The Association of Loneliness and Non-prescribed Opioid Use in Patients With Opioid Use Disorder.

OBJECTIVE: To investigate the relationship between loneliness and non-prescribed opioid use in patients diagnosed with opioid use disorder (OUD). METHODS: This was a cohort study conducted at a federally qualified health center (FQHC) in New Haven, CT. Patients who were treated for OUD by health center providers and prescribed buprenorphine were eligible. Participants were asked to complete the UCLA-Loneliness Scale Version 3. From the electronic medical record, we collected patient demographic and clinical characteristics as well as the results of biological fluid testing obtained throughout their treatment course since entry into care. Multivariable logistic regression was performed to identify independent predictors of the detection of non-prescribed opioids within biological fluid. RESULTS: Of the 82 patients enrolled in the study, 33 (40.3%) of the participants had at least 1 biological fluid test positive for non-prescribed opioids after maintenance onto buprenorphine treatment. A higher loneliness score was associated with increased odds of non-prescribed opioids (adjusted odds ratio 1.16; 95% confidence interval 1.06-1.27). Patient age, the number of problems on the problems list, and cocaine use were also positively associated with the presence of non-prescribed opioids whereas having diabetes was negatively associated. CONCLUSIONS: Among the individuals being treated with buprenorphine for OUD, loneliness may be a risk factor for the use of non-prescribed opioids or treatment failure.

Energy Consumption, Carbon Emissions and Global Warming Potential of Wolfberry Production in Jingtai Oasis, Gansu Province, China.

During the last decade, China's agro-food production has increased rapidly and been accompanied by the challenge of increasing greenhouse gas (GHG) emissions and other environmental pollutants from fertilizers, pesticides, and intensive energy use. Understanding the energy use and environmental impacts of crop production will help identify environmentally damaging hotspots of agro-production, allowing environmental impacts to be assessed and crop management strategies optimized. Conventional farming has been widely employed in wolfberry (Lycium barbarum) cultivation in China, which is an important cash tree crop not only for the rural economy but also from an ecological standpoint. Energy use and global warming potential (GWP) were investigated in a wolfberry production system in the Yellow River irrigated Jingtai region of Gansu. In total, 52 household farms were randomly selected to conduct the investigation using questionnaires. Total energy input and output were 321,800.73 and 166,888.80 MJ ha-1, respectively, in the production system. The highest share of energy inputs was found to be electricity consumption for lifting irrigation water, accounting for 68.52%, followed by chemical fertilizer application (11.37%). Energy use efficiency was 0.52 when considering both fruit and pruned wood. Nonrenewable energy use (88.52%) was far larger than the renewable energy input. The share of GWP of different inputs were 64.52% electricity, 27.72% nitrogen (N) fertilizer, 5.07% phosphate, 2.32% diesel, and 0.37% potassium, respectively. The highest share was related to electricity consumption for irrigation, followed by N fertilizer use. Total GWP in the wolfberry planting system was 26,018.64 kg CO2 eq ha-1 and the share of CO2, N2O, and CH4 were 99.47%, 0.48%, and negligible respectively with CO2 being dominant. Pathways for reducing energy use and GHG emission mitigation include: conversion to low carbon farming to establish a sustainable and cleaner production system with options of raising water use efficiency by adopting a seasonal gradient water pricing system and advanced irrigation techniques; reducing synthetic fertilizer use; and policy support: smallholder farmland transfer (concentration) for scale production, credit (small- and low-interest credit) and tax breaks.

Geometric morphometrics for the study of facial expressions in non-human animals, using the domestic cat as an exemplar.

Facial expression is a common channel for the communication of emotion. However, in the case of non-human animals, the analytical methods used to quantify facial expressions can be subjective, relying heavily on extrapolation from human-based systems. Here, we demonstrate how geometric morphometrics can be applied in order to overcome these problems. We used this approach to identify and quantify changes in facial shape associated with pain in a non-human animal species. Our method accommodates individual variability, species-specific facial anatomy, and postural effects. Facial images were captured at four different time points during ovariohysterectomy of domestic short haired cats (n = 29), with time points corresponding to varying intensities of pain. Images were annotated using landmarks specifically chosen for their relationship with underlying musculature, and relevance to cat-specific facial action units. Landmark data were subjected to normalisation before Principal Components (PCs) were extracted to identify key sources of facial shape variation, relative to pain intensity. A significant relationship between PC scores and a well-validated composite measure of post-operative pain in cats (UNESP-Botucatu MCPS tool) was evident, demonstrating good convergent validity between our geometric face model, and other metrics of pain detection. This study lays the foundation for the automatic, objective detection of emotional expressions in a range of non-human animal species.

Carbon benefits of wolfberry plantation on secondary saline land in Jingtai oasis, Gansu--A case study on application of the CBP model.

The largest global source of anthropogenic CO2 emissions comes from the burning of fossil fuel and approximately 30% of total net emissions come from land use and land use change. Forestation and reforestation are regarded worldwide as effective options of sequestering carbon to mitigate climate change with relatively low costs compared with industrial greenhouse gas (GHG) emission reduction efforts. Cash trees with a steady augmentation in size are recognized as a multiple-beneficial solution to climate change in China. The reporting of C changes and GHG emissions for sustainable land management (SLM) practices such as afforestation is required for a variety of reasons, such as devising land management options and making policy. The Carbon Benefit Project (CBP) Simple Assessment Tool was employed to estimate changes in soil organic carbon (SOC) stocks and GHG emissions for wolfberry (Lycium barbarum L.) planting on secondary salinized land over a 10 year period (2004-2014) in the Jingtai oasis in Gansu with salinized barren land as baseline scenario. Results show that wolfberry plantation, an intensively managed ecosystem, served as a carbon sink with a large potential for climate change mitigation, a restorative practice for saline land and income stream generator for farmers in soil salinized regions in Gansu province. However, an increase in wolfberry production, driven by economic demands, would bring environmental pressures associated with the use of N fertilizer and irrigation. With an understanding of all of the components of an ecosystem and their interconnections using the Drivers-Pressures-State-Impact-Response (DPSIR) framework there comes a need for strategies to respond to them such as capacity building, judicious irrigation and institutional strengthening. Cost benefit analysis (CBA) suggests that wolfberry cultivation was economically profitable and socially beneficial and thus well-accepted locally in the context of carbon sequestration. This study has important implications for Gansu as it helps to understand the role cash trees can play in carbon emission reductions. Such information is necessary in devising management options for sustainable land management (SLM).

Interdisciplinary interpretations and applications of the concept of scale in landscape research.

The spatial dimensions of many social, economic and environmental challenges facing 21st century societies can be addressed through the idea of landscape. The European Landscape Convention--ELC (Council of Europe, 2000--Article 1a) views landscape as representing not simply the environment, but the world "as perceived by people". As a concept, landscape is increasingly understood as uniting the physical, mental, natural and cultural dimensions of human existence; good quality landscapes are thus integral to our well-being. The problems and challenges facing our landscapes require greater understanding of how they function and change, as well as their meanings and values. Scholars working in the area of landscape research have increasingly advocated the need to enhance integrative approaches between the natural, human and applied sciences. However, drawing together the collective insights from across the sciences presents a range of conceptual and methodological issues. The question of scale as it pertains to different scientific realms is a key example of this kind of challenge to integrative approaches. The multi-scale nature of the social, environmental and economic challenges embedded in the landscape demands that scholars address these key issues of scale in their research. The aim of this paper is to review how the concept of scale has been interpreted and applied within the arena of landscape research, focussing specifically on three of the principal disciplinary contributors--ecology/landscape ecology, geography and spatial planning. The objective of this discussion is to synthesise scalar issues that feature within and across these perspectives, to better understand how they impact on the way landscape is conceptualised and thus produced through academic and related policy discourses. It seeks out points of tension as well as convergence when dealing with scale. It reflects on academic, policy and practice-related concerns that would form part of longer-term holistic strategies for landscape protection, planning and management in line with those being advocated by the ELC.

A multicenter comparison of the safety of oral versus intravenous acetylcysteine for treatment of acetaminophen overdose.

UNLABELLED: Oral and intravenous (IV) N-acetylcysteine (NAC) are used for the treatment of acetaminophen poisoning. The objective of this multicenter study was to compare the safety of these two routes of administration. METHODS: We conducted a multicenter chart review of all patients treated with NAC for acetaminophen poisoning. The primary safety outcome was the percentage of patients with NAC-related adverse events. RESULTS: A total of 503 subjects were included in the safety analysis (306 IV-only, 145 oral-only, and 52 both routes). There were no serious adverse events related to NAC for either route. Nausea and vomiting were the most common related adverse events and were more common with oral treatment (23 vs. 9%). Anaphylactoid reactions were more common with IV administration (6 vs. 2%). CONCLUSIONS: IV and oral NAC are generally mild adverse drug reactions.

State-wide hospital clinical laboratory plan for measuring cholinesterase activity for individuals suspected of exposure to nerve agent chemical weapons.

BACKGROUND: Hospital laboratories currently lack the capacity to provide emergency determination of cholinesterase activity. METHODS: We have developed a hospital-based 3-tiered system to test plasma for butyrylcholinesterase (BChE) activity and whole blood for red cell acetylcholinesterase (AChE) activity using available technology and personnel. Interagency communications, toxidrome definition, and patient triage will be coordinated by the Connecticut Department of Public Health and the Poison Control Center. DATA: Initial BChE data documents good precision between institutions (coefficient of variation < 8%). SUMMARY: Laboratory testing of plasma or blood for cholinesterase activity is important in the management of nerve agent exposure and in ruling out disease in those with non-specific symptoms in the setting of a terrorist attack or accidental exposure. Rapid availability of strong hospital-based analytic support in a smoothly functioning network of clinical, public health, and laboratory services will facilitate overall regional response to chemical terrorism or large scale HazMat events.

Oxidative 5-endo cyclization of enamides mediated by ceric ammonium nitrate.

[reaction: see text] Ceric ammonium nitrate mediates the oxidative 5-endo radical-polar crossover reactions of beta-enamide esters to give 5,5-C,O-disubstituted-gamma-lactams. Trapping of the intermediate cations leads to 5-hydroxy- or 5-alkoxy-gamma-lactams depending upon the reaction conditions. The methodology was used to synthesize the basic heterocyclic ring fragments of the natural products L-755,807, Quinolacticin C, and PI-091.