Impact of alcohol driving-while-impaired license suspension duration on future alcohol-related license events and motor vehicle crash involvement in North Carolina, 2007 to 2016.

BACKGROUND/PURPOSE: License suspensions are a strategy to address alcohol-impaired driving behavior and recidivism following an alcohol driving while impaired (alcohol-DWI) conviction. Little is known about the specific impacts of conviction-related suspensions on safety outcomes and given recent fluctuations in alcohol-impaired driving behavior, crashes, and suspension trends, updated and focused assessments of this intervention are necessary. This study aimed to 1) examine the association between type of recent alcohol-DWI suspension and having a secondary alcohol-related license outcome and/or future crash event in North Carolina (NC) between 2007 and 2016; and 2) assess potential modification of these associations by race/ethnicity. METHODS: We used linked NC licensing data, NC crash data, and county-level contextual data from a variety of data sources. We compared individuals ages 21 to 64 who sustained initial (1-year) versus repeat (4-year) suspensions for alcohol-related license and crash involvement outcomes. We estimated unadjusted and adjusted hazard ratios (aHRs) using Cox proportional hazards models and produced Kaplan-Meier (KM) survival curves using a three-year follow-up period. After observing statistically significant modification by race/ethnicity, we calculated stratified aHRs for each outcome (Black and White subgroups only, as other subgroups had low numbers of outcomes). RESULTS: 122,002 individuals sustained at least one alcohol-DWI conviction suspension (117,244 initial, 4,758 repeat). Adjusted KM survival curves indicated that within three years of the index suspension, the predicted risks of having a license outcome and crash outcome were about 8 % and 15 %, respectively, among individuals with an initial suspension and 5 % and 10 %, respectively, among individuals with a repeat suspension. After adjusting for potential confounding, we found that compared to those with an initial suspension, those with repeat suspensions had a lower incidence of future license (aHR: 0.49; 95 % CI: 0.42, 0.57) and crash outcomes (aHR: 0.67; 95 % CI: 0.60, 0.75). Among Black individuals, license outcome incidence was 162 % lower among repeat versus initial index suspension groups (aHR: 0.38; 95 % CI: 0.26, 0.55), while for White individuals, the incidence was 87 % lower (aHR: 0.54; 95 % CI: 0.45, 0.64). Similarly, crash incidence for repeat versus initial suspensions among Black individuals was 56 % lower (aHR: 0.64; 95 % CI: 0.50, 0.83), while only 39 % lower among White individuals (aHR: 0.72; 95 % CI: 0.63, 0.81). CONCLUSIONS: Decreased incidence of both license and crash outcomes were observed among repeat versus initial index suspensions. The magnitude of these differences varied by race/ethnicity, with larger decreases in incidence among Black compared to White individuals. Future research should examine the underlying mechanisms leading to alcohol-impaired driving behavior, convictions, recidivism, and crashes from a holistic social-ecological perspective so that interventions are designed to both improve road safety and maximize other critical public health outcomes, such as access to essential needs and services (e.g., healthcare and employment).

Competitive integrated employment for youth with disabilities: Aligning measurement with conceptualization using latent growth curve modeling.

PURPOSE: Although existing research has generated a wealth of information related to employment for individuals with disabilities, a major limitation is that common measurements of employment do not fully capture the scope of the optimal outcome specified in public policies, namely, competitive integrated employment. Therefore, we aimed to describe the change and stability in multiple aspects of employment for youth with disabilities from high school age to mid-30s under the structural equation modeling framework. METHODS: We identified a sample of 1,921 youth with disabilities who were at least 18 years old in 2003 from the National Longitudinal Survey of Youth- 1997. We estimated a series of latent growth curve models to assess trajectories of job quality, indicated by hourly pay, and stability, indicated by weekly work hours, over a period of 15 years. RESULTS: Trajectories of job quality and stability did not covary or load on a common factor, but there was substantial variability within the sample in both the intercept and slope of these two constructs, which were best captured by a cubic growth curve, and partially explained by health condition and several demographic variables. CONCLUSIONS: Competitive integrated employment comprises of multiple components which should ideally be considered along a time dimension. Future studies need to assess validity of the measurement model with a different sample and incorporate another important component of competitive integrated employment, that is, whether work is carried out at an integrated setting.

Unlicensed driving among young drivers in North Carolina: a quasi-induced exposure analysis.

BACKGROUND: Little is known about the prevalence of driving among teenagers who have not yet obtained a license. The primary objective of the present study was to estimate the prevalence of unlicensed driving among young drivers using the quasi-induced exposure (QIE) approach and to determine whether unlicensed driving was more common among minority and lower-income teenagers. Additionally, we examined whether unlicensed driving among adolescents increased following the implementation of a graduated driver licensing (GDL) system and whether GDL differentially affected minority and low-income adolescents. METHODS: Using North Carolina crash and driver license data, we identified 90,267 two-vehicle crashes from 1991 through 2016 where only one driver was considered contributory and the non-contributory driver was a White or Black 16 or 17 years old. In the QIE approach, these non-contributory young drivers are assumed to be representative of all adolescents driving in the state during this time period. The prevalence of unlicensed driving among adolescents by age and year was estimated by identifying the proportion of non-contributory drivers who had never been licensed by the time of their involvement in these two-vehicle crashes. We further conducted logistic regression analyses to examine the likelihood of a non-contributory young driver being unlicensed as a function of race, neighborhood income level, and licensing era (prior to or after GDL was implemented). RESULTS: During the 26 years for which data were available, the mean annual prevalence of unlicensed driving was 1.2% for 16-year-olds and 1.7% among 17-year-olds. Young Black drivers and individuals living in lower-income neighborhoods were somewhat more likely to drive before obtaining a license, but the rates of unlicensed driving among these groups were also quite low. Unlicensed driving increased slightly for 17-year-olds following the implementation of GDL, but returned to previous levels after a few years. CONCLUSION: Unlicensed driving among adolescents in North Carolina is substantially less common than suggested by previous self-report studies and analyses of fatal crash data.

The role of inexperience in motorcycle crashes among novice and returning motorcycle riders.

OBJECTIVES: To examine the crash trends of younger novice and older novice/returning motorcycle riders. METHODS: We used a linked database of North Carolina crash and licensing data from 1991 through 2018 that included 103,142 younger novice and 98,540 older novice/returning motorcycle riders. We examined the percent of riders who crashed each month after obtaining a motorcycle license. RESULTS: Crash rates peak for both younger novice and older novice/returning motorcycle riders immediately after licensure. Crash rates decline rapidly, and the rate of decrease resembles a power function. The improvement rate (IR) for younger novice riders is 0.42; that is, the crash rate for younger novices declines by approximately 42% as experience doubles. CONCLUSION: The crash curve for novice motorcyclists is similar to that of novice car drivers and is consistent with a learning process. PRACTICAL APPLICATIONS: The crash trends of novice motorcycle riders indicate that current training, licensing, and educational efforts are not adequately preparing new riders. Additional efforts to develop more effective training, and research to inform a well-calibrated graduated licensing process for new riders are needed.

Study on regulatory mechanism of compatibility of ginseng and gecko dispensing granule on neuroendocrine immune network in model rats with kidney yang deficiency / 中国药房

OBJECTIVE To explore the regulatory mechanism of compatibility of ginseng and gecko dispensing granule on kidney yang deficiency model rats. METHODS Male SD rats were randomly divided into normal group （no modeling ，no administration），model group （modeling，no administration ），Jinkui shenqi pill group （modeling，dose of 2.33 g/kg），ginseng group（modeling，dose of 0.53 g/kg），gecko group （modeling，dose of 0.21 g/kg）and compatibility group （modeling，ginseng 0.53 g/kg and gecko 0.21 g/kg）. The body mass and anal temperature of rats were measured at different time points ；the serum levels of cAMP ，cGMP，CRH，ACTH，CORT，T，T3，T4，E2，IgG and IgM were measured ；the pathomorphological changes of adrenal gland ，thyroid gland and testis were observed ；mRNA expression of CRH ，thyroid stimulating hormone releasing hormone （TRH）and gonadotropin releasing hormone （GnRH）in hypothalamus were detected. RESULTS Compared with model group ，the anal temperature ，the levels of cAMP ，CRH，ACTH，CORT，T3，T and cAMP/cGMP ，T/E2 in serum and mRNA expressions of TRH and GnRH in hypothalamus were significantly increased in the compatibility group （P＜0.05 or P＜0.01）；the levels of cGMP，E2 and IgG in serum and mRNA expression of CRH in hypothalamus decreased significantly （P＜0.05 or P＜0.01）； the pathological injuries of adrenal gland ，thyroid gland and testis were all improved. Compared with ginseng or gecko dispensing granules alone ，the anal temperature and T/E 2 of rats in the compatibility group increased significantly ，and mRNA expression of CRH in hypothalamus decreasedsignificantly （P＜0.05 or P＜0.01）. CONCLUSIONS Thecompatibility of ginseng and gecko dispensing granule has a synergistic regulatory effect on kidney yang deficiency model rats ， the mechanism of which may be associated with hypothalamus-pituitary-adrenal axis ， hypothalamus-pituitary-thyroid axis ， hypothalamus-pituitary-gonad axis and neuroendocrine immune network formed by immune function. Compatible drugs are better than single drugs.

The effect of extending graduated driver licensing to older novice drivers in Indiana.

INTRODUCTION: Graduated driver licensing (GDL) systems have been shown to reduce rates of crashes, injuries, and deaths of young novice drivers. However, approximately one in three new drivers in the United States obtain their first driver's license at age 18 or older, and thus are exempt from most or all provisions of GDL in most states. METHOD: In July 2015, the state of Indiana updated its GDL program, extending its restrictions on driving at night and on carrying passengers during the first 6 months of independent driving, previously only applicable to new drivers younger than 18, to all newly-licensed drivers younger than 21 years of age. The current study examined monthly rates of crashes per licensed driver under the affected conditions (driving at night and driving with passengers) among Indiana drivers first licensed at ages 18, 19, and 20 under the updated GDL system compared with drivers licensed at the same ages under the previous GDL system. We used Poisson regression to estimate the association between the GDL system and crash rates, while attempting to control for other factors that might have also influenced crash rates. We used linear regression to estimate the association between the GDL system and the proportion of all crashes that occurred under conditions restricted by the GDL program. RESULTS: Results showed, contrary to expectations, that rates of crashes during restricted nighttime hours and with passengers were higher among drivers licensed under the updated GDL system. This mirrored a statewide increase in crash rates among drivers of all ages over the study period and likely reflected increased overall driving exposure. The proportions of all crashes that were at night or with passengers did not change. Practical Applications: More research is needed to understand how older novice drivers respond when GDL systems originally designed for younger novice drivers are applied to them.

OxLDL/β2GPⅠ/β2GPⅠ-Ab complex in regulating the phenotypic transformation of A7r5 and the expression of lipid transporters / 临床检验杂志

Objective@#To investigate the effects of oxidized low-density lipoprotein/β2 glycoproteinⅠ/β2 glycoproteinⅠantibody (oxLDL/β2GPⅠ/β2GPⅠ-Ab) complex on the phenotypic transformation and lipid transpoters on the surface of rat thoracic aorta smooth muscle cell line (A7r5), and their correlation with toll-like receptor 4 (TLR4) signaling pathway. @*Methods@#A7r5 cells were stimulated by oxLDL, oxLDL/β2GPⅠ complex, oxLDL/β2GPⅠ-Ab complex, β2GPⅠ/β2GPⅠ-Ab complex and oxLDL/β2GPⅠ/β2GPⅠ-Ab complex respectively, and then total RNA and protein were collected. The expressions of α-smooth muscle actin (α-SMA), macrophage surface marker CD68, galectin-3 (LGALS3), scavenger receptor class B member 3 (CD36) and ATP-binding cassette transporter A1/G1 (ABCA1/ABCG1) were detected by real-time quantitative PCR (RT-qPCR), western blot and immunofluorescence (IF) respectively. The roles of TLR4 and its downstream signaling molecules in the phenotypic transformation and expression changes of lipid transporters of A7r5 cells induced by oxLDL/β2GPⅠ/β2GPⅠ-Ab complex were investigated by the pretreatment of TLR4 blocker TAK-242 (5 μmol/L) or c-Jun N-terminal kinases 1/2 (JNK 1/2) blocker SP600125 (90 nmol/L). @*Results@#The oxLDL/β2GPⅠ/β2GPⅠ-Ab complex significantly increased the levels of CD68 and LGALS3, and decreased the level of α-SMA, while TAK-242 could reverse this phenomenon. The oxLDL/β2GPⅠ/β2GPⅠ-Ab complex could promote the expression of CD36 and inhibit the expression of ABCA1/ABCG1, while TAK-242 and SP600125 could reverse this process. @*Conclusion@#The oxLDL/β2GPⅠ/β2GPⅠ-Ab complex promotes the phenotypic transformation of A7r5 cells to macrophage-like cells, regulates the expression of lipid transport-related molecules and enhances the ability of lipids transport into cells. TLR4 and JNK1/2 are closely related to this process.

β2GP/anti-β2GP complex inhibits oxLDL-mediated lipid accumulation and FAK activation in THP-1 macrophages / 临床检验杂志

Objective@#To investigate the effects of β2 glycoprotein Ⅰ/anti-β2 glycoprotein Ⅰ complex (β2/aβ2) on oxidized low density lipoprotein (oxLDL)-mediated lipid accumulation and focal adhesion kinase (FAK) activation in THP-1 macrophage, as well as the role of Toll-like receptor 4 (TLR4) during the process. @*Methods@#THP-1 cells were differentiated into THP-1 macrophage by PMA (100 ng/mL). THP-1 macrophages were treated with RPMI 1640 medium, oxLDL, oxLDL+β2/aβ2 or oxLDL+lipopolysaccharide (LPS). The mRNA expressions of lipid transportation molecules, ACAT1, ABCA1 and ABCG1 were detected by RT-qPCR. Intracellular total cholesterol (TC) and free cholesterol (FC) in THP-1 macrophages were evaluated by Trinder assay, then the content and proportion of intracellular cholesteryl ester (CE) were calculated. The expression and phosphorylation of FAK were detected by immune fluorescence, RT-qPCR and western blot. To evaluate the role of TLR4, THP-1 macrophages were pre-treated with or without TLR4 inhibitor TAK-242 (1 μg/mL). @*Results@#β2/aβ2 treatment significantly inhibited oxLDL-mediated lipid accumulation and FAK expression and phosphorylation in THP-1 macrophages, which could be reversed by TLR4 blockage. @*Conclusion@#β2/aβ2 inhibits the oxLDL-mediated lipid accumulation and FAK activation of THP-1 macrophage, which is related to the function of TLR4.

The Wishes and Expression of Gratitude of Youth / Os Desejos e a Expressão de Gratidão dos Jovens / Los Deseos y la Expresión de la Gratitud en los Jóvenes

AbstractLittle research has examined the development of gratitude in youth, and none has related their gratitude to their wishes. We therefore asked 358 7- to 14-year-old North American participants (56% female; 55% White) to write their greatest wish and what they would do for their benefactor. Using chi-square and linear curve estimation, we found that younger youth (aged 7 to 10) were significantly more likely to express hedonistic wishes (desire for immediate gain) and concrete gratitude (not taking the benefactor's wishes into account); older youth (aged 11 to 14) were significantly more likely to wish either for something involving future well-being for themselves or the well-being of others and connective gratitude (taking into account the benefactor's wishes). Within both age groups, there was a significant inverse relation between hedonistic wishes and connective gratitude. This research has implications for encouraging the feeling and expression of connective gratitude.(AU)

ResumoPoucos estudos examinaram o desenvolvimento da gratidão em jovens, e nenhum estabeleceu relações entre sua gratidão e seus desejos. Assim, solicitamos a 358 participantes norte-americanos entre 7 e 14 anos de idade (56% meninas; 55% brancos) que escrevessem qual seria o seu maior desejo e o que eles fariam a seu benfeitor. Utilizando qui quadrado e estimativa de curva linear, encontramos que os mais jovens (de 7 a 10 anos de idade) foram significativamente mais propensos a expressar desejos hedonistas (desejo por ganho imediato) e gratidão concreta (não considerando os desejos do benfeitor); os jovens mais velhos (de 11 a 14 anos de idade) foram significativamente mais propensos a desejar seja algo envolvendo bem-estar futuro para si mesmos seja o bem-estar de outros e gratidão conectiva (levando em conta os desejos do benfeitor).Em ambos os grupos etários, houve uma relação inversa significativa entre desejos hedonistas e gratidão conectiva.Esta pesquisa tem implicações para encorajar o sentimento e a expressão de gratidão conectiva.(AU)

ResumenPocos estudios han examinado el desarrollo de gratitud en los jóvenes, y ninguno ha relacionado su gratitud a sus deseos. Por lo tanto, pedimos a 358 participantes de América del Norte de 7 a 14 años de edad (55% femenino, 55% blanco) a escribir su mayor deseo y lo que harían por su benefactor. Utilizando un distribución ji-cuadrado y estimación curva lineal, encontramos que los más jóvenes (de 7 a 10 años de edad) fueron significativamente más propensos a expresar los deseos hedonistas (deseo de ganancia inmediata) y la gratitud de concreto (no tomar los deseos del benefactor en cuenta); los jóvenes mayores (de 11 a 14 años de edad) fueron significativamente más propensos a desear sea para algo relacionado con el bienestar futuro para sí mismos o para el bienestar de los demás y gratitud conectivo (tomando en cuenta los deseos del benefactor). Dentro de ambos grupos de edad, existe una relación inversa significativa entre los deseos hedonistas y gratitud conectivo. Esta investigación tiene implicaciones para fomentar el sentimiento y la expresión de gratitud conectivo.(AU)

The wishes and expression of gratitude of youth / Os desejos e a expressão de gratidão dos jovens / Los deseos y la expresión de la gratitud en los jóvenes

Little research has examined the development of gratitude in youth, and none has related their gratitude to their wishes. We therefore asked 358 7- to 14-year-old North American participants (56% female; 55% White) to write their greatest wish and what they would do for their benefactor. Using chi-square and linear curve estimation, we found that younger youth (aged 7 to 10) were significantly more likely to express hedonistic wishes (desire for immediate gain) and concrete gratitude (not taking the benefactor's wishes into account); older youth (aged 11 to 14) were significantly more likely to wish either for something involving future well-being for themselves or the well-being of others and connective gratitude (taking into account the benefactor's wishes). Within both age groups, there was a significant inverse relation between hedonistic wishes and connective gratitude. This research has implications for encouraging the feeling and expression of connective gratitude.

Poucos estudos examinaram o desenvolvimento da gratidão em jovens, e nenhum estabeleceu relações entre sua gratidão e seus desejos. Assim, solicitamos a 358 participantes norte-americanos entre 7 e 14 anos de idade (56% meninas; 55% brancos) que escrevessem qual seria o seu maior desejo e o que eles fariam a seu benfeitor. Utilizando qui quadrado e estimativa de curva linear, encontramos que os mais jovens (de 7 a 10 anos de idade) foram significativamente mais propensos a expressar desejos hedonistas (desejo por ganho imediato) e gratidão concreta (não considerando os desejos do benfeitor); os jovens mais velhos (de 11 a 14 anos de idade) foram significativamente mais propensos a desejar seja algo envolvendo bem-estar futuro para si mesmos seja o bem-estar de outros e gratidão conectiva (levando em conta os desejos do benfeitor).Em ambos os grupos etários, houve uma relação inversa significativa entre desejos hedonistas e gratidão conectiva.Esta pesquisa tem implicações para encorajar o sentimento e a expressão de gratidão conectiva.

Pocos estudios han examinado el desarrollo de gratitud en los jóvenes, y ninguno ha relacionado su gratitud a sus deseos. Por lo tanto, pedimos a 358 participantes de América del Norte de 7 a 14 años de edad (55% femenino, 55% blanco) a escribir su mayor deseo y lo que harían por su benefactor. Utilizando un distribución ji-cuadrado y estimación curva lineal, encontramos que los más jóvenes (de 7 a 10 años de edad) fueron significativamente más propensos a expresar los deseos hedonistas (deseo de ganancia inmediata) y la gratitud de concreto (no tomar los deseos del benefactor en cuenta); los jóvenes mayores (de 11 a 14 años de edad) fueron significativamente más propensos a desear sea para algo relacionado con el bienestar futuro para sí mismos o para el bienestar de los demás y gratitud conectivo (tomando en cuenta los deseos del benefactor). Dentro de ambos grupos de edad, existe una relación inversa significativa entre los deseos hedonistas y gratitud conectivo. Esta investigación tiene implicaciones para fomentar el sentimiento y la expresión de gratitud conectivo.

Analysis on 306 ADR Reports in Our Hospital / 中国药师

Objective:To study the regularity and characteristics of adverse drug reaction ( ADR) in our hospital. Methods: A retrospective analysis was conducted on 306 ADR reports collected in our hospital in 2013. The reports were statistically analyzed in re-spect of sex, age, route of drug administration, drug categories, organs/systems involved in ADR and clinical manifestations, classifi-cation of ADR, causality assessment, constituent ratio of the reporters etc. Results:In the 306 ADR reports, the incidence of ADR be-tween the age of 51 and 60 was the highest (20. 26%); the ratio of the ADR induced by intravenously drip administration was the highest in respect of the route of administrations (65. 58%);the radio of ADR induced by antibacterial agents was the highest in re-spect of drug types (20. 78%);digestive system was the maln lesion in ADR cases (23. 91%). The ADR cases were mostly reported by doctors (97. 71%). Conclusion:Our hospital should enhance the ADR monitoring and reporting, promote the clinical rational drug use, reduce or avoid the risk of ADR and protect medication safety of patients.

Beliefs in the legitimacy of decision authority among Chinese adolescents and parents: a person-centered approach.

The present study examined Chinese parents' and adolescents' beliefs in the legitimacy of decision authority with reference to specific issues from the prudential, conventional, multifaceted, and personal domains. The sample included 698 adolescents aged 12-15 and their parents from southern China. Parents and adolescents reported on their own beliefs respectively. Subgroups of parent and adolescent participants characterized by distinct patterns of beliefs across issues were identified with latent class analyses (LCA). Further, configural frequency analyses (CFA) were conducted to examine the match between parent subgroups and adolescent subgroups. In addition, the LCA-derived subgroups varied across residency status, sibling status, and child gender, and were linked to adolescent depressive symptoms and school misconduct. These associations with external variables provided evidence for the distinctiveness of the latent classes. Results were discussed in light of social domain theory and the socio-historical context where the participants were situated.