Blood Alcohol Research Articles

Ethanol stability from nine years of a blind quality control program in blood alcohol analysis.

A blind quality control (BQC) program in blood alcohol analysis was implemented at the Houston Forensic Science Center (HFSC) in September 2015. By mimicking authentic toxicology blood evidence, the laboratory can perform a concurrent evaluation of their technical and administrative casework procedures and test the accuracy and reliability of their volatile analysis method in a format that is blinded to the analyst. From September 2015 to November 2023, HFSC's Quality Division submitted 1228 antemortem whole blood samples: 292 ethanol-negative samples and 936 ethanol-positive samples at sixteen target concentrations (0.051, 0.080, 0.100, 0.110, 0.120, 0.130, 0.150, 0.160, 0.170, 0.180, 0.190, 0.200, 0.230, 0.240, 0.250, and 0.260 g/dL). A second, unopened blood tube in 168 of the 1228 BQCs was also analyzed after 721-1140 days: 24 ethanol-negative samples and 144 ethanol-positive samples at five target concentrations (0.080, 0.100, 0.130, 0.180, and 0.240 g/dL). All 316 ethanol-negative samples remained negative. After 42-758 days, the average (median, range) change in ethanol concentration of the 936 positive samples was -1.4% (-1.3%, -12.0% to +8.4%) with a statistically significant difference (P < 0.001) observed for the gradual decline in blood alcohol concentration (BAC) over time. The average BAC percentage differences per target concentration, ranged from -6.4% (-0.008 g/dL) to +5.7% (+0.011 g/dL), were within HFSC's current measurement uncertainty (9.4% at k=3), showing no apparent correlation between the change in ethanol and the theoretical target concentration. As the analysis time between the two blood specimens from the same evidence kit extended, the loss in ethanol significantly increased (P < 0.001).

Alcohol related emergencies among adolescents admitted in a referral acute-care center for adults in Genoa, northwest Italy

Abstract Background As a result of underage drinking, adolescents have an increased risk of physical, mental, emotional, and social harm. Methods In order to assess the emergencies for alcohol use, data of the emergency department (ED) of San Martino Hospital - the referral acute-care center for adults in Genoa, Northwest Italy - was analyzed retrospectively. 330 records of 320 adolescents visiting the ED between 2014 and 2023 were considered. Results The median age of access was 16 (IQR 2), 54.8% were males, 17.4% had foreign nationalities, and the average blood alcohol concentration (BAC) was 1.8 g/L (SD 0.7), with 14.7% testing positive for other substances (6.1% benzodiazepines and 11.2% other drugs). 16.8%, 46.6% and 36.6% were assigned an emergency, urgent, and not-urgent acuity code. 2.8% had a repeated episode, 3.4% had to be removed for inappropriate behavior, 7.8% left spontaneously, 13.1% were hospitalized for additional care (5.5% in the Psychiatry ward). The average length of stay was 1.24 days (SD 5.86). Multivariable logistic regression showed that higher age, an emergency code and the use of other substances were positively associated with hospitalization [ORs 1.74 (95%CI 1.1-2.7), p 0.01; 7.1 (95%CI 2.2-22.4) p &amp;lt; 0.001; and 15.6 (95%CI 6.8-35.6) p &amp;lt; 0.001, respectively]. Admission in Psychiatry, in particular, was strongly associated with the use of other substances [OR 11.8 (95%CI 3.8-36.6), p &amp;lt; 0.001]. Multivariable linear regression showed that, in comparison with other access reasons, accidents and decreased consciousness were associated with higher BAC [beta 0.6 (95%CI 0.1-1.1), p 0.01; beta 0.8 (95%CI 0.3-1.2) p &amp;lt; 0.001]. Length of stay, however, was associated with lower BAC [beta -0.2 (95%CI -0.3 -0.01), p 0.04]. Conclusions In Italy, binge drinking affects 120,000 adolescents aged 11-17. Our findings highlight the harm of this practice and support the need for prompt interventions to reduce the onset and prevalence of adolescent alcohol use.

Differences and similarities in adolescents accessing emergency care for acute alcohol intoxication in three urban regions in Italy, Belgium, and The Netherlands

Abstract Background Excessive drinking among adolescents in Western Europe is prevalent, posing significant health risks and societal costs. Early initiation of alcohol use and binge drinking are associated with adult alcohol use disorders. Collecting comprehensive data on adolescent drinking patterns is crucial for developing effective prevention strategies. Methods To gain insight into the demographic and clinical characteristics of acute alcohol intoxication (AAI), we analysed emergency department access data of adolescents aged 14-17 years presenting with AAI symptoms from 2015-2023. Three urban regions were included: the Reinier de Graaf Gasthuis in Delft (The Netherlands), eight combined hospitals in Antwerp (Belgium) and the IRCCS San Martino Hospital in Genoa (Italy). Results A total of 1841 patients with symptoms of AAI were included. The mean age of patients in the Netherlands was statistically significant younger than in Italy and Belgium (15.7 compared to 15.9 and 16.0 years old, respectively). Moreover, the blood alcohol concentration was higher in the Netherlands and Belgium compared to Italy (2.0‰ compared to 1.95‰ and 1.8‰ respectively). The distribution of sex was nearly equal in the Netherlands, while statistically significant differences were observed with a higher proportion of males in Italy (54.8%) and Belgium (56.8%). Combined drug use was lower in Belgium with 10.0%, compared to 13.4% in The Netherlands and 14.7% in Italy. The most common reason for admission was ‘reduced consciousness’ in the total population (45.2%). Conclusions This is one of the first international studies which combines data on AAI in minors. In the future, efforts should be made to establish a common European database where records of AAI can be stored and analysed more efficiently for prevention purposes.

Characteristics of adolescents with acute alcohol intoxication accessing emergency care in The Netherlands

Abstract Background Prevent alcohol consumption amongst minors is a major concern for national governments. Collecting comprehensive data on adolescent drinking patterns is crucial for developing effective prevention strategies. Therefore, the aim of this study is to give an overview of demographic and clinical characteristics of adolescents with an acute alcohol intoxication in the Netherlands. Methods This study was conducted using a cohort of adolescents aged 14-17 years presenting with acute alcohol intoxication symptoms at the emergency department from 2015-2023. Data were collected at the Reinier de Graaf Gasthuis in Delft in order to monitor trends in admissions for acute alcohol intoxication. Data on patients age, blood alcohol concentration, sex, combined drug use and reason of admission were collected. Results A total of 505 patients who presented themselves with symptoms of acute alcohol intoxication at the Reinier de Graaf Gasthuis were included. The mean age of patients was 15.7 years old. The mean blood alcohol concentration was 2.0‰. During the COVID-lockdown period there were statistically significant less admissions with alcohol intoxication. The distribution of sex was nearly equal with 50.3% females and 49.7% males. Combined drug use was present in 13.4% of all cases, with cannabis as the most frequent type of drugs found. The most common known reason for admission was ‘reduced consciousness’ (35.9%). Conclusions These findings are relevant for both the central government’s ongoing prevention initiatives and treatment strategies within hospitals. In the future, more countries should evaluate data on adolescent drinking patterns.

Efficacy and Safety of Wilac L Probiotic Complex Isolated from Kimchi on the Regulation of Alcohol and Acetaldehyde Metabolism in Humans.

Alcohol-related hangovers impact both physical and mental wellness, largely due to acetaldehyde levels produced through alcohol metabolism. The present study investigated the efficacy and safety of the Wilac L probiotic complex (Levilactobacillus brevis WiKim0168 and Leuconostoc mesenteroides WiKim0172 isolated from kimchi) in improving hangovers post-alcohol consumption. This study was conducted as a randomized, double-blind, crossover placebo-controlled clinical trial from August 2023 to February 2024. Subjects (n = 26) were randomized into six test groups consuming three products, the Wilac L probiotic complex, Wilac L35 (Wilac L probiotic complex with Pyrus pyrifolia Nakai), or placebo, in different orders with crossover after a wash-out interval of 7-10 days. Blood alcohol and acetaldehyde concentrations were measured 0, 0.25, 0.5, 1, 2, 4, 6, and 15 h after alcohol consumption. The blood acetaldehyde levels measured with Wilac L probiotic complex supplementation were significantly lower than the control at 0.25 (p = 0.0381), 0.5 (p = 0.0498), and 1 h (p = 0.0260) post-consumption. The blood acetaldehyde levels after Wilac L35 consumption compared to the control are significant at 0.25 (p = 0.0115), 0.5 (p = 0.0054), 1 (p = 0.0285), 2 (p = 0.0113), and 6 h (p = 0.0287) post-consumption. No significant adverse events were reported. The Wilac L probiotic complex is associated with decreased blood acetaldehyde levels and improved subjective hangover symptoms.

Differentiation of Suspected Methanol Poisoning From Ethanol Poisoning: A Review Study and Consensus Statement

Background: Ethanol and methanol poisoning pose significant clinical challenges due to their overlapping clinical presentations. This literature review and consensus statement aim to provide evidence-based guidelines for differentiating these two poisonings.Methods: We conducted a comprehensive literature review of relevant literature, including individual patient data (IPD) meta-analysis, to assess clinical, laboratory, and diagnostic findings in cases with ethanol and methanol poisoning. A literature review was also performed to gather case series of electrocardiograms of ethanol and methanol poisoning. We synthesized the evidence and convened an expert panel to develop consensus-based recommendations.Results: Based on the literature review and IPD analysis, cases of methanol poisoning often present later than 24 hours after alcohol consumption, emphasizing the importance of assessing patients with delayed referrals. Methanol-poisoned patients are frequently awake and responsive after 12 hours of ingestion, but symptoms alone do not reliably differentiate between the two poisonings. Declines in visual acuity and symptoms are strongly associated with methanol poisoning and should prompt immediate hospitalization and ophthalmic examination. Oliguria and anuria are more common in cases of methanol poisoning, warranting detailed urinary symptom assessment and close monitoring of urinary output. Electrocardiograms are essential for all alcohol poisoning patients, with non-sinus rhythm suggesting methanol poisoning. Arterial blood gas analysis, with low pH values, favors methanol poisoning. However, blood sugar levels alone cannot definitively determine the type of poisoning. Laboratory point-of-care tests to diagnose methanol in serum are urgently needed.Conclusion: This literature review and consensus statement offer guidance for healthcare providers facing cases of alcohol poisoning where point-of-care testing methods of blood alcohol concentrations are unavailable. A comprehensive assessment, considering clinical history, physical examination, laboratory data, and specialized evaluations such as ophthalmic examination and electrocardiograms, is essential for accurately differentiating ethanol and methanol poisoning.

Festival games: Inebriated and sober altruists

We report a staged field experiment during three concerts in the South of Italy characterized by the same traditional music and a comparable average level of alcohol consumption by attendees. Individual blood alcohol concentration is measured with electronic breathalyzers. The experimental games are payoff-equivalent private property and common property trust games. We find that alcohol consumption is associated with less sharing in the private property game and lower efficiency in the common property game. There is a game-form effect for sober participants who share less in the common property game than in the private property game. This finding is consistent with revealed altruism theory as more sharing reveals more altruistic behavior. The absence of such game-form effect among non-sober participants is consistent with alcohol myopia. Tourists share more than local residents, significantly so for sober participants. The private property game elicits more efficiency than the common property game. This game-form effect is robust across sober and non-sober participants.

B-148 Bacer: decentralized isotope dilution method with lab blinding for blood alcohol content

Abstract Background In legal medicine, the determination Blood Alcohol Content (BAC) usually faced the problems of insufficient sample size, ethanol degradation and impossible double check. In addition, the integrity of laboratory may also be questioned. To this end, we developed a decentralized solution based on isotope dilution method. Methods Patented deuterated ethanol vacuum tube was used in field as regular type, weight of blood was record to BACer terminal. Arbitrary amount of sample(ca.0.1-1.0g) was pipetted to GC sample vial and sealed tightly, then heated more than 2min at 70°C, 10µL headspace sample was injected into GC-MS. Blinded lab uploaded peak area ratio of ethanol/deuterated ethanol(mz31/33) to BACer to calculate the final BAC. Results Regression between peak area ratios of ethanol/deuterated ethanol showed good linearity in the range of 0.10-5.0 (R2&amp;gt;0.999). Regression equation of different instruments were proved good consistency with slopes ranged from 1.03 to 1.07, and the LOD and LOQ were around 0.01mg/g and 0.05mg/g, 3-level recoveries between 97%-101% with RSD less than 1%. During the 6-month stability test at 4°C and normal temperature, the blood sample test results maintained good stability. The proposed method was applied to 2021 CNAS proficiency testing (2021SF-CNAS002) organized by China Academy of Forensic Sciences with satisfactory results. The comparison with Chinese standard method SF/Z JD0107001-2010 yielded good agreement with Passing&amp;Bablok test (P&amp;gt;0.10). The expanded uncertainty estimated by Monte-carlo method was less than 3%. Conclusions This proposed method showed the possibility of decentralized determination of BAC with lab blinding, the separation of on-site sampling data and laboratory testing also provided the possibility of integrity of results. It also provided a possible solution for the scenarios where the storage condition of blood collection is poor, or the cross check is required. But good chromatographic separation and operation are compulsive due to the possibility of interference in IDMS.

A new approach to modeling transdermal ethanol kinetics.

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 glucagon-like peptide-1 and other endocrine responses to alcohol ingestion in women with versus without metabolic surgery.

Glucagon-like peptide-1 (GLP-1)-based therapies, effective in treating obesity and type 2 diabetes, hold potential for reducing alcohol-seeking behaviour. However, the understanding of how alcohol consumption affects endogenous GLP-1 responses-important for understanding GLP-1-based therapies' potential in addressing alcohol misuse-is limited, given the absence of placebo-controlled studies examining these effects. This study aimed to determine the acute effects of alcohol ingestion on GLP-1 and other peptides and evaluate whether metabolic surgery, which increases GLP-1 responses, blood alcohol concentrations (BAC) and alcohol misuse risk, influences this effect. Additionally, we assessed the acute effects of alcohol on plasma glucose and insulin concentrations. Using a placebo-controlled crossover study, we examined hormonal and glucose responses after oral alcohol consumption (0.5g/kg of fat-free mass) versus placebo drinks in 18 women who underwent metabolic surgery <5years ago and in 14 non-operated controls (equivalent in age, body mass index [BMI], race and alcohol consumption patterns). Women had a mean (SD) age of 41 (10) years and a BMI of 33 (5) kg/m2. Compared with the control group, the surgery group exhibited a higher peak BAC (0.99 [0.20] g/L vs. 0.75 [0.16] g/L; P < 0.005). Alcohol decreased GLP-1 by 34% (95% CI, 16%-52%) in both groups and decreased ghrelin more in the control (27%) than in the surgery group (13%). Alcohol modestly decreased plasma glucose and transiently increased insulin secretion in both groups (P < 0.05). However, alcohol lowered blood glucose concentrations to the hypoglycaemic range in 28% of the women in the surgery group versus none in the control group. These findings provide compelling evidence that acute alcohol consumption decreases GLP-1, a satiation signal, elucidating alcohol's 'apéritif' effect. This study also highlights the potential increase in alcohol-related hypoglycaemic effects after metabolic surgery.

Consumption of oxycodone prevents oxytocin from attenuating alcohol intake in rats

Alcohol and opioid polysubstance use (PSU) is common and often accompanied by higher trait anxiety. Oxytocin decreases anxiety, alcohol- and opioid-seeking and -taking but has not been assessed in the context of PSU. Here we developed a rat model of sequential oxycodone and alcohol PSU to examine the relationship between anxiety, alcohol and oxycodone intake, and the efficacy of systemic oxytocin to attenuate alcohol intake. Male and female Sprague-Dawley rats were assessed for baseline anxiety-like behavior using acoustic startle and the elevated plus maze (EPM). Rats were then given 2-bottle choice access to oxycodone and/or water for 6-hr/day for 7 days, followed by 2-bottle choice access to alcohol (20% v/v) and/or water for five 24-hr sessions across 10 days. Next, monosubstance (oxycodone- or alcohol-alone) rats continued to have access to only one substance/day while PSU rats had access to oxycodone and water for 3-hr, followed by alcohol and water for 6-hr. After 12 days, rats were tested in the EPM 20 hours after alcohol access to examine withdrawal-related anxiety. Next, oxytocin (0, 0.3 or 1.0 mg/kg IP) was administered following the oxycodone/water session, 30 minutes prior to alcohol access. Rats received intragastric oxycodone (2 mg/kg) or water followed by intragastric alcohol (2 g/kg) and blood was collected to determine blood alcohol levels. Elevated baseline anxiety-like behavior was accompanied by reduced alcohol intake. Consumption of oxycodone did not alter alcohol intake but resulted in less anxiety-like behavior during withdrawal and prevented oxytocin from attenuating alcohol intake. Oxytocin (1 mg/kg) reduced alcohol intake in the alcohol-only condition, an effect that persisted for days after a single oxytocin administration. Rats that received oxycodone prior to non-contingent alcohol displayed higher blood alcohol levels than those that did not. These results support the necessity for the testing of medications for substance use in rodent models of PSU.

Exploratory analysis of blood alcohol concentration-related technology use and drinking outcomes among young adults.

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. 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. 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. 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.

Neuroinflammatory responses and blood–brain barrier injury in chronic alcohol exposure: role of purinergic P2 × 7 Receptor signaling

Alcohol consumption leads to neuroinflammation and blood‒brain barrier (BBB) damage, resulting in neurological impairment. We previously demonstrated that ethanol-induced disruption of barrier function in human brain endothelial cells was associated with mitochondrial injury, increased ATP and extracellular vesicle (EV) release, and purinergic receptor P2 × 7R activation. Therefore, we aimed to evaluate the effect of P2 × 7R blockade on peripheral and neuro-inflammation in ethanol-exposed mice. In a chronic intermittent ethanol (CIE)-exposed mouse model, P2 × 7R was inhibited by two different methods: Brilliant Blue G (BBG) or gene knockout. We assessed blood ethanol concentration (BEC), brain microvessel gene expression by using RT2 PCR array, plasma P2 × 7R and P-gp, serum ATP, EV-ATP, number of EVs, and EV mtDNA copy numbers. An RT2 PCR array of brain microvessels revealed significant upregulation of proinflammatory genes involved in apoptosis, vasodilation, and platelet activation in CIE-exposed wild-type animals, which were decreased 15–50-fold in BBG-treated–CIE-exposed animals. Plasma P-gp levels and serum P2 × 7R shedding were significantly increased in CIE-exposed animals. Pharmacological or genetic suppression of P2 × 7R decreased receptor shedding to levels equivalent to those in control group. The increase in EV number and EV-ATP content in the CIE-exposed mice was significantly reduced by P2 × 7R inhibition. CIE mice showed augmented EV-mtDNA copy numbers which were reduced in EVs after P2 × 7R inhibition or receptor knockout. These observations suggested that P2 × 7R signaling plays a critical role in ethanol-induced brain injury. Increased extracellular ATP, EV-ATP, EV numbers, and EV-mtDNA copy numbers highlight a new mechanism of brain injury during alcohol exposure via P2 × 7R and biomarkers of such damage. In this study, for the first time, we report the in vivo involvement of P2 × 7R signaling in CIE-induced brain injury.

Sex-dependent effects of acute stress and alcohol exposure during adolescence on mRNA expression of brain signaling systems involved in reward and stress responses in young adult rats

BackgroundAdolescent stress and alcohol exposure increase the risk of maladaptive behaviors and mental disorders in adulthood, with distinct sex-specific differences. Understanding the mechanisms underlying these early events is crucial for developing targeted prevention and treatment strategies.MethodsMale and female Wistar rats were exposed to acute restraint stress and intermittent alcohol during adolescence. We assessed lasting effects on plasma corticosterone (CORT) and adrenocorticotropic hormone (ACTH) levels, and mRNA expression of genes related to corticotropin releasing hormone (CRH), neuropeptide Y (NPY), corticoid, opioid, and arginine vasopressin systems in the amygdala and hypothalamus.ResultsThe main findings are as follows: (1) blood alcohol concentrations (BAC) increased after the final alcohol administration, but stressed males had lower BAC than non-stressed males; (2) Males gained significantly more weight than females; (3) Stressed females showed higher ACTH levels than non-stressed females, with no changes in males; (4) Stress increased CORT levels in males, while stressed, alcohol-treated females had lower CORT levels than non-stressed females; (5) CRH: Females had lower Crhr1 levels in the amygdala, while alcohol reduced Crhr2 levels in males but not females. Significant interactions among sex, stress, and alcohol were found in the hypothalamus, with distinct patterns between sexes; (6) NPY: In the amygdala, stress reduced Npy and Npy1r levels in males but increased them in females. Alcohol decreased Npy2r levels in males, with varied effects in females. Similar sex-specific patterns were observed in the hypothalamus; (7) Corticoid system: Stress and alcohol had complex, sex-dependent effects on Pomc, Nr3c1, and Nr3c2 in both brain regions; (8) Opioid receptors: Stress and alcohol blunted the elevated expression of Oprm1, Oprd1, and Oprk1 in the amygdala of males and the hypothalamus of females; (8) Vasopressin: Stress and alcohol interacted significantly to affect Avp and Avpr1a expression in the amygdala, with stronger effects in females. In the hypothalamus, alcohol increased Avp levels in females.ConclusionsThis study demonstrates that adolescent acute stress and alcohol exposure induce lasting, sex-specific alterations in systems involved in reward and stress responses. These findings emphasize the importance of considering sex differences in the prevention and management of HPA dysfunction and psychiatric disorders.

The drunk side of trust: Generalized and instantaneous trust at gathering events

We present novel evidence on the nexus between alcohol intake and trust at a large cultural gathering event. Throughout six editions, we interviewed nearly 2,000 attendees and collected an objective measure of alcohol intake (Blood Alcohol Concentration, BAC) using electronic breathalyzers and self-perceived measures of intoxication. We elicited different self-reported trust measures toward eventgoers and the general public. While alcohol intoxication is not correlated with trust toward the general public, there is a positive and significant nexus between alcohol intake and trust toward the other participants in the event (Instantaneous trust). Only a small part of this effect (15%) is driven by an increased trust in other drinkers at the event. Taken together, these findings indicate endogenous group formation regarding alcohol intake.

Alcohol Feedback, Reflection, and Morning Evaluation (A-FRAME): Refining and testing feasibility and acceptability of a smartphone-delivered alcohol intervention for heavy-drinking young adults.

Young adults drink heavily and experience negative alcohol consequences. To capitalize on mornings after drinking as an optimal time to intervene, we developed a novel, theory-based personalized feedback intervention (PFI) called Alcohol Feedback, Reflection, and Morning Evaluation (A-FRAME), to reduce heavy drinking. An initial prototype was refined via feedback from college students who drink heavily. The goal of the present study was to conduct an open trial to establish feasibility and acceptability of the refined PFI. The refined PFI was delivered for 4 weeks to 18 heavy-drinking young adults (Mage = 22.61, 44% women, 66.7% White, 27.8% Black, 16.7% Asian, 5.6% Native American/Alaskan Indian, 22.2% Hispanic/Latino). Participants completed a goal-setting procedure, followed by 28 daily surveys. Surveys indicating prior-day drinking were followed by the option to view personalized feedback (e.g., goal attainment, blood alcohol concentration [BAC], peer norms, protective behaviors). Aggregated feedback was also delivered at the 14- and 28-day marks. Participants completed a post-test acceptability survey and individual interviews to inform further refinement. The response rate to daily surveys was 93.8% and all participants completed study procedures, demonstrating feasibility. Daily feedback was reviewed about half (45.5%) of the time it was offered (i.e., following drinking days). Biweekly feedback was viewed 50% and 56% of the time at 14- and 28-day marks, respectively. Other benchmarks for acceptability were supported by survey and interview results. Open trial results support the feasibility and acceptability of this theory-based intervention for heavy-drinking young adults. A planned randomized controlled trial will evaluate efficacy.

Effects of moderate alcohol consumption and hypobaric hypoxia: implications for passengers’ sleep, oxygen saturation and heart rate on long-haul flights

BackgroundPassengers on long-haul flights frequently consume alcohol. Inflight sleep exacerbates the fall in blood oxygen saturation (SpO2) caused by the decreased oxygen partial pressure in the cabin. We investigated the...

Consumption of Sylimarin, Pyrroloquinoline Quinone Sodium Salt and Myricetin: Effects on Alcohol Levels and Markers of Oxidative Stress-A Pilot Study.

Alcohol abuse is one of the most common causes of mortality worldwide. This study aimed to investigate the efficacy of a treatment in reducing circulating ethanol and oxidative stress biomarkers. Twenty wine-drinking subjects were investigated in a randomized controlled, single-blind trial (ClinicalTrials.gov. Identifier: NCT06548503; Ethical Committee of the University of Padova (HEC-DSB/12-2023) to evaluate the effect of the intake of a product containing silymarin, pyrroloquinoline quinone sodium salt, and myricetin (referred to as Si.Pi.Mi. for this project) on blood alcohol, ethyl glucuronide (EtG: marker for alcohol consumption) and markers of oxidative stress levels (Reactive Oxygen Species-ROS, Total Antioxidant Capacity-TAC, CoQ10, thiols redox status, 8-isoprostane, NO metabolites, neopterin, and uric acid). The effects of the treatment versus placebo were evaluated acutely and after 1 week of supplementation in blood and/or saliva and urine samples. Si.Pi.Mi intake reduced circulating ethanol after 120 min (-33%). Changes in oxidative stress biomarkers, particularly a TAC (range +9-12%) increase and an 8-isoprostane (marker of lipidic peroxidation) decrease (range -22-27%), were observed too. After the administration of Si.Pi.Mi, the data seemed to suggest a better alcohol metabolism and oxidative balance in response to wine intake. Further verification is requested.

Elevated blood-ethanol concentration promotes reduction of aliphatic ketones (acetone and ethyl methyl ketone) to secondary alcohols along with slower oxidation to aliphatic diols.

Many people convicted for drunken driving suffer from an alcohol use disorder and some traffic offenders consume denatured alcohol for intoxication purposes. Venous blood samples from people arrested for driving under the influence of alcohol were analyzed in triplicate by headspace gas chromatography (HS-GC) using three different stationary phases. The gas chromatograms from this analysis sometimes showed peaks with retention times corresponding to acetone, ethyl methylketone (2-butanone), 2-propanol, and 2-butanol in addition to ethanol and the internal standard (1-propanol). Further investigations showed that these drink-driving suspects had consumed an industrial alcohol (T-Red) for intoxication purposes, which contained > 90% w/v ethanol, acetone (~ 2% w/v), 2-butanone (~ 5% w/v) as well as Bitrex to impart a bitter taste. In n = 75 blood samples from drinkers of T-Red, median concentrations of ethanol, acetone, 2-butanone, 2-propanol and 2-butanol were 2050mg/L (2.05g/L), 97mg/L, 48mg/L, 26mg/L and 20mg/L, respectively. In a separate GC analysis, 2,3-butanediol (median concentration 87mg/L) was identified in blood samples containing 2-butanone. When the redox state of the liver is shifted to a more reduced potential (excess NADH), which occurs during metabolism of ethanol, this favors the reduction of low molecular ketones into secondary alcohols via the alcohol dehydrogenase (ADH) pathway. Routine toxicological analysis of blood samples from apprehended drivers gave the opportunity to study metabolism of acetone and 2-butanone without having to administer these substances to human volunteers.

The Impact of Standing Electric Scooters on Maxillofacial Fractures: An Italian Multi-Centric Epidemiological Study.

Objectives: This study aimed to determine the impact of standing electric scooters on maxillofacial on the Italian territory. Methods: The authors analyzed the epidemiology of the injuries to define electric mobility's impact on maxillofacial surgery practice. For this retrospective cohort study, data were collected by unifying the standing e-scooter-related fractures database from 10 Italian maxillofacial surgery departments. The reference period considered was from January 2020 to December 2023. The main data considered included age, gender, type of access, time slot of admission, type of admission, alcohol level, helmet use, dynamics of the accident, and area of the fracture. Results: A total of 79 patients were enrolled. The average age of the participants was approximately 31 years. The blood alcohol level was found to be above the Italian norm in 15 cases (19%). Only one patient wore a helmet. The most affected facial third was the middle one with 36 cases (45.5%), followed by the lower one (31, 39.3%). The most recurrent patterns were fractures of the orbito-malar-zygomatic complex (15, 19%), followed by multifocal (bifocal, trifocal) fractures of the mandible (14, 17.5%). Conclusions: This study demonstrated how maxillofacial fractures related to the use of electric scooters are associated with complex patterns, associated with a high rate of post-surgical aftermaths.