Last data update: Apr 22, 2024. (Total: 46599 publications since 2009)
Records 1-30 (of 53 Records) |
Query Trace: Dai S [original query] |
---|
A comprehensive analysis of neuroblastoma incidence, survival, and racial and ethnic disparities from 2001 to 2019
Campbell K , Siegel DA , Umaretiya PJ , Dai S , Heczey A , Lupo PJ , Schraw JM , Thompson TD , Scheurer ME , Foster JH . Pediatr Blood Cancer 2023 71 (1) e30732 BACKGROUND: We characterize the incidence and 5-year survival of children and adolescents with neuroblastoma stratified by demographic and clinical factors based on the comprehensive data from United States Cancer Statistics (USCS) and the National Program of Cancer Registries (NPCR). METHODS: We analyzed the incidence of neuroblastoma from USCS (2003-2019) and survival data from NPCR (2001-2018) for patients less than 20 years old. Incidence trends were calculated by average annual percent change (AAPC) using joinpoint regression. Differences in relative survival were estimated comparing non-overlapping confidence intervals (CI). RESULTS: We identified 11,543 primary neuroblastoma cases in USCS. Age-adjusted incidence was 8.3 per million persons [95% CI: 8.2, 8.5], with an AAPC of 0.4% [95% CI: -0.1, 0.9]. Five-year relative survival from the NPCR dataset (n = 10,676) was 79.7% [95% CI: 78.9, 80.5]. Patients aged less than 1 year had the highest 5-year relative survival (92.5%). Five-year relative survival was higher for non-Hispanic White patients (80.7%) or Hispanic patients (80.8%) compared to non-Hispanic Black patients (72.6%). CONCLUSION: Neuroblastoma incidence was stable during 2003-2019. Differences in relative survival exist by sex, age, race/ethnicity, and stage; patients who were male, older, non-Hispanic Black, or with distant disease had worse survival. Future studies could seek to assess the upstream factors driving disparities in survival, and evaluate interventions to address inequities and improve survival across all groups. |
Stable Flow-induced Expression of KLK10 Inhibits Endothelial Inflammation and Atherosclerosis (preprint)
Williams D , Mahmoud M , Liu R , Andueza A , Kumar S , Kang DW , Zhang J , Tamargo I , Villa-Roel N , Baek KI , Lee H , An Y , Zhang L , Tate EW , Bagchi P , Pohl J , Mosnier LO , Diamandis EP , Mihara K , Hollenberg MD , Dai Z , Jo H . bioRxiv 2021 2021.08.10.455857 Introduction Atherosclerosis preferentially occurs in arterial regions exposed to disturbed blood flow (d-flow), while regions exposed to stable flow (s-flow) are protected. The proatherogenic and atheroprotective effects of d-flow and s-flow are mediated in part by the global changes in endothelial cell gene expression, which regulates endothelial dysfunction, inflammation, and atherosclerosis. Previously, we identified Kallikrein-Related Peptidase 10 (KLK10, a secreted serine protease) as a flow-sensitive gene in arterial endothelial cells, but its role in endothelial biology and atherosclerosis was unknown.Methods and Results Here, we show that KLK10 is upregulated under s-flow conditions and downregulated under d-flow conditions using in vivo mouse models and in vitro studies with cultured endothelial cells (ECs). Single-cell RNA sequencing (scRNAseq) and scATAC sequencing (scATACseq) study using the partial carotid ligation mouse model showed flow-regulated KLK10 expression at the epigenomic and transcription levels. Functionally, KLK10 protected against d-flow-induced inflammation and permeability dysfunction in human artery ECs (HAECs). Further, treatment of mice in vivo with rKLK10 decreased arterial endothelial inflammation in d-flow regions. Additionally, rKLK10 injection or ultrasound-mediated transfection of KLK10-expressing plasmids inhibited atherosclerosis in ApoE-/- mice. Studies using pharmacological inhibitors and siRNAs revealed that the anti-inflammatory effects of KLK10 were mediated by a Protease Activated Receptors (PAR1/2)-dependent manner. However, unexpectedly, KLK10 did not cleave the PARs. Through a proteomics study, we identified HTRA1 (High-temperature requirement A serine peptidase 1), which bound and cleaved KLK10. Further, siRNA knockdown of HTRA1 prevented KLK10’s anti-inflammatory and barrier protective function in HAECs, suggesting that HTRA1 regulates KLK10 function. Moreover, KLK10 expression was significantly reduced in human coronary arteries with advanced atherosclerotic plaques compared to those with less severe plaques.Conclusion KLK10 is a flow-sensitive endothelial protein and, in collaboration with HTRA1, serves as an anti-inflammatory, barrier-protective, and anti-atherogenic factor.Competing Interest StatementThe authors have declared no competing interest. |
Automated classification of the phases relevant to work-related musculoskeletal injury risks in residential roof shingle installation operations using machine learning
Dutta A , Breloff SP , Mahmud D , Dai F , Sinsel EW , Warren CM , Wu JZ . Buildings 2023 13 (6) Awkward kneeling in sloped shingle installation operations exposes roofers to knee musculoskeletal disorder (MSD) risks. To address the varying levels of risk associated with different phases of shingle installation, this research investigated utilizing machine learning to automatically classify seven distinct phases in a typical shingle installation task. The classification process relied on analyzing knee kinematics data and roof slope information. Nine participants were recruited and performed simulated shingle installation tasks while kneeling on a sloped wooden platform. The knee kinematics data were collected using an optical motion capture system. Three supervised machine learning classification methods (i.e., k-nearest neighbors (KNNs), decision tree (DT), and random forest (RF)) were selected for evaluation. The KNN classifier provided the best performance for overall accuracy. The results substantiated the feasibility of applying machine learning in classifying shingle installation phases from workers’ knee joint rotation and roof slope angles, which may help facilitate method and tool development for automated knee MSD risk surveillance and assessment among roofers. © 2023 by the authors. |
Early detection of SARS-CoV-2 variants using traveler-based genomic surveillance at four US airports, September 2021- January 2022 (preprint)
Wegrzyn RD , Appiah GD , Morfino R , Milford SR , Walker AT , Ernst ET , Darrow WW , Li SL , Robison K , MacCannell D , Dai D , Girinathan BP , Hicks AL , Cosca B , Woronoff G , Plocik AM , Simen BB , Moriarty L , Guagliardo SAJ , Cetron MS , Friedman CR . medRxiv 2022 22 Background Despite layered mitigation measures, international travel during the COVID-19 pandemic continues to facilitate global spread of SARS-CoV-2, including novel variants of concern (VOCs). On November 26, 2021, B.1.1.529 (Omicron) was designated as a VOC by the World Health Organization [1]. On December 6, 2021, as part of measures to reduce the introduction and spread of Omicron, the requirement for a negative SARS-CoV-2 test taken before air travel to the United States was shortened from three days to one day pre-departure [1]. Although SARS-CoV-2 genomic sequencing has increased significantly during the pandemic [2], there is still a gap in early detection of emerging variants among arriving travelers. In September 2021, the Centers for Disease Control and Prevention (CDC), in collaboration with private partners, implemented a voluntary SARS-CoV-2 genomic surveillance pilot program. Initially we enrolled arriving air travelers from India. On November 28, we expanded the program to include travelers arriving from countries with high travel volumes, including those where Omicron was first detected. Methods Design, Setting, and Participants During September 29-November 27, 2021, the surveillance program included travelers arriving on seven direct flights from India at three international airports: John F. Kennedy, New York (September 29), Newark Liberty, New Jersey (October 4), and San Francisco, California (October 12). During November 28-January 23, Hartsfield-Jackson Atlanta International Airport, Georgia was added, and participation was offered to travelers from South Africa, Nigeria, the United Kingdom, France, Germany, and Brazil, arriving on approximately 50 flights per day. Participants were 18 years or older, provided informed consent, and completed demographic, clinical, and travel history questions. Copyright The copyright holder for this preprint is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. This article is a US Government work. It is not subject to copyright under 17 USC 105 and is also made available for use under a CC0 license. |
Pediatric rhabdomyosarcoma incidence and survival in the United States: An assessment of 5656 cases, 2001-2017
McEvoy MT , Siegel DA , Dai S , Okcu MF , Zobeck M , Venkatramani R , Lupo PJ . Cancer Med 2022 12 (3) 3644-3656 BACKGROUND: While rhabdomyosarcoma (RMS) is the most common soft tissue sarcoma in children and adolescents, past epidemiology studies of this malignancy used data that covered <30% of the US population. Therefore, we evaluated RMS incidence using data from U.S. Cancer Statistics (USCS) and survival trends using the National Program of Cancer Registries (NPCR), which covers 100% and 94% of the U.S. population, respectively. METHODS: Incidence and survival were assessed for pediatric patients diagnosed with RMS during 2003-2017 and 2001-2016, respectively. Both demographic and clinical variables were evaluated. Age-adjusted incidence rates, average annual percent change (AAPC), and 5-year relative survival (RS) were calculated, all with corresponding 95% confidence intervals (CIs). Cox regression models were used to evaluate the impact of demographic and clinical variables on survival. RESULTS: We identified 5656 primary RMS cases in USCS during 2003-2017. The age-adjusted incidence rate was 4.58 per 1 million (95% CI: 4.46-4.70) with an AAPC of 0.3% (95% CI: -0.7 to 1.2%). In NPCR, 5-year RS for all cases was 68.0% (95% CI: 66.6-69.3%). In multivariable analyses, non-Hispanic (NH) Black cases had worse survival compared with NH White cases (hazard ratio [HR] = 1.16, 95% CI: 1.01-1.33). CONCLUSION: The incidence and survival rates were stable in the largest and most comprehensive population-based analysis for pediatric RMS cases in the U.S. Additionally, we observed a survival disparity among NH Black cases. Findings from this study could inform interventions to address disparities, risk stratification strategies, and clinical trial design. |
Early detection of SARS-CoV-2 variants using traveler-based genomic surveillance at four US airports, September 2021- January 2022.
Wegrzyn RD , Appiah GD , Morfino R , Milford SR , Walker AT , Ernst ET , Darrow WW , Li SL , Robison K , MacCannell D , Dai D , Girinathan BP , Hicks AL , Cosca B , Woronoff G , Plocik AM , Simen BB , Moriarty L , Guagliardo SAJ , Cetron MS , Friedman CR . Clin Infect Dis 2023 76 (3) e540-e543 We enrolled arriving international air travelers in a severe acute respiratory syndrome coronavirus 2 genomic surveillance program. We used molecular testing of pooled nasal swabs and sequenced positive samples for sublineage. Traveler-based surveillance provided early-warning variant detection, reporting the first US Omicron BA.2 and BA.3 in North America. |
Incidence and 5-year survival of children and adolescents with hepatoblastoma in the United States
Kahla JA , Siegel DA , Dai S , Lupo PJ , Foster JH , Scheurer ME , Heczey AA . Pediatr Blood Cancer 2022 69 (10) e29763 OBJECTIVE: Hepatoblastoma (HB) is the most common pediatric primary malignant liver tumor, its incidence has been increasing worldwide, but recent changes in incidence and outcomes with high population coverage are not well characterized. METHODS: We defined the incidence of HB diagnosed during 2003-2017 from United States Cancer Statistics (USCS) database, and survival during 2001-2016 from the National Program of Cancer Registries (NPCR). Data were stratified by sex, race/ethnicity, age, tumor stage, county population, and diagnosis year. Incidence trends were assessed by calculating average annual percent change (AAPC) using Joinpoint regression. Differences in overall 5-year survival were estimated using Cox regression analysis. RESULTS: 2178 HB cases with an annual incidence rate of 1.76 per million persons were identified and incidence increased over time (AAPC = 2.2, 95% confidence interval [CI], 0.9-3.6). The 5-year relative survival was 76.9% (95% CI: 74.9-78.8) and the risk of death was lower for cases diagnosed after 2009 (hazard ratio [HR] = 0.77, 95% CI: 0.63-0.94), higher for ages 3-7 years and 8-19 years compared to 0-2 years (HR = 1.38, 95% CI: 1.10-1.76 and 1.83, 95% CI: 1.31-2.70, respectively), for distant compared to locoregional stage (HR = 2.77, 95% CI: 2.27-3.36), and for non-Hispanic Black compared to non-Hispanic White cases (HR = 1.39, 95% CI: 1.02-1.84). CONCLUSIONS: HB incidence increased, and survival improved over the study period. Disparities in survival exist by age, race or ethnicity, and stage. Further studies could identify factors affecting increases in HB cases, inform future interventions, and address disparities in outcomes. |
Prevalence of Americans reporting a family history of cancer indicative of increased cancer risk: Estimates from the 2015 National Health Interview Survey
Kumerow MT , Rodriguez JL , Dai S , Kolor K , Rotunno M , Peipins LA . Prev Med 2022 159 107062 The collection and evaluation of family health history in a clinical setting presents an opportunity to discuss cancer risk, tailor cancer screening recommendations, and identify people with an increased risk of carrying a pathogenic variant who may benefit from referral to genetic counseling and testing. National recommendations for breast and colorectal cancer screening indicate that men and women who have a first-degree relative affected with these types of cancers may benefit from talking to a healthcare provider about starting screening at an earlier age and other options for cancer prevention. The prevalence of reporting a first-degree relative who had cancer was assessed among adult respondents of the 2015 National Health Interview Survey who had never had cancer themselves (n = 27,999). We found 35.6% of adults reported having at least one first-degree relative with cancer at any site. Significant differences in reporting a family history of cancer were observed by sex, age, race/ethnicity, educational attainment, and census region. Nearly 5% of women under age 50 and 2.5% of adults under age 50 had at least one first-degree relative with breast cancer or colorectal cancer, respectively. We estimated that 5.8% of women had a family history of breast or ovarian cancer that may indicate increased genetic risk. A third of U.S. adults who have never had cancer report a family history of cancer in a first-degree relative. This finding underscores the importance of using family history to inform discussions about cancer risk and screening options between healthcare providers and their patients. |
Number of prostate-specific antigen (PSA) screening tests in the last five years reported by men in the United States in 2010, 2015, and 2018
Richards TB , Dai S , Gray SC , Hall IJ , Siegel DA . Urol Oncol 2022 40 (5) 192 e19-192 e25 BACKGROUND: Longer intervals between prostate-specific antigen (PSA) tests for routine prostate cancer screening can reduce the harms while maintaining the benefits of screening. Limited information has been published on PSA screening frequency. The purpose of this report is to describe the number of PSA tests in the last 5 years reported by men in the United States. METHODS: Using data from National Health Interview Survey Cancer Control Supplements in 2010, 2015, and 2018, the number of PSA tests in the last 5 years reported by men ≥40 years was categorized as 4 to 5 PSA tests, 1 to 3 PSA tests, and no PSA tests. Logistic regression was used to calculate model-adjusted prevalence risk ratios (aPRs) for the number of PSA tests in the last 5 years, adjusting for age, racial-ethnic group, education, marital status, and health insurance. RESULTS: The proportion of men aged ≥70 years who reported 4 to 5 PSA tests in the last 5 years decreased from 37.2% in 2010 to 31.1% in 2018, while the proportion reporting 1 to 3 PSA tests increased from 25.5% to 31.9%. In 2018, aPRs for 4 to 5 PSA tests vs. 1 to 3 PSA tests in the last 5 years were significantly higher among men aged 70 to 79 years than among men aged 55 to 69 years. CONCLUSIONS: Men aged ≥70 years reported a small shift to less intense PSA testing between 2010 and 2018, but PSA testing intensity remained higher in men aged ≥70 years than in men aged 55 to 69 years. |
Stable flow-induced expression of KLK10 inhibits endothelial inflammation and atherosclerosis.
Williams D , Mahmoud M , Liu R , Andueza A , Kumar S , Kang DW , Zhang J , Tamargo I , Villa-Roel N , Baek KI , Lee H , An Y , Zhang L , Tate EW , Bagchi P , Pohl J , Mosnier LO , Diamandis EP , Mihara K , Hollenberg MD , Dai Z , Jo H . Elife 2022 11 Atherosclerosis preferentially occurs in arterial regions exposed to disturbed blood flow (d-flow), while regions exposed to stable flow (s-flow) are protected. The proatherogenic and atheroprotective effects of d-flow and s-flow are mediated in part by the global changes in endothelial cell (EC) gene expression, which regulates endothelial dysfunction, inflammation, and atherosclerosis. Previously, we identified kallikrein-related peptidase 10 (Klk10, a secreted serine protease) as a flow-sensitive gene in mouse arterial ECs, but its role in endothelial biology and atherosclerosis was unknown. Here, we show that KLK10 is upregulated under s-flow conditions and downregulated under d-flow conditions using in vivo mouse models and in vitro studies with cultured ECs. Single-cell RNA sequencing (scRNAseq) and scATAC sequencing (scATACseq) study using the partial carotid ligation mouse model showed flow-regulated Klk10 expression at the epigenomic and transcription levels. Functionally, KLK10 protected against d-flow-induced permeability dysfunction and inflammation in human artery ECs, as determined by NFκB activation, expression of vascular cell adhesion molecule 1 and intracellular adhesion molecule 1, and monocyte adhesion. Furthermore, treatment of mice in vivo with rKLK10 decreased arterial endothelial inflammation in d-flow regions. Additionally, rKLK10 injection or ultrasound-mediated transfection of Klk10-expressing plasmids inhibited atherosclerosis in Apoe(-/-) mice. Moreover, KLK10 expression was significantly reduced in human coronary arteries with advanced atherosclerotic plaques compared to those with less severe plaques. KLK10 is a flow-sensitive endothelial protein that serves as an anti-inflammatory, barrier-protective, and anti-atherogenic factor. |
Epidemiology of anal human papillomavirus infection and high-grade squamous intraepithelial lesions in 29 900 men according to HIV status, sexuality, and age: a collaborative pooled analysis of 64 studies.
Wei F , Gaisa MM , D'Souza G , Xia N , Giuliano AR , Hawes SE , Gao L , Cheng SH , Donà MG , Goldstone SE , Schim van der Loeff MF , Neukam K , Meites E , Poynten IM , Dai J , Combes JD , Wieland U , Burgos J , Wilkin TJ , Hernandez AL , Iribarren Díaz M , Hidalgo-Tenorio C , Valencia Arredondo M , Nyitray AG , Wentzensen N , Chow EP , Smelov V , Nowak RG , Phanuphak N , Woo YL , Choi Y , Hu Y , Schofield AM , Woestenberg PJ , Chikandiwa AT , Hickey AC , de Pokomandy A , Murenzi G , Péré H , Del Pino M , Ortiz AP , Charnot-Katsikas A , Liu X , Chariyalertsak S , Strong C , Ong JJ , Yunihastuti E , Etienney I , Ferré VM , Zou H , Segondy M , Chinyowa S , Alberts CJ , Clifford GM . Lancet HIV 2021 8 (9) e531-e543 BACKGROUND: Robust age-specific estimates of anal human papillomavirus (HPV) and high-grade squamous intraepithelial lesions (HSIL) in men can inform anal cancer prevention efforts. We aimed to evaluate the age-specific prevalence of anal HPV, HSIL, and their combination, in men, stratified by HIV status and sexuality. METHODS: We did a systematic review for studies on anal HPV infection in men and a pooled analysis of individual-level data from eligible studies across four groups: HIV-positive men who have sex with men (MSM), HIV-negative MSM, HIV-positive men who have sex with women (MSW), and HIV-negative MSW. Studies were required to inform on type-specific HPV infection (at least HPV16), detected by use of a PCR-based test from anal swabs, HIV status, sexuality (MSM, including those who have sex with men only or also with women, or MSW), and age. Authors of eligible studies with a sample size of 200 participants or more were invited to share deidentified individual-level data on the above four variables. Authors of studies including 40 or more HIV-positive MSW or 40 or more men from Africa (irrespective of HIV status and sexuality) were also invited to share these data. Pooled estimates of anal high-risk HPV (HR-HPV, including HPV16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, and 68), and HSIL or worse (HSIL+), were compared by use of adjusted prevalence ratios (aPRs) from generalised linear models. FINDINGS: The systematic review identified 93 eligible studies, of which 64 contributed data on 29 900 men to the pooled analysis. Among HIV-negative MSW anal HPV16 prevalence was 1·8% (91 of 5190) and HR-HPV prevalence was 6·9% (345 of 5003); among HIV-positive MSW the prevalences were 8·7% (59 of 682) and 26·9% (179 of 666); among HIV-negative MSM they were 13·7% (1455 of 10 617) and 41·2% (3798 of 9215), and among HIV-positive MSM 28·5% (3819 of 13 411) and 74·3% (8765 of 11 803). In HIV-positive MSM, HPV16 prevalence was 5·6% (two of 36) among those age 15-18 years and 28·8% (141 of 490) among those age 23-24 years (p(trend)=0·0091); prevalence was 31·7% (1057 of 3337) among those age 25-34 years and 22·8% (451 of 1979) among those age 55 and older (p(trend)<0·0001). HPV16 prevalence in HIV-negative MSM was 6·7% (15 of 223) among those age 15-18 and 13·9% (166 of 1192) among those age 23-24 years (p(trend)=0·0076); the prevalence plateaued thereafter (p(trend)=0·72). Similar age-specific patterns were observed for HR-HPV. No significant differences for HPV16 or HR-HPV were found by age for either HIV-positive or HIV-negative MSW. HSIL+ detection ranged from 7·5% (12 of 160) to 54·5% (61 of 112) in HIV-positive MSM; after adjustment for heterogeneity, HIV was a significant predictor of HSIL+ (aPR 1·54, 95% CI 1·36-1·73), HPV16-positive HSIL+ (1·66, 1·36-2·03), and HSIL+ in HPV16-positive MSM (1·19, 1·04-1·37). Among HPV16-positive MSM, HSIL+ prevalence increased with age. INTERPRETATION: High anal HPV prevalence among young HIV-positive and HIV-negative MSM highlights the benefits of gender-neutral HPV vaccination before sexual activity over catch-up vaccination. HIV-positive MSM are a priority for anal cancer screening research and initiatives targeting HPV16-positive HSIL+. FUNDING: International Agency for Research on Cancer. |
Application of Data Fusion via Canonical Polyadic Decomposition in Risk Assessment of Musculoskeletal Disorders in Construction: Procedure and Stability Evaluation
Dutta A , Breloff SP , Dai F , Sinsel EW , Warren CM , Carey RE , Wu JZ . J Constr Eng Manage 2021 147 (8) Missing data is a common problem in data collection for work-related musculoskeletal disorder (WMSD) risk-assessment studies. It can cause incompleteness of risk indicators, leading to erroneous conclusion on potential risk factors. Previous studies suggested that data fusion is a potential way to solve this issue. This research evaluated the numerical stability of a data fusion technique that applies canonical polyadic decomposition (CPD) for WMSD risk assessment in construction. Two knee WMSD risk-related data sets - three-dimensional (3D) knee rotation (kinematics) and electromyography (EMG) of five knee postural muscles - collected from previous studies were fused for the evaluation. By comparing the consistency performance with and without data fusion, it revealed that for all low to high proportion of missing data (10%-70%) from both kinematics and EMG data sets, the WMSD risk assessment using fused data sets outperformed using unfused kinematics data sets. For large proportions of missing data (>50%) from both kinematics and EMG data sets, better performance was observed by using fused data sets in comparison with unfused EMG data sets. These findings suggest that data fusion using CPD generates a more reliable risk assessment compared with data sets with missing values and therefore is an effective approach for remedying missing data in WMSD risk evaluation. © 2021 American Society of Civil Engineers. |
Changes in Emergency Medical Services before and during COVID-19 in the United States, January 2018-December 2020.
Handberry M , Bull-Otterson L , Dai M , Mann CN , Chaney E , Ratto J , Horiuchi K , Siza C , Kulkarni A , Gundlapalli AV , Boehmer TK . Clin Infect Dis 2021 73 S84-S91 BACKGROUND: As a result of the continuing surge of COVID-19, many patients have delayed or missed routine screening and preventive services. Medical conditions, such as coronary heart disease, mental health issues, and substance use disorder, may be identified later, leading to increases in patient morbidity and mortality. METHODS: The National Emergency Medical Services Information System (NEMSIS) data were used to assess 911 Emergency Medical Services (EMS) activations during 2018-2020. For specific activation types, the percentage of total activations was calculated per week and joinpoint analysis was used to identify changes over time. RESULTS: Since March 2020, the number of 911 emergency medical services (EMS) activations has decreased, while the percentages of on-scene death, cardiac arrest, and opioid use/overdose EMS activations were higher than pre-pandemic levels. During the early pandemic period, percentages of total EMS activations increased for on-scene death (from 1.3% to 2.4% during weeks 11-15), cardiac arrest (from 1.3% to 2.2% during weeks 11-15), and opioid use/overdose (from 0.6% to 1.1% during weeks 8-18); the percentages then declined, but remained above pre-pandemic levels through calendar week 52. CONCLUSIONS: The COVID-19 pandemic has indirect consequences, such as relative increases in EMS activations for cardiac events and opioid use/overdose, possibly linked to disruptions is healthcare access and health-seeking behaviors. Increasing telehealth visits or other opportunities for patient-provider touch points for chronic disease and substance use disorders that emphasize counseling, preventive care, and expanded access to medications can disrupt delayed care-seeking during the pandemic and potentially prevent premature death. |
An alternative method for analyzing the slip potential of workers on sloped surfaces
Dong RG , Wu JZ , Dai F , Breloff SP . Saf Sci 2021 133 Slips and falls on sloped roof surfaces remain an important safety issue among construction workers. The slip potential has been conventionally analyzed and assessed primarily based on ground reaction forces, which cannot differentiate the specific roles of each of the force factors (e.g., workers’ motions-induced dynamic forces and slope-induced static forces) contributing to the slip potential. Their differentiation may enhance the understanding of the slip mechanisms on the sloped roof surfaces and help develop effective walking and working strategies/tactics to minimize the dangerous slips on the elevated roofs. Hence, the objective of this study is to develop a biodynamic method as an additional tool for analyzing the slip potential of a worker walking or working on sloped roof surfaces. A whole-body biodynamic model is proposed and used to develop the alternative method, in which the slip potential is expressed as an analytical function of its major controlling factors including coefficient of friction, slope angle, and biodynamic forces. Some experimental data available in the literature are used to demonstrate the application of the proposed method. The results suggest that the slope may not change the basic trends of the biodynamic forces, but the slope may affect their magnitudes, which can be explained using the system's energy equation also derived from the whole-body biodynamic model. The analytical results suggest that reducing the body acceleration in uphill direction or the deceleration in downhill direction can reduce the slip potential. ‘Zigging’ and ‘zagging’ walking on a sloped surface may also reduce the slip potential, as it reduces the effective slope angle. The proposed biodynamic theory can be used to enhance the safety guidelines not only for roofers but also for people walking on ramps, inclined walkways, and mountain terrains. |
An examination of gender differences in the National Diabetes Prevention Program's Lifestyle Change Program
Jackson MC , Dai S , Skeete RA , Owens-Gary M , Cannon MJ , Smith BD , Jabrah R , Masalovich SE , Soler RE . Diabetes Educ 2020 46 (6) 580-586 PURPOSE: The purpose of the study was to examine how gender was related to enrollment and number of sessions attended in the National Diabetes Prevention Program's Lifestyle Change Program (DPP LCP). METHODS: To better understand program uptake, a population of those who would be eligible for the LCP was compared to those who enrolled. Estimates of those eligible were computed using data from the National Health and Nutrition Examination Survey, whereas enrollment and sessions attended were computed using data from the Centers for Disease Control and Prevention's Diabetes Prevention Recognition Program. RESULTS: Results revealed that although similar numbers of males and females were eligible for the program, only 39 321 males versus 121 007 females had enrolled in the National DPP LCP by the end of 2017 (odds ratio = 3.20; 95% CI, 3.17-3.24). The gender differences persisted even when stratifying by age or race/ethnicity. In contrast, no significant gender differences were found between the average number of sessions attended for males (14.0) and females (13.8). DISCUSSION: Results of the study can help inform efforts to market and tailor programs to appeal more directly to men and other groups that are underrepresented in the National DPP LCP. |
Comparison of alternative full and brief versions of functional status scales among older adults in China
Reich J , Thompson MG , Cowling BJ , Iuliano AD , Greene C , Chen Y , Phadnis R , Leung NHL , Song Y , Fang VJ , Xu C , Dai Q , Zhang J , Zhang H , Havers F . PLoS One 2020 15 (8) e0234698 BACKGROUND: Brief assessments of functional status for community-dwelling older adults are needed given expanded interest in the measurement of functional decline. METHODS: As part of a 2015 prospective cohort study of older adults aged 60-89 years in Jiangsu Province, China, 1506 participants were randomly assigned to two groups; each group was administered one of two alternative 20-item versions of a scale to assess activities of daily living (ADL) and instrumental activities of daily living (IADL) drawn from multiple commonly-used scales. One version asked if they required help to perform activities (ADL-IADL-HELP-20), while the other version provided additional response options if activities could be done alone but with difficulty (ADL-IADL-DIFFICULTY-20). Item responses to both versions were compared using the binomial test for differences in proportion (with Wald 95% confidence interval [CI]). A brief 9-item scale (ADL-IADL-DIFFICULTY-9) was developed favoring items identified as difficult or requiring help by ≥4%, with low redundancy and/or residual correlations, and with significant correlations with age and other health indicators. We repeated assessment of the measurement properties of the brief scale in two subsequent samples of older adults in Hong Kong in 2016 (aged 70-79 years; n = 404) and 2017 (aged 65-82 years; n = 1854). RESULTS: Asking if an activity can be done alone but with difficulty increased the proportion of participants reporting restriction on 9 of 20 items, for which 95% CI for difference scores did not overlap with zero; the proportion with at least one limitation increased from 28.6% to 34.2% or an absolute increase of 5.6% (95% CI = 0.9-10.3%), which was a relative increase of 19.6%. The brief ADL-IADL-DIFFICULTY-9 maintained excellent internal consistency (α = 0.93) and had similar ceiling effect (68.1%), invariant item ordering (H trans = .41; medium), and correlations with age and other health measures compared with the 20-item version. The brief scale performed similarly when subsequently administered to older adults in Hong Kong. CONCLUSIONS: Asking if tasks can be done alone but with difficulty can modestly reduce ceiling effects. It's possible that the length of commonly-used scales can be reduced by over half if researchers are primarily interested in a summed indicator rather than an inventory of specific types of deficits. |
Fusing imperfect experimental data for risk assessment of musculoskeletal disorders in construction using canonical polyadic decomposition
Dutta A , Breloff SP , Dai F , Sinsel EW , Carey RE , Warren CM , Wu JZ . Autom Constr 2020 119 Field or laboratory data collected for work-related musculoskeletal disorder (WMSD) risk assessment in construction often becomes unreliable as a large amount of data go missing due to technology-induced errors, instrument failures or sometimes at random. Missing data can adversely affect the assessment conclusions. This study proposes a method that applies Canonical Polyadic Decomposition (CPD) tensor decomposition to fuse multiple sparse risk-related datasets and fill in missing data by leveraging the correlation among multiple risk indicators within those datasets. Two knee WMSD risk-related datasets—3D knee rotation (kinematics) and electromyography (EMG) of five knee postural muscles—collected from previous studies were used for the validation and demonstration of the proposed method. The analysis results revealed that for a large portion of missing values (40%), the proposed method can generate a fused dataset that provides reliable risk assessment results highly consistent (70%–87%) with those obtained from the original experimental datasets. This signified the usefulness of the proposed method for use in WMSD risk assessment studies when data collection is affected by a significant amount of missing data, which will facilitate reliable assessment of WMSD risks among construction workers. In the future, findings of this study will be implemented to explore whether, and to what extent, the fused dataset outperforms the datasets with missing values by comparing consistencies of the risk assessment results obtained from these datasets for further investigation of the fusion performance. |
Effects of working posture and roof slope on activation of lower limb muscles during shingle installation
Dutta A , Breloff SP , Dai F , Sinsel EW , Warren CM , Carey RE , Wu JZ . Ergonomics 2020 63 (9) 1-17 Awkward and extreme kneeling during roofing generates high muscular tension which can lead to knee musculoskeletal disorders (MSDs) among roofers. However, the combined impact of roof slope and kneeling posture on the activation of the knee postural muscles and their association to potential knee MSD risks among roofers have not been studied. The current study evaluated the effects of kneeling posture and roof slope on the activation of major knee postural muscles during shingle installation via a laboratory assessment. Maximum normalized electromyography (EMG) data were collected from knee flexor and extensor muscles of seven subjects, who mimicked the shingle installation process on a slope-configurable wooden platform. The results revealed a significant increase in knee muscle activation during simulated shingle installation on sloped rooftops. Given the fact that increased muscle activation of knee postural muscles has been associated with knee MSDs, roof slope and awkward kneeling posture can be considered as potential knee MSD risk factors.Practitioner Summary: This study demonstrated significant effects of roof slope and kneeling posture on the peak activation of knee postural muscles. The findings of this study suggested that residential roofers could be exposed to a greater risk of developing knee MSDs with the increase of roof slope during shingle installation due to increased muscle loading. |
Kneeling trunk kinematics during simulated sloped roof shingle installation
Breloff SP , Carey RE , Dutta A , Sinsel EW , Warren CM , Dai F , Wu JZ . Int J Ind Ergon 2020 77 Trunk musculoskeletal disorders are common among residential roofers. Addressing this problem requires a better understanding of the movements required to complete working tasks, such as affixing shingles on a sloped residential roof. We analyzed the extent to which the trunk kinematics during a shingling process are altered due to different angles of roof slope. Eight male subjects completed a kneeling shingle installation process on three differently sloped roof surfaces. The magnitude of the trunk kinematics was significantly influenced by both slope and task phase of the shingling process, depending on the metric. The results unequivocally point to roof slope and task phase as significant factors altering trunk kinematics. However, extension of the results to roofing workers should be done carefully, depending on the degree to which the study protocol represents the natural setting. Future studies on shingle installation in residential roofing should absolutely consider capturing a wider array of shingling procedures in order to encapsulate all the possible methods that are used due to the lack of a standardized procedure. |
Identifying potentially risky phases leading to knee musculoskeletal disorders during shingle installation operations
Dutta A , Breloff SP , Dai F , Sinsel EW , Warren CM , Wu JZ . J Constr Eng Manage 2020 146 (3) Repeated and prolonged awkward kneeling can result in musculoskeletal disorders (MSD) in construction roofers. However, a task-specific risk assessment for roofers' knee injuries is still missing in the literature. This study identified a ranking-based ergonomic method for suggesting potentially risky phases that may increase knee MSD risk during shingle installation operations. On a slope-adjustable wooden platform in a laboratory setting, nine subjects performed shingle installations that included seven phases: (1) reaching for shingles, (2) placing shingles, (3) grabbing nail gun, (4) moving to first nailing position, (5) nailing shingles, (6) replacing nail gun, and (7) returning to upright position. Flexion, abduction, adduction, and internal and external knee rotations were measured to assess relative risks of these phases by ranking them with a scoring model. The ranking results revealed that the phases of placing shingles and nailing shingles lead to the most knee MSD risk exposure, and awkward flexion, abduction, and adduction involved in these phases can significantly contribute to the potential knee MSD risk measurement. By using the ranking-based method, this study suggested that certain phases of the shingle installation process may increase knee MSD risk, which is useful for developing effective interventions to reduce knee injury risk exposures from roof shingle installation. |
Are knee savers and knee pads a viable intervention to reduce lower extremity musculoskeletal disorder risk in residential roofers
Breloff SP , Sinsel EW , Dutta A , Carey RE , Warren CM , Dai F , Ning S , Wu JZ . Int J Ind Ergon 2019 74 One factor commonly associated with musculoskeletal disorder risk is extreme postures. To lessen this risk, extreme postures should be reduced using proactive and prevention-focused methods. The effect of combinations of two interventions, knee pads and knee savers, on lower extremity kinematics during deep or near full flexion kneeling on differently sloped surfaces was analyzed. Nine male subjects were requested to keep a typical resting posture while kneeling on a sloped roofing simulator with and without knee pads and knee savers. Three-dimensional peak knee kinematics were recording using a motion capture system. The kinematic data were analyzed with a two-way—4(intervention) X 3(slope)—repeated measure analysis of variance (ANOVA). It was observed that knee pads did not alter lower extremity kinematics in a way that may reduce musculoskeletal injury risk, but they do provide comfort. Knee savers did statistically significantly reduce peak lower extremity kinematics, however these changes were small and it is uncertain if the changes will reduce musculoskeletal injury risk. This study has provided initial data that supports the use of knee savers as a potential intervention to reduce musculoskeletal disorder risk due to lower extremity joint angles on a sloped surface, nonetheless, further testing involving other musculoskeletal disorder risk factors is needed prior to a conclusive recommendation. |
Assessing work-related risk factors for musculoskeletal knee disorders in construction roofing tasks
Breloff SP , Dutta A , Dai F , Sinsel EW , Warren CM , Ning X , Wu JZ . Appl Ergon 2019 81 102901 Roofers often suffer from musculoskeletal disorders (MSDs) to their knees due to spending a large amount of time kneeling while performing work-related roofing activities on sloped rooftops. Several ergonomic studies have identified kneeling as a potential risk factor for knee injuries and disorders. Existing biomechanical models and sensor technologies used to assess work-related risk factors for different construction trades are not applicable in roof work settings especially on slanted rooftop surfaces. This work assesses the impacts of work-related factors, namely working posture and roof slope, on the potential risk of developing knee MSDs due to residential roofing tasks in a laboratory setting. Nine human subjects participated in the experiment and mimicked shingle installation on a slope-configurable wooden platform. Maximum angles of right and left knee flexion, abduction, adduction, and axial rotation (internal and external) were measured as risk indicators using a motion capture system under different roof slope settings. The results demonstrated that roof slope, working posture and their interaction may have significant impacts on developing knee MSDs during roofing activities. Knees are likely to be exposed to increased risk of MSDs due to working in a dynamic kneeling posture during shingle installation. In our study, flexion in both knees and adduction in the right knee were found lower in high-pitched rooftops; however, abduction in the left knee and internal rotation in the right knee were found higher during shingle installation. Hence proper attention is needed for these situations. This study provides useful information about the impact of roof work settings on knee MSDs development, which may facilitate effective interventions such as education, training, and tools to prevent knee injuries in construction roofing tasks. |
Diabetes-related emergency medical service activations in 23 states, United States 2015
Benoit SR , Kahn HS , Geller AI , Budnitz DS , Mann NC , Dai M , Gregg EW , Geiss LS . Prehosp Emerg Care 2018 22 (6) 705-712 OBJECTIVE: The use of emergency medical services (EMS) for diabetes-related events is believed to be substantial but has not been quantified nationally despite the diverse acute complications associated with diabetes. We describe diabetes-related EMS activations in 2015 among people of all ages from 23 U.S. states. METHODS: We used data from 23 states that reported >/=95% of their EMS activations to the U.S. National Emergency Medical Services Information System (NEMSIS) in 2015. A diabetes-related EMS activation was defined using coded EMS provider impressions of "diabetes symptoms" and coded complaints recorded by dispatch of "diabetic problem." We described activations by type of location, urbanicity, U.S. Census Division, season, and time of day; and patient-events by age category, race/ethnicity, disposition, and treatment with glucose. Crude and age-adjusted diabetes-related EMS patient-level event rates were calculated for adults >/=18 years of age with diagnosed diabetes using the Behavioral Risk Factor Surveillance System to estimate the population denominator. RESULTS: Of 10,324,031 relevant EMS records, 241,495 (2.3%) were diabetes-related activations, which involved over 235,000 hours of service. Most activations occurred in urban or suburban environ- ments (86.4%), in the home setting (73.5%), and were slightly more frequent in the summer months. Most patients (72.6%) were >/=45 years of age and over one-half (55.4%) were transported to the emergency department. The overall age-adjusted diabetes-related EMS event rate was 33.9 per 1,000 persons with diagnosed diabetes; rates were highest in patients 18-44 years of age, males, and non-Hispanic blacks and varied by U.S. Census Division. CONCLUSIONS: Diabetes results in a substantial burden on EMS resources. Collection of more detailed diabetes complication information in NEMSIS may help facilitate EMS resource planning and prevention strategies. |
Confluent impact of housing and geology on indoor radon concentrations in Atlanta, Georgia, United States
Dai D , Neal FB , Diem J , Deocampo DM , Stauber C , Dignam T . Sci Total Environ 2019 668 500-511 Radon is a naturally released radioactive carcinogenic gas. To estimate radon exposure, studies have examined various risk factors, but limited information exists pertaining to the confluent impact of housing characteristics and geology. This study evaluated the efficacy of housing and geological characteristics to predict radon risk in DeKalb County, Georgia, USA. Four major types of data were used: (1) three databases of indoor radon concentrations (n=6757); (2) geologic maps of rock types and fault zones; (3) a database of 402 in situ measurements of gamma emissions, and (4) two databases of housing characteristics. The Getis-Ord method was used to delineate hot spots of radon concentrations. Empirical Bayesian Kriging was used to predict gamma radiation at each radon test site. Chi-square tests, bivariate correlation coefficients, and logistic regression were used to examine the impact of geological and housing factors on radon. The results showed that indoor radon levels were more likely to exceed the action level-4 pCi/L (148Bq/m(3)) designated by the U.S. Environmental Protection Agency-in fault zones, were significantly positively correlated to gamma readings, but significantly negatively related to the presence of a crawlspace foundation and its combination with a slab. The findings suggest that fault mapping and in situ gamma ray measurements, coupled with analysis of foundation types and delineation of hot spots, may be used to prioritize areas for radon screening. |
Availability of the National Diabetes Prevention Program in United States counties, March 2017
Jayapaul-Philip B , Dai S , Kirtland K , Haslam A , Nhim K . Prev Chronic Dis 2018 15 E109 In the United States, 84.1 million adults are estimated to have prediabetes, a serious health condition in which blood sugar levels are higher than normal but not high enough for a diagnosis of diabetes (1). Prediabetes increases the risk for type 2 diabetes, heart disease, and stroke (1). Through the Centers for Disease Control and Prevention (CDC)-led National Diabetes Prevention Program (National DPP), people with prediabetes can learn to make practical, real-life changes that can reduce their risk for developing type 2 diabetes by as much as 58% (71% for people aged ≥60 years) (1). CDC is working to expand the lifestyle change program (LCP) across the country, via the National DPP (2). Given the large number of people affected by prediabetes, CDC has several efforts to increase the availability of the National DPP LCP including Cooperative Agreements such as “Scaling the National Diabetes Prevention Program in Underserved Areas” (DP17-1705). We assessed the presence of publicly available in-person LCP classes, as of March 1, 2017, by diabetes incidence and socioeconomic status at the county level, because higher diabetes incidence and lower socioeconomic status are correlated (3) and may be useful in targeting type 2 diabetes prevention efforts. Organizations wanting to expand the availability of the LCP may use these maps to determine counties most in need of new programs. |
Expression profiles of host immune response-related genes against HEV genotype 3 and genotype 1 infections in rhesus macaques.
Choi YH , Zhang X , Tran C , Skinner B . J Viral Hepat 2018 25 (8) 986-995 Hepatitis E virus (HEV) genotype (gt) 3 infection is food-borne causing sporadic infections in older individuals and gt1 infection is water-borne, often causing epidemics affecting primarily young adults. Although HEV infection causes self-limited disease, gt3 induces chronic infection in immunocompromised individuals. Hepatic host gene expression against gt3 infection remains unknown. Host gene expression profiles for HEV gt1 (n=3) and gt3 (n=7) infections were analyzed in the livers of experimentally infected rhesus macaques. HEV RNA was detected from 2 to 24 days after inoculation (DAI) in stool and serum, elevated alanine aminotransferase (ALT) activity was detected from 7 to 31 DAI, and anti-HEV antibody became detectable between 12 and 42 DAI. All 10 animals cleared the infection between 34 to 68 DAI. We found that 24%, 48%, and 41% of hepatic immune response genes against gt3 infection were upregulated during the early, peak, and decline phases of HEV RNA replication. For gt1 infection, 25% of hepatic immune response-related genes were downregulated during early viremia, but 6%, 34%, and 37% of genes were upregulated at the early, peak and during decline of HEV RNA replication, respectively. Our study demonstrated distinct differences in the expression profiles of host immune response-related genes of HEV gt3 and gt1 infections in experimentally infected rhesus macaques. This article is protected by copyright. All rights reserved. |
The use of gamma-survey measurements to better understand radon potential in urban areas
Berens AS , Diem J , Stauber C , Dai D , Foster S , Rothenberg R . Sci Total Environ 2017 607-608 888-899 Accounting for as much as 14% of all lung cancers worldwide, cumulative radon progeny exposure is the leading cause of lung cancer among never-smokers both internationally and in the United States. To understand the risk of radon progeny exposure, studies have mapped radon potential using aircraft-based measurements of gamma emissions. However, these efforts are hampered in urban areas where the built environment obstructs aerial data collection. To address part of this limitation, this study aimed to evaluate the effectiveness of using in situ gamma readings (taken with a scintillation probe attached to a ratemeter) to assess radon potential in an urban environment: DeKalb County, part of the Atlanta metropolitan area, Georgia, USA. After taking gamma measurements at 402 survey sites, empirical Bayesian kriging was used to create a continuous surface of predicted gamma readings for the county. We paired these predicted gamma readings with indoor radon concentration data from 1351 residential locations. Statistical tests showed the interpolated gamma values were significantly but weakly positively related with indoor radon concentrations, though this relationship is decreasingly informative at finer geographic scales. Geology, gamma readings, and indoor radon were interrelated, with granitic gneiss generally having the highest gamma readings and highest radon concentrations and ultramafic rock having the lowest of each. Our findings indicate the highest geogenic radon potential may exists in the relatively undeveloped southeastern part of the county. It is possible that in situ gamma, in concert with other variables, could offer an alternative to aerial radioactivity measurements when determining radon potential, though future work will be needed to address this project's limitations. |
Assessing work-related risk factors on low back disorders among roofing workers
Wang D , Dai F , Ning X , Dong RG , Wu JZ . J Constr Eng Manag 2017 143 (7) Roofers have long suffered from low back disorders (LBDs), which are a primary nonfatal injury in construction. Ergonomic studies have identified several risk factors associated with LBDs in workplaces and developed biomechanical models for general LBD risk assessments. However, these models cannot be directly used for assessments in roof workplaces because they are designed for general tasks without considering roofers' posture variance and effects of working on slanted roof surfaces. This paper examined the relationship between roofing work-related factors and LBD risk among roofers using a laboratory assessment. A pitch-configurable wood platform was built to mimic the rooftop. The maximum trunk flexion angle and normalized electromyography (EMG) signals were measured as indicators using a motion capture system and a skeletal muscle signal recording system under different settings, i.e., different roof slopes, postures, facing directions, and working paces. The results indicated the measured factors with significant effects on the LBD development and revealed unfavorable conditions (e.g., using a stooped posture to work on low-pitch rooftops at a fast pace) where the work on rooftops needs particular attention. Such information is useful for systematic understanding of roofing nonfatal LBD developments among construction professionals and may enable development of interventions and guidelines for reducing the prevalence of LBDs at roofing jobsites. |
The attributable proportion of specific leisure-time physical activities to total leisure activity volume among US adults, National Health and Nutrition Examination Survey 1999-2006
Watson KB , Dai S , Paul P , Carlson SA , Carroll DD , Fulton J . J Phys Act Health 2016 13 (11) 1192-1201 BACKGROUND: Previous studies have examined participation in specific leisure-time physical activities (PA) among US adults. The purpose of this study was to identify specific activities that contribute substantially to total volume of leisure-time PA in US adults. METHODS: Proportion of total volume of leisure-time PA moderate-equivalent minutes attributable to 9 specific types of activities was estimated using self-reported data from 21,685 adult participants (≥ 18 years) in the National Health and Nutrition Examination Survey 1999- 2006. RESULTS: Overall, walking (28%), sports (22%), and dancing (9%) contributed most to PA volume. Attributable proportion was higher among men than women for sports (30% vs. 11%) and higher among women than men for walking (36% vs. 23%), dancing (16% vs. 4%), and conditioning exercises (10% vs. 5%). The proportion was lower for walking, but higher for sports, among active adults than those insufficiently active and increased with age for walking. Compared with other racial/ethnic groups, the proportion was lower for sports among non- Hispanic white men and for dancing among non-Hispanic white women. CONCLUSIONS: Walking, sports, and dance account for the most activity time among US adults overall, yet some demographic variations exist. Strategies for PA promotion should be tailored to differences across population subgroups. |
Turtles as a Possible Reservoir of Nontyphoidal Salmonella in Shanghai, China.
Zhang J , Kuang D , Wang F , Meng J , Jin H , Yang X , Liao M , Klena JD , Wu S , Zhang Y , Xu X . Foodborne Pathog Dis 2016 13 (8) 428-33 Terrapins and turtles are known to transmit Salmonella to humans. However, little was known about the occurrence of this pathogen in soft-shelled terrapin that is a popular delicacy in Chinese and other East Asian cuisines. We isolated and characterized 82 (24.4%) isolates of Salmonella from 336 fecal samples of soft-shelled terrapins (51 of 172; 29.7%) and pet turtles (31 of 164; 18.9%) in Shanghai. Salmonella Thompson was the most common serotype (17.1%) among others. Many isolates (84.1%) were resistant to multiple antimicrobials (≥3). Molecular analysis of Salmonella Thompson and Salmonella Typhimurium using pulsed-field gel electrophoresis unveiled a close genetic relationship between several human and terrapin isolates. Our results highlight the risk associated with the handling and consumption of turtles and their role in the spread of Salmonella in the human salmonellosis. |
- Page last reviewed:Feb 1, 2024
- Page last updated:Apr 22, 2024
- Content source:
- Powered by CDC PHGKB Infrastructure