United States National Research Articles

Peers plus mobile app for treatment in HIV (PATH): protocol for a randomized controlled trial to test a community-based integrated peer support and mHealth intervention to improve viral suppression among Hispanic and Black people living with HIV

BackgroundSignificant disparities continue to exist in the HIV care continuum, whereby Hispanic and Black people living with HIV (PLWH) are less likely to achieve viral suppression compared to their White counterparts. Studies have shown that intervention approaches that involve peer navigation may play an important role in supporting patients to stay engaged in HIV care. However, implementation may be challenging in real-world settings where there are limited resources to support peer navigators. Combining a peer navigation approach with scalable mobile health (mHealth) technology may improve impact and implementation outcomes.MethodsWe combined a peer navigation intervention with a mHealth application and are conducting a randomized controlled trial (RCT) to test the efficacy of this integrated “Peers plus mobile App for Treatment in HIV” (PATH) intervention to improve HIV care engagement, and ultimately sustained viral suppression, among Hispanic and Black PLWH. We will enroll up to 375 PLWH into a two-arm prospective RCT, conducting follow-up assessments every 3 months up to 12 months post-baseline. Participants randomized to the control arm will continue to receive usual care Ryan White Program case management services. Individuals randomized to receive the PATH intervention will receive usual care plus access to two main intervention components: (1) a peer navigation program and (2) a mHealth web application. The primary outcome is sustained HIV viral suppression (undetectable viral load observed at 6- and 12-month follow-up). Secondary outcomes are retention in HIV care, gaps in HIV medical visits, and self-reported ART adherence. Recruitment for the RCT began in November 2021 and will continue until June 2024. Follow-up assessments and medical chart abstractions will be conducted to collect measurements of outcome variables.DiscussionThe efficacy trial of PATH will help to fill gaps in our scientific understanding of how a combined peer navigation and mHealth approach may produce effects on HIV care outcomes while addressing potential implementation challenges of peer navigation in Ryan White-funded clinics.Trial registrationThe PATH trial is registered at the United States National Institutes of Health National Library of Medicine (ClinicalTrials.gov) under ID # NCT05427318. Registered on 22 June 2022.

Prevalence and secular trends in premetabolic syndrome in the United States: Findings from 1999-2020 nationally representative data of adults

PurposeAlthough Premetabolic syndrome (PeMetSyn) is a precursor for metabolic syndrome (MetSyn), its prevalence and trends are unknown. This study examined the prevalence and trends in PreMetSyn and its association with sociodemographic risk factors in American adults. MethodsThe 1999–2000 to 2017–2020 United States National Health and Nutritional Health Surveys (NHANES) data were used. PreMetSyn was defined as co-occurrence two cardiometabolic risk factors consisting of abdominal obesity, elevated triglycerides, reduced HDL-C, elevated blood pressure, and fasting plasma glucose. We calculated sex-specific overall prevalence of PreMetSyn and by race/ethnicity, age, education, poverty, and body mass index (BMI) categories. Sex-specific logistic regression models were used to test the association between sociodemographic risk factors and PreMetSyn. ResultsFrom 1999 − 2000 to 2017–2020, the age-adjusted overall prevalence of PreMetSyn increased by 155.4% (from 9.2% to 23.5%) in men and by 131.3% (from 11.2% to 25.9%) in women. Increases in prevalence of PreMetSyn were observed by race/ethnicity, age, education, poverty and BMI levels in men and women from 1999–2000 to 2017–2020. Survey cycle, race/ethnicity, age, education, poverty-income ratio, and BMI were independently associated with greater odds of PreMetSyn in males and females. During this period, the co-occurrence of abdominal obesity and elevated blood pressure was the most common comorbidity and increased from 20.6% to 30.8% in men and from 27.8% to 36.1% in women. ConclusionsThis nationally representative study indicates a rapid increase from 1999–2000 to 2017–2020 in the proportion of American adults who meet the criteria for PreMetSyn. Early identification of subjects with PreMetSyn in the U.S. is a public health priority for initiating effective strategies to prevent the development of MetSyn and its associated chronic diseases.

Sugar-sweetened beverage intake and long-term mortality in individuals with metabolic dysfunction-associated steatotic liver disease: a longitudinal analysis of the National Health and Nutrition Examination Survey database.

Consuming sugar-sweetened beverages (SSBs) has been linked to the development of various adverse health conditions, including metabolic dysfunction-associated steatotic liver disease (MASLD). This study evaluated associations between SSB intake and long-term mortality among individuals with MASLD using a nationally representative database. This population-based, longitudinal study extracted data of adults aged 20-79 years with MASLD from the USA (US) National Health and Nutrition Examination Survey database 2003-2014. Associations between the amount of SSB intake and all-cause, cancer and cardiovascular disease mortality until the end of 2019 were determined using Cox proportional hazards regression analyses. A total of 12 965 individuals aged 20-79 years who had MASLD were identified in the database. After exclusion, 5630 participants remained for the analyses. This cohort can be extrapolated to 43 420 321 individuals in the entire US after proper weighting. The mean age of the study cohort was 44.1 years. After adjusting for confounders, no significant association was observed between SSB intake (tertile 3 vs. tertile 1) and all-cause [adjusted hazard ratio (aHR): 1.03, 95% confidence interval (CI), 0.60-1.76) or cancer mortality (aHR, 0.41; 95% CI, 0.15-1.16). However, higher SSB intake (tertile 3 vs. tertile 1) was significantly associated with elevated cardiovascular disease mortality risk (aHR = 2.83; 95% CI, 1.01-7.91). In US adults with MASLD, high SSB intake is associated with nearly three-fold increased cardiovascular disease mortality risk. The findings underscore the critical need for concerted action on the part of healthcare providers and policymakers.

Selected 2023 Highlights in Congenital Cardiac Anesthesia

This article reviews the highlights of pertinent literature of interest to the congenital cardiac anesthesiologist published in 2023. Following a search of the United States National Library of Medicine PubMed database, several topics emerged where significant contributions were made in 2023. The authors of this manuscript considered the following topics noteworthy to be included in this review: Advancements in percutaneous mechanical support in children with CHD, children with pulmonary hypertension undergoing surgery for congenital heart disease (CHD), Dexmedetomidine in pediatric cardiac surgery, and recommendations for pediatric heart surgery in the United States: Implications for pediatric cardiac anesthesia

Statistical Analysis of Ice Load on Icebreaker Ship Based on Stochastic Ice Fields

Accurately assessing ice loads is a fundamental issue in the field of structural design for ships in ice-covered regions. In this paper, we conducted research on extreme ice load estimation for icebreaking ships, combining stochastic theory with numerical simulation. Firstly, using sea ice data from the Arctic region of the United States National Snow and Ice Data Center, a stochastic ice field model was established under Arctic sea ice conditions using non-parametric estimation and the rejection sampling method, and ice field data were generated stochastically. Then, based on the stochastic ice field data, a three-dimensional numerical model of the interaction between the ice field and the ship hull was established, and the reliability of the numerical model was verified by experimental results. Finally, based on the numerical model of the interaction between the ice field and the ship hull, asymptotic methods were used to study the extreme ice load estimation in different parts of the ship hull, revealing the variation law of the extreme ice load in different parts of the ship hull. This study provides basic theory and technical support for the structural design of ships in polar regions and has engineering application value.

Prevalence of long COVID in the general adult population according to different definitions and sociodemographic and infection characteristics. A nationwide random sampling survey in France in autumn 2022

ObjectivesLong COVID has been recognized since early 2020, but its definition is not unanimous, which complicates epidemiological assessments. This study estimated the prevalence of long COVID based on several definitions and severity thresholds in the adult population of mainland France and examined variations according to sociodemographic and infection characteristics. MethodsA cross-sectional survey using random sampling was conducted in August–November 2022. Participants declaring SARS-CoV-2 infection were assessed for infection dates and context, post-COVID symptoms (from a list of 31, with onset time, daily functioning impact, and alternative diagnosis), and perceived long COVID. Long COVID prevalence was estimated according to the WHO, National Institute for Health and Care Excellence, United States National Centre for Health Statistics, and United Kingdom Office for National Statistics definitions. ResultsOf 10 615 participants, 5781 (54.5%) reported SARS-CoV-2 infection, with 123–759 (1.2–13.4%) having long COVID, depending on the definition. The prevalence of WHO post-COVID condition (PCC) was 4.0% (95% CI: 3.6–4.5) in the overall population and 8.0% (95% CI: 7.0–8.9) among infected individuals. Among the latter, the prevalence varied from 5.3% (men) to 14.9% (unemployed) and 18.6% (history of hospitalization for COVID-19). WHO-PCC overlapped poorly with other definitions (kappa ranging from 0.18 to 0.59) and perceived long COVID (reported in only 43% of WHO-PCC). DiscussionRegardless of its definition, long COVID remains a significant burden in the French adult population that deserves surveillance, notably for forms that strongly impact daily activities. More standardized definitions will improve integrated surveillance of, and better research on, long COVID.

Short-Term Outcomes of Conventional Laparoscopic versus Robot-Assisted Distal Pancreatectomy for Malignancy: Evidence from US National Inpatient Sample, 2005-2018.

The primary treatment for pancreatic cancer is surgical resection, and laparoscopic resection offers benefits over open surgery. This study aimed to compare the short-term outcomes of robot-assisted vs. conventional laparoscopic distal pancreatectomy. Data of adults ≥ 20 years old with pancreatic cancer who underwent conventional laparoscopic or robot-assisted laparoscopic distal pancreatectomy were extracted from the United States (US) Nationwide Inpatient Sample (NIS) 2005-2018 database. Comorbidities and complications were identified through the International Classification of Diseases (ICD) codes. Short-term outcomes were compared using logistic regression and included length of hospital stay (LOS), perioperative complications, in-hospital mortality, unfavorable discharge, and total hospital costs. A total of 886 patients were included; 27% received robot-assisted, and 73% received conventional laparoscopic surgery. The mean age of all patients was 65.3 years, and 52% were females. Multivariable analysis revealed that robot-assisted surgery was associated with a significantly reduced risk of perioperative complications (adjusted odds ratio (aOR) = 0.61, 95% confidence interval (CI): 0.45-0.83) compared to conventional laparoscopic surgery. Specifically, robot-assisted surgery was associated with a significantly decreased risk of VTE (aOR = 0.35, 95% CI: 0.14-0.83) and postoperative blood transfusion (aOR = 0.37, 95% CI: 0.23-0.61). Robot-assisted surgery was associated with a significantly shorter LOS (0.76 days shorter, 95% CI: -1.43--0.09) but greater total hospital costs (18,284 USD greater, 95% CI: 4369.03-32,200.70) than conventional laparoscopic surgery. Despite the higher costs, robot-assisted distal pancreatectomy is associated with decreased risk of complications and shorter hospital stays than conventional laparoscopic distal pancreatectomy.

An In-Depth Evaluation of Powdery Mildew Hosts Reveals One of the World's Most Common and Widespread Groups of Fungal Plant Pathogens.

Powdery mildews are highly destructive fungal plant pathogens that have a significant economic impact on both agricultural and ecological systems worldwide. The intricate relationship between powdery mildews and their host plants has led to cospeciation. In this study, we conducted an extensive evaluation of powdery mildew hosts to provide an updated understanding of the host ranges and distributions of these fungi. The "United States National Fungus Collections Fungus-Host Dataset" is the primary source of information for our analyses. The analysis of the dataset demonstrated the worldwide prevalence of powdery mildews; the data contained over 72,000 reports of powdery mildews, representing ∼8.7% of all host-fungal records. We have updated the taxonomy and nomenclature of powdery mildews. In total, powdery mildews infect ∼10,125 host taxa belonging to 205 families of flowering plants, which accounts for 1,970 genera in 200 countries across six continents. Furthermore, we estimate that powdery mildews infect approximately 2.9% of described angiosperm species. Our study underscores the need for regular updates on powdery mildew host information due to the continuously evolving taxonomy and the discovery of new host taxa. Since 1986, we estimate an additional 1,866 host taxa, 353 genera, and 36 families have been reported. Additionally, the identification of powdery mildew hosts provides valuable insights into the coevolutionary dynamics between the fungi and their plant hosts. Overall, this updated list provides valuable insights into the taxonomy and geographic distribution of powdery mildew species, which builds upon the previous work of Amano in 1986. Discerning the geographic spread and host range of economically significant plant pathogens is vital for biosecurity measures and identifying the origins and expansion of potentially harmful pathogens.

Examining Exposure Fires from the United States National Fire Incident Reporting System between 2002 and 2020

Fires resulting from antecedent fires, known as exposure fires, can manifest across diverse environments, including suburban, urban, and rural areas. Notably, exposure fires represented by structure-destroying fires within the wildland–urban interface (WUI) can extend into non-WUI suburban and urban regions, presenting significant challenges. Leveraging data from the United States National Fire Incident Reporting System (NFIRS) spanning 2002 to 2020, this study investigates 131,739 exposure fire incidents impacting 348,089 features (incidents). We analyze reported economic costs, affected feature types, and property utilization patterns for these exposure fires. We also compare these exposure fires to information documented in other databases. Finally, we examine structure separation distance at residential dwellings and describe ignition pathways for selected fires. Reported property losses for some fire incidents amounted to USD 5,647,121,172, with content losses totaling USD 1,777,345,793. Prominent fire incident categories include buildings, vehicles, and natural vegetation fires, predominantly occurring in residential, outdoor, and storage areas. While the NFIRS lacked information on most major structure-destroying WUI fires, highlighting this analysis’s lack of statistical representation, it did provide insights into less extensive exposure fires, both WUI and non-WUI, unrecorded elsewhere. Our study reveals significant distinctions in the distribution of separation distances between damaged-to-damaged structures (average separation of 6.5 m) and damaged-to-not-damaged structures (average separation of 18.1 m). Notably, 84% of the incidents in exposure fires involved fire suppression defensive actions. These defensive actions contributed to the differences in structure separation distance distributions, highlighting the often-neglected role of these measures in assessing structure responses during WUI fires. We examined ignition pathways at select exposure fires, highlighting some common features involved in fire spread and challenges in documenting these pathways. Finally, we propose a set of idealized attributes for documenting exposure fires, accentuating the inherent difficulties in collecting such data across expansive geographical areas, particularly when striving for statistical representation. Our findings yield valuable insights into the multifaceted nature of exposure fires, informing future research and database development to aid in mitigating their impact on vulnerable communities.

Clinical Features and Outcomes of Myxedema Coma in Patients Hospitalized for Hypothyroidism: Analysis of the United States National Inpatient Sample.

Background: Hypothyroidism is a common endocrine condition and chronic thyroid hormone deficiency is associated with adverse effects across multiple organ systems. In compensated hypothyroidism, however, patients remain clinically stable due to gradual physiological adaptation. In contrast, the clinical syndrome of decompensated hypothyroidism referred to as myxedema coma (MC) is an endocrine emergency with high risk of mortality. Because of its rarity, there are currently limited data regarding MC. This study analyzes the clinical features and hospital outcomes of MC compared with hypothyroid patients without MC (nonMChypo) in national United States hospital data. Methods: A retrospective analysis of the National Inpatient Sample, a public database of inpatient admissions to nonfederal hospitals in the United States, 2016-2018, including adult patients with primary diagnosis of MC (International Classification of Diseases 10th Revision [ICD-10]: E03.5) or nonMChypo (E03.0-E03.9, E89.0). Patient demographics, relevant clinical features, mortality, length of stay (LOS), and hospital costs were compared. Results: Of 18,635 patients hospitalized for hypothyroidism, 2495 (13.4%) had a diagnosis of MC. Sex distribution and race/ethnicity were similar between patients with MC and nonMChypo, whereas MC was associated with older patient age (p = 0.02), public insurance (p = 0.01), and unhoused status (p = 0.04). More admissions with MC occurred in winter compared with other seasons (p = 0.01). The overall mortality rate for MC was 6.8% versus 0.7% for nonMChypo (p < 0.001), and MC was independently associated with in-hospital mortality after adjusted regression analysis (adjusted odds ratio = 9.92 [CI 5.69-17.28], p < 0.001). Mean LOS ± standard error was 9.64 ± 0.73 days for MC versus 4.62 ± 0.12 days for nonMChypo (p < 0.001), and total hospital cost for MC was $21,768 ± $1759 versus $8941 ± $276 for nonMChypo (p = 0.07). In linear regression analyses, MC was an independent predictor of both increased LOS and total hospital cost. Conclusions: In summary, MC remains a clinically significant diagnosis in the modern era, independently associated with high mortality and health care costs. This continued burden demonstrates a need for further efforts to prevent, identify, and optimize treatment for patients with MC.

Sex and Age Characteristics in Acute or Chronic Myocarditis: A Descriptive, Multicenter Cohort Study

BackgroundUnderstanding the clinical features of myocarditis in various age groups is required to identify age-specific disease patterns. ObjectivesThe objective of this study was to examine differences in sex distribution and clinical outcomes in patients with myocarditis of various ages. MethodsPatients with acute or chronic myocarditis in 3 centers in Berlin, Germany from 2005 to 2021 and in the United States (National Inpatient Sample) from 2010 to 2019 were included. Age groups examined included “prepubescent” (below 11 years for females and below 13 years for males), adolescents (11 [female] or 13 [male] to 18 years), young adults (18-35 years), “middle-aged adults” (35-54 years), and older adults (age >54 years). In patients admitted to the hospital, hospital mortality, length of stay, and medical complication rates were examined. ResultsOverall, 6,023 cases in Berlin and 9,079 cases in the U.S. cohort were included. In both cohorts, there were differences in sex distribution among the 5 age categories, and differences in the distribution were most notable in adolescents (69.3% males vs 30.7% females) and in young adults (73.8% males vs 26.3% females). Prepubescent and older adults had the highest rates of in-hospital mortality, hospital length of stay, and medical complications. In the Berlin cohort, prepubescent patients had higher levels of leukocytes (P < 0.001), antistreptolysin antibody (P < 0.001), and NT-proBNP (P < 0.001) when compared to young adults. ConclusionsIn this study, we found that sex differences in myocarditis and clinical features of myocarditis were age-dependent.

Association between neighborhood household income and inpatient atrial fibrillation outcomes

BackgroundThe impact of socioeconomic status on the clinical outcomes of patients admitted to the hospital for atrial fibrillation (AF) is not well described. ObjectiveThe purpose of this study was to determine the association between median neighborhood household income (mNHI) and clinical outcomes among patients admitted to the hospital for AF. MethodsWe retrospectively analyzed primary AF hospitalizations from the United States National Inpatient Sample between 2016 and 2020. The analyzed sample was divided into quartiles based on the mNHI in the zip code of the patient’s residence. The lowest quartile was used as the reference category. Study outcomes included inpatient procedure utilization (ablation, cardioversion, percutaneous left atrial appendage closure), length of stay, cost, mortality, and disposition. Weighted multivariable logistic and linear regression, adjusting for multiple patient and hospital-level characteristics, was performed. ResultsPatients in the highest mNHI quartile had lower comorbidity burden, lower in-hospital mortality (odds ratio [OR] 0.78; 95% confidence interval [CI] 0.7–0.87; P <.001), lower discharges to care facility (OR 0.86; 95% CI 0.83–0.9; P <.001), shorter length of stay (adjusted mean difference –0.26; 95% CI –0.30 to –0.22; P <.001), higher procedure utilization, and higher health care costs ($12,124 vs $10,018) compared to the lowest mNHI quartile patients. ConclusionWe identified significantly higher in-hospital mortality and lower procedural/resource utilization in patients living in lower-income neighborhoods compared to higher-income neighborhoods. Further research is needed to better understand the drivers of these disparities and the strategies to improve health care disparities between socioeconomic groups.

Cognitive, psychological, and physiological effects of a web-based mindfulness intervention in older adults during the COVID-19 pandemic: an open study

BackgroundThe development of effective strategies to maintain good mental health of older adults is a public health priority. Mindfulness-based interventions have the potential to improve psychological well-being and cognitive functions of older adults, but little is known about the effect of such interventions when delivered through internet. During the COVID-19 pandemic we evaluated short- and long-term cognitive, psychological, and physiological effects of a mindfulness-based intervention (MBI) delivered via web-based videoconference in healthy older adults.MethodsFifty older adults participated in an 8-week MBI, which comprised structured 2-h weekly group sessions. A comprehensive evaluation encompassing cognitive (verbal memory, attention and processing speed, executive functions) and psychological assessments (depression and anxiety symptoms, mindfulness, worries, emotion regulation strategies, well-being, interoceptive awareness and sleep) was conducted. Additionally, electroencephalography (EEG) data were recorded before and after the MBI and at the 6-month follow-up (T6). Data were analyzed using an intention-to-treat approach, using linear mixed models adjusted for age. The effect size for time was computed as omega squared.ResultsWe observed significant improvements from pre-MBI to post-MBI and at the T6 across several measures. These improvements were notable in the areas of verbal memory (California Verbal Learning Test, p ≤ .007), attention and executive functions (Trail Making Test A and BA, p < .050), interoceptive awareness (Multidimensional Assessment of Interoceptive Awareness, p = .0002 for self-regulation and p < .05 for noticing, body listening, and trusting dimensions), and rumination (Heidelberg Form for Emotion Regulation Strategies, p = .018). These changes were associated with low to medium effect size. Moreover, we observed significant changes in EEG patterns, with a decrease in alpha1 (p = .004) and an increase in alpha2 (p < .0001) from pre-MBI to T6. Notably, improvements in TMTBA and rumination were correlated with the decrease in alpha1 (p < .050), while improvements in TMTA were linked to the increase in alpha2 (p = .025).ConclusionsThe results of our study show that a web-based MBI in older adults leads to improvements in cognitive and psychological measures, with associated modulations in specific brain rhythms. While these findings are promising, further controlled studies are required to validate these preliminary results.Trial registrationThe trial has been registered with the United States National Library of Medicine at the National Institutes of Health Registry of Clinical Trials under the code NCT05941143 on July 12, 2023.

Neglect of Potential Seasonal Streamflow Forecasting Skill in the United States National Water Model

AbstractUsing data from the NASA Soil Moisture Active/Passive mission, Koster et al. (2023, https://doi.org/10.1038/s41467‐023‐39318‐3) conclude that, for medium‐scale basins in the contiguous United States, a quarter of interannual variability in springtime streamflow is explained by interannual anomalies in late‐fall soil moisture. This lagged relationship can be leveraged for seasonal hydrologic forecasting, but only if effectively captured by existing prediction models. Here, we extend the analysis in Koster et al. (2023, https://doi.org/10.1038/s41467‐023‐39318‐3) to diagnose systematic errors present in the United States National Water Model (NWM). Results demonstrate that the NWM tends to underestimate both the trans‐winter temporal memory of 0–1 m soil moisture as well as the correlation between 0 and 1 m soil moisture and streamflow—thereby reducing the NWM's ability to leverage vertically averaged soil moisture as a source of hydrologic predictability.

Development of Interpretable Probability Ellipse in Tropical Cyclone Track Forecasts Using Multiple Operational Ensemble Prediction Systems

AbstractMost tropical cyclone (TC) forecasting centers have implemented a probabilistic circle to represent track uncertainty at a specified lead time. Recent studies suggest that probability ellipses constructed from ensemble prediction systems can convey the anisotropy of track predictability. In this study, a new probability ellipse model is developed to interpret the extent of forward speed and heading uncertainties in ensemble forecasts by selecting an equal proportion of members in the along‐ and cross‐track directions. This method is validated using the 2019–2021 western North Pacific (WNP) TC track forecasts from the ensemble predictions of the European Centre for Medium‐Range Weather Forecasts, the United States National Centers for Environmental Prediction, and the Korea Meteorological Administration. When the proportion of ensemble members in the ellipse is set to 70%, more than one‐half (50.0%–73.6%) of the forecasts, depending on the lead time, indicate reduced area compared with that of the circle. The mean areas of the probability ellipses are 4.9%, 7.0%, 10.0%, and 11.5% smaller than those of the circle in 48‐, 72‐, 96‐, and 120‐hr forecasts, respectively. The forward speed shows greater uncertainty than the heading, as evidenced by the along‐track radii being larger than the cross‐track counterpart in ∼60% of the samples, regardless of the lead time. In addition, the regional distribution of the along‐track/cross‐track ratio in the probability ellipses can explain the dominant direction of the track error in a particular location. The proposed probability ellipse shows potential for application in operational TC track predictions.

Perceived Relational Support Is Associated With Everyday Positive, But Not Negative, Affectivity in a U.S. Sample.

Research suggests that perceived social support bolsters emotional well-being. We tested whether perceived support from friends, family, and spouses/partners was associated with reduced negative and greater positive affectivity (i.e., everyday affective baseline), and whether perceived strain in these relationships had opposite effects, accounting for age and relevant covariates. Using data from the third waves of the Midlife in the United States survey and National Study of Daily Experience (n = 1,124), we found negative affectivity was not tied to relational support nor strain, but instead was associated positively with neuroticism and negatively with conscientiousness. In contrast, positive affectivity was related positively to support from friends and family, conscientiousness, and extroversion, and negatively to strain among partners and neuroticism. Exploratory analyses within second-wave Midlife in Japan data (n = 657) suggest patterns for future cross-cultural study. Some relationship dynamics may vary, but perceived support might enhance emotional well-being by bolstering positive, rather than mitigating negative, emotionality.

Beta-lactamase genes in bacteria from food animals, retail meat, and human surveillance programs in the United States from 2002 to 2021

The spread of beta-lactamase-producing bacteria is a global public-health concern. This study aimed to explore the distribution of beta-lactamases reported in three sampling sources (cecal, retail meat, and human) collected as part of integrated surveillance in the United States. We retrieved and analyzed data from the United States National Antimicrobial Resistance Monitoring Systems (NARMS) from 2002 to 2021. A total of 115 beta-lactamase genes were detected in E. coli, Salmonella enterica, Campylobacter, Shigella and Vibrio: including 35 genes from cecal isolates, 32 genes from the retail meat isolates, and 104 genes from the human isolates. Three genes in E. coli (blaCMY-2,blaTEM-1A, and blaTEM-1B), 6 genes in Salmonella enterica (blaCARB-2, blaCMY-2, blaCTXM-65, blaTEM-1A, blaTEM-1B, and blaHERA-3), and 2 genes in Campylobacter spp. (blaOXA-61 and blaOXA-449) have been detected across food animals (cattle, chicken, swine, and turkey) and humans over the study period. blaCTXM-55 has been detected in E. coli isolates from the four food animal sources while blaCTXM-15 and blaCTXM-27 were found only in cattle and swine. In Salmonella enterica, blaCTXM-2, blaCTXM-9, blaCTXM-14, blaCTXM-15, blaCTXM-27, blaCTXM-55, and blaNDM-1 were only detected among human isolates. blaOXAs and blaCARB were bacteria-specific and the only beta-lactamase genes detected in Campylobacter spp. and Vibrio spp respectively. The proportions of beta-lactamase genes detected varies from bacteria to bacteria. This study provided insights on the beta-lactamase genes detected in bacteria in food animals and humans in the United States. This is necessary for better understanding the molecular epidemiology of clinically important beta-lactamases in one health interface.

Characterizing Hematological Changes Following Repeated Exposure to Non-Targeted Low-Dose Ionizing Radiation in Prostate Cancer Patients.

The duration and magnitude of haematological changes following non-targeted low-dose radiation have not been well explored. We previously reported that low-dose radiation (150mGy 2x/week for 5 consecutive weeks) was well tolerated by participants (n = 15) with minimal toxicities and no changes in quality of life. Leukocytes, platelets and erythrocytes decreased from baseline measurement 12months following treatment, however changes were not clinically significant. T-cells, NK-cells, B-cells and neutrophils were found to decrease during treatment and return to baseline levels by 3months. The monocyte activation marker CD64 (FcγRI) was lower in participants whose cancer did not progress during the 12month study follow up period, potentially giving insights into a biomarker of treatment success. Herein, we provide one of the most detailed descriptions of hematologic changes during low dose radiation treatment and during one year follow up. Low-dose radiation was associated with minor hematologic changes that mostly resolved by 3months. (Clinical Trial Registered with the United States National Library of Medicine and National Institutes of Health under the title 'Low Dose Hemi-Body Radiation for Recurrent Prostate Cancer'; ID: NCT03196778).

Survivin in lung cancer: a potential target for therapy and prevention-a narrative review.

A versatile biomarker, survivin, is highly expressed in proliferating cells of multiple cancers in humans and animals. It is an apoptosis-regulating protein, engaging in a cascade of reactions that involve several other genes and protein interactions. Currently, researchers are investigating its therapeutic potential due to the evidence linking its overexpression to advanced-stage lung cancer. This review is centered around examining survivin-related molecular mechanisms and its therapeutic role specifically in lung cancer. Our objective is to discuss the role of survivin in prognosis and treatment response, shedding light on immune-targeted therapies, as well as outlining future directions for survivin-based vaccines in lung cancer. The PubMed database and the United States National Library of Medicine search engine at the National Institutes of Health were searched on 24 August 2023 to identify published research studies. Searching "((((((airway [Title/Abstract]) OR (lung [Title/Abstract])) OR (pulm[Title/Abstract])) OR (bronch[Title/Abstract])) OR (nslc[Title/Abstract])) AND (((cancer[Title/Abstract]) OR (carcino[Title/Abstract])) OR (oncol[Title/Abstract]))) AND (survivin[Title/Abstract])" gave 728 results. After screening the title and abstracts and excluding the review articles 168 titles were shortlisted and full text studied. The discussions are added to relevant sections. Survivin is a cell cycle-dependent, inhibitor of apoptosis protein that contributes to carcinogenesis, tumor vascularization, metastasis, and treatment resistance. Several treatments that impact survivin either directly or indirectly have been reported as effective in treating lung cancer. Immunity-based therapy, a novel approach known for its targeted nature and minimal side effects, is currently under investigation for lung cancer treatment. Emerging survivin-centered vaccines exhibit promising attributes in terms of safety, effectiveness, and ability to stimulate an immune response. These factors point towards a significant potential for advancing the future of lung cancer prevention and enhancing overall survival rates. Nuclear survivin is a potential biomarker for advanced non-small cell lung cancer. It plays a role in determining drug responsiveness and is found to be significantly elevated in cases of resistance to chemotherapy. Multiple compounds and immunization strategies have been identified to impact lung cancer cells; however, they are currently in the early stages of phase I or phase II clinical trials. The substantial promise of survivin-based immunogenicity-focused treatments warrants in-depth investigation and exploration.

Abstract TP172: Rising Trends in Cervical Artery Dissection Admissions: A Nationwide Study From 2005 to 2019

Introduction: A recent regional study suggested an upward trend in the incidence rates of spontaneous cervical artery dissection (sCAD). Utilizing a comprehensive nationwide database, we investigated these trends on a national scale. Method: We analyzed adult patients diagnosed with sCAD in the United States National Inpatient Sample database from 2005 to 2019, employing validated standard ICD-9 and ICD-10 diagnostic codes. By integrating the survey-weighted annual total of CAD cases with annual Census data, we estimated the incidence over the study period. The annualized percentage change (APC) over the study period was estimated using regression models and visually represented with an exponential regression line. Trends were further stratified by sex, age group, and race. Result: From 2005 to 2019, we identified 557,063,391 patients, of whom 125,102 (0.02%) had non-traumatic CAD. The incidence of CAD increased from 10.5 cases per million population in 2005 to 45.5 cases per million population in 2019 ( P &lt; 0.001), revealing a significant increase in admissions with CAD. Regression analysis estimated an APC of 9.6%, with a 95% CI of 8.4% to 10.7% (P &lt; 0.001) (Figure). This upward trend persisted across all strata of sex, age, and race. Conclusion: Our nationwide analysis demonstrates a significant rise in admissions with CAD from 2005 to 2019 across all demographic groups. The change in trend could be attributed to greater disease awareness leading to more frequent coding of CAD diagnoses, and/or to increased use of CT angiogram coinciding with the rise of mechanical thrombectomy for stroke. This underscores CAD's increasing clinical prevalence, warranting further investigation into its causes, prevention, and treatment.