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Background: Many clinical and population-based research studies pivoted from in-person assessments to phone-based surveys due to the COVID-19 pandemic. The impact of these transitions on survey response remains understudied, especially for people living with HIV. Given that there are gender-specific trends in alcohol and substance use, it is particularly important to capture these data for women.Objective: Identify factors associated with responding to an alcohol and substance use phone survey administered during the COVID-19 pandemic in the Women's Interagency HIV Study, a multicenter US prospective cohort of women living with and without HIV.Methods: We used multivariable logistic regression to assess for associations of pre-pandemic (April-September 2019) sociodemographic factors, HIV status, housing status, depressive symptoms, alcohol use, and substance use with response to an early-pandemic (August-September 2020) phone survey.Results: Of 1,847 women who attended an in-person visit in 2019, 78% responded to a phone survey during the pandemic. The odds of responding were lower for women of Hispanic ethnicity (aOR 0.47 95% CI 0.33-0.66, ref=Black/African American) and those who reported substance use (aOR 0.63 95% CI 0.41-0.98). By contrast, the odds were higher for White women (aOR 1.64 95% CI 1.02-2.70, ref=Black/African American) and those with stable housing (aOR 1.74 95% CI 1.24-2.43).Conclusions: Pivoting from an in-person to phone-administered alcohol and substance use survey may lead to underrepresentation of key subpopulations of women who are often neglected in substance use and HIV research. As remote survey methods become more common, investigators need to ensure that the study population is representative of the target population.

INTRODUCTION: People with opioid use disorder (OUD) have high rates of discharge against medical advice from the hospital. Interventions for addressing these patient-directed discharges (PDDs) are lacking. We sought to explore the impact of methadone treatment for OUD on PDD. METHODS: Using electronic record and billing data from an urban safety-net hospital, we retrospectively examined the first hospitalization on a general medicine service for adults with OUD from January 2016 through June 2018. Associations with PDD compared to planned discharge were examined using multivariable logistic regression. Administration patterns of maintenance therapy versus new in-hospital initiation of methadone were examined using bivariate tests. RESULTS: During the study time period, 1,195 patients with OUD were hospitalized. 60.6% of patients received medication for OUD, of which 92.8% was methadone. Patients who received no treatment for OUD had a 19.1% PDD rate while patients initiated on methadone in-hospital had a 20.5% PDD rate and patients on maintenance methadone during the hospitalization had a 8.6% PDD rate. In multivariable logistic regression, methadone maintenance was associated with lower odds of PDD compared to no treatment (aOR 0.53, 95% CI 0.34-0.81), while methadone initiation was not (aOR 0.89, 95% CI 0.56-1.39). About 60% of patients initiated on methadone received 30 mg or less per day. CONCLUSIONS: In this study sample, maintenance methadone was associated with nearly a 50% reduction in the odds of PDD. More research is needed to assess the impact of higher hospital methadone initiation dosing on PDD and if there is an optimal protective dose.

There are ∼20 types of retinal ganglion cells (RGCs) in mice, each of which has distinct molecular, morphological, and physiological characteristics. Each RGC type sends axon projections to specific brain areas that execute light-dependent behaviors. Here, we show that the T-box transcription factor Tbr2 is required for the development of several RGC types that participate in non-image-forming circuits. These types are molecularly distinct, project to non-image-forming targets, and include intrinsically photosensitive RGCs. Tbr2 mutant mice have reduced retinal projections to non-image-forming nuclei and an attenuated pupillary light reflex. These data demonstrate that Tbr2 acts to execute RGC type choice and/or survival in a set of RGCs that mediates light-induced subconscious behaviors.

The article presents a research which argues that Strawsonian accounts of moral responsibility are immune to manipulation arguments. The paper argues that manipulation is nothing like determinism in one relevant respect. It also considers two ways of modifying manipulation arguments to resist Strawsonian challenge. The paper also focuses on Derk Pereboom's four-case manipulation argument.

Objectives: Describe clinical and demographic associations with inpatient medication for opioid use disorder (MOUD) initiation on general medicine services and to examine associations between inpatient MOUD initiation by generalists and subsequent patient healthcare utilization. Methods: This is a retrospective study using medical record data from general medicine services at an urban safety-net hospital before an inpatient addiction consultation service. The patients were adults hospitalized for acute medical illness who had an opioid-related ICD-10 code associated with the visit. Associations with MOUD initiation were assessed using multivariable logistic regression. Hospital readmission, emergency department use, linkage to opioid treatment programs (OTP), and mortality at 30- and 90-days postdischarge were compared between those with and without hospital MOUD initiation using [chi] 2 tests. Results: Of 1,284 hospitalized patients with an opioid-related code, 59.81% received MOUD and 31.38% of these were newly initiated in-hospital. In multivariable logistic regression, Black race, mood disorder, psychotic disorder, and alcohol use disorder were negatively associated with MOUD initiation, while being aged 25-34, having a moderate hospital severity of illness score, and experiencing homelessness were positively associated. There were no bivariate associations between MOUD initiation and postdischarge emergency department use, hospital readmission, or mortality at 30- and 90-days, but those initiated on MOUD were more likely to present to an OTP within 90 days (30.57% vs 12.80%, P < 0.001). Conclusions: MOUD prescribing by inpatient generalists may help to increase the number of patients on treatment for opioid use disorder after hospital discharge. More research is needed to understand the impact of inpatient MOUD treatment without addiction specialty consultation. [ABSTRACT FROM AUTHOR]

The Moral Equality Account of Hypocrisy (ME) is a prominent theory of why hypocrites lack moral standing to blame. Hypocrites make exceptions for themselves and thereby implicitly deny moral equality, which is an essential premise of moral standing to blame. ME has recently faced challenges from philosophers who deny that it is the hypocrite's rejection of moral equality that causes her to lose moral standing to blame. I have distinguished three main challenges which I discuss and rebut in this article: "The Internal Blame and Blame of Fictional Characters Challenge", which I attribute to Todd (2019), and "The Hypercrite Challenge" and "The Inegalitarian Norm Challenge", which are due to Lippert-Rasmussen (2021). The article begins by offering an account of ME. It fills in a few gaps in the theory, by explaining why it is necessary for a blamer to invoke a special right to blame and by determining the type of right that standing to blame is. It also distinguishes between the question of why hypocrisy is wrong or bad, and the question of why it undermines moral standing to blame. I hold that several theories provide plausible answers to the first question, but only ME has so far given a good answer to the second question. When distinguishing properly between these two questions, we see that ME can respond satisfactorily to the three challenges. [ABSTRACT FROM AUTHOR]

The moral responsibility literature frequently relies on both explicit and implicit claims about "ideal" or "normal" agency that import unjustified normative assumptions into our theorizing. In doing so, it both fails to reckon with and misconstrues the reality of agential diversity. In this article I diagnose the root of this problem, which I trace back to the confluence of two factors: the search for fundamental agential capacities, and systemic discrimination toward psychological variance. I then preview three socially and politically important domains of inquiry that have been obscured by this paradigm as a way of motivating the need for and value of applying a neurodiversity perspective to moral responsibility and the ethics of blame. [ABSTRACT FROM AUTHOR]