The study reveals that among patients who participated in an in-hospital addiction medicine intervention at OHSU, three-quarters came into the hospital using more than one substance. Overall, participants used fewer substances in the months after working with the hospital-based addictions team than before.

The study published in the Journal of Substance Abuse Treatment.

“We found that polysubstance use is the norm,” said lead author Caroline King, M.P.H., a health systems researcher and current M.D./Ph.D. student in the OHSU School of Medicine’s biomedical engineering program. “This is important because we may need to offer additional support to patients using multiple drugs. If someone with opioid use disorder also uses alcohol or methamphetamines, we miss caring for the whole person by focusing only on their opioid use.”

About 40% of participants reported they had abstained from using at least one substance at least a month after discharge — a measure of success that isn’t typically tracked in health system record-keeping.

Researchers enrolled 486 people seen by an addiction medicine consult service while hospitalized at OHSU Hospital between 2015 and 2018, surveying them early during their stay in the hospital and then again 30 to 90 days after discharge.

Treatment of opioid use disorder can involve medication such as buprenorphine, or Suboxone, which normalizes brain function by acting on the same target in the brain as prescription opioids or heroin.

However, focusing only on the opioid addiction may not adequately address the complexity of each patient.

“Methamphetamine use in many parts of the U.S., including Oregon, is prominent right now,” said senior author Honora Englander, M.D., associate professor of medicine (hospital medicine) in the OHSU School of Medicine. “If people are using stimulants and opioids — and we only talk about their opioid use — there are independent harms from stimulant use combined with opioids. People may be using methamphetamines for different reasons than they use opioids.”

Englander leads the in-hospital addiction service, known as Project IMPACT, or Improving Addiction Care Team.

The initiative brings together physicians, social workers, peer-recovery mentors and community addiction providers to address addiction when patients are admitted to the hospital. Since its inception in 2015, the program has served more than 1,950 people hospitalized at OHSU.

The national opioid epidemic spiraled out of control following widespread prescribing of powerful pain medications beginning in the 1990s. Since then, it has often been viewed as a public health crisis afflicting rural, suburban and affluent communities that are largely white.

Englander said the new study suggests that a singular focus on opioids may cause clinicians to overlook complexity of issues facing many populations, including people of color, who may also use other substances.

“Centering on opioids centers on whiteness,” Englander said. “Understanding the complexity of people’s substance use patterns is really important to honoring their experience and developing systems that support their needs.”

Researchers say the finding further reinforces earlier research showing that hospitalization is an important time to offer treatment to people with substance use disorder, even if they are not seeking treatment for addiction when they come to the hospital.

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Materials provided by Oregon Health & Science University. Original written by Erik Robinson. Note: Content may be edited for style and length.

Rather, policy change in response to extreme weather events appears to depend on a combination of factors, including fatalities, sustained media coverage, the unusualness of the event and the political makeup of the community.

Climate scientists predict that the frequency and severity of extreme weather events will only continue to increase in coming decades. OSU researchers wanted to understand how local communities are reacting.

“There’s obviously national and state-level climate change policy, but we’re really interested in what goes on at the local level to adapt to these changes,” said lead author Leanne Giordono, a post-doctoral researcher in OSU’s College of Public Health and Human Sciences. “Local communities are typically the first to respond to extreme events and disasters. How are they making themselves more resilient — for example, how are they adapting to more frequent flooding or intense heat?”

For the study, which was funded by the National Science Foundation, Giordono and co-authors Hilary Boudet of OSU’s College of Liberal Arts and Alexander Gard-Murray at Harvard University examined 15 extreme weather events that occurred around the U.S. between March 2012 and June 2017, and any subsequent local climate policy change.

These events included flooding, winter weather, extreme heat, tornadoes, wildfires and a landslide.

The study, published recently in the journal Policy Sciences, found there were two “recipes” for local policy change after an extreme weather event.

“For both recipes, experiencing a high-impact event — one with many deaths or a presidential disaster declaration — is a necessary condition for future-oriented policy adoption,” Giordono said.

In addition to a high death toll, the first recipe consisted of Democrat-leaning communities where there was focused media coverage of the weather event. These communities moved forward with adopting policies aimed at adapting in response to future climate change, such as building emergency preparedness and risk management capacity.

The second recipe consisted of Republican-leaning communities with past experiences of other uncommon weather events. In these locales, residents often didn’t engage directly in conversation about climate change but still worked on policies meant to prepare their communities for future disasters.

In both recipes, policy changes were fairly modest and reactive, such as building fire breaks, levees or community tornado shelters. Giordono referred to these as “instrumental” policy changes.

“As opposed to being driven by ideology or a shift in thought process, it’s more a means to an end,” she said. “‘We don’t want anyone else to die from tornadoes, so we build a shelter.’ It’s not typically a systemic response to global climate change.”

In their sample, the researchers didn’t find any evidence of mitigation-focused policy response, such as communities passing laws to limit carbon emissions or require a shift to solar power. And some communities did not make any policy changes at all in the wake of extreme weather.

The researchers suggest that in communities that are ideologically resistant to talking about climate change, it may be more effective to frame these policy conversations in other ways, such as people’s commitment to their community or the community’s long-term viability.

Without specifically examining communities that have not experienced extreme weather events, the researchers cannot speak to the status of their policy change, but Giordono said it is a question for future study.

“In some ways, it’s not surprising that you see communities that have these really devastating events responding to them,” Giordono said. “What about the vast majority of communities that don’t experience a high-impact event — is there a way to also spark interest in those communities?”

“We don’t want people to have to experience these types of disasters to make changes.”

Addressing this unmet need, researchers at Texas A&M University have now invented a new technology that can drastically downsize the apparatus used for Raman spectroscopy, a well-known technique that uses light to identify the molecular makeup of compounds.

“Raman benchtop setups can be up to a meter long depending on the level of spectroscopic resolution needed,” said Dr. Pao-Tai Lin, assistant professor in the Department of Electrical and Computer Engineering and the Department of Materials Science and Engineering. “We have designed a system that can potentially replace these bulky benchtops with a tiny photonic chip that can snugly fit within the tip of a finger.”

In addition, Lin said that their innovative photonic device is also capable of high-throughput, real-time chemical characterization and despite its size, is at least 10 times more sensitive than conventional benchtop Raman spectroscopy systems.

A description of their study is in the May issue of the journal Analytical Chemistry.

The basis of Raman spectroscopy is the scattering of light by molecules. When hit by light of a certain frequency, molecules perform a dance, rotating and vibrating upon absorbing the energy from the incident beam. When they lose their excess energy, molecules emit a lower-energy light, which is characteristic of their shape and size. This scattered light, known as the Raman spectra, contains the fingerprints of the molecules within a sample.

Typical benchtops for Raman spectroscopy contain an assortment of optical instruments, including lenses and gratings, for manipulating light. These “free-space” optical components take a lot of space and are a barrier for many applications where chemical sensing is required within tiny spaces or locations that are hard to reach. Also, benchtops can be prohibitive for real-time chemical characterization.

As an alternative to traditional lab-based benchtop systems, Lin and his team turned to tube-like conduits, called waveguides, that can transport light with very little loss of energy. While many materials can be used to make ultrathin waveguides, the researchers chose a material called aluminum nitride since it produces a low Raman background signal and is less likely to interfere with the Raman signal coming from a test sample of interest.

To create the optical waveguide, the researchers employed a technique used by industry for drawing circuit patterns on silicon wafers. First, using ultraviolet light, they spun a light-sensitive material, called NR9, onto a surface made of silica. Next, by using ionized gas molecules, they bombarded and coated aluminum nitride along the pattern formed by the NR9. Finally, they washed the assembly with acetone, leaving behind an aluminum waveguide that was just tens of microns in diameter.

For testing the optical waveguide as a Raman sensor, the research team transported a laser beam through the aluminum nitride waveguide and illuminated a test sample containing a mixture of organic molecules. Upon examining the scattered light, the researchers found that they could discern each type of molecule within the sample based on the Raman spectra and with a sensitivity of at least 10 times more than traditional Raman benchtops.

Lin noted since their optical waveguides have very fine width, many of them can be loaded onto a single photonic chip. This architecture, he said, is very conducive to high-throughput, real-time chemical sensing needed for drug development.

“Our optical waveguide design provides a novel platform for monitoring the chemical composition of compounds quickly, reliably and continuously. Also, these waveguides can be easily manufactured at an industrial scale by leveraging the already existing techniques to make semiconductor devices,” said Lin. “This technology, we believe, has a direct benefit for not just pharmaceutical industries but even for other industries, like petroleum, where our sensors can be put along underground pipes to monitor the composition of hydrocarbons.”

Other contributors to this research are Megan Makela from the Department of Materials Science and Engineering; and Paul Gordon, Dandan Tu, Cyril Soliman, Dr. Gerard Coté and Dr. Kristen Maitland from the Department of Biomedical Engineering.

In Australia, more than 1.4 million people are employed in shift work, with more than 200,000 regularly working night or evening shifts.

Lead researcher, Dr Stephanie Centofanti from UniSA Online and the Sleep and Chronobiology Laboratory at UniSA says the finding could help counteract the kind of sleep inertia that is experienced by many shiftworkers.

“Shift workers are often chronically sleep-deprived because they have disrupted and irregular sleep patterns,” Dr Centofanti says.

“As a result, they commonly use a range of strategies to try to boost their alertness while on the nightshift, and these can include taking power naps and drinking coffee — yet it’s important to understand that there are disadvantages for both.

“Many workers nap during a night shift because they get so tired. But the downside is that they can experience ‘sleep inertia’ — that grogginess you have just after you wake up — and this can impair their performance and mood for up to an hour after their nap.

“Caffeine is also used by many people to stay awake and alert. But again, if you have too much coffee it can harm your overall sleep and health. And, if you use it to perk you up after a nap, it can take a good 20-30 minutes to kick in, so there’s a significant time delay before you feel the desired effect.

“A ‘caffeine-nap’ (or ‘caff-nap’) could be a viable alternative — by drinking a coffee before taking a nap, shiftworkers can gain the benefits of a 20-30-minute nap then the perk of the caffeine when they wake. It’s a win-win.”

The small pilot study tested the impact of 200 mg of caffeine (equivalent to 1-2 regular cups of coffee) consumed by participants just before a 3.30am 30-minute nap, comparing results with a group that took a placebo.

Participants taking a ‘caffeine-nap’ showed marked improvements in both performance and alertness, indicating the potential of a ‘caffeine-nap’ to counteract sleep grogginess.

Dr Centofanti says this shows a promising fatigue countermeasure for shift workers. She says the next move is to test the new finding on more people.

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Materials provided by University of South Australia. Note: Content may be edited for style and length.

To better understand the mechanism and pathways of SARS-CoV-2 infection and susceptibility to specific cell and tissue types as well as organ systems, the research team analyzed 85 human tissues for the presence of ACE2 receptors. ACE2 is a protein that is found on the surface of many immune and nonimmune cell types. An enzyme, it is part of the system that regulates blood pressure and fluid and electrolyte balance. It may also help regulate cardiovascular, neurovascular and renal function, as well as fertility. ACE2 receptors act like locks on cells, and the SARS-CoV-2 spike proteins act like keys that open the locks letting the virus enter cells to rapidly multiply. As well as controls, tissues tested included lung, digestive, renal-excretory, reproductive, eye tissues, and 21 different regions of the brain.

“Besides strong ACE2 expression in respiratory, digestive, renal-excretory and reproductive cells, high ACE2 expression was also found in the amygdala, cerebral cortex and brainstem,” reports Dr. Lukiw. “This may help explain cognitive deficits associated with SARS-CoV-2 infection. Some of the highest ACE2 expression levels were found in the pons and medulla oblongata in the human brainstem, an anatomical region of the brain containing the medullary respiratory centers, and this may in part explain the susceptibility of many CoV-19 patients to severe respiratory distress.”

The team further noted that ACE2 receptor activity was also easily detected in the eye, suggesting that the visual system may provide an additional entry point for SARS-CoV-2 invasion and that under certain conditions, eyeglasses or face shields may be as important as face masks in reducing SARS-CoV-2 transmission and infection.

“Several important research gaps remain,” Lukiw concludes. “A real danger of SARS-CoV-2 infection is not only its highly transmissible and contagious nature and lethality, but also its simultaneous and multipronged attack on many human cell and tissue types involving vital and critical respiratory, immunological, vascular, renal-excretory and neural systems as well as an unprecedented coordinated disruption of the complex neurophysiology, neurochemistry, neurobiology and neurology of the cells of the brain and central nervous system (CNS) that normally regulate these multiple physiological systems.”

The authors credit the late Dr. James M. Hill (formerly a Professor in the Departments of Microbiology, Ophthalmology and Pharmacology at LSU Health New Orleans School of Medicine) with whom they had a longstanding research collaboration on the expression of the ACE2 receptors, including those found in the Alzheimer’s disease brain. Aileen Pogue, from Alchem Biotech Research in Toronto, also participated in the research data tabulation, bioinformatics and statistical analysis.

The research was supported by grants from Research to Prevent Blindness (RPB); the Louisiana Biotechnology Research Network (LBRN); and NIH grants NEI EY006311, NIA AG18031 and NIA AG038834.

University of Queensland PhD candidate Pietro Viacava co-led a study that found similarities between northern quoll skulls across a 5000 kilometre range, which has raised hopes scientists will be able to cross-breed isolated populations.

“Northern quolls are in danger — a lot has been thrown at them,” Mr Viacava said.

“They’ve been victims of a devastating cane toad invasion, increases in bushfires and habitat fragmentation, all while facing stiff competition from other carnivores such as dingoes and cats.

“The problem we are facing with conserving the northern quoll is that there may be too little genetic diversity in these handful of remaining populations, scattered across Australia.

“If we cross-bred them, we might run the risk that they wouldn’t be ideally suited to these diverse environments.

“Their skulls, for example, might not be properly adapted to eat local prey, as it differs across Australia.

“Luckily, this doesn’t seem to be the case — these quolls seem to be incredibly versatile.”

The research team used a technique known as ‘geometric morphometrics’ to characterise skull shape variation in museum specimens of northern quolls.

They looked for shape differences between populations, or whether environmental conditions coincided with changes in skull shape.

Dr Vera Weisbecker from the Flinders University College of Science and Engineering supervised the study, and said the results appeared to be a win for northern quoll conservation.

“Quoll skull shapes were mostly similar across their entire range, although the shapes did vary with the size of the animals,” Dr Weisbecker said.

“This means, for example, that a quoll skull from Pilbara region in WA looked nearly the same as a similar-sized one from south-eastern Queensland, 5000 kilometres apart.

“Although other parts of the animal’s body and genetic factors need to be considered, we will most likely be able to breed animals from different populations for conservation without losing adaptations to feeding.”

However, there is also a much less positive potential explanation for the results.

“Scientists have long suspected that marsupial mammals — such as quolls, kangaroos and koalas — are seriously limited in the degree to which they can adapt their skull and skeleton,” Dr Weisbecker said.

“This is because newborn marsupials require a specifically shaped snout to be able to latch onto the mother’s teat.

“In that case, what we see may actually be a serious limitation on the ability of quolls to adapt, rather than the much more hopeful multipurpose solution we propose.”

To further explore this possibility, the team is now looking at how closely related species of antechinus — smaller quoll relatives — differ in skull shape.

The team includes researchers from UQ, Flinders University, Queensland University of Technology and the University of New England, with funding from the Australian Research Council.