Recent Incarceration, Substance Use, Overdose, and Service Use Among People Who Use Drugs in Rural Communities.

Importance: Drug use and incarceration have a substantial impact on rural communities, but factors associated with the incarceration of rural people who use drugs (PWUD) have not been thoroughly investigated.

Objective: To characterize associations between recent incarceration, overdose, and substance use disorder (SUD) treatment access among rural PWUD.

Design, Setting, And Participants: For this cross-sectional study, the Rural Opioid Initiative research consortium conducted a survey in geographically diverse rural counties with high rates of overdose across 10 US states (Illinois, Wisconsin, North Carolina, Oregon, Kentucky, West Virginia, Ohio, Massachusetts, New Hampshire, and Vermont) between January 25, 2018, and March 17, 2020, asking PWUD about their substance use, substance use treatment, and interactions with the criminal legal system.

Universal scaling of the dynamic BKT transition in quenched 2D Bose gases.

The understanding of nonequilibrium dynamics in many-body quantum systems is a fundamental issue in statistical physics. Experiments that probe universal properties of these systems can address such foundational questions. In this study, we report the measurement of universal dynamics triggered by a quench from the superfluid to normal phase across the Berezinskii-Kosterlitz-Thouless transition in a two-dimensional (2D) Bose gas.

Associations between stimulant use and return to illicit opioid use following initiation onto medication for opioid use disorder.

Aim: The aim of this study was to estimate how ongoing stimulant use affects return to illicit opioid use after initiation onto medication for opioid use disorder (MOUD).

Design: This was a secondary analysis of pooled data from two clinical trials comparing buprenorphine (BUP-NX) and extended-release naltrexone (XR-NTX).

Setting: Thirteen opioid treatment programs and HIV clinics across 10 states in the United States from 2014 to 2019 took part in this study.

Estimating the impact of stimulant use on initiation of buprenorphine and extended-release naltrexone in two clinical trials and real-world populations.

Background: Co-use of stimulants and opioids is rapidly increasing. Randomized clinical trials (RCTs) have established the efficacy of medications for opioid use disorder (MOUD), but stimulant use may decrease the likelihood of initiating MOUD treatment. Furthermore, trial participants may not represent "real-world" populations who would benefit from treatment.

Workforce Composition In Private Equity-Acquired Versus Non-Private Equity-Acquired Physician Practices.

Despite growth in private equity (PE) acquisitions of physician practices in the US, little is known about how changes in ownership influence workforce composition. Using clinician-level data linked to practice acquisition information, we estimated changes in clinician workforce composition in PE-acquired practice sites relative to non-PE-acquired independent practice sites for dermatology, ophthalmology, and gastroenterology specialties. We calculated a clinician replacement ratio (cumulative number of entering clinicians during 2014-19 divided by the cumulative number of exiting clinicians) across 213 PE-acquired practices and 995 matched non-PE-acquired practices.

Association of Methamphetamine and Opioid Use With Nonfatal Overdose in Rural Communities.

Importance: Overdoses continue to increase in the US, but the contribution of methamphetamine use is understudied in rural communities.

Objective: To estimate the prevalence of methamphetamine use and its correlates among people who use drugs (PWUD) in rural US communities and to determine whether methamphetamine use is associated with increased nonfatal overdoses.

Design, Setting, And Participants: From January 2018 through March 2020, the National Rural Opioid Initiative conducted cross-sectional surveys of PWUD in rural communities in 10 states (Illinois, Kentucky, New Hampshire, Massachusetts, North Carolina, Ohio, Oregon, Vermont, West Virginia, and Wisconsin).

Observation of the Berezinskii-Kosterlitz-Thouless Transition in a Two-Dimensional Bose Gas via Matter-Wave Interferometry.

We probe local phase fluctuations of trapped two-dimensional Bose gases using matter-wave interferometry. This enables us to measure the phase correlation function, which changes from an algebraic to an exponential decay when the system crosses the Berezinskii-Kosterlitz-Thouless (BKT) transition. We determine the temperature dependence of the BKT exponent η and find the critical value η_{c}=0.

Contraception and Healthcare Utilization by Reproductive-Age Women Who Use Drugs in Rural Communities: a Cross-Sectional Survey.

Background: Women who use drugs (WWUD) have low rates of contraceptive use and high rates of unintended pregnancy. Drug use is common among women in rural U.S.

Treatment retention, return to use, and recovery support following COVID-19 relaxation of methadone take-home dosing in two rural opioid treatment programs: A mixed methods analysis.

Objectives: In March 2020, the Substance Abuse and Mental Health Services Administration permitted Opioid Treatment Programs (OTPs) to relax restrictions on take-home methadone and promoted telehealth to minimize potential exposures to COVID-19. We assessed the effects of COVID-19-related changes on take-home methadone dosing in two OTPs serving five rural Oregon counties.

Methods: We used a mixed-methods convergent design.

Associations between fentanyl use and initiation, persistence, and retention on medications for opioid use disorder among people living with uncontrolled HIV disease.

Background: Associations between fentanyl use and initiation and retention on medications for opioid use disorder (MOUD) are poorly understood.

Methods: Data were from a multisite clinical trial comparing extended-release naltrexone (XR-NTX) with treatment as usual (TAU; buprenorphine or methadone) to achieve HIV viral suppression among people with OUD and uncontrolled HIV disease. The exposure of interest was fentanyl use, as measured by urine drug screening.

High-flux, adjustable, compact cold-atom source.

Magneto-optical traps (MOTs) are widely used for laser cooling of atoms. We have developed a high-flux compact cold-atom source based on a pyramid MOT with a unique adjustable aperture that is highly suitable for portable quantum technology devices, including space-based experiments. The adjustability enabled an investigation into the previously unexplored impact of aperture size on the atomic flux, and optimisation of the aperture size allowed us to demonstrate a higher flux than any reported cold-atom sources that use a pyramid, LVIS, 3D-MOT or grating MOT.

Development and Pragmatic Evaluation of a Rapid Response Team.

In response to national and local drivers, a clinical emergency response system (CERS) incorporating an intensivist-led rapid response team (RRT) was implemented at a Sydney (Australia) hospital. The authors present a pragmatic evaluation of the 5 years since this major initiative was commenced. A "partner not conquer" philosophy was adopted.

Hubbard Model for Atomic Impurities Bound by the Vortex Lattice of a Rotating Bose-Einstein Condensate.

We investigate cold bosonic impurity atoms trapped in a vortex lattice formed by condensed bosons of another species. We describe the dynamics of the impurities by a bosonic Hubbard model containing occupation-dependent parameters to capture the effects of strong impurity-impurity interactions. These include both a repulsive direct interaction and an attractive effective interaction mediated by the Bose-Einstein condensate.

How might healthcare systems influence speed of cancer diagnosis: a narrative review.

Striking differences exist in outcomes for cancer between developed countries with comparable healthcare systems. We compare the healthcare systems of 3 countries (Denmark, Norway, Sweden), 3 UK jurisdictions (England, Wales and Northern Ireland), 3 Canadian provinces (British Columbia, Manitoba, Ontario) and 2 Australian states (New South Wales, Victoria) using a framework which assesses the possible contribution of primary care systems to a range of health outcomes, drawing on key characteristics influencing population health. For many of the characteristics we investigated there are no significant differences between those countries with poorer cancer outcomes (England and Denmark) and the rest.

Development of a survey instrument to investigate the primary care factors related to differences in cancer diagnosis between international jurisdictions.

Background: Survival rates following a diagnosis of cancer vary between countries. The International Cancer Benchmarking Partnership (ICBP), a collaboration between six countries with primary care led health services, was set up in 2009 to investigate the causes of these differences. Module 3 of this collaboration hypothesised that an association exists between the readiness of primary care physicians (PCP) to investigate for cancer - the 'threshold' risk level at which they investigate or refer to a specialist for consideration of possible cancer - and survival for that cancer (lung, colorectal and ovarian).

High-stakes assessment of the non-technical skills of critical care trainees using simulation: feasibility, acceptability and reliability.

Objective: To evaluate the use of high-fidelity simulation for summative high-stakes assessment of intensive care trainees, focusing on non-technical skills (NTS), testing feasibility and acceptability of simulation assessment, and the reliability of two NTS rating scales.

Design, Setting And Participants: Prospective observational study of senior intensive care trainees in a simulated specialist examination.

Methods: Participants undertook a simulated patient management scenario and were assessed using two rating scales: the Anaesthesia Non-technical Skills (ANTS) scale and the Ottawa Global Rating Scale (GRS).

Precise shaping of laser light by an acousto-optic deflector.

We present a laser beam shaping method using acousto-optic deflection of light and discuss its application to dipole trapping of ultracold atoms. By driving the acousto-optic deflector with multiple frequencies, we generate an array of overlapping diffraction-limited beams that combine to form an arbitrary-shaped smooth and continuous trapping potential. Confinement of atoms in a flat-bottomed potential formed by a laser beam with uniform intensity over its central region confers numerous advantages over the harmonic confinement intrinsic to Gaussian beam dipole traps and many other trapping schemes.

The International Cancer Benchmarking Partnership: an international collaboration to inform cancer policy in Australia, Canada, Denmark, Norway, Sweden and the United Kingdom.

The International Cancer Benchmarking Partnership (ICBP) was initiated by the Department of Health in England to study international variation in cancer survival, and to inform policy to improve cancer survival. It is a research collaboration between twelve jurisdictions in six countries: Australia (New South Wales, Victoria), Canada (Alberta, British Columbia, Manitoba, Ontario), Denmark, Norway, Sweden, and the United Kingdom (England, Northern Ireland, Wales). Leadership is provided by policymakers, with academics, clinicians and cancer registries forming an international network to conduct the research.

Targets and prioritization: the case of cancer in the English NHS.

From 1999 onwards, patients judged by their general practitioners (GPs) to require urgent access to care for suspected cancer have been referred under the so-called two-week wait rule, or fast track, which guaranteed that they would be seen in a hospital clinic within that period. The two-week wait was introduced in the belief that England's relatively poor cancer outcomes were due, at least in part, to delays in accessing care. This paper assesses the impact of the two-week wait against a number of criteria.

The policy and practice of measuring patient experience.

The NHS outcomes framework makes clear that the provision of a 'good experience' of care for patients, alongside clinical effectiveness and safety, is a central goal for the NHS. Developing a comprehensive strategy for measuring patient experience requires a decision about what should be measured and how. This article discusses current policy direction and its implications for practice, and sets out the fundamentals of measuring patient experience.

The team focus on improving blood transfusion.

The current literature pertaining to associated morbidity and mortality with homologous blood transfusion in the surgical patient seems to be pointing only in one direction, which is we must start reducing our patients exposure to homologous blood and products. There appears to be ever mounting evidence of increases in infraction, stroke, transfusion related lung injury, infection, and death that authors are associating with transfusion. A number of authors are reporting success in reducing their patients' requirements for homologous transfusion simply by working as a team or what is known as a multidisciplinary approach and following set transfusion protocols and algorithms.

ICU fire evacuation preparedness in London: a cross-sectional study.

Background: Hospital fires present a sporadic but significant threat to patients and staff. This is especially so within an intensive care unit (ICU) setting, due to the complexity of moving acutely unwell patients reliant on invasive monitoring and organ support. Despite an average of 500 in-hospital fires reported to the UK department of health per annum, causing 65 injuries and 1-2 fatalities, the readiness of ICUs for urgent evacuation has not been assessed.