Public Health Informatics in Local and State Health Agencies: An Update From the Public Health Workforce Interests and Needs Survey

OBJECTIVE: To characterize public health informatics (PHI) specialists and identify the informatics needs of the public health workforce. DESIGN: Cross-sectional study. SETTING: US local and state health agencies. PARTICIPANTS: Employees from state health agencies central office (SHA-COs) and local health departments (LHDs) participating in the 2017 Public Health Workforce Interests and Needs Survey (PH WINS). We characterized and compared the job roles for self-reported PHI, "information technology specialist or information system manager" (IT/IS), "public health science" (PHS), and "clinical and laboratory" workers. MAIN OUTCOME MEASURE: Descriptive statistics for demographics, income, education, public health experience, program area, job satisfaction, and workplace environment, as well as data and informatics skills and needs. RESULTS: A total of 17 136 SHA-CO and 26 533 LHD employees participated in the survey. PHI specialist was self-reported as a job role among 1.1% and 0.3% of SHA-CO and LHD employees. The PHI segment most closely resembled PHS employees but had less public health experience and had lower salaries. Overall, fewer than one-third of PHI specialists reported working in an informatics program area, often supporting epidemiology and surveillance, vital records, and communicable disease. Compared with PH WINS 2014, current PHI respondents' satisfaction with their job and workplace environment moved toward more neutral and negative responses, while the IT/IS, PHS, and clinical and laboratory subgroups shifted toward more positive responses. The PHI specialists were less likely than those in IT/IS, PHS, or clinical and laboratory roles to report gaps in needed data and informatics skills. CONCLUSIONS: The informatics specialists' role continues to be rare in public health agencies, and those filling that role tend to have less public health experience and be less well compensated than staff in other technically focused positions. Significant data and informatics skills gaps persist among the broader public health workforce

Labeless and reversible immunosensor assay based upon an electrochemical current-transient protocol

A novel labeless and reversible immunoassay based upon an electrochemical current-transient protocol is reported which offers many advantages in comparison to classical immuno-biochemical analyses in terms of simplicity, speed of response, reusability and possibility of multiple determinations. Conducting polypyrrole films containing antibodies against 1) Bovine Serum Albumin (BSA) and 2) Digoxin were deposited on the surface of platinum electrodes to produce conductive affinity matrices having clearly defined binding characteristics. The deposition process has been investigated using 125I labelled anti-digoxin to determine optimal fabrication protocols. Antibody integrity and activity, together with non-specific binding of antigen on the conducting matrix have also been investigated using tritiated digoxin to probe polypyrrole/anti-digoxin films. Amperometric responses to digoxin were recorded in flow conditions using these films, but the technique was limited in use mainly due to baseline instability. Anti-BSA - polypyrrole matrices were investigated in more detail in both flow and quiescent conditions. No observable response was found in flow conditions, however under quiescent conditions (in non-stirred batch cell), anti-BSA – polypyrrole films have been demonstrated to function as novel quantitative chronoamperometric immuno-biosensors when interrogated using a pulsed potential waveform. The behaviour of the electrodes showed that the antibody/antigen binding and/or interaction process underlying the response observed was reversible in nature, indicating that the electrodes could be used for multiple sensing protocols. Calibration profiles for BSA demonstrated linearity for a concentration range of 0-50 ppm but tended towards a plateau at higher concentrations. Factors relating to replicate sensor production, sample measurement and reproducibility are discuss

An X-ray Mini-survey of Nearby Edge-on Starburst Galaxies II. The Question of Metal Abundance

(abbreviated) We have undertaken an X-ray survey of a far-infrared flux limited sample of seven nearby edge-on starburst galaxies. Here, we examine the two X-ray-brightest sample members NGC 253 and M 82 in a self-consistent manner, taking account of the spatial distribution of the X-ray emission in choosing our spectral models. There is significant X-ray absorption in the disk of NGC 253. When this is accounted for we find that multi-temperature thermal plasma models with significant underlying soft X-ray absorption are more consistent with the imaging data than single-temperature models with highly subsolar abundances or models with minimal absorption and non-equilibrium thermal ionization conditions. Our models do not require absolute abundances that are inconsistent with solar values or unusually supersolar ratios of the alpha-burning elements with respect to Fe (as claimed previously). We conclude that with current data, the technique of measuring abundances in starburst galaxies via X-ray spectral modeling is highly uncertain. Based on the point-like nature of much of the X-ray emission in the PSPC hard-band image of NGC 253, we suggest that a significant fraction of the ``extended'' X-ray emission in the 3-10 keV band seen along the disk of the galaxy with ASCA and BeppoSAX (Cappi et al.) is comprised of discrete sources in the disk, as opposed to purely diffuse, hot gas. This could explain the low Fe abundances of ~1/4 solar derived for pure thermal models.Comment: (accepted for publication in the Astrophysical Journal

Characterizing Informatics Roles and Needs of Public Health Workers: Results from the Public Health Workforce Interests and Needs Survey

Objective: To characterize public health workers who specialize in informatics and to assess informatics-related aspects of the work performed by the public health workforce. Methods (Design, Setting, Participants): Using the nationally representative Public Health Workforce Interests and Needs Survey (PH WINS), we characterized and compared responses from informatics, information technology (IT), clinical and laboratory, and other public health science specialists working in state health agencies. Main Outcome Measures: Demographics, income, education, and agency size were analyzed using descriptive statistics. Weighted medians and interquartile ranges were calculated for responses pertaining to job satisfaction, workplace environment, training needs, and informatics-related competencies. Results: Of 10 246 state health workers, we identified 137 (1.3%) informatics specialists and 419 (4.1%) IT specialists. Overall, informatics specialists are younger, but share many common traits with other public health science roles, including positive attitudes toward their contributions to the mission of public health as well as job satisfaction. Informatics specialists differ demographically from IT specialists, and the 2 groups also differ with respect to salary as well as their distribution across agencies of varying size. All groups identified unmet public health and informatics competency needs, particularly limited training necessary to fully utilize technology for their work. Moreover, all groups indicated a need for greater future emphasis on leveraging electronic health information for public health functions. Conclusions: Findings from the PH WINS establish a framework and baseline measurements that can be leveraged to routinely monitor and evaluate the ineludible expansion and maturation of the public health informatics workforce and can also support assessment of the growth and evolution of informatics training needs for the broader field. Ultimately, such routine evaluations have the potential to guide local and national informatics workforce development policy

Very Extended X-ray and H-alpha Emission in M82: Implications for the Superwind Phenomenon

We discuss the properties and implications of a 3.7x0.9 kpc region of spatially-coincident X-ray and H-alpha emission about 11.6 kpc to the north of the galaxy M82 previously discussed by Devine and Bally (1999). The PSPC X-ray spectrum is fit by thermal plasma (kT=0.80+-0.17 keV) absorbed by only the Galactic foreground column density. We evaluate the relationship of the X-ray/H-alpha ridge to the M82 superwind. The main properties of the X-ray emission can all be explained as being due to shock-heating driven as the superwind encounters a massive ionized cloud in the halo of M82. This encounter drives a slow shock into the cloud, which contributes to the excitation of the observed H-alpha emission. At the same time, a fast bow-shock develops in the superwind just upstream of the cloud, and this produces the observed X-ray emission. This interpretation would imply that the superwind has an outflow speed of roughly 800 km/s, consistent with indirect estimates based on its general X-ray properties and the kinematics of the inner kpc-scale region of H-alpha filaments. The gas in the M82 ridge is roughly two orders-of-magnitude hotter than the minimum "escape temperature" at this radius, so this gas will not be retained by M82. (abridged)Comment: 24 pages (latex), 3 figures (2 gif files and one postscript), accepted for publication in Part 1 of The Astrophysical Journa

The Origin of the Mass--Metallicity Relation: Insights from 53,000 Star-Forming Galaxies in the SDSS

We utilize Sloan Digital Sky Survey imaging and spectroscopy of ~53,000 star-forming galaxies at z~0.1 to study the relation between stellar mass and gas-phase metallicity. We derive gas-phase oxygen abundances and stellar masses using new techniques which make use of the latest stellar evolutionary synthesis and photoionization models. We find a tight (+/-0.1 dex) correlation between stellar mass and metallicity spanning over 3 orders of magnitude in stellar mass and a factor of 10 in metallicity. The relation is relatively steep from 10^{8.5} - 10^{10.5} M_sun, in good accord with known trends between luminosity and metallicity, but flattens above 10^{10.5} M_sun. We use indirect estimates of the gas mass based on the H-alpha luminosity to compare our data to predictions from simple closed box chemical evolution models. We show that metal loss is strongly anti-correlated with baryonic mass, with low mass dwarf galaxies being 5 times more metal-depleted than L* galaxies at z~0.1. Evidence for metal depletion is not confined to dwarf galaxies, but is found in galaxies with masses as high as 10^{10} M_sun. We interpret this as strong evidence both of the ubiquity of galactic winds and of their effectiveness in removing metals from galaxy potential wells.Comment: ApJ accepted, 15 pages, 9 figures, emulateapj.st

Absorption-Line Probes of Gas and Dust in Galactic Superwinds

We discuss moderate resolution spectra of the NaD absorption-line in a sample of 32 far-IR-bright starburst galaxies. In 18 cases, the line is produced primarily by interstellar gas, and in 12 of these it is blueshifted by over 100 km/s relative to the galaxy systemic velocity. The absorption-line profiles in these outflow sources span the range from near the galaxy systemic velocity to a maximum blueshift of 400 to 600 km/s. The outflows occur in galaxies systematically viewed more nearly face-on than the others. We therefore argue that the absorbing material consists of ambient interstellar gas accelerated along the minor axis of the galaxy by a hot starburst-driven superwind. The NaD lines are optically-thick, but indirect arguments imply total Hydrogen column densities of N_H = few X 10^{21} cm^{-2}. This implies that the superwind is expelling matter at a rate comparable to the star-formation rate. This outflowing material is very dusty: we find a strong correlation between the depth of the NaD profile and the line-of-sight reddening (E(B-V) = 0.3 to 1 over regions several-to-ten kpc in size). The estimated terminal velocities of superwinds inferred from these data and extant X-ray data are typically 400 to 800 km/s, are independent of the galaxy rotation speed, and are comparable to (substantially exceed) the escape velocities for $L_*$ (dwarf) galaxies. The resulting loss of metals can establish the mass-metallicity relation in spheroids, produce the observed metallicity in the ICM, and enrich a general IGM to 10$^{-1}$ solar metallicity. If the outflowing dust grains survive their journey into the IGM, their effect on observations of cosmologically-distant objects is significant.Comment: 65 pages, including 16 figures. ApJ, in pres

First radial velocity results from the MINiature Exoplanet Radial Velocity Array (MINERVA)

The MINiature Exoplanet Radial Velocity Array (MINERVA) is a dedicated observatory of four 0.7m robotic telescopes fiber-fed to a KiwiSpec spectrograph. The MINERVA mission is to discover super-Earths in the habitable zones of nearby stars. This can be accomplished with MINERVA's unique combination of high precision and high cadence over long time periods. In this work, we detail changes to the MINERVA facility that have occurred since our previous paper. We then describe MINERVA's robotic control software, the process by which we perform 1D spectral extraction, and our forward modeling Doppler pipeline. In the process of improving our forward modeling procedure, we found that our spectrograph's intrinsic instrumental profile is stable for at least nine months. Because of that, we characterized our instrumental profile with a time-independent, cubic spline function based on the profile in the cross dispersion direction, with which we achieved a radial velocity precision similar to using a conventional "sum-of-Gaussians" instrumental profile: 1.8 m s$^{-1}$ over 1.5 months on the RV standard star HD 122064. Therefore, we conclude that the instrumental profile need not be perfectly accurate as long as it is stable. In addition, we observed 51 Peg and our results are consistent with the literature, confirming our spectrograph and Doppler pipeline are producing accurate and precise radial velocities.Comment: 22 pages, 9 figures, submitted to PASP, Peer-Reviewed and Accepte

Probiotics, prebiotics, and the host microbiome: the science of translation

Recent advances in our understanding of the community structure and function of the human microbiome have implications for the potential role of probiotics and prebiotics in promoting human health. A group of experts recently met to review the latest advances in microbiota/microbiome research and discuss the implications for development of probiotics and prebiotics, primarily as they relate to effects mediated via the intestine. The goals of the meeting were to share recent advances in research on the microbiota, microbiome, probiotics, and prebiotics, and to discuss these findings in the contexts of regulatory barriers, evolving healthcare environments, and potential effects on a variety of health topics, including the development of obesity and diabetes; the long-term consequences of exposure to antibiotics early in life to the gastrointestinal (GI) microbiota; lactose intolerance; and the relationship between the GI microbiota and the central nervous system, with implications for depression, cognition, satiety, and mental health for people living in developed and developing countries. This report provides an overview of these discussions

Human Cytomegalovirus Intrahost Evolution--A New Avenue for Understanding and Controlling Herpesvirus Infections [preprint]

Human cytomegalovirus (HCMV) is exquisitely adapted to the human host, and much research has focused on its evolution over long timescales spanning millennia. Here, we review recent data exploring the evolution of the virus on much shorter timescales, on the order of days or months. We describe the intrahost genetic diversity of the virus isolated from humans, and how this diversity contributes to HCMV spatiotemporal evolution. We propose mechanisms to explain the high levels of intrahost diversity and discuss how this new information may shed light on HCMV infection and pathogenesis