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Vo HT, Kulikova A, Mayes TL, Carmody T, Shoptaw S, Ling W, Trombello JM, Trivedi MH. Psychometric properties of the Treatment Effectiveness Assessment in methamphetamine use disorder. J Subst Use Addict Treat 2023; 151:209085. [PMID: 37245855 DOI: 10.1016/j.josat.2023.209085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 05/01/2023] [Accepted: 05/23/2023] [Indexed: 05/30/2023]
Abstract
INTRODUCTION The ability for people living with stimulant use disorder to live meaningful lives requires not only abstinence from addictive substances, but also healthy engagement with their community, lifestyle practices, and overall health. The Treatment Effectiveness Assessment (TEA) assesses components of recovery consisting of four functional domains: substance use, health, lifestyle, and community. This secondary data analysis of 403 participants with severe methamphetamine use disorder tested the reliability and validity of the TEA. METHODS Participants were enrolled in the Accelerated Development of Additive Pharmacotherapy Treatment (ADAPT-2) for methamphetamine use disorder. The study used total TEA and domain scores at baseline to assess factor structure and internal consistency, as well as construct validity related to substance cravings (visual analog scale [VAS]), quality of life (quality-of-life assessment [QoL]), mental health (Patient Health Questionnaire-9 [PHQ-9], Concise Health Risk Tracking Scale Self-Report [CHRT-SR16]), and social support (CHRT-SR16). RESULTS Individual TEA items showed moderate to large correlations with each other (r = 0.27-0.51; p < .001), and strong correlations to the total score (r = 0.69-0.78; p < .001). Internal consistency was strong (coefficient α = 0.73 [0.68-0.77]; coefficient ω = 0.73 [0.69-0.78]). Construct validity was acceptable, with the strongest correlation between the TEA Health item and the general health status item on the QoL (r = 0.53, p < .001). CONCLUSIONS TEA has acceptable levels of reliability and validity supporting prior similar findings in a sample of participants with moderate to severe methamphetamine use disorder. Results from this study provide support for its use in assessing clinically meaningful changes beyond simply reduced substance use.
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Affiliation(s)
- Hoa T Vo
- Center for Depression Research and Clinical Care, Department of Psychiatry and Peter O'Donnell Jr. Brain Institute, UT Southwestern Medical Center, Dallas, TX, USA
| | - Alexandra Kulikova
- Center for Depression Research and Clinical Care, Department of Psychiatry and Peter O'Donnell Jr. Brain Institute, UT Southwestern Medical Center, Dallas, TX, USA
| | - Taryn L Mayes
- Center for Depression Research and Clinical Care, Department of Psychiatry and Peter O'Donnell Jr. Brain Institute, UT Southwestern Medical Center, Dallas, TX, USA
| | - Thomas Carmody
- Center for Depression Research and Clinical Care, Department of Psychiatry and Peter O'Donnell Jr. Brain Institute, UT Southwestern Medical Center, Dallas, TX, USA; Peter O'Donnell Jr. School of Public Health, UT Southwestern Medical Center, Dallas, TX, USA
| | - Steve Shoptaw
- University of California Los Angeles, Los Angeles, CA, USA
| | - Walter Ling
- University of California Los Angeles, Los Angeles, CA, USA
| | - Joseph M Trombello
- Center for Depression Research and Clinical Care, Department of Psychiatry and Peter O'Donnell Jr. Brain Institute, UT Southwestern Medical Center, Dallas, TX, USA
| | - Madhukar H Trivedi
- Center for Depression Research and Clinical Care, Department of Psychiatry and Peter O'Donnell Jr. Brain Institute, UT Southwestern Medical Center, Dallas, TX, USA.
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El Atwani O, Vo HT, Tunes MA, Lee C, Alvarado A, Krienke N, Poplawsky JD, Kohnert AA, Gigax J, Chen WY, Li M, Wang YQ, Wróbel JS, Nguyen-Manh D, Baldwin JKS, Tukac OU, Aydogan E, Fensin S, Martinez E. Author Correction: A quinary WTaCrVHf nanocrystalline refractory high-entropy alloy withholding extreme irradiation environments. Nat Commun 2023; 14:3490. [PMID: 37311813 DOI: 10.1038/s41467-023-39294-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023] Open
Affiliation(s)
- O El Atwani
- Materials Science and Technology Division, Los Alamos National Laboratory, Los Alamos, NM, USA.
| | - H T Vo
- Materials Science and Technology Division, Los Alamos National Laboratory, Los Alamos, NM, USA
| | - M A Tunes
- Materials Science and Technology Division, Los Alamos National Laboratory, Los Alamos, NM, USA
| | - C Lee
- Center for Integrated Nanotechnology, Los Alamos National Laboratory, Los Alamos, NM, USA
- Department of Materials and Mechanical Engineering, Auburn University, Auburn, AL, USA
| | - A Alvarado
- Theoretical Division, Los Alamos National Laboratory, Los Alamos, NM, USA
- Departments of Mechanical Engineering and Materials Science and Engineering, Clemson University, Clemson, SC, USA
| | - N Krienke
- Materials Science and Engineering, University of Wisconsin-Madison, Madison, WI, USA
| | - J D Poplawsky
- Materials Science and Technology Division, Oak Ridge National Laboratory, Oak Ridge, TN, USA
| | - A A Kohnert
- Materials Science and Technology Division, Los Alamos National Laboratory, Los Alamos, NM, USA
| | - J Gigax
- Center for Integrated Nanotechnology, Los Alamos National Laboratory, Los Alamos, NM, USA
| | - W-Y Chen
- Division of Nuclear Engineering, Argonne National Laboratory, Lemon, IL, USA
| | - M Li
- Division of Nuclear Engineering, Argonne National Laboratory, Lemon, IL, USA
| | - Y Q Wang
- Materials Science and Technology Division, Los Alamos National Laboratory, Los Alamos, NM, USA
| | - J S Wróbel
- Faculty of Materials Science and Engineering, Warsaw University of Technology, ul. Wołoska, 02-507, Warsaw, Poland
| | - D Nguyen-Manh
- Culham Center for Fusion Energy, United Kingdom Atomic Energy Authority, Abingdon, OX14 3DB, UK
- Department of Materials, University of Oxford, Oxford, OX1 3PH, UK
| | - J K S Baldwin
- Center for Integrated Nanotechnology, Los Alamos National Laboratory, Los Alamos, NM, USA
| | - O U Tukac
- Metallurgical and Materials Engineering, Middle East Technical University, Ankara, Turkey
| | - E Aydogan
- Metallurgical and Materials Engineering, Middle East Technical University, Ankara, Turkey
| | - S Fensin
- Center for Integrated Nanotechnology, Los Alamos National Laboratory, Los Alamos, NM, USA
| | - E Martinez
- Departments of Mechanical Engineering and Materials Science and Engineering, Clemson University, Clemson, SC, USA
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El Atwani O, Vo HT, Tunes MA, Lee C, Alvarado A, Krienke N, Poplawsky JD, Kohnert AA, Gigax J, Chen WY, Li M, Wang YQ, Wróbel JS, Nguyen-Manh D, Baldwin JKS, Tukac OU, Aydogan E, Fensin S, Martinez E. A quinary WTaCrVHf nanocrystalline refractory high-entropy alloy withholding extreme irradiation environments. Nat Commun 2023; 14:2516. [PMID: 37130885 PMCID: PMC10154406 DOI: 10.1038/s41467-023-38000-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 04/10/2023] [Indexed: 05/04/2023] Open
Abstract
In the quest of new materials that can withstand severe irradiation and mechanical extremes for advanced applications (e.g. fission & fusion reactors, space applications, etc.), design, prediction and control of advanced materials beyond current material designs become paramount. Here, through a combined experimental and simulation methodology, we design a nanocrystalline refractory high entropy alloy (RHEA) system. Compositions assessed under extreme environments and in situ electron-microscopy reveal both high thermal stability and radiation resistance. We observe grain refinement under heavy ion irradiation and resistance to dual-beam irradiation and helium implantation in the form of low defect generation and evolution, as well as no detectable grain growth. The experimental and modeling results-showing a good agreement-can be applied to design and rapidly assess other alloys subjected to extreme environmental conditions.
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Affiliation(s)
- O El Atwani
- Materials Science and Technology Division, Los Alamos National Laboratory, Los Alamos, NM, USA.
| | - H T Vo
- Materials Science and Technology Division, Los Alamos National Laboratory, Los Alamos, NM, USA
| | - M A Tunes
- Materials Science and Technology Division, Los Alamos National Laboratory, Los Alamos, NM, USA
| | - C Lee
- Center for Integrated Nanotechnology, Los Alamos National Laboratory, Los Alamos, NM, USA
- Department of Materials and Mechanical Engineering, Auburn University, Montgomery, AL, USA
| | - A Alvarado
- Theoretical Division, Los Alamos National Laboratory, Los Alamos, NM, USA
- Departments of Mechanical Engineering and Materials Science and Engineering, Clemson University, Clemson, SC, USA
| | - N Krienke
- Materials Science and Engineering, University of Wisconsin-Madison, Madison, WI, USA
| | - J D Poplawsky
- Materials Science and Technology Division, Oak Ridge National Laboratory, Oak Ridge, TN, USA
| | - A A Kohnert
- Materials Science and Technology Division, Los Alamos National Laboratory, Los Alamos, NM, USA
| | - J Gigax
- Center for Integrated Nanotechnology, Los Alamos National Laboratory, Los Alamos, NM, USA
| | - W-Y Chen
- Division of Nuclear Engineering, Argonne National Laboratory, Lemon, IL, USA
| | - M Li
- Division of Nuclear Engineering, Argonne National Laboratory, Lemon, IL, USA
| | - Y Q Wang
- Materials Science and Technology Division, Los Alamos National Laboratory, Los Alamos, NM, USA
| | - J S Wróbel
- Faculty of Materials Science and Engineering, Warsaw University of Technology, ul. Wołoska, 02-507, Warsaw, Poland
| | - D Nguyen-Manh
- Culham Center for Fusion Energy, United Kingdom Atomic Energy Authority, Abingdon, OX14 3DB, UK
- Department of Materials, University of Oxford, Oxford, OX1 3PH, UK
| | - J K S Baldwin
- Center for Integrated Nanotechnology, Los Alamos National Laboratory, Los Alamos, NM, USA
| | - O U Tukac
- Metallurgical and Materials Engineering, Middle East Technical University, Ankara, Turkey
| | - E Aydogan
- Metallurgical and Materials Engineering, Middle East Technical University, Ankara, Turkey
| | - S Fensin
- Center for Integrated Nanotechnology, Los Alamos National Laboratory, Los Alamos, NM, USA
| | - E Martinez
- Departments of Mechanical Engineering and Materials Science and Engineering, Clemson University, Clemson, SC, USA
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Miu AS, Vo HT, Palka JM, Glowacki CR, Robinson RJ. Teletherapy with serious mental illness populations during COVID-19: telehealth conversion and engagement. Counselling Psychology Quarterly 2020. [DOI: 10.1080/09515070.2020.1791800] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Adriana S. Miu
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Hoa T. Vo
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Jayme M. Palka
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | | | - Reed J. Robinson
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
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Stanger C, Scherer EA, Vo HT, Babbin SF, Knapp AA, McKay JR, Budney AJ. Working memory training and high magnitude incentives for youth cannabis use: A SMART pilot trial. Psychol Addict Behav 2019; 34:31-39. [PMID: 31246068 DOI: 10.1037/adb0000480] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
The purpose of this sequential multiple-assignment randomization treatment pilot study was to examine if (a) adding working memory training to contingency management (CM) for youth with cannabis use disorder (CUD) and (b) switching nonresponding youth to higher magnitude CM incentives boosts outcomes. In Phase 1, youth with CUD (n = 59, M age = 16, male = 71%) attending an intensive outpatient program were randomly assigned to 14 weeks of CM only or CM plus working memory training (WMT). In Week 4, a Phase 2 treatment was assigned. Those with negative urine drug tests (responders) continued in their Phase 1 treatment. Those who were drug positive (nonresponders) were randomly assigned to remain in their Phase 1 treatment or to higher magnitude CM. Zero-inflated negative binomial models comparing those assigned to CM versus CM + WMT indicated no differences in the likelihood of having ≥ 1 week of continuous abstinence or longer abstinence duration. Those assigned to WMT showed greater but nonsignificant improvements in working memory (n = 35; β = .69, p = .06). Working memory improvements were associated with achieving any abstinence (odds ratio = 3.50, 95% CI [1.01, 12.10], p = .05). Phase 2 randomization to higher magnitude CM did not boost outcomes. Overall results suggest that WMT appears promising, but the sample size was small, attrition was high, and replication is important. Alternative strategies should continue to be explored to improve outcomes for adolescent substance use disorders, such as different approaches for nonresponders, tailoring to other baseline or response characteristics, or more robust first-line interventions. (PsycINFO Database Record (c) 2020 APA, all rights reserved).
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Sweeney MM, Rass O, DiClemente C, Schacht RL, Vo HT, Fishman MJ, Leoutsakos JMS, Mintzer MZ, Johnson MW. Working Memory Training for Adolescents With Cannabis Use Disorders: A Randomized Controlled Trial. J Child Adolesc Subst Abuse 2018; 27:211-226. [PMID: 30524179 DOI: 10.1080/1067828x.2018.1451793] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Adolescent cannabis use is associated with working memory impairment. The present randomized controlled trial assigned adolescents ages 14 to 21 enrolled in cannabis use treatment to receive either working memory training (experimental group) or a control training (control group) as an adjunctive treatment. Cognitive function, drug use, and other outcomes were assessed before and after training. We observed few differences in cognitive, functional, or self-reported drug use outcomes as a function of training group, although tetrahydrocannabinol (THC) urinalysis results favored the experimental group. These findings are similar to previous studies in substance users, which have shown limited transfer effects for working memory training.
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Affiliation(s)
- Mary M Sweeney
- Department of Psychiatry and Behavioral Sciences, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Olga Rass
- Department of Psychiatry and Behavioral Sciences, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Cara DiClemente
- Department of Psychiatry and Behavioral Sciences, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Rebecca L Schacht
- Department of Psychiatry and Behavioral Sciences, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Hoa T Vo
- Mountain Manor Treatment Center, Baltimore, MD, USA
| | - Marc J Fishman
- Department of Psychiatry and Behavioral Sciences, School of Medicine, Johns Hopkins University, Baltimore, MD, USA.,Mountain Manor Treatment Center, Baltimore, MD, USA
| | - Jeannie-Marie S Leoutsakos
- Department of Psychiatry and Behavioral Sciences, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Miriam Z Mintzer
- Department of Psychiatry and Behavioral Sciences, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Matthew W Johnson
- Department of Psychiatry and Behavioral Sciences, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
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Abstract
Deaths due to prescription and illicit opioid overdose have been rising at an alarming rate, particularly in the USA. Although naloxone injection is a safe and effective treatment for opioid overdose, it is frequently unavailable in a timely manner due to legal and practical restrictions on its use by laypeople. As a result, an effort spanning decades has resulted in the development of strategies to make naloxone available for layperson or "take-home" use. This has included the development of naloxone formulations that are easier to administer for nonmedical users, such as intranasal and autoinjector intramuscular delivery systems, efforts to distribute naloxone to potentially high-impact categories of nonmedical users, as well as efforts to reduce regulatory barriers to more widespread distribution and use. Here we review the historical and current literature on the efficacy and safety of naloxone for use by nonmedical persons, provide an evidence-based discussion of the controversies regarding the safety and efficacy of different formulations of take-home naloxone, and assess the status of current efforts to increase its public distribution. Take-home naloxone is safe and effective for the treatment of opioid overdose when administered by laypeople in a community setting, shortening the time to reversal of opioid toxicity and reducing opioid-related deaths. Complementary strategies have together shown promise for increased dissemination of take-home naloxone, including 1) provision of education and training; 2) distribution to critical populations such as persons with opioid addiction, family members, and first responders; 3) reduction of prescribing barriers to access; and 4) reduction of legal recrimination fears as barriers to use. Although there has been considerable progress in decreasing the regulatory and legal barriers to effective implementation of community naloxone programs, significant barriers still exist, and much work remains to be done to integrate these programs into efforts to provide effective treatment of opioid use disorders.
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Affiliation(s)
- Christa R Lewis
- Maryland Treatment Centers, Baltimore, MD, USA.,Department of Psychology, Towson University, Towson, MD, USA
| | - Hoa T Vo
- Maryland Treatment Centers, Baltimore, MD, USA
| | - Marc Fishman
- Maryland Treatment Centers, Baltimore, MD, USA.,Department of Psychiatry, Johns Hopkins School of Medicine, Baltimore, MD, USA
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Sweeney MM, Rass O, Johnson PS, Strain EC, Berry MS, Vo HT, Fishman MJ, Munro CA, Rebok GW, Mintzer MZ, Johnson MW. Initial feasibility and validity of a prospective memory training program in a substance use treatment population. Exp Clin Psychopharmacol 2016; 24:390-399. [PMID: 27690506 PMCID: PMC5094364 DOI: 10.1037/pha0000091] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Individuals with substance use disorders have shown deficits in the ability to implement future intentions, called prospective memory. Deficits in prospective memory and working memory, a critical underlying component of prospective memory, likely contribute to substance use treatment failures. Thus, improvement of prospective memory and working memory in substance use patients is an innovative target for intervention. We sought to develop a feasible and valid prospective memory training program that incorporates working memory training and may serve as a useful adjunct to substance use disorder treatment. We administered a single session of the novel prospective memory and working memory training program to participants (n = 22; 13 men, 9 women) enrolled in outpatient substance use disorder treatment and correlated performance to existing measures of prospective memory and working memory. Generally accurate prospective memory performance in a single session suggests feasibility in a substance use treatment population. However, training difficulty should be increased to avoid ceiling effects across repeated sessions. Consistent with existing literature, we observed superior performance on event-based relative to time-based prospective memory tasks. Performance on the prospective memory and working memory training components correlated with validated assessments of prospective memory and working memory, respectively. Correlations between novel memory training program performance and established measures suggest that our training engages appropriate cognitive processes. Further, differential event- and time-based prospective memory task performance suggests internal validity of our training. These data support the development of this intervention as an adjunctive therapy for substance use disorders. (PsycINFO Database Record
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Affiliation(s)
- Mary M. Sweeney
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Olga Rass
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Patrick S. Johnson
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Eric C. Strain
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Meredith S. Berry
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Hoa T. Vo
- Mountain Manor Treatment Center, Baltimore, Maryland, USA
| | - Marc J. Fishman
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- Mountain Manor Treatment Center, Baltimore, Maryland, USA
| | - Cynthia A. Munro
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - George W. Rebok
- Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Miriam Z. Mintzer
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Matthew W. Johnson
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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Pinner KD, Wales CT, Gristock RA, Vo HT, So N, Jacobs AT. Flavokawains A and B from kava (Piper methysticum) activate heat shock and antioxidant responses and protect against hydrogen peroxide-induced cell death in HepG2 hepatocytes. Pharm Biol 2016; 54:1503-12. [PMID: 26789234 PMCID: PMC5040346 DOI: 10.3109/13880209.2015.1107104] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/23/2015] [Revised: 09/14/2015] [Accepted: 10/07/2015] [Indexed: 06/05/2023]
Abstract
Context Flavokawains are secondary metabolites from the kava plant (Piper methysticum Forst. f., Piperaceae) that have anticancer properties and demonstrated oral efficacy in murine cancer models. However, flavokawains also have suspected roles in rare cases of kava-induced hepatotoxicity. Objective To compare the toxicity flavokawains A and B (FKA, FKB) and monitor the resulting transcriptional responses and cellular adaptation in the human hepatocyte cell line, HepG2. Materials and methods HepG2 were treated with 2-100 μM FKA or FKB for 24-48 h. Cellular viability was measured with calcein-AM and changes in signalling and gene expression were monitored by luciferase reporter assay, real-time PCR and Western blot of both total and nuclear protein extracts. To test for subsequent resistance to oxidative stress, cells were pretreated with 50 μM FKA, 10 μM FKB or 10 μM sulphoraphane (SFN) for 24 h, followed by 0.4-2.8 mM H2O2 for 48 h, and then viability was assessed. Results FKA (≤100 μM) was not toxic to HepG2, whereas FKB caused significant cell death (IC50=23.2 ± 0.8 μM). Both flavokawains activated Nrf2, increasing HMOX1 and GCLC expression and enhancing total glutathione levels over 2-fold (p < 0.05). FKA and FKB also activated HSF1, increasing HSPA1A and DNAJA4 expression. Also, flavokawain pretreatment mitigated cell death after a subsequent challenge with H2O2, with FKA being more effective than FKB, and similar to SFN. Conclusions Flavokawains promote an adaptive cellular response that protects hepatocytes against oxidative stress. We propose that FKA has potential as a chemopreventative or chemotherapeutic agent.
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Affiliation(s)
- Keanu D. Pinner
- Department of Pharmaceutical Sciences, Daniel K. Inouye College of Pharmacy, University of Hawaii at Hilo, 200 W. Kawili St., Hilo, HI 96720
| | - Christina T.K. Wales
- Department of Pharmaceutical Sciences, Daniel K. Inouye College of Pharmacy, University of Hawaii at Hilo, 200 W. Kawili St., Hilo, HI 96720
| | - Rachel A. Gristock
- Department of Pharmaceutical Sciences, Daniel K. Inouye College of Pharmacy, University of Hawaii at Hilo, 200 W. Kawili St., Hilo, HI 96720
| | | | | | - Aaron T. Jacobs
- Department of Pharmaceutical Sciences, Daniel K. Inouye College of Pharmacy, University of Hawaii at Hilo, 200 W. Kawili St., Hilo, HI 96720
- University of Hawaii Cancer Center, 701 Ilalo Street, Honolulu HI 96813
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Abstract
BACKGROUND Despite the well-known effectiveness and widespread use of relapse prevention medications such as extended release naltrexone (XR-NTX) and buprenorphine for opioid addiction in adults, less is known about their use in younger populations. METHODS This was a naturalistic study using retrospective chart review of N = 56 serial admissions into a specialty community treatment program that featured the use of relapse prevention medications for young adults (19-26 years old) with opioid use disorders. Treatment outcomes over 24 weeks included retention and weekly opioid-negative urine tests. RESULTS Patients were of mean age 23.1, 70% male, 86% Caucasian, 82% with history of injection heroin use, and treated with either buprenorphine (77%) or XR-NTX (23%). The mean number of XR-NTX doses received was 4.1. Retention was approximately 65% at 12 weeks and 40% at 24 weeks, and rates of opioid-negative urine were 50% at 12 weeks and 39% at 24 weeks, with missing samples imputed as positive. There were no statistically significant differences in retention (t = 1.87, P = .06) or in rates of weekly opioid-negative urine tests (t = 1.96, P = .06) between medication groups, over the course of 24 weeks. The XR-NTX group had higher rates of weekly negative urine drug tests for other nonopioid substances (t = 2.83, P < .05) compared with the buprenorphine group. Males were retained in treatment longer and had higher rates of opioid-negative weeks compared with females. CONCLUSIONS These results suggest that relapse prevention medications including both buprenorphine and XR-NTX can be effectively incorporated into standard community treatment for opioid addiction in young adults with good results. Specialty programming focused on opioid addiction in young adults may provide a promising model for further treatment development.
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Affiliation(s)
- Hoa T Vo
- a Maryland Treatment Centers , Baltimore , Maryland , USA
| | - Erika Robbins
- a Maryland Treatment Centers , Baltimore , Maryland , USA
| | | | - Debra Lezama
- a Maryland Treatment Centers , Baltimore , Maryland , USA
| | - Marc Fishman
- a Maryland Treatment Centers , Baltimore , Maryland , USA.,b Johns Hopkins School of Medicine , Baltimore , Maryland , USA
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Abstract
BACKGROUND Cannabis and opioid use are associated with cognitive impairment, whether preexisting or substance-induced, but there have been few substance-specific assessments of cognitive functioning in adolescent substance users. Working memory impairment may be particularly important, as it has been linked to poorer performance in substance abuse treatment. METHODS Working memory (Wechsler Intelligence Scale for Children-IV or Adult Intelligence Scale-IV) and baseline substance use were assessed in 42 youth (mean age = 17.9 years, SD = 1.3, range: 16-20; 65% Caucasian, 30% female) 1-2 weeks after admission to residential treatment with supervised abstinence, 19 for primary cannabis dependence and 23 for primary opioid dependence. RESULTS There were substantial deficits in working memory in both groups, with significant differences (P < .001) between the opioid (M = 39.1th%ile, SD = 25.6) and cannabis (M = 16.3th%ile, SD = 13.6) groups. The primary opioid group had high rates of cannabis use, with no significant difference in past-month days of cannabis use from the primary cannabis group. The opioid group was older and had completed more years of formal education. Seventy-nine percent of the cannabis group had public health care coverage (mostly Medicaid), compared with 24% of the opioid sample. CONCLUSIONS Working memory impairment was substantial in treatment-seeking youth with primary cannabis and opioid dependence (the latter actually having comparable rates of cannabis use), and significantly more pronounced in the primary cannabis-dependent group. Without an assessment of working memory prior to substance exposure, the differential contributions of substance-induced vs. preexisting impairment are unclear. Lower scores in the cannabis group may reflect lower socioeconomic status (SES), which is typically correlated with cognitive performance. These findings highlight underrecognized cognitive impairment in youth with SUDs, especially inner-city cannabis-dependent youth. Modification of treatments to account for cognitive capacity and/or cognitive remediation interventions may be indicated to improve treatment outcomes.
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Affiliation(s)
- Hoa T Vo
- a Mountain Manor Treatment Center , Baltimore , Maryland , USA
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Hall JR, Johnson LA, Vo HT, Barber RC, Scott Winter A, O’Bryant SE. Biomarkers and Depressive Symptoms in Older Women with and without Cognitive Impairment. ACTA ACUST UNITED AC 2012. [DOI: 10.4236/jbbs.2012.22031] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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R. Hall J, T. Vo H, A. Johnson L, Wiechmann A, E. O’Bryant S. Boston Naming Test: Gender Differences in Older Adults with and without Alzheimer’s Dementia. ACTA ACUST UNITED AC 2012. [DOI: 10.4236/psych.2012.36068] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Abstract
Functional impairment is common in Alzheimer's disease (AD) and related to increased caregiver burden and institutionalization. There is a dearth of research investigating the relationship between specific biomarkers and basic activities of daily living (BADLs) such as toileting, feeding, dressing, grooming, bathing, and ambulating. The present study examined the relationship between serum based biomarkers and specific ADLs in a sample of AD patients. Data were collected from 196 participants enrolled in the Texas Alzheimer's Research and Care Consortium Project and diagnosed with AD. BADLs were measured using the Lawton-Brody Physical Self-Maintenance Scale. A panel of 22 biomarkers previously found to be related to AD pathology was used for the analysis. Stepwise regression modeling was used to assess the link between the biomarkers and BADLs. Results were also examined by gender. Nine of the 22 biomarkers were significantly related to BADLs. When stratified by gender, the biomarkers accounted for 32% of the variance in the males and 27% in females. The pattern of significant biomarkers differed by gender with IL 7 and Tenascin C significantly related to BADLs for females and IL 15 significantly related to BADLs for males. The results of this study indicated that a small number of serum based biomarkers are related to BADLs, and these biomarkers differed by gender.
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Affiliation(s)
- James R Hall
- Department of Psychiatry, Behavioral Health and Neuroscience, University of North Texas, Health Sciences Center, Fort Worth, TX 76107, USA.
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15
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Hall JR, Vo HT, Johnson LA, Barber RC, O'Bryant SE. The Link between Cognitive Measures and ADLs and IADL Functioning in Mild Alzheimer's: What Has Gender Got to Do with It? Int J Alzheimers Dis 2011; 2011:276734. [PMID: 21660245 PMCID: PMC3109554 DOI: 10.4061/2011/276734] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2010] [Revised: 03/09/2011] [Accepted: 03/22/2011] [Indexed: 12/01/2022] Open
Abstract
Objectives. To investigate the link between neurocognitive measures and various aspects of daily living (ADL and IADL) in women and men with mild Alzheimer's disease (AD). Methods. Participants were 202 AD patients (91 male, 111 female) with CDR global scores of ≤1. ADLs and IADLs ratings were obtained from caregivers. Cognitive domains were assessed with neuropsychological testing. Results. Memory and executive functioning were related to IADL scores. Executive functioning was linked to total ADL. Comparisons stratified on gender found attention predicted total ADL score in both men and women. Attention predicted bathing and eating ability in women only. Language predicted IADL functions in men (food preparation) and women (driving). Conclusions. Associations between ADLs/IADLs and memory, learning, executive functioning, and language suggest that even in patients with mild AD, basic ADLs require complex cognitive processes. Gender differences in the domains of learning and memory area were found.
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Affiliation(s)
- James R Hall
- Department of Psychiatry and Neuroscience, University of North Texas Health Science Center, 3500 Camp Bowie Boulevard, Fort Worth, TX 76107, USA
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16
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Hall JR, Harvey M, Vo HT, O'Bryant SE. Performance on a measure of category fluency in cognitively impaired elderly. Neuropsychol Dev Cogn B Aging Neuropsychol Cogn 2011; 18:353-61. [PMID: 21390875 DOI: 10.1080/13825585.2011.557495] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Measures of verbal fluency are widely used in the assessment of cognitive functioning of the elderly. However, limited research has evaluated patterns (across specific timed intervals) of performance on tasks of language fluency in different forms of dementia. The current study investigated semantic fluency in 488 elderly individuals (249 with Alzheimer's dementia, 97 Vascular dementia, 97 Mild Cognitive Impairment and 45 cognitively intact) across 15-second intervals in an animal naming task using retrospective chart review. Normal controls produced significantly more exemplars and AD patients produced fewer animal names than the other groups. After the first 15- second time interval, the demented groups produced significantly fewer exemplars than the non-demented. At the end of 30 seconds it was possible to differentiate normal aging from MCI who no longer differed from the VaD group. Overall, it appears that the greatest and most clinically meaningful differences between the diagnostic groups were detected in the first three 15-second intervals. The present findings support the use of time intervals and total scores on tasks of verbal fluency in clinical settings and for research purposes.
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Affiliation(s)
- James R Hall
- Department of Psychiatry and Neuroscience, University of North Texas Health Sciences Center, Fort Worth, TX, USA.
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Hall JR, Vo HT, Johnson LA, Winter S, Barber RC, O’Bryant SE. Biomarkers and Depressive Symptoms in a Sample of Cognitively Intact and Alzheimer’s Disease Elderly Males. ACTA ACUST UNITED AC 2011. [DOI: 10.4236/nm.2011.24040] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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18
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Ortiz GM, Wellons M, Brancato J, Vo HT, Zinn RL, Clarkson DE, Van Loon K, Bonhoeffer S, Miralles GD, Montefiori D, Bartlett JA, Nixon DF. Structured antiretroviral treatment interruptions in chronically HIV-1-infected subjects. Proc Natl Acad Sci U S A 2001; 98:13288-93. [PMID: 11687611 PMCID: PMC60863 DOI: 10.1073/pnas.221452198] [Citation(s) in RCA: 133] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
The risks and benefits of structured treatment interruption (STI) in HIV-1-infected subjects are not fully understood. A pilot study was performed to compare STI with continuous highly active antiretroviral therapy (HAART) in chronic HIV-1-infected subjects with HIV-1 plasma RNA levels (VL) <400 copies per ml and CD4(+) T cells >400 per microl. CD4(+) T cells, VL, HIV-1-specific neutralizing antibodies, and IFN-gamma-producing HIV-1-specific CD8(+) and CD4(+) T cells were measured in all subjects. STIs of 1-month duration separated by 1 month of HAART, before a final 3-month STI, resulted in augmented CD8(+) T cell responses in all eight STI subjects (P = 0.003), maintained while on HAART up to 22 weeks after STI, and augmented neutralization titers to autologous HIV-1 isolate in one of eight subjects. However, significant decline of CD4(+) T cell count from pre-STI level, and VL rebound to pre-HAART baseline, occurred during STI (P = 0.001 and 0.34, respectively). CD4(+) T cell counts were regained on return to HAART. Control subjects (n = 4) maintained VL <400 copies per ml and stable CD4(+) T cell counts, and showed no enhancement of antiviral CD8(+) T cell responses. Despite increases in antiviral immunity, no control of VL was observed. Future studies of STI should proceed with caution.
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Affiliation(s)
- G M Ortiz
- Gladstone Institute of Virology and Immunology, University of California, San Francisco, CA 94141-9100, USA.
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Montefiori DC, Hill TS, Vo HT, Walker BD, Rosenberg ES. Neutralizing antibodies associated with viremia control in a subset of individuals after treatment of acute human immunodeficiency virus type 1 infection. J Virol 2001; 75:10200-7. [PMID: 11581388 PMCID: PMC114594 DOI: 10.1128/jvi.75.21.10200-10207.2001] [Citation(s) in RCA: 76] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Immediate treatment of acute human immunodeficiency virus type 1 (HIV-1) infection has been associated with subsequent control of viremia in a subset of patients after therapy cessation, but the immune responses contributing to control have not been fully defined. Here we examined neutralizing antibodies as a correlate of viremia control following treatment interruption in HIV-1-infected individuals in whom highly active antiretriviral therapy (HAART) was initiated during early seroconversion and who remained on therapy for 1 to 3 years. Immediately following treatment interruption, neutralizing antibodies were undetectable with T-cell-line adapted strains and the autologous primary HIV-1 isolate in seven of nine subjects. Env- and Gag-specific antibodies as measured by enzyme-linked immunosorbent assay were also low or undetectable at this time. Despite this apparent poor maturation of the virus-specific B-cell response during HAART, autologous neutralizing antibodies emerged rapidly and correlated with a spontaneous downregulation in rebound viremia following treatment interruption in three subjects. Control of rebound viremia was seen in other subjects in the absence of detectable neutralizing antibodies. The results indicate that virus-specific B-cell priming occurs despite the early institution of HAART, allowing rapid secondary neutralizing-antibody production following treatment interruption in a subset of individuals. Since early HAART limits viral diversification, we hypothesize that potent neutralizing-antibody responses to autologous virus are able to mature and that in some persons these responses contribute to the control of plasma viremia after treatment cessation.
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Affiliation(s)
- D C Montefiori
- Department of Surgery, Duke University Medical Center, Durham, North Carolina 27710, USA.
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Montefiori DC, Safrit JT, Lydy SL, Barry AP, Bilska M, Vo HT, Klein M, Tartaglia J, Robinson HL, Rovinski B. Induction of neutralizing antibodies and gag-specific cellular immune responses to an R5 primary isolate of human immunodeficiency virus type 1 in rhesus macaques. J Virol 2001; 75:5879-90. [PMID: 11390589 PMCID: PMC114303 DOI: 10.1128/jvi.75.13.5879-5890.2001] [Citation(s) in RCA: 56] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The ability to generate antibodies that cross-neutralize diverse primary isolates is an important goal for human immunodeficiency virus type 1 (HIV-1) vaccine development. Most of the candidate HIV-1 vaccines tested in humans and nonhuman primates have failed in this regard. Past efforts have focused almost entirely on the envelope glycoproteins of a small number of T-cell line-adapted strains of the virus as immunogens. Here we assessed the immunogenicity of noninfectious virus-like particles (VLP) consisting of Gag, Pro (protease), and Env from R5 primary isolate HIV-1(Bx08). Immunogens were delivered to rhesus macaques in the form of either purified VLP, recombinant DNA and canarypox (ALVAC) vectors engineered to express VLP, or a combination of these products. Seroconversion to Gag and Pro was detected in all of the immunized animals. Antibodies that could neutralize HIV-1(Bx08) were detected in animals that received (i) coinoculations with DNA(Bx08) and VLP(Bx08), (ii) DNA(Bx08) followed by ALVAC(Bx08) boosting, and (iii) VLP(Bx08) alone. The neutralizing antibodies were highly strain specific despite the fact that they did not appear to be directed to linear epitopes in the V3 loop. Virus-specific cellular immune responses also were generated, as judged by the presence of Gag-specific gamma interferon (IFN-gamma)-producing cells. These cellular immune responses required the inclusion of DNA(Bx08) in the immunization modality, since few or no IFN-gamma-producing cells were detected in animals that received either VLP(Bx08) or ALVAC(Bx08) alone. The results demonstrate the feasibility of generating neutralizing antibodies and cellular immune responses that target an R5 primary HIV-1 isolate by vaccination in primates.
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Affiliation(s)
- D C Montefiori
- Department of Surgery, Duke University Medical Center, Durham, NC 27710, USA.
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