GABAergic Elicitation of Fear and Feeding in Nucleus Accumbens Shell Does Not Depend on Local Dopamine

Honors (Bachelor's)NeuroscienceUniversity of Michiganhttp://deepblue.lib.umich.edu/bitstream/2027.42/91799/1/aplaweck.pd

Comparison of Subjective Responses to Oral and Intravenous Alcohol Administration under Similar Systemic Exposures

Objective To test whether an individual's subjective responses to alcohol are similar when the breath alcohol concentration (BrAC) trajectory resulting from oral administration is matched by intravenous administration. Background Individuals perceive the effects of alcohol differently, and the variation is commonly used in research assessing the risk for developing an alcohol use disorder. Such research is supported by both oral and intravenous alcohol administration techniques, and any differences attributable to the route employed should be understood. Methods We conducted a 2‐session, within‐subject study in 44 young adult, healthy, non‐dependent drinkers (22 females and 22 males). In the first session, subjects ingested a dose of alcohol which was individually calculated, on the basis of total body water, to yield a peak BrAC near 80 mg/dl, and the resulting BrAC trajectory was recorded. A few days later, subjects received an intravenous alcohol infusion rate profile, pre‐computed to replicate each individual's oral alcohol BrAC trajectory. In both sessions, we assessed 4 subjective responses to alcohol: SEDATION, SIMULATION, INTOXICATION, and HIGH; at baseline and frequently for 4 hours. We compared the individuals’ baseline‐corrected responses at peak BrAC and at half‐peak BrAC on both the ascending and descending limbs. We also computed and compared Pearson‐product moment correlations of responses by route of administration, the Mellanby measure of acute adaptation to alcohol, and the area under the entire response curve for each subjective response. Results No significant differences in any measure could be attributed to the route of alcohol administration. Eleven of 12 response comparisons were significantly correlated across the routes of alcohol administration, with 9 surviving correction for multiple measures, as did the Mellanby effect and area under the response curve correlations. Conclusion The route of alcohol administration has a minimal effect on subjective responses to alcohol when an individual's BrAC exposure profiles are similar

Alcohol intoxication progressively impairs drivers' capacity to detect important environmental stimuli

Rationale Alcohol intoxication impairs driving skills, leading to an increased frequency of accidents and crash fatalities. Inebriation may specifically impair environmental vigilance, reducing the driver's capacity for attention to stimuli that are relevant to successful navigation. Objectives We examined the separate and interactive effects of breath alcohol concentration (BrAC) and simulated driving scenario on the capacity to correctly identify visual stimuli embedded in the environment. Methods Ten healthy young adult drivers (6 males; 4 females) each performed 4 driving scenarios at each of 3 steady breath alcohol concentration levels (0, 60 and 100 mg/dl). Scenarios were based on speed or distance keeping while navigating a rural 2-lane road in daytime or nighttime conditions. Drivers pressed a button on the steering wheel corresponding to the direction of an arrow (up or down) which appeared briefly on road signs embedded in the environment, either overhead or on the roadside. Results Increasing level of BrAC and subjective scenario difficulty manifested significant, separate, but not interactive influences in association with the number of arrows correctly identified. Significant impairments could be detected at a level of BrAC below the current American limit for legal operation of a motor vehicle. Conclusions Environmental vigilance is subject to impairment by either/both alcohol intoxication and driving conditions

Pairing Neutral Cues with Alcohol Intoxication: New Findings in Executive and Attention Networks

Rationale: Alcohol-associated stimuli capture attention, yet drinkers differ in the precise stimuli that become paired with intoxication. Objectives: Extending our prior work to examine the influence of alcoholism risk factors, we paired abstract visual stimuli with intravenous alcohol delivered covertly and examined brain responses to these Pavlovian conditioned stimuli in fMRI when subjects were not intoxicated. Methods: Sixty healthy drinkers performed task-irrelevant alcohol conditioning that presented geometric shapes as conditioned stimuli. Shapes were paired with a rapidly rising alcohol limb (CS+) using intravenous alcohol infusion targeting a final peak breath alcohol concentration of 0.045 g/dL or saline (CS−) infusion at matched rates. On day two, subjects performed monetary delay discounting outside the scanner to assess delay tolerance and then underwent event-related fMRI while performing the same task with CS+, CS−, and an irrelevant symbol. Results: CS+ elicited stronger activation than CS− in frontoparietal executive/attention and orbitofrontal reward-associated networks. Risk factors including family history, recent drinking, sex, and age of drinking onset did not relate to the [CS+ > CS−] activation. Delay-tolerant choice and [CS+ > CS−] activation in right inferior parietal cortex were positively related. Conclusions: Networks governing executive attention and reward showed enhanced responses to stimuli experimentally paired with intoxication, with the right parietal cortex implicated in both alcohol cue pairing and intertemporal choice. While different from our previous study results in 14 men, we believe this paradigm in a large sample of male and female drinkers offers novel insights into Pavlovian processes less affected by idiosyncratic drug associations

Impact of a specialty trained billing team on an academic otolaryngology practice

PURPOSE: To determine how the incorporation of specialty specific training for coders within a focused billing team affected revenue, efficiency, time to reimbursement, and physician satisfaction in an academic otolaryngology practice. MATERIALS AND METHODS: Our academic otolaryngology department recently implemented a new billing system, which incorporated additional training in otolaryngology surgical procedures for medical coders. A mixed model analysis of variance was used to compare billing outcomes for the 6 months before and 6 months after this new approach was initiated. The following metrics were analyzed: Current Procedural Terminology codes, total charges, time between services rendered and billing submission, and time to reimbursement. A survey of department physicians assessing satisfaction with the system was reviewed. RESULTS: There were 4087 Current Procedural Terminology codes included in the analysis. In comparing the periods before and after implementation of the new system, statistically significant decreases were found in the mean number of days to coding completion (19.3 to 12.0, respectively, p \u3c 0.001), days to posting of charges (27.0 to 15.2, p \u3c 0.001), days to final reimbursement (54.5 to 27.2, p \u3c 0.001), and days to closure of form (179.2 to 76.6, p \u3c 0.001). Physician satisfaction with communication and coder feedback increased from 36% to 64% after initiation of the new program. CONCLUSIONS: The implementation of additional specialty training for medical coders in the otolaryngology department of a large medical system was associated with improved revenue cycle efficiency. Additionally, this model appears to improve physician satisfaction and confidence with the coding system

Effect of Socioeconomic Status and Comorbidities on Thyroid Cancer Survival Outcomes

Purpose/Objectives: Thyroid cancer ranks among the most common head and neck malignancies and makes up 3% of new cancer cases per year, having increased in overall incidence in the last several decades. This study investigates patient characteristics, socioeconomic status (SES), and medical comorbidities as independent predictors of survival in patients with thyroid cancer, treated at a tertiary care hospital with a diverse, primarily low SES patient population. Materials/Methods: The Henry Ford Health System’s Virtual Data Warehouse Tumor Registry was used to identify patients with thyroid cancers from 1997 to 2016. Socioeconomic data was obtained from 2010 US Census. Comorbidities were quantified using the Charlson Comorbidity Index (CCI). Statistical analysis was performed using Kaplan-Meier estimator and Cox proportional hazards models. Results: There were 1042 patients with thyroid cancer. 5- and 10-year survival probabilities decreased with age \u3e=60 years (p\u3c0.001), stage 3/4 (p\u3c0.001), clinical N stage 1-3 (p\u3c0.001), black race (p=0.001), CCI\u3e1 (p\u3c0.001), and lowest quartile median household income (p\u3c0.001). In multivariate analysis, age (1-year increase HR: 1.97, 95% CI: 1.06-1.09), sex (female vs. male HR: 0.67, 95% CI: 0.48-0.95), and CCI (1-point increase HR: 1.26, 95% CI: 1.19-1.34) were significantly associated with survival outcomes. A CCI cutoff of \u3e1 was a reliable predictor of mortality (AUC: 0.759, 95% CI: 0.716-0.801). CCI was significantly correlated with stage (r=0.166, p=0.004) and median household income (r=-0.175, p\u3c0.001). Conclusion: Increased age, male sex, and medical comorbidities predicted significantly worse survival in thyroid cancer. Race and median household income were not independent significant prognostic indicators

Laboratory alcohol self-administration experiments do not increase subsequent real-life drinking in young adult social drinkers

BACKGROUND: While the utility of experimental free-access alcohol self-administration paradigms is well established, little data exist addressing the question of whether study participation influences subsequent natural alcohol consumption. We here present drinking reports of young adults before and after participation in intravenous alcohol self-administration studies. METHODS: Timeline Follow-back drinking reports for the 6 weeks immediately preceding the first, and the 6 weeks after the last experimental alcohol challenge were examined from subjects completing 1 of 2 similar alcohol self-administration paradigms. In study 1, 18 social drinkers (9 females, mean age 24.1 years) participated in 3 alcohol self-infusion sessions up to a maximum blood alcohol concentration (BAC) of 160 mg%. Study 2 involved 60 participants (30 females, mean age 18.3 years) of the Dresden Longitudinal Study on Alcohol Use in Young Adults (D-LAYA), who participated in 2 sessions of alcohol self-infusion up to a maximum BAC of 120 mg%, and a nonexposed age-matched control group of 42 (28 females, mean age 18.4 years) subjects. RESULTS: In study 1, participants reported (3.7%) fewer heavy drinking days as well as a decrease of 2.5 drinks per drinking day after study participation compared to prestudy levels (p < 0.05, respectively). In study 2, alcohol-exposed participants reported 7.1% and non-alcohol-exposed controls 6.5% fewer drinking days at poststudy measurement (p < 0.001), while percent heavy drinking days and drinks per drinking day did not differ. CONCLUSIONS: These data suggest that participation in intravenous alcohol self-administration experiments does not increase subsequent real-life drinking of young adults

Infant Spinal Reflex-Testing Apparatus

Final report and team photo for Project 05 of ME450, Fall 2009 semester.Recently-developed equipment can test the presence and stability of spinal-level reflexes in the primary gait muscles of infants 2-10 months old. This baseline data can then assist in the assessment of developmental neuromotor deficits and the development of tailored interventions for infants born with disabilities such as spina bifida, cerebral palsy, and Down syndrome. The goal of this project is to redesign the apparatus used in these tests to be more adjustable and portable.Beverly Ulrich (Kinesiology, U of M)http://deepblue.lib.umich.edu/bitstream/2027.42/86199/1/ME450 Fall2009 Final Report - Project 05 - Infant Spinal Reflex-Testing Apparatus.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/86199/2/ME450 Fall2009 Team Photo - Project 05 - Infant Spinal Reflex-Testing Apparatus.jp