Substance use disorders: a comprehensive update of classification,epidemiology, neurobiology,clinical aspects,treatment and prevention

Substance use disorders (SUDs) are highly prevalent and exact a large toll on individuals’ health, well-being, and social functioning. Long-lasting changes in brain networks involved in reward, executive function, stress reactivity, mood, and self-awareness underlie the intense drive to consume substances and the inability to control this urge in a person who suffers from addiction (moderate or severe SUD). Biological (including genetics and developmental life stages) and social (including adverse childhood experiences) determinants of health are recognized factors that contribute to vulnerability for or resilience against developing a SUD. Consequently, prevention strategies that target social risk factors can improve outcomes and, when deployed in childhood and adolescence, can decrease the risk for these disorders. SUDs are treatable, and evidence of clinically significant benefit exists for medications (in opioid, nicotine and alcohol use disorders), behavioral therapies (in all SUDs), and neuromodulation (in nicotine use disorder). Treatment of SUDs should be considered within the context of a Chronic Care Model, with the intensity of intervention adjusted to the severity of the disorder and with the concomitant treatment of comorbid psychiatric and physical conditions. Involvement of health care providers in detection and management of SUDs, including referral of severe cases to specialized care, offers sustainable models of care that can be further expanded with the use of telehealth. Despite advances in our understanding and management of SUDs, individuals with these conditions continue to be stigmatized and, in some countries, incarcerated, highlighting the need to dismantle policies that perpetuate their criminalization and instead develop policies to ensure support and access to prevention and treatment.     

Evaluation of PAPNET-assisted cervical rescreening

Evaluation of PAPNET-assisted cervical rescreening
We have compared the results of targeted manual rescreening of 1211 randomly selected smears with the results of PAPNET-assisted rescreening of 1613 cervical smears, containing at least 6.3% low-grade squamous intraepithelial lesion (SIL). PAPNET diagnosis and the targeted rescreening diagnosis were compared with the initial report, issued on the corresponding smear. Reproducibility scores for inadequacy, presence of endocervical and endometrial cells, specific infections and squamous cell abnormalities were determined. The reproducibility scores for the diagnosis of inadequate smears and specific infections were lower with the PAPNET-assisted rescreening. The detection of squamous cell abnormalities was excellent for both methods (>0.95), with a higher detection rate for false-negative smears with the PAPNET testing system.     

Image analysis, neural networks, and the taxonomic impediment to biodiversity studies

The taxonomic impediment to biodiversity studies may be influenced radically by the application of new technology, in particular, desktop image analysers and neural networks. The former offer an opportunity to automate objective feature measurement processes, and the latter provide powerful pattern recognition and data analysis tools which are able to 'learn' patterns in multivariate data. The coupling of these technologies may provide a realistic opportunity for the automation of routine species identifications. The potential benefits and limitations of these technologies, along with the development of automated identification systems are reviewed.     

Progress of 1D protein structure prediction at last

Accuracy of predicting protein secondary structure and solvent accessibility from sequence information has been improved significantly by using information contained in multiple sequence alignments as input to a neural 'network system. For the Asilomar meeting, predictions for 13 proteins were generated automatically using the publicly available prediction method PHD. The results confirm the estimate of 72% three-state prediction accuracy. The fairly accurate predictions of secondary structure segments made the tool useful as a starting point for modeling of higher dimensional aspects of protein structure. © 1995 Wiley-Liss, Inc.     

A phylogenetic study of the free-living amoeba

Immunological distances were determined for four strains of the free-living amoeba classified as Amoeba proteus, two strains classified as Polychaos dubia and a single strain classified as Chaos carolinensis. The data show that the _ShP strain does not belong to the proteus group; that A. proteus is more closely related to C. carolinensis and is derived from Chaos as is the _ShP strain; that P. dubia and C. carolinensis are the more distantly related species and appear to be the first of the above to have diverged from a common ancestor; and that the amoebae have a long evolutionary history. The accuracy of the phylogenetic tree and the distance Wagner network was discussed. Since the amoebae may be polyphyletic in origin, the latter was assumed to be a more accurate representation of the immunological distance data.     

Cone penetrometer testing,hydropunch®, and borehole geophysics applications for environmental investigations

An effective groundwater monitoring system can be implemented by the combined utilization of cone penetrometer (CPT), HydroPunch^® sampling, and borehole geophysical methods. The combined techniques provide a cost‐effective method for the design of a groundwater monitoring system for geologists or hydrogeologists assessing a site. With the relatively high costs associated with determining groundwater quality for site assessments, coupled with regulatory agency compliance, these combined methods can provide an effective edge in an increasingly competitive environmental industry. CPT combined with HydroPunch sampling can delineate the horizontal and vertical extent and concentration of a contaminant plume, define the extent and thickness of a free product plume, define soil and aquifer characteristics, and aid in the proper selection of well location and screen placement. The use of borehole geophysics further enhances the interpretation provided from the CPT. The interpretation of borehole geophysics provides additional information about the deposition regime of the area of investigation and a more detailed investigation of the stratigraphy. The CPT and HydroPunch can be used in unconsolidated sediments, and HydroPunch sampling can be combined with a hollow‐stem auger system. Borehole geophysics can be run in almost any environment. CPT and borehole geophysics provide information on specific lithologic characteristics necessary to obtain a groundwater sample from vertically separated aquifers. The HydroPunch can obtain a discrete, chemically representative groundwater sample from the targeted aquifer. CPT and borehole geophysics can also be used to determine lithology and for correlation of equivalent stratas from one borehole or well to the next. Borehole geophysical interpretation also provides a means of determining not only the stratigraphy and lithology but also the aquifer parameters and the type of fluids in the aquifer. Hydrogeologic and geologic data obtained from using these three methods can be employed to maximize the cost‐effectiveness and design efficiency of a groundwater monitoring system. Proper location of wells and screened interval placements are determined by a coherent design process rather than by random chance. Two studies demonstrating the combined applications of CPT, HydroPunch, and borehole geophysics for the design and placement of groundwater monitoring wells are presented in the following discussion.