Drug-related stigma among people who inject drugs – development and validation of the drug use stigma scale (DUSS)

by Robin A. Pollini, Catherine E. Paquette, Brandon Irvin, Jennifer L. Syvertsen, Christa L. Lilly

Drug use is a highly stigmatized behavior, and drug-related stigma is a key driver of behavioral risk, lower health care utilization, and associated adverse health outcomes among people who inject drugs (PWID). While instruments exist for measuring drug-related stigma, their applicability to community-based PWID across multiple stigma types (enacted, anticipated, internalized) and settings (health care, society, family) is limited, as most were developed using treatment-based samples and all were developed in urban populations. This study sought to develop a Drug Use Stigma Scale (DUSS) that addresses these limitations. We developed an initial list of 39 items based on literature review and qualitative interviews (N = 27) and three focus groups (N = 28) with PWID recruited from syringe services programs and via peer referral in two predominantly rural West Virginia counties. The scale items were administered in a survey to 336 PWID recruited from the same two counties divided into development and validation samples. Responses to the 39-item scale went through a multidimensional refinement process, including examination of internal consistency, Confirmatory Factor Analysis (CFA), and a three-factor CFA based on stigma setting. Next, a set of final measurement CFAs were conducted. Finally, the resulting scale was examined for criterion-related concurrent validation. The final DUSS consisted of 16 items with excellent fit statistics for the development sample: SRMR: 0.03, RMSEA: 0.09, GFI: 0.92, CFI: 0.96, NFI: 0.94. Fit attenuated but remained satisfactory for the validation sample. DUSS scores were significantly associated with increased odds of not seeking healthcare when needed (OR: 1.47, p = 0.001; OR: 1.61, p 

Effect of foliar application of potassium on wheat tolerance to salt stress

by Fiza Noor, Humera Nawaz, Ameer Khan, Muhammad Yousaf Shani, Muhammad Azmat, Syed Mohsin Abbas, Iqra Arshad, Robina Aziz, Muhammad Saleem, Francesco De Mastro, Muhammad Yasin Ashraf, Gennaro Brunetti, Claudio Cocozza

Salinity stress severely hampers wheat productivity by impairing growth, photosynthesis, and metabolic balance. Potassium nutrition, however, can mitigate these effects by supporting physiological and biochemical stability. This study assessed the impact of foliar potassium application (0, 200 and 400 ppm) on two wheat cultivars, Galaxy-13 and Uqab-2000, exposed to normal (0 mM NaCl) and saline conditions (100 and 150 mM NaCl, respectively). Salinity significantly reduced root and shoot growth, biomass, chlorophyll content, photosynthetic rate, and stomatal conductance. Potassium supplementation, particularly at 400 ppm, alleviated these reductions, with Galaxy-13 showing a 32.01% increase in shoot length and a 45.11% increase in shoot dry weight compared to Uqab-2000. Biochemical analyses revealed that Galaxy-13 sustained higher nitrate and nitrite reductase activities (6.23 and 3.63 μmol NO₂ g^-1 FW h^-1, respectively) and total soluble proteins (10.1 mg g^-1 FW), whereas Uqab-2000 accumulated more soluble sugars and free amino acids under stress (9.8 and 19.8 mg g^-1 FW, respectively). Oxidative stress indicators (malondialdehyde and hydrogen peroxide) rose under salinity, but potassium reduced their levels, with Galaxy-13 exhibiting stronger antioxidant regulation. Nutrient profiling further demonstrated that Galaxy-13 maintained higher N, P, and K contents and minimized Na uptake, unlike Uqab-2000, which showed severe ionic imbalance. Multivariate analyses (PCA, heatmap, and correlation) highlighted strong positive associations of potassium, especially K400, with biomass accumulation, photosynthetic efficiency, and nutrient homeostasis. The findings establish that Galaxy-13 possesses superior salinity tolerance and responds more favorably to potassium nutrition. This study provides novel evidence that cultivar-specific potassium management can enhance wheat resilience in saline environments, offering a practical strategy for sustaining yield under stress.

Homogenized and stigmatized: A discourse analysis of Asian sub-ethnic medical school aspirants

by Salman H. Choudhry, Keegan D’Mello, George Kim, Robin Mackin, Amrit Kirpalani

The study examines the influence of Asian sub-ethnic identity on the experiences of pre-medical students in the United States and Canada, aiming to understand how early interactions with the medical education system shape their pursuit of medicine. The researchers analyzed 132 discussion threads from popular online premedical school forums between June 2018 and 2023. The Asian Critical Theory framework guided the analysis along with cyclical inductive coding. Two major themes emerged: the homogenization of diverse Asian sub-ethnicities and external pressure related to sociocultural values. Terms like “over-represented minorities” contributed to the perception of Asians as a monolithic group, while expressions such as “Asian Parents” highlighted unique familial expectations. Non-Asian users often dismissed these barriers, reinforcing the model minority myth. The study emphasizes the negative consequences of framing Asians as a homogenous group in medical school admissions policies, perpetuating stereotypes, and overlooking the diversity within Asian sub-ethnic communities. The term “overrepresented” is critiqued for its role in homogenizing Asian identities and undermining the complexity of their experiences. These findings highlight the need for greater recognition of the nuanced challenges faced by Asian sub-ethnic medical trainees and the importance of dismantling stereotypes in medical education.