An Application of Social Vulnerability Index to Infant Mortality Rates in Ohio Using Geospatial Analysis- A Cross-Sectional Study.

BACKGROUND: Ohio ranks 43rd in the nation in infant mortality rates (IMR); with IMR among non-Hispanic black infants is three times higher than white infants. OBJECTIVE: To identify the social factors determining the vulnerability of Ohio counties to IMR and visualize the spatial association between relative social vulnerability and IMR at county and census tract levels. METHODS: The social vulnerability index (SVICDC) is a measure of the relative social vulnerability of a geographic unit. Five out of 15 social variables in the SVICDC were utilized to create a customized index for IMR (SVIIMR) in Ohio. The bivariate descriptive maps and spatial lag model were applied to visualize the quantitative relationship between SVIIMR and IMR, accounting for the spatial autocorrelation in the data. RESULTS: Southeastern counties in Ohio displayed highest IMRs and highest overall SVIIMR; specifically, highest vulnerability to poverty, no high school diploma, and mobile housing. In contrast, extreme northwestern counties exhibited high IMRs but lower overall SVIIMR. Spatial regression showed five clusters where vulnerability to low per capita income in one county significantly impacted IMR (p = 0.001) in the neighboring counties within each cluster. At the census tract-level within Lucas county, the Toledo city area (compared to the remaining county) had higher overlap between high IMR and SVIIMR. CONCLUSION: The application of SVI using geospatial techniques could identify priority areas, where social factors are increasing the vulnerability to infant mortality rates, for potential interventions that could reduce disparities through strategic and equitable policies.

Dietary behavior and urinary gallic acid concentration differences among underserved elder racial and ethnic minorities in New York City.

PURPOSE: Diet and nutrition are important for cancer prevention. To investigate associations between dietary behavior, demographics, and risk of cancer, we assessed dietary behavior and urinary concentration of gallic acid, a polyphenol with anticancer properties found in various fruits and vegetables, in racial and ethnic minorities. METHODS: Ninety-one (91) participants were recruited from senior centers in East Harlem, New York City, a racially diverse and underserved community. A National Institute of Health (NIH)-validated dietary survey questionnaire-was used to collect dietary fruits and vegetables consumption data. Demographic and cancer information were also collected. All 91 participants completed the survey and forty-five (45) participants provided urine samples for gallic acid analysis. RESULTS: Gender differences were significantly associated with dietary behavior and urinary gallic acid concentration (UGAC). Female participants had a higher total daily intake of fruits and a significantly higher UGAC compared to male participants (p < 0.05). Age was negatively associated with the serving quantity of French fries/fried potatoes and white potatoes (p < 0.05), while positively associated with the daily intake frequency and daily intake of fruits (p < 0.05). Furthermore, Asian race was associated with higher daily intake frequencies of fruits and vegetable soup (p < 0.05), compared to other races. In a multivariate analysis, a significant association was observed between the serving quantities of fruits and other vegetables and UGAC (p < 0.05) after controlling for demographic characteristics. CONCLUSION: The observed differences in dietary behavior and UGAC in this study provide limited information on the association between demographic differences and cancer prevalence in elder racial and ethnic minorities. Future research should investigate this association further for potential implications in cancer prevention.

An Unusual Case of Evolving Localized Tetanus Despite Prior Immunization and Protective Antibody Titer.

Centers for Disease Control and Prevention has reported that tetanus infection in a fully immunized person with the last dose within 10 years is extremely rare. The prevalence of localized tetanus in such a scenario is unknown. Only two case reports of localized tetanus in previously immunized patients have been reported so far, making this the third one. Also, this is the first case of its kind to demonstrate evolving localized tetanus. Our patient is a 19-year-old man who presented with shortness of breath, pain in right upper extremity, shoulder, and neck. His chest X-ray and creatine kinase were normal. The patient was sent home. He presented again to our hospital two days later with difficulty swallowing and speaking as well as chest tightness. Routine blood tests, electrocardiogram, CT angiography of the chest, and transthoracic echocardiogram were normal. He gave a history of a cut in the right middle finger while removing the carpet a week before his presentation. His immunization history was complete with documented last tetanus shot nine years and two months ago. He was treated with tetanus vaccine and penicillin. His tetanus antitoxoid titer came out protective.

Dietary Behavior and Urinary Gallic Acid Concentrations in Older Minority Residents of East Harlem, New York City.

In this multidisciplinary study, we explored relationships between demographic factors, dietary habits, and gallic acid, a polyphenolic biomarker that correlates with self-reported dietary behaviors and negatively correlates with the incidence of cancer. Thirty-three (33) participants were recruited from a senior center in East Harlem, New York City, a racially diverse and underserved community. A National Institute of Health (NIH)-validated survey questionnaire was used to gather dietary behavior data, alongside demographic and cancer history information. Urine samples were obtained from participants for analyzing gallic acid content level. All 33 recruited participants completed the survey and 25 of them provided urine samples for gallic acid analysis. Associations between demographic factors and intake of certain foods were observed. Specifically, age was negatively associated with French fries/fried potatoes, cooked dried beans, and tomato soup intake (p < 0.05), and Black/African American race was associated with increased consumption of fruits and vegetables in comparison to Hispanic/Latino ethnicity (p < 0.05). No associations between urinary gallic acid levels and demographic information was observed. However, French fries/fried potatoes intake was significantly associated with urinary gallic acid concentration (p < 0.01). The small sample size limited the execution of meaningful statistical analysis. However, this study provided preliminary findings about the dietary behavior of older adults in East Harlem, New York City, which will serve as a basis for a future larger study to investigate nutrition/dietary education intervention on cancer prevention among diverse elderly residents in New York City.

Pathology teach and tell: central nervous system atypical teratoid/rhabdoid tumor.

Atypical teratoid/rhabdoid tumor (AT/RT) is extremely malignant, highly aggressive primitive central nervous systemneoplasm of infancy with very poor prognosis. Histologically, AT/RT is defined as a polymorphous neoplasm often featuring rhabdoid, PNET, mesenchymal, and epithelial components. We report the clinical history, radiological, and pathological findings in a child affected bycentral nervous system AT/RT.