Rapid initiation of buprenorphine/naloxone, counseling, peer support and case management

Seeking treatment from the BAC/CRC (treatment as usual)

Opioid-use Disorder

Overdose

A mobile team will be led by a nurse practitioner (able to prescribe buprenorphine/naloxone in PA) and include a peer recovery specialist (PRS), and a case manager. The team will rapidly confirm opioid use disorder and risk of overdose, complete informed consent, and begin induction procedures for a "transitional" (one month) course of buprenorphine/naloxone treatment. During this time, the dedicated case manager and PRS will work with the participants to help them become engaged in existing medication assisted treatment programs

buprenorphine/naloxone

University of Pennsylvania

Rapid Initiation of Drug Treatment Engagement

Rapid Initiation of Buprenorphine/Naloxone to Optimize MAT Utilization in Philadelphia

Engagement in ongoing medication assisted treatment at 1-month post-enrollment

Number of participants who are still engaged in medication assisted treatment

Report of the number of fatal and non-fatal overdoses

Evaluation of the change in substance use between baseline and 6-month follow-up assessed by the drug and alcohol section of the Addiction Severity Index and urine drug screen

Cost evaluation of the mobile intervention using data collected with the DATCAP (Drug Abuse Treatment Cost Analysis Program) and NMOS (Non-Medical and Other Services)

Prevention Point Philadelphia

Public Health Management Corporation

Philadelphia Department of Public Health

Nebulization of ipratropium bromide/salbutamol sulfate (500 µg/2.5 mg) before the administration of the Glittre ADL-test

Nebulization of a placebo before the administration of the Glittre ADL-test

Chronic Obstructive Pulmonary Disease

Administration of a nebulized combination of bronchodilators before the administration of a functional test.

Bronchodilators

Administration of a nebulized placebo before the administration of a functional test

Placebos

Centre de recherche-Institut Universitaire de Cardiologie et Pneumologie de Québec

Glittre ADL-test: Responsiveness to Acute Bronchodilation in Chronic Obstructive Pulmonary Disease (COPD)

Glittre Activities of Daily Life-test: Responsiveness to Acute Bronchodilation in Chronic Obstructive Pulmonary Disease (COPD)

Time to complete 5 laps as fast as possible

Dyspnea and fatigue in the legs at the end of the Glittre ADL-test

Dyspnea and fatigue in the legs at the end of the 1-minute STST

Overall subjective experience of breathing discomfort after the Glittre ADL-test assessed with the Multidimensional Dyspnea Profile questionnaire

Overall subjective experience of breathing discomfort after the 1-minute STST assessed with the Multidimensional Dyspnea Profile questionnaire

Subduration (in seconds) in the Glittre ADL-test for each component, in each lap

Number of steps in the Glittre ADL-test for each walking section, in each lap

Vertical and horizontal acceleration and deceleration (m/s) in the Glittre ADL-test for each component, in each lap

Vertical and horizontal acceleration and deceleration (m/s) in the 1-minute STST for each repetition.

Change of IC between the beginning and end of the Glittre ADL-test completed after the administration of the placebo compared with the change of IC between the beginning and end of the Glittre test after the administration of the combination of bronchodilators

Change of IC between the beginning and end of the 1-minute STST completed after the administration of the placebo compared with the change of IC between the beginning and end of the 1-minute STST after the administration of the combination of bronchodilators

Minute ventilation (VE; L/min) during the two Glittre ADL-test compared to the VE during an incremental cardiopulmonary maximal exercise test on bike.

Minute ventilation (VE; L/min) during the two 1-minute STST compared to the VE during an incremental cardiopulmonary maximal exercise test on bike.

Ratio exchange rate (RER) the two Glittre ADL-tests compared to RER during an incremental cardiopulmonary maximal exercise test on bike.

Ratio exchange rate (RER) the two 1-minute STST compared to RER during an incremental cardiopulmonary maximal exercise test on bike.

VO2 and VCO2 during the two Glittre ADL-tests compared to those during an incremental cardiopulmonary maximal exercise test on bike.

VO2 and VCO2 during the two 1-minute STST compared to those during an incremental cardiopulmonary maximal exercise test on bike.

Peak Heart rate (HR; beats/minute) during the two Glittre ADL-test compared to peak heart rate during an incremental cardiopulmonary maximal exercise test on bike.

Peak Heart rate (HR; beats/minute) during the two 1-minute STST compared to peak heart rate during an incremental cardiopulmonary maximal exercise test on bike.

Peak respiratory rate (breaths/min) during the two Glittre ADL-test compared to peak heart rate during an incremental cardiopulmonary maximal exercise test on bike.

Peak respiratory rate (breaths/min) during the two 1-minute STST compared to peak heart rate during an incremental cardiopulmonary maximal exercise test on bike.

Number of full stand-up repetitions in the 1-Minute STST in both conditions (following the administration of the placebo and the bronchodilators)

Participant data sets on characterization (muscle and pulmonary function, cardiopulmonary exercise testing) and medical history collected during the recruitment interview will be made available to other researchers after the end of the study, upon request. Data will be obtained through electronical denominalized files.

Didier Saey

Researcher-Associate Professor

Laval University

Institut Universitaire de Cardiologie et Pneumologie de Québec

Participants receive one intervention (bronchodilation before performing a functional test) during the initial phase of the study and during the second phase of the study are evaluated in parallel after receiving a placebo or vice versa (random order)

Randomization to decide on which visit the participant will receive the placebo will be generated by a software and managed by the main investigator. Bronchodilators and the placebo will be put in an aerosol of same shape and color so the participants and outcomes assessor won't be able to tell which one is which.

To Evaluate the Effect of Therapy With IT MTX on the Disease Course of Patients With Progressive MS

12.5 mg of methotrexate diluted to a concentration of up to 4 mg/mL in 0.9 percent sodium chloride with 4 mg Dexamethasone via lumbar puncture needle.

Intrathecal methotrexate

Intrathecal Methotrexate for Progressive Multiple Sclerosis: An Open Label Single Arm Study

Disability will be measured every visit by the Multiple Sclerosis Functional Composite (MSFC)

adverse events will be followed until resolution. Serious adverse events will be reported to the IRB within 24 hours of noticed.

(Composite measure) We will measure new gd+ enhancing lesions, number of lesions, brain and upper spinal cord atrophy and cortical thickness and compare these measure between the time before and after treatment along. Overall each participant will undergo 5 scans , the first before treatment installation and then before each treatment . one scan will be done 3 month after the last treatment

(Composite measure) Cerebrospinal fluid (CSF) sample will be obtained and analyze for parameters including cell count and differential, protein and glucose concentration, oligoclonal bands, IgG concentration, cellular analysis by flow cytometry for CD3+, CD20+, CD14+ cell subsets, and measurement of several soluble mediators such as: CXCL13, CD23, light chains, TNFa, IFNg, IL-17, IL-2, IL-10, BDNF and Neurofilaments will be studied by ELISA

robin/atrofie

Rapid Initiation of Drug Treatment Engagement

Glittre ADL-test: Responsiveness to Acute Bronchodilation in Chronic Obstructive Pulmonary Disease (COPD)

Intrathecal Methotrexate for Progressive Multiple Sclerosis: An Open Label Single Arm Study

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