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Narcolepsy is mainly associated with excessive daytime sleepiness, but the characteristic feature is abnormal rapid eye movement (REM) sleep phenomena. REM sleep disturbances can manifest as cataplexy (in narcolepsy type 1), sleep paralysis, sleep-related hallucinations, REM sleep behavior disorder, abnormal dreams, polysomnographic evidence of REM sleep disruption with sleep-onset REM periods, and fragmented REM sleep. Characterization of REM sleep and related symptoms facilitates the differentiation of narcolepsy from other central hypersomnolence disorders and aids in distinguishing between narcolepsy types 1 and 2. A circuit comprising regions within the brainstem, forebrain, and hypothalamus is involved in generating and regulating REM sleep, which is influenced by changes in monoamines, acetylcholine, and neuropeptides. REM sleep is associated with brainstem functions, including autonomic control, and REM sleep disturbances may be associated with increased cardiovascular risk. Medications used to treat narcolepsy (and REM-related symptoms of narcolepsy) include stimulants/wake-promoting agents, pitolisant, oxybates, and antidepressants; hypocretin agonists are a potential new class of therapeutics. The role of REM sleep disturbances in narcolepsy remains an area of active research in pathophysiology, symptom management, and treatment. This review summarizes the current understanding of the role of REM sleep and its dysfunction in narcolepsy.

Fentanyl-mixed and substituted heroin is well-documented, but less is known about unintentional fentanyl use among people using stimulants. To determine the prevalence of and racial and ethnic disparities in unintentional fentanyl use among people experiencing a medically attended opioid overdose, we reviewed 448 suspected non-fatal overdose cases attended by a community paramedic overdose response team in San Francisco from June to September 2022. We applied a case definition for opioid overdose to paramedic records and abstracted data on intended substance use prior to overdose. Among events meeting case criteria with data on intended substance use, intentional opioid use was reported by 57.3%, 98.0% of whom intended to use fentanyl. No intentional opioid use was reported by 42.7%, with most intending to use stimulants (72.6%), including methamphetamine and cocaine. No intentional opioid use was reported by 58.5% of Black, 52.4% of Latinx, and 28.8% of White individuals (p = 0.021), and by 57.6% of women and 39.5% of men (p = 0.061). These findings suggest that unintentional fentanyl use among people without opioid tolerance may cause a significant proportion of opioid overdoses in San Francisco. While intentional fentanyl use might be underreported, the magnitude of self-reported unintentional use merits further investigation to confirm this phenomenon, explore mechanisms of use and disparities by race and ethnicity, and deploy targeted overdose prevention interventions.

To determine whether the psychostimulant lisdexamfetamine improves subjective and objective measures of cognitive functioning among women genetically at-risk for cancer who have undergone risk-reducing salpingo-oophorectomy and report new-onset executive functioning difficulties. 69 participants were assigned to a randomized controlled crossover trial with 6-week trials of active medication (lisdexamfetamine) and placebo, separated by a minimum 2-week washout in an intent-to-treat framework (clinical trial registration number: NCT03187353). At trial baseline, midpoint, and endpoint, participants completed a self-report measure of executive functioning (Brown Attention Deficit Disorder Scale). At study baseline and trial endpoint, participants completed sustained attention, attention/working memory, and verbal learning/memory cognitive tasks. Side effects were assessed at 2, 3, 4, and 6 weeks for each trial. From trial baseline to trial endpoint, lisdexamfetamine – relative to placebo – significantly improved total scores on the self-report Brown Attention Deficit Disorder Scale (and scores on four of five subdomains) as well as attention and working memory performance. Significantly more participants endorsed side effects across the lisdexamfetamine trial versus placebo; however, trial completion rates were similar, indicating that lisdexamfetamine was nonetheless well-tolerated. Lisdexamfetamine improved both subjective and objective measures of attention and working memory and could offer women experiencing cognitive difficulties post-risk-reducing salpingo-oophorectomy an alternative therapeutic option. • Lisdexamfetamine was superior to placebo in improving self-reported executive functioning among post-RRSO women. • Lisdexamfetamine was superior to placebo in improving attention and working memory task performance among post-RRSO women. • 82% of participants were treatment responders in the lisdexamfetamine trial versus 46% in the placebo trial. • Lisdexamfetamine was well-tolerated and could be considered as an intervention for new-onset post-RRSO cognitive problems. [ABSTRACT FROM AUTHOR]

Objectives: We aimed to determine the prevalence of self-reported naloxone use during pregnancy among people in the United States with a recent live birth. A secondary objective was to characterize people at increased risk of overdose who did and did not use naloxone. Methods: We analyzed data from the Pregnancy Risk Assessment Monitoring System from 26 US jurisdictions that conducted an opioid supplement survey from2019 to 2020. Respondentswith increased risk of experiencing an opioid overdose were identified based on self-reported use of illicit amphetamines, heroin, cocaine, or receiving medication for opioid use disorder (MOUD) during pregnancy. Weighted prevalence estimates and 95% confidence intervals were calculated for reported naloxone use at any point during pregnancy among people with an increased risk of overdose. Results: Naloxone use during pregnancy was reported by <1% of the overall study population (unweighted N = 88/34,528). Prevalence of naloxone use was 5.0% (95% CI: 0.0--10.6) among respondents who reported illicit amphetamine use, 15.2% (1.8--28.6) among those who reported heroin use, and 17.6% (0.0--38.1) among those who reported cocaine use. Naloxone use was 14.5% (8.4--20.6) among those who reported takingMOUD. Among peoplewith increased risk of overdose, no significant differences in naloxone use were observed by age, race/ethnicity, education level, residential metropolitan status, or insurance status. Conclusions: Prevalence of naloxone use among people with an increased risk of overdose during pregnancy ranged from 5.0% to 17.6%. Access to naloxone, overdose prevention education, and treatment for substance use disorders may help reduce morbidity and mortality. [ABSTRACT FROM AUTHOR]

The diagnosis of pediatric tuberculosis (TB) poses a challenge for clinical teams worldwide. TB-mediated changes in the expression of host genes in the peripheral blood can serve as diagnostic biomarkers and can provide better insights into the host immune mechanisms of childhood TB. Peripheral blood mononuclear cells (PBMCs) from children (n=102) with microbiologically confirmed TB disease, TB infection (TBI), pneumonia, and healthy controls (HC) were stimulated with either the Purified Protein Derivative (PPD) or the Early Secretory Antigen 6kDa-Culture Filtrate Protein 10 (ESAT6-CFP10) complex of Mycobacterium tuberculosis (Mtb). RNA was extracted and quantified using gene expression microarrays. Differential expression analysis was performed comparing microbiologically confirmed TB to the other diagnostic groups for the stimulated and unstimulated samples. Using variable selection, we identified sparse diagnostic gene signatures; one gene (PID1) was able to distinguish TB from pneumonia after ESAT6-CFP10 stimulation with an AUC of 100% in the test set, while a combination of two genes (STAT1 and IFI44) achieved an AUC of 91.7% (CI95% 75.0%-100%) in the test set after PPD stimulation. The number of significantly differentially expressed (SDE) genes was higher when contrasting TB to pneumonia or HC in stimulated samples, compared to unstimulated ones, leading to a larger pool of candidate diagnostic biomarkers. Our approach provides enlightened aspects of peripheral TB-specific responses and can form the basis for a point of care test meeting the World Health Organization (WHO) Target Product Profile (TPP) for pediatric TB. [ABSTRACT FROM AUTHOR]

Evidence from a number of paradigms suggests that methamphetamine use is associated with increased risk for the development of Parkinson's disease and parkinsonism, and that it may be associated with the premature development of Parkinson's disease. Prevalence of Parkinson's disease and parkinsonism is greater in both methamphetamine users and people who previously used methamphetamine, and evidence from animal studies provides a plausible mechanism for this observation. Despite this increased risk, Parkinson's disease is rarely diagnosed in methamphetamine users. Reasons for this may include under‐detection, premature mortality, and individual and substance use characteristics which moderate the risk, including higher rates of smoking. Clinicians should be vigilant to signs and symptoms of Parkinson's disease and parkinsonism in methamphetamine users. [ABSTRACT FROM AUTHOR]

Objectives: Stimulants, such as methylphenidate (MPH) and amphetamines, represent the first-line pharmacological option for attention-deficit/hyperactivity disorder (ADHD). Randomized controlled trials (RCTs) have demonstrated beneficial effects at a group level but could not identify characteristics consistently associated with varying individual response. Thus, more individualized approaches are needed. Experimental studies have suggested that the neurobiological response to a single dose is indicative of longer term response. It is unclear whether this also applies to clinical measures. Methods: We carried out a systematic review of RCTs testing the association between the clinical response to a single dose of stimulants and longer term improvement. Potentially suitable single-dose RCTs were identified from the MED-ADHD data set, the European ADHD Guidelines Group RCT Data set (https://med-adhd.org/), as updated on February 1, 2024. Quality assessment was carried out using the Cochrane Risk of Bias (RoB) 2.0 tool. Results: A total of 63 single-dose RCTs (94% testing MPH, 85% in children) were identified. Among these, only a secondary analysis of an RCT tested the association between acute and longer term clinical response. This showed that the clinical improvement after a single dose of MPH was significantly associated with symptom improvement after a 4-week MPH treatment in 46 children (89% males) with ADHD. The risk of bias was rated as moderate. A further RCT used near-infrared spectroscopy, thus did not meet the inclusion criteria, and reported an association between brain changes under a single-dose and longer term clinical response in 22 children (82% males) with ADHD. The remaining RCTs only reported single-dose effects on neuropsychological, neuroimaging, or neurophysiological measures. Conclusion: This systematic review highlighted an important gap in the current knowledge. Investigating how acute and long-term response may be related can foster our understanding of stimulant mechanism of action and help develop stratification approaches for more tailored treatment strategies. Future studies need to investigate potential age- and sex-related differences. [ABSTRACT FROM AUTHOR]

Methamphetamine is the illicit stimulant of choice in Australia. Countless initiatives have been employed to reduce methamphetamine use and drug‐related harm. Wastewater analysis (WWA) has been used effectively as an objective measure of drug use at a population level and can be compared to indicators of harm, such as the number of drug‐related fatalities. This paper attempts to describe methamphetamine use in the context of changes in levels measured in wastewater in South Australia whilst recognising considerable interventions over an 8‐year period. Validated liquid chromatography–mass spectrometry methods were used to determine methamphetamine (and MDMA) levels in wastewater over an 8‐year interval. The number of drug‐induced deaths and driver fatalities involving methamphetamine (and MDMA) was presented and described in the context of changes in use measured by WWA. A rise in methamphetamine use according to WWA was evident up to 2017, followed by a gradual decrease to 2020 back to 2015 levels. Both driver fatalities and drug‐induced deaths correlated well with use measured by WWA over the 8‐year period. Multiple initiatives to curb supply, distribution and harm within the state and nationally have been implemented. The decrease in methamphetamine use after 2017 suggests that timely interventions have successfully reduced overall drug use and has led to fewer fatalities. This study shows that the response to increasing methamphetamine use in South Australia has resulted in a reversal of the upward trend in consumption and fewer drug‐related fatalities. [ABSTRACT FROM AUTHOR]

Nonmedical use of psychostimulants as cognitive enhancers is increasingly common in young adults, despite studies showing mixed results and health risks, including sleep disturbance and addiction. Given the importance of sleep for complex cognitions, expected outcomes of stimulants for performance should be consider as a function of the reliance of each cognitive domain on 'offline' processes optimized during sleep. Thus, performance on attention and vigilance task may be sustained with stimulants, whereas executive functions, long-term memory, creativity and the like will show no enhancement or even worse performance. Nonmedical use of stimulants is a public health problem. More systematic investigations are needed that thoroughly account for the impact of stimulants on cognitive domains, stages of processing, and the mediating role of sleep disturbance, in the short and long term. Nonmedical use of psychostimulants for cognitive enhancement is widespread and growing in neurotypical individuals, despite mixed scientific evidence of their effectiveness. Sleep benefits cognition, yet the interaction between stimulants, sleep, and cognition in neurotypical adults has received little attention. We propose that one effect of psychostimulants, namely decreased sleep, may play an important and unconsidered role in the effect of stimulants on cognition. We discuss the role of sleep in cognition, the alerting effects of stimulants in the context of sleep loss, and the conflicting findings of stimulants for complex cognitive processes. Finally, we hypothesize that sleep may be one unconsidered factor in the mythology of stimulants as cognitive enhancers and propose a methodological approach to systematically assess this relation. [ABSTRACT FROM AUTHOR]

Despite extensive preclinical research over the years, a significant gap remains in our understanding of the specific effects of methamphetamine (METH) and amphetamine (AMPH) withdrawal. Understanding these differences could be pivotal to unveiling the unique pathophysiology underlying each stimulant. This may facilitate the development of targeted and effective treatment strategies tailored to the specific characteristics of each substance. Following PRISMA guidelines, this systematic review was conducted to examine alterations in spontaneous locomotor activity, specifically horizontal activity, in animals experiencing withdrawal from extended and repeated administration of AMPH or METH. Original articles were retrieved from four electronic databases, supplemented by a review of the references cited in the published papers. A total of thirty-one full-length articles (n = 31) were incorporated in the analysis. The results indicated that six studies documented a significant increase in horizontal activity among animals, seven studies reported decreased locomotion, and eighteen studies (8 AMPH; 10 METH) reported no significant alterations in the animals' locomotor activity. Studies reporting heightened locomotion mainly employed mice undergoing withdrawal from METH, studies reporting diminished locomotion predominantly involved rats undergoing withdrawal from AMPH, and studies reporting no significant changes in horizontal activity employed both rats and mice (12 rats; 6 mice). Drug characteristics, routes of administration, animal models, dosage regimens, duration, and assessment timing seem to influence the observed outcomes. Despite more than 50% of papers enlisted in this review indicate no significant changes in the locomotion during the stimulant withdrawal, the unique reactions of animals to withdrawal from METH and AMPH reported by some underscore the need for a more nuanced understanding of stimulant withdrawal. [ABSTRACT FROM AUTHOR]

Objectives: Nonmedical use (NMU) of stimulants is an increasingly common phenomenon worldwide. Motivated by enhancing academic performance, peer pressure, and seeking pleasure, students in the Middle East are thought to be a high-risk population. This is especially important in times when the political instability in the region facilitates the production and trafficking of such substances. This study aimed to unveil the burden of NMU of stimulants and examine associated correlates among senior high school and university students in Jordan. Methods: We describe a cross-sectional study of senior high school and university students in Jordan assessing NMU of stimulants. Data were collected between January and April of 2022 through a survey, which was distributed online leading to a google forms page. The survey queried sociodemographic characteristics, history of NMU of stimulants, use of other illicit substances, attitudes toward NMU of stimulants, as well as a mental health assessment. Results: A total of 8739 students completed the survey (mean age of 20.40 ± 2.45 years), of which 5.1% reported a lifetime NMU of stimulants. Fenethylline (Captagon) was the most widely reported stimulant (2.6%). Living in the southern region, being diagnosed with a personality disorder, and using concomitant illicit substances were associated with the NMU of stimulants. Conclusions: The NMU of CNS stimulants, especially fenethylline, is prevalent in Jordan. More surveillance ought to be heeded toward the southern borders of Jordan. Students who use stimulants for academic reasons must be made aware of the potential consequences of the NMU of stimulants. [ABSTRACT FROM AUTHOR]

Objective: Limited prospective data exist about the impact of stimulant therapy for attention-deficit hyperactivity disorder (ADHD) during adolescence on the risk for later prescription drug misuse (PDM; i.e., of benzodiazepines, opioids, and stimulants). Methods: National longitudinal multicohort panels (baseline cohort years 2005–2017) of U.S. 12th grade students (N=11,066; ages 17 and 18 years) from the Monitoring the Future study were surveyed via self-administered questionnaires and followed up biennially during young adulthood (ages 19–24). A multivariable analysis was used to assess whether adolescents' lifetime history of stimulant therapy for ADHD was associated with subsequent PDM. Results: Overall, 9.9% of adolescents reported lifetime stimulant therapy for ADHD at ages 17 and 18. No significant differences were found in the adjusted odds of later incidence or prevalence of past-year PDM during young adulthood between adolescents with lifetime stimulant therapy and adolescents with no stimulant therapy. Over the 5-year follow-up, past-year PDM during young adulthood was most prevalent among adolescents who reported both stimulant therapy and prescription stimulant misuse (53.1%) and those who reported prescription stimulant misuse only (51.5%). Compared with adolescents in a control group without lifetime stimulant therapy or misuse, adolescents reporting prescription stimulant misuse had significantly higher adjusted odds of later incidence and prevalence of PDM during young adulthood. Conclusions: Adolescents' stimulant therapy for ADHD was not significantly associated with increased risk for later PDM during young adulthood. In contrast, adolescents' misuse of prescription stimulants strongly predicted later PDM. Monitoring adolescents for prescription stimulant misuse may help identify and mitigate the risk for future PDM. [ABSTRACT FROM AUTHOR]

Chronic nicotine results in dependence with withdrawal symptoms on discontinuation of use, through desensitization of nicotinic acetylcholine receptors and altered cholinergic neurotransmission. Nicotine withdrawal is associated with increased whole-brain functional connectivity and decreased network modularity; however, the role of cholinergic neurons in those changes is unknown. To identify the contribution of nicotinic receptors and cholinergic regions to changes in the functional network, we analyzed the contribution of the main cholinergic regions to brain-wide activation of the immediate early-gene Fos during withdrawal in male mice and correlated these changes with the expression of nicotinic receptor mRNA throughout the brain. We show that the main functional connectivity modules included the main long-range cholinergic regions, which were highly synchronized with the rest of the brain. However, despite this hyperconnectivity, they were organized into two anticorrelated networks that were separated into basal forebrain-projecting and brainstem-thalamic-projecting cholinergic regions, validating a long-standing hypothesis of the organization of the brain cholinergic systems. Moreover, baseline (without nicotine) expression of Chrna2, Chrna3, Chrna10, and Chrnd mRNA of each brain region correlated with withdrawal-induced changes in Fos expression. Finally, by mining the Allen Brain mRNA expression database, we were able to identify 1755 gene candidates and three pathways (Sox2-Oct4-Nanog, JAK-STAT, and MeCP2-GABA) that may contribute to nicotine withdrawal-induced Fos expression. These results identify the dual contribution of the basal forebrain and brainstem-thalamic cholinergic systems to whole-brain functional connectivity during withdrawal; and identify nicotinic receptors and novel cellular pathways that may be critical for the transition to nicotine dependence.

The diagnosis of pediatric tuberculosis (TB) poses a challenge for clinical teams worldwide. TB-mediated changes in the expression of host genes in the peripheral blood can serve as diagnostic biomarkers and can provide better insights into the host immune mechanisms of childhood TB. Peripheral blood mononuclear cells (PBMCs) from children (n=102) with microbiologically confirmed TB disease, TB infection (TBI), pneumonia, and healthy controls (HC) were stimulated with either the Purified Protein Derivative (PPD) or the Early Secretory Antigen 6kDa-Culture Filtrate Protein 10 (ESAT6-CFP10) complex of Mycobacterium tuberculosis (Mtb). RNA was extracted and quantified using gene expression microarrays. Differential expression analysis was performed comparing microbiologically confirmed TB to the other diagnostic groups for the stimulated and unstimulated samples. Using variable selection, we identified sparse diagnostic gene signatures; one gene (PID1) was able to distinguish TB from pneumonia after ESAT6-CFP10 stimulation with an AUC of 100% in the test set, while a combination of two genes (STAT1 and IFI44) achieved an AUC of 91.7% (CI95% 75.0%-100%) in the test set after PPD stimulation. The number of significantly differentially expressed (SDE) genes was higher when contrasting TB to pneumonia or HC in stimulated samples, compared to unstimulated ones, leading to a larger pool of candidate diagnostic biomarkers. Our approach provides enlightened aspects of peripheral TB-specific responses and can form the basis for a point of care test meeting the World Health Organization (WHO) Target Product Profile (TPP) for pediatric TB.

The article suggests the use of methods of implementation science to close the research-to-practice gaps between the evidence for contingency management (CM) and ability of patients to access treatment of addiction. Recommendations to close the gap and implement behavioral interventions include the Implementation Research Logic Model. Emphasis is given on the need to implement CM in resource-constrained organizations and health systems.

Objectives: Stimulants are a class of drugs approved for the treatment of attention-deficit hyperactivity disorder (ADHD) and narcolepsy. However, they are also often used “off-label” as adjunct therapies for the treatment of obesity and depression. The objective of this study is to summarize how stimulant use is globally measured in the literature and to explore rates of stimulant use in Alberta, Canada. Methods: A traditional narrative literature review was conducted to summarize global methods of stimulant assessment. Then using definitions guided by the literature and current regulatory bodies in Alberta, we conducted a series of descriptive analyses to assess how frequent stimulant use was in Alberta patients from 2019 to 2021: 1) number of dispenses by year; 2) average days of drug supply; 3) proportion of days covered (PDC); and 4) defined daily dose (DDDs). Results: In the literature review, the most frequently used measures of stimulant drug use were trends over time (prevalence), types of drug use, and dispensations of prescriptions. In all, there is a global trend of increased use of stimulants among both adults and children. In Alberta, 173,789 patients were prescribed stimulant medication in 2019–2021, representing approximately 4 % of the entire Alberta population. Overall, 61.1 % were between the ages of 10–34 and 46.8 % were female. The number of dispensations rose from 713,896 in 2019 to 973,930 in 2021 – with up to 43 % being lisdexamfetamine stimulant dispenses. Conclusions: Although stimulant use in AB was measured using similar trend estimates as the literature, there is a lack of research to support whether these measures are accurate and effective at the population-level. Future steps to standardize both medical and nonmedical use of prescription stimulants are warranted in efforts to fully quantify both benefits and risks associated with stimulant use.

The dextroamphetamine transdermal system (d-ATS) is a stimulant patch recently approved by the United States (U.S.) Food and Drug Administration for the treatment of attention-deficit/hyperactivity disorder (ADHD). The composition of the d-ATS, pharmacokinetics, and metabolism are presented along with data from dermal trials evaluating the tolerability of patch application at various skin sites. Efficacy and safety data from a laboratory classroom study in children and adolescents including effect sizes are assessed. Pharmacokinetic-pharmacodynamic modeling of variable wear times is also discussed. Although stimulants are recommended as first-line treatment for ADHD in the U.S. some patients may have difficulty swallowing intact tablets and capsules, or dislike the taste or texture of chewable, oral disintegrating, or liquid formulations. The d-ATS fills an unmet need for those with ADHD who are unable or prefer not to take medication orally. Varying wear time of the d-ATS also gives flexibility in length of stimulant effect which may be useful for patients with changing schedules. However, dermal discomfort must be considered in addition to the usual amphetamine side effects when prescribing the d-ATS. Patient and provider experience will determine how frequent the use of d-ATS becomes. [ABSTRACT FROM AUTHOR]

This study presents a comprehensive examination of Pinus kesiya var. langbianensis (Pinus kesiya var. langbianensis), the primary resin-extraction tree species in Yunnan Province, China. In this study, we formulated different concentration gradients of 0.25%, 0.5%, 1%, and 2% of diquat solution as tapping stimulant to test the effect of different concentrations on the resin gain rate of Pinus kesiya, and analyzed the relationship between anatomical structure, major chemical composition of turpentine and resin yield by methods such as wood anatomy and chemical composition analysis of turpentine. The primary focus of the investigation was on exploring the interrelationships among resin-tapping stimulants, anatomical structures, turpentine components, and resin yield. Research findings demonstrate a significant enhancement in resin production due to the application of stimulants, with the highest increase rate reaching 55% in a specific group, while others achieved approximately 30% increments. Moreover, measurement data about resin duct dimensions indicate a noteworthy increase in resin duct area for the stimulant-treated group compared to the control group. However, it should be noted that the impact on resin duct area by varying stimulant concentrations was relatively minor. Furthermore, continuous observation of resin extraction from different resin-yield classes of P. kesiya revealed insignificant variation in resin yield over time for the low and moderate resin-yield groups. In contrast, the high resin-yield group exhibited a gradual increase in resin production. Interestingly, the high resin-yield group exhibited the smallest resin duct area, but the highest resin duct density, indicating an interconnectedness of resin duct-related data that influences resin yield. Additionally, correlative investigations between anatomical structures and resin yield demonstrate a positive correlation between resin duct area and resin yield, total resin production, and average resin yield. This underscores the importance of resin duct area as a significant factor in resin production. On the other hand, the influence of stimulant concentrations on the turpentine components was found to be negligible. Overall, the correlation results suggest that turpentine components cannot reliably predict or differentiate between high and low resin-yield trees. This study provides a comprehensive analysis of the interrelationships among stimulants, anatomical structures, and turpentine components, offering a theoretical foundation for the resin extraction and resin processing industries in Yunnan Province. [ABSTRACT FROM AUTHOR]

Objective: Despite community colleges accounting for 34% of all undergraduate enrollment, research on substance-use patterns among community college students is limited. Community college students may engage in substance use differently than their 4-year university counterparts due to differences in psychosocial factors and decreased availability of mental health services. The current study aimed to elucidate risk factors underlying non-medical use of prescription simulants (NMUS) and nicotine use by community college students. Methods: A web-based survey was administered to 10 of 13 community colleges within a southeastern state's Board of Regents school system. The survey included questions related to NMUS, nicotine use, alcohol use, mental health diagnosis, and demographics. Results: Overall, 9% of the participants reported NMUS, and 24.6% used nicotine. Multivariate analysis of variance and χ2 tests revealed group differences among individuals using only nicotine, only NMUS, both nicotine and NMUS, and neither nicotine nor NMUS. Post-hoc 2 × 2 χ2 tests indicated that individuals using both nicotine and NMUS had higher incidence of mental health diagnoses, were more likely to live in urban areas, reported higher weekly alcohol consumption, and were more likely to be male as compared to individuals using neither substance. Attention-deficit hyperactivity disorder (ADHD) symptoms were higher in individuals using only NMUS and both NMUS and nicotine as compared to those using only nicotine or neither substance. Conclusions: These findings provide insight into demographic and psychological variables associated with NMUS and nicotine use among community college students that could be benefitted by greater access to affordable mental health services. [ABSTRACT FROM AUTHOR]

The V-shaped descending tapping method was used with a tapping frequency of once per day. Different combinations of side gutter depths (reaching xylem at 2-3 mm depth and only reaching phloem) and stimulants (stimulant D and stimulant J) were tested. The results showed that different side gutter depths had no significant effects on resin yield and resin duct number;under the same side gutter depths, both Stimulant D and Stimulant J treatments significantly increased resin yield, especially Stimulant J which only reached phloem had the best yield promotion effect of 27%;both stimulants significantly promoted the increase in resin duct number in the 2022 growth ring, with growth rates ranging from 257% to 398%;stimulant application promoted resin duct number increase but decreased the size of individual resin ducts. In conclusion, stimulant J with wound only reaching phloem had the best yield promotion effect. Stimulant application increased resin duct number thereby enhancing resin yield, but decreased the size of individual resin ducts. [ABSTRACT FROM AUTHOR]

Despite distinct classes of psychoactive drugs producing putatively unique states of consciousness, there is surprising overlap in terms of their effects on episodic memory and cognition more generally. Episodic memory is supported by multiple subprocesses that have been mostly overlooked in psychopharmacology and could differentiate drug classes. Here, we reanalyzed episodic memory confidence ratings from 10 previously published data sets (28 drug conditions total) using signal detection models to estimate two conscious states involved in episodic memory and one consciously controlled metacognitive process of memory: autonoetic retrieval of specific details (recollection), noetic recognition absent of retrieved details (familiarity), and retrospective introspection of memory decisions (metamemory). Sedatives, dissociatives, psychedelics, stimulants, and cannabinoids had unique patterns of effects on these mnemonic processes dependent on whether they impacted encoding, consolidation, or retrieval (the formation, stabilization, and access to memory traces, respectively). Sedatives at encoding reliably impaired both recollection and familiarity but at consolidation enhanced recollection. Dissociatives and cannabinoids at encoding impaired recollection but less reliably impaired familiarity, and cannabinoids at retrieval increased false recollections. These drug-induced encoding impairments occasionally came with metamemory enhancements, perhaps because of less interstimulus interference. Psychedelics at encoding impaired recollection but tended to enhance familiarity and did not impact metamemory. Stimulants at encoding enhanced metamemory, at consolidation impaired metamemory, and at retrieval enhanced familiarity and metamemory. These findings allude to mechanisms underlying the idiosyncratic phenomena of drugs, such as blackouts from sedatives and presque vu from psychedelics. Finally, these findings converge on a model in which memory quantity and stability influence metamemory. [ABSTRACT FROM AUTHOR]

Background: Previous studies suggest that selective serotonin reuptake inhibitors (SSRIs) may increase the risk of suicide among children and youth, although the association between suicide risk and the combination of SSRIs with other medication such as stimulants in this population remains unclear. This study explored whether the combination of SSRIs with stimulants influenced suicide risk. Methods: A retrospective cohort study was conducted at a single children's hospital campus-based ambulatory psychiatric clinic between September 1, 2017, and September 30, 2020. Subjects were 6–21 years of age and prescribed either stimulants or stimulants and SSRIs only. The primary outcome was suicidal thoughts and behaviors (STB), defined by documented suicidal thoughts, plans, or behaviors. Firth logistic regression evaluated associations between medication class and STB. Results: Among 349 patients, the prevalence of STB was 5.7% (n = 20). In unadjusted model, patients prescribed SSRIs and stimulants had a 2.9-fold increase of STB compared to patients prescribed stimulants only, along with increasing age, male sex, and the diagnoses of anxiety and/or depression. In the final model adjusted for each of these factors, the observed association of medication regiment with STB was attenuated (odds ratio [OR]: 1.3, confidence interval [CI]: 0.3–4.9, p = 0.7). The magnitude of the adjusted association between depressive diagnosis and STB was notable (OR: 3.6, CI: 1.0–12.6, p = 0.049). Conclusions: Among patients followed in a children's hospital-based ambulatory psychiatric clinic, a combination medication regimen of SSRIs and stimulants after adjusting for genetic sex, age, anxiety diagnosis, and depression diagnosis, the observed association between STB and combination stimulant and SSRI treatment was attenuated. This finding suggests that other factors, including depression, may have contributed to the association between SSRI treatment and STB. Larger, prospective studies of the relationship between combination pharmacotherapy and suicide risk are warranted to guide clinical/pharmacological decision making and to better clarify these relationships. [ABSTRACT FROM AUTHOR]

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The ergogenic effects of acute caffeine intake on endurance cycling performance lasting ~1 h have been well documented in controlled laboratory studies. However, the potential benefits of caffeine supplementation in cycling disciplines such as cross-country/mountain biking have been rarely studied. In cross-country cycling, performance is dependent on endurance capacity, which may be enhanced by caffeine, but also on the technical ability of the cyclist to overcome the obstacles of the course. So, it is possible that the potential benefits of caffeine are not translated to cross-country cycling. The main objective of this study was to investigate the effects of acute caffeine intake, in the form of coffee, on endurance performance during a cross-country cycling time trial. Eleven recreational cross-country cyclists (mean ± SD: age: 22 ± 3 years; nine males and two females) participated in a single-blinded, randomised, counterbalanced and crossover experiment. After familiarisation with the cross-country course, participants completed two identical experimental trials after the ingestion of: (a) 3.00 mg/kg of caffeine in the form of soluble coffee or (b) 0.04 mg/kg of caffeine in the form of decaffeinated soluble coffee as a placebo. Drinks were ingested 60 min before performing a 13.90 km cross-country time trial over a course with eight sectors of varying technical difficulty. The time to complete the trial and the mean and the maximum speed were measured through Global Positioning System (GPS) technology. Heart rate was obtained through a heart rate monitor. At the end of the time trial, participants indicated their perceived level of fatigue using the traditional Borg scale. In comparison to the placebo, caffeine intake in the form of coffee significantly reduced the time to complete the trial by 4.93 ± 4.39% (43.20 ± 7.35 vs. 41.17 ± 6.18 min; p = 0.011; effect size [ES] = 0.300). Caffeine intake reduced the time to complete four out of eight sectors with different categories of technical difficulty (p ≤ 0.010; ES = 0.386 to 0.701). Mean heart rate was higher with caffeine (169 ± 6 vs. 162 ± 13 bpm; p = 0.046; ES = 0.788) but the rating of perceived exertion at the end of the trial was similar with caffeinated coffee than with the placebo (16 ± 1 vs. 16 ± 2 a.u.; p = 0.676; ES = 0.061). In conclusion, the intake of 3 mg/kg of caffeine delivered via soluble coffee reduced the time to complete a cross-country cycling trial in recreational cyclists. These results suggest that caffeine ingested as coffee may be an ergogenic substance for cross-country cycling. [ABSTRACT FROM AUTHOR]

Severe brain injury impairs consciousness by disrupting a broad spectrum of neurotransmitter systems. Emerging evidence suggests that pharmacologic modulation of specific neurotransmitter systems, such as dopamine, promotes recovery of consciousness. Clinical guidelines now endorse the use of amantadine in individuals with traumatic disorders of consciousness (DoC) based on level 1 evidence, and multiple neurostimulants are used off-label in clinical practice, including methylphenidate, modafinil, bromocriptine, levodopa, and zolpidem. However, the relative contributions of monoaminergic, glutamatergic, cholinergic, GABAergic, and orexinergic neurotransmitter systems to recovery of consciousness after severe brain injury are unknown, and personalized approaches to targeted therapy have yet to be developed. This review summarizes the state-of-the-science in the neurochemistry and neurobiology of neurotransmitter systems involved in conscious behaviors, followed by a discussion of how pharmacologic therapies may be used to modulate these neurotransmitter systems and promote recovery of consciousness. We consider pharmacologic modulation of consciousness at the synapse, circuit, and network levels, with a focus on the mesocircuit model that has been proposed to explain the consciousness-promoting effects of various monoaminergic, glutamatergic, and paradoxically, GABAergic therapies. Though fundamental questions remain about neurotransmitter mechanisms, target engagement and optimal therapy selection for individual patients, we propose that pharmacologic therapies hold great promise to promote recovery and improve quality of life for patients with severe brain injuries.

Despite extensive preclinical research over the years, a significant gap remains in our understanding of the specific effects of methamphetamine (METH) and amphetamine (AMPH) withdrawal. Understanding these differences could be pivotal to unveiling the unique pathophysiology underlying each stimulant. This may facilitate the development of targeted and effective treatment strategies tailored to the specific characteristics of each substance. Following PRISMA guidelines, this systematic review was conducted to examine alterations in spontaneous locomotor activity, specifically horizontal activity, in animals experiencing withdrawal from extended and repeated administration of AMPH or METH. Original articles were retrieved from four electronic databases, supplemented by a review of the references cited in the published papers. A total of thirty-one full-length articles (n = 31) were incorporated in the analysis. The results indicated that six studies documented a significant increase in horizontal activity among animals, seven studies reported decreased locomotion, and eighteen studies (8 AMPH; 10 METH) reported no significant alterations in the animals’ locomotor activity. Studies reporting heightened locomotion mainly employed mice undergoing withdrawal from METH, studies reporting diminished locomotion predominantly involved rats undergoing withdrawal from AMPH, and studies reporting no significant changes in horizontal activity employed both rats and mice (12 rats; 6 mice). Drug characteristics, routes of administration, animal models, dosage regimens, duration, and assessment timing seem to influence the observed outcomes. Despite more than 50% of papers enlisted in this review indicate no significant changes in the locomotion during the stimulant withdrawal, the unique reactions of animals to withdrawal from METH and AMPH reported by some underscore the need for a more nuanced understanding of stimulant withdrawal.

Introduction The Psychotropic Drug Safety Initiative (PDSI) is a national Veterans Affairs program that recommends obtaining cardiovascular vital signs semiannually and urine toxicology screening annually for veterans prescribed stimulants. The PDSI also recommends a risk review of concurrent central nervous system (CNS) depressants to ensure the benefits of coadministration with stimulants outweigh the risks. This project’s purpose was to evaluate the occurrence of coprescriptions for CNS depressants and stimulants and encourage compliance with the PDSI recommendations to increase safe and appropriate management of veterans prescribed the combination. This study aimed to evaluate the occurrence of coprescriptions for CNS depressants and stimulants, evaluate compliance with stimulant monitoring recommendations, and measure the proportion of pharmacist recommendations implemented by the prescriber. Methods This quality improvement project identified veterans with an outpatient prescription for a stimulant and any coprescription(s) for benzodiazepines, sedative-hypnotics, and/or opioids. A pharmacy intervention note was generated to request a risk review, provide recommendations for de-escalation, and notify the stimulant prescriber of overdue monitoring parameters. Impact was measured 60 days after intervention. Descriptive statistics and a McNemar test were used to compare preintervention and postintervention data. Results From the 61 patients included, there were 67 unique prescriptions for benzodiazepines (49.3%), sedative-hypnotics (34.3%), and opioids (16.4%) in combination with a stimulant. Pharmacist intervention resulted in de-escalation of coprescribing for 9 patients (16.1%) and was associated with statistically significant improvement in compliance to stimulant monitoring recommendations. Discussion Clinical pharmacists can assist in ensuring safe and appropriate monitoring and management of veterans prescribed stimulants.

Chronic constipation is a common gastrointestinal disorder, and its management often requires long-term use of laxatives. This review addresses the differences between two commonly used laxatives, lactulose and bisacodyl. The efficacy, side effect profiles, tolerance development, use in special populations, drug interactions, contraindications, and impacts on patient compliance and quality of life of these two laxatives are compared. Both lactulose and bisacodyl are effective in improving bowel movements and are widely used in clinical practice. However, lactulose might present a more favorable profile for certain patient populations when considering factors such as side effect profile, patient compliance, quality of life, and cost-effectiveness. Primary care physicians should consider these aspects when choosing the most appropriate treatment option for their patients, always considering individual patient characteristics and preferences.

IntroductionApplying innovative nanotechnology in agriculture is considered as one of the promising approaches to obtain significant increases of crop yield. Nanoparticles (NPs) are considered potential agents for agriculture as fertilizers and growth enhancers and using of nano-fertilizers has led to an increasing in the efficiency of nutrients, the correct management of fertilizer consumption, and a reduction of the frequency of fertilizer application. Stimulants are compounds that initiate signals for cells to increase or decrease the production of secondary metabolites and plant defense response. Stimulants such as Putrescine play a role in regulating various plant physiological processes. In this regard, considering the importance of using new technologies, including nanotechnology, in sustainable agriculture to increase the quantitative and qualitative performance of agricultural products, especially oil-medicinal plants, and the lack of sufficient information about the use of iron nanoparticles and polyamine putricine in Camelina plant nutrition, The effect of foliar spraying of these stimulants on functional, morphological and physiological traits of Camelina plant (Soheil veriety) was evaluated.Materials and MethodsThis research was conducted as factorial layout based on a randomized complete block design with three replications at the research fields of Baye-Kala Agricultural Research Station (BARS) at Neka city in 2021. The studied factors included iron nanoparticles in four concentrations (0, 20, 40, and 60 ppm) and polyamine putrescine in four concentrations (0, 0.5, 1, and 1.5 mM). Each experimental plot was prepared in 6 square meters area and the studied treatments were applied by foliar spraying at the beginning of the reproductive phase of the plant. Two weeks after applying the treatments, sampling was done to evaluate the different traits of the plant. After checking the normality of the data, they were analyzed with SAS (ver 9.1) software; obtained averages compared with using Duncan Test at the 5% probability level.Results and DiscussionThe results of variance analysis indicated the significance of the simple effect of iron nanoparticles and putrescine on all the studied traits at the 5% level, as well as the significance of the interaction of the two factors on all the studied traits except carotenoid and peroxidase in the reproductive stage at the 5% level. According to the results, the highest amount of carotenoid (0.142 and 0.141 mg.g-1, respectively) and peroxidase (4.96 and 4.38 mg.g-1, respectively) were observed in application of 60 ppm iron nanoparticles and 1.5 mM putrescine which had no statistically significant difference with the concentration of 40 ppm iron nanoparticles and 1 mM putrescine. The results indicated that the highest amount of flavonoid (40.72 mg.g-1), soluble sugar (139.27 mg.g-1), and plant height (115.75 cm) were observed in the treatment combination of 60 ppm iron and 1 mM putrescine, the highest percentage of oil (41.76) and protein (27.77) were observed in the treatment combination of 40 ppm iron and 1.5 mM putrescine and the highest amount of grain yield (210.27 g) and morphological components of yield were observed in the treatment combination of 40 ppm iron and 1 mM putrescine. The correlation result showed that there were the most positive and significant correlation values among the physiological traits and the yield trait had a positive and significant correlation with plant dry weight (0.44) and oil percentage (0.40).ConclusionThe results have demonstrated that foliar application of 40 ppm iron nanoparticles and 1.5 mM putrescine significantly enhanced various growth characteristics, including photosynthetic pigment content, crude protein, oil content, as well as the physiological and morphological aspects of Camelina. Additionally, the application of iron nanoparticles and putrescine via a uniform supply of low-consumption nutrients has been shown to strengthen the plant's defense system, ultimately leading to improvements in the growth, development, and yield of the medicinal-oil Camelina plant.

Caffeine, the extensively honored central nervous system boost constitute in coffee, tea, and chocolate, has been considerably delved for its different impacts on health . While moderate input offers benefits like enhanced mood and alertness , inordinate consumption poses pitfalls, including headaches, pulsations, and anxiety.

Patients with stimulant use disorder experience high rates of relapse. While neurobehavioral mechanisms involved in initiating drug use have been studied extensively, less research has focused on relapse. To assess motivational processes involved in relapse and diagnosis, we acquired functional magnetic resonance imaging responses to nondrug (monetary) gains and losses in detoxified patients with stimulant use disorder (n = 68) and community control participants (n = 42). In a prospective multimodal design, we combined imaging of brain function, brain structure, and behavior to longitudinally track subsequent risk for relapse. At the 6-month follow-up assessment, 27 patients remained abstinent, but 33 had relapsed. Patients with blunted anterior insula (AIns) activity during loss anticipation were more likely to relapse, an association that remained robust after controlling for potential confounds (i.e., craving, negative mood, years of use, age, and gender). Lower AIns activity during loss anticipation was associated with lower self-reported negative arousal to loss cues and slower behavioral responses to avoid losses, which also independently predicted relapse. Furthermore, AIns activity during loss anticipation was associated with the structural coherence of a tract connecting the AIns and the nucleus accumbens, as was functional connectivity between the AIns and nucleus accumbens during loss processing. However, these neurobehavioral responses did not differ between patients and control participants. Taken together, the results of the current study show that neurobehavioral markers predicted relapse above and beyond conventional self-report measures, with a cross-validated accuracy of 72.7%. These findings offer convergent multimodal evidence that implicates blunted avoidance motivation in relapse to stimulant use and may therefore guide interventions targeting individuals who are most vulnerable to relapse. [ABSTRACT FROM AUTHOR]

l-Noradrenaline (l-NE) is a neurotransmitter released by postganglionic neurons in the sympathetic nerve branch and stimulates the secretion of l-NE in human blood. Accurate monitoring of the l-NE concentration in serum is crucial for detecting stimulants and preventing fraud in competitive events. In this study, we introduce an approach for the detection of l-NE using a zeolite-like lanthanide metal–organic framework (Ln-MOF) named Eu0.479Tb0.521-ZMOF, constructed with a H2bpdc ligand (where H2bpdc stands for 2,2′-bipyridine-6,6′-dicarboxylate acid), and forming a nanorod. Notably, the ratiometric luminescent probe Eu0.479Tb0.521-ZMOF showcases superior sensing performance compared to single emission based on Ln-MOF, enabling highly efficient detection of l-NE among various antidepressant hormones. The limit of detection (LOD) for l-NE was 129 μM. Additionally, Eu0.479Tb0.521-ZMOF has been synthesized into nanorods, which promote effective detection of l-NE in human serum solutions, exhibiting an impressive recovery rate ranging from 97.5 to 100%. Additionally, a luminescent membrane, derived from Eu0.479Tb0.521-ZMOF, was successfully developed and utilized for visual detection of l-NE. In conclusion, our study comprehensively elucidates the detailed detection mechanism for l-NE based on zeolite-Like Ln-MOFs Eu0.479Tb0.521-ZMOF. [ABSTRACT FROM AUTHOR]

Pre-exercise intake of caffeine (from ~3 to 9 mg/kg) has been demonstrated as an effective supplementation strategy to increase fat oxidation during fasted exercise. However, a pre-exercise meal can alter the potential effect of caffeine on fat oxidation during exercise as caffeine modifies postprandial glycaemic and insulinemic responses. Hypothetically, the effect of caffeine on fat oxidation may be reduced or even withdrawn during fed-state exercise. The present systematic review aimed to meta-analyse investigations on the effect of acute caffeine intake on the rate of fat oxidation during submaximal aerobic exercise performed in the fed state (last meal < 5 h before exercise). A total of 18 crossover trials with randomised and placebo-controlled protocols and published between 1982 and 2021 were included, with a total of 228 participants (185 males and 43 females). Data were extracted to compare rates of fat oxidation during exercise with placebo and caffeine at the same exercise intensity, which reported 20 placebo–caffeine pairwise comparisons. A meta-analysis of the studies was performed, using the standardised mean difference (SMD) estimated from Hedges' g, with 95% confidence intervals (CI). In comparison with the placebo, caffeine increased the rate of fat oxidation during fed-state exercise (number of comparisons (n) = 20; p = 0.020, SMD = 0.65, 95% CI = 0.20 to 1.20). Only studies with a dose < 6 mg/kg of caffeine (n = 13) increased the rate of fat oxidation during fed-state exercise (p = 0.004, SMD = 0.86, 95% CI = 0.27 to 1.45), while no such effect was observed in studies with doses ≥6 mg/kg (n = 7; p = 0.97, SMD = −0.03, 95% CI = −1.40 to 1.35). The effect of caffeine on fat oxidation during fed-state exercise was observed in active untrained individuals (n = 13; p < 0.001, SMD = 0.84, 95% CI = 0.39 to 1.30) but not in aerobically trained participants (n = 7; p = 0.27, SMD = 0.50, 95% CI = −0.39 to 1.39). Likewise, the effect of caffeine on fat oxidation was observed in caffeine-naïve participants (n = 9; p < 0.001, SMD = 0.82, 95% CI = 0.45 to 1.19) but not in caffeine consumers (n = 3; p = 0.54, SMD = 0.57, 95% CI = −1.23 to 2.37). In conclusion, acute caffeine intake in combination with a meal ingested within 5 h before the onset of exercise increased the rate of fat oxidation during submaximal aerobic exercise. The magnitude of the effect of caffeine on fat oxidation during fed-state exercise may be modulated by the dose of caffeine administered (higher with <6 mg/kg than with ≥6 mg/kg), participants' aerobic fitness level (higher in active than in aerobically trained individuals), and habituation to caffeine (higher in caffeine-naïve than in caffeine consumers). [ABSTRACT FROM AUTHOR]

Attention deficit/hyperactivity disorder (ADHD) is overrepresented in prison populations globally. Although pharmacological treatment has generally been demonstrated to be an effective tool for managing ADHD symptoms in the general population, it remains controversial in the prison context. This is primarily due to concerns about the diversion and abuse of medication. To evaluate the impact of pharmacological ADHD treatment for adults who are or have been in prison, a narrative literature review was completed and seven international studies were identified. Further research into the use of stimulant medication in prisons, particularly within the Australian context, is recommended. [ABSTRACT FROM AUTHOR]

In their recent examination of the Monitoring the Future (MTF) data, McCabe et al. (Journal of Child Psychology and Psychiatry, 2023) address the complex, longstanding, and clinically valuable questions of whether and how stimulant medication treatment for adolescents with ADHD relates to their risk for substance use. Here, we expand on the authors' interpretations of their nuanced findings of increased risk for illicit stimulant use and non‐prescribed stimulant medication use for youth with later age of medication treatment initiation and shorter treatment duration. We particularly focus on highlighting tangible clinical implications, and we recommend ways future research can build on the authors' findings to further clarify this important issue. [ABSTRACT FROM AUTHOR]

Background: To assess whether age of onset and duration of stimulant therapy for attention‐deficit/hyperactivity disorder (ADHD) are associated with cocaine, methamphetamine, and prescription stimulant misuse during adolescence. Methods: Nationally representative samples of US 10th and 12th grade students (N = 150,395) from the Monitoring the Future study were surveyed via self‐administered questionnaires from 16 annual surveys (2005–2020). Results: An estimated 8.2% of youth received stimulant therapy for ADHD during their lifetime (n = 10,937). More than one in 10 of all youth reported past‐year prescription stimulant misuse (10.4%)—past‐year cocaine (4.4%) and methamphetamine (2.0%) use were less prevalent. Youth who initiated early stimulant therapy for ADHD (≤9 years old) and for long duration (≥6 years) did not have significantly increased adjusted odds of cocaine or methamphetamine use relative to population controls (ie, non‐ADHD and unmedicated ADHD youth). Youth who initiated late stimulant therapy for ADHD (≥10 years old) and for short duration (<1 year) had significantly higher odds of past‐year cocaine or prescription stimulant misuse in adolescence than those initiating early stimulant therapy for ADHD (≤9 years old) and for long duration (≥6 years). Youth who initiated late stimulant therapy for ADHD (≥10 years) for short duration (<1 year) had significantly higher odds of past‐year cocaine, methamphetamine, and prescription stimulant misuse versus population controls during adolescence. No differences in past‐year cocaine, methamphetamine, and prescription stimulant misuse were found between individuals who only used non‐stimulant therapy for ADHD relative to youth who initiated early stimulant therapy (≤9 years old) and for long duration (≥6 years). Conclusions: An inverse relationship was found between years of stimulant therapy and illicit and prescription stimulant misuse. Adolescents with later initiation and/or shorter duration of stimulant treatment for ADHD should be monitored for potential illicit and prescription stimulant misuse. [ABSTRACT FROM AUTHOR]

Introduction and Objective: Stimulants are compounds that initiate signals for cells to increase or decrease the production of secondary metabolites and plant defense response and stimulants such as Putrescine play a role in regulating various plant physiological processes. The use of nano-fertilizers has led to an increase in the efficiency of the use of nutrients, the correct management of fertilizer consumption, and a reduction in the frequency of fertilizer application. This research was conducted in order to investigate the effect of iron nanoparticle and putrescine as plant growth stimulants on the yield and yield components of the oil-medicinal plant Camelina. Material and Methods: This research was conducted as factorial design in a randomized complete block design with three replications in the research fields of Baye-Kala Agricultural Research Station (BARS) in Neka county in 2021. The studied factors included iron nanoparticles in four concentrations (zero, 20, 40, and 60 ppm) and polyamine putrescine in four concentrations (zero, 0.5, 1, and 1.5 mM). Results: The results of variance analysis of different traits indicated that the simple effect of iron nanoparticles and putrescine was significant on all the studied traits at the 5% level. Also, the interaction of the two factors was significant on all the studied traits except peroxidase in the reproductive stage and this interaction was nonsignificant on all physiological traits in vegetative stage. According to the results, the highest amount of flavonoid (21.871 and 21.389, respectively), soluble sugar (116.643 and 105.453, respectively), catalase (1.301 and 1.394, respectively) and peroxidase (5.056 and 4.687, respectively) were observed in the vegetative stage in the application of 40 ppm iron nanoparticles and 1.5 mM putrescine. The results indicated that the highest amount of flavonoid (40.72), soluble sugar (139.27) and plant height (115.75) were observed in the treatment combination of 60 ppm iron and 1 mM putrescine, the highest percentage of oil (41.76) and protein (27.77) were observed in the treatment combination of 40 ppm iron and 1.5 mM putrescine and the highest amount of grain yield (210.27) and morphological components of yield were observed in the treatment combination of 40 ppm iron and 1 mM putrescine. Conclusion: In general, the interaction effect of 40 ppm of iron nanoparticles and high concentration of putrescine had the best results, and the spraying of iron nanoparticles and putrescine through the more effective absorption of microelement nutrients and strengthening the plant's defense system can improve the growth, development and yield of the medicinal-oil Camelina plant. [ABSTRACT FROM AUTHOR]

Introduction: Stimulant drugs are thought to alter processing of rewarding stimuli. However, the mechanisms by which they do this are not fully understood. Method: In this study we used EEG to assess effects of single doses of methamphetamine (MA) on neural responses during anticipation and receipt of reward in healthy volunteers. Healthy young men and women (N = 28) completed three sessions in which they received placebo, a low MA dose (10 mg) or a higher MA dose (20 mg) under double blind conditions. Subjective and cardiovascular measures were obtained, and EEG was used to assess brain activity during an electrophysiological version of the Monetary Incentive Delay (eMID) task. Results: EEG measures showed expected patterns during anticipation and receipt of reward, and MA produced its expected effects on mood and cardiovascular function. However, MA did not affect EEG responses during either anticipation or receipt of rewards. Conclusions: These findings suggest that the effects of MA on EEG signals of reward processing are subtle, and not related to the drug's effects on subjective feelings of well-being. The findings contribute to our understanding of the neural effects of MA during behaviors related to reward. [ABSTRACT FROM AUTHOR]

Copyright of Polish Nursing / Pielegniarstwo Polskie is the property of Poznan University of Medical Sciences Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

With rising therapeutic use worldwide, prescription stimulants are increasingly implicated in poisonings. Most of the limited research on stimulant poisoning focuses on illicit amphetamines. We aimed to investigate the clinical effects of intentional prescription stimulant poisoning. This is a retrospective review of hospitalised patients referred to a Poisons Information Centre and a toxicology unit following intentional exposures to prescription stimulants (dexamfetamine, lisdexamfetamine and methylphenidate) from 1 January 2018 through 31 December 2021. Patients were identified from both units' databases and data extracted from medical records. To facilitate comparison a dexamfetamine-equivalent dose was calculated. There were 186 intentional exposures in 178 patients (median age 17 years, males 54%) over the study period, consisting of 44 (24%) dexamfetamine, 50 (27%) lisdexamfetamine and 92 (49%) methylphenidate exposures. Stimulant exposures rose annually from 34 presentations in 2018 to 61 in 2021. Deliberate self-poisoning accounted for 139 (75%) presentations and the remaining 47 (25%) were recreational. Co-ingestions were taken in 101 (54%) presentations, leaving 85 (46%) single-agent exposures with a median dexamfetamine-equivalent dose ingested of 135 mg (range 15-4500 mg). Of the single-agent exposures tachycardia (69%), hypertension (47%) and agitation (58%) were the commonest clinical features. Most patients (58%) had mild-moderate symptoms, managed solely with supportive cares or oral sedation. Twenty-three (27%) patients had severe agitation receiving parenteral sedation. Rhabdomyolysis occurred in 3 single-agent exposures (4%) and 8 (9%) had an acute kidney injury. Severe cardiovascular toxicity was rare, with one patient developing hypertensive crisis and another having a supraventricular tachycardia. The median length of stay for single-agent exposures was 11 h (IQR 5-19 h). Prescription stimulant poisoning appears to be rising and commonly results in tachycardia, hypertension, and agitation. Severe cardiovascular toxicity was rare. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Kirkuk University for Agricultural Sciences is the property of Republic of Iraq Ministry of Higher Education & Scientific Research (MOHESR) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Bagcilar Medical Bulletin / Bağcılar Tıp Bülteni is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

In the process of weightlifting, there is an increased load on both the respiratory system, the cardiovascular system, and on individual parts of the nervous system. At the same time, special attention is paid to the possibilities of providing a stable body functioning after the cancellation of treatment course and the corresponding pharmacological support of athletes with treatment schedule or without it. The novelty of the study is determined by the need to ensure constant and stable work of the cardiovascular system. The authors note that this is possible both when the body performance indicators return to the level before injury, and in conditions of returning to original sports results. It is determined in the paper that the use of the instrumental model will make it possible to develop sustainable energy consumption and coordinate the balancing of loads on an athlete during the period of recovery after injury. Model formation is based on uniform signals in a correlated random process in a simulation model. The practical significance of the study is determined by the need to structure the training loads in the post-traumatic period. This reduces a number of physiological and psychological stresses on a person and allows increasing in the long term the loads that the athlete plans to utilise after returning to the sports sector.

Abstract Background The shift from prescription to illicit drugs involved in drug poisoning deaths raises questions about the current utility of prescription drug monitoring program (PDMP) data to inform drug poisoning (overdose) prevention efforts. In this study, we describe relations between specific drugs involved in Kentucky drug poisoning deaths and antecedent controlled substance (CS) dispensing. Methods The study used linked death certificates and PDMP data for 2,248 Kentucky resident drug poisoning deaths in 2021. Death certificate literal text analysis identified drugs mentioned with involvement (DMI) in drug poisoning deaths. We characterized the concordance between each DMI and the CS dispensing history for this drug at varying timepoints since 2008. Results Overall, 25.5% of all decedents had dispensed CS in the month before fatal drug poisoning. Over 80% of decedents were dispensed opioid(s) since 2008; the percentage was similar regardless of opioid involvement in the poisoning death. One-third of decedents had dispensed buprenorphine for treatment of opioid use disorder since 2008, but only 6.1% had dispensed buprenorphine in the month preceding death. Fentanyl/fentanyl analogs were DMI in 1,568 (69.8%) deaths, yet only 3% had received a fentanyl prescription since 2008. The highest concordance in the month preceding death was observed for clonazepam (43.6%). Conclusion Overall, concordance between CS dispensing history and the drugs involved in poisoning deaths was low, suggesting a need to reevaluate the complex relationships between prescription medication exposure and overdose death and to expand harm reduction interventions both within and outside the healthcare system to reduce drug poisoning mortality.

The increasing prevalence of illicit stimulant use among those in opioid treatment programs poses a significant risk to public health, stimulant users have the lowest rate of retention and poorest outcomes among those in addiction treatment, and current treatment options are limited. Oxytocin administration has shown promise in reducing addiction-related behavior and enhancing salience to social cues. We conducted a randomized, double-blind, placebo-controlled clinical trial of intranasal oxytocin administered twice daily for 6 weeks to male Veterans with stimulant use disorder who were also receiving opioid agonist therapy and counseling (n = 42). There was no significant effect of oxytocin on stimulant use, stimulant craving, or therapeutic alliance over 6 weeks. However, participants receiving oxytocin (vs. placebo) attended significantly more daily opioid agonist therapy dispensing visits. This replicated previous work suggesting that oxytocin may enhance treatment engagement among individuals with stimulant and opioid use disorders, which would address a significant barrier to effective care.

This editorial published in Frontiers in Pharmacology titled "Substance use disorder: above and beyond addiction" provides a comprehensive examination of substance use disorder (SUD) from a multi-dimensional perspective. The editorial discusses various factors that contribute to the development, maintenance, and relapse of SUD, and highlights several studies on alcohol use disorder, opioid use, cocaine use disorder, and the impact of the COVID-19 pandemic on substance use. The authors hope that this research will enhance our understanding of SUD and inform comprehensive approaches to its management. The article also includes information about the funding and conflict of interest declarations for the research, with the authors receiving support from various research programs and declaring no conflicts of interest. The publisher emphasizes that the opinions expressed in the article are solely those of the authors and do not necessarily represent the views of their affiliated organizations or the publisher. [Extracted from the article]