The relationship between neighborhood economic deprivation and asthma-associated emergency department visits in Maryland

BackgroundAsthma represents a substantial public health challenge in the United States, affecting over 25 million adults. This study investigates the impact of neighborhood economic deprivation on asthma-associated Emergency Department (ED) visits in Maryland, using the Distressed Communities Index (DCI) for analysis.MethodsA retrospective analysis of Maryland's Emergency Department Databases from January 2018 to December 2020 was conducted, focusing on asthma-associated ED visits.ResultsThe study involved 185,317 ED visits, majority of which were females (56.3%) and non-Hispanic whites (65.2%). A significant association was found between increased neighborhood socioeconomic deprivation and asthma-related ED visits. The poorest neighborhoods showed the highest rates of such visits. Compared to prosperous areas, neighborhoods classified from Comfortable to Distressed had progressively higher odds for asthma-related ED visits (Comfortable: OR = 1.14, Distressed OR = 1.65). Other significant asthma predictors included obesity, female gender, tobacco smoking, and older age.ConclusionThere is a substantive association between higher asthma-related ED visits and high neighborhood economic deprivation, underscoring the impact of socioeconomic factors on health outcomes.Public health implicationsAddressing healthcare disparities and improving access to care in economically distressed neighborhoods is crucial. Targeted interventions, such as community health clinics and asthma education programs, can help mitigate the impact of neighborhood disadvantage

Impact of Point-of-Care Testing on the Management of Sexually Transmitted Infections in South Africa: Evidence from the HVTN702 Human Immunodeficiency Virus Vaccine Trial.

BACKGROUND: Alternative approaches to syndromic management are needed to reduce rates of sexually transmitted infections (STIs) in resource-limited settings. We investigated the impact of point-of-care (POC) versus central laboratory-based testing on STI treatment initiation and STI adverse event (STI-AE) reporting. METHODS: We used Kaplan-Meier and Cox regression models to compare times to treatment initiation and STI-AE reporting among HVTN702 trial participants in South Africa. Neisseria gonorrhoeae (NG) and Chlamydia trachomatis (CT) were diagnosed POC at eThekwini clinic and in a central laboratory at Verulam/Isipingo clinics. All clinics used POC assays for Trichomonas vaginalis (TV) testing. RESULTS: Among 959 women (median age, 23 [interquartile range, 21-26] years), median days (95% confidence interval [95%CI]) to NG/CT treatment initiation and NG/CT-AE reporting were 0.20 (.16-.25) and 0.24 (.19-.27) at eThekwini versus 14.22 (14.12-15.09) and 15.12 (13.22-21.24) at Verulam/Isipingo (all P .05). Cox regression analysis revealed that NG/CT treatment initiation (adjusted hazard ratio [aHR], 39.62 [95%CI, 15.13-103.74]) and NG/CT-AE reporting (aHR, 3.38 [95%CI, 2.23-5.13]) occurred faster at eThekwini versus Verulam/Isipingo, while times to TV treatment initiation (aHR, 0.93 [95%CI, .59-1.48]) and TV-AE reporting (aHR, 1.38 [95%CI, .86-2.21]) were similar. CONCLUSIONS: POC testing led to prompt STI management with potential therapeutic and prevention benefits, highlighting its utility as a diagnostic tool in resource-limited settings

An improved method for estimating ice line for zonal energy balance climate models

In this article we consider an energy balance climate model. For a given ice line, we use spectral method to derive an approximation of the solution. Then we propose a method to update the ice line and to derive an updated approximation of the solution. We compare the difference between the approximation with fixed ice line and the approximation with updated ice line by looking at the temperature profile at some specific locations and times. The significance of the method to update the ice line is that it is model free. Therefore, it can be used in other climate models

Interdomain Stabilization Impairs CD4 Binding and Improves Immunogenicity of the HIV-1 Envelope Trimer

International audienc