Last data update: Apr 29, 2024. (Total: 46658 publications since 2009)
Records 1-30 (of 137 Records) |
Query Trace: Yuan Y [original query] |
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Self-rated health and HIV outcomes among adults with diagnosed HIV - Medical Monitoring Project, United States, 2020-21
Cholli PA , Buchacz KM , Harris NS , Crim SM , Yuan X , Tie Y , Koenig LJ , Beer L . Aids 2024 OBJECTIVES: To evaluate associations between self-rated health (SRH) and care outcomes among United States adults with diagnosed HIV infection. DESIGN: We analyzed interview and medical record data collected during June 2020-May 2021 from the Medical Monitoring Project, a complex, nationally representative sample of 3,692 people with HIV (PWH). Respondents reported SRH on a 5-point Likert type scale (poor to excellent), which we dichotomized into "good or better" and "poor or fair". We computed weighted percentages with 95% confidence intervals (CIs) and age-adjusted prevalence ratios (aPRs) to investigate associations between SRH and HIV outcomes and demographic, psychosocial, and behavioral characteristics. RESULTS: Nationally, 72% of PWH reported "good or better" SRH. PWH with the following characteristics had a lower prevalence of "good or better" SRH, compared with those without: any missed HIV care appointment in the last 12 months (aPR 0.86, 95% CI:0.81-0.91), symptoms of moderate or severe depression (aPR 0.51, 95% CI:0.43-0.59) and anxiety (aPR 0.60, 95% CI:0.54-0.68), unstable housing or homelessness (aPR 0.77, 95% CI:0.71-0.82), and hunger or food insecurity (aPR 0.74, 95% CI:0.69-0.80), as well as having a mean CD4 count <200 cells/mm3 vs. CD4 >500 cells/mm3 (aPR 0.70, 95% CI:0.57-0.86). CONCLUSIONS: Though SRH is a holistic measure reflective of HIV outcomes, integrated approaches addressing needs beyond physical health are necessary to improve SRH among PWH in the U.S. Modifiable factors like mental health, unstable housing or homelessness, and food insecurity warrant further study as potential high-yield targets for clinical and policy interventions to improve SRH among PWH. |
Access to high-resolution anoscopy among persons with HIV and abnormal anal cytology results
Rim SH , Saraiya M , Beer L , Tie Y , Yuan X , Weiser J . JAMA Netw Open 2024 7 (3) e240068 This cross-sectional study evaluates use and availability of follow-up anoscopy among persons at highest risk for anal cancer. | eng |
Experimental study on suppression of lithium iron phosphate battery fires
Yuan L . Min Metall Explor 2024 Lithium-ion battery applications are increasing for battery-powered vehicles because of their high energy density and expected long cycle life. With the development of battery-powered vehicles, fire and explosion hazards associated with lithium-ion batteries are a safety issue that needs to be addressed. Lithium-ion batteries can go through a thermal runaway under different abuse conditions including thermal abuse, mechanical abuse, and electrical abuse, leading to a fire or explosion. The NIOSH Mining program is conducting research to prevent and respond to lithium-ion battery fires for battery electric vehicles in the mining industry. In this study, experiments were conducted to investigate the effectiveness of different suppression systems including dry chemical, class D powder, and water mist for lithium iron phosphate battery pack fires. The effects of activation time and release time of the water mist system on the suppression of lithium-ion battery fires were studied. The results of this study may be helpful for developing strategic firefighting and response plans for battery-powered vehicles used in mining. © This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply 2024. |
Coordinated evolution among hepatitis C virus genomic sites is coupled to host factors and resistance to interferon.
Lara J , Tavis JE , Donlin MJ , Lee WM , Yuan HJ , Pearlman BL , Vaughan G , Forbi JC , Xia GL , Khudyakov YE . In Silico Biol 2011 11 213-24 Machine-learning methods in the form of Bayesian networks (BN), linear projection (LP) and self-organizing tree (SOT) models were used to explore association among polymorphic sites within the HVR1 and NS5a regions of the HCV genome, host demographic factors (ethnicity, gender and age) and response to the combined interferon (IFN) and ribavirin (RBV) therapy. The BN models predicted therapy outcomes, gender and ethnicity with accuracy of 90%, 90% and 88.9%, respectively. The LP and SOT models strongly confirmed associations of the HVR1 and NS5A structures with response to therapy and demographic host factors identified by BN. The data indicate host specificity of HCV evolution and suggest the application of these models to predict outcomes of IFN/RBV therapy. |
Large-scale validation of skin prion seeding activity as a biomarker for diagnosis of prion diseases
Zhang W , Orrú CD , Foutz A , Ding M , Yuan J , Shah SZA , Zhang J , Kotobelli K , Gerasimenko M , Gilliland T , Chen W , Tang M , Cohen M , Safar J , Xu B , Hong DJ , Cui L , Hughson AG , Schonberger LB , Tatsuoka C , Chen SG , Greenlee JJ , Wang Z , Appleby BS , Caughey B , Zou WQ . Acta Neuropathol 2024 147 (1) 17 Definitive diagnosis of sporadic Creutzfeldt-Jakob disease (sCJD) relies on the examination of brain tissues for the pathological prion protein (PrP(Sc)). Our previous study revealed that PrP(Sc)-seeding activity (PrP(Sc)-SA) is detectable in skin of sCJD patients by an ultrasensitive PrP(Sc) seed amplification assay (PrP(Sc)-SAA) known as real-time quaking-induced conversion (RT-QuIC). A total of 875 skin samples were collected from 2 cohorts (1 and 2) at autopsy from 2-3 body areas of 339 cases with neuropathologically confirmed prion diseases and non-sCJD controls. The skin samples were analyzed for PrP(Sc)-SA by RT-QuIC assay. The results were compared with demographic information, clinical manifestations, cerebrospinal fluid (CSF) PrP(Sc)-SA, other laboratory tests, subtypes of prion diseases defined by the methionine (M) or valine (V) polymorphism at residue 129 of PrP, PrP(Sc) types (#1 or #2), and gene mutations in deceased patients. RT-QuIC assays of the cohort #1 by two independent laboratories gave 87.3% or 91.3% sensitivity and 94.7% or 100% specificity, respectively. The cohort #2 showed sensitivity of 89.4% and specificity of 95.5%. RT-QuIC of CSF available from 212 cases gave 89.7% sensitivity and 94.1% specificity. The sensitivity of skin RT-QuIC was subtype dependent, being highest in sCJDVV1-2 subtype, followed by VV2, MV1-2, MV1, MV2, MM1, MM1-2, MM2, and VV1. The skin area next to the ear gave highest sensitivity, followed by lower back and apex of the head. Although no difference in brain PrP(Sc)-SA was detected between the cases with false negative and true positive skin RT-QuIC results, the disease duration was significantly longer with the false negatives [12.0 ± 13.3 (months, SD) vs. 6.5 ± 6.4, p < 0.001]. Our study validates skin PrP(Sc)-SA as a biomarker for the detection of prion diseases, which is influenced by the PrP(Sc) types, PRNP 129 polymorphisms, dermatome sampled, and disease duration. |
The capacity of HIV care facilities to implement strategies recommended by the Ending the HIV Epidemic-The Medical Monitoring Project Facility Survey
Beer L , Williams D , Tie Y , McManus T , Yuan AX , Crim SM , Demeke HB , Creel D , Blackwell AD , Craw JA , Weiser J . J Acquir Immune Defic Syndr 2023 94 (4) 290-300 BACKGROUND: Data are needed to assess the capacity of HIV care facilities to implement recommended Ending the HIV Epidemic activities. SETTING: US HIV care facilities. METHODS: We analyzed 2021 survey data from 514 facilities that were recruited from a census of facilities providing care to a national probability sample of US adults with HIV. We present weighted estimates of facility characteristics, services, and policies and estimates of the proportion of all US HIV patients attending these facilities. RESULTS: Among HIV care facilities, 37% were private practices, 72% were in areas with population >1 million, and 21% had more than 1000 HIV patients. Most provided preexposure prophylaxis (83%) and postexposure prophylaxis (84%). More than 67% of facilities provided HIV-specific stigma or discrimination training for all staff (covering 70% of patients) and 66% provided training on cultural competency (covering 74% of patients). A majority of patients attended facilities that provided on-site access to HIV/sexually transmitted infection (STI) transmission risk reduction counseling (89%); fewer had on-site access to treatment for substance use disorders (35%). We found low provision of on-site assistance with food banks or meal delivery (14%) and housing (33%). Approximately 71% of facilities reported using data to systematically monitor patient retention in care. On-site access to adherence tools was available at 58% of facilities; 29% reported notifying patients of missed prescription pickups. CONCLUSION: Results indicate some strengths that support Ending the HIV Epidemic-recommended strategies among HIV care facilities, such as high availability of preexposure prophylaxis/postexposure prophylaxis, as well as areas for improvement, such as provision of staff antistigma trainings and adherence supports. |
Are there seasonal patterns for emergency department visits for head injuries in the USA? Findings from the National Electronic Injury Surveillance System-All Injury Program
Daugherty J , Yuan K , Sarmiento K , Law R . Inj Prev 2023 INTRODUCTION: Previous international research suggests that the incidence of head injuries may follow seasonal patterns. However, there is limited information about how the numbers and rates of head injuries, particularly sports- and recreation-related head injuries, among adults and children evaluated in the emergency department (ED) vary by month in the USA. This information would provide the opportunity for tailored prevention strategies. METHODS: We analysed data from the National Electronic Injury Surveillance System-All Injury Program from 2016 to 2019 to examine both monthly variation of ED visit numbers and rates for head injuries overall and those due to sports and recreation. RESULTS: The highest number of head injuries evaluated in the ED occurred in October while the lowest number occurred in February. Among males, children ages 0-4 years were responsible for the highest rates of head injury-related ED visits each year, while in females the highest rates were seen in both children ages 0-4 and adults ages 65 and older. The highest number of head injuries evaluated in the ED due to sports and recreation were seen in September and October. Head injury-related ED visits due to sports and recreation were much more common in individuals ages 5-17 than any other age group. CONCLUSION: This study showed that head injury-related ED visits for all mechanisms of injury, as well as those due to sports- and recreation-related activities, followed predictable patterns-peaking in the fall months. Public health professionals may use study findings to improve prevention efforts and to optimise the diagnosis and management of traumatic brain injury and other head injuries. |
Comparison of demographic characteristics and social determinants of health between adults with diagnosed HIV and all adults in the US
Dasgupta S , McManus T , Tie Y , Lin CY , Yuan X , Sharpe JD , Fletcher KM , Beer L . AJPM Focus 2023 2 (3) 100115 INTRODUCTION: Quantifying disparities in social determinants of health between people with HIV and the total population could help address health inequities, and ensure health and well-being among people with HIV in the U.S., but estimates are lacking. METHODS: Several representative data sources were used to assess differences in social determinants of health between adults with diagnosed HIV (Centers for Disease Control and Prevention Medical Monitoring Project) and the total adult population (U.S. Census Bureau's decennial census, American Community Survey, Household Pulse Survey, the Current Population Survey Annual Social and Economic Supplements; the Department of Housing and Urban Development's point-in-time estimates of homelessness; and the Bureau of Justice Statistics). The differences were quantified using standardized prevalence differences and standardized prevalence ratios, adjusting for differences in age, race/ethnicity, and birth sex between people with HIV and the total U.S. population. RESULTS: Overall, 35.6% of people with HIV were living in a household with an income at or below the federal poverty level, and 8.1% recently experienced homelessness. Additionally, 42.9% had Medicaid and 27.6% had Medicare; 39.7% were living with a disability. Over half (52.3%) lived in large central metropolitan counties and 20.6% spoke English less than very well based on survey responses. After adjustment, poverty (standardized prevalence difference=25.1%, standardized prevalence ratio=3.5), homelessness (standardized prevalence difference=8.5%, standardized prevalence ratio=43.5), coverage through Medicaid (standardized prevalence difference=29.5%, standardized prevalence ratio=3.0) or Medicare (standardized prevalence difference=7.8%), and disability (standardized prevalence difference=30.3%, standardized prevalence ratio=3.0) were higher among people with HIV than the total U.S. population. The percentage of people with HIV living in large central metropolitan counties (standardized prevalence difference=13.4%) or who were recently incarcerated (standardized prevalence ratio=5.9) was higher than the total U.S. population. CONCLUSIONS: These findings provide a baseline for assessing national-level disparities in social determinants of health between people with HIV and the total U.S. population, and it can be used as a model to assess local disparities. Addressing social determinants of health is essential for achieving health equity, requiring a multipronged approach with interventions at the provider, facility, and policy levels. |
Annual (2023) taxonomic update of RNA-directed RNA polymerase-encoding negative-sense RNA viruses (realm Riboviria: kingdom Orthornavirae: phylum Negarnaviricota)
Kuhn JH , Abe J , Adkins S , Alkhovsky SV , Avšič-Županc T , Ayllón MA , Bahl J , Balkema-Buschmann A , Ballinger MJ , Kumar Baranwal V , Beer M , Bejerman N , Bergeron É , Biedenkopf N , Blair CD , Blasdell KR , Blouin AG , Bradfute SB , Briese T , Brown PA , Buchholz UJ , Buchmeier MJ , Bukreyev A , Burt F , Büttner C , Calisher CH , Cao M , Casas I , Chandran K , Charrel RN , Kumar Chaturvedi K , Chooi KM , Crane A , Dal Bó E , Carlos de la Torre J , de Souza WM , de Swart RL , Debat H , Dheilly NM , Di Paola N , Di Serio F , Dietzgen RG , Digiaro M , Drexler JF , Duprex WP , Dürrwald R , Easton AJ , Elbeaino T , Ergünay K , Feng G , Firth AE , Fooks AR , Formenty PBH , Freitas-Astúa J , Gago-Zachert S , Laura García M , García-Sastre A , Garrison AR , Gaskin TR , Gong W , Gonzalez JJ , de Bellocq J , Griffiths A , Groschup MH , Günther I , Günther S , Hammond J , Hasegawa Y , Hayashi K , Hepojoki J , Higgins CM , Hongō S , Horie M , Hughes HR , Hume AJ , Hyndman TH , Ikeda K , Jiāng D , Jonson GB , Junglen S , Klempa B , Klingström J , Kondō H , Koonin EV , Krupovic M , Kubota K , Kurath G , Laenen L , Lambert AJ , Lǐ J , Li JM , Liu R , Lukashevich IS , MacDiarmid RM , Maes P , Marklewitz M , Marshall SH , Marzano SL , McCauley JW , Mirazimi A , Mühlberger E , Nabeshima T , Naidu R , Natsuaki T , Navarro B , Navarro JA , Neriya Y , Netesov SV , Neumann G , Nowotny N , Nunes MRT , Ochoa-Corona FM , Okada T , Palacios G , Pallás V , Papa A , Paraskevopoulou S , Parrish CR , Pauvolid-Corrêa A , Pawęska JT , Pérez DR , Pfaff F , Plemper RK , Postler TS , Rabbidge LO , Radoshitzky SR , Ramos-González PL , Rehanek M , Resende RO , Reyes CA , Rodrigues TCS , Romanowski V , Rubbenstroth D , Rubino L , Runstadler JA , Sabanadzovic S , Sadiq S , Salvato MS , Sasaya T , Schwemmle M , Sharpe SR , Shi M , Shimomoto Y , Kavi Sidharthan V , Sironi M , Smither S , Song JW , Spann KM , Spengler JR , Stenglein MD , Takada A , Takeyama S , Tatara A , Tesh RB , Thornburg NJ , Tian X , Tischler ND , Tomitaka Y , Tomonaga K , Tordo N , Tu C , Turina M , Tzanetakis IE , Maria Vaira A , van den Hoogen B , Vanmechelen B , Vasilakis N , Verbeek M , von Bargen S , Wada J , Wahl V , Walker PJ , Waltzek TB , Whitfield AE , Wolf YI , Xia H , Xylogianni E , Yanagisawa H , Yano K , Ye G , Yuan Z , Zerbini FM , Zhang G , Zhang S , Zhang YZ , Zhao L , Økland AL . J Gen Virol 2023 104 (8) In April 2023, following the annual International Committee on Taxonomy of Viruses (ICTV) ratification vote on newly proposed taxa, the phylum Negarnaviricota was amended and emended. The phylum was expanded by one new family, 14 new genera, and 140 new species. Two genera and 538 species were renamed. One species was moved, and four were abolished. This article presents the updated taxonomy of Negarnaviricota as now accepted by the ICTV. |
Efficient rescue of a newly classified Ebinur lake orthobunyavirus with GFP reporter and its application in rapid antiviral screening (preprint)
Ren N , Wang F , Zhao L , Wang S , Zhang G , Li J , Zhang B , Bergeron E , Yuan Z , Xia H . bioRxiv 2022 2022.03.25.485793 Orthobunyaviruses have been reported to cause severe diseases in humans or animals, posing a threat to human health and social economy. Ebinur lake virus (EBIV) is a newly classified orthobunyavirus, which needs further intensive study and therapies to cope with its potential infection risk to human and animals. Here, through the reverse genetics system, the recombinant EBIV of wild type (rEBIV/WT) and NP-conjugated-eGFP (rEBIV/eGFP/S) were rescued for the application of the rapid antiviral drug screening. The eGFP fluorescence signal of the rEBIV/eGFP/S was stable in the process of successive passage in BHK-21 cells (over 10 passages) and this recombinant virus could replicate in various cell lines. Compared to the wild type EBIV, the rEBIV/eGFP/S caused the smaller plaques and its peak titers were lower, suggesting attenuation due to the eGFP insertion. Through the high-content screening (HCS) system, ribavirin showed an inhibitory effect on the rEBIV/eGFP/S with an EC50 of 21.91 μM, while favipiravir did not inhibit, even at high concentrations. In addition, five of ninety-six natural compounds had antiviral against EBIV. The robust reverse genetics system for EBIV will facilitate investigation into replication and assembly mechanisms and assist drug and vaccine development.Competing Interest StatementThe authors have declared no competing interest. |
From people to Panthera: Natural SARS-CoV-2 infection in tigers and lions at the Bronx Zoo (preprint)
McAloose D , Laverack M , Wang L , Killian ML , Caserta LC , Yuan F , Mitchell PK , Queen K , Mauldin MR , Cronk BD , Bartlett SL , Sykes JM , Zec S , Stokol T , Ingerman K , Delaney MA , Fredrickson R , Ivančić M , Jenkins-Moore M , Mozingo K , Franzen K , Bergeson NH , Goodman L , Wang H , Fang Y , Olmstead C , McCann C , Thomas P , Goodrich E , Elvinger F , Smith DC , Tong S , Slavinski S , Calle PP , Terio K , Torchetti MK , Diel DG . bioRxiv 2020 2020.07.22.213959 We describe the first cases of natural SARS-CoV-2 infection detected in animals in the United States. In March 2020, four tigers and three lions at the Bronx Zoo developed mild respiratory signs. SARS-CoV-2 RNA was detected by rRT-PCR in respiratory secretions and/or feces from all seven affected animals; viral RNA and/or antibodies were detected in their keepers. SARS-CoV-2 was isolated from respiratory secretions or feces from three affected animals; in situ hybridization co-localized viral RNA with cellular damage. Whole genome sequence and haplotype network analyses showed tigers and lions were infected with two different SARS-CoV-2 strains, suggesting independent viral introductions. The source of SARS-CoV-2 infection in the lions is unknown. Epidemiological data and genetic similarities between keeper and tiger viruses indicate human to animal transmission.Competing Interest StatementThe authors have declared no competing interest. |
Notes from the field: Emergency department visits for nonfatal pedal cyclist injuries before and during the COVID-19 pandemic, United States, 2019-2020
Navon L , Yuan K , Beck L . MMWR Morb Mortal Wkly Rep 2023 72 (28) 769-771 During the early months of the COVID-19 pandemic, many jurisdictions implemented stay-at-home orders (1). Vehicle miles traveled (VMT)* in April 2020 declined by 40% compared with VMT in April 2019; annual VMT in 2020 declined by 13% compared with those in 2019 (2). Despite decreased VMT, pedal cyclist traffic crash fatalities increased by 10% from 859 in 2019 to 948 in 2020 (3). In 2021, pedal cyclist fatalities increased to 966, the highest number reported since 1975 (3,4). Given the increase in pedal cyclist fatalities despite the decline in VMT in 2020, emergency department (ED) visits for nonfatal pedal cyclist injuries in 2019 and 2020 were compared. |
Problems paying medical bills among adults with diagnosed HIV in the United States
Luna-Gierke RE , Tie Y , Yuan X , Luo Q , Beer L , Dasgupta S . J Assoc Nurses AIDS Care 2023 34 (5) 432-439 Problems paying medical bills may affect HIV outcomes among people with HIV (PWH), thus limiting progress toward achieving national HIV prevention goals. We analyzed nationally representative data from CDC's Medical Monitoring Project collected during 6/2018-5/2020. Among 8,108 PWH, we reported weighted percentages of characteristics and examined associations between problems paying medical bills and clinical outcomes using prevalence ratios with predicted marginal means, adjusting for potential confounding. Nineteen percent of PWH reported problems paying medical bills. Problems paying medical bills were more prevalent among persons who experienced homelessness (26.9% vs. 18.3%). People with problems paying medical bills were more likely to have adverse HIV outcomes and were more likely to have ≥1 emergency room visit (prevalence ratio [PR]: 1.59; 95% CI [1.51-1.68]) or hospitalization (PR: 1.72; 95% CI [1.55-1.91]) in the past year. Identifying PWH experiencing financial barriers and expanding access to safety net programs could improve access to care and outcomes. |
Emergency department visits for alcohol-associated falls among older adults inthe United States, 2011 to 2020
Yuan K , Haddad Y , Law R , Shakya I , Haileyesus T , Navon L , Zhang L , Liu Y , Bergen G . Ann Emerg Med 2023 82 (6) 666-677 STUDY OBJECTIVE: The aim of this study was to examine the epidemiology of alcohol-associated fall injuries among older adults aged ≥65 years in the United States. METHODS: We included emergency department (ED) visits for unintentional fall injuries by adults from the National Electronic Injury Surveillance System-All Injury Program during 2011 to 2020. We estimated the annual national rate of ED visits for alcohol-associated falls and the proportion of these falls among older adults' fall-related ED visits using demographic and clinical characteristics. Joinpoint regression was performed to examine trends in alcohol-associated ED fall visits between 2011 and 2019 among older adult age subgroups and to compare these trends with those of younger adults. RESULTS: There were 9,657 (weighted national estimate: 618,099) ED visits for alcohol-associated falls, representing 2.2% of ED fall visits during 2011 to 2020 among older adults. The proportion of fall-related ED visits that were alcohol-associated was higher among men than among women (adjusted prevalence ratio [aPR]=3.6, 95% confidence interval [CI] 2.9 to 4.5). The head and face were the most commonly injured body parts, and internal injury was the most common diagnosis for alcohol-associated falls. From 2011 to 2019, the annual rate of ED visits for alcohol-associated falls increased (annual percent change 7.5, 95% CI 6.1 to 8.9) among older adults. Adults aged 55 to 64 years had a similar increase; a sustained increase was not detected in younger age groups. CONCLUSION: Our findings highlight the rising rates of ED visits for alcohol-associated falls among older adults during the study period. Health care providers in the ED can screen older adults for fall risk and assess for modifiable risk factors such as alcohol use to help identify those who could benefit from interventions to reduce their risk. |
Comparison of fire suppression techniques on lithium-ion battery pack fires
Tang W , Yuan L , Thomas R , Soles J . Min Metall Explor 2023 Lithium-ion battery pack fires pose great hazards to the safety and health of miners. A detailed experimental study has been conducted at the National Institute for Occupational Safety and Health (NIOSH) Pittsburgh Mining Research Division (PMRD) to investigate the effectiveness of different fire suppression systems on Li-ion battery pack fire extinguishment. Tests were conducted in a well-ventilated container. Two sizes of battery packs (12 V, 24 V) were heated by heater strips to trigger thermal runaway and fire. Water mist with different flow rates, ABC powder, type D dry chemical, and water mist with F500 additives were used as the fire suppression agents. Multiple thermocouples were installed on the battery packs to measure the temperature evolution during the tests. The results indicated that the water mist with F500 additives is the most effective suppressant among the agents tested. Dry chemicals, however, do quench the fire for a moment, but cannot prevent re-ignition of the battery since they do not provide enough cooling. The findings of this paper can be used to develop safer battery fire suppression techniques in mining environments. © 2023, This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply. |
Intersectional discrimination in HIV healthcare settings among persons with diagnosed HIV in the United States, Medical Monitoring Project, 2018-2019
McCree DH , Beer L , Crim SM , Kota KK , Baugher A , Jeffries WLth , Patel D , Marcus R , Yuan XA , Luke Shouse R . AIDS Behav 2023 27 (11) 3623-3631 Experiences with stigma and discrimination in healthcare settings are associated with negative health outcome for persons with HIV (PWH). PWH may experience discrimination due to the intersection of multiple marginalized social identities. Describing these experiences is important for informing interventions and strategies to reduce stigma and discrimination. We report experiences with discrimination in HIV healthcare settings attributed to multiple characteristics, e.g., sexual orientation, race/ethnicity, income, or social class, and/or injection drug use, among a nationally representative sample of persons with diagnosed HIV in the United States using data from the Medical Monitoring Project (MMP). We calculated weighted prevalences and associated 95% confidence intervals for any discrimination and discrimination attributed to multiple characteristics (intersectional discrimination). Among those experiencing discrimination, nearly 1 in 4 persons reported intersectional discrimination, with a higher burden among key populations of focus for HIV prevention and treatment. Discrimination was attributed to HIV status (62.5%), sexual orientation (60.4%), and race/ethnicity (54.3%). Persons who experienced intersectional discrimination were less likely to have a regular HIV care provider, have trust in HIV care or treatment information from healthcare providers, and be antiretroviral treatment or HIV care visit adherent. Future studies should explore methods to operationalize and assess experiences with intersectional stigma and discrimination and use the outcomes to inform qualitative research that provides more context and a deeper understanding of experiences with intersectional discrimination among PWH. |
Prediagnostic blood levels of organochlorines and risk of non-Hodgkin lymphoma in three prospective cohorts in China and Singapore
Bassig BA , Shu XO , Sjödin A , Koh WP , Gao YT , Adams-Haduch J , Davis M , Wang R , Xiang YB , Engel LS , Purdue MP , Ji BT , Yang G , Jones RS , Langseth H , Hosgood HD , Grimsrud TK , Seow WJ , Wong JYY , Hu W , Chen D , Zheng W , Yuan JM , Lan Q , Rothman N . Int J Cancer 2020 146 (3) 839-849 Specific organochlorines (OCs) have been associated with non-Hodgkin lymphoma (NHL) with varying degrees of evidence. These associations have not been evaluated in Asia, where the high exposure and historical environmental contamination of certain OC pesticides (e.g., dichlorodiphenyltrichloroethane [DDT], hexachlorocyclohexane [HCH]) are different from Western populations. We evaluated NHL risk and prediagnostic blood levels of OC pesticides/metabolites and polychlorinated biphenyl congeners in a case-control study of 167 NHL cases and 167 controls nested within three prospective cohorts in Shanghai and Singapore. Conditional logistic regression was used to analyze lipid-adjusted OC levels and NHL risk. Median levels of p,p'-dichlorodiphenyldichloroethylene (p,p'-DDE), the primary DDT metabolite, and β-HCH were up to 12 and 65 times higher, respectively, in samples from the Asian cohorts compared to several cohorts in the United States and Norway. An increased risk of NHL was observed among those with higher β-HCH levels both overall (3rd vs. 1st tertile OR = 1.8, 95%CI = 1.0-3.2; p(trend) = 0.049) and after excluding cases diagnosed within 2 years of blood collection (3rd vs. 1st tertile OR = 2.0, 95%CI = 1.1-3.9; p(trend) = 0.03), and the association was highly consistent across the three cohorts. No significant associations were observed for other OCs, including p,p'-DDE. Our findings provide support for an association between β-HCH blood levels and NHL risk. This is a concern because substantial quantities of persistent, toxic residues of HCH are present in the environment worldwide. Although there is some evidence that DDT is associated with NHL, our findings for p,p'-DDE do not support an association. |
Understanding disparities in antiretroviral therapy adherence and sustained viral suppression among Black, Hispanic/Latina, and White women in the United States - Medical Monitoring Project, United States, 2015-2019
Raiford JL , Yuan X , Carree T , Beer L . J Acquir Immune Defic Syndr 2023 93 (5) 413-421 BACKGROUND: Racial and ethnic disparities in antiretroviral therapy (ART) adherence and sustained viral suppression (SVS) have been documented among women with HIV. We examined factors that may account for these racial/ethnic differences among women to inform interventions that increase health equity. METHODS: We used data from the 2015-2019 cycles of the Medical Monitoring Project, a probability sample of U.S. adults with diagnosed HIV. Using logistic regression with predicted marginal means, we calculated weighted prevalence differences (PDs) of ART adherence and SVS among Black, Hispanic/Latina, and White women taking ART. Using modeling with forward stepwise selection, we adjusted PDs for selected variables, including social determinants of health (SDOH) factors, to examine whether magnitude of PDs was attenuated by their inclusion. We assessed relative changes between unadjusted and adjusted PDs. RESULTS: After adjusting for poverty, transportation needs, health literacy, and gap in health insurance/coverage, the Black-White PD in adherence decreased by 11% (-16.0% to -14.2%). After adjusting for adherence, poverty, type of health insurance, and gap in health insurance/coverage, the Black-White PD in SVS reduced 37% (-7.9% to -5.0%) and was no longer statistically different. The Hispanic/Latina-White PD in adherence reduced 24% (-12.7% to -9.6%) after adjusting for poverty, health literacy and transportation needs. The unadjusted Hispanic/Latina-White PD in SVS was not significantly different. CONCLUSION: Racial/ethnic disparities in HIV outcomes among women taking ART were substantially reduced after accounting for SDOH and other factors, although differences remained. Structural interventions to improve SDOH are needed to improve health equity for women with HIV. |
Racial differences in social determinants of health and outcomes among Hispanic/Latino persons with HIV-United States, 2015-2020
Padilla M , Luna-Gierke RE , Carree T , Gutierrez M , Yuan X , Dasgupta S . J Racial Ethn Health Disparities 2023 BACKGROUND: Hispanic/Latino people with HIV (PWH) experience disparities in health outcomes compared with other racial and ethnic groups. Disaggregated data based on race for Hispanic/Latino PWH in the United States are rarely reported, potentially masking inequities. METHODS: The Medical Monitoring Project (MMP) is a complex sample survey of adults with diagnosed HIV. We used weighted interview and medical record data collected from June 2015-May 2021 to examine differences in social determinants of health (SDH) and health outcomes by self-reported race among Hispanic/Latino adults with diagnosed HIV. RESULTS: Compared with White Hispanic/Latino PWH, Black Hispanic/Latino PWH were more likely to be unemployed (PR, 1.4; CI, 1.2-1.8), have a disability (PR, 1.3; CI, 1.2-1.5), have experienced homelessness (PR, 1.8; CI, 1.2-2.6), and have been incarcerated (PR, 2.6; CI, 1.5-4.5). American Indian/Alaska Native (AI/AN) (PR, 1.8; CI, 1.1-2.7) and multiracial (PR, 2.0; CI, 1.4-2.9) Hispanic/Latino PWH were more likely to have experienced homelessness than White Hispanic/Latino PWH. Black (PR, 1.3; CI, 1.2-1.5) and multiracial (PR, 1.2; CI, 1.1-1.5) Hispanic/Latino PWH were more likely to be virally unsuppressed than White Hispanic/Latino PWH. CONCLUSION: Black, multiracial, and AI/AN Hispanic/Latino PWH experience disparities in SDH and HIV outcomes. Lumping Hispanic/Latino people into one racial and ethnic category obscures health disparities, which might limit our progress towards reaching national HIV goals. Future studies should consider disaggregating by other factors such as Hispanic origin, place of birth, immigration status, and primary language. Doing so recognizes the diversity of the Hispanic/Latino population. |
A standardized approach for collection of objective data to support outcome determination for late-phase TB trials
Kurbatova EV , Phillips PP , Dorman SE , Sizemore EE , Bryant KE , Purfield AE , Ricaldi J , Brown NE , Johnson JL , Wallis CL , Akol JP , Ocheretina O , Van Hung N , Mayanja-Kizza H , Lourens M , Dawson R , Nhung NV , Pierre S , Musodza Y , Shenje J , Badal-Faesen S , Vilbrun SC , Waja Z , Peddareddy L , Scott NA , Yuan Y , Vernon A , Goldberg SV , Swindells S , Chaisson RE , Nahid P . Am J Respir Crit Care Med 2023 207 (10) 1376-1382 INTRODUCTION: We developed a standardized method, "Possible poor treatment response" (PPTR), to help ascertain efficacy endpoints in Study S31/A5349 (NCT02410772), an open-label trial comparing two 4-month rifapentine-based regimens with a standard 6-month regimen for the treatment of pulmonary TB. We describe the use of the PPTR process and evaluate whether the goals of minimizing bias in efficacy endpoint assessment and attainment of relevant data to determine outcome for all participants were achieved. METHODS/DESIGN: A PPTR event was defined as the occurrence of one or more pre-specified triggers. Each PPTR required initiation of a standardized evaluation process that included obtaining multiple sputum samples for microbiology. RESULTS: Among 2,343 participants with culture-confirmed drug-susceptible TB, 454 individuals (19.4%) had a total of 534 individual PPTR events, of which 76.6% were microbiological (positive smear or culture at or after 17 weeks). At least one PPTR event was experienced by 92.4% (133 of 144) of participants with TB-related unfavorable outcome, and between 13.8 and 14.7% of participants with favorable and not assessable outcomes. 75% of participants with TB-related unfavorable outcomes had microbiological confirmation of failure to achieve disease-free cure. DISCUSSION: Standardized methodologies, such as our PPTR approach, could facilitate unbiased efficacy outcome determinations, improve discrimination between outcomes that are related and unrelated to regimen efficacy, and enhance the ability to conduct pooled analyses of contemporary trials. Clinical trial registration available at www. CLINICALTRIALS: gov, ID: NCT02410772. |
Needs for shelter or housing assistance among people with diagnosed HIV by jurisdiction: United States, 2015-2020
Dasgupta S , Beer L , Lu JF , Weiser J , Yuan X , Nair P , Banks L , Marcus R . AIDS 2023 37 (3) 535-540 OBJECTIVE: To describe the landscape of needs for housing assistance among people with HIV (PWH) and availability of Housing Opportunities for People with AIDS (HOPWA) funding with respect to housing service needs, nationally and for 17 US jurisdictions. DESIGN: The CDC Medical Monitoring Project (MMP) is an annual, cross-sectional survey designed to report nationally and locally representative estimates of characteristics and outcomes among adults with diagnosed HIV in the United States. METHODS: We analyzed 2015-2020 data from MMP and 2019 funding data from HOPWA. Weighted percentages and 95% confidence intervals (CIs) for national and jurisdiction-level estimates were reported. RESULTS: Nationally, 1 in 4 (27.7%) PWH had shelter or housing service needs. Among those who needed housing services, 2 in 5 (40.4%) did not receive them (range: 21.3% in New York to 62.3% in Georgia). Reasons for unmet needs were multifactorial and varied by jurisdiction. Available 2019 HOPWA funding per person in need would cover up to 1.24 months of rent per person nationally (range: 0.53 months in Virginia to 9.54 months in Puerto Rico), and may not have matched housing assistance needs among PWH in certain jurisdictions. CONCLUSION: Addressing housing service needs necessitates a multipronged approach at the provider, jurisdiction, and national level. Locally, jurisdictions should work with their partners to understand and address housing service needs among PWH. Nationally, distribution of HOPWA funding for housing services should be aligned according to local needs; the funding formula could be modified to improve access to housing services among PWH. |
Molecular evolution and antigenic drift of type 3 iVDPVs excreted from a patient with immunodeficiency in Ningxia, China.
Fan Q , Ma J , Li X , Jorba J , Yuan F , Zhu H , Hu L , Song Y , Wang D , Zhu S , Yan D , Chen H , Xu W , Zhang Y . J Med Virol 2023 95 (1) e28215 A 2.5-year-old pediatric patient with acute flaccid paralysis was diagnosed with primary immunodeficiency (PID) in Ningxia Province, China, in 2011. Twelve consecutive stool specimens were collected from the patient over a period of 10 months (18 February 2011 to 20 November 2011), and 12 immunodeficiency vaccine-derived poliovirus (iVDPV) strains (CHN15017-1 to CHN15017-12) were subsequently isolated. Nucleotide sequencing analysis of the plaque-purified iVDPVs revealed 2%-3.5% VP1-region differences from their parental Sabin 3 strain. Full-length genome sequencing showed they were all Sabin 3/Sabin 1 recombinants, sharing a common 2C-region crossover site, and the two key determinants of attenuation (U472C in the 5' untranslated region and T2493C in the VP1 region) had reverted. Temperature-sensitive experiments demonstrated that the first two iVDPV strains partially retained the temperature-sensitive phenotype's nature, while the subsequent ten iVDPV strains distinctly lost it, possibly associated with increased neurovirulence. Nineteen amino-acid substitutions were detected between 12 iVDPVs and the parental Sabin strain, of which only one (K1419R) was found on the subsequent 10 iVDPV isolates, suggesting this site's potential as a temperature-sensitive determination site. A Bayesian Monte Carlo Markov Chain phylogenetic analysis based on the P1 coding region yielded a mean iVDPV evolutionary rate of 1.02 × 10(-2) total substitutions/site/year, and the initial oral-polio-vaccine dose was presumably administered around June 2009. Our findings provide valuable information regarding the genetic structure, high-temperature growth sensitivity, and antigenic properties of iVDPVs following long-term evolution in a single PID patient, thus augmenting the currently limited knowledge regarding the dynamic changes and evolutionary pathway of iVDPV populations with PID during long-term global replication. |
Cisgender women with HIV in the United States: how have HIV care continuum outcomes changed over time 2015-2020
O'Shea JG , Neblett Fanfair R , Dasgupta S , Tie Y , Yuan X , Beer L , Weiser J . AIDS 2023 37 (2) 347-353 OBJECTIVE: To evaluate HIV care continuum trends over time among women with HIV (WWH). DESIGN: The Medical Monitoring Project (MMP) is a complex sample survey of adults with diagnosed HIV in the United States. METHODS: We used 2015-2019 MMP data collected from 5139 adults with diagnosed HIV infection who identified as cisgender women. We calculated weighted percentages with 95% confidence intervals (CIs) for all characteristics and estimated annual percentage change (EAPC) and the associated 95% CI to assess trends. EAPCs were considered meaningful from a public health perspective if at least 1% with P values less than 0.05. RESULTS: Among cisgender women with diagnosed HIV infection during 2015-2019, 58.8% were Black or African American (95% CI 54.4-63.3), 19% were Hispanic/Latina (95% CI 14.7-23.2), and 16% were Non-Hispanic White (95% CI 14.1-17.9) persons. There was a meaningful increase in the percentage who ever had stage 3 HIV disease from 55.8% (95% CI 51.0-60.5) in 2015 to 61.5% (95% CI 58.1-64.8) in 2019 (EAPC 1.7%; CI 1.5-1.9; P < 0.001). There were no meaningful changes over time among women, overall, in retention in care, antiretroviral therapy (ART) prescription, ART adherence, missed appointments, or recent or sustained viral suppression. CONCLUSION: The HIV care continuum outcomes among WWH did not meaningfully improve from 2015 to 2019, raising a concern that Ending the HIV Epidemic in the US (EHE) initiative goals will not be met. To improve health and reduce transmission of HIV among WWH, multifaceted interventions to retain women in care, increase ART adherence, and address social determinants of health are urgently needed. |
Child abuse-related homicides precipitated by caregiver use of harsh physical punishment
Wilson RF , Afifi TO , Yuan K , Lyons BH , Fortson BL , Oliver C , Watson A , Self-Brown S . Child Abuse Negl 2022 135 105953 BACKGROUND: Physical punishment (PP), which may involve the use of physical force, has been linked to negative effects in children and can escalate to abusive or harsh PP, resulting in injury or death. OBJECTIVE: To examine characteristics associated with fatal abuse involving caregiver use of harsh PP. METHODS: Data were from the National Violent Death Reporting System in 40 states, the District of Columbia, and Puerto Rico for years 2012-2018. Qualitative analysis was used to code textual material into categorial data, and logistic regression was used to examine associations between various characteristics and harsh PP. RESULTS: Approximately 4% (n=87) of the 2414 abuse-related homicides were known to have been precipitated by caregiver use of harsh PP. In adjusted models, homicides had greater odds of being harsh PP-related when incidents involved mothers' male companions (versus fathers), victims had a previous nonfatal injury (versus no previous nonfatal injury), and another adult participated in the fatal incident or had awareness of prior abuse/neglect (versus those without this characteristic). Two common precipitators of caregivers' use of harsh PP were: 1) child had a bathroom-related accident/soiled clothes (23.0%; n=20), and 2) child disobeyed a directive given by the perpetrator (17.2%; n=15). CONCLUSIONS: This study highlights characteristics associated with fatal abuse precipitated by caregiver use of harsh PP. Children were physically punished for developmentally normative behaviors. Ensuring caregivers are aware of and use effective parenting practices that focus on use of nonphysical discipline and promote healthy child development, may help decrease harsh PP and physical abuse-related homicides among children. |
Efficient rescue of a newly classified Ebinur lake orthobunyavirus with GFP reporter and its application in rapid antiviral screening.
Ren N , Wang F , Zhao L , Wang S , Zhang G , Li J , Zhang B , Wang J , Bergeron E , Yuan Z , Xia H . Antiviral Res 2022 207 105421 Orthobunyaviruses have been reported to cause severe diseases in humans or animals, posing a potential threat to human health and socio-economy. Ebinur lake virus (EBIV) is a newly classified orthobunyavirus, which can induce the histopathogenic change and even the high mortality of infected BALB/c mice. Therefore, it is needed to further study the viral replication and pathogenesis, and develop the therapies to cope with its potential infection to human or animals. Here, through the reverse genetics system, the recombinant EBIV of wild type (rEBIV/WT) and NP-conjugated-eGFP (rEBIV/eGFP/S) were rescued for the application of the high-content screening (HCS) of antiviral drug. The eGFP fluorescence signal of the rEBIV/eGFP/S was stable in the process of successive passage in BHK-21 cells (over 10 passages) and this recombinant virus could replicate in various cell lines. Compared to the wild type EBIV, the rEBIV/eGFP/S caused the smaller plaques (diameter around 1 mm on 3 dpi) and lower peak titers (10(5) PFU/mL), suggesting attenuation due to the eGFP insertion. Through the high-content screening (HCS) system, two antiviral compounds, ribavirin and favipiravir, which previously reported to have effect to some bunyavirus were tested firstly. Ribavirin showed an inhibitory effect on the rEBIV/eGFP/S (EC50 = 14.38 μM) as our expect, while favipiravir with no inhibitory effect even using high doses. Furthermore, Tyrphostin A9 (EC50 = 0.72 μM for rEBIV/eGFP/S, EC50 = 0.05 μM for EBIV-WT) and UNC0638 (EC50 = 1.26 μM for rEBIV/eGFP/S, EC50 = 1.10 μM for rEBIV/eGFP/S) were identified with strong antiviral effect against EBIV in vitro from 150 antiviral compounds. In addition, the time-of-addition assay indicated that Tyrphostin A9 worked in the stage of viral post-infection, and the UNC0638 in all pre-, co-, and post-infection stages. This robust reverse genetics system will facilitate the investigation into the studying of viral replication and assembly mechanisms, and the development of drug and vaccine for EBIV in the future. |
Hot surface ignition of liquid fuels under ventilation
Tang W , Bahrami D , Yuan L , Thomas R , Soles J . Min Metall Explor 2022 39 (3) 961-968 Mine equipment fires remain as one of the most concerning safety issues in the mining industry, and most equipment fires were caused by hot surface ignitions. Detailed experimental investigations were conducted at the NIOSH Pittsburgh Mining Research Division on hot surface ignition of liquid fuels under ventilation in a mining environment. Three types of metal surface materials (stainless steel, cast iron, carbon steel), three types of liquids (diesel fuel, hydraulic fluid, engine oil), four air ventilation speeds (0, 0.5, 1.5, 3 m/s) were used to study the hot surface ignition probability under these conditions. Visual observation and thermocouples attached on the metal surface were used to indicate the hot surface ignition from the measured temperatures. Results show that the type of metal has a noticeable effect on the hot surface ignition, while ventilation speed has a mixed influence on ignition. Different types of liquid fuels also show different ranges of ignition temperatures. Results from this work can be used to help understand equipment mine fires and develop mitigation strategies. |
COVID-19 Cases and Hospitalizations Among Medicare Beneficiaries With and Without Disabilities - United States, January 1, 2020-November 20, 2021.
Yuan Y , Thierry JM , Bull-Otterson L , Yeargin-Allsopp M , Clark KEN , Rice C , Ritchey M , Ryerson AB . MMWR Morb Mortal Wkly Rep 2022 71 (24) 791-796 Approximately 27% of adults in the United States live with a disability,* some of whom qualify for Medicare benefits. Persons with disabilities are at increased risk for severe COVID-19-associated outcomes compared with the general population (1); however, existing studies have limited generalizability() or only pertain to a specific disability (e.g., intellectual) (2). Older age is also associated with COVID-19-associated hospitalization and death, but the extent to which age might contribute to increased risk for severe COVID-19-associated outcomes among persons with disabilities is unknown (3). To describe the impact of COVID-19 on persons with disabilities and whether and how age contributes to disease rates, CDC assessed COVID-19 cases and hospitalizations during January 2020-November 2021, among Centers for Medicare & Medicaid Services (CMS) Medicare beneficiaries aged 18 years who were either eligible because of a disability (disability-eligible()) or only eligible because of age 65 years (age-eligible). COVID-19 incidence and hospitalization rates were higher in the disability-eligible group (10,978 and 3,148 per 100,000 population, respectively) throughout the study period compared with the age-eligible group (8,102 and 2,129 per 100,000 population, respectively). Both COVID-19 incidence and hospitalization rates increased with age in both disability- and age-eligible beneficiaries. American Indian or Alaska Native (AI/AN) persons had the highest disability-eligible (4,962 per 100,000) and age-eligible (5,024 per 100,000) hospitalization rates. Among all other racial and ethnic groups, hospitalization rates were higher among disability-eligible than among age-eligible patients. COVID-19 incidence and hospitalization rates among disability-eligible Medicare beneficiaries were disproportionally higher than rates among age-eligible beneficiaries. Collection of disability status as a core demographic variable in public health surveillance data and identification, as well as the addition of disability questions in other existing data sources can guide research and development of interventions for persons with disabilities. Efforts to increase access to and use of COVID-19 prevention and treatment strategies, including activities that support equitable vaccine access regardless of the substantial challenges that older adults and persons with disability face, are critical to reducing severe COVID-19-associated outcomes among these groups. |
PgtE Enzyme of Salmonella enterica Shares the Similar Biological Roles to Plasminogen Activator (Pla) in Interacting With DEC-205 (CD205), and Enhancing Host Dissemination and Infectivity by Yersinia pestis.
Li Q , Ye C , Zhao F , Li W , Zhu S , Lv Y , Park CG , Zhang Y , Jiang LY , Yang K , He Y , Cai H , Zhang S , Ding HH , Njiri OA , Tembo JM , Alkraiem AA , Li AY , Sun ZY , Li W , Yan MY , Kan B , Huo X , Klena JD , Skurnik M , Anisimov AP , Gao X , Han Y , Yang RF , Xiamu X , Wang Y , Chen H , Chai B , Sun Y , Yuan J , Chen T . Front Immunol 2022 13 791799 Yersinia pestis, the cause of plague, is a newly evolved Gram-negative bacterium. Through the acquisition of the plasminogen activator (Pla), Y. pestis gained the means to rapidly disseminate throughout its mammalian hosts. It was suggested that Y. pestis utilizes Pla to interact with the DEC-205 (CD205) receptor on antigen-presenting cells (APCs) to initiate host dissemination and infection. However, the evolutionary origin of Pla has not been fully elucidated. The PgtE enzyme of Salmonella enterica, involved in host dissemination, shows sequence similarity with the Y. pestis Pla. In this study, we demonstrated that both Escherichia coli K-12 and Y. pestis bacteria expressing the PgtE-protein were able to interact with primary alveolar macrophages and DEC-205-transfected CHO cells. The interaction between PgtE-expressing bacteria and DEC-205-expressing transfectants could be inhibited by the application of an anti-DEC-205 antibody. Moreover, PgtE-expressing Y. pestis partially re-gained the ability to promote host dissemination and infection. In conclusion, the DEC-205-PgtE interaction plays a role in promoting the dissemination and infection of Y. pestis, suggesting that Pla and the PgtE of S. enterica might share a common evolutionary origin. |
Injury-Related Emergency Department Visits During the COVID-19 Pandemic.
Law RK , Wolkin AF , Patel N , Alic A , Yuan K , Ahmed K , Idaikkadar N , Haileyesus T . Am J Prev Med 2022 63 (1) 43-50 INTRODUCTION: On March 13, 2020, the U.S. declared COVID-19 to be a national emergency. As communities adopted mitigation strategies, there were potential changes in the trends of injuries treated in emergency department. This study provides national estimates of injury-related emergency department visits in the U.S. before and during the pandemic. METHODS: A secondary retrospective cohort study was conducted using trained, on-site hospital coders collecting data for injury-related emergency department cases from medical records from a nationally representative sample of 66 U.S. hospital emergency departments. Injury emergency department visit estimates in the year before the pandemic (January 1, 2019-December 31, 2019) were compared with estimates of the year of pandemic declaration (January 1, 2020-December 31, 2020) for overall nonfatal injury-related emergency department visits, motor vehicle, falls-related, self-harm-, assault-related, and poisoning-related emergency department visits. RESULTS: There was an estimated 1.7 million (25%) decrease in nonfatal injury-related emergency department visits during April through June 2020 compared with those of the same timeframe in 2019. Similar decreases were observed for emergency department visits because of motor vehicle‒related injuries (199,329; 23.3%) and falls-related injuries (497,971; 25.1%). Monthly 2020 estimates remained relatively in line with 2019 estimates for self-harm‒, assault-, and poisoning-related emergency department visits. CONCLUSIONS: These findings provide updates for clinical and public health practitioners on the changing profile of injury-related emergency department visits during the COVID-19 pandemic. Understanding the short- and long-term impacts of the pandemic is important to preventing future injuries. |
Experimental study of improving a mine ventilation network model using continuously monitored airflow
Zhou L , Thomas RA , Yuan L , Bahrami D . Min Metall Explor 2022 39 (3) 887-895 A calibrated and well-tuned ventilation network model plays a critical role in mine ventilation planning, optimization, and ventilation control. Moreover, it is critical to the mine fire simulation program as well since the fire simulation is built upon the mine ventilation model. The contaminants generated from a fire are transported by airflows throughout the mine ventilation system. The accuracy of the fire simulation results not only depends on the fire source model itself but also on the ventilation network model. With the increasing use of atmospheric monitoring systems in underground mines, airflow is continuously monitored using airflow sensors in the key areas of mines to ensure a steady and reliable ventilation. Experimental studies have been conducted at an experimental mine, the Safety Research Coal Mine (SRCM), to gain a better understanding on how to use the continuously monitored airflow data to improve the calibration of the mine ventilation network model. This paper introduces an improved method to calibrate a ventilation network using continuous airflow monitoring and addresses the practical problems encountered while calibrating and tuning the ventilation network of the SRCM using continuously monitored airflow data. In this study, the fluctuation of the air velocity sensor readings is analyzed, and the sensor location correction factors are applied to obtain a more accurate average air velocity for the ventilation network calibration. © 2022, This is a U.S. government work and not under copyright protection in the U.S.; foreign copyright protection may apply. |
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