Sustained high alcohol intake is necessary but not sufficient to produce alcohol-related cirrhosis. Identification of risk factors, apart from lifetime alcohol exposure, would assist in discovery of ...mechanisms and prediction of risk.
We conducted a multicenter case-control study (GenomALC) comparing 1,293 cases (with alcohol-related cirrhosis, 75.6% male) and 754 controls (with equivalent alcohol exposure but no evidence of liver disease, 73.6% male). Information confirming or excluding cirrhosis, and on alcohol intake and other potential risk factors, was obtained from clinical records and by interview. Case-control differences in risk factors discovered in the GenomALC participants were validated using similar data from 407 cases and 6,573 controls from UK Biobank.
The GenomALC case and control groups reported similar lifetime alcohol intake (1,374 vs 1,412 kg). Cases had a higher prevalence of diabetes (20.5% (262/1,288) vs 6.5% (48/734), P = 2.27 × 10-18) and higher premorbid body mass index (26.37 ± 0.16 kg/m2) than controls (24.44 ± 0.18 kg/m2, P = 5.77 × 10-15). Controls were significantly more likely to have been wine drinkers, coffee drinkers, smokers, and cannabis users than cases. Cases reported a higher proportion of parents who died of liver disease than controls (odds ratio 2.25 95% confidence interval 1.55-3.26). Data from UK Biobank confirmed these findings for diabetes, body mass index, proportion of alcohol as wine, and coffee consumption.
If these relationships are causal, measures such as weight loss, intensive treatment of diabetes or prediabetic states, and coffee consumption should reduce the risk of alcohol-related cirrhosis.
To assess whether changes in sugar intake and craving occur during alcohol withdrawal in humans, we conducted a prospective, observational study in a university hospital addictions treatment center. ...Recruited patients had severe alcohol use disorder and were hospitalized for 7 days in the short‐stay unit for alcohol withdrawal and then for 6 weeks in the rehabilitation unit. During the hospital stay, they had no access to alcohol but had full access to sweet products and beverages in a shop and vending machines located inside the hospital. Alcohol craving was assessed using a visual analogue scale on Days 1, 15, and 45. Sugar craving, sweet products stored by patients in their rooms, and weight were assessed on the same days. Thirty‐five patients were included. Sugar craving increased in 14 patients during the hospital stay, whereas no change was observed in the remaining 21. Significant increases in both the amounts of sweet products stored in the patients' rooms (p < 0.02) and weight (p < 0.05) were observed only in the sugar craving group. During the same period, alcohol craving decreased significantly in all patients. Changes in tobacco smoking were not different according to the sugar craving status and therefore cannot explain the observed differences. In conclusion, increased intake and craving for sugar after alcohol withdrawal were observed in 40% of the patients included in our prospective study, and these results were similar to those of a study conducted in the alcohol post‐dependent state model in rats.
We assess whether changes in sugar intake and craving occur during alcohol withdrawal in 35 inpatients. Alcohol craving, sugar craving, sweet products stored by patients in their rooms, and weight were assessed on Days 1, 15, and 45. Sugar craving increased in 14 patients (40%). Significant increases in both the amounts of sweet products stored and weight were observed only in the group with increased sugar craving. Changes in tobacco smoking were not different according to the sugar craving status.
Behavioral addiction is an emerging concept based on the resemblance between symptoms or feelings provided by drugs and those obtained with various behaviors such as gambling, etc. Following an ...observational study of a tango dancer exhibiting criteria of dependence on this dance, we performed a survey to assess whether this case was unique or frequently encountered in the tango dancing community. Methods: We designed an online survey based on both the DSM-IV and Goodman’s criteria of dependence; we added questions relative to the positive and negative effects of tango dancing and a self-evaluation of the degree of addiction to tango. The questionnaire was sent via Internet to all the tango dancers subscribing to “ToutTango”, an electronic monthly journal. The prevalence of dependence was analyzed using DSM-IV, Goodman’s criteria and self-rating scores separately. Results: 1,129 tango dancers answered the questionnaire. Dependence rates were 45.1, 6.9 and 35.9%, respectively, according to the DSM-IV, Goodman’s criteria and self-rating scores. Physical symptoms of withdrawal were reported by 20% of the entire sample and one-third described a strong craving for dancing. Positive effects were high both in dependent and non-dependent groups and were markedly greater than negative effects. Long practice of tango dancing did not modify the dependence rate or reduce the level of positive effects. Conclusions: Tango dancing could lead to dependence as currently defined. However, this dependence is associated with marked and sustained positive effects whilst the negative are few. Identifying the precise substratum of this dependence needs further investigation.
Lakes are essential ecosystems that provide a large number of ecosystem services whose quality is strongly impacted by human pressures. Optimal uses of lakes require adapted management practices ...which in turn rely on physico-chemical and biological monitoring. Long-term ecological monitoring provides large sets of environmental data. When such data are available, they have to be associated to metadata and to be stored properly to be accessible and useable by the scientific community. We present a data informatics system accessible to anyone who requests it. Maintained online since 2014 (https://si-ola.inrae.fr), it is originated from the Observatory on LAkes (OLA). It contains long-term data from 4 peri-alpine lakes (Lakes Aiguebelette, Annecy, Bourget, Geneva/Leman) and 24 high-altitude lakes of the northern French Alps. We describe the generated long-term data series, the data type, the methodologies and quality control procedures, and the information system where data are made accessible. Data use is allowed under the condition of providing reference to the original source. We show here how such a platform clearly enhances data sharing and scientific collaboration. Various studies referring to these data are regularly published in peer-reviewed journals; providing in fine a better understanding of lakes' ecosystems functioning under local and global pressures.
Background:
Sodium oxybate (SMO) has been shown to be effective in the maintenance of abstinence (MoA) in alcohol-dependent patients in a series of small randomized controlled trials (RCTs). These ...results needed to be confirmed by a large trial investigating the treatment effect and its sustainability after medication discontinuation.
Aims:
To confirm the SMO effect on (sustained) MoA in detoxified alcohol-dependent patients.
Methods:
Large double-blind, randomized, placebo-controlled trial in detoxified adult alcohol-dependent outpatients (80% men) from 11 sites in four European countries. Patients were randomized to 6 months SMO (3.3–3.9 g/day) or placebo followed by a 6-month medication-free period. Primary outcome was the cumulative abstinence duration (CAD) during the 6-month treatment period defined as the number of days with no alcohol use. Secondary outcomes included CAD during the 12-month study period.
Results:
Of the 314 alcohol-dependent patients randomized, 154 received SMO and 160 received placebo. Based on the pre-specified fixed-effect two-way analysis of variance including the treatment-by-site interaction, SMO showed efficacy in CAD during the 6-month treatment period: mean difference +43.1 days, 95% confidence interval (17.6–68.5; p = 0.001). Since significant heterogeneity of effect across sites and unequal sample sizes among sites (n = 3–66) were identified, a site-level random meta-analysis was performed with results supporting the pre-specified analysis: mean difference +32.4 days, p = 0.014. The SMO effect was sustained during the medication-free follow-up period. SMO was well-tolerated.
Conclusions:
Results of this large RCT in alcohol-dependent patients demonstrated a significant and clinically relevant sustained effect of SMO on CAD.
Trial registration:
ClinicalTrials.gov Identifier: NCT04648423
This study is a quanti-qualitative analysis of all contacts to a helpline service for hospital workers during the COVID-19 crisis. Our aim was to describe the nature of mental burden in hospital ...workers and factors subjectively associated to this burden from the workers' perspective.
We included all 50 contacts from 25 different workers and 10 different professions over the course of 1 month. We described the corpus and reported the computerized qualitative analysis of summary of contacts. We performed a descendant hierarchical analysis and analyzed specificities of classes of age with a correspondence factor analysis.
The corpus was composed of three classes: (1) distress specific to the COVID-19 situation, (2) help provided, and (3) pre-existing psychological vulnerability. Factors subjectively responsible for mental distress were: (a) the contamination risk, (b) confinement, and (c) the rapidly evolving situation and changing instructions. Lack of "COVID-free time" seemed to increase negative emotions. Reassignment to a high viral density unit was a stressor, especially in older workers. Young workers mentioned pre-existing vulnerability more than others. Fear of death was shared by all classes of age, regardless of the objective risk of contamination.
Hospital workers experience mental distress factors both in common with the general population and specific to the hospital environment. Preserving and organizing support for the mental health of all hospital workers is a critical challenge, including those with poorly recognized professions. Leads for institutions to avoid additional stressors for hospital workers are presented. Young workers with pre-existing vulnerability seem particularly impacted.
IntroductionDevelopment of fully internet-based programs could provide a new avenue to improve access to healthcare for problem gamblers. In this project, we aim to assess the efficacy of a web-based ...cognitive intervention targeting inhibitory control among problem gamblers, using a randomised controlled design. As impaired inhibitory control is involved in self-regulation difficulties in behavioural addictions, it represents a particularly relevant cognitive process to target for an online psychological intervention.Methods and analysisThis will be a single-blinded, randomised, comparative therapeutic web-based, controlled trial. Up to 200 non-treatment seeking adult problem gamblers with a Problem Gambling Severity Index-recent (PGSI-recent) score ≥5 will be included. The intervention will be a computerised cognitive training program targeting inhibitory skills. The comparator, an active control, will be a computerised neutral sensorial program. Both programs will be carried out under similar conditions: biweekly online training for 6 weeks and optional telephone support will be offered to patients for debriefing. The main objective of the study is to assess the clinical efficacy of the online cognitive training program at 6 weeks, measured with the PGSI-recent. The secondary objectives are to assess the efficacy on the gambling behaviour assessed by the account-based gambling data, on the self-reported gambling practice, and on the inhibition performance at the neuropsychological level at 6, 14 and 52 weeks. We will also assess the acceptability of this program and the preferred level of guidance. Data analysis will be in intention-to-treat.Ethics and disseminationThis randomized controlled trial will be executed in compliance with the Helsinki Declaration, and was approved by the local ethics boards (Comité de Protection des Personnes) in October 2017. The findings will be published in peer-reviewed journals.Trial registration numberNCT03673800.
Models based on the uniqueness of addiction processes between behavioral addictions are highly contentious, and the inclusion of gaming disorder in the addiction nosography remains controversial. An ...exploratory approach could clarify a hypothesized common and subjectively identifiable process in addictive behaviors and the necessarily different expressions of the disorder due to behavior specificities, in particular the sociocultural characteristics and profiles of users.
The aim of this study was to describe the nature of contacts to a help service by exploring commonality and specificities of burden and help-seeking for problem gambling or gaming.
This was an observational quantitative-qualitative study. We included all contacts (ie, online questions and contacts by phone or chat when the helper completed a summary) to a helpline for gamers, gamblers, and relatives over a 7-year period. We constituted a text corpus with online questions and summaries of contacts by phone or chat. We collected basic sociodemographic data, including the device used to contact the service (phone or internet), contacting the service for oneself ("user") or being a relative of a user and type of relative, gambling (yes/no), gaming (yes/no), and age and sex of the gambler/gamer. We describe the corpus descriptively and report the computerized qualitative analysis of online questions, chat, and summary of phone calls. We performed a descendant hierarchical analysis on the data.
A total of 14,564 contacts were made to the helpline, including 10,017 users and 4547 relatives. The corpus was composed of six classes: (1) gaming specificities, (2) shared psychological distress and negative emotions, (3) the procedure for being banned from gambling, (4) the provided help, (5) gambling specificities, and (6) financial problems.
Negative emotions and shared distress linked to gambling and gaming support current scientific consensus that these behaviors can produce psychological distress in se; however, meaningful differences were observed in core symptoms of addiction between gamers and gamblers, beyond specificities related to the behavior itself: loss of control was elicited in the class corresponding to gambling specificities and not by gamers and their relatives.
Chronic alcohol use alters the distribution and the phenotypic and functional characteristics of blood monocyte subsets, which are partially restored following 2 wks of withdrawal.
Excessive alcohol ...consumption has a modulating effect on immune functions that may contribute to decreased immunity and host defense. It is associated with increased intestinal permeability to endotoxins that is normalized after 14 d of abstinence. Whether and how blood monocyte subsets are impaired in patients with an AUD and what their evolution is after alcohol withdrawal are the paper's objectives. With the use of flow cytometry, blood monocyte subsets were quantified in AUDs before (n = 40) and 2 wk after (n = 33) alcohol withdrawal and compared with HC donors (n = 20). Expression of TLR2 and TLR4 on monocyte subsets was also quantified. Cytokine response of monocytes was monitored following PGN and LPS stimulation. The CD14+CD16− subset was decreased, whereas the CD14dimCD16+ subset was expanded (P < 0.001) in AUD compared with HC. The frequencies of TLR2‐ and TLR4‐expressing monocytes were reduced in AUD compared with HC. Although the basal production of IL‐1, IL‐6, and TNF by monocytes in AUD was compared with HC, the PGN‐ and LPS‐mediated IL‐6 and TNF production was increased in AUD. Frequencies of IL‐6‐expressing monocytes were higher in AUD than HC. Alcohol withdrawal partially restored the distribution of monocyte subsets and the frequency of IL‐6‐producing monocytes and increased the frequency of TNF‐producing cells in response to LPS and PGN stimulation to levels compared with those in HC. Our findings indicate that chronic alcohol use alters the distribution as well as the phenotypic and functional characteristics of blood monocyte subsets, which are partially restored following 2 wk of alcohol withdrawal.
We present two datasets composed of high frequency sensors data, vertical in situ profiles and laboratory chemical analysis data, acquired during two different aquatic mesocosm experiments performed ...at the OLA (“Long-term observation and experimentation for lake ecosystems”) facility at the UMR CARRTEL in Thonon les Bains, on the French shore of Lake Geneva. The DOMLAC experiment lasted 3 weeks (4-21 October 2021) and aimed to simulate predicted climate scenarios (i.e. extreme events such as storms and floods) by reproducing changes in quality and composition of lake subsidies and runoff by increased inputs of terrestrial organic matter. The PARLAC experiment lasted 3 weeks (5-23 September 2022) and aimed to simulate turbid storms by light reduction.
The experimental setup consisted of nine inland polyester laminated tanks (2.1 m length, 2.1 m width and 1.1 m depth) with a total volume of approximately 4000 L and filled with water directly supplied from the lake at 4m depth. Both experimental design included three treatments each replicated three times. The DOMLAC experiment involved a control treatment (no treatment applied) and two treatments simulating allochthonous inputs from two different dissolved organic matter (DOM) extract from peat moss Sphagnum sp. (Peat-Moss treatment) and Phragmites australis (Phragmite treatment). The PARLAC experiment involved a control treatment (no treatment applied) and two treatments simulating two different intensity of light reduction. In the Medium treatment transmitted light was reduced to 70% and in the High treatment transmitted light was reduced to 15%.
The datasets are composed of: 1. In situ measures from automated data loggers of temperature, conductivity, dissolved oxygen and CO2 acquired every 5 minutes at 0.1, 0.5 and 1 m depth (DOMLAC) and 0.5m (PARLAC) for the entire period of the experiment. 2. In situ profiles (0-1 m) of temperature, conductivity, pH, dissolved oxygen (concentration and saturation) acquired twice a week during the experiment. 3. In situ measures of light spectral UV/VIS/IR irradiance (300-950 nm wavelength range) taken in the air and at 0, 0.5 and 1 m twice a week on the same day of the profiles at point 2. 4. Laboratory chemical analysis of integrated samples taken twice a week on the same day of the in situ profiles at point 2 and 3 of conductivity, pH, total alkalinity, NO3, total and particulate nitrogen (Ntot, Npart), PO4, total and particulate phosphorus (Ptot, Ppart), total and particulate organic carbon (TOC, POC), Ca, K, Mg, Na, Cl, SO4 and SiO2. Only for DOMLAC also analyses of NH4, NO2 and dissolved organic carbon (DOC). 5. Laboratory analysis of pigments (Chla, Chlc, carotenoids, phaeopigments) extracted from samples collected at point 4. 6. Only for DOMLAC, specific absorbance on the range 600-200nm of DOM (i.e. <0.7 µm) measured on samples collected at point 4.
This dataset aims to contribute our understanding of how extreme climate events can alter lake subsidies and affect the regulation of ecosystem processes such as production, respiration, nutrient uptake and pigment composition. The data can be used for a wide range of applications as being included in meta-analysis aiming at generalising the effect of climate change on large lakes including simulating future scenarios in a broad range of geographical areas as we used different inputs of DOM leached from litters reproducing catchments characteristics typical of different latitudes, such as mostly dominated by large leaf forests and phragmites at middle latitude, and coniferous forests rich of peat mosses that spread along the water surface typical of Northern regions.
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