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Background: Mobile health (mHealth) technology use may reduce alcohol use and related negative consequences; however, little is known about its efficacy without prompting from researchers or pay‐per‐use. This exploratory analysis assessed relationships between mHealth technology use frequency and alcohol‐use outcomes. Methods: Young adults who drink heavily (N = 97, Mage = 23, 51% male, 64% non‐Hispanic White, Mdrinks/week = 21) had the option to use three mHealth technologies (breathalyzer device/app, blood alcohol content estimator app, drink counting via text message) while drinking for 2 weeks. Relationships between alcohol‐related outcomes and any, multiple, and specific mHealth technology use across study days and drinking days were evaluated via bivariate correlations and multiple regressions. Results: Participants used one or more mHealth technologies on approximately 68% of drinking days (33% of field days), with multiple technologies used on 34% of drinking days. Bivariate correlations revealed that a higher percentage of study days with any mHealth technology use was related to higher mean weekly drinks. However, a higher percentage of drinking days with any mHealth technology use was related to lower mean weekly drinks, percent of heavy and high‐intensity drinking days, and negative consequences. There were several significant, inverse correlations between alcohol variables and using the mHealth technologies that provided personalized feedback. Multiple regression analyses (holding sex and baseline alcohol variables constant) indicated that a higher percentage of drinking days with any mHealth technology use was related to lower mean weekly drinks and lower percentage of heavy drinking days. Conclusions: Using mHealth technologies to moderate drinking without direct prompting from the research team or per‐use incentives was related to less overall alcohol use and heavy drinking. This indicates potential real‐world engagement with mHealth apps to assist with in‐the‐moment drinking. Normalizing mHealth technology use during drinking could help curb the public health crisis around harmful alcohol use in young adult populations. [ABSTRACT FROM AUTHOR]

Measurement of ethanol above the skin surface (supradermal) is used to monitor blood alcohol concentrations (BAC) in both legal and consumer settings. Previously, the relationship between supradermal alcohol concentration (SAC) and BAC was described using partial and ordinary differential equations (PDE model: J. Appl. Physiol. 100: 649‐55, 2006). Using a range of BAC profiles by varying absorption times and peak concentrations, the PDE model accurately predicted experimental measures of SAC. Recently, other mathematical models have relied on the PDE model. This paper proposes a new approach to modeling transdermal ethanol kinetics using a mass transfer coefficient and only ordinary differential equations (ODE model). Using a range of BAC profiles, the ODE model performed very similarly to the PDE model. The ODE model had slightly slower washout rates and slightly slower times to peak SAC and to zero SAC. Similar to the PDE model, a sensitivity analysis on the ODE model showed changes in solubility and diffusivity within the stratum corneum, stratum corneum thickness, and the volume of gas above the skin affected model performance. This new model will streamline integration into larger physiologic models, reduce computation time, and decrease the time to transform skin alcohol measurements to blood alcohol concentrations. [ABSTRACT FROM AUTHOR]

Ethanol is the most commonly encountered substance in forensic toxicology. Determining blood alcohol concentration (BAC) in autopsies accounts for the majority of work in forensic diagnosis. The most common method to assess BAC is the enzymatic oxidation method because of its low cost, easy operation, and high throughput. Still, the elevated lactate and lactate dehydrogenase (LDH) levels in postmortem blood may affect accuracy. This study uses headspace gas chromatography with a flame ionization detector (HS-GC/FID) to assess the interference of lactate and LDH levels on BAC in 110 autopsied blood samples determined by the enzymatic oxidation method. The results showed that lactate and LDH levels in postmortem blood were higher than in normal blood. There was a weak correlation between the lactate levels and BAC difference (r = 0.23, p < 0.05) and a strong correlation between LDH levels and BAC difference (r = 0.67, p < 0.001). The differentiation of BAC between the enzymatic oxidation method and HS-GC/FID was significant (p < 0.001), confirming the interference significantly. All postmortem blood samples with lactate and LDH levels higher than regular lead to a positive error in determining BAC by enzymatic oxidation method. The study results suggest that the HS-GC/FID method should be used to determine BAC in postmortem blood samples instead of the enzymatic oxidation method to avoid mistakes in forensic diagnosis. [ABSTRACT FROM AUTHOR]

Excessive alcohol consumption is one of the most important factors in a substantial number of violent deaths. The aim of our study was to investigate alcohol-related deaths in the Republic of North Macedonia in the period from 2007 to 2020, in order to study the influence of elevated blood alcohol levels in violent deaths. Five hundred sixty-four post-mortem blood samples from alcohol-related death cases—natural deaths and violent deaths (suicides, accidents, and homicides)—were analyzed, and the results were evaluated according to sex, age, and cause of death. Among 564 cases, traffic accidents were the leading cause of violent death (54.3% of the cases) followed by suicides (19.9% of the cases). In the examined post-mortem samples, BAC values ranged from 0.15–6.20 g/L. The average age was 45 ± 16 years for the male and 49 ± 19 years for the female group. The biggest proportion of high BAC values was found in the group of accidents specifically road traffic accidents and accidental intoxication as well as in the group of bolus deaths. The analysis of BAC in the cases of violent deaths in the Republic of North Macedonia confirmed that consumption of alcohol is strongly related to violent deaths. The data obtained from this study could raise caution and give aid in a national strategy for the prevention of alcohol-related violent deaths. [ABSTRACT FROM AUTHOR]

Abstract In December 2022, the Ministry of Health, Labour and Welfare (MHLW) of Japan issued and implemented the guideline for evaluating the effects of psychotropic drugs on motor vehicle driving performance. This guideline recommends the use of a tiered approach to assess clinically meaningful driving impairment. It is noted that adverse events cannot be solely explained by pharmacokinetics, as the onset and duration of these events vary. Among these adverse events, those affecting alertness, such as drowsiness caused by psychotropic drugs on driving performance, are more frequently observed during initial treatment stages and dose escalation. Hence, when evaluating the effects of psychotropic drugs on driving performance, it becomes crucial to assess the persistence of clinically meaningful impairment. Therefore, the MHLW guideline, developed by the authors, emphasizes the need to assess the temporal profile of adverse events affecting driving in all clinical trials. Additionally, the guideline states that when conducting driving studies, the timing of multiple dosing should consider not only the pharmacokinetics of the investigational drug but also its tolerance.

Although they comprise a relatively small subset of all traffic deaths, hit‐and‐run (HR) fatalities are both contemptible and preventable. We analyze longitudinal data from 1982 to 2008 to examine the effects of blood alcohol concentration (BAC) laws on HR traffic fatalities. Our results suggest that lower BAC limits may have an unintended consequence of increasing HR fatalities, whereas a similar effect is absent for non‐HR fatalities. Specifically, we find that the adoption of a 0.08 BAC limit is associated to an 8.3% increase in HR fatalities. This unintended effect is more pronounced in urban areas and during weekends, which are typical settings for HR incidents. [ABSTRACT FROM AUTHOR]

Alcohol consumption is a major social and forensic issue. It is often the cause of road accidents, industrial accidents, suicides and other crimes. On account of this, it is of fundamental importance in forensic toxicology to correctly quantify blood alcohol concentration (BAC). In this work, a straightforward method for the quantification of ethanol from blood samples by means of headspace gas chromatography with flame ionization detection is presented and validated. For method validation linearity, limit of detection (LOD), lower limit of quantification (LLOQ), accuracy, precision (% CV) and interference studies were carried out. All the validation conditions were satisfied according to the acceptance criteria. Proof of applicability was performed on 50 real blood samples, showing that the method was effective. [ABSTRACT FROM AUTHOR]

• Alcohol impairs perception, cognition, and action in manual driving, increasing accident risk. • Higher blood alcohol concentrations (BACs) result in more significant negative effects on driving. • More experienced drivers and drivers with more frequent alcohol consumption may be less impacted by the alcohol. • Limited studies on automated vehicles show similar impairments due to alcohol as in manual driving. • Methodological biases in reviewed studies may impact generalizability of findings. • Recommendations include in-car systems and assistive driving tech to improve road safety. Introduction : Almost a third of car accidents involve driving after alcohol consumption. Autonomous vehicles (AVs) may offer accident-prevention benefits, but at current automation levels, drivers must still perform manual driving tasks when automated systems fail. Therefore, understanding how alcohol affects driving in both manual and automated contexts offers insight into the role of future vehicle design in mediating crash risks for alcohol-impaired driving. Method: This study conducted a systematic review on alcohol effects on manual and automated (takeover) driving performance. Fifty-three articles from eight databases were analyzed, with findings structured based on the information processing model, which can be extended to the AV takeover model. Results: The literature indicates that different Blood Alcohol Concentration (BAC) levels affect driving skills essential for traffic safety at various information processing stages, such as delayed reacting time, impaired cognitive abilities, and hindered execution of driving tasks. Additionally, the driver's driving experience, drinking habits, and external driving environment play important roles in influencing driving performance. Conclusions : Future work is needed to examine the effects of alcohol on driving performance, particularly in AVs and takeover situations, and to develop driver monitoring systems. Practical applications: Findings from this review can inform future experiments, AV technology design, and the development of driver state monitoring systems. [ABSTRACT FROM AUTHOR]

In December 2022, the Ministry of Health, Labour and Welfare (MHLW) of Japan issued and implemented the guideline for evaluating the effects of psychotropic drugs on motor vehicle driving performance. This guideline recommends the use of a tiered approach to assess clinically meaningful driving impairment. It is noted that adverse events cannot be solely explained by pharmacokinetics, as the onset and duration of these events vary. Among these adverse events, those affecting alertness, such as drowsiness caused by psychotropic drugs on driving performance, are more frequently observed during initial treatment stages and dose escalation. Hence, when evaluating the effects of psychotropic drugs on driving performance, it becomes crucial to assess the persistence of clinically meaningful impairment. Therefore, the MHLW guideline, developed by the authors, emphasizes the need to assess the temporal profile of adverse events affecting driving in all clinical trials. Additionally, the guideline states that when conducting driving studies, the timing of multiple dosing should consider not only the pharmacokinetics of the investigational drug but also its tolerance. [ABSTRACT FROM AUTHOR]

Abstract Measurement of ethanol above the skin surface (supradermal) is used to monitor blood alcohol concentrations (BAC) in both legal and consumer settings. Previously, the relationship between supradermal alcohol concentration (SAC) and BAC was described using partial and ordinary differential equations (PDE model: J. Appl. Physiol. 100: 649‐55, 2006). Using a range of BAC profiles by varying absorption times and peak concentrations, the PDE model accurately predicted experimental measures of SAC. Recently, other mathematical models have relied on the PDE model. This paper proposes a new approach to modeling transdermal ethanol kinetics using a mass transfer coefficient and only ordinary differential equations (ODE model). Using a range of BAC profiles, the ODE model performed very similarly to the PDE model. The ODE model had slightly slower washout rates and slightly slower times to peak SAC and to zero SAC. Similar to the PDE model, a sensitivity analysis on the ODE model showed changes in solubility and diffusivity within the stratum corneum, stratum corneum thickness, and the volume of gas above the skin affected model performance. This new model will streamline integration into larger physiologic models, reduce computation time, and decrease the time to transform skin alcohol measurements to blood alcohol concentrations.

The utility of newly developed wearable biosensors for passively, noninvasively, and continuously measuring transdermal alcohol levels in the body in real time has been limited by the fact that raw transdermal alcohol data does not consistently correlate (quantitatively or temporally) with interpretable metrics of breath and blood across individuals, devices, and the environment. A novel method using a population model in the form of a random abstract hybrid system of ordinary and partial differential equations and linear quadratic tracking control in Hilbert space was developed to estimate blood or breath alcohol concentration from the biosensor-produced transdermal alcohol level signal. Using human subject data in the form of 270 drinking episodes, the method was shown to produce estimates of blood or breath alcohol concentration that are highly correlated and, thus, good predictors of breath analyzer measurements. Moreover, although the method required some advanced offline training on a laptop or on the cloud, it produced the estimated blood or breath alcohol concentration recursively online in real time, and required only computations that could be carried out on either the biosensor's built-in processor or on a portable mobile device such as a phone or tablet. [ABSTRACT FROM AUTHOR]

The analysis of blood alcohol concentration (BAC), a pivotal toxicological test, concerns acute alcohol intoxication (AAI) and driving under the influence (DUI). As such, BAC presents an organizational challenge for clinical laboratories, with unique complexities due to the need for forensic defensibility as part of the diagnostic process. Unfortunately, a significant number of scientific investigations dealing with the subject present discrepancies that make it difficult to identify optimal practices in sample collection, transportation, handling, and preparation. This review provides a systematic analysis of the preanalytical phase of BAC that aims to identify and explain the chemical, physiological, and pharmacological mechanisms underlying controllable operational factors. Nevertheless, it seeks evidence for the necessity to separate preanalytical processes for diagnostic and forensic BAC testing. In this regard, the main finding of this review is that no literature evidence supports the necessity to differentiate preanalytical procedures for AAI and DUI, except for the traceability throughout the chain of custody. In fact, adhering to correct preanalytical procedures provided by official bodies such as European federation of clinical chemistry and laboratory medicine for routine phlebotomy ensures both diagnostic accuracy and forensic defensibility of BAC. This is shown to depend on the capability of modern pre-evacuated sterile collection tubes to control major factors influencing BAC, namely non-enzymatic oxidation and microbial contamination. While certain restrictions become obsolete with such devices, as the use of sodium fluoride (NaF) for specific preservation of forensic BAC, this review reinforces the recommendation to use non-alcoholic disinfectants as a means to achieve "error-proof" procedures in challenging operational environments like the emergency department. [ABSTRACT FROM AUTHOR]

Alcohol consumption is a major social and forensic issue. It is often the cause of road accidents, industrial accidents, suicides and other crimes. On account of this, it is of fundamental importance in forensic toxicology to correctly quantify blood alcohol concentration (BAC). In this work, a straightforward method for the quantification of ethanol from blood samples by means of headspace gas chromatography with flame ionization detection is presented and validated. For method validation linearity, limit of detection (LOD), lower limit of quantification (LLOQ), accuracy, precision (% CV) and interference studies were carried out. All the validation conditions were satisfied according to the acceptance criteria. Proof of applicability was performed on 50 real blood samples, showing that the method was effective.

Introduction: The sex difference in alcohol use disorder (AUD) is ingrained in distinctive neurobiological responses between men and women, which necessitates further investigation for a more tailored management. Methods: Minding the findings of iron dysregulation in AUD and the sex difference in iron homeostasis in multiple physiological and pathological settings, we examined the sex difference in the association between serum ferritin and blood alcohol concentration (BAC) in intoxicated males (n = 125) and females (n = 59). We included patients with both serum ferritin tested of any value and a BAC above the level of detection during the same hospital admission period. We investigated sex difference in the relationship between BAC, serum ferritin and liver enzymes in intoxicated critically ill and noncritically ill patients. Results: We found a negative association between serum ferritin and BAC in critically ill, intoxicated females [R2 = 0.44, F(1,14) = 11.02, p = 0.005], with much attenuated serum ferritin in females compared to their male counterparts (194.5 ± 280.4 vs. 806.3 ± 3405.7 ng/L, p = 0.002). We found a positive association between serum ferritin and liver enzymes [alanine transaminase (ALT) and aspartate transferase (AST)] in critically ill intoxicated females [ALT: R2 = 0.48, F(1,10) = 9.1, p = 0.013; AST: R2 = 0.68, F(1,10) = 21.2, p = 0.001] and in noncritically ill intoxicated males [ALT: R2 = 0.1, F(1,83) = 9.4, p = 0.003; AST: R2 = 0.1, F(1,78) = 10.5, p = 0.002]. The effect of BAC on serum ferritin was not mediated by ALT [indirect effect: (B = 0.13, p = 0.1)]. We also found a significant effect of sex, anemia, intensive care unit (ICU) admission and mortality on serum ferritin. Discussion: Our results suggest that high BAC in intoxicated female patients is associated with attenuated serum ferritin levels, questioning the role of low serum ferritin in female vulnerability to alcohol. [ABSTRACT FROM AUTHOR]

The objective of this study was to summarize existing knowledge on the association between driving under the influence of alcohol and road safety outcomes and to assess factors that may explain why these estimates vary. Based on studies of the association between blood alcohol concentration (BAC) levels and crashes, we used multilevel metaregression to calculate summary effects of BAC level and analyze potential moderators of the association. Based on 60 studies and 393 effect estimates, we found that BAC level, outcome severity, use of hospital data, and geographical region contributed to heterogeneity in results. The effect of BAC on crash and injury risk and culpability is stronger at higher BAC levels and for more serious outcomes. The relationship between BAC level and outcome is approximately exponential. The relationship is stronger in studies from Nordic countries than in studies from other countries, possibly because of the relatively low level of drunk driving in these countries. Studies based on hospital data and studies using non-crash-involved control groups find smaller effects on average. [ABSTRACT FROM AUTHOR]

Abstract Background Most studies have focused on injuries sustained by intoxicated drivers themselves, but few have examined the effect of drunk driving on injury outcomes among VRUs (vulnerable road users) in developing countries. This study aims to evaluate the effect of drunk driving on fatal injuries among VRUs (pedestrians, cyclists, or motorcyclists). Methods The data were extracted from the National Taiwan Traffic Crash Dataset from January 1, 2011, to December 31, 2019. Crashes involving one motorized vehicle and one VRU were considered. This study examines the effect of drunk driving by estimating multivariate logistic regression models of fatal injuries among VRUs after controlling for other variables. Results Among 1,416,168 casualties, the fatality rate of VRUs involved in drunk driving was higher than that of general road users (2.1% vs. 0.6%). Drunk driving was a significant risk factor for fatal injuries among VRUs. Other risk factors for fatal injuries among VRUs included VRU age ≥ 65 years (adjusted odds ratio [AOR]: 5.24, 95% confidence interval [CI]: 5.53–6.07), a nighttime accident (AOR: 4.52, 95% CI: 4.22–4.84), and being hit by a heavy-duty vehicle (AOR: 2.83, 95% CI: 2.26–3.55). Subgroup analyses revealed a linear relationship between driver blood alcohol concentration (BAC) and the risk of fatal injury among motorcyclists. Motorcyclists exhibited the highest fatality rate when they had a BAC ≤ 0.03% (AOR: 3.54, 95% CI: 3.08–4.08). Conclusion Drunk driving was associated with a higher risk of fatality for all VRUs. The risk of fatal injury among motorcyclists was linearly related to the BAC of the drunk drivers. Injuries were more severe for intoxicated motorcyclists, even those with BAC ≤ 0.03%, which is within the legal limit.

Background: Alcohol use disorder (AUD) treatments, including medications, are increasingly offered via telehealth. Objective: This study characterizes 90-day treatment retention and changes in objectively measured blood alcohol concentration (BAC) in a large cohort receiving AUD telehealth. Methods: Patients received AUD treatment through Ria, a virtual (telehealth) program offering AUD treatment that is tailored to patient goals (e.g. abstinence or controlled drinking). Patients were encouraged to complete breathalyzer readings twice daily for measurement-based care. We characterized rates of 90-day treatment retention (i.e. completing a BAC reading or medical/coaching encounter on the 90th day or later) and used growth curve analyses to model changes in daily estimated peak BAC over 90 days. Results: Of 4121 patients (51.5% women), 50.1% had 90-day treatment retention (n = 2066, 52.2% women). Most patients received prescriptions for AUD medications (84.6%) and completed encounters with medical providers (86.7%) and coaches (86.1%). Patients with 90-day retention provided 184,817 BAC readings in the first 90 days. Growth curve analyses revealed significant reductions in daily estimated peak BAC (p <.001) from a mean of 0.092 (day 1) to 0.038 (day 90). Similar magnitudes of BAC reduction were observed for men and women and for patients with abstinence and controlled drinking goals. Conclusion: Telehealth appears to be a viable approach to delivering AUD treatments in a manner that promotes drinking reductions. Telehealth approaches can yield reductions in objectively measured BAC, including for some patient subgroups that have historically faced greater stigma in AUD treatment settings, such as women and people with non-abstinence drinking goals. [ABSTRACT FROM AUTHOR]

IntroductionThe sex difference in alcohol use disorder (AUD) is ingrained in distinctive neurobiological responses between men and women, which necessitates further investigation for a more tailored management.MethodsMinding the findings of iron dysregulation in AUD and the sex difference in iron homeostasis in multiple physiological and pathological settings, we examined the sex difference in the association between serum ferritin and blood alcohol concentration (BAC) in intoxicated males (n = 125) and females (n = 59). We included patients with both serum ferritin tested of any value and a BAC above the level of detection during the same hospital admission period. We investigated sex difference in the relationship between BAC, serum ferritin and liver enzymes in intoxicated critically ill and noncritically ill patients.ResultsWe found a negative association between serum ferritin and BAC in critically ill, intoxicated females [R2 = 0.44, F(1,14) = 11.02, p = 0.005], with much attenuated serum ferritin in females compared to their male counterparts (194.5 ± 280.4 vs. 806.3 ± 3405.7 ng/L, p = 0.002). We found a positive association between serum ferritin and liver enzymes [alanine transaminase (ALT) and aspartate transferase (AST)] in critically ill intoxicated females [ALT: R2 = 0.48, F(1,10) = 9.1, p = 0.013; AST: R2 = 0.68, F(1,10) = 21.2, p = 0.001] and in noncritically ill intoxicated males [ALT: R2 = 0.1, F(1,83) = 9.4, p = 0.003; AST: R2 = 0.1, F(1,78) = 10.5, p = 0.002]. The effect of BAC on serum ferritin was not mediated by ALT [indirect effect: (B = 0.13, p = 0.1)]. We also found a significant effect of sex, anemia, intensive care unit (ICU) admission and mortality on serum ferritin.DiscussionOur results suggest that high BAC in intoxicated female patients is associated with attenuated serum ferritin levels, questioning the role of low serum ferritin in female vulnerability to alcohol.

Driving under the influence of alcohol is one of the greatest dangers to the safety of road users not only in Germany, but across the rest of the world. An essential indicator for both punitive and corrective measures as well as for the prediction of recidivism is the blood alcohol concentration (BAC). This paper examines the relationships between BAC of first-time offenders, former drinking history, traffic related alcohol problem (TRAP), and the outcome of a medical-psychological assessment. The concept of TRAP combines syndromes from Alcohol Use Disorders (AUD) and a non-clinical delinquency category (drink and drive issue without AUD). It is in use for diagnostics among "hard core" alcohol-impaired offenders according to a diagnostic model which is applied in Germany and accepted by the legislator. The present study (N = 505) showed that a BAC of 0.11% upwards must be considered as a risk parameter for the identification of drivers with non-normative, and therefore traffic safety impairing drinking patterns. The importance of BAC as a risk indicator for road safety is underlined by significant correlations between BAC with drinking history and TRAP, but its prognostic value is poor, since BAC was unrelated to the outcome of the medical-psychological assessment. It could be demonstrated that TRAP severity increases with higher age, higher BAC, greater number of drinking days, higher occasion-related drinking amounts, and non-social drinking motivation (against stress and tension). Practical consequences are drawn regarding preconditions for re-issuing a driving licence.

This experiment supplements the study, "Statistical comparisons of blood alcohol samples from 6‐ml and 10‐ml grey‐top tubes". The initial study analyzed fortified samples for blood alcohol concentration (BAC) using two sizes of gray‐top tubes: a 10‐ml tube containing a nominal 1% sodium fluoride (NaF), a preservative, and a 6‐ml tube containing 0.25% NaF, using the variables of time, storage temperature, fill volume, and concentration. From that study, paired t‐tests determined no difference in BAC from data sets of the two tube sizes, however, Analysis of Variance, or ANOVA, testing determined the two tube sizes yielded different results at 0.08 g/100 ml. To investigate this potential disparity, this study fortified new samples at 0.08 g/100 and focused on two variables: fill volume and storage duration, while increasing the sample population (to n = 8). For this study, the two tube types yielded equivalent concentrations under the majority of conditions studied. Differences between the two tube types were found using paired t‐test for the high‐volume samples on Days 7 and 30; ANOVA yielded the same results but also determined one additional statistical difference for the Day 30 low‐volume samples. However, the differences observed between tube sizes fall within standard deviation ranges established for the analytical method precision profile, indicating statistical differences are not analytically significant. Further studies are needed to investigate the comparability of the tubes under real‐world conditions, under which oxygen and/or additives are not added during sample preparation steps or by usage of blood bank products. [ABSTRACT FROM AUTHOR]

Background: Wrist‐worn transdermal alcohol sensors have the potential to change how alcohol consumption is measured. However, hardware and data analytic challenges associated with transdermal sensor data have kept these devices from widespread use. Given recent technological and analytic advances, this study provides an updated account of the performance of a new‐generation wrist‐worn transdermal sensor in both laboratory and field settings. Methods: This work leverages machine learning models to convert transdermal alcohol concentration data into estimates of Breath Alcohol Concentration (BrAC) in a large‐scale laboratory sample (N = 256, study 1) and a pilot field sample (N = 27, study 2). Specifically, in both studies, the accuracy of the translation is evaluated by comparing BAC estimates yielded by BACtrack Skyn to real‐time breathalyzer measurements collected in the laboratory and in the field. Results: The newest version of the Skyn device demonstrates a substantially lower error rate than older hand‐assembled prototypes (0% to 7% vs. 29% to 53%, respectively). On average, real‐time estimates of BrAC yielded by these transdermal sensors are within 0.007 of true BAC readings in the laboratory context and within 0.019 of true BrAC readings in the field. In both contexts, the distance between true and estimated BrAC was larger when only alcohol episodes were examined (laboratory = 0.017; field = 0.041). Finally, results of power‐law‐curve projections indicate that, given their accuracy, transdermal BrAC estimates in real‐world contexts have the potential to improve markedly (>25%) with adequately sized datasets for model training. Conclusion: Findings from this study indicate that the latest version of the transdermal wrist sensor holds promise for the accurate assessment of alcohol consumption in field contexts. A great deal of additional work is needed to provide a full picture of the utility of these devices, including research with large participant samples in field contexts. [ABSTRACT FROM AUTHOR]

Abstract Background Injuries account for a major proportion of global morbidity and mortality related to alcohol use. Information on the prevalence of alcohol-related injury in rural Sri Lanka is limited. The aims of this study were to determine the burden of alcohol-related injury in a hospital-based sample in rural Sri Lanka and explore factors associated with an increased risk of alcohol-related injury. Methods Involvement of alcohol in injury amongst in-patients was assessed in three hospitals in the North Central Province of Sri Lanka over 6 months. Adult (≥ 18 years) patients were eligible. Patients were assessed for: injury characteristics, current alcohol use (in the past year) using the Alcohol Use Disorder Identification Test (AUDIT), and acute intoxication. Patients with a blood alcohol concentration (BAC) reading equivalent of 10 mg/dL (2.17 mmol/L) were considered as having an alcohol-related injury. Binary logistic regression was used to explore association between alcohol-related injury and demographic and injury characteristics. Results A total of 883 injured patients were eligible and consented to the study. No alcohol use was reported by 487 (55.2%) of patients (35.6% of men, 95.2% of women). Prevalence of alcohol-related injuries was 14.8% overall and 32.8% among current alcohol users. Almost all patients with an alcohol-related injury were male (122/123; 99.2%); 24 (18.8%) of these patients scored positive for possible alcohol dependence. Patients with an alcohol-related injury had significantly higher AUDIT scores (median = 15 vs 6, p

Background: Most studies have focused on injuries sustained by intoxicated drivers themselves, but few have examined the effect of drunk driving on injury outcomes among VRUs (vulnerable road users) in developing countries. This study aims to evaluate the effect of drunk driving on fatal injuries among VRUs (pedestrians, cyclists, or motorcyclists). Methods: The data were extracted from the National Taiwan Traffic Crash Dataset from January 1, 2011, to December 31, 2019. Crashes involving one motorized vehicle and one VRU were considered. This study examines the effect of drunk driving by estimating multivariate logistic regression models of fatal injuries among VRUs after controlling for other variables. Results: Among 1,416,168 casualties, the fatality rate of VRUs involved in drunk driving was higher than that of general road users (2.1% vs. 0.6%). Drunk driving was a significant risk factor for fatal injuries among VRUs. Other risk factors for fatal injuries among VRUs included VRU age ≥ 65 years (adjusted odds ratio [AOR]: 5.24, 95% confidence interval [CI]: 5.53–6.07), a nighttime accident (AOR: 4.52, 95% CI: 4.22–4.84), and being hit by a heavy-duty vehicle (AOR: 2.83, 95% CI: 2.26–3.55). Subgroup analyses revealed a linear relationship between driver blood alcohol concentration (BAC) and the risk of fatal injury among motorcyclists. Motorcyclists exhibited the highest fatality rate when they had a BAC ≤ 0.03% (AOR: 3.54, 95% CI: 3.08–4.08). Conclusion: Drunk driving was associated with a higher risk of fatality for all VRUs. The risk of fatal injury among motorcyclists was linearly related to the BAC of the drunk drivers. Injuries were more severe for intoxicated motorcyclists, even those with BAC ≤ 0.03%, which is within the legal limit. [ABSTRACT FROM AUTHOR]

Background and aims: Transdermal alcohol sensors carry immense promise for the continuous assessment of drinking but are inconsistent in detecting more fine‐grained indicators of alcohol consumption. Prior studies examining associations between transdermal alcohol concentration (TAC) and blood/breath alcohol concentration (BAC) have yielded highly variable correlations and lag times. The current review aimed to synthesize transdermal validation studies, aggregating results from more than three decades of research to characterize the validity of transdermal sensors for assessing alcohol consumption. Methods: Databases were searched for studies listed prior to 1 March 2022 that examined associations between transdermal alcohol sensor output and blood and breath‐based alcohol measures, resulting in 31 primarily laboratory‐derived participant samples (27 precise effect sizes) including both healthy and clinical populations. Correlation coefficients and lag times were pooled using three‐level random‐effects meta‐regression. Independent raters coded study characteristics, including the body position of transdermal sensors (ankle‐ versus arm/hand/wrist‐worn device) and methodological bias (e.g. missing data). Results: Analyses revealed that, in this primarily laboratory‐derived sample of studies, the average correlation between TAC and BAC was large in magnitude [r = 0.87, 95% confidence interval (CI) = 0.80, 0.93], and TAC lagged behind BAC by an average of 95.90 minutes (95% CI = 55.50, 136.29). Device body position significantly moderated both TAC–BAC correlation (b = 0.11, P = 0.009) and lag time (b = −69.41, P < 0.001). Lag times for ankle‐worn devices were approximately double those for arm/hand/wrist‐worn devices, and TAC–BAC correlations also tended to be stronger for arm/hand/wrist‐worn sensors. Conclusions: This meta‐analysis indicates that transdermal alcohol sensors perform strongly in assessing blood/breath alcohol concentration under controlled conditions, with particular promise for the newer generation of wrist‐worn devices. [ABSTRACT FROM AUTHOR]

Aims: To estimate the effect of acute alcohol consumption on risk‐taking while gambling, examine blood alcohol concentration as a moderator and explore possible moderators of this effect. Design, Setting and Participants: A systematic review and meta‐analysis was completed. A Boolean search strategy was used to identify studies that included (a) alcohol consumption as an independent variable; (b) a gambling or risk‐taking task; (c) a control or placebo comparison; (d) human participants; and (e) English publications. Descriptive information, sample characteristics and experimental data were extracted from each study. Searched databases included: PsycINFO, Web of Science, Medline, Cochrane Library and ProQuest Dissertations and Theses. Included as participants were experiments that compared the effects of alcohol and non‐alcoholic or placebo beverages on risk‐taking while gambling. Measurement: Comprehensive Meta‐Analysis version 3.3.070 was used. Standardized mean differences of risk‐taking while gambling between the experimental and control conditions were calculated when studies did not report effect sizes. Random‐effects models were used for overall effect and meta‐regressions while mixed‐effects models were used for subgroup analyses. Findings Twenty articles containing 47 alcohol versus control comparisons met inclusion criteria. The overall Hedges'g for the difference between groups consuming alcohol and groups consuming a placebo or non‐alcoholic drink control was 0.03, 95% confidence interval (CI) = −0.07, 0.12, p = 0.60, indicating no significant difference. Larger effect sizes were found for studies using non‐alcoholic control drinks (Hedges' g = 0.30, 95% CI = 0.01, 0.58) compared to placebo beverages (Hedges' g = −0.03, 95% CI = −0.13, 0.06), Cochran's Q = 4.67, p = 0.03. Conclusions: Finding that acute alcohol consumption had no reliable effect on risk‐taking while gambling was consistent with existing animal research. No support was found for the relation between alcohol dose and risk‐taking. The significantly larger effect size for experiments using non‐alcoholic versus placebo beverages suggests the potential role of expectancy effects. [ABSTRACT FROM AUTHOR]

Race/ethnicity has been strongly associated with substance use testing but little is known about this association in injured patients. We sought to identify trends and associations between race/ethnicity and urine toxicology (UTox) or Blood Alcohol Concentration (BAC) testing in a diverse population after trauma. We conducted a retrospective cross-sectional study of adult trauma patients admitted to a single Level-1 trauma center from 2012 to 2019. The prevalence of substance use testing was evaluated over time and analyzed using a multivariable logistic regression, with a subgroup analysis to evaluate the interaction of English language proficiency with race/ethnicity in the association of substance use testing. A total of 15,556 patients (40% White, 13% Black, 24% Latinx, 20% Asian, and 3% Native or Unknown) were included. BAC testing was done in 63.2% of all patients and UTox testing was done in 39.2%. The prevalence of substance use testing increased over time across all racial/ethnic groups. After adjustment, Latinx patients had higher odds of receiving a BAC test and Black patients had higher odds of receiving a UTox test (P < 0.001 and P < 0.001, respectively) compared to White patients. Asian patients had decreased odds of undergoing a UTox or BAC test compared to White patients (P < 0.001 and P < 0.001, respectively). Patients with English proficiency had higher odds of undergoing substance use testing compared to those with limited English proficiency (P < 0.001). Despite an increase in substance use testing over time, inequitable testing remained among racial/ethnic minorities. More work is needed to combat racial/ethnic disparities in substance use testing. [ABSTRACT FROM AUTHOR]

Background and aims: In the United States, until 2018 both the prevalence of heavy alcohol use and the suicide mortality rate increased among men and women; however, women had experienced a notably higher increase in both. As heavy alcohol use may have contributed to the observed sex disparity in the suicide mortality rate increase, the aim of the current study was to estimate the temporal trend of the sex‐ and age‐group‐specific proportion of suicides that were alcohol‐involved in the United States. Design: Using restricted‐access data from the National Violent Death Reporting System, we performed joinpoint regression analyses to investigate temporal trends in the sex‐ and age‐group (young adults = 18–34 years; middle‐aged adults = 35–64 years; and older adults = 65+ years)‐specific proportion of suicides that were alcohol‐involved. Setting: United States. Participants: A total of 115 202 suicide decedents 18+ years of age from 2003 to 2018. Measurements The sex‐ and age‐group‐specific proportion of suicides that were alcohol‐involved, among all suicide decedent, for which the decedent had a blood alcohol concentration (BAC) (a) ≥ 0.04 g/dl and (b) ≥ 0.08 g/dl. Findings For 2003–18, the proportion of suicides that were alcohol‐involved wherein the decedent had a BAC ≥ 0.08 g/day significantly increased on average annually for women of all age groups [young women: 2.80%, 95% confidence interval (CI) = 1.86%, 3.75%; middle‐aged women: 2.20%, 95% CI = 1.20%, 3.21%; older women: 10.48%, 95% CI = 1.17%, 20.65%], while only middle‐aged men experienced a significant average annual percentage increase (0.81%, 95% CI = 0.003%, 1.62%). Conclusion: In the United States between 2003 and 2018, alcohol use preceding death by suicide increased among women compared with men. [ABSTRACT FROM AUTHOR]

The posterior distribution (PD) of random parameters in a distributed parameter-based population model for biosensor measured transdermal alcohol is estimated. The output of the model is transdermal alcohol concentration (TAC), which, via linear semigroup theory can be expressed as the convolution of blood or breath alcohol concentration (BAC or BrAC) with a filter that depends on the individual participant or subject, the biosensor hardware itself, and environmental conditions, all of which can be considered to be random under the presented framework. The distribution of the input to the model, the BAC or BrAC, is also sequentially estimated. A Bayesian approach is used to estimate the PD of the parameters conditioned on the population sample's measured BrAC and TAC. We then use the PD for the parameters together with a weak form of the forward random diffusion model to deconvolve an individual subject's BrAC conditioned on their measured TAC. Priors for the model are obtained from simultaneous temporal population observations of BrAC and TAC via deterministic or statistical methods. The requisite computations require finite dimensional approximation of the underlying state equation, which is achieved through standard finite element (i.e., Galerkin) techniques. The posteriors yield credible regions, which remove the need to calibrate the model to every individual, every sensor, and various environmental conditions. Consistency of the Bayesian estimators and convergence in distribution of the PDs computed based on the finite element model to those based on the underlying infinite dimensional model are established. Results of human subject data-based numerical studies demonstrating the efficacy of the approach are presented and discussed.

Background: Only a few studies investigated the evolution of characteristics of patients presenting at the emergency department (ED) due to alcohol intoxication. The aim of this study was to investigate the evolution of three patient characteristics: age, gender, and blood alcohol concentration (BAC). Methods: A retrospective review of medical records of patients visiting the ED at two large university hospitals in Belgium was performed. All patients older than 16 years, presenting to the ED with a primary diagnosis of alcohol intoxication in 2009 were compared with those presenting in 2014. Results: Both hospitals had a marked increase in visits due to alcohol intoxication. Male-to-female ratio in one hospital showed a redistribution toward women, whereas this remained stable in the other hospital. Average BAC remained stable in both sexes and hospitals. More severe BAC-levels (>3 g/l) diminished in male patients of one hospital but kept stable in women. The other hospital showed no change in more severe BAC-levels (>3 g/l) of both sexes. Conclusion: Since total alcohol consumption in Belgium decreased, but total number of alcohol intoxicated patients increased in both hospitals, there probably has been a change in alcohol consumption pattern. Changes in the characteristics of patients visiting the ED due to alcohol intoxication still turns out to be demographic dependent, since the tendency of more young patients presenting could only be observed in one out of two hospitals. Implementing a screening method for alcohol abuse should be considered at the ED. [SJEMed 2021; 2(1.000): 48-53]

Transdermal alcohol biosensors that do not require active participation of the subject and yield near continuous measurements have the potential to significantly enhance the data collection abilities of alcohol researchers and clinicians who currently rely exclusively on breathalyzers and drinking diaries. Making these devices accessible and practical requires that transdermal alcohol concentration (TAC) be accurately and consistently transformable into the well-accepted measures of intoxication, blood alcohol concentration/breath alcohol concentration (BrAC). A novel approach to estimating BrAC from TAC based on covariate-dependent physics-informed hidden Markov models (HMMs) with two emissions is developed. The hidden Markov chain serves as a forward full-body alcohol model with BrAC and TAC, the two emissions, assumed to be described by a bivariate normal which depends on the hidden Markovian states and person-level and session-level covariates via built-in regression models. An innovative extension of hidden Markov modeling is developed wherein the HMM framework is regularized by a first-principles PDE model to yield a hybrid that combines prior knowledge of the physics of transdermal ethanol transport with data-based learning. Training, or inverse filtering, is effected via the Baumâ€"Welch algorithm and 256 sets of BrAC and TAC signals and covariate measurements collected in the laboratory. Forward filtering of TAC to obtain estimated BrAC is achieved via a new physics-informed regularized Viterbi algorithm which determines the most likely path through the hidden Markov chain using TAC alone. The Markovian states are decoded and used to yield estimates of BrAC and to quantify the uncertainty in the estimates. Numerical studies are presented and discussed. Overall good agreement between BrAC data and estimates was observed with a median relative peak error of 22% and a median relative area under the curve error of 25% on the test set. We also demonstrate that the physics-informed Viterbi algorithm eliminates non-physical artifacts in the BrAC estimates. [ABSTRACT FROM AUTHOR]

Driving under the influence of alcohol is one of the greatest dangers to the safety of road users not only in Germany, but across the rest of the world. An essential indicator for both punitive and corrective measures as well as for the prediction of recidivism is the blood alcohol concentration (BAC). This paper examines the relationships between BAC of first-time offenders, former drinking history, traffic related alcohol problem (TRAP), and the outcome of a medical-psychological assessment. The concept of TRAP combines syndromes from Alcohol Use Disorders (AUD) and a non-clinical delinquency category (drink and drive issue without AUD). It is in use for diagnostics among "hard core" alcohol-impaired offenders according to a diagnostic model which is applied in Germany and accepted by the legislator. The present study (N = 505) showed that a BAC of 0.11% upwards must be considered as a risk parameter for the identification of drivers with non-normative, and therefore traffic safety impairing drinking patterns. The importance of BAC as a risk indicator for road safety is underlined by significant correlations between BAC with drinking history and TRAP, but its prognostic value is poor, since BAC was unrelated to the outcome of the medical-psychological assessment. It could be demonstrated that TRAP severity increases with higher age, higher BAC, greater number of drinking days, higher occasion-related drinking amounts, and non-social drinking motivation (against stress and tension). Practical consequences are drawn regarding preconditions for re-issuing a driving licence. [ABSTRACT FROM AUTHOR]

Background: Injuries account for a major proportion of global morbidity and mortality related to alcohol use. Information on the prevalence of alcohol-related injury in rural Sri Lanka is limited. The aims of this study were to determine the burden of alcohol-related injury in a hospital-based sample in rural Sri Lanka and explore factors associated with an increased risk of alcohol-related injury.Methods: Involvement of alcohol in injury amongst in-patients was assessed in three hospitals in the North Central Province of Sri Lanka over 6 months. Adult (≥ 18 years) patients were eligible. Patients were assessed for: injury characteristics, current alcohol use (in the past year) using the Alcohol Use Disorder Identification Test (AUDIT), and acute intoxication. Patients with a blood alcohol concentration (BAC) reading equivalent of 10 mg/dL (2.17 mmol/L) were considered as having an alcohol-related injury. Binary logistic regression was used to explore association between alcohol-related injury and demographic and injury characteristics.Results: A total of 883 injured patients were eligible and consented to the study. No alcohol use was reported by 487 (55.2%) of patients (35.6% of men, 95.2% of women). Prevalence of alcohol-related injuries was 14.8% overall and 32.8% among current alcohol users. Almost all patients with an alcohol-related injury were male (122/123; 99.2%); 24 (18.8%) of these patients scored positive for possible alcohol dependence. Patients with an alcohol-related injury had significantly higher AUDIT scores (median = 15 vs 6, p < 0.001), were significantly more likely to be aged 26-40 (OR 2.29, 95% CI:1.11, 4.72) or 41-55 years (OR 2.76, 95% CI: 1.29, 5.90) (compared to 18-25 years), to have a transport-related injury (OR 5.14, 95% CI: 2.30, 11.49) (compared to animal/plant sting/bite), and have intentional injuries (OR 3.47, 95% CI: 1.01, 11.87).Conclusions: One in three injuries among people who drank alcohol in this sample were alcohol-related. In addition, problematic alcohol use was higher among those with alcohol-related injury. Further work is needed to explore whether this prevalence of alcohol-related injury is reflected in other rural settings in Sri Lanka. [ABSTRACT FROM AUTHOR]

Background: Alcohol use disorder is a chronic disorder with a high likelihood of relapse. The consistent monitoring of blood alcohol concentration through breathalyzers is critical to identifying relapse or misuse. Smartphone apps as a replacement of or in conjunction with breathalyzers have shown limited effectiveness. Yet, there has been little research that has effectively utilized wireless or Wi-Fi--enabled breathalyzers that can accurately, securely, and reliably measure blood alcohol concentration. Objective: The purpose of this study is to evaluate the impact of a wireless blood alcohol concentration device in collaboration with long-term treatment on dropout rates, psychological distress, treatment motivation, quality of life, and need for higher levels of follow-up care for patients with alcohol use disorder. Methods: The randomized clinical trial will include two arms, access to the wireless breathalyzer versus no access to the breathalyzer, while both groups have access to treatment. Evaluation will last 3 months with a 6-week follow-up, during which each participant will be interviewed at admission, 1 month in, 2 months in, 3 months in, and follow-up. Individuals will be recruited online through a secure telehealth meeting invitation. Outcomes will focus on the impact of the wireless breathalyzer within the alcohol use disorder population, and the combined effect on psychological distress, treatment motivation, and quality of life. In addition, we intend to investigate the impact of the breathalyzer on dropout rates and participants'need for higher levels of follow-up care and treatment. Results: The recruitment of this study started in July 2020 and will run until 2022. Conclusions: This information will be important to develop cost-effective treatments for alcohol dependence. Ongoing monitoring allows treatment providers to take an individualized disease management approach and facilitates timely intervention by the treatment provider. [ABSTRACT FROM AUTHOR]

Purpose: This review presents the current methods used for determining ethyl glucuronide (EtG) and ethyl sulfate (EtS) concentrations in postmortem specimens, including sample preparation, analysis and the role of EtG and EtS in the postmortem assessment of the extent of alcohol abuse. Methods: Papers pertaining to postmortem investigation were collected from scientific databases and reviewed. The papers were published between January 2006 and October 2020. Results: Most of the analyses involved postmortem blood and urine samples, with a few reports using other bodily specimens and tissues. The method validation was not conducted for all applications. These reports were mostly intended to present data rather than interpret them, and the lack of effort in relating these ethanol biomarkers with the cause of death and/or determination of the time of deaths due to ethanol intoxication might decrease the applicability of these makers after a promising start between 2006 and 2010. Nevertheless, by the beginning of 2020, papers investigating ethanol biomarkers were still increasing. A considerable number of methods used liquid chromatography coupled with mass spectrometry (LC-MS) techniques that require less sample preparation (e.g., protein precipitation extraction, dilution, filtration, and centrifugation). Although solid-phase extraction can be applied, only three applications were reported. Conclusions: Matrix effects can be a substantial challenge in analytical methods based on LC–MS because they directly affect the ionization of analytes. However, these problems can be avoided due to the high cutoff values used to identify positive results for these ethanol biomarkers, which are often above 0.1–1 mg/L, and using internal standards. Research on using tissue specimens is recommended as most of the reported results on this type of specimen were promising. [ABSTRACT FROM AUTHOR]

Purpose: A significant number of patients with traumatic brain injuries (TBI) are diagnosed with elevated blood alcohol concentration (BAC). Recent literature suggests a neuroprotective effect of alcohol on TBI, possibly associated with less morbidity and mortality. Our goal is to analyze the association of different levels of BAC with TBI characteristics and outcome. Methods: Adult patients with moderate to severe TBI (AIS ≥ 2) and measured BAC admitted to the Trauma Centre West (TCW), during the period 2010–2015, were retrospectively analyzed. Data included injury severity (AIS), length of hospitalization, admittance to the Intensive Care Unit (ICU) and in-hospital mortality. The association of BAC with ICU admittance and in-hospital mortality was analyzed using multivariable logistic regression analysis with correction for potentially confounding variables. Results: BACs were available in 2,686 patients of whom 42% had high, 26% moderate, 6% low and 26% had normal levels. Patients with high BAC's were predominantly male, were younger, had lower ISS scores, lower AIS-head scores and less concomitant injuries compared to patients in the other BAC subgroups. High BACs were associated with a lower risk for in-hospital mortality (AOR 0.36, 95% CI 0.14–0.97). Also, patients with moderate and high BACs were less often admitted to the ICU (respectively, AOR 0.36, 95% CI 0.25–0.52 and AOR 0.40, 95% CI 0.29–0.57). Conclusion: The current study suggests that in patients with moderate to severe TBI, increasing BACs are associated with less severe TBI, less ICU admissions and a higher survival. Further research into the pathophysiological mechanism is necessary to help explain these findings. [ABSTRACT FROM AUTHOR]

Death due to acute alcohol poisoning lacks specific anatomical characteristics, compared with other deaths due to drug poisoning. We report three forensic cases of death from acute alcohol poisoning due to inhibition of the respiratory centre and eventual asphyxia. Blood alcohol concentrations in the three fatalities were 5.28, 3.33 and 3.78 mg/mL, respectively. Lethal doses and blood alcohol concentrations showed differences between individuals. Detailed auxiliary tests besides autopsy were undertaken. These cases show that forensic scientists should exclude other causes of death, combine the autopsy with auxiliary tests, and then make an appraisal.

Although they comprise a relatively small subset of all traffic deaths, hit-and-run (HR) fatalities are both contemptible and preventable. We analyze longitudinal data from 1982 to 2008 to examine the effects of blood alcohol concentration (BAC) laws on HR traffic fatalities. Our results suggest that lower BAC limits may have an unintended consequence of increasing HR fatalities, whereas a similar effect is absent for non-HR fatalities. Specifically, we find that the adoption of a 0.08 BAC limit is associated to an 8.3% increase in HR fatalities. This unintended effect is more pronounced in urban areas and during weekends, which are typical settings for HR incidents., (© 2024 The Authors. Risk Analysis published by Wiley Periodicals LLC on behalf of Society for Risk Analysis.)

Background/Objective: The aim of the study was to evaluate the diagnostic usefulness of changes in transferrin isoforms, especially disialo-Tf, in identifying binge drinking children and adolescents admitted to hospital emergency. Methods: The study group consisted of 122 ambulatory children and adolescents below 18 years of age and 30 healthy subjects. From the group of drinkers, those with acute alcohol intoxication (AAI) were identified (ICD-11, code F10.0). The isoforms of transferrin were separated by capillary electrophoresis into five major fractions: asialo-Tf, disialo-Tf, trisialo-Tf, tetrasialo-Tf, and pentasialo-Tf. The differences between binge drinking youth and nondrinking subjects were evaluated by Mann-Whitney U-test. Results: In the total study group and in both genders, the concentration of disialo-Tf was significantly higher in the binge drinkers compared to the nondrinking youth ( p = 0.006). With respect to the gender, the level of disialo-Tf was significantly higher in binge drinking than nondrinking girls ( p = 0.028) and the value of trisialo-Tf was lower in binge drinking than nondrinking boys ( p = 0.011). In the AAI subgroup, the concentrations of disialo-Tf and tetrasialo-Tf were significantly higher in comparison to nondrinking subjects ( p = 0.002, p = 0.039, respectively). There were no significant correlations between the BAC and the transferrin isoforms in the total group and the AAI subgroup. The disialo-Tf reached the highest diagnostic power (AUC = 0.718) in identifying binge drinkers at diagnostic specificity and sensitivity of 86.7% and 51.6%, respectively (at cut-off 0.70), in the total group and it was growing up to AUC = 0.761 with the diagnostic sensitivity of 60% in the AAI subgroup. Conclusions: The disialo-Tf might be a useful biomarker to identify binge drinking children and adolescents.

The serotonin (5‐HT) system has been implicated in the pathophysiology of alcohol (ethanol; EtOH) use disorders. Lorcaserin, a 5‐HT2C receptor agonist, attenuates drug self‐administration in animal models. We investigated the effects of lorcaserin on EtOH intake using the drinking‐in‐the‐dark (DID) procedure, an animal model of binge‐like drinking. We compared the effects of lorcaserin to those of the Food and Drug Administration (FDA)‐approved drug naltrexone and examined the effects of combining lorcaserin and naltrexone. To examine whether effects were specific for EtOH, we examined the effects of lorcaserin and naltrexone, administered alone and in combination, on saccharin intake. Adult male C57BL/6J mice received EtOH access (20% v/v) for 2 h in the home‐cage during the first 3 days of the DID procedure, beginning 3 h into the dark cycle. On day 4, mice were injected with lorcaserin, naltrexone, or a combination of lorcaserin and naltrexone prior to a 4‐h EtOH access. Intake was measured at 2 and 4 h. Lorcaserin reduced EtOH intake in a dose‐dependent fashion over the 2‐ and 4‐h measurement periods. Naltrexone also reduced EtOH intake when administered alone, with dose‐dependent effects being more pronounced over 2 h rather than the full 4‐h session. Combining lorcaserin and naltrexone reduced binge‐like EtOH drinking to a greater extent than either drug alone. A similar pattern of results was obtained for saccharin intake. These results suggest that lorcaserin and naltrexone can have additive effects on binge‐like EtOH drinking. They also support continued research into the therapeutic potential of lorcaserin for alcohol use disorders. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to assess the prevalence of drinking and driving on roadways in urban areas and highways in Cameroon, and to determine the associations between drinking and driving and socio-demographic factors.Methods: A cross-sectional study of motor vehicle drivers was performed on Fridays, Saturdays, and Sundays between May and September 2020 with three driver groups: (1) random motor vehicle drivers (including riders) on major highways, (2) drivers recruited at car stations in Yaoundé, and (3) at fuel stations in Douala. Alcohol was measured using breathalyzers, and a questionnaire collected socio-demographic data.Results: In total, 2402 motor vehicle drivers were asked to participate in the study and 1701 (70.8%) gave informed consent. The vast majority (98.6%) were men. Drivers aged 30-39 years constituted the largest age group on highways and in Yaoundé, whereas 18-29 years was the largest age group in Douala. The highest prevalence of alcohol was observed among drivers in Yaoundé, which included mainly clandestine taxi car drivers and motorcycle taxi riders, where about 30% had blood alcohol concentrations (BAC) above the legal limit of 0.08%. The proportion with BACs above the legal limit was about 6% among the drivers in Douala, which included mainly motorcycle taxi riders, and about 4% among drivers on highways.Conclusions: The findings indicate that drinking and driving is a major traffic safety problem on Cameroonian public roads, especially among motorcycle taxi riders and clandestine taxi drivers in towns, which represent the major mass transportation means in the country. Drinking and driving education and legislation should be better developed and enforced in order to reduce the number road traffic crashes. [ABSTRACT FROM AUTHOR]

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Introduction:Rhodiola rosea (RR) and Rhodiola kirilowii (RK) are well known for their influence on central nervous system, however their impact on the development of alcohol tolerance has not yet been proven.

Background and aims: Debates regarding lowering the blood alcohol concentration (BAC) limit for drivers are intensifying in the United States and other countries, and the World Health Organization recommends that the limit for adults should be 0.05%. In January 2016, Uruguay implemented a law setting a zero BAC limit for all drivers. This study aimed to assess the effect of this policy on the frequency of moderate/severe injury and fatal traffic crashes. Design A quasi‐experimental study in which a synthetic control model was used with controls consisting of local areas in Chile as the counterfactual for outcomes in Uruguay, matched across population counts and pre‐intervention period outcomes. Sensitivity analyses were also conducted. Setting: Uruguay and Chile. Cases Panel data with crash counts by outcome per locality‐month (2013–2017). Intervention and comparator: A zero blood alcohol concentration law implemented on 9 January 2016 in Uruguay, alongside a continued 0.03 g/dl BAC threshold in Chile. Measurements Per‐capita moderate/severe injury (i.e. moderate or severe), severe injury and fatal crashes (2013–2017). Findings Our base synthetic control model results suggested a reduction in fatal crashes at 12 months [20.9%; P‐value = 0.018, 95% confidence interval (CI) = −0.340, −0.061]. Moderate/severe injury crashes did not decrease significantly (10.2%, P = 0.312, 95% CI = −0.282, 0.075). The estimated effect at 24 months was smaller and with larger confidence intervals for fatal crashes (14%; P = 0.048, 95% CI = −0.246, −0.026) and largely unchanged for moderate/severe injury crashes (−9.4%, P = 0.302, 95% CI = −0.248, 0.058). Difference‐in‐differences analyses yielded similar results. As a sensitivity test, a synthetic control model relying on an inferior treatment–control match pre‐intervention (measured by mean squared error) yielded similar‐sized differences that were not statistically significant. Conclusions: Implementation of a law setting a zero blood alcohol concentration threshold for all drivers in Uruguay appears to have resulted in a reduction in fatal crashes during the following 12 and 24 months. [ABSTRACT FROM AUTHOR]

Background: Although alcohol breath testing devices that pair with smartphones are promoted for the prevention of alcohol‐impaired driving, their accuracy has not been established. Methods: In a within‐subjects laboratory study, we administered weight‐based doses of ethanol to two groups of 10 healthy, moderate drinkers aiming to achieve a target peak blood alcohol concentration (BAC) of 0.10%. We obtained a peak phlebotomy BAC and measured breath alcohol concentration (BrAC) with a police‐grade device (Intoxilyzer 240) and two randomly ordered series of 3 consumer smartphone‐paired devices (6 total devices) with measurements every 20 min until the BrAC reached <0.02% on the police device. Ten participants tested the first 3 devices, and the other 10 participants tested the other 3 devices. We measured mean paired differences in BrAC with 95% confidence intervals between the police‐grade device and consumer devices. Results: The enrolled sample (N = 20) included 11 females; 15 white, 3 Asian, and 2 Black participants; with a mean age of 27 and mean BMI of 24.6. Peak BACs ranged from 0.06–0.14%. All 7 devices underestimated BAC by >0.01%, though the BACtrack Mobile Pro and police‐grade device were consistently more accurate than the Drinkmate and Evoc. Compared with the police‐grade device measurements, the BACtrack Mobile Pro readings were consistently higher, the BACtrack Vio and Alcohoot measurements similar, and the Floome, Drinkmake, and Evoc consistently lower. The BACtrack Mobile Pro and Alcohoot were most sensitive in detecting BAC driving limit thresholds, while the Drinkmate and Evoc devices failed to detect BAC limit thresholds more than 50% of the time relative to the police‐grade device. Conclusions: The accuracy of smartphone‐paired devices varied widely in this laboratory study of healthy participants. Although some devices are suitable for clinical and research purposes, others underestimated BAC, creating the potential to mislead intoxicated users into thinking that they are fit to drive. [ABSTRACT FROM AUTHOR]