Association between willingness to use an overdose prevention center and probation or parole status among people who use drugs in Rhode Island.

BACKGROUND: Overdose prevention centers (OPCs) are being implemented in the United States as a strategy to reduce drug-related mortality and morbidity. Previous studies have suggested that people who use drugs (PWUD) with a history of criminal legal system (CLS) involvement (e.g. current probation/parole) are at greater risk of overdose but may also encounter significant barriers to OPC use. The objective of this study was to explore the association between willingness to use an OPC and probation/parole status in a sample of PWUD in Rhode Island. METHODS: This study utilized data from the Rhode Island Prescription and Illicit Drug Study, which enrolled adult PWUD from August 2020 to February 2023. We used Pearson's chi-square and Wilcoxon rank-sum tests to assess bivariate associations between willingness to use an OPC and probation/parole status (current/previous/never), as well as other sociodemographic and behavioral characteristics. In multivariable Poisson analyses, we examined the association between willingness to use an OPC and probation/parole status, adjusting for key sociodemographic and behavioral characteristics. RESULTS: Among 482 study participants, 67% were male, 56% identified as white, 20% identified as Hispanic/Latine, and the median age was 43 (IQR 35-53). Nearly a quarter (24%) had never been on probation/parole, 44% were not currently on probation/parole but had a lifetime history of probation and parole, and 32% were currently on probation/parole. Most participants (71%) reported willingness to use an OPC, and in both bivariate and multivariable analyses, willingness to use an OPC did not vary by probation/parole status. Crack cocaine use and lifetime non-fatal overdose were associated with greater willingness to use an OPC (all p < 0.05). CONCLUSIONS: These data demonstrate high willingness to use OPC among PWUD in Rhode Island regardless of CLS-involvement. As OPCs begin to be implemented in Rhode Island, it will be imperative to engage people with CLS-involvement and to ensure access to the OPC and protection against re-incarceration due to potential barriers, such as police surveillance of OPCs.

Influence of comorbidity on mortality in patients with epilepsy and psychogenic nonepileptic seizures.

OBJECTIVE: This study aims to determine the contribution of comorbidities to excess psychogenic nonepileptic seizures (PNES) mortality. METHODS: A retrospective cohort study was conducted of tertiary epilepsy outpatients from St. Vincent's Hospital Melbourne, Australia with an 8:1 comparison cohort, matched by age, sex, and socioeconomic status (SES) to national administrative databases between 2007 and 2017. Privacy-preserving data linkage was undertaken with the national prescription, National Death Index, and National Coronial Information System. Forty-five comorbid disease classes were derived by applying the Australian validated RxRisk-V to all dispensed prescriptions. We fitted Cox proportional hazard models controlling for age, sex, SES, comorbidity, disease duration, and number of concomitant antiseizure medications, as a marker of disease severity. We also performed a parallel forward-selection change in estimate strategy to explore which specific comorbidities contributed to the largest changes in the hazard ratio. RESULTS: A total of 13 488 participants were followed for a median 3.2 years (interquartile range = 2.4-4.0 years), including 1628 tertiary epilepsy outpatients, 1384 patients with epilepsy, 176 with PNES, and 59 with both. Eighty-two percent of epileptic seizures and 92% of typical PNES events were captured in an epilepsy monitoring unit. The age-/sex-/SES-adjusted hazard ratio was elevated for epilepsy (4.74, 95% confidence interval [CI] = 3.36-6.68) and PNES (3.46, 95% CI = 1.38-8.68) and remained elevated for epilepsy (3.21, 95% CI = 2.22-4.63) but not PNES (2.15, 95% CI = .77-6.04) after comorbidity adjustment. PNES had more pre-existing comorbidities (p = .0007), with a three times greater median weighted Rx-RiskV score. Psychotic illness, opioid analgesia, malignancies, and nonopioid analgesia had the greatest influence on PNES comorbid risk. SIGNIFICANCE: Higher comorbidity appears to explain the excess PNES mortality and may represent either a wider underrecognized somatoform disorder or a psychological response to physical illness. Better understanding and management of the bidirectional relationship of these wider somatic treatments in PNES could potentially reduce the risk of death.

Adherence patterns in antiseizure medications influencing risk of sudden unexplained death in epilepsy: A data linkage study using dispensed prescriptions.

OBJECTIVE: Medication adherence is considered an important risk factor for sudden unexpected death in epilepsy (SUDEP), although measurement accuracy is difficult. Using prescription dispensations, this study aims to estimate antiseizure medication (ASM) adherence and identify adherence patterns that influence epilepsy mortality. METHODS: This is a retrospective cohort study of tertiary epilepsy outpatients seen at St Vincent's Hospital Melbourne, Victoria, Australia, from January 1, 2012 until December 31, 2017. Privacy-preserving data linkage with the Australian national prescription, death, and coroner's databases was performed. We fitted a four-cluster longitudinal group-based trajectory model for ASM adherence from recurring 90-day windows of prescription dispensations during a 3-year "landmark period" from January 1, 2012 to December 31, 2014, using the AdhereR package. We estimated the risk of SUDEP and all-cause death for each adherence pattern during an "observation period" from January 1, 2015 to December 31, 2017. The Cox proportional hazards and logistic regression models were adjusted for age, sex, socioeconomic status, epilepsy duration, comorbidity, drug resistance, and inadequate seizure control. RESULTS: One thousand one hundred eighty-seven participants were observed for a median of 3.2 years (interquartile range = 2.4-4.0 years). We observed 66 deaths with 10 SUDEP cases during the observation period. We identified four patterns of ASM adherence: good, 51%; declining, 24%; poor, 16%; and very poor, 9%. Declining adherence was associated with an increased risk for SUDEP, with hazard ratio (HR) = 8.43 (95% confidence interval [CI] = 1.10-64.45) at 1 year and HR = 9.17 (95% CI = 1.16-72.21) at 3 years. Compared to no ASM therapeutic change, the addition of a second to fourth ASM offered increased protection against SUDEP in patients with continuing drug-resistant epilepsy. SIGNIFICANCE: ASM nonadherence was observed in half of outpatients with epilepsy. A declining pattern of adherence, observed in a quarter of patients, was associated with more than eight times increased risk of SUDEP. Any ongoing medication interventions must include strategies to maintain and improve ASM adherence if we are to reduce the risk of SUDEP.

Sleep and circadian differences between light and heavy adult alcohol drinkers.

BACKGROUND: Numerous studies have reported that eveningness is associated with increased alcohol consumption. However, biological markers of circadian timing, such as dim light melatonin onset (DLMO) and circadian photoreceptor responsivity (post-illumination pupil response, PIPR), have rarely been assessed in the context of habitual alcohol consumption. This study aimed to examine sleep, circadian timing, and photoreceptor responsivity in adult alcohol drinkers. METHODS: Participants (21 to 45 years) included 28 light and 50 heavy drinkers. The 8-day study consisted of a week of ad lib sleep monitored with wrist actigraphy, followed by a 9-h laboratory session with a photoreceptor responsivity and circadian phase assessment. RESULTS: The heavy drinkers obtained on average 28 more minutes of sleep (p = 0.002) and reported more eveningness than the light drinkers (p = 0.029). There was a trend for a shorter DLMO-midsleep interval (p = 0.059) in the heavy drinkers, reflecting a tendency for them to sleep at an earlier circadian phase. The PIPR in the heavy drinkers was significantly smaller than in the light drinkers (p = 0.032), suggesting reduced circadian photoreceptor responsivity in the heavy drinkers. A larger PIPR was significantly associated with a later DLMO in the light drinkers (r = 0.44, p = 0.019), but this relationship was absent in the heavy drinkers (r = -0.01, p = 0.94). CONCLUSIONS: These results are consistent with earlier reports of more eveningness and a shorter DLMO-midsleep interval being associated with heavier alcohol drinking. The novel finding of reduced circadian photoreceptor responsivity in heavy drinkers is consistent with prior rodent studies. Future studies should explore the impact of habitual alcohol consumption on other measures of circadian photoreceptor responsivity.

'Hawa' and 'resistensiya': local health knowledge and the COVID-19 pandemic in the Philippines.

Understanding people's concepts of illness and health is key to crafting policies and communications campaigns to address a particular medical concern. This paper gathers cultural knowledge on infectious disease causation, prevention, and treatment the Philippines that are particularly relevant for the COVID-19 pandemic, and analyzes their implications for public health. This paper draws from ethnographic work (e.g. participant observation, interviews, conversations, virtual ethnography) carried out individually by each of the two authors from February to September 2020. The data was analyzed in relation to the anthropological literature on local health knowledge in the Philippines. We find that notions of hawa (contagion) and resistensiya (immunity) inform people's views of illness causation as well as their preventive practices - including the use of face masks and 'vitamins' and other pharmaceuticals, as well as the ways in which they negotiate prescriptions of face mask use and physical distancing. These perceptions and practices go beyond biomedical knowledge and are continuously being shaped by people's everyday experiences and circulations of knowledge in traditional and social media. Our study reveals that people's novel practices reflect recurrent, familiar, and long-held concepts - such as the moral undertones of hawa and experimentation inherent in resistensiya. Policies and communications efforts should acknowledge and anticipate how these notions may serve as either barriers or facilitators to participatory care and improved health outcomes.

Risk factors for injury in a community-treated cohort of patients with epilepsy in Australia.

OBJECTIVE: There remains a paucity of knowledge regarding specific epilepsy-related risk factors for accidents and injuries in people with epilepsy. Injury studies in people with epilepsy are overrepresented, with tertiary based populations that are prone to bias from severe disease. This study aims to assess the contribution of epilepsy-related risk factors to injuries in a community-based cohort. METHODS: We performed a retrospective nested case-control study on patients recruited into the Tasmanian Epilepsy Register (TER) from July 1, 2001 to June 30, 2002. The TER is a community-based cohort of patients with epilepsy in Tasmania, Australia, recruited from the national prescription database and interviewed for epilepsy diagnosis, injuries, and risk factors using validated questionnaires with diagnosis made by an epilepsy specialist. The primary outcome measures were lifetime and recent 12-month injury. Multivariate logistic regression with multiple imputation modeling responder nondisclosure was performed, adjusting for age, gender, region, socioeconomic status, seizure frequency, and epilepsy duration. RESULTS: A total of 819 patients with epilepsy were included in this study. Ten percent of patients experienced an injury in the preceding year. Before adjusting for seizure frequency, any seizure over the past 12 months was associated with recent injury (adjusted odds ratio [OR] = 7.90, 95% confidence interval [CI] = 4.17-14.96). Impaired awareness, cluster seizures, sleep-only seizures, and convulsive seizure were characteristics found to significantly influence injuries irrespective of seizure frequency. Although a warning appeared initially protective for recent injuries (OR = 0.39, 95% CI = 0.22-0.69), this was entirely explained by seizure frequency, with the effect becoming nonsignificant. SIGNIFICANCE: Likely due to their unpredictable nature, seizures expose patients with epilepsy to a high risk of life-threatening injury. These findings emphasize the importance of seizure freedom for maximizing the safety of patients with epilepsy.

Inter-visit variability of conjunctival microvascular hemodynamic measurements in healthy and diabetic retinopathy subjects.

Conjunctival microcirculation imaging provides a non-invasive means for detecting hemodynamic alterations due to systemic and ocular diseases. However, reliable longitudinal monitoring of hemodynamic changes due to disease progression requires establishment of measurement variability over time. The purpose of the current study was to determine inter-visit variability of conjunctival microvascular hemodynamic measurements in non-diabetic control (NC, N = 7) and diabetic retinopathy (DR, N = 10) subjects. Conjunctival microvascular imaging was performed during 2 visits, which were 17 ±â€¯12 weeks apart. Images were analyzed to determine vessel diameter (D), axial blood velocity (V), blood flow (Q), wall shear rate (WSR) and wall shear stress (WSS). The inter-visit variability was determined based on mean inter-visit differences. In NC, inter-visit variability of D, V, Q, WSR and WSS were 0.2 ±â€¯0.5 µm, -0.01 ±â€¯0.16 mm/s, -8 ±â€¯46 pl/s, -3 ±â€¯46 s-1 and -0.01 ±â€¯0.10 dyne/cm2, respectively. Inter-visit variability of D, V, Q, WSR and WSS were beyond the normal 95% confidence limits in 60%, 20%, 40%, 20% and 20% of DR subjects, respectively. The variability of hemodynamic measurements over time was established in non-diabetic subjects, suggestive of the potential of the method for detecting longitudinal changes due to progression of DR.

Retinal tissue oxygen tension and consumption during light flicker stimulation in rat.

Light flicker stimulation has been shown to increase inner retinal oxygen metabolism and supply. The purpose of the study was to test the hypothesis that sustained light flicker stimulation of various durations alters the depth profile metrics of oxygen partial pressure in the retinal tissue (tPO2) but not the outer retinal oxygen consumption rate (QO2). In 17 rats, tPO2 depth profiles were derived by phosphorescence lifetime imaging after intravitreal injection of an oxyphor. tPO2 profile metrics, including mean inner retinal tPO2, maximum outer retinal tPO2 and minimum outer retinal tPO2 were determined. QO2 was calculated using a one-dimensional oxygen diffusion model. Data were acquired at baseline (constant light illumination) and during light flicker stimulation at 10 Hz under the same mean illumination levels, and differences between values obtained during flicker and baseline were calculated. None of the tPO2 profile metrics or QO2 differences depended on the duration of light flicker stimulation (R2 ≤ 0.03). No significant change in any of the tPO2 profile metrics was detected with light flicker compared with constant light (P ≥ 0.08). Light flicker decreased QO2 from 0.53 ±â€¯0.29 to 0.38 ±â€¯0.30 mL O2/(min*100 gm), a reduction of 28% (P = 0.02). The retinal compensatory responses to the physiologic challenge of light flicker stimulation were effective in maintaining the levels of oxygen at or near baseline in the inner retina. Oxygen availability to the inner retina during light flicker may also have been enhanced by the decrease in QO2.

Sex differences in disordered eating and food addiction among college students.

This cross-sectional study aimed to assess sex differences and weight status differences in disordered eating behaviors (DEB) and food addiction (FA) along with their co-occurrence among college students. Self-reported demographic and weight information, the Eating Attitude Test (EAT-26), and Yale Food Addiction Scale (YFAS) were collected from 965 college students. Participants included 703 (72.8%) female, 720 (74.8%) white, and ranged in age from 18 to 25 years old. Female college students had a significantly higher prevalence of DEB (11.6% vs. 5.7%, p = 0.007, odds ratio (OR) = 2.19) and higher prevalence of FA (12.3% vs. 4.6%, p < 0.0001, OR = 3.04) than male students. The co-occurrence was also significantly higher in female students than in male students (5.4% vs. 1.9%, p = 0.022, OR = 3.03). Male and female obese participants versus healthy weight participants had higher prevalence of DEB (15.1% vs.8.6%, p = 0.047, OR = 1.91) and FA (19.4% vs. 8.9%, p = 0.002, OR = 2.51). Higher prevalence of DEB was positively associated with FA regardless of sex and weight status. The findings indicate higher prevalence of disordered eating in female college students than male students and add to the research on sex differences in food addiction. The co-occurrence of both and association between high prevalence of DEB and FA warrant additional research on the incidence as well as factors that contribute to sex differences. Understanding sex differences and comorbidity regarding DEB and FA is critical for the prevention and treatment of eating related disorders.

A Novel Open-Source Novel App Improves Anesthesia Operating Room Equipment Supply.

Anesthesiologists are dependent on specialized drugs and equipment being immediately available for patient care. Deficiencies in supplies impact on operating room efficiency and patient safety. In our institution, we do not have anesthesia assistants/aides and depend on general aides to stock anesthesia related equipment which resulted in many shortages. We hypothesized that a mobile app would be useful for tracking and reporting and informing changes to stocking resulting in an improvement in the supply of anesthesia equipment. Following institutional quality improvement approval, we developed an app to collect metrics (which included the last 2 months of paper documentation - September and October 2015) and the first 12 months of the app usage (November 2015 to November 2016). Descriptive statistics were used to analyze data from the app. The primary outcome was the number of reports made over time. Secondary outcomes include the impact of missing items on operating room efficiency and patient safety, the most commonly reported missing items, and the most common actions taken following the discovery of missing items. The app increased the reporting by more than 300% (compared to paper) over the first 2 months. Over the year, 549 items were reported missing. The most common category of missing items was airway related 274 (49.9%). The single most commonly reported missing item was the Wisconsin Laryngoscope Size 1 Blade 95 (17.3%). App users reported the missing item safety impact as high 86 (15.7%) times and efficiency impact as high 117 (21.3%) times. Changes to staffing and supply resulted in a decrease in missing items reported. Our results demonstrate that an app can be useful for reporting, tracking of real-time shortages of anesthesia equipment and is easy to design and implement. Furthermore, the app has generated useful and robust data that has led to staffing changes and improvements in the anesthesia equipment supply chain. The app design and use may be useful in other clinical areas.

Transfer of dynamic motor skills acquired during isometric training to free motion.

Recent studies have explored the prospects of learning to move without moving, by displaying virtual arm movement related to exerted force. However, it has yet to be tested whether learning the dynamics of moving can transfer to the corresponding movement. Here we present a series of experiments that investigate this isometric training paradigm. Subjects were asked to hold a handle and generate forces as their arms were constrained to a static position. A precise simulation of reaching was used to make a graphic rendering of an arm moving realistically in response to the measured interaction forces and simulated environmental forces. Such graphic rendering was displayed on a horizontal display that blocked their view to their actual (statically constrained) arm and encouraged them to believe they were moving. We studied adaptation of horizontal, planar, goal-directed arm movements in a velocity-dependent force field. Our results show that individuals can learn to compensate for such a force field in a virtual environment and transfer their new skills to the actual free motion condition, with performance comparable to practice while moving. Such nonmoving techniques should impact various training conditions when moving may not be possible.NEW & NOTEWORTHY This study provided early evidence supporting that training movement skills without moving is possible. In contrast to previous studies, our study involves 1) exploiting cross-modal sensory interactions between vision and proprioception in a motionless setting to teach motor skills that could be transferable to a corresponding physical task, and 2) evaluates the movement skill of controlling muscle-generated forces to execute arm movements in the presence of external forces that were only virtually present during training.

Detection and Characterization of the Effect of AB-FUBINACA and Its Metabolites in a Rat Model.

Synthetic cannabinoids were originally developed by academic and pharmaceutical laboratories with the hope of providing therapeutic relief from the pain of inflammatory and degenerative diseases. However, recreational drug enthusiasts have flushed the market with new strains of these potent drugs that evade detection yet endanger public health and safety. Although many of these drug derivatives were published in the medical literature, others were merely patented without further characterization. AB-FUBINACA is an example of one of the new indazole-carboxamide synthetic cannabinoids introduced in the past year. Even though AB-FUBINACA has become increasingly prominent in forensic drug and toxicology specimens analyses, little is known about the pharmacology of this substance. To study its metabolic fate, we utilized Wistar rats to study the oxidative products of AB-FUBINACA in urine and its effect on gene expressions in liver and heart. Rats were injected with 5 mg/kg of AB-FUBINACA each day for 5 days. Urine samples were collected every day at the same time. On day 5 after treatment, we collected the organs such as liver and heart. The urine samples were analyzed by mass spectrometry, which revealed several putative metabolites and positioning of the hydroxyl addition on the molecule. We used quantitative PCR gene expression array to analyze the hepatotoxicity and cardiotoxicity on these rats and confirmed by real-time quantitative RT-PCR. We identified three genes significantly associated with dysfunction of oxidation and inflammation. Our study reports in vivo metabolites of AB-FUBINACA in urine and its effect on the gene expressions in liver and heart.

Development and validation of an epidemiologic case definition of epilepsy for use with routinely collected Australian health data.

OBJECTIVES: We report the diagnostic validity of a selection algorithm for identifying epilepsy cases. STUDY DESIGN AND SETTING: Retrospective validation study of International Classification of Diseases 10th Revision Australian Modification (ICD-10AM)-coded hospital records and pharmaceutical data sampled from 300 consecutive potential epilepsy-coded cases and 300 randomly chosen cases without epilepsy from 3/7/2012 to 10/7/2013. Two epilepsy specialists independently validated the diagnosis of epilepsy. A multivariable logistic regression model was fitted to identify the optimum coding algorithm for epilepsy and was internally validated. RESULTS: One hundred fifty-eight out of three hundred (52.6%) epilepsy-coded records and 0/300 (0%) nonepilepsy records were confirmed to have epilepsy. The kappa for interrater agreement was 0.89 (95% CI=0.81-0.97). The model utilizing epilepsy (G40), status epilepticus (G41) and ≥1 antiepileptic drug (AED) conferred the highest positive predictive value of 81.4% (95% CI=73.1-87.9) and a specificity of 99.9% (95% CI=99.9-100.0). The area under the receiver operating curve was 0.90 (95% CI=0.88-0.93). CONCLUSION: When combined with pharmaceutical data, the precision of case identification for epilepsy data linkage design was considerably improved and could provide considerable potential for efficient and reasonably accurate case ascertainment in epidemiological studies.

A comparative study of carbon-platinum hybrid nanostructure architecture for amperometric biosensing.

Carbon and noble metal nanomaterials exhibit unique properties that have been explored over the last few decades for developing electrochemical sensors and biosensors. Hybridization of nanometals to carbon nanomaterials such as graphene or carbon nanotubes produces a synergistic effect on the electrocatalytic activity when compared to either material alone. However, to date there are no comparative studies that directly investigate the effects of nanocarbon concentration and nanocomposite arrangement on electron transport. This comparative study investigated the efficacy of various platinum-carbon hybrid nanostructures for amperometric biosensing. Electroactive surface area, sensitivity towards hydrogen peroxide, response time, limit of detection, and surface roughness were measured for various hybrid nanomaterial arrangements. Both design factors (nanocarbon concentration and network arrangement) influenced the performance of the reduced graphene oxide-based platforms; whereas only nanomaterial arrangement affected the performance of the carbon nanotube-composites. The highest sensitivity towards hydrogen peroxide for reduced graphene oxide nanocomposites (45 ± 3.2 µA mM(-1)) was measured for a graphene concentration of 2 mg mL(-1) in a "sandwich" structure; nanoplatinum layers enveloping the reduced graphene oxide. Likewise, the best carbon nanotube performance toward H2O2 (49 ± 1.4 µA mM(-1)) was measured for a sandwich-type structure with nanoplatinum. The enhanced electrocatalytic activity of this "sandwich" structure was due to a combined effect of electrical junctions formed amongst nanocarbon, and nanocomposite soldering to the electrode surface. The top-down carbon-platinum hybrid nanocomposites in this paper represent a simple, low-cost, approach for formation of high fidelity amperometric sensors with remarkable performance characteristics that are similar to bottom-up fabrication approaches.

'Everywhere I call, there's nothing available': Understanding the alcohol treatment landscape and needs among unstably housed people who use alcohol in Rhode Island.

INTRODUCTION: Alcohol is a leading cause of morbidity and mortality in the United States and people who are unstably housed are disproportionately impacted by adverse alcohol-related health outcomes. Addressing the needs of unstably housed people with high-intensity alcohol use (i.e., heavy episodic use or binge drinking), including those whose goal is not abstinence, is critical to reducing harms among this population. This study explores the alcohol-related treatment and support needs among unstably housed people who use alcohol. METHODS: Data collection included participant observation and semi-structured interviews (n = 25) with unstably housed people with high-intensity alcohol use. Data were analysed thematically, with attention to structural vulnerability and social-structural forces at shaping perceptions of and experiences with alcohol treatment. RESULTS: Participants underscored how housing instability was critical in precipitating and maintaining heavy alcohol use, with alcohol often used to manage the stress and anxiety related to housing instability. While participants regularly engaged with alcohol treatment programs, program design and barriers to access undermined the effectiveness of these services for participants. Participants described the need for a range of program and service options across a continuum of care to be implemented to support participants in meeting their diverse needs and identified goals regarding alcohol use. DISCUSSION AND CONCLUSIONS: Alcohol treatment and supports need to be modified so that they include a range of harm reduction and abstinence-based models to better meet people's diverse needs. Furthermore, treatment must be paired with permanent and affordable housing to address underlying drivers of alcohol-related harm for unstably housed people.

Do sleep and circadian characteristics predict alcohol use in adult drinkers?

BACKGROUND: While sleep and circadian rhythms are recognized contributors to the risk for alcohol use and related problems, few studies have examined whether objective sleep and circadian measures can predict future alcohol use in humans, and no such studies have been conducted in adults. This study examined whether any baseline sleep and/or circadian characteristics of otherwise healthy adults predicted their alcohol use over the subsequent 12 months. METHODS: Participants (21-42 years) included 28 light and 50 heavy drinkers. At baseline, a comprehensive range of self-reported and objective sleep/circadian measures was assessed via questionnaires, wrist actigraphy, and measurement of dim light melatonin onset and circadian photoreceptor responsivity. Following this, the number of alcoholic drinks per week and binge drinking episodes per month were assessed quarterly over the subsequent 12 months. Anticipated effects of alcohol (stimulation, sedation, and rewarding aspects) were also assessed quarterly over the 12 months. Analyses included generalized linear mixed-effects models and causal mediation analysis. RESULTS: Across the range of measures, only self-reported insomnia symptoms and a longer total sleep time at baseline predicted more drinks per week and binges per month (ps <0.02). There was a trend for the anticipated alcohol effect of wanting more alcohol at the 6-month timepoint to mediate the relationship between insomnia symptoms at baseline and drinks per week at 12 months (p = 0.069). CONCLUSIONS: These results suggest that in otherwise healthy adults, insomnia symptoms, even if subclinical, are a significant predictor of future drinking, and appear to outweigh the influence of circadian factors on future drinking, at least in otherwise healthy adults. Insomnia symptoms may be a modifiable target for reducing the risk of alcohol misuse.

Complete genome sequences and characteristics of mycobacteriophages Diminimus, Dulcita, Glaske16, and Koreni.

Complete genome sequences of four novel mycobacteriophages, Diminimus, Dulcita, Glaske16, and Koreni, isolated from soil are presented. All these bacteriophages belong to subcluster M1, except Koreni that belongs to subcluster A4. Moreover, all have siphovirus morphologies, with genome sizes ranging from 51,055 to 81,156 bp.

Seizure-related injuries, drowning and vehicular crashes -- a critical review of the literature.

Injury is common in patients with epilepsy, can have serious consequences (fractures, burns), and can sometimes even be fatal (drowning, vehicular crashes). Seizure-related injuries, drowning, and vehicular crashes have been investigated across differing populations using various methodologies hindering consistent estimates with respect to its frequency, magnitude, and potential risk factors. Knowledge is further complicated by the low incidence of injury outcomes, the not insignificant background frequency of injury in the general population, and the emphasis on seizure-related explanatory mechanisms. Although not without its own complexity, privacy preserving data linkage is an emerging powerful technique that is being increasingly used in epilepsy and other chronic conditions to answer important questions, especially when measuring low incidence health outcomes prospectively, such as injury. This review examines the frequency of overall and specific seizure-related injures, describes the known risk factors and finally suggests future directions for research that may improve our understanding in the area.