Excessive Alcohol Research Articles

Risk Factor Profile for Cardiovascular Diseases Among Farmhouse Residents in Vijayapura District, Karnataka: A Cross-Sectional Study.

Background Cardiovascular illnesses are widely regarded as the leading cause of mortality worldwide, with 17.9 million deaths every year. Rheumatic heart disease, coronary heart disease, and cerebrovascular illness are among the conditions relating to the heart and blood vessels together, known as cardiovascular diseases. The main behavioural risk factors for heart disease and stroke include poor diet, inactivity, tobacco use, and excessive alcohol consumption. In contrast, one of the significant environmental risk factors is air pollution. People may experience high blood pressure and high blood sugar due to obesity and overweight as risk factors. Objectives This study aims to find the risk factor profile for cardiovascular diseases among the farmhouse residents of the Vijayapura district, India. Materials and methods A cross-sectional descriptive study was conducted with the farmhouse inhabitants of the Vijayapura district. Using a prestructured proforma that included details on the sociodemographic profile and risk factors of the farmhouse dwellers, 450 sample participants were questioned. Five families within a chosenprimary sampling unit (PSU) were chosen randomly from a pool of PSUs that were picked using a probability proportional to size sampling technique. All characteristics were summarized descriptively. Results The study included 450 participants, 50.9% males and 49.1% females. The age range of 21.4% of the male participants was between 41 and 50, whereas 21.7% of the female participants belonged to the 41 to 50 age group. The study showed a proportion of them had the habit of alcohol consumption (5.8%), chewing tobacco (2%), and smoking (1.6%). Compared to female participants (1.3% vs. 1.3%), the majority of male individuals (4.8% vs. 7%) had hypertension and diabetes mellitus, respectively. Conclusion The findings of the current research indicated that the majority of farm inhabitants in the rural Vijayapura district were illiterate, belonged to a lower socioeconomic class, and had intermediate and behavioural risk factors for cardiovascular illnesses.

Benefits of population-level interventions for dementia risk factors: an economic modelling study for England

Individual-level interventions for dementia risk factors could reduce costs associated with dementia and some are cost-effective. We aimed to estimate the cost-effectiveness of population-level interventions for tackling dementia risk factors. In this economic modelling study, we included recommended population-based interventions from a previously published review article for which there was consistent and robust evidence of effectiveness in tackling a dementia risk factor (tobacco smoking, excess alcohol use, hypertension, obesity, air pollution, and head injury). We only included interventions if they had not been introduced in England or were in place but could be extended. The interventions studied were increases in tobacco pricing, minimum pricing for alcohol, raising alcohol price, salt reduction policies, sugar reduction policies, low emission zones, and compulsory helmet use for cycling by children (aged 5-18years). We used published intervention effect sizes and relative risks for each risk factor and a Markov model to estimate progression to dementia in populations with and without the intervention, looking at lifetime risk, in the population of England. We estimated that reductions in excess alcohol use through minimum unit pricing would lead to cost-savings of £280million and 4767 quality-adjusted life-years (QALYs) gained over an indefinite succession of age cohorts. Reformulation of food products to reduce salt would lead to cost-savings of £2·4billion and 39 433QALYs gained and reformulation to reduce sugar would lead to cost-savings of £1·046billion and 17 985QALYs gained. Reducing dementia risk from air pollution by introducing low emission zones in English cities with a population of 100 000or more (that do not already impose restrictions) would lead to £260million cost-savings and 5119QALYs gained. Raising cigarette prices by 10% to reduce dementia risk from smoking would lead to 2277QALYs gained and cost-savings of £157million. Making bicycle helmets compulsory for children (aged 5-18years) to reduce dementia risk from head injury would lead to cost-savings of £91million and 1554QALYs gained. Population-level interventions could help tackle life course dementia risk and save costs. UK National Institute for Health and Care Research Three Schools dementia research programme.

Recollecting a previous drinking episode reduces subsequent motivation for alcohol in females

Research has consistently demonstrated the effects of alcohol on memory, but the extent to which memory influences prospective drinking behaviour has not been studied extensively. Here, we adapt and extend theory from the food domain to explore whether memory for a previous drinking episode can reduce the motivation to consume alcohol. Female participants (N = 50) completed the Alcohol Use Disorder Identification Test (AUDIT) and were then cued to recall either a previous alcohol drinking episode and estimate the number of alcohol calories consumed (Alcohol Cue, AC) or a control (Neutral Cue, NC). They then consumed an alcoholic beverage in their own time followed by providing an estimate of subsequent alcohol intake. We found that the duration to finish the drink was longer in the AC versus NC condition. Additionally, irrespective of condition, those individuals at a higher alcohol (AUDIT) risk, consumed the drink at a faster rate and wished to consume more subsequent alcohol. These findings suggest that for females, memory for a previous drinking alcohol episode, reduces subsequent desire for alcohol and could offer a potentially useful way to help avoid excess alcohol consumption.

Evaluation and comparison of sensitivity of alcohol biomarkers PEth, EtG and EtPa in civil cases in England 2022–2023

This study details trends in direct alcohol biomarker concentrations from civil cases within the United Kingdom (UK). Our subject cohort in this study related to family law litigation, where an individual was subject to an alcohol monitoring order by the court. This monitoring was conducted by quantification of alcohol biomarkers Phosphatidlyethanol (PEth) in dried blood spots (DBS) and Ethyl Glucuronide (EtG) and Ethyl Palmitate (EtPa) from hair segments. In total 298 PEth cases predominantly from the South East of England during the period July 2022 to August 2023 were analysed for alcohol biomarkers in DBS and hair. Subjects alcohol intake was classified as abstinence/low alcohol consumption, moderate or excessive alcohol consumption, based on a combination of Society for Hair Testing and PEth Net guidelines. Our results indicate that 33 % of PEth concentrations were consistent with excessive alcohol use (>200 ng/mL DBS), with 36 % consistent with social or moderate alcohol use (20–200 ng/mL DBS). In relation to EtG and EtPa 23 % and 31 % of subjects were classified as excessive alcohol users respectively. This study indicates that DBS sampling of PEth is a more sensitive predictor of alcohol use, in particular, at differentiating between moderate and excessive alcohol use compared to EtG and EtPa testing in hair. The authors suggest that increased frequency in the sampling of PEth in DBS (multiple occasions per month) may provide a more accurate assessment and simplification of the interpretation criteria of alcohol patterns rather than the combined hair testing and DBS sampling that are typically requested by UK courts.

Alcoholic Liver Disease in China: A Disease Influenced by Complex Social Factors That Should Not Be Neglected.

Alcoholic liver disease (ALD) encompasses liver damage caused by chronic, excessive alcohol consumption. It manifests initially as marked hepatocellular steatosis and can progress to steatohepatitis, liver fibrosis, and cirrhosis. With China's rapid economic growth, coupled with a complex social background and the influence of a deleterious wine culture, the number of patients with ALD in China has increased significantly; the disease has become a social and health problem that cannot be ignored. In this review, we briefly described the social factors affecting ALD in China and elaborated on differences between alcoholic and other liver diseases in terms of complications (e.g., cirrhosis, upper gastrointestinal bleeding, hepatic encephalopathy, hepatocellular carcinoma, addiction, and other extrahepatic diseases). We also emphasized that ALD was more dangerous and difficult to treat than other liver diseases due to its complications, and that precise and effective treatment measures were lacking. In addition, we considered new ideas and treatment methods that may be generated in the future.

Association between excessive alcohol consumption and incident diabetes mellitus among Japanese based on propensity score matching

The available evidence on the connection between excessive alcohol consumption and diabetes is controversial. Therefore, the primary objective of this investigation was to examine the connection between excessive alcohol consumption and incident diabetes in a Japanese population through the utilization of propensity score matching (PSM) analysis. Our retrospective cohort study encompassed a sample of 15,464 Japanese individuals who were initially free of diabetes between the years 2004 and 2015. The study utilized comprehensive medical records of individuals who underwent a physical examination. Employing a one:one PSM analysis, the current research included 2298 individuals with and without excessive alcohol consumption. Furthermore, a doubly robust estimation method was employed to ascertain the connection between excessive alcohol consumption and diabetes. The findings revealed that individuals with excessive alcohol consumption exhibited a 73% higher likelihood of developing diabetes (HR = 1.73, 95% CI 1.08–2.77). Furthermore, upon adjusting for variables, the PSM cohort demonstrated that individuals with excessive alcohol consumption had a 78% increased risk of developing diabetes in comparison to those with non-excessive alcohol consumption (HR = 1.78, 95% CI 1.08–2.93). Individuals with excessive alcohol consumption were found to have a 73% higher risk of developing diabetes compared to those with non-excessive alcohol consumption, even after controlling for propensity score (HR = 1.73, 95% CI 1.08–2.78). Participants in the PSM cohort with excessive alcohol consumption had a 73% higher risk of developing diabetes than those with non-excessive alcohol consumption after controlling for confounding factors. These findings underscore the importance of alcohol consumption guidelines aimed at reducing excessive drinking. Clinicians should be vigilant in screening for alcohol use in patients, particularly those at risk for diabetes, and provide appropriate counseling and resources to support alcohol reduction.

Serum Resistin Levels in Patients with Nonalcoholic Fatty Liver Disease in an Iranian Population

Introduction: Non-alcoholic fatty liver disease (NAFLD) is a major global health problem, in which liver fat exceeds 5% of the liver weight, without secondary causes of fat accumulation or excessive alcohol consumption. Resistin plays a key role in energy homeostasis, insulin resistance, inflammation, and metabolic disorders. This study aimed to investigate the relationship between resistin (RETN) level and NAFLD. Methods: In this cross-sectional study, 80 patients with NAFLD and 80 healthy individuals as controls were evaluated. Biochemical variables, liver enzymes, insulin, and resistin were measured. Data were analyzed using SPSS version 16 software. Results: The variables of cholesterol, insulin, triglyceride, HDL, body mass index, age, and liver enzymes were significantly different between the two groups of patients with NAFLD and healthy individuals (p<0.05). In patients, resistin was associated with triglyceride (r=0.243, p=0.045). No association was found between resistin level and NAFLD grades (p≥0.05). Conclusion: The results of this study indicate that there is a relationship between resistin and NAFLD. There is no association between resistin level and the degree of NAFLD.

AYURVEDIC MANAGEMENT OF AVASCULAR NECROSIS WITH CHANDAN BALA LAKSHADI TAIL AND LAKSHADI GUGGUL

Avascular Necrosis (AVN) is a progressive degenerative condition of bone that mainly affects the bone of the lower region. It is more common in the hip joint. Avascular necrosis of the femoral head refers to the death of osteocytes with subsequent structural changes due to impaired blood supply. People between 30 and 50 years of age are usually affected. It is associated with excessive alcohol intake and long-term use of high-dose steroidal medications. On the contrary, Ayurvedic treatment provides long-term relief and prevents disease progression without drawbacks. it is Vata Pradhana Tridoshaja Vyadhi with Vikruti of Asthi-Majja Dhatu. In modern medicine, no specific treatment other than surgery is available. The present case study is upon a 45year male patient, diagnosed with avascular necrosis involving nearly 50 percent of the femoral head with moderate marrow oedema (stage 3rd) femoral head with complaints of pain in the bilateral hip region since one and half years, which was associated with difficulty in doing normal daily activities such as walking, sitting, squatting along with a change in the gate.

Quality assessment of the screening test for predictors of coronary heart disease

Background. Coronary heart disease (CHD) ranks first among the causes of death, morbidity, and disablement. The development of innovative methods for predicting CHD will reduce these losses.The aim of the work. To assess the quality of the screening test for predictors of coronary heart disease using statistical quality control of a verifiable diagnostic test (with binary outcomes).Materials and methods. In 2008–2013, 70 cases of CHD were registered in a groupof 7959 initially healthy men 18–66 years old who were the members of locomotive crews. Statistical analysis identified CHD predictors: arterial hypertension; psychosocial stress; hyperglycemia; dyslipidemia; excessive alcohol consumption; obesity of degree I–III; age 34–66 years; microalbuminuria; thickening of the intima- media complex/atherosclerotic plaque (IMC/ASP); pulse wave velocity (PWV) > 12 m/s; left ventricular hypertrophy; grade I–II retinopathy; atherosclerosis of aorta. DiagStat (Russian Federation) software determined their predictive ability when used in screening tests to predict CHD. We demonstrated the use of this method to assess the predictive ability of risk factors for any disease.Results. CHD predictors have high to moderate specificity for the absence of CHD in individuals who test negative for the above-listed factors. IMC/ASP, microalbuminuria, PWV > 12 m/s, grade III obesity moderately increase the posterior odds of developing CHD versus its absence in comparison with the prior odds after receiving a positive result of the verifiable diagnostic test for these factors. Age 34–66 years moderately increases the posterior odds in favor of the absence of CHD versus its occurrence compared with the prior odds after receiving a negative result of the verifiable diagnostic test.Conclusion. When assessing the result of the verifiable diagnostic test, we should focus on both the probability of occurrence and the absence of CHD in the presence or absence of a predictor in the patient. Since the determination of PWV > 12 m/s, atherosclerosis of aorta, microalbuminuria, stress, and excessive alcohol consumption among workers of locomotive crews is not mandatory, it is necessary to conduct a targeted search for them

AUDIT C compared to PEth in middle-aged volunteers.

To compare Alcohol Use Disorders Identification Test (AUDIT C) to phosphatidylethanol (PEth) in middle-aged randomly selected volunteers. Apply previously suggested lower cut-offs for PEth using moderate alcohol intake according to AUDIT C as a reference. Within the Swedish CardioPulmonary BioImage Study, 2255 middle-aged (50-64years of age) volunteers in northern Sweden participated in comparing AUDIT C to PEth 16:0/18:1. There was a moderate correlation between PEth 16:0/18:1 and AUDIT C (r = 0.66). None of the participants with the AUDIT C-score 0 had a measurable PEth. Of moderate alcohol consumers, according to AUDIT C (AUDIT C 1-3 women, 1-4 men), 96% had a PEth below 0.3μmol/L, 91% had a PEth below 0.16μmol/L, and 84% had a PEth below 0.11μmol/L. With PEth equivalent to excessive alcohol consumption (≥0.3μmol/L), 26% had an AUDIT C-score below excessive alcohol consumption (<4 for women and <5 for men). Thirty percent of patients with a PEth ≥0.16μmol/L had an AUDIT C-score below excessive alcohol consumption, and 37% had a PEth ≥0.11μmol/L. We found no significant correlation between BMI and PEth or AUDIT C. There is a significant correlation between AUDIT C and PEth. Using AUDIT C alone, 26% of high-consumers, according to PEth, are not found in our cohort, but an AUDIT C-score of 0 will exclude high consumption, according to PEth. Our findings support the current cut-off for PEth of 0.3μmol/L, but a lower cut-off seems reasonable.

Exploring the Hepatoprotective Potential of Plants: A Comprehensive Review

The liver is an important organ that aids in the metabolism and elimination of xenobiotics from the body. Liver injury or malfunction is a serious public health issue that affects not only doctors and nurses, but also the pharmaceutical business and drug regulatory bodies. Excessive alcohol use, toxic chemicals (particular antibiotics, chemotherapeutic drugs, carbon tetrachloride (CCL4), thioacetamide (TAA), and microorganisms all induce liver cell harm. In this scenario, the current synthetic medications to treat liver problems promote more liver damage. As a result, herbal drugs have grown in popularity and are widely used. For a long time, herbal remedies have been utilized to treat liver problems. There are a variety of herbal preparations on the market. The goal of this review is to compile information on promising phytochemicals from medicinal plants that have been investigated in hepatotoxicity models utilizing cutting-edge scientific methods.

Heart health champions: how to develop student nurses as role models for cardiovascular health

Abstract Background Nurses as health promotors are optimally placed to identify cardiovascular disease risk factors and discuss behaviour change strategies for modifiable risk factors, but most undergraduate curriculums lack detailed content regarding these topics. Unfortunately evidence indicates that student nurses often demonstrate risky behaviours such as smoking, physical inactivity, excessive alcohol consumption and poor nutritional choices. As nursing is a pressurised career with long shifts and often challenging emotional encounters, it can be easy to overlook personal health behaviours. Purpose Given that nursing students are our potential health promotors of the future, we aimed to enhance cardiovascular knowledge and behaviour change awareness in their undergraduate education by implementing a co-designed digital educational resource - ASMOSUS. It sought to embed knowledge and risk assessment of cardiovascular disease risk factors, while motivating and sustaining behaviour change within undergraduates, facilitating them to make healthier lifestyle choices themselves and act as role models for patients. We developed roles of ‘Heart Health Champions’ within university and clinical placements, which is novel for both clinical practice and Higher Education Institutes. Methods Any nursing student who had received the ASMOSUS digital educational resource in the first semester of their undergraduate program and had an interest in further knowledge acquisition and health promotion amongst their peers were invited to become a Heart Health Champion. Alongside the recruitment of Heart Health Champions the cohort received cardiovascular risk factor specific educational sessions on physical exercise, smoking and vaping cessation, nutrition and alcohol consumption. Results We recruited 9 Heart Health Champions from the cohort representing all fields of undergraduate nursing. These students have undertaken 30 hours of required participation, leading to a university recognised qualification- FutureReady on graduation. This included attending cardiac risk and prevention training with cardiac rehabilitation nurses. They have taken the initiative to plan activities such as a sponsored walk, a ‘dancercise' class and support for their peers in harnessing healthy lifestyle behaviours through role modelling and motivational interviewing techniques. Results demonstrate that these sessions and student led activities are well attended and positively evaluated, which shows that including cardiovascular prevention techniques in undergraduates is feasible and acceptable. Conclusion Heart Health Champions are a valuable asset and can promote modifiable risk factor change amongst their peers and may help to maintain a healthy lifestyle. Further Heart Health Champions will be recruited over the next undergraduate nursing cohorts with a planned study to explore their effectiveness.

Detection of Common Respiratory Infections, Including COVID-19, Using Consumer Wearable Devices in Health Care Workers: Prospective Model Validation Study.

The early detection of respiratory infections could improve responses against outbreaks. Wearable devices can provide insights into health and well-being using longitudinal physiological signals. The purpose of this study was to prospectively evaluate the performance of a consumer wearable physiology-based respiratory infection detection algorithm in health care workers. In this study, we evaluated the performance of a previously developed system to predict the presence of COVID-19 or other upper respiratory infections. The system generates real-time alerts using physiological signals recorded from a smartwatch. Resting heart rate, respiratory rate, and heart rate variability measured during the sleeping period were used for prediction. After baseline recordings, when participants received a notification from the system, they were required to undergo testing at a Northwell Health System site. Participants were asked to self-report any positive tests during the study. The accuracy of model prediction was evaluated using respiratory infection results (laboratory results or self-reports), and postnotification surveys were used to evaluate potential confounding factors. A total of 577 participants from Northwell Health in New York were enrolled in the study between January 6, 2022, and July 20, 2022. Of these, 470 successfully completed the study, 89 did not provide sufficient physiological data to receive any prediction from the model, and 18 dropped out. Out of the 470 participants who completed the study and wore the smartwatch as required for the 16-week study duration, the algorithm generated 665 positive alerts, of which 153 (23.0%) were not acted upon to undergo testing for respiratory viruses. Across the 512 instances of positive alerts that involved a respiratory viral panel test, 63 had confirmed respiratory infection results (ie, COVID-19 or other respiratory infections detected using a polymerase chain reaction or home test) and the remaining 449 had negative upper respiratory infection test results. Across all cases, the estimated false-positive rate based on predictions per day was 2%, and the positive-predictive value ranged from 4% to 10% in this specific population, with an observed incidence rate of 198 cases per week per 100,000. Detailed examination of questionnaires filled out after receiving a positive alert revealed that physical or emotional stress events, such as intense exercise, poor sleep, stress, and excessive alcohol consumption, could cause a false-positive result. The real-time alerting system provides advance warning on respiratory viral infections as well as other physical or emotional stress events that could lead to physiological signal changes. This study showed the potential of wearables with embedded alerting systems to provide information on wellness measures.

Impact of Healthy Lifestyle Factors on Life Expectancy and Lifetime Health Care Expenditure: Nationwide Cohort Study.

The association between lifestyle risk factors and the risk of mortality and chronic diseases has been established, while limited research has explored the impact of healthy lifestyle factors on lifetime health care expenditure using longitudinal individual data. We aimed to determine the individual and combined effects of 5 healthy lifestyle factors on life expectancy and lifetime health care expenditure in Taiwan. Using data from the National Health Interview Survey cohort, 5 healthy lifestyle behaviors were defined and analyzed: nonsmoking, avoiding excessive alcohol consumption, engaging in sufficient physical activity, ensuring sufficient fruit and vegetable intake, and maintaining a normal weight. We used a rolling extrapolation algorithm that incorporated inverse probability of treatment weighting to estimate the life expectancy and lifetime health care expenditure of the study populations with and without healthy lifestyle factors. A total of 19,893 participants aged ≥30 (mean age 48.8, SD 13.4) years were included, with 3815 deaths recorded during a median follow-up period of 15.6 years. The life expectancy and per capita estimated lifetime health care expenditures for the overall study population were 35.32 years and US $58,560, respectively. Multivariable-adjusted hazard ratios for all-cause mortality in participants adhering to all 5 healthy lifestyle factors, compared with those adhering to none, were 0.37 (95% CI 0.27-0.49). We found significant increases in life expectancy for nonsmokers (2.31 years; 95% CI 0.04-5.13; P=.03), those with sufficient physical activity (1.85 years; 95% CI 0.25-4.34; P=.02), and those with adequate fruit and vegetable intake (3.25 years; 95% CI 1.29-6.81; P=.01). In addition, nonsmokers experienced a significant reduction in annual health care expenditure (-9.78%; 95% CI -46.53% to -1.45%; P=.03), as did individuals maintaining optimal body weight (-18.36%; 95% CI -29.66% to -8.57%; P=.01). Overall, participants adhering to all 5 healthy lifestyle behaviors exhibited a life gain of 7.13 years (95% CI 1.33-11.11; P=.02) compared with those adhering to one or none, with a life expectancy of 29.19 years (95% CI 25.45-33.62). Furthermore, individuals adopting all 5 healthy lifestyle factors experienced an average annual health care expenditure reduction of 28.12% (95% CI 4.43%-57.61%; P=.02) compared with those adopting one or none. Adopting a healthy lifestyle is associated with a longer life expectancy and a reduction of health care expenditure in Taiwanese adults. This contributes to a more comprehensive understanding of the impact of healthy lifestyle factors on the overall health and economic burden.

The Genomic Epidemiology of Clinical Burkholderia pseudomallei Isolates in North Queensland, Australia.

Background:Burkholderia pseudomallei, the causative agent of melioidosis, is highly genetically recombinant, resulting in significant genomic diversity. Multiple virulence factors have been associated with specific disease presentations. To date, there are limited data relating to genomic diversity and virulence factors associated with melioidosis cases in North Queensland, Australia. Aim: To describe the genetic diversity of B. pseudomallei and identify virulence factors associated with clinical risk factors and patient outcomes. Methods: Whole genome sequencing of clinical isolates was performed and analysed with clinical data obtained from a retrospective melioidosis cohort study. Results: Fifty-nine distinct sequence types (STs) were identified from the 128 clinical isolates. Six STs comprised 64/128 (50%) isolates. Novel STs accounted for 38/59 (64%) STs, with ST TSV-13 as the most prevalent (n = 7), and were less likely to possess an LPS A genotype or YLF gene cluster (p < 0.001). These isolates were most likely to be found outside the inner city (aOR: 4.0, 95% CI: 1.7-9.0, p = 0.001). ST TSV-13 was associated with increased mortality (aOR: 6.1, 95% CI: 1.2-30.9, p = 0.03). Patients with a history of alcohol excess were less likely to be infected by fhaB3 (aOR 0.2, 95% CI: 0.1-0.7, p = 0.01) or YLF (aOR: 0.4, 95% CI: 0.2-0.9, p = 0.04) positive isolates. Conclusions: There are a significant number of novel sequence types in Townsville, Australia. An emerging novel ST appears to have an association with geographic location and mortality. Ongoing investigation is required to further understand the impact of this ST on the Townsville region.

Groove pancreatitis: From enigma to future directions-A comprehensive review.

Groove pancreatitis (GP) is a rare and clinically distinct form of chronic pancreatitis affecting the pancreaticoduodenal groove comprising the head of the pancreas, duodenum, and the common bile duct. It is more prevalent in individuals in their 4-5th decade of life and disproportionately affects men compared with women. Excessive alcohol consumption, tobacco smoking, pancreatic ductal stones, pancreatic divisum, annular pancreas, ectopic pancreas, duodenal wall thickening, and peptic ulcers are significant risk factors implicated in the development of GP. The usual presenting symptoms include severe abdominal pain, nausea, vomiting, diarrhea, weight loss, and jaundice. Establishing a diagnosis of GP is often challenging due to significant clinical and radiological overlap with numerous benign and malignant conditions affecting the same anatomical location. This can lead to a delay in initiation of treatment leading to increasing morbidity, mortality, and complication rates. Promising research in artificial intelligence (AI) has garnered immense interest in recent years. Due to its widespread application in diagnostic imaging with a high degree of sensitivity and specificity, AI has the potential of becoming a vital tool in differentiating GP from pancreatic malignancies, thereby preventing a missed or delayed diagnosis. In this article, we provide a comprehensive review of GP, covering the etiology, pathogenesis, clinical presentation, radiological and endoscopic evaluation, management strategies, and future directions. This article also aims to increase awareness about this lesser known and often-misdiagnosed clinical entity amongst clinicians to ultimately improve patient outcomes.

Examining Audiences' Psychological Reactance to Christian-Sourced Excessive Alcohol Consumption Messages in the United States.

This study experimentally investigated the effect of dogmatic and suggestive language in Christian-sourced excessive alcohol consumption messages among college-aged participants who identify as Christians or non-Christians, as well as the role of perceived similarity with the message source, on their self-reported freedom-threat, psychological reactance, and behavioral intentions to consume alcohol. The results from this study support psychological reactance theory and demonstrate the various message strategies to effectively communicate the negative health effects of excessive alcohol consumption to individuals who identify either as Christians or non-Christians.

Family History of Pathological Gambling, Related Factors Effects, and Suicidality in Rural Greece

ABSTRACT The aim of this study is to understand the family history of people pathologically engaging in gambling in rural Greece along with the factors and effects (suicidal thoughts/attempts) related thereto, according to participants’ perspective. Qualitative in nature, the study was based on 32 semi-structured interviews carried out with adults who attended a Treatment Facility for pathological gambling in Heraklion Crete, in Greece. A past family history of excessive gambling was reported by most of the participants, while in many cases were reported a family history of alcohol misuse. Participants perceived self-characteristics, losses/traumatic experiences, paternal and nuclear family characteristics, work-related problems, peers who also gamble and upbringing practices influenced by culture as principal pathological gambling factors. Participants also reported that pathological gambling has various effects on one’s psychological mood, behavior, and relationship patterns with self and others. Most participants also reported having suicidal thoughts, whereas a few of them mentioned at least one suicide attempt. The study concludes that pathological gambling in the current population is associated with a past family history of excessive gambling or alcohol misuse. Multiple factors also seem to contribute to its manifestation and to such adverse effects, such as suicidal thoughts and attempts.

The prevalence of metabolic dysfunction-associated steatotic liver disease (MASLD)-related advanced fibrosis and cirrhosis in the United States population utilizing AGILE 3 + and AGILE 4 scores: analysis of the NHANES 2017–2018 cycle

BackgroundStudies attempted to estimate MASLD-related advanced fibrosis (AF) and cirrhosis (MC) prevalence utilized tests with low positive predictive value (PPV) which overestimates prevalence. AGILE3 + and 4 scores were developed to increase the PPV of both; respectively. In this study, we used these scores to assess the prevalence of AF and MC.MethodsParticipants aged ≥ 18 years with VCTE exam in the NHANES 2017–2018 cycle were included. We excluded pregnant women, patients with excessive alcohol intake, hepatitis B/C, and ALT or AST > 500 IU/L. MASLD was defined with CAP score > 248 dB/m. MASLD subjects with AGILE 3 + score of ≥ 0.68 and AGILE 4 score of ≥ 0.57 were considered to have advanced fibrosis and cirrhosis; respectively. AGILE 3 + of 0.45–0.67 and AGILE 4 of 0.25–0.57 were grey zone, whereas AGILE 3 + < 0.45 and AGILE 4 < 0.25 were considered a rule-out.Results1244 subjects were included in the final analysis. The Median age was 53 (51.4–54.6) years, 55.6% were male, median BMI was 33.8 kg/m2 and 41.1% had T2DM. Based on AGILE 3+, 80.3% of the MASLD population were at low risk for AF and 11.5% were in grey zone. The prevalence of AF due to MASLD was 8.1% corresponding to 4.5 million Americans. Based on AGILE 4 score, 96.5% of the MASLD population were at low risk for cirrhosis and 2.4% were in the grey zone. The prevalence of MASLD-cirrhosis was 1.1% corresponding to 610,000 Americans.ConclusionOur results suggest that approximately 4.5 million people in the U.S. have AF and 0.6 million have cirrhosis due to MASLD.

Gastroprotective Effect of Isoferulic Acid Derived from Foxtail Millet Bran against Ethanol-Induced Gastric Mucosal Injury by Enhancing GALNT2 Enzyme Activity.

Excessive alcohol consumption has led to the prevalence of gastrointestinal ailments. Alleviating gastric disorders attributed to alcohol-induced thinning of the mucus layer has centered on enhancing mucin secretion as a pivotal approach. In this study, foxtail millet bran polyphenol BPIS was divided into two components with MW < 200 D and MW > 200 D by molecular interception technology. Combined with MTT, cell morphology observation, and trypan blue staining, isoferulic acid (IFA) within the MW < 200 D fraction was determined as the effective constituent to mitigate ethanol-induced damage of gastric epithelial cells. Furthermore, a Wistar rat model with similar clinical features to alcohol-induced gastric mucosal injury was established. Then, gastric morphological observation, H&E staining, and assessments of changes in gastric hexosamine content and gastric wall binding mucus levels were carried out, and the results revealed that IFA (10 mg/Kg) significantly ameliorated alcohol-induced gastric mucosal damage. Finally, we applied techniques including Co-IP, molecular docking, and fluorescence spectroscopy and found that IFA inhibited the alcohol-induced downregulation of N-acetylgalactosamintransferase 2 (GALNT2) activity related to mucus synthesis through direct interaction with GALNT2 in gastric epithelial cells, thus promoting mucin synthesis. Our study lays a foundation for whole grain dietary intervention tailored to individuals suffering from alcoholic gastric mucosal injury.