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Objective For parents with opioid use disorder (OUD) and their children, group well child care (WCC) is an under-studied intervention that may reduce stigma, increase quality of care, and improve clinical outcomes. We explored barriers and facilitators to this intervention using an implementation science framework. Methods A qualitative study was conducted from October 2020-March 2021 as part of the planning phase of a cluster-randomized trial of group WCC. Parent participants were recruited from one urban, university-affiliated OUD treatment center to participate in semi-structured telephone interviews. Eligible parents had a child under two years old and were English speaking. Clinician participants were recruited from a nearby pediatric primary care practice. Inductive thematic analysis of interview responses was led by two investigators using open coding procedures. Results Thirty-one parents and thirteen pediatric clinicians participated in the interviews. Most parents (68%) reported that they would be likely or very likely to bring their child to the OUD treatment center for WCC. Six themes emerged describing perceived implementation barriers, including intervention difficulty, complexity, and potential negative outcomes such as loss of privacy. Six themes emerged as implementation facilitators: (1) focus on parental OUD and recovery, (2) peer support, (3) accessibility and coordination of care, (4) clinician skill and expertise in parental OUD, (5) increased time for patient care, and (6) continuity of care. Conclusions for Practice Parents and clinicians expressed multiple perceived benefits of this intervention. Identified barriers and facilitators will inform implementation and evaluation of group WCC within one OUD treatment program., Author(s): Neera Goyal [sup.1] [sup.2] [sup.5] , Meghan Gannon [sup.3] , Erica Sood [sup.1] [sup.2] , Grace Harris [sup.2] , Elizabeth Franko [sup.2] , Diane J. Abatemarco [sup.3] , Dennis [...]

Nonalcoholic fatty liver disease (NAFLD) is a growing cause of chronic liver disease. Using a proxy NAFLD definition of chronic elevation of alanine aminotransferase (cALT) levels without other liver diseases, we performed a multiancestry genome-wide association study (GWAS) in the Million Veteran Program (MVP) including 90,408 cALT cases and 128,187 controls. Seventy-seven loci exceeded genome-wide significance, including 25 without prior NAFLD or alanine aminotransferase associations, with one additional locus identified in European American-only and two in African American-only analyses (P

We investigated ASD-diagnosed adults' and neurotypical (NT) controls' processing of emoji and emoji influence on the emotionality of otherwise-neutral sentences. Study 1 participants categorised emoji representing the six basic emotions using a fixed-set of emotional adjectives. Results showed that ASD-diagnosed participants' classifications of fearful, sad, and surprised emoji were more diverse and less 'typical' than NT controls' responses. Study 2 participants read emotionally-neutral sentences; half paired with sentence-final happy emoji, half with sad emoji. Participants rated sentence + emoji stimuli for emotional valence. ASD-diagnosed and NT participants rated sentences + happy emoji as equally-positive, however, ASD-diagnosed participants rated sentences + sad emoji as more-negative than NT participants. We must acknowledge differential perceptions and effects of emoji, and emoji-text inter-relationships, when working with neurodiverse stakeholders., Author(s): Christopher J. Hand [sup.1] , Ashley Kennedy [sup.2] , Ruth Filik [sup.3] , Melanie Pitchford [sup.4] , Christopher M. Robus [sup.5] Author Affiliations: (1) grid.8756.c, 0000 0001 2193 314X, [...]

Selecting appropriate buffers is crucial for evaluating the chemical durability of glass under controlled conditions such as in the EPA 1313 test designed to measure elemental release as a function of pH. The efficacy of two alkali-metal free buffers, TRIS (NH2C(CH2OH)3) and ammonium chloride—ammonia (NH3/NH4Cl), was investigated during EPA 1313 testing of a simulated Hanford low-activity waste borosilicate glass in the alkaline regime (pH 8.5–10.5) at varying temperatures (RT, 40 °C, and 60 °C). While both buffers maintained the desired pH at room temperature, and up to 40 °C, the effectiveness of TRIS decreased at elevated temperatures, particularly at pH 10.5. Although 11B NMR showed evidence of TRIS-B complexation, its effect on the rate of elemental release was found to be negligible under the test conditions. With ammonium buffer, the release of alkali cations was slightly elevated when compared to the same conditions with TRIS at early time points. [ABSTRACT FROM AUTHOR]

Objectives: Our study evaluated if rapid inpatient titration of methadone for pregnant patients with opioid use disorder (OUD) improved outcomes without increasing the risk for overdose. Methods: This is a retrospective cohort study of pregnant patients admitted for inpatient methadone titration from January 2020 to June 2022.Outcomeswere compared between standard versus rapid titration protocols. Standard titration involved an initial methadone dose with additional doses every 6 hours if clinical opiate withdrawal score (COWS) is >9. Rapid titration involved an initial methadone dose with additional doses every 4 hours if COWS is >9. The primary outcome was time required to achieve stable dose. Secondary outcomes included elopement prior to achieving stable dose, methadone-related readmission, opioid overdose, and final dose. Results: There were 97 patients in the standard titration (STP) and 97 patients in the rapid titration (RTP) groups. Demographic characteristics and substance use history did not differ between the 2 groups. Time to stable dose did not differ between the 2 groups (RTP, 5.0 days ±4.0; STP, 4.0 days ±3.0; P = 0.08). Patients in the rapid titration group were less likely to elope from the hospital prior to stabilization (RTP 23.0% vs STP 37.9%, P = 0.03) and had fewer methadone-related readmissions (P < 0.001). One patient (1.0%) in the RTP group required naloxone treatment while inpatient for concern for overdose, while none did in the STP group (P = 0.32). There was no difference in median final stable dose between the 2 groups (P = 0.07). Conclusions: Rapid titration of methadone for pregnant patients with OUD was associated with decreased medical elopement and methadone-related readmission, without increasing the risk for overdose. [ABSTRACT FROM AUTHOR]

Studies examining the effect of social isolation on cognitive function typically involve older adults and/or specialist groups (e.g., expeditions). We considered the effects of COVID-19-induced social isolation on cognitive function within a representative sample of the general population. We additionally considered how participants 'shielding' due to underlying health complications, or living alone, performed. We predicted that performance would be poorest under strictest, most-isolating conditions. At five timepoints over 13 weeks, participants (N = 342; aged 18-72 years) completed online tasks measuring attention, memory, decision-making, time-estimation, and learning. Participants indicated their mood as 'lockdown' was eased. Performance typically improved as opportunities for social contact increased. Interactions between participant sub-groups and timepoint demonstrated that performance was shaped by individuals' social isolation levels. Social isolation is linked to cognitive decline in the absence of ageing covariates. The impact of social isolation on cognitive function should be considered when implementing prolonged pandemic-related restrictive conditions.

The influence of domain knowledge on reading behavior has received limited investigation compared to the influence of, for example, context and/or word frequency. The current study tested participants with and without domain knowledge of the "Harry Potter" (HP) universe. Fans and non-fans read sentences containing HP, high-frequency (HF), or low-frequency target-words. Targets were presented in contexts that were supportive or unsupportive within a 2 (group: fans, non-fans) × 3 (context: HP, HF, LF) × 3 (word type: HP, HF, LF) mixed design. Thirty-two fans and 22 non-fans read 72 two-sentence experimental items while eye-movement behavior was recorded: Initial sentences established context; second sentences contained target-words. Fans processed HP words faster than non-fans. No group difference was observed on HF or LF processing durations, suggesting equivalent reading capabilities. In HP contexts, HP and LF targets were processed equivalently. Processing of HF and LF words was facilitated by their supportive context as expected. Non-fans made more regressions into the target region in HP contexts and regressed more into HP targets than other targets; fans regressed into target word regions equivalently across all context and word types. Results suggest that domain knowledge influences early but not immediate lexical access, while the processing effect of novelty was seen in regressive eye movements. These results are more supportive of modular accounts of linguistic processing and serial models of eye movement control. Words without grounding in reality, or true embodiment, were integrated into fans' mental lexicons.