Continuous Access Research Articles

In Case You Haven't Heard…

The U.S. Drug Enforcement Administration (DEA) and Substance Abuse and Mental Health Services Administration (SAMHSA) have issued a temporary rule that extends telemedicine flexibilities adopted during the COVID‐19 Public Health Emergency (PHE), an American Psychiatric Association's Psychiatric News Alert reported. The temporary rule was expected to go into effect on May 11, when the COVID‐19 PHE expires, and it extends the full set of telemedicine flexibilities adopted during the COVID‐19 PHE for six months (through Nov. 11, 2023). Additional flexibilities will extend to established patients until Nov. 11, 2024. “Access to evidence‐based treatment is a pillar of the HHS [U.S. Health and Human Services] Overdose Prevention Strategy,” said Miriam E. Delphin‐Rittmon, Ph.D., HHS assistant secretary for mental health and substance use and the leader of SAMHSA, in a May 9 press release issued by SAMHSA. “We strongly support policies that promote access to effective and safe treatment for opioid use disorder, including through telemedicine platforms, and ensuring continued access to necessary controlled medications past the COVID‐PHE.”

DEA, SAMHSA Release Temporary Rule Extending Telemedicine Flexibilities

Back to table of contents Previous article Next article ProfessionalFull AccessDEA, SAMHSA Release Temporary Rule Extending Telemedicine FlexibilitiesTerri D'ArrigoTerri D'ArrigoSearch for more papers by this authorPublished Online:11 May 2023https://doi.org/10.1176/appi.pn.2023.06.6.2AbstractThe rule extends the full set of telemedicine flexibilities adopted during the COVID-19 PHE through November 11. Additional flexibilities will extend to established patients until November 11, 2024.The U.S. Drug Enforcement Administration (DEA) and Substance Abuse and Mental Health Services Administration (SAMHSA) issued a temporary rule on May 10 that extends telemedicine flexibilities adopted during the COVID-19 Public Health Emergency (PHE). The temporary rule is effective today, May 11, and extends the full set of telemedicine flexibilities adopted during the COVID-19 PHE for six months (through November 11). Additional flexibilities will extend to established patients until November 11, 2024.“Access to evidence-based treatment is a pillar of the HHS Overdose Prevention Strategy,” said Miriam E. Delphin-Rittmon, Ph.D., the Health and Human Services (HHS) assistant secretary for mental health and substance use and the leader of SAMHSA, in a press release issued by SAMHSA. “We strongly support policies that promote access to effective and safe treatment for opioid use disorder, including through telemedicine platforms, and ensuring continued access to necessary controlled medications past the COVID-PHE.”This development is the latest in a story that began back in February, when the DEA announced two proposed rules (Docket No. DEA–407 and Docket No. DEA–948) for the prescribing of controlled medications via telemedicine. There was a 30-day public comment period for the proposed rules, which ended on March 31.The nation cannot afford policies that make it more difficult for patients to get the medications they need, says APA CEO and Medical Director Saul Levin, M.D., M.P.A.APA filed two letters with the DEA in response to the proposed rules during this time, recommending that the DEA “focus on balancing common-sense safeguards for DEA enforcement without decreasing access to lifesaving treatment” and consider ways to extend flexibilities made during the COVID-19 PHE. These comments were just two of the tens of thousands of comments that the agency received.DEA Administrator Anne Milgram on May 3 announced that the agency had received “a record 38,000 comments on its proposed telemedicine rules” and would delay releasing the two permanent rules that were set to go into effect when the COVID-19 PHE ends. “We take those [38,000] comments seriously and are considering them carefully,” Milgram said.The SAMHSA release noted: “For any practitioner-patient telemedicine relationships that have been or will be established up to November 11, 2023, the full set of telemedicine flexibilities regarding prescription of controlled medications established during the COVID-19 PHE will be extended for one year—through November 11, 2024.”“We recognize the importance of telemedicine in providing Americans with access to needed medications, and we have decided to extend the current flexibilities while we work to find a way forward to give Americans that access with appropriate safeguards,” Milgram said.“We are pleased that the DEA is taking the time to consider carefully the impact the proposed rules would have on patients, many of whom rely on telehealth as a means of accessing care,” said APA CEO and Medical Director Saul Levin, M.D., M.P.A. “At a time when the nation faces both a mental health crisis and an opioid crisis, we cannot afford policies that make it harder for patients to get the medications they need.” ■ResourcesThe temporary DEA rule “Temporary Extension of COVID-19 Telemedicine Flexibilities for Prescription of Controlled Medications”Proposed DEA rule “Telemedicine Prescribing of Controlled Substances When the Practitioner and the Patient Have Not Had a Prior In-Person Medical Evaluation”Proposed DEA rule “Expansion of Induction of Buprenorphine via Telemedicine Encounter”Statement from the DEA Administrator Anne Milgram on COVID-19 Telemedicine Flexibilities for Prescription of Controlled Medications ISSUES NewArchived

Library books: Aging and preservation

This opinion piece focuses on the topic of preserving library books that are facing the problem of aging, and it delves into the importance of preserving such books and the challenges faced in doing so. The strategies adopted for preservation are discussed, and some questions are posed that need to be answered in the area of preservation of library books. This work may serve as a useful guide for librarians and others concerned with the preservation of books, providing insights into the best practices, challenges, and strategies for maintaining library books for posterity. Indeed, the preservation of library books is crucial for ensuring the continued accessibility and availability of knowledge and information for future generations.

The global impact of COVID-19 on abortion care

BackgroundThe COVID-19 pandemic placed unprecedented strain on healthcare globally, which exacerbated factors leading to unplanned pregnancies. ObjectivesThe primary objective was to analyze the effect of COVID-19 on abortion services globally. Secondary objectives were to discuss issues regarding access to safe abortion and provide recommendations on continued access during pandemics. Search strategyA search for relevant articles was conducted by utilizing multiple databases (PubMed, Cochrane, etc.). Selection criteriaStudies on COVID-19 and abortion were included. Data collection & analysisThe legislation governing abortion services across the globe was examined, inclusive of modifications to service provision during the pandemic. Global data on abortion rates and analyses of selected articles were also included. Main results14 countries instituted legislative changes related to the pandemic, 11 relaxed abortion regulations, while three restricted abortion access. An increase in abortion rates was seen particularly where telemedicine was available. Where abortions were postponed, second-trimester abortions increased after services resumed. ConclusionsLegislation, risk of exposure to infection, and access to telemedicine affect access to abortion. The use of novel technologies, maintaining existing infrastructure and enhancing the roles of trained manpower for safe abortion access is recommended to avoid the marginalization of women's health and reproductive rights.

The rise and fall of onion production; its multiple constraints on pre-harvest and post-harvest management issues along the supply chain in northwest Ethiopia

Food and nutrition security is not only addressed by increasing production alone, it should also ensure by reducing food loss. Onion has a great contribution to both economic and health issues, however, its production and productivity in the country is low. Thus, the study was initiated to identify multiple constraints on onion production and postharvest handling practices and to determine the extent of postharvest loss along the supply chain in northwestern Ethiopia. The survey was conducted on production, marketing, and consumption at farm, wholesale, retailer, and consumers level. The multistage sampling procedure was employed. The present results revealed that sex, age, educational level, production experience, land covered by onion, and household size has a significant influence on onion production. Sex, age, education level, active household size, selling experience, amount purchased, and storage duration have a significant association with onion production and postharvest loss. Major onion production and post-harvest loss constraints were high perishability, nature of the crop, market, linkage problem and low market price, lack of awareness of using post-harvest technologies, absence of better storable varieties, shortage of fertilizer access, disease and insect pests. The whole purchased produce never reached the consumer's hands. The total postharvest loss of onion at the farmer, wholesale, retail, and consumer level was found to be 29.775%, of which the higher proportion of losses (35.5%) was observed at the farmer's level. Based on the findings of the present study, onion producers were challenged by timely and adequate supplies and unfair, high cost of major production inputs, and high post-harvest loss. Therefore, producers and handlers in each supply chain need to be trained on affordable and applicable postharvest technologies. In addition, continuous capacity-building training, improving infrastructures, and input access along the supply chain should be designed and implemented to improve better crop management and postharvest handling practices. Moreover, marketing cooperatives working on onion postharvest handling and marketing systems should be functional to absorb surplus production and ensure continuous supply to the market. Thus, meaningful interventions in the development and implementation of policy on sustainable production, handling practices, and supply of onion should be designed.

No Island is an Island: Understanding the Geo-social Interaction of Small Islands in the Philippine Archipelagoscape

Studies that focus on archipelagos and the interaction between and among islands in an archipelago are lacking. This study aims to contribute to this emerging discussion by determining the geo-social interactions of small islands in the Naranjo Group of Islands, Philippines. Using Social Network Analysis (SNA), descriptive network connectivity statistics — degree centrality, geographical centrality, and network density indices were generated. The geo-social interaction intensity (GSII) index was also calculated to assess the degree of geo-social interactions of the small islands. The geo-social interaction between and among islands in the Naranjo Group of Islands involves access or exchange of resources, goods, and services. The degree of geo-social interaction in the archipelagoscape was influenced by the islanders’ need to access resources, resource availability, distance, weather, transport, and sea condition. The degree of linkages between and among islands in an archipelagoscape serves as a safeguard during a disturbance by promoting resilience against challenges by ensuring continued access to resources or constraining its spread. The study recommends a strengthened geo-social interaction to ensure a continued flow of goods and services necessary for island existence, survival, and well-being. Further research on the relationship between island resilience and connectivity from an archipelagic perspective is also suggested.

Prelimbic cortex inactivation prevents ABA renewal based on satiety state

We have previously shown that the rat prelimbic cortex (PL) is necessary for contexts to promote the performance of instrumental behaviors that have been learned in them, whether the context is physical (operant chamber) or behavioral (recent performance of a behavior that has historically preceded the target in a behavior chain). In the present experiment, we investigated the role of the PL in satiety level as an interoceptive acquisition context. Rats were trained to lever-press for sweet/fat pellets while sated (22 hrs continuous food access) followed by the extinction of the response while hungry (22 hrs food deprived). Pharmacological inactivation of the PL (with baclofen/muscimol infusion) attenuated renewal of the response that occurred upon a return to the sated context. In contrast, animals that received a vehicle (saline) infusion showed renewal of the previously extinguished response. These results support the hypothesis that the PL monitors the relevant contextual elements (physical, behavioral, or satiety state) associated with reinforcement of a response and promotes the subsequent performance of that response in their presence.

An Assessment of Psychological Distress Symptoms and Accessing Mental Health Treatment Among Aging Incarcerated Persons

ABSTRACT There has been a “graying” of the prison population during the last several decades. Little research has been done on the psychological distress symptoms and treatment access of the growing older incarcerated population. This study considers how age affects rates of psychological distress symptoms and mental health treatment for incarcerated persons. Data included state respondents from the Survey of Prison Inmates, 2016. Ordinal logistic regression was used to assess the relationship between psychological distress symptoms and aging in prison. Binary logistic regression was used to examine the relationship between accessing mental health treatment and aging in prison. Older incarcerated individuals were more likely than younger incarcerated individuals to report feeling symptoms of psychological distress if they were not currently accessing treatment. Older individuals who had accessed treatment in prison were more likely to be currently accessing treatment than younger incarcerated individuals, and the longer one was incarcerated the less likely one was to access treatment. How do we ensure that those who need treatment are getting it? Especially those who have been incarcerated for a long time. Overall, this study shows that older incarcerated persons need continued access to treatment tailored to their unique needs as a group.

Gastrointestinal endoscopy devices and the European Union Medical Device Regulation: European Society of Gastrointestinal Endoscopy (ESGE) Position Statement.

Gastrointestinal endoscopy is largely dependent on medical devices. The European Union (EU) has recently introduced stricter rules and regulations for the approval of medical devices. This has consequences both for endoscopists and for patients. The new regulations increase the need for clinical trials and observational studies for new and current devices used in endoscopy to ensure clinical benefit and reduce patient harm. European endoscopy environments should facilitate industry-sponsored clinical trials and registry studies to meet the demand for robust data on endoscopic devices as required in the new legislation. The European Society of Gastrointestinal Endoscopy (ESGE) will play an active role in the establishment of the new system.The EU is establishing independent expert panels for device regulation in gastroenterology and hepatology, including endoscopy, that are charged with assessing the requirements for device testing. The ESGE encourages endoscopists with expertise in the technical and clinical performance of endoscopy devices to apply for expert panel membership. The ESGE has provided information for interested endoscopists on the ESGE website. Private European companies called "notified bodies" are entitled to conduct device approval for the EU. The ESGE will actively engage with these notified bodies for topics related to the new endoscopy device approval process to ensure continued access to high quality endoscopy devices for endoscopists in Europe.

Feasibility and acceptability of an evidence-informed digital intervention to support self-management in people with non-alcoholic fatty liver disease: protocol for a non-randomised feasibility study (VITALISE)

BackgroundNon-alcoholic fatty liver disease (NAFLD) represents a spectrum of disease ranging from simple fatty liver to non-alcoholic steatohepatitis, cirrhosis, liver cancer and liver failure. NAFLD affects up to 30–40% of adults in Western countries and is directly linked to overweight and obesity. There are no approved drugs to specifically target NAFLD, therefore weight loss achieved through changes in dietary and physical activity behaviours is the recommended management approach. However, achieving and sustaining weight loss is challenging for patients with NAFLD. We developed a NAFLD-specific digital lifestyle intervention (VITALISE) to target changes in dietary and physical activity behaviours of patients with NAFLD to initiate weight loss and weight loss maintenance. This study aims to evaluate the feasibility and acceptability of VITALISE in a secondary care clinical setting.MethodsA single-centre, one-arm, prospective design will be used to assess the feasibility and acceptability of recruitment, uptake, engagement and completion of VITALISE. Health-related outcomes will be assessed at baseline and 6-months. An interim measure of self-reported weight, physical activity and self-efficacy will be recorded at 12-weeks. Qualitative semi-structured interviews conducted at 6 months follow up will further explore acceptability and feasibility and fidelity of receipt and enactment. The study aims to recruit 35 patients with newly diagnosed NAFLD over a 6-month time period. Eligible patients will have continuous access to VITALISE and monthly tele-coaching support for 6 months prior to follow-up with a hepatologist.DiscussionVITALISE offers access to evidence and theory-informed tailored dietary and physical activity support for patients with NAFLD. The intervention is designed for use by patients in their own time, outside of the hospital setting to overcome well documented challenges including attending additional appointments, and lack of time during routine appointments to adequately address lifestyle behaviour change. This feasibility study will determine the feasibility of VITALISE to support clinical care delivery.Trial registrationISRCTN12893503.

How the timing of visual feedback influences goal-directed arm movements: delays and presentation rates

Visual feedback normally helps guide movements to their goal. When moving one’s hand, such guidance has to deal with a sensorimotor delay of about 100 ms. When moving a cursor, it also has to deal with a delay of tens of milliseconds that arises between the hand moving the mouse and the cursor moving on the screen. Moreover, the cursor is presented at a certain rate, so only positions corresponding with the position of the mouse at certain moments are presented. How does the additional delay and the rate at which cursor positions are updated influence how well the cursor can be guided to the goal? We asked participants to move a cursor to consecutive targets as quickly as they could. They did so for various additional delays and presentation rates. It took longer for the mouse to reach the target when the additional delay was longer. It also took longer when a lower presentation rate was achieved by not presenting the cursor all the time. The fraction of the time during which the cursor was present was more important than the rate at which the cursor’s position was updated. We conclude that the way human arm movements are guided benefits from continuous access to recent visual feedback.

Applying behavioral economics-based approaches to examine the effects of liquid sucrose consumption on motivation

Overconsumption of sugar contributes to obesity in part by changing the activity of brain areas that drive the motivation to seek out and consume food. Sugar-sweetened beverages are the most common source of excess dietary sugar and contribute to weight gain. However, very few studies have assessed the effects of liquid sucrose consumption on motivation. This is due in part to the need for novel approaches to assess motivation in pre-clinical models. To address this, we developed a within-session behavioral economics procedure to assess motivation for liquid sucrose. We first established and validated the procedure: we tested several sucrose concentrations, evaluated sensitivity of the procedure to satiety, and optimized several testing parameters. We then applied this new procedure to determine how intermittent vs. continuous access to liquid sucrose (1 M) in the home cage affects sucrose motivation. We found that intermittent liquid sucrose access results in an escalation of sucrose intake in the home cage, without altering motivation for liquid sucrose during demand testing (1 M or 0.25 M) compared to water-maintained controls. In contrast, continuous home cage access selectively blunted motivation for 1 M sucrose, while motivation for 0.25 M sucrose was similar to intermittent sucrose and control groups. Thus, effects of continuous home cage liquid sucrose access were selective to the familiar sucrose concentration. Finally, effects of sucrose on motivation recovered after removal of liquid sucrose from the diet. These data provide a new approach to examine motivation for liquid sucrose and show that escalation of intake and motivation for sucrose are dissociable processes.

Difference in general practice telehealth utilisation associated with birth country during Covid-19 from two Australian states.

Telehealth has been an integral part of ensuring continued general practice access during the Covid-19 pandemic. Whether telehealth was similarly adopted across different ethnic, cultural, and linguistic groups in Australia is unknown. In this study, we assessed how telehealth utilisation differed by birth country. In this retrospective observational study, electronic health record data from 799 general practices across Victoria and New South Wales, Australia between March 2020 to November 2021 were extracted (12,403,592 encounters from 1,307,192 patients). Multivariate generalised estimating equation models were used to assess the likelihood of a telehealth consultation (against face-to-face consultation) by birth country (relative to Australia or New-Zealand born patients), education index, and native language (English versus others). Patients born in South-eastern Asia (aOR 0.54; 95%CI 0.52 - 0.55), Eastern Asia (aOR 0.63; 95%CI 0.60 - 0.66), and India (aOR 0.64; 95%CI 0.63 - 0.66) had a lower likelihood of having a telehealth consultation compared to those born in Australia or New Zealand. Northern America, British Isles, and most European countries did not present with a statistically significant difference. Additionally, higher education levels (aOR 1.34 95%CI 1.26 - 1.42) was associated with an increase in the likelihood of a telehealth consultation, while being from a non-English speaking country was associated with a reduced likelihood (aOR 0.83 95%CI 0.81 - 0.84). This study provides evidence showing differences in telehealth use associated with birth country. Strategies to ensure continued healthcare access for patients whose native language is not English, such as providing interpreter services for telehealth consultations, would be beneficial. Understanding cultural and linguistic differences may reduce health disparities in telehealth access in Australia and could present an opportunity to promote healthcare access in diverse communities.

Hidden Markov Chain Model-Based Intelligent Distributed Optimization Scheduling Operation Error Prevention Method for Main Network

After the implementation of the intelligent distributed optimal dispatching mode of the main network, the number of operations is more frequent, resulting in the problem of operation error, which affects the reliability and stability of the power grid operation. In this paper, a hidden Markov chain (HMC) model-based intelligent distributed optimization scheduling operation error prevention method for the main network is proposed. In this study, the power grid topology model is established through continuous access, which lays the foundation for the dynamic tracking of dispatching operation instructions. The hidden Markov chain model is used to estimate the operational risk of scheduling. Combining with the association mining theory, the anti-error detection rules between risk and anti-error strategy are established, and the anti-error strategy is implemented. The results show that under the application of the operation error prevention method, the operation error prevention response time difference and the voltage fluctuation range of the power grid reach the minimum. Through this study, it is expected to provide a reliable reference for dispatchers to make more effective dispatching decisions and correct dispatching errors in time.

Shifting ground or moving furniture around: Youth participatory action research in Kakuma Refugee Camp

AbstractThis reflection is drawn from a youth participatory action research (YPAR) collaboration set in Kakuma Refugee Camp in Kenya. It explores the ways youth co‐researchers employed YPAR tools to both critique and uphold their limited educational opportunity structure. It also questions the limits of transformative methodologies that embolden young people to critique the structures that govern their lives, especially for stateless peoples whose survival depends on continued access to those same structures.

Summative content analysis of the recommendations from Project ECHO Ontario Autism.

Practitioners report a lack of knowledge and confidence in treating autistic children, resulting in unmet healthcare needs. The Extension of Community Healthcare Outcomes (ECHO) Autism model addresses this through discussion of participant-generated cases, helping physicians provide best-practice care through co-created recommendations. Recommendations stemming from ECHO cases have yet to be characterized and may help guide the future care of autistic children. Our objective was to characterize and categorize case discussion recommendations from Project ECHO Ontario Autism to better identify gaps in clinician knowledge. We conducted a summative content analysis of all ECHO Ontario Autism case recommendations to identify categories of recommendations and their frequencies. Two researchers independently coded recommendations from five ECHO cases to develop the coding guide. They then each independently coded all remaining cases and recommendations from three cycles of ECHO held between October 2018 to July 2021, meeting regularly with the ECHO lead to consolidate the codes. A recommendation could be identified with more than one code if it pertained to multiple aspects of autism care. Categories from the various codes were identified and the frequency of each code was calculated. Of the 422 recommendations stemming from 62 cases, we identified 55 codes across ten broad categories. Categories included accessing community resources (n = 224), referrals to allied health and other providers (n = 202), ongoing autism care (n = 169), co-occurring mental and physical health conditions (n = 168), resources and tools for further learning (n = 153), physician to provide education and coaching to families (n = 150), promoting parent and family wellness (n = 104), supporting community autism diagnosis (n = 97), promoting patient empowerment and autonomy (n = 87), and COVID-19 (n = 26). This is the first time that recommendations from ECHO Autism have been characterized and grouped into categories. Our results show that advice for autism identification and management spans many different facets of community-based care. Specific attention should be paid to providing continued access to education about autism, streamlining referrals to allied health providers, and a greater focus on patient- and family-centered care. Physicians should have continued access to autism education to help fill knowledge gaps and to facilitate families' service navigation.

Fleeting energy protections: State and utility level policy responses to energy poverty in the United States during COVID-19

Millions of American households suffer from energy poverty, threatening their continued access to electricity. The COVID-19 pandemic of 2020 has unveiled the entrenched environmental and energy injustices that threaten public health at the household level and has inspired energy protection responses to address pandemic-caused economic hardship. While policies supporting energy protections have been in place for years, they vary spatially. Moreover, the scholarly research that explores energy protection responses during the pandemic is limited. This paper explores energy protection responses to the pandemic implemented in 25 major metropolitan areas in the United States. We employ a content analysis of policy language to examine the response time, authorization level, and type of energy protections deployed during the initial months of the pandemic. We demarcate authorization level as either mandatory or voluntary measures and characterize ‘energy resiliency responses’ as a suite of residential energy protections required to reduce vulnerability to energy poverty and build resilience during the pandemic. We examine the total number and type of responses relative to household energy burden. We find differences in residential consumer energy protections among low-income and highly energy burdened households and conclude that protections are unevenly deployed across the country. Our findings motivate contemporary national, state, and local energy poverty recognition and responses that center personal and economic wellbeing during and after crises.

A novel monobactam lacking antimicrobial activity, MC-100093, reduces sex-specific ethanol preference and depressive-like behaviors in mice

Several β-lactam derivatives upregulate astrocytic glutamate transporter type 1expression and are known to improve measures in models of mood and alcohol use disorders (AUD) through normalizing glutamatergic states. However, long-term, and high doses of β-lactams may cause adverse side effects for treating mood disorders and AUD. Studies suggest that MC-100093, a novel β-lactam lacking antimicrobial activity, rescues GLT1 expression. Thus, we sought to investigate whether MC-100093 improves affective behaviors and reduces voluntary ethanol drinking. We intraperitoneally administered MC-100093 (50 mg/kg) or vehicle once per day to C57BL/6J male and female mice (8–10 weeks old) over 6 days. We employed the open field test and the elevated plus maze to examine the effect of MC-100093 on anxiety-like behaviors. We assayed MC-100093's effects on depressive-like behaviors using the tail suspension and forced swim tests. Next, utilizing a separate cohort of male and female C57BL6 mice, we assessed the effects MC100093 treatment on voluntary ethanol drinking utilizing the 2-bottle choice continuous access drinking paradigm. After screening and selecting high-drinking mice, we systematically administered MC-100093 (50 mg/kg) or vehicle to the high-drinking mice over 6 days. Overall, we found that MC-100093 treatment resulted in sex-specific pharmacological effects with female mice displaying reduced innate depressive-like behaviors during the tail suspension and force swim testing juxtaposed with male treated mice who displayed no changes in tail suspension and a paradoxical increased depressive-like behavior during the forced swim testing. Additionally, we found that MC100093 treatment reduced female preference for 10% EtOH during the 2-bottle choice continuous access drinking with no effects of MC100093 treatment detected in male mice. Overall, this data suggests sex-specific regulation of innate depressive-like behavior and voluntary EtOH drinking by MC100093 treatment. Western blot analysis of the medial prefrontal cortex and hippocampus revealed no changes in male or female GLT1 protein abundance relative to GAPDH.

Serotonin regulation of intermittent and continuous alcohol drinking in male and female C57BL/6J mice with systemic SB242084 and buspirone.

This study aims to assess the therapeutic potentials of novel serotonergic compounds in treating alcohol use disorders by investigating the effects of SB242084 and buspirone on intermittent and continuous alcohol consumption in male and female mice. Adult male and female C57BL/6J mice were given two-bottle choice to 20% ethanol and water on an intermittent or continuous availability schedule. Drug testing consisted of intraperitoneal injections of 0.3, 1, 3mg/kg SB242084 or 1, 3, 10mg/kg buspirone, and subsequent alcohol and water consumption were measured. To monitor the drug effects on anxiety-like and locomotor behavior, the highest dose of each compound was administered before free activity in an open field. SB242084 dose-dependently attenuated alcohol drinking for intermittent alcohol drinking in male mice but did not significantly alter alcohol drinking in mice given continuous access. Two-hour and four-hour female drinking behavior was unaffected by SB242084. In comparison, buspirone not only suppressed intermittent and continuous alcohol drinking in both males and females but also reduced distance traveled in the open field test. Observed differences in responses to SB242084 between drinking groups may imply differing neural mechanisms between episodic and continuous drinking driven by serotonin. Reductions in drinking after buspirone treatment may be related to non-specific properties. These findings suggest the therapeutic potential of compounds blocking the 5-HT2C receptor for alcohol use disorders.

The burden and scope of childhood cancer in displaced patients in Jordan: The King Hussein Cancer Center and Foundation Experience.

Jordan hosts one of the highest numbers of refugees per capita in the world, with the Syrian crisis leading to an influx of displaced persons to the already vulnerable population. However, limited resources and a lack of cancer-care strategies have made it difficult for refugees in Jordan to access quality cancer care. The King Hussein Cancer Center (KHCC) and Foundation (KHCF) have played a pivotal role in providing financial and medical support for displaced children with cancer, treating 968 non-Jordanian children with cancer between 2011-2022, with a median age of 6 years. Of these, 84% were fully funded by KHCF, and nationalities included Syrians (29%), Palestinians (26%), Iraqis (23%), and Yemenis (17%). Cancer diagnoses included solid tumors (44%), leukemia (23%), lymphoma (13%), bone sarcomas (9.5%), and retinoblastoma (9.1%). The median cost of treatment was JOD 18,000 (USD 25,352), with a total estimated cost of JOD 23.8 million (USD 33.5 million). More recently, in partnership with St. Jude Children's Research Hospital (SJCRH), two successive humanitarian funds (HF) were established to optimize cancer care for displaced children in Jordan. Between February 2018 and September 2022, 51 children were fully treated on KHCC-SJCRH-HF, with a median age of 6 years and nationalities including Syrians (80%), Iraqis (6%), and Yemenis (8%). The most common cancer diagnoses were leukemia (41%), lymphoma (25%), solid tumors (24%), retinoblastoma (6%), and brain tumors (4%). Of these, 94% are alive and 51% are still receiving coverage. The median coverage for patients was JOD 21,808 (USD 30,715), and the total cost of treatment on KHCC/KHCF-SJCRH/American Lebanese Syrian-Associated Charities HF1 and HF2 was JOD 1.44 million (USD 1.97 million) and JOD 1.18 million (USD 1.67 million), respectively. This experience highlights the high burden of displaced children with cancer in Jordan, and the importance of local foundations like KHCC/KHCF and partnerships with international partners like SJCRH in providing lifesaving humanitarian initiatives and quality cancer care. Innovative cancer-care delivery models and sustainable financing are essential to ensure continuous coverage and access to cancer care for displaced persons in Jordan.