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2.
Brain ; 143(3): 800-810, 2020 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-32203578

RESUMO

Amyotrophic lateral sclerosis is a fatal disease resulting from motor neuron degeneration in the cortex and spinal cord. Cortical hyperexcitability is a hallmark feature of amyotrophic lateral sclerosis and is accompanied by decreased intracortical inhibition. Using electrophysiological patch-clamp recordings, we revealed parvalbumin interneurons to be hypoactive in the late pre-symptomatic SOD1*G93A mouse model of amyotrophic lateral sclerosis. We discovered that using adeno-associated virus-mediated delivery of chemogenetic technology targeted to increase the activity of the interneurons within layer 5 of the primary motor cortex, we were able to rescue intracortical inhibition and reduce pyramidal neuron hyperexcitability. Increasing the activity of interneurons in the layer 5 of the primary motor cortex was effective in delaying the onset of amyotrophic lateral sclerosis-associated motor deficits, slowing symptom progression, preserving neuronal populations, and increasing the lifespan of SOD1*G93A mice. Taken together, this study provides novel insights into the pathogenesis and treatment of amyotrophic lateral sclerosis.

3.
A A Pract ; 14(6): e01177, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32132361

RESUMO

We report a case of fatal immune checkpoint inhibitor (ICI)-associated myocarditis in a 77-year-old man with metastatic non-small cell lung cancer (NSCLC) who presented for mediport placement at our outpatient surgical center. He denied any cardiac complaints and had a previously normal electrocardiogram (EKG) off treatment. Intraoperatively and postoperatively, he displayed cardiac rhythm abnormalities. The patient was then transferred to a tertiary facility, where he expired within 48 hours. As cancer immunotherapy becomes increasingly prominent, ICI-associated myocarditis should be considered a potentially critical contributor to perioperative cardiac morbidity and mortality.

4.
J AAPOS ; 2020 Mar 17.
Artigo em Inglês | MEDLINE | ID: mdl-32198080

RESUMO

PURPOSE: To describe the surgical management, dose-response, and postoperative outcomes of strabismus surgery in patients with thyroid eye disease. METHODS: The medical records of patients operated on between 2014 and 2018 were reviewed retrospectively. Patient characteristics and surgical data were collected. Motor success was defined as vertical deviation of ≤5Δ and horizontal deviation of ≤10Δ; sensory success, as no diplopia in primary gaze. RESULTS: A total of 76 patients (mean age, 62.2 ±12.9 years; 50 females) underwent 87 surgeries, most commonly unilateral inferior rectus recession (unilateral IR, 48%) and bilateral medial rectus recession (bilateral MR, 23%). Motor success was achieved in 69% and sensory success in 58%. For unilateral IR surgery, the dose-responses were 3.25Δ/mm (SE = 0.616; ß = 0.650; P < 0.001) at distance and 2.48Δ/mm (SE = 0.752; ß = 0.472; P = 0.002) at near; for bilateral MR surgery, 3.93Δ/mm (SE = 0.997; ß = 0.680; P = 0.001) at distance and 5.05Δ/mm (SE = 1.374; ß = 0.655; P = 0.002) at near. Median (Q1, Q3) postoperative drift was toward overcorrection for both procedures (unilateral IR, -2Δ [-8, 0] at distance and -2Δ [-7, 0] at near; bilateral MR, -2Δ [-8, 2] at distance and -2Δ [-10, 0] at near). Sex, age, duration of strabismus, prior orbital decompression, and concurrent vertical and horizontal procedures were not associated with dose-response or postoperative drift. CONCLUSIONS: Concurrent vertical and horizontal surgery did not affect the motor success rate, dose-response, or postoperative drift. Although unilateral IR surgery had a larger dose-response at distance, bilateral MR surgery had a larger dose-response at near. Most procedures tended to have a postoperative drift toward overcorrection.

5.
J Perinat Med ; 2020 Mar 14.
Artigo em Inglês | MEDLINE | ID: mdl-32171001

RESUMO

Background Preeclampsia (PE) is a pregnancy-specific vascular endothelial disorder characterized by multi-organ system involvement. This includes the maternal kidneys, with changes such as continuous vasospasm of renal arteries and reduced renal blood flow. However, it is unclear whether similar renal vascular changes are seen in the fetus. This study sought to compare renal artery impedance in fetuses of women with and without PE. Methods This was a prospective Doppler assessment study of the fetal renal artery impedance in 48 singleton fetuses. The group with PE consisted of 24 appropriately grown fetuses in pregnancy complicated by both mild and severe PE and a control group of 24 uncomplicated pregnancies. Doppler studies included renal artery systolic/diastolic (S/D) ratio, pulsatility index (PI), resistance index (RI), and identification of end-diastolic blood flow. Results Fetuses of mothers with PE were more likely to have a lower renal artery Doppler S/D ratio (7.85 [6.4-10.2] vs. 10.8 [7.75-22.5], P = 0.03) and lower RI (0.875 [0.842-0.898] vs. 0.905 [0.872-0.957], P = 0.03). However, there was no statistically significant difference in PI. There was also no difference in the incidence of absent end-diastolic flow. Conclusion This study suggests that PE results in changes in blood flow to the renal arteries of the fetus. This may be associated with long-term adverse health effects later in adulthood.

6.
Health Psychol ; 2020 Mar 23.
Artigo em Inglês | MEDLINE | ID: mdl-32202823

RESUMO

OBJECTIVE: The purpose of this study was to evaluate associations between executive functioning and caregiver adherence monitoring with objective antihypertensive medication adherence over 24 months in adolescents with chronic kidney disease (CKD). METHODS: Adolescents (N = 97, 11-20 years old) with CKD taking antihypertensive medication and their caregivers were recruited from three pediatric nephrology clinics. At baseline, adolescents and caregivers reported on adolescents' executive functioning and caregivers reported on their adherence monitoring. Antihypertensive medication adherence was objectively assessed via electronic monitoring at baseline and every 6 months after for 24 months. Associations between executive functioning, caregiver monitoring, and longitudinal adherence were evaluated with linear mixed models. RESULTS: Up to 38% of adolescents had elevated executive functioning scores indicating more severe impairments, with rates varying by scale and reporter (adolescent vs. caregiver). Caregiver monitoring showed a significant, negative association with adherence, but adolescents' executive functioning was not significantly associated with adherence. Neither variable was associated with the rate of change in adherence over time. CONCLUSIONS: Given that adolescents' executive functioning was not associated with antihypertensive medication adherence or changes in adherence over time, adherence to daily pill-form medications may involve less cognitive effort than more complex medical regimens. Higher levels of caregiver monitoring were unexpectedly associated with lower adherence levels. This unanticipated finding may reflect increased caregiver monitoring efforts when faced with adolescents' medication nonadherence, but this finding warrants further investigation. Adolescents with CKD who are nonadherent may benefit from medication adherence-promoting strategies beyond increasing caregiver monitoring. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

7.
Curr Hypertens Rep ; 22(2): 17, 2020 Feb 12.
Artigo em Inglês | MEDLINE | ID: mdl-32052203

RESUMO

PURPOSE OF REVIEW: To review the rationale and biological plausibility and discuss the current research on novel interventions for the prevention of preeclampsia. RECENT FINDINGS: Preeclampsia affects up to 8% of pregnancies worldwide and remains a major cause of maternal and neonatal morbidity and mortality. Multiple medications have been investigated or repurposed as potential effective interventions for preeclampsia prevention. Aspirin is currently the only drug for which there is some evidence of benefit for preeclampsia prevention, and its use is recommended by professional societies for pregnancies at risk. Statins have shown promise for prevention of preeclampsia in animal models and human pilot studies, without any trend or concerns for safety signals or teratogenicity. The use of metformin has also gained popularity in experimental studies, but observations from randomized clinical trials were not consistent on its utility as a possible intervention for preeclampsia prevention. While initial studies evaluating esomeprazole were promising, randomized trials failed to show benefit. Contemporary research shows exciting new opportunities for prophylactic treatment for preeclampsia, to prevent this debilitating and life-threatening disease.

8.
Allergol. immunopatol ; 48(1): 48-55, ene.-feb. 2020. graf, tab
Artigo em Inglês | IBECS | ID: ibc-186591

RESUMO

Background: Several pro-inflammatory and anti-inflammatory mediators play a role in the immunopathogenesis of food allergy (FA). The aim of this study was to investigate the utility of serum biomarkers like interleukin (IL)-10, TNF-alfa, and IL-6 in the diagnosis and/or follow-up of FA. Methods: Sixty (25 females, 41.6%) newly diagnosed FA patients [IgE mediated (group-1, n = 37), non-IgE (group-2, n = 23)] with a median age of nine (1-33) months were enrolled. Twenty-four healthy children with a median age of eight (1-36) months constituted the control group (CG). In all the subjects, serum TNF-alfa, IL-6 and IL-10 levels were evaluated at the time of diagnosis and reassessed four weeks after therapeutic elimination diet (TED). Results: The mean white blood cell count and median absolute eosinophile count of the CG were significantly lower than group-1 (p values were 0.019 and 0.006, respectively). The mean absolute neutrophile count and the median IL-6 were significantly higher in group-1 when compared with group-2 (p values were 0.005 and 0.032, respectively. Median TNF-alfa and IL-6 levels were significantly higher in the pre-TED among all patients (p values were 0.005 and 0.018, respectively). In group-1, median TNF-α and IL-6 levels decreased significantly after TED (p values were 0.01 and 0.029, respectively). Conclusions: Our findings support the role of inflammation in the pathogenesis of FA. Serum TNF-alfa and IL-6 levels may be useful markers for follow-up in FA, especially among IgE-mediated FA patients. Evaluation of IL-10 results was not sufficient for an interpretation of clinical tolerance


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Assuntos
Humanos , Masculino , Feminino , Recém-Nascido , Lactente , Pré-Escolar , Interleucina-10/sangue , Interleucina-6/sangue , Hipersensibilidade Alimentar/diagnóstico , Hipersensibilidade Imediata/diagnóstico , Fator de Necrose Tumoral alfa/sangue , Mucosa Intestinal/imunologia , Algoritmos , Alérgenos , Anafilaxia/imunologia , Biomarcadores , Fator de Necrose Tumoral alfa/imunologia , Fator de Necrose Tumoral alfa/análise
9.
Strabismus ; : 1-6, 2020 Feb 21.
Artigo em Inglês | MEDLINE | ID: mdl-32079447

RESUMO

Purpose: To quantify the amount of insertion shift after disinsertion of the rectus muscles and identify factors that may influence the shift.Methods: Patients who underwent rectus muscle surgery between November 2018 and April 2019 were included. During surgery, the limbal-insertion distance (LID) distance was measured in millimeters with calipers from the limbus to the center of the insertion at the anterior border of the rectus muscle prior to and after disinsertion. The primary outcome was the shift of the rectus muscle insertion after disinsertion. This was calculated by subtracting the LID after disinsertion from the LID before disinsertion. The secondary outcome was the identification of preoperative and intraoperative factors that influenced insertion shift. Randomization was performed to select one rectus muscle per patient. Patients with a history of prior scleral buckle procedure, glaucoma drainage device, orbital wall fracture and strabismus surgery in the same rectus muscle were excluded.Results: 110 patients were included. The median (Q1, Q3) LID before disinsertion was shortest for the medial rectus muscle [5.0 (4.5, 6.0)], followed by lateral rectus muscle [6.0 (6.0, 7.0)] and inferior rectus muscle [6.0 (5.5, 7.0)]. The overall median (Q1, Q3) insertion shift was 1.0 (0.8, 1.0) mm (p < .001), which did not significantly differ between each rectus muscle subgroup (p = .158). Factors that influenced the amount of shift were moderate to severe restriction on forced duction testing (FDT) (B = 0.320, SE = 0.105, p = .003) and longer LID before disinsertion (B = 0.172, SE = 0.036, p < .001).Conclusions: We found a significant anterior insertion shift after disinsertion of rectus muscles. Moderate to severe restriction on FDT and longer LID before disinsertion can result in larger insertion shifts.

10.
Acad Pediatr ; 2020 Feb 17.
Artigo em Inglês | MEDLINE | ID: mdl-32081766

RESUMO

BACKGROUND AND OBJECTIVES: Telemedicine may have the ability to reduce avoidable transfers by allowing remote specialists the opportunity to more effectively assess patients during consultations. In this study, we examined whether telemedicine consultations were associated with reduced transfer rates compared to telephone consultations among a cohort of term and late preterm newborns. We hypothesized that neonatologist consultations conducted over telemedicine would result in fewer interfacility transfers than consultations conducted over telephone. METHODS: We collected data on all newborns who received a neonatal telemedicine or telephone consultation at six rural hospitals in northern and central California between August 2014 and June 2018. We used adjusted analyses to compare transfer rates between telemedicine and telephone cohorts. RESULTS: A total of 317 patients were included in the analysis; 89 (28.1%) of these patients received a telemedicine consultation and 228 (71.9%) received a telephone consultation only. The overall transfer rate was 77.0%. Patient consultations conducted using telemedicine were significantly less likely to result in a transfer than patient consultations conducted using the telephone (64.0% vs 82.0%, p=0.001). After controlling for 5-minute Apgar score, birthweight, gestational age, site of consultation, and transport risk index of physiologic stability (TRIPS-II) score, the odds of transfer for telemedicine consultations was 0.48 (95% CI: 0.26,0.90, p=0.02). CONCLUSION: Our findings suggest that telemedicine may have the potential to reduce potentially avoidable transfers of term and late preterm newborns. Future research on potentially avoidable transfers and patient outcomes is needed to better understand the ways in which telemedicine affects clinical decision making.

11.
BMC Pregnancy Childbirth ; 20(1): 99, 2020 Feb 11.
Artigo em Inglês | MEDLINE | ID: mdl-32046663

RESUMO

BACKGROUND: Sedentary behavior (SED) is a potential risk factor for poor pregnancy outcomes. We evaluated the validity of several common and one new method to assess SED across three trimesters of pregnancy. METHODS: This cohort study of pregnant women measured objective and self-reported SED each trimester via thigh-worn activPAL3 micro (criterion), waist-worn Actigraph GT3X, and self-report from the Pregnancy Physical Activity Questionnaire (PPAQ) and the de novo Sedentary Behavior Two Domain Questionnaire (SB2D). SED (hours per day) and percent time in SED (SED%) from activPAL were compared to GT3X, SB2D, and PPAQ using Pearson's r, ICC, Bland-Altman analysis, and comparison of criterion SED and SED% across tertiles of alternative methods. RESULTS: Fifty-eight women (mean age 31.5 ± 4.8 years; pre-pregnancy BMI 25.1 ± 5.6 kg/m2; 76% white) provided three trimesters of valid activPAL data. Compared to activPAL, GT3X had agreement ranging from r = 0.54-0.66 and ICC = 0.52-0.65. Bland-Altman plots revealed small mean differences and unpatterned errors, but wide limits of agreement (greater than ±2 h and ± 15%). The SB2D and PPAQ had r < 0.5 and ICC < 0.3 vs. activPAL SED, with lower agreement during the 2nd and 3rd trimesters, and performed poorly in Bland-Altman analyses. SED% from the modified SB2D performed best of the self-reported instruments with modest mean differences, r ranging from 0.55 to 0.60, and ICCs from 0.31-0.33; though, limits of agreement were greater than ±35%. Significant trends in activPAL SED were observed across increasing tertiles of SB2D SED in the 1st and 3rd trimesters (both p ≤ 0.001), but not the 2nd trimester (p = 0.425); and for PPAQ SED in the 1st and 2nd trimesters (both p < 0.05), but not the 3rd trimester (p = 0.158). AcitvPAL SED and SED% increased significantly across tertiles of GT3X SED and SED% as well as SB2D SED% (all p-for-trend ≤ 0.001). CONCLUSIONS: Compared to activPAL, waist-worn GT3X produced moderate agreement, though similar mean estimates of SED across pregnancy. Self-report questionnaires had large absolute error and wide limits of agreement for SED hr./day; SB2D measurement of SED% was the best self-report method. These data suggest activPAL be used to measure SED when possible, followed by GT3X, and - when necessary - SB2D assessing SED% in pregnancy. TRIAL REGISTRATION: www.clinicaltrials.gov NCT03084302 on 3/20/2017.

12.
Med Sci Sports Exerc ; 2020 Jan 06.
Artigo em Inglês | MEDLINE | ID: mdl-31913245

RESUMO

PURPOSE: We evaluated the associations between accelerometer-estimated physical activity (PA) intensity and heart rate variability (HRV) and examined mediation of these associations by glycemic control indices and other cardiovascular disease (CVD) risk factors. METHODS: Data were from 1,668 participants (X[Combining Overline]age=45.9±3.5 years, 58.0% female, 39.9% black) who participated in Year 20 (2005-06) of the Coronary Artery Risk Development in Young Adults (CARDIA) Fitness Study. The ActiGraph 7164 estimated participants' mean min/day of vigorous-intensity PA (VPA), moderate-intensity PA (MPA), and light-intensity PA (LPA) over seven days. Three sequential 10-sec 12-lead ECG strips were used to derive standard deviation of all normal RR intervals (SDNN) and root mean square of all successive RR intervals (rMSSD) HRV. Mediators representing glycemic control indices included fasting glucose, fasting insulin, and 2-hour oral glucose tolerance, with other mediators being traditional CVD risk factors. Multiple linear regression assessed independent associations of PA intensity with HRV per 1-SD. Mediation analyses computed the proportion of the PA-HRV association attributable to physiological mediators. RESULTS: Participants averaged 2.7±6.2, 33.0±22.0, and 360.2±83.8 min/day of VPA, MPA, and LPA, respectively, with mean values for SDNN (32.6±22.4 ms) and rMSSD (34.0±24.8 ms) similar. After adjustment for demographic and lifestyle behaviors, VPA was associated with both HRV metrics (SDNN: std beta=0.06 [0.03, 0.10]; rMSSD: std beta=0.08, [0.05, 0.12]) and LPA with rMSSD only (std beta=0.05, [0.01, 0.08]). Fasting insulin and glucose mediated 11.6%-20.7% of the association of VPA and LPA with HRV, with triglycerides also potentially mediating these associations (range: 9.6%-13.4%). CONCLUSIONS: Accelerometer-estimated VPA was associated with higher (i.e., improved) HRV. LPA also demonstrated a positive association. Mediation analyses suggested these associations may be most attributable to glucose-insulin dynamics.

13.
J Addict Med ; 2020 Jan 24.
Artigo em Inglês | MEDLINE | ID: mdl-31985512

RESUMO

BACKGROUND: Youth with chronic medical conditions (YCMC) use alcohol at levels similar to their healthy peers but face elevated risk for adverse health consequences. As salient reasons to abstain from or limit drinking (RALD) among YCMC are unknown, we sought to identify clusters of RALD and test associations with use behaviors. METHODS: Eligible YCMC (ages 9-18) recruited from outpatient clinics reported their use behaviors and importance of potential RALD. Cluster analysis was used to discern RALD patterns, which were examined as predictors of alcohol use using multivariate regression. RESULTS: Among 398 participants, 30.9% reported past year alcohol use. Concerns about impacts on medications, school, and disease status were the most frequently endorsed RALD; prior negative experiences with alcohol and family history were the least frequently endorsed. Five RALD clusters were identified for all YCMC and 2 for recent drinkers. Compared to the cluster with high endorsement of multiple general and health-related RALD, those predominantly citing concerns about addiction and those not strongly endorsing any RALD consistently reported greater alcohol use. Among recent drinkers, the cluster characterized by low concern across multiple RALD also consistently reported greater alcohol use compared to their counterparts expressing moderate concern. CONCLUSIONS: For YCMC, RALD are complex but endorsement of multiple general and health-related RALD is associated with less use, and health concerns are especially prevalent. More research is needed to understand how salient RALD can inform tailored interventions that aim to delay and reduce substance use and improve health outcomes for YCMC.

15.
J Binocul Vis Ocul Motil ; 70(1): 33-36, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31922921

RESUMO

Transient diplopia (TD) is a potentially significant form of visual disability experienced by adults with acquired strabismus. Though this phenomenon can be challenging to quantify, objectively assessing TD may be helpful in the evaluation and management of these patients, as well as defining their visual disability in real-world dynamic conditions.

16.
Sch Psychol ; 35(1): 1-9, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31670550

RESUMO

Reading depends on the integration of both cognitive and motivational factors, yet reading motivation has received little attention in the research literature. The purpose of the present study was to evaluate the psychometric properties of the Baylor Revision of the Motivation to Read Survey (B-MRS; Watkins & Browning, 2015) with a sample of 731 students in Grades 6-8. The results of exploratory and confirmatory factor analyses supported the oblique two-factor structure of the B-MRS, which was invariant across gender, and regression analyses indicated that gender and grade were not significant predictors of reading motivation. These results add to the growing body of literature providing preliminary support for the B-MRS. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

17.
J Arthroplasty ; 35(3): 801-804, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31678016

RESUMO

BACKGROUND: This study compared (1) perioperative outcomes, (2) postoperative complications, and (3) reoperation rates after primary total hip arthroplasty (THA) between short stature patients and matched control patients. METHODS: A review of primary THA patients from 2012 to 2017 using an institutional database was conducted. This yielded 12,850 patients of which 108 were shorter than 148 cm. These patients were matched 1:1 by age (P = .527), gender (P = .664), and body mass index (P = .240) to controls. The final study population with minimum 1-year follow-up that was included for analysis comprised 47 patients in the short stature cohort and 57 patients in the control cohort. The following outcomes/complications were compared: operative times, lengths of stay (LOSs), intraoperative fractures, minor complications, 90-day readmissions, and revisions. RESULTS: Operative times were significantly longer in the short stature cohort than in the matched control cohort (133 ± 65 minutes vs 104 ± 30 minutes, P = .005). In addition, hospital LOS was slightly longer in the short stature group than in the matched control groups (3.2 ± 1.5 days vs 2.6 ± 1.0, P = .017). Rates of intraoperative fractures (P = 1.000), minor complications P = .406), 90-day readmissions (P = .5000), and revision (P = .202) were similar between the short stature and control cohorts. CONCLUSION: Patients with disproportionately short stature had longer operative times and slight longer LOS. However, complication and readmission rates were similar. Future studies with larger sample sizes are warranted to confirm these findings and further evaluate implant survivorship in this unique THA patient population.

18.
Clin Obstet Gynecol ; 63(1): 134-151, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31764000

RESUMO

Intrahepatic cholestasis of pregnancy is a common disorder of pregnancy manifested by pruritus and elevated bile acids. The etiology of cholestasis is poorly understood and management is difficult due to the paucity of data regarding its diagnosis, treatment, and related adverse outcomes. In this article, we review the epidemiology, pathophysiology, risk factors, laboratory findings, complications, treatment, management, and current evidence surrounding intrahepatic cholestasis of pregnancy.

20.
Am J Prev Med ; 58(1): 79-88, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31806270

RESUMO

INTRODUCTION: Harnessing engagement in online searching and social media may provide complementary information for monitoring alcohol use, informing prevention and policy evaluation, and extending knowledge available from national surveys. METHODS: Relative search volumes for 7 alcohol-related keywords were estimated from Google Trends (data, 2014-2017), and the proportion of alcohol use-related Twitter posts (data, 2014-2015) was estimated using natural language processing. Searching/posting measures were created for all 50 U.S. states plus Washington, D.C. Survey reports of alcohol use and summaries of state alcohol policies were obtained from the Behavioral Risk Factor Surveillance System (data, 2014-2016) and the Alcohol Policy Scale. In 2018-2019, associations among searching/posting measures and same state/year Behavioral Risk Factor Surveillance System reports of recent (past-30-day) alcohol use and maximum number of drinks consumed on an occasion were estimated using logistic and linear regression, adjusting for sociodemographics and Internet use, with moderation tested in regressions that included interactions of select searching/posting measures and the Alcohol Policy Scale. RESULTS: Recent alcohol use was reported by 52.93% of 1,297,168 Behavioral Risk Factor Surveillance System respondents, which was associated with all state-level searching/posting measures in unadjusted and adjusted models (p<0.0001). Among drinkers, most searching/posting measures were associated with maximum number of drinks consumed (p<0.0001). Associations varied with exposure to high versus low levels of state policy controls on alcohol. CONCLUSIONS: Strong associations were found among individual alcohol use and state-level alcohol-related searching/posting measures, which were moderated by the strength of state alcohol policies. Findings support using novel personally generated data to monitor alcohol use and possibly evaluate effects of alcohol control policies.

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