Miracle-dz/UniFAR-FTUs huggingface dataset:
The enduring influence of drinking motives on alcohol consumption after fateful trauma.

OBJECTIVE Drinking motives predict later levels of alcohol consumption and development of alcohol dependence, but their effects on stress-related drinking are less clear. Proximity to the terrorist attack on the World Trade Center (WTC) on 9/11/01 was significantly associated with alcohol consumption 1 and 16 weeks after 9/11/01. We investigated the relationship between drinking motives measured a decade earlier, proximity to the WTC, and drinking after 9/11/01. This event constitutes a natural experiment for studying the effects of previously measured drinking motives on alcohol consumption after fateful trauma. METHODS Adult drinkers (N = 644) residing in a New Jersey county were evaluated for four drinking motives: coping with negative affect, for enjoyment, for social facilitation and social pressure. After 9/11/01, their exposure to the WTC attack and subsequent drinking were assessed. Poisson regression was used to assess the relationships between proximity to the WTC, drinking motives and post-9/11/01 drinking; models were adjusted for alcohol dependence, age, gender and race. RESULTS Drinking to cope with negative affect predicted alcohol consumption 1 week after 9/11/01 (p = 0.04) and drinking for enjoyment predicted drinking 1 and 16 weeks after 9/11/01 (p = 0.001 and 0.01, respectively). The associations were independent of proximity to the WTC. No interactions were observed between drinking motives, proximity to the WTC or lifetime alcohol dependence. CONCLUSION Drinking motives a decade earlier predicted higher alcohol consumption after fateful trauma independently from proximity to the WTC on 9/11/01. Results suggest that drinking motives constitute a robust, enduring influence on drinking behavior, including after traumatic experiences.
Patient health education literature: Maximising its effect

Abstract Modern healthcare delivery is concerned with actively engaging patients in such a way that independence and self-control is attainable. This is particularly important for those with chronic disease, requiring lifelong learning and consequential lifestyle adjustment. Patient education offers an enabling opportunity for patients to access information and resources that facilitate self-management skills. One facet of patient educational practices involves the use of health education literature. Health professionals are ideally placed to develop or make available the most appropriate patient focused literature. However, these professionals must have the necessary knowledge and skills to determine the validity of such educational material. This paper provides an overview of salient issues and advice to guide health professionals in their choice of health education literature to be incorporated into patient care.
Antigen‐induced arthritis

During the acute phase of antigen-induced arthritis, cartilage was obtained from five different sites within the joint, and chondrocyte activity was assessed by autoradiography of sections labeled with 35S-sulfate. There was a marked inhibition of chondrocyte proteoglycan synthesis in all weight-bearing areas; in addition, the complete superficial layer of cells and many mid-zone cells in these areas were completely inactive. Electron microscopy showed that the inactive surface cells had degenerated completely, and that many mid-zone cells contained an accumulation of intracytoplasmic filaments and were depleted in biosynthetic organelles. A biochemical study of the inhibition showed that: 1) the incorporation of 35S-sulfate and 3H-acetate into glycosaminoglycans was inhibited to a similar extent; 2) the inhibition of glycosaminoglycan synthesis could not be reversed either by the addition of benzyl-beta-D-xyloside to incubations or by maintenance of the cartilage in organ culture for 6 days; 3) the inhibited chondrocytes exhibited a decreased ability to secrete proteoglycans into the extracellular fraction of the cartilage.
Impact of multiple types of childhood trauma exposure on risk of psychiatric comorbidity among alcoholic inpatients.

BACKGROUND This study examined the prevalence of single- and multiple-type childhood trauma exposure (CTE) among alcoholic patients undergoing inpatient detoxification and treatment. The relationships between various types of CTE and lifetime psychiatric comorbidities and suicide attempts were also explored. METHODS A total of 196 alcoholic inpatients were assessed by Structured Clinical Interview for DSM-IV Axis I Disorders and Childhood Trauma Questionnaire (CTQ) for CTE history. RESULTS The overall prevalence of CTE in the entire sample was high (55.1%). Specifically, the prevalence of emotional abuse was 21.4%, physical abuse 31.1%, sexual abuse 24.0%, emotional neglect 20.4%, and physical neglect 19.9%. Regarding multiple types of CTE, 31.7 and 18.9% reported at least 2 and at least 3 CTE types, respectively. Strikingly, among those with at least 1 positive CTQ category, more than half reported 2 or more CTE types. A history of emotional abuse increased the risk of mood disorder, in particular major depressive disorder, as well as posttraumatic stress disorder (PTSD). Physical abuse contributed to the prediction of suicide attempts, while sexual abuse was associated with a diagnosis of anxiety disorder, PTSD, and multiple comobidities (e.g., anxiety and mood disorder). The number of reported CTE types or the total score of the CTQ predicted an increased risk of having single or multiple psychiatric comorbidities as well as suicide attempts. CONCLUSIONS We observed high rates of a broad range of CTE types and a trend for CTE-specific enhancement of risk for various psychiatric outcomes among alcoholic inpatients. Of note, a dose-response relationship between number of CTE types and risk of psychiatric comorbidities as well as suicide attempts was found. We suggest a wide range of CTE should be included when exploring the effects of CTE or developing prevention and treatment strategies among alcoholic subjects.
Adolescence and parental history of alcoholism: insights from the sleep EEG.

BACKGROUND Disrupted sleep is a common complaint of individuals with alcohol use disorder and in abstinent alcoholics. Furthermore, among recovering alcoholics, poor sleep predicts relapse to drinking. Whether disrupted sleep in these populations results from prolonged alcohol use or precedes the onset of drinking is not known. The aim of this study was to examine the sleep electroencephalogram (EEG) in alcohol-naïve, parental history positive (PH+), and negative (PH-) boys and girls. METHODS All-night sleep EEG recordings in 2 longitudinal cohorts (child and teen) followed at 1.5 to 3 year intervals were analyzed. The child and teen participants were 9/10 and 15/16 years old at the initial assessment, respectively. Parental history status was classified by Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria applied to structured interviews (DIS-IV) resulting in 14 PH- and 10 PH+ children and 14 PH- and 10 PH+ teens. Sleep data were visually scored in 30-second epochs using standard criteria. Power spectra were calculated for EEG derivations C3/A2, C4/A1, O2/A1, O1/A2 for nonrapid eye movement (NREM) and rapid eye movement (REM) sleep. RESULTS We found no difference between PH+ and PH- individuals in either cohort for any visually scored sleep stage variable. Spectral power declined in both cohorts across assessments for NREM and REM sleep in all derivations and across frequencies independent of parental history status. With regard to parental history, NREM sleep EEG power was lower for the delta band in PH+ teens at both assessments for the central derivations. Furthermore, power in the sigma band for the right occipital derivation in both NREM and REM sleep was lower in PH+ children only at the initial assessment. CONCLUSIONS We found no gross signs of sleep disruption as a function of parental history. Modest differences in spectral EEG power between PH+ and PH- children and teens indicate that a marker of parental alcohol history may be detectable in teens at risk for problem drinking.
The relationship between alcohol consumption and fatal motor vehicle injury: high risk at low alcohol levels.

BACKGROUND Alcohol consumption causes motor vehicle accident (MVA) injury in a dose-response fashion. However, the relationship between how this risk is different with respect to fatal and nonfatal outcomes is not clear. A meta-analysis has already been completed for alcohol consumption and nonfatal MVA injury, but none exists for fatal injury. Thus, an analysis of the acute dose-response relationship between alcohol and motor vehicle injury death is warranted to generate single occasion- and dose-specific relative risks for the first time. METHODS A systematic literature review and inverse-variance weighted, random effects meta-analysis were conducted to fill this gap. Fractional polynomial regression was used to model the dose-response relationship. Usual tests of heterogeneity and publication bias were run. RESULTS Five studies meeting the inclusion criteria of this analysis were selected. At all levels of blood alcohol concentration (BAC), the odds ratio (OR) of fatal motor vehicle injury was significant. Overall, the 5 combined studies yielded an OR of fatal injury of 1.74 (95% CI: 1.43-2.14) for every 0.02% increase in BAC. At 0.08, the legal limit in most countries, the OR was 13.0 (95% CI: 11.1-15.2). CONCLUSIONS This study is able to definitively show and quantify, for the first time, the significantly increased OR for fatal motor vehicle injury. This analysis showed some evidence of both study heterogeneity and publication bias, likely due to the increased variation we could expect from a small study number. The alcohol-caused fatal motor vehicle injury literature is sparse with respect to dose-response information. More studies investigating this relationship and other injury types are recommended in this area to be able to calculate stable estimates of risk overall and by injury type specifically.
Gain of chromosome 1q portends worse prognosis in multiple myeloma despite novel agent-based induction regimens and autologous transplantation

Abstract We aimed to identify whether the use of autologous hematopoietic cell transplantation (HCT) impacts outcomes for multiple myeloma patients with gains of chromosome 1q (+1q). We retrospectively identified 95 patients, 21% having +1q. For patients with +1q, the overall response rate to induction was 85%, with 40% having ≥ VGPR and 20% achieving a CR, similar to non +1q patients (p = .64). The median PFS from diagnosis with +1q was 2.1 years (95% CI: 1.2–not reached (NR)) vs 4.3 years (95% CI: 3.3 yrs–NR) without +1q (p = .003). Median OS from diagnosis was 4.4 years (95% CI: 2.9–NR) vs not reached, respectively (p = .005). On molecular analysis using the Foundation One Heme assay, the most common mutations seen in +1q patients included TP53 (38%) and KRAS (25%). Overall, gain of 1q portends worse PFS and OS which was not negated by auto HCT. Such patients will likely require additional therapy to improve their survival.
Intranasal oxytocin blocks alcohol withdrawal in human subjects.

BACKGROUND The neuropeptide, oxytocin (OT), has been reported to block tolerance formation to alcohol and decrease withdrawal symptoms in alcohol-dependent rodents. Numerous recent studies in human subjects indicate that OT administered by the intranasal route penetrates into and exerts effects within the brain. METHODS In a randomized, double-blind clinical trial, intranasal OT (24 IU/dose, N = 7) or placebo (N = 4) was given twice daily for 3 days in alcohol-dependent subjects admitted to a research unit for medical detoxification using Clinical Institute Withdrawal Assessment for Alcohol (CIWA) score-driven PRN administration of lorazepam. Subjects rated themselves on the Alcohol Withdrawal Symptom Checklist (AWSC) each time CIWA scores were obtained. Subjects also completed the Penn Alcohol Craving Scale, an Alcohol Craving Visual Analog Scale (ACVAS) and the Profile of Mood States (POMS) on inpatient days 2 and 3. RESULTS All subjects had drunk heavily each day for at least 2 weeks prior to study and had previously experienced withdrawal upon stopping/decreasing alcohol consumption. OT was superior to placebo in reducing alcohol withdrawal as evidenced by: less total lorazepam required to complete detoxification (3.4 mg [4.7, SD] vs. 16.5 [4.4], p = 0.0015), lower mean CIWA scores on admission day 1 (4.3 [2.3] vs. 11.8 [0.4], p < 0.0001) and day 2 (3.4 [2.2] vs. 11.1 [3.6], p < 0.002), lower AWSC scores on days 1 and 2 (p < 0.02; p = 0.07), and lower ACVAS ratings (p = 0.01) and lower POMS Tension/Anxiety subscale scores on day 2 (p < 0.01). CONCLUSIONS This is the first demonstration that OT treatment may block alcohol withdrawal in human subjects. Our results are consistent with previous findings in rodents that OT inhibits neuroadaptation to and withdrawal from alcohol. OT could have advantages over benzodiazepines in managing alcohol withdrawal because it may reverse rather than maintain sedative-hypnotic tolerance. It will be important to test whether OT treatment is effective in reducing drinking in alcohol-dependent outpatients.
Dementias That Present With and Without Posterior Cortical Features: An Important Clinical Distinction

There are distinct qualitative differences between the dementias that present with and without posterior cortical features. These can be utilized in dementia assessment. This paper reviews the validity and potential utility of a dichotomy based on generalized cortical (Type 1) versus isolated frontal system pathology (Type 2). These syndromes are associated with distinct differentials and problem behaviors. They may also result in different caregiving burdens or treatment responses. Alzheimer's disease (AD) is by far the most common cause of the Type 1 syndrome. Type 2 presentations select for potentially reversible non‐AD conditions. Common cognitive screening instruments are insensitive to Type 2 cases. However, the Type 1/Type 2 distinction can be made reliably using qualitative clinical rating scales. We will review these instruments and discuss their application in clinical settings.
Assessment of safe delivery service utilization among women of childbearing age in north Gondar Zone, north west Ethiopia

Abstract Background: Though women comprise a large proportion of a given society, still many of them in developing countries are at a greater disadvantage in terms of high maternal morbidity and mortality. A large number of women are dying due to factors related to pregnancy and childbirth in these countries. Objective: This study assessed safe delivery services utilization and associated factors among mothers who gave birth during five years preceding a survey conducted in North Gondar Administrative Zone, Amhara Regional State. Method: A community-based cross-sectional comparative survey was conducted in November and December 2002. A total of 1,242 women who had at least one live birth in the five years preceding the survey were selected randomly. Results: The study revealed that a total of 13.5% of mothers gave birth to their last babies in health facilities. Only about 25 of the rural women gave birth in the health institutions. Untrained traditional birth attendants and relatives attended 76.4% of the deliveries. The reported reasons were: absence of health problems, short duration of labor, preferring the attention of relatives and trust in traditional birth attendants. Educational status of the mothers, place of residence, access to radio, monthly income, prenatal care, history of intrapartum complications and other selected obstetric behaviors of the respondents showed statistically significant association with the utilization of safe delivery services (p<0.05, for each factor). Conclusion: In general, this study revealed that the proportion of births delivered in health facilities is low in the area. Demographic and socio-cultural factors were found to be barriers to the utilization of safe delivery services. Enhancing the establishment of more emergency obstetric care centers within reasonable access, providing Information, Education and Communication (IEC) on maternity services utilization and harmful traditional practices and improving the status of women in the community are recommended. [Ethiop.J.Health Dev. 2004;18(3):145-152]
METABOLIC SYNDROME AND PHYSICAL ACTIVITY IN SOUTHERN BRAZILIAN COMMUNITY‐DWELLING ELDERLY PEOPLE

ACKNOWLEDGMENTS Conflict of Interest: The editor in chief has reviewed the conflict of interest checklist provided by the authors and has determined that the authors have no financial or any other kind of personal conflicts with this letter. Author Contributions: Study concept and design: Wing-Keung Cheung. Acquisition of subjects and data: Wing-Keung Cheung and Po-Wen Cheng. Analysis and interpretation of data: Wing-Keung Cheung, Po-Wen Cheng, and Kao-Lun Wang. Preparation of manuscript: WingKeung Cheung. Critical review and approval: All authors. Sponsor’s Role: None.
Prospective randomized trial of 5 days azacitidine versus supportive care in patients with lower-risk myelodysplastic syndromes without 5q deletion and transfusion-dependent anemia

Abstract In this prospective trial, the efficacy of azacitidine in lower-risk myelodysplastic syndromes (LR-SMD) lacking del(5q) was compared to best supportive care (BSC) at 1:1. The primary endpoint was the achievement of erythroid hematologic improvement (HI-E) after nine cycles. Thirty-six patients received at least ≥1 cycle. HI-E was confirmed 44.4% randomized to Aza and in 5.5% of patients receiving BSC (p < .01). After entry in Aza extension period, transfusion independence was achieved in all Aza responders with a median duration of 50 weeks (range: 17–231). No significant differences were observed in secondary endpoints. Importantly, variant allele frequency (VAF) of some mutated genes (RET, SF3B1, ASXL1) decreased after 9 months of treatment in Aza-responder patients. In conclusion, LR-MDS patients lacking del5q and resistant to ESAs, who receive 5 days Aza, achieve TI in a substantial proportion of cases and results in modifications in mutational landscape.
The mutational landscape of small lymphocytic lymphoma compared to non-early stage chronic lymphocytic leukemia

Abstract Small lymphocytic lymphoma (SLL) is considered as the non-leukemic form of presentation of chronic lymphocytic leukemia (CLL). We have compared the features, genomic alterations, and outcome of 890 patients with CLL and SLL. One hundred and thirteen patients presented as SLL and more frequently had unmutated-IGHV, CD38high, ZAP-70high, CD49dhigh, +12, alterations in genes of NOTCH1, cell cycle, RNA metabolism, and NFkB pathways than CLL. During the follow-up, 46% of SLL patients developed CLL. Time to first treatment (TTFT) was shorter in SLL (10-year: 75% vs 62%; p = .006). Binet stage, SLL, and IGHV were independent predictive factors for TTFT. Transformation to diffuse large B-cell lymphoma was higher (10-year: 12% vs 6%; p = .003), and overall survival was shorter in SLL (10-year: 55% vs 66%; p = .004). When A0 CLL patients were excluded, only CD38 and CD49d expression, +12, and 10-year TTFT remained different between the SLL and CLL patients. In summary, SLL showed only minor clinicobiological differences when compared with CLL in similar clinical stages.
Diabetes Connect: Developing a Mobile Health Intervention to Link Diabetes Community Health Workers With Primary Care

Community health worker (CHW) interventions can help improve diabetes self-management and health outcomes. There is limited evidence on how to effectively integrate CHW programs with primary care efforts. Mobile health technology (mHealth) can connect CHWs to members of the health care team and enhance care. We tested a model for the integration of a CHW-delivered mHealth intervention to improve diabetes self-management. Seventy-two African American patients with diabetes were followed using the mHealth tool. This project partnered an academic institution, a safety-net clinic, and African American churches. The integration of mHealth technology into CHW programs was successfully achieved and readily accepted.
Prognostic value of pre-therapy C-reactive protein level in diffuse large B-cell lymphoma: a meta-analysis

Abstract The current meta-analysis was conducted aiming to explore the association between pre-therapy CRP and DLBCL survival outcomes. We retrieved previously published studies available from PubMed, EMBASE, Web of Science, The Cochrane Library, Wanfang databases, and China National Knowledge Infrastructure databases by June 2017. A total of 12 studies composed of 3000 patients were included in this study according to our selection criteria. The pooled HRs of elevated pre-therapy CRP were 2.66 (95% CI = 1.95–3.64, p < .001) for OS while 2.19 (95% CI = 1.72–2.78, p < .001) for PFS. Sensitivity analysis and subgroup analysis indicated that CRP remained a prognostic biomarker for OS and PFS. The pooled HR was 3.01 (95% CI = 2.38-3.81, p < .001) for OS if excluding 3 heterogeneous studies, and the heterogeneity decreased from 59.6% to 11.2%. Our study revealed that pre-therapy CRP can be a potential prognostic marker for patients with DLBCL.
Decitabine for myelodysplastic syndromes: dose comparison in a real world clinical setting

Abstract We retrospectively studied 133 myelodysplastic syndrome patients receiving decitabine during January 2009 and September 2017. The dose of 15 mg/m2/d (n = 83) and 20 mg/m2/d (n = 50) had comparable overall response rates (ORR) (51.8% vs. 52.00%) and complete remission rate (CRR) (15.66% vs. 22.00%). The 15 mg/m2/d group had a lower incidence of grade 3/4 neutropenia (60.24% vs. 88.00%, p < .05) and thrombocytopenia (65.06% vs. 88.00%, p < .05). The 15 mg/m2/d group had a longer median overall survival (OS) (21.60 months vs. 15.23 months, p = .02). The same results were seen in refractory anemia with excess blasts (RAEB) patients: The 15 mg/m2/d group also had comparable ORR, CRR, decreased hematological toxicities and longer OS. Further analysis suggested that survival benefit of 15 mg/m2/d group was mainly in those patients with lower risk stratification. In conclusion, 15 mg/m2/d decitabine is associated with a lower incidence of hematological toxicities and longer OS and may be more suitable for patients with relatively lower risk.