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1.
Child Maltreat ; 29(1): 176-189, 2024 02.
Artigo em Inglês | MEDLINE | ID: mdl-35678142

RESUMO

This observational ecological study examined county-level associations between evidence-based home visiting (EHV) provisions and child maltreatment report (CMR) rates, using national county-level data from 2016-2018. We found that longitudinal changes of EHV provisions were significantly negatively associated with county CMR rates while controlling for potential confounders. Our model estimated that after EHV provisions were launched in counties, their CMR rates decreased (or after they were ceased, rates increased) by 2.21 per 1000 children overall, 2.88 per 1000 children aged 0-5, 2.59 per 1000 children aged 6-11, 2.13 per 1000 male children, and 2.24 per 1000 female children. When limiting attention to EHV provisions funded by the Maternal, Infant and Early Childhood Home Visiting (MIECHV) program, we found no significant association perhaps because MIECHV-funded EHV provisions were a small subset of all EHV provisions. These findings propose potential protective impacts of county EHV provisions on overall county CMR rates. Yet, the small effect sizes suggest that EHV provisions should be considered as a part of a complete response to child maltreatment rather than in isolation. Given that EHV is provided to a very small part of the population, nevertheless, our findings suggest that expanding coverage would increase effect sizes.


Assuntos
Maus-Tratos Infantis , Lactente , Criança , Humanos , Pré-Escolar , Masculino , Feminino , Maus-Tratos Infantis/prevenção & controle , Visita Domiciliar , Família
2.
Child Youth Serv Rev ; 1562024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-38031557

RESUMO

This study includes a scoping review of prior studies investigating the effects of policy changes on child poverty rates. It further conducts an empirical analysis to estimate the relationship between child poverty rates and child maltreatment report (CMR) rates, utilizing national county-level data. The study then calculates the indirect effects of policy changes on CMR rates, mediated through child poverty rates, by integrating information from previous studies with its own empirical findings. Among the policy changes explored in prior studies, those related to a child allowance and a fully refundable Child Tax Credit demonstrate the largest indirect effects but also the highest costs. The expansion of in-kinds and near-cash benefits, such as the Supplemental Nutrition Assistance Program benefits and housing vouchers, shows moderate effects with moderate costs. Tax credits like the Earned Income Tax Credit exhibit lower effects and costs when targeted at the lowest earners, and moderate effects and costs for broader expansion. Focused tax credits, such as the Child and Dependent Care Tax Credit, had lower effects and costs, even if made fully refundable. Despite certain limitations, the study's approach yields consistent estimates with a recent simulation study, indicating its potential validity. While some proposed policy changes may seem expensive, implementing them is anticipated to substantially reduce CMR rates, with the benefits outweighing the associated costs. Overall, the findings suggest that addressing child poverty to reduce CMRs is an attractive strategy with numerous potential benefits.

3.
Bioengineering (Basel) ; 10(11)2023 Nov 02.
Artigo em Inglês | MEDLINE | ID: mdl-38002403

RESUMO

We propose a novel transfer learning framework for pathological image analysis, the Response-based Cross-task Knowledge Distillation (RCKD), which improves the performance of the model by pretraining it on a large unlabeled dataset guided by a high-performance teacher model. RCKD first pretrains a student model to predict the nuclei segmentation results of the teacher model for unlabeled pathological images, and then fine-tunes the pretrained model for the downstream tasks, such as organ cancer sub-type classification and cancer region segmentation, using relatively small target datasets. Unlike conventional knowledge distillation, RCKD does not require that the target tasks of the teacher and student models be the same. Moreover, unlike conventional transfer learning, RCKD can transfer knowledge between models with different architectures. In addition, we propose a lightweight architecture, the Convolutional neural network with Spatial Attention by Transformers (CSAT), for processing high-resolution pathological images with limited memory and computation. CSAT exhibited a top-1 accuracy of 78.6% on ImageNet with only 3M parameters and 1.08 G multiply-accumulate (MAC) operations. When pretrained by RCKD, CSAT exhibited average classification and segmentation accuracies of 94.2% and 0.673 mIoU on six pathological image datasets, which is 4% and 0.043 mIoU higher than EfficientNet-B0, and 7.4% and 0.006 mIoU higher than ConvNextV2-Atto pretrained on ImageNet, respectively.

4.
Metabolites ; 13(11)2023 Nov 18.
Artigo em Inglês | MEDLINE | ID: mdl-37999255

RESUMO

Atherosclerosis (AS) is a metabolic disorder and the pre-stage of several cardiovascular diseases, including myocardial infarction, stroke, and angina pectoris. Early detection of AS can provide the opportunity for effective management and better clinical results, along with the prevention of further progression of the disease. In the current study, an untargeted and targeted metabolomic approach was used to identify possible metabolic signatures that have altered levels in AS patients. A total of 200 serum samples from individuals with AS and normal were analyzed via liquid chromatography-high-resolution mass spectrometry. Univariate and multivariate analysis approaches were used to identify differential metabolites. A group of metabolites associated with bile acids, amino acids, steroid hormones, and purine metabolism were identified that are capable of distinguishing AS-risk sera from normal. Further, the targeted metabolomics approach confirmed that six metabolites, namely taurocholic acid, cholic acid, cortisol, hypoxanthine, trimethylamine N-oxide (TMAO), and isoleucine, were found to be significantly upregulated, while the concentrations of glycoursodeoxycholic acid, glycocholic acid, testosterone, leucine, methionine, phenylalanine, tyrosine, and valine were found to be significantly downregulated in the AS-risk sera. The receiver operating characteristic curves of three metabolites, including cortisol, hypoxanthine, and isoleucine, showed high sensitivity and specificity. Taken together, these findings suggest cortisol, hypoxanthine, and isoleucine as novel biomarkers for the early and non-invasive detection of AS. Thus, this study provides new insights for further investigations into the prevention and management of AS.

5.
Arch Virol ; 168(11): 267, 2023 Oct 06.
Artigo em Inglês | MEDLINE | ID: mdl-37801138

RESUMO

Genotype 4 (G4) Eurasian avian-like lineage swine H1N1 influenza A viruses, which are reassortants containing sequences from the pandemic 2009 H1N1 virus lineage, triple-reassortant-lineage internal genes, and EA-lineage external genes, have been reported in China since 2013. These have been predominant in pig populations since 2016 and have exhibited pandemic potential. In this study, we developed a one-step multiplex RT-qPCR assay targeting the M, HA1, and PB2 genes to detect G4 and related EA H1N1 viruses, with detection limits of 1.5 × 101 copies/µL and 1.15 × 10-2 ng/µL for the purified PCR products and RNA templates, respectively. The specificity of the detection method was confirmed using various influenza virus subtypes. When the one-step multiplex RT-qPCR assay was applied to swine respiratory samples collected between 2020 and 2022 in Korea, a virus related to G4 EA H1N1 strains was detected. Phylogenetic analysis based on portions of all eight genome segments showed that the positive sample contained HA, NA, PB2, NS, and NP genes closely related to those of G4 EA H1N1 viruses, confirming the ability of our assay to accurately detect G4 EA H1N1 viruses in the field.


Assuntos
Vírus da Influenza A Subtipo H1N1 , Vírus da Influenza A , Infecções por Orthomyxoviridae , Doenças dos Suínos , Suínos , Animais , Vírus da Influenza A Subtipo H1N1/genética , Infecções por Orthomyxoviridae/epidemiologia , Infecções por Orthomyxoviridae/veterinária , Filogenia , Fazendas , Vírus Reordenados/genética , Aves , Genótipo , República da Coreia/epidemiologia , Doenças dos Suínos/epidemiologia
7.
Am J Orthopsychiatry ; 93(6): 532-542, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37561475

RESUMO

Child neglect is a multidimensional concept encompassing various forms. Prior studies suggest that risk factors differ by neglect subtypes such as physical or supervisory neglect, but few studies address how risk factors vary between other neglect subtypes. This study aimed to examine how risk factors were related to neglect subtypes such as physical neglect, lack of supervision, exposure to domestic violence, substance-abusing parent, and mixed neglect. This study used secondary data from a nationally representative sample of children (National Survey of Child and Adolescent Well-Being-II, N = 5,872), and 786 children with a first-time child protective services investigation for neglect allegations alone were selected. Multinomial logistic regression analysis was used to explore how individual, family, and community risk factors may be associated with specific neglect subtypes. Five risk factors were able to discriminate between subtypes of neglect. For example, being a young child is associated with a greater risk of experiencing multiple forms of neglect. Caregiver's mental health problem is associated with a higher likelihood of being referred for multiple forms of neglect, particularly as compared with the risk of being referred for lack of supervision. Having poor social support is associated with a higher risk of physical neglect, and caregiver high stress is related to a higher risk of domestic violence. While most intervention programs target risk factors for overall child neglect, not specific neglect subtypes cases, our findings suggest that the intervention approach based on an understanding of the heterogeneity in risk factors between neglect subtypes is advisable. (PsycInfo Database Record (c) 2023 APA, all rights reserved).


Assuntos
Maus-Tratos Infantis , Violência Doméstica , Transtornos Relacionados ao Uso de Substâncias , Adolescente , Criança , Humanos , Maus-Tratos Infantis/psicologia , Proteção da Criança , Fatores de Risco , Transtornos Relacionados ao Uso de Substâncias/psicologia
8.
Child Abuse Negl ; 143: 106333, 2023 09.
Artigo em Inglês | MEDLINE | ID: mdl-37379728

RESUMO

BACKGROUND: Poverty is among the most powerful predictors of child maltreatment risk and reporting. To date, however, there have been no studies assessing the stability of this relationship over time. OBJECTIVE: To examine whether the county-level relationship between child poverty rates and child maltreatment report (CMR) rates changed over time in the United States in 2009-2018, overall and across of child age, sex, race/ethnicity, and maltreatment type. PARTICIPANTS AND SETTING: U.S. Counties in 2009-2018. METHODS: Linear multilevel models estimated this relationship and its longitudinal change, while controlling for potential confounding variables. RESULTS: We found that the county-level relationship between child poverty rates and CMR rates had intensified almost linearly from 2009 to 2018. Per one-percentage-point increase in child poverty rates, CMR rates significantly increased by 1.26 per 1000 children in 2009 and by 1.74 per 1000 children in 2018, indicating an almost 40 % increase in the poverty-CMR relationship. This increasing trend was also found within all subgroups of child age and sex. This trend was found among White and Black children, but not among Latino children. This trend was strong among neglect reports, weaker among physical abuse reports, and not found among sexual abuse reports. CONCLUSIONS: Our findings highlight the continued, perhaps increasing importance of poverty as a predictor of CMR. To the degree that our findings can be replicated, they could be interpreted as supporting an increased emphasis on reducing child maltreatment incidents and reports through poverty amelioration efforts and the provision of material family supports.


Assuntos
Maus-Tratos Infantis , Revelação , Notificação de Abuso , Pobreza , Determinantes Sociais da Saúde , Criança , Humanos , Maus-Tratos Infantis/estatística & dados numéricos , Maus-Tratos Infantis/tendências , Etnicidade , Hispânico ou Latino/estatística & dados numéricos , Abuso Físico/estatística & dados numéricos , Abuso Físico/tendências , Pobreza/estatística & dados numéricos , Pobreza/tendências , Estados Unidos/epidemiologia , Determinantes Sociais da Saúde/estatística & dados numéricos , Determinantes Sociais da Saúde/tendências , Revelação/estatística & dados numéricos , Revelação/tendências , Negro ou Afro-Americano/estatística & dados numéricos , Brancos/estatística & dados numéricos
9.
J Interpers Violence ; 38(17-18): 10309-10332, 2023 09.
Artigo em Inglês | MEDLINE | ID: mdl-37148250

RESUMO

U.S. Latino and foreign-born populations show lower child maltreatment report (CMR) rates despite their low socioeconomic positions, perhaps due to protective cultural factors within these populations. However, discriminatory Immigration and Customs Enforcement (ICE) activities may attenuate such protection. We examined how ethnic and foreign-born compositions and local ICE activities were associated with community CMR rates, overall and within racial/ethnic groups (i.e., White, Black, Latino), and how these associations changed over time. We used national county-level data linking multiple administrative/archival data sources (i.e., CMR, Census, and ICE data) longitudinally for 2015 to 2018 across the United States. Multilevel (county-years, counties, and states) models estimated how percentages of Latino, percentages of foreign-born, and ICE arrest rates were related to overall and race/ethnicity-specific CMR rates among counties while adjusting for a range of demographic, socioeconomic, child care burden, health insurance, residential mobility, and urbanicity factors. Higher percentages of foreign-born residents within counties were significantly associated with lower CMR rates, both overall and within all racial/ethnic groups. These protective associations became significantly stronger over the study period. Higher percentages of Latino residents were significantly associated with lower total and White CMR rates but not with Black or Latino CMR rates. The interaction between the percentage of Latino residents and year was not significant. ICE arrest rates showed no significant associations with CMR rates. Our findings suggest that communities with more foreign-born and Latino residents may be more protective against CMRs. While the foreign-born and Latino concentrations were both independently predictive of decreased CMR rates, the protective associations of the foreign-born concentration were more consistent within racial/ethnic groups and grew stronger over time. These findings suggest the need to investigate community-level protective mechanisms that may explain these results. The null findings for ICE activity also require further research with alternative measures of discriminatory state action.


Assuntos
Maus-Tratos Infantis , Emigração e Imigração , Humanos , Estados Unidos , Criança , Hispânico ou Latino , Etnicidade , Grupos Raciais
10.
Am J Orthopsychiatry ; 93(5): 375-388, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37184964

RESUMO

This article examines whether county opioid prescription rates were associated with county child maltreatment report (CMR) rates in the United States and whether this relationship changed over time. We linked multiple national data sets to assemble retail opioid prescription data, CMR data, rural-urban codes (to control for urbanicity), and census data (to control for other community characteristics, such as poverty rates) covering 2009-2018. Multilevel linear modeling analyzed the linked data. We found that the strength of the county-level relationship between opioid prescription rates and CMR rates increased almost linearly during the study period. The relationship was not significant in 2009-2011; it became significant in 2012 and grew stronger in the next 6 years. In 2012, there was one more CMR per 1,000 children in a county for every 14.3 more opioid prescriptions per 100 people. In 2018, the number of prescriptions related to this effect was 3.6. In other words, the county-level relationship between opioid prescriptions and CMRs was four times as strong in 2018 as it had been in 2012. This trend was also observed within all subgroups of child age and sex. By type, this trend was somewhat more pronounced for neglect, but somewhat less for sexual abuse. Our findings suggest a growing need for greater efforts to prevent child maltreatment in communities with high opioid prescription rates. Further research is warranted to reveal the underlying factors for this concerning trend. (PsycInfo Database Record (c) 2023 APA, all rights reserved).


Assuntos
Analgésicos Opioides , Maus-Tratos Infantis , Criança , Humanos , Estados Unidos/epidemiologia , Analgésicos Opioides/uso terapêutico , Prescrições , Pobreza
11.
Sci Rep ; 13(1): 8323, 2023 05 23.
Artigo em Inglês | MEDLINE | ID: mdl-37221276

RESUMO

The association between ulcerative colitis (UC) and uterine cervical cancer is still unclear. To investigate cervical cancer risk in South Korean women with UC, we analyzed the Korean National Health Insurance claims data. UC was defined using both ICD-10 codes and UC-specific prescriptions. We analyzed incident cases of UC diagnosed between 2006 and 2015. Age-matched women without UC (control group) were randomly selected from the general population (1:3 ratio). Hazard ratios were calculated using multivariate Cox proportional hazard regression, and the event was defined as occurrence of cervical cancer. A total of 12,632 women with UC and 36,797 women without UC were enrolled. The incidence of cervical cancer was 38.8 per 100,000 women per year in UC patients and 25.7 per 100,000 women per year in controls, respectively. The adjusted HR for cervical cancer was 1.56 (95% CI 0.97-2.50) in the UC group with reference to the control group. When stratified by age, the adjusted HR for cervical cancer was 3.65 (95% CI 1.54-8.66) in elderly UC patients (≥ 60 years) compared to elderly control group (≥ 60 years). Within UC patients, increased age (≥ 40 years) and low socioeconomic status were associated with an increased risk of cervical cancer. The incidence of cervical cancer was found to be higher among elderly patients (≥ 60 years) with newly diagnosed UC in South Korea, compared to age-matched controls. Therefore, regular cervical cancer screening is recommended for elderly patients who have recently been diagnosed with UC.


Assuntos
Colite Ulcerativa , Neoplasias do Colo do Útero , Idoso , Humanos , Feminino , Pessoa de Meia-Idade , Adulto , Detecção Precoce de Câncer , República da Coreia , Povo Asiático
12.
J Clin Med ; 12(8)2023 Apr 13.
Artigo em Inglês | MEDLINE | ID: mdl-37109180

RESUMO

BACKGROUND: Few studies have investigated the risk of gastric cancer (GC) in ulcerative colitis (UC), and the results have been inconsistent. This study aimed to assess the risk of gastric cancer in newly diagnosed UC patients. METHODS: Based on claims data from Korean National Health Insurance from January 2006 to December 2015, we identified 30,546 patients with UC and randomly selected 88,829 non-UC individuals as controls, who were matched by age and sex. Multivariate Cox proportional hazards regression was used to calculate adjusted hazard ratios (HRs) for gastric cancer events, with covariates taken into account. RESULTS: During the study period, a total of 77 (0.25%) patients with UC and 383 (0.43%) non-UC individuals were diagnosed with GC. After multivariable adjustment, the HR for GC was 0.60 (95% CI: 0.47-0.77) in patients with UC, using non-UC individuals as the reference group. When stratified by age, the adjusted HRs for GC in UC patients were 0.19 (95% CI: 0.04-0.98) for those aged 20-39 years at the time of UC diagnosis, 0.65 (95% CI: 0.45-0.94) for 40-59, and 0.60 (95% CI: 0.49-0.80) for ≥60 as compared to non-UC individuals in the corresponding age groups. When stratified by sex, the adjusted HR for GC was 0.54 (95% CI: 0.41-0.73) in male UC patients of all ages. Within UC patients, a multivariable analysis revealed that the HR for GC was 12.34 (95% CI: 2.23-68.16) for those aged ≥ 60 years at the time of diagnosis of UC. CONCLUSIONS: Patients with UC had a decreased GC risk compared with non-UC individuals in South Korea. Within the UC population, advancing age (≥60 years) was identified as a significant risk factor for GC.

13.
Child Maltreat ; 28(4): 683-699, 2023 11.
Artigo em Inglês | MEDLINE | ID: mdl-36990447

RESUMO

We used National Child Abuse and Neglect Data System and Census data to examine Black-White and Hispanic-White disparities in reporting, substantiation, and out-of-home placement both descriptively from 2005-2019 and in multivariate models from 2007-2017. We also tracked contemporaneous social risk (e.g., child poverty) and child harm (e.g., infant mortality) disparities using non-child protective services (CPS) sources and compared them to CPS reporting rate disparities. Black-White CPS reporting disparities were lower than found in non-CPS risk and harm benchmarks. Consistent with the Hispanic paradox, Hispanic-White CPS reporting disparities were lower than risk disparities but similar to harm disparities. Descriptive and multivariate analyses of data from the past several years indicated that Black children were less likely to be substantiated or placed into out-of-home care following a report than White children. Hispanic children were slightly more likely to be substantiated or placed in out-of-home care than White children overall, but this difference disappeared in multivariate models. Available data provide no evidence that Black children were overreported relative to observed risks and harms reflected in non-CPS data. Reducing reporting rates among Black children will require addressing broader conditions associated with maltreatment.


Assuntos
Maus-Tratos Infantis , Serviços de Proteção Infantil , Criança , Humanos , Lactente , População Negra , Hispânico ou Latino , Brancos
14.
J Interpers Violence ; 38(1-2): NP262-NP287, 2023 01.
Artigo em Inglês | MEDLINE | ID: mdl-35337217

RESUMO

Current literature suggests that food insecurity increases child maltreatment risk. Yet, existing evidence is limited to individual-level associations among low-income, high-risk populations based on local, mostly urban data. This study aims to generalize prior findings to community-level associations in general populations, using national data including all urban-rural areas. We examined, for the first time, if food insecurity rates increase child maltreatment report (CMR) rates at the county level after controlling for potential confounders. We examined both within-community longitudinal changes (i.e., within-effects) and inter-community differences (i.e., between-effects) of food insecurity rates and their associations with CMR rates. We also examined differences by age, sex, race/ethnicity, maltreatment type, and urbanicity. We constructed longitudinal county-level data by linking multiple national databases, including all substantiated and unsubstantiated CMR records, the Map the Meal Gap's community food insecurity estimates, and Census data. The data covered over 96% of U.S. counties from 2009 to 2018. For analysis, we used within-between random effects models. Regarding between-effects, we found that in inter-community comparisons, higher food insecurity rates were significantly associated with increased CMR rates. This association was consistent by age, sex, maltreatment type, and urbanicity. For within-effects, we found that the association between longitudinal changes of food insecurity rates and CMR rates significantly differed by urbanicity. Specifically, longitudinal increases of food insecurity rates significantly increased CMR rates among large urban counties, but not among small urban and rural counties. Study findings highlight the importance of conducting further research to better understand the mechanisms through which food insecurity impact child maltreatment at both individual and community levels. Our community-level findings from general populations especially have significant implications for community-based programs and large-scale policies to achieve population-level impact on child well-being.


Assuntos
Maus-Tratos Infantis , Criança , Humanos , Insegurança Alimentar , Pobreza , Notificação de Abuso , População Rural
15.
Child Maltreat ; 28(4): 589-598, 2023 11.
Artigo em Inglês | MEDLINE | ID: mdl-36171183

RESUMO

The past several years have seen calls from QuantCrit scholars to "disaggregate" samples into same-race groups. To date, however, there has been no attempt to empirically evaluate the benefits of disaggregation within a child welfare sample. Using a child maltreatment dataset derived from the National Child Abuse and Neglect Data System and Census data, we empirically evaluate the utility of employing sample disaggregation (in which separate records are created for White, Black and Latino populations in each county) as well as variable creation disaggregation (in which we avoid using "full county" economic measures, but instead employ "same race/ethnicity" measures). Using model fit and convergence with findings from individual-level studies as evaluation metrics, we find that both kinds of disaggregation are demonstrably beneficial. We recommend that sample and variable disaggregation be considered by any future researchers using national geographically structured child maltreatment data.


Assuntos
Maus-Tratos Infantis , Etnicidade , Criança , Humanos , Proteção da Criança , Hispânico ou Latino , Brancos , Negro ou Afro-Americano
16.
Child Abuse Negl ; 134: 105884, 2022 12.
Artigo em Inglês | MEDLINE | ID: mdl-36126420

RESUMO

BACKGROUND: Research is sparse on the community-level impacts of home visiting programs on child maltreatment. OBJECTIVE: To examine community-level associations between state-funded home visiting programs (i.e., IDHS-HV), federal-funded home visiting programs (i.e., MIECHV), and child maltreatment report (CMR) rates, overall and within subgroups of age, sex, and maltreatment type. PARTICIPANTS AND SETTING: 3824 zip code-years during 2011-2018 in Illinois for IDHS-HV/CMR associations and 1896 zip code-years during 2015-2018 for MIECHV/CMR associations. METHODS: We measured county-level IDHS-HV rates (per 1000 children aged 0-5) since data were only available at that level. MIECHV rates (per 1000 children aged 0-5), CMR rates (per 1000 children), and all controls were measured at the zip code level. We used spatial linear models to handle spatial autocorrelation. RESULTS: Adjusted for controls, longitudinal increases of IDHS-HV rates were significantly associated with decreased overall CMR rates (coefficient: -0.28; 95 % CI: -0.45, -0.11), age 0-5 CMR rates (-0.52; -0.82, -0.22), age 6-11 CMR rates (-0.31; -0.55, -0.06), male CMR rates (-0.25; -0.45, -0.05), female CMR rates (-0.29; -0.49, -0.08), and neglect report rates (-0.13; -0.24, -0.02). In contrast, longitudinal increases of MIECHV rates were significantly associated with increased CMR rates within several subgroups. CONCLUSIONS: Our findings suggest that increasing state-funded home visiting services in communities may have benefits in lowering their CMR rates. Given the very low MIECHV service rates and the federal policy that requires MIECHV to target at-risk communities, the significant positive MIECHV/CMR associations we found might indicate MIECHV programs are typically in higher risk communities.


Assuntos
Maus-Tratos Infantis , Visita Domiciliar , Criança , Masculino , Feminino , Humanos , Lactente , Notificação de Abuso , Illinois/epidemiologia , Políticas
17.
Child Abuse Negl ; 134: 105880, 2022 12.
Artigo em Inglês | MEDLINE | ID: mdl-36113376

RESUMO

BACKGROUND: Research on community-level relationships between mental/physical health and child maltreatment is sparse. OBJECTIVE: We examined how rates of mental distress, physical distress, mental health professionals, and primary care physicians were related to child maltreatment report rates at the county level. PARTICIPANTS AND SETTING: U.S. counties from 2014 to 2017. METHODS: Within-between random effects models estimated both within-effects (i.e., longitudinal changes) and between-effects (i.e., inter-county differences) of mental distress rates, physical distress rates, mental health professional rates, and primary care physician rates and their associations with overall and age-specific maltreatment report rates, while adjusting for potential confounders. RESULTS: Longitudinal increases of mental distress rates marginally significantly (p < .10) increased overall maltreatment report rates (ß = 0.50) and significantly (p < .05) increased age 0-5 maltreatment report rates (ß = 0.84). Conversely, longitudinal increases of mental health professional rates significantly decreased overall (ß = -0.38), age 0-5 (ß = -0.59), and age 6-11 (ß = -0.31) maltreatment report rates and marginally significantly decreased age 12-17 maltreatment report rates (ß = -0.13). Between-effects of metal distress rates and mental health professional rates were mostly not significant. Neither within-effects nor between-effects of physical distress rates and primary care physician rates were significant. CONCLUSIONS: Our findings suggest that community mental distress is a risk factor for child maltreatment reports and that community availability of mental health professionals is a protective factor. Community-based strategies to address mental distress and human resource approaches to supply sufficient mental health professionals in communities may help reduce maltreatment report rates in communities. Further research is required to confirm our findings and to better understand underlying mechanisms.


Assuntos
Maus-Tratos Infantis , Saúde Mental , Criança , Humanos , Recém-Nascido , Lactente , Pré-Escolar , Adolescente , Maus-Tratos Infantis/psicologia , Notificação de Abuso
18.
Sci Rep ; 12(1): 9611, 2022 06 10.
Artigo em Inglês | MEDLINE | ID: mdl-35688851

RESUMO

Pig-to-human organ transplantation is a feasible solution to resolve the shortage of organ donors for patients that wait for transplantation. To overcome immunological rejection, which is the main hurdle in pig-to-human xenotransplantation, various engineered transgenic pigs have been developed. Ablation of xeno-reactive antigens, especially the 1,3-Gal epitope (GalT), which causes hyperacute rejection, and insertion of complement regulatory protein genes, such as hCD46, hCD55, and hCD59, and genes to regulate the coagulation pathway or immune cell-mediated rejection may be required for an ideal xenotransplantation model. However, the technique for stable and efficient expression of multi-transgenes has not yet been settled to develop a suitable xenotransplantation model. To develop a stable and efficient transgenic system, we knocked-in internal ribosome entry sites (IRES)-mediated transgenes into the α 1,3-galactosyltransferase (GGTA1) locus so that expression of these transgenes would be controlled by the GGTA1 endogenous promoter. We constructed an IRES-based polycistronic hCD55/hCD39 knock-in vector to target exon4 of the GGTA1 gene. The hCD55/hCD39 knock-in vector and CRISPR/Cas9 to target exon4 of the GGTA1 gene were co-transfected into white yucatan miniature pig fibroblasts. After transfection, hCD39 expressed cells were sorted by FACS. Targeted colonies were verified using targeting PCR and FACS analysis, and used as donors for somatic cell nuclear transfer. Expression of GalT, hCD55, and hCD39 was analyzed by FACS and western blotting. Human complement-mediated cytotoxicity and human antibody binding assays were conducted on peripheral blood mononuclear cells (PBMCs) and red blood cells (RBCs), and deposition of C3 by incubation with human complement serum and platelet aggregation were analyzed in GGTA1 knock-out (GTKO)/CD55/CD39 pig cells. We obtained six targeted colonies with high efficiency of targeting (42.8% of efficiency). Selected colony and transgenic pigs showed abundant expression of targeted genes (hCD55 and hCD39). Knocked-in transgenes were expressed in various cell types under the control of the GGTA1 endogenous promoter in GTKO/CD55/CD39 pig and IRES was sufficient to express downstream expression of the transgene. Human IgG and IgM binding decreased in GTKO/CD55/CD39 pig and GTKO compared to wild-type pig PBMCs and RBCs. The human complement-mediated cytotoxicity of RBCs and PBMCs decreased in GTKO/CD55/CD39 pig compared to cells from GTKO pig. C3 was also deposited less in GTKO/CD55/CD39 pig cells than wild-type pig cells. The platelet aggregation was delayed by hCD39 expression in GTKO/CD55/CD39 pig. In the current study, knock-in into the GGTA1 locus and GGTA1 endogenous promoter-mediated expression of transgenes are an appropriable strategy for effective and stable expression of multi-transgenes. The IRES-based polycistronic transgene vector system also caused sufficient expression of both hCD55 and hCD39. Furthermore, co-transfection of CRISPR/Cas9 and the knock-in vector not only increased the knock-in efficiency but also induced null for GalT by CRISPR/Cas9-mediated double-stranded break of the target site. As shown in human complement-mediated lysis and human antibody binding to GTKO/CD55/CD39 transgenic pig cells, expression of hCD55 and hCD39 with ablation of GalT prevents an effective immunological reaction in vitro. As a consequence, our technique to produce multi-transgenic pigs could improve the development of a suitable xenotransplantation model, and the GTKO/CD55/CD39 pig developed could prolong the survival of pig-to-primate xenotransplant recipients.


Assuntos
Galactosiltransferases , Leucócitos Mononucleares , Animais , Animais Geneticamente Modificados , Antígenos CD55/metabolismo , Proteínas do Sistema Complemento/genética , Galactosiltransferases/genética , Galactosiltransferases/metabolismo , Técnicas de Inativação de Genes , Humanos , Leucócitos Mononucleares/metabolismo , Suínos , Porco Miniatura/genética , Transplante Heterólogo/métodos
19.
Ann Epidemiol ; 73: 30-37, 2022 09.
Artigo em Inglês | MEDLINE | ID: mdl-35718099

RESUMO

PURPOSE: We examined how longitudinal changes and inter-community differences of food insecurity rates were associated with child maltreatment report (CMR) rates at the zip code level. We assessed these associations overall, by urbanicity, and within subgroups of age, sex, and maltreatment type. METHODS: We used Illinois statewide zip code-level data from 2011 to 2018. We measured CMR rates based on Illinois child protective services records and food insecurity rates from Feeding America's Map the Meal Gap. We conducted spatial linear modeling to account for spatial dependence with controls for various socioeconomic, demographic, care burden, and instability conditions of communities. RESULTS: Both longitudinal changes and inter-community differences of food insecurity rates were significantly associated with increased CMR rates overall and within all subgroups. These associations were significant among all large urban, small urban, and rural areas, while longitudinal changes of food insecurity rates had significantly stronger associations among small urban areas compared with other areas. CONCLUSIONS: Communities experiencing higher food insecurity had higher CMR rates. Increases in food insecurity over time were associated with increases in CMR rates. These associations were reproduced within subgroups of child age, sex, maltreatment type, and urbanicity. Attention and collaborative efforts are warranted for high food insecure communities.


Assuntos
Maus-Tratos Infantis , Insegurança Alimentar , Criança , Abastecimento de Alimentos , Humanos , Illinois/epidemiologia , Fatores Socioeconômicos
20.
Sensors (Basel) ; 22(9)2022 May 06.
Artigo em Inglês | MEDLINE | ID: mdl-35591230

RESUMO

A random number generator (RNG), a cryptographic technology that plays an important role in security and sensor networks, can be designed using a linear feedback shift register (LFSR). This cryptographic transformation is currently done through CMOS. It has been developed by reducing the size of the gate and increasing the degree of integration, but it has reached the limit of integration due to the quantum tunneling phenomenon. Quantum-dot cellular automata (QCA), one of the quantum circuit design technologies to replace this, has superior performance compared to CMOS in most performance areas, such as space, speed, and power. Most of the LFSRs in QCA are designed as shift registers (SR), and most of the SR circuits proposed based on the existing QCA have a planar structure, so the cell area is large and the signal is unstable when a plane intersection is implemented. Therefore, in this paper, we propose a multilayered 2-to-1 QCA multiplexer and a D-latch, and we make blocks based on D-latch and connect these blocks to make SR. In addition, the LFSR structure is designed by adding an XOR operation to it, and we additionally propose an LFSR capable of dual-edge triggering. The proposed structures were completed with a very meticulous design technique to minimize area and latency using cell interaction, and they achieve high performance compared to many existing circuits. For the proposed structures, the cost and energy dissipation are calculated through simulation using QCADesigner and QCADesigner-E, and their efficiency is verified.

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