Identification of “Kratom” (Mitragyna speciosa) Alkaloids in Commercially Available Products

“Kratom” is the common name for the botanical mitragyna speciosa. It is a tree native to Southeast Asia in which leaves contain the psychoactive alkaloids mitragynine and 7-hydroxymitragynine. Kratom is often ingested as teas, chewed, or smoked. It acts as a stimulant in small doses and as an opioid in large doses. Overdoses can result in vomiting, seizures, and death. Recently the Drug Enforcement Agency (DEA) placed Kratom on Schedule 1, but, due to public outcry, it was almost immediately removed. Eleven kratom based products were obtained from various tobacco shops, “headshops” and via the internet including: Choice brand capsule and powder, Krave brand capsule, Lucky brand powder, King Kratom and Purple Haze e-liquids with 0 mg nicotine and 12 mg nicotine, Mojo brand capsule, O.P.M.S Liquid Kratom concentrate, and a K. Kratom chocolate bar. These products and methanol extracted samples were analyzed for psychoactive alkaloids and other components using an AccuTOF Direct Analysis in Real Time Mass Spectrometry (DART-MS) and Gas Chromatography-Mass Spectrometry (GC-MS). The psychoactive alkaloids mitragynine and 7-hydroxymitragynine along with four other alkaloids, corynantheidine, corynoxine, paynantheine, and speciofoline, were identified in all 11 products. Unregulated commercial products made from kratom contain psychoactive alkaloids such as mitragynine and 7-hydroxymitragynine. They are readily available in a variety of forms and may be prone to abuse.https://scholarscompass.vcu.edu/uresposters/1246/thumbnail.jp

The Forensic Characterization of Bacterial and Fungal Organisms in Traditional Chinese Medicine

There has been an increase in use of Traditional Chinese Medicine (TCM) in the United States because they are less expensive and believed to be more effective with less adverse effects in comparison to traditional pharmaceutics. Therefore, sales have increased in the US, despite articles and case studies demonstrating the dangers, such as injury and death, related to TCM, stemming from improper labelling, toxic contaminants, and, in some cases, the presence of pathogenic bacteria. The aim of this study was to perform a survival experiment to demonstrate the importance of proper herbal brewing technique and to conduct a molecular and biochemical survey of microorganisms present on eleven Chinese herbal samples. The survival study compared Chinese brewing preparation and American brewing preparation by fortifying the herbal mixture with known bacteria and assessing its survival after brewing. The American brewed herbal tea was calculated to contain upwards of 3000 CFU (colony forming units)/mL, where the Chinese brewed herbal tea contained roughly 50 CFU/mL. FAME (Fatty Acid Methyl Ester) analysis was performed on the herbs to characterize any microorganisms present on the plant material already, following purchase. Strains within the Bacillus genus were identified in nearly all eleven of the herbal samples. These included B. subtilis and B. megaterium. Organisms belonging to the Bacillus ACT group (anthracis, cereus, thuringiensis) were identified in five out of eleven herb cultures as evidenced by the large ratio of 15:0 iso to 15:0 anteiso fatty acid biomarkers. Nine out of eleven herbal specimens also exhibited fungal biomarkers such as polyunsaturated 20:4 ω6,9,12,15c, and 18:3 ω6c (6,9,12).https://scholarscompass.vcu.edu/uresposters/1291/thumbnail.jp

Innovating in the Time of Covid: Adapting Services for Young People Experiencing Extra‐Familial Risks and Harms

This paper explores how seven organisations from the children's social care sector in England adapted their service during the Covid-19 pandemic restrictions to better meet the needs of young people experiencing extra-familial risks and harms. Particularly, it focuses on these organisations' experience of attempting to transform services in a unique crisis context and considers what insights this situated study offers into the processes of innovation and practice improvement in the sector. Twelve respondents from these seven organisations participated in semi-structured interviews, which were analysed both narratively and thematically. Six of these participants were interviewed longitudinally over 6 months, enabling consideration of barriers encountered within their innovation journeys and the factors and conditions that facilitated the process. From these, three longitudinal narrative accounts were selected, highlighting themes emblematic of the overall dataset. The findings indicate that, unencumbered by the usual constraints of bureaucracy, organisations could adapt service provision with unprecedented speed, to respond in more youth-centred and welfare-oriented ways to young people's needs. Rapid cycles of iterative development in response to young people's feedback suggested a surprising potential for agility and responsivity in the children's services sector, raising questions about whether and how this might be mobilised outside of crisis conditions

Evaluation of Two Commercially Available Cannabidiol Formulations for Use in Electronic Cigarettes

Since 24 states and the District of Columbia have legalized marijuana in some form, suppliers of legal marijuana have developed Cannabis sativa products for use in electronic cigarettes (e-cigarettes). Personal battery powered vaporizers, or e-cigarettes, were developed to deliver a nicotine vapor such that smokers could simulate smoking tobacco without the inherent pathology of inhaled tobacco smoke. The liquid formulations used in these devices are comprised of an active ingredient such as nicotine mixed with vegetable glycerin (VG) and/or propylene glycol (PG) and flavorings. A significant active ingredient of C. sativa, cannabidiol (CBD), has been purported to have anti-convulsant, anti-nociceptive, and anti-psychotic properties. These properties have potential medical therapies such as intervention of addictive behaviors, treatments for epilepsy, management of pain for cancer patients, and treatments for schizophrenia. However, CBD extracted from C. sativa remains a DEA Schedule I drug since it has not been approved by the FDA for medical purposes. Two commercially available e-cigarette liquid formulations reported to contain 3.3 mg/mL of CBD as the active ingredient were evaluated. These products are not regulated by the FDA in manufacturing or in labeling of the products and were found to contain 6.5 and 7.6 mg/mL of CBD in VG and PG with a variety of flavoring agents. Presently, while labeled as to content, the quality control of manufacturers and the relative safety of these products is uncertain

Safeguarding Young People Beyond the Family Home

EPDF and EPUB available Open Access under CC-BY-NC-ND licence. During adolescence, young people are exposed to a range of risks beyond their family homes including sexual and criminal exploitation, peer-on-peer abuse and gang-related violence. However, it has only been over the past two decades that the critical safeguarding implications of these harms have started to be recognised. Social care organisations are increasingly experimenting with new approaches but continue to experience challenges in supporting affected young people and their families. This book analyses the results of the first rapid evidence assessment of social care organisations’ responses to risks and harms outside the home across 10 countries. The authors highlight key areas for service development, give insights into how these risks and harms can be understood, and consider wider implications for policy and practice

Safeguarding Young People Beyond the Family Home

EPDF and EPUB available Open Access under CC-BY-NC-ND licence. During adolescence, young people are exposed to a range of risks beyond their family homes including sexual and criminal exploitation, peer-on-peer abuse and gang-related violence. However, it has only been over the past two decades that the critical safeguarding implications of these harms have started to be recognised. Social care organisations are increasingly experimenting with new approaches but continue to experience challenges in supporting affected young people and their families. This book analyses the results of the first rapid evidence assessment of social care organisations’ responses to risks and harms outside the home across 10 countries. The authors highlight key areas for service development, give insights into how these risks and harms can be understood, and consider wider implications for policy and practice

The Effect of Electronic Cigarette User Modifications and E-liquid Adulteration on the Particle Size Profile of an Aerosolized Product

Electronic cigarettes (e-cigarettes) are an alternate nicotine delivery system that generate a condensation aerosol to be inhaled by the user. The size of the droplets formed in the aerosol can vary and contributes to drug deposition and ultimate bioavailability in the lung. The growing popularity of e-cigarette products has caused an increase in internet sources promoting the use of drugs other than nicotine (DOTNs) in e-cigarettes. The purpose of this study was to determine the effect of various e-cigarette and e-liquid modifications, such as coil resistance, battery voltage, and glycol and drug formulation, on the aerosol particle size. E-liquids containing 12 mg/mL nicotine prepared in glycol compositions of 100% propylene glycol (PG), 100% vegetable glycerin (VG), or 50:50 PG:VG were aerosolized at three voltages and three coil resistances. Methamphetamine and methadone e-liquids were prepared at 60 mg/mL in 50:50 PG:VG and all e-liquids were aerosolized onto a 10 stage Micro-Orifice Uniform Deposit Impactor. Glycol deposition correlated with drug deposition, and the majority of particles centered between 0.172–0.5 μm in diameter, representing pulmonary deposition. The 100% PG e-liquid produced the largest aerosol particles and the 100% VG and 50:50 PG:VG e-liquids produced ultra-fine particles \u3c0.3 μm. The presence of ultrafine particles indicates that drugs can be aerosolized and reach the pulmonary alveolar regions, highlighting a potential for abuse and risk of overdose with DOTNs aerosolized in an e-cigarette system

The Analysis of Commercially Available Kratom Products in Richmond, Virginia

Kratom is a novel psychoactive substance that has gained popularity within the past ten years. Originating from Southeast Asia, the leaves of the Mitragyna speciosa tree contain two principal alkaloids, mitragynine and 7-hydroxymitragynine, that play a key role in opioid-like effects. Twenty-nine kratom products were obtained from tobacco shops in the Richmond, Virginia area, including powders, teas, capsules, extracts, and a carbonated beverage. Samples were analyzed using Direct Analysis in Real Time-Mass Spectrometry (DART-MS) for kratom alkaloids, labeled ingredients, and other possible organic compounds. Inductively Coupled Plasma-Optical Emission Spectroscopy (ICP-OES) was used to quantitate aluminum, arsenic, copper, iron, magnesium, nickel, and lead with yttrium as the internal standard. Mitragynine and 7-hydroxymitragynine were present in every kratom sample. Kratom tea samples were found to have up to 20 times the tolerable upper intake of manganese. Overexposure to manganese can lead to Parkinsonian symptoms including tremors, dystonia, and facial muscle spasms. Gas Chromatography-Mass Spectrometry (GC-MS) was used to qualitatively confirm the presence of alkaloids and differentiate diastereomers. One non-kratom product was analyzed and was found to contain phenibut, an anxiolytic and nootropic substance. Phenibut was not listed on the label of this product. This work contributes to bring attention to the absence of quality control standards on kratom manufacturers as well as proper labeling of products sold at smoke and tobacco shops, prompting a public health concern due to the association of toxic metal levels in commercial kratom products.https://scholarscompass.vcu.edu/gradposters/1175/thumbnail.jp

Exploring Curriculum Making in Scottish Secondary Schools: Trends and Effects

This article presents the findings from a recent study funded by the Nuffield Foundation, which aimed to provide insights into the experiences of young people and teachers in secondary schools across Scotland under the Curriculum for Excellence (CfE). Our research has uncovered a decrease in the number of National Qualifications entries in S4 under CfE, a phenomenon commonly referred to in Scotland as 'curriculum narrowing.' Furthermore, we have identified evidence of social stratification in overall and subject entry patterns in S4, with students from disadvantaged areas experiencing a more significant decline in entries and being limited to a narrower range of subjects. Marina Shapira is an Associate Professor in Sociology in the Faculty of Social Sciences at the University of Stirling and the Principal Investigator on the Nuffield Foundation funded project: Choice, attainment and positive destinations: exploring the impact of curriculum policy change on young people. Additionally, our study has revealed signs of curriculum fragmentation during the Broad General Education phase (years S1-S3). The findings from our study also suggest that the curriculum decisions made in schools are primarily driven by the demand for better attainment data, particularly in National Qualifications during the Senior Phase (school years S4-S6), with less emphasis on what it means for an individual to become an educated person in a modern and complex society. Based on our findings, we have concluded that curriculum fragmentation and narrowing under CfE have a detrimental impact on the progression and attainment of young people. Schools that offer a broader curriculum in S4 demonstrate higher enrolment rates for Higher qualifications in S5 and Advanced Higher qualifications in S6. In contrast, schools that offer a narrower curriculum in S4, particularly those in deprived areas, are more likely to experience delays in higher-level qualification entry. A broader curriculum in S4 has been associated with improved performance in National 5 qualifications, higher scores in international tests such as PISA English and Maths, and higher scores on OECD measures of global competences. On the other hand, a narrower curriculum is correlated with less favourable outcomes after leaving school, especially in terms of Higher Education enrolment

Explore Transplant at Home: A randomized control trial of an educational intervention to increase transplant knowledge for Black and White socioeconomically disadvantaged dialysis patients

BackgroundCompared to others, dialysis patients who are socioeconomically disadvantaged or Black are less likely to receive education about deceased donor kidney transplant (DDKT) and living donor kidney transplant (LDKT) before they reach transplant centers, often due to limited availability of transplant education within dialysis centers. Since these patients are often less knowledgeable or ready to pursue transplant, educational content must be simplified, made culturally sensitive, and presented gradually across multiple sessions to increase learning and honor where they are in their decision-making about transplant. The Explore Transplant at Home (ETH) program was developed to help patients learn more about DDKT and LDKT at home, with and without telephone conversations with an educator.Methods and study designIn this randomized controlled trial (RCT), 540 low-income Black and White dialysis patients with household incomes at or below 250 % of the federal poverty line, some of whom receive financial assistance from the Missouri Kidney Program, will be randomly assigned to one of three education conditions: (1) standard-of-care transplant education provided by the dialysis center, (2) patient-guided ETH (ETH-PG), and (3) health educator-guided ETH (ETH-EG). Patients in the standard-of-care condition will only receive education provided in their dialysis centers. Those in the two ETH conditions will receive four video and print modules delivered over an 8 month period by mail, with the option of receiving supplementary text messages weekly. In addition, patients in the ETH-EG condition will participate in multiple telephonic educational sessions with a health educator. Changes in transplant knowledge, decisional balance, self-efficacy, and informed decision making will be captured with surveys administered before and after the ETH education.DiscussionAt the conclusion of this RCT, we will have determined whether an education program administered to socioeconomically disadvantaged dialysis patients, over several months directly in their homes, can help more individuals learn about the options of DDKT and LDKT. We also will be able to examine the efficacy of different educational delivery approaches to further understand whether the addition of a telephone educator is necessary for increasing transplant knowledge.Trial registrationClinicalTrials.gov, NCT02268682