***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: BACKGROUND Previous research on alcohol mixed with energy drinks ( AmED ) suffers from measurement problems . Missing from the research literature are studies that assess caffeine-alcohol co-ingestion in natural drinking environments . METHODS This field study collected data in a U.S. college bar district from 328 r and omly selected patrons . Anonymous data were obtained from face-to-face interviews and self-administered surveys , and from breath tests . RESULTS Cola-caffeinated alcoholic beverage consumers left bars in a more highly intoxicated state than those who consumed alcohol only . There was no significant difference between the intoxication level of the AmED group and the cola-caffeinated alcoholic beverage group . Results from a multivariate regression model indicated that quantity of caffeinated alcoholic beverage consumption had a significant , positive association with bar patron intoxication after adjusting for potential confounders . CONCLUSIONS Findings indicate that caffeine may have a dose-dependent relationship with alcohol intoxication in the bar/nightclub setting . In addition , results revealed that cola-caffeinated alcoholic drinks may pose similar levels of risk to bar patrons as those associated with AmED beverage consumption . Product labeling requirements about alcohol risks may need to be extended not only to energy drinks , but to caffeinated soft drinks as well Background Energy drink consumption has continued to gain in popularity since the 1997 debut of Red Bull , the current leader in the energy drink market . Although energy drinks are targeted to young adult consumers , there has been little research regarding energy drink consumption patterns among college students in the United States . The purpose of this study was to determine energy drink consumption patterns among college students , prevalence and frequency of energy drink use for six situations , namely for insufficient sleep , to increase energy ( in general ) , while study ing , driving long periods of time , drinking with alcohol while partying , and to treat a hangover , and prevalence of adverse side effects and energy drink use dose effects among college energy drink users . Methods Based on the responses from a 32 member college student focus group and a field test , a 19 item survey was used to assess energy drink consumption patterns of 496 r and omly surveyed college students attending a state university in the Central Atlantic region of the United States . Results Fifty one percent of participants ( n = 253 ) reported consuming greater than one  energy drink  each month in an average month for the current semester ( defined as energy drink user ) . The majority of users consumed energy drinks for insufficient sleep ( 67 % ) , to increase energy ( 65 % ) , and to drink with alcohol while partying ( 54 % ) . The majority of users consumed one energy drink to treat most situations although using three or more was a common practice to drink with alcohol while partying ( 49 % ) . Weekly jolt and crash episodes were experienced by 29 % of users , 22 % reported ever having headaches , and 19 % heart palpitations from consuming energy drinks . There was a significant dose effect only for jolt and crash episodes . Conclusion Using energy drinks is a popular practice among college students for a variety of situations . Although for the majority of situations assessed , users consumed one energy drink with a reported frequency of 1 – 4 days per month , many users consumed three or more when combining with alcohol while partying . Further , side effects from consuming energy drinks are fairly common , and a significant dose effect was found with jolt and crash episodes . Future research should identify if college students recognize the amounts of caffeine that are present in the wide variety of caffeine-containing products that they are consuming , the amounts of caffeine that they are consuming in various situations , and the physical side effects associated with caffeine consumption BACKGROUND There are popular reports on the combined use of alcohol and energy drinks ( such as Red Bull and similar beverages , which contain caffeine , taurine , carbohydrates , etc . ) to reduce the depressant effects of alcohol on central nervous system , but no controlled studies have been performed . The main purpose of this study was to verify the effects of alcohol , and alcohol combined with energy drink , on the performance of volunteers in a maximal effort test ( cycle ergometer ) and also on physiological indicators ( oxygen uptake , ventilatory threshold , respiratory exchange rate , heart rate , and blood pressure ) , biochemical variables ( glucose , lactate , insulin , cortisol , ACTH , dopamine , noradrenaline , and adrenaline ) , and blood alcohol levels . METHODS Fourteen healthy subjects completed a double-blind protocol made up of four sessions : control ( water ) , alcohol ( 1.0 g/kg ) , energy drink ( 3.57 ml/kg Red Bull ) , and alcohol + energy drink , each 1 week apart . The effort test began 60 min after drug or control ingestion , and the dependent variables were measured until 60 min after the test . RESULTS Heart rate at the ventilatory threshold was higher in the alcohol and alcohol + energy drink sessions in comparison with control and energy drink sessions . Although in comparison to the control session , the peak oxygen uptake was 5.0 % smaller after alcohol ingestion , 1.4 % smaller after energy drink , and 2.7 % smaller after the combined ingestion , no significant differences were detected . Lactate levels ( 30 min after drug ingestion , 30 and 60 min after the effort test ) and noradrenaline levels ( 30 min after the effort test ) were higher in the alcohol and alcohol + energy drink sessions compared with the control session . CONCLUSIONS The performance in the maximal effort test observed after alcohol + energy drink ingestion was similar to that observed after alcohol only . No significant differences between alcohol and alcohol + energy drink were detected in the physiological and biochemical parameters analyzed . Our findings suggest that energy drinks , at least in the tested doses , did not improve performance or reduce alterations induced by acute alcohol ingestion BACKGROUND Well-known reports suggest that the use of energy drinks might reduce the intensity of the depressant effects of alcohol . However , there is little scientific evidence to support this hypothesis . OBJECTIVE AND METHODS The present study aim ed at evaluating the effects of the simultaneous ingestion of an alcohol ( vodka(37.5%v/v ) ) and an energy drink ( Red Bull-3.57 mL/kg ) , compared with those presented after the ingestion of an alcohol or an energy drink alone .  Twenty-six young healthy volunteers were r and omly assigned to 2 groups that received 0.6 or 1.0 g/kg alcohol , respectively . They all completed 3 experimental sessions in r and om order , 7 days apart : alcohol alone , energy drink alone , or alcohol plus energy drink . We evaluated the volunteers '  breath alcohol concentration , subjective sensations of intoxication , objective effects on their motor coordination , and visual reaction time . RESULTS When compared with the ingestion of alcohol alone , the ingestion of alcohol plus energy drink significantly reduced subjects ' perception of headache , weakness , dry mouth , and impairment of motor coordination . However , the ingestion of the energy drink did not significantly reduce the deficits caused by alcohol on objective motor coordination and visual reaction time . The ingestion of the energy drink did not alter the breath alcohol concentration in either group . CONCLUSIONS Even though the subjective perceptions of some symptoms of alcohol intoxication were less intense after the combined ingestion of the alcohol plus energy drink , these effects were not detected in objective measures of motor coordination and visual reaction time , as well as on the breath alcohol concentration BACKGROUND Recently , Marczinski and colleagues ( 2013 ) showed that energy drinks combined with alcohol augment a person 's desire to drink more alcohol relative to drinking alcohol alone . The current study replicates the findings of Marczinski and colleagues ( 2013 ) using a robust measure of alcohol craving . METHODS Seventy-five participants aged 18 to 30 years were assigned to an alcohol only or alcohol+energy drink condition in a double-blind r and omized pre- versus posttest experiment . Participants received a cocktail containing either 60 ml of vodka and a Red Bull ( ® ) Silver Edition energy drink ( alcohol+energy drink condition ) or 60 ml of vodka with a soda water vehicle ( alcohol-only condition ) ; both cocktails contained 200 ml of fruit drink . The primary outcome measure was the Alcohol Urge Question naire taken at pretest and at 20 minutes ( posttest ) . Other measures taken at posttest were the Biphasic Alcohol Effects Question naire , the Drug Effects Question naire , and breath alcohol concentration ( BAC ) . RESULTS The alcohol+energy drink condition showed a greater pre- versus posttest increase in urge to drink alcohol compared with the alcohol-only condition ( B = 3.24 , p = 0.021 , d = 0.44 ) . Participants in the alcohol+energy drink condition had significantly higher ratings on liking the cocktail and wanting to drink more of the cocktail , and lower BACs , than the alcohol-only condition . When examined at specific BACs , the effect of the energy drink on the pre- to posttest increase in urge to drink was largest and only significant at BACs of 0.04 - 0.05 ( cf . < 0.04 g/dl).There were no significant differences in stimulation , sedation , feeling the effects of the cocktail , or feeling high . CONCLUSIONS Combining energy drinks with alcohol increased the urge to drink alcohol relative to drinking alcohol alone . More research is needed to underst and what factors mediate this effect and whether it increases subsequent alcohol consumption 1 . The dynamic and kinetic interactions of alcohol and caffeine were studied in a double-blind , placebo controlled , cross-over trial . Treatments were administered to eight healthy subjects in four experimental sessions , leaving a 1 week wash-out period between each , as follows : 1 ) placebo , 2 ) alcohol ( 0.8 g kg-1 ) , 3 ) caffeine ( 400 mg ) and 4 ) alcohol ( 0.8 g kg-1 ) + caffeine ( 400 mg ) . 2 . Evaluations were performed by means of : 1 ) objective measures : a ) psychomotor performance ( critical flicker fusion frequency , simple reaction time and tapping test ) , b ) long latency visual evoked potentials ( ' pattern reversal ' ) ; 2 ) subjective self-rated scales ( visual analogue scales and profile of mood states ) ; 3 )  caffeine and alcohol plasma concentration determinations . 3 . The battery of pharmacodynamic tests was conducted at baseline and at + 0.5 h , + 1.5 h , + 2.5 h , + 4 h and + 6 h. An analysis of variance was applied to the results , accepting a P < 0.05 as significant . The plasma-time curves for caffeine and alcohol were analysed by means of model-independent methods . 4 . Results obtained with caffeine in the objective measures demonstrated a decrease in simple reaction time and an increase in the amplitude of the evoked potentials ; the subjects ' self-ratings showed a tendency to be more active . Alcohol increased simple reaction time and decreased amplitude of the evoked potentials , although the subjects rated themselves as being active . The combination of alcohol + caffeine showed no significant difference from placebo in the objective tests ; nevertheless , the subjective feeling of drunkenness remained . The area under the curve ( AUC ) for caffeine was significantly higher when administered with alcohol . ( ABSTRACT TRUNCATED AT 250 WORDS OBJECTIVES The consumption of alcohol mixed with energy drinks ( AmED ) is popular on college campuses in the United States . Limited research suggests that energy drink consumption lessens subjective intoxication in persons who also have consumed alcohol . This study examines the relationship between energy drink use , high-risk drinking behavior , and alcohol-related consequences . METHODS In Fall 2006 , a Web-based survey was conducted in a stratified r and om sample of 4,271 college students from 10 universities in North Carolina . RESULTS A total of 697 students ( 24 % of past 30-day drinkers ) reported consuming AmED  in the past 30 days . Students who were male , white , intramural athletes , fraternity or sorority members or pledges , and younger were significantly more likely to consume AmED . In multivariable analyses , consumption of AmED was associated with increased heavy episodic drinking ( 6.4 days vs. 3.4 days on average ; p < 0.001 ) and twice as many episodes of weekly drunkenness ( 1.4 days/week vs. 0.73 days/week ; p < 0.001 ) . Students who reported consuming AmED had significantly higher prevalence of alcohol-related consequences , including being taken advantage of sexually , taking advantage of another sexually , riding with an intoxicated driver , being physically hurt or injured , and requiring medical treatment ( p < 0.05 ) . The effect of consuming AmED on driving while intoxicated depended on a student 's reported typical alcohol consumption ( interaction p = 0.027 ) . CONCLUSIONS Almost one-quarter of college student current drinkers reported mixing alcohol with energy drinks . These students are at increased risk for alcohol-related consequences , even after adjusting for the amount of alcohol consumed . Further research is necessary to underst and this association and to develop targeted interventions to reduce risk AIM To assess event-level associations between  energy drink consumption , alcohol intoxication , and intention to drive a motor vehicle in patrons exiting bars at night . METHOD Alcohol field study . Data collected in a U.S. college bar district from 802 r and omly selected and self-selected patrons .  Anonymous interview and survey data were obtained as well as breath alcohol concentration ( BrAC ) readings . RESULTS Results from logistic regression models revealed that patrons who had consumed alcohol mixed with energy drinks were at a 3-fold increased risk of leaving a bar highly intoxicated ( BrAC > or = 0.08g/210L ) , as well as a 4-fold increased risk of intending to drive upon leaving the bar district , compared to other drinking patrons who did not consume 
    Output:
    
Young adults who consumed AED  drank more alcohol and experienced more alcohol-related harm than other drinkers .
There was insufficient evidence to conclude that AED led to increased alcohol consumption or altered the nature of alcohol-related harm .
However , AED consumers reported that AED increased stimulation and alertness , offset fatigue from drinking , and facilitated drinking .
Experimental research also found that combining ED or caffeine with alcohol increased stimulation and alertness , offset alcohol-related fatigue and increased the desire to keep drinking .
It did not change BAC , perceived intoxication , perceived impairment and it did not reverse alcohol-induced impairment on simple psychomotor tasks .
Combining ED/caffeine with alcohol  reduced alcohol-induced impairment on some but not all aspects of complex tasks .