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Due to the COVID-19 pandemic, many clinical addiction treatment programs have been required to transition to telephonic or virtual visits. Novel solutions are needed to enhance substance use treatment during a time when many patients are disconnected from clinical care and social support. Digital phenotyping, which leverages the unique functionality of smartphone sensors (GPS, social behavior, and typing patterns), can buttress clinical treatment in a remote, scalable fashion. Specifically, digital phenotyping has the potential to improve relapse prediction and intervention, relapse detection, and overdose intervention. Digital phenotyping may enhance relapse prediction through coupling machine learning algorithms with the enormous amount of collected behavioral data. Activity-based analysis in real time can potentially be used to prevent relapse by warning substance users when they approach locational triggers such as bars or liquor stores. Wearable devices detect when a person has relapsed to substances through measuring physiological changes such as electrodermal activity and locomotion. Despite the initial promise of this approach, privacy, security, and barriers to access are important issues to address.

Objective The aim of this study was to evaluate overdilation of 10-mm standard and 8–10 mm controlled-expansion Viatorr stents to 12 mm during transjugular intrahepatic portosystemic shunt (TIPS) placement when insufficient reduction (<50%) in portosystemic gradient (PSG) is achieved with standard 10 mm dilation. Materials and Methods It is a single-institution, institutional review board-approved, retrospective review of TIPS (2013–2022) to identify patients in the overdilation group (12 mm dilation of a 10-mm stent) and a control group (10 mm dilation of a 10-mm stent) matched for age, indication, stent type, Model for End-Stage Liver Disease (MELD) score, pre-TIPS PSG, and variceal embolization. Stent diameter, technical success, clinical outcomes, and adverse events were assessed for both groups. Results TIPS was created for the overdilation group (n = 35, 57 ± 11 years, 69% male; MELD: 14 ± 5) and control group (n = 35, 57 ± 11 years, 83% male; MELD: 14 ± 5). Overdilation to 12 mm adequately reduced PSG by more than 50% (55 vs. 65% in the control group, p = 0.11). The stent diameter was larger in the overdilation group on cross-sectional imaging (9.8 ± 0.2 vs. 9.5 ± 0.4 mm, p < 0.001), with an estimated 57% higher volume flow rate (p = 0.002). Patients were followed for a median of 11.3 months (range: 0.03–75) and 15.6 months (range: 0.03–106) in the overdilation and control groups, respectively. There was an equivalent rate of ascites resolution (56 vs. 63%, p = 0.68) and rebleeding (13 vs. 17%, p = 0.82) in the overdilation and control groups, with a similar risk of new-onset hepatic encephalopathy (41 vs. 33%, p = 0.51) and TIPS occlusion (11 vs. 9%, p = 0.69). Overdilation did not result in any instance of stent fracture. Conclusion Overdilation of 10-mm Viatorr stents with 12 mm balloons may provide benefit by potentially reducing PSG further for patients initially having inadequate PSG reduction with short-term safety. [ABSTRACT FROM AUTHOR]

The conservation of a rare species requires an understanding of its habitat requirements, including its response to different light levels. Accordingly, we conducted a study of the light requirements of Pycnanthemum verticillatum var. verticillatum, a New York State S1S2-Endangered perennial forb found on Staten Island, Richmond County, NY. Much of its present habitat in this urban county is along disturbed roadsides and is undergoing increased shading due to woody encroachment. We grew plants in full sunlight (no shade cloth), medium sunlight (30% shade cloth), and low sunlight (60% shade cloth), and measured their growth, reproductive, and morphological responses. Plants were largest and most likely to produce flowers in the full and medium sunlight treatments. Plants exhibited typical shade-avoidant responses such as stem elongation and increased secondary ramet production in the low sunlight treatment. We conclude that Pycnanthemum verticillatum var. verticillatum may survive in deep shade, but partial and full sun result in more vigorous growth and reproduction. Canopy thinning to maintain no more than 30–50% shade is necessary for the plants to thrive. Managing for sunny habitats, such as meadows and open-canopy forests, would have broad conservation benefits for this species and other native plants that require high-light environments in the region. [ABSTRACT FROM AUTHOR]

Organizational innovation climates have been found to be effective predictors of employee creativity and organizational innovation. As such, climate assessments provide a basis for useful organizational interventions in enhancing creativity and innovation. Researchers now call for better articulation of the motivational mechanisms that link social context to employee innovation. In responding to the above call, this study found that employee positive psychological capital (PsyCap) is more influential than organizational innovation climate on employee innovative behavior. With a large sample (N = 781) from 16 organizations and a cross-level analysis, we examined the relationship between organizational innovation climate and employee innovative behavior with employee PsyCap as mediator. The results showed that both organizational innovation climate and employee PsyCap significantly affect employee innovative behavior, and more importantly, employee PsyCap fully mediates this relationship. The innovation journey is a challenging and risky one with many frustrations and discouraging moments from idea generation to idea implementation. The research results presented here imply that to be innovatively effective, organizations are advised to manage both social (organizational innovation climate) and psychological (PsyCap) resources of employees in enhancing employee innovative behavior. Other theoretic and practical implications are discussed.

Background and Objectives: Alcohol use disorder (AUD) is a significant public health concern, with underutilized effective treatments, particularly in special populations. This article summarizes the current evidence and guidelines for treating AUD in special populations. Methods: This article is a literature review that synthesizes the latest research on AUD treatment for special populations. We screened 242 articles and included 57 in our final review. Results: There are four food and Drug Administration‐approved medications for AUD (MAUD): disulfiram, oral naltrexone, extended‐release injectable naltrexone (XR‐NTX), and acamprosate. Naltrexone and disulfiram have the potential to cause liver toxicity, and acamprosate should be avoided in patients with severe kidney disease. Psychosocial treatments should be considered first‐line for pregnant and nursing patients. Naltrexone is contraindicated in patients on opioids, as it may precipitate acute withdrawal. For patients experiencing homelessness, nonabstinent treatment goals may be more practical, and XR‐NTX should be considered to improve adherence. Limited evidence suggests medication can improve AUD treatment outcomes in adolescents and young adults. For patients with poor treatment response despite adequate medication adherence, switching to a different medication and augmentation with psychosocial treatments should be considered. Discussion and Conclusions: Understanding the unique considerations for special populations with AUD is crucial, and addressing their special needs may improve their treatment outcomes. Scientific Significance: Our study significantly contributes to the existing literature by summarizing crucial information for the treatment of AUD in special populations, highlighting distinct challenges, and emphasizing tailored approaches to improve overall health and well‐being. [ABSTRACT FROM AUTHOR]

Aim: Survey alcohol use and workload among Chinese psychiatrists and explore their associations. Methods: We conducted an online questionnaire among psychiatrists working in large psychiatric institutions across the country. We collected data including demographic factors, alcohol use, and workload. Alcohol use was assessed using the Alcohol Use Disorder Identification Test-Consumption (AUDIT-C), and workload-related questions included working hours, night shifts, and caseloads. Results: In total, 3,549 psychiatrists completed the survey. Nearly half (47.6%) reported alcohol use, and the percentage of alcohol use in males (74.1%) was significantly higher than in females. 8.1% exceeded the AUDIT-C cutoff scores for probable alcohol misuse (19.6%in males and 2.6%in females). AUDIT-C scores were significantly correlated with working hours per week (p = 0.017) and the number of outpatient visits per week (p = 0.006). Regressional analysis showed that alcohol use was significantly associated with the following factors: longer working hours (Working more than 44 h/week, OR = 1.315), having an administrative position (OR = 1.352), being male (OR = 6.856), being single (OR = 1.601), being divorced or widowed (OR = 1.888), smoking (OR = 2.219), working in the West (OR = 1.511) or the Northeast (OR = 2.440). Regressional analysis showed that alcohol misuse was significantly associated with the following factors: fewer night shifts (Three to four night shifts/month, OR = 1.460; No more than 2 night shifts/month, OR = 1.864), being male (OR = 4.007), working in the Northeast (OR = 1.683), smoking (OR = 2.219), frequent insomnia (OR = 1.678). Conclusion: Nearly half of the psychiatrists in China reported alcohol use and 8.1% had probable AUD. Alcohol consumption is significantly associated with several workload-related factors, such as long working hours, heavy caseload, and administrative duties. Alcohol misuse was inversely associated with the number of night shifts per month. While the direction of causality is unclear, our findings may help identify vulnerable professional groups and develop more targeted interventions to improve healthcare professionals' well-being. [ABSTRACT FROM AUTHOR]

Creativity research on the personality approach has focused on the relationship between individual attributes and innovative behavior. However, few studies have empirically examined the effects of positive psychological traits on innovative behavior in an organizational setting. This study examines the relationships among creative self-efficacy, optimism, and innovative behavior as well as the moderating effect of optimism. Longitudinal data across two periods were collected from 120 spa employees of a diet and beauty salon company in Taiwan. After controlling for the effects of job tenure and the Big Five personality traits, this study found that employees with a high level of creative self-efficacy demonstrate a high level of innovative behavior at work, and optimism does not have a direct effect on employees' innovative behavior, but it does play a moderating role. When employees' creative self-efficacy is high, those with greater optimism exhibit greater innovative behavior at work. Toward the end, this paper offers suggestions for future research and discusses the practical implications of this study. (Contains 1 figure and 2 tables.)

Substantial advancement in the diagnosis and treatment of psychiatric disorders may come from assembling diverse data streams from clinical notes, neuroimaging, genetics, and real-time digital footprints from smartphones and wearable devices. This is called "deep phenotyping" and often involves machine learning. We argue that incidental findings arising in deep phenotyping research have certain special, morally and legally salient features: They are specific, actionable, numerous, and probabilistic. We consider ethical and legal implications of these features and propose a practical ethics strategy for managing them. [ABSTRACT FROM AUTHOR]

Background: In recent years, there has been increasing interest in implementing digital technologies to diagnose, monitor, and intervene in substance use disorders. Smartphones are now a vehicle for facilitating telepsychiatry visits, measuring health metrics, and communicating with health care professionals. In light of the COVID-19 pandemic and the movement toward web-based and hybrid clinic visits and meetings, it has become especially salient to assess phone ownership among individuals with substance use disorders and their comfort in navigating phone functionality and using phones for mental health purposes. Objective: The aims of this study were to summarize the current literature around smartphone ownership, smartphone utilization, and the acceptability of using smartphones for mental health purposes and assess these variables across two disparate substance use treatment sites. Methods: We performed a focused literature review via a search of two academic databases (PubMed and Google Scholar) for publications since 2007 on the topics of smartphone ownership, smartphone utilization, and the acceptability of using mobile apps for mental health purposes among the substance use population. Additionally, we conducted a cross-sectional survey study that included 51 participants across two sites in New England--an inpatient detoxification unit that predominantly treats patients with alcohol use disorder and an outpatient methadone maintenance treatment clinic. Results: Prior studies indicated that mobile phone ownership among the substance use population between 2013 and 2019 ranged from 83% to 94%, while smartphone ownership ranged from 57% to 94%. The results from our study across the two sites indicated 96% (49/51) mobile phone ownership and 92% (47/51) smartphone ownership among the substance use population. Although most (43/49, 88%) patients across both sites reported currently using apps on their phone, a minority (19/48, 40%) reported previously using any apps for mental health purposes. More than half of the participants reported feeling at least neutrally comfortable with a mental health app gathering information regarding appointment reminders (32/48, 67%), medication reminders (33/48, 69%), and symptom surveys (26/45, 58%). Most patients were concerned about privacy (34/51, 67%) and felt uncomfortable with an app gathering location (29/47, 62%) and social (27/47, 57%) information for health care purposes. Conclusions: The majority of respondents reported owning a mobile phone (49/51, 96%) and smartphone (47/51, 92%), consistent with prior studies. Many respondents felt comfortable with mental health apps gathering most forms of personal information and with communicating with their clinician about their mental health. The differential results from the two sites, namely greater concerns about the cost of mental health apps among the methadone maintenance treatment cohort and less experience with downloading apps among the older inpatient detoxification cohort, may indicate that clinicians should tailor technological interventions based on local demographics and practice sites and that there is likely not a one-size-fits-all digital psychiatry solution. [ABSTRACT FROM AUTHOR]

Research has been conducted on the transition state interactions in the Tetrahymena ribozyme reaction. The oxygen atoms near the reaction center have been examined in investigating the effect of these interactions on the catalysis, and the use of the new type DNA substrate where 5'-oxygen is replaced with a methylene has been described.

Micronutrients are essential small molecules required by organisms in minute quantity for survival. For instance, vitamins and minerals, the two major categories of micronutrients, are central for biological processes such as metabolism, cell replication, differentiation, and immune response. Studies estimated that around two billion humans worldwide suffer from micronutrient deficiencies, also known as "hidden hunger," linked to weakened immune responses. While micronutrients affect the immune system at multiple levels, recent studies showed that micronutrients potentially impact the differentiation and function of immune cells as cofactors for epigenetic enzymes, including the 2‐oxoglutarate‐dependent dioxygenase (2OGDD) family involved in histone and DNA demethylation. Here, we will first provide an overview of the role of DNA methylation in T cells and B cells, followed by the micronutrients ascorbate (vitamin C) and iron, two critical cofactors for 2OGDD. We will discuss the emerging evidence of these micronutrients could regulate adaptive immune response by influencing epigenetic remodeling. [ABSTRACT FROM AUTHOR]

Abstract Background Apathy is frequently observed in numerous neurological disorders, including Alzheimer's and Parkinson's, as well as neuropsychiatric disorders including schizophrenia. Apathy is defined as a lack of motivation characterized by diminished goal-oriented behavior and self-initiated activity. This study evaluated a chronic restraint stress (CRS) protocol in modeling apathetic behavior, and determined whether administration of an anticholinesterase had utility in attenuating CRS-induced phenotypes. Methods We assessed behavior as well as regional neuronal activity patterns using FosB immunohistochemistry after exposure to CRS for 6 h/d for a minimum of 21 d. Based on our FosB findings and recent clinical trials, we administered an anticholinesterase to evaluate attenuation of CRS-induced phenotypes. Results CRS resulted in behaviors that reflect motivational loss and diminished emotional responsiveness. CRS-exposed mice showed differences in FosB accumulation, including changes in the cholinergic basal forebrain system. Facilitating cholinergic signaling ameliorated CRS-induced deficits in initiation and motivational drive and rescued immediate early gene activation in the medial septum and nucleus accumbens. Conclusions Some CRS protocols may be useful for studying deficits in motivation and apathetic behavior. Amelioration of CRS-induced behaviors with an anticholinesterase supports a role for the cholinergic system in remediation of deficits in motivational drive.

Adequate pain control after multisystem trauma including the chest wall is essential for improved patient outcomes, especially with sternum and rib fractures. The thoracic epidural is considered the gold standard in pain management of thoracic injury; however, failure or patchy epidural is not uncommon. Pectointercostal fascial plane block (PIFB) is regularly used in cardiac surgery to provide analgesia to the anterior chest wall; however, there are few reports of PIFB being used as a primary block for the management of thoracic injuries. We present a case in which PIFB was used as a rescue block for the successful management of sternal pain following patchy thoracic epidural block in a patient with thoracic polytrauma. [ABSTRACT FROM AUTHOR]

A case study is presented of 23-year-old patient who has severe anxiety. It mentions that she also has asthma and reports during your exploration of her family history that her father has been diagnosed with schizophrenia. It also mentions that she has been using 3 cartridges of cannabis vape daily to help calm her mind but has never tried other psychotropic medications.

Byline: Michael L.A. Hsu, Maggie Hui-Fen Chen, Binshan Lin This study reviews the relevant literature on the relation between top management and the organisational innovation based on 21 empirical studies. This study found that: (1) Top management directly influence organisational innovation via characteristics, leadership and behaviour of the Chief Executive Officer (CEO)/Top Management Team (TMT); (2) Top management influence organisational innovation via mediators. The first mediator is strategic decision or choice made by CEO/TMT. The second is the outcomes of top management. Meanwhile, commitment, communication and involvement of CEO/TMT can serve as mediators between organisational activities and organisational innovation; (3) Three levels of variables moderate the relationship between top management and organisational innovation, the first is the social level, including socialcultural context, culture and technological dynamism; the second is the organisational level, e.g. the novelty of business; the third is the group level, including interfunctional coordination of TMT and managerial creativity of TMT.

Purpose: To study the effects of altering condylar settings and pin openings on the trueness and precision of virtual articulators vs. mechanical articulators. Materials and Methods: Maxillary and mandibular typodonts with fiducial markers were mounted on a mechanical Artex‐CR articulator, and the mandibular teeth were prepared to allow guidance solely by the posterior determinants of the articulator and the incisal table. The relationship of the mounted typodonts was preserved digitally by scanning using manufacturer transfer plate adaptors. On the mechanical articulator, pattern resin was allowed to set between the maxillary and mandibular occlusal surfaces (area #25‐30) at the endpoints of dynamic movements at 3 condylar inclinations (SCI): 10°, 30°, and 45°, n = 12/inclination, or at 3 incisal pin openings (2, 5, and 10 mm, n = 12/opening). All other articulator settings were kept constant. Resin specimens attached to the typodonts were scanned within 5 minutes of setting, then removed, and the articulated typodonts rescanned. Fixed dental prostheses (FDPs) #25‐30 were designed on the virtual articulator using identical parameters to the mechanical articulator. Dynamic virtual movements were used to sculpt the design, and a file of the design was saved. The files of both types of samples were aligned and overlaid. Interocclusal separation was measured in triplicate at the indentation created by the mesiolabioincisal point angle on the incisal edge of #8 and the mesiobucco‐occlusal point angle of #3. Trueness and precision of both types of articulators were calculated and compared using one‐way ANOVA, followed by the Tukey HSD test (α = 0.05). Results: There was no statistically significant difference at altered pin openings in either trueness (F = 0.202, p = 0.37) or precision (F = 3.134, p = 0.09) for the majority of measurements. The only significant difference was in the precision between the 2 types of articulators at 5 mm incisal opening, and only at the anterior measurement point (F = 15.134, p = 0.0008); however, these differences were less than 100 μm. When the SCI was altered, there was no statistically significant difference (F = 3.624, p > 0.05) between the virtual and mechanical articulators in trueness for 5 of the 6 measurements obtained (F = 3.624, p = 0.07) or for all of the precision measurements (F = 3.529, p = 0.07). The one trueness measurement that was significantly different (F = 9.237, p = 0.006) occurred at SCI of 10°, and it was less than 100 µm. Conclusions: Dynamic movements on the virtual articulator were shown to be as true and precise as to the mechanical articulator. When there were deviations, these deviations were less than 100 µm and thus, these deviations may not be clinically relevant. [ABSTRACT FROM AUTHOR]

Objectives: The purpose of this study was to assess whether study population definition influences the effect of age on outcomes after blunt head trauma. We hypothesized that examining 'all comers' receiving head computerized tomography after blunt head trauma, fewer older individuals would meet Veterans Administration and Department of Defense (VA/DoD) criteria for traumatic brain injury (TBI), and would, therefore, display better outcomes than younger cohorts. However, restricting to participants meeting VA/DoD criteria for TBI, we hypothesized that older individuals would have worse outcomes. Methods: Data from a recently completed prospective cohort study were analysed with age dichotomized at 65 years. Logistic regression modelling, controlled for potential confounders including head trauma severity, was estimated to measure the effect of age on functional recovery, post-concussion symptoms (PCS), and depressive symptoms at 1-month post-TBI. Results: Fewer older than younger individuals met VA/DoD criteria for TBI. Older individuals had better functional, PCS, and depressive outcomes at 1 month. Restricting to those meeting VA/DoD criteria for TBI, older individuals continued to have better functional and PCS outcomes but had outcomes comparable to younger on depressive symptoms. Conclusions: Contrary to our hypothesis, there was a tendency for older adults to have better outcomes than younger, independent of the diagnostic criteria applied. [ABSTRACT FROM AUTHOR]