol detoxification. METHOD: We conducted a single-interview-per-participant qualitative study, sampling participants (n = 23) that had visited the Stockholm substance use disorder emergency department for alcohol-related reasons, of whom n = 8 were purposively included due to having missed their scheduled follow-up outpatient appointment. Semistructured telephone interviews were conducted (2021-2022) and then systematically analyzed using reflexive thematic analysis. RESULTS: Across both areas of analysis, we identified six themes in total. We clustered barriers to postdetoxification treatment into three themes (10 subthemes) that may offer a nuancing perspective on previous research: "Misalignment between the treatment system and the individual," "Practical hurdles" and "Between reaching out and retreating." We identified three themes in participants' perspectives on mHealth as aftercare support, revealing expectations that such an approach may promote "self-awareness on own terms," assist in "navigating from solitary substance use struggles to supportive connections," and "offer a lifeline when needed most," thereby potentially resolving several barriers to treatment. CONCLUSIONS: This first qualitative study on barriers to alcohol treatment and mHealth potential postdetoxification offered various insights that may be translated into effective, real-world solutions to bridge the postdetoxification treatment gap. A natural next step for future research is to evaluate the impact of mHealth postdetoxification. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
Addictive substances are prevalent world-wide, and their use presents a substantial and persistent public health problem. A wide range of digital interventions to decrease use and negative consequences thereof have been explored, differing in approach, theoretical grounding, use of specific technologies, and more. The current study was designed to comprehensively map the recent (2015-2022) extant literature in a systematic manner, and to identify neglected and emerging knowledge gaps. Four major databases (Medline, Web of Science Core Collection, and PsychInfo) were searched using database-specific search strategies, combining terms related to clinical presentation (alcohol, tobacco or other drug use), technology and aim. After deduplication, the remaining n=13,917 unique studies published were manually screened in two stages, leaving a final n=3,056 studies, the abstracts of which were subjected to a tailored coding scheme. Findings revealed an accelerating rate of publications in this field, with randomized trials being the most common study type. Several meta-analyses on the topic have now been published, revealing promising and robust effects. Digital interventions are being offered on numerous levels, from targeted prevention to specialized clinics. Detailed coding was at times made difficult by inconsistent use of specific terms, which has important implications for future meta-analyses. Moreover, we identify several gaps in the extant literature - few health economic assessments, unclear descriptions of interventions, weak meta-analytic support for some type of interventions, and limited research on many target groups, settings and new interventions like video calls, chatbots and artificial intelligence - that we argue are important to address in future research.
RESUMEN La bacteriosis vascular de la yuca, causada por la bacteria gram negativa Xanthomonas phaseoli pv. manihotis (Xpm), anteriormente conocida como Xanthomonas axonopodis pv. manihotis, es la principal enfermedad bacteriana que compromete su producción. Con la meta de generar una resistencia durable y de amplio espectro a la bacteriosis es posible explotar los mecanismos naturales presentes en plantas no-hospedero. Arabidopsis es una planta modelo extensamente estudiada, la cual es no-hospedero de Xpm. La meta de este estudio fue determinar si la resistencia no-hospedero de Arabidopsis es consecuencia de la presencia de barreras físicas o si esta depende de determinantes genéticos. En este trabajo se evaluó la capacidad de plantas de Arabidopsis de responder a la inoculación con Xpm. Ninguno de los ocho ecotipos de Arabidopsis evaluados mostraron una respuesta hipersensible a la inoculación con ocho diferentes cepas de Xpm. Aunque no se identificó la presencia de especies reactivas de oxígeno si se encontró un bloqueo en el crecimiento de Xpm en las plantas de Arabidopsis. En conjunto, los resultados aquí presentados sugieren que Arabidopsis no está activando una respuesta contra Xpm y que la resistencia observada puede ser consecuencia de las barreras físicas presentes en Arabidopsis que Xpm no es capaz de superar.
ABSTRACT Cassava bacterial blight (CBB), caused by the gram-negative bacteria Xanthomonas phaseoli pv. manihotis (Xpm), previously known as Xanthomonas axonopodis pv. manihotis, is the main bacterial disease compromising cassava production. With the aim to generate durable and broad-spectrum resistance to CBB is possible to exploit the natural mechanism present in non-host plants. Arabidopsis is an extensively studied model plant, which is a non-host of Xpm. The aim of this study was to determinate if the Arabidopsis non-host resistance is a consequence of physical barriers or if it depends on genetic determinants. In this work we evaluated the ability of Arabidopsis plants to respond after Xpm inoculation. None of the eight Arabidopsis ecotypes showed a hypersensitive response after inoculation with eight different Xpm strains. Although reactive oxygen species (ROS) production was not present, impairment in Xpm proliferation was found. These results suggest that Arabidopsis is not activating an immunity response against Xpm and the resistance might be a consequence of physical barriers present in Arabidopsis that Xpm is not able to overcome.
Background: Numerous trials have demonstrated the efficacy of internet interventions targeting alcohol or cannabis use, yet a substantial proportion of users do not benefit from the format, warranting further research to identify moderators of treatment effects. Users' initial attitudes toward treatment is a potential moderator, yet no previous study has investigated users' attitudes in the context of internet interventions for addictive disorders. Method: In this secondary analysis on two internet-based trials targeting harmful alcohol use (n = 1,169) and regular cannabis use (n = 303), respectively, we compared user groups' attitudes at the item level; explored within-group heterogeneity by submitting attitude scores to a k-means cluster analysis; and investigated whether latent subgroups in each user group moderated the treatment effects. Outcome models were run using generalized linear models with 10,000 bias-corrected bootstraps accounting for subject-level clustering. Results: While substance groups and latent subgroups converged in enjoying the anonymity provided by the format, their interest toward treatment differed. Outcome analyses revealed a significant and negative time by subgroup effect on grams of cannabis consumed and screening test score (CAST), favoring the subgroup with positive treatment attitudes. There were not any significant effects of subgroup on alcohol consumption. Despite initial treatment reluctance, participants in the neutral subgroup decreased their cannabis use (gram) significantly when receiving the intervention vs. control. Conclusions: This first, exploratory study revealed key differences between substance groups' attitudes, but more importantly that within-group heterogeneity appear to affect cannabis outcomes. Assessing attitudes could be key in patient-treatment matching, yet more research is needed.
Objective: To reveal clinical characteristics of suboptimal responses to deep brain stimulation (DBS) in a multi-country DYT1 dystonia cohort. Methods: In this multi-country multi-center retrospective study, we analyzed the clinical data of DYT1 patients who experienced suboptimal responses to DBS defined as <30% improvement in dystonia scales at the last follow-up compared with baseline. We used a literature-driven historical cohort of 112 DYT1 patients for comparison. Results: Approximately 8% of our study cohort (11 out of 132) experienced suboptimal responses to DBS. Compared with the historical cohort, the multi-country cohort with suboptimal responses had a significantly younger age at onset (mean, 7.0 vs. 8.4 years; p = 0.025) and younger age at DBS (mean, 12.0 vs. 18.6 years; p = 0.019). Additionally, cranial involvement was more common in the multi-country cohort (before DBS, 64% vs. 45%, p = 0.074; before or after DBS, 91% vs. 47%, p = 0.001). Mean motor improvement at the last follow-up from baseline were 0% and 66% for the multi-country and historical cohorts, respectively. All 11 patients of the multi-country cohort had generalization of dystonia within 2.5 years after disease onset. All patients experienced dystonia improvement of >30% postoperatively; however, secondary worsening of dystonia commenced between 6 months and 3 years following DBS. The improvement at the last follow-up was less than 30% despite optimally-placed leads, a trial of multiple programming settings, and additional DBS surgeries in all patients. The on-/off-stimulation comparison at the long-term follow-up demonstrated beneficial effects of DBS despite missing the threshold of 30% improvement over baseline. Conclusion: Approximately 8% of patients represent a more aggressive phenotype of DYT1 dystonia characterized by younger age at onset, faster disease progression, and cranial involvement, which seems to be associated with long-term suboptimal responses to DBS (e.g., secondary worsening). This information could be useful for both clinicians and patients in clinical decision making and patient counseling before and following DBS implantations. Patients with this phenotype may have different neuroplasticity, neurogenetics, or possibly distinct neurophysiology.
In addition to the largest existing expanse of tropical forests, the Brazilian Amazon has among the largest area of mangroves in the world. While recognized as important global carbon sinks that, when disturbed, are significant sources of greenhouse gases, no studies have quantified the carbon stocks of these vast mangrove forests. In this paper, we quantified total ecosystem carbon stocks of mangroves and salt marshes east of the mouth of the Amazon River, Brazil. Mean ecosystem carbon stocks of the salt marshes were 257 Mg C ha-1 while those of mangroves ranged from 361 to 746 Mg C ha-1 Although aboveground mass was high relative to many other mangrove forests (145 Mg C ha-1), soil carbon stocks were relatively low (340 Mg C ha-1). Low soil carbon stocks may be related to coarse textured soils coupled with a high tidal range. Nevertheless, the carbon stocks of the Amazon mangroves were over twice those of upland evergreen forests and almost 10-fold those of tropical dry forests.
Carbon/analysis , Soil/chemistry , Wetlands , Brazil , Ecosystem
Heart failure is a complex syndrome that has been a major contributor to readmissions into hospitals in the USA. Currently, a large number of medications are being used to treat the symptoms of the disease-digoxin, diuretics, renin-angiotensin-aldosterone system inhibitors, ß-blockers, and vasodilators. There is no doubt that the given pharmaceutical therapy has been effective in lowering hospital readmission rates and prolonging life in individual chronic heart failure patients. Despite this, admission rates following heart failure hospitalization remain high, resulting in a substantial financial strain on healthcare institutions. Clearly, there is much room for improvement in heart failure therapy and management in reducing readmission rates. In this review, we address the unmet needs in the current drug treatment of chronic heart failure and describe novel drug targets that are currently under investigation.
Cardiotonic Agents/therapeutic use , Heart Failure/drug therapy , Chronic Disease , Humans
We report on the effect of arrays of Au nanopillars of controlled size and spacing on the spectral response of a P3HT: PCBM bulk heterojunction solar cell. Prototype nanopillar-patterned devices have nearly the same overall power conversion efficiency as those without nanopillars. The patterned devices do show higher external quantum efficiency and calculated absorption in the wavelength range from approximately 640 nm to 720 nm, where the active layer is not very absorbing. The peak enhancement was approximately 60% at 675 nm. We find evidence that the corresponding resonance involves both localized particle plasmon excitation and multiple reflections/diffraction within the cavity formed by the electrodes. We explore the role of the attenuation coefficient of the active layer on the optical absorption of such an organic photovoltaic device.
This study evaluates respiratory symptoms, lung function, and exposure to airborne particles among waste-picking children. We enrolled 103 waste-picking children at a dump in Managua, Nicaragua and 103 children who do not pick waste. Exposure to airborne particles was assessed by area sampling. Health data were obtained from a questionnaire, clinical examination, and spirometry. Exposure effects were evaluated with multivariate regression analysis. Exposure to particles exceeded national and international standards. Wheezing among children was related to exposure status, with waste-picking children who are both "never highly exposed" and "ever highly exposed" having greater prevalence of wheezing compared to the children who do not pick waste. FEV1 among "ever highly exposed" waste-picking children with wheeze was 13% lower than non-waste-picking children with wheeze. Exposure to small particles was unacceptably high and associated with wheeze and decreased lung function.
Air Pollutants, Occupational/toxicity , Occupational Diseases/chemically induced , Occupational Exposure/adverse effects , Particulate Matter/toxicity , Respiratory Tract Diseases/etiology , Waste Products/adverse effects , Adolescent , Child , Cross-Sectional Studies , Female , Health Surveys , Humans , Male , Nicaragua/epidemiology , Nitrogen Dioxide/analysis , Respiratory Function Tests , Time Factors
We report on the near-field optical microscopic (NSOM) imaging of single-crystal Nd1/2Sr1/2MnO3 near the first-order phase transition from the CE-type charge-ordered insulator (COI) to the ferromagnetic metal (FMM) at 165 K. Using polarized light, the measurements are sensitive to twin domains through optical anisotropy and to hysteretic inhomogeneous strain associated with the phase transition. Optical evidence for strain relaxation and multiphase coexistence is observed through the transition from 150 to 165 K. The multiphase coexistence is seen as the formation of FMM "nanoneedles" with widths less than 100 nm and lengths of at least several micrometers at temperatures well below TC. The work demonstrates polarized NSOM as a technique for the study of first-order solid-state phase transformations on the nanometer spatial scale.
Crystallization/methods , Magnetics , Nanostructures/chemistry , Nanostructures/ultrastructure , Nanotechnology/methods , Nanotubes/chemistry , Nanotubes/ultrastructure , Macromolecular Substances/chemistry , Materials Testing , Molecular Conformation , Particle Size , Surface Properties
Under the influence of a 0.05 T magnetic field, 15-nm diameter cobalt nanoparticles covered with surfactants in a colloidal solution assemble into highly constrained linear chains along the direction of the magnetic field. The magnetic-field-induced (MFI) chains become floppy after removal of the field, folding into three-dimensional (3D) coiled structures upon gentle agitation. The 3D structures are broken into smaller units with vigorous agitation. The nanoparticles redisperse into the solvent upon ultrasonic agitation. Optical microscopy and transmission electron microscopy (TEM) are used to characterize the morphologies of the nanoparticle assemblies at various stages of this reversible process. The hysteresis loops and zero-field cooled/field cooled (ZFC/FC) curves reveal the interparticle coupling in the assemblies. MFI assembly provides a powerful tool to manipulate magnetic nanoparticles.
