Last data update: May 13, 2024. (Total: 46773 publications since 2009)
Records 1-30 (of 68 Records) |
Query Trace: Weaver J[original query] |
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Personal journeys to and in human genetics and dysmorphology
Schwartz CE , Aylsworth AS , Allanson J , Battaglia A , Carey JC , Curry CJ , Davies KE , Eichler EE , Graham JM Jr , Hall B , Hall JG , Holmes LB , Hoyme HE , Hunter A , Innis J , Johnson J , Keppler-Noreuil KM , Leroy JG , Moore C , Nelson DL , Neri G , Opitz JM , Picketts D , Raymond FL , Shalev SA , Stevenson RE , Stumpel Ctrm , Sutherland G , Viskochil DH , Weaver DD , Zackai EH . Am J Med Genet A 2024 e63514 Genetics has become a critical component of medicine over the past five to six decades. Alongside genetics, a relatively new discipline, dysmorphology, has also begun to play an important role in providing critically important diagnoses to individuals and families. Both have become indispensable to unraveling rare diseases. Almost every medical specialty relies on individuals experienced in these specialties to provide diagnoses for patients who present themselves to other doctors. Additionally, both specialties have become reliant on molecular geneticists to identify genes associated with human disorders. Many of the medical geneticists, dysmorphologists, and molecular geneticists traveled a circuitous route before arriving at the position they occupied. The purpose of collecting the memoirs contained in this article was to convey to the reader that many of the individuals who contributed to the advancement of genetics and dysmorphology since the late 1960s/early 1970s traveled along a journey based on many chances taken, replying to the necessities they faced along the way before finding full enjoyment in the practice of medical and human genetics or dysmorphology. Additionally, and of equal importance, all exhibited an ability to evolve with their field of expertise as human genetics became human genomics with the development of novel technologies. |
Optimization of Aspergillus versicolor culture and aerosolization in a murine model of inhalational fungal exposure
Blackwood CB , Croston TL , Barnes MA , Lemons AR , Rush RE , Goldsmith T , McKinney WG , Anderson S , Weaver KL , Sulyok M , Park JH , Germolec D , Beezhold DH , Green B . J Fungi (Basel) 2023 9 (11) Aspergillus versicolor is ubiquitous in the environment and is particularly abundant in damp indoor spaces. Exposure to Aspergillus species, as well as other environmental fungi, has been linked to respiratory health outcomes, including asthma, allergy, and even local or disseminated infection. However, the pulmonary immunological mechanisms associated with repeated exposure to A. versicolor have remained relatively uncharacterized. Here, A. versicolor was cultured and desiccated on rice then placed in an acoustical generator system to achieve aerosolization. Mice were challenged with titrated doses of aerosolized conidia to examine deposition, lymphoproliferative properties, and immunotoxicological response to repeated inhalation exposures. The necessary dose to induce lymphoproliferation was identified, but not infection-like pathology. Further, it was determined that the dose was able to initiate localized immune responses. The data presented in this study demonstrate an optimized and reproducible method for delivering A. versicolor conidia to rodents via nose-only inhalation. Additionally, the feasibility of a long-term repeated exposure study was established. This experimental protocol can be used in future studies to investigate the physiological effects of repeated pulmonary exposure to fungal conidia utilizing a practical and relevant mode of delivery. In total, these data constitute an important foundation for subsequent research in the field. |
Fatal occupational asthma in cannabis production - Massachusetts, 2022
Weaver VM , Hua JT , Fitzsimmons KM , Laing JR , Farah W , Hart A , Braegger TJ , Reid M , Weissman DN . MMWR Morb Mortal Wkly Rep 2023 72 (46) 1257-1261 Multiple respiratory hazards have been identified in the cannabis cultivation and production industry, in which occupational asthma and work-related exacerbation of preexisting asthma have been reported. An employee working in a Massachusetts cannabis cultivation and processing facility experienced progressively worsening work-associated respiratory symptoms, which culminated in a fatal asthma attack in January 2022. This report represents findings of an Occupational Safety and Health Administration inspection, which included a worksite exposure assessment, coworker and next-of-kin interviews, medical record reviews, and collaboration with the Massachusetts Department of Public Health. Respiratory tract or skin symptoms were reported by four of 10 coworkers with similar job duties. Prevention is best achieved through a multifaceted approach, including controlling asthmagen exposures, such as cannabis dust, providing worker training, and conducting medical monitoring for occupational allergy. Evaluation of workers with new-onset or worsening asthma is essential, along with prompt diagnosis and medical management, which might include cessation of work and workers' compensation when relation to work exposures is identified. It is important to recognize that work in cannabis production is potentially causative. |
Developing a prototype pathogen plan and research priorities for the alphaviruses
Powers AM , Williamson LE , Carnahan RH , Crowe JE Jr , Hyde JL , Jonsson CB , Nasar F , Weaver SC . J Infect Dis 2023 228 S414-s426 The Togaviridae family, genus, Alphavirus, includes several mosquito-borne human pathogens with the potential to spread to near pandemic proportions. Most of these are zoonotic, with spillover infections of humans and domestic animals, but a few such as chikungunya virus (CHIKV) have the ability to use humans as amplification hosts for transmission in urban settings and explosive outbreaks. Most alphaviruses cause nonspecific acute febrile illness, with pathogenesis sometimes leading to either encephalitis or arthralgic manifestations with severe and chronic morbidity and occasional mortality. The development of countermeasures, especially against CHIKV and Venezuelan equine encephalitis virus that are major threats, has included vaccines and antibody-based therapeutics that are likely to also be successful for rapid responses with other members of the family. However, further work with these prototypes and other alphavirus pathogens should target better understanding of human tropism and pathogenesis, more comprehensive identification of cellular receptors and entry, and better understanding of structural mechanisms of neutralization. |
Survey of invasive mosquito surveillance and control capacity in Southeastern USA reveals training and resource needs
Nguyen V , Weaver-Romero AL , Wang X , Tavares Y , Bauer A , McDowell RC , Dorsainvil C , Eason MD , Malcolm AN , Raz CD , Byrd BD , Riegel C , Clark M , Ber J , Harrison RL , Evans CL , Zohdy S , Allen B , Campbell LP , Killingsworth D , Grey EW , Riles MT , Lee Y , Giordano BV . J Am Mosq Control Assoc 2023 39 (2) 108-121 Several invasive mosquito species that are nuisances or of medical and veterinary importance have been introduced into the Southeastern region of the USA, posing a threat to other species and the local ecosystems and/or increasing the risk of pathogen transmission to people, livestock, and domestic pets. Prompt and effective monitoring and control of invasive species is essential to prevent them from spreading and causing harmful effects. However, the capacity for invasive mosquito species surveillance is highly variable among mosquito control programs in the Southeast, depending on a combination of factors such as regional geography and climate, access to resources, and the ability to interact with other programs. To facilitate the development of invasive mosquito surveillance in the region, we, the Mosquito BEACONS (Biodiversity Enhancement and Control of Non-native Species) working group, conducted a survey on the capacities of various public health agencies and pest control agencies engaged in mosquito surveillance and control in seven Southeastern states (Alabama, Florida, Georgia, Louisiana, Mississippi, North Carolina, and South Carolina). Ninety control programs completed the survey, representing an overall response rate of 25.8%. We report key findings from our survey, emphasizing the training and resource needs, and discuss their implications for future invasive mosquito surveillance and control capacity building. By increasing communication and collaboration opportunities (e.g., real-time sharing of collection records, coordinated multistate programs), the establishment of Mosquito BEACONS and the implementation of this survey can accelerate knowledge transfer and improve decision support capacity in response to or in preparation for invasive mosquito surveillance and can establish infrastructure that can be used to inform programs around the world. |
From Surveillance To Control: Evaluation of A Larvicide Intervention Against Aedes aegypti In Brownsville, Texas
Garcia-Luna SM , Chaves LF , Juarez JG , Bolling BG , Rodriguez A , Presas YE , Mutebi JP , Weaver SC , Badillo-Vargas IE , Hamer GL , Qualls WA . J Am Mosq Control Assoc 2019 35 (3) 233-237 South Texas is recognized as a potential area for the emergence and re-emergence of mosquito-borne diseases due to recent circulation of Zika, chikungunya, and dengue viruses. During 2017, high Aedes aegypti abundance found in the city of Brownsville, TX, in combination with the previous year's local transmission of Zika virus, triggered the activation of the Texas Department of State Health Services Emergency Mosquito Control Contingency Contract. A contract with the Clarke Environmental and Mosquito Control was a response to control Ae. aegypti, using a ground-based wide-area larvicide spray (WALS™) containing Bacillus thuringiensis israelensis. The WALS application was evaluated through a field-based bioassay and by comparing surveillance data pre- and post-WALS application. The WALS application bioassay demonstrated that the larvicide was effective up to 60 m into the target properties. Additionally, the number of Ae. aegypti captured in traps decreased in the WALS intervention areas compared with the untreated control areas, with an estimated 29% control. |
Occupational safety and health with technological developments in livestock farms: A literature review
Hayden MA , Barim MS , Weaver DL , Elliott KC , Flynn MA , Lincoln JM . Int J Environ Res Public Health 2022 19 (24) In recent decades, there have been considerable technological developments in the agriculture sector to automate manual processes for many factors, including increased production demand and in response to labor shortages/costs. We conducted a review of the literature to summarize the key advances from installing emerging technology and studies on robotics and automation to improve agricultural practices. The main objective of this review was to survey the scientific literature to identify the uses of these new technologies in agricultural practices focusing on new or reduced occupational safety risks affecting agriculture workers. We screened 3248 articles with the following criteria: (1) relevance of the title and abstract with occupational safety and health; (2) agriculture technologies/applications that were available in the United States; (3) written in English; and (4) published 2015-2020. We found 624 articles on crops and harvesting and 80 articles on livestock farming related to robotics and automated systems. Within livestock farming, most (78%) articles identified were related to dairy farms, and 56% of the articles indicated these farms were using robotics routinely. However, our review revealed gaps in how the technology has been evaluated to show the benefits or potential hazards to the safety and well-being of livestock owners/operators and workers. |
Perception of Local COVID-19 Transmission and Use of Preventive Behaviors Among Adults with Recent SARS-CoV-2 Infection - Illinois and Michigan, June 1-July 31, 2022.
Czeisler MÉ , Lane RI , Orellana RC , Lundeen K , Macomber K , Collins J , Varma P , Booker LA , Rajaratnam SMW , Howard ME , Czeisler CA , Flannery B , Weaver MD . MMWR Morb Mortal Wkly Rep 2022 71 (46) 1471-1478 During the early stages of the COVID-19 pandemic, use of preventive behaviors was associated with perceived risk for contracting SARS-CoV-2 infection (1,2). Over time, perceived risk has declined along with waning COVID-19-related media coverage (3,4). The extent to which communities continue to be aware of local COVID-19 transmission levels and are implementing recommended preventive behaviors is unknown. During June 1-July 31, 2022, health departments in DuPage County, Illinois and metropolitan Detroit, Michigan surveyed a combined total of 4,934 adults who had received a positive test result for SARS-CoV-2 during the preceding 3 weeks. The association between awareness of local COVID-19 transmission and use of preventive behaviors and practices was assessed, both in response to perceived local COVID-19 transmission levels and specifically during the 2 weeks preceding SARS-CoV-2 testing. Both areas had experienced sustained high COVID-19 transmission during the study interval as categorized by CDC COVID-19 transmission levels.* Overall, 702 (14%) respondents perceived local COVID-19 transmission levels as high, 987 (20%) as substantial, 1,902 (39%) as moderate, and 581 (12%) as low; 789 (16%) reported they did not know. Adjusting for geographic area, age, gender identity, and combined race and ethnicity, respondents who perceived local COVID-19 transmission levels as high were more likely to report having made behavioral changes because of the level of COVID-19 transmission in their area, including wearing a mask in public, limiting travel, and avoiding crowded places or events. Continued monitoring of public perceptions of local COVID-19 levels and developing a better understanding of their influence on the use of preventive behaviors can guide COVID-19 communication strategies and policy making during and beyond the pandemic. |
Evaluation of advanced curve speed warning system to prevent fire truck rollover crashes.
Simeonov P , Nimbarte A , Hsiao H , Current R , Ammons D , Choi HS , Rahman MM , Weaver D . J Safety Res 2022 83 388-399 Introduction: A disproportionately high number of deadly crash-incidents involve fire-tanker rollovers during emergency response driving. Most of these rollover incidents occur at dangerous horizontal curves (“curves”) due to unsafe speed. This study examined the effects of a curve speed warning system (CSWS) on fire tanker drivers’ emergency response behavior to develop system improvement suggestions. Method: Twenty-four firefighters participated in driving tests using a simulator. A fire tanker model, carrying a full tank of water, was used in emergency driving tests performed with and without CSWS. The CSWS was designed using the algorithm for passenger vehicles with a few initial modifications considering the unique requirements of heavy fire tanker and emergency driving. Results: The results indicated that the CSWS was effective in issuing preemptive warnings when the drivers were approaching curves with unsafe speed during emergency response. Warnings occurred more frequently at curves with smaller radius. Although the CSWS improved driving performance, it did not significantly reduce the number of rollover events. A detailed analysis of the rollover events provided suggestions for improvement of CSWS algorithms. Conclusions: To further improve the CSWS algorithm, the following may be considered: including increased safety speed margin below the rollover critical speed, moving the speed warning trigger from the curve apex to the curve entry point, extending the safe speed-control zone to cover the entire curve, and employing artificial intelligence to accommodate individual driving styles. Practical Applications: Fire tankers continue to be at increased risk of rollover during emergency response due to unsafe negotiation of dangerous curves. Development and use of advanced driver assist systems such as CSWS evaluated in this study may be an effective strategy to prevent deadly rollover crash-incidents. The knowledge generated by this study will be useful for system designers to improve the CSWS specifically designed for heavy emergency vehicles. © 2022 |
Intent among Parents to Vaccinate Children before Pediatric COVID-19 Vaccine Recommendations, Minnesota and Los Angeles County, California-May-September 2021.
Suvada KA , Quan SF , Weaver MD , Sreedhara M , Czeisler MÉ , Como-Sabetti K , Lynfield R , Grounder P , Traub E , Amoon A , Ladva CN , Howard ME , Czeisler CA , Rajaratnam SMW , Ekwueme DU , Flannery B , Lane RI . Vaccines (Basel) 2022 10 (9) Objectives: This study assessed the associations between parent intent to have their child receive the COVID-19 vaccination, and demographic factors and various child activities, including attendance at in-person education or childcare. Methods: Persons undergoing COVID-19 testing residing in Minnesota and Los Angeles County, California with children aged <12 years completed anonymous internet-based surveys between 10 May and 6 September 2021 to assess factors associated with intention to vaccinate their child. Factors influencing the parents' decision to have their child attend in-person school or childcare were examined. Estimated adjusted odds rations (AORs, 95% CI) were computed between parents' intentions regarding children's COVID-19 vaccination and participation in school and extra-curricular activities using multinomial logistic regression. Results: Compared to parents intending to vaccinate their children (n = 4686 [77.2%]), those undecided (n = 874 [14.4%]) or without intention to vaccinate (n = 508 [8.4%]) tended to be younger, non-White, less educated, and themselves not vaccinated against COVID-19. Their children more commonly participated in sports (aOR:1.51 1.17-1.95) and in-person faith or community activities (aOR:4.71 3.62-6.11). A greater proportion of parents without intention to vaccinate (52.5%) indicated that they required no more information to make their decision in comparison to undecided parents (13.2%). They further indicated that additional information regarding vaccine safety and effectiveness would influence their decision. COVID-19 mitigation measures were the most common factors influencing parents' decision to have their child attend in-person class or childcare. Conclusions: Several demographic and socioeconomic factors are associated with parents' decision whether to vaccinate their <12-year-old children for COVID-19. Child participation in in-person activities was associated with parents' intentions not to vaccinate. Tailored communications may be useful to inform parents' decisions regarding the safety and effectiveness of vaccination. |
Primary and Secondary Attack Rates by Vaccination Status after a SARS-CoV-2 B.1.617.2 (Delta) Variant Outbreak at a Youth Summer Camp - Texas, June 2021.
Baker JM , Shah MM , O'Hegarty M , Pomeroy M , Keiser P , Ren P , Weaver SC , Maknojia S , Machado RRG , Mitchell BM , McConnell A , Tate JE , Kirking HL . J Pediatric Infect Dis Soc 2022 11 (12) 550-556 Children are capable of initiating COVID-19 transmission into households, but many questions remain about the impact of vaccination on transmission. Data from a COVID-19 Delta variant outbreak at an overnight camp in Texas during June 23-27, 2021 were analyzed. The camp had 451 attendees, including 364 youths aged <18 years and 87 adults. Detailed interviews were conducted with 92 (20.4%) of consenting attendees and 117 household members of interviewed attendees with COVID-19. Among 450 attendees with known case status, the attack rate was 41%, including 42% among youths; attack rates were lower among vaccinated (13%) than among unvaccinated youths (48%). The secondary attack rate was 51% among 115 household contacts of 55 interviewed index patients. Secondary infections occurred in 67% of unvaccinated household members and 33% of fully or partially vaccinated household members. Analyses suggested that household member vaccination and camp attendee masking at home protected against household transmission. |
Defining the risk of SARS-CoV-2 variants on immune protection.
DeGrace MM , Ghedin E , Frieman MB , Krammer F , Grifoni A , Alisoltani A , Alter G , Amara RR , Baric RS , Barouch DH , Bloom JD , Bloyet LM , Bonenfant G , Boon ACM , Boritz EA , Bratt DL , Bricker TL , Brown L , Buchser WJ , Carreo JM , Cohen-Lavi L , Darling TL , Davis-Gardner ME , Dearlove BL , Di H , Dittmann M , Doria-Rose NA , Douek DC , Drosten C , Edara VV , Ellebedy A , Fabrizio TP , Ferrari G , Florence WC , Fouchier RAM , Franks J , Garca-Sastre A , Godzik A , Gonzalez-Reiche AS , Gordon A , Haagmans BL , Halfmann PJ , Ho DD , Holbrook MR , Huang Y , James SL , Jaroszewski L , Jeevan T , Johnson RM , Jones TC , Joshi A , Kawaoka Y , Kercher L , Koopmans MPG , Korber B , Koren E , Koup RA , LeGresley EB , Lemieux JE , Liebeskind MJ , Liu Z , Livingston B , Logue JP , Luo Y , McDermott AB , McElrath MJ , Meliopoulos VA , Menachery VD , Montefiori DC , Mhlemann B , Munster VJ , Munt JE , Nair MS , Netzl A , Niewiadomska AM , O'Dell S , Pekosz A , Perlman S , Pontelli MC , Rockx B , Rolland M , Rothlauf PW , Sacharen S , Scheuermann RH , Schmidt SD , Schotsaert M , Schultz-Cherry S , Seder RA , Sedova M , Sette A , Shabman RS , Shen X , Shi PY , Shukla M , Simon V , Stumpf S , Sullivan NJ , Thackray LB , Theiler J , Thomas PG , Trifkovic S , Treli S , Turner SA , Vakaki MA , vanBakel H , VanBlargan LA , Vincent LR , Wallace ZS , Wang L , Wang M , Wang P , Wang W , Weaver SC , Webby RJ , Weiss CD , Wentworth DE , Weston SM , Whelan SPJ , Whitener BM , Wilks SH , Xie X , Ying B , Yoon H , Zhou B , Hertz T , Smith DJ , Diamond MS , Post DJ , Suthar MS . Nature 2022 605 (7911) 640-652 The global emergence of many severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants jeopardizes the protective antiviral immunity induced following infection or vaccination. To address the public health threat caused by the increasing SARS-CoV-2 genomic diversity, the National Institute of Allergy and Infectious Diseases (NIAID) within the National Institutes of Health (NIH) established the SARS-CoV-2 Assessment of Viral Evolution (SAVE) program. This effort was designed to provide a real-time risk assessment of SARS-CoV-2 variants potentially impacting transmission, virulence, and resistance to convalescent and vaccine-induced immunity. The SAVE program serves as a critical data-generating component of the United States Government SARS-CoV-2 Interagency Group to assess implications of SARS-CoV-2 variants on diagnostics, vaccines, and therapeutics and for communicating public health risk. Here we describe the coordinated approach used to identify and curate data about emerging variants, their impact on immunity, and effects on vaccine protection using animal models. We report the development of reagents, methodologies, models, and pivotal findings facilitated by this collaborative approach and identify future challenges. This program serves as a template for the response against rapidly evolving pandemic pathogens by monitoring viral evolution in the human population to identify variants that could erode the effectiveness of countermeasures. |
Encumbered and Traditional Anthropometry of Law Enforcement Officers for Vehicle Workspace and Protective Equipment Design
Hsiao H , Whisler R , Weaver D , Hause M , Newbraugh B , Zwiener J , Ronaghi M , Bradtmiller B , Rockwell B , McDougall V , Brake T . Hum Factors 2021 66 (1) 187208211064371 OBJECTIVES: This study investigated anthropometric changes of national law enforcement officers (LEOs) in 46 years, compared the differences between LEO data and civilian anthropometry, and identified the magnitude of differences in dimensions measured with gear versus semi-nude measurements. BACKGROUND: The best available 46-year-old anthropometric dataset of LEOs has largely become outdated due to demographic changes. Additionally, anthropometric data of female LEOs and LEO measurements with gear are lacking. METHOD: Thirty-four traditional body dimensions and 15 with gear measurements of 756 male and 218 female LEOs were collected through a stratified national survey using a data collection trailer that traveled across the U.S. and the data were compared to the LEO anthropometric data from 1975 and existing civilian anthropometric databases. RESULTS: LEO body size and shape have evolved over the past 46 years - an increase of 12.2 kg in body weight, 90 mm in chest circumference, and 120 mm in waist circumference for men. No previous data was available for comparison for females. Compared to civilians, both male and female LEOs have a larger upper body build. LEO gear added 91 mm in waist breadth for men and 120 mm for women, and 11 kg in weight for men and 9 kg for women. CONCLUSION: The study reveals that equipment design based on the existing civilian datasets or 46-year-old LEO dataset would not accommodate the current LEO population. The new data fill this gap. Application: The differences reported above are important for LEO body gear, vehicle console, and vehicle ingress/egress design. |
Health Care Access and Use Among Adults with Diabetes During the COVID-19 Pandemic - United States, February-March 2021.
Czeisler MÉ , Barrett CE , Siegel KR , Weaver MD , Czeisler CA , Rajaratnam SMW , Howard ME , Bullard KM . MMWR Morb Mortal Wkly Rep 2021 70 (46) 1597-1602 Diabetes affects approximately one in 10 persons in the United States(†) and is a risk factor for severe COVID-19 (1), especially when a patient's diabetes is not well managed (2). The extent to which the COVID-19 pandemic has affected diabetes care and management, and whether this varies across age groups, is currently unknown. To evaluate access to and use of health care, as well as experiences, attitudes, and behaviors about COVID-19 prevention and vaccination, a nonprobability, Internet-based survey was administered to 5,261 U.S. adults aged ≥18 years during February-March 2021. Among respondents, 760 (14%) adults who reported having diabetes currently managed with medication were included in the analysis. Younger adults (aged 18-29 years) with diabetes were more likely to report having missed medical care during the past 3 months (87%; 79) than were those aged 30-59 years (63%; 372) or ≥60 years (26%; 309) (p<0.001). Overall, 44% of younger adults reported difficulty accessing diabetes medications. Younger adults with diabetes also reported lower intention to receive COVID-19 vaccination (66%) compared with adults aged ≥60 years(§) (85%; p = 0.001). During the COVID-19 pandemic, efforts to enhance access to diabetes care for adults with diabetes and deliver public health messages emphasizing the importance of diabetes management and COVID-19 prevention, including vaccination, are warranted, especially in younger adults. |
Evaluation of advanced curve speed warning system for fire trucks
Simeonov P , Hsiao H , Nimbarte A , Current R , Ammons D , Choi HS , Rahman MM , Weaver D . Appl Ergon 2021 97 103527 A curve speed warning system (CSWS) for firetrucks was developed and tested in this study. The CSWS algorithm was developed based on guidelines in the public domain for general vehicles and modified for firetrucks for their configuration and emergency driving. Twenty-four firefighters participated in the test in a driving simulator. The results show that the CSWS was effective in issuing preemptive warnings when the drivers were approaching curves with unsafe speed during emergency responses. Drivers reduced their driving speed at curve approaching and entering phases for most challenging curves, without affecting the overall time in completing the test route. Drivers had reduced number of severe braking and decreased average in-curve distance traveled over the safety speed limits, when the CSWS was in use. Drivers also rated the CSWS as assisting, effective and useful. In summary, the CSWS can enhance firetruck safety during emergency driving without sacrificing drivers' precious response time. |
Mental Health Among Parents of Children Aged <18 Years and Unpaid Caregivers of Adults During the COVID-19 Pandemic - United States, December 2020 and February-March 2021.
Czeisler MÉ , Rohan EA , Melillo S , Matjasko JL , DePadilla L , Patel CG , Weaver MD , Drane A , Winnay SS , Capodilupo ER , Robbins R , Wiley JF , Facer-Childs ER , Barger LK , Czeisler CA , Howard ME , Rajaratnam SMW . MMWR Morb Mortal Wkly Rep 2021 70 (24) 879-887 Early during the COVID-19 pandemic, nearly two thirds of unpaid caregivers of adults reported adverse mental or behavioral health symptoms, compared with approximately one third of noncaregivers(†) (1). In addition, 27% of parents of children aged <18 years reported that their mental health had worsened during the pandemic (2). To examine mental health during the COVID-19 pandemic among U.S. adults on the basis of their classification as having a parenting role (i.e., unpaid persons caring for children and adolescents aged <18 years, referred to as children in this report) or being an unpaid caregiver of adults (i.e., persons caring for adults aged ≥18 years),(§) CDC analyzed data from cross-sectional surveys that were administered during December 2020 and February-March 2021 for The COVID-19 Outbreak Public Evaluation (COPE) Initiative.(¶) Respondents were categorized as parents only, caregivers of adults only, parents-caregivers (persons in both roles), or nonparents/noncaregivers (persons in neither role). Adjusted odds ratios (aORs) for any adverse mental health symptoms, particularly suicidal ideation, were higher among all respondents who were parents, caregivers of adults, or both compared with respondents who were nonparents/noncaregivers and were highest among persons in both roles (parents-caregivers) (any adverse mental health symptoms: aOR = 5.1, 95% confidence interval [CI] = 4.1-6.2; serious suicidal ideation: aOR = 8.2, 95% CI = 6.5-10.4). These findings highlight that parents and caregivers, especially those balancing roles both as parents and caregivers, experienced higher levels of adverse mental health symptoms during the COVID-19 pandemic than adults without these responsibilities. Caregivers who had someone to rely on for support had lower odds of experiencing any adverse mental health symptoms. Additional measures are needed to improve mental health among parents, caregivers, and parents-caregivers. |
Delay or Avoidance of Medical Care Because of COVID-19-Related Concerns - United States, June 2020.
Czeisler MÉ , Marynak K , Clarke KEN , Salah Z , Shakya I , Thierry JM , Ali N , McMillan H , Wiley JF , Weaver MD , Czeisler CA , Rajaratnam SMW , Howard ME . MMWR Morb Mortal Wkly Rep 2020 69 (36) 1250-1257 Temporary disruptions in routine and nonemergency medical care access and delivery have been observed during periods of considerable community transmission of SARS-CoV-2, the virus that causes coronavirus disease 2019 (COVID-19) (1). However, medical care delay or avoidance might increase morbidity and mortality risk associated with treatable and preventable health conditions and might contribute to reported excess deaths directly or indirectly related to COVID-19 (2). To assess delay or avoidance of urgent or emergency and routine medical care because of concerns about COVID-19, a web-based survey was administered by Qualtrics, LLC, during June 24-30, 2020, to a nationwide representative sample of U.S. adults aged ≥18 years. Overall, an estimated 40.9% of U.S. adults have avoided medical care during the pandemic because of concerns about COVID-19, including 12.0% who avoided urgent or emergency care and 31.5% who avoided routine care. The estimated prevalence of urgent or emergency care avoidance was significantly higher among the following groups: unpaid caregivers for adults* versus noncaregivers (adjusted prevalence ratio [aPR] = 2.9); persons with two or more selected underlying medical conditions(†) versus those without those conditions (aPR = 1.9); persons with health insurance versus those without health insurance (aPR = 1.8); non-Hispanic Black (Black) adults (aPR = 1.6) and Hispanic or Latino (Hispanic) adults (aPR = 1.5) versus non-Hispanic White (White) adults; young adults aged 18-24 years versus adults aged 25-44 years (aPR = 1.5); and persons with disabilities(§) versus those without disabilities (aPR = 1.3). Given this widespread reporting of medical care avoidance because of COVID-19 concerns, especially among persons at increased risk for severe COVID-19, urgent efforts are warranted to ensure delivery of services that, if deferred, could result in patient harm. Even during the COVID-19 pandemic, persons experiencing a medical emergency should seek and be provided care without delay (3). |
Mental Health, Substance Use, and Suicidal Ideation During the COVID-19 Pandemic - United States, June 24-30, 2020.
Czeisler ME , Lane RI , Petrosky E , Wiley JF , Christensen A , Njai R , Weaver MD , Robbins R , Facer-Childs ER , Barger LK , Czeisler CA , Howard ME , Rajaratnam SMW . MMWR Morb Mortal Wkly Rep 2020 69 (32) 1049-1057 The coronavirus disease 2019 (COVID-19) pandemic has been associated with mental health challenges related to the morbidity and mortality caused by the disease and to mitigation activities, including the impact of physical distancing and stay-at-home orders.* Symptoms of anxiety disorder and depressive disorder increased considerably in the United States during April-June of 2020, compared with the same period in 2019 (1,2). To assess mental health, substance use, and suicidal ideation during the pandemic, representative panel surveys were conducted among adults aged ≥18 years across the United States during June 24-30, 2020. Overall, 40.9% of respondents reported at least one adverse mental or behavioral health condition, including symptoms of anxiety disorder or depressive disorder (30.9%), symptoms of a trauma- and stressor-related disorder (TSRD) related to the pandemic(†) (26.3%), and having started or increased substance use to cope with stress or emotions related to COVID-19 (13.3%). The percentage of respondents who reported having seriously considered suicide in the 30 days before completing the survey (10.7%) was significantly higher among respondents aged 18-24 years (25.5%), minority racial/ethnic groups (Hispanic respondents [18.6%], non-Hispanic black [black] respondents [15.1%]), self-reported unpaid caregivers for adults(§) (30.7%), and essential workers(¶) (21.7%). Community-level intervention and prevention efforts, including health communication strategies, designed to reach these groups could help address various mental health conditions associated with the COVID-19 pandemic. |
Isolation and characterization of SARS-CoV-2 from the first US COVID-19 patient.
Harcourt J , Tamin A , Lu X , Kamili S , Sakthivel SK , Murray J , Queen K , Tao Y , Paden CR , Zhang J , Li Y , Uehara A , Wang H , Goldsmith C , Bullock HA , Wang L , Whitaker B , Lynch B , Gautam R , Schindewolf C , Lokugamage KG , Scharton D , Plante JA , Mirchandani D , Widen SG , Narayanan K , Makino S , Ksiazek TG , Plante KS , Weaver SC , Lindstrom S , Tong S , Menachery VD , Thornburg NJ . bioRxiv 2020 The etiologic agent of the outbreak of pneumonia in Wuhan China was identified as severe acute respiratory syndrome associated coronavirus 2 (SARS-CoV-2) in January, 2020. The first US patient was diagnosed by the State of Washington and the US Centers for Disease Control and Prevention on January 20, 2020. We isolated virus from nasopharyngeal and oropharyngeal specimens, and characterized the viral sequence, replication properties, and cell culture tropism. We found that the virus replicates to high titer in Vero-CCL81 cells and Vero E6 cells in the absence of trypsin. We also deposited the virus into two virus repositories, making it broadly available to the public health and research communities. We hope that open access to this important reagent will expedite development of medical countermeasures. |
Severe Acute Respiratory Syndrome Coronavirus 2 from Patient with Coronavirus Disease, United States.
Harcourt J , Tamin A , Lu X , Kamili S , Sakthivel SK , Murray J , Queen K , Tao Y , Paden CR , Zhang J , Li Y , Uehara A , Wang H , Goldsmith C , Bullock HA , Wang L , Whitaker B , Lynch B , Gautam R , Schindewolf C , Lokugamage KG , Scharton D , Plante JA , Mirchandani D , Widen SG , Narayanan K , Makino S , Ksiazek TG , Plante KS , Weaver SC , Lindstrom S , Tong S , Menachery VD , Thornburg NJ . Emerg Infect Dis 2020 26 (6) 1266-1273 The etiologic agent of an outbreak of pneumonia in Wuhan, China, was identified as severe acute respiratory syndrome coronavirus 2 in January 2020. A patient in the United States was given a diagnosis of infection with this virus by the state of Washington and the US Centers for Disease Control and Prevention on January 20, 2020. We isolated virus from nasopharyngeal and oropharyngeal specimens from this patient and characterized the viral sequence, replication properties, and cell culture tropism. We found that the virus replicates to high titer in Vero-CCL81 cells and Vero E6 cells in the absence of trypsin. We also deposited the virus into 2 virus repositories, making it broadly available to the public health and research communities. We hope that open access to this reagent will expedite development of medical countermeasures. |
"Submergence" of Western equine encephalitis virus: Evidence of positive selection argues against genetic drift and fitness reductions.
Bergren NA , Haller S , Rossi SL , Seymour RL , Huang J , Miller AL , Bowen RA , Hartman DA , Brault AC , Weaver SC . PLoS Pathog 2020 16 (2) e1008102 Understanding the circumstances under which arboviruses emerge is critical for the development of targeted control and prevention strategies. This is highlighted by the emergence of chikungunya and Zika viruses in the New World. However, to comprehensively understand the ways in which viruses emerge and persist, factors influencing reductions in virus activity must also be understood. Western equine encephalitis virus (WEEV), which declined during the late 20th century in apparent enzootic circulation as well as equine and human disease incidence, provides a unique case study on how reductions in virus activity can be understood by studying evolutionary trends and mechanisms. Previously, we showed using phylogenetics that during this period of decline, six amino acid residues appeared to be positively selected. To assess more directly the effect of these mutations, we utilized reverse genetics and competition fitness assays in the enzootic host and vector (house sparrows and Culex tarsalis mosquitoes). We observed that the mutations contemporary with reductions in WEEV circulation and disease that were non-conserved with respect to amino acid properties had a positive effect on enzootic fitness. We also assessed the effects of these mutations on virulence in the Syrian-Golden hamster model in relation to a general trend of increased virulence in older isolates. However, no change effect on virulence was observed based on these mutations. Thus, while WEEV apparently underwent positive selection for infection of enzootic hosts, residues associated with mammalian virulence were likely eliminated from the population by genetic drift or negative selection. These findings suggest that ecologic factors rather than fitness for natural transmission likely caused decreased levels of enzootic WEEV circulation during the late 20th century. |
Determinants of linear growth faltering among children with moderate-to-severe diarrhea in the Global Enteric Multicenter Study
Brander RL , Pavlinac PB , Walson JL , John-Stewart GC , Weaver MR , Faruque ASG , Zaidi AKM , Sur D , Sow SO , Hossain MJ , Alonso PL , Breiman RF , Nasrin D , Nataro JP , Levine MM , Kotloff KL . BMC Med 2019 17 (1) 214 BACKGROUND: Moderate-to-severe diarrhea (MSD) in the first 2 years of life can impair linear growth. We sought to determine risk factors for linear growth faltering and to build a clinical prediction tool to identify children most likely to experience growth faltering following an episode of MSD. METHODS: Using data from the Global Enteric Multicenter Study of children 0-23 months old presenting with MSD in Africa and Asia, we performed log-binomial regression to determine clinical and sociodemographic factors associated with severe linear growth faltering (loss of >/= 0.5 length-for-age z-score [LAZ]). Linear regression was used to estimate associations with DeltaLAZ. A clinical prediction tool was developed using backward elimination of potential variables, and Akaike Information Criterion to select the best fit model. RESULTS: Of the 5902 included children, mean age was 10 months and 43.2% were female. Over the 50-90-day follow-up period, 24.2% of children had severe linear growth faltering and the mean DeltaLAZ over follow-up was - 0.17 (standard deviation [SD] 0.54). After adjustment for age, baseline LAZ, and site, several factors were associated with decline in LAZ: young age, acute malnutrition, hospitalization at presentation, non-dysenteric diarrhea, unimproved sanitation, lower wealth, fever, co-morbidity, or an IMCI danger sign. Compared to children 12-23 months old, those 0-6 months were more likely to experience severe linear growth faltering (adjusted prevalence ratio [aPR] 1.97 [95% CI 1.70, 2.28]), as were children 6-12 months of age (aPR 1.72 [95% CI 1.51, 1.95]). A prediction model that included age, wasting, stunting, presentation with fever, and presentation with an IMCI danger sign had an area under the ROC (AUC) of 0.67 (95% CI 0.64, 0.69). Risk scores ranged from 0 to 37, and a cut-off of 21 maximized sensitivity (60.7%) and specificity (63.5%). CONCLUSION: Younger age, acute malnutrition, MSD severity, and sociodemographic factors were associated with short-term linear growth deterioration following MSD. Data routinely obtained at MSD may be useful to predict children at risk for growth deterioration who would benefit from interventions. |
Comparison of self-reported female condom failure and biomarker-confirmed semen exposure
Walsh TL , Snead MC , St Claire BJ , Schwartz JL , Mauck CK , Frezieres RG , Blithe DL , Archer DF , Barnhart KT , Jensen JT , Nelson AL , Thomas MA , Wan LS , Weaver MA . Contraception 2019 100 (5) 406-412 OBJECTIVE: To investigate whether rates of self-reported Woman's Condom (WC) clinical failure and semen exposure from a functionality study are comparable to results from a contraceptive efficacy substudy. STUDY DESIGN: We structured our comparative analysis to assess whether functionality studies might credibly supplant contraceptive efficacy studies when evaluating new female condom products. Couples not at risk of pregnancy in the functionality (breakage/slippage/invagination/penile misdirection) study and women in the contraceptive efficacy study completed condom self-reports and collected pre and postcoital vaginal samples for up to four uses of the WC. Both studies used nearly identical self-report questions and the same self-sampling procedures and laboratory for prostatic specific antigen (PSA), a well-studied semen biomarker. We compared condom failure and semen exposure proportions using generalized estimating equations methods accounting for within-couple correlation. RESULTS: Ninety-five (95) efficacy substudy participants used 334 WC and 408 functionality participants used 1572 WC. Based on self-report, 19.2% WC (64 condoms) clinically failed in the efficacy substudy compared to 12.3% WC (194 condoms) in the functionality study (p-value=0.030). Of the 207 WC efficacy uses with evaluable post-coital PSA levels, 14.5% (30 uses) resulted in semen exposure compared to 14.2% (184 uses) of the 1293 evaluable WC functionality study uses. CONCLUSIONS: When evaluating the ability of an experimental condom to prevent semen exposure, the rate of clinical condom failure reported by participants risking pregnancy in an efficacy substudy was significantly higher than the rate reported by participants not risking pregnancy in a functionality study. The rate of semen exposure, assessed by an objective biomarker was nearly identical for the two studies. IMPLICATIONS: Our results suggest that an objective marker of semen exposure in functionality studies could provide a reasonable alternative to contraceptive efficacy studies in evaluating risk of unintended pregnancy and inferring protection from sexually transmitted infection than condom failure rates based on self-report. |
Estimating the cost of illness and burden of disease associated with the 2014-2015 chikungunya outbreak in the U.S. Virgin Islands
Feldstein LR , Ellis EM , Rowhani-Rahbar A , Hennessey MJ , Staples JE , Halloran ME , Weaver MR . PLoS Negl Trop Dis 2019 13 (7) e0007563 Chikungunya virus (CHIKV), an alphavirus that causes fever and severe polyarthralgia, swept through the Americas in 2014 with almost 2 million suspected or confirmed cases reported by April 2016. In this study, we estimate the direct medical costs, cost of lost wages due to absenteeism, and years lived with disability (YLD) associated with the 2014-2015 CHIKV outbreak in the U.S. Virgin Islands (USVI). For this analysis, we used surveillance data from the USVI Department of Health, medical cost data from three public hospitals in USVI, and data from two studies of laboratory-positive cases up to 12 months post illness. On average, employed case-patients missed 9 days of work in the 12 months following their disease onset, which resulted in an estimated cost of $15.5 million. Estimated direct healthcare costs were $2.9 million for the first 2 months and $0.6 million for 3-12 months following the outbreak. The total estimated cost associated with the outbreak ranged from $14.8 to $33.4 million (approximately 1% of gross domestic product), depending on the proportion of the population infected with symptomatic disease, degree of underreporting, and proportion of cases who were employed. The estimated YLDs associated with long-term sequelae from the CHIKV outbreak in the USVI ranged from 599-1,322. These findings highlight the significant economic burden of the recent CHIKV outbreak in the USVI and will aid policy-makers in making informed decisions about prevention and control measures for inevitable, future CHIKV outbreaks. |
Plasmodium falciparum (Haemosporodia: Plasmodiidae) and O'nyong-nyong Virus Development in a Transgenic Anopheles gambiae (Diptera: Culicidae) Strain.
Mumford JD , Long CA , Weaver SC , Miura K , Wang E , Rotenberry R , Dotson EM , Benedict MQ . J Med Entomol 2019 56 (4) 936-941 Transgenic Anopheles gambiae Giles (Diptera: Culicidae) mosquitoes have been developed that confer sexual sterility on males that carry a transgene encoding a protein which cuts ribosomal DNA. A relevant risk concern with transgenic mosquitoes is that their capacity to transmit known pathogens could be greater than the unmodified form. In this study, the ability to develop two human pathogens in these transgenic mosquitoes carrying a homing endonuclease which is expressed in the testes was compared with its nontransgenic siblings. Infections were performed with Plasmodium falciparum (Welch) and o'nyong-nyong virus (ONNV) and the results between the transgenic and nontransgenic sibling females were compared. There was no difference observed with ONNV isolate SG650 in intrathoracic infections or the 50% oral infectious dose measured at 14 d postinfection or in mean body titers. Some significant differences were observed for leg titers at the medium and highest doses for those individuals in which virus titer could be detected. No consistent difference was observed between the transgenic and nontransgenic comparator females in their ability to develop P. falciparum NF54 strain parasites. This particular transgene caused no significant effect in the ability of mosquitoes to become infected by these two pathogens in this genetic background. These results are discussed in the context of risk to human health if these transgenic individuals were present in the environment. |
Neutralizing antibodies inhibit chikungunya virus budding at the plasma membrane
Jin J , Galaz-Montoya JG , Sherman MB , Sun SY , Goldsmith CS , O'Toole ET , Ackerman L , Carlson LA , Weaver SC , Chiu W , Simmons G . Cell Host Microbe 2018 24 (3) 417-428 e5 Neutralizing antibodies (NAbs) are traditionally thought to inhibit virus infection by preventing virion entry into target cells. In addition, antibodies can engage Fc receptors (FcRs) on immune cells to activate antiviral responses. We describe a mechanism by which NAbs inhibit chikungunya virus (CHIKV), the most common alphavirus infecting humans, by preventing virus budding from infected human cells and activating IgG-specific Fcgamma receptors. NAbs bind to CHIKV glycoproteins on the infected cell surface and induce glycoprotein coalescence, preventing budding of nascent virions and leaving structurally heterogeneous nucleocapsids arrested in the cytosol. Furthermore, NAbs induce clustering of CHIKV replication spherules at sites of budding blockage. Functionally, these densely packed glycoprotein-NAb complexes on infected cells activate Fcgamma receptors, inducing a strong, antibody-dependent, cell-mediated cytotoxicity response from immune effector cells. Our findings describe a triply functional antiviral pathway for NAbs that might be broadly applicable across virus-host systems, suggesting avenues for therapeutic innovation through antibody design. |
Dynamic changes in ORC localization and replication fork progression during tissue differentiation.
Hua Brian L, Bell George W, Kashevsky Helena, Von Stetina Jessica R, Orr-Weaver Terry L. BMC genomics 2018 Aug 19(1) 623 . BMC genomics 2018 Aug 19(1) 623 Hua Brian L, Bell George W, Kashevsky Helena, Von Stetina Jessica R, Orr-Weaver Terry L. BMC genomics 2018 Aug 19(1) 623 |
Bunyavirus taxonomy: Limitations and misconceptions associated with the current ICTV criteria used for species demarcation
Blitvich BJ , Beaty BJ , Blair CD , Brault AC , Dobler G , Drebot MA , Haddow AD , Kramer LD , LaBeaud AD , Monath TP , Mossel EC , Plante K , Powers AM , Tesh RB , Turell MJ , Vasilakis N , Weaver SC . Am J Trop Med Hyg 2018 99 (1) 11-16 The International Committee on Taxonomy of Viruses (ICTV) has implemented numerous changes to the taxonomic classification of bunyaviruses over the years. Whereas most changes have been justified and necessary because of the need to accommodate newly discovered and unclassified viruses, other changes are a cause of concern, especially the decision to demote scores of formerly recognized species to essentially strains of newly designated species. This practice was first described in the seventh taxonomy report of the ICTV and has continued in all subsequent reports. In some instances, viruses that share less than 75% nucleotide sequence identity across their genomes, produce vastly different clinical presentations, possess distinct vector and host associations, have different biosafety recommendations, and occur in nonoverlapping geographic regions are classified as strains of the same species. Complicating the matter is the fact that virus strains have been completely eliminated from ICTV reports; thus, critically important information on virus identities and their associated biological and epidemiological features cannot be readily related to the ICTV classification. Here, we summarize the current status of bunyavirus taxonomy and discuss the adverse consequences associated with the reclassification and resulting omission of numerous viruses of public health importance from ICTV reports. As members of the American Committee on Arthropod-borne Viruses, we encourage the ICTV Bunyavirus Study Group to reconsider their stance on bunyavirus taxonomy, to revise the criteria currently used for species demarcation, and to list additional strains of public and veterinary importance. |
ICTV virus taxonomy profile: Togaviridae
Chen R , Mukhopadhyay S , Merits A , Bolling B , Nasar F , Coffey LL , Powers A , Weaver SC , Ictv Report Consortium . J Gen Virol 2018 99 (6) 761-762 The Togaviridae is a family of small, enveloped viruses with single-stranded, positive-sense RNA genomes of 10-12 kb. Within the family, the genus Alphavirus includes a large number of diverse species, while the genus Rubivirus includes the single species Rubella virus. Most alphaviruses are mosquito-borne and are pathogenic in their vertebrate hosts. Many are important human and veterinary pathogens (e.g. chikungunya virus and eastern equine encephalitis virus). Rubella virus is transmitted by respiratory routes among humans. This is a summary of the International Committee on Taxonomy of Viruses (ICTV) Report on the taxonomy of the Togaviridae, which is available at www.ictv.global/report/togaviridae. |
Lack of evidence for Zika virus transmission by Culex mosquitoes
Roundy CM , Azar SR , Brault AC , Ebel GD , Failloux AB , Fernandez-Salas I , Kitron U , Kramer LD , Lourenco-de-Oliveira R , Osorio JE , Paploski ID , Vazquez-Prokopec GM , Ribeiro GS , Ritchie SA , Tauro LB , Vasilakis N , Weaver SC . Emerg Microbes Infect 2017 6 (10) e90 Since Zika virus (ZIKV) emerged in the Americas, major research efforts have been focused on identifying the mosquito species responsible for transmission. While almost all published results support Aedes aegypti and potentially Ae. albopictus as urban vectors, a recent article1 suggests that Culex quinquefasciatus may serve as a ZIKV vector in Recife, Brazil, a region that has experienced a high incidence of infection. Accurately identifying the vector of a pathogen enables public health agencies to implement appropriate control strategies and inform citizens of proper prevention measures. Additionally, establishing the vector for an emerging pathogen paves the way for researchers to advance our understanding of virus–vector interactions and pursue novel methods of control. In contrast, erroneously incriminating a vector could lead to misdirected use of limited government funds, diversion of research efforts and misinforming the public through misdirected media and educational programs. | Traditional criteria for arthropod vector incrimination include: (i) demonstration of feeding or other effective contact with pathogen’s host; (ii) association in time and space of the vector and the pathogen-infected host; (iii) repeated demonstration of natural infection of the vector and (iv) experimental transmission of the pathogen by the vector.2 |
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