Factors Affecting Initiation and Retention of Medication-Assisted Recovery (MAR) within a Pilot Pharmacist-Involved Practice Model at a Federally Qualified Healthcare Center (FQHC) during the COVID-19 Pandemic.

BACKGROUND: During the COVID-19 pandemic, opioid-related overdose deaths increased. Although Medication-Assisted Treatment or Recovery (MAT or MAR) is available, initiation and retention rates vary. The goal of this study was to evaluate clinical, demographic, and Social Determinant of Health factors affecting MAR initiation, on-time initiation of medications, and successful retention in the program. The secondary goal was to evaluate the impact of a novel interprofessional practice model incorporating pharmacists. METHODS: A retrospective analysis was conducted using electronic health record data from a pilot MAR Program initiated within a California Federally Qualified Healthcare Center. RESULTS: From September 2019 to August 2020, 48 patients enrolled into the program. On-time initiation of medications occurred in 68% of patients and average program retention was 96.4 ± 95.8 days. Patients currently using opioids (p = 0.005) and those receiving supportive medications (p = 0.049) had lower odds of on-time MAR initiation. There were no statistically significant factors associated with successful retention in the program. The number of visits with members of the interprofessional team did not significantly affect on-time initiation or successful retention. CONCLUSIONS: Current opioid use and receipt of supportive medications were associated with lower on-time medication initiation. Further studies are warranted to explore additional factors which may affect initiation and retention.

Covid-19 Mppt Algorithm Application to Solar Energy Conversion System

Alternative energy alternatives to traditional energy sources like coal and fossil fuels include solar PV and wind energy conversion systems. The solar and wind energy conversion system's maximum power may be obtained by activating the converters. There are several MPPT (Maximum Power Point Tracking) regulating methods for solar and wind energy conversion systems. For solar PV energy conversion systems, this study suggests two MPPT controlling techniques: Covid-19 MPPT and FLC-based MPPT. The two MPPT methods that are suggested are put into practise using MATLAB. The first Covid-19 approach that has been developed combines aspects of hill climbing and progressive conductance methods. Calculate the direction of the perturbation for the PV modules' operation using the incremental conductance approach. The method of ascending hills is straightforward and involves fewer variables. When dI/dV equals the incremental conductance, the Maximum Power Point (MPP) is attained using the incremental conductance approach. In the hill climbing approach, the MPP is determined by comparing the power in the present and the past. Both incremental conductance and change of power are taken into account in the proposed Covid-19 MPPT regulating approach to obtain the MPP. With this hybrid approach, solar PV generates the most electricity possible under all conditions of temperature and irradiance. As a result, the planned Covid-19 technique moves forward as intended and swiftly reaches the MPP.Copyright © 2022, Anka Publishers. All rights reserved.

Determinants of Intention to Use e-Wallet post-Covid-19 Pandemic in Malaysia: Integration of UTAUT and MAT models

The COVID-19 pandemic has indirectly accelerated the lifestyle transition to a cashless society and the application of digital payment transactions. However, compared to existing digital payment channels, the acceptance of e-wallets among consumers in Malaysia is still minimal. Therefore, this study aims to identify factors affecting the consumers' intention to use e-wallets during the post-COVID-19 pandemic in Malaysia. The study integrates the Unified Theory of Acceptance and Use of Technology (UTAUT) and Mental Accounting Theory (MAT) models by considering additional factors of perceived benefit, perceived security, and trust. It uses the purposive sampling technique and collected 303 responses through a survey. Based on the PLS-SEM analysis, the findings indicate that perceived benefits, perceived security, trust, and social influence positively impact the intention to use e-wallets. Meanwhile, the effects of performance expectation and effort expectation are not significant. This study provides knowledge to the industry to understand consumer behaviour during post-pandemic to develop business strategies and digital payment applications such as by enhancing e-wallet design, content, system and features. © 2022 Authors. All rights reserved.

21stRSC/SCI Medicinal Chemistry Symposium Cambridge/Virtual - September 13-15, 2021

The Royal Chemistry Society/Society of Chemistry Industry (RSC/SCI) Medicinal Chemistry Symposium is a key symposium in the field of medicinal chemistry that takes place every 2 years at the University of Cambridge, U.K., under the auspices of the RSC and the SCI. This year, in its 21st edition, it was run as a hybrid event, simultaneously attended by both in-person and virtual attendees. Its theme was 'Improving Success', and 25 orals and 30 posters were presented. The scientific program covered recent medicinal chemistry achievements in major therapeutic areas, with a few first-time structure disclosure presentations and particular emphasis on emerging early-stage drug discovery and lead optimization strategies, including reports of successful case studies illustrating fragment-based screening and phenotypic target engagement approaches. Applications of artificial intelligence (AI), mass spectrometry and photochemistry in drug design and discovery were also highlighted. This report will cover some of the medicinal chemistry presentations delivered at the meeting.

Multilayered Triboelectric Energy Harvester as a Smart Floor Mat

This paper develops a multilayered triboelectric energy harvester and demonstrates its application as a smart floor mat. Triboelectrification is the process in which contact and separation between two triboelectric electrode surfaces result in the generation of opposite charges on them. Due to the tendency of conductive materials to attain charge equilibrium, the electrons flow from the ground to the conductor or vice versa to make it neutral. As a result, an alternating current (AC) flows in the external circuit as the materials contact and separate. In this work, we fabricated an array of triboelectric nanogenerators (TENG) by connecting eight zigzag-shaped multilayered TENGs (each containing three units) in series to realize a smart floor mat. The TENG array was sandwiched between two wooden slabs and was placed in front of the library entrance to control the occupancy by tracking the number of people entering/leaving. This smart floor mat generated a maximum output power of 119.7 μW, which lit up to 40 light-emitting diodes (2mA current with 10μF capacitance) when the mat was compressed and released periodically. The device will have potential applications in tracking the number of people entering/leaving a facility. In this Covid-19 era, the control of occupancy rate becomes more crucial in an indoor setting such as in libraries, shopping malls, etc. This study provides a simple, straightforward, and low-cost solution to achieving the control measure. In addition, the traditional occupancy tracking systems based on cameras, processors, and sensors are expensive compared to our low-cost and energy-efficient smart floor mat. Hence, our design has the potential to provide a promising alternative to the existing solutions. © 2022 IEEE.

Effects of COVID-19 on individuals in Opioid Addiction Recovery

Opioid Use Disorder (OUD) is one of the most severe health care problems in the USA. People addicted to opioids need various treatments, including Medication-Assisted Treatment (MAT), proper counseling, and behavioral therapies. However, during the peak time of the COVID-19 pandemic, the supply of emergency medications was disrupted seriously. Patients faced severe medical care scarcity since many pharmaceutical companies, drugstores, and local pharmacies were closed. Import-export was also canceled to consent to the government emergency law, i.e., lockdown, quarantine, and isolation. These circumstances and their negative effects on OUD patient's psychology could have led them to a drop out of MAT medications and persuaded to resume illicit opioid use. This project involves collecting and analyzing a large volume of Twitter data related to MAT medications for OUD patients. We discover the Active MAT Medicine Users (AMMUs) on twitter. For this, we build a seed dictionary of words related to OUD and MAT and apply association rules to expand it. Further, AMMUs' tweet posts are studied 'before the pandemic' (BP) and 'during the pandemic' (DP) to understand how the drug behaviors and habits have changed due to COVID-19. We also perform sentiment analysis on Tweets to determine the impact of the COVID-19 pandemic on the psychology of AMMUs. Our analysis shows that the use of MAT medications has decreased around 30.54%, where the use of illicit drugs and other prescription opioids increased 18.06% and 12.12%, respectively, based on AMMUs' tweets posted during the lockdown compared with before the lockdown statistics. The COVID-19 pandemic and lockdown may result in the resumption of illegal and prescription opioid abuse by OUD patients. Necessary steps and precautions should be taken by health care providers to ensure the emergency supply of medicines and also psychological support and thus prevent patients from illicit opioid use. © 2021 IEEE.

MODERN MICROBIALITES and MICROBIAL MATS in VOLCANOES, WETLANDS and SALT FLATS of the CENTRAL ANDES. PROSPECTION, SCIENCE, PRESERVATION and BIOTECHNOLOGICAL APPLICATIONS

The wetlands and salt flats of the Central Andes region are unique extreme environments as they are located in high-altitude saline deserts, largely influenced by volcanic activity. Environmental factors such as ultraviolet (UV) radiation, arsenic content, high salinity, low dissolved oxygen content, extreme daily temperature fluctuation, and oligotrophic conditions, resemble the early Earth and potentially extraterrestrial conditions. The discovery of modern microbialites and microbial mats in the Central Andes during the past decade has increased the interest in this area as an early Earth analog. Along 10 years of prospection of these microbial ecosystems, we have reported, for first time for science, around 35 new systems along wetlands, lakes, volcanoes, and salt flats of Central Andes region of Argentina, Chile, and Bolivia. Microbial biodiversity and metagenomic characterization, together with ancestral biogeochemical cycles, including arsenic and carbon together with bacterial rhodopsin systems, photoreceptors characterization and plasmid biology were studied in these systems. This production of knowledge was accompanied by involvement of Andean ancestral communities, mining industries and governments in order to promote the preservation of these ancestral ecosystems. Finally, the last year, during pandemic, two stories of biotech applications based on basic knowledge of Andean extremophiles became in two Start Ups invested by the GRID X incubator program https://gridexponential.com: 1- CASPR-BIOTECH https://caspr.bio develops diagnostic kits that apply to COVID19, Hanta virus and Dengue and is based on new CRISPR-Cas systems that we discovered in the Puna salt flats and patented in the USA. 2- We founded CKAPUR https://Ckapur.com, a company that develops sustainable biotechnology applied to agriculture based on Extremophilic microorganisms: "ancestral stardust recyclers" isolated from salt flats. In this moment this Start Up is being part on Indiebio program in San Francisco USA https://indiebio.co/ In that way, studying and preserving microbial extreme biodiversity from salt pads can generate economic development in local communities through NAGOYA treaty as much as it does in mining development, only without any type of environmental impact.

Implications of Increased Access to Buprenorphine for Medical Providers in Rural Areas: A Review of the Literature and Future Directions.

Buprenorphine/Naloxone (Suboxone®) is an efficacious treatment for opioid use disorder (OUD) due to its more convenient dosing, superior safety profile, and decreased incidence of negative side effects when compared to other forms of medications for opioid use disorder (MOUD). In the United States, updated legislation in 2021 entitled, "The Practice Guidelines for the Administration of Buprenorphine for Treating Opioid Use Disorder", released by the Department of Health and Human Services, creates an exemption for the previously required Drug Addiction Treatment Act of 2000 (DATA) waiver for buprenorphine prescribing for clinicians. This legislation was born out of a need for making MOUD more accessible for patients living with OUD as rates of opioid-related deaths in the United States have continued to rise and have increased disproportionately during the time period of the COVID-19 pandemic. This legislation has the potential to improve access to MOUD across all geographic locations, but may have the most profound impact in rural areas where significant disparities and challenges still exist in patients' ability to access buprenorphine. The purpose of this literature review is to 1) examine how MOUD prescribing has changed after previous legislation changes, 2) explore the current state of buprenorphine access for treatment of OUD in rural America, 3) detail existing barriers in patients' ability to access MOUD, and 4) discuss future directions and considerations as a result of new legislation. This literature review found several existing barriers to receiving MOUD such as increasing costs, insufficient education, significant stigma, and the need for more innovative methods of delivery. We also found that there is currently a large opportunity for growth in the number of rural clinicians able to prescribe buprenorphine, particularly in primary care, that may now occur as a result of this new legislation. Overall, this legislation has the potential to have a positive impact on combating OUD, especially in rural areas, and may be a critical step towards ending the current opioid epidemic in the United States as these described barriers are addressed.

Association of body composition parameters measured on CT with risk of hospitalization in patients with Covid-19.

PURPOSE: To assess prognostic value of body composition parameters measured at CT to predict risk of hospitalization in patients with COVID-19 infection. METHODS: 177 patients with SARS-CoV-2 infection and with abdominopelvic CT were included in this retrospective IRB approved two-institution study. Patients were stratified based on disease severity as outpatients (no hospital admission) and patients who were hospitalized (inpatients). Two readers blinded to the clinical outcome segmented axial CT images at the L3 vertebral body level for visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT), muscle adipose tissue (MAT), muscle mass (MM). VAT to total adipose tissue ratio (VAT/TAT), MAT/MM ratio, and muscle index (MI) at L3 were computed. These measures, along with detailed clinical risk factors, were compared in patients stratified by severity. Various logistic regression clinical and clinical + imaging models were compared to discriminate inpatients from outpatients. RESULTS: There were 76 outpatients (43%) and 101 inpatients. Male gender (p = 0.013), age (p = 0.0003), hypertension (p = 0.0003), diabetes (p = 0.0001), history of cardiac disease (p = 0.007), VAT/TAT (p < 0.0001), and MAT/MM (p < 0.0001), but not BMI, were associated with hospitalization. A clinical model (age, gender, BMI) had AUC of 0.70. Addition of VAT/TAT to the clinical model improved the AUC to 0.73. Optimal model that included gender, BMI, race (Black), MI, VAT/TAT, as well as interaction between gender and VAT/TAT and gender and MAT/MM demonstrated the highest AUC of 0.83. CONCLUSION: MAT/MM and VAT/TAT provides important prognostic information in predicting patients with COVID-19 who are likely to require hospitalization.

Buprenorphine Induction in a Rural Maryland Detention Center During COVID-19: Implementation and Preliminary Outcomes of a Novel Telemedicine Treatment Program for Incarcerated Individuals With Opioid Use Disorder.

Over 10 million individuals pass through U.S. detention centers on an annual basis, with nearly two-thirds meeting criteria for drug dependence/abuse. Despite proven efficacy, treatment with medications for opioid use disorder (MOUD) is underutilized in jail settings-a gap that could be addressed using telemedicine. Here we describe a new program of telemedicine-based clinical provision of new/continuing buprenorphine treatment for individuals detained in a rural jail. Implementation objectives were completed between January and August 2020, and patient encounters were conducted between August 2020 and February 2021. We established (i) telemedicine hardware/software capability; (ii) a screening process; (iii) buprenorphine administration methods; (iv) necessary medical release procedures; (v) telemedicine encounter coordination and medication prescription procedures; and (vi) a research platform. Seven incarcerated patients have been treated, two of whom were referred from community treatment. Patients were mostly male (71%), non-Hispanic White (86%), and averaged 33 years old. All patients tested positive for an opioid upon intake and began/continued buprenorphine treatment in the jail. Average time to first MOUD appointment was 9 days and patients were maintained in treatment an average 21 days. Referrals for continuing community treatment were offered to all patients prior to discharge. We report successful implementation of telemedicine MOUD in a rural detention center, with treatment engagement and initiation occurring prior to the high-risk period of discharge. The fact that this program was launched during the height of the pandemic highlights the flexibility of telemedicine-based buprenorphine treatment. Challenges and obstacles to implementation of buprenorphine treatment in a correctional system are discussed.

Polyisobutylene-New Opportunities for Medical Applications.

This paper presents the results of the first part of testing a novel electrospun fiber mat based on a unique macromolecule: polyisobutylene (PIB). A PIB-based compound containing zinc oxide (ZnO) was electrospun into self-supporting mats of 203.75 and 295.5 g/m2 that were investigated using a variety of techniques. The results show that the hydrophobic mats are not cytotoxic, resist fibroblast cell adhesion and biofilm formation and are comfortable and easy to breathe through for use as a mask. The mats show great promise for personal protective equipment and other applications.

How Does the Pandemic Facilitate Mobile Payment? An Investigation on Users' Perspective under the COVID-19 Pandemic.

Owing to the convenience, reliability and contact-free feature of Mobile payment (M-payment), it has been diffusely adopted in China during the COVID-19 pandemic to reduce the direct and indirect contacts in transactions, allowing social distancing to be maintained and facilitating stabilization of the social economy. This paper aims to comprehensively investigate the technological and mental factors affecting users' adoption intentions of M-payment under the COVID-19 pandemic, to expand the domain of technology adoption under the emergency situation. This study integrated Unified Theory of Acceptance and Use of Technology (UTAUT) with perceived benefits from Mental Accounting Theory (MAT), and two additional variables (perceived security and trust) to investigate 739 smartphone users' adoption intentions of M-payment during the COVID-19 pandemic in China. The empirical results showed that users' technological and mental perceptions conjointly influence their adoption intentions of M-payment during the COVID-19 pandemic, wherein perceived benefits are significantly determined by social influence and trust, corresponding with the situation of pandemic. This study initially integrated UTAUT with MAT to develop the theoretical framework for investigating users' adoption intentions. Meanwhile, this study originally investigated the antecedents of M-payment adoption under the pandemic situation and indicated that users' perceptions will be positively influenced when technology's specific characteristics can benefit a particular situation.

A chance to do it better: Methadone maintenance treatment in the age of Covid-19.

Methadone maintenance treatment (MMT) in the United States, and particularly the clinic system of distribution, is often criticized as punitive, over-regulated, and misaligned to the needs of many patients. However, changes to the regulations that COVID-19 caused may have provided an opportunity for improving service. This commentary uses literature and my own experience to provide a brief description of how MMT programs responded to the threat of Covid-19 and how such responses fit into the larger context of attempts to reform treatment. It discusses, in particular, opportunities for liberalizing "take-home" doses and implementing office-based MMT.

Another silver lining?: Anthropological perspectives on the promise and practice of relaxed restrictions for telemedicine and medication-assisted treatment in the context of COVID-19.

As a response to the COVID-19 pandemic, the United States Drug Enforcement Administration (DEA) has temporarily relaxed restrictions to serve people who are opioid dependent during social distancing mandates. Changes include allowing patients to take home more doses of methadone and buprenorphine rather than coming to the clinic every day (for methadone) or weekly (for buprenorphine) and relaxed restrictions on telehealth delivery. Telemedicine Program representatives have described the relaxing of federal regulations as a "silver lining" to the COVID-19 pandemic. Drawing from medical anthropology approaches to epidemic surveillance and understandings of risk, we critically evaluate media representations of recent changes to telemedicine, prescribing, and opioid treatment delivery. Ethnographic research with providers and stakeholders in Arizona from 2017 to the present add insight to our analysis of media reports on these topics. Our findings demonstrate that media portrayal of access to medication-assisted treatment (MAT) as the key to preventing both COVID-19 and overdose among people who are opioid dependent misses important risks and potential inequities. Applied social science questions raised by the new guidelines include: who receives take-home doses of methadone and buprenorphine and why; and how media representations of risk and benefit rationales shape real-world policy and practice.

A multiscale absorption and transit model for oral delivery of hydroxychloroquine: Pharmacokinetic modeling and intestinal concentration prediction to assess toxicity and drug-induced damage in healthy subjects.

Hydroxychloroquine (HCQ) is commonly used in the treatment of malaria and rheumatic diseases. Recently it has also been identified as possible therapeutic option in combating COVID-19. However, the use of HCQ is known to induce cytotoxicity. In 2020, we developed a multiscale absorption and transit (MAT) toolkit to simulate the dissolution, transport, absorption, distribution, metabolism, and elimination of orally administered drugs in the human GIT at multiple levels. MAT was constructed by integrating the spatially accurate first-principles driven high-fidelity drug transport, dissolution, and absorption model in the human stomach and GIT using the recently published Quasi-3D framework. The computational results showed that MAT was able to match the experimental concentration results better than the traditional compartmental models. In this study, we adapted MAT, to predict the pharmacokinetics of orally delivered HCQ in healthy subjects. The computational results matched the experimental concentration results. The simulated stomach and intestinal fluid and enterocyte concentrations were compared with the in vitro CC50 values. While the peak enterocyte concentrations were several orders lower than the in vitro CC50 values, the peak stomach and the intestinal fluid concentrations were only one order smaller than the in vitro CC50 values. In particular, the peak stomach and the duodenum fluid concentrations were just 3× smaller than the in vitro CC50 values. This implies that the lumen walls are much more susceptible to cytotoxicity-based damage than the enterocyte layers. We envision that MAT can be used to optimize the dosing regimen of HCQ by maximizing its bioavailability, while simultaneously minimizing the cytotoxic damage.