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Merging paths to healing - efficacy of integrated vs. non-integrated treatment programs for comorbid substance use disorder and posttraumatic stress disorder: A systematic review
(London's Global University, 2024) Hakeem, Haneen; Yang, Justin
Introduction: The heightened prevalence of comorbid posttraumatic stress disorder (PTSD) and substance use disorder (SUD) constitutes an increasing cause for concern as both disorders become more severe and challenging to treat. Integrated treatment (IT) programs address the substantial interaction between symptoms of PTSD and SUD and thus aim to address both disorders simultaneously. Despite rapid development in IT programs in the last decade, there is a scarcity of studies that comprehensively investigate treatment outcomes and patient acceptability. Therefore, the current study aims to examine the evidence for integrated compared to non-integrated programs in the treatment of comorbid PTSD and SUD. Methods: Studies that used randomised controlled trials to examine the efficacy of ITs compared to non- ITs for adults with SUD and PTSD between 2012 and 2023 were searched through Medline, PsycINFO, Embase, CINAHL Plus, Cochrane Central Register of Controlled Trials, Electronic Theses Online Service, OpenGrey, and ProQuest. PROSPERO CRD42023442012. Results: The search identified 871 studies, and after de-duplication, 676 studies were screened for title/ abstract. Of those, 55 studies were assessed for eligibility based on full texts, of which 9 met eligibility criteria. A narrative synthesis revealed that ITs effectively alleviated symptoms of both PTSD and SUD, demonstrating sustained improvement from the initial treatment phase to the longest follow-up. Nevertheless, the studies presented varied outcomes concerning the comparative advantage of IT over non-IT. While some indicated superior effectiveness of IT on either SUD or PTSD symptoms, others found comparable improvement effects. Both treatment approaches exhibited similar levels of acceptability, as evidenced by equivalent retention, engagement, and completion rates. Conclusions. This review showed that IT programs effectively improved symptoms of both PTSD and SUD. However, there was limited evidence supporting the superiority of IT programs over non-IT comparators in reducing PTSD and SUD symptoms, and patient acceptability. Nonetheless, given these similar treatment outcomes, the consideration of treatment choice may shift toward a patient-centred approach, where individuals are educated about treatment choices and can thus make informed decisions about their treatment.
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AMIGO3 gene expression and function during oligodendrocyte differentiation in the central nervous system
(University of Birmingham, 2024-04-23) Almutairi, Majed; Fulton, Daniel; Ahmed, Zubair
Demyelination causes disruption to neuronal signalling and occurs in many neurodegenerative diseases or in response to brain injury. There are no cures available for demyelinating diseases, including multiple sclerosis (MS), the most common autoimmune inflammatory disease in the central nervous system (CNS). Current approaches to treat MS focus on anti-inflammatory drugs, which prevent demyelination progression and reduce clinical relapses, but do not allow repair or replacement myelin. A natural repair process called remyelination can occur following demyelination. Remyelination can help to repair demyelinating plaques and protect axons from degeneration, but endogenous remyelination is inefficient and fails with ageing and disease progression, Improving remyelination is therefore an important for the focus for the development of MS therapies. Studies of animal models have to led to the discovery of new therapeutic targets which can promote endogenous remyelination. An example is the leucine rich repeat protein (LRRP) leucine rich repeat and immunoglobulin-like domain containing protein 1 (LINGO1). Inhibition of LINGO1 promoted remyelination in several animal models of demyelination, but clinical inhabitation of LINGO1 showed unsuccessful results in clinical trials. We considered the idea that the LINGO1 clinical trials failed due to compensation from another LRRP, amphoterin-induced gene and open reading fram-3 (AMIGO3). AMIGO3 is upregulated more rapidly than LINGO1 after spinal cord injury (SCI) in animal models, and also increases in expression rapidly after axotomy in culture of dorsal root ganglion neurons and retinal ganglion cells. Importantly, AMIGO3 expression is rapidly increased in the CNS during postnatal development when myelinating oligodendrocyte (OL) are generated, and decreases again quickly after myelination begins. AMIGO3 may therefore act a regulator of OL differentiation, and its inhibition could be an alternative therapeutic target for demyelinating diseases.
Considering the above, the first aim of this project was to study the function of AMIGO3 using in vitro models of OL differentiation. For this work, a primary mixed glial culture system was developed to study OL differentiation during early stage of CNS development. Using this system we found that AMIGO3 is downregulated in mixed glial cultures during OL differentiation. We also found that downregulation of AMIGO3 expression by siRNA resulted in the upregulation of OL maturation. On the other hand, increased AMIGO3 levels produced by treatment with recombinant AMIGO3 reduced OL maturation, and activated RhoA GTP activity, a molecule involved in AMIGO3 intracellular signalling. These findings suggest that AMIGO3 downregulates OL differentiation via RhoA GTP signalling.
AMIGO3 is known to engage in homotypic interactions, thus expression on different glial cells could allow cell to cell signalling. Also, AMIGO3 is expressed in cells of the OL lineage and astrocytes, thus AMIGO3 expression in non-OL glia could provide a signal to regulate OL differentiation. Considering this idea, the second aim in this thesis was to compare the expression of AMIGO3 and LINGO1 in primary cultures of astrocytes and microglia. Using Western blot and immunocytochemistry we found strong expression of AMIGO3 proteins in astrocytes, but not in microglia. Surprisingly, we also found that astrocytes express LINGO1 proteins. This work shows that astrocytes, but not microglia, are an abundant source of both AMIGO3 and LINGO1, which together could influence OL differentiation and myelin formation and repair.
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FemTech Ethics – An Empirical and Normative Analysis of FemTech and Women’s mHealth Apps
(University of Zurich, 2023-09-28) Alfawzan, Najd; Christen, Markus; Biller-Andorno, Nikola; Hamper, Josie
FemTech (female technology) is a growing market with a large user base globally.
The investments in FemTech are huge. Collecting women’s health data is
important for closing the gender health gap. However, as women have been
subject to historical sociocultural oppression and surveillance, legal
consequences might follow women who provide their data to FemTech
companies. The primary thesis of this work is that an ethical perspective and
grounding are critical for the analysis of FemTech, because technology is
inextricably linked to morality, norms, and the sociocultural context in which it
acts. FemTech is distinct from other types of technology and markets in that it
emerged from these circumstances and has a significant impact on users within
their social contexts. In my thesis, I focused on the ethical concerns in data
privacy, sharing, and security by studying the privacy policies and consent
practices of FemTech companies, particularly in the context of women’s mHealth
apps. Data privacy and protection have been introduced as fundamental human
rights. Notably, the women’s health data collected by FemTech is considered to
be intimate, sensitive, and private data. Moreover, some women’s mHealth apps
collect not only women’s sensitive data, but also data of their children and
infants. This layer of complexity introduced by including children's data let me
investigate in depth the practices of apps that collect children’s data and the
related ethical and legal concerns. In short, the collection of women’s personal
and health data could have negative consequences on women in certain legal
and social systems of the world. The worldwide nature of the services provided
by FemTech companies presents challenges in complying with the many
regulations and laws that exist in different nations. Data protection and privacy
legislation, for example, can differ widely from country to country. Furthermore,
the sensitivity of women's health issues can differ depending on local cultural or
religious considerations, with possible repercussions for national laws,
particularly when it comes to sexual orientation and reproduction. In some
cases, the data collected could even become evidence in criminal proceedings.
Therefore, the handling of women’s intimate data must be approached with
sensitivity to protect women's privacy rights.
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DEVELOP BIOCHAR-BASED CONTROL RELEASE NITROGEN FERTILIZERS USING BIODEGRADABLE POLYPROPYLENE
(South Dakota State University, 2023-12-21) Aldekhail, Abdulkarim; Muthukumarappan, Kasiviswanathan
Nitrogen (N) is an indispensable key nutrient for crop plant growth, health, and yield, which significantly affects crop productivity. N fertilizers are wildly utilized in agriculture. Managing N application stands as a necessity to achieve optimal crop yield. Urea is one of the most common N fertilizers in agricultural practices due to its high N content and cost-effectiveness. Due to its commercial scale, feasibility, and reliability, it is demonstrating potential as a medium to improve agricultural sustainability. However, economic challenges, and environmental pollution remain as setbacks. This research focuses on selecting cost-effective and environmentally friendly coating materials for the fabrication of biochar-based controlled-release nitrogen fertilizers (BCRNFs) to address the challenges, such as nitrogen use efficiency (NUE), N lost through leaching, volatilization, and runoff into the water systems. To address economic challenges, biodegradable polypropylene (PP) was selected in this study to examine its economic viability and biodegradability in the BCRNF fabrication and application. This material was used to coat the BCRNF particles using a dipping method, which enables the particles to control the release of nitrogen, synchronizing with the nitrogen uptake of crops. The BCRNF particles were synthesized by mixing biochar, urea, and water, resulting in characterized pellets with 3mm diameter and a length that varied from 5 to 7 mm. Particles were made through a palletization process. Subsequently, a complete evaluation of different concentrations of PP solutions was done by employing dipping technology to coat the particles of BCRNFs. The biochar particles undergo examination to elucidate their nitrogen release dynamic within aqueous environments. These developed biochar samples went under comprehensive assessment to determine their efficiency in promoting the growth of various crops, with more focus on the corn and wheat trials. The findings of the research were recorded as a promising approach in the agricultural field. Furthermore, the broad vision of this research topic is to endeavor to the commercialization of modern technology. It is projected that the research will lead to the widespread production of BCRNFs, and it will significantly enhance the productivity of the agricultural sector and the future of sustainability in precision agriculture. The new environmentally friendly fertilizer BCRNF was fabricated in a pelletizing machine and coated with PP 15(%). The results show that the release of Nitrogen was 99.65 (%) for the coated samples which corresponded to 8 (hr), and it can be compromised depending on the efficiency of the dipping method. The produced particles showed more successes on plants growth, health, and overall yield on the wheat trial in the greenhouse. The single coat layer observed under the microscope can be distinguished from the non-coated samples. Due to the large pores and high surface area, biochar shows improvements in keeping water which was the result of water retention, and absorption in soil and air. The BCRNFs retained water at 80 (%) and 60 (%) on the 3rd and 6th day respectively. BCRNFs reflected the maximum weight gain within the 4th day, and the weights were observed for the coated particles and non-coated at 3% and 2% respectively.
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المحددات الاجتماعية والثقافية عند اختيار الزوج
(Qassim University, 2024-02-11) الغماس، خلود سليمان فهد; Alghammas, Kholood Suliman Fahd; حسين، صابرين حسن
هدفت الدراسة الحالية إلى التعرف على معايير اختيار الزوج بالنسبة للفتيات، وتوضيح المحددات الاجتماعية والثقافية عند اختيار الزوج، وكانت عينة الدراسة مكونة من (217) طالبة من طالبات مرحلة البكالوريوس بجامعة القصيم (كلية الشريعة والدراسات الإسلامية، كلية اللغات والعلوم الإنسانية، كلية الطب، كلية الصيدلة)، ولتحقيق هذا الهدف قامت الباحثة:
بتصميم استبيان يحقق أهداف البحث ويجيب عن أسئلة الدراسة (من إعداد الباحثة).
وتكونت الاستبانة من (16) فقرة، على أربعة محاور: المحور الأول: ويتناول معايير اختيار الزوج، ويتكون من 4 فقرات. والمحور الثاني: ويتناول المحددات الاجتماعية والثقافية عند اختيار الزوج، ويحتوي على أربعة فقرات. بينما المحور الثالث: يتناول الوعي الاجتماعي بالمشكلات الأسرية وعلاقتها بسوء الاختيار، ويحتوي على أربعة فقرات، أما المحور الرابع: فيتناول المسؤولية الاجتماعية المطلوبة من شريك الزواج، ويحتوي أيضًا على أربعة فقرات.
وقد توصلت الدراسة إلى النتائج التالية:
وصلت الدراسة إلى أن أفراد العينة من طالبات جامعة القصيم، أصبحت لديهن اهتمام كبير بمعايير اختيار الزوج وبالمحددات الثقافية والمعايير الاجتماعية التي تقيس وتربط الوعي الاجتماعي بمشكلة اختيار الزوج؛ وبالتالي علاقتها بالمشكلات الأسرية، كما أصبحت لديهن خصائص علمية واشتراطات جمالية مطلوبة في شريك الزواج تناسب متطلباتهن، كما اهتمت الفتيات بشكل عام بضرورة توفر الوظيفة الدائمة لزوج المستقبل، واتجهن الى اشتراط تحمل الرجل مسؤولية الرعاية الكاملة والانفاق المالي.
كما توصلت الدراسة إلى أن ثقافة الفتيات تعلي من شأن صفة التدين، حيث ان غالبية مجتمع البحث يحرصن على اختيار شريك للزواج متدين من عالٍ على وسط، مع عدم رغبتهن أن يكون زوج المستقبل مدخنًا، كما تبين عدم تفضيل ان يكون الزواج من خارج المنطقة أو المدينة، مع تفضيل ان يرتبطن بأزواج يتمتعون بمكانة اقتصادية واجتماعية عالية. كما توصلت الدراسة إلى وجود فروق ذات دلالة احصائية (؟ -0.05) بين معايير اختيار الزوج والمحددات الاجتماعية والثقافية في نوع التخصص بين أفراد العينة، كما يوجد فروق ذات دلالة إحصائية (؟ - 0.05) بين معايير اختيار الزوج والمحددات الاجتماعية والثقافية من حيث سبب قرار الزواج، وجاءت الفروق لصالح القرار الشخصي.