The uneven impact of Medicaid expansion on rural and urban Black, Latino/a, and White mortality.

PURPOSE: To determine the differential impact of Medicaid expansion on all-cause mortality between Black, Latino/a, and White populations in rural and urban areas, and assess how expansion impacted mortality disparities between these groups. METHODS: We employ a county-level time-varying heterogenous treatment effects difference-in-difference analysis of Medicaid expansion on all-cause age-adjusted mortality for those 64 years of age or younger from 2009 to 2019. For all counties within the 50 US States and the District of Columbia, we use restricted-access vital statistics data to estimate Average Treatment Effect on the Treated (ATET) for all combinations of racial and ethnic group (Black, Latino/a, White), rurality (rural, urban), and sex. We then assess aggregate ATET, as well as how the ATET changed as time from expansion increased. FINDINGS: Medicaid expansion led to a reduction in all-cause age-adjusted mortality for urban Black populations, but not rural Black populations. Urban White populations experienced mixed effects dependent on years after expansion. Latino/a populations saw no appreciable impact. While no effect was observed for rural Black and Latino/a populations, rural White all-cause age-adjusted mortality unexpectedly increased due to Medicaid expansion. These effects reduced rural- and urban-specific Black-White mortality disparities but did not shrink the rural-urban mortality gap. CONCLUSIONS: The mortality-reducing impact of Medicaid expansion has been uneven across racial and ethnic groups and rural-urban status; suggesting that many populations-particularly rural individuals-are not seeing the same benefits as others. It is imperative that states work to ensure Medicaid expansion is being appropriately implemented in rural areas.

Social and political correlates of adult and dependent-child COVID-19 vaccination behavior in rural America.

Objective: This paper describes the individual-level correlates of self and dependent-child COVID-19 vaccination behavior among adults in rural America. Methods: We draw on the data from a large-scale survey of rural Americans conducted in 2022, after most Americans had the opportunity to receive the vaccination easily and freely. The survey yielded an analytic sample of 841 adults and 530 adults with dependent children. We fit a series of linear probability models predicting vaccine refusal and full vaccination for adult respondents and vaccine refusal and full vaccine coverage among their dependent children. Predictors of interest include political party, social and economic conservatism, race and ethnicity, age, education, and workplace vaccine requirements. Results: We find political party, ideology, education, and work requirements were significant (p <.05) drivers of rural adults' vaccination behavior, and that the correlates of vaccine refusal and full vaccination largely mirrored one another among adults. For dependent children, few of our focal predictors are associated with vaccination. Politics played a lesser role in children's vaccination than for adults, and older parents were the least likely to refuse vaccines for their children. Race and ethnicity had inconsistent associations across outcomes and model specifications. Conclusion: This analysis presents important evidence on the drivers of COVID-19 vaccine behaviors among rural American households. Documentation of vaccination behaviors in settings when vaccines are widely available can isolate demand- from supply-side factors and thus inform future public health crises.

New structural insights provide a different angle on steroid sulfatase action.

A central part of human sulfation pathways is the spatially and temporally controlled desulfation of biologically highly potent steroid hormones. The responsible enzyme - steroid sulfatase (STS) - is highly expressed in placenta and peripheral tissues, such as fat, colon, and the brain. The shape of this enzyme and its mechanism are probably unique in biochemistry. STS was believed to be a transmembrane protein, spanning the Golgi double-membrane by stem region formed by two extended internal alpha-helices. New crystallographic data however challenge this view. STS now is portraited as a trimeric membrane-associated complex. We discuss the impact of these results on STS function and sulfation pathways in general and we hypothesis that this new STS structural understanding suggests product inhibition to be a regulator of STS enzymatic activity.

Structure and mechanics of water-holding feathers of Namaqua sandgrouse (Pterocles namaqua).

Desert sandgrouse, such as the Namaqua sandgrouse, nest up to 30 km away from watering holes. Adult male desert sandgrouse have specially adapted feathers on their bellies that hold water, even during flight, allowing the birds to transport water back to the chicks at the nest. The structure of the belly feathers and aspects of the mechanism by which they hold water was first described by Cade and Maclean (Cade, Maclean 1967 Condor 69, 323-343 (doi:10.2307/1366197)). Here, we use scanning electron microscopy and micro-computed tomography as well as videography to characterize the geometry of different components of the belly feathers and to show how differences in their bending stiffnesses contribute to the water-holding mechanism. The results of this study will be used in a companion paper to model computationally water uptake by the feather.

Informal modes of social support among residents of the rural American West during the COVID-19 pandemic.

During the first year of the COVID-19 pandemic, federal spending to government safety net programs in the U.S. increased dramatically. Despite this unparalleled spending, government safety nets were widely critiqued for failing to fully meet many households' needs. Disaster research suggests that informal modes of social support often emerge during times of disruption, such as the first year of the pandemic. However, use of formal government programs and informal support are rarely examined relative to each other, resulting in an incomplete picture of how households navigate disaster impacts and financial shocks. This study compares estimates of informal social support to formal government program use in the rural U.S. West, drawing on data from a rapid-response survey fielded during the summer of 2020 and the 2021 Annual Social and Economic Supplement of the Current Population Survey (CPS-ASEC). We find that informal social support systems were, on aggregate, used almost as extensively as long-standing government programs. Our findings highlight the critical role of person-to-person assistance, such as sharing financial resources, among rural households during a disruptive disaster period. Routine and standardized data collection on these informal support behaviors could improve future disaster research and policy responses, especially among rural populations.

Exposure of maize seeds to liquid nitrogen modifies the morphology and hormonal response of young plants.

BACKGROUND: Cryopreservation currently represents the most suitable strategy for the long-term conservation of plant germplasm. While much effort has focused on the development of protocols to enable successful cryostorage, there are few, if any reports, that consider the effect of cryogenic temperatures on the phytohormone status of the seed and developing seedlings. OBJECTIVE: To investigate the effect of cryopreservation on external seed coat features as well as levels of indole-3-acetic acid (IAA), abscisic acid (ABA) and 1-aminocyclopropane-1-carboxylic acid (ACC) in maize. MATERIALS AND METHODS: Two groups of seeds at 6% moisture content were compared: one was maintained at 4 degree C (control) while the other was exposed to LN within cryo-vials. RESULTS: Seeds exposed to cryogenic temperatures were characterized by the presence of large cracks in the seed coat compared with control seeds. Cryogenic exposure also resulted in a reduction in biomass and plant height. Results from the phytohormone analysis showed an initial reduction in the levels of IAA, ABA and ACC after 7 days of growth followed by sharp increase in levels relative to the control by 14 days. Whilst the roles of ABA and ethylene (and by extension, its precursor ACC) are well studied as stress response molecules, much less is known about the potentially vital role of auxins in regulating plant growth under conditions of low temperature stress. CONCLUSION: It is postulated that the interaction of all three hormones modulate crosstalk between various stress responses and recovery pathways to ameliorate the damage caused by freezing stress and enable plant survival. Given the dearth of information on phytohormones in cryobiology, more studies are needed to fully elucidate these relationships in the context of freezing stress caused by liquid nitrogen. Doi.org/10.54680/fr23610110612.

Serum concentration trends and apparent half-lives of per- and polyfluoroalkyl substances (PFAS) in Australian firefighters.

BACKGROUND: Per- and polyfluoroalkyl substances (PFASs) are persistent manmade compounds used in aqueous film forming foam (AFFF). The extensive use of AFFF has led to widespread environmental PFAS contamination and exposures of firefighters. OBJECTIVES: To determine PFAS blood serum concentration trends and apparent serum half-lives in firefighters after the replacement of AFFF. METHODS: Current and former employees of an Australian corporation providing firefighting services, where AFFF formulations had been used since the 1980s up until 2010, were recruited in 2018-2019 to participate in this study. Special focus was put on re-recruiting participants who had provided blood samples five years prior (2013-2014). Participants were asked to provide a blood sample and fill in a questionnaire. Serum samples were analysed for 40 different PFASs using HP LC-MS/MS. RESULTS: A total of 799 participants provided blood samples in 2018-2019. Of these, 130 previously provided blood serum in 2013-2014. In 2018-2019, mean (arithmetic) serum concentrations of perfluorooctane sulfonate (PFOS, 27 ng/mL), perfluoroheptane sulfonate (PFHpS, 1.7 ng/mL) and perfluorohexane sulfonate (PFHxS, 14 ng/mL) were higher than the levels in the general Australian population. Serum concentrations were associated with the use of PFOS/PFHxS based AFFF. Participants who commenced service after the replacement of this foam had serum concentrations similar to those in the general population. Mean (arithmetic) individual apparent half-lives were estimated to be 5.0 years (perfluorooctanoic acid (PFOA)), 7.8 years (PFHxS), 7.4 years (PFHpS) and 6.5 years (PFOS). CONCLUSION: This study shows how workplace interventions such as replacement of AFFF can benefit employees at risk of occupational exposure.

Design and calibration of a Tonpilz transducer for low frequency medical ultrasound tomography.

The design and performance of a transducer for low frequency ultrasound tomography is presented, motivated by recent research demonstrating that acoustic waves transmitting at frequencies between 10 kHz and 750 kHz penetrate the lungs and may be useful for thoracic imaging. An adaptation of the traditional Tonpilz design was developed, vibrational amplitude and electrical impedance were measured, and an optimal frequency was determined. The design is found to meet the desired mechanical, electrical, and safety specifications. Thus, it was considered a promising option for the target application of pulmonary imaging with ultrasound computed tomography between 50 and 200 kHz; highest efficiency achieved around 125 kHz and 156 kHz, and beam divergence of 40°.

Cost of Living Variation, Nonmetropolitan America, and Implications for the Supplemental Poverty Measure.

Poverty scholarship in the United States is increasingly reliant upon the Supplemental Poverty Measure (SPM) as opposed to the Official Poverty Measure of the United States for research and policy analysis. However, the SPM still faces several critiques from scholars focused on poverty in nonmetropolitan areas. Key among these critiques is the geographic adjustment for cost of living employed in the SPM, which is based solely upon median rental costs and pools together all nonmetropolitan counties within each state. Here, we evaluate the current geographic adjustment of the SPM using both microdata and aggregate data from the American Community Survey for 2014-2018. By comparing housing costs, tenure, and commuting, we determine that median rent is likely an appropriate basis for geographic adjustment. However, by demonstrating the wide variability between median rents of nonmetropolitan counties within the same state, we show that the current operationalization of this geographic adjustment could be improved through the use of more-specific categories such as metropolitan adjacency or Rural Urban Continuum Codes.

Temporal trends of perfluoroalkyl substances in an Australian wastewater treatment plant: A ten-year retrospective investigation.

Per- and poly-fluoroalkyl substances (PFAS) are a problematic group of chemicals used in various industrial and household products. They have been extensively detected in wastewater as a result of day-to-day product usage. Due to concerns about their safety, voluntary and regulatory action to limit the manufacture and use of some individual PFAS has occurred since the year 2000. The impact that this intervention has had on the use and potential exposure of Australians has not been measured. Wastewater serves as a powerful tool to assess the chemical use or consumption patterns of a population over time. We accessed a ten-year wastewater archiving program to conduct a temporal analysis of PFAS trends in an urban Australian population between the years 2010 and 2020. Results showed a decline in the concentrations for most PFAS, and a change in the PFAS profile from perfluorosulfonic acids and long-chain perfluorocarboxylic acids, to the short-chain perfluorocarboxylic acids and PFOS-replacement degradation products such as 5:3 FTCA. Intermittent pulses of PFAS that were significantly higher than 'background' levels (i.e., representing the PFAS input from primarily households) were observed, suggesting continuing industrial PFAS input within the wastewater catchment. This study highlights the long-term consequences of the diffuse use of persistent chemicals in products, and their ability to continue to enter the wastewater stream for decades.

Elevated serious psychological distress, economic disruption, and the COVID-19 pandemic in the nonmetropolitan American West.

In this study we examined the psychological distress, self-rated health, COVID-19 exposure, and economic disruption of a sample of the nonmetropolitan western U.S. population and labor force one year after the start of the COVID-19 pandemic. Using novel primary survey data from non-metropolitan counties in the eleven contiguous western United States collected from February 28 until April 3, 2021 (n = 1203), we descriptively analyzed variables and estimated binomial and multinomial logit models of the association between economic disruption, COVID-19 exposure, self-rated health, and psychological distress. Results showed there was widespread presence of psychological distress, COVID-19 exposure, and economic disruption among the overall sample and members of the labor force. There was extremely high incidence of serious psychological distress (14.8% CI [12.1,17.8] of the weighted sample), which was heightened among the labor force (16.6%, CI [13.0,20.9] of those in the labor force). We found economic disruption was associated with severe psychological distress, but exposure to infection was not. Comparatively, overall self-rated health was at similar levels as prior research and was not significantly associated with economic disruption or COVID-19 exposure. COVID-19, particularly its associated economic effects, had a significant relationship with serious psychological distress in this sample of adults in the nonmetropolitan western United States.

The 2020 US Census Differential Privacy Method Introduces Disproportionate Discrepancies for Rural and Non-White Populations.

The recently finalized changes to the disclosure avoidance policies of the U.S. Census Bureau for the 2020 census, grounded in differential privacy, have faced increasing criticism from demographers and other social scientists. Scholars have found that estimates generated via Census-released test data are accurate for aggregate total population statistics of larger spatial units (e.g. counties), but introduce considerable discrepancies for estimates of subgroups. At present, the ramifications of this new approach remain unclear for rural populations. In this brief, we focus on rural populations and evaluate the ability of the finalized differential privacy algorithm to provide accurate population counts and growth rates from 2000 to 2010 across the rural-urban continuum for the total, non-Hispanic white, non-Hispanic Black, Hispanic or Latino/a, and non-Hispanic American Indian population. We find the method introduces significant discrepancies relative to the prior approach into counts and growth rate estimates at the county level for all groups except the total and non-Hispanic white population. Further, discrepancies increase dramatically as we move from urban to rural. Thus, the differential privacy method likely introduced significant discrepancies for rural and non-white populations into 2020 census tabulations.

The Poverty Balancing Equation: Expressing Poverty of Place as a Population Process.

The accurate measurement of poverty is essential for the development of effective poverty policy. Unfortunately, approaches that use poverty rates to assess the causes and consequences of poverty do not fully capture the components of change in the poverty population because changes in the conventional poverty rate can occur owing to processes of natural increase, migration, or transitions in and out of poverty. This article presents an accounting framework for changes in poverty within and between places. The framework, termed the poverty balancing equation, generates a series of summary statistics that can be used in place of the conventional poverty rate in future research. The approach is demonstrated using the 2014 panel of the Survey of Income and Program Participation to generate state-level estimates of the poverty components of change for three states in the American South between January and December of 2013. Results show that even when poverty rates remain constant, there is significant dynamism within poor and nonpoor populations. By applying this approach, either completely or in part, researchers can provide more specific and actionable evidence for poverty alleviation policy.

The widespread and unjust drinking water and clean water crisis in the United States.

Many households in the United States face issues of incomplete plumbing and poor water quality. Prior scholarship on this issue has focused on one dimension of water hardship at a time, leaving the full picture incomplete. Here we complete this picture by documenting the full scope of water hardship in the United States and find evidence of a regionally-clustered, socially unequal nationwide household water crisis. Using data from the American Community Survey and the Environmental Protection Agency, we show there are 489,836 households lacking complete plumbing, 1,165 community water systems in Safe Drinking Water Act Serious Violation, and 21,035 Clean Water Act permittees in Significant Noncompliance. Further, we demonstrate this crisis is regionally clustered, with the specific spatial pattern varying by the specific form of water hardship. Elevated levels of water hardship are associated with the social dimensions of rurality, poverty, indigeneity, education, and age-representing a nationwide environmental injustice.

Converting multi-trait breeding objectives into operative selection indexes to ensure genetic gains in low-input sheep and goat breeding programmes.

Small ruminant breeding programmes in low-input production systems are best organised at the community level. Participant farmers have to agree on goal traits and their relative importance. When BLUP breeding values of goal traits are not available in time, appropriate selection indexes can be used to aid visual selection. Taking Ethiopian Abergelle goat and Bonga sheep community-based breeding programmes (CBBPs) as an example, breeding objective functions were defined and selection indexes were constructed and evaluated. Breeding goals for Abergelle goats included early sale weight, survival and milk production. Breeding goals for Bonga included the number of offspring born, sale weight and survival. Economic weights of objective traits can be used in several ways depending on measured traits and the reliability of their genetic parameters. Selection indexes included combinations of objective traits measured on candidates and their dams and situations when Abergelle communities prefer to restrict genetic changes in number of offspring born or adult weight and when Bonga communities prefer to restrict changes in adult weight. Genetic and economic gains were evaluated as well as sensitivity to feed cost assumptions and to repeated dam records. After independent culling on preponderant traits such as coat colour and horn/tail type, sires in Abergelle goat community breeding programmes should be selected on indexes including at least own early live weight and their dams average milk production records. Sires for Bonga sheep programmes should be selected on own early live weight and desirably also on their dam's number of offspring born. Sensitivity to feed cost assumptions was negligible but repeated measurements of dam records improved index accuracies considerably. Restricting genetic changes in number of offspring born or adult weight is not recommended.

Tuberculosis and COVID-19 interaction: A review of biological, clinical and public health effects.

Evidence is accumulating on the interaction between tuberculosis (TB) and COVID-19. The aim of the present review is to report the available evidence on the interaction between these two infections. Differences and similarities of TB and COVID-19, their immunological features, diagnostics, epidemiological and clinical characteristics and public health implications are discussed. The key published documents and guidelines on the topic have been reviewed. Based on the immunological mechanism involved, a shared dysregulation of immune responses in COVID-19 and TB has been found, suggesting a dual risk posed by co-infection worsening COVID-19 severity and favouring TB disease progression. The available evidence on clinical aspects suggests that COVID-19 happens regardless of TB occurrence either before, during or after an active TB diagnosis. More evidence is required to determine if COVID-19 may reactivate or worsen active TB disease. The role of sequeale and the need for further rehabilitation must be further studied Similarly, the potential role of drugs prescribed during the initial phase to treat COVID-19 and their interaction with anti-TB drugs require caution. Regarding risk of morbidity and mortality, several risk scores for COVID-19 and independent risk factors for TB have been identified: including, among others, age, poverty, malnutrition and co-morbidities (HIV co-infection, diabetes, etc.). Additional evidence is expected to be provided by the ongoing global TB/COVID-19 study.

Development of a LC-MS/MS method to measure serum 3-sulfate and 3-glucuronide 25-hydroxyvitamin D3 metabolites; comparisons to unconjugated 25OHD in pregnancy and polycystic ovary syndrome.

Vitamin D status is routinely assessed by measuring circulating concentrations of 25-hydroxyvitamin D (25OHD2 or 25OHD3). However as deconjugation is not routinely incorporated into sample treatment prior to analysis, conjugated forms of 25OHD (particularly the more abundant 25OHD3) are often not considered in determining serum concentrations of total 25OHD. Two major circulating conjugated forms of 25OHD3 are 25-hydroxyvitamin D3-3-sulfate (25OHD3-S) and 25-hydroxyvitamin D3-3-glucuronide (25OHD3-G). Incorporating these two conjugated metabolites into the measurement of vitamin D status could improve our understanding of vitamin D status in health, particularly if there are changes in sulfation and glucuronidation activities. The aim of this study was to develop a liquid chromatography tandem-mass spectrometry (LC-MS/MS) targeted method for measurement of 25OHD3-S and 25OHD3-G in serum to enable comparisons with circulating levels of the free 25OHD3 form. We developed and validated a new LC-MS/MS method that measured both 25OHD3-S and 25OHD3-G following a solid phase extraction sample preparation method. Partial separation of analytes by LC, and the separation of analytes by the optimized multiple reaction monitoring transitions enabled the quantitation of both 25OHD3-S and 25OHD3-G in the single method. Serum concentrations of 25OHD3-S (24.7 ± 11.8 ng/mL) and 25OHD3-G (2.4 ± 1.2 ng/mL) were shown to be a significant proportion of circulating vitamin D metabolites in healthy donor serums. These levels of 25OHD3-S and 25OHD3-G closely associated with 25OHD3 concentrations, r = 0.728, p = 0.001 and r = 0.632, p = 0.006 respectively. However in serum from pregnant women and non-pregnant women with polycystic ovary syndrome (PCOS) significant differences in the ratios between conjugated and free 25OHD3 were observed between pregnancy groups (25OHD3/25OHD3-S and 25OHD3/25OHD3-G p < 0.001), and between healthy and PCOS subjects (25OHD3/25OHD3-G p < 0.050). Development of this novel high-throughput LC-MS/MS method indicates that 25OHD3-S and 25OHD3-G are substantial components of circulating vitamin D metabolites. The concentrations of these metabolites relative to conventional 25OHD3 may vary in different physiological and pathophysiological settings, and may therefore play an unrecognized but important role in the actions of vitamin D.