Crossover associations of alcohol and smoking, craving and biochemically verified alcohol and nicotine use in heavy drinking smokers.

This study examined associations between drinking and smoking prior to treatment (biochemically measured at baseline), alcohol and tobacco craving, and biochemical alcohol and tobacco use during the analog trial period. We conducted a secondary data analysis of a randomized clinical analog trial where participants with a Diagnostic and Statistical Manual, Fourth Edition Text Revision (DSM-IV-TR) diagnosis of alcohol dependence, abuse or reported heavy drinking, with a co-occurring DSM-IV-TR diagnosis of nicotine dependence, abuse or reported heavy use, who were not seeking treatment were recruited. A generalized estimation equation model for longitudinal binary outcomes was created (N = 34) to determine the predictive effects of baseline tobacco use, alcohol craving, and tobacco craving on alcohol use over the 4 weeks of the trial. Baseline smoking was significantly (*p < 0.05) associated with drinking over time [odds ratio (OR) = 3.09*], while baseline drinking was associated with smoking (OR = 4.17*). Baseline alcohol and tobacco craving were positively associated with smoking over time (OR = 3.21* and OR = 1.92*, respectively) but were negatively associated with alcohol use over time (OR = 0.79* and OR = 0.57*, respectively). Heavier use of either tobacco or alcohol preceding treatment may require more intensive interventions in order to reduce tobacco and alcohol use. Future trials designed to address mechanisms of behavior change in the context of novel treatments could promote a better understanding of the cross-rewarding effects related to the co-use of these substances and lead to the development of more integrated and appropriately intense treatments for individuals with concomitant tobacco and alcohol use disorders.

Development and application of a primer and reference assessment tool for neonatal abstinence syndrome: A phase I pilot study.

BACKGROUND: Despite evidence for the efficacy of strict neonatal abstinence syndrome (NAS) treatment protocols, no national standardized education, diagnosis or treatment strategy is available. OBJECTIVES: To describe the development and preliminary usability of an electronic bedside primer and decision support tool for medical providers, with embedded, interactive education and reference modules. METHODS: A panel of NAS experts established a standard operating procedure for the best practices of NAS management and developed an interactive mobile primer and reference and assessment tool to assess NAS with a curriculum and decision support system. We tested the feasibility and usability of this tool with n = 8 users, including registered nurses, last-year undergraduate nursing students and neonatal physicians. RESULTS: Participants rated the usability of the modules positively, with an average rating of 4.5 (scale of "1 = Strongly disagree" to "5 = Strongly agree"). Participants appreciated the ability to score the infant at the bedside using real time electronic entry. Seven users noted that the electronic device entry would be as accurate as paper or computer-based Electronic Medical Records entry and one user indicated it would potentially be more accurate during post-usability interviews. Users recommended improvements to the curriculum, including increasing detail of definitions and adding videos for additional NAS signs. CONCLUSION: The assessment tool appears to be acceptable and usable by potential users. The strong ratings across users provides support for further testing whether its acceptability and usability remain high in a hospital setting, while assessing the impact on clinical outcomes such as newborn hospital length of stay.

Aggregation and protein corona formation on gold nanoparticles affect viability and liver functions of primary rat hepatocytes.

AIM: We examined the impact of aggregation and protein corona formation of gold nanoparticles (AuNPs) on the cytotoxicity, uptake and metabolism, specifically urea and albumin synthesis, of primary rat hepatocytes. MATERIALS & METHODS: The AuNPs were synthesized via citrate reduction and the human serum protein corona was preformed on the AuNPs. Primary hepatocytes were isolated from male Wistar rats via two-step in situ collagenase perfusion method, and were dosed with both citrate-capped (AuNP-Cit) and protein corona coated AuNPs (AuNP-Cor). RESULTS: The AuNP-Cor showed higher cell uptake and reduced cell viability compared with aggregated AuNP-Cit. Urea and albumin secretions showed AuNP dose dependency. Both AuNP-Cit and AuNP-Cor exerted only an acute effect on the albumin synthesis of hepatocytes with no chronic impact.