Housing First for People with Opioid Use disorder (OUD) and engagement with Medication-assisted Treatment (MAT) and Harm Reduction Services

Intro: Opioid Use Disorder (OUD)is one of the most prevalent and deadly SUD’s in the country and many barriers exist for individuals living with homelessness and concurrent psychiatric illnesses when hoping to engage in Medication-Assisted-Recovery/Treatment (MAR/MAT). The current study evaluates the Pathways to Housing PA’s (PTHPA) Housing First(HF) model which provides scatter-site housing with social and maintenance services to individuals with a history of chronic homelessness and a diagnosis of OUD. Methods: A retrospective chart analysis was completed for to assess factors relating to MAT engagement using PTHPA’s Credible BH recording system. MAT engagement prior to HF, psychiatric, homelessness, and medical history were all collected from a Psychiatric Assessment performed upon admission into the HF program. MAT retention and engagement during HF was obtained from self-reported information provided in case notes from PTHPA team members. Results: 76.7% of people engaged in MAT with methadone or buprenorphine treatment after being housed for at least 2 months (n=133). Re-engagement in MAT was higher in individuals who had prior MAT participation prior to the housing first intervention. Years homeless, age and race did not have a significant association with MAT participation following the HF intervention, although gender was associated with different levels of MAT participation between males and females. 23.33% of individuals were able to retain/stay on MAT prior to engaging in HF. 81.375% of individuals who engaged in MAT during the HF intervention were able to retain/stay on MAR by the end of the recording period. Conclusion: There was a significant association of increased MAT engagement in individuals with prior MAR participation. The study at hand suggests that a scatter-site HF model with adequate social service and MAR support can be associated with greater rates of retention in MAR while supporting higher rates of MAR participation in individuals experiencing chronic homelessness and primary OUD than the general population

Effect of Portland cement concrete characteristics and constituents on thermal expansion

textThe coefficient of thermal expansion (CTE) is one of the major factors responsible for distresses in concrete pavements and structures. Continuously reinforced concrete pavements (CRCPs) in particular are highly susceptible to distresses caused by high CTE in concrete. CRCP is a popular choice across the U.S. and around the world for its long service life and minimal maintenance requirements. CRCP has been built in more than 35 states in the U.S., including Texas. In order to prevent CRCP distresses, the Texas Department of Transportation (TxDOT) has limited the CTE of CRCP concrete to a maximum of 5.5 x10-6 strain/oF (9.9 x10-6 strain/oC). Coarse aggregate sources that produce concrete with CTE higher than the allowable limit are no longer accepted in the TxDOT CRCP projects. Moreover, CTE is an important input in the Mechanistic-Empirical Pavement Design Guide (MEPDG). Small deviations in input CTE can affect the pavement thickness significantly in MEPDG designs. Therefore, accurate determination of concrete CTE is important, as it allows for enhanced concrete structure and pavement design as well as accurate screening of CRCP coarse aggregates. Moreover, optimizing the CTE of concrete according to a structure’s needs can reduce that structure’s cracking potential. This will result in significant savings in repair and rehabilitation costs and will improve the durability and longevity of concrete structures. This study found that the CTEs determined from saturated concrete samples were affected by the internal water pressure. As a result, the TxDOT method yielded higher values than did the American Association of State Highway and Transportation Officials (AASHTO) method. To further investigate the effect of internal water pressure, an analytical model was developed based on the poroelastic phenomenon of concrete. According to the model, porosity, permeability, and the rate of temperature change are the major factors that influence the internal water pressure development. Increasing the permeability of concrete can reduce the internal water pressure development and can thus improve the consistency of measured CTE values. Preconditioning concrete samples by subjecting them to several heating and cooling cycles prior to CTE testing and reducing the rate of temperature change improved the consistency of the CTE test results. Concrete CTE can be reduced by blending low-CTE aggregates with high-CTE aggregates and reducing the cement paste volume. Based on these findings, a concrete CTE optimization technique was developed that provides guidelines for the selection of concrete constituents to achieve target concrete CTE. A concrete proportioning technique was also developed to meet the need for CTE optimization. This concrete proportioning technique can use aggregate from any sources, irrespective of gradation, shape, and texture. The proposed technique has the potential to reduce the cement requirement without sacrificing performance and provides guidelines for multiple coarse and fine aggregate blends.Civil, Architectural, and Environmental Engineerin

OXIDATIVE STRESS IN ALGAE: METHOD DEVELOPMENT AND EFFECTS OF TEMPERATURE ON ANTIOXIDANT NUCLEAR SIGNALING COMPOUNDS

Non-enzymatic antioxidants neutralize the oxidative stress through scavenging reactive oxygen species. The structural complexity of non-enzymatic nuclear signaling antioxidants poses are more challenges for traditional quantitative analysis as these compounds have multiple forms and structurally diverse than proteins and therefore, challenge traditional analytical techniques. Current analytical methods cannot distinguish the carotenoids, and vitamin A and D metabolites within a single sample. To find an appropriate method to measure all the nuclear signaling compounds in algae, Isochrysis sp. , under thermal stress, HPLC/ESI-MS and HPLC /APPI-MS was used. Standards of those compounds were run by QQQ HPLC/ ESI-MS and HPLC /APPI-MS methods by multiple reaction monitoring to optimize the most sensitive transition ion for each compound. Organic solvents (cold acetone and petroleum ether) were used for extraction. Neither APPI nor ESI method showed the sensitivity to detect all targeted non- enzymatic compounds. ESI method detects lower number of compounds than APPI method, but the sensitivity of this method was higher than APPI. Isochrysis sp. , was kept at 25 °C, 30 °C and 35 °C for 96 hrs to observe the changes of non-enzymatic antioxidants (carotenoids and vitamins) oxidative stress. Algae were grown with continuous light and aeration in 70 ml test tube. Samples were collected from culture tubes (50 ml) at 0, 6, 12, 24, 48, 72 and 96 hrs Isochrysis showed best growth at 30 °C and lowest at 35 °C. Algae grown at 35 °C had significantly (P\u3c0.05) higher concentrations of MDA compared to algae grown at lower temperatures and the MDA concentrations decreased over time. Fucoxanthin was the dominating pigment followed by diadinoxanthin for all treatment groups. The quantity of carotenoids (fucoxanthin, diadinoxanthin, diatoxanthin and antheraxanthin) and pro-vitamin A (retinol, retinal, retinoic acid) was higher in algae grown at 35 °C and algae grown at 30 °C had lower quantity of these carotenoids, Algae grown at higher temperature had higher MDA. These data indicate that OS induced by thermal change alter carotenoids of antioxidants nuclear signaling compounds

Goals of Care 101

Hospice and Palliative Medicine - Alexandra Evans, DO Approaching Goals of Care in the Outpatient World - Elham Siddiqui, MD Inpatient Goals of Care Discussion - Adam Pennarola, M

STATISTICALLY OPTIMIZED AND BOX-BEHNKEN DESIGN ASSISTED METHOD DEVELOPMENT AND VALIDATION OF AN ANTIPSYCHOTIC MEDICATION OLANZAPINE AND ITS RELATED IMPURITIES BY REVERSE-PHASE HPLC-UV SPECTROSCOPY

Objective: Statistically designed and Box-Behnken design (BBD) assisted reversed-phase high-performance liquid chromatography-ultraviolet (HPLC-UV) method was developed and validated for the identification of an antipsychotic medication Olanzapine and its organic impurities in pure drug along with forced degradation studies. Methods: The present developed method employed BBD optimized chromatographic conditions comprising of an Inertsil ODS 3V analytical column with dimension 250 mm x 4.6 mm and particle size 5µ. The isocratic mobile phase was used as a mixture of monobasic sodium phosphate buffer (0.01 M, pH 6), methanol and acetonitrile in the proportion of 40/30/30, v/v. The mobile phase flow rate and UV λmax was 1 ml/min and 260 nm, respectively. The method was optimized by Box-Behnken design using design expert software, comprising of three factors for Olanzapine for instance flow rate (A), mobile phase composition (B) and pH (C) while resolution between Olanzapine related compound A and Olanzapine related compound B (Y1) and tailing of Olanzapine (Y2) were taken as a response. Results: Application of BBD yielded statistically designed method with excellent quality parameters achieved in terms of linearity with the coefficient of correlation (R2>0.9999), limit of detection (LOD, 0.0023-0.16 µg/ml), the limit of quantification (LOQ, 0.007-0.39 µg/ml), accuracy (99-100%) and precision ((2%, relative standard deviation (%RSD) were evaluated as per latest available procedures. Conclusion: Forced degradation conditions were carried out, demonstrated that the optimized method was stable and no any interfering peaks eluting at the similar retention time of the studied compounds. The method was found to be stable, easy, rugged and robust, could be applied for the similar types of the pure drug

Tackling the COVID-19 pandemic: the Bangladesh perspective

An outbreak of a COVID-19 pandemic disease, caused by a novel coronavirus SARS-CoV-2, has posed a serious threat to global human health. Bangladesh has also come under the attack of this viral disease. Here, we aimed to describe the responses of Bangladesh to tackle the COVID-19, particularly on how Bangladesh is dealing with this novel viral disease with its limited resources. The first case of a COVID-19 patient was detected in Bangladesh on March 8, 2020. Since then, a total of 263,503 peoples are officially reported as COVID-19 infected with 3,471 deaths until August 11, 2020. To combat the COVID-19, the government has taken various steps viz. diagnosis of the suspected cases, quarantine of doubted people and isolation of infected patients, local or regional lockdown, closure of all government and private offices, increase public awareness and enforce social distancing, etc. Moreover, to address the socio-economic situations, the government announced several financial stimulus packages of about USD 11.90 billion. However, the government got 3 months since the disease was first reported in China, but the country failed in making proper strategies including contact tracing, introducing antibody/antigen-based rapid detection kit, and also failed to make multi-disciplinary team to combat this disease. Further, limited testing facilities and inadequate treatment service along with public unawareness are the major challenges for Bangladesh to tackle this situation effectively. Along with the government, personal awareness and assistance of non-government organizations, private organizations, researchers, doctors, industrialists, and international organizations are firmly required to mitigate this highly contagious disease