Geographic heterogeneity in COVID-19 outcomes in the United States is well-documented and has been linked with factors at the county level, including sociodemographic and health factors. Whether an ...integrated measure of place-based risk can classify counties at high risk for COVID-19 outcomes is not known.
We conducted an ecological nationwide analysis of 2,701 US counties from 1/21/20 to 2/17/21. County-level characteristics across multiple domains, including demographic, socioeconomic, healthcare access, physical environment, and health factor prevalence were harmonized and linked from a variety of sources. We performed latent class analysis to identify distinct groups of counties based on multiple sociodemographic, health, and environmental domains and examined the association with COVID-19 cases and deaths per 100,000 population.
Analysis of 25.9 million COVID-19 cases and 481,238 COVID-19 deaths revealed large between-county differences with widespread geographic dispersion, with the gap in cumulative cases and death rates between counties in the 90
and 10
percentile of 6,581 and 291 per 100,000, respectively. Counties from rural areas tended to cluster together compared with urban areas and were further stratified by social determinants of health factors that reflected high and low social vulnerability. Highest rates of cumulative COVID-19 cases (9,557 2,520) and deaths (210 97) per 100,000 occurred in the cluster comprised of rural disadvantaged counties.
County-level COVID-19 cases and deaths had substantial disparities with heterogeneous geographic spread across the US. The approach to county-level risk characterization used in this study has the potential to provide novel insights into communicable disease patterns and disparities at the local level.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Quantifying ammonia (NH3) to methane (CH4) enhancement ratios from agricultural sources is important for understanding air pollution and nitrogen deposition. The northeastern Colorado Front Range is ...home to concentrated animal feeding operations (CAFOs) that produce large emissions of NH3 and CH4. Isolating enhancements of NH3 and CH4 in this region due to agriculture is complicated because CAFOs are often located within regions of oil and natural gas (O&NG) extraction that are a major source of CH4 and other alkanes. Here, we utilize a small research aircraft to collect in situ 1 Hz measurements of gas-phase NH3, CH4, and ethane (C2H6) downwind of CAFOs during three flights conducted in November 2019. Enhancements in NH3 and CH4 are distinguishable up to 10 km downwind of CAFOs with the most concentrated portions of the plumes typically below 0.25 km AGL. We demonstrate that NH3 and C2H6 can be jointly used to separate near-source enhancements in CH4 from agriculture and O&NG. Molar enhancement ratios of NH3 to CH4 are quantified for individual CAFOs in this region, and they range from 0.8 to 2.7 ppbv ppbv–1. A multivariate regression model produces enhancement ratios and quantitative regional source contributions that are consistent with prior studies.
•High-intensity drinking was associated with an increased risk of nonmedical use of prescription drugs (NMUPD).•Co-ingestion of alcohol and NMUPD was more prevalent among high-intensity ...drinkers.•These findings were similar across different classes of prescription drugs.
Nearly 10% of U.S. 12th graders report high-intensity drinking (10+ or 15+ drinks in a row), but the extent to which these drinkers also engage in nonmedical use of prescription drugs (NMUPD) is largely unknown. This study examined the associations between different thresholds of past two-week high-intensity drinking and past-month NMUPD among U.S. 12th graders.
The sample consisted of eleven nationally representative cross-sections of 12th graders in the Monitoring the Future study (2005–2015) who answered questions on past two-week drinking behaviors and past-month nonmedical use of prescription opioids, sedative, stimulants, and tranquilizers (N=26,502 respondents).
High-intensity drinking during the past two-weeks was associated with an increased risk of past-month NMUPD. The odds of NMUPD were four times larger among 12th graders who indicated drinking 15 or more drinks on at least one occasion (AOR=4.43, 95% CI=3.18, 5.01) relative to those who had 0–4 drinks during the past two-weeks, after adjusting for relevant covariates. These associations were similar across different classes of prescription drugs and tended to be stronger among non-white respondents. A sub-analysis revealed simultaneous co-ingestion of alcohol and NMUPD was more prevalent among high-intensity drinkers.
More than 1 in every 4 U.S 12th graders who engage in high-intensity drinking (15+ drinks in a row) also report NMUPD. Given the greater likelihood of simultaneous co-ingestion of alcohol and prescription drugs among high-intensity drinkers, adolescent substance use interventions need to address the risks associated with mixing alcohol and prescription drugs.
Agricultural emissions, including those from concentrated animal feeding operations (CAFOs) for beef and dairy cattle, make up a large portion of the United States' total greenhouse gas (GHG) ...emissions. However, many CAFOs reside in areas where methane (CH4) from oil and natural gas (ONG) complicates the quantification of CAFO emissions. Traditional approaches to quantify emissions in such regions often relied on inventory subtraction of other known sources. We compare the results of two approaches to attribute the CAFO CH4 emission rate from the total CH4 emission rate derived from an aircraft mass balance technique. These methods make use of the mixing ratio data of CH4, ethane (C2H6), and ammonia (NH3) that were collected simultaneously in-flight downwind of CAFOs in northeastern Colorado. The first approach, the subtraction method (SM), is similar to inventory subtraction, except the amount to be removed is derived from the observed C2H6 to CH4 ratio rather than an inventory estimate. The results from this approach showed high uncertainty, primarily due to how error propagates through subtraction. Alternatively, multivariate regression (MVR) can be used to estimate CAFO CH4 emissions using the NH3 emission rate and an NH3 to CH4 ratio. These results showed significantly less uncertainty. We identified criteria to determine the best attribution method; these criteria can support attribution in other regions. The final emission estimates for the CAFOs presented here were 13 ± 3 g of CH4 per head per hour and 13 ± 2 g of NH3 per head per hour. These estimates are higher than the inventory of the US Environmental Protection Agency (EPA) and previous studies highlighting the need for more measurements of CH4 and NH3 emission rates.
Objectives
Longitudinal survey data allow for the estimation of developmental trajectories of substance use from adolescence to young adulthood, but these estimates may be subject to attrition bias. ...Moreover, there is a lack of consensus regarding the most effective statistical methodology to adjust for sample selection and attrition bias when estimating these trajectories. Our objective is to develop specific recommendations regarding adjustment approaches for attrition in longitudinal surveys in practice.
Methods
Analyzing data from the national U.S. Monitoring the Future panel study following four cohorts of individuals from modal ages 18 to 29/30, we systematically compare alternative approaches to analyzing longitudinal data with a wide range of substance use outcomes, and examine the sensitivity of inferences regarding substance use prevalence and trajectories as a function of college attendance to the approach used.
Results
Our results show that analyzing all available observations in each wave, while simultaneously accounting for the correlations among repeated observations, sample selection, and attrition, is the most effective approach. The adjustment effects are pronounced in wave‐specific descriptive estimates but generally modest in covariate‐adjusted trajectory modeling.
Conclusions
The adjustments can refine the precision, and, to some extent, the implications of our findings regarding young adult substance use trajectories.
Epidemiological studies have highlighted the disparate impact of coronavirus disease 2019 (COVID-19) on racial and ethnic minority and socioeconomically disadvantaged populations, but data at the ...neighborhood-level is sparse. The objective of this study was to investigate the disparate impact of COVID-19 on disadvantaged neighborhoods and racial/ethnic minorities in Chicago, Illinois. Using data from the Cook County Medical Examiner, we conducted a neighborhood-level analysis of COVID-19 decedents in Chicago and quantified age-standardized years of potential life lost (YPLL) due to COVID-19 among demographic subgroups and neighborhoods with geospatial clustering of high and low rates of COVID-19 mortality. We show that age-standardized YPLL was markedly higher among the non-Hispanic (NH) Black (559 years per 100,000 population) and the Hispanic (811) compared with NH white decedents (312). We demonstrate that geomapping using residential address data at the individual-level identifies hot-spots of COVID-19 mortality in neighborhoods on the Northeast, West, and South areas of Chicago that reflect a legacy of residential segregation and persistence of inequality in education, income, and access to healthcare. Our results may contribute to ongoing public health and community-engaged efforts to prevent the spread of infection and mitigate the disproportionate loss of life among these communities due to COVID-19 as well as highlight the urgent need to broadly target neighborhood disadvantage as a cause of pervasive racial inequalities in life and health.
•COVID-19 has disproportionately impacted racial and ethnic minorities in Chicago.•There are striking racial/ethnic disparities in COVID-19-related years of potential life lost (YPLL).•Geospatial mapping of individual COVID-19 decedents in Chicago identifies COVID-19 hot and cold spots.•Place-based disparities in COVID-19 mortality in Chicago reflect generations of residential segregation and inequity.•Geomapping strategies may be used to inform equitable public health interventions.
Dengue virus (DENV) is endemic in many parts of the world. Antibody dependent enhancement (ADE) in DENV infections occurs when a person with primary immunity is infected by a second, different DENV ...strain. Antibodies to Zika virus (ZIKV), which emerged in the Western Hemisphere in 2015, are cross reactive with DENV and theoretically could provoke ADE in a DENV naïve individual. We report the first known patient in the United States with a rapidly progressive and fatal case of travel-associated DENV in which prior exposure to ZIKV likely played a role in triggering an ADE phenomenon. This association of prior ZIKV immunity and subsequent new dengue infection is a worrisome phenomenon and an important contribution to the body of knowledge on immunity to flaviviruses.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
•E-cigarette users had greater odds of nonmedical prescription drug use one year later.•E-cigarette users had greater risk of incidence of other drug use one year later.•In unadjusted prospective ...analyses, e-cigarette users had greater risk of alcohol use.
As e-cigarette use continues to increase in the U.S., research is needed to understand its prospective risk for cigarette smoking and other substance use in young adulthood, including alcohol, marijuana, and nonmedical prescription drugs (NMPDs).
This study used data from the Monitoring the Future (MTF) study a nationally representative annual survey of 12th graders (modal age 18) in the US. The analytic sample included 2014–2016 MTF cohorts that were selected and completed follow up one year later (modal age 19; n = 717). Using logistic regression, we examined cross-sectional and prospective associations of past 30-day e-cigarette use with past 30-day cigarette, alcohol, marijuana, and NMPD use. We examined prospective associations among the full sample and associations with incidence of each of these substances among those who reported no history of use in 12th grade.
In cross-sectional analysis, those who reported past 30-day e-cigarette use at age 18 were more likely to report past 30-day cigarette use, alcohol use, marijuana use, and NMPD use at age 19. In multivariable longitudinal analysis, past 30-day e-cigarette users at age 18 were more likely to report past 30-day cigarette, marijuana, and NMPD use at age 19, including e-cigarette users who had no history of using these substances at age 18.
This study suggests that e-cigarette use may be an indicator of future substance use risk in young adulthood. Adolescent e-cigarette users may benefit from secondary prevention efforts to mitigate this risk.
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