Miracle-dz/UniFAR-FTUs huggingface dataset:
The burden of alcohol use disorders in US military veterans: results from the National Health and Resilience in Veterans Study.

AIMS To analyze data from a large, contemporary, nationally representative sample of US veterans to evaluate: (1) the prevalence of life-time alcohol use disorder (AUD) and past-year AUD; (2) common psychiatric comorbidities associated with life-time AUD; and (3) correlates of life-time and past-year probable AUD. DESIGN Data were analyzed from the National Health and Resilience in Veterans Study (NHRVS), a web-based survey of a random probability sample of a contemporary, nationally representative sample of US military veterans. SETTING United States. PARTICIPANTS Nationally representative sample of 3157 US veterans aged 21 years and older. MEASUREMENTS Life-time alcohol abuse and dependence were assessed according to DSM-IV diagnostic criteria using the Mini International Neuropsychiatric Interview, and combined into a single variable: AUD. Past-year probable AUD was assessed using the Alcohol Use Disorders Identification Test-Consumption (AUDIT-C). Correlates of AUD, including psychiatric comorbidities, suicidality and demographic characteristics, were also assessed. FINDINGS The prevalence of life-time AUD and past-year probable AUD was 42.2% [95% confidence interval (CI) = 40.5-43.9%)] and 14.8% (95% CI = 13.6-16.0%), respectively. Compared with veterans without AUD, those with life-time AUD had substantially elevated rates of life-time and current mood and anxiety disorders [odds ratios (ORs) = 2.6-4.1], drug use disorder (OR = 10.7), life-time suicide attempt (OR = 4.1) and current suicidal ideation (OR = 2.1). Younger age, male sex, lower education, lower annual household income and greater number of life-time traumatic events were associated independently with life-time AUD. Younger age, male sex, unpartnered marital status and a life-time diagnosis of major depressive disorder were associated independently with past-year probable AUD. CONCLUSIONS More than 40% of US military veterans have a life-time history of alcohol use disorder. Veterans with a life-time history of alcohol use disorder have substantial comorbid psychiatric burden, including elevated rates of suicidal ideation and attempts. Certain socio-demographic (e.g. younger age, male sex, lower education) and clinical (e.g. trauma burden, history of depression) characteristics are associated with increased risk of AUD.
Cognitive ability and risk for substance misuse in men: genetic and environmental correlations in a longitudinal nation-wide family study.

AIMS To investigate the association in males between cognitive ability in late adolescence and subsequent substance misuse-related events, and to study the underlying genetic and environmental correlations. DESIGN A population-based longitudinal study with three different family-based designs. Cox proportional hazards models were conducted to investigate the association at the individual level. Bivariate quantitative genetic modelling in (1) full brothers and maternal half-brothers, (2) full brothers reared together and apart and (3) monozygotic and dizygotic twin brothers was used to estimate genetic and environmental correlations. SETTING Register-based study in Sweden. PARTICIPANTS The full sample included 1 402 333 Swedish men born 1958-91 and conscripted at mean age 18.2 [standard deviation (SD) = 0.5] years. A total of 1 361 066 men who had no substance misuse events before cognitive assessment at mandatory military conscription were included in the Cox regression models, with a follow-up time of up to 35.6 years. MEASURES Cognitive ability was assessed at conscription with the Swedish Enlistment Battery. Substance misuse events included alcohol- and drug-related court convictions, medical treatments and deaths, available from governmental registries. FINDINGS Lower cognitive ability in late adolescence predicted an increased risk for substance misuse events [hazard ratio (HR) for a 1-stanine unit decrease in cognitive ability: 1.29, 95% confidence interval (CI) = 1.29-1.30]. The association was somewhat attenuated within clusters of full brothers (HR = 1.21, 95% CI = 1.20-1.23). Quantitative genetic analyses indicated that the association was due primarily to genetic influences; the genetic correlations ranged between -0.39 (95% CI = -0.45, -0.34) and -0.52 (95% CI -0.55, -0.48) in the three different designs. CONCLUSIONS Shared genetic influences appear to underlie the association between low cognitive ability and subsequent risk for substance misuse events among Swedish men.
Identification of Auditory Neuropathy in Infants and Children

Auditory neuropathy (AN) is distinct from sensory hearing loss in several ways. The degree of hearing in AN loss is not related to hair cell damage. Speech perception in patients with AN is poor and not predicted by degree of loss. Auditory brainstem response (ABR) results are always poor and are not related to hearing thresholds in patients with AN. Finally, otoacoustic emissions (OAEs) are generally present with AN regardless of the degree of hearing loss.The most common risk factors for AN in infants are hyperbilirubinemia and family history. As many as 40% of patients with AN may have a genetic basis for the disease. Also, studies predict that 1 child in 10 with hearing loss has AN and 3 per thousand neonates with risk factors such as enrollment in the newborn intensive care unit have the disorder. Newborn hearing screening programs that allow a normal OAE result to pass an infant will miss neonates with AN. This may be the case in as many as 70% of screening programs in the United States. Finally, the au-diologic diagnosis of AN must include a battery of tests including ABR, OAE, immittance, middle ear muscle reflexes, and standard audiometry
Updating a Tuberculosis Surveillance Program

Tuberculosis surveillance programs have used the same testing methods for almost a century. New testing methods have been approved and are available, but how does a health care provider determine which diagnostic test is best in a given situation? Reviewing research statistics can be confusing, and the types of studies conducted may not be similar to a particular application. Development of an organizational needs assessment based on Centers for Disease Control and Prevention (CDC) requirements, organizational resources, the needs of the employee population, and the logistics of multiple campus sites prior to evaluating the available testing methods can assist occupational health nurses navigate the decision-making process. This article presents an example of a moderately sized health care facility to illustrate how to conduct a needs assessment that results in a decision as to which program best suits the organization.
Ganaxolone: A prospective overview

Ganaxolone is a synthetic analogue of the endogenous neurosteroid allopregnanolone, a metabolite of progesterone. Like allopregnanoiene, ganaxolone is a potent positive allosteric modulator of aminobutyric acid type A (GABA) receptors. Ganaxolone has robust anticonvuisant effects in a variety of animal models of epilepsy, is orally active and lacks hormonal side effects. Unlike diazepam, anticonvulsant tolerance does not develop to ganaxolone following chronic therapy. Recent predlinical studies suggest that ganaxolone is a particularly promising treatment for catamenial epilepsy. a menstrual cycle-related seizure disorder characterized by an increase in seizures at the time or menstruation. Preliminary evidence of the efficacy of ganaxolone in the treatment of epilopsy is encouraging. In general, ganaxolone has a favorable safety profile. The most frequentiy reported side effect is somnolence, which occurs with an acceptable therapeutic index. Ganaxoione has demonstrated significant clinical efficacy in suppressing complex partial seizures. Two open-label trials of ganaxolone in infantile spasms have been reported with indications of efficacy in both cases, Ganaxolone has enhanced potency in an animal model of catamenial epilepsy, and there is promising preliminary evidence for the efficacy of ganaxolone 'pulse therapy' for catamenial selzures in women. In addition, since premenstrual syndrome (PMS) is associated with allopregnanolone deficiency, ganaxolone may also have utility in the management of PMS. As a novel GABA a receptor modulator with unique, broad-spectrum protective efficacy, ganaxolone may have additional therapeutic potential in alcohol and cocaine withdrawal seizures, as well as in the treatment of anxiety and other mood disorders.
Long-term efficacy of catheter ablation as first-line therapy for paroxysmal atrial fibrillation: 5-year outcome in a randomised clinical trial

Objective The Medical ANtiarrhythmic Treatment or Radiofrequency Ablation in Paroxysmal Atrial Fibrillation (MANTRA-PAF) trial compared radiofrequency catheter ablation (RFA) with antiarrhythmic drug therapy (AAD) as first-line treatment for paroxysmal atrial fibrillation (AF). Endpoint of ablation was elimination of electrical activity inside pulmonary veins. We present the results of the 5-year follow-up. Methods This pre-specified 5-year follow-up included assessment of any AF and symptomatic AF burden by one 7-day Holter recording and quality of life (QoL) assessment, using SF-36 questionnaire physical and mental component scores. Analysis was intention-to-treat. Imputation was used to compensate for missing Holter data. Results 245 of 294 patients (83%) randomised to RFA (n=125) or AAD (n=120) attended the 5-year follow-up, 227 with Holter recording. Use of class I or III AAD was more frequent in AAD group (N=61 vs 13, p<0.001). More patients in the RFA group were free from AF (126/146 (86%) vs 105/148 (71%), p=0.001, relative risk (RR) 0.82; 95% CI 0.73 to 0.93) and symptomatic AF (137/146 (94%) vs 126/148 (85%), p=0.015, χ2 test, RR 0.91; 95% CI 0.84 to 0.98) in 7-day Holter recording. AF burden was significantly lower in the RFA group (any AF: p=0.003; symptomatic AF: p=0.02). QoL scores did not differ between randomisation groups. QoL scores remained improved from baseline (both components p<0.001), and did not differ from 2-year scores. Conclusions At 5 years, the occurrence and burden of any AF and symptomatic AF were significantly lower in the RFA group than in the AAD group. Improved QoL scores observed after 2 years persisted after 5 years without between-group differences. Trial registration number NCT00133211; Results.
Alcohol consumption during adolescence is associated with reduced grey matter volumes

BACKGROUND AND AIMS Cognitive impairment has been associated with excessive alcohol use, but its neural basis is poorly understood. Chronic excessive alcohol use in adolescence may lead to neuronal loss and volumetric changes in the brain. Our objective was to compare the grey matter volumes of heavy- and light-drinking adolescents. DESIGN This was a longitudinal study: heavy-drinking adolescents without an alcohol use disorder and their light-drinking controls were followed-up for 10 years using questionnaires at three time-points. Magnetic resonance imaging was conducted at the last time-point. SETTING The area near Kuopio University Hospital, Finland. PARTICIPANTS The 62 participants were aged 22-28 years and included 35 alcohol users and 27 controls who had been followed-up for approximately 10 years. MEASUREMENTS Alcohol use was measured by the Alcohol Use Disorders Identification Test (AUDIT)-C at three time-points during 10 years. Participants were selected based on their AUDIT-C score. Magnetic resonance imaging was conducted at the last time-point. Grey matter volume was determined and compared between heavy- and light-drinking groups using voxel-based morphometry on three-dimensional T1-weighted magnetic resonance images using predefined regions of interest and a threshold of P < 0.05, with small volume correction applied on cluster level. FINDINGS Grey matter volumes were significantly smaller among heavy-drinking participants in the bilateral anterior cingulate cortex, right orbitofrontal and frontopolar cortex, right superior temporal gyrus and right insular cortex compared to the control group (P < 0.05, family-wise error-corrected cluster level). CONCLUSIONS Excessive alcohol use during adolescence appears to be associated with an abnormal development of the brain grey matter. Moreover, the structural changes detected in the insula of alcohol users may reflect a reduced sensitivity to alcohol's negative subjective effects.
Contemporary natural history of bicuspid aortic valve disease: a systematic review

We performed a systematic review of the current state of the literature regarding the natural history and outcomes of bicuspid aortic valve (BAV). PubMed and the reference lists of the included articles were searched for relevant studies reporting on longitudinal follow-up of BAV cohorts (mean follow-up ≥2 years). Studies limited to patients undergoing surgical interventions were excluded. 13 studies (11 502 patients with 2–16 years of follow-up) met the inclusion criteria. There was a bimodal age distribution (30–40 vs ≥50 years), with a 3:1 male to female ratio. Complications included moderate to severe aortic regurgitation (prevalence 13%–30%), moderate to severe aortic stenosis (12%–37%), infective endocarditis (2%–5%) and aortic dilatation (20%–40%). Aortic dissection or rupture was rare, occurring in 38 patients (0.4%, 27/6446 in native BAV and 11/2232 in post). With current aggressive surveillance and prophylactic surgical interventions, survival in three out of four studies was similar to that of a matched general population. In this systematic review, valvular dysfunction warranting surgical intervention in patients with BAV were common, aortic dissection was rare and, with the current management approach, survival was similar to that of the general population.
The costs of crime during and after publicly funded treatment for opioid use disorders: a population‐level study for the state of California

Background and aims Treatment for opioid use disorders (OUD) reduces the risk of mortality and infectious disease transmission; however, opportunities to quantify the potential economic benefits of associated decreases in drug‐related crime are scarce. This paper aimed to estimate the costs of crime during and after periods of engagement in publicly funded treatment for OUD to compare total costs of crime during a hypothetical 6‐month period following initiation of opioid agonist treatment (OAT) versus detoxification. Design Retrospective, administrative data‐based cohort study with comprehensive information on drug treatment and criminal justice systems interactions. Setting Publicly funded drug treatment facilities in California, USA (2006–10). Participants A total of 31 659 individuals admitted for the first time to treatment for OUD, and who were linked with criminal justice and mortality data, were followed during a median 2.3 years. Median age at first treatment admission was 32, 35.8% were women and 37.1% primarily used prescription opioids. Measurements Daily costs of crime (US$2014) were calculated from a societal perspective and were composed of the costs of policing, court, corrections and criminal victimization. We estimated the average marginal effect of treatment engagement in OAT or detoxification adjusting for potential fixed and time‐varying confounders, including drug use and criminal justice system involvement prior to treatment initiation. Findings Daily costs of crime during treatment compared with after treatment were $126 lower for OAT [95% confidence interval (CI) = $116, $136] and $144 lower for detoxification (95% CI = $135, $154). Summing the costs of crime during and after treatment over a hypothetical 6‐month period using the observed median durations of OAT (161 days) and detoxification (19 days), we estimated that enrolling an individual in OAT as opposed to detoxification would save $17 550 ($16 840, $18 383). Conclusions In publicly funded drug treatment facilities in California, USA, engagement in treatment for opioid use disorders is associated with lower costs of crime in the 6 months following initiation of treatment, and the economic benefits were far greater for individuals receiving time‐unlimited treatment.
Generalizability of findings from randomized controlled trials: application to the National Institute of Drug Abuse Clinical Trials Network

AIMS To compare randomized controlled trial (RCT) sample treatment effects with the population effects of substance use disorder (SUD) treatment. DESIGN Statistical weighting was used to re-compute the effects from 10 RCTs such that the participants in the trials had characteristics that resembled those of patients in the target populations. SETTINGS Multi-site RCTs and usual SUD treatment settings in the United States. PARTICIPANTS A total of 3592 patients in 10 RCTs and 1 602 226 patients from usual SUD treatment settings between 2001 and 2009. MEASUREMENTS Three outcomes of SUD treatment were examined: retention, urine toxicology and abstinence. We weighted the RCT sample treatment effects using propensity scores representing the conditional probability of participating in RCTs. FINDINGS Weighting the samples changed the significance of estimated sample treatment effects. Most commonly, positive effects of trials became statistically non-significant after weighting (three trials for retention and urine toxicology and one trial for abstinence); also, non-significant effects became significantly positive (one trial for abstinence) and significantly negative effects became non-significant (two trials for abstinence). There was suggestive evidence of treatment effect heterogeneity in subgroups that are under- or over-represented in the trials, some of which were consistent with the differences in average treatment effects between weighted and unweighted results. CONCLUSIONS The findings of randomized controlled trials (RCTs) for substance use disorder treatment do not appear to be directly generalizable to target populations when the RCT samples do not reflect adequately the target populations and there is treatment effect heterogeneity across patient subgroups.
Prevalence of Mycobacterium tuberculosis and human immunodeficiency virus infections in Abeokuta, Ogun State, Nigeria

This study was conducted to evaluate Mycobacterium tuberculosis and human Immunodeficiency virus infections among individuals aged 15 years and above attending outpatient clinic of three hospitals in Abeokuta Metropolis in south-western Nigeria. Of 150 sputum and blood samples examined, the overall prevalence of Mycobacterium tuberculosis and human immunodeficiency virus (HIV) infections was 14.0% and 14.7% respectively. There was no sex significant difference in the prevalence of Mycobacterium tuberculosis (p = 0.706) and HIV (p = 0.558). There was also no significance difference between age-groups for Mycobacterium tuberculosis (p = 0.994) and HIV (p= 0.140) infections. However, Mycobacterium tuberculosis and HIV infections were significantly high among the patients with anaemia (p Mycobacterium tuberculosis and HIV infected patients, all had significantly elevated erythrocyte sedimentation rate (p> 51 mm/hr) (p Keywords : Mycobacterium tuberculosis and HIV infections; prevelence, aged 15 years, Abeokuta, Nigeria. Nigerian Journal of Parasitology Vol. 28 (1) 2007: pp. 39-43
Introduction of a new instrument to measure motivation for gaming: the electronic gaming motives questionnaire

AIMS To adapt the four-dimensional Gambling Motives Questionnaire-Revised (GMQ-R) to measure the motivation for engaging in electronic gaming, and to validate the internal structure and investigate the criterion validity of the new Electronic Gaming Motives Questionnaire (EGMQ). DESIGN AND SETTING The GMQ-R was adapted to measure motivation for playing video games and the new instrument was tested on a sample of Norwegian conscripts selected randomly from the pool of conscripts who started their military service between 2013 and 2015. PARTICIPANTS The questionnaire was administered to all those who had played video games during the last 6 months and consisted of 853 gamers (86.8% men, mean age = 19.4 years). MEASUREMENTS All participants completed the EGMQ, as well as other measures of gaming behaviour, gaming problems, boredom, loneliness and depression. FINDINGS The confirmatory factor analyses showed that the proposed EGMQ (measuring enhancement, coping, social and self-gratification motives) displayed satisfactory fit and internal consistency. Hierarchical regression analyses showed that gender emerged as a significant predictor (P < 0.001) of all the dependent variables (variety, hours weekly gaming, loss of control and gaming problems) and the first step explained between 1 and 6.1% of the variance in the gaming behaviours. In the second step the four motivational dimensions explained an additional 5.8-38.8% of the variance. Coping and self-gratification predicted gaming problems (P < 0.001) and coping alone predicted loss of control (P < 0.001). The four motivational dimensions were also predicted differentially by indicators of psychosocial wellbeing, indicating divergent validity of the four motives. CONCLUSIONS The four-dimensional Electronic Gaming Motives Questionnaire is a valid instrument for measuring motives for gaming.
Clinical features and prognosis of patients with isolated severe aortic stenosis and valve area less than 1.0 cm2

Objective Current guidelines define severe aortic stenosis (AS) as an aortic valve area (AVA)≤1.0 cm2, but some authors have suggested that the AVA cut-off be decreased to 0.8 cm2. The aim of this study was, therefore, to better describe the clinical features and prognosis of patients with an AVA of 0.8–0.99 cm2. Methods Patients with isolated, severe AS and ejection fraction ≥55% with an AVA of 0.8–0.99 cm2 (n=105) were compared with those with an AVA<0.8 cm2 (n=155) and 1.0–1.3 cm2 (n=81). The endpoint of this study was a combination of death from any cause or aortic valve replacement at or before 3 years. Results Patients with an AVA of 0.8–0.99 cm2 group comprised predominantly normal-flow, low-gradient (NFLG) AS, while high gradients and low flow were more often observed with an AVA<0.8 cm2. The frequency of symptoms was not significantly different between an AVA of 0.8–0.99 cm2 and 1.0–1.3 cm2. The combined endpoint was achieved in 71%, 52% and 21% of patients with an AVA of 0.8 cm2, 0.8–0.99 cm2and 1.0–1.3 cm2, respectively (p<0.001). Among patients with an AVA of 0.8–0.99 cm2, NFLG AS was associated with a lower hazard (HR=0.40, 95% CI 0.23 to 0.68, p=0.001) of achieving the combined endpoint with outcomes similar to moderate AS in the first 1.5 years of follow-up. Patients with high-gradient or low-flow AS with an AVA of 0.8–0.99 cm2 had outcomes similar to those with an AVA<0.8 cm2. The sensitivity for the combined endpoint was 61% for an AVA cut-off of 0.8 cm2 and 91% for a cut-off of 1.0 cm2. Conclusions The outcomes of patients with AS with an AVA of 0.8–0.99 cm2 are variable and are more precisely defined by flow-gradient status. Our findings support the current AVA cut-off of 1.0 cm2.