Blood alcohol concentration as a measure of risk among pedestrian fatalities in the U.S., 2016-2020

OBJECTIVE

In the United States, deaths among pedestrians have increased dramatically since 2009 relative to other vulnerable road users, with substance use described as an important risk factor. This study aimed to explore blood alcohol concentrations (BAC g/dL) among pedestrian fatalities in the United States between 2016 and 2020. Exploring the presence of alcohol among pedestrian cases will support targeted interventions designed to reduce risk.

METHODS

This study utilized pedestrian fatality and alcohol screening data provided by the Fatality Analysis Reporting System (FARS). Logistic models were examined to identify statistical associations (ORs, 95% CI) by age, race, and sex relative to positive BAC exposure (BAC > 0.0 g/dL), mild exposure (BAC > 0.0 < .079 g/dL), moderate to severe alcohol exposure (BAC 0.08-.299 g/dL), and severe exposure (BAC ≥ 0.30 g/dL).

RESULTS

Between 2016 and 2020, 33,375 pedestrian fatalities were reported to FARS with 75.1% of cases retained for analysis (n = 25,077). Fatalities were more likely to be White (69.3%), male (69.9%), and between 25-64 years of age (67.3%). 74.0% of fatalities were tested for alcohol, with 40.9% screening positive. Females, cases ≥ 75 years of age, and those identified as Asians reported the lowest odds of being positive for alcohol exposure.

CONCLUSIONS

Results suggest an ongoing threat to pedestrians due to alcohol consumption and that exposure odds vary by demographic characteristics. Unfortunately, analytical approaches to understanding the roles played by drugs and alcohol among vulnerable road users tend to be marginalized in the literature. Analytical, evidence-based investigations are needed to curtail the risk of pedestrian fatalities in the U.S.

Introspective Learning From Interprofessional Virtual Grand Rounds

BACKGROUND

Interprofessional collaboration in health care settings improves patient safety and outcomes, yet collaboration among health professionals requires specific competencies and skills. Providing nursing students with interprofessional learning experiences with multiple health professions is possible yet challenging.

PROBLEM

Opportunities for effective online interprofessional learning are lacking.

APPROACH

This article explores nursing students' reflections on how an interprofessional learning experience, Virtual Grand Rounds (VGRs), influenced their personal development and provided meaningful learning that they can use in their practices as professional nurses. Thematic analysis was done on the open-ended questions in students' final reflection assignment.

OUTCOMES

Analysis of student reflections identified 5 learning themes including the value of teamwork and collaboration, the importance of communication skills, professional identity, plans to engage diverse health professions, and the desire for future learning.

CONCLUSIONS

Student reflections indicate the VGR was an effective method for nursing students to experience collaboration with multiple health professions without disrupting curriculums.

Impact of Service Learning on Student Attitudes Toward the Poor and Underserved

BACKGROUND

Patient-centered care necessitates an appreciation of one's socioeconomic status and its influence on health and well-being.

PURPOSE

We explored how student attitudes toward poverty changed as a result of participation in an interprofessional service-learning experience.

METHODS

Students from 6 health profession programs participated in an interprofessional military-sponsored free health care event serving nearly 8000 individuals from our community. Students' pre-post attitudes toward poverty were measured using the Attitude Toward Poverty Short Form (ATP-SF) and Beliefs About the Relationship Between Poverty and Health (BRPH) scale.

RESULTS

Two subscales and 14 items on the ATP-SF and 3 items on the BRPH had significant differences between their pre and post experience. Students expressed less bias, a decrease in stereotypic views, and a heightened willingness to advocate on behalf of those with limited means of support.

CONCLUSION

Findings suggest that experiential, transformative service learning has a positive impact on students' attitudes toward poverty and the underserved.

Delirium: Why Are Nurses Confused?

Nurses have a key role in detection of delirium, yet this condition remains under recognized and poorly managed. The aim of this study was to explore nurses' knowledge of delirium-related information as well as their perception of their level of knowledge.

Neuronal injury in hippocampus with human immunodeficiency virus transactivating protein, Tat

Patients with human immunodeficiency virus infection may develop a dementing illness. Using both in vitro and in vivo models, we investigated the susceptibility of the hippocampal formation to the Tat protein of human immunodeficiency virus. We also determined the pattern of hippocampal injury in patients with human immunodeficiency virus encephalitis. Following exposure of hippocampal slices to Tat, marked susceptibility of CA3 region with relative insensitivity of the CA1/2 region was observed. Injection of Tat into different regions of the rat hippocampus produced similar neuronal loss in both CA3 region and the dentate gyrus. In animals administered Tat, lesions were dose-dependent and immunohistochemical staining showed marked gliosis and loss of microtubule associated protein-2 in the affected areas at 3 days post-injection. Interestingly, synaptophysin staining was relatively preserved. In hippocampal tissue from patients with human immunodeficiency virus encephalitis, loss of microtubule-associated protein-2 staining was reduced in the molecular layer of the dentate gyrus. The results of our experiments demonstrate a unique pattern of hippocampal injury in organotypic culture and rats exposed to Tat. Our observations that patients with human immunodeficiency virus reveal a similar pattern of damage suggests that Tat protein may be pathophysiological relevant in human immunodeficiency virus encephalitis.

Sphingolipids are potential heat stress signals in Saccharomyces

The ability of organisms to quickly respond to stresses requires the activation of many intracellular signal transduction pathways. The sphingolipid intermediate ceramide is thought to be particularly important for activating and coordinating signaling pathways during mammalian stress responses. Here we present the first evidence that ceramide and other sphingolipid intermediates are signaling molecules in the Saccharomyces cerevisiae heat stress response. Our data show a 2-3-fold transient increase in the concentration of C18-dihydrosphingosine and C18-phytosphingosine, more than a 100-fold transient increase in C20-dihydrosphingosine and C20-phytosphingosine, and a more stable 2-fold increase in ceramide containing C18-phytosphingosine and a 5-fold increase in ceramide containing C20-phytosphingosine following heat stress. Treatment of cells with dihydrosphingosine activates transcription of the TPS2 gene encoding a subunit of trehalose synthase and causes trehalose, a known thermoprotectant, to accumulate. Dihydrosphingosine induces expression of a STRE-LacZ reporter gene, showing that the global stress response element, STRE, found in many yeast promoter sequences can be activated by sphingolipid signals. The TPS2 promoter contains four STREs that may mediate dihydrosphingosine responsiveness. Using genetic and other approaches it should be possible to identify sphingolipid signaling pathways in S. cerevisiae and quantify the importance of each during heat stress.

Effect of lumbar sympathectomy in distal arterial obstruction

We developed a model that simulates distal arterial occlusive disease to determine the effects of sympathectomy on certain hemodynamic changes. Two groups of seven dogs each received unilateral distal popliteal artery ligation. Intra-arterial BPs, angiography, pulse volume recordings (PVRs), and photoplethysmograms were taken of the distal hind limb throughout the experiment. After ligation, PVR and distal hind limb pressures were lowered to less than half of the preligation values. Four days after unilateral distal popliteal artery ligation, group 2 dogs received lumbar sympathectomy on the same side as the ligation. One week after sympathectomy, the PVR amplitudes and pressures showed a transient significant rise. Two weeks after sympathectomy, the PVR pressures and amplitudes returned to the previous, diminished postligation values.

Droperidol-fentanyl as an aid to blood collection in rabbits

Administration of a droperidol-fentanyl combination to laboratory rabbits at a dose of 2.5 mg/kg and 0.05 mg/kg body weight, respectively, produced vasodilatation which greatly facilitated blood withdrawal from the central auricular artery. The method eliminated the need for vacuum devices or topical irritants and posed little risk or discomfort to the animal.

Testing and treatment of arterial graft thrombosis

The in vivo technique of Sauvage et al for determining prosthetic arterial graft thrombogenicity was employed in the sheep carotid model using 4 mm commercial expanded polytetrafluoroethylene (Gore-Tex) grafts. Expanded polytetrafluoroethylene was found to be thrombogenic at 4 hours of low flow in this model. At 24 hours all of these grafts were totally occluded at low flow rates. Intravenous use of ibuprofen (Motrin), a thromboxane inhibitor, in this model markedly reduced occlusion and thrombogenicity at 4 and 24 hours. All grafts were patent at 24 hours when ibuprofen was used.

Platelet function and coagulation parameters in sheep during experimental vascular surgery

Various clotting parameters (prothrombin time, activated coagulation time, activated partial thromboplastin time, platelet counts, and platelet aggregation) were obtained from unanesthetized sheep and from sheep at various times during 5 hours of vascular surgery. The values obtained were not influenced by anesthesia and surgery and were consistent between sheep. Ovine platelets were less prone to aggregate in the presence of collagen, epinephrine, and ristocetin than those of man. Platelet aggregation induced by adenosine diphosphate was similar to that seen in man. Based on these parameters, the sheep would seem to be a reasonable model for experimental vascular surgery when results are to be applied to man.

Reaction of methyl azidoformate with norbornene

The thermal reaction of methyl azidoformate and norbornene has been found to proceed via 1,3-dipolar-cycloaddition yielding exo triazoline adduct, 15a. Thermal decomposition of the triazoline results in the loss of nitrogen and the formation of at least 5 products. The major products of the thermal decomposition in decalin were 3-carbomethoxy-3-azatricyclo(3.2.1.02,4 exo)octane, 18a, and N-carbomethoxy-2-norbornimine, 20. In addition, syn-2-norbornene-7-methyl carbamate, 21, and 3-carbomethoxy-3-azatricyclo(3.2.1.02,3 endo)octane, 19a, were isolated. The thermal decomposition of the triazoline adduct is considered to proceed by a multi-step mechanism. The first step is considered to involve heterolytic cleavage of the N3—N4 bond togive a zwitterion which may lead to products or rearrange via carbon–carbon bond cleavage to give a diazoalkyl imine.