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Abstract Background Buprenorphine (BUP) treatment has been successfully integrated into primary care and other general medical settings; however, potential BUP prescribers frequently report inadequate training and resources to provide psychosocial counseling as barriers to providing care. Group medical visits, which combine psychosocial support and chronic condition management, have been described for BUP treatment, but few studies have explored what is gained and/or lost by offering BUP treatment in groups instead of individual visits. Methods Five focus groups with 3–11 participants each were conducted at an urban community health center that housed a mature office-based BUP treatment program. Participants were persons with opioid use disorder (OUD) who had previously received BUP treatment. A semi-structured interview guide covered the following domains: experience with BUP, experience with group counseling, and preferences for BUP in a group format or individual setting. Qualitative analysis followed a modified grounded theory approach. Results Of 33 participants, 28 were male, median age range was 50–54, 20 identified as Hispanic/Latinx, and 24 reported past experiences with substance use disorder treatment groups. Four main themes were: (1) Groups can address the psychological aspects of addiction; (2) Groups introduce positive peer support; (3) Balancing OUD treatment and management of other chronic conditions; (4) Groups must be voluntary. Conclusions Findings demonstrate that many persons with OUD taking BUP desire assistance with recovery skills, peer support, and learning about the risks and benefits of BUP. Group medical visits can efficiently deliver these services in primary care, but findings also emphasize that group counseling will be best received when voluntary and group members are committed and authentic.

El estudio de los factores de riesgo de la perpetración de ciberacoso en Educación Primaria asociados al uso de las tecnologías en el hogar es mucho menos frecuente que la investigación sobre dichos factores en Educación Secundaria o en el caso de la victimización de ciberacoso. Es por ello que el objetivo de este estudio es identificar factores de riesgo de la perpetración de ciberacoso en Educación Primaria, relacionados con el uso de las tecnologías en el hogar. A tal fin, se seleccionó una muestra de 1169 familias cuyos hijos cursaban 5º y 6º de Educación Primaria, encuestada a través de un cuestionario autoadministrado (α = .84). El análisis de datos realizado con el software R versión 4.1.0 consistió en la implementación de modelos bivariantes de regresión logística binaria, y partiendo de estos, en un modelo multivariante de regresión logística mediante el método stepwise. El modelo multivariante lo conformaron el tiempo de exposición diaria, el número de dispositivos tecnológicos, la finalidad del uso de las tecnologías con acceso a Internet y la zona de uso en el hogar. Así pues, el uso de más de un dispositivo tecnológico, durante más de una hora diaria, en la propia habitación del niño para hablar con amigos presentan una relación conjunta con la perpetración de ciberacoso en Educación Primaria. Estos resultados son de gran utilidad para diseñar propuestas psicoeducativas de intervención para las familias que deben potenciar la mediación parental activa y el uso conjunto de las tecnologías con sus hijos, a partir de estrategias basadas en el establecimiento de normas consensuadas, la comunicación asertiva y el apoyo intrafamiliar.

Olive oil, a staple of the Mediterranean diet, encounters substantial commercial obstacles in Spain and other olive oil-producing nations. Historically, these obstacles have been examined from a consumer demand standpoint, focusing on aspects such as quality enhancement, pricing issues, and consumer awareness deficiencies. This study shifts the focus to the supply-side perspective, providing novel insights into the factors affecting the marketing and sale of olive oil. To investigate these factors, a comprehensive consultation with an expert panel consisting of industry leaders from olive oil mills was conducted. These experts evaluated 13 critical factors identified through a literature review and their practical experience. The findings from this panel offer immediate practical applications, emphasizing the importance of marketing strategies, professionalization, internationalization, and the utilization of social networks and e-commerce in driving olive oil sales. The implications of these findings suggest that companies must restructure to become more professional and market-oriented to navigate and surmount the traditional commercial barriers in the olive oil industry. Overall, this research enhances our understanding of the supply-side dynamics influencing the marketing and sale of olive oil in the Spanish context and beyond.

This study explored substance use trajectories and associations with mental health among an ethnically/racially diverse college student sample before and during the COVID-19 pandemic. We combined repeated cross-sections and panel data from a total of 3,247 college students assessed with an online survey in 2018, 2019, and in three waves in 2020. We estimated trends in substance use and their relation to mental health over the survey waves using generalized estimating equations (GEE). Our results revealed notable associations between 30-day substance use patterns, time of assessment, and psychological well-being. These findings suggest a complex interplay between access to substances, context of substance use, and mental health. We discuss several initiatives that have been launched in response to the results of this ongoing study. Such initiatives may serve as examples for expanding similar efforts to other commuter colleges to prevent further increases in mental health problems and risky substance use.

PurposeCombined BRAF/MEK inhibition with encorafenib (E) plus binimetinib (B) has demonstrated efficacy and tolerability in phase III clinical trials, and is the standard of care for advanced/metastatic BRAFV600-mutant melanoma. However, real-life evidence is limited, particularly in patients pre-treated with immune checkpoint inhibitors (ICI).Patients and methodsBECARE GEM 2002 was a retrospective, non-interventional study aimed at investigating the real-world effectiveness and tolerability of EB in patients with unresectable or metastatic BRAFV600-mutant melanoma conducted at 21 sites in Spain. The primary objective of this study was to characterise the population of patients receiving EB and assess the efficacy and tolerability of EB in real life. The study included patients treated according to standard clinical practice with EB as the 1st line or 2nd line after progression to ICI for an unresectable or metastatic stage. Patients who previously received treatment with BRAF and/or MEK inhibitor, other than as adjuvants, that ended ≥ 6 m before EB were not eligibleResultsFrom September 2021 to March 2023, 117 patients were included; 89 (76.1%) and 28 (23.9%) patients received EB as 1st line and 2nd line, respectively. The median follow-up was 13.8 months (95% CI: 12.0-17.4). In patients with EB as 1st line treatment, ORR and median PFS were 75% and 12 months (95% CI: 9.4-18.6), respectively. In patients with EB as 2nd line treatment after ICI, ORR and median PFS were 77.8% and 12.5 months (95% CI: 6.6-NA), respectively. In patients with brain metastasis ORR and median PFS were 70.8% and 6.3 months (95% CI: 6.1-10.3). Treatment-related adverse events of grade ≥3 were reported in 17 (14.5%) patients; transaminitis (9.4%) and diarrhoea (2.6%) were the most frequent adverse events.ConclusionIn this real-world study, EB treatment demonstrated effectiveness and a consistent safety profile in patients with BRAFV600-mutant melanoma treated according to standard clinical practice, including in those with prior ICI treatment and of brain metastasis; therefore, EB is a feasible treatment option for unresectable and metastatic melanoma.Clinical trial identification: REec: 0004-2021-OBSClinical trial identificationREec: 0004-2021-OBS.

La erosión dental, definida como la pérdida irreversible de los tejidos duros del diente debido a la acción de ácidos no bacterianos, es un problema de salud bucal prevalente en la población adulta. El objetivo de esta investigación fue revisar la relación entre los hábitos alimenticios y la erosión dental documentada en la literatura científica reciente. La metodología incluyó un análisis bibliográfico de publicaciones entre 2019 y 2024, utilizando bases de datos como Scopus, PubMed, Web of Science y SciELO. Los resultados indican que la erosión dental se manifiesta por una pérdida gradual del esmalte, causada por factores extrínsecos como una dieta ácida e intrínsecos como el reflujo gastroesofágico. Se identificaron tres etapas de erosión: temprana, establecida y grave, cada una con características clínicas distintivas. Los hábitos alimenticios, especialmente el consumo de bebidas carbonatadas y ácidas, juegan un papel fundamental en el desarrollo de la erosión. Además, ciertos medicamentos y condiciones médicas como el ERGE pueden exacerbar el proceso erosivo. Se concluye que la erosión dental es una enfermedad multifactorial que requiere un enfoque integral para su prevención y manejo, incluyendo modificación de hábitos dietéticos, educación del paciente y colaboración entre profesionales de la salud.

IntroductionThis study examines suicide among older adults in Honduras over a 15-year period (2008-2022).MethodsData were collected from the National Violence Observatory attached to the University Institute of Democracy, Peace and Security of the National Autonomous University of Honduras (ONV-IUDPAS-UNAH), and 593 suicide cases were analyzed with a quantitative approach of descriptive scope, to identify suicide decedent characteristics and patterns in the cases.ResultsIt was observed that 94.1% of the suicide decedents were male, with an average age of 70 years, predominantly from urban areas; the highest prevalence was in 2021 (7.77), generally in the mornings and mostly by hanging or asphyxiation in private spaces.DiscussionThere is a significant difference in the prevalence of suicide by gender (16 males per female). Similar to worldwide reports, an increase in post-pandemic suicides is observed. The aging of the population and the increasing incidence of suicide in older adults gives relevance to this study, which has been limited by the lack of systematic data collection and previous research that would allow a better understanding of the problem and, in turn, the generation of public policies focused on the mental health of older adults.

El ciberacoso es un acto agresivo e intencional de un agresor/es hacia una víctima, mediante el uso de las tecnologías. La prevalencia de la perpetración de ciberacoso en Educación Primaria en España se sitúa entre el 1.3% y el 13.3%, aunque se ha incrementado a causa del confinamiento derivado de la COVID-19. La cibervictimización en Educación Secundaria y las variables familiares dinámicas han sido más estudiadas en comparación con la ciberperpetración en Educación Primaria y las variables familiares sociodemográficas, respectivamente. Por ello, el objetivo del estudio consiste en evaluar la relación entre las variables sociodemográficas familiares (edad, género, nivel educativo, antecedentes de inmigración, estructura familiar y grado de ruralidad del municipio de residencia familiar) y la ciberperpetración de sus hijos en Educación Primaria. Una muestra constituida por 1169 familias del alumnado de 5º y 6º de Educación Primaria, fue encuestada mediante un cuestionario autoadministrado (α = .84). El análisis de datos se realizó a través de la regresión logística binaria utilizando el software estadístico R versión 4.1.0. El modelo multivariante se implementó a partir de un procedimiento stepwise hasta obtener el mejor modelo predictivo en términos del Criterio de Información de Akaike (AIC). Los antecedentes de inmigración, el nivel educativo del progenitor y la estructura familiar influyen significativamente de forma conjunta en la ciberperpetración de los estudiantes de Educación Primaria. Se concluye que las variables familiares sociodemográficas predicen la implicación del alumnado como ciberagresor. Se propone el desarrollo de un programa de prevención del ciberacoso siguiendo los modelos de whole policy.

BACKGROUND: Self-report measures are important in substance use assessment, yet they are susceptible to reporting errors. Urine drug screens (UDS) are often considered a more valid alternative. However, collecting in-person UDS may not always be feasible, contributing to the need to understand factors that influence the validity of self-reported substance use. METHODS: In this secondary analysis of data from 295 women with co-occurring PTSD and substance use disorders (SUD) who participated in a clinical trial testing behavioral interventions, we examined concordance and discordance between self-reported drug use and associated UDS results. Generalized linear mixed models were used to examine the impact of treatment type and participant characteristics on the associations between self-reported drug use and UDS results. RESULTS: Findings revealed higher disagreement between self-report and UDS for opioids and sedatives (ranging from.77 to.90) and lower disagreement rates for cannabis and cocaine (ranging from.26 to.33). Treatment type was not a significant moderator of the associations between self-report and UDS across all drugs. Among those with a positive opioid UDS, those who reported employment in the past three years were more likely to self-report no opioid use compared to their counterparts without employment in the past three years. CONCLUSIONS: Findings add to the literature that supports the validity of self-reported cannabis and cocaine use. The greater discrepancies between self-report and UDS test results of opioids and sedatives suggest adjunctive UDS may be required, although a variety of factors other than inaccurate self-report may be associated with this discrepancy.

OBJECTIVE: Treatment efficacy for co-occurring posttraumatic stress disorder (PTSD) and substance use disorders is well established, yet direct evidence for comparative effectiveness across treatments is lacking. The present study compared the effectiveness of several behavioral and pharmacological therapies for adults with co-occurring PTSD and alcohol or other drug use disorders. METHODS: A systematic search of PsycINFO, MEDLINE, and ClinicalTrials.gov was conducted through December 2020 for trials targeting PTSD, alcohol or other drug use disorders, or both disorders (36 studies, N=4,046). Primary outcomes were severity scores for PTSD, alcohol use, and drug use, estimated via moderated nonlinear factor analysis. Propensity score weight-adjusted multilevel models were used. Model-predicted effect sizes were estimated for each treatment, and comparative effect sizes for each active arm against treatment as usual, at end of treatment and at 12-month follow-up. RESULTS: Compared with treatment as usual, combining trauma-focused therapy and pharmacotherapy for substance use disorders showed the largest comparative effect sizes for PTSD severity (d=-0.92, 95% CI=-1.57, -0.30) and alcohol use severity (d=-1.10, 95% CI=-1.54, -0.68) at end of treatment. Other treatments with large comparative effect sizes included pharmacotherapies for alcohol or other drug use disorders, trauma-focused integrated therapies, and trauma-focused nonintegrated therapies. Reductions in outcomes for PTSD symptoms and alcohol use were observed for nearly all treatments. CONCLUSIONS: The findings provide support for treating comorbid PTSD and substance use disorders using a variety of approaches, with alcohol-targeted pharmacotherapies and trauma-focused behavioral therapies as a combination of treatments that lead to early and sustained improvements in PTSD and alcohol use severity. Further treatment development is indicated for combining behavioral and pharmacological treatments for synergized impact and understanding the mechanisms of action and conditions under which each treatment type is optimized.

Objective: The co-occurrence of substance use disorders (SUD) and trauma-exposure is a risk factor for suicidal thoughts and behaviors (STB). However, traditional methods of measurement for suicidal thoughts and behaviors are limited by an overreliance on dichotomous (i.e., yes or no) and averaged/summed scale score measurements. Further, among trauma-exposed individuals with SUD, it remains unclear which specific demographic factors, types of SUDs, and trauma sequelae (e.g., posttraumatic stress disorder [PTSD] symptom clusters) may be associated with elevated STB. The present study utilized item response theory to (a) generate empirically derived STB severity scores and, (b) examine which demographic factors, SUD diagnoses, and DSM-IV PTSD symptom clusters are associated with suicidality in a trauma-exposed sample with SUDs. Method: Female trauma-exposed participants with SUDs (N = 544) were recruited from community substance use treatment facilities in the National Drug Abuse Treatment Clinical Trials Network (CTN). Clinician-administered interviews assessed STB, SUDs, and PTSD symptoms. Results: Results indicated that the unidimensional item response theory (IRT) model used to estimate latent STB severity scores fit well, with strong local reliability at higher levels of latent STB severity. Regression predictors of elevated STB severity included younger age, opioid dependence, and higher PTSD reexperiencing symptoms. Conclusions: Clinicians are advised to screen for and target opioid use disorders and reexperiencing symptoms when addressing suicidal thoughts and behavior in trauma-exposed individuals with SUDs. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Multiple factor analytic and item response theory studies have shown that items/symptoms vary in their relative clinical weights in structured interview measures for posttraumatic stress disorder (PTSD). Despite these findings, the use of total scores, which treat symptoms as though they are equally weighted, predominates in practice, with the consequence of undermining the precision of clinical decision-making. We conducted an integrative data analysis (IDA) study to harmonize PTSD structured interview data (i.e., recoding of items to a common symptom metric) from 25 studies (total N = 2,568). We aimed to identify (a) measurement noninvariance/differential item functioning (MNI/DIF) across multiple populations, psychiatric comorbidities, and interview measures simultaneously and (b) differences in inferences regarding underlying PTSD severity between scale scores estimated using moderated nonlinear factor analysis (MNLFA) and a total score analog model (TSA). Several predictors of MNI/DIF impacted effect size differences in underlying severity across scale scoring methods. Notably, we observed MNI/DIF substantial enough to bias inferences on underlying PTSD severity for two groups: African Americans and incarcerated women. The findings highlight two issues raised elsewhere in the PTSD psychometrics literature: (a) bias in characterizing underlying PTSD severity and individual-level treatment outcomes when the psychometric model underlying total scores fails to fit the data and (b) higher latent severity scores, on average, when using DSM-5 (net of MNI/DIF) criteria, by which multiple factors (e.g., Criterion A discordance across DSM editions, changes to the number/type of symptom clusters, changes to the symptoms themselves) may have impacted severity scoring for some patients.

# Background Patients with chronic lung disease (CLD), such as asthma or chronic obstructive pulmonary disease, were expected to have an increased risk of clinical manifestations and severity of COVID-19. However, these comorbidities have been reported less frequently than expected. Chronic treatment with inhaled corticosteroids (ICS) may impact the clinical course of COVID-19. The main objective of this study is to know the influence of chronic treatment with ICS on the prognosis of COVID-19 hospitalized patients with CLD. # Methods A multicenter retrospective cohort study was designed, including patients hospitalized with COVID-19. Epidemiological and clinical data were collected at admission and at seven days, and clinical outcomes were collected. Patients with CLD with and without chronic treatment with ICS were compared. # Results Two thousand five hundred ninety-eight patients were included, of which 1,171 patients had a diagnosis of asthma and 1,427 of COPD (53.37% and 41.41% with ICS, respectively). No differences were found in mortality, transfer to ICU, or development of moderate-severe ARDS. Patients with chronic ICS had a longer hospital stay in both asthma and COPD patients (9 vs. 8 days, *p =* 0.031 in asthma patients), (11 vs. 9 days, *p =* 0.018 in COPD patients); although they also had more comorbidity burden. # Conclusions Patients with chronic inhaled corticosteroids had longer hospital stays and more chronic comorbidities, measured by the Charlson comorbidity index, but they did not have more severe disease at admission, evaluated with qSOFA and PSI scores. Chronic treatment with inhaled corticosteroids had no influence on the prognosis of patients with chronic lung disease and COVID-19.

Additively manufactured Scalmalloy® using laser powder bed fusion (LPBF) has been showing increasing potential for industrial adoption. Its intended application in space, aerospace, and automotive industries requires extensive testing and characterization to produce parts with repeatable properties and safe operations. In the present paper, a thorough investigation of the association between small-scale (micro/nano-scale) and macro-scale (e.g., tensile) properties and microstructural features has been conducted. The prime novelty is the correlation of the small-scale hardness with the tensile properties, which is studied in both as-built and heat-treated conditions (325 °C/4 h) along parallel and perpendicular build directions of the samples. Advanced microstructural characterization including scanning and transmission electron microscopies (SEM/TEM), as well as electron backscatter diffraction (EBSD), was carried out on each condition to correlate microstructure and mechanical properties. While significant improvement in strength was found from as-built to heat-treated conditions, due to the precipitation of secondary Al3Sc and Al3(Sc, Zr), grain size or texture did not change considerably. The grain size analysis revealed a fine-grained zone (FGZ: mostly between 0.5 and 1 μm) next to the coarse-grained zone (CGZ: mostly between 2 and 15 μm). All samples show texture-free FGZ and textured CGZ with a predominance of crystal directions parallel to the building direction.

Background: infection by the human immunodeficiency virus is one of the most important sexually transmitted infections for health worldwide and one of the most frightening of this century.Objective: to characterize the infection by the human immunodeficiency virus in people aged 50 years and older.Methods: a cross-sectional descriptive observational research was carried out, which included all the people diagnosed with the human immunodeficiency virus, in Cienfuegos, from 1986 to 2021. The analyzed variables were: age, sex, sexual orientation, research group, diagnoses by year and residence municipality.Results: people in the age group of 50 to 59 years contributed the highest incidence with 75.21%; the predominant sexual orientation was homosexual (58,9 %). According to the research groups, in the three age groups the captured group stands out with 41.88%. A sustained increase was observed in the province, mainly in the male sex, rising in recent years.Conclusions: the increase in patients aged 50 and older diagnosed with human immunodeficiency virus indicates that it is necessary to address the problem with a different clinical-epidemiological approach. These characteristics increase the risk of HIV infection, they must be monitored with the application of the MINSAP 50 and + Work Line. It is necessary to carry out activities aimed at reducing the risk.