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60 [95 % CI 1.03-2.48]), not retained (OR = 1.30 [95 % CI 1.13-1.50]), and HIV RNA not in control (OR = 1.91 [95 % CI 1.60-2.27]). Alcohol measures were not independently associated with outcomes. The combination of unhealthy alcohol use and smoking (versus neither) was associated with higher odds of not being linked to care (OR = 2.83 [95 % CI 1.40-5.71]), although the interaction did not reach significance (p = 0.18).

In this large sample of PWH in an integrated health care system, smoking, both independently and in combination with unhealthy alcohol use, was associated with worse HIV care continuum outcomes.

In this large sample of PWH in an integrated health care system, smoking, both independently and in combination with unhealthy alcohol use, was associated with worse HIV care continuum outcomes.

Although craving is a formal DSM-5 criterion and a commonly reported feature of opioid use disorder (OUD), there is no universally accepted assessment of opioid craving for treatment outcome studies or clinical trials. This mixed-methods study characterized dimensions of opioid craving identified in qualitative responses collected via Amazon Mechanical Turk (AMT).

Thirty-nine participants completed an online screener on AMT and met inclusion criteria (e.g., > = 18 years old and past 30-day illicit opioid use). These participants completed a series of closed- and open-ended questions about their opioid use and craving, including several commonly-used craving measures. Degrasyn They also rated their preference for how different questions described craving. Responses to the open-ended question "What do you mean when you say you are craving opioids?" were coded according to dimensions in existing opioid craving assessments and other common themes identified in the data.

Among the 39 participants, 8 different dimensions were identified and coded. Descriptions of craving were most frequently categorized as "Anticipation of Negative Reinforcement" (n = 17/39) and "Interfering Thoughts" (N = 14/39). Individuals with drug use characteristics reflecting greater severity of use were more likely to describe craving as "Interfering Thoughts". Participants may prefer opioid craving questions that included Visual Analog Scale response formats relative to Likert scales.

There is a wide range of dimensions that were used to describe opioid craving and no single unifying dimension was identified. These data suggest opioid craving is a multidimensional construct including dimensions currently not included in common craving assessments.

There is a wide range of dimensions that were used to describe opioid craving and no single unifying dimension was identified. These data suggest opioid craving is a multidimensional construct including dimensions currently not included in common craving assessments.

Research has proposed that selective serotonin reuptake inhibitors (SSRIs) were associated with a reduction of the risk of hepatocellular carcinoma (HCC). The objective of this study is to investigate whether SSRIs use is associated with decreased risk of HCC in patients with alcohol use disorder (AUD).

We conducted a retrospective population-based cohort study using Taiwan's National Health Insurance Research Database (NHIRD) from 1997 to 2013 and enrolled patients with newly diagnosed AUD. After propensity scores matching at a ratio 14, total of 4945 SSRI users and 19,785 non-SSRI users were included in the matched cohort. Patients were followed up from the 365th day after the date of first exposure to SSRIs to occurrence of HCC, the date of death, or the end of 2013. Cox proportional hazard regressions were performed to evaluate hazard ratio (HRs) for HCC in SSRI-exposed patients compared with unexposed patients.

In the main study cohort, SSRI use was associated with significant lower risk of HCC compared to the non-SSRI users after adjusting for age, sex, income, urbanization, alcoholic fatty liver, alcoholic hepatitis and diabetes (adjusted hazard ratio [aHR] = 0.31, 95 % CI = 0.24-0.39). The negative association of SSRI use and HCC was replicated in the matched cohort (aHR = 0.58, 95 % CI = 0.44-0.77). The effect of SSRI use on HCC was dose-related in both cohorts (p for trend < 0.0001).

This study showed that SSRIs use was associated with a reduction risk of HCC among AUD patients in a cumulative dose effect manner.

This study showed that SSRIs use was associated with a reduction risk of HCC among AUD patients in a cumulative dose effect manner.

Polysubstance involvement is increasing among fatal drug overdoses. However, little is known about the epidemiology of polysubstance drug overdoses. This paper describes emerging trends in unintentional polysubstance overdose deaths in North Carolina (NC) and examines associations with individual and community factors.

Using 2009-2018 NC death certificate data, we identified unintentional drug overdose deaths and commonly involved substances (opioids, stimulants, benzodiazepines, alcohol, and antiepileptics). We examined polysubstance combinations, comparing opioid and non-opioid involved deaths. We examined individual level correlates from death certificate data and community level correlates from the American Community Survey and Robert Wood Johnson Foundation County Health Rankings to quantify associations.

From 2009-2018, 53 % of opioid and 19 % of non-opioid overdose deaths involved multiple substances. During this period, polysubstance overdose death increased dramatically, from 2.9 to 12.1 per 10 NC. These findings can be used to inform public health interventions addressing polysubstance deaths and associated individual and community level factors.CRISPR/Cas9 systems have revolutionised the field of gene editing, allowing for precise modifications to be generated in vivo to mimic the genetic events found in human cancer cells. These systems may be used to generate germline or somatic loss-of-function of events, and also chromosomal rearrangements, either constitutively or in a spatiotemporally controlled manner. Forward genetic screens have also been performed using CRISPR/Cas9 systems to identify new driver genes and approaches using catalytically inactive Cas9 fused to base editors have enabled genome editing with single-base precision. Here we discuss the many 'flavours' of the CRISPR/Cas9 system and give examples of their use for the generation of clinically-relevant mouse models of cancer.