The pathogenic and spoilage bacteria associated with red meat and application of different approaches of high CO2 packaging to extend product shelf-life.

With the fast-global development of packaging techniques, the potential antimicrobial effect of CO2, as a safe, cheap and readily available gas, makes it the integral component for packaging of meat products. The associated spoilage and/or pathogenic bacteria on raw meat may respond in different ways to elevated CO2 concentrations. The growth of some aerobic Gram-negative bacteria such as Pseudomonas spp. is significantly inhibited but some LAB bacteria may be allowed to grow faster and dominate the product. The antimicrobial efficacy of enriched CO2 packaging is attributed to the rate of CO2 solubility in the product which is itself affected by the level of headspace CO2, product pH, temperature and the ratio of headspace gas to product (G:P). This review, first, explores the varied range of beef and sheep meat spoilage and pathogenic bacteria and the intrinsic and extrinsic parameters that may influence the pattern of microbial growth and meat spoilage rate during storage. Then, the antimicrobial mechanism of elevated CO2 packaging will be discussed and the different approaches of achieving enriched CO2 packaging i.e. the traditional technique of flushing a desired gas mixture and/or using the new commercially developed CO2 emitters will then be compared in terms of their strengths, limitations and technical mode of action.

The 2021 World Health Organization Classification of Tumors of the Central Nervous System: What Neuroradiologists Need to Know.

Neuroradiologists play a key role in brain tumor diagnosis and management. Staying current with the latest classification systems and diagnostic markers is important to provide optimal patient care. Publication of the 2016 World Health Organization Classification of Tumors of the Central Nervous System introduced a paradigm shift in the diagnosis of CNS neoplasms. For the first time, both histologic features and genetic alterations were incorporated into the diagnostic framework, classifying and grading brain tumors. The newly published 2021 World Health Organization Classification of Tumors of the Central Nervous System, May 2021, 5th edition, has added even more molecular features and updated pathologic diagnoses. We present, summarize, and illustrate the most salient aspects of the new 5th edition. We have selected the key "must know" topics for practicing neuroradiologists.

Electrical and Immunohistochemical Properties of Cochlear Fibrocytes in 3D Cell Culture and in the Excised Spiral Ligament of Mice.

Fibrocyte degeneration in the cochlear lateral wall is one possible pathology of age-related metabolic hearing loss (presbycusis). Within the lateral wall fibrocytes play a role in potassium recycling and maintenance of the endocochlear potential. It has been proposed that cell replacement therapy could prevent fibrocyte degeneration in the CD/1 mouse model of hearing loss. For this to work, the replacement fibrocytes would need to take over the structural and physiological role of those lost. We have grown lateral wall fibrocytes from neonatal CD/1 mice in a 3D-collagen gel culture with the aim of assessing their functional similarity to native lateral wall fibrocytes, the latter in a slice preparation and in excised spiral ligament pieces. We have compared cultured and native fibrocytes using both immuno-labelling of characteristic proteins and single cell electrophysiology. Cultured fibrocytes exhibited rounded cell bodies with extending processes. They labelled with marker antibodies targeting aquaporin 1 and calcium-binding protein S-100, precluding an unambiguous identification of fibrocyte type. In whole-cell voltage clamp, both native and cultured fibrocytes exhibited non-specific currents and voltage-dependent K+ currents. The non-specific currents from gel-cultured and excised spiral ligament fibrocytes were partially and reversibly blocked by external TEA (10 mM). The TEA-sensitive current had a mean reversal potential of + 26 mV, suggesting a permeability sequence of Na+ > K+. These findings indicate that 3D-cultured fibrocytes share a number of characteristics with native spiral ligament fibrocytes and thus might represent a suitable population for transplantation therapy aimed at treating age-related hearing loss.

Prevalence and correlates of anemia among women in the reproductive age (15-49 years) in a rural area of Tamil Nadu: An exploratory study.

BACKGROUND: Anemia is a major public health problem among reproductive-aged women in India. Despite many programs implemented for decades to fight anemia, still the prevalence of anemia is high because its associated factors vary among different regions. This exploratory study was carried out to find the prevalence of anemia and factors influencing it among nonpregnant reproductive-aged women (15-49 years) in a rural area of Coimbatore. MATERIALS AND METHODS: The study was conducted in the field practice area of Rural Health Training Centre, PSG IMSR, Coimbatore, during March 2016 to August 2016. Participants were recruited by two-staged random sampling method and 426 participants were enrolled. A predesigned semi-structured questionnaire was used to collect the data pertaining to the factors influencing the prevalence of anemia, and their hemoglobin level was measured using a hemoglobin photometer. The data were analyzed using SPSS-24. (IBM Corporation, SPSS Inc., Chicago, IL, USA) Univariate analysis was done using Chi-square test and the strength of association was estimated by odds ratio. Those factors which were found to be significant by univariate analysis were further subjected to multivariate logistic regression analysis. P < 0.05 was considered statistically significant. RESULTS: The prevalence of anemia was estimated as 64.8% (95% confidence interval: 60%-69%). Significant predictors for anemia among the study participants were less frequent intake of green leafy vegetables (adjusted odds ratio [AOR] = 3.65, confidence interval [CI]: 2.17-6.12), low socioeconomic status (AOR = 3.36, CI: 1.93-5.84), illiteracy (AOR = 3.09, CI: 1.09-5.24), birth spacing <2 years (AOR = 2.49, CI: 1.19-5.25), excessive menstrual bleeding (AOR = 2.27, CI: 1.09-4.76), and inadequate knowledge regarding anemia (AOR = 2.03, CI: 1.19-3.44). CONCLUSION: Anemia is still prevalent in high magnitude in reproductive-aged women, and measures to prevent and control it are not optimum. Hence, its multifactorial determinants have to be addressed to alleviate its burden.

Assessment of the potential use of MALDI-TOF MS for the identification of bacteria associated with chilled vacuum-packaged lamb meat.

The focus of this study was to compare the effectiveness of MALDI-TOF MS and partial 16S rRNA gene sequencing for the identification of bacteria isolated from VP lamb meat stored chilled at 5 °C for 21 days, at the same time gaining insights into bacterial changes over time. The identity of bacterial isolates on non-selective and selective agars was determined by both methods and results compared. Results showed that total bacterial numbers increased over the 21 days (as expected) with Staphylococcus and Pseudomonas (day 0) being replaced by Carnobacterium, Brochothrix and members of the Enterobacteriaceae family by day 21. A high level of agreement (86-100%) for bacterial isolates' identity at genus level was observed between MALDI-TOF MS and partial 16S rRNA gene-based sequencing for isolates where identification was possible. With its cheaper cost and faster turnaround time, once optimized, MALDI-TOF MS could become a useful alternative to 16S rRNA gene-sequencing for the rapid identification of red meat bacterial isolates.

A systematic review and meta-analysis of laparotomy compared with laparoscopic management of interstitial pregnancy.

BACKGROUND: Interstitial pregnancy is a rare but life-threatening condition accounting for 1-4% of all types of tubal ectopic pregnancies. It can be managed by open and minimally invasive surgical techniques. Our goal was to compare laparoscopic and open surgery for managing interstitial pregnancy. SEARCH STRATEGY: We searched PubMed, Scopus, Web of Science, and Cochrane up to May 2020. SELECTION CRITERIA: 1) Women with interstitial pregnancy, 2) Intervention: laparoscopic surgery, 3) Comparator: open surgery, 4) Outcomes: Hospital stay, operation time, pain scale, blood loss. Secondary outcomes: any other reported 5) Study designs: interventional and observational. DATA COLLECTION AND ANALYSIS: Data was extracted from the relevant articles and was pooled as mean difference (MD) or relative risk (RR) with a 95% confidence interval (CI). MAIN RESULTS: We included six studies, three of which provided eligible data. The duration of hospital stay was lower in the laparoscopic surgery group (MD = -1.42, 95% CI [-1.72, -0.76], P < 0.0001). There was no significant difference in operative time (MD = 5.90, 95% CI [-11.30, 23.09], P = 0.50, blood loss (MD = -9.43, 95% CI [-214.18, 195.32], P = 0.93), complications (RR = 1.54, 95% CI [0.20, 11.85], P = 0.68), or blood transfusions (RR = 0.77, 95% CI [0.50, 1.25], P = 0.30). CONCLUSION: Laparoscopic surgery is associated with shorter hospital stay, with no difference in terms of blood loss, post-, and intraoperative complications, and need for blood transfusion compared with laparotomy.

Cognitive, behavioral and psychological functioning of children and adults with conservatively managed metopic synostosis.

Children diagnosed with metopic synostosis (MS) commonly experience poor neuropsychological outcomes, with research suggesting that children whose MS is managed conservatively (without surgery) potentially having worse outcomes than their operated peers. However, studies of children whose MS was managed conservatively are scarce. This study therefore examined the cognitive, behavioral, and psychological functioning of children/adults with conservatively managed MS (N = 38) and compares their outcomes to individually matched healthy controls (N = 38) of the same age and sex (matched-pairs design) from the general community. Age-appropriate, validated assessments measuring general cognition, verbal and visuospatial ability, attention and working memory, executive functioning, behavior, depression, anxiety, and satisfaction with appearance were utilized. Group differences were estimated using linear regression for (a) the overall sample and (b) by broad developmental stages: 2&3 yrs; ≥6-≤17. Moderate to large negative effects (g = -0.38 to -1.30) were evident before controlling for socio-economic status (SES), with the MS group performing significantly worse on 8 out of the 10 cognitive domains (general cognition, visuospatial ability, working memory, information processing, executive functioning: semantic & initial letter verbal fluency, switching, inhibition+switching). However, only initial letter verbal fluency (g = -0.99) and switching (g = -1.19) remained significant after adjusting for SES. The MS group displayed more behavioral problems, although this was not significant. Depression, anxiety, and satisfaction with appearance did not differ between the groups. Regular monitoring of cognitive functioning, particularly executive functioning, should be undertaken for those with conservatively managed MS.

Microbiota and Metabolite Profiling Combined With Integrative Analysis for Differentiating Cheeses of Varying Ripening Ages.

Cheese maturation and flavor development results from complex interactions between milk substrates, cheese microbiota and their metabolites. In this study, bacterial 16S rRNA-gene sequencing, untargeted metabolomics (gas chromatography-mass spectrometry) and data integration analyses were used to characterize and differentiate commercial Cheddar cheeses of varying maturity made by the same and different manufacturers. Microbiota and metabolite compositions varied between cheeses of different ages and brands, and could be used to distinguish the cheeses. Individual amino acids and carboxylic acids were positively correlated with the ripening age for some brands. Integration and Random Forest analyses revealed numerous associations between specific bacteria and metabolites including a previously undescribed positive correlation between Thermus and phenylalanine and a negative correlation between Streptococcus and cholesterol. Together these results suggest that multi-omics analyses has the potential to be used for better understanding the relationships between cheese microbiota and metabolites during ripening and for discovering biomarkers for validating cheese age and brand authenticity.

Tumefactive Primary Central Nervous System Vasculitis: Imaging Findings of a Rare and Underrecognized Neuroinflammatory Disease.

Primary central nervous system vasculitis (PCNSV) is a poorly understood neuroinflammatory disease of the CNS affecting the intracranial vasculature. Although PCNSV classically manifests as a multifocal beaded narrowing of the intracranial vessels, some patients may not have angiographic abnormalities. A rare subset of patients with PCNSV present with masslike brain lesions mimicking a neoplasm. In this article, we retrospectively review 10 biopsy-confirmed cases of tumefactive PCNSV (t-PCNSV). All cases of t-PCNSV in our series that underwent CTA or MRA were found to have normal large and medium-sized vessels. T-PCNSV had a variable MR imaging appearance with most cases showing cortical/subcortical enhancing masslike lesion (70%), often with microhemorrhages (80%). Diffusion restriction was absent in all lesions. In summary, normal vascular imaging does not exclude the diagnosis of t-PCNSV. Advanced imaging techniques including MR perfusion and MR spectroscopy failed to demonstrate specific findings for t-PCNSV but assisted in excluding neoplasm in the differential diagnosis. Biopsy remains mandatory for definitive diagnosis.

New insights into cheddar cheese microbiota-metabolome relationships revealed by integrative analysis of multi-omics data.

Cheese microbiota and metabolites and their inter-relationships that underpin specific cheese quality attributes remain poorly understood. Here we report that multi-omics and integrative data analysis (multiple co-inertia analysis, MCIA) can be used to gain deeper insights into these relationships and identify microbiota and metabolite fingerprints that could be used to monitor product quality and authenticity. Our study into different brands of artisanal and industrial cheddar cheeses showed that Streptococcus, Lactococcus and Lactobacillus were the dominant taxa with overall microbial community structures differing not only between industrial and artisanal cheeses but also among different cheese brands. Metabolome analysis also revealed qualitative and semi-quantitative differences in metabolites between different cheeses. This also included the presence of two compounds (3-hydroxy propanoic acid and O-methoxycatechol-O-sulphate) in artisanal cheese that have not been previously reported in any type of cheese. Integrative analysis of multi-omics datasets revealed that highly similar cheeses, identical in age and appearance, could be distinctively clustered according to cheese type and brand. Furthermore, the analysis detected strong relationships, some previously unknown, which existed between the cheese microbiota and metabolome, and uncovered specific taxa and metabolites that contributed to these relationships. These results highlight the potential of this approach for identifying product specific microbe/metabolite signatures that could be used to monitor and control cheese quality and product authenticity.

Visual impairment and spectacles ownership among upper secondary school students in northwestern China.

PURPOSE: To assess the prevalence of visual impairment and spectacles ownership among academic and vocational upper secondary school students in rural China. METHODS: This cross-sectional study included 5583 students from four academic upper secondary schools (AUSSs) and two vocational upper secondary schools (VUSSs) in Mei and Qianyang counties, Baoji Prefecture, Shaanxi Province. In March and April 2016, students underwent assessment of visual acuity (VA) and completed a questionnaire regarding spectacles use and family characteristics. Students with visual impairment (presenting VA ≤6/12 in the better eye) and students needing spectacles (uncorrected VA ≤6/12 in the better eye, which could be improved to >6/12 with refraction) were identified. RESULTS: Among 5583 students (54% boys, mean age 16.4±1.0 years) in grades 10 and grade 11 attending AUSSs (n=4549) and VUSSs (n=1034), visual impairment was detected in 4026 students. Among the AUSS students, 3425 (75%) needed spectacles; 2551 (75%) had them. Among the VUSS students, 601 (58%) needed spectacles; this proportion was significantly smaller (P=0.004), as was the proportion who had spectacles (n=212, 35%, P<0.001), compared with the AUSS students. Multivariate analysis showed that ownership of spectacles among children who needed them was associated with worse uncorrected VA (P<0.001), male sex (P<0.001), and residence in an urban area (P<0.034). Spectacles ownership was also strongly associated with AUSS education (P<0.001). CONCLUSION: There is a high rate of unmet need in visual care among upper secondary school students. Lack of spectacles ownership among children who needed them was significantly associated with VUSS education.

Cheesomics: the future pathway to understanding cheese flavour and quality.

Cheese is a fermented dairy product, harboring diverse microbial communities (microbiota) that change over time and vary depending on the type of cheese and their respective starter and adjunct cultures. These microorganisms play a crucial role in determining the flavor, quality and safety of the final product. Exploring the composition of cheese microbiota and the underlying molecular mechanisms involved in cheese ripening has been the subject of many studies. Recent advances in next generation sequencing (NGS) methods and the development of sophisticated bioinformatics tools have provided deeper insights into the composition and potential functionality of cheese microbiota far beyond the information provided by culture-dependent methods. These advances, which include rRNA gene amplicon sequencing and metagenomics, have been complemented and expanded in recent years by the application of metatranscriptomics, metaproteomics and metabolomics. This paper reviews studies in which application of these meta-omics technologies has led to a better understanding of the microbial composition and functionality of cheese and highlights opportunities by which the integration of outputs from diverse multi-omics analytical platforms (cheesomics) could be used in the future to advance our knowledge of the cheese ripening process and identify biomarkers for predicting cheese flavor, quality, texture and safety, and bioactive metabolites with potential to influence human health.

The role of aquaculture farm biosecurity in global food security.

The aquaculture industry can play a key role in global food security; however, the lack of comprehensive implementation of effective biosecurity measures is preventing the sector from reaching its potential. Biosecurity begins with an evaluation of the risk of the introduction of pathogens from outside the system, as well as the spread of pathogenic agents within and from the culture system. This involves establishing a clear picture of the physical infrastructure of the system, systematically identifying the relevant pathways of transmission of pathogenic agents, analysing the risks associated with each pathway and implementing mitigation measures to minimise the risks. The farm biosecurity plan provides benefits that improve health and prevent disease-related losses through the use of best management practices, standard operating procedures, staff training, surveillance, emergency response plans, record keeping and audit of farm performance. Biosecurity supports gains in animal productivity, production and growth, thus ensuring the continuity of supply necessary for food security. Disease puts at risk the sector's resilience and reliability and will continue to limit aquaculture's contribution to global food security until comprehensive biosecurity programmes are in place. Responsibility for biosecurity is shared by all stakeholders. Overarching support from the national and international communities, including investment in innovative solutions, technological advancements and training and education, is required to achieve comprehensive global biosecurity. Implementation requires local leadership and meaningful engagement in the involved industries and communities. Each farmer must be enabled to prevent, detect and respond to disease events at the local level. Only by enabling the individual farmer can there be a decrease in the risk of disease issues becoming regional, national or international.

Le secteur de l'aquaculture peut contribuer significativement à la sécurité alimentaire mondiale mais l'absence de mesures efficaces et exhaustives de biosécurité empêche le secteur de réaliser ce potentiel. La biosécurité des systèmes d'aquaculture commence par l'évaluation des risques associés aux agents pathogènes, c'est-à-dire le risque de leur introduction dans un système à partir du milieu extérieur et celui de leur propagation au sein du système ou vers l'extérieur. Ces évaluations requièrent l'élaboration d'un schéma clair décrivant l'infrastructure matérielle du système, l'identification systématique des voies potentielles de transmission d'agents pathogènes, l'analyse des risques associés à chacune de ces voies et la mise en place de mesures d'atténuation des risques. Les plans de biosécurité appliqués dans les fermes aquacoles ont pour effet d'améliorer la santé et de prévenir les pertes associées aux maladies à travers de bonnes pratiques de gestion, la mise en place de procédures opérationnelles normalisées, la formation du personnel, les plans d'intervention d'urgence, la tenue de registres et les évaluations des performances des fermes. La biosécurité améliore la production animale et la productivité des élevages et favorise la croissance, ce qui permet de garantir la continuité de l'offre nécessaire à la sécurité alimentaire. La présence de maladies représentant un risque pour la résilience et la fiabilité du secteur, la contribution de l'aquaculture à la sécurité alimentaire mondiale sera mise à mal tant que des programmes exhaustifs de biosécurité ne seront pas en place. La biosécurité relève de la responsabilité de toutes les parties prenantes. La réalisation des objectifs d'une biosécurité exhaustive au niveau mondial requiert un soutien global au niveau national et international, y compris sous forme d'investissements pour mettre au point des solutions innovantes, introduire les avancées technologiques et organiser une offre de formation adéquate. Leur mise en œuvre passe par l'exercice d'un leadership local et d'une participation conséquente des secteurs et des communautés concernés. Chaque éleveur doit être en mesure de prévenir ou de détecter la survenue d'un événement sanitaire, mais aussi d'intervenir en cas de besoin au niveau local. Ce n'est qu'à travers l'acquisition et l'exercice de cette capacité par chaque éleveur individuellement que l'on pourra réduire le risque que les maladies se propagent en prenant une dimension régionale, nationale ou internationale.

Aunque el sector de la acuicultura puede cumplir una función decisiva para la seguridad alimentaria mundial, la incompleta aplicación de medidas eficaces de seguridad biológica está impidiendo que el sector se desarrolle al máximo de sus posibilidades. La seguridad biológica empieza con una evaluación del riesgo de introducción de patógenos desde el exterior del sistema de cultivo y de propagación de agentes patógenos en y desde el interior del sistema. Para ello es preciso disponer de una clara imagen de la infraestructura física del sistema, identificar sistemáticamente las principales vías de transmisión de agentes patógenos, analizar los riesgos inherentes a cada vía y aplicar medidas de mitigación para reducir estos riesgos al mínimo. El plan de seguridad biológica de la explotación aporta beneficios que se traducen en un mejor estado sanitario y en la prevención de pérdidas derivadas de enfermedades gracias al uso de prácticas idóneas de gestión y procedimientos operativos normalizados, así como a la formación del personal, la vigilancia, planes de respuesta a situaciones de emergencia, el mantenimiento de registros y auditorías del funcionamiento de la explotación. La seguridad biológica propicia mayores niveles de productividad, producción y crecimiento de los animales, asegurando con ello la continuidad del abastecimiento que se necesita para la seguridad alimentaria. Las enfermedades, que ponen en peligro la resiliencia y fiabilidad del sector, seguirán limitando la contribución de la acuicultura a la seguridad alimentaria mundial mientras no se instituyan programas integrales de seguridad biológica. Todos los interlocutores del sector comparten la responsabilidad de la seguridad biológica. Para lograr una completa seguridad biológica a escala mundial es preciso que las instancias nacionales e internacionales presten un apoyo de gran amplitud, en particular invirtiendo en soluciones innovadoras, adelantos tecnológicos y actividades de enseñanza y formación. Su aplicación práctica requiere liderazgo local y una resuelta participación de los sectores y las poblaciones que hagan al caso. Todo productor debe estar en condiciones de prevenir episodios infecciosos, detectarlos y responder a ellos a escala local. Solo dotando de esa capacidad a cada uno de los explotadores será posible reducir el riesgo de que un problema sanitario acabe cobrando dimensión nacional, regional o internacional.

Influence of bioaugmentation and biostimulation on PAH degradation in aged contaminated soils: Response and dynamics of the bacterial community.

Polycyclic aromatic hydrocarbons (PAHs) represent a group of hazardous compounds that are ubiquitous and persistent. The main aim of this study was to investigate the degradation of PAHs in chronically contaminated, aged and weathered soils obtained from a former gas plant of Australia. Biostimulation and bioaugmentation using individual isolates (Rhodococcus sp. (NH2), Achromobacter sp. (NH13), Oerskovia paurometabola (NH11), Pantoea sp. (NH15), Sejongia sp. (NH20), Microbacterium maritypicum (NH30) and Arthrobacter equi (NH21)) and a consortium of these isolates were tested during mesocosm studies. A significant reduction (99%) in PAH concentration was observed in all the treatments. In terms of the abundance of PAH-degrading genes and microbial community structure during PAH degradation, qPCR results revealed that Gram-positive bacteria were dominant over other bacterial communities in all the treatments. 16S sequencing results revealed that the inoculated organisms did not establish themselves during the treatment. However, substantial bacterial community changes during the treatments were observed, suggesting that the natural community exhibited sufficient resilience and diversity to enable an active, but changing degrading community at all stages of the degradation process. Consequently, biostimulation is proposed as the best strategy to remediate PAHs in aged, weathered and chronically contaminated soils.

Cognitive, behavioral and psychological functioning in children with metopic synostosis: a meta-analysis examining the impact of surgical status.

Neurodevelopmental delays are known to occur in children with metopic synostosis, but it is presently unclear whether the cognitive, behavioral and psychological outcomes of children with metopic synostosis differ to those of their healthy peers. This meta-analysis consolidated data from 17 studies (published prior to August 2017) that examined the cognitive, behavioral and psychological outcomes of children (n = 666; aged ≤19 yrs) with metopic synostosis. Hedges'g (gw) effect sizes compared the outcomes of samples with metopic synostosis (unoperated, operated) to healthy controls or normative data and, where available, the prevalence of problems/disorders was calculated. Children with unoperated metopic synostosis performed significantly worse than their healthy peers on measures of: general cognition (gw = -.38), motor functioning, (gw = -.81), and verbal (gw = -.82) and visuospatial (gw = -.92) abilities. Children with operated metopic synostosis performed significantly worse on measures of motor functioning (gw = -.45), visuospatial skills (gw = -.32), attention (gw = -.50), executive functioning (gw = -.36), arithmetic ability (gw = -.37), and behavior (gw = -.34). Cognitive, behavioral, and psychological problems were prevalent, but variable. Overall, the cognitive, behavioral, and psychological outcomes of children with metopic synostosis are generally worse than their healthy peers, regardless of surgical status. However, research is sparse, samples small, controls are rarely recruited, and the severity of metopic synostosis often not stated. Nevertheless, the findings suggest that children with metopic synostosis are likely to experience a variety of negative outcomes and should therefore receive ongoing monitoring and support.

Trial protocol: a clustered, randomised, longitudinal, type 2 translational trial of alcohol consumption and alcohol-related harm among adolescents in Australia.

BACKGROUND: This cluster randomised control trial is designed to evaluate whether the Communities That Care intervention (CTC) is effective in reducing the proportion of secondary school age adolescents who use alcohol before the Australian legal purchasing age of 18 years. Secondary outcomes are other substance use and antisocial behaviours. Long term economic benefits of reduced alcohol use by adolescents for the community will also be assessed. METHODS: Fourteen communities and 14 other non-contiguous communities will be matched on socioeconomic status (SES), location, and size. One of each pair will be randomly allocated to the intervention in three Australian states (Victoria, Queensland and Western Australia). A longitudinal survey will recruit grade 8 and 10 students (M = 15 years old, N = 3500) in 2017 and conduct follow-up surveys in 2019 and 2021 (M = 19 years old). Municipal youth populations will also be monitored for trends in alcohol-harms using hospital and police administrative data. DISCUSSION: Community-led interventions that systematically and strategically implement evidence-based programs have been shown to be effective in producing population-level behaviour change, including reduced alcohol and drug use. We expect that the study will be associated with significant effects on alcohol use amongst adolescents because interventions adopted within communities will be based on evidence-based practices and target specific problems identified from surveys conducted within each community. TRIAL REGISTRATION: The trial was retrospectively registered in September, 2017 ( ACTRN12616001276448 ), as communities were selected prior to trial registration; however, participants were recruited after registration. Findings will be disseminated in peer-review journals and community fora.

Impact of day-of-injury alcohol consumption on outcomes after traumatic brain injury: A meta-analysis.

Although a known risk factor for traumatic brain injury (TBI), alcohol has been found to both promote and protect against secondary brain damage. However, it is presently unclear whether the cognitive, psychological and medical/functional outcomes of adults who have consumed alcohol prior to sustaining a TBI differ from those who have not. This meta-analysis examined the outcomes of groups that differed in terms of their day-of-injury (DOI) blood alcohol levels (BALs) by comparing positive with zero BAL (BAL+/BAL-) and high with low BAL (BALhigh/BALlow) samples. The PubMed, PsycINFO, EMBASE, and Scopus databases were searched from inception until the end of March 2015. Hedge's g effects (continuous data) and odds ratios (categorical data) were calculated for 27 studies that compared either the outcomes of BAL+ and BAL- groups or BALhigh and BALlow groups. BAL+ was associated with significantly poorer cognitive outcomes (overall and on general tests) and higher levels of disability, and BALhigh was associated with shorter stays in intensive care. More generally, however, most effect sizes were small to low-moderate in size, non-significant and inconsistent in their direction. Although DOI alcohol consumption increases the risk of sustaining a TBI, it is not consistently associated with better or worse outcomes, other than subtle cognitive deficits; the source of which remains to be determined.