Last data update: Jan 27, 2025. (Total: 48650 publications since 2009)
Records 1-30 (of 343 Records) |
Query Trace: Ray C[original query] |
---|
Characteristics of nursing homes with high rates of invasive methicillin-resistant Staphylococcus aureus infections
See I , Jackson KA , Hatfield KM , Paul P , Li R , Nadle J , Petit S , Ray SM , Harrison LH , Jeffrey L , Lynfield R , Bernu C , Dumyati G , Gellert A , Schaffner W , Markus T , Gokhale RH , Stone ND , Jacobs Slifka K . J Am Geriatr Soc 2025 ![]() BACKGROUND: Nursing home residents experience a large burden of invasive methicillin-resistant Staphylococcus aureus (MRSA) infections. Data are limited regarding nursing home characteristics associated with differences in facility-level invasive MRSA rates. METHODS: We analyzed 2011-2015 data from CDC's Emerging Infections Program (EIP) active population- and laboratory-based surveillance for invasive MRSA cases within seven states. A nursing home-onset case was defined as MRSA cultured from a normally sterile site in a person living in a nursing home 3 days before culture collection. Facility rates were calculated as nursing home-onset cases per 100,000 resident-days. Nursing home resident-day denominators and facility characteristics were obtained from four Centers for Medicare & Medicaid Services (CMS) datasets. A general estimating equations model with a logit link assessed characteristics of the facilities with highest rates comprising 50% of nursing home MRSA cases ("high rates"). RESULTS: The 626 nursing homes in the surveillance area had 2824 invasive MRSA cases; 82% of facilities had at ≥1 case. The 20% of facilities with highest rates (≥3.84 cases/100,000 resident-days) had 50% of nursing home-onset cases. In multivariable regression, facilities with high rates were more likely to have CMS-derived characteristics of presence of a resident with a multidrug-resistant organism; or greater proportions of residents who were male, were short stay (in the facility <100 days), had a nasogastric or percutaneous gastrostomy tube, or require extensive assistance with bed repositioning; and more likely to be in an EIP area with higher hospital-onset MRSA rates. Higher registered nurses staffing levels (hours/resident/day) and higher proportions of White residents were associated with lower rates. CONCLUSIONS: Facilities with higher invasive MRSA rates served residents with more clinical and functional care needs. Increasing registered nurse staffing in high-risk facilities might assist with reduction of invasive MRSA rates. These findings could help prioritize nursing homes for future MRSA prevention work. |
Convenience sampling for pandemic surveillance of severe acute respiratory syndrome coronavirus 2 in children in Jackson, Mississippi
Inagaki K , Penny A , Gwyn S , Malloch L , Martin L , Hankins E , Ray C , Byers P , Harrison A , Handali S , Martin D , Hobbs CV . Pediatr Infect Dis J 2024 We assessed severe acute respiratory syndrome coronavirus 2 seroprevalence on residual blood samples for pediatric COVID-19 surveillance: 2263 samples were collected during routine outpatient visits (<18 years, April 2020-August 2021). Seroprevalence increased over time, coinciding with or preceding virus circulation in the community and with or preceding pediatric severe COVID-19 hospitalization peaks. Residual blood sample seroprevalence may be a useful surveillance tool in future outbreaks. |
Exploring the effects of student and educator perceptions of school climate on substance use, emotional problems, and prosocial behavior among middle school students
Ray CM , Vaziri N , Tracy AJ , DeGue S , Le VD , Estefan LF , Niolon PH , Little TD . J Sch Violence 2024 Bullying and cyberbullying are major public health issues affecting youth. One potential protective mechanism within schools is positive school climate. We examine how bullying, cyberbullying, and school climate are associated with substance use, emotional problems, and prosocial behavior using data from 5,143 middle school students and 1,584 educators. We found bullying and cyberbullying experiences are associated with all student outcomes, finding a stronger relationship with cyberbullying for some outcomes. Student perceptions of clear school rules and consequences were consistently protective across all outcomes. Educator’s perceptions of school conflict were associated with more substance use and less prosocial behavior. More research is needed to identify aspects of school climate that may be protective and how schools can promote them. © This work was authored as part of the Contributor’s official duties as an Employee of the United States Government and is therefore a work of the United States Government. In accordance with 17 U.S.C. 105, no copyright protection is available for such works under U.S. Law. |
Release of crystalline silica nanoparticles during engineered stone fabrication
Rishi K , Ku BK , Qi C , Thompson D , Wang C , Dozier A , Vogiazi V , Zervaki O , Kulkarni P . ACS Omega 2024 9 (51) 50308-50317 Inhalation exposure to respirable crystalline silica (RCS) during the fabrication of engineered stone-based kitchen countertops has been on the rise in recent years and has become a significant occupational health problem in the United States and globally. Little is known about the presence of nanocrystalline silica (NCS), i.e., particles below 100 nm. We present a methodology to quantify the crystalline silica content in the sub-100 nm size fraction of the aerosol released during engineered stone fabrication using X-ray diffraction (XRD) and Fourier transform infrared (FTIR) spectroscopy. Aerosol was generated in a test chamber designed per EN 1093-3 and sampled using cascade impactors. XRD and FTIR analysis showed the presence of both α-quartz (15-60%) and cristobalite (10-50%) polymorphs in all size fractions. With increasing particle size, the cristobalite content increased. Seventy percent of the total aerosol mass in the sub-100 nm fraction was found to be crystalline silica, qualitatively confirmed by electron diffraction and electron energy loss spectroscopy. The presence of other minerals was detected in all size fractions; no polymeric resin binder was detected in the sub-100 nm fraction. Although the sub-100 nm fraction was about 1% of the aerosol mass, it accounted for 4-24% of the aerosol surface area based on the total lung deposition. If the surface area is a more relevant exposure metric, the assessment of the efficacy of current engineering control systems using mass as an exposure metric may not provide adequate protection. |
TB treatment delays and associated risk factors in Dushanbe, Tajikistan, 2019-2021
Sharifov R , Nabirova D , Tilloeva Z , Zikriyarova S , Kishore N , Jafarov N , Yusufi S , Horth R . BMC Infect Dis 2024 24 (1) 1398 BACKGROUND: In Tajikistan, where there are about 8,000 cases annually, many new cases are being diagnosed with severe disease, indicating a delay in receiving care. We aimed to estimate the proportion with delayed care and the main factors contributing to delayed care. METHODS: Using a retrospective cohort design, we conducted a study that included all people aged over 15 years who were newly diagnosed with pulmonary TB in Dushanbe from 2019 to 2021. We defined 'patient delay' as > 14 days from TB symptom onset to the first provider visit and 'provider delay' as > 3 days from the first visit to treatment initiation. Data was abstracted from medical records and participants were interviewed in-person. Multivariable negative binomial regression was used to estimate adjusted risk ratios (aRR) and 95% confidence intervals (CI). RESULTS: Of 472 participants, 49% were male, 65% had lung tissue cavitation, 33% had drug resistant TB, 11% had diabetes, 4% had HIV, and. Reported cases dropped from 196 in 2019 to 109 in 2020 and increased to 167 in 2021. The proportion of people experiencing patient delays was 82%, 72%, and 90% per year, respectively. The proportion of provider delays was 44%, 41% and 29% per year. Patient delay was associated with year (aRR: 1.09 [CI:1.02-1.18] in 2021 vs. 2019), age (aRR:0.91 [0.82-0.99] for 40-59-year-olds vs. 15-39-year-olds), having HIV (aRR:1.22 [1.08-1.38]), having blood in sputum (aRR:1.19 [1.10-1.28]), chest pain (aRR:1.32 [1.14-1.54]), having at least two structural barriers vs. none (aRR:1.52 [1.28-1.80]), having one of the following barriers: long wait lines (aRR:1.36 [1.03-1.80]), feeling that healthcare services were expensive (aRR:1.54 [1.28-1.85]), or having no time or too much work (aRR:1.54 [1.29-1.84]). Provider delay was associated with year (aRR: 0.67 [0.51-0.89] in 2021 vs. 2019), patients having to pay for X-ray services (aRR: 1.59 [1.22-2.07]) and lacking direct-observed-therapy (DOTS) in facility (aRR: 1.61 [1.03-2.52]). CONCLUSIONS: Patient delay was high before the COVID-19 pandemic and increased in 2021, while provider delay decreased during this time. Addressing structural barriers to healthcare services, such as increased DOTS facilities, expanded hours, and zero fees, may decrease delays. |
Influenza vaccine effectiveness against hospitalizations and emergency department or urgent care encounters for children, adolescents, and adults during the 2023-2024 season, United States
Tenforde MW , Reeves EL , Weber ZA , Tartof SY , Klein NP , Dascomb K , DeSilva MB , Yang DH , Grannis SJ , Irving SA , Ong TC , Link-Gelles R , Salas SB , Sy LS , Lewin B , Contreras R , Zerbo O , Fireman B , Hansen J , Timbol J , Sheffield T , Bride D , Arndorfer J , VanOtterloo J , McEvoy CE , Akinsete OO , Essien IJ , Dixon BE , Rogerson C , Fadel WF , Duszynski T , Naleway AL , Barron MA , Rao S , Mayer D , Chavez C , Ball SW , Payne AB , Ray C , Dickerson M , Neelam V , Adams K , Flannery B , DeCuir J , Garg S . Clin Infect Dis 2024 BACKGROUND: The 2023-2024 influenza season had predominant influenza A(H1N1)pdm09 virus activity, but A(H3N2) and B viruses co-circulated. Seasonal influenza vaccine strains were well-matched to these viruses. METHODS: Using health care encounters data from health systems in 8 states, we evaluated influenza vaccine effectiveness (VE) against influenza-associated medical encounters from October 2023-April 2024. Using a test-negative design, we compared the odds of vaccination between patients with an acute respiratory illness (ARI) who tested positive (cases) versus negative (controls) for influenza by molecular assay, adjusting for confounders. VE was stratified by age group, influenza type (overall, influenza A, influenza B), and care setting (hospitalization, emergency department or urgent care [ED/UC] encounter). RESULTS: Overall, 74,000 encounters in children and adolescents aged 6 months - 17 years (3,479 hospitalizations, 70,521 ED/UC encounters) and 267,606 in adults aged ≥18 years (66,828 hospitalizations, 200,778 ED/UC encounters) were included. Across care settings, among children and adolescents 15% (2,758/17,833) of cases versus 32% (18,240/56,167) of controls had received vaccination. Among adults, 25% (11,632/46,614) of cases versus 44% (97,811/220,992) of controls across care settings had received vaccination. VE was 58% (95% confidence interval [95% CI]: 44-69%) against hospitalization and 58% (95% CI: 56-60%) against ED/UC encounters for children and adolescents, and 39% (95% CI: 35-43) against hospitalization and 47% (95% CI: 46-49%) against ED/UC encounters for adults. Across age groups, VE was higher against influenza B than influenza A. CONCLUSIONS: Influenza vaccines provided protection against influenza-associated illness across health care settings and age groups during the 2023-2024 influenza season. |
Intimate partner violence-related homicides of hispanic and latino persons - National Violent Death Reporting System, United States, 2003-2021
Treves-Kagan S , Ruvalcaba Y , Corry DT , Ray CM , Le VD , Lee RD , Siordia C , Mercado MC , Estefan LF , Vera TM , Kearns MC , Mercer Kollar LM , Satter DE , Penman-Aguilar A , Montero JT . MMWR Surveill Summ 2024 73 (9) 1-17 PROBLEM/CONDITION: In 2022, homicide was the second leading cause of death for Hispanic and Latino persons aged 15-24 years in the United States, the third leading cause of death for those aged 25-34 years, and the fourth leading cause of death for those aged 1-14 years. The majority of homicides of females, including among Hispanic and Latino persons, occur in the context of intimate partner violence (IPV). This report summarizes data from CDC's National Violent Death Reporting System (NVDRS) on IPV-related homicides of Hispanic and Latino persons in the United States. PERIOD COVERED: 2003-2021. DESCRIPTION OF SYSTEM: NVDRS collects data regarding violent deaths in the United States and links three sources: death certificates, coroner or medical examiner reports, and law enforcement reports. IPV-related homicides include both intimate partner homicides (IPHs) by current or former partners and homicides of corollary victims (e.g., children, family members, and new partners). Findings describe victim and suspect sex, age group, and race and ethnicity; method of injury; type of location where the homicide occurred; precipitating circumstances (i.e., events that contributed to the homicide); and other selected characteristics. Deaths related to each other (e.g., an ex-partner kills the former partner and their new partner) are linked into a single incident. State participation in NVDRS has expanded over time, and the number of states participating has varied by year; data from all available years (2003-2021) and U.S. jurisdictions (49 states, Puerto Rico, and the District of Columbia) were used for this report. Of the 49 states that collect data, all except California and Texas collect data statewide; Puerto Rico and District of Columbia data are jurisdiction wide. Florida was excluded because the data did not meet the completeness threshold for circumstances. RESULTS: NVDRS collected data on 24,581 homicides of Hispanic and Latino persons, and data from all available years (2003-2021) and U.S. jurisdictions (49 states, Puerto Rico, and the District of Columbia) were examined. Among homicides with known circumstances (n = 17,737), a total of 2,444 were classified as IPV-related (13.8%). Nearly half of female homicides (n = 1,453; 48.2%) and 6.7% (n = 991) of male homicides were IPV-related; however, among all Hispanic and Latino homicides, most victims were male (n = 20,627; 83.9%). Among the 2,319 IPV-related homicides with known suspects, 85% (n = 1,205) of suspects were current or former partners for female victims, compared with 26.2% (n = 236) for male Hispanic and Latino victims. Approximately one fifth (71 of 359 [19.8%]) of female IPV-related homicide victims of childbearing age with known pregnancy status were pregnant or ≤1 year postpartum. Approximately 5% of IPV-related homicide victims were identified as Black Hispanic or Latino persons (males: n = 67; 6.8%; females: n = 64; 4.4%). A firearm was used in the majority of Hispanic and Latino IPV-related homicides (males: n = 676; 68.2%; females: n = 766; 52.7%). INTERPRETATION: This report provides a detailed summary of NVDRS data on IPV-related homicides of Hispanic and Latino persons in the United States during 2003-2021. This report found heterogeneity of characteristics and circumstances of Hispanic and Latino IPV-related homicides. Whereas most Hispanic and Latino homicide victims were male, nearly 60% of Hispanic and Latino IPHs and IPV-related homicide victims were female. Additional research is needed to better understand the relation between IPHs and IPV-related homicides and race (distinct from ethnicity) and pregnancy. PUBLIC HEALTH ACTION: NVDRS provides critical and ongoing data on IPV-related homicides of Hispanic and Latino persons in the United States that can be used to identify existing strategies and develop new early intervention strategies to prevent IPV and the escalation of IPV to IPH. Strategies that have demonstrated promise in reducing rates of IPH include expanded availability of low-income housing units; sanctuary policies that outline the relation between immigration enforcement and law officers; state laws prohibiting firearm access to those subject to domestic violence restraining orders; improvement of community relations with police to implement risk-based interventions; and comprehensive social, economic, medical, and legal safety nets to create pathways out of abusive relationships, including for pregnant women. Community, local, state, and Federal leaders can combine data on IPV-related deaths and the best available evidence-based programming and policy to create community-engaged solutions that reflect the experience of their Hispanic and Latino communities, including historical and societal factors that increase risk for violence. |
A label-free optical biosensor-based point-of-care test for the rapid detection of Monkeypox virus
Aslan M , Seymour E , Brickner H , Clark AE , Celebi I , Townsend MB , Satheshkumar PS , Riley M , Carlin AF , Ünlü MS , Ray P . Biosens Bioelectron 2024 269 116932 ![]() ![]() Diagnostic approaches that combine the high sensitivity and specificity of laboratory-based digital detection with the ease of use and affordability of point-of-care (POC) technologies could revolutionize disease diagnostics. This is especially true in infectious disease diagnostics, where rapid and accurate pathogen detection is critical to curbing the spread of disease. We have pioneered an innovative label-free digital detection platform that utilizes Interferometric Reflectance Imaging Sensor (IRIS) technology. IRIS leverages light interference from an optically transparent thin film, eliminating the need for complex optical resonances to enhance the signal by harnessing light interference and the power of signal averaging in shot-noise-limited operation In our latest work, we have further improved our previous 'Single-Particle' IRIS (SP-IRIS) technology by allowing the construction of the optical signature of target nanoparticles (whole virus) from a single image. This new platform, 'Pixel-Diversity' IRIS (PD-IRIS), eliminated the need for z-scan acquisition, required in SP-IRIS, a time-consuming and expensive process, and made our technology more applicable to POC settings. Using PD-IRIS, we quantitatively detected the Monkeypox virus (MPXV), the etiological agent for Monkeypox (Mpox) infection. MPXV was captured by anti-A29 monoclonal antibody (mAb 69-126-3) on Protein G spots on the sensor chips and were detected at a limit-of-detection (LOD) - of 200 PFU/mL (∼3.3 aM). PD-IRIS was superior to the laboratory-based ELISA (LOD - 1800 PFU/mL) used as a comparator. The specificity of PD-IRIS in MPXV detection was demonstrated using Herpes simplex virus, type 1 (HSV-1), and Cowpox virus (CPXV). This work establishes the effectiveness of PD-IRIS and opens possibilities for its advancement in clinical diagnostics of Mpox at POC. Moreover, PD-IRIS is a modular technology that can be adapted for the multiplex detection of pathogens for which high-affinity ligands are available that can bind their surface antigens to capture them on the sensor surface. |
Epidemiology of human metapneumovirus among children with severe or very severe pneumonia in high pneumonia burden settings: the PERCH study experience
Miyakawa R , Zhang H , Brooks WA , Prosperi C , Baggett HC , Feikin DR , Hammitt LL , Howie SRC , Kotloff KL , Levine OS , Madhi SA , Murdoch DR , O'Brien KL , Scott JAG , Thea DM , Antonio M , Awori JO , Bunthi C , Driscoll AJ , Ebruke B , Fancourt NS , Higdon MM , Karron RA , Moore DP , Morpeth SC , Mulindwa JM , Park DE , Rahman MZ , Rahman M , Salaudeen RA , Sawatwong P , Seidenberg P , Sow SO , Tapia MD , Knoll MD . Clin Microbiol Infect 2024 ![]() OBJECTIVES: After respiratory syncytial virus (RSV), human metapneumovirus (hMPV) was the second-ranked pathogen attributed to severe pneumonia in the PERCH study. We sought to characterize hMPV-positive cases in high burden settings, which have limited data, by comparing to RSV-positive and other cases. METHODS: Children aged 1-59 months hospitalized with suspected severe pneumonia and age/season-matched community controls in seven African and Asian countries had nasopharyngeal/oropharyngeal swabs tested by multiplex PCR for 32 respiratory pathogens, among other clinical and lab assessments at admission. Odds ratios adjusted for age and site (aOR) were calculated using logistic regression. Etiologic probability was estimated using Bayesian nested partial latent class analysis. Latent class analysis identified syndromic constellations of clinical characteristics. RESULTS: HMPV was detected more frequently among cases (267/3887, 6.9%) than controls (115/4976, 2.3%), among cases with pneumonia chest X-ray findings (8.5%) than without (5.5%), and among controls with respiratory tract illness (3.8%) than without (1.8%; all p≤0.001). HMPV-positive cases were negatively associated with the detection of other viruses (aOR=0.18), especially RSV (aOR=0.11; all p<0.0001), and positively associated with the detection of bacteria (aORs 1.77, p=0.03). No single clinical syndrome distinguished hMPV-positive from other cases. Among hMPV-positive cases, 65.2% were aged <1 year and 27.5% had pneumonia danger signs; positive predictive value was 74.5%; mortality was 3.9%, similar to RSV-positive (2.4%) and lower than other cases (9.6%). CONCLUSIONS: HMPV-associated severe pediatric pneumonia in high burden settings was predominantly in young infants and clinically indistinguishable from RSV. HMPV-positives had low case fatality, similar to that in RSV-positives. |
Mid-childhood plasma concentrations of per- and polyfluoroalkyl substances, modifiable lifestyle factors, and bone mineral density through late adolescence
Rokoff LB , Rifas-Shiman SL , Aris IM , Lin PD , Rosen CJ , Calafat AM , Gordon CM , Oken E , Fleisch AF . Environ Sci Technol 2024 There is limited research on associations of per- and polyfluoroalkyl substances (PFAS) with areal bone mineral density (aBMD) through adolescence and whether bone-strengthening factors ameliorate effects. In the Project Viva cohort (N = 484; 50% female), we used sex-stratified linear regression and quantile g-computation mixture models to examine associations of mid-childhood (median: 7.8 years; 2007-2010) plasma PFAS concentrations with a dual-energy X-ray absorptiometry total-body aBMD Z-score in early and late adolescence (median: 12.9 and 17.6 years, respectively). We explored stratum-specific estimates by parent/self-reported physical activity and dairy intake. Using linear mixed models, we evaluated associations with aBMD accrual from mid-childhood through late adolescence. Females with higher perfluorooctanoate (PFOA) and perfluorodecanoate (PFDA) had lower early adolescent aBMD Z-score [e.g., β(95%CI)] per doubling PFOA: -0.19(-0.41, 0.03)]. Youth with higher PFOA and PFDA had lower late adolescent aBMD Z-score, but CIs were wide [e.g., PFOA: females, -0.12(-0.40, 0.16); males, -0.10(-0.42, 0.21)]. Mixture models generally corroborated single PFAS results, and in linear mixed models, females with higher PFAS concentrations, and males with higher PFOA, had slower aBMD accrual. Less active males with higher PFOA, PFDA, and the PFAS mixture had lower late adolescent aBMD Z-score. Some PFAS appeared more negatively associated with the aBMD Z-score among those who consumed less dairy, but there was not consistent evidence of effect modification. Exposure to select PFAS may affect bone accrual through adolescence, with possible resilience conferred by greater physical activity and dairy intake. |
Infectious etiology of intussusception in Indian children less than 2 years old: a matched case-control analysis
Praharaj I , Reddy SN , Nair NP , Tate JE , Giri S , Thiyagarajan V , Mohan VR , Revathi R , Maheshwari K , Hemavathy P , Kumar N , Gupte MD , Arora R , Senthamizh S , Mekala S , Goru KB , Pamu P , Badur M , Pradhan S , Dash M , Mohakud NK , Ray RK , Gathwala G , Gupta M , Kanojia R , Gupta R , Goyal S , Sharma P , Mathew MA , Kochukaleekal Jacob TJ , Sundaram B , Girish Kumar CP , Dorairaj P , Pitchumani R , Maniam R , Kumaravel S , Jain H , Goswami JK , Wakhlu A , Gupta V , Liu J , Houpt ER , Parashar UD , Kang G . Gut Pathog 2024 16 (1) 61 BACKGROUND: Enteric infections are hypothesized to be associated with intussusception in children. A small increase in intussusception following rotavirus vaccination has been seen in some settings. We conducted post-marketing surveillance for intussusception following rotavirus vaccine, Rotavac introduction in India and evaluated association of intussusception with enteric pathogens. METHODS: In a case-control study nested within a large sentinel hospital-based surveillance program in India, stool samples from 272 children aged less than 2 years admitted for intussusception and 272 age-, gender- and location-matched controls were evaluated with Taqman array card based molecular assays to detect enteric viruses, bacterial enteropathogens and parasites. Matched case-control analysis with conditional logistic regression evaluated association of enteropathogens with intussusception. Population attributable fractions (PAF) were calculated for enteropathogens significantly associated with intussusception. RESULTS: The most prevalent enteropathogens in cases and controls were enteroaggregative Escherichia coli, adenovirus 40/41, adenovirus C serotypes and enteroviruses. Children with intussusception were more likely to harbor adenovirus C serotypes (adjusted odds-ratio (aOR) = 1.74; 95% confidence interval (CI) 1.06-2.87) and enteroviruses (aOR = 1.77; 95% CI 1.05-2.97) than controls. Rotavirus was not associated with increased intussusception risk. Adenovirus C (PAF = 16.9%; 95% CI 4.7% - 27.6%) and enteroviruses (PAF = 14.7%; 95% CI 4.2% - 24.1%) had the highest population attributable fraction for intussusception. CONCLUSION: Adenovirus C serotypes and enteroviruses were significantly associated with intussusception in Indian children. Rotavirus was not associated with risk of intussusception. |
Development and validation of a deep learning model for detecting signs of tuberculosis on chest radiographs among US-bound immigrants and refugees
Lee SH , Fox S , Smith R , Skrobarcek KA , Keyserling H , Phares CR , Lee D , Posey DL . PLOS Digit Health 2024 3 (9) e0000612 ![]() Immigrants and refugees seeking admission to the United States must first undergo an overseas medical exam, overseen by the US Centers for Disease Control and Prevention (CDC), during which all persons ≥15 years old receive a chest x-ray to look for signs of tuberculosis. Although individual screening sites often implement quality control (QC) programs to ensure radiographs are interpreted correctly, the CDC does not currently have a method for conducting similar QC reviews at scale. We obtained digitized chest radiographs collected as part of the overseas immigration medical exam. Using radiographs from applicants 15 years old and older, we trained deep learning models to perform three tasks: identifying abnormal radiographs; identifying abnormal radiographs suggestive of tuberculosis; and identifying the specific findings (e.g., cavities or infiltrates) in abnormal radiographs. We then evaluated the models on both internal and external testing datasets, focusing on two classes of performance metrics: individual-level metrics, like sensitivity and specificity, and sample-level metrics, like accuracy in predicting the prevalence of abnormal radiographs. A total of 152,012 images (one image per applicant; mean applicant age 39 years) were used for model training. On our internal test dataset, our models performed well both in identifying abnormalities suggestive of TB (area under the curve [AUC] of 0.97; 95% confidence interval [CI]: 0.95, 0.98) and in estimating sample-level counts of the same (-2% absolute percentage error; 95% CIC: -8%, 6%). On the external test datasets, our models performed similarly well in identifying both generic abnormalities (AUCs ranging from 0.89 to 0.92) and those suggestive of TB (AUCs from 0.94 to 0.99). This performance was consistent across metrics, including those based on thresholded class predictions, like sensitivity, specificity, and F1 score. Strong performance relative to high-quality radiological reference standards across a variety of datasets suggests our models may make reliable tools for supporting chest radiography QC activities at CDC. |
Adolescents' adverse childhood experiences, poor mental health, and substance use during the COVID-19 pandemic
Swedo EA , Anderson KN , Okwori G , DePadilla L , Clayton HB , Villaveces A , Ray CM , Niolon PH , Massetti GM . J Adolesc Health 2024 PURPOSE: Adverse childhood experiences (ACEs) increase the risk for poor mental health (MH) and substance use. We describe relationships between adolescents' ACEs, substance use, and poor MH occurring during the COVID-19 pandemic. METHODS: We conducted a secondary analysis of data among U.S. high school students aged <18 years, who participated in the nationally representative Adolescent Behaviors and Experiences Survey. Data were collected from January to June 2021. Bivariate and multivariable analyses assessed associations between individual ACEs (physical, emotional abuse by parent or caregiver, parent or caregiver job loss, food insecurity, sexual violence, physical dating violence, or cyber bullying) and cumulative ACEs (0, 1-2, 3, 4+) experienced during the pandemic and substance use; stratified analyses assessed effects of poor MH on associations between ACEs and substance use. RESULTS: Use of all substances was higher among adolescents with ACEs, particularly those who experienced both ACEs and poor MH during the COVID-19 pandemic. Prevalence of substance use was especially high among adolescents exposed to any sexual violence or physical dating violence. Compared to adolescents without ACEs, a higher percentage of adolescents with 4+ ACEs reported current use of alcohol (adjusted prevalence ratio [aPR], 5.32) or marijuana (aPR, 5.86), misuse of prescription pain medications (aPR, 8.82), binge drinking (aPR, 7.70), and increased alcohol (aPR, 6.54) or drug (aPR, 7.09) use during the pandemic. DISCUSSION: The individual and combined impact of ACEs and MH on adolescent substance use reinforce the need for trauma-informed care and primary prevention of ACEs to prevent and mitigate poor MH and substance use among adolescents. |
Trends in contacts made by immigrants to the National Domestic Violence Hotline, before and during the COVID-19 Pandemic
Treves-Kagan S , Le VD , Berra LS , Ray CM , Ruvalcaba Y , Wood L , D'Angelo DV , Vera TM , Estefan LF . Public Health Rep 2024 333549241279101 OBJECTIVES: Immigrants in the United States are more likely than nonimmigrants to experience risk factors for intimate partner violence (IPV) and problems in getting support. The COVID-19 pandemic and recent incidents of xenophobia and anti-immigrant sentiment may have exacerbated exposure to IPV risk factors. We examined immigrant experiences of IPV before and during the COVID-19 pandemic. METHODS: This study identified changes in characteristics of abuse, services used, referrals, and barriers to services among those who contacted the National Domestic Violence Hotline (NDVH) and identified as immigrants, reported immigration status as a concern, needed immigration support, and/or identified immigration status as a barrier to accessing services (N = 49 817). We used joinpoint regressions to examine whether the rate of change differed significantly from 2016-2019 (before the pandemic) to 2019-2021 (during the pandemic). RESULTS: The number of immigrant contacts to NDVH peaked in 2017 (n = 9333) and declined 25% to 6946 in 2021. During 2016-2019, the percentage of contacts reporting the following increased significantly: technology-facilitated violence (+12.7 percentage points), economic/financial abuse (+10.8 percentage points), and involvement of firearms (+4.8 percentage points); during 2019-2021, these trends reversed. The percentage of contacts reporting separation or divorce was relatively flat until 2019 and then increased from 14.6% in 2019 to 19.9% in 2021 (+5.2 percentage points). Housing instability increased during 2017-2020 (+9.3 percentage points), but requests for shelters decreased (-4.5 percentage points). Immigration status and personal finances were commonly reported barriers to services; both decreased during 2016-2019 but then increased during 2019-2021. CONCLUSIONS: This study can inform prevention and response strategies relevant for immigrants experiencing or reporting IPV. |
Influenza vaccine effectiveness against influenza a-associated emergency department, urgent care, and hospitalization encounters among US Adults, 2022-2023
Tenforde MW , Weber ZA , Yang DH , DeSilva MB , Dascomb K , Irving SA , Naleway AL , Gaglani M , Fireman B , Lewis N , Zerbo O , Goddard K , Timbol J , Hansen JR , Grisel N , Arndorfer J , McEvoy CE , Essien IJ , Rao S , Grannis SJ , Kharbanda AB , Natarajan K , Ong TC , Embi PJ , Ball SW , Dunne MM , Kirshner L , Wiegand RE , Dickerson M , Patel P , Ray C , Flannery B , Garg S , Adams K , Klein NP . J Infect Dis 2024 230 (1) 141-151 BACKGROUND: The 2022-2023 United States influenza season had unusually early influenza activity with high hospitalization rates. Vaccine-matched A(H3N2) viruses predominated, with lower levels of A(H1N1)pdm09 activity also observed. METHODS: Using the test-negative design, we evaluated influenza vaccine effectiveness (VE) during the 2022-2023 season against influenza A-associated emergency department/urgent care (ED/UC) visits and hospitalizations from October 2022 to March 2023 among adults (aged ≥18 years) with acute respiratory illness (ARI). VE was estimated by comparing odds of seasonal influenza vaccination among case-patients (influenza A test positive by molecular assay) and controls (influenza test negative), applying inverse-propensity-to-be-vaccinated weights. RESULTS: The analysis included 85 389 ED/UC ARI encounters (17.0% influenza A positive; 37.8% vaccinated overall) and 19 751 hospitalizations (9.5% influenza A positive; 52.8% vaccinated overall). VE against influenza A-associated ED/UC encounters was 44% (95% confidence interval [CI], 40%-47%) overall and 45% and 41% among adults aged 18-64 and ≥65 years, respectively. VE against influenza A-associated hospitalizations was 35% (95% CI, 27%-43%) overall and 23% and 41% among adults aged 18-64 and ≥65 years, respectively. CONCLUSIONS: VE was moderate during the 2022-2023 influenza season, a season characterized with increased burden of influenza and co-circulation with other respiratory viruses. Vaccination is likely to substantially reduce morbidity, mortality, and strain on healthcare resources. |
Title evaluation of FluSight influenza forecasting in the 2021-22 and 2022-23 seasons with a new target laboratory-confirmed influenza hospitalizations
Mathis SM , Webber AE , León TM , Murray EL , Sun M , White LA , Brooks LC , Green A , Hu AJ , Rosenfeld R , Shemetov D , Tibshirani RJ , McDonald DJ , Kandula S , Pei S , Yaari R , Yamana TK , Shaman J , Agarwal P , Balusu S , Gururajan G , Kamarthi H , Prakash BA , Raman R , Zhao Z , Rodríguez A , Meiyappan A , Omar S , Baccam P , Gurung HL , Suchoski BT , Stage SA , Ajelli M , Kummer AG , Litvinova M , Ventura PC , Wadsworth S , Niemi J , Carcelen E , Hill AL , Loo SL , McKee CD , Sato K , Smith C , Truelove S , Jung SM , Lemaitre JC , Lessler J , McAndrew T , Ye W , Bosse N , Hlavacek WS , Lin YT , Mallela A , Gibson GC , Chen Y , Lamm SM , Lee J , Posner RG , Perofsky AC , Viboud C , Clemente L , Lu F , Meyer AG , Santillana M , Chinazzi M , Davis JT , Mu K , Pastore YPiontti A , Vespignani A , Xiong X , Ben-Nun M , Riley P , Turtle J , Hulme-Lowe C , Jessa S , Nagraj VP , Turner SD , Williams D , Basu A , Drake JM , Fox SJ , Suez E , Cojocaru MG , Thommes EW , Cramer EY , Gerding A , Stark A , Ray EL , Reich NG , Shandross L , Wattanachit N , Wang Y , Zorn MW , Aawar MA , Srivastava A , Meyers LA , Adiga A , Hurt B , Kaur G , Lewis BL , Marathe M , Venkatramanan S , Butler P , Farabow A , Ramakrishnan N , Muralidhar N , Reed C , Biggerstaff M , Borchering RK . Nat Commun 2024 15 (1) 6289 Accurate forecasts can enable more effective public health responses during seasonal influenza epidemics. For the 2021-22 and 2022-23 influenza seasons, 26 forecasting teams provided national and jurisdiction-specific probabilistic predictions of weekly confirmed influenza hospital admissions for one-to-four weeks ahead. Forecast skill is evaluated using the Weighted Interval Score (WIS), relative WIS, and coverage. Six out of 23 models outperform the baseline model across forecast weeks and locations in 2021-22 and 12 out of 18 models in 2022-23. Averaging across all forecast targets, the FluSight ensemble is the 2(nd) most accurate model measured by WIS in 2021-22 and the 5(th) most accurate in the 2022-23 season. Forecast skill and 95% coverage for the FluSight ensemble and most component models degrade over longer forecast horizons. In this work we demonstrate that while the FluSight ensemble was a robust predictor, even ensembles face challenges during periods of rapid change. |
The frequency and function of nucleoprotein-specific CD8(+) T cells are critical for heterosubtypic immunity against influenza virus infection
Amoah S , Cao W , Sayedahmed EE , Wang Y , Kumar A , Mishina M , Eddins DJ , Wang WC , Burroughs M , Sheth M , Lee J , Shieh WJ , Ray SD , Bohannon CD , Ranjan P , Sharma SD , Hoehner J , Arthur RA , Gangappa S , Wakamatsu N , Johnston HR , Pohl J , Mittal SK , Sambhara S . J Virol 2024 e0071124 ![]() Cytotoxic T lymphocytes (CTLs) mediate host defense against viral and intracellular bacterial infections and tumors. However, the magnitude of CTL response and their function needed to confer heterosubtypic immunity against influenza virus infection are unknown. We addressed the role of CD8(+) T cells in the absence of any cross-reactive antibody responses to influenza viral proteins using an adenoviral vector expressing a 9mer amino acid sequence recognized by CD8(+) T cells. Our results indicate that both CD8(+) T cell frequency and function are crucial for heterosubtypic immunity. Low morbidity, lower viral lung titers, low to minimal lung pathology, and better survival upon heterosubtypic virus challenge correlated with the increased frequency of NP-specific CTLs. NP-CD8(+) T cells induced by differential infection doses displayed distinct RNA transcriptome profiles and functional properties. CD8(+) T cells induced by a high dose of influenza virus secreted significantly higher levels of IFN-γ and exhibited higher levels of cytotoxic function. The mice that received NP-CD8(+) T cells from the high-dose virus recipients through adoptive transfer had lower viral titers following viral challenge than those induced by the low dose of virus, suggesting differential cellular programming by antigen dose. Enhanced NP-CD8(+) T-cell functions induced by a higher dose of influenza virus strongly correlated with the increased expression of cellular and metabolic genes, indicating a shift to a more glycolytic metabolic phenotype. These findings have implications for developing effective T cell vaccines against infectious diseases and cancer. IMPORTANCE: Cytotoxic T lymphocytes (CTLs) are an important component of the adaptive immune system that clears virus-infected cells or tumor cells. Hence, developing next-generation vaccines that induce or recall CTL responses against cancer and infectious diseases is crucial. However, it is not clear if the frequency, function, or both are essential in conferring protection, as in the case of influenza. In this study, we demonstrate that both CTL frequency and function are crucial for providing heterosubtypic immunity to influenza by utilizing an Ad-viral vector expressing a CD8 epitope only to rule out the role of antibodies, single-cell RNA-seq analysis, as well as adoptive transfer experiments. Our findings have implications for developing T cell vaccines against infectious diseases and cancer. |
Chronic health conditions in the workplace: work stressors and supportive supervision, work design, and programs
McGonagle AK , Chosewood LC , Hartley TA , Newman LS , Ray T , Rosemberg MA . Occup Health Sci 2024 8 (2) 233-241 A large and growing number of workers are managing chronic physical and mental health conditions while working, necessitating attention from both researchers and leaders and practitioners in organizations. Much of the current discourse around research and practice in this area is focused on prevention of chronic disease and rehabilitation of disability to help workers return to work. Less commonly attended to are workplace factors that can support the quality of working life and the longevity of working life for workers with chronic health conditions. This Special Issue contains a set of interdisciplinary articles examining common stressors for workers with chronic health conditions, including work-health conflict, anticipated stigma, and job insecurity. It also contains articles examining important supportive relational and social and motivational work design factors, including supervisor support, psychosocial safety climate (shared perceptions of work policies, practices, and procedures that are meant to protect worker psychological health and safety), sense of community, organizational fairness, and health-related leeway (freedom available to workers to self-regulate work activities while self-managing day-to-day symptom fluctuations). The focal populations in this set of articles include, broadly, workers with various types of chronic health conditions, and more specifically, workers with mental health conditions, workers with diabetes, and breast cancer survivors. We hope this Special Issue sparks additional interest in these important topics and others that are critical to supporting workers with chronic health conditions in organizations. |
Syndromic gastrointestinal panel diagnostic tests have changed our understanding of the epidemiology of yersiniosis-Foodborne Diseases Active Surveillance Network, 2010-2021
Ray LC , Payne DC , Rounds J , Trevejo RT , Wilson E , Burzlaff K , Garman KN , Lathrop S , Rissman T , Wymore K , Wozny S , Wilson S , Francois Watkins LK , Bruce BB , Weller DL . Open Forum Infect Dis 2024 11 (6) ofae199 ![]() ![]() BACKGROUND: In the US, yersinosis was understood to predominantly occur in winter and among Black or African American infants and Asian children. Increased use of culture-independent diagnostic tests (CIDTs) has led to marked increases in yersinosis diagnoses. METHODS: We describe differences in the epidemiology of yersiniosis diagnosed by CIDT versus culture in 10 US sites, and identify determinants of health associated with diagnostic method. RESULTS: Annual reported incidence increased from 0.3/100 000 in 2010 to 1.3/100 000 in 2021, particularly among adults ≥18 years, regardless of race and ethnicity, and during summer months. The proportion of CIDT-diagnosed infections increased from 3% in 2012 to 89% in 2021. An ill person's demographic characteristics and location of residence had a significant impact on their odds of being diagnosed by CIDT. CONCLUSIONS: Improved detection due to increased CIDT use has altered our understanding of yersinosis epidemiology, however differential access to CIDTs may still affect our understanding of yersinosis. |
Correction: High school follow-up of the Dating Matters(®) RCT: Effects on teen dating violence and relationship behaviors
Niolon PH , Estefan LF , DeGue S , Le VD , Tracy AJ , Ray C , Bontempo D , Little TD , Vivolo-Kantor AM , Latzman N , Taylor B , Tharp A . Prev Sci 2024 |
Challenges of COVID-19 case forecasting in the US, 2020-2021
Lopez VK , Cramer EY , Pagano R , Drake JM , O'Dea EB , Adee M , Ayer T , Chhatwal J , Dalgic OO , Ladd MA , Linas BP , Mueller PP , Xiao J , Bracher J , Castro Rivadeneira AJ , Gerding A , Gneiting T , Huang Y , Jayawardena D , Kanji AH , Le K , Mühlemann A , Niemi J , Ray EL , Stark A , Wang Y , Wattanachit N , Zorn MW , Pei S , Shaman J , Yamana TK , Tarasewicz SR , Wilson DJ , Baccam S , Gurung H , Stage S , Suchoski B , Gao L , Gu Z , Kim M , Li X , Wang G , Wang L , Wang Y , Yu S , Gardner L , Jindal S , Marshall M , Nixon K , Dent J , Hill AL , Kaminsky J , Lee EC , Lemaitre JC , Lessler J , Smith CP , Truelove S , Kinsey M , Mullany LC , Rainwater-Lovett K , Shin L , Tallaksen K , Wilson S , Karlen D , Castro L , Fairchild G , Michaud I , Osthus D , Bian J , Cao W , Gao Z , Lavista Ferres J , Li C , Liu TY , Xie X , Zhang S , Zheng S , Chinazzi M , Davis JT , Mu K , Pastore YPiontti A , Vespignani A , Xiong X , Walraven R , Chen J , Gu Q , Wang L , Xu P , Zhang W , Zou D , Gibson GC , Sheldon D , Srivastava A , Adiga A , Hurt B , Kaur G , Lewis B , Marathe M , Peddireddy AS , Porebski P , Venkatramanan S , Wang L , Prasad PV , Walker JW , Webber AE , Slayton RB , Biggerstaff M , Reich NG , Johansson MA . PLoS Comput Biol 2024 20 (5) e1011200 During the COVID-19 pandemic, forecasting COVID-19 trends to support planning and response was a priority for scientists and decision makers alike. In the United States, COVID-19 forecasting was coordinated by a large group of universities, companies, and government entities led by the Centers for Disease Control and Prevention and the US COVID-19 Forecast Hub (https://covid19forecasthub.org). We evaluated approximately 9.7 million forecasts of weekly state-level COVID-19 cases for predictions 1-4 weeks into the future submitted by 24 teams from August 2020 to December 2021. We assessed coverage of central prediction intervals and weighted interval scores (WIS), adjusting for missing forecasts relative to a baseline forecast, and used a Gaussian generalized estimating equation (GEE) model to evaluate differences in skill across epidemic phases that were defined by the effective reproduction number. Overall, we found high variation in skill across individual models, with ensemble-based forecasts outperforming other approaches. Forecast skill relative to the baseline was generally higher for larger jurisdictions (e.g., states compared to counties). Over time, forecasts generally performed worst in periods of rapid changes in reported cases (either in increasing or decreasing epidemic phases) with 95% prediction interval coverage dropping below 50% during the growth phases of the winter 2020, Delta, and Omicron waves. Ideally, case forecasts could serve as a leading indicator of changes in transmission dynamics. However, while most COVID-19 case forecasts outperformed a naïve baseline model, even the most accurate case forecasts were unreliable in key phases. Further research could improve forecasts of leading indicators, like COVID-19 cases, by leveraging additional real-time data, addressing performance across phases, improving the characterization of forecast confidence, and ensuring that forecasts were coherent across spatial scales. In the meantime, it is critical for forecast users to appreciate current limitations and use a broad set of indicators to inform pandemic-related decision making. |
Effects of dust controls on respirable coal mine dust composition and particle sizes: case studies on auxiliary scrubbers and canopy air curtain
Animah F , Keles C , Reed WR , Sarver E . Int J Coal Sci Technol 2024 11 (1) Control of dust in underground coal mines is critical for mitigating both safety and health hazards. For decades, the National Institute of Occupational Safety and Health (NIOSH) has led research to evaluate the effectiveness of various dust control technologies in coal mines. Recent studies have included the evaluation of auxiliary scrubbers to reduce respirable dust downstream of active mining and the use of canopy air curtains (CACs) to reduce respirable dust in key operator positions. While detailed dust characterization was not a focus of such studies, this is a growing area of interest. Using preserved filter samples from three previous NIOSH studies, the current work aims to explore the effect of two different scrubbers (one wet and one dry) and a roof bolter CAC on respirable dust composition and particle size distribution. For this, the preserved filter samples were analyzed by thermogravimetric analysis and/or scanning electron microscopy with energy dispersive X-ray. Results indicate that dust composition was not appreciably affected by either scrubber or the CAC. However, the wet scrubber and CAC appeared to decrease the overall particle size distribution. Such an effect of the dry scrubber was not consistently observed, but this is probably related to the particular sampling location downstream of the scrubber which allowed for significant mixing of the scrubber exhaust and other return air. Aside from the insights gained with respect to the three specific dust control case studies revisited here, this work demonstrates the value of preserved dust samples for follow-up investigation more broadly. © The Author(s) 2024. |
An urgent call to address work-related psychosocial hazards and improve worker well-being
Schulte PA , Sauter SL , Pandalai SP , Tiesman HM , Chosewood LC , Cunningham TR , Wurzelbacher SJ , Pana-Cryan R , Swanson NG , Chang CC , Nigam JAS , Reissman DB , Ray TK , Howard J . Am J Ind Med 2024 Work-related psychosocial hazards are on the verge of surpassing many other occupational hazards in their contribution to ill-health, injury, disability, direct and indirect costs, and impact on business and national productivity. The risks associated with exposure to psychosocial hazards at work are compounded by the increasing background prevalence of mental health disorders in the working-age population. The extensive and cumulative impacts of these exposures represent an alarming public health problem that merits immediate, increased attention. In this paper, we review the linkage between work-related psychosocial hazards and adverse effects, their economic burden, and interventions to prevent and control these hazards. We identify six crucial societal actions: (1) increase awareness of this critical issue through a comprehensive public campaign; (2) increase etiologic, intervention, and implementation research; (3) initiate or augment surveillance efforts; (4) increase translation of research findings into guidance for employers and workers; (5) increase the number and diversity of professionals skilled in preventing and addressing psychosocial hazards; and (6) develop a national regulatory or consensus standard to prevent and control work-related psychosocial hazards. |
Risk of COVID-19 hospitalization and protection associated with mRNA vaccination among US adults with psychiatric disorders
Levy ME , Yang DH , Dunne MM , Miley K , Irving SA , Grannis SJ , Weber ZA , Griggs EP , Spark TL , Bassett E , Embi PJ , Gaglani M , Natarajan K , Valvi NR , Ong TC , Naleway AL , Stenehjem E , Klein NP , Link-Gelles R , DeSilva MB , Kharbanda AB , Raiyani C , Beaton MA , Dixon BE , Rao S , Dascomb K , Patel P , Mamawala M , Han J , Fadel WF , Barron MA , Grisel N , Dickerson M , Liao IC , Arndorfer J , Najdowski M , Murthy K , Ray C , Tenforde MW , Ball SW . Influenza Other Respir Viruses 2024 18 (3) e13269 ![]() ![]() BACKGROUND: Although psychiatric disorders have been associated with reduced immune responses to other vaccines, it remains unknown whether they influence COVID-19 vaccine effectiveness (VE). This study evaluated risk of COVID-19 hospitalization and estimated mRNA VE stratified by psychiatric disorder status. METHODS: In a retrospective cohort analysis of the VISION Network in four US states, the rate of laboratory-confirmed COVID-19-associated hospitalization between December 2021 and August 2022 was compared across psychiatric diagnoses and by monovalent mRNA COVID-19 vaccination status using Cox proportional hazards regression. RESULTS: Among 2,436,999 adults, 22.1% had ≥1 psychiatric disorder. The incidence of COVID-19-associated hospitalization was higher among patients with any versus no psychiatric disorder (394 vs. 156 per 100,000 person-years, p < 0.001). Any psychiatric disorder (adjusted hazard ratio [aHR], 1.27; 95% CI, 1.18-1.37) and mood (aHR, 1.25; 95% CI, 1.15-1.36), anxiety (aHR, 1.33, 95% CI, 1.22-1.45), and psychotic (aHR, 1.41; 95% CI, 1.14-1.74) disorders were each significant independent predictors of hospitalization. Among patients with any psychiatric disorder, aHRs for the association between vaccination and hospitalization were 0.35 (95% CI, 0.25-0.49) after a recent second dose, 0.08 (95% CI, 0.06-0.11) after a recent third dose, and 0.33 (95% CI, 0.17-0.66) after a recent fourth dose, compared to unvaccinated patients. Corresponding VE estimates were 65%, 92%, and 67%, respectively, and were similar among patients with no psychiatric disorder (68%, 92%, and 79%). CONCLUSION: Psychiatric disorders were associated with increased risk of COVID-19-associated hospitalization. However, mRNA vaccination provided similar protection regardless of psychiatric disorder status, highlighting its benefit for individuals with psychiatric disorders. |
High school follow-up of the Dating Matters® RCT: Effects on teen dating violence and relationship behaviors
Niolon PH , Estefan LF , DeGue S , Le VD , Tracy AJ , Ray C , Bontempo D , Little TD , Vivolo-Kantor AM , Latzman N , Taylor B , Tharp A . Prev Sci 2024 Teen dating violence (TDV) is a significant public health problem that can have lifelong consequences. Using a longitudinal, cluster randomized controlled trial (RCT), this study examines whether the Dating Matters comprehensive prevention model, implemented in middle school, prevented TDV and negative relationship behaviors and promoted positive relationship behaviors in high school (9th-11th grades), when compared with a standard of care intervention. Dating Matters includes programs for sixth to eighth grade youth and their parents, training for school staff, a youth communications program, and policy and data activities implemented in the community. Self-report survey data were collected from students in 46 middle schools that were randomly assigned to condition within site. Students completed two surveys (fall and spring) in each middle school grade and a single survey in the spring of each high school grade. This study examined self-reported TDV perpetration and victimization, use of negative conflict resolution strategies, and positive relationship skills in the high school follow-up. While varying patterns emerged, latent panel models demonstrated significant program effects for all outcomes. Dating Matters students reported 19% reduced risk for TDV perpetration, 24% reduced risk for TDV victimization, 7% reduced risk for use of negative conflict strategies, and 3% more use of positive relationship skills, on average across time and cohort, than standard of care students. On average, Dating Matters, implemented in middle school, continued to be more effective at reducing TDV perpetration, TDV victimization, and use of negative conflict resolution strategies in high school than an evidence-based comparison program.Trial Registration: clinicaltrials.gov Identifier: NCT01672541. |
PTSD symptoms among college students: Linkages with familial risk, borderline personality, and sexual assault
Tyler KA , Ray CM . J Child Sex Abus 2024 1-19 College students have high rates of post-traumatic stress disorder (PTSD) symptoms as well as high rates of sexual assault. What is less clear, however, is whether different sexual assault types (e.g. coercive, physically forced, and incapacitation) are associated with greater PTSD symptoms. Moreover, understanding early familial and mental health histories of college students is important for explaining PTSD symptoms. As such, we use a social stress framework to examine the relationships between early familial risk (i.e. child abuse, perceived maternal rejection), borderline personality (BP) symptoms, and three sexual assault types with PTSD symptoms among college students. A total of 783 undergraduate students (65.4% female) completed paper and pencil surveys in fall 2019 and spring 2020 at a large public university. Results revealed that females were more likely to experience child sexual abuse and all three forms of sexual assault, while males experienced higher rates of child physical abuse. OLS regression results showed positive associations between child sexual abuse, perceived maternal rejection, BP symptoms and all three types of sexual assault with PTSD symptoms. Females also experienced more PTSD symptoms compared to males. Findings have implications for targeted interventions to improve mental health outcomes. |
Genetics and genomics for the prevention and treatment of cardiovascular disease: update: a scientific statement from the American Heart Association.
Ganesh SK , Arnett DK , Assimes TL , Basson CT , Chakravarti A , Ellinor PT , Engler MB , Goldmuntz E , Herrington DM , Hershberger RE , Hong Y , Johnson JA , Kittner SJ , McDermott DA , Meschia JF , Mestroni L , O'Donnell CJ , Psaty BM , Vasan RS , Ruel M , Shen WK , Terzic A , Waldman SA . Circulation 2013 128 (25) 2813-51 ![]() Cardiovascular diseases (CVDs) are a major source of morbidity and mortality worldwide. Despite a decline of ≈30% over the past decade, heart disease remains the leading killer of Americans.1 For rare and familial forms of CVD, we are increasingly recognizing single-gene mutations that impart relatively large effects on individual phenotype. Examples include inherited forms of cardiomyopathy, arrhythmias, and aortic diseases. However, the prevalence of monogenic disorders typically accounts for a small proportion of the total CVD observed in the population. CVDs in the general population are complex diseases, with several contributing genetic and environmental factors. Although recent progress in monogenic disorders has occurred, we have seen a period of intense investigation to identify the genetic architecture of more common forms of CVD and related traits. | | Genomics serves several roles in cardiovascular health and disease, including disease prediction, discovery of genetic loci influencing CVD, functional evaluation of these genetic loci to understand mechanisms, and identification of therapeutic targets. For single-gene CVDs, progress has led to several clinically useful diagnostic tests, extending our ability to inform the management of afflicted patients and their family members. However, there has been little progress in developing genetic testing for complex CVD because individual common variants have only a modest impact on risk. The study of the genomics of complex CVDs is further challenged by the influence of environmental variables, phenotypic heterogeneity, and pathogenic complexity. Characterization of the clinical phenotype requires consideration of the clinical details of the diseases and traits under study. |
Lactic acid salts of nicotine potentiate the transfer of toxic metals into electronic cigarette aerosols
Pappas RS , Gray N , Halstead M , Watson CH . Toxics 2024 12 (1) The designs and liquid formulations of Electronic Nicotine Delivery System (ENDS) devices continue to rapidly evolve. Thus, it is important to monitor and characterize ENDS aerosols for changes in toxic constituents. Many ENDS liquid formulations now include the addition of organic acids in a 1 to 1 molar ratio with nicotine. Metal concentrations in aerosols produced by ENDS devices with different nicotine salt formulations were analyzed. Aerosols from devices containing lactic acid had higher nickel, zinc, copper, and chromium concentrations than aerosols produced by devices containing benzoic acid or levulinic acid. Our scanning electron microscope with energy dispersive X-ray analytical findings showed that the metals determined in the inductively coupled plasma-mass spectrometry analytical results were consistent with the metal compositions of the ENDS device components that were exposed to the liquids and that nickel is a major constituent in many ENDS internal components. As a result of the exposure of the nickel-containing components to the ENDS liquids, resulting aerosol nickel concentrations per puff were higher from devices that contained lactic acid in comparison to devices with benzoic or levulinic acid. The aerosol nickel concentrations in 10 puffs from ENDS-containing lactic acid were, in some cases, hundreds of times higher than cigarette mainstream smoke nickel deliveries. Thus, the design of an ENDS device in terms of both physical construction components and the liquid chemical formulations could directly impact potential exposures to toxic constituents such as metals. |
Respirable coal mine dust in the vicinity of a roof bolter: an inter-laboratory study to compare wet versus dry dust collection systems
Animah F , Greth A , Afrouz S , Keles C , Akinseye T , Pan L , Reed WR , Sarver E . Min Metall Explor null [Epub ahead of print] Among underground coal miners, roof bolter operators are generally considered to have some of the highest risks for hazardous respirable dust exposure. This is because bolting requires drilling into roof strata that can often be a source of silica and silicate dust, which are associated with occupational lung diseases. However, little is known about the variability of dust characteristics (e.g., mineralogy constituents, particle size) in the vicinity of the bolter-or when specific dust controls are applied. As part of a prior NIOSH study, respirable dust samples were collected during several different events in standardized locations around an active roof bolter, and personal samples were also collected from the operator during the cleanout of the bolter's dust collection system when it was equipped with a novel wet dust box versus a traditional dry box. Those samples were made available for follow-up analysis by scanning electron microscopy with energy-dispersive X-ray spectroscopy (SEM-EDX), as well as direct-on-filter Fourier transform infrared spectroscopy (FTIR). Results showed variability in dust constituents and particle sizes at locations around the roof bolter, and indicated some event-to-event differences in dust sources. Additionally, compared to the dry dust box, the wet dust box appeared to reduce (by 41-82%) the relative silica and silicate content in the respirable dust to which the operator was exposed during cleanout. Furthermore, an inter-laboratory comparison demonstrated the reproducibility of a standardized direct-on-filter FTIR method for estimating quartz mass (i.e., the predominant form of crystalline silica) in respirable coal mine dust samples. However, for constituent analysis by SEM-EDX, differences observed between results from two independent labs indicate that standardization of the analytical protocol is necessary to enable comparability of results. |
Value of rigorous review and evaluation to support implementation of effective sexual violence prevention programming
Coker Ann L , Ray Colleen M . J Adolesc Health 2024 74 (1) 210-210 The goal of identifying evidence-based programming that reduces sexual violence (SV) on college campuses and elsewhere is crucial given SV's high lifetime frequency, the range of mental and physical health consequences linked to SV, and its economic costs [1]. To reduce SV on college campuses, the US Campus Sexual Assault Violence Elimination (SaVE) Act of 2013 (www.campussaveact.org) mandated institutions of higher learning to provide primary prevention and awareness programming to reduce SV. Sexual Assault Violence Elimination (SaVE) now acts as an impetus for novel SV prevention programming development and evaluation. Yet when SaVE was enacted, few SV prevention programs had been rigorously evaluated for their efficacy to prevent or reduce SV, including in which settings and with which students. Systematic reviews are strategic approaches to establish the effectiveness of SV programming to prevent SV or mitigate the, often life-long, trauma associated with SV [2,3] and are used to inform resources that can be used by communities for action. The Centers for Disease Control and Prevention's STOP SV resource for action [4] provides a summary of the best available evidence needed to establish an evidence base for selecting SV prevention programming. While important, the STOP SV resource for action was published in 2016, and an update is needed to reflect the recent evaluations as well an expanded range of settings and persons that could benefit from SV prevention intervention programming. |
- Page last reviewed:Feb 1, 2024
- Page last updated:Jan 27, 2025
- Content source:
- Powered by CDC PHGKB Infrastructure