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Music serves as a prevalent emotional regulation tool among young people. However, the correlational and causal relationships between music use, emotion regulation ability, and emotional symptoms remain unclear. This study aimed to investigate the associations and causal relationships between healthy and unhealthy music use, emotion regulation ability, and emotional symptoms, including alexithymia, depression, and anxiety. This study included 16,588 college students nationwide in China. All participants were assessed online with the Healthy‐Unhealthy Music Scale (HUMS), the Regulatory Emotional Self‐Efficacy Scale (RESE), the Toronto Alexithymia Scale (TAS‐20), and the 10‐item Kessler Psychological Stress Scale (K10) using a cluster convenience sampling method. We applied a regularized partial correlation network (RPCN) and Bayesian network to analyze the network characteristics of the outcomes. In the RPCN analysis, healthy music use showed the second strongest expected influence (one‐step) and correlated positively with emotion regulation self‐efficacy while inversely correlating with externally oriented thinking of alexithymia and depression. The Bayesian network indicated that healthy music use was located downstream of the network, positively predicted by managing anger‐irritation and expressing positive affect in emotion regulation self‐efficacy. In contrast, unhealthy music use in the RPCN displayed the strongest bridge strength and bridge expected influence (one‐step). It negatively correlated with expressing positive affect in emotion regulation self‐efficacy and positively correlated with alexithymia, anxiety, and depression. The Bayesian network highlighted that unhealthy music use was positively affected by anxiety, depression, and difficulty identifying feelings. In addition, managing despondency‐distress influences difficulty identifying feelings through depression, subsequently affecting unhealthy music use and, finally, influencing externally oriented thinking. This study provides a novel framework for understanding the role of emotion regulation self‐efficacy and alexithymia in the relationship between music use and emotional symptoms. Emotion regulation and mental health may benefit from music‐based interventions and therapies informed by the findings of this study. [ABSTRACT FROM AUTHOR]

Several commonly used opioid analgesics, such as fentanyl, sufentanil, alfentanil, and hydrocodone, are by report primarily metabolized by the CYP3A4 enzyme. The concurrent use of ritonavir, a potent CYP3A4 inhibitor, can lead to significant drug interactions. Using physiologically based pharmacokinetic (PBPK) modeling and simulation, this study examines the effects of different dosing regimens of ritonavir on the pharmacokinetics of these opioids. The findings reveal that co-administration of ritonavir significantly increases the exposure of fentanyl analogs, with over a 10-fold increase in the exposure of alfentanil and sufentanil when given with ritonavir. Conversely, the effect of ritonavir on fentanyl exposure is modest, likely due to additional metabolism pathways. Additionally, the study demonstrates that the steady-state exposure of hydrocodone and its active metabolite hydromorphone can be increased by up to 87% and 95%, respectively, with concurrent use of ritonavir. The extended-release formulation of hydrocodone is particularly affected. These insights from PBPK modeling provide valuable guidance for optimizing opioid dosing and minimizing the risk of toxicity when used in combination with ritonavir-containing prescriptions. [ABSTRACT FROM AUTHOR]

As the effect of P-glycoprotein (P-gp) transport on antidepressant delivery has been extensively evaluated using in vitro cellular and in vivo rodent models, an increasing number of publications have addressed the effect of P-gp in limiting brain penetration of antidepressants and causing treatment-resistant depression in current clinical therapies. However, contradictory results have been observed in different systems. It is of vital importance to understand the potential for drug interactions related to P-gp at the blood-brain barrier (BBB), and whether coadministration of a P-gp inhibitor together with an antidepressant is a good clinical strategy for dosing of patients with treatment-resistant depression. In this review, the complicated construction of the BBB, the transport mechanisms for compounds that cross the BBB, and the basic characteristics of antidepressants are illustrated. Further, the reliability of different systems related to antidepressant brain delivery, including in vitro bidirectional transport cell lines, in vivo Mdr1 knockout mice, and chemical inhibition studies in rodents are analyzed, supporting a low possibility that P-gp affects currently marketed antidepressants when these results are extrapolated to the human BBB. These findings can also be applied to other central nervous system drugs.

PurposeRecent controversial publications, citing studies purporting to show that P-gp mediates the transport of propranolol, proposed that passive biological membrane transport is negligible. Based on the BDDCS, the extensively metabolized-highly permeable-highly soluble BDDCS class 1 drug, propranolol, shows a high passive permeability at concentrations unrestricted by solubility that can overwhelm any potential transporter effects. Here we reinvestigate the effects of passive diffusion and carrier-mediated transport on S-propranolol.MethodsBidirectional permeability and inhibition of efflux transport studies were carried out in MDCK, MDCK-MDR1 and Caco-2 cell lines at different concentrations. Transcellular permeability studies were conducted at different apical pHs in the rat jejunum Ussing chamber model and PAMPA system.ResultsS-propranolol exhibited efflux ratios lower than 1 in MDCK, MDCK-MDR1 and Caco-2 cells. No significant differences of Papp, B->A in the presence and absence of the efflux inhibitor GG918 were observed. However, an efflux ratio of 3.63 was found at apical pH 6.5 with significant decrease in Papp, A->B and increase in Papp, B->A compared to apical pH 7.4 in Caco-2 cell lines. The pH dependent permeability was confirmed in the Ussing chamber model. S-propranolol flux was unchanged during inhibition by verapamil and rifampin. Furthermore, pH dependent permeability was also observed in the PAMPA system.ConclusionsS-propranolol does not exhibit active transport as proposed previously. The "false" positive efflux ratio can be explained by the pH partition theory. As expected, passive diffusion, but not active transport, plays the primary role in the permeability of the BDDCS class 1 drug propranolol.

Women with substance use disorders (SUDs) are more inclined to use drugs and relapse for regulating emotions compared to men. This study aimed to explore the effects of group music and imagery in alleviating anxiety, depression, emotion regulation difficulties, and craving for women with methamphetamine use disorder (MUD) in a compulsory rehabilitation context. A total of 90 women with MUD were randomly assigned to the music therapy treatment arm (n = 45) or control treatment arm (n = 45). Participants in the music therapy treatment arm received 12 biweekly sessions of group music and imagery (GrpMI) and those in the control treatment arm received 6 weeks of usual care. Anxiety, depression, emotion regulation difficulties, and craving were assessed at pre-test and post-test. After the intervention, participants in the GrpMI group reported significantly greater improvements than those in the control group for state anxiety (F = 6.27; p =.02; Partial η2 =.13), trait anxiety (F = 4.49; p =.04; Partial η2 =.09), depression (F = 5.48; p =.02; Partial η2 =.11), and craving (F = 4.53; p =.04; Partial η2 =.09). There was no significant difference between groups in emotion regulation difficulties (F =.95, p =.34, Partial η2 =.09). GrpMI significantly decreased depression, anxiety, and craving for women with MUD. Emotion regulation ability may need a longer period of treatment for significant improvement. Future studies could add long-term follow-up and compare the effects of group music therapy in women versus men with SUDs. [ABSTRACT FROM AUTHOR]

Objective: To compare the treatment effects of laparoscopy versus laparotomy on heterotopic pregnancy (HP) after in vitro fertilization‐embryo transfer (IVF‐ET). Methods: The retrospective case–control study enrolled 109 patients diagnosed with HP after IVF‐ET treatment in our hospital from January 2009 to March 2020. All patients received surgical treatment by either laparoscopy or laparotomy. Data for general characteristics, diagnostic features, surgical parameters, as well as perinatal and neonatal outcomes were collected. Results: Sixty‐two patients received laparoscopy and 47 received laparotomy. Significantly lower percentage of large hemoperitoneum (P = 0.001), shorter surgery duration (P < 0.001), less intraoperative blood loss (P = 0.001), higher rates of general anesthesia (P < 0.001), and lower cesarean section rates for singletons (P = 0.003) were found in the laparoscopy group. The perinatal and neonatal outcomes were comparable between the two groups. When interstitial pregnancy was considered alone, the surgical blood loss was significantly reduced in the laparoscopy group (P = 0.021), but there was no significant difference in hemoperitoneum, surgery duration, or perinatal and neonatal outcomes in singletons. Conclusion: Both laparoscopy and laparotomy are effective surgical treatments for HP after IVF‐ET. Laparoscopy is minimally invasive but laparotomy can be an alternative in emergency situations. Synopsis: Laparoscopy is an effective, safe and minimally invasive treatment for heterotopic pregnancy after in vitro fertilization and embryo transfer. [ABSTRACT FROM AUTHOR]