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BACKGROUND: It is unknown whether short-term transportation affects endocrine responses similarly in horses with and without insulin dysregulation (ID). OBJECTIVES: To characterise the effect of short-term transportation on stress parameters and insulin responses to an oral sugar test (OST) in horses with and without ID. STUDY DESIGN: Longitudinal cohort study. METHODS: Fourteen adult non-pregnant, non-PPID mares of mixed light breeds were grouped as either ID (n = 7) or non-ID (n = 7) based on endocrine testing. Over 2 weeks, horses were transported once, in groups of 3-4 in a horse trailer on a round-trip journey of ~1.5 h. Blood and saliva were collected 24 h and 1 h pre-transportation, directly after unloading and 15 min, 1 h, 3 h plus 24 h post-transportation. An OST was performed 24 h pre-transportation and 3 h post-transportation with a pre- (T0) and post-OST sample collected 60 min later (T60). Heart rates and rectal temperatures were also collected throughout the study. Serum insulin, serum cortisol, and plasma glucose were measured using validated assays. Repeated measures ANOVA were used to determine differences after transportation and between ID and non-ID horses. Non-normal data were log-transformed and multiple comparisons were adjusted using Bonferroni post hoc tests. RESULTS: Mean insulin was higher in ID horses versus non-ID horses (mean = 109.9 µU/mL vs. 30.2 µU/mL, p < 0.001; 95% CI for mean difference = [55.6-107.7 µU/mL]). Mean serum insulin increased following OST at T60 in ID horses pre- (154.6 µU/mL, p = 0.04; 95% CI = [86.3-223.0 µU/mL]) and post-transportation (284.6 µU/mL, p = 0.03; 95% CI = [114.3-454.8 µU/mL]). Non-ID horses had a mean OST T60 insulin post-transportation of 56.6 µU/mL (95% CI = [29.1-84.1 µU/mL]); above recognised threshold [45 µU/mL] for ID diagnosis. MAIN LIMITATIONS: Small number of horses, only mares used, and OST not performed immediately post-transportation. CONCLUSIONS: Performing an OST 3 h following short-term transportation may result in inaccurate ID status.

CONTEXTO: Atualmente não se sabe se o transporte de curto prazo afeta as respostas endócrinas de maneira semelhante em cavalos com e sem disfunção insulinêmica (DI). OBJETIVOS: Caracterizar o efeito do transporte de curto prazo nos parâmetros de estresse e nas respostas de insulina a um teste de açúcar oral (TAO) em cavalos com e sem DI. DELINEAMENTO DO ESTUDO: Estudo de coorte longitudinal. MÉTODOS: Quatorze éguas adultas não prenhes, sem disfunção da pars intermédia da pituitária, de raças leves foram agrupadas como DI (n = 7) ou não­DI (n = 7) com base em testes endócrinos. Durante 2 semanas, as éguas foram transportadas uma vez, em grupos de 3 a 4,em um caminhão de cavalos, em uma viagem de ida e volta de ~1,5 h. Sangue e saliva foram coletados 24 h e 1 h antes do transporte, diretamente após o descarregamento e 15 min, 1 h, 3 h e 24 h após o transporte. Um TAO foi realizado 24 h antes do transporte e 3 h após o transporte, com uma amostra pré­ (T0) e pós­TOA coletada 60 min depois (T60). Frequências cardíacas e temperaturas retais também foram coletadas ao longo do estudo. Insulina sérica, cortisol sérico e glicose plasmática foram medidos usando ensaios validados. ANOVA de medidas repetidas foi utilizada para determinar diferenças após o transporte e entre cavalos com e sem DI. Dados não normais foram transformados logaritmicamente e comparações múltiplas foram ajustadas usando testes post hoc de Bonferroni. RESULTADOS: A média de insulina foi maior em cavalos com DI em comparação aos cavalos sem DI (média = 109,9 µU/mL vs 30,2 µU/mL, p < 0,001; IC 95% para diferença de média = [55,6­107,7 µU/mL]). A média de insulina sérica aumentou após o TAO em T60 em cavalos com DI antes (154,6 µU/mL, p = 0,04; IC 95% = [86,3­223,0 µU/mL]) e após o transporte (284,6 µU/mL, p = 0,03; IC 95% = [114,3­454,8 µU/mL]). Cavalos sem DI tiveram uma média de insulina TAO T60 pós­transporte de 56,6 µU/mL (IC 95% = [29,1­84,1 µU/mL]); acima do limite reconhecido [45 µU/mL] para diagnóstico de DI. PRINCIPAIS LIMITAÇÕES: Pequeno número de cavalos, uso apenas de éguas e TAO não realizado imediatamente após o transporte. CONCLUSÕES: Realizar um TAO 3 horas após o transporte de curto prazo pode resultar em um status de DI impreciso.

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BACKGROUND: There is a discrepancy in the surgical and endoscopic literature for managing duodenal perforations. Although often managed conservatively, surgical repair is the standard treatment for duodenal perforations. This contrasts with the gastroenterology literature, which now recommends endoscopic repair of duodenal perforations, which are more frequently iatrogenic from the growing field of advanced endoscopic procedures. This study aims to provide a scoping review to summarize the current literature content and quality on endoscopic repair of duodenal perforations. METHODS: The protocol for performing this scoping review was outlined by the Joanna Briggs Institute. All studies that reported primary outcomes of patients who had undergone endoscopic repair of duodenal perforations before February 2022, regardless of perforation etiology or repair type were reviewed, with studies after 1999 meeting inclusion criteria. The study excluded articles that did not report clinical outcomes of endoscopic repair, articles that did not describe where in the gastrointestinal tract the endoscopic repair occurred, pediatric patients, and animal studies. RESULTS: 7606 abstracts were screened, with 474 full articles reviewed and 152 studies met inclusion criteria. 560 patients had duodenal perforations repaired endoscopically, with a technical success rate of 90.4% and a survival rate of 86.7%. Most of these perforations (74.5%) were iatrogenic from endoscopic procedures or surgery. Only one randomized control trial (RCT) was found, and 53% of studies were case reports. CONCLUSION: These results suggest that endoscopic repair could emerge as a viable first-line treatment for duodenal perforation and highlight the need for more high-quality research in this topic.

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BACKGROUND: Information on health care and health status of U.S. senior horses (≥15 years of age) is currently sparse. OBJECTIVES: (A) Provide an overview of owner-reported (1) medical conditions, (2) management/treatment practices for equine metabolic syndrome and pituitary pars intermedia dysfunction (PPID), (3) frequencies of routine health care practices and (4) supplement and pharmaceutical use in U.S. senior horses (≥15 years of age). (B) Evaluate potential risk factors for certain medical conditions and for low routine health care. STUDY DESIGN: Online survey. METHODS: Descriptive and inferential analysis (binomial logistic regression and ANOVA) of 2717 questionnaires from owners of U.S. senior horses. RESULTS: The most common owner-reported veterinary-diagnosed medical conditions were osteoarthritis (30%), dental disorders (15%), lameness (14%), PPID (12%) and ocular disorders (6%). Advancing age was found to be a risk factor for PPID (odds ratio [OR] [95% confidence interval, CI] = 1.14 [1.10-1.18]), dental (OR [95% CI] = 1.18 [1.15-1.22]) and ocular (OR [95% CI] = 1.05 [1.01-1.10]) disorders. Only 36% of horses were free of owner-reported veterinary-diagnosed medical conditions at the time of the survey. During the year prior to the survey, most routine healthcare practices (i.e., veterinary health care, dental care and anthelmintic treatment) were typically undertaken one to two times per year, while farrier visits occurred mostly every 5-6 weeks. Retired senior horses had a higher risk of no health care visits (OR [95% CI] = 2.1 [1.38-3.06]), no dental care (OR [95% CI] = 2.0 [1.31-3.00]) and low farrier attendance (i.e., ≤4 times/year) (OR [95% CI] = 2.4 [1.57-3.63]) compared with senior horses used for pleasure riding. The most frequently administered drug was firocoxib (18%) and joint supplements were the most provided supplements (41%). MAIN LIMITATIONS: Potential recall, response and sampling bias. Risk factor analyses do not establish causal relationships. CONCLUSIONS: Medical conditions are highly prevalent in U.S. senior horses. Retired senior horses have an increased risk of low routine health care.

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Intra-articular corticosteroids are a popular treatment choice for joint-associated pain and inflammation in horses despite recent work on the metabolic effects of these drugs. The goal of this project was to compare metabolic effects between intra-articular (IA) triamcinolone acetonide (TA) and an autologous protein solution (APS). Five mixed-breed geldings (4-9 years) were utilized for this project. Three identical and consecutive 28-day treatment blocks were used, with metacarpophalangeal IA treatments consisting of equal volumes of saline, a commercially available APS, or 9 mg of TA. Regular plasma and serum samples were collected for ACTH, cortisol, glucose, insulin, and thyroid hormone analysis, in addition to thyrotropin-releasing hormone (TRH) and oral sugar tests (OSTs). Significant treatment effects of IA TA were present at 48 h post-injection in both the TRH and the OST. There was also significant suppression by IA TA of baseline ACTH and cortisol between 2 h and 96 h post-treatment, hyperglycemia between 12 h and 48 h, and hyperinsulinemia at 32 h post-treatment. There were no treatment effects with respect to any measured thyroid hormones, nor were there any significant treatment effects of APS noted. Results suggest at least 2 days and up to 7 days should elapse between a single 9 mg IA TA treatment and OST and/or TRH testing. This study found that TA exhibits significant effects on ACTH, cortisol, glucose, and insulin, while the APS does not.

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INTRODUCTION: Sacral nerve stimulation (SNS) has now been used as a treatment for fecal incontinence (FI) for >20 years. The aim of this systematic review was to determine the long-term efficacy of SNS on the treatment of FI. MATERIALS AND METHODS: A comprehensive search of the MEDLINE, Embase, and Cochrane Central data bases was performed to find publications, excluding case reports, reporting outcomes of SNS treatment for FI in adults with ≥36 months of follow-up. Bias was assessed using the Risk of Bias in Non-randomized Studies-of Interventions tool. Data were summarized per reported FI-related outcomes for symptom severity and quality of life. RESULTS: In total, 3326 publications were identified, and 36 studies containing 3770 subjects were included. All studies had a serious risk of bias. Success was variably defined by each publication and ranged from 59.4% to 87.5% for per-protocol analyses and 20.9% to 87.5% for intention-to-treat analyses. All studies reporting bowel diary data, St Mark's scores, and Cleveland Clinic Incontinence Scores indicated significant improvement with SNS treatment in the long term. Studies that evaluated quality-of-life outcomes also all showed improvements in quality of life as measured by the Fecal Incontinence Quality of Life Scale. The aggregate revision rate was 35.2%, and the explantation rate was 19.7%. CONCLUSIONS: Improvements in objective and subjective outcomes at ≥36 months support using SNS for the long-term treatment of FI. Interpretation of these data is limited by a lack of comparative trials and heterogeneity of the included studies.

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BACKGROUND: Buprenorphine, a partial opioid agonist, has emerging evidence as an alternative to full agonist opioids for treatment of acute pain. This systematic review aimed to evaluate the safety and efficacy of buprenorphine for acute pain in older adults. METHODS: PubMed Medline, Embase, Cochrane Central Register of Controlled Trials, CINHAL, Web of Science database, and Google Scholar were searched. We included articles that reported buprenorphine as an intervention to treat acute pain among patients 60 years or older. Primary outcome was difference in pain scores for patients treated with buprenorphine compared to other analgesia. Secondary outcomes included adverse events, opioid consumption, and patient satisfaction. Meta-analysis was conducted on difference in pain scores and differences in nausea and vomiting. RESULTS: Twenty-two studies were included (n = 2610). Buprenorphine was administered as nerve blocks in six studies, transdermal in eight, intravenous or intramuscular in five, sublingual in two studies, and both intravenous and sublingual in one study. 10 out of 20 (50%) studies found improved pain control in buprenorphine groups. Meta-analysis found no significant difference in pain scores between buprenorphine and control analgesia at 24 hours (Cohen's d = -0.29 [95% CI -0.85 to 0.27]) and 7 days (Cohen's d = -0.89 [95% CI -2.66-0.88]). Six studies (54.5%) found reduced opioid consumption in patients receiving buprenorphine. There was no difference in adverse effects in most studies. CONCLUSIONS: This review did not find buprenorphine to be superior to alternative analgesia; however the mixed results provide scientific rationale for future studies testing buprenorphine in older populations.

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A 63-y-old woman with a history of breast cancer presented with concerns of osseous metastasis. Initial whole-body planar bone scintigraphy revealed a focus of concern overlying the sternum. SPECT/CT images revealed the anomaly-localized activity in the needleless hub attached to the chemotherapy port. If not for the precision of SPECT/CT, such a rare artifact could have led to a false-positive diagnosis, particularly impactful in breast cancer patients. This case emphasizes the critical role of SPECT/CT in accurate diagnoses.

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Horses are regularly transported in the United States (U.S.); however, how, and why horses travel by road has not been explored. Consequently, an online nationwide survey was conducted to understand 1) the most common reasons for travel; 2) the types of journeys undertaken when being transported by road in the U.S. and 3) the general management practices when transporting for 3 h or less. Responses were collected from 1294 participants with at least one response from every state in the continental U.S. The most common survey taker was a female (93.9 %), adult amateur (81.2 %), horse owner (64.6 %) who rode recreationally (33.1 %) and transported their own horse (79.4 %). The most common reasons for travel were for trail or leisure riding (34.2 %) followed by showing and competition (25.3 %); however, this varied by discipline. The most common trip duration was less than one hour (46.8 %), with only 12.4 % of the most common trip durations being 4 h or more. The most common specific horse transported by road for 3 h or less was an adult (age 5-15; 59.0 %), Quarter Horse (21.2 %), used for pleasure or trail riding (44.3 %). The biggest concern when transporting was injury to the horse (26.7 %), whilst the biggest factor when planning to travel was the weather (24.1 %). These results provide insight into why horses are being transported by road in the U.S. and that it is more common to transport horses for shorter durations.

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Bacteroides species are successful colonizers of the human gut and can utilize a wide variety of complex polysaccharides and oligosaccharides that are indigestible by the host. To do this, they use enzymes encoded in Polysaccharide Utilization Loci (PULs). While recent work has uncovered the PULs required for use of some polysaccharides, how Bacteroides utilize smaller oligosaccharides is less well studied. Raffinose family oligosaccharides (RFOs) are abundant in plants, especially legumes, and consist of variable units of galactose linked by α-1,6 bonds to a sucrose (glucose α-1-ß-2 fructose) moiety. Previous work showed that an α-galactosidase, BT1871, is required for RFO utilization in Bacteroides thetaiotaomicron. Here, we identify two different types of mutations that increase BT1871 mRNA levels and improve B. thetaiotaomicron growth on RFOs. First, a novel spontaneous duplication of BT1872 and BT1871 places these genes under control of a ribosomal promoter, driving high BT1871 transcription. Second, nonsense mutations in a gene encoding the PUL24 anti-sigma factor likewise increase BT1871 transcription. We then show that hydrolases from PUL22 work together with BT1871 to break down the sucrose moiety of RFOs and determine that the master regulator of carbohydrate utilization (BT4338) plays a role in RFO utilization in B. thetaiotaomicron. Examining the genomes of other Bacteroides species, we found homologs of BT1871 in subset and show that representative strains of species containing a BT1871 homolog grew better on melibiose than species that lack a BT1871 homolog. Altogether, our findings shed light on how an important gut commensal utilizes an abundant dietary oligosaccharide.

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Bacterial pathogens remain poorly characterized in bats, especially in North America. We describe novel (and in some cases panmictic) hemoplasmas (12.9% positivity) and bartonellae (16.7% positivity) across three colonies of Mexican free-tailed bats (Tadarida brasiliensis), a partially migratory species that can seasonally travel hundreds of kilometers. Molecular analyses identified three novel Candidatus hemoplasma species most similar to another novel Candidatus species in Neotropical molossid bats. We also detected novel hemoplasmas in sympatric cave myotis (Myotis velifer) and pallid bats (Antrozous pallidus), with sequences in the latter 96.5% related to C. Mycoplasma haemohominis. We identified eight Bartonella genotypes, including those in cave myotis, with 96.7% similarity to C. Bartonella mayotimonensis. We also detected Bartonella rochalimae in migratory Tadarida brasiliensis, representing the first report of this human pathogen in bats. The seasonality and diversity of these bacteria observed here suggest that additional longitudinal, genomic, and immunological studies in bats are warranted.

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BACKGROUND: A single dose of metformin administered 1 h prior to oral glucose challenge was previously shown to reduce insulinaemic responses in horses with experimentally-induced insulin dysregulation (ID). Targeted administration could be useful for controlling post-prandial hyperinsulinaemia in horses with naturally-occurring ID. OBJECTIVES: The objective was to compare the insulinaemic and glycaemic responses to oral sugar testing (OST) performed at different intervals after a single dose of metformin in horses with naturally-occurring ID. We hypothesised that pre-treatment with one dose of metformin would significantly decrease the insulinaemic response to OST. STUDY DESIGN: Randomised cross-over in vivo experiment. METHODS: Eight university-owned adult horses with naturally-occurring ID underwent OST 1, 2 and 6 h following a single oral dose of metformin (30 mg/kg) or 1 h after placebo (240 mL water) with a 7-day washout between treatments over a period of 3 weeks. Plasma insulin, C-peptide and glucose concentrations were measured at 0, 60 and 90 min after 0.45 mL/kg light corn syrup and the effect of treatment (and the interval since dosing) examined using a mixed effects linear regression model. RESULTS: Metformin treatment had no significant effect on plasma glucose, insulin or C-peptide concentrations at any time point compared with placebo (p > 0.05). For OST 1 h post metformin, median (IQR) plasma insulin was 91.3 (62.4-114.9) µIU/mL at 60 min versus 76.2 (59.1-134.5) for placebo (p = 0.8) and 62.7 (31.4-109.7) at 90 min versus 51.8 (29.2-126.3) for placebo (p = 0.9). MAIN LIMITATIONS: Small sample size may limit identification of more subtle decreases in insulin concentration with metformin pre-dosing. The results of this study are relevant only for one pre-treatment dose (30 mg/kg) which limits extrapolation to predictions about the effects of longer-term metformin administration on insulin and glucose dynamics in the horse. CONCLUSIONS AND CLINICAL IMPORTANCE: The results do not support the use of targeted metformin treatment to reduce post-prandial hyperinsulinaemia in horses with naturally-occurring ID.

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BACKGROUND: Information on the management and health of US senior horses (≥15 years of age) is currently limited. OBJECTIVES: Provide information on (1) primary use of US senior horses, (2) reasons and risk factors for horse retirement, (3) exercise management, (4) prevalence of low muscle mass and (5) risk factors for, and owner-perceived consequences of, low muscle mass. STUDY DESIGN: Online survey. METHODS: Survey responses from 2717 owners of U.S.-resident senior horses (≥15 years of age) were analysed descriptively and inferentially, using ordered and binomial logistic regression, ANOVA and the Kruskal-Wallis test. RESULTS: The most frequently reported primary uses were pleasure riding/driving (38.5%) and full retirement (39.8%). Most horses (61.5%) were retired between 15 and 24 years of age, with health problems being the main reason. Age, female sex, Thoroughbred breed and various medical conditions were identified as risk factors for retirement. In working horses (i.e., those not retired or semi-retired), exercise intensity was negatively associated with age. The owner-reported prevalence of low muscle mass in all horses was 17.2% (95%CI = 15.7-18.7). In those affected by low muscle mass, the ability to work and welfare-related aspects were commonly perceived to be impaired. Increasing age, sex (gelding), pituitary pars intermedia dysfunction, osteoarthritis, laminitis and primary use (retired and semi-retired vs. use for competition) were identified as risk factors for owner-reported low muscle mass. MAIN LIMITATIONS: Potential response, recall and sampling bias. Causal relationships cannot be established. CONCLUSIONS: Although structured exercise into old age may provide health benefits (as seen in elderly people), a large proportion of horses were fully retired in the current study. Senior horses were mainly retired for health problems and characterising these problems may aid in extending their work/active life. Low muscle mass was perceived to affect horses' welfare and ability to work, and identification of prevention and treatment strategies is therefore warranted.

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Hyperinsulinemia-associated laminitis (HAL) is the primary concern for insulin dysregulated (ID) equids and their insulin response to the consumption of oral, nonstructural carbohydrates (NSC) has been shown to be a risk predictor for HAL development. This randomized, crossover study's objective was to examine the insulinemic responses to 3 forage pellets (1 g/kg BW) (timothy hay, TH, 9.5 % CP & 10 % NSC DM; alfalfa hay, AH, 16.3 % CP & 9.8 % NSC DM; timothy-alfalfa hay; TAH, 17.2 % CP & 9.8 % NSC DM) along with a positive (dehulled oats; OG, 14.7 % CP & 59.7 % NSC DM) and negative dietary challenge control (low-NSC; LNSC, 12.8 % CP & 5.4 % NSC DM) of ID (n = 8; 16.1 ± 2.2 yr; 565.4 ± 99.1 kgs.) and non-ID (NID; n = 7; 17.0 ± 2.8 yr; 583.6 ± 57.9 kgs.) horses. ID horses had higher positive incremental area under the curve for insulin (IAUCi) (ID: 890 ± 925 µIU/mL*minute vs. NID: 225 ± 228 µIU/mL*minute), peak (ID: 101.5 ± 80.72 µIU/mL vs. NID: 25.7 ± 7.2 µIU/mL), and delta (ID: 45.5 ± 77.1 µIU/mL vs. NID: 4.9 ± 5.3 µIU/mL) insulin for all forage pellets compared to NID (p < 0.01). ID horses IAUCi for the forage pellets was not different compared to the LNSC (218 ± 327 µIU/mL*minute) but was different from OG (10,522 ± 4,565 µIU/mL*minute). ID horses' lack of an augmented insulinemic response to the low NSC forage pellets (fed in small amounts) indicates that they could be a safe feedstuff for ID animals.

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Background: Despite the benefits of breastfeeding, there are significant disparities in rates among various racial, social, and economic groups. Society poses various barriers to breastfeeding, threatening the child's access to a basic human right. Exploring and understanding these issues can ensure that effective interventions are implemented. Objective: To present situations in which the mother's and child's basic human right to breastfeeding is threatened and to highlight opportunities to uphold their rights within social and health care systems. Methods: A literature search of relevant articles was performed via PubMed regarding (1) rights to optimal protections for breastfeeding, (2) situations in which the rights of breastfeeding parents are threatened, and (3) challenges in providing inclusive and equitable breastfeeding care along with strategies to uphold the human right to breastfeed. Results: Maternity leave of at least 12 weeks was associated with higher breastfeeding rates, whereas mandated breaks in the workplace resulted in either positive or inconclusive effects. Peer counseling, institutional initiatives, and mass media campaigns were among the most effective interventions; however, effects on breastfeeding varied among different racial groups. Conclusions: There are clear benefits of breastfeeding for mothers and infants, which highlight the importance of prioritizing breastfeeding as a basic human right. Regardless, there are numerous societal barriers to providing equitable breastfeeding care. Although there are interventions that have proven to be helpful in breastfeeding promotion, protection, and support, further standardized research will be beneficial in identifying effective and inclusive interventions.

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Transportation of horses on short journeys can lead to an increase in stress. There are known age-associated changes in immune and metabolic responses in horses; however, no research exists evaluating how age may influence these responses to transportation stress. Eleven mares within two age groups, aged (n = 5, 22 ± 1 year) or young (n = 6, 2 ± 1 year), were transported 1 hour and 20 minutes. Peripheral blood and saliva were collected before and after transportation at baseline (2 to 3 weeks prior to transportation), 24 hours pre-transport, 1 hour before loading, 15 minutes, 30 minutes, 1 to 3 hours, 24 hours and 8 days post-transport. Heart rates, rectal temperatures, under the tail temperatures, serum cortisol, plasma ACTH, serum insulin, salivary cortisol and salivary IL-6 were measured. Whole blood gene expression of the cytokines IL-1b, IL-2, IL-6, IL-10, IFNγ, and TNFα were determined through qPCR, and peripheral blood mononuclear cells were isolated, stimulated, and stained to determine IFNγ and TNFα production. Serum cortisol (P < .0001), salivary cortisol (P < .0001) and heart rate (P = .0002) increased in response to transportation with no age differences. Rectal (P = .03) and under the tail temperatures (P = .02) were increased in young versus aged horses. ACTH was higher in aged horses (P = .007) and post-transportation (P = .0001). Aged horses showed a greater increase in insulin compared with young horses (P < .0001). While age does not seem to impact cortisol responses to short-term transportation in horses, it did influence the post transportation insulin response to stress in aged horses.

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INTRODUCTION: We aimed to streamline the NIDA Phenotyping Assessment Battery (PhAB), a package of self-report scales and neurobehavioral tasks used in substance use disorder (SUD) clinical trials, for clinical administration ease. Tailoring the PhAB to shorten administration time for a treatment setting is critical to expanding its acceptability in SUD clinical trials. This study's primary objectives were to develop a brief version of PhAB (PhAB-B) and assess its operational feasibility and acceptability in a female clinical treatment sample. METHODS: Assessments of the original PhAB were evaluated along several criteria to identify a subset for the PhAB-B. Non-pregnant females (N=55) between ages 18-65, stabilized on buprenorphine for opioid use disorder (OUD) at an outpatient addiction clinic, completed this abbreviated battery remotely or after a provider visit in clinic. Participant satisfaction questions were administered. REDCap recorded the time to complete PhAB-B measures. RESULTS: The PhAB-B included 11 measures that probed reward, cognition, negative emotionality, interoception, metacognition, and sleep. Participants who completed the PhAB-B (N =55) were 36.1 ± 8.9 years of age, White (54.5%), Black (34.5%), and non-Latinx (96.0%). Most participants completed the PhAB-B remotely (n = 42, 76.4%). Some participants completed it in-person (n = 13, 23.6%). PhAB-B mean completion time was 23.0 ± 12.0 min. Participant experiences were positive, and 96% of whom reported that they would participate in the study again. CONCLUSION: Our findings support the clinical feasibility and acceptability of the PhAB-B among a female opioid use disorder outpatient addiction treatment sample. Future studies should assess the PhAB-B psychometric properties among broader treatment samples.

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User-based evaluation by end users is an essential step in designing useful interfaces. Inspection methods can offer an alternate approach when end-user recruitment is problematic. A Learning Designers' usability scholarship could offer usability evaluation expertise adjunct to multidisciplinary teams in academic settings. The feasibility of Learning Designers as 'expert evaluators' is assessed within this study. Two groups, healthcare professionals and Learning Designers, applied a hybrid evaluation method to generate usability feedback from a palliative care toolkit prototype. Expert data were compared to end-user errors detected from usability testing. Interface errors were categorised, meta-aggregated and severity calculated. The analysis found that reviewers detected N = 333 errors, with N = 167 uniquely occurring within the interface. Learning Designers identified errors at greater frequencies (60.66% total interface errors, mean (M) = 28.86 per expert) than other evaluator groups (healthcare professionals 23.12%, M = 19.25 and end users 16.22%, M = 9.0). Patterns in severity and error types were also observed between reviewer groups. The findings suggest that Learning Designers are skilled in detecting interface errors, which benefits developers assessing usability when access to end users is limited. Whilst not offering rich narrative feedback generated by user-based evaluations, Learning Designers complement healthcare professionals' content-specific knowledge as a 'composite expert reviewer' with the ability to generate meaningful feedback to shape digital health interfaces.

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INTRODUCTION: Opioid use disorder affects 2.1 million individuals in the USA, causing more than 100 000 overdose-related deaths annually. While the neurobiological model of addiction is well described and accepted, there is a lack of morbidity and mortality prognosticators for patients struggling with opioid use disorder. Allostatic load index is a promising candidate for the basis of a prognostication tool. Previous studies show that allostatic load predicts both morbidity and mortality in a variety of cohorts. This scoping review protocol provides the rationale and steps for summarising and presenting existing evidence surrounding allostatic load in the context of opioid use disorder. Identification of current knowledge gaps will pave the way for subsequent prospective studies. METHODS AND ANALYSIS: This scoping review protocol will follow the five-step method designed by Arksey and O'Malley. All studies written in English on allostatic load in the context of opioid use disorder, as defined in our inclusion criteria, will be included. There will be no limit on the year of publication. We will search PubMed, Embase, CINAHL, PsycINFO and Google Scholar. We will hand-review reference lists of included articles, and we will hand search grey literature. We will then group, analyse and present the data in narrative, tabular and diagrammatic format according to themes identified in the scoping review. ETHICS AND DISSEMINATION: Ethics approval is not necessary, as data are gathered from publicly accessible sources. The results will be disseminated through a peer-reviewed journal and reported at conferences related to addiction medicine. TRIAL REGISTRATION NUMBER: 10.17605/OSF.IO/4J6DQ.

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Cannabidiol (CBD) has potential to reduce pain and inflammation in humans leading to the interest of use in equine. The purpose of this study was to determine the effects of CBD on immune function by measuring inflammatory cytokines and antibody responses to vaccination, as well as other health parameters in senior horses. Horses were orally-dosed with CBD (2 mg/kg: 13 horses) or control (soy oil: 14 horses) daily for 90 days, from July 2021 to November 2021. Peripheral blood samples were collected on days 0, 30, 60, and 90 before administering treatments. On day 90 all horses were kept on treatment and vaccinated with an equine influenza vaccine and blood samples were collected post-vaccination on days 14 and 21. For all time points, plasma samples were analyzed for determination of CBD and metabolites, 7-OH CBD and 7-COOH CBD, using tandem mass spectrometry. For time points 0, 30, 60 and 90, blood samples were analyzed for CBC and chemistry. Additionally, peripheral blood mononuclear cells (PBMC) were isolated, stimulated with phorbol 12-myristate 13-acetate (PMA) and ionomycin, stained intracellularly for interferon gamma (IFN-γ) and tumor necrosis factor alpha (TNF-α) then analyzed via flow cytometry. Real-time PCR (RT-PCR) analyzed both stimulated PBMCs and whole blood for cytokine gene expression. Inflammatory proteins C-reactive protein, interleukin 1 receptor agonist, and prostaglandin E2 were measured with equine-specific enzyme linked immunosorbent assays. Thyrotropin-releasing hormone stimulation test and oral sugar test were performed on all horses before and after the study to analyze metabolic function. Hemagglutination inhibition (HI) titers were measured for immune responses pre- and post-vaccination. All data were analyzed using either a paired t-test or a two-way repeated measures analysis of variance (significance P < 0.05). Plasma concentrations of CBD and metabolites were determined with 7-COOH CBD, the most significant metabolite, in CBD treated horses compared to control treated horses. A significant decrease was determined for whole blood inflammatory cytokine expression of IFN-γ at day 60, and for IL6 at day 60 and 90 for CBD-treated horses when compared to control horses. CBD did not significantly affect any other immune factors, HI titers, or health parameters. This study demonstrated that treatment with CBD reduced some inflammatory cytokine production with no negative side effects as measured by CBC or chemistry profiles. This study reveals the initial understanding of CBD in the horse, however more in-depth research is needed to fully understand its efficacy on the health of the horse.

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