The Relationship between Neighborhood Disadvantage Trajectories and Health Outcomes in a Large Urban US City

Neighborhood Disadvantage is the sum of a series of socioeconomic indicators that triangulate disadvantaged living conditions in a neighborhood (i.e., poverty, unemployment, home vacancies, female headed households, educational attainment, and segregation). Associations between Neighborhood Disadvantage (ND) and health outcomes have been widely explored. However, findings on mental and behavioral health outcomes remain inconclusive, and individual-level covariates often attenuate relationships between ND and health outcomes. This inconclusive evidence has denied researchers the opportunity to focus on neighborhoods as points of intervention. A potential reason for inconclusive findings is that neighborhoods and individuals are both subject to macro-level socioeconomic events, such as segregation and deindustrialization (loss of manufacturing jobs). This may generate between-level multicollinearity issues in traditional multilevel models because both neighborhoods and individuals are subject to these macro-level events. Instead, this dissertation focused on classifying neighborhoods based on their socioeconomic trajectories. A trajectory was defined as the changes in ND scores that occurred in a neighborhood over time. The objective of this dissertation was to determine whether ND trajectories from 1970 to 2000 were associated with residents\u27 health outcomes in a 2001-2003 study of Chicago residents. This method intended to capture the types of socioeconomic influences, such as segregation and deindustrialization, which may have contributed to variation in neighborhoods\u27 health resources and social norms in later years. Residents\u27 health outcomes were compared across trajectories. This approach was compared to the traditional multilevel model used to analyze associations between ND and health outcomes.;In the first method, The Long-Term Census Tract Database (LTDB) was used to create the Neighborhood Disadvantage. I employed a latent profile analysis of ND scores across 343 Neighborhood Clusters in Chicago from 1970-2000. A multiple-regression was performed to investigate the association between Neighborhood trajectory classifications and three outcomes: depressive symptoms, smoking, and drug dependence symptoms among Chicago Community Adult Health Study (2001-2003) participants (n=3,105). The adjusted models indicated that: residents in Long-Term (LT) Very Disadvantaged and LT Inequality trajectories had significantly greater depressive symptom scores than the LT Advantaged trajectory. Residents of Declining trajectories were 1.66 (95% CI: 1.08-2.55) times more likely to smoke compared to the LT Advantaged trajectory. Residents of LT Very Disadvantaged trajectories were 3.25 times more likely to suffer from drug dependence symptoms than the LT Advantaged trajectory (95% CI: 1.32-8.05). The second method was a mixed-effects multilevel analysis of year 2000 ND and each aforementioned health outcome. ND was significantly and positively associated with depressive symptoms, not associated with drug dependence symptoms, and was negatively associated with smoking in the unadjusted and adjusted models. Overall, the Neighborhood trajectory method for identifying neighborhoods as points of intervention shows promise. Future work may investigate whether the neighborhood trajectory technique is useful in identifying neighborhoods for specific health interventions

Perceptions of the Role of West Virginia’s Cooperative Extension Service in Tobacco Control Coalitions

Despite the fact that the consequences of tobacco use are well identified and known, it remains the single most preventable cause of disease and death in the United States. In West Virginia alone, the adult prevalence of cigarette smoking is 26.8%. This study researches the perceptions of the Cooperative Extension Service’s involvement and role in county-level coalitions that address tobacco use in West Virginia. The research findings provide practical areas to increase the role of the Extension Service in these vital efforts to save lives, reduce economic hardships on families, and reduce the health-care burden on the state governmen

Identifying High-Risk Intersections for Walking and Bicycling Using Multiple Data Sources in the City of San Diego

Over the last decade, demand for active transportation modes such as walking and bicycling has increased. While it is desirable to provide high levels of safety for these eco-friendly modes of travel, unfortunately, the overall percentage of pedestrian and bicycle fatalities increased from 13% to 18% of total road-related fatalities in the last decade. In San Diego County, although the total number of pedestrian and bicyclist fatalities decreased over the same period of time, a similar trend with a more drastic change is observed; the overall percentage of pedestrian and bicycle fatalities increased from 19.5% to 31.8%. This study aims to estimate pedestrian and bicyclist exposure and identify signalized intersections with highest risk for walking and bicycling within the city of San Diego, California, USA. Multiple data sources such as automated pedestrian and bicycle counters, video cameras, and crash data were utilized. Data mining techniques, a new sampling strategy, and automated video processing methods were adopted to demonstrate a holistic approach that can be applied to identify facilities with highest need of improvement. Cluster analysis coupled with stratification was employed to select a representative sample of intersections for data collection. Automated pedestrian and bicycle counting models utilized in this study reached a high accuracy, provided certain conditions exist in video data. Results from exposure modeling showed that pedestrian and bicyclist volume was characterized by transportation network, population, traffic generators, and land use variables. There were both similarities and differences between pedestrian and bicycle models, including different spatial scales of influence by mode. Additionally, the study quantified risk incorporating injury severity levels, frequency of victims, distance crossed, and exposure into a single equation. It was found that not all intersections with the highest number of pedestrian and bicyclist victims were identified as high-risk after exposure and other factors such as crash severity were taken into account. Document type: Articl

Disk or Companion: Characterizing Excess Infrared Flux in Seven White Dwarf Systems with Near-Infrared Spectroscopy

Excess infrared flux from white dwarf stars is likely to arise from a dusty debris disk or a cool companion. In this work, we present near-infrared spectroscopic observations with Keck/MOSFIRE, Gemini/GNIRS, and Gemini/Flamingos-2 of seven white dwarfs with infrared excesses identified in previous studies. We confirmed the presence of dust disks around four white dwarfs (Gaia J0611-6931, Gaia J0006+2858, Gaia J2100+2122, and WD 0145+234) as well as two new white dwarf brown dwarf pairs (Gaia J0052+4505 and Gaia J0603+4518). In three of the dust disk systems, we detected for the first time near-infrared metal emissions (Mg I, Fe I, and Si I) from a gaseous component of the disk. We developed a new Markov Chain Monte Carlo framework to constrain the geometric properties of each dust disk. In three systems, the dust disk and the gas disk appear to coincide spatially. For the two brown dwarf white dwarf pairs, we identified broad molecular absorption features typically seen in L dwarfs. The origin of the infrared excess around Gaia J0723+6301 remains a mystery. Our study underlines how near-infrared spectroscopy can be used to determine sources of infrared excess around white dwarfs, which has now been detected in hundreds of systems photometrically.Comment: 23 pages, 10 figures, 5 tables, AJ, in pres

An Evaluability Assessment of the West Virginia Physical Activity Plan, 2015: Lessons Learned for Other State Physical Activity Plans

Background The US National Physical Activity Plan (NPAP) was released in 2009 as a national strategic plan to increase physical activity (PA). The NPAP emphasized implementing state and local PA pro- grams. Dissemination of information about NPAP has been lim- ited, however. Community Context West Virginia is a predominantly rural state with high rates of chronic diseases associated with physical inactivity. In 2015 an evaluability assessment (EA) of the West Virginia Physical Activ- ity Plan (WVPAP) was conducted, and community stakeholders were invited to participate in updating the plan. Methods A good EA seeks stakeholder input, assists in identifying program areas that need improvement, and ensures that a full evaluation will produce useful information. Data for this EA were collected via national stakeholder interviews, document reviews, discussions among workgroups consisting of state and local stakehold- ers, and surveys to determine how well the WVPAP had been im- plemented. Outcome The EA highlighted the need for WVPAP leaders to 1) establish a specific entity to implement local PA plans, 2) create sector-spe- cific logic models to simplify the WVPAP for local stakeholders, 3) evaluate the PA plan’s implementation frequently from the out- set, 4) use quick and efficient engagement techniques with stake- holders when working with them to select strategies, tactics, and measurable outcomes, and 5) understand the elements necessary to implement, manage, and evaluate a good PA plan. Interpretation An EA process is recommended for other leaders of PA plans. Our project highlights the stakeholders’ desire to simplify the WVPAP so that it can be set up as a locally driven process that engages communities in implementation

Elevated preoperative Galectin-3 is associated with acute kidney injury after cardiac surgery

Abstract Background Previous research suggests that novel biomarkers may be used to identify patients at increased risk of acute kidney injury following cardiac surgery. The purpose of this study was to evaluate the relationship between preoperative levels of circulating Galectin-3 (Gal-3) and acute kidney injury after cardiac surgery. Methods Preoperative serum Gal-3 was measured in 1498 patients who underwent coronary artery bypass graft (CABG) surgery and/or valve surgery as part of the Northern New England Biomarker Study between 2004 and 2007. Preoperative Gal-3 levels were measured using multiplex assays and grouped into terciles. Univariate and multinomial logistic regression was used to assess the predictive ability of Gal-3 terciles and AKI occurrence and severity. Results Before adjustment, patients in the highest tercile of Gal-3 had a 2.86-greater odds of developing postoperative KDIGO Stage 2 or 3 (p < 0.001) and 1.70-greater odds of developing KDIGO Stage 1 (p = < 0.001), compared to the first tercile. After adjustment, patients in the highest tercile had 2.95-greater odds of developing KDIGO Stage 2 or 3 (p < 0.001) and 1.71-increased odds of developing KDIGO Stage 1 (p = 0.001), compared to the first tercile. Compared to the base model, the addition of Gal-3 terciles improved discriminatory power compared to without Gal-3 terciles (test of equality = 0.042). Conclusion Elevated preoperative Gal-3 levels significantly improves predictive ability over existing clinical models for postoperative AKI and may be used to augment risk information for patients at the highest risk of developing AKI and AKI severity after cardiac surgery.https://deepblue.lib.umich.edu/bitstream/2027.42/145735/1/12882_2018_Article_1093.pd

Thrombin promotes diet-induced obesity through fibrin-driven inflammation

Obesity promotes a chronic inflammatory and hypercoagulable state that drives cardiovascular disease, type 2 diabetes, fatty liver disease, and several cancers. Elevated thrombin activity underlies obesity-linked thromboembolic events, but the mechanistic links between the thrombin/fibrin(ogen) axis and obesity-associated pathologies are incompletely understood. In this work, immunohistochemical studies identified extravascular fibrin deposits within white adipose tissue and liver as distinct features of mice fed a high-fat diet (HFD) as well as obese patients. Fibγ390–396A mice carrying a mutant form of fibrinogen incapable of binding leukocyte αMβ2-integrin were protected from HFD-induced weight gain and elevated adiposity. Fibγ390–396A mice had markedly diminished systemic, adipose, and hepatic inflammation with reduced macrophage counts within white adipose tissue, as well as near-complete protection from development of fatty liver disease and glucose dysmetabolism. Homozygous thrombomodulin-mutant ThbdPro mice, which have elevated thrombin procoagulant function, gained more weight and developed exacerbated fatty liver disease when fed a HFD compared with WT mice. In contrast, treatment with dabigatran, a direct thrombin inhibitor, limited HFD-induced obesity development and suppressed progression of sequelae in mice with established obesity. Collectively, these data provide proof of concept that targeting thrombin or fibrin(ogen) may limit pathologies in obese patients

Relationship Between Child Perfectionism and Psychological Disorders

Objective: Perfectionism is one of the variables related to the correct emotional development or with the appearance of clinical symptomatology in childhood. A study has been designed to evaluate the differential effect that each dimension of perfectionism (external pressure, self-exigency, and negative self-evaluation) has in a Spanish children sample of general population for each of the following clinical aspects: irritability, worthlessness feelings, thinking problems, and psychophysiological symptoms. Method: By a random cluster sampling, a total of 2,636 children from 8 to 12 years (M = 9.9, SD = 1.2; 51.3% boys) took part in this research. A serial multiple mediators model was used to check the relation between external pressure over the clinical symptoms through self-exigency and negative-self-evaluation. Results: The results have shown a predictive effect of external pressure over a great variety of clinical symptomatology (irritability, worthlessness, thinking problems, and psychophysiological symptoms), a relation mediated by self-exigency and negative self-evaluation. These relations suggest that external pressure and negative self-evaluation are maladaptive dimensions as they predict the appearance of symptomatology, being the level of self-exigency a protective dimension and favoring the child’s positive development. Conclusions: In consequence, these results point to the importance of the study of these variables that can generate difficulties in childhood in order to improve children’s quality of life and their correct development.This research was supported by the Spanish Ministry of Economy and Competitiveness [Ref. PSI2017-85724-P and Ref. PSI2017- 83966-R (MINECO/AEI/FEDER/UE)]

Identification and characterization of a novel non-structural protein of bluetongue virus

Bluetongue virus (BTV) is the causative agent of a major disease of livestock (bluetongue). For over two decades, it has been widely accepted that the 10 segments of the dsRNA genome of BTV encode for 7 structural and 3 non-structural proteins. The non-structural proteins (NS1, NS2, NS3/NS3a) play different key roles during the viral replication cycle. In this study we show that BTV expresses a fourth non-structural protein (that we designated NS4) encoded by an open reading frame in segment 9 overlapping the open reading frame encoding VP6. NS4 is 77–79 amino acid residues in length and highly conserved among several BTV serotypes/strains. NS4 was expressed early post-infection and localized in the nucleoli of BTV infected cells. By reverse genetics, we showed that NS4 is dispensable for BTV replication in vitro, both in mammalian and insect cells, and does not affect viral virulence in murine models of bluetongue infection. Interestingly, NS4 conferred a replication advantage to BTV-8, but not to BTV-1, in cells in an interferon (IFN)-induced antiviral state. However, the BTV-1 NS4 conferred a replication advantage both to a BTV-8 reassortant containing the entire segment 9 of BTV-1 and to a BTV-8 mutant with the NS4 identical to the homologous BTV-1 protein. Collectively, this study suggests that NS4 plays an important role in virus-host interaction and is one of the mechanisms played, at least by BTV-8, to counteract the antiviral response of the host. In addition, the distinct nucleolar localization of NS4, being expressed by a virus that replicates exclusively in the cytoplasm, offers new avenues to investigate the multiple roles played by the nucleolus in the biology of the cell