Injury Type, Injury Severity, and Repeat Occurrence of Alcohol-Related Trauma in Adolescents

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/66113/1/j.1530-0277.1994.tb00011.x.pd

Birth Cohort Differences in Features of Antisocial Alcoholism among Men and Women

Background: This study examines the relations between birth cohort, gender, and family history of alcohol problems on alcohol dependence, and on the endorsement of alcohol abuse/dependence symptoms related to antisocial behavior. Methods: Men (n = 1365) and women (n = 625) were recruited from the community, hospitals, and other treatment sites and were given a structured diagnostic interview. Data were analyzed by using logistic regression. Results: Age of first regular alcohol use was lower in more recent birth cohorts for both men and women, with those born in the most recent cohort reporting earliest regular use. The decline across cohort was more dramatic in women than in men. For those participants with a diagnosis of alcohol dependence, being born in a more recent cohort was associated with increased risk of dependence onset before age 25. Among those participants with onset of alcohol dependence before age 25 (nmen = 400; nwomen = 51), being born in a more recent cohort was associated with increased risk of fights while drinking, police involvement, and drunk driving trouble as well as with increased risk for a diagnosis of abuse or dependence on another drug. Conclusions: These results suggest that the prevalence of antisocial alcoholism may be increasing for both men and women. These data exemplify how societal change may affect expression of underlying vulnerability for traits thought to be genetically influenced

Alcohol Abuse/Dependence in Motor Vehicle Crash Victims Presenting to the Emergency Department

Objective: 1) To determine the prevalence of current alcohol abuse/alcohol dependence (AA/AD) among the full injury range of ED motor vehicle crash (MVC) patients; and 2) compare AA/AD and non-AA/AD patient characteristics. Methods: This was a prospective cohort study using a stratified random sample of MVC patients aged ≥18 years presenting to a university hospital and university-affiliated community hospital ED from May 1, 1992, to August 30, 1994. A diagnosis of current AA/AD was based on the alcohol section of the Diagnostic Interview Survey (DIS). Other measurements included the presence of blood alcohol (BAC +), Injury Severity Score (ISS-85), occupant status (driver/passenger), age, gender, seat belt use, culpability for crash, and ED disposition (admitted vs released). A weighted prevalence was determined; subgroups were compared using t-tests, Χ 2 . 2-factor analysis, and logistic regression modeling; Α = 0.05. Results: 1,161 patients were studied. The weighted prevalence of current AA/AD was 22.5%; 53% of these patients were released from the ED. Almost 45% of the patients with current AA/AD were BAC —. When controlling for BAC and AA/AD, greater injury severity and culpability were associated with a BAC +, but not with current AA/AD. Conclusion: Almost 23% of ED MVC patients have current AA/AD; BAC testing does not accurately identify these patients. Intervention strategies must be directed to both admitted and released patients.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/73408/1/j.1553-2712.1997.tb03545.x.pd

Associations between body mass index and suicide in the veterans affairs health system

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/102714/1/oby20422.pd

Exploration of the faecal microbiota and biomarker discovery in equine grass sickness

Equine grass sickness (EGS) is a frequently fatal disease of horses, responsible for the death of 1-2% of the UK horse population annually. The etiology of this disease is currently uncharacterized although there is evidence it is associated with Clostridium botulinum neurotoxin in the gut. Prevention is currently not possible and ileal biopsy diagnosis is invasive. The aim of this study was to characterize the fecal microbiota and biofluid metabolic profiles of EGS horses, to further understand the mechanisms underlying this disease and identify metabolic biomarkers to aid in diagnosis. Urine, plasma and feces were collected from horses with EGS, matched controls (MC), and hospital controls (HC). Sequencing the16S rRNA gene of the fecal bacterial population of the study horses found a severe dysbiosis in EGS horses, with an increase in Bacteroidetes and a decrease in Firmicutes bacteria. Metabolic profiling by 1H nuclear magnetic resonance (NMR) spectroscopy found EGS to be associated with the lower urinary excretion of hippurate and 4-cresyl sulfate and higher excretion of O-acetyl carnitine and trimethylamine-N-oxide (TMAO). The predictive ability of the complete urinary metabolic signature and using the four discriminatory urinary metabolites to classify horses by disease status was assessed using a second (test) set of horses. The urinary metabolome and a combination of the four candidate biomarkers showed promise in aiding the identification of horses with EGS. Characterization of the metabolic shifts associated with EGS offers the potential of a non-invasive test to aid pre-mortem diagnosis

Interfacial motion in flexo- and order-electric switching between nematic filled states

We consider a nematic liquid crystal, in coexistence with its isotropic phase, in contact with a substrate patterned with rectangular grooves. In such a system, the nematic phase may fill the grooves without the occurrence of complete wetting. There may exist multiple (meta)stable filled states, each characterised by the type of distortion (bend or splay) in each corner of the groove and by the shape of the nematic-isotropic interface, and additionally the plateaux that separate the grooves may be either dry or wet with a thin layer of nematic. Using numerical simulations, we analyse the dynamical response of the system to an externally- applied electric field, with the aim of identifying switching transitions between these filled states. We find that order-electric coupling between the fluid and the field provides a means of switching between states where the plateaux between grooves are dry and states where they are wet by a nematic layer, without affecting the configuration of the nematic within the groove. We find that flexoelectric coupling may change the nematic texture in the groove, provided that the flexoelectric coupling differentiates between the types of distortion at the corners of the substrate. We identify intermediate stages of the transitions, and the role played by the motion of the nematic-isotropic interface. We determine quantitatively the field magnitudes and orientations required to effect each type of transition.Comment: 14 pages, 12 fig

Opioid dose and risk of suicide

Chronic pain is associated with increased risk of suicide, and opioids are commonly used to treat moderate to severe pain. However, the association between opioid dose and suicide mortality has not been examined closely. This retrospective data analysis described the risk of suicide associated with differing prescribed opioid doses. Data were from Veterans Affairs health care system treatment records and the National Death Index. Records analyzed were those of Veterans Affairs patients with chronic pain receiving opioids in fiscal years 2004 to 2005 (N = 123,946). Primary predictors were maximum prescribed morphine-equivalent daily opioid dose and opioid fill type. The main outcome measured was suicide death, by any mechanism, and intentional overdose death during 2004 to 2009. Controlling for demographic and clinical characteristics, higher prescribed opioid doses were associated with elevated suicide risk. Compared with those receiving ≤20 milligrams/day (mg/d), hazard ratios were 1.48 (95% confidence intervals [CI], 1.25-1.75) for 20 to <50 mg/d, 1.69 (95% CI, 1.33-2.14) for 50 to <100 mg/d, and 2.15 (95% CI, 1.64-2.81) for 100+ mg/d. The magnitude of association between opioid dose and suicide by intentional overdose was not substantially different from that observed for the overall measure of suicide mortality. Risk of suicide mortality was greater among individuals receiving higher doses of opioids, and treatment providers may want to view high opioid dose as a marker of elevated risk for suicide. Additional research is needed on opioid use, pain treatment, and suicide

Universal continuous-variable quantum computation: Requirement of optical nonlinearity for photon counting

Although universal continuous-variable quantum computation cannot be achieved via linear optics (including squeezing), homodyne detection and feed-forward, inclusion of ideal photon counting measurements overcomes this obstacle. These measurements are sometimes described by arrays of beam splitters to distribute the photons across several modes. We show that such a scheme cannot be used to implement ideal photon counting and that such measurements necessarily involve nonlinear evolution. However, this requirement of nonlinearity can be moved "off-line," thereby permitting universal continuous-variable quantum computation with linear optics.Comment: 6 pages, no figures, replaced with published versio

Some biases in the alcohol investigative process in traffic fatalities

This study compares data regarding alcohol involvement from police records and from chemical analyses of body fluids taken prior to or after death of 121 traffic fatalities in Washtenaw County, Michigan. Differences regarding the choice of who will or will not be screened for alcohol were found. The police and emergency room personnel were more likely to focus on males and drivers, while medical examiners were less biased. The police documented whether or not drinking took place in only 36% of the cases and suspected drinking in only half of these cases. Males and at-fault drivers were most likely to be investigated. Blood alcohol level was measured before death in 11 of 29 emergency room treated victims, with 10 (91%) positive samples. All but two of those tested before death were drivers, and all but one were males. After death, blood alcohol was measured in 47% of the 121 cases, with a higher proportion of males and motor-vehicle occupants tested, compared to females and pedestrians. Alcohol was detected in 63% of the samples. A lower mean blood alcohol concentration was found in victims who received intravenous treatment, and a higher proportion of positive samples was found in victims who died immediately in the crash. Thus, the frequency of alcohol-related traffic fatalities varied between the different data sources. The police records revealed 51%, the emergency records 91%, and the medical examiner records 63% with alcohol involvement. This wide discrepancy has the potential of leading to erroneous results here and possibly in studies done elsewhere. To avoid a bias in blood alcohol figures, the authors stress the importance of routinely investigating all severely and fatally injured traffic victims. To yield an accurate result, the sample should ideally be taken as soon as possible after the crash and prior to intravenous treatment.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/29822/1/0000168.pd