Alcohol-related non-fatal motor vehicle crash injury in the US from 2019 to 2022.

Background: Information on recent alcohol-related non-fatal motor vehicle crash (MVC) injuries is limited.Objectives: To analyze alcohol-related non-fatal MVC injuries, 2019-2022, considering COVID-19 and Stay-at-Home policies.Methods: State-level counts of alcohol-related non-fatal MVC injuries (involving individuals age 15+) from Emergency Medical Services data in 18 US states, chosen for comprehensive coverage, were analyzed for the annual rate. The total non-fatal MVC injury count in each state served as the denominator. We used analysis of variance to evaluate annual rate changes from 2019 to 2022 and used robust Poisson regression to compare annual mean rates to the 2019 baseline, pre-pandemic, excluding Quarter 1 due to COVID-19's onset in Quarter 2. Additional Poisson models compared rate changes by 2020 Stay-at-Home policies.Results: Data from 18 states were utilized (N = 1,487,626, 49.5% male). When evaluating rate changes of alcohol-related non-fatal MVC injuries from period 1 (Q2-4 2019) through period 4 (Q2-4 2022), the rate significantly increased from period 1 (2019) to period 2 (2020) by 0.024 (p = .003), then decreased from period 2 to period 4 (2022) by 0.016 (p = .04). Compared to the baseline (period 1), the rate in period 2 was 1.27 times higher. States with a 2020 Stay-at-Home policy, compared to those without, had a 30% lower rate (p = .05) of alcohol-related non-fatal MVC injuries. States with partial and mandatory Stay-at-Home policies had a 5.2% (p = .01) and 10.5% (p < .001) annual rate decrease, respectively.Conclusion: Alcohol-related non-fatal MVC injury rates increased initially (2019-2020) but decreased thereafter (2020-2022). Stay-at-home policies effectively reduced these rates.

E-cigarette Use Among Community-Recruited Adults with a History of Asthma in North Central Florida.

Use of e-cigarettes have become an important public health concern in the US, particularly among those with health issues like asthma, which has remained high over the last decade. We examined associations between lifetime e-cigarette use and traditional cigarette use, cannabis use, and related health factors among community members with a history of asthma in North Central Florida. Data came from HealthStreet, a University of Florida community engagement program. Adults with a history of asthma (n = 1,475) were interviewed between 2014 and 2021. Bivariate and logistic regression analyses were conducted to examine differences between participants with and without a history of lifetime e-cigarette use. In this sample, lifetime prevalence of e-cigarette use was 19.9%. Over half of the sample reported ever smoking traditional cigarettes (54.4%) or cannabis (55.4%). Compared to those who identified as White, those who identified as Black/African American had lower odds for lifetime e-cigarette use (aOR = 0.30, 95% CI: 0.22, 0.42). Those reporting lifetime traditional cigarette use (aOR = 10.60, 95% CI: 6.93, 16.68) or cannabis use (aOR = 1.81, 95% CI: 1.27, 2.61) had higher odds for reporting lifetime e-cigarette use. Overall, among a community sample of adults with a history of asthma, nearly a fifth reported lifetime e-cigarette use. The use of e-cigarettes was most common among those with lifetime traditional cigarette use and cannabis use. Findings can inform prevention and intervention efforts in this population.

Effects of the Competitive Season and Off-Season on Knee Articular Cartilage in Collegiate Basketball Players Using Quantitative MRI: A Multicenter Study.

BACKGROUND: Injuries to the articular cartilage in the knee are common in jumping athletes, particularly high-level basketball players. Unfortunately, these are often diagnosed at a late stage of the disease process, after tissue loss has already occurred. PURPOSE/HYPOTHESIS: To evaluate longitudinal changes in knee articular cartilage and knee function in National Collegiate Athletic Association (NCAA) basketball players and their evolution over the competitive season and off-season. STUDY TYPE: Longitudinal, multisite cohort study. POPULATION: Thirty-two NCAA Division 1 athletes: 22 basketball players and 10 swimmers. FIELD STRENGTH/SEQUENCE: Bilateral magnetic resonance imaging (MRI) using a combined T1ρ and T2 magnetization-prepared angle-modulated portioned k-space spoiled gradient-echo snapshots (MAPSS) sequence at 3T. ASSESSMENT: We calculated T2 and T1ρ relaxation times to compare compositional cartilage changes between three timepoints: preseason 1, postseason 1, and preseason 2. Knee Osteoarthritis Outcome Scores (KOOS) were used to assess knee health. STATISTICAL TESTS: One-way variance model hypothesis test, general linear model, and chi-squared test. RESULTS: In the femoral articular cartilage of all athletes, we saw a global decrease in T2 and T1ρ relaxation times during the competitive season (all P < 0.05) and an increase in T2 and T1ρ relaxation times during the off-season (all P < 0.05). In the basketball players' femoral cartilage, the anterior and central compartments respectively had the highest T2 and T1ρ relaxation times following the competitive season and off-season. The basketball players had significantly lower KOOS measures in every domain compared with the swimmers: Pain (P < 0.05), Symptoms (P < 0.05), Function in Daily Living (P < 0.05), Function in Sport/Recreation (P < 0.05), and Quality of Life (P < 0.05). CONCLUSION: Our results indicate that T2 and T1ρ MRI can detect significant seasonal changes in the articular cartilage of basketball players and that there are regional differences in the articular cartilage that are indicative of basketball-specific stress on the femoral cartilage. This study demonstrates the potential of quantitative MRI to monitor global and regional cartilage health in athletes at risk of developing cartilage problems. LEVEL OF EVIDENCE: 2 Technical Efficacy Stage: 2.

Reactivity of Triplet Excited States of Dissolved Natural Organic Matter in Stormflow from Mixed-Use Watersheds.

Dissolved organic matter (DOM) quantity and composition control the rate of formation (Rf,T) of triplet excited states of dissolved natural organic matter (3DOM*) and the efficiency of 3DOM* formation (the apparent quantum yield, AQYT). Here, the reactivity of 3DOM* in stormflow samples collected from watersheds with variable land covers is examined. Stormflow DOM reflects variability in DOM quantity and composition as a function of land cover and may be important in controlling the fate of cotransported pollutants. Rf,T and AQYT were measured using 2,4,6-trimethylphenol in stormflow samples under simulated sunlight. The DOM source and composition was characterized using absorbance and fluorescence spectroscopies and high-resolution mass spectrometry. Rf,T and the total rate of light absorption by the water samples (Ra) increased with the dissolved organic carbon (DOC) concentration. AQYT was independent of DOC concentration, but varied with DOM source: developed land cover (4-6%) ≈ open water > vegetated land cover (3%). AQYT was positively related to an index for microbial/algal DOM content and negatively related to DOM molecular weight, DOM aromaticity, and the content of polyphenols. This work demonstrates that TMP is an effective probe for the determination of Rf,T and AQYT in whole water samples after accounting for the inhibition of TMP photodegradation by DOM.

Is removal and destruction of perfluoroalkyl and polyfluoroalkyl substances from wastewater effluent affordable?

Several jurisdictions are currently evaluating regulatory standards for perfluoroalkyl and polyfluoroalkyl substances (PFAS) in municipal water resource recovery facility (WRRF) effluent. Effective and responsible implementation of PFAS effluent limits should consider the costs and capabilities of currently available technologies, because the costs of meeting WRRF PFAS limits could disproportionally fall to ratepayers. Cost curves were developed for currently available PFAS separation and destruction options, assuming effluent treatment targets near current analytical detection limits. Removing and destroying PFAS from municipal WRRF effluent is estimated to increase costs per household by a factor of between 2 and 210, using Minnesota-specific data as an example. Estimated costs per household would increase more for residents of smaller communities, averaging 33% of median household income (MHHI) in communities smaller than 1000 people. This exceeds the U.S. Environmental Protection Agency (EPA)-developed affordability index of 2% of MHHI by a factor of 16. Estimated costs per household to remove and destroy PFAS varied among locations, primarily based on WRRF and community size, median income, rural versus urban, and type of wastewater treatment processes currently used. PRACTITIONER POINTS: Required tertiary treatment before WRRF effluent PFAS separation, using currently available technologies, is a significant portion (~40-80%) of estimated costs. Adding PFAS separation, destruction, and pre-treatment would make Minnesota wastewater rates unaffordable (defined by EPA affordability guidance) without external funding. The estimated cost per household is higher for smaller communities and would require substantial external funding to maintain rate affordability. Design and operating uncertainties remain for full-scale WRRF retrofits to consistently remove and destroy effluent PFAS with limited full-scale applications.

Are null segregants new combinations of heritable material and should they be regulated?

Through genome editing and other techniques of gene technology, it is possible to create a class of organism called null segregants. These genetically modified organisms (GMOs) are products of gene technology but are argued to have no lingering vestige of the technology after the segregation of chromosomes or deletion of insertions. From that viewpoint regulations are redundant because any unique potential for the use of gene technology to cause harm has also been removed. We tackle this question of international interest by reviewing the early history of the purpose of gene technology regulation. The active ingredients of techniques used for guided mutagenesis, e.g., site-directed nucleases, such as CRISPR/Cas, are promoted for having a lower potential per reaction to create a hazard. However, others see this as a desirable industrial property of the reagents that will lead to genome editing being used more and nullifying the promised hazard mitigation. The contest between views revolves around whether regulations could alter the risks in the responsible use of gene technology. We conclude that gene technology, even when used to make null segregants, has characteristics that make regulation a reasonable option for mitigating potential harm. Those characteristics are that it allows people to create more harm faster, even if it creates benefits as well; the potential for harm increases with increased use of the technique, but safety does not; and regulations can control harm scaling.

THE LOWER EXTREMITY GRADING SYSTEM (LEGS) TO EVALUATE BASELINE LOWER EXTREMITY PERFORMANCE IN HIGH SCHOOL ATHLETES.

BACKGROUND AND PURPOSE: Lower extremity athletic injuries result in impairments in balance, power, and jump-landing mechanics. Unilateral injury has bilateral effects and the literature supports that it is important to assess neuromuscular impairments such as balance, power, and jumping mechanics following injury and for safe return to sport after injury rehabilitation. Currently, individual tests are established in the literature, but no combined approach or clinical tool exists for this purpose. The purpose of this study is to describe and provide the initial data for the Lower Extremity Grading System (LEGS), comprised of three neuromuscular components for use as a baseline pre-season assessment for high school athletes to assess lower extremity performance. Furthermore, this study focuses on the differences in baseline lower extremity performance outcomes between male and female soccer and basketball athletes. METHODS: One hundred and eighty-five high school basketball, and soccer athletes (94 female, 91 male; mean age = 15.6 ± 4.4) participated. The participants were administered the LEGS assessment during the preseason for their respective sports, which includes three component tests: (1) Y-balance test, (2) drop vertical jump test, (3) triple-crossover-hop-for-distance test. Participants' scores on each test were recorded, and then totaled to present an overall LEGS composite score. Participants' baseline LEGS scores were then analyzed according to sex and sport, and standard normal distribution was calculated for all scores to enable percentile rankings to be established. RESULTS: Mean scores and standard deviation for each functional performance test are presented. Furthermore, a LEGS composite score combining the test scores was established and presented as a normal distribution curve allowing for further comparison and analysis. The mean LEGS composite score for males was 700.3 ( ± 76.6), while the mean LEGS composite score for females was 587.4 ( ± 51.6). Statistically different LEGS composite scores were found between males and females. CONCLUSION: The current findings present descriptive data for the utility of the LEGS as a neuromuscular baseline assessment before high school sports participation and/or as a tool for assessing return to sports after injury rehabilitation. The LEGS may augment current assessment tools and may serve as a composite score and combined approach to the assessment of lower extremity risk of injury and readiness to return to sports. LEVEL OF EVIDENCE: 3.

Computer-assisted Diagnostic Checklist in Clinical Neurology.

Considering computers are more efficient at processing large amounts of information than the human brain, speaks to the need to explore more intelligent computer-assisted diagnostic approaches. Two diagnostic checklist programs, one for single key term entry (NeurologyINDEX), and another, with more advanced algorithms to process multiple key terms and perform additional functions (NeurologicDx) are discussed. Both programs are internet based, access the same database, and are designed to generate diagnostic checklists and disease profiles accessible with hand-held or other computer device. The development of systems that use "smart algorithms" to generate valid diagnostic checklists is the goal.

Seasonal and spatial variabilities in the water chemistry of prairie pothole wetlands influence the photoproduction of reactive intermediates.

The hydrology and water chemistry of prairie pothole wetlands vary spatially and temporally, on annual and decadal timescales. Pesticide contamination of wetlands arising from agricultural activities is a foremost concern. Photochemical reactions are important in the natural attenuation of pesticides and may be important in limiting ecological and human exposure. Little is known, however, about the variable influence of wetland water chemistry on indirect photochemistry. In this study, seasonal water samples were collected from seven sites throughout the prairie pothole region over three years to understand the spatiotemporal dynamics of reactive intermediate photoproduction. Samples were classified by the season in which they were collected (spring, summer, or fall) and the typical hydroperiod of the wetland surface water (temporary or semi-permanent). Under photostable conditions, steady-state concentrations and apparent quantum yields or quantum yield coefficients were measured for triplet excited states of dissolved organic matter, singlet oxygen, hydroxyl radical, and carbonate radical under simulated sunlight. Steady-state concentrations and quantum yields increased on average by 15% and 40% from spring to fall, respectively. Temporary wetlands had 40% higher steady-state concentrations of reactive intermediates than semi-permanent wetlands, but 50% lower quantum yields. Computed quantum yields for reactive intermediate formation were used to predict the indirect photochemical half-lives of seven pesticides in average temporary and semi-permanent prairie pothole wetlands. As a first approximation, the predictions agree to within two orders of magnitude of previously reported half-lives.

Phototransformation of pesticides in prairie potholes: effect of dissolved organic matter in triplet-induced oxidation.

Photochemical reactions involving a variety of photosensitizers contribute to the abiotic transformation of pesticides in prairie pothole lakes (PPLs). Despite the fact that triplet excited state dissolved organic matter (DOM) enhances phototransformation of pesticides by acting as a photosensitizer, it may also decrease the overall phototransformation rate through various mechanisms. In this study, the effect of DOM on the phototransformation of four commonly applied pesticides in four different PPL waters was investigated under simulated sunlight using photoexcited benzophenone-4-carboxylate as the oxidant with DOM serving as an anti-oxidant. For atrazine and mesotrione, a decrease in phototransformation rates was observed, while phototransformations of metolachlor and isoproturon were not affected by DOM inhibition. Phototransformation rates and the extent of inhibition/enhancement by DOM varied spatially and temporally across the wetlands studied. Characterization of DOM from the sites and different seasons suggested that the DOM type and variations in the DOM structure are important factors controlling phototransformation rates of pesticides in PPLs.