Use of Zip Code Based Aggregate Indicators to Assess Race Disparities in COVID-19

Objective

In the first six months of the pandemic, information on race and ethnicity was missing for half of the US COVID-19 cases. Combining case ascertainment with census-based zip code indicators may identify COVID-19 race-ethnicity disparities in the absence of individual-level data.

Design

Ecological retrospective study for the period March-July 2020.

Setting

Population-based investigation, Allegheny County, Pennsylvania.

Participants

All COVID-19 cases, adjusted for zip code area population, in the early period of the pandemic.

Main Outcome Measures

Monthly COVID-19 incidence and requests for human services by zip code level indicators of race-ethnicity and poverty.

Results

In the early period of the pandemic, COVID-19 incidence was higher in zip codes with a greater proportion of racial and ethnic minorities. Zip codes with the highest quartile of minority residents (>25.1% of population) had a COVID-19 incidence of 60.1 (95% CI: 51.7-68.5) per 10,000 in this period; zip codes with the lowest quartile of minority residents (<6.3%) had an incidence of 31.3 (95% CI: 14.4-48.2). Requests for human services during this period (volume of 211 calls and county services) confirm these disparities.

Conclusion

Use of census-defined race-ethnicity proportions by zip code offers a way to identify disparities when individual race-ethnicity data are unavailable.

Injury Profile of Children 0&ndash;14 Years Old in Honduras

Aim:

At the University Medical School Hospital in Honduras, a paper-based injury surveillance system (InSS) registered all injury cases in the emergency department in 2013. This is the first study to identify the injury profiles of children in Honduras, using the InSS data.

Materials and methods:

A case-series study was carried out using the InSS. Children aged 0–14 years were identified in the data set, and the descriptive statistics and bivariate analyzes were completed using this data.

Results:

Of 17,971 study patients, 5,873 (32.7%) patients were 0–14 years old with an average age of 7.3 ± 4.1 years. Unintentional injuries, most commonly road traffic incidents, falls, and blunt force trauma, constituted 94.2% of the total injuries. In all, 1.9% (109) self-inflicted injuries and 3.9% (230) deliberate interpersonal injuries with 35.8% due to blunt force trauma and 22.6% due to gunshot wounds. The mortality rate was 0.2%, and 84% of children spent 3 or fewer days in the hospital. Firearm injuries were more severe and resulted in a longer hospital stay.

Conclusion:

Childhood injuries are highly prevalent and a public concern throughout Honduras. This study profiles these injuries of over an entire year and provides insight into the types of interventions that could be effective in preventing and managing the high burden of pediatric injuries in this region.

Clinical significance:

This study provides the groundwork to profiling the high burden of injuries in Honduran children. Targeted injury prevention strategies and interventions can begin to be developed and implemented using the profile.

Improving tissue-sample profiling: The optimization and application of immunohistochemistry

Though it has been used for more than 70 years, immunohistochemistry (IHC) is still an essential research and diagnostic tool in many scientific laboratories. Understanding the basic principles underlying IHC and how to address the technical aspects of experimental design are key to producing high-quality, reproducible data. IHC is used in a variety of fields—from cancer diagnostics to neuroscience research—but some common advice can be applied across-the-board. Many variables are vital for generating valuable results and require optimization when designing IHC experiments, such as fixing tissue, choosing the proper antibodies, and defining the proper controls. In this webinar, we will hear from experts who will share their insights into the key aspects of assay design.

Auditory stimulus-induced changes in immediate-early gene expression related to an inborn perceptual predisposition

Auditory-induced expression of the immediate-early gene ZENK was examined in 18 brain areas of domestic chicken and Japanese quail subjects with no previous exposure to parental vocalizations. After one 30-min exposure (approximately 120 calls) within 24 h of hatching to either the chicken or quail maternal call, paired subjects from each species showed significantly more intense levels of ZENK staining to conspecific (own species) calls. Single brain areas did not show consistent, large differences in ZENK expression across all subject pairs. Instead, a majority of brain areas exhibited a small conspecific stimulus-induced staining advantage in each species. The species differed in the quantitative distribution of ZENK responses among brain areas; qualitative patterns of call-induced staining exhibited both similarities and differences. The results suggest shared neural correlates and potential developmental/evolutionary differences in congenital brain responses to biologically significant auditory stimuli in naïve individuals of the two species.

Transferring an inborn auditory perceptual predisposition with interspecies brain transplants

Inborn species' perceptual preferences are thought to serve as important guides for neonatal learning in most species of higher vertebrates. Although much work has been carried out on experiential contributions to the expression of such preferences, their neural and developmental correlates remain largely unexplored. Here we use embryonic neural transplants between two bird species, the Japanese quail and the domestic chicken, to demonstrate that an inborn auditory perceptual predisposition is transferable between species. The transfer of the perceptual preference was dissociated from changes to the vocalizations of the resulting animals (called chimeras), suggesting that experiential differences in auditory self-stimulation cannot explain the perceptual change. A preliminary localization of the effective brain region for the behavioral transfer by using a naturally occurring species-cell marker revealed that it is not contained within the major avian auditory pathways. To our knowledge, this is the first demonstration that abstract aspects of auditory perception can be transferred between species with transplants of the central nervous system.

Evolutionary conservation of the immediate-early gene ZENK

Immediate-early genes are part of a cellular response mechanism that reacts to biochemical, electrical, pharmacological, and physiological stimuli as well as changes in behavioral state. In the brain, immediate-early genes-such as egr-1 have been used as markers for neuronal activity. These markers could be invaluable in studies that utilize the chick-quail chimaera system to investigate neural components of behavior. Therefore, we decided to clone avian homologs of immediate-early genes to allow an expression analysis in behavioral paradigms and to determine the degree of conservation among diverse species. We report in this study the cloning of the ZENK gene, an egr-1 homolog, from chicken, quail, zebrafinch, and canary. We show that the coding region of this gene is highly conserved and follows established phylogenetic relationships. In situ hybridization demonstrates that the expression pattern is also conserved among species. We further demonstrate that there are regions in the 3' untranslated area of the ZENK gene that are as highly conserved as the protein-coding region and that may play a role in postranscriptional regulatory mechanisms of ZENK gene expression.

Perceptual and cognitive visual functions of parietal and temporal cortices in the cat

We used reversible cooling deactivation to compare the functions of cortices lining the middle suprasylvian (MS) sulcus and forming the ventral portion of the posterior suprasylvian (vPS) gyrus. A battery of attentional, motion and mnemonic processing tasks were used and performance was examined during deactivation of each region. The results show a clear dissociation of functions. Deactivation of MS cortex resulted in profound deficits on a visual orienting task and on the discrimination of direction of motion, whereas deactivation of vPS cortex severely impaired both retention and learning of novel and overlearned object discriminations. In addition, deactivation of either MS or vPS cortex impaired discrimination of learned patterns when components of the patterns were in motion, whereas only deactivation of vPS cortex impaired the discrimination when all components were static. Together, these results show that a region of parietal cortex contributes to the processing of visual motion and to attentional processes, whereas a region of temporal cortex contributes to the learning and recognition of three-dimensional objects and two-dimensional patterns. This functional dissociation is linked to differences in underlying visual pathways, which have many features in common with the parietal and temporal visual processing streams previously identified in monkeys and humans. Furthermore, the broad similarity in neural operations carried out in parietal and temporal cortices of cats, monkeys and humans suggests the existence of a common plan for cortical processing machinery within mammals with well developed cerebral cortices.

Increased oxidative metabolism in middle suprasylvian cortex following removal of areas 17 and 18 from newborn cats

We measured changes in metabolic activity in middle suprasylvian (MS) cortex of cats subjected to early or late removal of areas 17 and 18 to localize shifts in activity possibly indicative of regions within MS cortex that may receive expanded inputs and be involved in the sparing of some visual behaviors following early primary visual cortex damage. Cytochrome oxidase (CO) activity was measured in MS cortex of mature, intact cats and of others with areas 17 and 18 removed in adulthood (P180), or on postnatal day 28 (P28) or postnatal day 1 (P1). Not less than 9 months after the ablation, brain sections were prepared and reacted for the presence of CO. The density of CO reactivity in each of the six cortical layers in MS cortex was measured and standardized against densities from ventral periaqueductal gray or hypothalamus on the same section. Following lesions on P1, significant increases in CO activity occurred in deep layer III and in layer IV of the medial bank of the MS sulcus, including all of area PMLS and the posterior portion of AMLS. In contrast, there were no significant differences in the level of CO activity among P28, P180, or intact cats for any of the cortical layers, and all had lower levels than the P1 cats. This metabolic change provides an anatomical marker for localizing adjustments in MS cortex and can be linked to amplified projections into MS cortex from the thalamus (LPm and A and C laminae of the dorsal lateral geniculate nucleus) and ventral posterior suprasylvian cortex following P1 ablations. Furthermore, this neurochemical analysis implicates a distinct region of MS cortex as the cortical locus of some spared visual functions following early primary visual cortex damage.

Feasibility of a telephone follow-up on use of emergency contraceptive pills in a college health center

The authors examined the feasibility and effectiveness of a telephone follow-up procedure on use of emergency contraceptive pills (ECP) at a college health center. They made 264 telephone calls to the 97 women who had received ECPs during one 16-week academic semester and were successful in reaching 65 (67%) of the women, who responded with information about their experiences with ECPs. The women demonstrated a high rate of adherence to the medical regimen and reported very few side effects from ECPs; a majority said that ECPs did not affect their ability to carry out daily activities. On weighing the relative absence of problems following ECP distribution against the time, effort, and cost required to reach just over two thirds of the women, the researchers concluded that an ECP telephone follow-up procedure was neither cost-effective nor particularly useful.