Racial Disparities in Air Pollution Burden and COVID-19 Deaths in Louisiana, USA, in the Context of Long-Term Changes in Fine Particulate Pollution

Black Americans in Louisiana are disproportionately dying from COVID-19, and environmental disparities may be contributing to this injustice. While Black communities in Louisiana\u27s industrialized regions (e.g., Cancer Alley, Calcasieu Parish) have been overburdened with pollution for decades, this disparity has not been evaluated by using recent data. Here, we explore statewide relationships among air pollution burden, race, COVID-19 death rates, and other health/socioeconomic factors. Measures of pollution burden included satellite-derived particulate matter (PM2.5) concentrations and health risks from toxic air pollution (i.e., respiratory hazard [RH] and immunological hazard [IH], estimated by the Environmental Protection Agency). In addition, we evaluate changes in emissions and ambient concentrations of fine PM(2.5)in Louisiana over the past few decades. Our overall goal was to better understand Louisiana\u27s burden of air pollution in the context of COVID-19. By all measures, a higher burden of air pollution was associated with larger percentages of Black residents and increased unemployment across Louisiana census tracts. Across parishes, higher COVID-19 death rates were associated with increased RH and IH and larger percentages of Black residents. These associations were not driven by diabetes, obesity, smoking, age, or poverty. Industrial sources comprised more of Louisiana\u27s PM(2.5)in 2017 versus 1990, as vehicle contributions declined 75% whereas industrial emissions remained about the same overall (despite variation in the interim). Ambient concentrations of PM(2.5)decreased statewide from 2000 to 2015, but subsequently increased in south Louisiana, concurrent with an upward trend in industrial emissions. Our findings highlight the critical need to address Louisiana\u27s pollution disparities and to recognize air pollution exposure as a risk factor for COVID-19

A Low-Cost Wireless Portable Particulate Matter Monitoring System

This paper describes a portable sensor system design for environmental research. The designed system has been deployed in many environments and has been EMI/EMC approved for operation in commercial aircraft cabins. The sensor suite includes particulate matter, CO, CO2, temperature, humidity, pressure, light intensity, and sound sensors. Multiple sensor systems can be deployed at once to form a wireless sensor network. Each sensor node is powered either with six AA batteries or via a transformer and standard outlet. The data collected by a node can be stored locally on the device and/or sent through the integrated ZigBee mesh network to a central coordinator node. As of this writing, single nodes have been carried by passengers to monitor the normal airliner cabin flight conditions, and networks have been used to monitor indoor and outdoor air quality conditions

Frequency and Significance of HIV Infection among Patients Diagnosed with Thrombotic Thrombocytopenic Purpura

Background. Case series of patients with a diagnosis of thrombotic thrombocytopenic purpura (TTP) have reported different frequencies of human immunodeficiency virus (HIV) infection; some series suggest that HIV infection may cause TTP. Methods. We systematically reviewed all reports of HIV infection in case series of patients with TTP. We analyzed data from the Oklahoma TTP-HUS (hemolytic uremic syndrome) Registry, an inception cohort of 362 consecutive patients, for 1989-2007. Results. Nineteen case series reported the occurrence of HIV infection at the time of diagnosis of TTP in 0%-83% of patients; individual patient data were rarely described. The Oklahoma TTP-HUS Registry determined the HIV status at the time of diagnosis of TTP in 351 (97%) of 362 patients. HIV infection was documented in 6 (1.84%; 95% CI, 0.68%-4.01%) of 326 adult patients (age, 26-51 years); follow-up data were complete for all 6 patients. The period prevalence of HIV infection among all adults in the Oklahoma TTP-HUS Registry region for 1989-2007 was 0.30%. One patient had typical features of TTP with 5 relapses. Five patients had single episodes; in 4, the clinical features that had initially suggested the diagnosis of TTP were subsequently attributed to malignant hypertension (in 3 patients) and disseminated Kaposi sarcoma (in 1 patient). Conclusions. HIV infection, similar to other inflammatory conditions, may trigger acute episodes of TTP in susceptible patients. More commonly, acquired immunodeficiency syndrome-related disorders may mimic the clinical features of TTP. If the diagnosis of TTP is suggested in a patient with HIV infection, there should be careful evaluation for alternative diagnoses and cautious consideration of plasma exchange, the required treatment for TT

What is the Impact of Regional Training Centers on Practice Location and Specialty Choice of Medical Students?

In comparison to Indianapolis students, those who train at regional campuses are more likely to go into Primary Care and Family Medicine, in particular. Regional campus students are more likely to return to the region to practice medicine after completing training.AAMC Central Group on Education Affairs (CGEA) Spring Meetin

Resolving the ancestry of Austronesian-speaking populations

There are two very different interpretations of the prehistory of Island Southeast Asia (ISEA), with genetic evidence invoked in support of both. The “out-of-Taiwan” model proposes a major Late Holocene expansion of Neolithic Austronesian speakers from Taiwan. An alternative, proposing that Late Glacial/postglacial sea-level rises triggered largely autochthonous dispersals, accounts for some otherwise enigmatic genetic patterns, but fails to explain the Austronesian language dispersal. Combining mitochondrial DNA (mtDNA), Y-chromosome and genome-wide data, we performed the most comprehensive analysis of the region to date, obtaining highly consistent results across all three systems and allowing us to reconcile the models. We infer a primarily common ancestry for Taiwan/ISEA populations established before the Neolithic, but also detected clear signals of two minor Late Holocene migrations, probably representing Neolithic input from both Mainland Southeast Asia and South China, via Taiwan. This latter may therefore have mediated the Austronesian language dispersal, implying small-scale migration and language shift rather than large-scale expansion

Maternal exposure to polychlorinated biphenyls and the secondary sex ratio: an occupational cohort study

Though commercial production of polychlorinated biphenyls was banned in the United States in 1977, exposure continues due to their environmental persistence. Several studies have examined the association between environmental polychlorinated biphenyl exposure and modulations of the secondary sex ratio, with conflicting results. Our objective was to evaluate the association between maternal preconceptional occupational polychlorinated biphenyl exposure and the secondary sex ratio. We examined primipara singleton births of 2595 women, who worked in three capacitor plants at least one year during the period polychlorinated biphenyls were used. Cumulative estimated maternal occupational polychlorinated biphenyl exposure at the time of the infant's conception was calculated from plant-specific job-exposure matrices. A logistic regression analysis was used to evaluate the association between maternal polychlorinated biphenyl exposure and male sex at birth (yes/no). Maternal body mass index at age 20, smoking status, and race did not vary between those occupationally exposed and those unexposed before the child's conception. Polychlorinated biphenyl-exposed mothers were, however, more likely to have used oral contraceptives and to have been older at the birth of their first child than non-occupationally exposed women. Among 1506 infants liveborn to polychlorinated biphenyl-exposed primiparous women, 49.8% were male; compared to 49.9% among those not exposed (n = 1089). Multivariate analyses controlling for mother's age and year of birth found no significant association between the odds of a male birth and mother's cumulative estimated polychlorinated biphenyl exposure to time of conception. Based on these data, we find no evidence of altered sex ratio among children born to primiparous polychlorinated biphenyl-exposed female workers