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Type 2 innate lymphoid cells (ILC2s) are crucial in regulating immune responses and various physiological processes, including tissue repair, metabolic homeostasis, inflammation, and cancer surveillance. Here, we present a protocol that outlines the isolation, expansion, and adoptive transfer of human ILC2s from peripheral blood mononuclear cells for an in vivo lineage tracking experiment in a mouse model. Additionally, we detail the steps involved in the adoptive transfer of human ILC2s to recipient mice bearing human liquid or solid tumors. For complete details on the use and execution of this protocol, please refer to Li et al.1.
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BACKGROUND: Structural racism contributes to geographical inequalities in pre-exposure prophylaxis (PrEP) coverage in the United States (US). This study aims to investigate county-level variability in PrEP utilization across diverse dimensions of structural racism. METHODS: The 2013-2021 nationwide county-level PrEP rate and PrEP-to-need ratio (PNR) data were retrieved from AIDSVu. PrEP rate was defined as the number of PrEP users per 100,000 population, and PNR was defined as the ratio of PrEP users to new HIV diagnoses per calendar year. Linear mixed effect regression was employed to identify associations of county-level structural racism (e.g., structural racism in housing and socioeconomic status) with PrEP rate and PNR on a nationwide scale of the US. RESULTS: From 2013 to 2021, the mean PrEP rate and PNR increased from 3.62 to 71.10 and from 0.39 to 10.20, respectively. Counties with more structural racism in housing were more likely to have low PrEP rates (adjusted ß = - 5.80, 95% CI [- 8.84, - 2.75]). Higher PNR was found in counties with lower structural racism in socioeconomic status (adjusted ß = - 2.64, 95% CI [- 3.68, - 1.61]). Regionally, compared to the Midwest region, counties in the West region were more likely to have higher PrEP rate (adjusted ß = 30.99, 95% CI [22.19, 39.80]), and counties in the South had lower PNR (adjusted ß = - 1.87, 95% CI [- 2.57, - 1.17]). CONCLUSIONS: County-level structural racism plays a crucial role in understanding the challenges of scaling up PrEP coverage. The findings underscore the importance of tailored strategies across different regions and provide valuable insights for future interventions to optimize PrEP implementation.
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Intercellular adhesion molecule 1 (ICAM1) is a cell surface adhesion glycoprotein in the immunoglobulin supergene family. It is associated with several epithelial tumorigenesis processes, as well as with inflammation. However, the function of ICAM1 in the prognosis of tumor immunity is still unclear. This study aimed to examine the immune function of ICAM1 in 33 tumor types and to investigate the prognostic value of tumors. Using datasets from the Cancer Genome Atlas (TCGA), Genotype Tissue Expression (GTEx), Cancer Cell Lines Encyclopedia (CCLE), Human Protein Atlas (HPA), and cBioPortal, we investigated the role of ICAM1 in tumors. We explored the potential correlation between ICAM1 expression and tumor prognosis, gene mutations, microsatellite instability, and tumor immune cell levels in various cancers. We observed that ICAM1 is highly expressed in multiple malignant tumors. Furthermore, ICAM1 is negatively or positively associated with different malignant tumor prognoses. The expression levels of ICAM1 were correlated with the tumor mutation burden (TMB) in 11 tumors and with MSI in eight tumors. ICAM1 is a gene associated with immune infiltrating cells, such as M1 macrophages and CD8+ T cells in gastric and colon cancer. Meanwhile, the expression of ICAM1 is associated with several immune-related functions and immune-regulation-related signaling pathways, such as the chemokine signaling pathway. Our study shows that ICAM1 can be used as a prognostic biomarker in many cancer types because of its function in tumorigenesis and malignant tumor immunity.
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Biomarcadores de Tumor , Molécula 1 de Adhesión Intercelular , Neoplasias , Humanos , Molécula 1 de Adhesión Intercelular/metabolismo , Molécula 1 de Adhesión Intercelular/genética , Biomarcadores de Tumor/genética , Biomarcadores de Tumor/metabolismo , Pronóstico , Neoplasias/inmunología , Neoplasias/genética , Neoplasias/metabolismo , Mutación , Regulación Neoplásica de la Expresión Génica , Inestabilidad de Microsatélites , Microambiente Tumoral/inmunologíaRESUMEN
This study explored individual- and county-level risk factors of late presentation with advanced disease (LPAD) among people with HIV (PWH) and their longer delay time from infection to diagnosis in South Carolina (SC), using SC statewide Enhanced HIV/AIDS Reporting System (eHARS). LPAD was defined as having an AIDS diagnosis within three months of initial HIV diagnosis, and delay time from HIV infection to diagnosis was estimated using CD4 depletion model. 3,733 (41.88%) out of 8,913 adult PWH diagnosed from 2005 to 2019 in SC were LPAD, and the median delay time was 13.04 years. Based on the generalized estimating equations models, PWH who were male (adjusted prevalence ratio [aPR]: 1.22, 95% CI: 1.12 â¼ 1.33), aged 55+ (aPR: 1.76, 95% CI: 1.62 â¼ 1.92), were Black (aPR: 1.09, 95% CI: 1.03 â¼ 1.15) or Hispanic (aPR: 1.42, 95% CI: 1.26 â¼ 1.61), and living in counties with a larger proportion of unemployment individuals (aPR: 1.02, 95% CI: 1.01 â¼ 1.03) were more likely to be LPAD. Among PWH who were LPAD, Hispanic (adjusted beta: 1.17, 95% CI: 0.49 â¼ 1.85) instead of Black (adjusted beta: 0.11, 95% CI: -0.30 â¼ 0.52) individuals had significant longer delay time compared to White individuals. Targeted and sustained interventions are needed for older, male, Hispanic or Black individuals and those living in counties with a higher percentage of unemployment because of their higher risk of LPAD. Additionally, specific attention should be paid to Hispanic individuals due to their longer delay time to diagnosis.
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We described previously a human natural killer (NK) cell population that upregulates PD-L1 expression upon recognizing and reacting to tumor cells or exposure to a combination of IL12, IL18, and IL15. Here, to investigate the safety and efficacy of tumor-reactive and cytokine-activated (TRACK) NK cells, human NK cells from umbilical cord blood were expanded, transduced with a retroviral vector encoding soluble (s) IL15, and further cytokine activated to induce PD-L1 expression. Our results show cryopreserved and thawed sIL15_TRACK NK cells had significantly improved cytotoxicity against non-small cell lung cancer (NSCLC) in vitro when compared with non-transduced (NT) NK cells, PD-L1+ NK cells lacking sIL15 expression (NT_TRACK NK), or NK cells expressing sIL15 without further cytokine activation (sIL15 NK cells). Intravenous injection of sIL15_TRACK NK cells into immunodeficient mice with NSCLC significantly slowed tumor growth and improved survival when compared with NT NK and sIL15 NK cells. The addition of the anti-PD-L1 atezolizumab further improved control of NSCLC growth by sIL15_TRACK NK cells in vivo. Moreover, a dose-dependent efficacy was assessed for sIL15_TRACK NK cells without observed toxicity. These experiments indicate that the administration of frozen, off-the-shelf allogeneic sIL15_TRACK NK cells is safe in preclinical models of human NSCLC and has potent antitumor activity without and with the administration of atezolizumab. A phase I clinical trial modeled after this preclinical study using sIL15_TRACK NK cells alone or with atezolizumab for relapsed or refractory NSCLC is currently underway (NCT05334329).
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Antígeno B7-H1 , Carcinoma de Pulmón de Células no Pequeñas , Interleucina-15 , Células Asesinas Naturales , Neoplasias Pulmonares , Ensayos Antitumor por Modelo de Xenoinjerto , Carcinoma de Pulmón de Células no Pequeñas/inmunología , Carcinoma de Pulmón de Células no Pequeñas/terapia , Humanos , Células Asesinas Naturales/inmunología , Células Asesinas Naturales/metabolismo , Animales , Neoplasias Pulmonares/inmunología , Neoplasias Pulmonares/terapia , Antígeno B7-H1/metabolismo , Ratones , Anticuerpos Monoclonales Humanizados/uso terapéutico , Anticuerpos Monoclonales Humanizados/farmacología , Línea Celular Tumoral , Ratones SCID , Ratones Endogámicos NOD , FemeninoRESUMEN
Due to the limitations of autologous chimeric antigen receptor (CAR)-T cells, alternative sources of cellular immunotherapy, including CAR macrophages, are emerging for solid tumors. Human induced pluripotent stem cells (iPSCs) offer an unlimited source for immune cell generation. Here, we develop human iPSC-derived CAR macrophages targeting prostate stem cell antigen (PSCA) (CAR-iMacs), which express membrane-bound interleukin (IL)-15 and truncated epidermal growth factor receptor (EGFR) for immune cell activation and a suicide switch, respectively. These allogeneic CAR-iMacs exhibit strong antitumor activity against human pancreatic solid tumors in vitro and in vivo, leading to reduced tumor burden and improved survival in a pancreatic cancer mouse model. CAR-iMacs appear safe and do not exhibit signs of cytokine release syndrome or other in vivo toxicities. We optimized the cryopreservation of CAR-iMac progenitors that remain functional upon thawing, providing an off-the-shelf, allogeneic cell product that can be developed into CAR-iMacs. Overall, our preclinical data strongly support the potential clinical translation of this human iPSC-derived platform for solid tumors, including pancreatic cancer.
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Antígenos de Neoplasias , Proteínas Ligadas a GPI , Células Madre Pluripotentes Inducidas , Macrófagos , Neoplasias Pancreáticas , Humanos , Neoplasias Pancreáticas/terapia , Neoplasias Pancreáticas/patología , Neoplasias Pancreáticas/inmunología , Animales , Macrófagos/inmunología , Macrófagos/metabolismo , Ratones , Antígenos de Neoplasias/inmunología , Antígenos de Neoplasias/metabolismo , Células Madre Pluripotentes Inducidas/metabolismo , Proteínas Ligadas a GPI/metabolismo , Receptores Quiméricos de Antígenos/metabolismo , Receptores Quiméricos de Antígenos/inmunología , Proteínas de Neoplasias/metabolismo , Línea Celular Tumoral , Ensayos Antitumor por Modelo de Xenoinjerto , Inmunoterapia Adoptiva/métodos , Ratones SCIDRESUMEN
Targeting the metabolic dependencies of acute myeloid leukemia (AML) cells is a promising therapeutical strategy. In particular, the cysteine and methionine metabolism pathway (C/M) is significantly altered in AML cells compared to healthy blood cells. Moreover, methionine has been identified as one of the dominant amino acid dependencies of AML cells. Through RNA-seq, we found that the two nucleoside analogs 8-chloro-adenosine (8CA) and 8-amino-adenosine (8AA) significantly suppress the C/M pathway in AML cells, and methionine-adenosyltransferase-2A (MAT2A) is one of most significantly downregulated genes. Additionally, mass spectrometry analysis revealed that Venetoclax (VEN), a BCL-2 inhibitor recently approved by the FDA for AML treatment, significantly decreases the intracellular level of methionine in AML cells. Based on these findings, we hypothesized that combining 8CA or 8AA with VEN can efficiently target the Methionine-MAT2A-S-adenosyl-methionine (SAM) axis in AML. Our results demonstrate that VEN and 8CA/8AA synergistically decrease the SAM biosynthesis and effectively target AML cells both in vivo and in vitro. These findings suggest the promising potential of combining 8CA/8AA and VEN for AML treatment by inhibiting Methionine-MAT2A-SAM axis and provide a strong rationale for our recently activated clinical trial.
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Compuestos Bicíclicos Heterocíclicos con Puentes , Sinergismo Farmacológico , Leucemia Mieloide Aguda , Metionina Adenosiltransferasa , Metionina , S-Adenosilmetionina , Sulfonamidas , Leucemia Mieloide Aguda/tratamiento farmacológico , Leucemia Mieloide Aguda/metabolismo , Leucemia Mieloide Aguda/patología , Humanos , Compuestos Bicíclicos Heterocíclicos con Puentes/farmacología , Sulfonamidas/farmacología , Metionina/metabolismo , Metionina/análogos & derivados , Metionina Adenosiltransferasa/metabolismo , Metionina Adenosiltransferasa/antagonistas & inhibidores , Metionina Adenosiltransferasa/genética , Animales , Ratones , S-Adenosilmetionina/farmacología , S-Adenosilmetionina/metabolismo , Adenosina/análogos & derivados , Adenosina/farmacología , Ensayos Antitumor por Modelo de Xenoinjerto , Línea Celular TumoralRESUMEN
The Canadian wildfires in June 2023 significantly impacted the northeastern United States, particularly in terms of worsened air pollution and environmental justice concerns. While advancements have been made in low-cost sensor deployments and satellite observations of atmospheric composition, integrating dynamic human mobility with wildfire PM2.5 exposure to fully understand the environmental justice implications remains underinvestigated. This study aims to enhance the accuracy of estimating ground-level fine particulate matter (PM2.5) concentrations by fusing chemical transport model outputs with empirical observations, estimating exposures using human mobility data, and evaluating the impact of environmental justice. Employing a novel data fusion technique, the study combines the Weather Research and Forecasting model with Chemistry (WRF-Chem) outputs and surface PM2.5 measurements, providing a more accurate estimation of PM2.5 distribution. The study addresses the gap in traditional exposure assessments by incorporating human mobility data and further investigates the spatial correlation of PM2.5 levels with various environmental and demographic factors from the US Environmental Protection Agency (EPA) Environmental Justice Screening and Mapping Tool (EJScreen). Results reveal that despite reduced mobility during high PM2.5 levels from wildfire smoke, exposure for both residents and individuals on the move remains high. Regions already burdened with high environmental pollution levels face amplified PM2.5 effects from wildfire smoke. Furthermore, we observed mixed correlations between PM2.5 concentrations and various demographic and socioeconomic factors, indicating complex exposure patterns across communities. Urban areas, in particular, experience persistent high exposure, while significant correlations in rural areas with EJScreen factors highlight the unique vulnerabilities of these populations to smoke exposure. These results advocate for a comprehensive approach to environmental health that leverages advanced models, integrates human mobility data, and addresses socio-demographic disparities, contributing to the development of equitable strategies against the growing threat of wildfires.
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Contaminantes Atmosféricos , Contaminación del Aire , Incendios Forestales , Humanos , Contaminantes Atmosféricos/análisis , Justicia Ambiental , Canadá , Contaminación del Aire/análisis , Material Particulado/análisis , Exposición a Riesgos AmbientalesRESUMEN
Nocturnal light pollution, an underappreciated mood manipulator, disturbs the circadian rhythms of individuals in modern society. Preclinical and clinical studies have suggested that exposure to lights at night (LANs) results in depression-like phenotypes. However, the mechanism underlying the action of LANs remains unclear. Therefore, this study explored the potential influence of LANs on depression-related brain regions by testing brain-derived neurotrophic factor (BDNF), synaptic transmission, and plasticity in male Sprague-Dawley rats. Depression-related behavioral tests, enzyme-linked immunosorbent assays, and intracellular and extracellular electrophysiological recordings were performed. Resultantly, rats exposed to either white or blue LAN for 5 or 21 days exhibited depression-like behaviors. Both white and blue LANs reduced BDNF expression in the medial prefrontal cortex (mPFC) and ventrolateral periaqueductal gray (vlPAG). Moreover, both lights at night (LANs) elevated the plasma corticosterone levels. Pharmacologically, the activation of glucocorticoid receptors mimics the LAN-mediated effects on depression-like behaviors and reduces BDNF levels, whereas the inhibition of glucocorticoid receptors blocks LAN-mediated behavioral and molecular actions. Electrophysiologically, both LANs attenuated the stimulation-response curve, increased the paired-pulse ratio, and decreased the frequency and amplitude of miniature excitatory postsynaptic currents in the vlPAG. In the mPFC, LANs attenuate long-term potentiation and long-term depression. Collectively, these results suggested that white and blue LANs disturbed BDNF expression, synaptic transmission, and plasticity in the vlPAG and mPFC in a glucocorticoid-dependent manner. The results of the present study provide a theoretical basis for understanding the effects of nocturnal light exposure on depression-like phenotypes.
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Factor Neurotrófico Derivado del Encéfalo , Glucocorticoides , Ratas , Animales , Masculino , Ratas Sprague-Dawley , Glucocorticoides/farmacología , Glucocorticoides/metabolismo , Factor Neurotrófico Derivado del Encéfalo/metabolismo , Depresión/metabolismo , Receptores de Glucocorticoides/metabolismo , Corteza PrefrontalRESUMEN
Partial-thickness cartilage defect (PTCD) is a common and formidable clinical challenge without effective therapeutic approaches. The inherent anti-adhesive characteristics of the extracellular matrix within cartilage pose a significant impediment to the integration of cells or biomaterials with the native cartilage during cartilage repair. Here, an injectable photocrosslinked bioadhesive hydrogel, consisting of gelatin methacryloyl (GM), acryloyl-6-aminocaproic acid-g-N-hydroxysuccinimide (AN), and poly(lactic-co-glycolic acid) microspheres loaded with kartogenin (KGN) (abbreviated as GM/AN/KGN hydrogel), is designed to enhance interfacial integration and repair of PTCD. After injected in situ at the irregular defect, a stable and robust hydrogel network is rapidly formed by ultraviolet irradiation, and it can be quickly and tightly adhered to native cartilage through amide bonds. The hydrogel exhibits good adhesion strength up to 27.25 ± 1.22 kPa by lap shear strength experiments. The GM/AN/KGN hydrogel demonstrates good adhesion, low swelling, resistance to fatigue, biocompatibility, and chondrogenesis properties in vitro. A rat model with PTCD exhibits restoration of a smoother surface, stable seamless integration, and abundant aggrecan and type II collagen production. The injectable stable adhesive hydrogel with long-term chondrogenic differentiation capacity shows great potential to facilitate repair of PTCD.
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Anilidas , Condrogénesis , Hidrogeles , Ácidos Ftálicos , Ratas , Animales , Hidrogeles/farmacología , Hidrogeles/química , Preparaciones de Acción Retardada/farmacología , CartílagoRESUMEN
The therapeutic potential for human type 2 innate lymphoid cells (ILC2s) has been underexplored. Although not observed in mouse ILC2s, we found that human ILC2s secrete granzyme B (GZMB) and directly lyse tumor cells by inducing pyroptosis and/or apoptosis, which is governed by a DNAM-1-CD112/CD155 interaction that inactivates the negative regulator FOXO1. Over time, the high surface density expression of CD155 in acute myeloid leukemia cells impairs the expression of DNAM-1 and GZMB, thus allowing for immune evasion. We describe a reliable platform capable of up to 2,000-fold expansion of human ILC2s within 4 weeks, whose molecular and cellular ILC2 profiles were validated by single-cell RNA sequencing. In both leukemia and solid tumor models, exogenously administered expanded human ILC2s show significant antitumor effects in vivo. Collectively, we demonstrate previously unreported properties of human ILC2s and identify this innate immune cell subset as a member of the cytolytic immune effector cell family.
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Granzimas , Inmunidad Innata , Linfocitos , Neoplasias , Animales , Humanos , Ratones , Apoptosis , Citocinas , Neoplasias/inmunología , Neoplasias/terapiaRESUMEN
Light is an underappreciated mood manipulator. People are often exposed to electronic equipment, which results in nocturnal blue light exposure in modern society. Light pollution drastically shortens the night phase of the circadian rhythm. Preclinical and clinical studies have reported that nocturnal light exposure can influence mood, such as depressive-like phenotypes. However, the effects of blue light at night (BLAN) on other moods and how it alters mood remain unclear. Here, we explored the impact of BLAN on stress-provoked aggression in male SpragueâDawley rats, focusing on its influence on basolateral amygdala (BLA) activity. Resident-intruder tests, extracellular electrophysiological recordings, and enzyme-linked immunosorbent assays were performed. The results indicated that BLAN produces stress-induced heightened aggressive and anxiety-like phenotypes. Moreover, BLAN not only potentiates long-term potentiation and long-term depression in the BLA but also results in stress-induced elevation of brain-derived neurotrophic factor (BDNF), mature BDNF, and phosphorylation of tyrosine receptor kinase B expression in the BLA. Intra-BLA microinfusion of BDNF RNAi, BDNF neutralizing antibody, K252a, and rapamycin blocked stress-induced heightened aggressive behavior in BLAN rats. In addition, intra-BLA application of BDNF and 7,8-DHF caused stress-induced heightened aggressive behavior in naïve rats. Collectively, these results suggest that BLAN results in stress-evoked heightened aggressive phenotypes, which may work by enhancing BLA BDNF signaling and synaptic plasticity. This study reveals that nocturnal blue light exposure may have an impact on stress-provoked aggression. Moreover, this study provides novel insights into the BLA BDNF-dependent mechanism underlying the impact of the BLAN on mood.
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Mobile location data has emerged as a valuable data source for studying human mobility patterns in various contexts, including virus spreading, urban planning, and hazard evacuation. However, these data are often anonymized overviews derived from a panel of traced mobile devices, and the representativeness of these panels is not well documented. Without a clear understanding of the data representativeness, the interpretations of research based on mobile location data may be questionable. This article presents a comprehensive examination of the potential biases associated with mobile location data using SafeGraph Patterns data in the United States as a case study. The research rigorously scrutinizes and documents the bias from multiple dimensions, including spatial, temporal, urbanization, demographic, and socioeconomic, over a five-year period from 2018 to 2022 across diverse geographic levels, including state, county, census tract, and census block group. Our analysis of the SafeGraph Patterns dataset revealed an average sampling rate of 7.5% with notable temporal dynamics, geographic disparities, and urban-rural differences. The number of sampled devices was strongly correlated with the census population at the county level over the five years for both urban (r > 0.97) and rural counties (r > 0.91), but less so at the census tract and block group levels. We observed minor sampling biases among groups such as gender, age, and moderate-income, with biases typically ranging from -0.05 to +0.05. However, minority groups such as Hispanic populations, low-income households, and individuals with low levels of education generally exhibited higher levels of underrepresentation bias that varied over space, time, urbanization, and across geographic levels. These findings provide important insights for future studies that utilize SafeGraph data or other mobile location datasets, highlighting the need to thoroughly evaluate the spatiotemporal dynamics of the bias across spatial scales when employing such data sources.
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Renta , Urbanización , Humanos , Estados Unidos , Dinámica Poblacional , Población Rural , SesgoRESUMEN
Developing hydrogels that can quickly reach deep bleeding sites, adhere to wounds, and expand to stop lethal and/or noncompressible bleeding in civil and battlefield environments remains a challenge. Herein, an injectable, antibacterial, self-expanding, and self-propelling hydrogel bioadhesive with procoagulant activity and rapid gelation is reported. This hydrogel combines spontaneous gas foaming and rapid Schiff base crosslinking for lethal massive hemorrhage. Hydrogels have rapid gelation and expansion rate, high self-expanding ratio, excellent antibacterial activity, antioxidant efficiency, and tissue adhesion capacity. In addition, hydrogels have good cytocompatibility, procoagulant ability, and higher blood cell/platelet adhesion activity than commercial combat gauze and gelatin sponge. The optimized hydrogel (OD-C/QGQL-A30) exhibits better hemostatic ability than combat gauze and gelatin sponge in rat liver and femoral artery bleeding models, rabbit volumetric liver loss massive bleeding models with/without anticoagulant, and rabbit liver and kidney incision bleeding models with bleeding site not visible. Especially, OD-C/QGQL-A30 rapidly stops the bleedings from pelvic area of rabbit, and swine subclavian artery vein transection. Furthermore, OD-C/QGQL-A30 has biodegradability and biocompatibility, and accelerates Methicillin-resistant S. aureus (MRSA)-infected skin wound healing. This injectable, antibacterial, self-expanding, and self-propelling hydrogel opens up a new avenue to develop hemostats for lethal massive bleeding, abdominal organ bleeding, and bleeding from coagulation lesions.
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Hidrogeles , Staphylococcus aureus Resistente a Meticilina , Ratas , Animales , Conejos , Porcinos , Hidrogeles/farmacología , Adhesivos , Cicatrización de Heridas , Gelatina , Hemorragia/tratamiento farmacológico , Antibacterianos/farmacología , Antibacterianos/uso terapéuticoRESUMEN
BACKGROUND: COVID-19 had a greater impact in the Deep South compared with other regions in the United States. While vaccination remains a top priority for all eligible individuals, data regarding the progress of booster coverage in the Deep South and how the coverage varies by county and age are sparse. Despite existing evidence of racial and ethnic disparities in COVID-19 vaccinations at the individual level, there is an urgent need for evidence at the population level. Such information could highlight vulnerable communities and guide future health care policy-making and resource allocation. OBJECTIVE: We aimed to evaluate county-level COVID-19 booster coverage by age group in the Deep South and explore its association with residential segregation. METHODS: An ecological study was conducted at the population level by integrating COVID-19 vaccine surveillance data, residential segregation index, and county-level factors across the 418 counties of 5 Deep South states from December 15, 2021, to October 19, 2022. We analyzed the cumulative percentages of county-level COVID-19 booster uptake by age group (eg, 12 to 17 years, 18 to 64 years, and at least 65 years) by the end of the study period. The longitudinal relationships were examined between residential segregation, the interaction of time and residential segregation, and COVID-19 booster coverage using the Poisson model. RESULTS: As of October 19, 2022, among the 418 counties, the median of booster uptake was 40% (IQR 37.8%-43%). Compared with older adults (ie, at least 65 years; median 63.1%, IQR 59.5%-66.5%), youth (ie, 12 to 17 years; median 14.1%, IQR 11.3%-17.4%) and adults (ie, 18 to 64 years; median 33.4%, IQR 30.5%-36.5%) had lower percentages of booster uptake. There was geospatial heterogeneity in the county-level COVID-19 booster coverage. We found that higher segregated counties had lower percentages of booster coverage. Such relationships attenuated as time increased. The findings were consistent across the age groups. CONCLUSIONS: The progress of county-level COVID-19 booster coverage in the Deep South was slow and varied by age group. Residential segregation precluded the county-level COVID-19 booster coverage across age groups. Future efforts regarding vaccination strategies should focus on youth and adults. Health care facilities and resources are needed in racial and ethnic minority communities.
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COVID-19 , Etnicidad , Adolescente , Humanos , Estados Unidos/epidemiología , Anciano , Niño , COVID-19/epidemiología , COVID-19/prevención & control , Segregación Residencial , Vacunas contra la COVID-19 , Grupos MinoritariosRESUMEN
INTRODUCTION: Health disparities exist at every step of the HIV care continuum (HCC) among racial/ethnic minority population. Such racial/ethnic disparities may have significantly delayed the progress in HCC in the Southern US states that are strongly represented among geographic focus areas in the 2019 federal initiative titled 'Ending the HIV Epidemic: A Plan for America'. However, limited efforts have been made to quantify the long-term spatiotemporal variations of HCC disparities and their contributing factors over time, particularly in the context of COVID-19 pandemic. This project aims to identify the spatiotemporal patterns of racial disparities of each HCC outcome and then determine the contribution of contextual features for temporal change of disparities in HCC. METHODS AND ANALYSIS: This cohort study will use statewide HIV cohort data in South Carolina, including all people living with HIV (PLWH) who were diagnosed with HIV in 2005-2020. The healthcare encounter data will be extracted from longitudinal EHR from six state agencies and then linked to aggregated county-level community and social structural-level data (eg, structural racism, COVID-19 pandemic) from multiple publicly available data sources. The South Carolina Revenue of Fiscal and Affairs will serve as the honest broker to link the patient-level and county-level information. We will first quantify the HCC-related disparities by creating a county-level racial/ethnic disparity index (RDI) for each key HCC outcomes (eg, HIV testing, timely diagnosis), examine the temporal patterns of each RDI over time and then using geographical weighted lasso model examine which contextual factors have significant impacts on the change of county-level RDI from 2005 to 2020. ETHICS AND DISSEMINATION: The study was approved by the Institutional Review Board at the University of South Carolina (Pro00121718) as a Non-Human Subject study. The study's findings will be published in peer-reviewed journals and disseminated at national and international conferences and through social media.
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Etnicidad , Infecciones por VIH , Disparidades en Atención de Salud , Grupos Raciales , Humanos , Estudios de Cohortes , Continuidad de la Atención al Paciente , COVID-19 , Infecciones por VIH/epidemiología , Infecciones por VIH/terapia , Grupos Minoritarios , Pandemias , Estados Unidos/epidemiologíaRESUMEN
BACKGROUND: COVID-19 testing is essential for pandemic control, and insufficient testing in areas with high disease burdens could magnify the risk of poor health outcomes. However, few area-based studies on COVID-19 testing disparities have considered the disease burden (e.g., confirmed cases). The current study aims to investigate socioeconomic drivers of geospatial disparities in COVID-19 testing relative to disease burden across 46 counties in South Carolina (SC) in the early (from April 1, 2020, to June 30, 2020) and later (from July 1, 2020, to September 30, 2021) phases of the pandemic. METHODS: Using SC statewide COVID-19 testing data, the COVID-19 testing coverage was measured by monthly COVID-19 tests per confirmed case (hereafter CTPC) in each county. We used modified Lorenz curves to describe the unequal geographic distribution of CTPC and generalized linear mixed-effects regression models to assess the association of county-level social risk factors with CTPC in two phases of the pandemic in SC. RESULTS: As of September 30, 2021, a total of 641,201 out of 2,941,227 tests were positive in SC. The Lorenz curve showed that county-level disparities in CTPC were less apparent in the later phase of the pandemic. Counties with a larger percentage of Black had lower CTPC during the early phase (ß = -0.94, 95%CI: -1.80, -0.08), while such associations reversed in the later phase (ß = 0.28, 95%CI: 0.01, 0.55). The association of some other social risk factors diminished as the pandemic evolved, such as food insecurity (ß: -1.19 and -0.42; p-value is < 0.05 for both). CONCLUSIONS: County-level disparities in CTPC and their predictors are dynamic across the pandemic. These results highlight the systematic inequalities in COVID-19 testing resources and accessibility, especially in the early stage of the pandemic. Counties with greater social vulnerability and those with fewer health care resources should be paid extra attention in the early and later phases, respectively. The current study provided empirical evidence for public health agencies to conduct more targeted community-based testing campaigns to enhance access to testing in future public health crises.
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COVID-19 , Humanos , South Carolina/epidemiología , COVID-19/diagnóstico , COVID-19/epidemiología , Prueba de COVID-19 , Registros Electrónicos de Salud , Costo de EnfermedadRESUMEN
The prevalence of cardiometabolic diseases in the United States is presumably linked to an obesogenic retail food environment that promotes unhealthy dietary habits. Past studies, however, have reported inconsistent findings about the relationship between the two. One underexplored area is how humans interact with food environments and how to integrate human activity into scalable measures. In this paper, we develop the retail food activity index (RFAI) at the census tract level by utilizing Global Positioning System tracking data covering over 94 million aggregated visit records to approximately 359,000 food retailers across the United States over two years. Here we show that the RFAI has significant associations with the prevalence of multiple cardiometabolic diseases. Our study indicates that the RFAI is a promising index with the potential for guiding the development of policies and health interventions aimed at curtailing the burden of cardiometabolic diseases, especially in communities characterized by obesogenic dietary behaviors.
Asunto(s)
Enfermedades Cardiovasculares , Obesidad , Humanos , Estados Unidos/epidemiología , Obesidad/epidemiología , Alimentos , Ambiente , Actividades Humanas , Enfermedades Cardiovasculares/epidemiología , Características de la ResidenciaRESUMEN
Geospatial social media (GSM) data has been increasingly used in public health due to its rich, timely, and accessible spatial information, particularly in infectious disease research. This review synthesized 86 research articles that use GSM data in infectious diseases published between December 2013 and March 2022. These articles cover 12 infectious disease types ranging from respiratory infectious diseases to sexually transmitted diseases with spatial levels varying from the neighborhood, county, state, and country. We categorized these studies into three major infectious disease research domains: surveillance, explanation, and prediction. With the assistance of advanced statistical and spatial methods, GSM data has been widely and deeply applied to these domains, particularly in surveillance and explanation domains. We further identified four knowledge gaps in terms of contextual information use, application scopes, spatiotemporal dimension, and data limitations and proposed innovation opportunities for future research. Our findings will contribute to a better understanding of using GSM data in infectious diseases studies and provide insights into strategies for using GSM data more effectively in future research.
RESUMEN
BACKGROUND: The COVID-19 pandemic has posed unprecedented pressure to health care systems, and interrupted health care delivery and access including HIV care in the United States' Deep South, which endures a double epidemic of HIV and COVID-19. Ryan White programs cover HIV care services for over half of PLWH in the Deep South. Given the important role of Ryan White programs, examining the visitation changes to Ryan White facilities during the pandemic offers insights into the impact of the pandemic on HIV healthcare utilization. OBJECTIVES: Analyze the geographic distribution of HIV facility visitors at the county level before and during the pandemic in the nine US states of Deep South (Alabama, Florida, Georgia, Louisiana, Mississippi, North Carolina, South Carolina, Tennessee, Texas) to reveal the geographic and racial disparity in visitation disruption caused by the pandemic. METHODS: We first extracted mobile device-based visitation data for Ryan White HIV facilities in the Deep South during 2019 and 2020. To quantify the disruption in visitations during 2020, we calculated the visitation reduction rate (VRR) for each county, using 2019 data as the baseline. Next, we conducted a spatial analysis of the VRR values to uncover geographical disparities in visitation interruptions. To investigate racial disparities, we performed spatial regression analyses with VRR as the dependent variable, and the percentages of Black, Hispanic, and Asian populations as the independent variables. In this analysis, we controlled for potential confounders. RESULTS: Geographic disparities in visitation reduction were observed, with all nine Deep South states experiencing significant drops. Georgia experienced the highest visitation loss (VRR = -0.58), followed by Texas (-0.47), Alabama (0.47), and Tennessee (-0.46), while South Carolina had the smallest reductions (-0.11). All the regression models consistently revealed racial disparities in visitation interruption. That is, counties with a higher proportion of Black population tended to have higher RW facility visitation reductions. CONCLUSIONS: Our analysis revealed distinct geographic disparities in visitation interruptions at Ryan White HIV facilities in the Deep South during the COVID-19 pandemic in 2020. Furthermore, we found that the Black/African American population experienced a greater disruption at the county level in the Deep South during this period.