Blood basophil activation is a reliable biomarker of allergic bronchopulmonary aspergillosis in cystic fibrosis.

The diagnosis of cystic fibrosis (CF) patients with allergic bronchopulmonary aspergillosis (ABPA) is clinically challenging, due to the absence of an objective biological test. Since blood basophils play a major role in allergic responses, we hypothesised that changes in their surface activation pattern discriminate between CF patients with and without ABPA.We conducted a prospective longitudinal study (Stanford cohort) comparing basophil activation test CD203c levels by flow cytometry before and after activation with Aspergillus fumigatus allergen extract or recombinant Asp f1 in 20 CF patients with ABPA (CF-ABPA) and in two comparison groups: CF patients with A. fumigatus colonisation (AC) but without ABPA (CF-AC; n=13) and CF patients without either AC or ABPA (CF; n=12). Patients were tested every 6 months and when ill with pulmonary exacerbation. We also conducted cross-sectional validation in a separate patient set (Dublin cohort).Basophil CD203c surface expression reliably discriminated CF-ABPA from CF-AC and CF over time. Ex vivo stimulation with A. fumigatus extract or recombinant Asp f1 produced similar results within the Stanford (p<0.0001) and the Dublin cohorts. CF-ABPA patients were likelier to have elevated specific IgE to A. fumigatus and were less frequently co-infected with Staphylococcus aureus.Basophil CD203c upregulation is a suitable diagnostic and stable monitoring biomarker of ABPA in CF.

Utilization of psychiatric services by postpartum women in a predominantly minority, low-socioeconomic-status, urban population.

This study describes the utilization of health care services related to psychiatric diagnoses in an inner city community health organization with a largely Hispanic population of low socioeconomic status. We reviewed the frequency and timing of postpartum mental health diagnoses among 5,731 patients who delivered babies and were followed-up for postpartum care. 286 women (5 %) had at least one mental health diagnosis. The rates in white, black, and Hispanic women were 12, 8, and 5 % respectively (p < .05). White and black women were 2.5 (95 % CI 1.24, 5.07), and 1.62 (95 % CI 1.09, 2.40) times more likely to have a mental health diagnosis, respectively, compared to Hispanic women. The most common diagnoses were mood disorders (64 %) followed by anxiety disorders (29 %). 87 % of cases were diagnosed after 4 weeks postpartum. The postpartum mental health diagnosis rate seen here is lower than might be expected, particularly among Hispanic women. Possible explanations are discussed.

Travel history among persons infected with SARS-CoV-2 variants of concern in the United States, December 2020-February 2021.

The first three SARS-CoV-2 phylogenetic lineages classified as variants of concern (VOCs) in the United States (U.S.) from December 15, 2020 to February 28, 2021, Alpha (B.1.1.7), Beta (B.1.351), and Gamma (P.1) lineages, were initially detected internationally. This investigation examined available travel history of coronavirus disease 2019 (COVID-19) cases reported in the U.S. in whom laboratory testing showed one of these initial VOCs. Travel history, demographics, and health outcomes for a convenience sample of persons infected with a SARS-CoV-2 VOC from December 15, 2020 through February 28, 2021 were provided by 35 state and city health departments, and proportion reporting travel was calculated. Of 1,761 confirmed VOC cases analyzed, 1,368 had available data on travel history. Of those with data on travel history, 1,168 (85%) reported no travel preceding laboratory confirmation of SARS-CoV-2 and only 105 (8%) reported international travel during the 30 days preceding a positive SARS-CoV-2 test or symptom onset. International travel was reported by 92/1,304 (7%) of persons infected with the Alpha variant, 7/55 (22%) with Beta, and 5/9 (56%) with Gamma. Of the first three SARS-CoV-2 lineages designated as VOCs in the U.S., international travel was common only among the few Gamma cases. Most persons infected with Alpha and Beta variant reported no travel history, therefore, community transmission of these VOCs was likely common in the U.S. by March 2021. These findings underscore the importance of global surveillance using whole genome sequencing to detect and inform mitigation strategies for emerging SARS-CoV-2 VOCs.

Development of a Data Visualization Tool for Occupational Exposure to Chemicals of Concern for Breast Cancer Among California Working Women, 2010-2014.

We identified the occupations that employ California women and a list of chemicals of concern for breast cancer. We evaluated the likelihood of on-the-job exposure to the categories of chemicals by occupation among formally and informally employed women. We selected 145 occupations representing more than 6.6 million women (85% of California working women), along with an additional sixteen occupations for informal workers only. We organized 1012 chemicals (including mammary gland carcinogens, developmental toxicants, and endocrine-disrupting chemicals) into twenty-five categories. More than 80 percent of occupations investigated had possible or probable exposure to at least one category of chemicals. This is the first categorization of occupational exposure to chemicals of concern for breast cancer among California working women. Our investigation revealed significant data gaps, which could be improved by policy changes resulting in enhanced collection of data on occupation and chemical exposure.

Consumer perceptions of direct-to-consumer personalized genomic risk assessments.

PURPOSE: To evaluate consumer perceptions of direct-to-consumer personalized genomic risk assessments and assess the extent to which consumer characteristics may be associated with attitudes toward testing. METHODS: Adult participants aged 18-85 years of age purchased a personalized genomic risk test at a subsidized rate and were administered a web-based health assessment that included questions regarding perceptions and attitudes toward undergoing testing. RESULTS: Assessments were obtained for 3640 individual study participants, and 49.7% expressed overall concerns about undergoing testing. Logistic regression analysis revealed that women were more likely to express concerns (odds ratio [OR] = 1.20, 95% confidence interval [CI]: 1.04 -1.39), as were individuals employed by a health care organization (OR = 1.23, 95% CI: 1.04 -1.46). Further, younger age (OR = 0.97, 95% CI: 0.96-0.98), higher education (OR = 1.09, 95% CI: 1.04 -1.14), and higher trait anxiety (OR = 1.28, 95% CI: 1.20-1.37) were also significantly associated with expressing concerns related to testing. Attitudes regarding disclosure of genetic risk for a nonpreventable disease were also assessed. None of the individuals in our sample indicated that they would definitely not want to know their risk, and a total of 82.4% indicated that they would want to know. CONCLUSION: Among individuals who undergo direct-to-consumer genetic testing, approximately half still express concerns about the process/experience. Further, given that concerns vary among different subgroups of consumers, if the clinical validity and utility of these tests are demonstrated, tailored genetic education and counseling services may be of benefit.

Monoamine oxidase inhibitory activity of flavoured e-cigarette liquids.

BACKGROUND AND AIMS: Monoamine oxidase inhibitors have been hypothesised to be important in tobacco dependence, reinforcing the brain's response to nicotine by delaying the degradation of neurotransmitters by monoamine oxidases. The development of electronic cigarettes has provided an alternative nicotine delivery system, which is widely viewed as less toxic than tobacco smoke. However, significant data gaps remain. This paper reports the results of measurements of monoamine oxidase inhibitory activity in a small sample of commercially available, flavoured e-liquids. METHODS: Twelve e-liquids were tested for monoamine oxidase inhibitory activity, using the kynuramine assay and monoamine oxidase enzymes (human, recombinant). Control samples of carrier liquids, propylene glycol and glycerol, and nicotine were also tested. RESULTS: Four e-liquids contained high levels of inhibitory activity, four more were moderately inhibitory. The remaining four e-liquids were mildly inhibitory, while the carrier liquids, and nicotine were inactive at relevant concentrations. The active compounds in the e-liquids were subsequently identified as vanillin and ethyl vanillin. Under some conditions of use, the sampled e-liquids with the highest concentrations of monoamine oxidase inhibitory activity have the potential to expose consumers to physiologically significant levels of MAO inhibitory activity. CONCLUSIONS: While only a small sample of e-liquids was tested, the findings suggest that some flavours have pharmacological actions, with potential to enhance the response to nicotine or to other drugs. The public health implications of these preliminary findings on addiction and smoking cessation warrant exploration and further research.

Effect of antioxidant intake on sperm chromatin stability in healthy nonsmoking men.

Oxidative stress is detrimental to sperm function and a significant factor in the etiology of male infertility. This report examines the association between dietary and supplementary intake of the antioxidants vitamin C, vitamin E, and beta-carotene and sperm chromatin integrity. Eighty-seven healthy male volunteers donated semen samples, completed food-frequency questionnaires, and provided information about their sociodemographic characteristics, medical and reproductive histories, and lifestyle habits. Sperm chromatin integrity was measured using the DNA fragmentation index (DFI) and related parameters, obtained from the sperm chromatin structure assay (SCSA). SCSA measures the susceptibility of sperm DNA to acid-induced denaturation in situ. After adjusting for age and duration of abstinence, there was no dose-response association between any DFI outcome and any antioxidant intake measure. Non-dose-related associations were found between beta-carotene intake and both the standard deviation of DFI (SD DFI) and the percent of immature sperm. Participants with moderate, but not high, beta-carotene intake had an increase in SD DFI compared with participants with low intake (adjusted means 206.7 and 180.5, respectively; P = .03), as well as an increase in the percentage of immature sperm (adjusted means 6.9% and 5.0%, respectively; P = .04). If antioxidant intake in the range studied is indeed beneficial for fertility in healthy men, it does not appear to be mediated through the integrity of sperm chromatin. The results of this study do not preclude possible beneficial effects of high antioxidant intake on sperm chromatin integrity for men with fertility problems.

Presymptomatic risk assessment for chronic non-communicable diseases.

The prevalence of common chronic non-communicable diseases (CNCDs) far overshadows the prevalence of both monogenic and infectious diseases combined. All CNCDs, also called complex genetic diseases, have a heritable genetic component that can be used for pre-symptomatic risk assessment. Common single nucleotide polymorphisms (SNPs) that tag risk haplotypes across the genome currently account for a non-trivial portion of the germ-line genetic risk and we will likely continue to identify the remaining missing heritability in the form of rare variants, copy number variants and epigenetic modifications. Here, we describe a novel measure for calculating the lifetime risk of a disease, called the genetic composite index (GCI), and demonstrate its predictive value as a clinical classifier. The GCI only considers summary statistics of the effects of genetic variation and hence does not require the results of large-scale studies simultaneously assessing multiple risk factors. Combining GCI scores with environmental risk information provides an additional tool for clinical decision-making. The GCI can be populated with heritable risk information of any type, and thus represents a framework for CNCD pre-symptomatic risk assessment that can be populated as additional risk information is identified through next-generation technologies.

Fish consumption and advisory awareness among low-income women in California's Sacramento-San Joaquin Delta.

Fishing is a culturally important activity to the ethnically diverse population living in California's Sacramento-San Joaquin Delta. Due to runoff from abandoned gold mines, certain Delta fish are contaminated with methylmercury, a neurodevelopmental toxin. A state health advisory recommends limited consumption of certain Delta fish, to be followed in conjunction with a federal advisory for commercial and sport fish. We conducted a survey of low-income women at a Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) clinic, to characterize commercial and sport fish consumption patterns and advisory awareness. Ninety-five percent of women consumed commercial fish. Thirty-two percent consumed sport fish; this proportion was much higher in Hmong (86%) and Cambodian (75%) women. Ninety-nine percent of sport fish consumers also consumed commercial fish. The overall fish consumption rate among consumers was 27.9 g/day (geometric mean, past 30 days, cooked portion); commercial and sport fish consumption rates were 26.3 and 10.5 g/day, respectively. We found ethnic differences in overall fish consumption rates, which were highest in African Americans (41.2 g/day) and Asians (35.6 g/day), particularly Vietnamese and Cambodians. Pregnant women ate less fish overall than other women (16.8 vs. 30.0 g/day, p=0.0001), as did women who demonstrated specific advisory awareness (23.3 vs. 30.3 g/day, p=0.02). Twenty-nine percent of all women exceeded federal fish consumption advisory limits. These results highlight the need for culturally and linguistically appropriate interventions that address both commercial and sport fish consumption.