Neighborhood location and nutritional resources as a risk factor for congenital heart disease in the fetus.

BACKGROUND: Congenital heart disease (CHD) is the most common birth defect, influenced by maternal health, environmental conditions, and genetics. Maternal health and nutrition, particularly maternal diabetes, is a modifiable risk factor for development of CHD in the fetus. However, the importance of food access during pregnancy on the development of CHD remains unknown. The objective of this study was to investigate the association between maternal neighborhood characteristics, particularly food access, and occurrence of prenatally diagnosed CHD. METHODS: A retrospective case series studied maternal-fetal dyads with prenatally diagnosed CHD between 2019 and 2021 in Washington, DC. Moran's I of maternal addresses evaluated geographic clustering of disease. Negative binomial regression assessed association between census tract demographics and population-adjusted CHD rate. RESULTS: A total of 307 dyads were analyzed. Global Moran's I showed significant CHD clustering (p-value = .004). However, degree of clustering was not clinically meaningful. After adjusting for neighborhood socioeconomic status, residing in food deserts was not a predictor for CHD. However, neighborhoods with a higher percentage of households receiving Supplemental Nutrition Assistance Program (SNAP) benefits were associated with higher rates of conotruncal heart defects (Incident Rate Ratio [IRR] = 1.04, CI = 1.01-1.08) and aggregate CHD (IRR = 1.03, CI = 1.01-1.05). CONCLUSIONS: Neighborhood location and food access were not associated with CHD. However, increased enrollment in SNAP was associated with higher rates of CHD. The association between CHD and SNAP benefits warrants further exploration. Understanding food access and maternal nutrition may illuminate disparities in the burden of CHD.

Disparities in colorectal cancer time-to-treatment and survival time associated with racial and economic residential segregation surrounding the diagnostic hospital, Georgia 2010-2015.

PURPOSE: To evaluate patient-level colorectal cancer outcomes in relation to residential income and racial segregation and composition of the neighborhood surrounding the diagnosing hospitals, and characterize presence of cancer-relevant diagnosis and treatment modalities that might contribute to these associations. METHODS: We utilized Georgia state cancer registry data (2010-2015), matching diagnosis information to hospital technology provided by the American Hospital Association and spatial information to the US Census. We modeled time-to-treatment and survival time, using Cox proportional hazards models, stratified by segregation. Segregation was examined as residential economic and racial evenness (Atkinson index) and isolation (isolation index) and mean income at the Census tract level. To assess possible contributing factors, analysis of hospital diagnosis and treatment technologies in relation to segregation was conducted. RESULTS: Average income of the Census tract and racial residential segregation of the diagnosing hospital's neighborhood was generally unassociated with time-to-treatment or survival time. Higher income evenness around the diagnosing hospital was associated with shorter time-to-treatment, with no association with time-to-death. Higher income isolation for the diagnosing hospital, conversely, was associated with longer times to treatment, but also longer survival times. Hospitals in regions with higher level of residential income segregation were less likely to have a particular diagnosing or treatment technologies, such as virtual colonoscopy and chemotherapy. CONCLUSION: Hospital resources may be a function of their immediate economic environment, and this may have influence on cancer outcomes. Future work should evaluate patient outcomes in light of technologies or therapies utilized within particular economic environments.

Wild bees respond differently to sampling traps with vanes of different colors and light reflectivity in a livestock pasture ecosystem.

Wild bees are important pollinators and monitoring their abundance and diversity is necessary to develop conservation protocols. It is imperative to understand differences in sampling efficiency among different trap types to help guide monitoring efforts. This study used a new vane trap design to collect bees in a livestock pasture ecosystem and examined the impact of six different vane colors on wild bee sampling. We recorded 2230 bees comprising 49 species and five families. The most abundant species were Augochlorella aurata (25.8%), Lasioglossum disparile (18.3%), Lasioglossum imitatum (10.85%), Agapostemon texanus (10.8%), Melissodes vernoniae (9.9%) and Halictus ligatus (4.7%). Traps with bright blue vanes captured the greatest number and diversity of bees as compared to traps with bright yellow, dark blue, dark yellow, and purple vanes. Red vanes had the lowest captures rates of individuals and species. Different colors were associated with different bee species arrays and only nine species were found in all vane color types. Vanes with higher light reflectance properties (within 400-600 nm range) attracted the greatest number of bees. These results show that different light wavelengths and reflectivity of vane traps influence bee capture rates, and such findings can help optimize bee sampling methods in different ecosystems.

Differentiating Black and Hispanic: outcome differences of segregated communities and police shootings in the USA, 2015-2020.

BACKGROUND: Police shootings are unevenly spatially distributed, with substantive spikes throughout the USA. While minorities are disproportionately the victims of police force, social or structural factors associated with this distribution are not well understood. The objective of this work was to evaluate police shootings in relation to victim race or ethnicity and residential segregation and racial diversity. METHODS: Validated crowdsourced data from the Washington Post's Fatal Force (2015-2020) were linked with census tract-level data from the American Community Survey. Residential minority dissimilarity, interaction, and a racial and ethnic diversity metric were calculated in order to assess the potentially variant importance of evenness in distribution, exposure likelihood, and general representation. Logistic and multinomial regression was used to model associations between segregation and diversity, adjusted for other ecological characteristics. Analyses were stratified by victim race or ethnicity (Black, Asian, or Hispanic). RESULTS: Across all races combined, the odds of a police shooting in a particular census tract were associated with non-Hispanic Black dissimilarity (OR = 0.98, 95% CI 0.97, 0.99) and racial and ethnic diversity (1.046, 95% CI 1.044, 1.060). Areas with higher racial diversity had a higher likelihood of having a police shooting event with Black victims (OR = 1.092, 95% CI 1.064, 1.120) or Asian victims (OR = 1.188, 1.051, 1.343) than less diverse areas. Higher non-Hispanic Black interaction was associated with a lower likelihood of having a police shooting event with Black victims (OR = 0.914, 95% CI 0.833, 0.946) than lower interaction areas. Higher Hispanic dissimilarity was associated with a lower likelihood of having a police shooting event with a Hispanic victim (OR = 0.398, 95% CI 0.324, 0.489) than lower dissimilarity areas. CONCLUSIONS: The variant effects of residential segregation are only seen when victims are analyzed separately by race. There appears to be a protective effect for Hispanic populations in Hispanic communities, while the reverse is true of Black individuals. We urge law enforcement responsible for locations with segregated communities to monitor individual interactions that police have with residents as well as the patterns of frequency and context of those interactions.

All-cause mortality and residential racial and ethnic segregation and composition as experienced differently by individual-level race, ethnicity, and gender: Mortality disparities in american communities data.

PURPOSE: Use a large nationally representative population to evaluate whether differences in mortality in relation to residential racial and ethnic segregation and diversity varied by gender, and race or Hispanic ethnicity in the United States. METHODS: The Mortality Disparities in American Communities (MDAC) was used to evaluate mortality risk in relation to segregation. MDAC is a nationally representative record linkage of the 2008 American Community Survey data with mortality outcomes derived from the National Death Index through 2015. Gender-stratified mortality risk for White, Black, and Hispanic groups in relation to quartiles of residential segregation, composition, and diversity were modeled using parametric survival regression with an exponential distribution, adjusted for individual-level socioeconomic characteristics. RESULTS: The study population included >3,950,000 individuals and >273,000 all-cause mortality outcomes. Statistically significant differences in associations were observed with Black segregation vs. Hispanic segregation across Black or Hispanic groups; some differences in stratification by gender for Hispanic and Non-Hispanic Black groups, but gender-stratified associations were more similar in non-Hispanic Whites. CONCLUSIONS: Future multidisciplinary and ethnographic research is needed to identify the specific structural mechanisms by which these associations differ to support means by which to more effectively target public health interventions.

Not just another nasal polyp: Chondro-osseous respiratory epithelial adenomatoid hamartomas of the sinonasal tract.

OBJECTIVES: Chondro-osseous respiratory epithelial adenomatoid hamartomas (COREAH) are extremely rare benign lesions in the sinonasal cavity. We aim to (a) report two cases of COREAH and (b) perform a literature review with a summary on previously published cases of COREAH till August 2019. METHODS: A literature review identified 16 cases, but only 12 cases from publications from 2005 to 2019 were included in analysis. In addition, we report two cases of COREAH from our tertiary academic medical center. RESULTS: COREAH is found in patients from 3 to 83 years old. It originates from various sites in the nasal cavity and sinuses but the most common location is the lateral nasal wall. Calcification on imaging is a common finding. CONCLUSION: COREAH is an uncommon entity that is important to recognize and distinguish from other sinister nasal masses. It is a slow growing benign lesion which lacks aggressive features on imaging. Future studies are needed to evaluate the possibility of an underlying genetic predisposition. LEVEL OF EVIDENCE: 4.

Longer time-to-treatment but better survival for colorectal cancer patients presumptively not diagnosed in a hospital.

PURPOSE: To evaluate time-to-treatment and survival time in colorectal cancer (CRC) patients who presumptively were not diagnosed in a hospital. METHODS: Colorectal tumor-level data from Georgia Cancer Registry (GCR) was merged with American Hospital Association data for 2010-2015 using hospital identification number. Patients with tumors lacking a diagnosis hospital in the GCR were classified as presumptive non-hospital diagnosis (PNHD). Cox proportional hazard models were used to model PNHD and time-to-treatment and time-to-death following cancer diagnosis, stratified by race and controlling for personal and tumor characteristics. RESULTS: PNHD (n = 6,885, 29.6%) was associated with a lower likelihood of treatment at a given point in time (i.e., longer time-to-treatment), but did not differ for Black (HR = 0.77, 95% CI: 0.73, 0.82) and White (HR = 0.73, 95% CI: 0.71, 0.76) patients. Time-to-death was longer (i.e., better survival) with PNHD, which also did not differ for Black (HR = 0.70, 95% CI: 0.64, 0.76) and White (HR = 0.71, 95% CI: 0.67, 0.75) patients. These results were not explained by confounding factors or differences in tumor stage at diagnosis. CONCLUSIONS: These observations warrant further research to understand whether there are potentially modifiable factors associated with the diagnosing location that can be used to benefit patient treatment trajectory and survival.

Color of Pan Trap Influences Sampling of Bees in Livestock Pasture Ecosystem.

The decline in insect pollinators has increased the importance of accurately monitoring pollinator diversity and abundance over time. Sampling techniques include the use of passive insect traps such as pan traps, yet there is still discussion over their utility and effectiveness in different ecosystems. The objective was to examine four different colors of pan traps (blue, green, yellow, and purple) for their utility in sampling bees in native forages rotationally grazed by sheep and to compare the relative abundance, richness, similarity, and community assemblage patterns among the four trap colors. Most bees were from the Halictidae family (89%). The most abundant species were Lasioglossum imitatum (42.2%), Augochlorella aurata (8.3%), L. subviridatum (6.8), Agapostemon texanus (6.4), and L. birkmani (4.1%). Blue color traps exhibited the highest rates of bee capture and species accumulation. Purple and yellow colored traps were moderately effective in capturing bees, while the green color pan traps were least effective. Similarly, observed and extrapolated species richness was highest in blue trap, followed by purple, yellow, and green. Notably, the blue trap captured the highest number of unique species, followed by purple, yellow and green traps. Considering the total number of insects collected (including bees and other insects), yellow and green traps captured a significantly higher number of insects than other colored traps. The light reflectance from blue, purple, green and yellow pan traps had peaks at ~450, 400, 550, and 600 nm, respectively. Since different insects respond to different light intensities, wavelengths, and reflectivity, these results could be used to guide future trapping protocols targeting certain insect groups in livestock pasture and similar ecosystems.

Descriptive Epidemiology of Homicides With Victim and Suspect Race or Hispanic Ethnicity Discordance in the United States: Analysis of National Violent Death Reporting System (NVDRS) 2005-2015.

Cross-racial violence is a high-profile issue in the United States; however, there is little empirical research on the epidemiology of cross-racial homicides. The objective of this work was to use national-level data to evaluate the characteristics of homicides in which the victim and suspect are of the same or different race or Hispanic ethnicity. Victims and suspects from National Violent Death Reporting System data (2005-2015) were classified into seven-categories on the basis of race/ethnicity (six non-Hispanic races or Hispanic ethnicity), and 51,454 homicide events were classified as concordant (same race or ethnicity), discordant (different race or ethnicity), or unknown (missing race or ethnicity or no suspect information). While discordancy was observed to be similar across all race and ethnicity groups, it was less likely with relatives, romantic partners, and relatives of romantic partners; less likely to occur at home; less likely to occur in intimate partner violence-related homicides; less likely when the homicide was preceded by an argument over money or property; less likely when the homicide was associated with a family problem; more likely among rival gangs and strangers than other known person relationships; and more likely with drug-involved homicides. There were differences for victims of non-Hispanic Black race. Notably, discordance was more likely for justifiable self-defense and more likely with victim having used a weapon. These results suggest that discordant homicides may follow patterns of peer groups and close relationships in society regardless of victim race/ethnicity, that is, individuals may form closer relationships with individuals of the same race/ethnicity.

Next-Generation Allergic Rhinitis Care in Singapore: 2019 ARIA Care Pathways.

Allergic rhinitis (AR) is prevalent in Singapore, with a significant disease burden. Afflicting up to 13% of the population, AR impairs quality of life, leads to reduced work productivity and is an independent risk factor for asthma. In the last 2 decades, local studies have identified patient and physician behaviours leading to suboptimal control of the disease. Yet, there is an overall lack of attention to address this important health issue. Allergic Rhinitis and its Impact on Asthma (ARIA) is a European organisation aimed at implementing evidence-based management for AR worldwide. Recent focus in Europe has been directed towards empowering patients for self-management, exploring the complementary role of mobile health, and establishing healthcare system-based integrated care pathways. Consolidation of these ongoing efforts has led to the release of the 2019 ARIA care pathways. This review summarises the ARIA update with particular emphasis on the current status of adult AR in Singapore. In addition, we identify unmet needs and future opportunities for research and clinical care of AR in the local context.

Publisher Correction: Diversified Floral Resource Plantings Support Bee Communities after Apple Bloom in Commercial Orchards.

An amendment to this paper has been published and can be accessed via a link at the top of the paper.

Spatial Associations Between Land Use and Infectious Disease: Zika Virus in Colombia.

Land use boundaries represent human-physical interfaces where risk of vector-borne disease transmission is elevated. Land development practices, coupled with rural and urban land fragmentation, increases the likelihood that immunologically naïve humans will encounter infectious vectors at land use interfaces. This research consolidated land use classes from the GLC-SHARE dataset; calculated landscape metrics in linear (edge) density, proportion abundance, and patch density; and derived the incidence rate ratios of the Zika virus occurrence in Colombia, South America during 2016. Negative binomial regression was used to evaluate vector-borne disease occurrence counts in relation to Population Density, Average Elevation, Per Capita Gross Domestic Product, and each of three landscape metrics. Each kilometer of border length per square kilometer of area increase in the linear density of the Cropland and Grassland classes is associated with an increase in Zika virus risk. These spatial associations inform a risk reduction approach to rural and urban morphology and land development that emphasizes simple and compact land use geometry that decreases habitat availability for mosquito vectors of Zika virus.

Racial disparities in colorectal cancer time-to-treatment and survival time in relation to diagnosing hospital cancer-related diagnostic and treatment capabilities.

BACKGROUND: There is a need to understand structural issues, such as differential access to or utilization of technologies or capabilities, to better understand racial disparities in cancer outcomes. The objective of this work was to evaluate time-to-treatment and survival in relation to cancer-related diagnostic and treatment technologies of the diagnosing hospital. METHODS: Colorectal tumor-level data from George Cancer Registry was merged with hospital-level cancer technology data from the American Hospital Association (2010-2015). Cox proportional hazard models were used to model time-to-treatment and time-to-death following cancer diagnosis with cancer-related technologies for colon and rectosigmoid/rectal tumors, stratified by race and controlling for personal and tumor characteristics. RESULTS: Black individuals experienced lower likelihood of treatment (HR: 0.92, 95 % CI: 0.89, 0.96) for colon tumors, but not significantly different survival (HR: 1.03, 95 % CI: 0.98, 1.09). Larger capacity or size indicators (total surgical operations, emergency room visits, and licensed beds) were associated with higher likelihood of treatment in whites, but not blacks. Higher counts of treatment related technologies were associated with better survival in whites (HR = 0.92, 95 % CI: 0.85, 0.99), but not blacks (HR: 1.07, 95 % CI: 0.95, 1.19). Virtual colonoscopy emerged as a technology related to survival favorably in whites (HR: 0.84, 95 % CI: 0.77, 0.92) and blacks (HR: 0.89, 95 % CI: 0.79, 1.00). Overall results were similar for rectosigmoid/rectal tumors as observed for colon tumors. CONCLUSION: The role of cancer-related technologies presence or utilization for colorectal cancer outcomes and potential racial disparities warrants further research.

Environmental impacts of reduced-risk and conventional pesticide programs differ in commercial apple orchards, but similarly influence pollinator community.

Insect pollinators such as bees and syrphid flies play a crucial role in pollinating many food crops, and their diversity and abundance may be influenced by pesticide application patterns. Over three years, we assessed the ecotoxicological impacts on the diversity and abundance of bees and syrphid flies between reduced-risk pesticide programs and standard, conventional pesticide programs in paired plots at six spatially distinct commercial apple orchards. In particular, we quantified pesticide inputs, environmental impact, and community response of bees and syrphids to these pesticide programs. Relative environmental impacts of reduced-risk versus conventional pesticide programs were calculated using Environmental Impact Quotient analysis, while ecological impacts were characterized by assessing the abundance, richness, and species assemblages of bees and syrphids. Adopting a reduced-risk pesticide program for apple pest management reduced the use (in terms of kg a.i./ha) of organophosphate and pyrethroid insecticides by approximately 97.6% and 100% respectively, but increased the use of neonicotinoid pesticides (acetamiprid, imidacloprid, thiacloprid) by 40.4% compared to the orchards under standard conventional pesticide program. Regardless of pesticide inputs, abundance, richness and species assemblages of bees and syrphids did not differ between reduced-risk and conventional pest management programs. However, the environmental impact of pesticide inputs was reduced by 89.8% in reduced-risk pesticide program. These findings suggest that the implementation of reduced-risk pesticide program may reduce pesticide environmental impact, in addition to being safer to farm workers, without adversely affecting the robust community composition of bees and syrphids in commercial apple orchards in the mid-Atlantic region.

Next-Generation Allergic Rhinitis Care in Singapore: 2019 ARIA Care Pathways

Allergic rhinitis (AR) is prevalent in Singapore, with a significant disease burden. Afflicting up to 13% of the population, AR impairs quality of life, leads to reduced work productivity and is an independent risk factor for asthma. In the last 2 decades, local studies have identified patient and physician behaviours leading to suboptimal control of the disease. Yet, there is an overall lack of attention to address this important health issue. Allergic Rhinitis and its Impact on Asthma (ARIA) is a European organisation aimed at implementing evidence-based management for AR worldwide. Recent focus in Europe has been directed towards empowering patients for self-management, exploring the complementary role of mobile health, and establishing healthcare system-based integrated care pathways. Consolidation of these ongoing efforts has led to the release of the 2019 ARIA care pathways. This review summarises the ARIA update with particular emphasis on the current status of adult AR in Singapore. In addition, we identify unmet needs and future opportunities for research and clinical care of AR in the local context.

Diversified Floral Resource Plantings Support Bee Communities after Apple Bloom in Commercial Orchards.

Natural habitats, comprised of various flowering plant species, provide food and nesting resources for pollinator species and other beneficial arthropods. Loss of such habitats in agricultural regions and in other human-modified landscapes could be a factor in recent bee declines. Artificially established floral plantings may offset these losses. A multi-year, season-long field study was conducted to examine how wildflower plantings near commercial apple orchards influenced bee communities. We examined bee abundance, species richness, diversity, and species assemblages in both the floral plantings and adjoining apple orchards. We also examined bee community subsets, such as known tree fruit pollinators, rare pollinator species, and bees collected during apple bloom. During this study, a total of 138 species of bees  were collected, which included 100 species in the floral plantings and 116 species in the apple orchards. Abundance of rare bee species was not significantly different between apple orchards and the floral plantings. During apple bloom, the known tree fruit pollinators were more frequently captured in the orchards than the floral plantings. However, after apple bloom, the abundance of known tree fruit pollinating bees increased significantly in the floral plantings, indicating potential for floral plantings to provide additional food and nesting resources when apple flowers are not available.

Parasitism of the Invasive Brown Marmorated Stink Bug, Halyomorpha halys (Hemiptera: Pentatomidae), by the Native Parasitoid, Trichopoda pennipes (Diptera: Tachinidae).

The invasive brown marmorated stink bug, Halyomorpha halys (Hemiptera: Pentatomidae), has been an important agricultural pest in the Mid-Atlantic United States since its introduction in 1996. Biological control by native species may play an important role in suppressing H. halys populations and reduce reliance on chemical control. We collected H. halys adults in agricultural areas of five Pennsylvania counties over two years to examine the extent and characteristics of adult stink bug parasitism by Trichopoda pennipes (Diptera: Tachinidae), a native parasitoid of hemipterans. The overall parasitism rate (in terms of T. pennipes egg deposition) was 2.38 percent. Rates differed among counties and seasons, but not between years. Instances of supernumerary oviposition were evident, and eggs were more commonly found on the ventral side of the thorax, although no differences in egg deposition were found between males and female hosts. T. pennipes has begun to target H. halys adults in Pennsylvania and has the potential to play a role in regulating this pest. Adult parasitism of H. halys by T. pennipes should continue to be monitored, and landscape management and ecological pest management practices that conserve T. pennipes populations should be supported in agricultural areas where H. halys is found.

County-level socioeconomic factors and residential racial, Hispanic, poverty, and unemployment segregation associated with drug overdose deaths in the United States, 2013-2017.

PURPOSE: The purpose of the study was to evaluate overdose death rates in relation to socioeconomic characteristics and measures of socioeconomic residential segregation at substate geography. METHODS: County overdose deaths were linked to socioeconomic characteristics that are related to social vulnerability. Dissimilarity and isolation segregation (comparing individual counties to the adjacent counties and state) and diversity were calculated for race, Hispanic ethnicity, poverty, and unemployment. Negative binomial regression was used to compare county characteristics to death rates. RESULTS: Percent civilian disabled was positively associated with mortality across race and Hispanic ethnicity groups. Some discordant associations included racial and unemployment diversity (null for White, inverse for Hispanic and Black), percent unemployment (positive for White, inverse for Hispanic), percent crowded housing (positive for Black), uninsured (null for White, inverse for Black and Hispanic), and per capita income (positive for Black, inverse for Hispanic). Several residential segregation measures were also significantly associated with overdose death rates, and different magnitudes and directions of associations were observed by race and Hispanic ethnicity. CONCLUSIONS: These results provide future directions, including roles of civilian disability, diversity, and evaluating differential impacts of segregation across racial and ethnic groups. Individual-level data, drug overdose incidence, or larger studies to evaluate interactions may help to elucidate mechanisms.

Complexity of the Basic Reproduction Number (R0).

The basic reproduction number (R0), also called the basic reproduction ratio or rate or the basic reproductive rate, is an epidemiologic metric used to describe the contagiousness or transmissibility of infectious agents. R0 is affected by numerous biological, sociobehavioral, and environmental factors that govern pathogen transmission and, therefore, is usually estimated with various types of complex mathematical models, which make R0 easily misrepresented, misinterpreted, and misapplied. R0 is not a biological constant for a pathogen, a rate over time, or a measure of disease severity, and R0 cannot be modified through vaccination campaigns. R0 is rarely measured directly, and modeled R0 values are dependent on model structures and assumptions. Some R0 values reported in the scientific literature are likely obsolete. R0 must be estimated, reported, and applied with great caution because this basic metric is far from simple.