The examination of the relationships among digital addiction, loneliness, shyness, and social anxiety in adolescents / El examen de las relaciones entre adicción digital, soledad, timidez y ansiedad social en adolescentes

La adicción digital, que se determina como un problema común entre los adolescentes en los últimos años, afecta negativamente la vida de los adolescentes en muchos aspectos. El objetivo del estudio es examinar las relaciones entre la adicción digital, la soledad, la timidez y la ansiedad social de los adolescentes. Gate se reunió con adolescentes que completaron la Escala de adicción digital, la versión corta de la Escala de soledad de UCLA, la Escala de timidez y la Escala de gravedad del trastorno de ansiedad social DSM-5 - Formulario infantil. Las hipótesis sugeridas se han probado utilizando los datos recopilados de 991 adolescentes y un análisis de regresión jerárquica. Los resultados de la investigación encontraron una relación positiva y significativa entre la adicción digital, la soledad, la timidez y la ansiedad social entre los adolescentes. Además, los hallazgos muestran que la adicción digital, la soledad y la timidez predicen la ansiedad social. Los resultados obtenidos demuestran que la adicción digital, la soledad y la timidez tienen efecto sobre la ansiedad social. Según los hallazgos, se sugiere aplicar diversas intervenciones educativas por parte de profesionales de la salud mental a adolescentes que presenten signos de adicción digital, soledad, timidez y ansiedad social.(AU)

Digital addiction, which is determined as a common problem among adolescents in the last years, affects the lives of adolescents nega-tively in terms of many aspects. The aim of the study is to examine the re-lationships between adolescents' digital addiction, loneliness, shyness and social anxiety. Gate gathered from adolescents who completed Digital Ad-diction Scale, Short Form of UCLA Loneliness Scale, Shyness Scale, and DSM-5 Social Anxiety Disorder Severity Scale -Child Form. The suggest-ed hypotheses have been tested using the data gathered from 991 adoles-cents and hierarchical regression analysis. The research findings found a positive and significant relationship between digital addiction, loneliness, shyness and social anxiety among adolescents. Furthermore, the findings show that digital addiction, loneliness, and shyness predict social anxiety. The results obtained prove that digital addiction, loneliness and shyness have an effect on social anxiety. According to the findings, it is suggested to applyvarious educational interventions by mental health professionals to adolescents who show signs of digital addiction, loneliness, shyness, and social anxiety.(AU)

Melatonin Regulates Neuronal Synaptic Plasticity in the Supramammillary Nucleus and Attenuates Methamphetamine-Induced Conditioned Place Preference and Sensitization in Mice.

Methamphetamine (METH) is an addictive drug that threatens human health. The supramammillary nucleus (SuM) and its neural circuits play key roles in the regulation of spatial memory retrieval, and hippocampal contextual or social memory. Melatonin (MLT), a pineal hormone, can regulate hypothalamic-neurohypophysial activity. Our previous study showed that MLT attenuates METH-induced locomotor sensitization. However, whether MLT regulates SuM function and participates in METH-induced contextual memory retrieval remains unclear. Using a mouse model of METH-conditioned place preference (CPP) and sensitization, we found that METH activated c-Fos expression and elevated calcium (Ca²âº) levels in SuM neurons. Chemogenetic inhibition of SuM attenuates CPP and sensitization. Pretreatment with MLT decreased c-Fos expression and Ca2+ levels in the SuM and reversed METH-induced addictive behavior, effects that were blocked with the selective MT2 receptors antagonist 4P-PDOT and the MT1 receptors antagonist S26131. Furthermore, MLT reduced SuM synaptic plasticity, glutamate (Glu) release, and neuronal oscillations caused by METH, which were blocked by 4P-PDOT. In conclusion, our data revealed that MLT regulates neuronal synaptic plasticity in the SuM, likely through the MLT receptors (MTs), and plays a role in modulating METH-addictive behavior.

Racial Differences in Medications for Opioid Use Disorder Initiation in a Carceral Setting.

BACKGROUND: The opioid overdose crisis significantly affects marginalized communities, with people of color experiencing higher rates of overdose and barriers to treatment. The syndemic of opioid use disorder and mass incarceration exacerbates racial health disparities. Some carceral facilities offer medication for addiction treatment, though no significant research explores differences in type of treatment uptake by race in these settings. This study focuses on the racial differences in medications for opioid use disorder (MOUD) preferences among incarcerated individuals. METHODS: A retrospective cohort study was conducted at the Rhode Island Department of Corrections (RIDOC), examining MOUD-type preferences (buprenorphine or methadone) among incarcerated individuals. The study utilized RIDOC electronic medical records from January 1, 2017 to December 31, 2022, involving 3533 unique incarceration events. Participants were categorized by race (White vs non-White) and MOUD status (new initiation vs community continuation), with logistic regression models. RESULTS: The study found no direct racial disparity in preferences for MOUD type. However, an interaction between race and MOUD initiation status significantly influenced MOUD-type preference. Among those initiating MOUD during incarceration, non-White individuals were more likely to choose buprenorphine compared to their White counterparts. CONCLUSIONS: This research provides new insights into the intersection of race, incarceration, and MOUD preferences. While direct racial disparities in MOUD type were not observed, the analysis uncovered a notable interaction effect: race influences the relationship between MOUD initiation status and the selected MOUD treatment during incarceration. Specifically, data demonstrate that the likelihood of choosing buprenorphine varies significantly based on both racial background and whether the treatment was initiated during incarceration or in the community. Further research is needed in different geographic settings to understand the broader implications to help guide equitable healthcare delivery in jails and prisons.

Extensive social media use and frequency of current e-cigarette use among US youth.

Introduction: Both electronic cigarette (e-cigarette) and social media use among youth are public health concerns. While the health impacts of extensive social media use and frequent use of e-cigarettes have been discussed independently in the literature, little is known about the relationship between the two. This study aims to examine the potential association between extensive social media use and the frequency of current, e-cigarette use among United States (US) youth. Methods: Data from the 2022 National Youth Tobacco Survey (NYTS) were analyzed. The sample included 23,655 middle and high school students aged 9-18 years. Frequency of current e-cigarette use was categorized based on past-30 day use (i.e., never/former, 1-9 days, 10-29 days, or 30 days). Social media use was dichotomized into less than 4 hours daily and 4+ hours daily (i.e., extensive use). Multivariable multinomial logistic regression estimated the relationship between social media use and e-cigarette use frequency. Results: Over one-third (35.8 %) of youth used social media extensively and 8.6 % reported current use of e-cigarettes. Extensive social media use was associated with daily e-cigarette use (OR: 1.94, 95 % CI: 1.48-2.56) but not with other use categories. Older age, female sex, lower grades, current other tobacco use, and family tobacco use were also associated with daily e-cigarette use. Conclusions: Extensive social media use is associated with daily e-cigarette use among US youth. Public health interventions should consider the influence of social media on tobacco use behaviors and tailor prevention strategies to address this potential modifiable risk factor.

Prevalence and association between alcohol, tobacco, and COVID-19: a study from a tribal predominant district in eastern India.

Introduction: Alcohol and tobacco use has been proposed to significantly affect COVID-19 outcomes. The study aimed to estimate the prevalence of alcohol and tobacco use among COVID-19-positive patients and compare it with the general population prevalence rates. It also aimed to assess and determine the association between the severity of COVID-19 illness and the complications with alcohol and tobacco use. Method: For this, a cross-sectional, retrospective, telephone-based study was conducted using a structured questionnaire among COVID-19 diagnosed patients in the district of Deoghar of the Indian state of Jharkhand. A multinomial logistic regression is done to determine the association. Results: Among 1,425 patients interviewed, tobacco and alcohol were used by 22.31 and 9.96%, significantly more than the prevalence of tobacco (Z = 4.9485, p < 0.00001) and alcohol use (Z = 7.118, p < 0.00001), respectively, in the district (tobacco-11.7% and alcohol-4.8%).In a regression model, patients with co-morbidity had higher odds of severe [3.34 (1.99-5.62)] and moderate [2.95 (1.97-4.41)] COVID-19. Young [0.12 (0.04-0.38)] and middle-aged individuals [0.23 (0.13-0.4)], people below the poverty line 0.28 (0.11-0.69) are at lower odds of severe COVID-19. Tobacco users [1.58 (1.16-2.14)], alcohol users [1.53 (1.03-2.28)], incomplete vaccination [3.24 (1.49-7.01)], and patients with comorbidity [3.6 (2.79-4.68)] were found to have higher odds of post-COVID-19 complications. Discussion: People with COVID-19 in our study population had significantly higher tobacco and alcohol use compared to the general population. Tobacco and alcohol use significantly increases the risk of post-COVID-19 complications. The study highlights the need for addiction treatment services to prevent complications during future pandemics.

Exploring the association between online gaming addiction and academic performance among the school-going adolescents in Bangladesh: A cross-sectional study.

Background and Aims: The pervasive nature of online gaming, notably accentuated during the COVID-19 pandemic, has spurred concerns regarding gaming addiction among children. This study explores the intricate ramifications of online gaming addiction on the academic performance and social dynamics of children in Bangladesh. Our primary objective is to gauge the extent of online gaming addiction and unravel its profound effects on academic performance. Methods: Conducting a nationwide survey from January 1, 2023, to June 30, 2023, we analyzed 502 responses from participants aged 6-17 years. The survey encompassed sociodemographic details, gaming addiction assessment, and academic performance following a simple random sampling method. We analyzed participant demographics utilizing descriptive statistics, chi-square tests, and logistic regression. Results: Key findings revealed a majority within the 13-17 age bracket (75.50%), predominantly male (58.57%), and enrolled in secondary education (83.27%). A robust inverse relationship showed that nonaddicted students towards online gaming had higher academic performance. Therefore, it is important to implement targeted strategies to address online gaming addiction among Bangladeshi children. Conclusion: Recommending early intervention, academic initiatives, and holistic therapy, we advocate for collaboration among educational institutions, mental health professionals, parents, and policymakers. All of these initiatives are essential to navigate the evolving challenges presented by gaming addiction. Furthermore, our call for ongoing research seeks to deepen our understanding of enduring consequences on academic and social dimensions, fostering a digitally supportive environment conducive to the holistic well-being of children.

High quality, high throughput, and low-cost simultaneous video recording of 60 animals in operant chambers using PiRATeMC.

BACKGROUND: The development of Raspberry Pi-based recording devices for video analyses of drug self-administration studies has been shown to be promising in terms of affordability, customizability, and capacity to extract in-depth behavioral patterns. Yet, most video recording systems are limited to a few cameras making them incompatible with large-scale studies. NEW METHOD: We expanded the PiRATeMC (Pi-based Remote Acquisition Technology for Motion Capture) recording system by increasing its scale, modifying its code, and adding equipment to accommodate large-scale video acquisition, accompanied by data on throughput capabilities, video fidelity, synchronicity of devices, and comparisons between Raspberry Pi 3B+ and 4B models. RESULTS: Using PiRATeMC default recording parameters resulted in minimal storage (~350MB/h), high throughput (< ~120seconds/Pi), high video fidelity, and synchronicity within ~0.02seconds, affording the ability to simultaneously record 60 animals in individual self-administration chambers for various session lengths at a fraction of commercial costs. No consequential differences were found between Raspberry Pi models. COMPARISON WITH EXISTING METHOD(S): This system allows greater acquisition of video data simultaneously than other video recording systems by an order of magnitude with less storage needs and lower costs. Additionally, we report in-depth quantitative assessments of throughput, fidelity, and synchronicity, displaying real-time system capabilities. CONCLUSIONS: The system presented is able to be fully installed in a month's time by a single technician and provides a scalable, low cost, and quality-assured procedure with a high-degree of customization and synchronicity between recording devices, capable of recording a large number of subjects and timeframes with high turnover in a variety of species and settings.

Within-session chasing of losses and wins in an online eCasino.

Chasing refers to the escalation of betting behaviour. It is conventionally seen when losing but can also be seen after wins. Diagnostic and screening items for gambling problems describe chasing as returning 'another day' to gamble. However, gamblers may also chase within sessions, and this is particularly relevant in online gambling. This study focused on two expressions of within-session chasing: (1) increasing the bet amount, or (2) a reduced probability of quitting the session, as a function of prior losses or wins. These expressions were examined across five online gambling products: slot machines, probability games, blackjack, video poker, and roulette. Our results showed that gamblers bet more and played longer sessions after immediate losses, but they bet less and played shorter sessions when losing cumulatively. The reversed pattern in the cumulative model may be due to financial constraints. For wins, gamblers bet more after both immediate and cumulative wins, but they also played shorter sessions. Chasing patterns were qualitatively similar by game type-with limited evidence for our hypothesis that chasing would be greatest for slot machines as an established high-risk category. Overall, chasing is multi-faceted, varying across the behavioural expressions, by the immediate or cumulative timeframe of prior outcomes, and by game type.

The impact of anger on intertemporal decision-making in individuals with internet addiction: an fNIRS study.

Intertemporal decision-making is the choice between an immediate smaller reward (SS) and a delayed larger reward (LL). Intertemporal decision-making depends on the interaction of the cognitive and emotional systems, and the latter is particularly vital. According to the Appraisal Tendency Frame (ATF) theory, anger influences intertemporal decision-making by increasing an individual's sense of certainty and control. This study examined whether anger affects intertemporal decision-making in individuals with internet addiction (IA) in this manner and investigated its neural mechanisms. Nineteen individuals with IA and 20 healthy controls were recruited. All subjects performed the Monetary choice task under anger and neutral emotions while functional near-infrared spectroscopy (fNIRS) equipment simultaneously recorded the hemodynamics in the prefrontal cortex (PFC). Individuals with IA showed a more considerable delay discount and lower brain activations in the orbitofrontal cortex (OFC) and left dorsolateral prefrontal cortex (L-dlPFC) compared to HC. Moreover, individuals with IA made more LL choices in the angry condition than in the neutral emotion, yet there was no difference in HC. The brain activation in L-dlPFC of individuals with IA tends to increase in the angry condition compared to the neutral condition. These findings revealed that impairment of intertemporal decision-making in individuals with individuals with IA might be related to the dysfunction of OFC and L-dlPFC. Our work also provided initial footing for the applicability of the appraisal tendency frame theory to individuals with IA, and L-dlPFC might play a role in the effects of anger on intertemporal decision-making.

Effects of socio-demographical characteristics of high school students on smartphone addiction and depression.

This study was conducted to determine the smartphone addiction and severity of depressive symptoms of high school students. In this descriptive cross-sectional and correlational study, the sample consisted of 1744 high school students. In the study, data were collected using a Descriptive Questionnaire, the Smartphone Addiction Scale-Short Form, and the Depression Scale for Children. Data were analyzed in independent groups Student's t test, One-way ANOVA, Pearson correlation analysis, and a multiple regression model. It was determined that the students' mean smartphone addiction score was affected by gender, grade level, school success, having problems with the family, relationship with family, relationship with friends, and social self-evaluation. The mean depression score was affected by family type, economic status, social self-evaluation. According to the multiple regression analysis, effects of socio-demographic variables on smartphone addiction were 25%. It was concluded that the socio-demographic characteristics of high school students have an effect on smartphone addiction and depression.

The Bergen-Yale Sexual Addiction Scale (BYSAS): Longitudinal Measurement Invariance Across a Two-Year Interval.

The Bergen-Yale Sexual Addiction Scale (BYSAS; [1]) is arguably the most popular questionnaire at present for assessing sex addiction. Employing Confirmatory Factor Analysis (CFA) and treating item scores as ordered categorical, we applied Weighted Least Square Mean and Variance Adjusted Chi-Square (WLSMV) extraction to investigate the longitudinal measurement and structural invariance of ratings on the BYSAS among 276 adults (mean = 31.86 years; SD = 9.94 years; 71% male) over a two-year period, with ratings at three yearly intervals. Overall, there was support for configural invariance, full loading, full threshold, the full unique factor invariance; and all structural (latent variances and covariances) components. Additionally, there was no difference in latent mean scores across the three-time points. The psychometric and practical implications of the findings are discussed.

Substance Use and Addiction.

Efforts to reveal the molecular, cellular, and circuit mechanisms of addiction have largely focused on neurons. Yet accumulating data regarding the ability of glial cells to impact synaptic function, circuit activity, and behavior demands that we explore how these nonneuronal cells contribute to substance use disorders and addiction. Important work has shown that glial cells, including microglia, exhibit changes in phenotype following exposure to drugs of abuse and that modification of glial responses can impact behaviors related to drug seeking and drug taking. While these are critical first steps to understanding how microglia can impact addiction, there are still substantial gaps in knowledge that need to be addressed. This chapter reviews some of the key studies that have shown how microglia are affected by and can contribute to addiction. It also discusses areas where more knowledge is urgently needed to reveal new therapeutic and preventative approaches.

Experiences and perspectives of sugar-sweetened beverage consumption among Indigenous adults living in Manitoba.

Sugar-sweetened beverages (SSB) are a health policy target. Indigenous populations are among the highest consumers of SSB in Canada. However, the Truth and Reconciliation Commission calls on governments to recognize health disparities among Indigenous populations as a consequence of colonialism and governmental policies. The purpose of this analysis was to explore emergent perspectives of Indigenous adults on experiences and perspectives of SSB consumption. We conducted a community-based participatory study in partnership with three Indigenous-led organizations. From 2019 to 2022, we completed qualitative interviews with Indigenous adults living in Island Lake Anisininew First Nation, Flin Flon, and Winnipeg's North End, a neighbourhood with high concentration of Indigenous people. Interviews were audio-recorded, transcribed verbatim, and analyzed thematically. Seventy-four adults participated in interviews, including 46 women, 26 men, and two identifying as two-spirit. Many participants, across all three locations, repeatedly and consistently described SSB or sugar as an addiction, which formed the primary theme for this analysis: addictive-like consumption of SSB. Addictive-like SSB consumption included comparison to other addictive substances, loss of control, and physical symptoms resulting from SSB intake (both positive and adverse) or attempting to reduce SSB intake. We identified two other secondary themes, i) perceived drivers and contexts of SSB consumption, and ii) health outcomes as a motivator for change. Perceived drivers or contexts included consuming SSB as a means to cope with stress, boredom, and poverty; SSB intake as being intertwined with other addictions or addictive substances; and drinking alone. In conclusion, addictive-like SSB consumption was reported by Indigenous adults. To address SSB intake among Indigenous populations, trauma-informed approaches should be explored that consider the colonial context.

A bio-inspired reinforcement learning model that accounts for fast adaptation after punishment.

Humans and animals can quickly learn a new strategy when a previously-rewarding strategy is punished. It is difficult to model this with reinforcement learning methods, because they tend to perseverate on previously-learned strategies - a hallmark of impaired response to punishment. Past work has addressed this by augmenting conventional reinforcement learning equations with ad hoc parameters or parallel learning systems. This produces reinforcement learning models that account for reversal learning, but are more abstract, complex, and somewhat detached from neural substrates. Here we use a different approach: we generalize a recently-discovered neuron-level learning rule, on the assumption that it captures a basic principle of learning that may occur at the whole-brain-level. Surprisingly, this gives a new reinforcement learning rule that accounts for adaptation and lose-shift behavior, and uses only the same parameters as conventional reinforcement learning equations. In the new rule, the normal reward prediction errors that drive reinforcement learning are scaled by the likelihood the agent assigns to the action that triggered a reward or punishment. The new rule demonstrates quick adaptation in card sorting and variable Iowa gambling tasks, and also exhibits a human-like paradox-of-choice effect. It will be useful for experimental researchers modeling learning and behavior.

Predictive factors of weight loss in obese patients referred to an obesity specialized centre.

INTRODUCTION AND AIMS: In obese patients, long-term weight loss maintenance remains challenging. Identifying factors predicting adhesion to lifestyle therapy and weight loss would help optimizing obesity management. AIMS: to identify predictive factors of weight loss after one year of medical therapy in obese patients (primary) and predictive factors of drop-out during the year of therapy (secondary). METHODS: In this retrospective study, obese patients consulting for the first time in an obesity specialized center were included. All patients fulfilled the criteria for obesity surgery and were managed to change their lifestyle by following a 1-year therapeutical education program based on intuitive eating. Significant weight loss was defined by ≥5 % after 1 year. Patients were considered as dropouts, i.e. absence of adhesion to therapy, once they missed one consultation without informing the unit. Stepwise multivariable analyses determined the predictive factors. RESULTS: Of the 310 patients (mean age, 44.5±11.9 yr, 79% women) included, 155 (50%) maintained their follow-up at 1 year and 37 (24%) experienced weight loss ≥5%. Male gender (odds ratio (OR)=6.25 [95% confidence interval, 1.78; 21.92], P=0.004), ≥5 consultations with intuitive eating (OR=3.69 [1.14;11.87], P=0.03), and tobacco addiction (OR=0.18 [0.04; 0.82], P=0.03) were associated to weight loss ≥5%. Older age (OR=0.97 [0.95; 0.99], P=0.014), physical activity (OR=0.11 [0.05; 0.24], P<0.0001) and the patient desire for obesity surgery (OR=0.22 [0.12; 0.41], P<0.0001) were associated with a better adhesion to therapy. CONCLUSION: The identified predictive factors would help identifying the patients with the greater chance of losing weight and adhering to therapy. Offering more therapeutic education sessions should increase therapy success in obese patients fulfilling the criteria for obesity surgery.

Sub-chronic nicotine exposure influences methamphetamine self-administration and dopamine overflow in a sex-and genotype-dependent manner in humanized CHRNA6 3'-UTR SNP (rs2304297) adolescent rats.

Introduction: The rewarding effects of drugs of abuse are associated with the dopaminergic system in the limbic circuitry. Nicotine exposure during adolescence is linked to increased use of drugs of abuse with nicotine and methamphetamine (METH) commonly used together. Nicotine acts on neuronal nicotinic acetylcholine receptor (nAChR) systems, critical for reward processing and drug reinforcement, while METH leads to a higher dopamine (DA) efflux in brain reward regions. A human single nucleotide polymorphism (SNP) in the 3'-untranslated region (UTR) of the α6 nicotinic receptor subunit gene (CHRNA6, rs2304297), has been linked with tobacco/nicotine and general substance use during adolescence. Using CRISPR-Cas9 genomic engineering, our lab recapitulated the CHRNA6 3'UTRC123G SNP, generating α6CC and α6GG allele carriers in Sprague Dawley rats. We hypothesized the CHRNA6 3'UTRC123G SNP would sex- and genotype-dependently enhance nicotine-induced METH self-administration as well as nicotine-induced DA overflow in the nucleus accumbens shell of adolescent α6GG and α6CC carriers. Methods: Adolescent male and female rats underwent a 4-day sub-chronic, low-dose (0.03 mg/kg/0.1 mL, x2) nicotine pretreatment paradigm to assess intravenous METH (0.02 mg/kg/0.1 mL) self-administration as well as nicotine- and METH (0.02 mg/kg/0.1 mL)-induced DA overflow in the nucleus accumbens shell (NAcS) using in vivo microdialysis coupled with high-performance liquid-chromatography-electrochemical detection (HPLC-ECD). Results: Nicotine pretreatment sex- and genotype-dependently enhanced subsequent METH self-administration in adolescent CHRNA6 3'UTRC123G SNP rats. Further nicotine and METH-induced DA overflow is observed in α6CC females as compared to α6GG females, with METH-induced DA overflow enhanced in α6GG males when compared to α6CC males. Conclusion: These findings demonstrate that the CHRNA6 3'-UTRC123G SNP can sex- and genotype-dependently impact adolescent nicotine-induced effects on METH self-administration and stimulant-induced DA overflow in reward regions of the brain.

Intolerance of uncertainty and internet addiction among college students in China post-pandemic era: the mediating role of future anxiety.

Due to the repeated changes in the COVID-19 pandemic, we live in an era of various uncertainties that raise future anxiety and behavioral addiction problems. According to the Protection Motivation Theory (PMT), the present study attempted to explore the impact of COVID-19 intolerance of uncertainty (COVID-19 IU) on internet addiction (IA) among college students and the mediating role of future anxiety (FA) by constructing a mediating model. A questionnaire survey was conducted on 679 Chinese college students and PROCESS 3.5 was utilized to test the hypotheses. The results indicated that the COVID-19 IU was significantly positively correlated with IA and FA, and FA was significantly positively correlated with IA. COVID-19 IU had a significant positive predictive effect on IA; FA played a complementary partial mediating role between COVID-19 IU and IA. The results supported the PMT, which not only enriched our understanding of FA under uncertain life circumstances, but also deepened our understanding of the potential mechanisms of the effects of IA. Finally, discussions and suggestions were presented based on the results.

Neurocognitive function and medical care utilization in Veterans treated for substance use disorder.

BACKGROUND: Veterans with substance use disorder (SUD) are at high risk for cognitive problems due to neurotoxic effects of chronic drug and alcohol use coupled in many cases with histories of traumatic brain injury (TBI). These problems may in turn result in proneness to SUD relapse and reduced adherence to medical self-care regimens and therefore reliance on health care systems. However, the direct relationship between cognitive function and utilization of Veterans Health Administration (VHA) SUD and other VHA health care services has not been evaluated. We sought initial evidence as to whether neurocognitive performance relates to repeated health care engagement in Veterans as indexed by estimated VHA care costs. METHODS: Neurocognitive performance in 76 Veterans being treated for SUD was assessed using CNS-Vital Signs, a commercial computerized cognitive testing battery, and related to histories of outpatient and inpatient/residential care costs as estimated by the VHA Health Economics Resource Center. RESULTS: After controlling for age, an aggregate metric of overall neurocognitive performance (Neurocognition Index) correlated negatively with total VHA health care costs, particularly with SUD-related outpatient care costs but also with non-mental health-related care costs. Barratt Impulsiveness Scale scores also correlated positively with total VHA care costs. CONCLUSIONS: In Veterans receiving SUD care, higher impulsivity and lower cognitive performance were associated with greater health care utilization within the VHA system. This suggests that veterans with SUD who show lower neurocognitive performance are at greater risk for continued health problems that require healthcare engagement. Cognitive rehabilitation programs developed for brain injury and other neurological conditions could be tried in Veterans with SUD to improve their health outcomes.

The role of physical activity in mitigating stress-induced internet addiction among Chinese college students.

BACKGROUND: This study addresses the nexus of stress, physical exercise, and internet addiction in college students, aiming to unravel their complex interactions. With prior research hinting at correlations, this study seeks deeper insights into the optimal exercise duration and the mediating role of physical activity in the stress-internet addiction relationship. METHODS: We examined 2892 Chinese college students, assessing psychosocial traits via established scales: the Chinese Internet Addiction Scale (CIAS-R), International Physical Activity Questionnaire (IPAQ), and DASS-21 for stress. We adopted a questionnaire survey method to collect data, and through convenience sampling, participants were selected. Analysis involved Structural Equation Model (SEM) and restricted cubic splines (RCS). RESULTS: Among participants, 22.0 % self-reported internet addiction symptoms. Notably, a non-linear correlation between moderate (MPA) and vigorous physical activity (VPA) and internet addiction was evident (P < 0.001), while light physical activity (LPA) showed no significant association (P = 0.182). MPA initially reduced internet addiction as activity hours increased, but its efficacy lessened after 0.8 h/day. Conversely, VPA's impact fluctuated, declining from 0 to 0.18 h/day, then stabilizing. SEM analysis highlighted VPA and MPA's partial mediation in the stress-internet addiction relationship. Specifically, the path coefficient from stress to MPA was -0.037 (P < 0.05), and the path coefficient from MPA to internet addiction was -0.056 (P < 0.01). Additionally, the path coefficient from stress to VPA was -0.067 (P < 0.001), and the path coefficient from VPA to internet addiction was -0.102 (P < 0.001). CONCLUSION: This study unveils the intricate interplay between physical activity, stress, and internet addiction among college students. With 22.0 % reporting addiction symptoms, urgent interventions tailored to promoting healthy physical activity levels are imperative to mitigate internet addiction risks. LIMITATIONS: The cross-sectional nature of our design precludes the establishment of causal relationships between psychological stress and internet addiction.

Profiles of Primary Brain Abscesses and Their Impact on Survival: An International ID-IRI Study.

OBJECTIVES: This study of 331 primary brain abscess (PBA) patients aimed to understand infecting agents, predisposing factors, and outcomes, with a focus on factors affecting mortality. METHODS: Data were collected from 39 centers across 16 countries between January 2010 and December 2022, and clinical, radiological, and microbiological findings, along with their impact on mortality, were analyzed. RESULTS: The patients had a mean±SD age of 46.8±16.3 years, with a male predominance of 71.6%. Common symptoms included headache (77.9%), fever (54.4%), and focal neurological deficits (53.5%). Gram-positive cocci were the predominant pathogens, with viridans group streptococci identified as the most frequently isolated organisms. All patients received antimicrobial therapy and 71.6% underwent interventional therapies. The 42-day and 180-day survival rates were 91.9% and 86.1%, respectively. Significant predictors of 42-day mortality included intravenous drug addiction (HR: 6.02, 95% CI: 1.38-26.26), malignancy (HR: 3.61, 95% CI: 1.23-10.58), confusion (HR: 2.65, 95% CI:1.19-5.88), and unidentified bacteria (HR: 4.68, 95% CI: 1.76-12.43). Significant predictors of 180-day mortality included malignancy (HR: 2.70, 95% CI: 1.07-6.81), confusion (HR: 2.14, 95% CI: 1.11-4.15), temporal lobe involvement (HR: 2.10, 95% CI: 1.08-4.08), and unidentified bacteria (HR: 3.02, 95% CI: 1.49-6.15). CONCLUSION: The risk of death in PBA extends beyond the infection phase, with different factors influencing the 42-day and 180-day mortality rates. Intravenous drug addiction was associated with early mortality, while temporal lobe involvement was associated with late mortality.