Management of Acute Sickle Cell Disease Pain.

Pain is a common complication of sickle cell disease. Sickle cell pain can often be effectively managed by pediatricians in outpatient and hospital settings. Acute pain management should be initiated quickly. Patients need to be evaluated for sickle cell complications and other causes of pain. Nonsteroidal anti-inflammatory drugs and opioids are the mainstay of pain treatment, but additional therapies include hydration, local pain control, muscle relaxants, and nonpharmacologic approaches. Healthy lifestyle habits and good behavioral and mental health are important for preventing and coping with sickle cell disease pain. Disease-modifying therapies, such as hydroxyurea, can help prevent sickle hemoglobin polymerization and acute pain episodes. Because sickle cell disease largely affects people who are racialized minorities in the United States, health-care providers need to be aware of how their own personal biases may affect care of these patients.

Multicenter assessment of the outcomes of subcutaneous ICD implantation in patients with prior or future sternotomy.

BACKGROUND: The subcutaneous ICD (S-ICD) is a viable alternative to transvenous ICD and avoids intravascular complications in patients without a pacing indication. The outcomes of S-ICD implantation are uncertain in patients with prior sternotomy. OBJECTIVE: We aim to compare the implant techniques and outcomes with S-ICD implantation in patients with and without prior sternotomy. METHODS: Multicenter retrospective cohort study including adult patients with an S-ICD implanted between January 2014 and June 2020. Outcomes were compared between patients with and without prior sternotomy. RESULTS: Among the 212 patients (49 ± 15 years old, 43% women, BMI 30 ± 8 kg/m2 , 68% primary prevention, 30% ischemic cardiomyopathy, LVEF median 30% IQR 25%-45%) who underwent S-ICD implantation, 47 (22%) had a prior sternotomy. There was no difference in the sensing vector (57% vs. 53% primary, p = 0.55), laterality of the S-ICD lead to the sternum (94% vs. 96% leftward, p = 0.54), or the defibrillation threshold (65 ± 1.4 J vs. 65 ± 0.8 J, p = 0.76) with versus without prior sternotomy. The frequency of 30-day complications was similar with and without prior sternotomy (n = 3/47 vs. n = 15/165, 6% vs. 9%, p = 0.56). Over a median follow-up of 28 months (IQR 10-49 months), the frequency of inappropriate shocks was similar between those with and without prior sternotomy (n = 3/47 and n = 16/165, 6% vs. 10%, p = 0.58). CONCLUSION: Implantation of an S-ICD in patients with prior sternotomy is safe with a similar risk of 30-day complications and inappropriate ICD shocks as patients without prior sternotomy.

Analysis of global DNA methylation changes in human keratinocytes immediately following exposure to a 900 MHz radiofrequency field.

The increasing use of nonionizing radiofrequency electromagnetic fields (RF-EMFs) in a wide range of technologies necessitates studies to further understanding of biological effects from exposures to such forms of electromagnetic fields. While previous studies have described mechanisms for cellular changes occurring following exposure to low-intensity RF-EMFs, the role of molecular epigenetics has not been thoroughly investigated. Specifically unresolved is the effect of RF-EMFs on deoxyribonucleic acid (DNA) methylation, which is a powerful epigenetic process, used by cells to regulate gene expression. DNA methylation is dynamic and can be rapidly triggered in response to external stimuli such as exposure to RF-EMFs. In the present study, we performed a global analysis of DNA methylation patterns in human keratinocytes exposed to 900 MHz RF-EMFs for 1 h at a low dose rate (estimated mean specific absorption rate (SAR) < 10 mW/kg). We used a custom system to allow stable exposure of cell cultures to RF-EMFs under biologically relevant conditions (37 °C, 5% CO2 , 95% humidity). We performed whole genome bisulfite sequencing directly following RF-EMF exposure to examine the immediate changes in DNA methylation patterns and identify early differentially methylated genes in RF-EMF-exposed keratinocytes. By correlating global gene expression to whole genome bisulfite sequencing, we identified six common targets that were both differentially methylated and differentially expressed in response to RF-EMF exposure. The results highlight a potential epigenetic role in the cellular response to RF-EMFs. Particularly, the six identified targets may potentially be developed as epigenetic biomarkers for immediate responses to RF-EMF exposure. Bioelectromagnetics. 1-13, © 2023 Bioelectromagnetics Society. This article has been contributed to by U.S. Government employees and their work is in the public domain in the USA.

Evaluation of Viral Inactivation on Dry Surface by High Peak Power Microwave (HPPM) Exposure.

Previous research has shown that virus infectivity can be dramatically reduced by radio frequency exposure in the gigahertz (GHz) frequency range. Given the worldwide SARS-CoV-2 pandemic, which has caused over 1 million deaths and has had a profound global economic impact, there is a need for a noninvasive technology that can reduce the transmission of virus among humans. RF is a potential wide area-of-effect viral decontamination technology that could be used in hospital rooms where patients are expelling virus, in grocery and convenience stores where local populations mix, and in first responder settings where rapid medical response spans many potentially infected locations within hours. In this study, we used bovine coronavirus (BCoV) as a surrogate of SARS-CoV-2 and exposed it to high peak power microwave (HPPM) pulses at four narrowband frequencies: 2.8, 5.6, 8.5, and 9.3 GHz. Exposures consisted of 2 µs pulses delivered at 500 Hz, with pulse counts varied by decades between 1 and 10,000. The peak field intensities (i.e. the instantaneous power density of each pulse) ranged between 0.6 and 6.5 MW/m2 , depending on the microwave frequency. The HPPM exposures were delivered to plastic coverslips containing BCoV dried on the surface. Hemagglutination (HA) and cytopathic effect analyses were performed 6 days after inoculation of host cells to assess viral infectivity. No change in viral infectivity was seen with increasing dose (pulse number) across the tested frequencies. Under all conditions tested, exposure did not reduce infectivity more than 1.0 log10. For the conditions studied, high peak power pulsed RF exposures in the 2-10 GHz range appear ineffective as a virucidal approach for hard surface decontamination. © 2023 Bioelectromagnetics Society.

Temperature Dynamics in Rat Brains Exposed to Near-Field Waveguide Outputs at 2.8 GHz.

Biological effects in the microwave band of the radiofrequency (RF) spectrum are thermally mediated. For acute high-power microwave exposures, these effects will depend on transient time-temperature histories within the tissue. In this article, we summarize the transient temperature response of rats exposed to RF energy emanating from an open-ended rectangular waveguide. These exposures produced specific absorption rates of approximately 36 and 203 W/kg in the whole body and brain, respectively. We then use the experimentally measured thermal data to infer the baseline perfusion rate in the brain and modify a custom thermal modeling tool based upon these findings. Finally, we compare multi-physics simulations of rat brain temperature against empirical measurements in both live and euthanized subjects and find close agreement between model and experimentation. This research revealed that baseline brain perfusion rates in rat subjects could be larger than previously assumed in the RF thermal modeling literature, and plays a significant role in the transient thermal response to high-power microwave exposures. © 2021 Bioelectromagnetics Society.

HIV-Tat Exacerbates the Actions of Atazanavir, Efavirenz, and Ritonavir on Cardiac Ryanodine Receptor (RyR2).

The incidence of sudden cardiac death (SCD) in people living with HIV infection (PLWH), especially those with inadequate viral suppression, is high and the reasons for this remain incompletely characterized. The timely opening and closing of type 2 ryanodine receptor (RyR2) is critical for ensuring rhythmic cardiac contraction-relaxation cycles, and the disruption of these processes can elicit Ca2+ waves, ventricular arrhythmias, and SCD. Herein, we show that the HIV protein Tat (HIV-Tat: 0-52 ng/mL) and therapeutic levels of the antiretroviral drugs atazanavir (ATV: 0-25,344 ng/mL), efavirenz (EFV: 0-11,376 ng/mL), and ritonavir (RTV: 0-25,956 ng/mL) bind to and modulate the opening and closing of RyR2. Abacavir (0-14,315 ng/mL), bictegravir (0-22,469 ng/mL), Rilpivirine (0-14,360 ng/mL), and tenofovir disoproxil fumarate (0-18,321 ng/mL) did not alter [3H]ryanodine binding to RyR2. Pretreating RyR2 with low HIV-Tat (14 ng/mL) potentiated the abilities of ATV and RTV to bind to open RyR2 and enhanced their ability to bind to EFV to close RyR2. In silico molecular docking using a Schrodinger Prime protein-protein docking algorithm identified three thermodynamically favored interacting sites for HIV-Tat on RyR2. The most favored site resides between amino acids (AA) 1702-1963; the second favored site resides between AA 467-1465, and the third site resides between AA 201-1816. Collectively, these new data show that HIV-Tat, ATV, EFV, and RTV can bind to and modulate the activity of RyR2 and that HIV-Tat can exacerbate the actions of ATV, EFV, and RTV on RyR2. Whether the modulation of RyR2 by these agents increases the risk of arrhythmias and SCD remains to be explored.

COVID-19 and social distancing measures in Queensland, Australia, are associated with short-term decreases in recorded violent crime.

Objectives: The objective of this study is to test whether recorded rates of violent crime declined in the context of social distancing regulations in Queensland, Australia. Methods: ARIMA modeling was used to compute 6-month-ahead forecasts of rates for common assault, serious assault, sexual offenses, and breaches of domestic violence orders. These forecasts (and their 95% confidence intervals) are compared to the observed data for March and April 2020. Results: By the end of April, 2020, rates of common, serious, and sexual assault had declined to their lowest level in a number of years. For serious assault and sexual assault, the decline was beyond statistical expectations. The rate at which domestic violence orders were breached remained unchanged. Conclusions: Social distancing regulations are temporally correlated with reductions in some violent crimes. Social distancing is likely to have significantly limited interpersonal interaction, especially in locations and at times when violence is usually prevalent.

Delayed access to feed alters gene expression associated with hormonal signaling, cellular differentiation, and protein metabolism in muscle of newly hatch chicks.

Birds rely solely on utilization of the yolk sac as a means of nutritional support throughout embryogenesis and early post-hatch, before first feeding occurs. Newly hatched broiler (meat-type) chickens are frequently not given immediate access to feed, and this can result in numerous alterations to developmental processes, including those that occur in muscle. The objective of this study was to characterize the gene expression profile of newly hatched chicks' breast muscle with regards to hormonal regulation of growth and metabolism and development and differentiation of muscle tissue, and determine impacts of delayed access to feed on these profiles. Within 3 h of hatch, birds were placed in battery pens and given immediate access to feed (Fed) or delayed access to feed for 48 h (Delayed Fed). Breast muscle collected from male birds at hatch, or 4 h, 1 day (D), 2D, 4D, and 8D after hatch was used for analysis of mRNA expression by reverse transcription-quantitative PCR. Under fully fed conditions, insulin-like growth factor receptor and leptin receptor mRNA expression decreased as birds aged; however, delayed access to feed resulted in prolonged upregulation of these genes so their mRNA levels were higher in Delayed Fed birds at 2D. These expression profiles suggest that delayed feed access alters sensitivity to hormones that may regulate muscle development. Myogenin, a muscle differentiation factor, showed increasing mRNA expression in Fed birds through 2D, after which expression decreased. A similar expression pattern in Delayed Fed birds was deferred until 4D. Levels of myostatin, a negative regulator of muscle growth, increased in Fed birds starting at 2D, while levels in Delayed Fed birds began to increase at 4D. In Fed birds, levels of transcripts for two genes associated with protein catabolism, F-box protein 32 and forkhead box O3, were lower at 2D, while Delayed Fed mRNA levels did not decrease until 4D. Mechanistic target of rapamycin mRNA levels decreased from 1D through 8D in both treatments, except for a transient increase in the Delayed Fed birds between 1D and 2D. These data suggest that within breast muscle, delayed feeding alters hormonal signaling, interrupts tissue differentiation, postpones onset of growth, and may lead to increased protein catabolism. Together, these processes could ultimately contribute to a reduction in proper growth and development of birds not given feed immediately after hatch, and ultimately hinder the long-term potential of muscle accretion in meat type birds.

Delayed access to feed alters expression of genes associated with carbohydrate and amino acid utilization in newly hatched broiler chicks.

Newly hatched chicks must transition from lipid-rich yolk to carbohydrate-rich feed as their primary nutrient source, and posthatch delays in access to feed can have long-term negative consequences on growth and metabolism. In this study, impacts of delayed access to feed at hatch on expression of genes related to nutrient uptake and utilization in two metabolically important tissues, liver and muscle, were determined in broiler (meat-type) chickens. Hatched chicks were given access to feed within 3 h (fed) or delayed access to feed for 48 h (delayed fed), and liver and breast muscle were collected from males at hatch and 4 h, 1 day, 2 days, 4 days, and 8 days posthatch for analysis of gene expression. Differential expression of carbohydrate response element-binding protein and peroxisome proliferator-activated receptor-γ in muscle and liver was observed, with results indicating a transitional delay from lipid to carbohydrate metabolism when hatched chicks were not given immediate access to feed. Extended upregulation of insulin receptor mRNA was observed in both tissues in delayed fed birds, suggesting increased sensitivity to circulating levels of the hormone. Developmental delays in expression patterns of cationic amino acid transporters 1 and 2 in both tissues and large neutral amino acid transporter 1 in muscle were also apparent when immediate feed access was prevented. These data suggest that delayed transition to carbohydrate use and altered nutrient transport and utilization within liver and breast muscle are key factors negatively affecting growth and metabolism following delayed feed access in broiler chickens.

Management of severe chronic pain with methadone in pediatric patients with sickle cell disease.

Vasocclusive pain crises are common among pediatric patients with sickle cell disease (SCD). Some patients with repeated pain crises develop chronic pain. We performed a retrospective cohort study of pediatric patients with SCD with chronic pain treated with methadone. We identified a significant reduction in pain hospitalizations following methadone treatment (0.35 ± 0.19 vs. 0.19 ± 0.17 hospitalizations/month, P = 0.016). In addition, we did not observe overt organ toxicity nor symptoms of opioid withdrawal during methadone wean. We suggest that methadone is safe and has some clinical benefit, which should be proven in prospective randomized trials for pediatric patients with SCD and chronic pain.

Impact of early analgesia on hospitalization outcomes for sickle cell pain crisis.

BACKGROUND: Painful events are the leading cause of hospitalizations for patients with sickle cell disease. Individualized pain plans targeting patient-specific maximum opioid dosing may shorten hospitalization length and are recommended by national guidelines. Prior to implementing individualized sickle cell pain plans, we tested the hypothesis that a shorter time to achieve a maximum opioid dose would improve hospitalization outcomes. PROCEDURE: Two-year IRB-approved, retrospective study of pediatric patients admitted for vaso-occlusive crisis (VOC). We recorded the emergency department admission time, order entry time for the maximum opioid dose during the hospitalization, and time of discharge orders.  We categorized patients as infrequent if they required <3 admissions for VOC over two years and patients as frequent if they required ≥3 admissions for VOC over two years. To account for multiple admissions, generalized linear modeling was performed. RESULTS: We identified 236 admissions for acute pain observed in 108 patients. Achieving an earlier maximum opioid dose was significantly associated with shorter length of hospitalization for frequent and infrequent pain patients (both P ≤ 0.0001). As total hospitalization length can be impacted by the time a maximum opioid order was placed, we also analyzed hospitalization length after the maximum opioid order was placed. Frequent pain patients who achieved earlier analgesia had a significantly shorter hospitalization from the time the maximum opioid order was placed (P = 0.03) while no association was found for infrequent pain patients (P = 0.84). CONCLUSIONS: Early achievement of maximum analgesia improved hospitalization outcomes and warrant further investigation in prospective studies of individualized pain plans.

Author Correction to: Dynamic Scheduling for Veterans Health Administration Patients Using Geospatial Dynamic Overbooking.

The original version of this article unfortunately contained a mistake. The name of Matthew Gerber was incorrectly spelled as Mathew Gerber. The correct spelling is now presented correctly in this correction article.

Dynamic Scheduling for Veterans Health Administration Patients using Geospatial Dynamic Overbooking.

The Veterans Health Administration (VHA) is plagued by abnormally high no-show and cancellation rates that reduce the productivity and efficiency of its medical outpatient clinics. We address this issue by developing a dynamic scheduling system that utilizes mobile computing via geo-location data to estimate the likelihood of a patient arriving on time for a scheduled appointment. These likelihoods are used to update the clinic's schedule in real time. When a patient's arrival probability falls below a given threshold, the patient's appointment is canceled. This appointment is immediately reassigned to another patient drawn from a pool of patients who are actively seeking an appointment. The replacement patients are prioritized using their arrival probability. Real-world data were not available for this study, so synthetic patient data were generated to test the feasibility of the design. The method for predicting the arrival probability was verified on a real set of taxicab data. This study demonstrates that dynamic scheduling using geo-location data can reduce the number of unused appointments with minimal risk of double booking resulting from incorrect predictions. We acknowledge that there could be privacy concerns with regards to government possession of one's location and offer strategies for alleviating these concerns in our conclusion.

Distribution of α-Gustducin and Vimentin in premature and mature taste buds in chickens.

The sensory organs for taste in chickens (Gallus sp.) are taste buds in the oral epithelium of the palate, base of the oral cavity, and posterior tongue. Although there is not a pan-taste cell marker that labels all chicken taste bud cells, α-Gustducin and Vimentin each label a subpopulation of taste bud cells. In the present study, we used both α-Gustducin and Vimentin to further characterize chicken taste buds at the embryonic and post-hatching stages (E17-P5). We found that both α-Gustducin and Vimentin label distinct and overlapping populations of, but not all, taste bud cells. A-Gustducin immunosignals were observed as early as E18 and were consistently distributed in early and mature taste buds in embryos and hatchlings. Vimentin immunoreactivity was initially sparse at the embryonic stages then became apparent in taste buds after hatch. In hatchlings, α-Gustducin and Vimentin immunosignals largely co-localized in taste buds. A small subset of taste bud cells were labeled by either α-Gustducin or Vimentin or were not labeled. Importantly, each of the markers was observed in all of the examined taste buds. Our data suggest that the early onset of α-Gustducin in taste buds might be important for enabling chickens to respond to taste stimuli immediately after hatch and that distinctive population of taste bud cells that are labeled by different molecular markers might represent different cell types or different phases of taste bud cells. Additionally, α-Gustducin and Vimentin can potentially be used as molecular markers of all chicken taste buds in whole mount tissue.

Massive localized lymphedema: a clinicopathologic study of 46 patients with an enrichment for multiplicity.

Massive localized lymphedema is a monstrous tumefactive pseudosarcoma seen in middle-aged morbidly obese adults. Since its initial description in 1998, the etiology remains unknown, although associations with trauma, surgeries, and hypothyroidism have been reported. Herein, we report the largest study of massive localized lymphedema and expand upon its clinicopathologic features. Fifty-four cases from 46 patients were retrospectively identified from the institutional archives of The Ohio State University Wexner Medical Center between 2002 and 2015. Forty-six patients (21 males and 25 females, mean age 50 years) presented with large masses developing over a 5-60-month period. The majority of patients were Caucasian (n=39). All patients were obese with a mean weight of 384.7 lb and a mean body mass index of 59.6 kg/m(2). Thirty-six patients had a history of atherosclerotic cardiovascular disease and diabetes mellitus type 2 was present in 22 patients. Eight patients had multifocal massive localized lymphedema. The sites included thigh (n=33), abdomen (n=17), suprapubic region (n=1), mons pubis (n=6), scrotum (n=2), perianal region (n=1), and right flank (n=1). Mostly, the clinical impression was benign processes, including pannus or lymphedema pseudotumor. Grossly, the mean weight was 8237 g and the mean size was 53.2 cm. Histologically, eight cases showed a unique pattern of dystrophic calcifications mimicking hyperchromatic, atypical nuclei that might lead to misdiagnosis of liposarcoma, four cases showed focal metaplastic ossification, and three cases showed multinucleated cells in addition to prototypic features of massive localized lymphedema. We report that this is the largest series of massive localized lymphedema. This is a lesion mostly seen in morbidly obese patients and the thigh is the most common site of involvement. We note a marked racial predilection for Caucasians and a tendency towards multiplicity. We suggest that obesity itself and the related metabolic syndrome have an important role in its pathogenesis.

Cellular effects of acute exposure to high peak power microwave systems: Morphology and toxicology.

Electric fields produced by advanced pulsed microwave transmitter technology now readily exceed the Institute of Electrical and Electronic Engineers (IEEE) C.95.1 peak E-field limit of 100 kV/m, highlighting a need for scientific validation of such a specific limit. Toward this goal, we exposed Jurkat Clone E-6 human lymphocyte preparations to 20 high peak power microwave (HPPM) pulses (120 ns duration) with a mean peak amplitude of 2.3 MV/m and standard deviation of 0.1 with the electric field at cells predicted to range from 0.46 to 2.7 MV/m, well in excess of current standard limit. We observed that membrane integrity and cell morphology remained unchanged 4 h after exposure and cell survival 24 h after exposure was not statistically different from sham exposure or control samples. Using flow cytometry to analyze membrane disruption and morphological changes per exposed cell, no changes were observed in HPPM-exposed samples. Current IEEE C95.1-2005 standards for pulsed radiofrequency exposure limits peak electric field to 100 kV/m for pulses shorter than 100 ms [IEEE (1995) PC95.1-Standard for Safety Levels with Respect to Human Exposure to Electric, Magnetic and Electromagnetic Fields, 0 Hz to 300 GHz, Institute of Electrical and Electronic Engineers: Piscataway, NJ, USA]. This may impose large exclusion zones that limit HPPM technology use. In this study, we offer evidence that maximum permissible exposure of 100 kV/m for peak electric field may be unnecessarily restrictive for HPPM devices. Bioelectromagnetics. 37:141-151, 2016. © 2016 Wiley Periodicals, Inc.

Recovery resources and psychiatric severity among persons with substance use disorders.

A comparative analysis of recovery resources (abstinence social support, abstinence self-efficacy) was conducted among two groups exiting inpatient treatment for substance use disorders: persons with psychiatric comorbid substance use disorders and persons with substance use disorders. Both groups reported comparable levels of abstinence social support, but this resource was not significantly related to substance use among persons with psychiatric comorbid substance use disorders. Although abstinence self-efficacy was significantly related to substance use, persons with psychiatric comorbid substance use disorders reported significantly lower levels of abstinence self-efficacy than persons with substance use disorders. Findings suggest that persons with psychiatric comorbid substance use disorders exit alcohol/drug treatment with lower levels of abstinence self-efficacy compared to their substance use disorder peers.

Free-Living and Particle-Associated Bacterioplankton in Large Rivers of the Mississippi River Basin Demonstrate Biogeographic Patterns.

The different drainage basins of large rivers such as the Mississippi River represent interesting systems in which to study patterns in freshwater microbial biogeography. Spatial variability in bacterioplankton communities in six major rivers (the Upper Mississippi, Missouri, Illinois, Ohio, Tennessee, and Arkansas) of the Mississippi River Basin was characterized using Ion Torrent 16S rRNA amplicon sequencing. When all systems were combined, particle-associated (>3 µm) bacterial assemblages were found to be different from free-living bacterioplankton in terms of overall community structure, partly because of differences in the proportional abundance of sequences affiliated with major bacterial lineages (Alphaproteobacteria, Cyanobacteria, and Planctomycetes). Both particle-associated and free-living communities ordinated by river system, a pattern that was apparent even after rare sequences or those affiliated with Cyanobacteria were removed from the analyses. Ordination of samples by river system correlated with environmental characteristics of each river, such as nutrient status and turbidity. Communities in the Upper Mississippi and the Missouri and in the Ohio and the Tennessee, pairs of rivers that join each other, contained similar taxa in terms of presence-absence data but differed in the proportional abundance of major lineages. The most common sequence types detected in particle-associated communities were picocyanobacteria in the Synechococcus/Prochlorococcus/Cyanobium (Syn/Pro) clade, while free-living communities also contained a high proportion of LD12 (SAR11/Pelagibacter)-like Alphaproteobacteria. This research shows that while different tributaries of large river systems such as the Mississippi River harbor distinct bacterioplankton communities, there is also microhabitat variation such as that between free-living and particle-associated assemblages.

Valence explains how and why positive affects and negative affects correlate: A conceptual replication and extension of Diener et al.'s (1995) the personality structure of affect.

Diener et al. (1995) used a multimethod approach to test a hierarchical model of trait affect. The model suggests that specific trait affects are related to each other by two, distinct, but negatively correlated factors. We report the results of a conceptual replication study that addressed several limitations of Diener et al.'s (1995) study. We used three ethnically diverse samples which included a group of undergraduates along with both of their biological parents. As such, in terms of generalizability, we improved upon the original study which was limited to a student sample by also including middle-aged adults as targets. Most importantly, we included measures of hedonic tone to validate the interpretation of the higher-order factors as positive affect and negative affect. Also, we did not average informant ratings to model individual rating biases. Further, we used item-level indicators rather than item averages as indicators of basic affects. Our results confirm Diener et al.'s (1995) model and demonstrate that positive trait affect and negative trait affect are negatively correlated and account for the covariance among specific affects. We discuss the implications of these results in the context of personality theories that consider positive trait affect and negative trait affect as independent factors related to extraversion and neuroticism, respectively (Costa & McCrae, 1980). We argue that this model cannot account for the negative correlation between positive affect and negative affect and that further research is needed to locate affect within the Big Five model of personality. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Substance use treatment completion and criminal justice system contact in Chile: A retrospective, linked data cohort study.

BACKGROUND AND AIMS: Substance use treatment (SUT) has shown to be effective in reducing self-reported offending; however, the association between SUT completion and criminal justice system (CJS) contact has been underexplored, especially in Latin America. This study aimed to estimate the association between SUT completion status and (1) any subsequent CJS contact and (2) CJS contact leading to imprisonment, at 1, 3 and 5 years post-discharge, in Chile. DESIGN: Retrospective cohort study using multivariable survival analysis based on linked administrative data from 2010 to 2019. SETTING: This study took place in Chile, where SUT is available at no cost through Chile's publicly funded health-care, and is provided in outpatient and inpatient modalities in public and private centres. PARTICIPANTS: A total of 70 854 individuals received their first SUT from 2010 to 2019. They were mainly males (76.3%), and their main substance used at admission was cocaine paste (39.2%). MEASUREMENTS: SUT completion status included completion, late dropout (≥ 3 months) and early dropout (< 3 months). Outcomes were (1) any CJS contact and (2) CJS contact leading to imprisonment after baseline treatment. We estimated the association between treatment completion and CJS contact through flexible parametric Royston-Parmar models while adjusting for several covariates. FINDINGS: Those who completed SUT (27.2%) were less likely to have any CJS contact at 5 years post-SUT compared with those who dropped out late [with a gap of -9.5%, 95% confidence interval (CI) = -8.7, -10.3] and early (-11.2%, 95% CI = -10.1, -12.3). Also, those who completed SUT were less likely to have CJS contact leading to imprisonment at 5 years post-SUT compared with those who dropped out late (-2.6%, 95% CI = -2.2, -3.1) and early (-4.0%, 95% CI = -3.3, -4.6). These differences were also observed at 1 and 3 years post-SUT for each outcome. CONCLUSIONS: In Chile, completion of substance use treatment appears to be associated with lower probabilities of both any criminal justice system contact and contact leading to imprisonment.