Addressing the Spectrum of Opioid Misuse Prevention, Treatment, and Recovery in Rural Washington State Communities: Provider Identified Barriers and Needs.

The opioid overdose epidemic has significantly impacted rural communities. Rural settings present unique challenges to addressing opioid misuse. The purpose of the current study was to understand the similarities and differences between rural and urban-based providers serving rural communities. Washington state-based opioid-related service providers who serve rural communities (N = 75) completed an online survey between July and September 2020. Chi-square tests of association were used to examine significant differences in proportions between rural providers and rural-serving urban providers across opioid prevention, treatment, and recovery training topics. Rural providers reported receiving significantly less opioid treatment and recovery training on the criminal legal system, workplace-based education on treatment and recovery, and co-occurring disorder treatment; and significantly higher prior opioid prevention training on the prevention programs for youth and accessing prevention funding. Differences between rural and rural-serving urban providers demonstrate ways in which rural-urban partnerships can be strengthened to enhance public health.

Effect Of Carica Papaya Leaf Extract On Platelet Count In Chronic Immune Thrombocytopenic Purpura: A Case Series.

The leaves of Carica papaya have been used to treat thrombocytopenia in Dengue fever in areas where the virus is endemic. This case series describes the use of C. papaya leaf liquid extract (CPLE) as an adjunctive therapy for four patients receiving standard-of-care treatment for chronic immune thrombocytopenic purpura (ITP). The cases presented here indicate that CPLE may prove beneficial in the management of chronic ITP for patients interested in alternative therapy before progressing to second-line treatments. A larger clinical trial is warranted to evaluate CPLE as an adjunctive therapy in chronic ITP.

Anatomy of fleshy fruits in the monocots.

PREMISE OF THE STUDY: An anatomical and developmental study of distantly related fleshy fruits in the monocots was undertaken to better understand the evolution of baccate fruits in the monocot clade as a whole. We studied 14 species with fleshy fruits spanning the Alismatales, Arecales, Asparagales, Commelinales, Dioscoreales, Liliales, and Poales to determine various mechanisms through which baccate fruits attain fleshiness at maturity. METHODS: Flowers and fruits of various stages were collected, sectioned, stained, and examined using light microscopy and scanning electron microscopy. KEY RESULTS: Three basic pathways for attaining fleshiness were identified within the species examined (true berries, with a uniform pericarp; typical drupes, with an endocarp differentiated by the presence of stony pyrenes; and specialized drupes, involving mesocarp and endocarp differentiated by stone pyrenes). Furthermore, developmental characters differentiating basic fruit types were identified. CONCLUSIONS: Fleshy fruits in the monocots do not develop through a single shared pathway, indicating that fleshiness has evolved multiple times within the clade.