Epidemiology of alcohol and other drug use among motor vehicle crash victims admitted to a trauma center

The objectives of this research were to (1) determine the incidence and prevalence of alcohol and other drug use among motor vehicle crash (MVC) victims admitted to a regional Level-I trauma center, and (2) to examine the utility of using a rapid point-of-collection (POC) drug-testing device to identify MVC patients with drug involvement. Blood and urine specimens were routinely collected per clinical protocol for each MVC victim at the time of admission. Blood alcohol concentration (BAC) levels were determined per standard clinical protocol. Clinical urine specimens were routinely split so that a POC drug-testing device for the detection of commonly abused drugs (Marijuana, Cocaine, Amphetamines, Methamphetamines, and Opiates) could be compared to that of the standard hospital laboratory analysis of each urine specimen (which also included Barbiturates and Benzodiazepines). In the six-month period of this study, nearly two-thirds of trauma center admissions were victims of motor vehicle crashes. During this time, blood and urine was collected from 322 MVC victims. Toxicology results indicated that 59.3% of MVC victims tested positive for either commonly abused drugs or alcohol. More patients tested positive for drug use than tested positive for alcohol, with 33.5% testing positive for drug use only, 15.8% testing positive for alcohol use only, and 9.9% testing positive for both drugs and alcohol. Less than half (45.2%) of the substance-abusing patients in this study would have been identified by an alcohol test alone. After alcohol, marijuana and benzodiazepines were the most frequently detected drugs. Point of collection (POC) test results correlated well with laboratory results and provide important information to initiate rapid intervention/treatment for substance use problems among injured patients.     

Cell-free DNA screening in twin pregnancies: A more accurate and reliable screening tool

Objective

Outcome data from cell-free DNA (cfDNA) screening in twin gestations are limited. This study adds an appreciable number of confirmed outcomes to the literature, and assesses performance of cfDNA screening in twins over a 4.5-year period at one large clinical laboratory.

Method

Prenatal cytogenetic and SNP microarray results were cross-referenced with cfDNA results for twin pregnancies, yielding 422 matched cases. Using diagnostic results as truth, performance of cfDNA screening in this population was assessed.

Results

Of the 422 twin pregnancies with both cfDNA and diagnostic results, 3 specimens failed amniocyte analysis, and 48 samples (11.5%) were nonreportable from the initial cfDNA draw. Analysis of the 371 reportable samples demonstrated a collective sensitivity of 98.7% and specificity of 93.2% for trisomies 21/18/13. Positive predictive values (PPVs) in this study population, which is enriched for aneuploidy, were 78.7%, 84.6%, and 66.7% for trisomy 21, 18, and 13, respectively.

Conclusion

CfDNA screening in a cohort of twin pregnancies with matched diagnostic results showed superior performance compared to traditional serum biochemical screening in twins. This study adds to a growing body of evidence suggesting that cfDNA is an accurate and reliable screening tool for the major trisomies in twin pregnancies.

     

Failing to Site Hazardous Waste Facilities Voluntarily: Implications for the Production of Sustainable Goods

A current approach to the process of siting hazardous waste facilities is to seek 'willing host' communities that will not oppose but rather voluntarily accept risky facilities. Voluntary siting strategies have been put forward as the solution to hazardous waste location problems, and there have indeed been a small number of siting successes achieved voluntarily. This paper argues that, despite claims about voluntary processes, there are indications that few 'willing host' sites will be found in response to the many that are proposed. Instead, it suggests that the limited success of siting attempts, voluntary or otherwise, signals a new phase in hazardous waste management, a shift in focus from where to site a facility to whether a good is worth producing at all if its wastes are not siteable. A characteristic of this phase is the growing influence that the disposal potential of the generated waste can have on future management decisions to produce a good. In practice, siting failure may be one of the critical turning points on the road to sustainable production. It can accomplish what technology and environmental assessments have generally been unable to do: foresee the sustainability of a good. In this way, siteability can be seen as one indicator of sustainable production. A good can be considered sustainable if the wastes associated with its production are siteable.     

Assessment of the phototoxicity of weathered Alaska North Slope crude oil to juvenile pink salmon

Petroleum products are known to have greater toxicity to the translucent embryos and larvae of aquatic organisms in the presence of ultraviolet radiation (UV) compared to toxicity determined in tests performed under standard laboratory lighting with minimal UV. This study assessed the acute phototoxicity of the water accommodated fractions of weathered Alaska North Slope crude oil (ANS) to juvenile pink salmon, which are a heavily pigmented life stage. Fish in the highest ANS treatments exhibited melanosis, less mobility, reduced startle response, erratic swimming, and loss of equilibrium. Gills from fish exposed to ANS had elevated levels of hydroperoxides in oil-only, UV-only, and oil+UV treatments compared to control fish, which was indicative of increased lipid peroxidation in gill tissue. Under the test conditions of moderate salinity, low UV and high short-term oil exposure there were no indications of photoenhanced toxicity as assessed by elevation of mortality, behavioral impairment, or gill lipid peroxidation in oil+UV treatments. The results of this study suggest that pink salmon may be at less risk from photoenhanced toxicity compared to the translucent early-life stages of several other Alaska species.     

Predicting ozone-induced soybean losses: sensitivity to model form and inputs

In this study, alternative dose-response equations for assessing the effects of O3 on soybeans (Glycine max (L.) Merr.) were established. For each of three soybean cultivars, three models (linear, quadratic, and Weibull) were fitted to relate different measures of O3 dose, during the soybean flowering maturity period, to the soybean yield. The dose measures were 7-h (9:00 a.m. to 4:00 p.m.) and 12-h (7:00 a.m. to 7:00 p.m.) means, 7-h and 12-h total doses, and the 90th and 75th percentile O3 concentrations. Using data for primarily rural and small city O3 monitoring sites, county-level O3 doses were calculated, and soybean losses due to O3 were predicted for Illinois, Kentucky, and Virginia. The sensitivity of O3-induced soybean loss predictions to model forms and inputs was determined with regard to: (1) inter-year differences in ambient O3, (2) differences among the six dose measures, (3) differences among the three different model forms, (4) the impact of the agricultural practice of double-cropped soybean production, and (5) variance in response to O3 among three different soybean cultivars.