Spatial Patterning of Spontaneous and Medically Indicated Preterm Birth in Philadelphia.

Preterm birth (PTB) remains a key public health issue that disproportionately affects Black individuals. Since spontaneous PTB (sPTB) and medically indicated PTB (mPTB) may have different causes and interventions, we quantified racial disparities for sPTB and mPTB, and we characterized the geographic patterning of these phenotypes, overall and according to race/ethnicity. We examined a pregnancy cohort of 83,952 singleton births at 2 Philadelphia hospitals from 2008-2020, and classified each PTB as sPTB or mPTB. We used binomial regression to quantify the magnitude of racial disparities between non-Hispanic Black and non-Hispanic White individuals, then generated small area estimates by applying a Bayesian model that accounts for small numbers and smooths estimates of PTB risk by borrowing information from neighboring areas. Racial disparities in both sPTB and mPTB were significant (relative risk of sPTB = 1.83, 95% confidence interval: 1.70, 1.98; relative risk of mPTB = 2.20, 95% confidence interval: 2.00, 2.42). The disparity was 20% greater in mPTB than sPTB. There was substantial geographic variation in PTB, sPTB, and mPTB risks and racial disparity. Our findings underscore the importance of distinguishing PTB phenotypes within the context of public health and preventive medicine. Future work should consider social and environmental exposures that may explain geographic differences in PTB risk and disparities.

Does Urban Greenspace Reduce Mortality Inequalities Based on Poverty, Race, or Both in Philadelphia, PA?

While past research suggests that urban greenspace is associated with weaker income-based mortality inequities, little is known about associations with racial inequities, which may be distinct owing to historical and contemporary forms of racism. We quantified the extent to which different measures of greenspace modified socioeconomic and racial/ethnic inequities in all-cause and cardiovascular disease mortality. For every residential census tract in Philadelphia, PA (N = 376), we linked counts of all-cause and cardiovascular mortality (years 2008-2015) with measures of greenspace (proportion tree canopy or grass/shrub cover, proportion residents reporting park access, and the normalized difference vegetation index measure of overall greenness) and American Community Survey-based measures of sociodemographic composition (proportion of residents living in poverty, proportion identifying as non-Hispanic Black, and the index of concentration at the extremes (ICE) representing racialized economic deprivation). We used age- and sex-adjusted negative binomial models, with the natural logarithm of age-specific population counts as an offset, to quantify the magnitude of inequities by each composition variable, overall and stratified by categories of each greenspace measure. Inequities in mortality were weaker among neighborhoods with higher proportion grass/shrub cover or overall greenness. The most substantially narrowed inequities were those by the ICE. Mortality inequities did not differ substantially by perceived park access, and tree canopy was associated with weaker ICE-based inequities only. In this ecologic analysis, neighborhood greenspace was associated with weaker mortality inequities. However, associations varied across greenspace type and sociodemographic composition metrics, with generally stronger associations with overall greenness and grass/shrub coverage, and for ICE-basedinequities.

Time Series Analysis: Associations Between Temperature and Primary Care Utilization in Philadelphia, Pennsylvania.

INTRODUCTION: Earth's temperature has risen by an average of 0.11°Fahrenheit per decade since 1850 and experts predict continued global warming. Studies have shown that exposure to extreme temperatures is associated with adverse health outcomes. Missed primary care visits can lead to incomplete preventive health screenings and unmanaged chronic diseases. This study examines the associations between extreme temperature conditions and primary care utilization among adult Philadelphians. METHODS: 1,048,575 appointments from 91,580 patients age ≥ 18 years enrolled in the study at thirteen university-based outpatient clinics in Philadelphia from January 1, 2009, to December 31, 2019. Statistical analysis was performed from June to December 2023. Data on attended and missed appointments was linked with measures of daily maximum temperature and precipitation, stratified by warm and cold seasons. Sociodemographic variables and associations with chronic disease status were explored. RESULTS: Rates of missed appointments increased by 0.72% for every 1°F decrease in daily maximum temperatures below 39°F and increased by 0.64% for every 1°F increase above 89°F. Individuals≥65 years and those with chronic conditions had stronger associations with an increased rate of missed appointments. CONCLUSIONS: Temperature extremes were associated with higher rates of missed primary care appointments. Individuals with chronic diseases were more likely to have missed appointments associated with extreme temperatures. The findings suggest the need for primary care physicians to explore different modes of care delivery to support vulnerable populations, such as making telemedicine during extreme weather events a viable and affordable option.

Associations of greenspace use and proximity with self-reported physical and mental health outcomes during the COVID-19 pandemic.

Research has shown that the COVID-19 pandemic affected individual's mental and physical health. The aim of this study was to estimate associations between greenspace use and proximity with perceived mental and physical health during the COVID-19 pandemic. We surveyed metropolitan Philadelphia residents, October 20-December 1, 2020, about walking time to the nearest greenspace from their home, frequency of greenspace use in the past 30 days, change in frequency of greenspace use during the COVID-19 pandemic, and perceived physical and mental health outcomes. We ran unadjusted and adjusted log-binomial regression models to derive Risk Ratio (RR) and 95% Confidence Intervals (CI) estimates of associations of loneliness, physical and mental health outcomes with: (1) self-reported walking time to nearest greenspace; (2) reported greenspace use frequency; and (3) changes in greenspace use frequency. Of 485 survey participants, 244 (51.4%) reported feeling lonelier, 147 (31.37%) reported higher perceived stress, 261 (54.9%) reported worsened mental health, and 137 (28.7%) reported worsened physical health during vs. before the start of pandemic-restrictions in mid-March of 2020. After adjustment for gender, age, and change in financial status, RR estimates suggested modest protective associations between visiting greenspaces more frequently during vs. before the pandemic and worsened mental (RR: 0.84, 95% CI: 0.70-1.00), and physical health (RR 0.77, 95% CI: 0.56-1.10), and loneliness (RR: 0.91, 95% CI: 0.75-1.1) and perceived stress (RR 0.83, 95% CI: 0.61-1.13). Shorter walking distances to the nearest greenspace were associated with reduced risk of reporting worsened physical health and higher perceived stress; however, living shorter walking distances from greenspace were not associated with protection against worsened mental health or loneliness. These results suggest that active greenspace use may provide mental and physical health protection, particularly during a stressful public health crisis.

Genetic correlations between meat quality traits and growth and carcass traits in Merino sheep1.

Genetic correlations between 16 meat quality and nutritional value traits and live weight at various ages, live ultrasound fat and muscle depth, carcass measures, and carcass dissection traits were estimated for Merino sheep in the Information Nucleus (IN). Genetic correlations between live weight at various ages and the carcass traits are also reported. The IN comprised 8 genetically linked flocks managed across a range of Australian sheep environments. Meat quality traits included between 1,200 and 1,300 records for progeny from over 170 sires for intramuscular fat (IMF), lean meat yield (LMY), shear force (SF5), pH, meat color, and meat nutritional value traits including iron and zinc levels and long-chain omega-3 and omega-6 polyunsaturated fatty acid levels. The genetic correlations indicated that selection of Merino sheep to either reduce fat or increase muscle using ultrasound assessments will result in little change in IMF and SF5. Myoglobin levels would tend to be reduced following selection for reduced ultrasound fat depth (0.35 ± 0.21, 0.43 ± 0.14), whereas increases in myoglobin levels would occur due to selection for increased ultrasound muscle depth (0.25 ± 0.24, 0.38 ± 0.15). Selection for increased live weight will result in favorable correlated responses in hot carcass weight (0.76 to 0.97), dressing percentage (0.13 to 0.47), and carcass muscle (0.37 to 0.95), but unfavorable responses of increases in carcass fatness (0.13 to 0.65) and possible small reductions in muscle oxidative activity (-0.13 ± 0.14 to -0.73 ± 0.33) and iron content (-0.14 ± 0.15 to -0.38 ± 0.16), and a possible deterioration of shear force from selection at later ages (0.15 ± 0.26, 0.27 ± 0.24). Negligible changes are generally expected for LMY and meat color traits following selection for increased live weight (most genetic correlations less than 0.20 in size). Selection for increased LMY would tend to result in unfavorable changes in several aspects of meat quality, including reduced IMF (-0.27 ± 0.18), meat tenderness (0.53 ± 0.26), and meat redness (-0.69 ± 0.40), as well as reduced iron levels (-0.25 ± 0.22). These genetic correlations are a first step in assisting the development of breeding values for new traits to be incorporated into genetic evaluation programs to improve meat production from Merino sheep and other dual-purpose sheep breeds.

Evidence for multiple alleles effecting muscling and fatness at the ovine GDF8 locus.

BACKGROUND: The current investigation surveyed genetic polymorphism at the ovine GDF8 locus and determined its contribution to variation in muscling and fatness in sheep. RESULTS: Re-sequencing 2988 bp from a panel of 15 sires revealed a total of six SNP, none of which were located within exons of the gene. One of the identified SNP, g+6723G>A, is known to increase muscularity within the Belgian Texel. A genetic survey of 326 animals revealed that the mutation is near fixation within Australian Texels and present in additional breeds including White Suffolk, Poll Dorset and Lincoln. Using a resource population comprising 15 sires and 1191 half-sib progeny with genotypic data, the effect of this and other SNP was tested against a set of 50 traits describing growth, muscling, fatness, yield, meat and eating quality. The loss of function allele (g+6723A) showed significant effects on slaughter measurements of muscling and fatness. No effect was detected on objectively assessed meat quality however evidence was found for an association between g+6723G>A, decreased intramuscular fat and reduced eating quality. Haplotype analysis using flanking microsatellites was performed to search for evidence of currently unidentified mutations which might affect production traits. Four haplotypes were identified that do not carry g+6723A but which showed significant associations with muscling and fatness. CONCLUSION: The finding that g+6723G>A is present within Australian sheep facilitated an independent evaluation into its phenotypic consequence. Testing was conducted using a separate genetic background and animals raised in different environments to the Belgian Texel in which it was first identified. The observation that the direction and size of effects for g+6723A is approximately consistent represented a robust validation of the effects of the mutation. Based on observed allele frequencies within breeds, selection for g+6723A will have the largest impact within the White Suffolk. GDF8 may harbour additional mutations which serve to influence economically important traits in sheep.

Health beneficial long chain omega-3 fatty acid levels in Australian lamb managed under extensive finishing systems.

The variation in levels of the health claimable long chain omega-3 fatty acids, eicosapentaenoic acid (EPA, 20:5n-3) plus docosahexaenoic acid (DHA, 22:6n-3) across production regions of Australia was studied in 5726 lambs over 3 years completed in 87 slaughter groups. The median level of EPA plus DHA differed dramatically between locations and sometimes between slaughters from the same location. The ratio of EPA plus DHA from lambs with high values (97.5% quantile) to lambs with low values (2.5% quantile) also differed dramatically between locations, and between slaughters from the same location. Consistency between years, at a location, was less for the high to low value ratio of EPA plus DHA than for the median value of EPA plus DHA. To consistently obtain high levels of omega-3 fatty acids in Australian lamb, there must be a focus on lamb finishing diets which are likely to need a supply of α-linolenic acid (18:3n-3), the precursor for EPA and DHA.