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UK experts share their work in the field of opioid use disorder research at 2022 Rx Summit

Jacob Scott

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University of Kentucky experts on the front lines of the nation’s opioid and addiction crises will share their work in the field of opioid use disorder research, treatment and prevention this week at the 2022 Rx Drug Abuse & Heroin Summit in Atlanta April 18-22.

The Rx Summit is the nation’s largest annual gathering focused on combating the opioid epidemic and returns to an in-person format this year after being held virtually the last two years due to the COVID-19 pandemic.

A UK delegation including President Eli Capilouto and experts across multiple disciplines will collaborate with a global community of stakeholders who come together annually at the event to share best practices and strategies for prevention, treatment and recovery.

The meeting takes place at a critical time, with U.S. overdose rates at record highs and deaths due to drug overdose topping 1 million for the first time since the Centers for Disease Control and Prevention (CDC) began collecting data on the problem more than two decades ago.

With Kentucky among the states hardest hit by the nation’s opioid epidemic, UK experts tackling the crisis in the Commonwealth are at the forefront of the national effort to cultivate change and develop sustainable solutions.

HEALing communities study

On Tuesday, April 19 at 2:15 p.m., UK experts will present “HEALing Communities Study: Deploying Evidence-Based Practices to Reduce Opioid Overdose Deaths Through Community Engagement and Partnerships.” Presenters are UK Center on Drug and Alcohol Research Director Sharon Walsh, Ph.D.; UK College of Arts & Sciences Professor of Sociology Carrie Oser, Ph.D.; UK College of Nursing Assistant Professor and Voices of Hope Program Director Amanda Fallin-Bennett, Ph.D.; and Jennifer Gulley with the Clark County Health Department.

In 2019, UK researchers spanning seven colleges, in partnership with state leaders, launched a project through the NIH’s HEALing (Helping End Addiction Long Term) Communities Study aimed at reducing opioid overdose deaths.

The four-year, $87 million study is the largest research grant ever received by UK and leverages existing resources and initiatives, in partnership with communities, to implement various evidence-based strategies to reduce opioid deaths across Kentucky.

The randomized study includes 16 Kentucky counties impacted by opioids and is broken down into two waves of eight counties each. With project activities for the first wave of eight counties – Boyd, Boyle, Clark, Fayette, Floyd, Franklin, Kenton and Madison, collectively known as WAVE 1 – nearly complete, UK experts will highlight the community engagement, criminal justice and peer support roles of the study.

UK’s HEALing Communities Study has established partnerships with behavioral/health care and criminal justice agencies in counties to expand capacity for medication treatment for opioid use disorder (MOUD), link and retain clients on MOUD, provide overdose education and distribute naloxone, a lifesaving medication that can immediately reverse the effects of opioids.

The presentation will highlight strategies used for community-level decision making around evidence-based practices for opioid use disorder, explore the barriers to and opportunities for expanding care to those suffering from opioid use disorder in criminal justice settings and examine the important role of peer support specialists and recovery coaches in linking people to care and helping retain them in treatment.

The HEALing Communities Study team, in partnership with many state and community partners, is implementing evidence-based practices and removing barriers to care and recovery to turn the tide on the impact of opioid use in the Commonwealth. With WAVE 1 of the study nearly complete, the summit provides an opportunity for our team to share best practices, successes and challenges with other experts working to develop sustainable solutions for the opioid epidemic. The hope is that what we have implemented can become a national model for reducing opioid overdose deaths.”

Sharon Walsh, PhD, Study Principal Investigator, University of Kentucky

Insights from state data on overdose deaths

On Wednesday, April 20 at 4:30 p.m., UK experts will present “Insights From State Data Into Deaths Related to Fentanyl, Fentanyl Analogs, Psychostimulants, and Novel Psychoactive Substances.” UK College of Pharmacy Professor Chris Delcher, Ph.D., and UK College of Public Health Assistant Professor Dana Quesinberry, J.D., D.P.H., will be joined by Jessica Bitting with the Centers for Disease Control and Prevention (CDC)/National Network of Public Health Institutes (NNPHI); Bruce A. Goldberger, Ph.D., with the University of Florida’s College of Medicine; and Michael B. Meit from East Tennessee State University’s Center for Rural Health Research.

Quesinberry will share findings from Kentucky state data on overdose deaths related to fentanyl and other psychoactive substances including methamphetamine and discuss how this data is shared with the community to inform prevention and response efforts.

Delcher will also present data showing shifts in the proportional impacts of these substances in geography, time, and periods relative to other policy and societal changes including the COVID-19 pandemic.

The Kentucky Injury Prevention and Research Center (KIPRC), an agent for the Kentucky Department for Public Health located at UK’s College of Public Health, publishes annual drug overdose reports based on data collected from the Kentucky Office of State Medical Examiner’s Office and county coroner offices and placed in the Kentucky Drug Overdose Fatality Surveillance System (DOFSS) with other data.

The DOFSS’s inclusion of multiple data sources provides additional case-level information about drug overdose deaths that can better inform state and local prevention and response efforts, Quesinberry said.

“The overdose death investigation process is actually very complicated, with data from many sources including the coroner, medical examiner and toxicology labs. Pulling all of this information into one single database gives a more comprehensive picture about what has happened in an event that has caused a fatality,” Quesinberry said.

The toxicology data in DOFSS is also helping experts understand how the opioid epidemic is evolving. Once mostly caused by prescription opioids like oxycodone and later heroin, drug overdose deaths in Kentucky are now driven by the synthetic opioid fentanyl. From 2019 to 2020, Kentucky overdose deaths that included fentanyl in toxicology reports nearly doubled, with most being linked to illicitly manufactured fentanyl.

While fentanyl is the most commonly found drug in toxicology reports, data is also starting to show increasing co-involvement with methamphetamine and cocaine. Quesinberry says these new trends warrant further investigation to better understand why this is happening. Delcher and Quesinberry were awarded a grant called STIMuLINK from the CDC to investigate stimulant-related overdoses in Kentucky.

Launched in 2017, DOFSS is now developed as part of KIPRC’s implementation of the CDC’s Overdose Data to Action surveillance strategies to reduce the burden of substance use disorders and drug overdoses in Kentucky.

Policy, prescribing and clinical practice: lessons from recent evaluations in Kentucky

On Thursday, April 21 at 11:15 a.m., UK experts will present “Policy, Prescribing, and Clinical Practice: Lessons From Recent Evaluations in Kentucky.” Presenters are UK College of Pharmacy Professor Trish Freeman, Ph.D.; UK College of Medicine Professor Michelle Lofwall, M.D.; and UK College of Public Health Associate Professor Svetla Slavova, Ph.D. They will be joined by the CDC’s Kristin Holland, Ph.D.

The presentation will highlight three recent UK-led studies on opioid policy prescribing and clinical practice:


Kentucky’s All Schedule Prescription Electronic Reporting (KASPER) prescription drug monitoring program is designed to be a source of information to assist practitioners and pharmacists with providing patient care using controlled substance medications. In 2018, a new Kentucky law mandated that patient drug conviction data be made available to prescribers and pharmacists on KASPER. A UK research team developed a continuing education program to inform prescribers and dispensing pharmacists on how to interpret this newly available data in the context of patient care. Lofwall will share insights gained about the usefulness of criminal drug records for prescribing and dispensing decisions.
Slavova will present a study examining the utilization of buprenorphine, a medication used for the treatment of opioid use disorder (MOUD), during the initial weeks of the COVID-19 pandemic. Findings show that buprenorphine treatment increased during the pandemic after the initial interruption from March to April of 2020. Slavova says that future studies are needed to examine treatment retention for individuals initiated on buprenorphine via telemedicine, and there is also a need to assess the association between the drop in individuals on MOUD and the increase in opioid overdose deaths during the initial weeks of the COVID-19 pandemic.
The “days’ supply” is a key number that allows pharmacists to calculate average daily doses for opioid prescriptions. Since days’ supply isn’t always included on a prescription, it is often up to pharmacists to make the calculation and interpret the doctor’s instructions. Freeman will share a study examining the overall accuracy of opioid days’ supply in Kentucky pharmacies. Results show that the calculation is influenced by a variety of factors such as special instructions to the pharmacy, ‘as-needed’ directions, and payer source and suggest that these factors should be accounted for in research studies that depend on days’ supply for data.

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Genetic bottlenecks could impact Wyoming toads’ ability to respond to new pathogens

Jacob Scott

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A new study from North Carolina State University examines immune system diversity in the critically endangered Wyoming toad and finds that genetic bottlenecks could impact a species’ ability to respond to new pathogens. The findings could inform captive breeding strategies for endangered animal populations.

The Wyoming toad, Anaxyrus baxteri, suffered a severe population decline throughout the latter part of the 20th century due to factors including habitat destruction and fungal infection. The toad was brought into a captive breeding program in the 1990s in order to save the species. Scientists estimate a current wild population of only 400 to 1,500 animals, meaning that the toad is considered critically endangered.

Population reduction in this species created a genetic bottleneck to begin with, meaning the level of genetic diversity is already very small. This is the first study to look specifically at genetic diversity in the immune systems of these toads and how it could impact them as a population.”

Jeff Yoder, professor of comparative immunology at NC State and co-corresponding author of paper

Yoder, with co-corresponding author Alex Dornburg of the University of North Carolina at Charlotte, performed RNA sequencing on immune tissues from three healthy, retired Wyoming toad breeders. Study co-author Michael Stoskopf, who was on the Wyoming Toad Recovery Implementation Team established in 2008, obtained the samples.

“We were focused specifically on sequences encoding toll-like receptors – TLRs – and the proteins of the major histocompatibility complex, or MHC, expressed in these tissues,” says Kara Carlson, first author of the study and current Ph.D. candidate at NC State. “These sets of genes are major components of the immune system.”

TLRs are the first responders of the immune system, and are similar, or well-conserved, between species. The MHC, on the other hand, is a large and diverse group of genes that varies between species and individuals. It can determine why one group is more resistant to a particular pathogen than another.

“MHC genes are some of the most rapidly evolving sequences in the genome,” Carlson says. “So in a healthy population there’s a lot of variety that gets passed along to descendants, enabling the species at large to adapt to different pathogens. However, if disease survivors do so because of their MHC, then that group would have a similar MHC.

“The Wyoming toads that were brought into captivity to save the species were all able to resist the fungus that had decimated the population, but that could mean that their immune diversity is reduced.”

The researchers compared the TLR and MHC of the three Wyoming toads to each other, as well as to samples from a common toad and a cane toad. Both the common toad and the cane toad showed more MHC diversity than the Wyoming toad, even though the cane toad underwent a similar genetic bottleneck.

“The small sample size in this study – which was unavoidable due to the endangered status of the toad – nevertheless lays an important framework for conservation,” Carlson says.

“Amphibians in general don’t have as many genomic resources as other organisms,” Yoder says. “And captive breeding from a small population further decreases genetic diversity. But while these toads may be better protected against the fungal infection that nearly wiped them out, they may not be equipped to deal with new pathogens down the road.”

“While we weren’t necessarily surprised by the lack of immunogenic diversity in the Wyoming toad, it does spark an important question,” Dornburg says. “How equipped are other species of conservation concern for a battle with an emergent pathogen?”

“By understanding the genetic diversity of the immune system we can inform captive breeding to increase the chance of a species to resist disease in the wild,” Yoder adds. “Studies like this one are invaluable for captive breeding practices going forward.”

Source:
Journal reference:

Carlson, K.B., et al. (2022) Transcriptome annotation reveals minimal immunogenetic diversity among Wyoming toads, Anaxyrus baxteri. Conservation Genetics. doi.org/10.1007/s10592-022-01444-8.

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Video conferencing hinders creativity

Jacob Scott

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In-person teamwork has now transformed into virtual collaboration due to the COVID-19 pandemic. But does this affect innovation and creativity?

An interesting study on virtual communication led by Dr. Melanie S. Brucks from Columbia University and Prof. Jonathan Levav from Stanford University is published in the journal Nature. The study examines whether videoconferencing affects creative idea generation.

Study: Virtual communication curbs creative idea generation. Image Credit: Andrey_Popov / Shutterstock

Communication and collaboration

Collaboration is essential for several workplace tasks. It leads to innovation and idea generation. Historically, these collaborations have been in-person and required sharing of the same physical space. The use of traditional communication technologies like letters, emails, and phone calls hinder the smooth exchange of information and limits collaboration.

Now, due to advances in audio-visual technology, face-to-face interaction is possible via videoconferencing, allowing virtual collaboration. Videoconferencing has replaced in-person interactions due to pandemic-driven social distancing. Video interaction and in-person interaction allow communication of the same information.

While videoconferencing replacing in-person interaction has been beneficial in the social scenario, does it come with a cost in the workplace scenario? For example, does it affect collaborative idea generation?

Experiments

The investigators performed a Laboratory experiment and a field experiment to test the difference between in-person interaction and videoconferencing in collaborative idea generation. First, they recruited participants and divided them into pairs: half of the pairs were assigned to an in-person setting, and the rest were assigned to a virtual setting.

Laboratory experiment

A total of 602 participants were recruited for the laboratory experiment and divided into pairs. The participants were in separate rooms in the virtual setting and communicated through videoconferencing. The pairs were allotted five minutes to generate creative uses for a frisbee (150 pairs) or bubble wrap (151 pairs) and then one minute to select their most innovative idea.

The pairs were evaluated by counting the number of creative ideas and ideas they generated. The virtual pairs generated significantly fewer total and creative ideas compared to in-person pairs.

So, virtual collaboration hampered creative ideas. This could be because the virtual space narrows the visual scope, which in turn narrows the cognitive scope. To assess the visual focus, two methods were used. Firstly, the participants had to recollect the individual props in the room and point them on a worksheet. Secondly, the participants’ eye gaze was recorded during the experiment.

The virtual pairs narrowed their focus to the screen. Compared to in-person pairs, they spent significantly more time looking directly at their partner and less time looking at the surrounding room, and remembered significantly fewer props in the surrounding room.

As a consequence, the virtual medium narrowed the visual focus and inhibited the generation of ideas.

However, these results are in the context of a controlled laboratory setting.

Field experiment

The experiment was repeated in ‘the field’ under actual work conditions within a large multinational telecommunications company to see if these results could be extrapolated to the real world. The field experiment was conducted in five country sites – in Europe, the Middle East, and South Asia. In this setting, the participants knew their partners and used video conferencing regularly for work. Moreover, it included domain experts highly invested in the outcome of the collaboration.

A total of 1,490 engineers were recruited to participate in an ideation workshop and randomly divided into pairs. The pairs were allotted an hour to generate product ideas and submit one idea as future product innovation for the company.

The engineer pairs who worked on the task virtually generated fewer total ideas and creative ideas than in-person pairs at all five sites.

However, the decision quality was not affected by virtual collaboration. The in-person pairs generated a significantly higher top-scoring idea, but the selected idea did not significantly differ in quality between the virtual pairs and in-person pairs.

Other reasons for reduced creativity

The could be other reasons why virtual collaboration negatively affected idea generation. Therefore, the investigators explored the alternative explanations.

More ideas

Since the in-person collaborators generated more total and creative ideas than the virtual collaborators, they could generate additional ideas similar to each other. However, upon semantic analysis, it was observed that they generated diverse and disconnected ideas.

Feelings of connection and trust

Studies have shown that feelings of connection and trust can foster team creativity. The virtual pairs may have reduced feelings of connection and trust toward their partner.

However, when assessed for subjective feelings of closeness, verbal and non-verbal behaviors, and mimicry, the virtual pairs were similar to in-person pairs in the laboratory experiment.

Thus, virtual and in-person interactions are very similar in terms of social connection or social behavior.

Communication coordination

Usually, there is a lack of coordination in a conversation in virtual interactions due to the absence of eye contact. However, it could not wholly explain the effect of virtual interaction on idea generation.

Interpersonal processes

This study also assessed the effect of interpersonal processes on idea generation. Interpersonal processes fear of evaluation, dominance, social facilitation, social loafing, social sensitivity, perceptions of performance, and production blocking were affected in virtual collaborations and these, in turn, affected idea generation.

Implications of the study

This study supports previous research suggesting that pairs perform better than large groups, both in-person and online. Therefore, this study recommends ideation in pairs and in person. Also, this study suggests that larger videoconferencing screens would not impact idea generation.

In-person collaborations offer a cognitive advantage. Now several workplaces are moving towards a hybrid setup. This study indicates that the creative idea generation should be reserved for in-person meetings.

Journal reference:
Brucks, M.S., Levav, J. (2022) Virtual communication curbs creative idea generation. Nature. https://doi.org/10.1038/s41586-022-04643-y, https://www.nature.com/articles/s41586-022-04643-y

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Gum Health Day 2022 calls for prevention, early detection, and effective treatment of gum diseases

Jacob Scott

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“Treat your gums” is the slogan for Gum Health Day 2022, a worldwide awareness campaign organized by the European Federation of Periodontology (EFP). The event aims to inform the public of the detrimental effects of gum diseases – gingivitis, periodontitis, peri-implant mucositis, and peri-implantitis – on both oral and overall health. The campaign calls for the prevention, early detection, and – where necessary – effective treatment of gum diseases.

Although still poorly acknowledged by the public, gum diseases are chronic inflammatory conditions affecting a high proportion of adults worldwide, causing tooth loss and other problems in the mouth. Crucially, gum diseases are also linked to major systemic health issues including diabetes mellitus, cardiovascular diseases, chronic kidney disease, adverse pregnancy outcomes, rheumatoid arthritis, Alzheimer’s disease, erectile dysfunction, certain forms of cancer, and more severe Covid-19 outcomes. This means that gum diseases and their prevention and treatment are of major importance not only for oral health, but also for the whole body.

This year’s campaign focuses heavily on the treatment part – we know that millions of people suffer from gum diseases that can be treated effectively. ‘Treat your gums’ calls for this treatment – with all the documented positive effects for the mouth and whole body – to actually happen.”

Moritz Kebschull, coordinator of Gum Health Day 2022

That is why the hashtag for the campaign is #TreatYourGums, and why the recent EFP-produced clinical practice guidelines on the treatment of periodontitis are a major part of the Gum Health Day 2022 initiative.

“The new EFP-produced clinical practice guidelines on the treatment of all four stages of periodontitis are a crucial development, as they are the first high-quality international guidelines to outline a structured and easily implemented pathway for the efficient and effective treatment of gum disease,” Prof. Kebschull says. “In a nutshell, gum disease treatment that works!”

He adds: “It is important to underline that gum disease is one of the most widespread chronic diseases in the worldwide adult population, and that it is usually painless, so its early detection and successful treatment depends heavily on how fast the patient takes action.”

A major innovation of Gum Health Day 2022 is an EFP-designed “customized content generator”, a feature that allows the federation’s 37 affiliated national societies of periodontology, their individual members – as well as practices, hospitals, and members of the public – to customise their own Gum Health Day 2022 materials, based on a series of graphic templates and catchphrases.

In the framework of Gum Health Day 2022, the EFP encourages periodontists, dentists, researchers, and other health-related professionals to sign and disseminate the EFP Manifesto: Perio and General Health, an international call to action for the prevention, early detection, and treatment of gum disease. Individuals and organisations are invited to endorse it and join the 1,200+ professionals, dental practices, companies, and universities that have so far supported it.


The European Federation of Periodontology (EFP, ww.efp.org) is a non-profit organization dedicated to promoting awareness of periodontal science and the importance of gum health. Its guiding vision is “periodontal health for a better life.”

Founded in 1991, the EFP is a federation of 37 national periodontal societies that represents more than 16,000 periodontists, dentists, researchers, and oral-health professionals from Europe and around the world. It supports evidence-based science in periodontal and oral health, and it promotes events and campaigns aimed at both professionals and the public.

The EFP organizes EuroPerio, the world’s leading congress in periodontology and implant dentistry, as well as other important professional and expert events such as Perio Master Clinic and Perio Workshop. The annual Gum Health Day on May 12, organized by the EFP and its member societies, brings key messages on gum health to millions of people across the world.

The EFP also organizes workshops and outreach campaigns with its partners: projects to date have covered the relationship between periodontal disease and diabetes, cardiovascular disease, and caries, as well as women’s oral health during pregnancy.

The EFP’s Journal of Clinical Periodontology is the most authoritative scientific publication in this field. The federation also publishes JCP Digest, a monthly digest of research, and the Perio Insight magazine, which features experts’ views and debates.

The EFP’s work in education is also highly significant, notably its accreditation programme for postgraduate education in periodontology and implant dentistry.

The EFP has no professional or commercial agenda.

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