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Late preterm newborns often require treatment with potent drugs. Drug disposition is inadequately studied in this population, but when studied it is usually immature compared with that of term newborns. This immaturity reflects biologic immaturity and can be analyzed systematically according to the principal steps in pharmacokinetics: absorption, distribution, metabolism, and elimination. When studied developmentally, drug disposition often does not mature linearly with age, nor necessarily in predictable or generalizable patterns. Instead, more detailed study of specific pathways of drug disposition is needed in the late preterm newborn to support safe and effective drug therapy. Copyright © 2006 by Elsevier Inc. [ABSTRACT FROM AUTHOR]

Introduction: The human epidermal growth factor receptor 2 (HER2)-targeted therapies trastuzumab (T) and lapatinib (L) show high efficacy in patients with HER2-positive breast cancer, but resistance is prevalent. Here we investigate resistance mechanisms to each drug alone, or to their combination using a large panel of HER2-positive cell lines made resistant to these drugs.Methods: Response to L + T treatment was characterized in a panel of 13 HER2-positive cell lines to identify lines that were de novo resistant. Acquired resistant lines were then established by long-term exposure to increasing drug concentrations. Levels and activity of HER2 and estrogen receptor (ER) pathways were determined by qRT-PCR, immunohistochemistry, and immunoblotting assays. Cell growth, proliferation, and apoptosis in parental cells and resistant derivatives were assessed in response to inhibition of HER or ER pathways, either pharmacologically (L, T, L + T, or fulvestrant) or by using siRNAs. Efficacy of combined endocrine and anti-HER2 therapies was studied in vivo using UACC-812 xenografts.Results: ER or its downstream products increased in four out of the five ER+/HER2+ lines, and was evident in one of the two intrinsically resistant lines. In UACC-812 and BT474 parental and resistant derivatives, HER2 inhibition by T reactivated HER network activity to promote resistance. T-resistant lines remained sensitive to HER2 inhibition by either L or HER2 siRNA. With more complete HER2 blockade, resistance to L-containing regimens required the activation of a redundant survival pathway, ER, which was up-regulated and promoted survival via various Bcl2 family members. These L- and L + T-resistant lines were responsive to fulvestrant and to ER siRNA. However, after prolonged treatment with L, but not L + T, BT474 cells switched from depending on ER as a survival pathway, to relying again on the HER network (increased HER2, HER3, and receptor ligands) to overcome L's effects. The combination of endocrine and L + T HER2-targeted therapies achieved complete tumor regression and prevented development of resistance in UACC-812 xenografts.Conclusions: Combined L + T treatment provides a more complete and stable inhibition of the HER network. With sustained HER2 inhibition, ER functions as a key escape/survival pathway in ER-positive/HER2-positive cells. Complete blockade of the HER network, together with ER inhibition, may provide optimal therapy in selected patients. [ABSTRACT FROM AUTHOR]

Pharmacologic study is needed in the extremely immature newborns who currently survive. Study is needed of both the drug treatment previously established in more mature neonates and of novel drug therapy. Carefully controlled studies are needed to identify accurately both beneficial and harmful drug therapy and the mechanisms of that toxicity. Careful pharmacologic study of drug disposition and its mechanisms might lead to dosing paradigms or patient selection that minimize toxicity and maximize efficacy. In vivo, translational models of neonatal diseases are limited, but can be used to identify novel treatments and study mechanisms of established, successful therapy. Findings from such studies can generate hypotheses for study in humans leading to a continuing scientific interchange from bedside to bench to bedside. Similarly, clinical observations can generate hypotheses for study in translational models where more invasive analyses are possible. Specific areas of drug treatment should focus on neonatal disorders with long-term, adverse outcomes, such as chronic lung disease, that is amenable to translational study with animal models. National data show a progressive decrease in the clinician-scientist pool entering biomedical research. The future of neonatal pharmacology studies requires an increase in training programs for the physician-scientist whose clinical education in neonatology can be complemented by rigorous basic-science training. Success as a clinician-scientist will require collaboration with full-time basic scientists who can continue studies during periods of clinical work and provide critical study methodology to the overall study design. Such a work environment must be supported by academic institutions and may require more flexibility in the promotion and tenure schedule and process, such as the nature of what it rewards. To complement this, the NIH could modify its grant reporting process to identify co-investigators in studies who may provide unique input to the study concepts and design, such as clinical correlations or clinical investigations.Journal of Perinatology (2006) 26, S8-S12. doi:10.1038/sj.jp.7211423. [ABSTRACT FROM AUTHOR]

Medical educational opportunities and resources are considerably limited in the developing world. The expansion of computing and Internet access means that there exists a potential to provide education to students through distance learning programmes. This study investigated the feasibility of providing distance learning course in surgery in Malawi. The study investigated the user requirements, technical requirements and Internet connections in two teaching hospitals in Malawi. In addition the appropriateness of current course material from the Edinburgh Surgical Sciences Qualification to Malawi trainees was assessed. The study found a high degree of interest from Malawian trainees in distance learning. The provision of basic science modules such as anatomy and physiology and the ability to access journals were considered highly desirable. The current ESSQ course would require extensive re-modelling to make it suitable to an African trainee's requirements. Internet speeds remain slow and access is currently expensive. There is considerable interest in distance learning programmes in Malawi but access to them is limited partly because of slow and expensive Internet access. Understanding the needs of trainees in countries such as Malawi will allow better direction of educational aid and resources to support surgical training. [ABSTRACT FROM AUTHOR]

Introduction: The COVID-19 pandemic impacted young people's drinking. Yet, despite social gatherings posing a known risk for increased contraction, some college students still congregated to drink. Furthermore, some students posted about these drinking events to their public and/or private social media feeds. It is crucial to understand the relationships between posting alcohol-related content (ARC), drinking and adherence to COVID-19 recommendations because they may have contributed to the spread of the virus., Methods: The current interval contingent, 14-day diary study assessed students' (N = 129) public and private ARC; their drinking; percentage of time wearing a mask and social distancing; and number of people they socialised with during drinking events (total crowd size) each day., Results: Multilevel structural equation modelling was employed to examine relationships between ARC posting, drinking and behavioural outcomes. On days in which students posted both public and private ARC, they tended to drink more and in turn, reported attending gatherings with larger crowds. Curiously, on days in which students drank more, they indicated more mask wearing and social distancing, and on days in which students posted more private ARC, they also reported larger crowds. Finally, an indirect effect of drinking on the links between public and private ARC and mask wearing, social distancing and total crowd sizes emerged., Discussion and Conclusions: Findings revealed students continued to post and drink socially despite the risks, which may have encouraged others within their networks to engage in similar risky behaviours. Future public health crises should balance young people's need for social connection with risk mitigation efforts., (© 2024 Australasian Professional Society on Alcohol and other Drugs.)

Objective: Research among young adults (YA), in samples of majority White college students, indicates links between posting about alcohol on social media and self-reported drinking behavior. We sought to extend this work by examining unique associations between public versus private posting about alcohol and the high-risk outcome of alcohol-related blackouts among a sample of racially/ethnically diverse YA not in 4-year college., Method: A sample of 499 participants (ages 18-29; 52.5% female; 37.5% Black/African American, 26.9% White, 25.3% Hispanic/Latinx) completed an online survey about social media use and drinking behavior., Results: Across three platforms (Instagram, TikTok, Twitter [now known as "X"]), public posting on Instagram was most common. Adjusting for covariates, a higher frequency of private posting about alcohol was associated with a higher frequency of past-month blackouts. Tests of simple effects of posting on blackouts within racial/ethnic subgroups indicated that private posting about alcohol was significantly associated with past-month blackouts only among those who most strongly identified as Black/African American or White but not among those who most strongly identified as Hispanic/Latinx. Further, public posting was significantly associated with past-month blackouts, though the association was specific to White participants., Conclusions: Whether posting about alcohol may be useful in identifying risky drinking behavior may depend on racial/ethnic identification as well as whether private or public posting is being considered. Results have implications for eventual online interventions, which can identify individuals potentially at risk for hazardous drinking based on their social media posting behavior. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Objectives: The purpose of the current study is to examine college student status (international vs. domestic) across alcohol social norms perception., Methods: Undergraduates ( n  = 3081) were recruited for the study. Most participants were female (69.9%) and White (98.2%), with the average age of participants was 19.97 ( SD  = 1.61). Approximately 17.3% ( n  = 534) of the students were international (i.e., nonresident alien who are in the US for a bachelor's degree). It is a cross-sectional study., Results: International students reported significantly lower social norms than domestic students. International students in later college years reported norms closer to domestic students. International women endorsed social norms at a higher level than international men., Conclusions: Assimilation into U.S. drinking culture may be linked with increased support of drinking norms among International students. This study shows the importance of incorporating drinking norms prevention strategy and cultural diversity awareness training to increase international students' knowledge and prevent misconceptions. International students' social norms should be examined for future drinking interventions. Interventions for college drinking should target specific events and context with short-term increase in hazardous drinking behavior but long-lasting effects.

Sexual decision making is often grounded in social scripts that can be detrimental to women's healthy relationship and sexual development during the transition to college. Little is known about the malleable decision-making processes and drinking behaviors that influence sexual behaviors from day-to-day. We examined whether women were more likely to engage in sexual behaviors on days they had higher intentions and willingness to engage in sex or drink alcohol. We also explored interactions between sex- and alcohol-related decision constructs. Eighty-two first-year college women completed 14-days of ecological momentary assessment, reporting on alcohol- and sex-related intentions and willingness (3x daily) and daily drinking and sexual behaviors. We found partial support for our hypotheses: intentions and willingness to have sex were positively associated with sex behaviors, but willingness to drink was negatively associated with sex behaviors. Heavy drinking was associated with sexual behavior, even when women indicated no prior willingness to engage in sexual behavior on those days. Findings highlight the need to address event-level variability in sexual decision making, with a particular focus on how alcohol impacts these processes. Further, the robust association between sexual intentions and behavior suggests intention setting may be a particularly useful sexual empowerment education tool.

The onset of the pandemic saw shifts in messaging around the acceptability of alcohol consumption at different times and contexts. A psychometric analysis of responses to injunctive norms may reveal important differences in specific aspects of norms that were influenced by the pandemic. Study 1 used alignment analysis to evaluate measurement invariance in low- and high-risk injunctive norms across samples of Midwestern college students from 2019 to 2021. Study 2 used an alignment-within-confirmatory factor analysis (CFA) approach to replicate the solution from Study 1 in an independent longitudinal sample ( N = 1,148) who responded between 2019 and 2021. For Study 1, the latent mean for high-risk norms was significantly higher in 2021, and the endorsement of four specific norms also differed. In Study 2, increases in latent means for low- and high-risk norms were observed across 2020 and 2021, and differential endorsement emerged for one high-risk norm item. Examining scale-level changes in injunctive drinking norms provides insight into how college students' perceptions changed in response to the COVID-19 pandemic., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Introduction: Risky alcohol use patterns, characterized by heavy episodic drinking (HED) and alcohol-induced blackout, are prevalent in college students. However, it is not clear if experiencing HED and blackout among college-attending cannabis users heightens risk for adverse cannabis use consequences. The purpose of this study was to examine whether heavy episodic drinking and blackout episodes moderate the relationship between cannabis consumption and cannabis use consequences among college students., Methods: Undergraduate college students ( n = 4331) were recruited from a Midwest University in 2021. This analysis used a subset of data from past 6-month cannabis users ( n = 772; 17.8% of the full sample). Among cannabis users, 64.5% identified as female and 87.8% were White with an average age of 19.99 ( SD =2.88). A linear regression was conducted with two two-way interactions of cannabis consumption and HED frequency as well as cannabis consumption and alcohol-induced blackout episodes., Results: Results showed a statistically significant positive association between cannabis consumption and cannabis use consequences (B=0.73, p <.001), adjusting for the other variables in the model. Blackout, but not HED, was a significant moderator (B=0.19, p =.003)., Discussion: The findings of this study indicate that blackout experiences amplify the relationship between cannabis use and cannabis-related consequences among college students. This underscores that blackouts not only signal a risk of problematic drinking but also exacerbate the association between cannabis use and its negative consequences., Conclusion: Findings may inform college campus interventions targeting cannabis and alcohol concurrent-users who experience alcohol-induced blackouts to reduce their additional risk for cannabis-related consequences., Competing Interests: The authors declare no conflicts of interest., (© 2023 Authors et al.)

College student-athletes represent a high-risk group for heavy alcohol consumption and negative alcohol-related consequences. Although college drinking correlates with access to low-cost alcohol, no study has examined demand, or the relationship between price and consumption, in student-athletes. Furthermore, the prevalence of anxiety, depression, and drinking to cope motives in student-athletes suggest athlete-specific risks of alcohol consumption that have not yet been examined in conjunction with demand. Therefore, the present study examined gender differences in alcohol demand, alcohol consumption, and anxiety and depressive symptoms in student-athletes ( n = 118) and nonathletes ( n = 78) at three colleges/universities. Participants completed the Alcohol Purchase Task and measures of alcohol-related behaviors and mental health. Observed demand indices including intensity (i.e., consumption at zero price), O max (i.e., maximum expenditure), P max (i.e., price associated with O max ), and breakpoint-1, or BP₁ (i.e., highest price of nonzero consumption) were calculated at the individual level. The rate of change in demand elasticity (i.e., decrease in consumption relative to price increases) was calculated at the group level. Overall, students reported lower alcohol consumption at higher alcohol prices, but men reported higher alcohol consumption and demand intensity than women, student-athletes reported higher O max than nonathletes, and student-athletes reported lower depressive symptoms than nonathletes. These findings support reducing access to low-cost alcohol in college drinking environments as a harm-reduction strategy, particularly for high-risk student populations, such as men and those involved in athletics. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Objective: Combined alcohol and disordered eating (drunkorexia) are alcohol fueled weight management behaviors. Mindfulness negatively relates to both disordered eating and alcohol use. Participants: Participants ( n  = 344, average age 20) were primarily female (85.2%, n  = 293), and Caucasian (82.6%, n  = 284). Methods: Students reported drunkorexia and mindfulness. Results: Drunkorexia behaviors were negatively correlated with Acting with Awareness (AA; full attention to a present moment; r = -.21, p <  .001) and Nonjudgment (NJ; understanding and leniency toward oneself; r = -.22, p  < .001). Drunkorexia motivations are significantly correlated with AA ( r = -.13, p =  .01) and NJ ( r = -.18 , p =  .001). Structural equation modeling revealed higher levels of NJ related to higher levels of drunkorexia. Conclusion: The objective was to determine a potential relationship between drunkorexia behaviors and motivations, and trait mindfulness. Findings suggest a nonjudgmental disposition relates to lower levels of drunkorexia.

Background: Links between alcohol-induced blackouts and sexual assault (SA) are understudied. We tested whether: (1) history of blackouts, past 30-day blackouts, and past 30-day blackout intentions would be higher among women with histories of SA relative to women without; (2) baseline history of blackouts, past 30-day blackouts, and blackout intentions would predict an increase in SA severity (i.e., a continuous variable that considers SA tactic type and assault frequency) at a one-year follow-up. Methods: 1721 undergraduate women completed a baseline survey and 313 completed the follow-up. Results: Women with SA history had 2.10 higher odds of history of blackouts, 1.47 higher odds of past 30-day blackout during "one" drinking episode, 1.78 higher odds of blackout during a "few" drinking episodes, 3.21 higher odds of blackout during "most/all" drinking episodes, and 1.54 higher odds of blackout intentions in the last 30-days. Longitudinally, history of blackouts and past 30-day blackouts at baseline were associated with an increase in SA severity at follow-up, when peak drinks were not controlled. Conclusion: Longitudinal findings provide some evidence that lifetime history of blackouts and past 30-day blackouts are significant predictors of an increase in SA severity at follow-up and therefore an essential target for interventions.

Transition metal-catalyzed, non-enzymatic nitrene transfer (NT) reactions to selectively transform C-H and C=C bonds to new C-N bonds are a powerful strategy to streamline the preparation of valuable amine building blocks. However, many catalysts for these reactions use environmentally unfriendly solvents that include dichloromethane, chloroform, 1,2-dichloroethane and benzene. We developed a high-throughput experimentation (HTE) protocol for heterogeneous NT reaction mixtures to enable rapid screening of a broad range of solvents for this chemistry. Coupled with the American Chemical Society Pharmaceutical Roundtable (ACSPR) solvent tool, we identified several attractive replacements for chlorinated solvents. Selected catalysts for NT were compared and contrasted using our HTE protocol, including silver supported by N-dentate ligands, dinuclear Rh complexes and Fe/Mn phthalocyanine catalysts., (© 2023 Wiley-VCH GmbH.)

Introduction: Frequent exposure to peer-shared alcohol-related content (ARC) on social media is associated with greater alcohol consumption and related consequences among undergraduates. Social media influencers also share ARC; yet, the effect of exposure to influencer-shared ARC on alcohol outcomes has not been examined. The current study examined whether following influencers who share ARC and the frequency of sharing were associated with alcohol outcomes, and associations between influencer type (e.g., actors) and alcohol outcomes., Methods: Undergraduates (N = 528) from two universities in the United States completed an online survey assessing demographics, social media use, alcohol use and related consequences. They listed up to five influencers they followed and viewed the most content from. A series of linear regression models were conducted., Results: Having a larger proportion of influencers sharing ARC was associated with greater quantity, frequency and peak drinks, but not consequences. Frequency of influencers sharing ARC was associated with greater quantity and peak drinks, but not frequency or consequences. Findings remained significant, even after controlling for peer ARC. Actor ARC, everyday person ARC and 'other' type influencer ARC were associated with several alcohol outcomes., Discussion and Conclusions: This study added to the literature by examining how following influencers who share ARC, and sharing frequency, were associated with drinking outcomes over and above exposure to peer ARC. It also examined whether ARC content from specific types of influencers was associated with alcohol outcomes. Findings highlight that the source of ARC is relevant when studying the effects of ARC exposure on college drinking., (© 2023 Australasian Professional Society on Alcohol and other Drugs.)

Objective: Excessive alcohol consumption and its consequences among college women continues despite prevention efforts. One common consequence, alcohol-related blackouts (ARBs), are periods of alcohol-activated anterograde amnesia. The purpose of the current project is to extend the ARB and drinking motive literature by examining their relationship over time., Method: A sample of 424 women (88.9% White) completed online surveys assessing their ARBs and drinking motives weekly for 10 weeks. A series of hierarchical generalized linear models were estimated to examine the between-person and within-person effects of each drinking motive on repeated measures of experiencing a blackout across the time points., Results: Women who report higher levels of drinking motives compared with others were more likely to report having blackout experiences. College women who reported higher levels of conformity motives did not have increased odds of experiencing a blackout. In weeks when they reported elevated levels of drinking motives, they were also more likely to experience an ARB., Conclusions: In general, college women who reported higher levels of social, coping, or enhancement motives experienced more blackouts than students who reported lower levels of these motives. Women who were underage were more likely to experience a blackout compared with women who were 21 or older. In a given week, 52.6% to 70.7% of the students consumed alcohol, and among women who drank in a given week, the prevalence of blackouts ranged from 8.5% to 14.6%. The results suggest that changes in motivational levels might provide a possible intervention point for ARBs risk.

Introduction: Alcohol-related content (ARC) on social media and drinking motives impact college students' drinking. Most studies have examined peer-generated ARC on drinking outcomes but have yet to extend this relationship to other sources of influence. The current study explores the link between drinking motives, alcohol company ARC, celebrity ARC, and alcohol-related problems among college students., Methods: Students (N = 454) from two US universities completed a cross-sectional online survey assessing demographics; drinking motives (Drinking Motives Questionnaire-Revised; Cooper, Psychol Assess. 1994;6:117-28); following/awareness of alcohol company ARC; engagement with celebrity ARC; peak drinks (most drinks consumed on one occasion); and alcohol-related problems (e.g., passed out)., Results: Greater celebrity ARC was linked to coping, enhancement, and conformity motives, and peak drinks. Frequent engagement with celebrity ARC was associated with higher problems. Positive indirect effects were observed from celebrity ARC to problems through coping and conformity motives, and peak drinks. After having adjusted for the influence of celebrity ARC, no significant pathways were found between alcohol company ARC and any of the drinking motives, peak drinks or problems, nor were there any indirect effects between alcohol company ARC and problems., Discussion and Conclusions: Results revealed that a possible explanation for why students who engaged with celebrity ARC experience problems was due to coping and conformity motives as well as peak drinks. Interventions targeting alcohol cognitions might assess engagement with and exposure to different sources of ARC given their potential to influence problems., (© 2023 Australasian Professional Society on Alcohol and other Drugs.)

This Report Updates Previous Cdc Guidelines and Recommendations on Preferred Prevention and Treatment Regimens Regarding Naturally Occurring Anthrax. Also Provided Are a Wide Range of Alternative Regimens to First-Line Antimicrobial Drugs for Use If Patients Have Contraindications or Intolerances or After a Wide-Area Aerosol Release of: Bacillus anthracis spores if resources become limited or a multidrug-resistant B. anthracis strain is used (Hendricks KA, Wright ME, Shadomy SV, et al.; Workgroup on Anthrax Clinical Guidelines. Centers for Disease Control and Prevention expert panel meetings on prevention and treatment of anthrax in adults. Emerg Infect Dis 2014;20:e130687; Meaney-Delman D, Rasmussen SA, Beigi RH, et al. Prophylaxis and treatment of anthrax in pregnant women. Obstet Gynecol 2013;122:885-900; Bradley JS, Peacock G, Krug SE, et al. Pediatric anthrax clinical management. Pediatrics 2014;133:e1411-36). Specifically, this report updates antimicrobial drug and antitoxin use for both postexposure prophylaxis (PEP) and treatment from these previous guidelines best practices and is based on systematic reviews of the literature regarding 1) in vitro antimicrobial drug activity against B. anthracis; 2) in vivo antimicrobial drug efficacy for PEP and treatment; 3) in vivo and human antitoxin efficacy for PEP, treatment, or both; and 4) human survival after antimicrobial drug PEP and treatment of localized anthrax, systemic anthrax, and anthrax meningitis., Changes From Previous Cdc Guidelines and Recommendations Include an Expanded List of Alternative Antimicrobial Drugs to Use When First-Line Antimicrobial Drugs Are Contraindicated or Not Tolerated or After a Bioterrorism Event When First-Line Antimicrobial Drugs Are Depleted or Ineffective Against a Genetically Engineered Resistant: B. anthracis strain. In addition, these updated guidelines include new recommendations regarding special considerations for the diagnosis and treatment of anthrax meningitis, including comorbid, social, and clinical predictors of anthrax meningitis. The previously published CDC guidelines and recommendations described potentially beneficial critical care measures and clinical assessment tools and procedures for persons with anthrax, which have not changed and are not addressed in this update. In addition, no changes were made to the Advisory Committee on Immunization Practices recommendations for use of anthrax vaccine (Bower WA, Schiffer J, Atmar RL, et al. Use of anthrax vaccine in the United States: recommendations of the Advisory Committee on Immunization Practices, 2019. MMWR Recomm Rep 2019;68[No. RR-4]:1-14). The updated guidelines in this report can be used by health care providers to prevent and treat anthrax and guide emergency preparedness officials and planners as they develop and update plans for a wide-area aerosol release of B. anthracis., Competing Interests: All authors have completed and submitted the International Committee of Medical Journal Editors form for disclosure of potential conflicts of interest. CDC and contributors to this work disclose that they have no financial interests or other relationships with the manufacturers of commercial products, suppliers of commercial services, or commercial supporters that would unfairly influence these CDC recommendations with the following exceptions: Arthur Friedlander reports funding from the U.S. Department of Defense Threat Reduction Agency for research on anthrax vaccines and therapeutics. However, none of the vaccines or therapeutics were discussed for inclusion in the guidelines. Adolf W. Karchmer receives an honorarium for service on the data and safety monitoring board (tofacitinib) for Pfizer. Todd Semla’s spouse owns stock in Abbott. Both Pfizer and Abbott manufacture antimicrobial drugs included in the guidelines. No other potential conflicts of interest were disclosed.

College drinkers commonly report blacking out (i.e., alcohol-induced amnesia), and those who drink with the intention to blackout are at risk for harmful consequences. Drunkorexia (i.e., restriction of calories on planned drinking days) is a high-risk behavior potentially associated with blacking out. Informed by the Theory of Planned Behavior (TPB), this study explores blackout experiences and intentions to blackout association with drunkorexia. College students (n = 2335) who primarily identified as female and White participated via an online survey. Participants received a $3 coupon for completion of the study. Consistent with the literature, 40% and 60.7% of participants reported experiencing blackouts and drunkorexia, respectively, in the last year. Informed by the TPB, a structural equation model assessed whether more frequent blackout experiences (IV) were related to drunkorexia behaviors (DV1) and alcohol behaviors (DV2), and whether there was a significant indirect effect through blackout intention. The model fit the data well (CFI = .98, TLI = .95), which suggests that more frequent blackout experiences relate to more drunkorexia experiences (R 2  = .04) and higher levels of alcohol consumption (R 2  = .44). In addition, the relationship between blackout experiences and drunkorexia flows through intentions to blackout (i.e., a significant indirect effect). Findings are consistent with TPB, which suggests that intentions predict health behavior. Future interventions should consider modifying intentions and other possible TPB constructs to minimize high-risk alcohol consumption and drunkorexia behaviors., (Published by Elsevier Inc.)

Background: Numerous reports contend opioids can augment or inhibit malignancy. At present, there is no consensus on the risk or benefit posed by opioids on malignancy or chemotherapeutic activity. Distinguishing the consequences of opioid use from pain and its management is challenging. Additionally, opioid concentration data is often lacking in clinical studies. A scoping review approach inclusive of preclinical and clinical data will improve our understanding of the risk-benefit relationship concerning commonly prescribed opioids and cancer and cancer treatment., Objective: The aim of the study is to map diverse studies spanning from preclinical to clinical regarding opioids with malignancy and its treatment., Methods: This scoping review will use the Arksey six stages framework to (1) identify the research question; (2) identify relevant studies; (3) select studies meeting criteria; (4) extract and chart data; (5) collate, summarize, and report results; and (6) conduct expert consultation. An initial pilot study was undertaken to (1) parameterize the extent and scale of existing data for an evidence review, (2) identify key factors to be extracted in systematic charting efforts, and (3) assess opioid concentration as a variable for its relevance to the central hypothesis. Six databases will be searched with no filters: MEDLINE, Embase, CINAHL Complete, Cochrane Library, Biological Sciences Collection, and International Pharmaceutical Abstracts. Trial registries will include ClinicalTrials.gov, Cochrane CENTRAL, International Standard Randomised Controlled Trial Number Registry, European Union Clinical Trials Register, and World Health Organization International Clinical Trials Registry. Eligibility criteria will include preclinical and clinical study data on opioids effects on tumor growth or survival, or alteration on the antineoplastic activity of chemotherapeutics. We will chart data on (1) opioid concentration from human subjects with cancer, yielding a "physiologic range" to better interpret available preclinical data; (2) patterns of opioid exposure with disease and treatment-related patient outcomes; and (3) the influence of opioids on cancer cell survival, as well as opioid-related changes to cancer cell susceptibility for chemotherapeutics., Results: This scoping review will present results in narrative forms as well as with the use of tables and diagrams. Initiated in February 2021 at the University of Utah, this protocol is anticipated to generate a scoping review by August 2023. The results of the scoping review will be disseminated through scientific conference proceedings and presentations, stakeholder meetings, and by publication in a peer-reviewed journal., Conclusions: The findings of this scoping review will provide a comprehensive description of the consequences of prescription opioids on malignancy and its treatment. By incorporating preclinical and clinical data, this scoping review will invite novel comparisons across study types that could inform new basic, translational, and clinical studies regarding risks and benefits of opioid use among patients with cancer., International Registered Report Identifier (irrid): PRR1-10.2196/38167., (©Jonathan E Constance, Mary M McFarland, Tallie Casucci, Michael W Deininger, Elena Y Enioutina, Kathleen Job, Richard S Lemons, Carol S Lim, Robert M Ward, Venkata Yellepeddi, Kevin M Watt. Originally published in JMIR Research Protocols (https://www.researchprotocols.org), 22.05.2023.)

Food and alcohol disturbance (FAD; restricting caloric intake before, during, or after drinking to either offset calories or to increase intoxication) is common among college students and poses a threat to students' health. In conjunction, sexual minority (SM; i.e., not exclusively heterosexual) college students may be at increased risk of engaging in alcohol misuse and disordered eating compared to their heterosexual peers due to exposure to minority stress. However, little research has examined whether engagement in FAD differs by SM status. Body esteem (BE) is an important resilience factor among SMs that may influence SM students' risk of participating in FAD. Therefore, the aim of the present study was to understand the association between SM status and FAD with additional interest in BE as a moderating factor. Participants were 459 college students who engaged in past 30-day binge drinking. Most participants identified as White (66.7 %), female (78.4 %), heterosexual (69.3 %), with a mean age of 19.60 (SD = 1.54) years. Participants completed two surveys (3 weeks apart) over the course of an academic semester. Analyses revealed a significant interaction between SM status and BE, such that SMs with lower BE (T1) reported more engagement in FAD-intoxication (T2), whereas SMs with higher BE (T1) reported less engagement in FAD-calories (T2) and FAD-intoxication (T2) than their heterosexual peers. Stressors associated with body esteem may contribute to increased FAD engagement among SM students. Consequently, BE may be an especially important target for interventions aimed at reducing FAD among SM college students., Competing Interests: Declaration of competing interest The authors do not have any conflicts of interest to disclose., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Prescription drug use is prevalent during pregnancy, yet there is limited knowledge about maternal-fetal safety and efficacy of this drug use because pregnant individuals have historically been excluded from clinical trials. Underrepresentation has resulted in a lack of data available to estimate or predict fetal drug exposure. Approaches to study fetal drug pharmacology are limited and must be evaluated for feasibility and accuracy. Anatomic and physiological changes throughout pregnancy fluctuate based on gestational age and can affect drug pharmacokinetics (PK) for both mother and fetus. Drug concentrations have been studied throughout different stages of gestation and at or following delivery in tissue and fluid biospecimens. Sampling amniotic fluid, umbilical cord blood, placental tissue, meconium, umbilical cord tissue, and neonatal hair present surrogate options to quantify and characterize fetal drug exposure. These sampling methods can be applied to all therapeutics including small molecule drugs, large molecule drugs, conjugated nanoparticles, and chemical exposures. Alternative approaches to determine PK have been explored, including physiologically based PK modeling, in vitro methods, and traditional animal models. These alternative approaches along with convenience sampling of tissue or fluid biospecimens can address challenges in studying maternal-fetal pharmacology. In this narrative review, we 1) present an overview of the current understanding of maternal-fetal drug exposure; 2) discuss biospecimen-guided sampling design and methods for measuring fetal drug concentrations throughout gestation; and 3) propose methods for advancing pharmacology research in the maternal-fetal population., Competing Interests: We declare that EE and KJ are Associate Editors for the Obstetric and Pediatric Pharmacology section of Frontiers in Pharmacology. We declare that CS is a Specialty Chief Editor in Frontiers Obstetric and Pediatric Pharmacology for the Frontiers in Pharmacology Journal. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Hudson, Metz, Ward, McKnite, Enioutina, Sherwin, Watt and Job.)

Campus sexual assault (CSA) research predominately focuses on the victimization experiences of domestic college students. Therefore, there is little knowledge on, and understanding of, international student's CSA victimization experiences. The present study analyzed results from a campus climate survey conducted in 2018 at a midsized Midwestern university. Twenty-three percent of international women and 18% of international men reported being a CSA victim. A series of analyses then compared CSA victimizations in relation to international victims vs. international nonvictims and international victims vs. domestic victims. Results showed international victims vs. international nonvictims were more likely to be a sexual minority and be a member of a sorority or fraternity. Compared with domestic women, international women were more likely to report being non-victims. Compared with domestic men, international men were more likely to report being CSA victims. Results are discussed in relation to research on CSA and propose future directions of study., (© Copyright 2023 Springer Publishing Company, LLC.)

Competing Interests: Disclosure. The author declares no conflicts.

Introduction: Posting and viewing of alcohol-related content to social media is prevalent among college students and is related to problematic drinking. However, the cognitive self-presentation and self-monitoring processes behind users' alcohol-related content posts to different platforms are largely unknown., Methods: Through in-depth, qualitative interviews with college students (n = 15) who drink heavily and post alcohol-related content regularly, we developed the Alcohol Self-Presentation Model., Results: Using a multi-step thematic analysis approach, the themes of protectiveness and acquisitiveness emerged; these themes served as the basis of our model. In total, three protectiveness (perceived permanence of the content, privacy and reputation concerns) factors and four acquisitiveness (provocative, impulsive, high-status, maintaining relevance and connections) factors were derived., Discussion and Conclusions: Our model delineated the alcohol self-presentations which allowed participants to demonstrate disparate versions of themselves to certain social media audiences. Our results illuminated that what people identify as being alcohol-related content, and what motivates the individual to post alcohol-related content, are essential to better comprehending how their alcohol-related content uniquely contributes to their drinking. Understanding students' alcohol self-presentations is important since their alcohol-related content may be putting themselves, and others, at-risk by perpetuating patterns of frequent posting and heavy drinking within the network. Our model may inform future behavioural interventions targeting the reduction of drinking among young people who are active on social media., (© 2022 Australasian Professional Society on Alcohol and other Drugs.)

Microplastic transfer between horseshoe crabs (Limulus polyphemus) and migratory shorebirds through consumption of crab eggs was examined in Jamaica Bay, New York. Fertilized and unfertilized crab eggs, shorebird fecal pellets, beach sand, and bay water were processed with a hydrogen peroxide solution to remove organic material, then stained with a Nile Red to identify microplastics using fluorescence microscopy. Microplastics were present in all samples and ranged from approximately26-1300 μm. Unfertilized and fertilized eggs contained significantly higher numbers of microplastic particles per gram than shorebird fecal pellets, beach sand, and bay water. The presence of microplastics in unfertilized egg samples indicates that microplastics undergo maternal transfer during oogenesis. We estimated that 1 g of horseshoe crab eggs could contain approximately 426 to 840 microplastic particles, suggesting that shorebirds feeding on this resource could be ingesting a substantial burden of microplastics during their migratory stopover, much of which appears to be retained by shorebirds, rather than being eliminated in their fecal pellets., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

Social networking sites (SNSs) are popular among college-aged adults. The defining characteristic of SNSs is that they are a platform to electronically share content. Most students report posting alcohol-related content (ARC) on SNSs. Little is known concerning these students who consume both alcohol and ARC yet choose not to generate ARC., Objective: The purpose of the current study was to compare key characteristics of posters and non-posters and develop a measure assessing reasons for not posting ARC., Method: The researchers recruited a diverse sample of 1063 college students from two universities for an online study., Results: Relative to posters of ARC, non-posters tend to drink less, have fewer alcohol-related problems, and report fewer reasons for drinking. Non-posters also report viewing several positive and negative consequences of drinking on SNSs, but at lower levels than ARC posters. The Reasons Not to Post ARC Scale was correlated with common alcohol measures (drinking motives, drinking problems) and self-monitoring. The scale was not correlated with some other measures (posting and sharing alcohol-related content)., Conclusions: Given the dominant echo chamber effects of ARC on SNSs, examining non-posters can provide insight into the cognitions that might prevent others from joining the ARC social media culture., (Copyright © 2022 Elsevier Inc. All rights reserved.)

Clinical pharmacology is a branch of the field of pharmacology that evolved following the recognition that the nature, duration, and intensity of drug action depend on both the intrinsic properties of the drug and an interaction with the host to whom the drug is given. Advances in drug development have placed highly specific and extremely potent therapeutic agents in the marketplace. While these advances have progressed rapidly in adult medicine, pediatric clinical pharmacology has not kept pace and until very recently has lagged behind the research and attention paid to the proper use of therapeutic and diagnostic drugs in adults. Recognition that advances in the science of developmental pharmacology and pediatric clinical pharmacology were essential in the development of new drugs to treat children came in the 1950s and 1960s mostly through the work of 2 pioneering scientists in fetal and perinatal clinical pharmacology, Drs Sumner Yaffe and Bernard Mirkin. Here we pay a tribute to these most influential pioneers in the United States who were instrumental in paving the path for advancing the field of fetal and perinatal pharmacology concepts and their incorporation into pediatric drug development programs., (© 2022 American College of Clinical Pharmacology. This article has been contributed to by U.S. Government employees and their work is in the public domain in the USA.)

Objective: Electronic nicotine delivery system (ENDS) use on college campuses increased dramatically in recent years. Little is known about how ENDS use among college students relates to other substance use. Participants: Undergraduates ( n  = 3,917) at a mid-sized Midwestern public university in the United States. Methods: Cross-sectional survey data and latent class analysis of ENDS, cigarettes, alcohol, marijuana, and non-medical use of attention-deficit/hyperactivity disorder (ADHD) medication. Results: Over 95% of ENDS users fit into one of two classes comprising a minority of college students engaged in multiple and often problematic substance use behaviors. Only 4% of ENDS users were grouped into a class comprising 85% of the sample and characterized by either little/no substance use or moderate alcohol consumption. Conclusions : ENDS use in this sample was not indicative of general exploration with substances, nor was it indicative of isolated tobacco use, but rather more heavy and problematic substance use.

Objective: Examine whether exercise and diet motivation are associated with 4 biomarkers related to cardiovascular disease., Design: Cross-sectional analysis. Data collection involved questionnaires, blood draws, body composition assessments, and accelerometry., Setting: Small, midwestern college town., Participants: Community older adults (≥ 58 years of age; n = 79) recruited through convenience sampling; the sample was representative of the population of interest for some demographic characteristics (eg, age and sex) but not representative of other characteristics (eg, level of activity)., Variables Measured: Independent variables comprised self-reported intrinsic exercise motivation (Behavioral Regulation for Exercise Questionnaire-3) and intuitive eating (Intuitive Eating Scale-2). Dependent variables included inflammatory proteins (C-reactive protein and interleukin-6) and lipid levels (low-density lipoprotein/high-density lipoprotein and triglycerides) quantified from blood samples. Covariates included age, body mass index, sex, and objective physical activity measured by accelerometers worn for 7 days., Analysis: Multiple linear regression was used to assess the association between diet and exercise motivation and biomarker outcomes; we analyzed 4 regression models (1 for each biomarker). Significance level P < 0.05., Results: Greater intuitive eating was associated with a lower low-density lipoprotein/high-density lipoprotein ratio (β = -0.45, P = 0.001) and lower triglycerides (β = -0.37, P = 0.003). Intrinsic exercise motivation was not associated with the biomarkers., Conclusions and Implications: Intuitive eating may be a key determinant of certain biomarkers and could be a viable target for interventions to help decrease the risk of cardiovascular disease among older adults., (Copyright © 2022 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.)

Background: Comprehensive measures to evaluate the effectiveness of medical interventions in extremely preterm infants are lacking. Although length of stay is used as an indicator of overall health among preterm infants in clinical studies, it is confounded by nonmedical factors (e.g. parental readiness and availability of home nursing support)., Objectives: To develop the PREMature Infant Index (PREMII ™ ), an electronic content-valid clinician-reported outcome measure for assessing functional status of extremely preterm infants (<28 weeks gestational age) serially over time in the neonatal intensive care unit. We report the development stages of the PREMII, including suggestions for scoring., Methods: We developed the PREMII according to US Food and Drug Administration regulatory standards. Development included five stages: (1) literature review, (2) clinical expert interviews, (3) Delphi panel survey, (4) development of items/levels, and (5) cognitive interviews/usability testing. Scoring approaches were explored via an online clinician survey., Results: Key factors reflective of functional status were identified by physicians and nurses during development of the PREMII, as were levels within each factor to assess functional status. The resulting PREMII evaluates eight infant health factors: respiratory support, oxygen administration, apnea, bradycardia, desaturation, thermoregulation, feeding, and weight gain, each scored with three to six gradations. Factor levels are standardized on a 0-100 scale; resultant scores are 0-100. No usability issues were identified. The online clinician survey identified optimal scoring methods to capture functional status at a given time point., Conclusions: Our findings support the content validity and usability of the PREMII as a multifunction outcome measure to assess functional status over time in extremely preterm infants. Psychometric validation is ongoing.

This study examined the interrelationship of intimate partner violence (IPV), sexual assault (SA), and eating disorder (ED) symptomatology among a sample of college students ( n = 1,580). Students reporting a history of SA were 2.5 times more likely to screen positively for further ED assessment. A history of IPV also increased odds of having a positive ED screener. The model showed that 6% of the variance in ED symptomatology was explained by IPV and SA. Results did not differ based on gender. This study furthers our understanding of the relationship between IPV, SA, and ED to guide future prevention and treatment efforts. Specifically, the use of trauma-informed ED treatment could assist with full ED recovery and other comorbid mental health conditions., (© Copyright 2022 Springer Publishing Company, LLC.)

Background: Alcohol use varies throughout the year and often peaks on weekends or during celebrations (e.g., New Year's). There is not a perfect correlation between alcohol use and negative consequences, and the extent to which one particularly risky consequence-an alcohol-related blackout-is more common during certain times of the year is unknown. Identifying when blackouts occur may help identify which periods are associated with more risk and be critical in designing public health campaigns. Thus, we examined Twitter data to ascertain whether alcohol-related blackouts occur more during certain holidays/celebrations than typical weekends and whether they differed in timing from general alcohol-related Tweets., Methods: We used a Twitter-sponsored platform to access unique Tweets written in the United States referencing blackouts (e.g., "blackout") and alcohol generally (e.g., "drunk")., Results: The final dataset included 3.5 million blackout Tweets and 591 million alcohol Tweets (written between 2009 and 2020). Both blackout and alcohol Tweets were written in the late evening, on weekends, and during certain holidays (New Years, St. Patrick's). However, relative to typical weekends, only blackout Tweets were more common during Thanksgiving and only general alcohol-related Tweets were more common during Cinco de Mayo., Conclusion: While blackout and alcohol-related Tweets were similar in time of day (peaking in the evening) and day of week (peaking on weekends), they differed during certain celebrations/holidays, suggesting that while alcohol use may be more common during some celebrations, others are more associated with serious harms., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Background: The vast majority of adolescents and young adults are active on social networking sites (SNSs). SNSs are influential, risk-conducive environments for alcohol use among adolescents and young adults. Specifically, posting or sharing alcohol-related content (ARC) is associated with higher levels of alcohol use. However, it is unknown if sharing different types of ARC associates differentially with alcohol use and consequences. Objective: The goal of the current project was to develop a measure of the likelihood of posting key types of ARC posted by adolescents and young adults and to examine their associations with SNS use patterns and actual alcohol-related behavior. Method: Participants were 15-20 years of age ( n  = 306; 46.7% male; 56.6% Caucasian/White; 27.0% Asian) who completed a battery of self-report measures. Results: Results from an exploratory factor analysis revealed four types of ARC: (1) self and friend consumption, (2) memes and viral photos, (3) status updates: others' drinking and consequences, and (4) pictures: others' drinking and consequences. Conclusions: Participants' likelihood of posting self and Friend Consumption was significantly associated with heightened Snapchat use, typical drinks per week, peak drinking, and negative drinking consequences. Whereas youth appear to share more readily alcohol-related viral posts and memes, it seems that the sharing of ARC that is specifically related to the participants' own use or friends' use is salient concerning alcohol use and problems. Therefore, interventions might consider sending targeted prevention messages to individuals who share certain types of ARC which are more associated with problematic alcohol behaviors.

Background: There are anecdotal reports on reversible QTc prolongation during therapeutic hypothermia (TH) for moderate to severe neonatal encephalopathy after asphyxia. As the QTc interval is a relevant biomarker for pharmacovigilance during medication development, a structured search and review on published neonatal QTc values to generate reference values is warranted to facilate medication development in this specific population., Methods: A structured search and literature assessment (PubMed, Embase, and Google Scholar) with 'Newborn/Infant, QT and hypothermia' was conducted (October 2021). Retrieved individual values were converted to QTc (Bazett) over postnatal age (day 1-7)., Results: We retrieved 94 QTc intervals (during TH (n = 50, until day 3) or subsequent normothermia (n = 44, day 4-7)) in 33 neonates from 6 publications. The median (range) of QTc intervals during TH was 508 (430-678), and 410 (317-540) ms afterwards (difference 98 ms, or +28 ms/°C decrease). Four additional cohorts (without individual QTc intervals) confirmed the pattern and magnitude of the effect of body temperature on the QTc interval., Conclusions: We highlighted a relevant non-maturational covariate (°C dependent TH) and generated reference values for the QTc interval in this specific neonatal subpopulation. This knowledge on QTc during TH should be considered and integrated in neonatal medication development.

Objective: "Drunkorexia" or compensatory eating behaviors in response to alcohol consumption, resembles a subclinical eating disorder, and is a current public health concern. Eating disorders and alcohol abuse are associated with dysfunction of the hypothalamic-pituitary-adrenal axis (HPA). One index of HPA function is cortisol. As causes of drunkorexia remain elusive, the present study examined cortisol function as it relates to drunkorexia. Participants: n  = 73 (49 women) college students. Method: Participants provided daytime saliva samples for cortisol analyses prior to completing an online survey measuring alcohol consumption, drunkorexia, and alcohol problems as measured by the Rutgers Alcohol Problem Index (RAPI). Results: Multiple regressions indicated that baseline cortisol significantly positively correlated with drunkorexia behaviors in women but not men. Higher baseline cortisol and aspects of drunkorexia related to alcohol problems. Conclusion: Programs educating about stress management and health risks of drunkorexia may decrease engagement in drunkorexia behaviors among college students.

Radical-mediated trifunctionalizations of allenes are virtually unknown, in contrast to well-studied radical difunctionalizations of alkenes and alkynes. In this article, we describe a light-promoted reaction that transforms all three allene carbons to new carbon-heteroatom bonds in one pot with no expensive transition-metal catalyst. Formation of an electron donor-acceptor complex between an electron-deficient aryl and K 2 CO 3 , followed by photochemical generation of an amidyl radical and cyclization, yields a vinyl radical that can be trapped by TEMPO to ultimately furnish the product. Insights into the impact of the allene substitution pattern, radical source, and donor are presented, along with studies to unravel the mechanism of this unusual transformation.

Introduction and Aims: In October 2020, New Zealanders will vote on whether cannabis should be legalised for recreational use. With this in mind, the aim of the present study is to gauge the views and opinions of the New Zealand population on cannabis via tweets. To achieve this, we conducted a sentiment analysis of all historic cannabis-related tweets and referendum-specific tweets written in New Zealand., Design and Methods: We used a Twitter-sponsored commercial platform to access all historic cannabis-related tweets written in New Zealand and used search terms to remove non-cannabis-related terms. Next, we used the platform's machine learning function to code the sentiment of tweets (i.e. positive/pro-cannabis, negative/anti-cannabis or neutral)., Results: Between July 2009 and August 2020, 304 760 cannabis-related tweets were written in New Zealand. Overall, the tweets were predominantly positive (62.0%) and there was a higher proportion of positive tweets written in 2020 (65.3%) compared to negative or neutral tweets. Similarly, for referendum-specific tweets, the 2020 data reveal a generally positive view of cannabis (53.5%)., Discussion and Conclusions: Both cannabis-related, and referendum-specific tweets, suggest that Twitter users in New Zealand have a generally positive view of cannabis. Given the nature of Twitter, the current method will allow us to study whether views toward cannabis change as the referendum nears and capture any late swings in pro- or anti-cannabis sentiment (abcd-lab.shinyapps.io/cannabis&#95;sentiment/)., (© 2020 Australasian Professional Society on Alcohol and other Drugs.)

Introduction: Graft survival in pediatric kidney transplant patients has increased significantly within the last three decades, correlating with the discovery and utilization of new immunosuppressants as well as improvements in patient care. Despite these developments in graft survival for patients, there is still improvement needed, particularly in long-term care in pediatric patients receiving grafts from deceased donor patients. Maintenance immunosuppressive therapies have narrow therapeutic indices and are associated with high inter-individual and intra-individual variability. Areas covered: In this review, we examine the impact of pharmacokinetic variability on renal transplantation and its association with age, genetic polymorphisms, drug-drug interactions, drug-disease interactions, renal insufficiency, route of administration, and branded versus generic drug formulation. Pharmacodynamics are outlined in terms of the mechanism of action for each immunosuppressant, potential adverse effects, and the utility of pharmacodynamic biomarkers. Expert opinion: Acquiring abetter quantitative understanding of immunosuppressant pharmacokinetics and pharmacodynamic components should help clinicians implement treatment regimens to maintain the balance between therapeutic efficacy and drug-related toxicity.

Objective: Chronic lung disease of prematurity (CLDP) is a frequent complication of prematurity. We aimed to identify what clinicians believe are the most important factors determining the severity of CLDP in extremely preterm infants (<28 weeks gestational age) after discharge from the neonatal intensive care unit (NICU) through 12 months corrected age (CA), and to evaluate how these factors should be weighted for scoring, to develop a CLDP severity scale., Study Design: Clinicians completed a three-round online survey utilizing Delphi methodology. Clinicians rated the importance of various factors used to evaluate the severity of CLDP, from 0 (not at all important) to 10 (very important) for the period between discharge home from the NICU and 12 months CA. Fourteen factors were considered in Round 1; 13 in Rounds 2 and 3. The relative importance of factors was explored via a set of 16 single-profile tasks (i.e., hypothetical patient profiles with varying CLDP severity levels)., Results: Overall, 91 clinicians from 11 countries who were experienced in treating prematurity-related lung diseases completed Round 1; 88 completed Rounds 2 and 3. Based on Round 3, the most important factors in determining CLDP severity were mechanical ventilation (mean absolute importance rating, 8.89), supplemental oxygen ≥2 L/min (8.49), rehospitalizations (7.65), and supplemental oxygen <2 L/min (7.56). Single-profile tasks showed that supplemental oxygen had the greatest impact on profile classification., Conclusion: The most important factors for clinicians assigning CLDP severity during infancy were mechanical ventilation, supplemental oxygen ≥2 L/min, and respiratory-related rehospitalizations., (© 2021 The Authors. Pediatric Pulmonology Published by Wiley Periodicals LLC.)