Benzodiazepine prescribing patterns and drug overdose deaths among individuals receiving opioid analgesics

OBJECTIVE: To study the association between benzodiazepine prescribing patterns including dose, type and dosing schedule and the risk of drug overdose death among US veterans receiving opioid analgesics. DESIGN: Case-cohort study SETTING: Veterans Health Administration (VHA), 2004 through 2009. PARTICIPANTS: US veterans, primarily male, who received opioid analgesics between 2004 and 2009. All veterans who died of a drug overdose (n = 2,400) while receiving opioid analgesics and a random sample of veterans (n = 420,386) who received VHA medical services and opioid analgesics were included in the study. Main outcome measure: Drug overdose death, defined as any intentional, unintentional or indeterminate poisoning death caused by any medication or drug, determined by cause of death information from the National Death Index. RESULTS: Twenty seven percent of veterans who received opioid analgesics also received benzodiazepines during the study period. Approximately half of the drug overdose deaths (n=1,185) occurred when veterans were concurrently prescribed benzodiazepines and opioids. Risk of drug overdose death increased based on benzodiazepine prescription history: formerly prescribed vs. not prescribed (adjusted hazard ratio [HR]=2.33, 95% confidence interval [CI]: 2.05-2.64); currently prescribed vs. not prescribed (HR=3.86, CI:3.49-4.26). Risk of drug overdose death increased as daily benzodiazepine dose increased. When compared to clonazepam, temazepam was associated with a decreased drug overdose death risk (HR=0.63, CI: 0.48-0.82). Benzodiazepine dosing schedule was not associated with drug overdose death risk. CONCLUSIONS: Among veterans receiving opioid analgesics, receipt of benzodiazepines was associated with an increased risk of drug overdose death in a dose-response fashion

Seroprevalence of low pathogenic avian influenza (H9N2) and associated risk factors in the Gyeonggi-do of Korea during 2005-2006

Between November 2005 and March 2006, a total of 253 poultry flocks in the Gyeonggi-do of Korea were examined for seroprevalence against avian influenza (AI) using a hemagglutination inhibition (HI) test and an agar gel precipitation test. No low pathogenic avian influenza (LPAI) virus was isolated from 47 seropositive flocks that lacked clinical signs during sampling. The unadjusted percentage of seroprevalence rates of layer and broiler flocks were not significantly different, i.e., 26% (25/96) and 23% (22/97), respectively. The HI titer of the layers (mean = 89) was higher than the broilers (mean = 36; p < 0.001). A cross-sectional study was conducted for the seroprevalence of LPAI in the layers. Of 7 risk factors, farms employing one or more workers had a higher seropositive prevalence as compared to farms without hired employees (adjusted prevalence OR = 11.5, p = 0.031). Layer flocks older than 400 d had higher seropositivity than flocks younger than 300 d (OR = 4.9, p = 0.017). The farmers recognized at least one of the clinical signs in seropositive flocks, such as decreased egg production, respiratory syndromes, and increased mortality (OR = 2.3, p = 0.082). In a matched case-control study, 20 pairs of case and control flocks matched for type of flock, hired employees, age, and flock size were compared. Frequent cleansing with disinfectants was associated with a decreased risk of seropositivity (OR = 0.2, p = 0.022). Although there was a low statistical association, using a foot disinfectant when entering the building led to a decreased rate of seropositivity (OR = 0.3, p = 0.105)

Container transport network for sustainable development in South Korea

The ever-increasing tendency toward economic globalization highlights the importance of sustainable container transport networks to a country’s international trade, especially for an economy that is highly dependent on exports. This paper aims to develop a transport network connectivity index (TNCI) to measure the container transport connectivity from a multi-modal perspective. The proposed index is based on both graph theory and economics, considering transport infrastructure and capacity, cargo flow, and capacity utilization. Using the case of South Korea as an example, we apply the TNCI to assess the connectivity of the Busan, Gwangyang, and Incheon ports, representing approximately 96% of the container throughput in South Korea. The calculated TNCI not only provides insight into the assessment of sustainable port competitiveness, it also helps policymakers identify bottlenecks in multi-modal transport networks. To eliminate these bottlenecks, this paper offers some appropriate measures and specific strategies for port development, which in turn improves the connectivity of container transport networks for sustainable development

Schwannomatosis of the tibial nerve

Schwannoma is the most common type of benign tumor arising from the sheaths of the peripheral nerves. It occurs as a solitary tumor in most cases, but when it appears in multiple forms, it is necessary to differentiate it from plexiform schwannoma, schwannomatosis, neurofibroma and malignant peripheral nerve tumors. The authors experienced schwannomatosis in the tibial nerve without the features of neurofibromatosis type 2, so here we present a case report and literature review

DeeLeMa: Missing information search with Deep Learning for Mass estimation

We present DeeLeMa, a deep learning network to analyze energies and momenta in particle collisions at high energy colliders, especially DeeLeMa is constructed based on symmetric event topology, and the generated mass distributions show robust peaks at the physical masses after the combinatoric uncertainties, and detector smearing effects are taken into account. DeeLeMa can be widely used in different event topologies by adopting the corresponding kinematic symmetries