Perceptions of alcohol health warning labels in a large international cross sectional survey of people who drink alcohol

Aims: This paper aimed to explore perceptions of alcohol health warning labels among a large international sample of people who drink alcohol. Methods: The Global Drug Survey (GDS) is the world’s largest annual cross sectional survey of drug use. Seven health warning labels were presented (relating to heart disease, liver, cancer, calories, violence, taking two days off and the myth of benefits to moderate drinking). People were asked if they were aware of the information, believed it, if it was personally relevant, and if it would change their drinking. This paper included data from 75,969 respondents from 29 countries/regions who reported the use of alcohol in the last 12 months, collected during November-December 2017 (GDS2018). Results: The fact that drinking less can reduce the risk of seven types of cancer was the least well known, and yet was demonstrated to encourage almost 40% of drinkers to consider drinking less. Women and high risk drinkers were more likely to indicate they would reduce their drinking in response to all labels. Personal relevance was identified as a key predictor of individual responses. Conclusions: Findings highlight the potential of a range of health messages displayed on alcoholic beverages to raise awareness of alcohol related harms and potentially support a reduction in drinking. Further research should explore what influences personal relevance of messages as this may be a barrier to effectiveness

Intention to reduce drinking alcohol and preferred sources of support: An international cross-sectional study

Introduction. Drinking alcohol is legal in most countries of the world. Given the social acceptance of this behavior despite potential negative impact on health, help-seeking behavior could differ when compared to other drugs. This paper aimed to assess intentions to reduce drinking and the preferred sources of support among a large international sample of people who drink alcohol. Materials and methods. The Global Drug Survey (GDS) is the world’s largest annual survey of drug use. This paper included data from 82,190 respondents from 12 countries on four continents who reported the use of alcohol in the last 12 months, collected during November 2016 - January 2017 (GDS2017). Results. Overall, 34.8% said they would like to drink less in the following 12 months and 7.6% said they would like help to drink less. Online tools were the preferred source of support to reduce drinking by respondents from Australia, New Zealand, and the UK, those with low AUDIT scores and without a mental health condition. Specialist counselling was most preferred by those from Germany, Switzerland, and Denmark and those with high AUDIT scores, not educated to degree level and with a mental health condition. Conclusion. Interest in online interventions for harmful drinking is significant and highest among people who drink at low risk. Online tools should offer brief screening and feedback, ensuring that people with high risk drinking patterns are referred to more specialist services

A Review of Transcranial Magnetic Stimulation and Multimodal Neuroimaging to Characterize Post-Stroke Neuroplasticity

Following stroke, the brain undergoes various stages of recovery where the central nervous system can reorganize neural circuitry (neuroplasticity) both spontaneously and with the aid of behavioral rehabilitation and non-invasive brain stimulation. Multiple neuroimaging techniques can characterize common structural and functional stroke-related deficits, and importantly, help predict recovery of function. Diffusion tensor imaging (DTI) typically reveals increased overall diffusivity throughout the brain following stroke, and is capable of indexing the extent of white matter damage. Magnetic resonance spectroscopy (MRS) provides an index of metabolic changes in surviving neural tissue after stroke, serving as a marker of brain function. The neural correlates of altered brain activity after stroke have been demonstrated by abnormal activation of sensorimotor cortices during task performance, and at rest, using functional magnetic resonance imaging (fMRI). Electroencephalography (EEG) has been used to characterize motor dysfunction in terms of increased cortical amplitude in the sensorimotor regions when performing upper limb movement, indicating abnormally increased cognitive effort and planning in individuals with stroke. Transcranial magnetic stimulation (TMS) work reveals changes in ipsilesional and contralesional cortical excitability in the sensorimotor cortices. The severity of motor deficits indexed using TMS has been linked to the magnitude of activity imbalance between the sensorimotor cortices. In this paper, we will provide a narrative review of data from studies utilizing DTI, MRS, fMRI, EEG, and brain stimulation techniques focusing on TMS and its combination with uni- and multimodal neuroimaging methods to assess recovery after stroke. Approaches that delineate the best measures with which to predict or positively alter outcomes will be highlighted

Where and what you drink is linked to how much you drink: A survey of alcohol use in 17 countries

Background:  This paper aimed to explore the differences in subjective experiences of intoxication depending on drinking location and drink type. Methods: Data came from 32,194 respondents to The Global Drug Survey (GDS) 2015, an annual, cross-sectional, online survey. Respondents selected their usual drinking location (home alone: home with partner/family: house parties: pubs/bars or clubs) and usual drink (wine; beer/cider/lager; spirits or alcopops/coolers). They indicated how many drinks they required to reach three stages of intoxication (feeling the effects; an ideal stage of intoxication; and the tipping point) and how frequently they reached each stage. Results: Drink type affected grams of alcohol reported to reach the tipping point: 109gm wine, 127gm alcopops, 133gm of beer, and 134gm of spirts. Respondents who drank at home alone, or in clubs reached their tipping point more frequently compared to other locations. Conclusions: Where people drink, and the type of alcohol they drink, affected the amount of alcohol reported to reach different stages of intoxication. Understanding why different drinking locations, and drink types lead to a need for greater consumption to reach an ideal state of drunkenness, such as social cues from other people who drink, may enable people to reduce their drinking

Drinking to excess and the tipping point: An international study of alcohol intoxication in 61,000 people

Background: People who drink alcohol often seek to manage their intake in order to maximise the pleasurable effects, such as feelings of sociability and relaxation, without reaching their ‘tipping point’, where they feel out of control, or unwell. This paper aimed to explore three stages of intoxication; feeling the effects; being as drunk as you would like to be; and reaching the tipping point (feeling more drunk than you want to be) in a large international sample. Methods: The Global Drug Survey (GDS) is an annual, cross-sectional, online survey of drug use. This paper draws on data from 61,043 respondents (63.7% male) from 21 countries who took part in GDS2015 collected in November 2014 to January 2015. Respondents reported their usual type of drink; how many drinks they would require to reach each stage of intoxication and how frequently they reached each stage. Alongside socio-demographic measures, they also completed the Alcohol Use Disorders Identification Test (AUDIT). Results: Male respondents reported consuming 87.55gm to be as drunk as they want to be and female respondents reported 70.16gm, on average. The tipping point was reached at 138.65gm for male respondents and 106.54 gm for female respondents. Overall 20.3% reported reaching their tipping point at least once a month. Being male, aged under 25 and at higher risk for alcohol use disorder was associated with reporting reaching the tipping point more frequently. Conclusions: The amount of alcohol being consumed to reach a desired point of intoxication is much higher than the maximum daily, and sometimes weekly, amount recommended by country guidelines. Encouraging people to avoid reaching their tipping point may be a useful intervention point alongside better communication of low risk drinking guidelines

Imiquimod 3.75% Cream Applied Daily to Treat Anogenital Warts: Combined Results from Women in Two Randomized, Placebo-Controlled Studies

Objective. To evaluate if new imiquimod formulations using a shorter treatment duration are safe and efficacious to treat anogenital warts. Methods. In two studies 534 women ≥12 years of age (mean 33.4) with 2–30 warts (mean 7.9) and total wart area ≥10 mm2 (mean 166.3) were randomized (1 : 2 : 2) to placebo (106), imiquimod 2.5% (212) or 3.75% (216) creams applied once daily until complete clearance or a maximum of 8 weeks. Results. For placebo, imiquimod 2.5% and 3.75%, respectively, complete clearance of all warts was achieved in 14.2%, 28.3%, and 36.6% of women (intent-to-treat, P = 0.008 imiquimod 2.5%, and P < 0.001 3.75% versus placebo). Mean changes in wart counts were −10.7%, −50.9%, and −63.5% (per-protocol, P < 0.001 each active versus placebo) and safety-related discontinuation rates 0.9%, 1.4%, and 2.3%. Conclusions. Imiquimod 3.75% applied daily for up to 8 weeks was well tolerated and superior to placebo in treating women with external anogenital warts

Extraterrestrial nucleobases in the Murchison meteorite

Carbon-rich meteorites, carbonaceous chondrites, contain many biologically relevant organic molecules and delivered prebiotic material to the young Earth. We present compound-specific carbon isotope data indicating that measured purine and pyrimidine compounds are indigenous components of the Murchison meteorite. Carbon isotope ratios for uracil and xanthine of delta13C=+44.5per mil and +37.7per mil, respectively, indicate a non-terrestrial origin for these compounds. These new results demonstrate that organic compounds, which are components of the genetic code in modern biochemistry, were already present in the early solar system and may have played a key role in life's origin.Comment: 31 pages, 4 figures, 3 table

Final Results of Urelumab, an Anti-CD137 Agonist Monoclonal Antibody, in Combination With Cetuximab or Nivolumab in Patients With Advanced Solid Tumors

BACKGROUND: Resistance to immune checkpoint inhibitors and targeted treatments for cancer is common; thus, novel immunotherapy agents are needed. Urelumab is a monoclonal antibody agonist that binds to CD137 receptors expressed on T cells. Here, we report two studies that evaluated urelumab in combination with cetuximab or nivolumab in patients with select, advanced solid tumors. METHODS: CA186-018: Patients with metastatic colorectal cancer or metastatic squamous cell carcinoma of the head and neck (SCCHN) were treated in a dose-evaluation phase with urelumab 0.1 mg/kg (urelumab-0.1) every 3 weeks (Q3W)+cetuximab 250 mg/m RESULTS: CA186-018: 66 patients received study treatment. The most frequent treatment-related adverse events (TRAEs) were fatigue (75%; n=3) with urelumab-0.1+cetuximab-250 and dermatitis (45%; n=28) with urelumab-8+cetuximab-250. Three patients (5%) discontinued due to TRAE(s) (with urelumab-8+cetuximab-250). One patient with SCCHN had a partial response (objective response rate (ORR) 5%, with urelumab-8+cetuximab-250).CA186-107: 134 patients received study treatment. Fatigue was the most common TRAE (32%; n=2 with urelumab-3+nivolumab-3; n=1 with urelumab-8+nivolumab-3; n=40 with urelumab-8+nivolumab-240). Nine patients (7%) discontinued due to TRAE(s) (n=1 with urelumab-3+nivolumab-3; n=8 with urelumab-8+nivolumab-240). Patients with melanoma naive to anti-PD-1 therapy exhibited the highest ORR (49%; n=21 with urelumab-8+nivolumab-240). Intratumoral gene expression in immune-related pathways (CD3, CD8, CXCL9, GZMB) increased on treatment with urelumab+nivolumab. CONCLUSIONS: Although the addition of urelumab at these doses was tolerable, preliminary response rates did not indicate an evident additive benefit. Nevertheless, the positive pharmacodynamics effects observed with urelumab and the high response rate in treatment-naive patients with melanoma warrant further investigation of other anti-CD137 agonist agents for treatment of cancer