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© 2020 Wiley Periodicals, Inc.AIMS To characterize changes in patterns of adolescent substance use in Sweden between 1988 and 2011, and to assess whether sex and psychosomatic problems were associated with substance use and whether these associations changed over time. DESIGN Secondary analysis of repeated cross-sectional survey data. Survey data were collected eight times and analyzed as four cohorts (1988-91, 1995-98, 2002-05 and 2008-11). SETTING AND PARTICIPANTS The sample included all 15-16-year-olds in Värmland County, Sweden (n = 20 057). read more MEASUREMENTS Binary-coded substance use measures included life-time use of alcohol and tobacco, getting drunk and past school year use of inhalants. An eight-item scale was used to assess psychosomatic problems. FINDINGS A three-class model fitted the data best (i.e. non/low use, mainly alcohol use and polysubstance use). The patterns of substance use were different among cohorts; most notably, adolescents in the last cohort had lower odds of being included in the alcohol and polysubstance use claBACKGROUND & AIMS Opioid substitution treatment is used in many countries as an effective harm minimization strategy. There is a need for more information about patient safety incidents and resulting harm relating to this treatment. We aimed to characterise patient safety incidents involving opioid-substitution treatment with methadone or buprenorphine in community-based care by (i) identifying the sources and nature of harm, and (ii) describing and interpreting themes to identify priorities to focus future improvement work. DESIGN Mixed-methods study examining patient safety incident reports involving opioid substitution treatment with either methadone or buprenorphine in community-based care. SETTING Data submitted between 2005 and 2015 from the National Reporting and Learning System (NRLS), a national repository of patient safety incident reports from across England and Wales. PARTICIPANTS 2,284 reports were identified involving patients receiving community-based opioid substitution treatment. MEASUREMENTSised dispensing, and monitoring and communication. This article is protected by copyright. All rights reserved.Weak fluorescence (quantum yields less then 1% in cyclohexane) of phenothiazine ( PTZ ) impedes its further utilization. Besides, the nitro group (-NO 2 ) is a well-known fluorescence quencher. Interestingly, we obtained a highly fluorescent chromophore by combining these two moieties, forming 3-nitrophenothiazine ( PTZ-NO 2 ). For comparison, a series of PTZ derivatives with electron-withdrawing groups (EWG) (cyano -CN and formyl -CHO) and electron-donating group (EDG) (methoxy -OMe) group at C3-position were designed and synthesized. The EWGs exhibit intensified emission compared with parent PTZ or EDG derivatives. Computational approaches unveil that for PTZ and PTZ-OMe , the transitions are from HOMOs dominated by π orbitals to LUMOs of sulphur nonbonding-mixed π* orbitals, and hence are partially forbidden. On the contrary, the EWGs lower the energy level of lone pair electrons on the sulphur atom, suppressing the mixing of nonbonding orbital with π* in LUMO such that the allowed ππ* transition becomes dominant. This work thus demonstrates a judicious chemical design to fine-tune the transition character in PTZ analogues, making PTZ-NO 2 attains unity emission quantum yield in nonpolar solvents. © 2020 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.Prenatal alcohol exposure is one of the most important causes of preventable cognitive impairment in the world. The developing neurological system is exquisitely sensitive to harm from alcohol and there is now also substantial evidence that alcohol-related harm can extend beyond the individual person, leading to epigenetic changes and intergenerational vulnerability and disadvantage. There is no known safe level or timing of drinking for pregnant or lactating women and binge drinking (> four drinks within 2 hours for women) is the most harmful. Alcohol-exposure increases the risk of congenital problems, including Fetal Alcohol Spectrum Disorder (FASD) and its most severe form, Fetal Alcohol Syndrome (FAS). The impact of FASD and FAS is enduring and life-long with no current treatment or cure. Emerging therapeutic options may mitigate the worst impact of alcohol exposure but significant knowledge gaps remain. This review discusses the history, epidemiology and clinical presentations of prenatal alcohol exposure, focusing on FASD and FAS, and the impact of evidence on future research, practice and policy directions. This article is protected by copyright. All rights reserved.A straightforward multicomponent decarboxylative cross coupling of redox-active esters (N-hydroxyphthalimide ester), sodium dithionite, and electrophiles was established to construct sterically bulky sulfones. The inorganic salt sodium dithionite not only served as the sulfur dioxide source, but also acted as an efficient radical initiator for the decarboxylation. Notably, diverse naturally abundant carboxylic acids and artificially prepared carboxyl-containing drugs with multiple heteroatoms and sensitive functional groups successfully underwent this decarboxylative sulfonylation to provide sterically bulky tertiary sulfones. Mechanistic studies further demonstrated that decarboxylation was the rate-determining step and occurred via a single-electron transfer (SET) process with the assistance of sodium dithionite. © 2020 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.OBJECTIVES Increased nuchal translucency (NT) is an antenatal marker of aneuploidy or malformation that frequently leads to pregnancy termination. This study assessed the long-term prognosis of infants with isolated, increased NT. METHODS We prospectively followed 490 infants with an NT thickness above the 95th percentile during the first trimester, but with a normal karyotype and no major anomalies. At 2 years of corrected age, they were compared to controls matched for birthweight, Apgar score, birthplace, mothers' parity and gestational age. Their developmental quotient (DQ), postural, language, coordination, sociability and global scores were assessed by the Brunet-Lézine test. RESULTS Results were available for 203 infants in the increased NT group and 208 in the control group (84%). The mean DQ was significantly lower in the NT group than in the controls (108.6 ±9.7 versus 112.8 ±8.3) (p less then 0.0001), but within the normal range. Only one case had a DQ below 70. The results remained significant for an NT threshold above the 99th percentile and when the data were adjusted for NT thickness, sex and mothers' education.
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