Disparities in pediatric injury are widely documented and partly driven by differential exposures to social determinants of health (SDH). Here, we examine associations between neighborhood-level SDH ...and pediatric firearm-related injury admissions as a step to defining specific targets for interventions to prevent injury.
We conducted a retrospective review of patients ≤16 years old admitted to our level 1 pediatric trauma center (2010-2019) after a firearm-related injury. We extracted patients' demographic characteristics and intent of injury. We geocoded home addresses to enable quantification of injury-related admissions at the neighborhood (census tract) level. Our population-level exposure variable was a socioeconomic deprivation index for each census tract.
Out of 15,686 injury-related admissions, 140 were for firearm-related injuries (median age 14 years IQR 11,15). Patients with firearm-related injuries were 75% male and 64% Black; 66% had public insurance. Nearly half (47%) of firearm-related injuries were a result of assault, 32% were unintentional, and 6% were self-inflicted; 9% died. At the neighborhood level, the distribution of firearm-related injuries significantly differed by deprivation quintile (p < .05). Children from the highest deprivation quintile experienced 25% of injuries of all types, 57% of firearm-related injuries, and 70% of all firearm-related injuries from assault. They had an overall risk of firearm-related injury 30-times that of children from the lowest deprivation quintile.
Increased neighborhood socioeconomic deprivation is associated with more firearm-related injuries requiring hospitalization, at rates far higher than injury-related admissions overall. Addressing neighborhood-level social determinants of health may help prevent pediatric firearm-related injury.
Prognostic and Epidemiological - Level III.
•Patient level factors are associated with admission from interpersonal violence-related injury.•Neighborhood deprivation, assessed at the census-tract level, is strongly associated with admission ...for interpersonal-violence related injury.•Inequities in interpersonal violence-related injury experienced by Black children are largely driven by associations with neighborhood context and socioeconomic status.
Background: Disparities in pediatric injury have been widely documented and are driven, in part, by differential exposures to social determinants of health (SDH). Here, we hypothesized that neighborhood socioeconomic deprivation and specific sociodemographic characteristics would be associated with interpersonal violence-related injury admission.
Methods: We conducted a retrospective cohort study of all patients ≤16 years, residing in Hamilton County, admitted to our level 1 pediatric trauma center. Residential addresses were geocoded to link admissions with a census tract-level socioeconomic deprivation index. Admissions were categorized as resulting from interpersonal violence or not – based on a mechanism of injury (MOI) of abuse or assault. The percentage of interpersonal violence-related injury admissions was compared across patient demographics and neighborhood deprivation index tertiles. These factors were then evaluated with multivariable regression analysis.
Results: Interpersonal violence accounted for 6.2% (394 of 6324) of all injury-related admissions. Interpersonal violence-related injury admission was associated with older age, male sex, Black race, public insurance, and living in tertiles of census tracts with higher socioeconomic deprivation. Those living in the most deprived tertile experienced 62.2% of all interpersonal violence-related injury admissions but only 36.9% of non-violence related injury admissions (p < 0.001). After adjustment, insurance and neighborhood deprivation accounted for much of the increase in interpersonal violence-related admissions for Black compared to White children.
Conclusions: Children from higher deprivation neighborhoods, who are also disproportionately Black and publicly insured, experience a higher burden of interpersonal violence-related injury admissions.
Level of evidence Level III.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Social isolation undermines health. Inequities in social networks exist due to historical and contemporary practices of socioeconomic and racial segregation. Thus, lower income and minority families ...are less likely to have the number, strength, and variety of social connections as higher income and white families. Therefore, social isolation may contribute to inequities in health and well‐being across socioeconomic and racial groups. Disrupting social isolation by strengthening social networks may be a meaningful way to equitably improve population health. In this study we aimed to better understand the factors that influence the formation and sustainment of social connections in neighbourhoods experiencing a disproportionate burden of social needs and poor health outcomes. Participants were recruited through our community–academic partnership, Healthy Homes (HH). Healthy Homes serves families with pregnant women and/or children <6 years in two low‐income, high‐morbidity neighbourhoods, focusing on supporting families’ needs and hopes. Between October 2016 and April 2017, we conducted in‐depth qualitative interviews (n = 20) with English‐speaking mothers and grandmothers of children under <6 years. Interviews were audio‐recorded, transcribed verbatim and independently coded. After applying an a priori code list, we conducted emergent coding to identify additional themes. Themes focused on the social environment, including social connections and social isolation, among vulnerable populations in included neighbourhoods. Families want connection to one another and to resources but look to others to facilitate those connections. Families may want or need social connections but do not engage if it means sacrificing their values or sense of self‐worth. These findings provide a deeper understanding of the factors that might allow us to disrupt social isolation by building relationships in communities that face social and health inequities.
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BFBNIB, DOBA, FZAB, GIS, IJS, IZUM, KILJ, NLZOH, NUK, OILJ, PILJ, PNG, SAZU, SBCE, SBMB, SIK, UILJ, UKNU, UL, UM, UPUK, VSZLJ
Antigen-specific CD4 and CD8 T cells are important components of the immune response to
, yet little information is currently known regarding how the breadth, specificity, phenotype, and function of
...-specific T cells correlate with
infection outcome in humans. To facilitate evaluation of human
-specific T cell responses targeting multiple different Ags, we sought to develop a high throughput and reproducible T cell response spectrum assay requiring low blood sample volumes. We describe here the optimization and standardization of a microtiter plate-based, diluted whole blood stimulation assay utilizing overlapping peptide pools corresponding to a functionally diverse panel of 60
Ags. Using IFN-γ production as a readout of Ag specificity, the assay can be conducted using 50 μl of blood per test condition and can be expanded to accommodate additional Ags. We evaluated the intra- and interassay variability, and implemented testing of the assay in diverse cohorts of
-unexposed healthy adults, foreign-born adults with latent
infection residing in the United States, and tuberculosis household contacts with latent
infection in a tuberculosis-endemic setting in Kenya. The
-specific T cell response spectrum assay further enhances the immunological toolkit available for evaluating
-specific T cell responses across different states of
infection, and can be readily implemented in resource-limited settings. Moreover, application of the assay to longitudinal cohorts will facilitate evaluation of treatment- or vaccine-induced changes in the breadth and specificity of Ag-specific T cell responses, as well as identification of
-specific T cell responses associated with
infection outcomes.
Background
The association of periodontal disease with atherosclerotic cardiovascular diseases is well known, but not specifically with incident peripheral artery disease (PAD). Therefore, we studied ...the associations of periodontal disease with incident PAD in a population‐based setting.
Methods
Among 9,793 participants (aged 53–75 years) without prevalent PAD, self‐reported history of periodontal disease was ascertained. Of these, 5,872 participants underwent full‐mouth examinations from which periodontal status was defined using the US Centers for Disease Control and Prevention‐American Academy of Periodontology (CDC‐AAP) definition. We quantified the association of periodontal disease with incident PAD (defined by hospital admission diagnosis or procedures) using multivariable Cox regression models.
Results
During a median follow‐up of 20.1 years, 360 participants (3.6%) developed PAD. In models accounting for potential confounders including diabetes and smoking pack‐years, there was higher hazard of PAD in participants with self‐reported tooth loss because of periodontal disease (hazard ratio:1.54 95% CI:1.20–1.98), history of periodontal disease treatment (1.37 1.05–1.80), and periodontal disease diagnosis (1.38 1.09–1.74), compared to their respective counterparts. The clinical measure of periodontal disease (n = 5,872) was not significantly associated with incident PAD in the fully adjusted model (e.g., 1.53 0.94–2.50 in CDC‐AAP‐defined severe periodontal disease versus no disease).
Conclusion
We observed a modest association of self‐reported periodontal disease, especially when resulting in tooth loss, with incident PAD in the general population. Nonetheless, a larger study with the clinical measure of periodontal disease is warranted.
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BFBNIB, CMK, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SAZU, SBCE, SBMB, UL, UM, UPUK
The rapid melt of snow and sea ice during the Arctic summer provides a significant source of low-salinity meltwater to the surface ocean on the local scale. The accumulation of this meltwater on, ...under, and around sea ice floes can result in relatively thin meltwater layers in the upper ocean. Due to the small-scale nature of these upper-ocean features, typically on the order of 1 m thick or less, they are rarely detected by standard methods, but are nevertheless pervasive and critically important in Arctic summer. Observations during the Multidisciplinary drifting Observatory for the Study of Arctic Climate (MOSAiC) expedition in summer 2020 focused on the evolution of such layers and made significant advancements in understanding their role in the coupled Arctic system. Here we provide a review of thin meltwater layers in the Arctic, with emphasis on the new findings from MOSAiC. Both prior and recent observational datasets indicate an intermittent yet long-lasting (weeks to months) meltwater layer in the upper ocean on the order of 0.1 m to 1.0 m in thickness, with a large spatial range. The presence of meltwater layers impacts the physical system by reducing bottom ice melt and allowing new ice formation via false bottom growth. Collectively, the meltwater layer and false bottoms reduce atmosphere-ocean exchanges of momentum, energy, and material. The impacts on the coupled Arctic system are far-reaching, including acting as a barrier for nutrient and gas exchange and impacting ecosystem diversity and productivity.
Large sediment diversions are proposed and expected to build new wetlands to alleviate the extensive wetland loss (5000 km2) affecting coastal Louisiana during the last 78 years. Current assessment ...and prediction of the impacts of sediment diversions have focused on the capture and dispersal of both water and sediment on the adjacent river side and the immediate outfall marsh area. However, little is known about the effects of sediment diversions on existing wetland surface elevation and vertical accretion dynamics in the receiving basin at the landscape scale. In this study, we used a spatial wetland surface elevation model developed in support of Louisiana's 2012 Coastal Master Plan to examine such landscape-scale effects of sediment diversions. Multiple sediment diversion projects were incorporated in the model to simulate surface elevation and vertical accretion for the next 50 years (2010–2060) under two environmental (moderate and less optimistic) scenarios. Specifically, we examined landscape-scale surface elevation and vertical accretion trends under diversions with different geographical locations, diverted discharge rates, and geomorphic characteristics of the receiving basin. Model results indicate that small diversions (<283 m3 s−1) tend to have limited effects of reducing landscape-scale elevation loss (<3%) compared to a future without action (FWOA) condition. Large sediment diversions (>1500 m3 s−1) are required to achieve landscape-level benefits to promote surface elevation via vertical accretion to keep pace with rising sea level.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK
Antigen (Ag)-specific CD4 and CD8 T cells are important components of the
immune response to
Mycobacterium tuberculosis
(Mtb), yet little
information is currently known regarding how the breadth, ...specificity, phenotype
and function of Mtb-specific T cells correlate with Mtb infection outcome in
humans. To facilitate evaluation of human Mtb-specific T cell responses
targeting multiple different Ags, we sought to develop a high throughput and
reproducible T cell response spectrum assay (RSA) requiring low blood sample
volumes. We describe here the optimization and standardization of a microtiter
plate-based, diluted whole blood stimulation assay utilizing overlapping peptide
pools corresponding to a functionally diverse panel of 60 Mtb Ags. Using
IFN-γ production as a readout of Ag specificity, the assay can be
conducted using 50µl of blood per test condition and can be expanded to
accommodate additional Ags. We evaluated the intra- and inter-assay variability,
and implemented testing of the assay in diverse cohorts of Mtb-unexposed healthy
adults, foreign-born adults with latent Mtb infection (LTBI) residing in the
U.S., and TB household contacts with LTBI in a TB-endemic setting in Kenya. The
Mtb-specific T cell RSA further enhances the immunological toolkit available for
evaluating Mtb-specific T cell responses across different states of Mtb
infection, and can be readily implemented in resource limited settings.
Moreover, application of the assay to longitudinal cohorts will facilitate
evaluation of treatment- or vaccine-induced changes in the breadth and
specificity of Ag-specific T cell responses, as well as identification of
Mtb-specific T cell responses associated with Mtb infection outcomes.
In this study, the effect of post-deposition heat treatments on an Al–Mg–Si alloy processed with additive friction stir deposition (AFS-D), a solid-state additive manufacturing process, is examined. ...Results reveal that wrought-like microstructure and mechanical properties are achievable in AFS-D builds through the application of a post-deposition heat treatment.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
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