Advances in our understanding of the intricate molecular mechanisms for transformation of a normal cell to a cancer cell, and the aberrant control of complementary pathways, have presented a much ...more complex set of challenges for the diagnostic and therapeutic disciplines than originally appreciated. The oncology field has entered an era of personalized medicine where treatment selection for each cancer patient is becoming individualized or customized. This advance reflects the molecular and genetic composition of the tumors and progress in biomarker technology, which allow us to align the most appropriate treatment according to the patient's disease. There is a worldwide acceptance that advances in our ability to identify predictive biomarkers and provide them as companion diagnostics for stratifying and subgrouping patients represents the next leap forward in improving the quality of clinical care in oncology. As such, we are progressing from a population-based empirical 'one drug fits all' treatment model, to a focused personalized approach where rational companion diagnostic tests support the drug's clinical utility by identifying the most responsive patient subgroup.
Binge drinking and sexual assault are serious inter-related public health problems faced by college students. State-level alcohol policy restrictiveness has been found to decrease binge drinking ...among college students and, therefore, may also reduce occurrences of alcohol-related criminal offenses. It was hypothesized that more restrictive state alcohol policy environments would be associated with fewer liquor law violations and sexual assault offenses on U.S. college campuses.
Data were aggregated across 3 academic years (2016-2017, 2017-2018, and 2018-2019) and represented n=1,290 institutions. Zero-inflated negative binomial regression modeling was performed in 2022-2023 to evaluate associations of state-level young adult binge drinking and the Alcohol Policy Scale (APS) with the numbers of campus-level alcohol-related arrests, alcohol-related disciplinary actions, rape offenses, and fondling offenses reported in national Campus Safety and Security data.
Higher APS scores had direct associations with fewer alcohol-related arrests (1.79% decrease per one-unit increase in APS, p=0.05), alcohol-related disciplinary actions (2.27% decrease per one-unit increase in APS, p=0.027), and rape offenses (0.85% decrease per one-unit increase in APS, p=0.021). The associations APS scores had with disciplinary actions and rape offenses were partially and fully mediated, respectively, by state-level young adult binge drinking. No associations were found between APS and fondling offenses.
This cross-sectional study presents evidence that more restrictive state alcohol policies are associated with fewer alcohol-related arrests and disciplinary actions, and rape offenses on college campuses. Future research should identify the alcohol policy domains that are most protective against these outcomes.
Objective: College students' prescription stimulant and opioid misuse (PSM and POM) share psychosocial risks with other substance use. We sought to extend a prior study of these issues. Methods: ...National College Health Assessment (2015-2016) participants ages 18-24 years (n = 79,336) reporting 12-month PSM (defined as use of a drug not prescribed to them), 30-day other illicit drug use (non-cannabis), both, or neither, were compared on other substance use, psychopathology, academic adjustment, attention deficit hyperactivity disorder, and chronic pain. Models were repeated for POM. Results: Relative to those who only misused the prescription drug, those who used other illicit drugs had lower odds of chronic pain and academic problems, but higher odds on nearly every other outcome especially if they also misused the prescription drug. Conclusions: Findings suggest PSM and POM are on a continuum of risk shared with illicit drug use, but also are linked to outcomes specific to these drugs' perceived medical purposes.
Within-person studies are lacking regarding how recreational cannabis legalization (RCL) and the numbers of neighborhood cannabis retailers relate to adolescents’ cannabis use. Study participants ...were 146 offspring (55% girls; 77% White non-Latinx) of men recruited in childhood from neighborhoods with high delinquency rates. Youth were assessed for past-year cannabis and alcohol use one or more times from ages 13 to 20 years (age M
SD
= 16.4 2.1 years across 422 observations), while they were living in Oregon or Washington from 2005 to 2019 (where cannabis retail stores opened to adults ages 21 years and older in 2014 and 2015, respectively). We calculated distances between addresses of licensed cannabis retailers and participants’ homes. Multilevel models that accounted for effects of age on cannabis use did not support that the number of retail stores within 2-, 5-, 10-, or 20-mile radii of adolescents’ homes increased likelihood of past-year cannabis use at the within- or between-subjects levels. Likewise, primary models did not support a greater likelihood of cannabis use among youth whose adolescence coincided more fully with the post-RCL period. A secondary model suggested that after adjusting for adolescents’ concurrent alcohol use as a marker of general substance use risk, RCL was associated with cannabis use (between-subjects
B
95% CI = .35 .05–.66,
p
= .024). Further research is needed with larger prospective samples, at-risk subgroups, and as cannabis markets mature.
Background: Children's early problem behavior that manifests in multiple contexts is often more serious and stable. The concurrent and predictive validity of ratings of externalizing and ...internalizing by four informants was examined at preschool and early school age in an at‐risk sample.
Methods: Two hundred forty children were assessed by mothers and fathers (Child Behavior Checklist (CBCL)), and teachers and laboratory examiners (Teacher Report Form (TRF)) at ages 3 and 5 years.
Results: All informants’ ratings of externalizing converged on a common factor at ages 3 and 5 that showed strong stability over time (β = .80). All informants’ age 3 externalizing ratings significantly predicted the problem factor at age 5; mothers’, fathers’, and teachers’ ratings were independently predictive. Ratings of internalizing (except by examiners at age 3) also converged at both ages; the problem factor showed medium stability (β = .39) over time. Only fathers’ ratings of age 3 internalizing predicted the age 5 problem factor.
Conclusions: Findings support the value of multi‐informant assessment, uphold calls to include fathers in childhood research, and suggest that examiners provide valid, though non‐unique assessment data. Examiner contributions may prove useful in many research contexts.
The number of publications on deep learning for cancer diagnostics is rapidly increasing, and systems are frequently claimed to perform comparable with or better than clinicians. However, few systems ...have yet demonstrated real-world medical utility. In this Perspective, we discuss reasons for the moderate progress and describe remedies designed to facilitate transition to the clinic. Recent, presumably influential, deep learning studies in cancer diagnostics, of which the vast majority used images as input to the system, are evaluated to reveal the status of the field. By manipulating real data, we then exemplify that much and varied training data facilitate the generalizability of neural networks and thus the ability to use them clinically. To reduce the risk of biased performance estimation of deep learning systems, we advocate evaluation in external cohorts and strongly advise that the planned analyses, including a predefined primary analysis, are described in a protocol preferentially stored in an online repository. Recommended protocol items should be established for the field, and we present our suggestions.
Objective:
We examined alcohol use and harms, and their interrelations among cisgender and transgender college students.
Method:
We conducted a secondary analysis using a U.S. sample of ...4-year-college students (n = 242,624; M
age = 20.24, SD = 1.67; 12.31% Hispanic/Latinx and 62.11% non-Hispanic/Latinx White, 3.99% Black, 11.88% Asian or Pacific Islander,0.37% American Indian, Alaskan Native or Native Hawaiian, 9.35% Multiracial/ethnic/other). These outcomes were compared between cisgender women (68.53%) and cisgender men (29.27%), transgender men (0.91%), transgender women (0.23%), and nonbinary students (1.06%): level (number of drinks) of recent alcohol use, frequency of binge drinking (≥5 drinks) in the past 2 weeks, and occurrence and count of harms while drinking in the past year. Gender differences in the association between drinking level and consequences were also examined.
Results:
Cisgender women were the reference group for all of the comparisons. Cisgender men reported less occurrence of regret, sex without their consent, and unprotected sex when drinking, but the greater occurrence of injury and trouble with the police. Transgender women and nonbinary individuals reported lower odds of regret and unprotected sex when drinking. Transgender men and nonbinary individuals reported increased odds of sex without their consent when drinking. All transgender subgroups reported increased odds of suicidal ideation when drinking. Finally, associations between the level of recent drinking and odds of experiencing harms differed by gender identity.
Conclusions:
Patterns of alcohol use, consequences, and their interrelationship differed for cisgender men, transgender women and men, and nonbinary individuals relative to cisgender women. There is a need for gender-inclusive prevention for alcohol harms among students.
Public Health Significance Statement
This study identified that the risk of experiencing harms when drinking differed between cisgender, transgender, and nonbinary college students. This suggests that gender identity should be considered when making recommendations about low-risk drinking levels and when designing interventions to prevent alcohol harms for students with diverse gender identities.
Highlights • We examined social mechanisms of risk for early onset of marijuana use. • We assessed fathers’ adolescent marijuana use and children's onset prospectively. • Parents’ adolescent use ...added general and marijuana-specific risks to offspring. • Parents’ adolescent use hastened children's onset via deviant peer contact.
•College students’ patterns of alcohol and cannabis use differed on frequency, intensity, and co-use.•Compared to their peers, college students in states with recreational cannabis legalization (RCL) ...less often showed patterns characterized by light and heavy alcohol use with no cannabis use, and more often reported abstinence.•In RCL states, college students more often reported patterns of frequent cannabis use with some alcohol use, or with heavy co-use of both substances.
Evidence is mixed on how young adults’ cannabis and alcohol use and co-use patterns have changed following recreational cannabis legalization (RCL). Incorporating measures of frequency and intensity of use we examined changes in college students' use and co-use patterns following RCL.
Four-year college students (n = 845,589) ages 18–24 years participated in the National College Health Assessment between 2008 and 2018, including students from 7 states that enacted RCL and 42 that did not. Latent profile analyses identified six patterns of use from four indicator variables tapping frequency of cannabis use and frequency and intensity of alcohol use: Abstainers, Light Alcohol Only, Heavy Alcohol Only, Predominantly Heavy Cannabis Use, Moderate Co-use, and Heavy Co-use.
Regression models that adjusted for time and person- and institution-level covariates indicated that students’ exposure to RCL was associated with lower odds of being in the two alcohol-only use classes, higher odds of being in the Predominantly Heavy Cannabis Use, Heavy Co-Use and Abstainers classes, and was not significantly related to Moderate Co-Use class membership.
RCL was positively associated with patterns of frequent cannabis use and frequent and intense co-use but also with abstinence. Use of alcohol-only became less prevalent after RCL. Research on how RCL influences the prevalence of problematic patterns of substance use will inform and improve prevention efforts.
Objective: The prevalence of misuse of prescription opioids across adulthood and the associations of such misuse with symptoms of psychopathology and use of other substances were examined for an ...at-risk community sample of men. Method: For a longitudinal study of boys (N = 206) followed to adulthood, misuse of prescription opioids was assessed on 13 occasions from ages 20-21 years to 37-38 years. Prediction of misuse was examined from prospectively assessed risk factors in 3 models: (a) parental substance use during the men's adolescence; (b) the men's own risk behaviors in adolescence-delinquent behavior, depressive symptoms, and use of tobacco, alcohol, marijuana, and opioids; and (c) within- and between-individual effects of the men's risk behaviors during adulthood. Results: Opioid misuse was reported by 29% of men. After accounting for effects of age and considered individually, parent marijuana use and all of the adolescent and adult risk factors (except adolescent depressive symptoms) were significant between-individual predictors of opioid misuse. Furthermore, within-individual prediction was significant for adult delinquency and alcohol use after accounting for increases in opioid misuse with age. When risk factors were tested simultaneously, men's adult delinquency and use of marijuana and tobacco remained significant between-individual predictors, whereas no parental or adolescent risk factors remained significant in these models. Conclusion: Both adolescent and adult risk factors were examined that predicted adult opioid misuse. Preventing adolescent problem behavior and using such histories to inform screening for misuse risk in adulthood may reduce the burden of the opioid crisis.
What is the public health significance of this article?
Misuse of prescription opioids is contributing to a public health crisis. There are little longitudinal data on predictors of such opioid misuse. This study examined prediction from parental, adolescent, and adult substance use and psychopathology symptoms for a sample of men at risk for substance use. Findings indicated that the men's adolescent and adult criminal acts and use of alcohol and marijuana, in particular, were associated with opioid misuse. Thus, prevention programs for men should be targeted particularly to substance users and those involved in criminal behavior.
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