Last data update: Jul 18, 2025. (Total: 49602 publications since 2009)
Records 1-30 (of 1322 Records) |
Query Trace: Chen J[original query] |
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Effects of K-12 School District Nonpharmaceutical Interventions on Community-Level Prevalence of Acute Respiratory Infection During the COVID-19 Pandemic
He C , Goss MD , Norton D , Chen G , Uzicanin A , Temte JL . Influenza Other Respir Viruses 2025 19 (7) e70139 ![]() BACKGROUND: Responding to the COVID-19 pandemic, kindergarten through 12th grade schools implemented nonpharmaceutical interventions (NPIs). The effects of school-based NPIs on broader community levels of acute respiratory infection (ARI) have not been defined. We utilized an existing longitudinal cohort of households reporting weekly ARI cases to evaluate the effects of evolving school districtwide NPIs on ARI activity at eight transition points from December 2019 through October 2022. METHODS: Household ARI data were reported through the GReat Oregon Child Absenteeism due to Respiratory Disease Study (ORCHARDS) Vaccine Effectiveness Study-a prospective cohort study based in the Oregon School District (OSD) (GROVES). Participating GROVES families completed weekly online surveys with respiratory illness updates. Mixed effects logistic regression was used to examine the association between eight school-related transition events during the COVID-19 pandemic and changes in the trajectory of ARI risk for GROVES family members, while accounting for family clusters. Transition events were assessed using a ±4-week window of community data. RESULTS: Opening schools with maximal NPIs (mandated masking and physical distancing, with hybrid education) was not associated with increased community ARI activity. The four transition events associated with significant ARI risk trajectory increases included summer breaks (June 2020, p = 0.001; June 2021, p = 0.002), and the start of school with mandatory masking only (September 2021, p < 0.001) or without NPIs (September 2022, p < 0.001). CONCLUSIONS: School-based NPI implementation was associated with reduced risks for community ARI activity. Enhanced surveillance platforms such as the weekly online surveys used in this study are valuable tools for better understanding and monitoring SARS-CoV-2 and respiratory virus transmission in schools and surrounding communities. |
Maternal occupational exposure to noise: prevalence, maternal effects and infant outcomes in the National Birth Defects Prevention Study, 1997-2011
Van Buren KW , Rocheleau CM , Chen IC , Sanderson WT , MacDonald LA , Masterson EA , Nestoridi E , Ailes EC . Occup Environ Med 2025 ![]() OBJECTIVES: We investigated associations between occupational noise and gestational diabetes mellitus, pregnancy-related hypertension (including pre-eclampsia/eclampsia), preterm birth and small for gestational age (SGA) infants. METHODS: Data were analysed for 7889 singleton, live-born infants without major birth defects or chromosomal disorders and their mothers from the National Birth Defects Prevention Study from 1997 to 2011. Typical maternal occupational noise exposure in all jobs held from 1 month prior to conception through the end of pregnancy was estimated by expert rater and categorised as quiet (<60 A-weighted decibels (dBA)), low (60-75 dBA), moderate (76-84 dBA) or loud (>85 dBA). Multiple logistic regression was used to estimate associations (adjusted ORs and 95% CIs) between noise exposure levels and outcomes. RESULTS: Approximately 77.4% of pregnant workers had quiet levels of occupational noise exposure, 11.0%, 10.1% and 1.5% had low, moderate and loud exposure levels, respectively. Compared with quiet levels of noise, pregnant workers exposed to low levels of noise had decreased odds of delivering an SGA infant (adjusted OR (aOR)=0.72; 95% CI 0.53 to 0.99) and those exposed to moderate levels had increased odds of delivering an SGA infant (aOR=1.37; 95% CI 1.05 to 1.77). No other significant associations were observed. CONCLUSION: Maternal occupational noise exposure below the 85 dBA threshold recognised as hazardous may be associated with SGA among infants. Elevated point estimates (>1) were observed for the highest noise exposure category and all outcomes, though CIs were wide and statistical significance was not attained. Further research is warranted to address existing knowledge gaps. |
Inadequate Aerobic Physical Activity and Healthcare Expenditures in the United States: An Updated Cost Estimate
Matjasko JL , Chen Z , Whitfield GP , Whitsel LP , Rose K , Roy K . Am J Health Promot 2025 8901171251357128 ![]() |
Safely reopening and operating a primary healthcare facility after closure due to SARS-CoV-2 infection in a healthcare worker - Nairobi, Kenya, 2020
Ndegwa LK , Kimani D , Njeru M , Chen TH , Macharia C , Ouma A , Mboya FO , Oliech J , Kwambai TK , Liban A , Mutisya I , Wangusi R , Bulterys M , Samandari T . Int J Infect Control 2024 20 1-7 The first COVID-19 case in a healthcare worker in Kenya was reported on March 30, 2020, in Nairobi, leading to a 41-day closure of the health facility where he had worked. We assessed infection prevention and control (IPC) activities and implemented recommendations to re-open and operate the facility. We conducted a risk assessment of the facility in April 2020 using a modified World Health Organization, six-element IPC facility risk assessment tool. IPC recommendations were made, and a follow-up assessment of their implementation was conducted in July 2020. Breaches in IPC measures included poor ventilation in most service delivery areas; lack of physical distancing between patients; inadequate COVID-19 information, education, and communication materials; lack of standard operating procedures on cleaning and disinfecting high-touch areas; insufficient IPC training; inadequate hand hygiene facilities; insufficient personal protective equipment supplies; and an inactive IPC committee. Strengthening IPC measures is critical to prevent healthcare facility closures. |
Associations of prenatal per- and polyfluoroalkyl substances with whole blood folate levels in pregnant women in the Health Outcomes and Measures of the Environment (HOME) Study
Lee H , Hall AM , Calafat AM , Chen A , Fazili Z , Lanphear BP , Pfeiffer CM , Yolton K , Braun JM . Environ Epidemiol 2025 9 (4) e406 BACKGROUND: Folate plays a critical role during pregnancy, preventing neural tube defects and possibly adverse neurodevelopment. Per- and polyfluoroalkyl substances (PFAS) are synthetic chemicals that may decrease folate levels. Although some studies have found associations between PFAS and folate, we are unaware of studies conducted in pregnant women. To address this knowledge gap, we evaluated associations between PFAS and whole blood folate (WBF) in pregnant women. METHODS: We used data from 288 pregnant women in the Health Outcomes and Measures of the Environment (HOME) Study, a pregnancy and birth cohort in the Cincinnati Ohio area. We measured eight serum PFAS and WBF concentrations at 16 weeks' gestation. We used linear regression to estimate the effect of each PFAS on WBF, and quantile-based g-computation and Bayesian kernel machine regression (BKMR) to investigate the joint effect of PFAS on WBF, adjusting for parity, prenatal vitamin intake, maternal race/ethnicity, household income, maternal age, and second trimester smoking status in all models. In addition, we investigated interactions between PFAS using BKMR. RESULTS: We did not observe inverse associations of individual PFAS or their mixture with WBF, nor interactions between PFAS in the BKMR model in pregnant women. CONCLUSION: Future studies could consider WBF measures in late pregnancy to evaluate other periods of susceptibility. Furthermore, as people are exposed to multiple PFAS, future studies should continue to consider joint PFAS exposure. |
DC-SIGN (CD209)-mediated interactions between bacteria, lung cancer tissues, and macrophages promote cancer metastasis
Li Q , Hasan N , Zhao F , Xue Y , Zhu S , Lv Y , Jiang LY , Yang K , Li W , Zhang Y , He Y , Cai H , Ding H , Klena JD , Anisimov AP , Wang SG , Chen H , Ye C , Yuan J , Chen T . Infect Agent Cancer 2025 20 (1) 40 One of the hallmarks of lung cancers is the earlier metastasis resulting from the dissemination of cancer cells. Although accumulating evidence suggests that bacterial infection may be involved in the development of the metastasis of lung cancer, few studies have explored the molecular mechanisms of bacterial infection in the dissemination of lung cancer cells. A series of studies have indicated that certain Gram-negative bacteria are able to hijack antigen-presenting cells (APCs) via interaction with DC-SIGN (CD209) receptors to facilitate the dissemination of pathogens, including viruses, bacteria, fungi, and parasites. Therefore, in the present work, it was hypothesized that bacterial infection may promote the dissemination of cancer cells via the utilization of a similar mechanism. It was first discovered that human lung cancer tissues contain a very high diversity of bacterial DNAs, indicating the co-existence of lung cancer tissues and microbial organisms. It was then found that lung cancer tissues express DC-SIGN, leading to binding with a Gram-negative bacterium, Shigella sonnei. Further, this bacterium was found to be able not only to induce the expression of DC-SIGN on macrophages but also to enhance the migration ability of lung cancer cells in vitro. The in vivo experiments supported these observations, showing that in wild-type (WT) mice, Shigella sonnei infection significantly increased tumor size, weight, and metastatic nodules compared to SIGNR1 knockout (KO) mice. These observations were associated with increasing DC-SIGN expression in WT mice. Finally, these results suggest that bacterial infections could play a significant role in promoting lung cancer progression and metastasis via DC-SIGN-mediated mechanisms. |
Self-Reported Reasons Preventing US Adults From Walking to Places Within 10 Minutes of Home
Zaganjor H , Chen TJ , Van Dyke ME , Soto GW , Whitfield GP , Smith A , Devlin HM , Irani K , Rose K , Matjasko JL . Prev Chronic Dis 2025 22 E29 INTRODUCTION: Increasing walking for transportation is a strategy to integrate physical activity into daily life. We examined reported environmental, access, and individual reasons for not walking to places near home among US adults, by sociodemographic characteristics and geographic location. METHODS: We used data from the 2022 SummerStyles survey on 3,967 US adults aged 18 years or older. We calculated prevalence of reporting 11 selected reasons for not walking to places within 10 minutes of home, overall and by sex, race or ethnicity, age, education, income, US census region, and metropolitan residence (an area with at least 1 urban area of ≥50,000 inhabitants) versus nonmetropolitan residence. We used Bonferroni-corrected pairwise comparisons and orthogonal polynomial contrasts (ordered groups) to compare prevalence by subgroup. RESULTS: Overall, 79.0% of respondents identified at least 1 reason for not walking to places near home (within 10 minutes). Commonly reported reasons were hot and humid conditions (36.0%), no places to walk within 10 minutes (24.9%), a preference for driving (22.1%), and inconvenience (21.5%). The reasons varied significantly across sociodemographic and geographic subgroups. The prevalence of reporting none of the listed reasons was higher among males than females, higher among non-Hispanic Black and non-Hispanic Asian adults than non-Hispanic White adults, and higher among adults from the Northeast versus the South. CONCLUSION: Eight of 10 US adults reported at least 1 environmental, access, or individual reason for not walking to places near home. Designing communities to make walking for transportation more accessible, convenient, and desirable may help address the leading reasons reported, which may support adults in adding more physical activity to their daily lives. |
Income-Related Inequalities in Vision Difficulty Among US Adults, 1999-2018
Chen Y , Kim M , Lundeen EA , Rolka DB , Ehrlich JR , Newman-Casey PA , Elam A , Rein D , Holliday C , Saaddine J . Am J Ophthalmol 2025 PURPOSE: Research has shown that the prevalence of vision difficulty is higher among US adults with low income than among those with higher income. We aimed to examine the trends in income-related inequalities in vision difficulty and to identify the contributions of explanatory factors. DESIGN: A cross-sectional and trend study. METHODS: Our study estimated income-related inequalities in self-reported vision difficulty among US adults aged 18 years or older using data from the National Health Interview Survey (NHIS) during 1999-2018. The concentration index was used to measure income-related inequality in vision difficulty and was decomposed into contributing factors. We examined temporal changes in income-related vision difficulty inequalities and contributors to those changes from 1999 to 2018. RESULTS: We found that vision difficulty was concentrated among lower income groups and the degree of income-related inequality in vision difficulty widened between 1999 and 2018. Decomposition analysis revealed that poverty-to-income ratio and public health insurance coverage were important contributors to income-related inequalities in vision difficulty, with smaller contributions made by smoking, physical inactivity, and female sex. Among all variables, non-White race/ethnicity, lower physical activity, and poverty-to-income ratio were important factors explaining the change in income-related inequality in vision difficulty. CONCLUSION: Vision difficulty was more prevalent in low-income populations. Our study enhances the understanding of socioeconomic disparities in vision difficulty, which could inform how to best target the deployment of eye care resources to maximize the visual potential of the US population. |
Special Section: 12th International Computational Advances in Bio and Medical Sciences (ICCABS 2023)
Bansal MS , Chen W , Khudyakov Y , Măndoiu II , Moussa MR , Patterson M , Rajasekaran S , Skums P , Thankachan SV , Zelikovsky A . J Comput Biol 2025 |
Factors Preventing Walking to Near-Home Destinations by Transportation Walking Status, U.S. Adults, 2022
Chen TJ , Zaganjor H , Van Dyke ME , Matjasko JL , Whitfield GP . J Healthy Eat Act Living 2024 4 (3) 120-127 Increasing transportation walking (i.e., walking to get to and from destinations) is a key strategy for increasing physical activity, but what is not well understood are factors preventing people who do not walk for transportation from initiating that practice and current transportation walkers from maintaining or increasing this behavior. This study describes factors preventing adults who report walking or not walking for transportation from regularly walking to destinations near home. National data from the 2022 Summer Styles survey included 3,955 U.S. adults who indicated factors preventing them from regularly walking to places within a 10-minute walk of their home, selecting all that apply from 11 environmental, access, or individual factors, or "None of the above." We estimated weighted prevalence for each factor and conducted pairwise t-tests to identify significant differences (p<.05) by transportation walking status. About 31% of adults not walking for transportation in the past 7 days reported having no places to walk to within a 10-minute walk, more than double the prevalence among transportation walkers (14%). Compared to transportation walkers, more adults not walking for transportation reported individual factors (i.e., 24% preferred driving or being driven, vs. 19%; 23% reported inconvenience, vs. 19%), while more transportation walkers reported environmental factors (e.g., 40% reported hot or humid conditions, vs. 34%) or none of the factors. These findings suggest those not walking for transportation may need varied interventions, such as mixed land use for near-home destinations and individual supports, to meet their needs for transportation walking. |
"I Didn't Know Him Before the Pandemic… Now He's on My Speed Dial": Strengthening Collaboration Between Infectious Diseases Physicians and State and Local Public Health for Future Public Health Emergencies
Valencia D , Edwards L , Horter L , Turner H , Kaur M , Vaidya M , Johnson T , Briggs E , Wollins D , Phua S , Chen AY , Felt-Lisk S , Werbel WA , Kim AI , Lim S , Lynch JB , Foote MMK , Wiley Z , Vaishampayan J , Patel P , Santibañez S . Clin Infect Dis 2025 BACKGROUND: Infectious diseases (ID) physicians play a crucial role in public health emergencies. Effective collaboration between public health agencies and healthcare providers is essential for a coordinated response. However, there is limited information on how ID physicians and health departments collaborate and which areas need to be improved. Here, we identify ways to enhance public health preparedness through increased collaboration between ID physicians and state, tribal, local, and territorial health departments. METHODS: We performed a secondary qualitative analysis of 37 telephone interviews conducted using a semistructured discussion guide. Interviews were conducted from July 2023 through September 2023 as part of a pandemic preparedness needs assessment by the Infectious Diseases Society of America's COVID-19 Real-Time Learning Network. Participants included ID physicians (n = 13), public health workers (n = 7), healthcare facility-based pandemic leaders (n = 7), and national stakeholders (n = 10). RESULTS: While some jurisdictions had robust connections between ID physicians and public health staff, lack of coordination in other areas led to duplication of efforts, confusion, and underutilization of resources. Respondents indicated that collaboration can be strengthened over time. Recommendations included better data systems, standardized reporting procedures, early dissemination of updates, and training of ID physicians in the incident command structure and media communication. CONCLUSIONS: The opportunity to build on institutional knowledge from the coronavirus disease 2019 pandemic will be lost without a commitment of time, resources, and planning. Public health officials can use this experience as a catalyst for building strong collaborative relationships between ID physicians and public health practitioners, a cornerstone of future pandemic response. |
Genomic Characterization of Escherichia coli O157:H7 Associated with Multiple Sources, United States
Wirth JS , Leeper MM , Smith PA , Vasser M , Katz LS , Vidyaprakash E , Carleton HA , Chen JC . Emerg Infect Dis 2025 31 (13) 109-116 ![]() In the United States, Shiga toxin-producing Escherichia coli (STEC) outbreaks cause >265,000 infections and cost $280 million annually. We investigated REPEXH01, a persistent strain of STEC O157:H7 associated with multiple sources, including romaine lettuce and recreational water, that has caused multiple outbreaks since emerging in late 2015. By comparing the genomes of 729 REPEXH01 isolates with those of 2,027 other STEC O157:H7 isolates, we identified a highly conserved, single base pair deletion in espW that was strongly linked to REPEXH01 membership. The biological consequence of that deletion remains unclear; further studies are needed to elucidate its role in REPEXH01. Additional analyses revealed that REPEXH01 isolates belonged to Manning clade 8; possessed the toxins stx2a, stx2c, or both; were predicted to be resistant to several antimicrobial compounds; and possessed a diverse set of plasmids. Those factors underscore the need to continue monitoring REPEXH01 and clarify aspects contributing to its emergence and persistence. |
Patterns of Decline in Measles, Mumps, and Rubella Neutralizing Antibodies and Protection Levels Through 10 Years After a Second and Third Dose of MMR Vaccine
Lutz CS , Nguyen HQ , McClure DL , Masters NB , Chen MH , Colley H , Sowers SB , Crooke SN , Marin M . Open Forum Infect Dis 2025 12 (4) ofaf188 BACKGROUND: In the United States, 2 doses of measles-mumps-rubella (MMR)-containing vaccines are recommended routinely during childhood; a third dose may be given under certain circumstances. We present observed seroprotection rates and estimate long-term dynamics of measles, mumps, and rubella neutralizing antibody (nAb) levels among 2- and 3-dose MMR (MMR2 and MMR3, respectively) vaccinees. METHODS: Persons who received MMR2 at age 4-12 years or MMR3 at age 18-31 years were enrolled in 1994-1995 and 2009-2010, respectively. Per cohort, sera were collected before vaccination (baseline) and at various intervals ranging from 1 month to 10 years postvaccination to assess nAb levels. Annual changes in nAb levels per virus and cohort were estimated through 10 years postvaccination using generalized estimating equations. Models were stratified by baseline nAb levels. RESULTS: Among MMR2 participants (n = 621), 93.7%, 73.4%, and 83.9% had protective nAb levels against measles, mumps, and rubella, respectively, at the 10-year visit; among MMR3 participants (n = 665), 90.5%, 69.1%, and 100% had protective nAb levels, respectively, at the 9-11-year visit. Estimated nAb levels declined annually across both cohorts, all viruses, and baseline nAb strata, though patterns and magnitude varied. More than one-quarter of participants had mumps nAb levels below the presumed seroprotection threshold at the terminal visits. CONCLUSIONS: These findings indicate that even when MMR antibodies wane, protection against disease is largely retained. Waning of mumps antibodies was greater than for measles and rubella in both 2- and 3-dose vaccinees, likely because a greater proportion failed to mount a robust initial response. |
From disease specific to universal health coverage in Lesotho: successes and challenges encountered in Lesotho's digital health journey
Maoeng M , Bruce K , Motebang M , Chen CW , Lecher S , Gadisa T , Saito S , Ntsaba M . Oxf Open Digit Health 2024 2 oqae021 ![]() In Lesotho, the Ministry of Health and key donors have made significant advancements to develop digital health solutions specific to HIV services including an eRegister which is interoperable with the health management information system, pharmacy services and the laboratory information system. New investments from the Millennium Challenge Corporation will expand digital health services to all reported communicable and non-communicable disease areas at health facilities throughout the country. This paper explores how digital health interventions designed to support comprehensive HIV care can be leveraged to provide universal digital health coverage. Specifically, three priority areas will be addressed: (i) governance, security, and system architecture (ii) power, connectivity, and equipment (iii) human resources and change management. |
Enhanced Influenza Vaccines Extend A(H3N2) Antibody Reactivity in Older Adults but Prior Vaccination Effects Persist
Fox A , Sánchez-Ovando S , Carolan L , Hadiprodjo AJ , Chen Y , Ho F , Cheng SMS , Thompson MG , Iuliano AD , Levine MZ , Valkenburg SA , Ip DKM , Peiris JSM , Sullivan SG , Cowling BJ , Leung NHL . Clin Infect Dis 2025 BACKGROUND: Influenza vaccine effectiveness can be reduced in older adults and among repeatedly vaccinated groups. Results from year 1 of "PIVOT," a randomized trial among adults aged ≥65 years in Hong Kong, showed that adjuvanted (Adj), high-dose (HD), and recombinant hemagglutinin (rHA) vaccines induced greater antibody responses against vaccine viruses than standard-dose (SD) influenza vaccine. Here, we examine the breadth of A(H3N2)-reactive antibodies induced during the first 2 study years (2017/2018, 2018/2019), and compare participants who received influenza vaccination annually, or not at all, for 5 years preceding enrollment. METHODS: 14-20 PIVOT participants per vaccine and prior vaccination group (0/5 or 5/5 prior years) who provided sera on days 0, 30, and 182 in year 1 and days 0 and 30 in year 2 were assessed. Hemagglutination inhibition (HAI) antibody titers were measured against 30 viruses spanning 1968 to 2018. RESULTS: In year 1, rHA and Adj but not HD vaccines induced titers ≥40 and titer rises ≥4-fold (seroconversion) against significantly more strains than SD vaccine among participants vaccinated 0/5 prior years. Only rHA and Adj vaccines induced titers ≥40 against post-vaccine strains. Antibody responses were poor among participants vaccinated 5/5 compared with 0/5 prior years and only rHA increased the breadth of seroconversion compared with the SD vaccine in this group. Antibody responses were weaker across groups in year 2. CONCLUSIONS: The results suggest that Adj and particularly rHA vaccines may improve the breadth of protection against A(H3N2) viruses but may not overcome attenuating effects of repeated vaccination in older adults. CLINICAL TRIALS REGISTRATION: NCT03330132. |
Computer vision and tactile glove: A multimodal model in lifting task risk assessment
Chen H , Liu P , Zhou G , Lu ML , Yu D . Appl Ergon 2025 127 104513 ![]() Work-related injuries from overexertion, particularly lifting, are a major concern in occupational safety. Traditional assessment tools, such as the Revised NIOSH Lifting Equation (RNLE), require significant training and practice for deployment. This study presents an approach that integrates tactile gloves with computer vision (CV) to enhance the assessment of lifting-related injury risks, addressing the limitations of existing single-modality methods. Thirty-one participants performed 2747 lifting tasks across three lifting risk categories (LI < 1, 1 ≤ LI ≤ 2, LI > 2). Features including hand pressure measured by tactile gloves during each lift and 3D body poses estimated using CV algorithms from video recordings were combined and used to develop prediction models. The Convolutional Neural Network (CNN) model achieved an overall accuracy of 89 % in predicting the three lifting risk categories. The results highlight the potential for a real-time, non-intrusive risk assessment tool to assist ergonomic practitioners in mitigating musculoskeletal injury risks in workplace environments. |
Development of an early-stage thermal runaway detection model for lithium-ion batteries
Tam WC , Chen J , Fang H , Tang W , Deng J , Putorti A . J Power Sources 2025 641 This paper presents the development of a fast-responding and accurate detection model for early-stage thermal runaway of a lithium-ion battery utilizing acoustics and deep learning paradigms. A series of single-cell battery tests with different state-of-charge and battery orientations is conducted to collect acoustic data. Using data augmentation, 1330 acoustic samples of early-stage thermal runaway are obtained. To facilitate the development of a detection model that can be used in real-life settings, 1128 acoustic samples, including various human activities, are also used. Utilizing 10-s acoustic data as the input and a convolutional neural network model structure as the backbone, excellent model performance is achieved. The overall accuracy is about 93 % with a precision and recall score of about 92 % and 97 %, respectively. Parametric studies are also carried out to evaluate the robustness of the proposed model structure and the effectiveness of the data augmentation methods. In addition, the model performance against two entire tests is assessed using leave-one test-out cross-validation. It is hoped that the proposed work can help to develop a robust detection device that can provide early warning of thermal runaways and allow users to have extra time to mitigate the potential extreme fire hazards and/or to safely evacuate. © 2025 |
Sex- and age-specific lyme disease testing patterns in the United States, 2019 and 2022
Li Y , Matsushita F , Chen Z , Jones RS , Bare LA , Petersen JM , Hinckley AF . Public Health Rep 2025 333549251314419 OBJECTIVES: Serologic testing is a useful adjunct for the diagnosis of Lyme disease, a major public health problem in certain US regions. We aimed to determine whether Lyme disease serologic testing and results differed by sex and age group. METHODS: We identified 2 cohorts of individuals across all ages who underwent serologic testing for Lyme disease at a national reference laboratory in 2019 (cohort 1) and 2022 (cohort 2). If an individual had multiple tests in the same year, we included only the first test. We excluded individuals who had been tested in the previous 5 years. RESULTS: Cohorts 1 and 2 consisted of 578 052 and 550 674 people, respectively. Fewer males than females were tested in cohort 1 (42.7% vs 57.3%) and cohort 2 (42.3% vs 57.7%), although similar numbers were tested for both sexes among nonadults. More males than females had a positive test result in cohort 1 (53.9% more males) and cohort 2 (52.9% more males). The odds ratio of receiving a positive test result among males versus females was 2.09 (95% CI, 2.01-2.17) in cohort 1 and 2.12 (95% CI, 2.05-2.19) in cohort 2. Among people with positive test results, females (except children) were more likely than males to have positive immunoglobulin M and negative immunoglobulin G results, which can serve as a marker of early infection (odds ratio = 1.43 [95% CI, 1.31-1.55] in cohort 1 and 1.38 [95% CI, 1.29-1.47] in cohort 2). CONCLUSIONS: Further studies are needed to understand whether the observed differences in Lyme disease testing and positivity result from sex- and age-associated disparities in social behavior, health care seeking, clinical practice, or other factors. |
Longitudinal associations of PFAS exposure with insulin sensitivity and β-cell function among Hispanic women with gestational diabetes mellitus history
Kang N , Chen W , Osazuwa N , Qiu C , Botelho JC , Calafat AM , Jones D , Buchanan T , Xiang AH , Chen Z . Diabetes Care 2025 48 (4) 564-568 OBJECTIVE: We investigated associations between per- and polyfluoroalkyl substances (PFAS) and changes in diabetes indicators from pregnancy to 12 years after delivery among women with a history of gestational diabetes mellitus (GDM). RESEARCH DESIGN AND METHODS: Eighty Hispanic women with GDM history were followed from the third trimester of pregnancy to 12 years after delivery. Oral and intravenous glucose tolerance tests were conducted during follow-up. Plasma PFAS concentrations were measured at the third trimester of pregnancy and first postpartum visit. A linear mixed-effects model was used to analyze associations between PFAS and trajectories of diabetes indicators, adjusted for age, breastfeeding status, daily total calorie intake, and body fat percentage. RESULTS: Increased 2-(N-methyl-perfluorooctane sulfonamido) acetate level was associated with faster increase in concentrations of fasting glucose (P = 0.003). Increased perfluorononanoate (PFNA) and linear perfluorooctanoate (n-PFOA) concentrations were associated with faster increase in fasting insulin concentrations (P = 0.04 for PFNA; P = 0.02 for n-PFOA) and faster decrease in acute insulin response to glucose (P = 0.04 for PFNA; P = 0.02 for n-PFOA). CONCLUSIONS: PFAS exposure is associated with glucose intolerance, insulin resistance, and β-cell dysfunction, thus increasing type 2 diabetes risk. |
Attribution of Salmonella enterica to Food Sources by Using Whole-Genome Sequencing Data
Rose EB , Steele MK , Tolar B , Pettengill J , Batz M , Bazaco M , Tameru B , Cui Z , Lindsey RL , Simmons M , Chen J , Posny D , Carleton H , Bruce BB . Emerg Infect Dis 2025 31 (4) 783-790 ![]() ![]() Salmonella enterica bacteria are a leading cause of foodborne illness in the United States; however, most Salmonella illnesses are not associated with known outbreaks, and predicting the source of sporadic illnesses remains a challenge. We used a supervised random forest model to determine the most likely sources responsible for human salmonellosis cases in the United States. We trained the model by using whole-genome multilocus sequence typing data from 18,661 Salmonella isolates from collected single food sources and used feature selection to determine the subset of loci most influential for prediction. The overall out-of-bag accuracy of the trained model was 91%; the highest prediction accuracy was for chicken (97%). We applied the trained model to 6,470 isolates from humans with unknown exposure to predict the source of infection. Our model predicted that >33% of the human-derived Salmonella isolates originated from chicken and 27% were from vegetables. |
Circulating neutralizing antibodies and SARS-CoV-2 variant replication following postvaccination infections
Garcia-Knight MA , Kelly JD , Lu S , Tassetto M , Goldberg SA , Zhang A , Pineda-Ramirez J , Anglin K , Davidson MC , Chen JY , Fortes-Cobby M , Park S , Martinez A , So M , Donovan A , Viswanathan B , Richardson ET , McIlwain DR , Gaudilliere B , Rutishauser RL , Chenna A , Petropoulos C , Wrin T , Deeks SG , Abedi GR , Saydah S , Martin JN , Briggs Hagen M , Midgley CM , Peluso MJ , Andino R . JCI Insight 2025 10 (5) ![]() The effect of preexisting neutralizing antibodies (NAb) on SARS-CoV-2 shedding in postvaccination infection (PVI) is not well understood. We characterized viral shedding longitudinally in nasal specimens in relation to baseline (pre/periinfection) serum NAb titers in 125 participants infected with SARS-CoV-2 variants. Among 68 vaccinated participants, we quantified the effect of baseline NAb titers on maximum viral RNA titers and infectivity duration. Baseline NAbs were higher and targeted a broader range of variants in participants with monovalent ancestral booster vaccinations compared with those with a primary vaccine series. In Delta infections, baseline NAb titers targeting Delta or Wuhan-Hu-1 correlated negatively with maximum viral RNA. Per log10 increase in Delta-targeting baseline NAb IC50, maximum viral load was reduced -2.43 (95% CI: -3.76, -1.11) log10 nucleocapsid copies, and infectious viral shedding was reduced -2.79 (95% CI: -4.99, -0.60) days. Conversely, in Omicron infections (BA.1, BA.2, BA.4, or BA.5), baseline NAb titers against Omicron lineages or Wuhan-Hu-1 did not predict viral outcomes. Our results provide robust estimates of the effect of baseline NAbs on the magnitude and duration of nasal viral replication after PVI (albeit with an unclear effect on transmission) and show how immune escape variants efficiently evade these modulating effects. |
Feasibility of cohort event monitoring and assessment of reactogenicity and adverse events among a cohort of AstraZeneca and Moderna COVID-19 vaccine recipients in Nigeria, 2021
Bolu O , Alo OD , Iwara E , Longley AT , Hadley I , Ogar CK , Ezekwe C , Elemuwa U , Adedokun O , Ramadhani HO , Ohakanu S , Ortiz N , Antonza G , Abubakar A , Asekun A , Fraden B , Chen R , Nordenberg D , Adebajo S , Adeyeye MC , Stafford KA . Vaccine 2025 52 126907 BACKGROUND: To generate COVID-19 vaccine safety data in Nigeria, passive reporting was supplemented with cohort event monitoring (CEM), an active surveillance system. We described reactogenicity within 7 days and adverse events up to 3 months after each AstraZeneca or Moderna COVID-19 vaccine dose while assessing the feasibility of implementing CEM in a low- to middle-income country (LMIC) during a mass vaccination campaign. METHODS: Participants were aged ≥18 years with access to mobile phones who received the first dose of an authorized COVID-19 vaccine from participating health facilities in 6 states of Nigeria during September and October 2021. Data collectors interviewed participants via phone on days 0, 3, 7, and thereafter every 7 days for 3 months. The same schedule was restarted if a participant received a second vaccine dose. Proportions of participant-reported adverse events following COVID-19 vaccine receipt were calculated. Investigation and causality assessment were conducted on deaths using the World Health Organization causality guidelines. RESULTS: We enrolled 12,317 participants (AstraZeneca 6990; Moderna 5327); 6167/6990 (88.2 %) AstraZeneca and 4879/5327 (91.6 %) Moderna recipients completed a follow-up interview days 0-7 after the first dose; among them, 2685/6167 (43.5 %) AstraZeneca and 3533/4879 (72.4 %) Moderna recipients reported local reactions and 2456/6167 (39.8 %) AstraZeneca and 2087/4879 (42.8 %) Moderna recipients reported systemic reactions. Overall, 3891/6990 (55.7 %) AstraZeneca and 3978/5327 (72.8 %) Moderna recipients received a second dose of COVID-19 vaccine, among whom 897/3891 (23 %) AstraZeneca and 1979/3978 (49.7 %) Moderna recipients reported local reactions and 727/3891 (18.7 %) AstraZeneca and 1680/3978 (42.2 %) Moderna recipients reported systemic reactions. Among all enrolled, 11 died; there was no evidence to suggest any deaths were vaccine-related. CONCLUSIONS: No unexpected patterns of adverse events were detected, providing additional data on the safety of these COVID-19 vaccines in Nigerian adults. We demonstrated that implementing CEM was feasible and may be valuable for safety monitoring of vaccines introduced in LMICs. |
Gestational PBDE concentrations and executive function in adolescents with self- and caregiver-report: The HOME study
Cecil KM , Xu Y , Chen A , Braun JM , Sjodin A , Lanphear BP , Vuong AM , Yolton K . Environ Res 2025 273 121256 BACKGROUND: Polybrominated diphenyl ethers (PBDEs), synthetic chemicals previously used as flame retardants in commercial products, impact human behaviors, mood symptoms and cognitive abilities. OBJECTIVE: We estimated the association of gestational PBDE serum concentrations with early adolescent self- and caregiver-reported ratings of executive function in a prospective pregnancy and birth cohort. METHODS: We measured gestational serum concentrations of five PBDE congeners and created a summary exposure variable (∑(5)BDE: 28, -47, -99, -100 and -153). At age 12 years, we assessed executive function for 237 adolescents using self- and caregiver-reports with the Behavior Rating Inventory of Executive Functioning (BRIEF-2). We used multivariable linear regression models to estimate covariate-adjusted associations of lipid standardized, log(10)-transformed gestational PBDE concentrations with BRIEF-2 T-scores. We evaluated potential effect measure modification (EMM) of sex by examining sex-stratified regression models. RESULTS: As higher scores indicate greater deficits in executive function, gestational PBDE concentrations were positively associated with adolescent-reported BRIEF-2 T-scores for Global Executive Composite (BDE-28: β = 6.31 (95%CI: 2.59, 10.03), BDE-47: (β = 3.32 (95%CI: 0.1, 6.54), ∑(5)BDE: (β = 3.70 (95%CI: 0.37, 7.03), Behavior Regulation Index (BDE-28: β = 5.36 (95%CI: 1.56, 9.15), BDE-99: β = 3.53 (95%CI: 0.33, 6.74), ∑(5)BDE: β = 3.93 (95%CI: 0.57, 7.3), Emotion Regulation Index (BDE-28: β = 4.76 (95%CI: 0.88, 8.64) and the Cognitive Regulation Index (BDE-28: β = 6.69 (95%CI: 3.08, 10.31), BDE-47: β = 3.45 (95%CI: 0.3, 6.59), ∑(5)BDE: β = 3.57 (95%CI: 0.32, 6.82) and several other scales. We observed stronger associations with gestational PBDE concentrations for all congeners among males, especially for the caregiver-rated scales (all EMM p-values <0.1). DISCUSSION: This study provides evidence that gestational PBDE serum concentrations may adversely influence offspring executive function during adolescence. |
Recent use of novel data streams during foodborne illness cluster investigations by the United States Food and Drug Administration: Qualitative review
Bazaco MC , Carstens CK , Greenlee T , Blessington T , Pereira E , Seelman S , Ivory S , Jemaneh T , Kirchner M , Crosby A , Viazis S , van Twuyver S , Gwathmey M , Malais T , Ou O , Kenez S , Nolan N , Karasick A , Punzalan C , Schwensohn C , Gieraltowski L , Chen Parker C , Jenkins E , Harris S . JMIR Public Health Surveill 2025 11 e58797 ![]() ![]() Foodborne illness is a continuous public health risk. The recognition of signals indicating a cluster of foodborne illness is key to the detection, mitigation, and prevention of foodborne adverse event incidents and outbreaks. With increased internet availability and access, novel data streams (NDSs) for foodborne illness reports initiated by users outside of the traditional public health framework have emerged. These include, but are not limited to, social media websites, web-based product reviews posted to retailer websites, and private companies that host public-generated notices of foodborne illnesses. Information gathered by these platforms can help identify early signals of foodborne illness clusters or help inform ongoing public health investigations. Here we present an overview of NDSs and 3 investigations of foodborne illness incidents by the US Food and Drug Administration that included the use of NDSs at various stages. Each example demonstrates how these data were collected, integrated into traditional data sources, and used to inform the investigation. NDSs present a unique opportunity for public health agencies to identify clusters that may not have been identified otherwise, due to new or unique etiologies, as shown in the 3 examples. Clusters may also be identified earlier than they would have been through traditional sources. NDSs can further provide investigators supplemental information that may help confirm or rule out a source of illness. However, data collected from NDSs are often incomplete and lack critical details for investigators, such as product information (eg, lot numbers), clinical or medical details (eg, laboratory results of affected individuals), and contact information for report follow-up. In the future, public health agencies may wish to standardize an approach to maximize the potential of NDSs to catalyze and supplement adverse event investigations. Additionally, the collection of essential data elements by NDS platforms and data-sharing processes with public health agencies may aid in the investigation of foodborne illness clusters and inform subsequent public health and regulatory actions. |
Evaluation of passive silicone samplers compared to active sampling methods for polycyclic aromatic hydrocarbons during fire training
Sen P , Calkins M , Stakes K , Neumann DL , Chen IC , Horn GP . Toxics 2025 13 (2) 132 Firefighters are occupationally exposed to many chemicals, including polycyclic aromatic hydrocarbons (PAHs), which are formed by the incomplete combustion of organic matter during fire response and training activities. However, due to the harsh environments in which firefighters work, as well as consideration for time and physical safety while wearing bulky equipment, traditional active sampling methods may not be feasible to measure PAH exposures. Silicone passive samplers offer an alternative approach to assess exposure during fire responses and live fire training due to their heat resistance and ease of deployment in remote or time-limited environments. In this study, the primary objective was to investigate and determine the statistical strength of the relationship between active air sampling methods and passive silicone samplers for PAHs. In this study, silicone wristbands were paired with active sampling devices in a series of burn experiments to compare PAH measurements. Silicone-based measurements correlated strongly with active air samples for the dominant PAHs found, naphthalene and phenanthrene; however, detection was limited in the wristbands when air concentrations were low in active samples. In situations where PAH levels are expected to be high and the potential for contaminant loss via off-gassing is low, silicone samplers may be a useful tool for industrial hygienists to measure PAHs in fire and other emergency responses in extreme environments. |
Differences in Long COVID severity by duration of illness, symptom evolution, and vaccination: a longitudinal cohort study from the INSPIRE group
Gottlieb M , Yu H , Chen J , Spatz ES , Gentile NL , Geyer RE , Santangelo M , Malicki C , Gatling K , Saydah S , O'Laughlin KN , Stephens KA , Elmore JG , Wisk LE , L'Hommedieu M , Rodriguez RM , Montoy JCC , Wang RC , Rising KL , Kean E , Dyal JW , Hill MJ , Venkatesh AK , Weinstein RA . Lancet Reg Health - Am 2025 44 Background: Although short-term outcomes of Long COVID have been described, longer-term physical and mental health outcomes of Long COVID are less well-established. This study sought to assess differences in long-term physical and mental health outcomes extending up to three years among those with current, resolved, and no Long COVID, as well as duration of Long COVID and vaccination status. Methods: This was a prospective, multisite, study of participants with SARS-CoV-2 infection from 12/7/2020-8/29/2022, with data collected through 4/2/2024. Surveys included validated tools for physical and mental health. Data were analyzed by Long COVID status (never-had, resolved, current), Long COVID duration and vaccination status. Findings: Of 3663 participants, 2604 (71.1%) never had Long COVID, 994 (27.1%) reported current Long COVID, and 65 (1.8%) reported resolved Long COVID. Compared to never having Long COVID, current Long COVID had lower/worse scores for Patient-Reported Outcomes Measurement Information System (PROMIS) version 29 Physical (7.8; 95% confidence interval [CI] 7.3–8.3) and Mental Health (9.4; 95% CI 8.8–10.1) and higher likelihood of moderate-to-high stress (adjusted odds ratio [aOR]: 2.0; 95% CI 1.6–2.4), moderate-to-high loneliness (aOR: 1.6; 95% CI 1.4–2.0), moderate-to-severe fatigue (aOR: 3.0; 95% CI 2.5–3.7), insufficient activity (aOR for Speedy Nutrition and Physical Activity Assessment ≤4: 0.6; 95% CI 0.5–0.7; aOR for Exercise Vital Sign ≤150 min/week: 0.7, 95% CI 0.6–1.0), and worse dyspnea (aOR: 5.0; 95% CI 4.3–5.8). Resolved Long COVID had lower scores for PROMIS Physical by 2.0 (95% CI 0.2–3.8) and Mental Health by 2.3 (95% CI 0.2–4.4) than the never-had-Long COVID cohort. Number of COVID-19 vaccinations was associated with better outcomes across all measures. Interpretation: Among participants followed up to 3 years after initial infection, those with current Long COVID had worse physical and mental health outcomes. The majority of those with Long COVID did not resolve, with less than 2% having resolved Long COVID. The resolved Long COVID cohort had moderately worse physical and mental health compared with those never-having-Long COVID. COVID-19 vaccination was associated with better outcomes. Funding: Centers for Disease Control and Prevention. © 2025 The Author(s) |
Global guideline for the diagnosis and management of candidiasis: an initiative of the ECMM in cooperation with ISHAM and ASM
Cornely OA , Sprute R , Bassetti M , Chen SC , Groll AH , Kurzai O , Lass-Flörl C , Ostrosky-Zeichner L , Rautemaa-Richardson R , Revathi G , Santolaya ME , White PL , Alastruey-Izquierdo A , Arendrup MC , Baddley J , Barac A , Ben-Ami R , Brink AJ , Grothe JH , Guinea J , Hagen F , Hochhegger B , Hoenigl M , Husain S , Jabeen K , Jensen HE , Kanj SS , Koehler P , Lehrnbecher T , Lewis RE , Meis JF , Nguyen MH , Pana ZD , Rath PM , Reinhold I , Seidel D , Takazono T , Vinh DC , Zhang SX , Afeltra J , Al-Hatmi AMS , Arastehfar A , Arikan-Akdagli S , Bongomin F , Carlesse F , Chayakulkeeree M , Chai LYA , Chamani-Tabriz L , Chiller T , Chowdhary A , Clancy CJ , Colombo AL , Cortegiani A , Corzo Leon DE , Drgona L , Dudakova A , Farooqi J , Gago S , Ilkit M , Jenks JD , Klimko N , Krause R , Kumar A , Lagrou K , Lionakis MS , Lmimouni BE , Mansour MK , Meletiadis J , Mellinghoff SC , Mer M , Mikulska M , Montravers P , Neoh CF , Ozenci V , Pagano L , Pappas P , Patterson TF , Puerta-Alcalde P , Rahimli L , Rahn S , Roilides E , Rotstein C , Ruegamer T , Sabino R , Salmanton-García J , Schwartz IS , Segal E , Sidharthan N , Singhal T , Sinko J , Soman R , Spec A , Steinmann J , Stemler J , Taj-Aldeen SJ , Talento AF , Thompson GR 3rd , Toebben C , Villanueva-Lozano H , Wahyuningsih R , Weinbergerová B , Wiederhold N , Willinger B , Woo PCY , Zhu LP . Lancet Infect Dis 2025 ![]() Candida species are the predominant cause of fungal infections in patients treated in hospital, contributing substantially to morbidity and mortality. Candidaemia and other forms of invasive candidiasis primarily affect patients who are immunocompromised or critically ill. In contrast, mucocutaneous forms of candidiasis, such as oral thrush and vulvovaginal candidiasis, can occur in otherwise healthy individuals. Although mucocutaneous candidiasis is generally not life-threatening, it can cause considerable discomfort, recurrent infections, and complications, particularly in patients with underlying conditions such as diabetes or in those taking immunosuppressive therapies. The rise of difficult-to-treat Candida infections is driven by new host factors and antifungal resistance. Pathogens, such as Candida auris (Candidozyma auris) and fluconazole-resistant Candida parapsilosis, pose serious global health risks. Recent taxonomic revisions have reclassified several Candida spp, potentially causing confusion in clinical practice. Current management guidelines are limited in scope, with poor coverage of emerging pathogens and new treatment options. In this Review, we provide updated recommendations for managing Candida infections, with detailed evidence summaries available in the appendix. |
Prevalence, patterns, and predictors of SARS-CoV-2 RNA and culturable virus in tears of a case-ascertained household cohort. (Special Issue: COVID-19.)
So Matthew , Goldberg Sarah A , Lu Scott , Garcia-Knight Miguel , Davidson Michelle C , Tassetto Michel , Murray Victoria Wong , Anglin Khamal , Pineda-Ramirez Jesus , Chen Jessica Y , Rugart Paulina R , Richardson Eugene T , Briggs-Hagen Melissa , Midgley Claire M , Andino Raul , Seitzman Gerami D , Gonzales John , Peluso Michael J , Martin Jeffrey N , Kelly John Daniel . Am J Ophthalmol 2024 265 48-53 ![]() ![]() Purpose: To investigate the prevalence, patterns, and predictors of SARS-CoV-2 RNA and culturable virus in tears of a case-ascertained household cohort. Design: Prospective, longitudinal case-ascertained household cohort identified through convenience sampling. MethodsThis analysis was restricted to individuals who were non-hospitalized, symptomatic, and tested positive for SARS-CoV-2 by nasal RT-PCR. Tears and anterior nasal biospecimens were serially collected throughout the acute period. Tears specimens were collected by the study staff using Schirmer test strips, and nasal specimens were self-collected. For both, SARS-CoV-2 RNA was quantified using qRT-PCR, and culturable virus was detected using presence of cytopathic effect (CPE) in tissue culture; positive CPE was confirmed by a qRT-PCR step. A series of cross-sectional unadjusted analyses were performed investigating the relationship between different sociodemographic determinants and biological factors associated with tears RNA positivity. |
Global metabolomic alterations associated with endocrine-disrupting chemicals among pregnant individuals and newborns
Puvvula J , Song LC , Zalewska KJ , Alexander A , Manz KE , Braun JM , Pennell KD , DeFranco EA , Ho SM , Leung YK , Huang S , Vuong AM , Kim SS , Percy Z , Bhashyam P , Lee R , Jones DP , Tran V , Kim DV , Calafat AM , Botelho JC , Chen A . Metabolomics 2025 21 (1) 20 ![]() BACKGROUND: Gestational exposure to non-persistent endocrine-disrupting chemicals (EDCs) may be associated with adverse pregnancy outcomes. While many EDCs affect the endocrine system, their effects on endocrine-related metabolic pathways remain unclear. This study aims to explore the global metabolome changes associated with EDC biomarkers at delivery. METHODS: This study included 75 pregnant individuals who delivered at the University of Cincinnati Hospital from 2014 to 2017. We measured maternal urinary biomarkers of paraben/phenol (12), phthalate (13), and phthalate replacements (4) from the samples collected during the delivery visit. Global serum metabolome profiles were analyzed from maternal blood (n = 72) and newborn (n = 63) cord blood samples collected at delivery. Fifteen of the 29 urinary biomarkers were excluded due to low detection frequency or potential exposures during hospital stay. We assessed metabolome-wide associations between 14 maternal urinary biomarkers and maternal/newborn metabolome profiles. Additionally, performed enrichment analysis to identify potential alterations in metabolic pathways. RESULTS: We observed metabolome-wide associations between maternal urinary concentrations of phthalate metabolites (mono-isobutyl phthalate), phthalate replacements (mono-2-ethyl-5-carboxypentyl terephthalate, mono-2-ethyl-5-hydroxyhexyl terephthalate) and phenols (bisphenol-A, bisphenol-S) and maternal serum metabolome, using q-value < 0.2 as a threshold. Additionally, associations of phthalate metabolites (mono-n-butyl phthalate, monobenzyl phthalate) and phenols (2,5-dichlorophenol, BPA) with the newborn metabolome were noted. Enrichment analyses revealed associations (p-gamma < 0.05) with amino acid, carbohydrate, lipid, glycan, vitamin, and other cofactor metabolism pathways. CONCLUSION: Maternal paraben, phenol, phthalate, and phthalate replacement biomarker concentrations at delivery were associated with maternal and newborn serum global metabolome. |
marlod: an R package to model environmental exposure and biomonitoring data with repeated measurements and values below the limit of detection
Chen IC . J Expo Sci Environ Epidemiol 2025 |
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