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1.
Crit Rev Eukaryot Gene Expr ; 34(4): 69-102, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38505874

RESUMO

Vaccination rates for the human papillomavirus (HPV) among rural youth in northern New England lag those of more urbanized areas. Reasons include a lack of available medical offices, time constraints, perceptions of vaccines and HPV, and, to a smaller degree, delays caused by the COVID-19 pandemic. We have a responsibility to increase vaccinations in these communities. To do so, vaccination experts recommend addressing the three C's of vaccination hesitation: confidence, complacency, and convenience. With this framework as our foundation, in this article we detail a plan to address these important elements, and we add several more C's: clinics, communication, collaboration, community, capacity, and commitment to the list as we discuss the essential pieces-human, infrastructural, and perceptual-needed to create and promote successful, community-supported, school-based HPV vaccination clinics to serve youths aged nine to 18. We then integrate research and storytelling science into an innovative Persuasion Playbook, a guide for local opinion leaders to use in creating evidence-based, pro-vaccine messages on the community level to promote the clinics via evidence-based, pro-vaccination messages.


Assuntos
Neoplasias , Infecções por Papillomavirus , Vacinas contra Papillomavirus , Humanos , Adolescente , Infecções por Papillomavirus/epidemiologia , Pandemias , Vacinação , Comunicação , New England
2.
BMJ Open ; 14(3): e076839, 2024 Mar 21.
Artigo em Inglês | MEDLINE | ID: mdl-38514142

RESUMO

INTRODUCTION: The need for public research funding to be more accountable and demonstrate impact beyond typical academic outputs is increasing. This is particularly challenging and the science behind this form of research is in its infancy when applied to collaborative research funding such as that provided by the Australian National Health and Medical Research Council to the Centre for Research Excellence in Digestive Health (CRE-DH). METHODS AND ANALYSIS: In this paper, we describe the protocol for applying the Framework to Assess the Impact from Translational health research to the CRE-DH. The study design involves a five-stage sequential mixed-method approach. In phase I, we developed an impact programme logic model to map the pathway to impact and establish key domains of benefit such as knowledge advancement, capacity building, clinical implementation, policy and legislation, community and economic impacts. In phase 2, we have identified and selected appropriate, measurable and timely impact indicators for each of these domains and established a data plan to capture the necessary data. Phase 3 will develop a model for cost-consequence analysis and identification of relevant data for microcosting and valuation of consequences. In phase 4, we will determine selected case studies to include in the narrative whereas phase 5 involves collation, data analysis and completion of the reporting of impact.We expect this impact evaluation to comprehensively describe the contribution of the CRE-DH for intentional activity over the CRE-DH lifespan and beyond to improve outcomes for people suffering with chronic and debilitating digestive disorders. ETHICS AND DISSEMINATION: This impact evaluation study has been registered with the Hunter New England Human Research Ethics Committee as project 2024/PID00336 and ethics application 2024/ETH00290. Results of this study will be disseminated via medical conferences, peer-reviewed publications, policy submissions, direct communication with relevant stakeholders, media and social media channels such as X (formely Twitter).


Assuntos
Projetos de Pesquisa , Pesquisa Translacional Biomédica , Humanos , Austrália , New England
3.
Vector Borne Zoonotic Dis ; 24(4): 226-236, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38436222

RESUMO

Introduction: Lyme disease (LD) affects ∼476,000 people each year in the United States. Symptoms are variable and include rash and flu-like symptoms. Reasons for the wide variation in disease outcomes are unknown. Powassan virus (POWV) is a tick-borne flavivirus that causes disease ranging from asymptomatic infection to encephalitis, neurologic damage, and death. POWV and LD geographic case distributions overlap, with Ixodes species ticks as the common vectors. Clinical ramifications of coinfection or sequential infection are unknown. Objectives: This study's primary objective was to determine the prevalence of POWV-reactive antibodies in sera samples collected from previously studied cohorts of individuals with self-reported LD history residing in the Northeastern United States. As a secondary objective, we studied clinical differences between people with self-reported LD history and low versus high POWV antibody levels. Methods: We used an enzyme-linked immunosorbent assay (ELISA) to quantify IgG directed at the POWV envelope (E) protein domain III in 538 samples from individuals with self-reported LD history and 16 community controls. The samples were also tested with an ELISA assay to quantify IgG directed at the POWV NS1 protein. Results: The percentage of individuals with LD history and possible evidence of POWV exposure varied depending on the assay utilized. We found no significant difference in clinical symptoms between those with low or high POWV IgG levels in the in-house assay. Congruence of the EDIII and NS1 assays was low with only 12% of those positive in the in-house EDIII ELISA testing positive in the POWV NS1 ELISA. Conclusions: The results highlight the difficulty in flavivirus diagnostic testing, particularly in the retrospective detection of flavivirus exposure. The findings suggest that a prospective study with symptomatic patients using approved clinical testing is necessary to address the incidence and clinical implications of LD and POWV co-infection or sequential infection.


Assuntos
Vírus da Encefalite Transmitidos por Carrapatos , Encefalite Transmitida por Carrapatos , Ixodes , Doença de Lyme , Animais , Humanos , Estados Unidos/epidemiologia , Prevalência , Estudos Retrospectivos , Estudos Prospectivos , Encefalite Transmitida por Carrapatos/veterinária , Doença de Lyme/epidemiologia , Doença de Lyme/veterinária , New England/epidemiologia , Anticorpos Antivirais , Imunoglobulina G
4.
Environ Mol Mutagen ; 65(1-2): 47-54, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38465801

RESUMO

The etiology of bladder cancer among never smokers without occupational or environmental exposure to established urothelial carcinogens remains unclear. Urinary mutagenicity is an integrative measure that reflects recent exposure to genotoxic agents. Here, we investigated its potential association with bladder cancer in rural northern New England. We analyzed 156 bladder cancer cases and 247 cancer-free controls from a large population-based case-control study conducted in Maine, New Hampshire, and Vermont. Overnight urine samples were deconjugated enzymatically and the extracted organics were assessed for mutagenicity using the plate-incorporation Ames assay with the Salmonella frameshift strain YG1041 + S9. Logistic regression was used to estimate the odds ratios (OR) and 95% confidence intervals (CI) of bladder cancer in relation to having mutagenic versus nonmutagenic urine, adjusted for age, sex, and state, and stratified by smoking status (never, former, and current). We found evidence for an association between having mutagenic urine and increased bladder cancer risk among never smokers (OR = 3.8, 95% CI: 1.3-11.2) but not among former or current smokers. Risk could not be estimated among current smokers because nearly all cases and controls had mutagenic urine. Urinary mutagenicity among never-smoking controls could not be explained by recent exposure to established occupational and environmental mutagenic bladder carcinogens evaluated in our study. Our findings suggest that among never smokers, urinary mutagenicity potentially reflects genotoxic exposure profiles relevant to bladder carcinogenesis. Future studies are needed to replicate our findings and identify compounds and their sources that influence bladder cancer risk.


Assuntos
Mutagênicos , Neoplasias da Bexiga Urinária , Humanos , Mutagênicos/toxicidade , Bexiga Urinária , Estudos de Casos e Controles , Neoplasias da Bexiga Urinária/induzido quimicamente , Neoplasias da Bexiga Urinária/epidemiologia , Neoplasias da Bexiga Urinária/genética , New England/epidemiologia , Carcinógenos , Testes de Mutagenicidade
5.
J Environ Manage ; 355: 120478, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38432011

RESUMO

Anthropogenic nutrient loading has resulted in eutrophication and habitat degradation within estuaries. Study of eutrophication in estuaries has often focused on larger systems, while there has been increasing interest in understanding the governing processes in smaller systems. In this study, we incorporate both monitoring data and mechanistic modeling to improve our understanding of eutrophication in a small, shallow New England estuary. High-frequency continuous and discrete water quality samples were collected from 2018 to 2020 along a salinity gradient and at varying depth to provide temporal and spatial resolution of the system. Conditions of this estuary were simulated using the Hydrological Simulation Program - FORTRAN (HSPF) and the Water Quality Analysis Simulation Program (WASP) to develop a mechanistic, numerical fate and transport model. Our findings suggest complex hydrodynamics with three distinct salinity gradients and variability in salinity concentration upstream. Simulated and observed nutrient trends demonstrated decreasing total nitrogen concentration moving downstream and low total phosphorus concentration throughout the system. Simulated nutrient depletion and shading via macroalgae suggest their importance in similar modeling initiatives. Dynamic spatiotemporal variability in dissolved oxygen concentrations ([DO]) resulted from hydrodynamic and ecological processes such as large, rapid swings in phytoplankton. Carbonaceous biological oxygen demand was suggested to be the driver of hypoxia in surface waters, while sediment oxygen demand may drive low [DO] in the stratified, benthic waters. These findings suggest that the coordination of monitoring and modeling was important to understanding the governing mechanisms of eutrophication and hypoxia. Insights from this study could be used to support regional management strategies to increase [DO], improve water clarity, and recover indigenous seagrass beds. This work has the potential to inform future study and management of small, complex estuaries.


Assuntos
Estuários , Qualidade da Água , Humanos , New England , Eutrofização , Hipóxia , Monitoramento Ambiental/métodos
6.
Proc Natl Acad Sci U S A ; 121(6): e2313661121, 2024 Feb 06.
Artigo em Inglês | MEDLINE | ID: mdl-38300867

RESUMO

In the United States, estimates of excess deaths attributable to the COVID-19 pandemic have consistently surpassed reported COVID-19 death counts. Excess deaths reported to non-COVID-19 natural causes may represent unrecognized COVID-19 deaths, deaths caused by pandemic health care interruptions, and/or deaths from the pandemic's socioeconomic impacts. The geographic and temporal distribution of these deaths may help to evaluate which explanation is most plausible. We developed a Bayesian hierarchical model to produce monthly estimates of excess natural-cause mortality for US counties over the first 30 mo of the pandemic. From March 2020 through August 2022, 1,194,610 excess natural-cause deaths occurred nationally [90% PI (Posterior Interval): 1,046,000 to 1,340,204]. A total of 162,886 of these excess natural-cause deaths (90% PI: 14,276 to 308,480) were not reported to COVID-19. Overall, 15.8 excess deaths were reported to non-COVID-19 natural causes for every 100 reported COVID-19 deaths. This number was greater in nonmetropolitan counties (36.0 deaths), the West (Rocky Mountain states: 31.6 deaths; Pacific states: 25.5 deaths), and the South (East South Central states: 26.0 deaths; South Atlantic states: 25.0 deaths; West South Central states: 24.2 deaths). In contrast, reported COVID-19 death counts surpassed estimates of excess natural-cause deaths in metropolitan counties in the New England and Middle Atlantic states. Increases in reported COVID-19 deaths correlated temporally with increases in excess deaths reported to non-COVID-19 natural causes in the same and/or prior month. This suggests that many excess deaths reported to non-COVID-19 natural causes during the first 30 mo of the pandemic in the United States were unrecognized COVID-19 deaths.


Assuntos
COVID-19 , Humanos , Estados Unidos/epidemiologia , Pandemias , Teorema de Bayes , Causas de Morte , New England , Mortalidade
7.
Soc Work Public Health ; 39(3): 234-249, 2024 Apr 02.
Artigo em Inglês | MEDLINE | ID: mdl-38421683

RESUMO

This study's purpose was to explore the current models and approaches of pregnancy options counseling across three types of agency settings in a Northeastern state. Additionally, this study aimed to determine if individuals who receive pregnancy options counseling obtained medically factual, non-directive, and non-biased information needed to make informed decisions related to their pregnancy decisions. Using qualitative research methodology, semi-structured interviews were conducted with 10 participants across three different agency settings in one state in the Northeastern United States. Results indicated agencies shared a definition of pregnancy options counseling. Outcomes also suggest agency type impacted how pregnancy options counseling was delivered, as variations were found in education provided to patients. Lastly, the interviews imply no standardized model or training for pregnancy options counselors is currently being used.


Assuntos
Aborto Induzido , Gravidez , Feminino , Humanos , Escolaridade , Aconselhamento/educação , Aconselhamento/métodos , Pesquisa Qualitativa , New England
8.
Emerg Infect Dis ; 30(3): 591-594, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38407227

RESUMO

We report 2 autochthonous feline thelaziosis cases caused by the eyeworm Thelazia callipaeda and discuss the spread among dogs in the northeastern United States. Phylogenetic analysis suggests the parasite was introduced from Europe. Adopting a One Health approach is needed to limit further spread of T. callipaeda eyeworms in North America.


Assuntos
Doenças do Gato , Doenças do Cão , Thelazioidea , Gatos , Animais , Cães , Doenças do Gato/epidemiologia , Filogenia , Doenças do Cão/epidemiologia , New England , Loa , Thelazioidea/genética
9.
Innovations (Phila) ; 19(1): 54-63, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38318656

RESUMO

OBJECTIVE: The optimal approach and choice of initial aortic valve replacement (AVR) is evolving in the growing era of transcatheter AVR. Further survival and hemodynamic data are needed to compare the emerging role of rapid deployment (rdAVR) versus stented (sAVR) valve options for AVR. METHODS: The Northern New England Cardiovascular Database was queried for patients undergoing either isolated AVR or AVR + coronary artery bypass grafting (CABG) with rdAVR or sAVR aortic valves between 2015 and 2021. Exclusion criteria included endocarditis, mechanical valves, dissection, emergency case status, and prior sternotomy. This resulted in a cohort including 1,616 sAVR and 538 rdAVR cases. After propensity weighting, procedural characteristics, hemodynamic variables, and survival outcomes were examined. RESULTS: The breakdown of the overall cohort (2,154) included 1,164 isolated AVR (222 rdAVR, 942 sAVR) and 990 AVR + CABG (316 rdAVR, 674 sAVR). After inverse propensity weighting, cohorts were well matched, notable only for more patients <50 years in the sAVR group (4.0% vs 1.9%, standardized mean difference [SMD] = -0.12). Cross-clamp (89 vs 64 min, SMD = -0.71) and cardiopulmonary bypass (121 vs 91 min, SMD = -0.68) times were considerably longer for sAVR versus rdAVR. Immediate postreplacement aortic gradient decreased with larger valve size but did not differ significantly between comparable sAVR and rdAVR valve sizes or overall (6.5 vs 6.7 mm Hg, SMD = 0.09). Implanted rdAVR tended to be larger with 51% either size L or XL versus 37.4% of sAVR ≥25 mm. Despite a temporal decrease in pacemaker rate within the rdAVR cohort, the overall pacemaker frequency was less in sAVR versus rdAVR (4.4% vs 7.4%, SMD = 0.12), and significantly higher rates were seen in size L (10.3% vs 3.7%, P < 0.002) and XL (15% vs 5.6%, P < 0.004) rdAVR versus sAVR. No significant difference in major adverse cardiac events (4.6% vs 4.6%, SMD = 0.01), 30-day survival (1.5% vs 2.6%, SMD = 0.08), or long-term survival out to 4 years were seen between sAVR and rdAVR. CONCLUSIONS: Rapid deployment valves offer a safe alternative to sAVR with significantly decreased cross-clamp and cardiopulmonary bypass times. Despite larger implantation sizes, we did not appreciate a comparative difference in immediate postoperative gradients, and although pacemaker rates are improving, they remain higher in rdAVR compared with sAVR. Longer-term hemodynamic and survival follow-up are needed.


Assuntos
Estenose da Valva Aórtica , Implante de Prótese de Valva Cardíaca , Próteses Valvulares Cardíacas , Substituição da Valva Aórtica Transcateter , Humanos , Próteses Valvulares Cardíacas/efeitos adversos , Valva Aórtica/cirurgia , Implante de Prótese de Valva Cardíaca/métodos , Estenose da Valva Aórtica/cirurgia , New England/epidemiologia , Resultado do Tratamento , Fatores de Risco
10.
J Pediatr Gastroenterol Nutr ; 78(2): 204-210, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38374558

RESUMO

OBJECTIVE: To describe the clinical, endoscopic, histologic, and treatment outcomes of Helicobacter heilmannii (H. heilmannii) associated gastritis in children in the New England region of the United States. METHODS: Retrospective study of children (1-18 years) with H. heilmannii identified on gastric mucosal biopsies from two pediatric centers over a 21-year period, January 2000-December 2021. Cases were identified by querying pathology databases at each institution. Demographic and clinical data were obtained from the medical record. Endoscopic and histologic findings were extracted from endoscopy and pathology reports, respectively. RESULTS: Thirty-eight children were diagnosed with H. heilmannii-associated gastritis during the study period. The mean age at diagnosis was 10.1 ± 5.3 years, and 25/38 (66%) cases were male. Abdominal pain (32%) and nausea with or without vomiting (26%) were the most common symptoms. Thirty-two children (84%) had endoscopic findings including gastric nodularity (55%) and erythema (26%). All children had histologic signs of chronic gastritis, including those with normal endoscopic exams. Antibiotic regimens used for treating Helicobacter pylori were frequently prescribed. Of the 17 children who underwent a follow-up endoscopy (range 2-68 months), 15 (88%) did not have H. heilmannii identified on gastric biopsies. CONCLUSION: H. heilmannii was an infrequent but potential cause of epigastric abdominal pain and nausea in our cohort of New England children. While morphologically distinct from H. pylori, the bacteria can result in similar endoscopic and histologic findings of nodularity and chronic gastritis, respectively. The rate of eradication, as assessed by histology following treatment with H. pylori therapies, was below the 90% recommended goal for antimicrobial therapies.


Assuntos
Gastrite , Infecções por Helicobacter , Helicobacter heilmannii , Helicobacter pylori , Criança , Humanos , Masculino , Feminino , Estudos Retrospectivos , Gastrite/diagnóstico , Gastrite/tratamento farmacológico , Gastrite/microbiologia , Infecções por Helicobacter/diagnóstico , Infecções por Helicobacter/tratamento farmacológico , Infecções por Helicobacter/microbiologia , New England , Náusea , Dor Abdominal
11.
Circ Cardiovasc Qual Outcomes ; 17(2): e009986, 2024 02.
Artigo em Inglês | MEDLINE | ID: mdl-38240159

RESUMO

BACKGROUND: Type 2 myocardial infarction (T2MI) and type 1 myocardial infarction (T1MI) differ with respect to demographics, comorbidities, treatments, and clinical outcomes. Reliable quality and outcomes assessment depends on the ability to distinguish between T1MI and T2MI in administrative claims data. As such, we aimed to develop a classification algorithm to distinguish between T1MI and T2MI that could be applied to claims data. METHODS: Using data for beneficiaries in a Medicare accountable care organization contract in a large health care system in New England, we examined the distribution of MI diagnosis codes between 2018 to 2021 and the patterns of care and coding for beneficiaries with a hospital discharge diagnosis International Classification of Diseases, Tenth Revision code for T2MI, compared with those for T1MI. We then assessed the probability that each hospitalization was for a T2MI versus T1MI and examined care occurring in 2017 before the introduction of the T2MI code. RESULTS: After application of inclusion and exclusion criteria, 7759 hospitalizations for myocardial infarction remained (46.5% T1MI and 53.5% T2MI; mean age, 79±10.3 years; 47% female). In the classification algorithm, female gender (odds ratio, 1.26 [95% CI, 1.11-1.44]), Black race relative to White race (odds ratio, 2.48 [95% CI, 1.76-3.48]), and diagnoses of COVID-19 (odds ratio, 1.74 [95% CI, 1.11-2.71]) or hypertensive emergency (odds ratio, 1.46 [95% CI, 1.00-2.14]) were associated with higher odds of the hospitalization being for T2MI versus T1MI. When applied to the testing sample, the C-statistic of the full model was 0.83. Comparison of classified T2MI and observed T2MI suggest the possibility of substantial misclassification both before and after the T2MI code. CONCLUSIONS: A simple classification algorithm appears to be able to differentiate between hospitalizations for T1MI and T2MI before and after the T2MI code was introduced. This could facilitate more accurate longitudinal assessments of acute myocardial infarction quality and outcomes.


Assuntos
Medicare , Infarto do Miocárdio , Idoso , Humanos , Feminino , Estados Unidos/epidemiologia , Idoso de 80 Anos ou mais , Masculino , Infarto do Miocárdio/diagnóstico , Infarto do Miocárdio/epidemiologia , Infarto do Miocárdio/terapia , Comorbidade , Algoritmos , New England
12.
Diagn Microbiol Infect Dis ; 108(4): 116169, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38295682

RESUMO

Cerebrospinal fluid (CSF) metagenomic next generation sequencing (mNGS) can detect diverse pathogens in patients with central nervous system infection. Due to its high cost and unclear clinical utility, it is typically reserved for patients with unrevealing routine workups. A multi-center retrospective analysis of real-world CSF mNGS was performed involving orders between 2017 and 2022 at a large New England healthcare system. CSF mNGS was performed 64 times with 17 positive results (27 %). In 11/17 positive samples (65 %), the infectious agent had not been previously detected using routine methods. Arboviruses (n = 8) were the most frequently detected agents, particularly Powassan virus (n = 6). Results changed therapy in 3/64 cases (5 %). Positive results were associated with immunodeficiency (p = 0.06), especially anti-B-cell therapy (p = 0.02), and earlier sample collection (p = 0.06). The association with compromised humoral immunity was stronger in the arbovirus and Powassan virus subgroups (p = 0.001), whose constituents were older than the overall cohort and had higher mortality rates.


Assuntos
Infecções do Sistema Nervoso Central , Vírus da Encefalite Transmitidos por Carrapatos , Humanos , Sequenciamento de Nucleotídeos em Larga Escala , Metagenômica/métodos , New England , Estudos Retrospectivos , Sensibilidade e Especificidade
13.
Harm Reduct J ; 21(1): 23, 2024 Jan 28.
Artigo em Inglês | MEDLINE | ID: mdl-38282000

RESUMO

BACKGROUND: Hepatitis C virus (HCV) disproportionately affects rural communities, where health services are geographically dispersed. It remains unknown whether proximity to a syringe services program (SSP) is associated with HCV infection among rural people who inject drugs (PWID). METHODS: Data are from a cross-sectional sample of adults who reported injecting drugs in the past 30 days recruited from rural counties in New Hampshire, Vermont, and Massachusetts (2018-2019). We calculated the road network distance between each participant's address and the nearest fixed-site SSP, categorized as ≤ 1 mile, 1-3 miles, 3-10 miles, and > 10 miles. Staff performed HCV antibody tests and a survey assessed past 30-day injection equipment sharing practices: borrowing used syringes, borrowing other used injection equipment, and backloading. Mixed effects modified Poisson regression estimated prevalence ratios (aPR) and 95% confidence intervals (95% CI). Analyses were also stratified by means of transportation. RESULTS: Among 330 PWID, 25% lived ≤ 1 mile of the nearest SSP, 17% lived 1-3 miles of an SSP, 12% lived 3-10 miles of an SSP, and 46% lived > 10 miles from an SSP. In multivariable models, compared to PWID who lived within 1 mile of an SSP, those who lived 3 to 10 miles away had a higher prevalence of HCV seropositivity (aPR: 1.25, 95% CI 1.06-1.46), borrowing other used injection equipment (aPR: 1.23, 95% CI 1.04-1.46), and backloading (aPR: 1.48, 95% CI 1.17-1.88). Similar results were observed for PWID living > 10 miles from an SSP: aPR [HCV]: 1.19, 95% CI 1.01-1.40; aPR [borrowing other used equipment]:1.45, 95% CI 1.29-1.63; and aPR [backloading]: 1.59, 95% CI 1.13-2.24. Associations between living 1 to 3 miles of an SSP and each outcome did not reach statistical significance. When stratified by means of transportation, associations between distance to SSP and each outcome (except borrowing other used injection equipment) were only observed among PWID who traveled by other means (versus traveled by automobile). CONCLUSIONS: Among PWID in rural New England, living farther from a fixed-site SSP was associated with a higher prevalence of HCV seropositivity, borrowing other used injection equipment, and backloading, reinforcing the need to increase SSP accessibility in rural areas. Means of transportation may modify this relationship.


Assuntos
Usuários de Drogas , Infecções por HIV , Hepatite C , Abuso de Substâncias por Via Intravenosa , Adulto , Humanos , Estados Unidos , Hepacivirus , Abuso de Substâncias por Via Intravenosa/epidemiologia , Infecções por HIV/epidemiologia , População Rural , Estudos Transversais , Hepatite C/epidemiologia , New England , Programas de Troca de Agulhas
14.
Eur J Protistol ; 92: 126049, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38163403

RESUMO

Testate amoebae (order Arcellinida) are abundant in freshwater ecosystems, including low pH bogs and fens. Within these environments, Arcellinida are considered top predators in microbial food webs and their tests are useful bioindicators of paleoclimatic changes and anthropogenic pollutants. Accurate species identifications and characterizations of diversity are important for studies of paleoclimate, microbial ecology, and environmental change; however, morphological species definitions mask cryptic diversity, which is a common phenomenon among microbial eukaryotes. Lineage-specific primers recently designed to target Arcellinida for amplicon sequencing successfully captured a poorly-described yet diverse fraction of the microbial eukaryotic community. Here, we leveraged the application of these newly-designed primers to survey the diversity of Arcellinida in four low-pH New England bogs and fens, investigating variation among bogs (2018) and then across seasons and habitats within two bogs (2019). Three OTUs represented 66% of Arcellinida reads obtained across all habitats surveyed. 103 additional OTUs were present in lower abundance with some OTUs detected in only one sampling location, suggesting habitat specificity. By establishing a baseline for Arcellinida diversity, we provide a foundation to monitor key taxa in habitats that are predicted to change with increasing anthropogenic pressure and rapid climate change.


Assuntos
Amoeba , Amebozoários , Lobosea , Amoeba/genética , Ecossistema , Áreas Alagadas , Filogenia , New England
15.
Child Dev ; 95(2): e139-e154, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-37902615

RESUMO

As they learn to navigate the social world, children construct frameworks to interpret others' behavior. The present studies examined two such frameworks: a mentalistic framework, which construes behavior as driven by internal mental states; and a normative framework, which presumes people act in accordance with social norms. Participants included 101 children (ages 4, 7, and 10; 81% White; 41% female) and 35 adults (66% female) tested in the northeastern United States from 2019 to 2021. Children and adults utilized both mentalistic and normative frameworks to explain others' behaviors. Framework use depended on features of the behavior being explained. Minimal developmental differences were observed. The relative independence and the utility of the mentalistic and normative frameworks for naïve reasoning about behavior are considered.


Assuntos
Aprendizagem , Comportamento Social , Criança , Adulto , Humanos , Feminino , Masculino , Resolução de Problemas , New England
16.
J Environ Manage ; 351: 119683, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38042076

RESUMO

In the United States and elsewhere, there are a growing number of dams which have exceeded their design life and will need to be repaired or removed in the coming decades. Most of these dams no longer serve their original purpose and removal can provide ecological benefits and eliminate future maintenance costs and hazards. However, many decision-makers have been ill-prepared by community resistance to proposals to remove dams. Given the number of dam removal initiatives that have failed or been delayed due to community resistance, both ecological and social attributes of dams need to be better mapped and conveyed in understandable ways. The goal of this study was to support future decisions regarding dams by 1) developing a set of metrics to assess the social and ecological dimensions of dams, and 2) using these metrics to develop a GIS database, for the 1000+ dams in the Narragansett Bay/Rhode Island area of southern New England. The database characterizes the ecological benefits of dam removal or modification, in terms of fish passage, and the social dimensions that may need to be considered when engaging a community in discussions about the future of a dam. Our emphasis was on small-head dams (i.e. <5 m tall) which comprise most dams in the study area. We created social value metrics that used GIS data to assess dams and their impoundments for potential benefits to waterfront properties, history, sense-of-place, and recreation. We modeled our ecological metrics and ranking system after the Nature Conservancy's Northeast Aquatic Connectivity study which considered factors relating to river connectivity and watershed quality. We evaluated our social and ecological metrics using case studies of dams in the study area that had been previously removed or modified. We assumed that both sets of dams were ecologically important, but the modified dams had higher social value that prohibited their removal. Dams that had been removed or modified were both ranked as high priority in terms of value for fish passage, particularly for diadromous fish. Dams that were modified to include fish passage had substantially larger impoundments, more waterfront properties, and more features associated with recreational or cultural value (e.g. boating opportunity, visibility, etc.). Our social metrics were consistent with expectations based on the limited case studies (7 removals, 19 modifications) available in the study area. We made the dam assessment metrics readily accessible to stakeholders through an interactive ArcGIS Online web map.


Assuntos
Conservação dos Recursos Naturais , Sistemas de Informação Geográfica , Animais , New England , Rios , Peixes , Ecossistema
17.
Health Serv Res ; 59 Suppl 1: e14234, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-37749998

RESUMO

OBJECTIVE: Identify factors affecting the use of a community resource referral platform among local community-based organizations (CBOs) and test strategies to increase platform use. DATA SOURCES AND STUDY SETTING: Data sources included platform usage data and semi-structured interviews. The study took place in a small city in the Northeastern United States from 2020 to 2022. STUDY DESIGN: We analyzed platform data and conducted interviews with local organizations and organizations in other communities to understand barriers to CBOs' use of the referral platform and identify strategies that might increase use. We then tested 4 strategies and assessed impacts via time trend analysis of platform usage and qualitative interviews. DATA COLLECTION/EXTRACTION METHODS: Platform usage data were obtained from the platform. Semi-structured interviews were conducted with staff and leaders of 36 local CBOs and 9 external organizations. PRINCIPAL FINDINGS: Four years after launch, platform use remained relatively low. None of the tested strategies (data insight reports, a referral hub, tailored training, and a communication campaign) noticeably increased platform use. The main barrier to the use of the platform was the lack of perceived usefulness, mostly because existing processes for identifying resources and referring clients worked well enough and because many organizations were already required to use a client management or referral tool. Additional barriers included the lack of comfort with and, in some cases, active dislike of e-referrals, and lack of comfort with technology tools overall. Organizations that were most likely to find the platform useful and to use it were those that provided referrals for a wide range of needs and whose staff were not already familiar with local resources. CONCLUSIONS: Organizations seeking to implement referral platforms should not assume that local CBOs will automatically take up these platforms. For these platforms to succeed, much more attention needs to be paid to ensuring the platforms provide value to the CBOs they seek to engage.


Assuntos
Recursos Comunitários , Encaminhamento e Consulta , Humanos , New England
18.
Drug Alcohol Depend ; 254: 111055, 2024 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-38071894

RESUMO

SIGNIFICANCE: Adolescent vaping behavior includes vaping of multiple substances, including both nicotine and cannabis (dual-vaping). This study describes the prevalence and the sociodemographic correlates of past 30-day dual-vaping. METHODS: We recruited adolescents ages 13-17 from five New England states (Massachusetts, Connecticut, Rhode Island, Vermont, New Hampshire) through the Prodege online survey panel from April 2021 to August 2022. Dual-vaping was defined as vaping both nicotine and cannabis (THC and/or CBD) in the past 30-days. We analyzed the prevalence of sole-nicotine, sole-cannabis, and dual-vaping of nicotine and cannabis and used multinomial logistic regression to examine associations between sociodemographic factors and sole- and dual-vaping of nicotine and cannabis. RESULTS: The analytic sample included 2013 observations from 1858 participants (mean age 15.1 years, 46.2% female, 74.1% White, 82.2% heterosexual). Among these observations, 5.6% reported past 30-day sole-nicotine vaping, 5.5% reported sole-cannabis vaping, and 7.3% had dual-vaped. Correlates for higher odds of past 30-day dual-vaping included total social media sites used and household tobacco use, in contrast with sole-cannabis vaping, which included older age and self-reported depression (all p's <0.05). DISCUSSION: Adolescent past 30-day dual-vaping of nicotine and cannabis was more prevalent than past 30-day sole-vaping of either nicotine or cannabis alone. Future studies should continue to collect detailed data on the type of substances, besides nicotine, that adolescents are vaping.


Assuntos
Cannabis , Sistemas Eletrônicos de Liberação de Nicotina , Alucinógenos , Vaping , Humanos , Adolescente , Feminino , Masculino , Nicotina , Vaping/epidemiologia , Prevalência , New England/epidemiologia
19.
Environ Sci Pollut Res Int ; 31(4): 5526-5539, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-38123781

RESUMO

Foraging for edible and medicinal mushrooms is a cultural and social practice both globally and in the United States. Determining the toxic and nutrient element concentrations of edible and medicinal mushrooms is needed to ensure the safe consumption of this food source. Our research examined wild, foraged mushrooms in New England, USA to assess nutrient (Ca, K, Mg, P) and toxic (As, Hg, Pb, Cd) element relationships between mushrooms, substrates, and soils. We examined a gradient in nutrient and toxic elements from more rural Mountain and Hill Zones in Massachusetts, Vermont, and New Hampshire to more developed and urban Valley and Coastal Zones in Connecticut. Substrates and mineral soils were moderate to weak predictors of mushroom tissue concentrations. We found significant differences in nutrient and toxic element concentration among the five common genera: Ganoderma, Megacollybia, Pluteus, Pleurotus, and Russula. In particular, Pluteus had consistently higher toxic element concentrations while Pleurotus and Russula had the highest Bioaccumulation Factors (BAFs). We found that the urban areas of the Valley and Coastal zones of Connecticut had Cd Target Hazard Quotient (THQ) values and ΣTHQ values > 1.0, indicating potential non-carcinogenic health hazard. However, the trend was largely driven by the > 2.0 Cd THQ for Pluteus. Our results suggest that foraging in more urban areas can still yield mushrooms with safe concentrations of toxic elements and abundant nutrients. Further research of this kind needs to be conducted within this region and globally to ensure humans are consuming safe, foraged mushrooms.


Assuntos
Agaricales , Pleurotus , Humanos , Cádmio , Connecticut , Rios , Solo , New England , Nutrientes
20.
Crit Care Med ; 52(1): 68-79, 2024 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-37695139

RESUMO

OBJECTIVES: High mechanical power and driving pressure (ΔP) have been associated with postoperative respiratory failure (PRF) and may be important parameters guiding mechanical ventilation. However, it remains unclear whether high mechanical power and ΔP merely reflect patients with poor respiratory system mechanics at risk of PRF. We investigated the effect of mechanical power and ΔP on PRF in cohorts after exact matching by patients' baseline respiratory system compliance. DESIGN: Hospital registry study. SETTING: Academic hospital in New England. PATIENTS: Adult patients undergoing general anesthesia between 2008 and 2020. INTERVENTION: None. MEASUREMENTS AND MAIN RESULTS: The primary exposure was high (≥ 6.7 J/min, cohort median) versus low mechanical power and the key-secondary exposure was high (≥ 15.0 cm H 2 O) versus low ΔP. The primary endpoint was PRF (reintubation or unplanned noninvasive ventilation within seven days). Among 97,555 included patients, 4,030 (4.1%) developed PRF. In adjusted analyses, high intraoperative mechanical power and ΔP were associated with higher odds of PRF (adjusted odds ratio [aOR] 1.37 [95% CI, 1.25-1.50]; p < 0.001 and aOR 1.45 [95% CI, 1.31-1.60]; p < 0.001, respectively). There was large variability in applied ventilatory parameters, dependent on the anesthesia provider. This facilitated matching of 63,612 (mechanical power cohort) and 53,260 (ΔP cohort) patients, yielding identical baseline standardized respiratory system compliance (standardized difference [SDiff] = 0.00) with distinctly different mechanical power (9.4 [2.4] vs 4.9 [1.3] J/min; SDiff = -2.33) and ΔP (19.3 [4.1] vs 11.9 [2.1] cm H 2 O; SDiff = -2.27). After matching, high mechanical power and ΔP remained associated with higher risk of PRF (aOR 1.30 [95% CI, 1.17-1.45]; p < 0.001 and aOR 1.28 [95% CI, 1.12-1.46]; p < 0.001, respectively). CONCLUSIONS: High mechanical power and ΔP are associated with PRF independent of patient's baseline respiratory system compliance. Our findings support utilization of these parameters for titrating mechanical ventilation in the operating room and ICU.


Assuntos
Respiração Artificial , Insuficiência Respiratória , Adulto , Humanos , Mecânica Respiratória , Sistema Respiratório , Insuficiência Respiratória/epidemiologia , New England , Volume de Ventilação Pulmonar
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