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What makes social movements successfully deter entry in contested industries? We develop a contingency framework explaining how movements' success depends on the internal fit between their private and public politics strategies with the tactics of mass and elite mobilization. We also highlight the importance of how these tactics fit with external conditions like the cognitive legitimacy of the industry and industry countermobilization. When movements rely on a private politics strategy to condemn an industry in the eyes of the public, social movement mass will be decisive. Alternatively, when movements use a public politics strategy to push for regulatory intervention, mobilization of elites is crucial. We develop our understanding of external contingency factors by exploring how cognitive legitimacy residuals from local ancestral populations affect both mass-driven private politics and elite-driven public politics, and how national-level industry countermobilization efforts affect elite-driven public politics strategies. We test these ideas in a historical study of the Scottish whisky distilling industry during the rise of temperance movements (1823–1921). We contribute to the social movements literature by showing how movements' entry deterrence in contested industries depends on the internal fit between their strategies and mobilization tactics, as well as on their engagement with external contingencies. [ABSTRACT FROM AUTHOR]

Background: Prior research has shown that using lifetime abstainers as the reference group to examine the association between alcohol use and health‐related consequences has several disadvantages. The aim of the present study was to examine the consistency of self‐reported lifetime abstention and never‐binge drinking, respectively, using national, longitudinal data collected in 2019 and 2020. Additionally, the prevalence of alcohol‐related morbidity among lifetime abstainers was examined by linking survey data to alcohol‐related morbidity data in a national patient register. Methods: Data come from the Danish Health and Wellbeing Survey in 2019 and from a follow‐up survey of the same individuals in 2020. A random sample of 14,000 individuals aged 15 years or older was drawn in mid‐August 2019. Data were collected between September and December 2019. All those who were invited to the survey in 2019 and who were still alive and living in Denmark were invited to participate in a follow‐up survey in 2020. Data in both waves were collected by self‐administered questionnaires. Both questionnaires included the standard questions on alcohol consumption from the European Health Interview Survey model questionnaire. Information on alcohol‐related morbidity was obtained from the Danish National Patient Register. Results: In all, 5000 individuals completed the questionnaire in both waves. Approximately half (44.4%) of the individuals who declared that they were lifetime abstainers in 2020 (n = 252) had reported in 2019 to have drunk at some point in their life. Moreover, 39.7% contradicted earlier reported binge drinking. Furthermore, 2.4% of the respondents who defined themselves as lifetime abstainers in 2020 had earlier been diagnosed with an alcohol‐related health condition. Conclusion: The present research reaffirms previous studies which have found self‐reported lifetime abstainers to be unreliable as a consistent reference group. Additionally, the results indicated that a non‐negligible proportion of lifetime abstainers had been diagnosed with an alcohol‐related health condition. [ABSTRACT FROM AUTHOR]

Background: Alcohol use disorder (AUD) is a chronic, relapsing disease, highly comorbid with anxiety and depression. The bed nucleus of the stria terminalis (BNST) and Crh+ neurons in this region play a key role in chronic ethanol‐induced increases in volitional intake, hypothesized to be driven by emergent negative affective behaviors. Excitatory N‐methyl‐d‐aspartate receptors (NMDARs) are a major target of ethanol, and chronic ethanol exposure has been shown to regulate NMDAR function and expression. Specifically, GluN2D subunit‐containing NMDARs have emerged as a target of interest due to their limited distribution and potential roles in affective behavior. Methods: Male and female mice underwent a home cage chronic drinking forced abstinence model (CDFA) to assess the impact of 1 day or 2 weeks of ethanol abstinence on BNST synaptic transmission and BNST Grin gene expression. Constitutive and conditional BNST GluN2D knockout mice were used to assess the impact of GluN2D deletion on continuous access ethanol intake as well as negative affect behaviors, using the open field, elevated zero maze, and forced swim tasks. Results: We report here that excitatory transmission undergoes time‐dependent upregulation in BNST Crh+ cells. Further, knockdown of dorsal BNST (dBNST) GluN2D expression significantly decreases ethanol intake in female, but not male, mice. While BNST Grin2b expression was significantly increased in protracted abstinence following CDFA, no differences in Grin2d expression were observed in the dBNST or dBNST Crh+ neurons. Finally, we find that deletion of GluN2D fails to alter negative affect in ethanol‐naïve female mice. Conclusions: These data suggest a role for BNST GluN2D‐containing NMDARs in ethanol drinking but not ethanol abstinence, highlighting sex differences and behavioral specificity. Overall, these data further suggest roles for BNST synaptic signaling in volitional ethanol intake that are partially independent of actions on affective behavior. [ABSTRACT FROM AUTHOR]

Background: Patients with alcohol use disorder (AUD) tend to selectively approach alcohol cues in the environment, demonstrating an alcohol‐approach bias. Alcohol‐approach‐bias modification (Alcohol‐ApBM) effectively increases abstinence rates in patients with AUD when added to abstinence‐focused treatment, but the evidence for its proposed working mechanism (reduction of the alcohol‐approach bias) is limited. Moreover, not all patients benefit from Alcohol‐ApBM, and previous research did not identify reliable pretreatment predictors of Alcohol‐ApBM effectiveness. Therefore, the current study focused on learning processes during the Alcohol‐ApBM training itself. Specifically, we examined whether changes in approach‐avoidance tendencies over the course of Alcohol‐ApBM would predict abstinence after inpatient treatment. Methods: The training data of 543 AUD patients in Germany (70% male, M = 47.96, SD = 9.08), receiving Alcohol‐ApBM training during inpatient treatment, were used to examine whether various aspects of learning during training predicted abstinence 1 year after treatment discharge, both separately and in interaction with potential sociodemographic and clinical moderators of Alcohol‐ApBM effectiveness. Results: Overall, successful learning across six Alcohol‐ApBM training sessions was observed; that is, the approach tendency toward alcoholic stimuli was reduced over time. However, none of the examined learning parameters were predictive of abstinence, neither separately nor in combination with clinical or sociodemographic variables. Conclusions: Previous studies have shown that Alcohol‐ApBM is an effective add‐on to abstinence‐focused treatment for AUD, and this study showed that learning took place during Alcohol‐ApBM training. However, specific learning parameters during training did not predict abstinence 1 year after treatment discharge. Therefore, we cannot specify which patients are most likely to benefit from ApBM with regard to abstinence after 1 year. [ABSTRACT FROM AUTHOR]

The article focuses on Edgar Allan Poe's "The Black Cat" as a reflection on recovery and the complexities of addiction, presenting the narrator's confession as a means of personal accountability. Topics include the interpretation of Poe's work as a critique of temperance literature, the portrayal of the narrator as an unstable yet insightful figure, and the blending of gothic and didactic elements to highlight spiritual recovery rather than sensationalism.

Purpose: We explored factors predicting repeated or hazardous alcohol use among autistic and non-autistic U.S. youth ages 16 to 20 years. Methods: Autistic (n = 94) and non-autistic (n = 92) youth completed an online survey. By design, half of each group reported past-year alcohol use. We compared drinking patterns for autistic and non-autistic youth, and within each group between abstinent or infrequent drinkers (0–1 drinking episodes in past year) versus those who drank 2 + times in past year. Results: Autistic (vs. non-autistic) youth who drank did so less frequently and consumed fewer drinks per occasion. However, 15% of autistic youth who drank in the past year reported heavy episodic drinking and 9.3% screened positive for AUDIT-C hazardous drinking. For autistic youth only, a diagnosis of depression, bullying or exclusion histories were positively associated with drinking 2 + times in the past year. Autistic youth who put more effort into masking autistic traits were less likely to report drinking 2 + times in the past year. As compared to non-autistic youth, autistic participants were less likely to drink for social reasons, to conform, or to enhance experiences, but drank to cope at similar rates. Conclusion: Repeated and hazardous underage alcohol occur among autistic youth. Targeted prevention programs designed to address the specific drinking profiles of autistic youth are needed. [ABSTRACT FROM AUTHOR]

Abstract: Background: Both alcohol and tobacco consumption during pregnancy present significant health risks to the unborn child, including developmental disorders and cognitive deficits. By abstinence from alcohol and tobacco during pregnancy these risks can be completely avoided. Aim: The article provides an overview of prevention and intervention methods, such as education, brief interventions, and treatment and provision of support. It also highlights the importance of systematic screening in health care facilities to identify pregnant women at an early stage and to facilitate access to support services. Conclusions: However, serious gaps in the German care system hinder adequate guideline-based prevention and treatment. Lastly, the article underscores the responsibility of society and health policy to create an environment where abstaining from alcohol and tobacco is the norm, thereby promoting the choice of a smoke-free and alcohol-free life in pregnancy and beyond. [ABSTRACT FROM AUTHOR]

Abstract:Background: Smoking during pregnancy poses a major health risk to pregnant smokers and their children. Pregnancy could be an opportune moment for cessation. Yet many smokers do not quit during pregnancy. This study aims to explore potential influencing factors for successful smoking cessation in pregnancy. Methods: Cross-sectional data was collected in an anonymous online survey (n=358). Data of n=60 women between the 24th week of pregnancy and four months postpartum was analysed. Variables showing significant differences between women who successfully quit smoking during pregnancy ("ex-smokers", n=40) and women who were still smoking at the time of the survey ("smokers", n=20) were included in a logistic regression to identify potentially important influencing factors. Results: Ex-smokers showed higher education levels, were employed, had a planned pregnancy, abstained from alcohol during pregnancy, and scored lower on the Fagerström test for cigarette dependence. They showed greater satisfaction with life and higher scores on the personality trait "agreeableness". In the regression model, a planned pregnancy, alcohol abstinence and higher agreeableness scores increased the odds of being an ex-smoker. Conclusions: Planned pregnancies could be particularly suitable for smoking cessation. Alcohol should be considered, as abstinence could contribute to smoking cessation. A personality characterised by high agreeableness could be beneficial at least in addition to other factors. [ABSTRACT FROM AUTHOR]

Background and aims: Alcohol consumption has decreased in England in recent decades, while alcohol‐specific death rates have remained relatively stable. Age–period–cohort (APC) models offer the potential for understanding these paradoxical trends. This study aimed to use an APC model approach to measure long‐term trends in alcohol abstention and consumption in England from 2001 to 2019. Design, setting and participants: The study used grouped and proxy‐variable APC models of repeat cross‐sectional survey data, set in England (2001–19). Participants were residents in England aged 13 years or over who took part in the Health Survey for England. Measurements: Outcome variables were alcohol abstention and consumption in units. We created nine age groups (13–15, 16–17, 18–24, 25–34, until 65–74 and 75+, reference 45–54 years), four periods (2001–04, 2005–09, 2010–14 to 2015–19, reference 2005–09) and 18 5‐year birth cohorts (1915–19 to 2000–04, reference 1960–64). We proxied age effects (systolic and diastolic blood pressure), period effects (alcohol affordability, internet usage and household alcohol expenditure) and birth cohort effects (prevalence of smoking and prevalence of overweight). Findings The odds of abstaining were considerably larger at young ages, 13–15 years [odds ratio (OR) = 5.38; 95% confidence interval (CI) = 4.50–6.43], were lowest during the first period, 2001–04 (OR = 0.83; 95% CI = 0.79–0.86) and had a U‐shaped pattern by birth cohort. For units of alcohol, the incidence rate ratio (IRR) increased until age 18–24 years (IRR = 1.41, 95% CI = 1.34–1.48) and decreased afterwards, were highest during the first period, 2001–04 (IRR = 1.07; 95% CI = 1.05–1.08) and showed an inverted J‐shape by birth cohort. Our proxy variable approach revealed that using blood pressure measures, alcohol affordability and prevalence of overweight as proxies resulted in APC effects that differed from our base‐case model. However, internet usage, household expenditure on alcohol and smoking prevalence resulted in APC effects similar to our base‐case model. Conclusions: The discrepancy between decreasing alcohol consumption and increasing alcohol‐related deaths observed in England from 2001 to 2019 may, in part, be explained by the halt in abstention trends since 2010 and a slight consumption decline since 2001. [ABSTRACT FROM AUTHOR]

Introduction Smokeless tobacco (SLT) use in low- and middle-income countries has adverse health consequences. We hypothesize that it is feasible to test an intervention of mobile phone messages and face-to-face counseling sessions for SLT cessation in India. Aims and Methods We conducted an exploratory, individual parallel two group, randomized controlled trial (RCT), with baseline and end-point (3 months from randomization) assessments in urban primary health centers in Odisha, India. A total of 250 current (i.e. users in the last 3 months) SLT users or dual users (ie, smokers and SLT users) were recruited to the trial (125 in each group). Participants were randomized to either routine care, face-to-face counseling, and reminder mobile messages or routine care only. The primary outcomes were to assess the feasibility of running a full RCT including recruitment, compliance, and retention. Results A total of seven (77.8%) out of nine primary care centers took part in the trial. Out of the 315 SLT users invited to participate, 250 provided consent and were randomized [79.4% (95% CI: 74.5, 83.7)]. Out of the 250 randomized SLT users, 238 [95% (95% CI: 91.8, 97.5)] were followed up at 3 months (117 in the intervention group and 121 in the control group). Of the participants in the intervention group, 74 (63.8%) reported that they received the mobile messages. Conclusions This exploratory trial demonstrated the feasibility of delivering and evaluating an intervention of mobile phone messages and face-to-face counseling for SLT users in Indian primary care in a full randomized trial Implications This study found that combining mobile messages with face-to-face counseling for smokeless tobacco users visiting primary health care settings in India is feasible in terms of recruitment of users, compliance with the intervention, and retention of study participants within the trial. The biochemically verified smokeless tobacco abstinence rate was higher in the intervention group compared with the control group. There was poor agreement between self-reported tobacco cessation and the measured salivary cotinine in smokeless tobacco users. The findings support the feasibility and acceptability of the intervention signaling the need for a larger clinical trial to test the effectiveness of the intervention. [ABSTRACT FROM AUTHOR]

In British society, historically it was assumed that a woman's place was principally in the domestic sphere. In the nineteenth century, in a changing social, political and economic context, British women found opportunities to take on roles outside the home. This paper explores the way nineteenth-century British Baptist women – slowly and over time – found ways to become more involved in denominational life, which culminated in their membership of the Baptist Union Council in 1911. [ABSTRACT FROM AUTHOR]

Most traditional marketers avoid using mindful consumption (MC) despite fast-rising consumer mindfulness, MC-advocation by trade magazines, and the success of tech-savvy, MC-oriented start-ups. We identify two gaps for this divergence—varying conceptions of MC and lack of a valid MC scale. Conception clarity and a valid MC scale are important for advancing managerial practice. We first integrate current, varying conceptions to identify three MC dimensions: Awareness, Caring, and Temperance. These signify awareness of self, society, and the environment (SSE), caring for the effects of consumption on SSE, and temperance in consumption. We then develop, refine, and validate the MC scale using 10 studies. We also assess the MC nomological network and scale robustness across genders, ages, occupations, and incomes. Marketers can use MC scale for product innovation, differentiation, and diversification. Policymakers can use this to nudge people towards MC-oriented sustainable behavior. This research opens multiple avenues for future research. [ABSTRACT FROM AUTHOR]

Introduction Methods Results Discussion and Conclusions Phosphatidylethanol (PEth) is a specific and persisting marker of ethanol (alcohol) consumption. Early success of medically necessary abstinence can be assessed by monitoring PEth disappearance at a biologically plausible rate. This requires an understanding of PEth elimination, its variability and its determinants. To achieve this, we characterised PEth elimination in drinkers who voluntarily abstained. We aimed to derive a nomogram from the data to assist practitioners in recognising abstinence.Twenty‐nine usual drinkers who were prepared to abstain from alcohol consumption for 4 weeks were recruited. Erythrocyte PEth was measured weekly. A population pharmacokinetic model for PEth was developed, describing the time‐course of PEth elimination. Estimates were derived for population average, inter‐individual variability in PEth half‐life and any covariate influences. These estimates informed a nomogram of PEth elimination that incorporated a boundary separating continued abstinence from resumed drinking. The nomogram was tested to identify drinking events among participants.The model estimated a population average elimination rate constant (k) of 0.088 day−1, corresponding to a half‐life of 7.9 days with a residual coefficient of variation of 8.5%. Elimination was first order and no covariate influences were identified. The nomogram was internally assessed as predictively accurate for 21 successfully abstinent participants and in detecting alcohol consumption in 2 further participants, using a 99.9% prediction interval.The value of PEth in distinguishing alcohol abstinence from consumption is enhanced by using a nomogram to confirm abstinence within weeks of its medically necessary imposition. Further work will establish the value of this approach in clinical practice. [ABSTRACT FROM AUTHOR]

Background Aims Methods Results Conclusion So what? Pharmacist‐led smoking cessation programs in pre‐admission clinics (PAC) have shown to increase quit attempts and achieve abstinence by the day of surgery (DOS).To evaluate the feasibility of Pharmacist E‐script Transcription Service (PETS) initiated nicotine replacement therapy (NRT) in PAC, including smoking cessation on DOS.A single centre, pre and post‐intervention pilot study conducted at an Australian public hospital PAC. In a two‐month intervention period, PAC nursing staff invited smokers (≥1 cigarette/day) to see a smoking cessation PET pharmacist. Pharmacist‐initiated NRT and Quitline© referrals were offered. Cessation outcomes were compared with the preceding two‐month control period. Primary outcome: feasibility of intervention. Secondary outcomes: DOS smoking abstinence rates and three‐months post‐surgery.PAC nurses identified 112 smokers over 4 months; 53 during pre‐intervention period, and 59 during intervention period. Twenty‐two intervention patients (37%) accepted seeing the pharmacist, with 16 subsequent Quitline© referrals (73%) and 11 NRT prescriptions (50%) written. The median nursing smoking status documentation time increased in the intervention period (1 min vs. 4, p < .001). The intervention did not impact pharmacist's workload. Verified abstinence increased from 8.5% (4/47) pre‐intervention to 9.4% (5/53) post‐intervention, p =1.00. Relapse rates in the intervention period increased (20% vs. 50%) at three‐months post‐surgery.A PETS‐initiated NRT program in PAC is feasible and increased preoperative use of NRT and Quitline© with minimal impact on smoking cessation.This study has highlighted the importance of implementing a multidisciplinary smoking cessation program in PAC however, larger studies are needed to determine the true impact of the program on smoking cessations. [ABSTRACT FROM AUTHOR]

Introduction: Alcohol consumption has an impact on the frailty, but current research in China lacks a detailed classification of alcohol use. This study aimed to explore the relationship between different drinking patterns and frailty in older adults. Methodology: The data came from the 2018 Chinese Longitudinal Healthy Longevity Survey (CLHLS) study, which included older adults (aged ≧ 60). Their demographic data, drinking status, and frailty index were collected in CLHLS. Through logistic regression models to analyze the correlation between alcohol consumption and frailty. Results: A total of 14,931 participants were included in the analysis. The prevalence of frailty was 29.1%, 35.2%, and 14.9% among risk-free, past risky, and now risky drinkers, respectively. After adjusting for covariates, past risky drinking was a risk factor for frailty (p =.003). Discussion: High-risk alcohol consumption is positively correlated with frailty. Prevention and reduction of risky drinking in older adults may help protect them from developing frailty. [ABSTRACT FROM AUTHOR]

Background: High prevalence of hypertension (HTN) is of major concern among the middle-aged population of Kerala. Understudied in the context of HTN is oxidative damage to DNA, which is caused by free radical assaults. The modern lifestyle associated with an unhealthy diet and lack of exercise plays a key role in oxidative stress induction. Aims and Objectives: The objective of this study was to assess the significance of oxidative stress and the effectiveness of DNA repair mechanisms in young hypertensives along with how it correlates with aspects of lifestyle. Materials and Methods: This prospective case-control study enrolled clinically proven hypertensive patients referred from the outpatient department of Hridayalaya, Institute of Preventive Cardiology, Thiruvananthapuram, to Genetika, a research center for Cytogenetic Studies in South Kerala. Hypertensive patients (n=180) within the age group of 18-39 were compared with matched healthy controls (n=140). Associated lifestyle factors were determined. Results: In comparison to controls, cases had noticeably higher mean levels of malondialdehyde (MDA) and mean break per cell (P<0.05). There was a difference that was statistically significant (P<0.05) between the patients and controls in terms of diet, exercise, physical activity, obesity, mental stress, alcohol, and tobacco use. On comparing MDA and mean break per cell values with lifestyle factors, a statistically significant difference was detected (P<0.05). Observed a significant positive correlation of break per cell value with MDA (P<0.05). Conclusion: The current study demonstrated increased DNA damage and decreased DNA repair efficiency in young hypertensive and was strongly associated with lifestyle factors. Appropriate measures such as regular BP checkups, regular exercises, and abstinence from alcohol and smoking are to be taken for the prevention and control of HTN. [ABSTRACT FROM AUTHOR]

South Africa has one of the highest prevalence rates globally for fetal alcohol spectrum disorders. Despite this, few interventions are routinely available for countering the adverse effects of perinatal drinking. The current study used the ADAPT-ITT framework to guide the development of a behavioral intervention with remote alcohol use monitoring and provision of financial incentives contingent on alcohol abstinence for people who are pregnant and postpartum. The study aims to maximize the intervention's relevance, acceptance, and effectiveness in reducing alcohol use during pregnancy and lactation, ultimately improving maternal and infant health outcomes in South Africa. Thirty-two in-depth interviews with people who were pregnant and 16 key-informant interviews with clinic and community members were conducted to help inform the intervention. The adapted intervention was pretested with 20 people who were pregnant or breastfeeding, and additional feedback was obtained from the community collaborative board. While there was widespread support for the intervention elements, some concerns were raised, including perceived high street value of a monitoring device, access to mobile phones to use such a device, frequency of monitoring, cheating when using a remote monitoring device, devices being lost or stolen, and the sustainability of long-term monitoring. The adapted intervention combines alcohol monitoring-based contingency management with text-based health promotion and information on where to access services tailored to maternal populations ready for testing in feasibility and efficacy trials. [ABSTRACT FROM AUTHOR]

• Low dose ondansetron (AD04) notably decreased heavy drinking days among individuals with alcohol use disorder and a specific genetic profile. • This genotypic profile is in the serotonin transporter and serotonin-3AB receptor complex. • AD04′s adverse events match those of a placebo. • Combining AD04 with psychological intervention will improve access to and acceptance of modern AUD treatment. • These findings are an important advance in the field of precision medicine. Alcohol use disorder (AUD) is among the leading causes of morbidity and mortality worldwide, and over 95 million people live with alcohol dependence globally. The estimated heritability of AUD is 50–60 %, and multiple genes are thought to contribute to various endophenotypes of the disease. Previous clinical trials support a precision medicine approach using ondansetron (AD04, a 5-HT3 antagonist) by segregating AUD populations by the bio-genetic endophenotype of specific serotonergic genotypes and the bio-psychosocial endophenotype of the severity of drinking or both. By targeting the modulation of biogenetic signaling within the biopsychosocial context of AUD, low-dose AD04 holds promise in reducing alcohol consumption among affected individuals while minimizing adverse effects. This was a phase III, 6-month, 25-site, randomized, placebo-controlled clinical trial using AD04 to treat DSM-V–categorized AUD individuals who were pre-stratified into the endophenotypes of heavy or very heavy drinking individuals and possessed a pre-defined profile of genetic variants related to the serotonin transporter and serotonin-3AB receptor. Participants (N = 303) presented moderate to severe AUD, >80 % were men, mostly in their fifties, and >95 % were of European descent. Low-dose AD04 (approx. 033 mg twice daily) or a matching placebo was administered twice daily for 6 months. Brief Behavioral Compliance Enhancement Treatment (BBCET [ 53 ]) was administered every two weeks to enhance medication compliance and clinic attendance. There was a significant reduction in the monthly percentage of heavy drinking days, PHDD (-46·7 % (2·7 %), 95 %CI: -52·1 % to -41·2 % vs. -38·1 % (2·9 %), 95 %CI: -43·8 % to -32·5 %, respectively; LS mean difference=-8·5 %; p = 0.03) among AD04-treated vs. placebo-receiving heavy drinking individuals at month 6. Heavy drinking individuals were also less likely to be diagnosed with AUD [Month 1: -32·0 % (2·8 %), 95 %CI: -37·5 % to -26·5 % vs. -23·2 % (2·9 %), 95 %CI: -28·9 to -17·5 %; LS mean difference= -8·8 %; p = 0·026)], and improved on the WHO quality of life BREF scale with a significant effect for at least a 1-level downward shift (OR = 3.4; 95 % CI: 1·03–11·45, p = 0·044). Importantly, heavy drinking individuals, as distinct from very heavy drinking individuals, were the bio-psychosocial endophenotype more predictive of therapeutic response to AD04. AD04 had an exceptional safety and tolerability profile, like the placebo's. In this Phase 3 clinical trial, AD04 was shown to be a promising treatment for currently drinking heavy drinking individuals with AUD who also possess a specific genotypic profile in the serotonin transporter and serotonin-3AB receptor complex. Using AD04 to reduce the harm of AUD in heavy drinking individuals who are currently drinking, without the necessity of abstinence or detoxification from alcohol use, is an important advance in the field of precision medicine. AD04's adverse events profile, which was like placebo, should enhance accessibility and acceptance of modern medical treatment for AUD by lowering the incorrect but commonly perceived stigma of personal failure. [Display omitted] [ABSTRACT FROM AUTHOR]

Introduction Recruiting special populations to smoking cessation trials is challenging and approaches beyond in-clinic recruitment may be beneficial. This secondary analysis of data from a smoking cessation RCT for individuals with a history of cervical cancer or cervical intraepithelial neoplasia (CIN) explored differences associated with in-clinic vs. online recruitment. Aims and Methods Participants were recruited from clinics within a university-based NCI-designated cancer center (n  = 87) and online nationally via Facebook (n  = 115). Baseline measures included sociodemographics, smoking history, and cancer or CIN history. Study retention and smoking abstinence were assessed 12 months post-baseline. Group differences in baseline characteristics were evaluated. Retention and abstinence were evaluated while controlling for group differences and predictors. Results Participants recruited online (vs. in-clinic) had higher educational attainment (p  = .01) and health literacy (p  = .003). They were more likely to have CIN versus cancer, to be further from the time of diagnosis, and to have completed active treatment (p values < .001). While controlling for these group differences and independent predictors, retention was higher among participants recruited online (log-likelihood χ2(1) = 11.41, p  < .001). There were no recruitment differences in self-reported (p  = .90) or biochemically confirmed smoking abstinence (p  = .18). Conclusions Compared to individuals recruited in-person, individuals recruited online were more educated, had higher health literacy, and presented with a different clinical profile (ie, more likely to have CIN vs. cancer and to have completed active treatment). There were few differences in participant characteristics between recruitment approaches, and no differences on any smoking-related variables. Online recruitment has the potential to improve enrollment of cancer survivors in smoking cessation trials. Implications People with a history of CIN or cervical cancer recruited to a smoking cessation RCT online (vs. in-clinic) were more likely to have a diagnosis of CIN versus cancer and were more educated and health literate. Participants recruited online were more likely to be retained in the study and there were no differences in smoking abstinence rates at 12 months. Incorporating online recruitment increased the reach of tobacco treatment efforts to a larger and more diverse sample. This could reduce the burden of tobacco-related disease, improve CIN and cancer treatment outcomes, and reduce secondary malignancies and morbidity among this underserved group. [ABSTRACT FROM AUTHOR]

Rationale: No previous studies examined the discriminative stimulus effects of intravenous (IV) nicotine in humans. Objectives: To evaluate a pulsed IV nicotine infusion procedure designed to mimic inhaled nicotine delivery and to identify a range of nicotine doses that may capture the threshold doses for the subjective and discriminative stimulus effects of nicotine. By determining these thresholds, we can gain valuable insights into the addictive threshold of nicotine. Methods: Eleven participants had 2 Test Sessions following overnight abstinence from smoking. Test Session 1 examined participants' ability to discriminate 0.1 mg nicotine/pulse nicotine from saline. Test Session 2 examined if participants can discriminate 0.05, 0.025, and 0.0125 mg nicotine/pulse of nicotine from saline. These nicotine doses were delivered as a cluster of 4 pulsed-nicotine infusions of 2-second duration with a 28-second interval between each pulse. Results: The lowest doses of nicotine that produced greater responses than saline for discrimination, subjective effects, and heart rate ranged from 0.05 to 0.1 mg nicotine/pulse. Conclusions: These findings support the validity of our pulsed-infusion procedure as a model for nicotine delivery by smoking and its utility in examining factors that may impact the addictive threshold of nicotine. [ABSTRACT FROM AUTHOR]

Alcohol and nicotine are the two most important risk factors of chronic pancreatitis, and they often occur together. It is still unclear how much they influence the severity of the disease and which of the two addictions should be treated with priority. We performed a single-center, retrospective, cross-sectional study in a mixed medicosurgical cohort of 870 patients diagnosed with chronic pancreatitis (CP). We analyzed the impact of the drinking pattern and abstinence for alcohol and nicotine on the course of the disease. Patients with alcoholic CP were subdivided into 1) patients with "life-time drinking history" (LTDH), 2) "current drinkers" with current alcohol abuse without signs of LTDH, and 3) "former drinkers" who stopped or reduced alcohol intake dramatically. Compared to patients with LTDH, "former drinkers" had a lower rate of exocrine insufficiency (29% vs. 59%) and pseudocysts (33% vs. 49%), were more often relapse-free (37% vs. 5%), and had less abdominal pain. There was no correlation detected between the quantity of alcohol consumption and the severity or progression of the disease. Regarding nicotine, 29 pack-years are the threshold for developing the early stage of CP. Under nicotine abstinence, only slightly more patients were relapse-free (37% vs. 22%). In contrast, the cumulative amount of nicotine consumed correlated with overall disease severity and the development of pseudocysts. The need for surgery was increased, with odds ratios of 1.8, for both alcohol and nicotine abuse. Alcohol cessation in chronic pancreatitis reduces exocrine insufficiency, abdominal pain, and local complications. The effect of nicotine cessation is less pronounced in our cohort. However, nicotine abuse represents an important factor for the development of the disease. • Alcohol cessation results in a lower rate of exocrine insufficiency, pseudocysts, and acute pancreatitis episodes. • The drinking pattern, but not the absolute amount of alcohol, correlates with the disease severity. • We were able to identify a threshold of 29 pack-years for the development of chronic pancreatitis. • Smoking cessation only reduced the relapse frequency of acute pancreatitis episodes without affecting the disease severity. [ABSTRACT FROM AUTHOR]

Although most cognitive impairments induced by prolonged alcohol consumption tend to improve within the initial months of abstinence, there is evidence suggesting certain cognitive deficits may persist. This study aimed to investigate the impact of aerobic exercise on learning and memory in alcohol use disorder (AUD) mice following a period of abstinence from alcohol. We also sought to assess the levels of monoamine neurotransmitters in the hippocampus. To this end, we established an AUD mouse model through a two‐bottle choice (sucrose fading mode and normal mode) and chronic intermittent alcohol vapor (combined with intraperitoneal injection) and randomly allocated mice into exercise groups to undergo treadmill training. Learning and memory abilities were assessed through the Morris water maze test and spontaneous activity was evaluated using the open field test. The levels of dopamine, norepinephrine, serotonin, and brain‐derived neurotrophic factor in the hippocampus were quantified using enzyme‐linked immunoassay (ELISA) kits. The findings reveal that after cessation of alcohol consumption, learning and memory abilities in AUD mice did not completely return to normal levels. The observed enhancement of cognitive functions in AUD mice through aerobic exercise may be attributed to restoring levels of monoamine neurotransmitters in the hippocampus, boosting brain‐derived neurotrophic factor (BDNF) concentrations, and facilitating an increase in hippocampal mass. These results offer empirical evidence to support aerobic exercise as a viable therapeutic strategy to alleviate cognitive deficits associated with AUD. [ABSTRACT FROM AUTHOR]

Alcohol-associated liver disease (ALD) represents one of the deadliest yet preventable consequences of excessive alcohol use. It represents 5.1 % of the global burden of disease, mainly involving the productive-age population (15-44 years) and leading to an increased mortality risk from traffic road injuries, suicide, violence, cardiovascular disease, neoplasms, and liver disease, among others, accounting for 5.3 % of global deaths. Daily alcohol consumption, binge drinking (BD), and heavy episodic drinking (HED) are the patterns associated with a higher risk of developing ALD. The escalating global burden of ALD, even exceeding what was predicted, is the result of a complex interaction between the lack of public policies that regulate alcohol consumption, low awareness of the scope of the disease, late referral to specialists, underuse of available medications, insufficient funds allocated to ALD research, and non-predictable events such as the COVID-19 pandemic, where increases of up to 477 % in online alcohol sales were registered in the United States. Early diagnosis, referral, and treatment are pivotal to achieving the therapeutic goal in patients with alcohol use disorder (AUD) and ALD, where complete alcohol abstinence and prevention of alcohol relapse are expected to enhance overall survival. This can be achieved through a combination of cognitive behavioral, motivational enhancement and pharmacological therapy. Furthermore, the appropriate use of available pharmacological therapy and implementation of public policies that comprehensively address this disease will make a real difference. [ABSTRACT FROM AUTHOR]

Raphael Woolf's book, "Plato's Charmides," provides a thorough examination of Plato's ethical dialogue on temperance. Woolf's interpretation is based on analyzing the text independently and separating Plato's intentions from Socrates'. He argues that Socrates' interactions are driven by erotic desire, specifically to access Charmides' beautiful soul. Woolf also suggests that Plato aims to encourage readers to critically evaluate the arguments presented. The document is a review of Woolf's book, praising his attention to detail and analysis of Socrates' questioning methods. It acknowledges that some readers may struggle with Woolf's emphasis on eros and mentions opposing viewpoints on focusing solely on the Charmides. The reviewer concludes that Woolf's book is essential for those studying the dialogue. [Extracted from the article]

Objective: To determine if treatment of co-occurring adult ADHD and Cannabis Use Disorder (CUD) with extended-release mixed amphetamine salts (MAS-ER) would be effective at improving ADHD symptoms and promoting abstinence. Method: A 12-week randomized, double-blind, two-arm pilot feasibility trial of adults with comorbid ADHD and CUD (n = 28) comparing MAS-ER (80 mg) to placebo. Main outcomes: ADHD: ≥30% symptom reduction, measured by the Adult ADHD Investigator Symptom Rating Scale (AISRS). CUD: Abstinence during last 2 observed weeks of maintenance phase. Results: Overall, medication was well-tolerated. There was no significant difference in ADHD symptom reduction (MAS-ER: 83.3%; placebo: 71.4%; p =.65) or cannabis abstinence (MAS-ER: 15.4%; placebo: 0%; p =.27). MAS-ER group showed a significant decrease in weekly cannabis use days over time compared to placebo (p <.0001). Conclusions: MAS-ER was generally well-tolerated. The small sample size precluded a determination of MAS-ER's superiority reducing ADHD symptoms or promoting abstinence. Notably, MAS-ER significantly reduced weekly days of use over time. [ABSTRACT FROM AUTHOR]

Alcohol-associated liver disease (ALD) is a major cause of chronic liver disease, with few effective treatments besides alcohol abstinence. Angelicae Gigantis Radix (AG), Glycyrrhizae Radix et Rhizoma (GR), Paeoniae Radix (PR), and Zizyphi Fructus (ZF) are traditional herbs used to treat various ailments, including liver diseases. While several studies have reported the beneficial effects of GR on ALD, the effects of AG, PR, and ZF remain underexplored. Therefore, their efficacy and mechanisms against ALD were investigated using an alcohol-related liver injury model. The model was induced by ethanol gavage in C57BL/6J mice for 14 days, followed by oral administration of AG, GR, PR, and ZF one hour post-induction. The administration of these herbs reduced liver weight, and improved serum biomarkers of liver injury (ALT, AST, albumin). The herbs enhanced hepatic antioxidant capacity (GSH, SOD, catalase) and suppressed the production of proinflammatory cytokines (TNF-α, IL-1β) and apoptotic changes (caspase-3). The mechanisms of action involved lipid-lowering gene modulation through regulation of the cytochrome P450 2E1/Sirtuin 1/Nrf2 pathways. Histopathological and immunohistochemical analyses revealed that these herbs attenuated hepatocyte damage and steatosis via antioxidant, anti-inflammatory, and antiapoptotic effects. These findings suggest that traditional herbs, particularly AG, could be promising alternative therapies for treating ALD. [ABSTRACT FROM AUTHOR]

Background: Nowadays, metabolic syndrome has become a major health threat, and affects over one billion people globally. It also plays a great role in the growth of diseases like type 2 diabetes, coronary diseases, stroke, and other chronicity. It increases the risk of cardiovascular disorder and stroke by three to ten times and diabetic mellitus by ten times. The prevalence of metabolic syndrome is increasing globally as a result of epidemiological shift. Low and middle-income countries are facing an increasing burden of metabolic syndrome. There is a need for concerted efforts to modify behavioral risk factors that significantly contribute to the prevalence of the syndrome. This can be done by developing and implementing appropriate interventions that can bring behavior change after testing for effectiveness, feasibility, and acceptability. Thus, this study aims to develop and test the effectiveness, feasibility and acceptability of an education intervention promoting healthy lifestyle to reduce risk factors for metabolic syndrome, among office workers in Ethiopia. Methods and analysis: This randomized controlled trial will be implemented with 226 bank employees (age ≥18 years) with metabolic syndrome from government and private banks in Bahir Dar City, Ethiopia. Participants will be randomized to intervention (education) and control (general health advice) groups. The intervention group will be given one-on -one base education about healthy diets, physical exercise, stress management, avoidance of harmful alcohol consumption and smoking cessation by experts on health promotion. Text messages will be sent every two weeks and reading materials will also be provided. Additionally, a review meeting will be held at the 3rd and 6th month of the intervention. The primary outcomes of interest will be change in metabolic parameters (obesity levels, blood pressure, fasting blood glucose, total cholesterol, high density lipoprotein, low density lipoprotein, and triglycerides). Secondary outcomes will be knowledge, attitudes and practice of the participants towards lifestyle and cardiovascular risk factors, feasibility, acceptability, implementation fidelity, and cost-effectiveness of the intervention. Data will be collected at three time points: at baseline, at the 6th month of the intervention and at the end of the intervention (9 months). Generalized linear mixed models will be utilized to compare the desired outcome between the trial arms, after accounting for baseline variations. Cost-benefit analysis and a qualitative process evaluation of the intervention will also be conducted. Discussion: This randomized control trial study will provide information on the effectiveness, feasibility, and acceptability of an education intervention promoting healthy lifestyle to reduce risk factors for metabolic syndrome, among office workers in Ethiopia, where the burden of metabolic syndrome is high among office workers. Clinical trial registration: This trial has been prospectively registered at the Australian New Zealand Clinical Trials Registry: ACTRN12623000409673p. [ABSTRACT FROM AUTHOR]

Background Purpose Cannabis use in the general population is prevalent and is rising because of increased acceptance of its use, legalization in most US states, and perceived health benefits. Cannabis product potency has dramatically increased with higher delta‐9‐tetrahydrocannabinol content. Cannabis has documented antiemetic properties and cannabinoid pharmaceuticals are used in disorders like chemotherapy‐induced nausea and vomiting.Forty to eighty percent of cyclic vomiting syndrome (CVS) patients use cannabis products, which reportedly reduce stress as well as nausea and vomiting. Cannabinoid hyperemesis syndrome (CHS) has a presentation similar to CVS, but is associated with longstanding, high dose cannabis use, and is thought to be relieved by sustained cannabis abstinence. Most CHS patients have used cannabis on a daily or near‐daily basis for more than 2 years. Compulsive hot‐water bathing behaviors are reported by most CHS patients, but are not specific for this disorder as they are also noted by about half of CVS patients. Episodic vomiting associated with cannabis use contributes to extensive health resource use, including emergency department visits and inpatient hospitalizations, and impacts patients and their families negatively. Treatment for CHS overlaps with CVS although cannabis abstinence remains the cornerstone of its management. Challenges associated with cannabis use cessation in CHS include patient skepticism of the role of cannabis as a cause of symptoms, perceived benefits of cannabis, and a lack of other effective therapies. In this review, we highlight cannabis use patterns in the US and discuss diagnosis and management of CHS and gaps in knowledge about this disorder. [ABSTRACT FROM AUTHOR]

Background: Previous research literature reported different results regarding the long-term effects that cannabis use can exert on the frontal lobe neurocognitive functions of its users. Another body of research suggested that cannabis use negatively affects the person's general level of occupational and psychosocial functioning consequently to these alterations. Some other research results did not support these findings. To date, it is still debatable whether chronic cannabis use triggers negative neurocognitive effects in chronic users even after a period of abstinence. Research data exploring consequent adverse outcomes on the general individual occupational and psychosocial functioning is not yet conclusive. Results: We conducted this study to examine the residual neurocognitive effects of cannabis use, whether it is affected by duration of cannabis use before abstinence, and its relation to individual's global assessment of functioning exhibited in the person's occupational and social life whether it's family or friends. Our sample comprised 80 male participants (18–45 years old) who were grouped into 4 groups (3 groups with different durations of use and a control group), with no significant difference between the four studied groups regarding age, education, and socioeconomic level. The Kruskal Wallis test was used to test the significance of differences in the distribution of total frontal lobe battery results and the general assessment of function scores using GAF scores between study groups. Post hoc testing was performed to adjust for multiple comparisons using Bonferroni method. Conclusion: Data analysis showed that cannabis users experienced general functional disturbances that encompass impairments in social and occupational life aspects. These impairments in function are correlated with the presence of neurocognitive deficits even after a period of abstinence. Both having significant positive correlation with longer duration of cannabis use. [ABSTRACT FROM AUTHOR]

Introduction Methods Results Discussion and Conclusions Identifying subgroups of Temporary (alcohol) Abstinence Challenge (TAC) participants may offer opportunities to enhance intervention effectiveness. However, knowledge about such subgroups is missing. This study aimed to (i) describe a TAC population; (ii) identify subgroups of participants based on determinants of changes in drinking behaviour; and (iii) characterise subgroups in terms of sociodemographic and other characteristics.Data from 3803 Dutch TAC participants were analysed to identify subgroups using three‐step Latent Class Analysis. Classes were based on determinants of changes in drinking behaviour (i.e., drinking refusal self‐efficacy, craving and behavioural automaticity) and were characterised by sociodemographic characteristics, drinking behaviour, previous participation in TACs, self‐reported health and life satisfaction.The majority of TAC participants were female, highly educated, employed, 53 years old on average, participated in previous TACs and reported relatively high alcohol use. Four classes of participants were identified: (i) ‘ordinary drinkers’ (49.0%); (ii) ‘drinkers in control’ (21.4%); (iii) ‘habitual drinkers with perceived control to refuse’ (18.4%); and (iv) ‘drinkers not in control’ (11.2%). Class 2 drank least often and non‐excessive volumes, while other classes typically drank 4 or more days per week and 3 to 4 glasses per drinking day, with the highest alcohol use found in class 4.Different configurations of determinants in this study's four subgroups may require different intervention approaches and might inform personalised support. Future research is needed to examine the predictive value of these subgroups on post‐challenge drinking behaviour to assess support needs and participation value. [ABSTRACT FROM AUTHOR]

The authors present a case concerning an adult male patient who developed multiple sites of root caries adjacent to the area where he habitually held a sugar‐free nicotine lozenge that contained mannitol and maltodextrin. The root caries occurred despite the patient's excellent oral hygiene, exemplary dietary habits, and clinically normal salivary flow. Between 1999 and 2008, he had only required two restorations to repair carious lesions. This patient had a 20+‐year habit of using smokeless tobacco before switching to a cessation aid nicotine lozenge in May of 2008. A full‐mouth series of radiographs taken in November 2009 revealed carious lesions on virtually every posterior tooth. The nicotine lozenge's principal ingredients were mannitol (75.7%) and maltodextrin. According to the United States' current Food and Drug Administration (FDA) guidelines, manufacturers can advertise these lozenges as sugar‐free. Thus, it is assumed by the public that these types of products are incapable of "causing a cavity." However, this case report presents evidence suggesting that frequent use of sugar‐free nicotine lozenges may be associated with dental caries. [ABSTRACT FROM AUTHOR]

Alcohol use among older adults, often denied, is a real public health problem in view of the harmful consequences it induces. The objective of this systematic review was to identify articles on the biopsychosocial factors, assessment tools, and treatment options that have proved useful for the early detection and management of alcohol use among older adults. With a view to producing a narrative synthesis from several databases, 66 articles were identified and studied, of which 45.4% (n = 30) were published between 2015 and 2020. The review is reported according to PRISMA guidelines. Although differences appear to exist between the samples studied, the analyses show that biopsychosocial factors such as quality of life, well-being, emotions, perceived stress, coping strategies, and mood disorders are associated with unhealthy alcohol use. Psychosocial factors such as strong social support appear to be correlated with low levels of alcohol use and abstinence. In general, the tools used to screen for alcohol use are AUDIT, CAGE, DPI, CARET, and SMAST-G. Interventions to prevent and manage alcohol use in older adults include CBT and brief interventions. This review of the literature provides a better understanding of which assessment tools should be used for screening. Emphasis should be placed on process-oriented scientific studies, which to date do not exist. Psychological processes mediated by biopsychosocial factors would enable the development of effective prevention interventions to be conducted in order to improve the quality of life of older adults. [ABSTRACT FROM AUTHOR]

Atrial fibrillation (AF), with its significant associated morbidity and mortality contributes to significant healthcare utilisation and expenditure. Given its progressively rising incidence, strategies to limit AF development and progression are urgently needed. Lifestyle modification is a potentially potent but underutilised weapon against the AF epidemic. The purpose of this article is to review the role of lifestyle factors as risk factors for AF, outline potential mechanisms of pathogenesis and examine the available evidence for lifestyle intervention in primary and secondary AF prevention. It will also highlight the need for investment by physicians, researchers, health services and governments in order to facilitate delivery of the comprehensive, multidisciplinary AF care that is required to manage this complex and multifactorial disease. [Display omitted] • Lifestyle modification is key to reducing AF incidence, burden and progression. • Targets include weight loss, exercise, alcohol abstinence and smoking cessation. • Collaboration at every level of healthcare is needed to improve AF care delivery. [ABSTRACT FROM AUTHOR]

This paper examines the predictions of expectations-based reference-dependent models for risk-apportionment tasks that elicit higher-order risk attitudes. We consider some of the most commonly used specifications of Kőszegi and Rabin (2006, 2007) and disappointment aversion models. Our analysis reveals that higher order risky choices exhibited by decision makers defined by those model specifications depend on whether risks to be apportioned in these tasks are symmetric or asymmetric, whether they include small probability outcomes, and on the level of loss aversion. We highlight that some of the predicted choice behaviour in the risk-apportionment tasks differs from the ones in alternative models of decision under risk. We employ experimental data to examine whether choice patterns in the risk apportionment tasks are in line with the predictions of the model specifications described here. We find that only a small proportion of them are consistent with those predictions. [ABSTRACT FROM AUTHOR]

Purpose: The association between type 2 diabetes mellitus (T2DM), lifestyle factors, and the risk of osteoporosis (OP) is well-established. However, the impact of a healthy lifestyle on diabetes-related osteoporosis needs further investigation. Our objective was to explore if a combination of healthy lifestyle factors could mitigate the risk of OP in individuals with type 2 diabetes. Methods: This longitudinal analysis included 237,725 middle-aged and older participants. An overall lifestyle score, ranging from 0 to 7, was calculated by assigning a point for each of the seven healthy lifestyle factors, including no current smoking, non-excessive alcohol consumption, regular physical activity, healthy diet, adequate sleep duration, less sedentary behavior, and adequate sunshine exposure. Results: During a median follow-up 12.21 years, 5760 OP cases were documented. Participants with T2DM showed a higher risk of OP than those without diabetes. Compared with participants without diabetes who had a lifestyle score of 6–7, the hazard ratios (HRs) for OP were 1.58 (95% CI 1.23–2.03), 1.62 (95% CI 1.16–2.25), and 2.58 (95% CI 1.64–4.05) for participants with T2DM who had a lifestyle score of 4, 3, and 0–2, respectively. There was a graded association between higher lifestyle scores and lower risks of incident OP among participants without diabetes as well as among those with T2DM. We estimated that the population attributable fraction for not adhering to 6–7 lifestyle behaviors was 15.7%. Conclusions: Participants with T2DM who adhered to a variety of healthy lifestyle factors demonstrated a substantially reduced risk of developing OP. [ABSTRACT FROM AUTHOR]

Introduction Our safety-net hospital implemented a hospital-based tobacco treatment intervention in 2016. We previously showed the intervention, an "opt-out" Electronic Health Record (EHR)-based Best Practice Alert (BPA)+ order-set that triggers consultation to an inpatient Tobacco Treatment Consult (TTC) service for all patients who smoke, improves smoking abstinence. We now report on sustainability, 6 years after inception. Aims and Methods We analyzed data collected between July 2016–June 2022 of patients documented as "currently smoking" in the EHR. Across the 6 years, we used Pearson's correlation analysis to compare Adoption (clinician acceptance of the BPA+ order-set, thus generating consultation to the TTC service); Reach (number of consultations completed by the TTC service); and Effectiveness (receipt of pharmacotherapy orders between patients receiving and not receiving consultations). Results Among 39 558 adult admissions (July 2016–June 2022) with "currently smoking" status in the EHR for whom the BPA triggered, clinicians accepted the TTC order set on 50.4% (19 932/39 558), though acceptance varied across services (eg, Cardiology [71%] and Obstetrics-Gynecology 12%]). The TTC service consulted on 17% (6779/39 558) of patients due to staffing constraints. Consultations ordered (r  = −0.28, p  = .59) and completed (r  = 0.45, p  = .37) remained stable over 6-years. Compared to patients not receiving consultations, patients receiving consultations were more likely to receive pharmacotherapy orders overall (inpatient: 50.8% vs. 35.1%, p  < .0001; at discharge: 27.1% vs. 10%, p  < .0001) and in each year. Conclusions The "opt-out" EHR-based TTC service is sustainable, though many did not receive consultations due to resource constraints. Health care systems should elevate the priority of hospital-based tobacco treatment programs to increase reach to underserved populations. Implications Our study shows that opt-out approaches that utilize the EHR are a sustainable approach to providing evidence-based tobacco treatment to all hospitalized individuals who smoke, regardless of readiness to stop smoking and clinical condition. [ABSTRACT FROM AUTHOR]

Ambiguity exists over treatment and surveillance strategies after endoscopic submucosal dissection (ESD) for esophageal squamous cell neoplasia (ESCN) with unfavorable histologic features. This study investigated the long-term outcomes of ESD in high-risk ESCN patients. We retrospectively included early ESCN patients treated with ESD at two medical centers in Taiwan between August 2010 and December 2023. Demographic, endoscopic and pathological data were collected. Among 146 patients (mean age 59.17 years) with 183 lesions, 73 (50%) had a history of head and neck cancer (HNC). En bloc and R0 resections were achieved in 100% and 95.6% of the lesions, respectively. The 5-year overall survival (OS), disease-specific survival (DSS) and local recurrence rates were 42.7%, 94.7% and 11%. R0 resections were significantly associated with recurrence in a univariate analysis (HR: 0.19, 95% CI: 0.06–0.66, p = 0.008). Alcohol abstinence was independently associated with lower recurrence (HR: 0.34, 95% CI: 0.16–0.73, p = 0.006). Patients with pT1a-MM (muscularis mucosa invasion) had comparable OS (p = 0.82), DSS (p = 0.617) and recurrence (p = 0.63) rates to those with pT1a-EP/LPM (epithelium/lamina propria invasion). The long-term outcomes of ESCN patients after ESD for expanded indications were satisfactory. ESD could be considered in selected ESCN patients involving the muscularis mucosa, notably among high-risk HNC patients. [ABSTRACT FROM AUTHOR]

The article examines the memoirs of four women who provided nursing care in the Crimean War: Mary Seacole, Elizabeth Davis, Martha Nicol and Fanny Margaret Taylor. It argues that these memoirs are also Orientalist travelogues that reflect the women's participation in Britain's informal empire in the eastern Mediterranean. These women used Orientalist tropes, such as scenic vistas, idle servants and foreign customs like the harem, to attract a readership for their publications. Additionally, by allying themselves with the British civilizing mission, these women sought acceptance from British society. The middle-class volunteer nurses, like Fanny Margaret Taylor or Martha Nicol, attempted to excuse their seemingly unconventional behavior in journeying far from the traditional female domestic sphere to serve as war nurses, while Elizabeth Davis, a working-class nurse, aimed to overcome the stereotypes of intemperance and immorality associated with her profession. Finally, as a mixed-race woman, Mary Seacole faced a great difficulty in gaining the sympathy of her white British readership but by intensively associating herself with the British military and its customs, she gained the affection of the British public. [ABSTRACT FROM AUTHOR]

Introduction People with cancer who smoke exhibit greater cigarette dependence than people without cancer who smoke, a crucial factor in smoking cessation. Research is limited on the predictive potential of the Fagerström Test for Cigarette Dependence (FTCD) and the Heaviness of Smoking Index (HSI) on smoking abstinence in cancer patients undergoing smoking cessation treatment. Aims and Methods We analyzed data from 5934 cancer patients seeking smoking cessation treatment at The University of Texas MD Anderson Cancer Center (female 52.08%; Mean age = 55.52, SD = 11.17). We evaluated the predictive accuracy of FTCD and HSI on abstinence at 3, 6, and 9 months from the first consultation, and assessed the concordance between these tools in measuring cigarette dependence using Cohen's kappa test and different correlation and regression models. We also analyzed variations across sex at birth and race/ethnicity. Results Both the FTCD and the HSI demonstrated comparable predictive accuracy for smoking cessation at all follow-ups, with neither showing high accuracy (Areas Under the Curve scores around 0.6). Concordance analysis revealed substantial agreement between FTCD and HSI scores (Cohen's kappa ~ 0.7), particularly at lower levels of dependence. However, this agreement varied by race, with reduced concordance observed in non-Hispanic Blacks. Conclusions Our results indicate that both the FTCD and HSI are effective tools for predicting smoking cessation in cancer patients, with the HSI offering a less burdensome assessment option. Nevertheless, the findings suggest the need for tailored approaches in assessing cigarette dependence that could predict smoking cessation more accurately, considering racial differences. Implications The burden of assessing cigarette dependence in cancer care settings can be reduced by using the HSI instead of the FTCD. In addition, both instruments could be substantially interchanged and used for meta-analytic studies examining dependence and abstinence, but race/ethnicity should be considered. [ABSTRACT FROM AUTHOR]

Objective: Electronic cigarettes (ECs) are an efficacious support for some but not all people wishing to stop using tobacco. While advice and practical support have been identified as increasing quit success, little research has explored the role of changes in smoking and EC‐related social identities. Methods: A prospective study following 573 people attempting to quit smoking with EC support. Self‐report measures of identification with being a smoker, non‐smoker, vaper and dual user (people using ECs and tobacco products) were taken prior to the quit attempt and at a 12‐week follow‐up. Results: Baseline identifications with being a smoker, non‐smoker or dual user were not associated with smoking outcomes. Baseline vaper identity baseline was linked to more frequent tobacco abstinence at follow‐up and lower levels of cigarette smoking. Levels of social identification at follow‐up were consistently linked with outcomes, with vaper identity and non‐smoking identities being protective and dual user identity being related to lower abstinence rates but decreased tobacco usage. Changes in identity over time were the most consistent predictor of outcomes. Conclusions: Findings have implications for smoking cessation practice, informing how and when identity‐based interventions may be effective and our understanding of how identity transitions occur. [ABSTRACT FROM AUTHOR]

Cardiac death is the second most common cause of death among patients with acute ischemic stroke (IS), following neurological death resulting directly from acute IS. Risk prediction models and screening tools including electrocardiograms can assess the risk of adverse cardiovascular events after IS. Prolonged heart rate monitoring and early anticoagulation therapy benefit patients with a higher risk of adverse events, especially stroke patients with atrial fibrillation. IS and cardiovascular diseases have similar risk factors which, if optimally managed, may reduce the incidence of recurrent stroke and other major cardiovascular adverse events. Comprehensive risk management emphasizes a healthy lifestyle and medication therapy, especially lipid-lowering, glucose-lowering, and blood pressure-lowering drugs. Although antiplatelet and anticoagulation therapy are preferred to prevent cardiovascular events after IS, a balance between preventing recurrent stroke and secondary bleeding should be maintained. Optimization of early rehabilitation care comprises continuous care across environments thus improving the prognosis of stroke survivors. [ABSTRACT FROM AUTHOR]

A healthy lifestyle is a key determinant of health, especially for people with chronic diseases such as diabetes or hypertension. The health behaviours which contribute to a healthy lifestyle include the following: regular physical activity, preventive examinations, maintaining a proper diet and avoiding the consumption of alcohol or cigarettes. They have a significant impact on the disease process, controlling symptoms and preventing complications. The aim of this study was to examine the health behaviours related to diet, physical activity and prevention among Polish primary health care patients and to identify predictors of health behaviours. For this reason, the standardized Health Behaviour Scale (HBS) questionnaire was used. The study was conducted among 269 patients (including 61.71% women) in primary health care facilities. The mean age of participants was 52.89 years (±17.76). The mean HBS score was 36.93 ± 9.66. A statistically significant association was found between HBS scores and such sociodemographic variables as education (p = 0.0061, r = 0.17), body mass index (p = 0.0018, r = −0.20, β = −0.36) and self-assessed economic status (p = 0.0094, r = 0.16). Women's health behaviours as measured by HBS were significantly better than men's (p < 0.001, β = −6.82). A special focus should be given to the groups manifesting poorer health behaviours (e.g., men, older people and persons with low socioeconomic status) by offering them tailored health-promoting interventions. [ABSTRACT FROM AUTHOR]

Two revolutionary developments impacted the United States criminal justice system over the past 30 years that are now primed for an institutional reckoning—the legalization of medical marijuana at the state level and the exponential rise of adult drug treatment courts across the country. The states that have legalized medical marijuana also provide criminal immunity protections for qualifying medical marijuana patients, including those serving probationary sentences. Drug treatment courts are a form of intensive probation offering treatment services for participants plagued by substance use disorders. Most drug treatment courts operate on an abstinence‐based model and do not permit the use of medical marijuana. Consequently, challenges by drug court participants to the continued prohibition of medical marijuana are on the horizon. The purpose of this article is to highlight the contours of these knotty issues from a sociolegal perspective. The material for this article stems from a review of existing judicial decisions in addition to qualitative data collected during my case studies of three different adult drug treatment courts. [ABSTRACT FROM AUTHOR]

Alcohol-induced cardiomyopathy (AC) is an acquired form of dilated cardiomyopathy (DCM) caused by prolonged and heavy alcohol intake in the absence of other causes. The amount of alcohol required to produce AC is generally considered as >80 g/day over 5 years, but there is still some controversy regarding this definition. This review on AC focuses on pathogenesis, which involves different mechanisms. Firstly, the direct toxic effect of ethanol promotes oxidative stress in the myocardium and activation of the renin–angiotensin system. Moreover, acetaldehyde, the best-studied metabolite of alcohol, can contribute to myocardial damage impairing actin–myosin interaction and producing mitochondrial dysfunction. Genetic factors are also involved in the pathogenesis of AC, with DCM-causing genetic variants in patients with AC, especially titin-truncating variants. These findings support a double-hit hypothesis in AC, combining genetics and environmental factors. The synergistic effect of alcohol with concomitant conditions such as hypertension or liver cirrhosis can be another contributing factor leading to AC. There are no specific cardiac signs and symptoms in AC as compared with other forms of DCM. However, natural history of AC differs from DCM and relies directly on alcohol withdrawal, as left ventricular ejection fraction recovery in abstainers is associated with an excellent prognosis. Thus, abstinence from alcohol is the most crucial step in treating AC, and specific therapies are available for this purpose. Otherwise, AC should be treated according to current guidelines of heart failure with reduced ejection fraction. Targeted therapies based on AC pathogenesis are currently being developed and could potentially improve AC treatment in the future. [ABSTRACT FROM AUTHOR]

Purpose: This study was performed to assess the lifestyle-related behaviors of patients with gastric cancer (GC) and to investigate the associations between the time since GC diagnosis and these behaviors. Materials and Methods: This study included 29,478 adults (including 338 patients with GC) aged ≥ 40 years who participated in the Korea National Health and Nutrition Examination Survey 2014-2021. Multiple logistic regression analysis explored the associations between the time since GC diagnosis (patients diagnosed with GC less than 5 years ago [<5 years group] and those diagnosed with GC 5 or more than years ago [≥5 years group]) and lifestyle factors. Subgroup analyses were conducted based on age and sex. Results: The current smoking rate was not lower in the GC group than in the healthy group, regardless of time since diagnosis. Compared to the healthy controls, monthly alcohol intake was lower in the <5 years group (odds ratio [OR], 0.450; 95% confidence interval [CI], 0.275–0.736). The ≥5 years group showed a lower rate of strength training (OR, 0.548; CI, 0.359–0.838), compared with the healthy control group. Subgroup analysis focusing on the ≥5 years group revealed a significantly lower rate of strength training, particularly in patients aged ≥65 years and male patients (OR, 0.519 and 0.553; CI, 0.302–0.890 and 0.340–0.901, respectively). Conclusions: Clinicians should continue educating patients on lifestyle behavior modifications, particularly alcohol abstinence, even beyond 5 years after GC diagnosis. Education on strength training is especially important for patients ≥65 years or male patients. [ABSTRACT FROM AUTHOR]

Background: Chronic preconception paternal alcohol use adversely modifies the sperm epigenome, inducing fetoplacental and craniofacial growth defects in the offspring of exposed males. A crucial outstanding question in the field of paternal epigenetic inheritance concerns the resilience of the male germline and its capacity to recover and correct sperm‐inherited epigenetic errors after stressor withdrawal. Objectives: We set out to determine if measures of the sperm‐inherited epigenetic program revert to match the control treatment 1 month after withdrawing the daily alcohol treatments. Materials and methods: Using a voluntary access model, we exposed C57BL/6J males to 6% or 10% alcohol for 10 weeks, withdrew the alcohol treatments for 4 weeks, and used RNA sequencing to examine gene expression patterns in the caput section of the epididymis. We then compared the abundance of sperm small RNA species between treatments. Results: In the caput section of the epididymis, chronic alcohol exposure induced changes in the transcriptional control of genetic pathways related to the mitochondrial function, oxidative phosphorylation, and the generalized stress response (EIF2 signaling). Subsequent analysis identified region‐specific, alcohol‐induced changes in mitochondrial DNA copy number across the epididymis, which correlated with increases in the mitochondrial DNA content of alcohol‐exposed sperm. Notably, in the corpus section of the epididymis, increases in mitochondrial DNA copy number persisted 1 month after alcohol cessation. Analysis of sperm noncoding RNAs between control and alcohol‐exposed males 1 month after alcohol withdrawal revealed a ∼100‐fold increase in mir‐196a, a microRNA induced as part of the nuclear factor erythroid 2‐related factor 2 (Nrf2)‐driven cellular antioxidant response. Discussion and conclusion: Our data reveal that alcohol‐induced epididymal mitochondrial dysfunction and differences in sperm noncoding RNA content persist after alcohol withdrawal. Further, differences in mir‐196a and sperm mitochondrial DNA copy number may serve as viable biomarkers of adverse alterations in the sperm‐inherited epigenetic program. [ABSTRACT FROM AUTHOR]

Emerson Bainbridge was an important entrepreneur, philanthropist and (briefly) Liberal M.P. whose influence has been overlooked and under-estimated by historians. His wide-ranging industrial success, particularly in coal mining, and his growing personal wealth enabled him to play an important role in the North Midlands region particularly from 1890. His familial roots in Methodism and Temperance and his adherence to the main tenets of political nonconformity and Liberalism were the foundations of his 'world view'. This was to prove of critical importance in the design, development and ethos of the 'model villages' his company founded in the Derbyshire and Nottinghamshire coalfield. The impact and influence of this 'enlightened paternalism' long outlasted him. [ABSTRACT FROM AUTHOR]

Background: Very brief advice (VBA; ≤ 3 min) on quitting is practical and scalable during brief medical interactions with patients who smoke. This study aims to synthesize the effectiveness of VBA for smoking cessation and summarize the implementation strategies. Methods: We searched randomized controlled trials aiming at tobacco abstinence and comparing VBA versus no smoking advice or no contact from Medline, Embase, CINAHL, Cochrane Library, PsycInfo databases, six Chinese databases, two trial registries ClinicalTrials.gov and WHO-ICTRP from inception to September 30, 2023. Grading of Recommendations, Assessment, Development, and Evaluations framework was used to assess the certainty of the evidence of the meta-analytic findings. The outcomes were self-reported long-term tobacco abstinence at least 6 months after treatment initiation, earlier than 6 months after treatment initiation, and quit attempts. Effect sizes were computed as risk ratio (RR) with 95% CI using frequentist random-effect models. Data Synthesis: Thirteen randomized controlled trials from 15 articles (n = 26,437) were included. There was moderate-certainty evidence that VBA significantly increased self-reported tobacco abstinence at ≥ 6 months in the adjusted model (adjusted risk ratio ARR 1.17, 95% CI: 1.07–1.27) compared with controls. The sensitivity analysis showed similar results when abstinence was verified by biochemical validation (n = 6 studies, RR 1.53, 95% CI 0.98–2.40). There was high-certainty evidence that VBA significantly increased abstinence at < 6 months (ARR 1.22, 95% CI: 1.01–1.47). Evidence of effect on quit attempts (ARR 1.03, 95% CI 0.97–1.08) was of very low certainty. Discussion: VBA delivered in a clinical setting is effective in increasing self-reported tobacco abstinence, which provides support for wider adoption in clinical practice. [ABSTRACT FROM AUTHOR]

Epidemiological data demonstrate strong associations between psoriasis and metabolic comorbidities, including obesity, hypertension, diabetes mellitus, dyslipidemia, and non-alcoholic fatty liver disease. The presence of metabolic comorbidities significantly influences the selection and effectiveness of pharmacological treatments. Some drugs should be prescribed with caution in patients with metabolic comorbidities because of an increased risk of adverse events, while others could have a reduced effectiveness. The aim of this narrative review is to highlight the challenges that healthcare professionals may face regarding the management of psoriasis in patients with metabolic comorbidities. In the first part of the article, the epidemiological association between psoriasis and metabolic comorbidities and their pathogenetic mechanisms is summarized. The second part describes the efficacy and safety profile of conventional and biologic drugs in patients with selected metabolic comorbidities including obesity, non-alcoholic fatty liver disease/hepatic steatosis, and diabetes. Finally, the role of pharmacological and non-pharmacological interventions, such as diet, alcohol abstinence, physical activity, and smoking avoidance is discussed. In conclusion, the choice of the best approach to manage patients with psoriasis with metabolic comorbidities should encompass both tailored pharmacological and individualized non-pharmacological interventions. [ABSTRACT FROM AUTHOR]