Prevalence and determinants of minimum dietary diversity for women of reproductive age in Uganda

BACKGROUND

Globally, over a billion women of reproductive age (WRA) suffer from some kind of undernutrition micronutrient deficiencies, and/or anemia as a result of inadequate dietary diversity. This leads to poor maternal and child health outcomes, however, there is limited research on population level research on minimum dietary diversity for women (MDD-W). This study assessed the prevalence and predictors of MDD-W among WRA in Uganda.

METHODS

This study was a secondary analysis of data from the lot quality assurance sampling (LQAS) survey conducted across 55 Ugandan districts between May and September 2022. Women of various ages were interviewed across 5 study subgroups that this study used to construct its study population (WRA). Descriptive analyses, tests for outcome differences, and multilevel mixed-effects logistic regression were conducted at a 5% statistical significance level using STATA version 17. The results were reported using Adjusted Odds Ratios (aOR) as the measure of the outcome.

RESULTS

The study analyzed responses from 29,802 WRA with a mean age of 27.8 (± 6.8) years. Only 8.8% (95% CI 8.5-9.3) achieved the MDD-W, the least proportion was observed in the South-Central region (3.13%). In the adjusted analysis, WRA who were older than 25 years (aOR 1.1, 95% CI 1.1-1.3, p < 0.001), had secondary education (aOR = 1.4, 95% CI 1.1-1.7, p = 0.003) or above (aOR = 1.7, 95% CI 1.3-2.2, p < 0.001), and used modern contraceptives (aOR = 1.1, 95% CI 1.0-1.3, p = 0.01) were more likely to achieve the MDD-W. Conversely, WRA who travelled longer distances to the nearest household water source (aOR = 0.8, 95% CI 0.7-0.9, p = 0.002) and those residing in larger households (aOR = 0.9, 95% CI 0.8-1.0, p = 0.019) were less likely to achieve the MDD-W.

CONCLUSION

A low proportion of WRA met the MDD-W. Age, education level, household sizes and use of modern contraception were predictors of MDD-W among WRA in Uganda. MDD-W-related program efforts in Uganda should strengthen multisectoral collaboration with prioritization of younger women, education, household sizes and access to safe water sources.

An analysis of differences in Carbapenem-resistant Enterobacterales in different regions: a multicenter cross-sectional study

OBJECTIVE

This study aimed to explore the characteristics of carbapenem-resistant Enterobacterales (CRE) patients in the intensive care unit (ICU) in different regions of Henan Province to provide evidence for the targeted prevention and treatment of CRE.

METHODS

This was a cross-sectional study. CRE screening was conducted in the ICUs of 78 hospitals in Henan Province, China, on March 10, 2021. The patients were divided into provincial capital hospitals and nonprovincial capital hospitals for comparative analysis.

RESULTS

This study involved 1009 patients in total, of whom 241 were CRE-positive patients, 92 were in the provincial capital hospital and 149 were in the nonprovincial capital hospital. Provincial capital hospitals had a higher rate of CRE positivity, and there was a significant difference in the rate of CRE positivity between the two groups. The body temperature; immunosuppressed state; transfer from the ICU to other hospitals; and use of enemas, arterial catheters, carbapenems, or tigecycline at the provincial capital hospital were greater than those at the nonprovincial capital hospital (P < 0.05). However, there was no significant difference in the distribution of carbapenemase strains or enzymes between the two groups.

CONCLUSIONS

The detection rate of CRE was significantly greater in provincial capital hospitals than in nonprovincial capital hospitals. The source of the patients, invasive procedures, and use of advanced antibiotics may account for the differences. Carbapenem-resistant Klebsiella pneumoniae (CR-KPN) was the most prevalent strain. Klebsiella pneumoniae carbapenemase (KPC) was the predominant carbapenemase enzyme. The distributions of carbapenemase strains and enzymes were similar in different regions.

Effects of population variations and temperature on Chrysomya megacephala (Diptera: Calliphoridae) development: implications for estimating the postmortem interval

Forensic entomology requires knowledge of the developmental rates of the species that colonize a body after death to estimate the postmortem interval (PMI). These developmental rates may vary depending not only on the species but also on the geographic location due to population differences. Therefore, the objectives of this work were to determine the developmental duration of the forensically important fly Chrysomya megacephala under constant controlled and field condition temperatures and to compare these results, through a meta-analysis, with data reported by other authors on populations from different localities. For this, C. megacephala colonies were established in the laboratory, and the duration of the life cycle was studied at two controlled temperatures (25 °C and 27 °C) and field conditions (27.5 ± 3.2 °C). Analysis of variance was performed to determine differences in developmental time and larval length between constant laboratory temperatures and field conditions. A generalized linear model was performed with predictor variables extracted from the literature (diet, relative humidity, latitude, longitude) to evaluate the effect of population variation on developmental times. The results showed significant differences in developmental times between 25 and 27 °C. As expected, the complete life cycle of C. megacephala was shorter at 27 °C. Finally, the meta-analysis suggested differences between the developmental times of different populations, based on temperature and geographic location. The results of this study provide fundamental developmental data to use C. megacephala in PMI estimations. Finally, we suggest that, when making expert reports, information from local populations should be used to determine a more accurate and reliable PMI.

The role of the cultural environment in the development of physical literacy and physical activity of Iranian children

BACKGROUND

The investigation of physical literacy (PL) and physical activity (PA) should be done in an ecological context because the socio-cultural situation can encourage or inhibit children's activity. The present study aimed to study the role of the cultural environment in the development of PL and PA in Iranian children.

METHODS

The statistical population consisted of Iranian children aged 8 to 12, of whom 270 students were recruited by cluster sampling from six provinces. They complete the Canadian Assessment of Physical Literacy 2 (CAPL-2) and the International Physical Activity Survey. To examine the cultural environment, the components of geographic location (west, south, central, east, and northwest), place of residence (downtown, suburban, and village), and gender (boys and girls) were used. A multivariate ANOVA analysis was used to analyze the data.

RESULTS

From the geographic location, the findings showed that students inhabit in the west and east of Iran have significantly higher scores than their counterparts living in the central, south, and northwest at PA and PL (P < 0.001). From the place of residence, we observed a higher level of PA and PL in children living in the village than in those living in the suburbs and downtown (P < 0.001). In terms of gender, boys have higher PL and PA scores (P < 0.001).

CONCLUSION

The findings demonstrate that socio-cultural factors, geographic location, place of residence, and gender have different impacts on children's PL and physical activity. Therefore, we suggest using ecologically appropriate decentralized planning in a physical education curriculum.

Fine-scale spatial variation shape fecal microbiome diversity and composition in black-tailed prairie dogs (Cynomys ludovicianus)

BACKGROUND

Host associated gut microbiota are important in understanding the coevolution of host-microbe, and how they may help wildlife populations to adapt to rapid environmental changes. Mammalian gut microbiota composition and diversity may be affected by a variety of factors including geographic variation, seasonal variation in diet, habitat disturbance, environmental conditions, age, and sex. However, there have been few studies that examined how ecological and environmental factors influence gut microbiota composition in animals' natural environments. In this study, we explore how host habitat, geographical location and environmental factors affect the fecal microbiota of Cynomys ludovicianus at a small spatial scale. We collected fecal samples from five geographically distinct locations in the Texas Panhandle classified as urban and rural areas and analyzed them using high throughput 16S rRNA gene amplicon sequencing.

RESULTS

The results showed that microbiota of these fecal samples was largely dominated by the phylum Bacteroidetes. Fecal microbiome diversity and composition differed significantly across sampling sites and habitats. Prairie dogs inhabiting urban areas showed reduced fecal diversity due to more homogenous environment and, likely, anthropogenic disturbance. Urban prairie dog colonies displayed greater phylogenetic variation among replicates than those in rural habitats. Differentially abundant analysis revealed that bacterial species pathogenic to humans and animals were highly abundant in urban areas which indicates that host health and fitness might be negatively affected. Random forest models identified Alistipes shahii as the important species driving the changes in fecal microbiome composition. Despite the effects of habitat and geographic location of host, we found a strong correlation with environmental factors and that- average maximum temperature was the best predictor of prairie dog fecal microbial diversity.

CONCLUSIONS

Our findings suggest that reduction in alpha diversity in conjunction with greater dispersion in beta diversity could be indicative of declining host health in urban areas; this information may, in turn, help determine future conservation efforts. Moreover, several bacterial species pathogenic to humans and other animals were enriched in prairie dog colonies near urban areas, which may in turn adversely affect host phenotype and fitness.

Community assembly patterns and processes of microbiome responses to habitats and Mytilopsis sallei invasion in the tidal zones of the Pearl River Estuary

The sustainability of estuarine ecosystem functions depends on the stabilization of microbial ecological processes. However, due to the unique and variable habitat characteristics of estuarine areas, in-depth studies on ecological processes such as the spatial distribution and assembly patterns of microbial community structure are lacking. As methods to elucidate this structure, we used 16S rDNA, 18S rDNA and ITS sequencing technologies to study the composition, diversity, spatial pattern and aggregation mechanism of the bacterial, protist and fungal communities in the tidal zones of the Pearl River Estuary (PRETZ). The abundance of bacterial communities was much higher than that of protists and fungi, and the spatial pattern was obvious in PRETZ. The application of neutral and null models revealed the assembly process of three microbial communities dominated by stochastic processes. Among the stochastic processes, undominated processes (64.03 %, 62.45 %, and 59.29 %) were the most critical processes in the assembly of bacterial, fungal and protist communities. Meanwhile, environmental variables, geographic locations, and biological factors were associated with the composition and assembly of bacterial, protist, and fungal communities. Among the environmental variables, dissolved oxygen and salinity were the main predictors that jointly affected the differences in the community structure of the three microorganisms, and geographic location was the second predictor affecting the community structure of the three microorganisms and had a more pronounced effect on the diversity and network structure of the bacterial and fungal communities. However, biological factors exerted a weaker effect on the microbial community structure than spatial factors and only affected bacteria and protists; the invasive species Mytilopsis sallei only affected the process of protist community assembly. In addition, environmental variables affected the relative importance of stochastic processes. In summary, the formation of microbial communities in the PRETZ was affected by random processes, environmental variables, geographic location, and invasive species.

Distribution of soil viruses across China and their potential role in phosphorous metabolism

BACKGROUND

Viruses are the most abundant biological entities on the planet and drive biogeochemical cycling on a global scale. Our understanding of biogeography of soil viruses and their ecological functions lags significantly behind that of Bacteria and Fungi. Here, a viromic approach was used to investigate the distribution and ecological functions of viruses from 19 soils across China.

RESULTS

Soil viral community were clustered more significantly by geographical location than type of soil (agricultural and natural). Three clusters of viral communities were identified from North, Southeast and Southwest regions; these clusters differentiated using taxonomic composition and were mainly driven by geographic location and climate factors. A total of 972 viral populations (vOTUs) were detected spanning 23 viral families from the 19 viromes. Phylogenetic analyses of the phoH gene showed a remarkable diversity and the distribution of viral phoH genes was more dependent on the environment. Notably, five proteins involved in phosphorus (P) metabolism-related nucleotide synthesis functions, including dUTPase, MazG, PhoH, Thymidylate synthase complementing protein (Thy1), and Ribonucleoside reductase (RNR), were mainly identified in agricultural soils.

CONCLUSIONS

The present work revealed that soil viral communities were distributed across China according to geographical location and climate factors. In addition, P metabolism genes encoded by these viruses probably drive the synthesis of nucleotides for their own genomes inside bacterial hosts, thereby affecting P cycling in the soil ecosystems.

A dataset for mobile edge computing network topologies

Mobile Edge Computing (MEC) is vital to support the numerous, future applications that are envisioned in the 5G and beyond mobile networks. Since computation capabilities are available at the edge of the network, applications that need ultra low-latency, high bandwidth and reliability can be deployed more easily. This opens up the possibility of developing smart resource allocation approaches that can exploit the MEC infrastructure in an optimized way and, at the same time, fulfill the requirements of applications. However, up to date, the progress of research in this area is limited by the unavailability of publicly available true MEC topologies that could be used to run extensive experiments and to compare the performance on different solutions concerning planning, scheduling, routing etc. For this reason, we decided to infer and make publicly available several synthetic MEC topologies and scenarios. Specifically, based on the experience we have gathered with our experiments Xiang et al. [1], we provide data related to 3 randomly generated topologies, with increasing network size (from 25 to 100 nodes). Moreover, we propose a MEC topology generated from OpenCellID [2] real data and concerning the Base Stations' location of 234 LTE cells owned by a mobile operator (Vodafone) in the center of Milan. We also provide realistic reference parameters (link bandwidth, computation and storage capacity, offered traffic), derived from real services provided by MEC in the deployment of 5G networks.

Analysis of trends and factors determining initial antiseizure medication choice for epilepsy in Taiwan

PURPOSE

To evaluate the current trends and factors associated with the first anti-seizure medications (ASMs) prescribed for epilepsy in Taiwan.

METHODS

Data for patients with epilepsy were collected from the National Health Insurance Research Database, a population-based claims database. We selected patients with newly diagnosed epilepsy from 2013 to 2016. Multivariate logistic regression was used to examine the factors associated with the selection of newer ASMs for the first prescription.

RESULTS

A total of 73,891 patients with newly diagnosed epilepsy were eligible for the study, and the annual incidence was approximately 0.79 per 1,000 people. The five ASMs most prescribed for monotherapy were valproic acid, phenytoin, levetiracetam, gabapentin, and oxcarbazepine, accounting for nearly 90% of all ASMs. Valproic acid was the most-prescribed ASM (more than 30%), and levetiracetam has replaced phenytoin as the second choice since 2015. Factors associated with the selection of newer ASMs for the first prescription were patients' year of diagnosis, gender, socioeconomic level, and previous or existing comorbidities and the profiles of the care providers (accreditation level, service volume, geographic location, and degree of urbanization of the surrounding area).

CONCLUSION

The data indicated that the trends in ASMs first prescribed for patients in Taiwan accorded with most of the international epilepsy treatment guidelines. However, there were some differences between our results and those in developed countries. In addition, we observed a large urban-rural disparity in the administration of ASMs.

Hospital Geographic Location and Unexpected Complications in term Newborns in Florida

INTRODUCTION

Birth trauma rates in term of neonates is a quality measure used by the Joint Commission. In the United States birth trauma rates occurs at a rate of 37 per 1000 live births and are on the decline. However, this decline has been significantly lower among term neonates born in rural facilities. There is a critical lack of evidence toward the influence geographical risk factors has on birth trauma rates for neonatal patients. We sought to measure rural community and hospital characteristics associated with birth trauma.

METHODS

A retrospective longitudinal study design was used to examine inpatient medical discharge data across 103 hospitals of neonates at birth from 2013 to 2018. Discharge data was linked to the American Hospital Association annual survey. We used a multi-level mixed effect model to investigate the relationship between individual and hospital-level attributes associated with increased risk of birth trauma among neonatal patients.

RESULTS

We found that rural hospitals were 3.99 times (p < 0.001) more likely to experience higher birth trauma than urban hospitals. Medium sized hospitals were 2.11 times (p < 0.001) more likely to experience higher birth trauma. Hospitals who indicate having a safety culture were more likely (p < 0.05) to have high rates of birth trauma.

DISCUSSION

Neonates born at rural hospitals, were more likely to experience a birth-related injury. Policy strategies focusing on improving health care quality in rural areas are critical to mitigating this increased risk of birth trauma. Further research is required to assess how physician characteristics may impact birth trauma rates.

International heterogeneity in coronavirus disease 2019 pediatric mortality rates

Background

Severe coronavirus disease 2019 (COVID-19) is infrequent in children and shows a mortality rate of around 0.08%. This study aims to explore international differences in the pediatric mortality rate.

Methods

We analyzed several countries with populations over 5 million that report disaggregated data of COVID-19 deaths by quinquennial or decennial age groups. Data were extracted from COVID-19 cases and deaths by age database, National Ministeries of Health, and the World Health Organization.

Results

We included 23 countries in the analysis. Pediatric mortality varied from 0 to 12.1 deaths per million children of the corresponding age group, with the highest rate in Peru. In most countries, deaths were more frequent in the 0-4-year-old age group, except for Brazil. The pediatric/general COVID-19 mortality showed a great variation and ranged from 0% (Republic of Korea) to 10.4% (India). Pediatric and pediatric/general COVID mortality correlates strongly with 2018 neonatal mortality (r = 0.77, p < 0.001; and r = 0.88, p < 0.001, respectively), while shows a moderate or no correlation (r = 0.47, p = 0.02; and r = 0.19, p = 0.38, respectively) with COVID-19 mortality in the general population.

Conclusions

International heterogeneity in pediatric COVID-19 mortality importantly parallels historical neonatal mortality. Neonatal mortality is a well-known index of the quality of a country's health system, which points to the importance of social determinants of health in pediatric COVID-19 mortality disparities. This issue should be further explored.

Black and unarmed: statistical interaction between age, perceived mental illness, and geographic region among males fatally shot by police using case-only design

PURPOSE

We examine whether the race and armed status interact to modify the risk of being fatally shot by police within categories of civilian age and mental illness status, and U.S. region.

METHODS

Data are from The Washington Post online public-use database of all U.S. police-involved shooting deaths. The sample includes black and white males with known armed status who were killed from 1/1/2015 through 12/31/2019 (n = 3090). A case-only design is used to assess multiplicative interaction using adjusted logistic regression.

RESULTS

The fully adjusted interaction estimate is null (SOR = 0.75; 95% confidence interval [CI] = 0.55-1.04). However, adjusted estimates within strata show that the risk of being armed versus unarmed when fatally shot is smaller for black than white males older than 54 years (SOR = 0.18; 95% CI = 0.06-0.65), those showing mental illness signs (SOR = 0.50; 95% CI = 0.26-0.98), and those killed in the South (SOR = 0.52; 95% CI = 0.33-0.83), and that the risk is greater in the Midwest (SOR = 2.42; 95% CI = 1.11-5.26). Notably, there is no black-white difference in armed status among younger age groups (SOR≈0.89).

CONCLUSION

The race and armed status may interact leaving black males at a higher risk of being unarmed than white males when fatally shot by police among those older than 54 years, mentally impaired, and residing in the South. Causal interaction suggests a lower risk for unarmed blacks in the Midwest. Researchers should further explore the utility of the case-only design to study social-environmental interaction.

Composition and functional comparison of vetiver root endophytic microbiota originating from different geographic locations that show antagonistic activity towards Fusarium graminearum

Given the current trend towards reducing the use of chemical controls in agriculture, microbial resources such as plant endophytes are being intensively investigated for traits that are conducive to plant protection. Among the various important target pathogens, Fusarium graminearum is a fungal pathogen of cereal crops that is responsible for severe yield losses and mycotoxin contamination in grains. In the present study, we investigated the bacterial endophytic communities from vetiver (Chrysopogon zizanioides (L.) Roberty) roots originating from 5 different geographic locations across Europe and Africa. This study relies on a global 16S metabarcoding approach and the isolation/functional characterization of bacterial isolates. The results we obtained showed that geographical location is a factor that influences the composition and relative abundance of root endophyte communities in vetiver. Three hundred eighty-one bacterial endophytes were isolated and assessed for their in vitro antagonistic activities towards F. graminearum mycelium growth. In total, 46 % of the isolates showed at least 50 % inhibitory activity against F. graminearum. The taxonomic identification of the bioactive isolates revealed that the composition of these functional culturable endophytic communities was influenced by the geographic origins of the roots. The selected communities consisted of 15 genera. Some endophytes in Bacillus, Janthinobacterium, Kosakonia, Microbacterium, Pseudomonas, and Serratia showed strong growth inhibition activity (≥70 %) against F. graminearum and could be candidates for further development as biocontrol agents.

Trends in glioblastoma: outcomes over time and type of intervention: a systematic evidence based analysis

INTRODUCTION

Despite aggressive treatment with chemoradiotherapy and maximum surgical resection, survival in patients with glioblastoma (GBM) remains poor. Ongoing efforts are aiming to prolong the lifespan of these patients; however, disparities exist in reported survival values with lack of clear evidence that objectively examines GBM survival trends. We aim to describe the current status and advances in the survival of patients with GBM, by analyzing median overall survival through time and between treatment modalities.

METHODS

A systematic review was conducted according to PRISMA guidelines to identify articles of newly diagnosed glioblastoma from 1978 to 2018. Full-text glioblastoma papers with human subjects, ≥ 18 years old, and n ≥ 25, were included for evaluation.

RESULTS

The central tendency of median overall survival (MOS) was 13.5 months (2.3-29.6) and cumulative 5-year survival was 5.8% (0.01%-29.1%), with a significant difference in survival between studies that predate versus postdate the implementation of temozolomide and radiation, [12.5 (2.3-28) vs 15.6 (3.8-29.6) months, P < 0.001]. In clinical trials, bevacizumab [18.2 (10.6-23.0) months], tumor treating fields (TTF) [20.7 (20.5-20.9) months], and vaccines [19.2 (15.3-26.0) months] reported the highest central measure of median survival.

CONCLUSION

Coadministration with radiotherapy and temozolomide provided a statistically significant increase in survival for patients suffering from glioblastoma. However, the natural history for GBM remains poor. Therapies including TTF pooled values of MOS and provide means of prolonging the survival of GBM patients.

Does Location of Practice or Religiosity Predict Negative Physician Attitudes or Beliefs Toward LGB+ Individuals?

The purpose of this study is to extend the Sabin et al's. (Am J Public Health 105(9):1831-1841, 2015. https://doi.org/10.2105/AJPH.2015.302631) findings to examine the extent to which religiosity and/or geographic region is predictive of negative attitudes or beliefs toward lesbian, gay, bisexual, and asexual (LGB+) individuals. Secondary data from the Sexuality Implicit Association Test were analyzed. Data included only participants from 2013 to 2015 who identified "Healthcare - Diagnosing and Treating Practitioners" as their occupation (n = 1376). The results of a factorial ANOVA revealed significant group differences accounting for 22.4% of the variance in attitudes toward LGB+ individuals. Religiosity was a significant factor in determining negative attitudes toward LGB+ individuals. However, the study was underpowered (5.8%) to detect an effect of geographic location in determining negative attitudes toward LGB+ individuals. It is important to validate a tool that can adequately measure the common assumptions associated with both religion and geographic region. Additionally, medical educators need to learn how to recognize and address negative attitudes among their students.

Determinants of per- and polyfluoroalkyl substances (PFAS) in midlife women: Evidence of racial/ethnic and geographic differences in PFAS exposure

BACKGROUND

Per- and poly-fluoroalkyl substances (PFAS) are public health concerns because of widespread exposure through contaminated foods/drinking water. Although some determinants of PFAS exposure have been suggested, the role of geographic location and race/ethnicity in PFAS exposure has not been well characterized.

OBJECTIVES

We examined potential determinants of PFAS from the Study of Women's Health Across the Nation (SWAN).

METHODS

This study includes 1302 women aged 45-56 years from 5 SWAN sites where white women and women from one minority group were recruited (black from Southeast Michigan, Pittsburgh, Boston; Chinese from Oakland; Japanese from Los Angeles). We determined concentrations of 11 PFAS in serum samples collected in 1999-2000 and examined 7 PFAS detected in most women (>97%). Linear regression with backward elimination was used to identify important determinants of PFAS serum concentrations among a set of pre-specified variables (age, body mass index, site, race/ethnicity, education, financial hardship, occupation, born outside the United States (US), parity, menstrual bleeding within the past year, smoking status, alcohol consumption, and consumption of fish, dairy, pizza, salty snack, and French fries).

RESULTS

Site and race/ethnicity were two major determinants of PFAS. White women had higher concentrations of linear perfluorooctanoic acid (PFOA) compared with the Chinese in Oakland (p < 0.0001) and blacks in Pittsburgh (p = 0.048). Black women in Southeast Michigan and Boston (vs. white women) had higher concentrations of linear (p < 0.001 for Southeast Michigan; p < 0.0001 for Boston) and total perfluorooctane sulfonic acid (PFOS) (p < 0.001 for both Southeast Michigan and Boston) and 2-(N-methyl-perfluorooctane sulfonamido) acetic acid (p = 0.02 for Southeast Michigan; p < 0.001 for Boston). Chinese (Oakland) and Japanese (Los Angeles) women had higher concentrations of perfluorononanoic acid (PFNA) compared with white women in each site (p < 0.01 for both). Within white women, those in Pittsburgh had relatively higher concentrations of PFAS. Within Chinese and Japanese women, those who were born outside the US had significantly lower concentrations of most PFAS but significantly higher PFNA concentrations. Menstrual bleeding and parity were significantly associated with lower PFAS concentrations. Higher intake of salty snacks including popcorn was significantly associated with higher concentrations of linear PFOA, PFOS and 2-(N-ethyl-perfluorooctane sulfonamido) acetic acid.

DISCUSSION

Geographic locations and race/ethnicity play an important role in differential exposure to PFAS, with racial/ethnic burdens differing between PFOS, PFOA and PFNA. Menstruation and parity were also determinants of PFAS concentrations possibly as an elimination route.

Obesity and Dental Caries in Young Children in Plymouth, United Kingdom: A Spatial Analysis

OBJECTIVE

To examine the spatial clustering of obesity and dental caries in young children in Plymouth, United Kingdom, to evaluate the association between these conditions and deprivation, and explore the impact of neighbourhood-level characteristics on their distribution.

BASIC RESEARCH DESIGN

Cross-sectional study analysing data from the National Child Measurement Programme (N=2427) and the Local Dental Health Survey (N=1425). The association of deprivation with weight status and caries was determined at individual and area level, using ANOVA and Poisson models. The overall spatial clustering was assessed using a modified version of the Global Moran's I, while clusters were located through Local Indicators of Spatial Association. Spatial autocorrelation was assessed using the variograms of the raw values. Log-linear Poisson models were fitted to assess the significance of neighbourhood characteristics on overweight/obesity and caries distribution.

RESULTS

At an individual level, deprivation was not associated with BMI z-scores but was a significant predictor of caries (p⟨0.05). However, at area level, deprivation related to the rates of both conditions. A significant positive autocorrelation was observed across neighbourhoods for caries. The variograms suggested spatial autocorrelations up to 2.5 km and 3 km for overweight/obesity and caries, respectively. Among several neighbourhood characteristics, the proportion of people on benefits was found to be a significant predictor of caries rates.

CONCLUSIONS

Our results underline the importance of considering geographic location and characteristics of the broader environment when developing strategies to target obesity and caries.

Impact of community disadvantage and air pollution burden on geographic disparities of ovarian cancer survival in California

Ovarian cancer survival varies geographically throughout California. The objective of this study is to determine the impact of living in disadvantaged communities on spatial patterns of survival disparities. Including a bivariate spatial smooth of geographic location within the Cox proportional hazard models is an effective approach for spatial analyses of cancer survival. Women diagnosed with advanced Stage IIIC/IV epithelial ovarian cancer (1996-2006) were identified from the California Cancer Registry. The impact of living in disadvantaged communities, as measured by the California Office of Environmental Health Hazard Assessment cumulative CalEnviroScreen 2.0 score, on geographic disparities in survival was assessed while controlling for age, tumor characteristics, quality of care, and race. Community-level air quality indicators and socioeconomic status (SES) were also independently examined in secondary analyses. The Cox proportional hazard spatial methods are available in the MapGAM package implemented in R. An increase in the community disadvantage from the 5th (less disadvantage) to the 95th percentile (more disadvantage) was significantly associated with poorer ovarian cancer survival (hazard ratio [HR], 1.16; 95% confidence interval [CI], 1.07-1.26). Ozone levels and SES were the most influential indicators on geographic disparities that warrant further investigation. The use of a bivariate smoother of location within the survival model allows for more advanced spatial analyses for exploring potential air quality-related predictors of geographic disparities.

Influence of geography, seasons and pedology on chemical composition and anti-inflammatory activities of essential oils from Lippia multiflora Mold leaves

ETHNOPHARMACOLOGICAL RELEVANCE

Lippia multiflora is a plant with nutritional and pharmaco-therapeutic properties that is native to central and occidental Africa. The potential effects of plants on health are associated with their chemical composition. Therefore, the present study aimed to identify chemical variations in essential oils of Lippia multiflora as a function of geographic origin and time of annual harvest to determine optimal chemical profiles for ethno-pharmacotherapeutic applications.

MATERIALS AND METHODS

Experimental plants were cultivated at Abidjan (LPA), Toumodi (LPT) and Bondoukou (LPB). Natural Lippia multiflora seeds were sourced to produce standardized plants over a period of six months. Standard plants (n=40) were re-introduced into natural plots, cultivated for 12 months and leaves were sampled monthly in a standardized fashion. Essentials oils (n=36) were then extracted from these samples by hydro-distillation according to the European Pharmacopoeia and qualitatively and quantitatively analyzed using GC/FID and GC/MS. These data were then analyzed using Principal Component Analysis (PCA). Anti-inflammatory properties were also assessed against activated macrophages in vitro.

RESULTS

The results indicated that chemical profiles and essential oil yields vary according to the location where the plants were cultivated. One essential oil chemotype corresponded to the LPA and LPT sites and one corresponded to the LPB site. Statistical analysis of the chemical profiles and monthly evolution of the three sites over a period of one year allowed assessment of variations in composition and the subsequent choice of the optimal harvest time for ethnopharmacological applications. Anti-inflammatory activity apparently correlated with chemical profiles of essential oils and the geographic origins of the plants.

CONCLUSION

The optimal harvest time was associated with the maximum yield of pharmacological compounds with the most potential interest for health.

Spatial heterogeneity of lake eutrophication caused by physiogeographic conditions: An analysis of 143 lakes in China

In order to identify the effect of geographic characteristics on the variations of nutrient concentrations and the utilization efficiency of nutrients by phytoplankton, data from 143 lakes, from 2008 to 2010, including three very different types of topography, i.e., the first topography ladder (FTL), second topography ladder (STL), and third topography ladder (TTL), were statistically analyzed. Lakes in the FTL and STL, located at high elevation (above 1000 m) and low longitudes (lower than 105° E), were sporadically oligotrophic, whereas lakes in the TTL were almost all mesotrophic and eutrophic. The trophic level index (TLI) became higher with the rise of longitude. Two turning points (5 and 15°C) on the curve of TLI as function of the average annual temperature (AAT) corresponded with the AAT in different lake regions in the STL and TTL. Because the responses of TLI to AAT differ significantly, there were variations of nutrient and algal biomass concentrations in different lake regions in the same type of topography ladder. According to the differences in utilization efficiency of total nitrogen or total phosphorus by phytoplankton, China could be partitioned into six lake regions. Scientific nutrient criteria for each lake region shall be established considering these differences in China.

Spatial analysis of adherence to treatment guidelines for advanced-stage ovarian cancer and the impact of race and socioeconomic status

OBJECTIVE

To determine the impact of geographic location on advanced-stage ovarian cancer care adherence to the National Comprehensive Cancer Network (NCCN) guidelines in relation to race and socioeconomic status (SES).

METHODS

Patients diagnosed with stage IIIC/IV epithelial ovarian cancer (1/1/96-12/31/06) were identified from the California Cancer Registry. Generalized additive models were created to assess the effect of spatial distributions of geographic location, proximity to a high-volume hospital (≥20 cases/year), distance traveled to receive care, race, and SES on adherence to NCCN guidelines, with simultaneous smoothing of geographic location and adjustment for confounding variables. Disparities in geographic predictors of treatment adherence were analyzed with the x(2) test for equality of proportions.

RESULTS

Of the 11,770 patients identified, 45.4% were treated according to NCCN guidelines. Black race (OR=1.49, 95%CI=1.21-1.83), low-SES (OR=1.46, 95%CI=1.24-1.72), and geographic location ≥80 km/50 mi from a high-volume hospital (OR=1.88, 95%CI=1.61-2.19) were independently associated with an increased risk of non-adherent care, while high-volume hospital treatment (OR=0.59, 95%CI=0.53-0.66) and travel distance to receive care ≥32 km/20 mi (OR=0.80, 95%CI=0.69-0.92) were independently protective. SES was inversely associated with location ≥80 km/50 mi from a high-volume hospital, ranging from 6.3% (high-SES) to 33.0% (low-SES) (p<0.0001). White patients were significantly more likely to travel ≥32 km/20 mi to receive care (21.8%) compared to Blacks (14.4%), Hispanics (15.9%), and Asian/Pacific Islanders (15.5%) (p<0.0001).

CONCLUSION

Geographic proximity to a high-volume hospital and travel distance to receive treatment are independently associated with NCCN guideline adherent care for advanced-stage ovarian cancer. Geographic barriers to standard ovarian cancer treatment disproportionately affect racial minorities and women of low-SES.