Polycyclic aromatic hydrocarbons (PAHs) are combustion pollutants that are released into the environment through natural events and anthropogenic activities. Exposures to PAHs occur in military personnel during garrison (non-combat) and active deployment (combat) environments. Exposures that occur at low levels during deployment could lead to health issues, post-deployment. A scoping review was conducted to address the pathways of exposure, and the adverse effects caused by PAHs in active-duty personnel and veterans. Out of 50,171 scientific publications screened from 5 databases, 296 studies were identified that focused on the relationship between exposure to PAHs from various point sources and debilitating health issues reported in veterans. The findings revealed that in combat conditions, PAHs are released into the environment through explosions caused by bombing, artillery fire, and missile attacks on military installations, petrochemical industries, oil well fires set by saboteurs, and burn pits used to incinerate ammunition waste and military base refuse. Significant exposure of troops to PAHs occurred during active combat in the Operation Desert Shield, Operation Desert Storm, and Operation Enduring Freedom campaigns launched against hostile forces. The PAH releases contaminated not only the affected service personnel and staff, but also the surrounding environment. The coastal environment, including its flora and fauna, were affected by oil tanker fires, petroleum storage tanks that caught fire during conflict and subsequent release of PAHs into the marine environment. The human health effects resulting from PAH exposures included severe lung-, kidney-, and reproductive dysfunctions, as well as an increased risk of cancer, mostly manifested in Veterans as part of the Gulf War Syndrome. The Exposome approach utilizing the omics-based biomarkers to characterize individual service member profile with wearable monitors (wrist bands and sensors) to characterize the external environment when combined with biomonitoring studies holds significant promise for treatment of troops during combat and post deployment.

Obesity is one of the factors that potentiate the development of colorectal cancer (CRC). Our previous studies using a rat model, the Polyposis In the Rat Colon (PIRC) kindred type revealed that compared to regular diet (RD), the Western diet (WD) accelerated the progression of colon tumors caused by benzo(a)pyrene [B(a)P], an environmental toxicant. The objective of this study was to investigate the relationship between B(a)P dose, diet type, and accumulation of B(a)P in different adipose depots and its impact on CRC development. Groups of PIRC rats were fed with AIN-76A standard diet (RD) or Western diet (WD) and received 25, 50, or 100 µg B(a)P/kg body weight via oral gavage for 60 days. After exposure, rats were euthanized; colons were removed, polyp numbers were counted, and adipose tissues from the B(a)P-treated rats were collected for subsequent analysis. The white adipose tissue (WAT) included visceral-, mesenteric-, subcutaneous-, epididymal-, retroperitoneal-, and inguinal fats while the brown adipose tissue (BAT) included mediastinal-, cervical-, interscapular-, and perirenal fats. The plasma and tissue samples were analyzed by reverse phase-HPLC for B(a)P metabolites. The WAT showed significantly greater concentrations of B(a)P metabolites (two- to four-fold increase) compared to BAT in a B(a)P dose-dependent manner. The colon polyp numbers showed a strong correlation with mesenteric- and visceral fat tissues. Our findings indicate that B(a)P accumulated in the adipose tissue will have a greater likelihood of fueling colon tumor growth in long-term exposures.

With the rapid advancements in human genetics and genomics research, it is crucial to build genomics capacity at minority-serving institutions (MSIs), which play a key role in developing diverse workforce in genomics and precision medicine, driven by their commitment to educating and training underrepresented students and trainees. Moreover, MSIs are instrumental in tackling chronic diseases, including cancer, that disproportionately affect minority and underserved populations. A comprehensive cross-sectional survey was conducted from August to October 2024 across six MSIs within the Diversity Centers for Genome Research (DCGR) Consortium, established by the National Human Genome Research Institute (NHGRI), to assess their genomic infrastructure and capacity. The surveyed institutions included the Pacific Center for Genome Research at the University of Hawai’i at Mānoa, the University of Texas Rio Grande Valley, Florida International University, Morehouse School of Medicine, Meharry Medical College, and the Carver Genomic Research Center at Tuskegee University, with the last three being Historically Black Colleges/Universities (HBCUs). These MSIs serve diverse and historically underrepresented minority populations, including Native Hawaiian and Pacific Islander, Asian Americans, Hispanic/Latino communities, and African Americans. The survey consisted of 32 questions covering a wide range of topics, including DCGR budget allocations, available sequencing equipment, proteomics instruments, biorepository sample collection and management, etc. An important aspect of the survey is MSIs’ access to cutting-edge next-generation sequencing technologies, a critical component of genomic research infrastructure. Among the six MSIs surveyed, four currently have Illumina short-read sequencers, and three have long-read sequencers, either Nanopore or Ion Torrent. However, none of the institutions owns a PacBio long-read sequencer, an increasingly popular platform for applications where accuracy, read length, and the ability to resolve complex genomic regions outweigh throughput needs. The six MSIs also vary in their computing infrastructure, proteomics instruments, and mass spectrometers, among other resources. Furthermore, all six MSIs own or plan to establish human tissue biorepositories. The survey reveals two common challenges regarding biorepositories across these institutions: (1) effective biorepository management and (2) securing sustainable funding. These results provide valuable insights into the genomic infrastructure and capacity of the six MSIs in the DCGR Consortium. The data collected and insights gained lay a strong foundation for supporting MSIs and fostering future collaborations among them to tackle the common challenges they face in building robust genomics programs. Xuexia Wang, Francisco A. Fernandez-Lima, Zoran Bursac, Stephen Black, Marianna Baum, Jeremy W. Pettit, Deepa Bedi, Honghe Wang, Balasubramanyam Karanam, Melissa B. Davis, Martini Rachel, Erica L. Johnson, Brian Rivers, Anderson Winkler, Jacob Galan, John Blangero, Sarah Williams-Blangero, Maarit Tiirikainen, Lang Wu, Youping Deng, Grace Pan, Olga Korolkova, Alla Ivanova, Harshana Rajakaruna, Thanigaivelan Kanagasabai, Dorin B. Borza, Rajbir Singh, Sanika Chirwa, LaMonica Stewart, Stephania T. Miller-Hughes, Aramandla Ramesh, Ebony Madden, Anil Shanker, Qingguo Wang. A cross-sectional survey of genomics infrastructure at six NHGRI-funded Diversity Centers for Genome Research [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2025; Part 1 (Regular Abstracts); 2025 Apr 25-30; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2025;85(8_Suppl_1):Abstract nr 7111.

Particulate matter with an aerodynamic diameter of less than 2.5 µm (PM2.5) is one of the criteria air pollutants that (1) serve as an essential carrier of airborne toxicants arising from combustion-related events including emissions from industries, automobiles, and wildfires and (2) play an important role in transient to long-lasting cognitive dysfunction as well as several other neurological disorders. A systematic review was conducted to address differences in study design and various biochemical and molecular markers employed to elucidate neurological disorders in PM2.5 -exposed humans and animal models. Out of 340,068 scientific publications screened from 7 databases, 312 studies were identified that targeted the relationship between exposure to PM2.5 and cognitive dysfunction. Equivocal evidence was identified from pre-clinical (animal model) and human studies that PM2.5 exposure contributes to dementia, Parkinson disease, multiple sclerosis, stroke, depression, autism spectrum disorder, attention deficit hyperactivity disorder, and neurodevelopment. In addition, there was substantial evidence from human studies that PM2.5 also was associated with Alzheimer's disease, anxiety, neuropathy, and brain tumors. The role of exposome in characterizing neurobehavioral anomalies and opportunities available to leverage the neuroexposome initiative for conducting longitudinal studies is discussed. Our review also provided some areas that warrant consideration, one of which is unraveling the role of microbiome, and the other role of climate change in PM2.5 exposure-induced neurological disorders.

Colorectal cancer (CRC) is the third leading cause of cancer-related mortalities in the USA and around 52,550 people were expected to die from this disease by December 2023. The objective of this study was to investigate the effect of diet type on benzo(a)pyrene [B(a)P]-induced colon cancer in an adult male rat model, the Polyposis In the Rat Colon (PIRC) kindred type. Groups of PIRC rats (n = 10) were fed with AIN-76A regular diet (RD) or Western diet (WD) and received 25, 50 and 100 µg B(a)P/kg body wt. via oral gavage for 60 days. Rats fed diets alone, but no B(a)P, served as controls. After exposure, rats were euthanized; colon and liver samples were analyzed for activation of drug metabolizing enzymes (DMEs) CYP1A1, CYP1B1, SULT and GST. Plasma and tissue samples were analyzed by reverse phase-HPLC for B(a)P metabolites. In addition to these studies, DNA isolated from colon and liver tissues was analyzed for B(a)P-induced DNA adducts by the 32P-postlabeling method using a thin-layer chromatography system. Western diet consumption resulted in a marked increase in DME expression and B(a)P metabolite concentrations in rats that were administered 100 µg/kg B(a)P + WD (p < 0.05) compared to other treatment groups. Our findings demonstrate that WD accelerates the development of colon tumors induced by B(a)P through enhanced biotransformation, and the products of this process (metabolites) were found to bind with DNA and form B(a)P-DNA adducts, which may have given rise to colon polyps characterized by gain in tumor number, sizes, and dysplasia.

Background: Congenital heart disease (CHD) is one of the commonly seen malformations, with incidence varying from 7 to 8/1000 live birth. Causes are multifactorial. Routine examination of neonates may miss more than 50% of cases. Pulse oximetry is a simple, noninvasive, bedside test which estimates the percentage of oxygen bound to hemoglobin (oxygen saturation [SpO 2 ]). Detection of critical CHD (CCHD) has been possible with SpO 2 screening. Many countries included SpO 2 as part of newborn screening due to this. As a primary approach, both pre- and post-ductal extremity SpO 2 is measured after 24 h of life. Echocardiography (ECHO) will be done on neonates with SpO 2 readings <95%. Neonates born in high-altitude regions, studies have suggest to use adjusted threshold values. In India, there are limited studies. Aims: The aim of this study was to determine the usefulness of pulse oximetry as a screening tool for early detection of CHD in otherwise asymptomatic newborns. To determine, the accuracy of SpO 2 for detecting clinically unrecognized CCHD in newborns. Materials and Methods: This is a prospective observational study done in the department of pediatrics in a tertiary hospital. The study was conducted over 12 months. During the study period, all neonates born who fulfilled the inclusion criteria were included in the study. After 24 h of life, neonates were examined clinically and the pre- and post-ductal SpO 2 was measured. Neonates with SpO 2 <90% in room air were excluded from the study. If the SpO 2 was between 90% and 94%, clinical examination was repeated, if suspicious of CHD, they were referred for ECHO. If there was no suspicion of CHD, SpO 2 was repeated after 6 h and ECHO was done if SpO 2 ≤95. The difference of SpO 2 >3% between the right upper limb and right lower limb was considered positive. Positive neonates were evaluated with two-dimensional echocardiograph. Inclusion criteria - All hemodynamically stable neonates were born during the study period. Exclusion criteria (1) Antenatally diagnosed cardiac anomalies, (2) Outborn neonates, (3) Parents/guardians are not willing to participate in the study and/or further investigation, (4) Sick neonates and those with SpO 2 <90% at birth. Results: 1117 (83.7%) were eligible for the study out of 1333 neonates born. 669 (59.9%) were born by cesarean section and 448 (40.1%) by vaginal delivery. 996 (89.2%) were born at term (≥37 weeks of gestation) and 121 (10.8%) were preterm (<37 weeks of gestation). The male-to-female ratio was 1.03:1. The mean birth weight of the neonates was 2.91 ± 0.46 kg (mean ± standard deviation). The mean SPO 2 in the right upper limb was 96.62 ± 1.73, in the right lower limb was 96.87 ± 1.76, in the left upper limb was 96.59 ± 1.90, and in the left lower limb was 97.06 ± 1.74. The average SPO 2 difference between the right upper limb and right lower limb was 1.04 ± 1.07. Based on SpO 2, 858 (76.8%) cases were not suspected of having CHD and 259 (23.3%) were suspected of having CHD and were evaluated with ECHO. Six (0.5%) neonates had CHD in whom echo was done. In our study, for detecting CCHD, SPO 2 cutoff value of ≤90% showed 90% sensitivity, 99.94% specificity, 75% positive predictive value, and 99.98% negative predictive value. Conclusions: This study emphasizes noninvasive SPO 2 as reliable and feasible, with good negative predictive value screening for CHD in neonates.

As data grows exponentially across diverse fields, effectively leveraging big data has become increasingly crucial. In data science and computational genomics, however, minority groups, including African Americans, are significantly underrepresented, coupled with the lack of resources and infrastructure in minority-serving institutions. This paper summarizes the second phase of our funded project that aims to enhance the data science capacity of Meharry Medical College (MMC), a Historically Black College/University (HBCU), by providing training and fostering collaborations between data scientists and researchers in basic science and biomedical fields. Using diverse training approaches and formats, we introduced data science and computational genomics to hundreds of MMC researchers and students in the past 2 years. The training modules designed for dental curriculums introduced artificial intelligence and machine learning to ~250 dental students, 80% of which are African Americans (AA). We have also fostered partnerships between data scientists and other MMC researchers for joint publications and grant applications in various areas that impact the health of AA population. The multiple grants awarded recently to MMC clearly indicate an enhanced data science and genomics capacity of MMC and the impact of our work on the local community.

Purpose:The goal of the National Center for Medical Education Development and Research Center (NCMEDR) is to support the education and training of medical students in the care of vulnerable populations. Access to primary care services in the US is fundamental to the health and wellness of all people regardless of their socioeconomic status. LGBQ+ persons, (lesbian, gay, bisexual, transgender, queer, and other sexual and gender minority), Persons Experiencing Homelessness (PEH), and Migrant Farm Workers (MFW) are among the most underserved, marginalized, and socially vulnerable groups in the US. NCMEDR in the Department of Family and Community Medicine at Meharry Medical College was established in part, with funding from the Department of Health and Human Services (DHHS) and the Health Resources and Services Administration (HRSA). NCMEDR was developed to provide educational pathways for transforming medical education and clinical practice in the US by ascertaining whether medical students were being trained to provide primary care, and behavioral health services to LGBTQ+ persons, PEH, and MFW. Here we focus on the impact of the COVID-19 pandemic on these specific populations because they represent marginalized groups that have been heavily impacted by the pandemic, have poor social determinants of health (SDOH), and are more likely to be uninsured, and are less likely to engage primary care providers outside of emergency room care. Methods:In this study, a scoping literature review was conducted to assess the impact of COVID-19 on primary care of LQBTQ+ persons, PEH, and MFW. Results and Discussion:The pandemic provided a serious health disparities gap for the defined vulnerable populations under review by the NCMEDR. The pandemic identified the need for transformative measures for clinical practices, medical education, and health care policies required for implementation to improve health care for vulnerable groups. We make recommendations for interventions with defined populations that may influence clinical, environmental health, and SDOH in the COVID era. Conclusions:The COVID pandemic directed the need for medical schools, health care and social organizations to intervene in new and different ways in vulnerable and marginalized communities. The recommendations provide a model for advancing health equity, access, quality, utilization, care coordination, and treatment.

Aim and Objective: To study the prevalence and risk factors of prehypertension and hypertension among adolescents (18–19 years) at the entry level of professional course. Materials and Methods: After institutional ethics committee approval and informed consent from participants, the data were collected and entered into the Excel sheet. Appropriate statistical analysis was applied. The final result was statistically interpreted. Results: A total of 273 student participants were included in the study. There were 104 males and 169 females. One hundred and seven participants were 18 years old and 168 were 19 years old. Male: female ratio is 1:1.6. Prehypertension was seen in 91 (33.3%) and hypertension was observed in 34 (12.57%). Seven (20.6%) cases had a family history of hypertension. Twenty-two (8.1%) had addictive habits. Inadequate physical activity was seen in 32 (94.1%) of cases who had hypertension. Poor sleep quality was seen in hypertensives (17; 50%). In our study also, there was no statistically significant association between gender and systolic blood pressure and diastolic blood pressure ( P > 0.05). There is a statistical significance association between the gender and body mass index (BMI) but not between BMI and hypertension status. There was statistically significant association was there between prehypertension and hypertension with habits. Conclusion: Change in habits and dietary modification will have impact on the development of prehypertension and or hypertension among adolescents. More emphasis must be given to screen adolescents at college entry. Adolescents are best target age group for primordial prevention.

Transgender and gender-diverse (TGD) patients experience a greater burden of health disparities compared with their heterosexual/cisgender counterparts. Some of the poorer health outcomes observed in these populations are known to be associated with the prevalence of implicit bias, bullying, emotional distress, alcoholism, drug abuse, intimate partner violence, sexually transmitted infections (eg, human immunodeficiency virus and human papilloma virus), and cancer. The TGD populations face unique barriers to receiving both routine and gender-affirming health care (acquiring hormones and gender-affirming surgeries). Additional barriers to implementing affirming care training for TGD patients are lack of expertise among medical education faculty and preceptors both in undergraduate and in graduate medical education programs. Drawing on a systematic review of the literature, we propose a policy brief aimed at raising awareness about gender-affirming care among education planners and policy makers in government and advisory bodies.

BACKGROUND: The exposome serves as a popular framework in which to study exposures from chemical and nonchemical stressors across the life course and the differing roles that these exposures can play in human health. As a result, data relevant to thc exposome have been used as a resource in the quest to untangle complicated health trajectories and help connect thc clots from exposures to adverse outcome pathways. OBJECTIVES: The primary aim of this methods seminar is to clarify and review preprocessing techniques critical for accurate and effective external exposomic data analysis. Scalability is emphasized through an application of highly innovative combinatorial techniques coupled with more traditional statistical strategies. The Public Health Exposome is used as an archetypical model. The novelty and innovation of this seminar ' s focus stem from its methodical, comprehensive treatment of preprocessing and its demonstration of the positive effects preprocessing can have on downstream analytics. DisscussloN: State-of-the-art technologies are described for data harmonization and to mitigate noise, which can stymie downstream interpretation, and to select key exposomic features, without which analytics may lose focus. A main task is the reduction of multicollinearity, a particularly formidable problem that frequently arises from repeated measurements of similar events taken at various times and from multiple sources. Empirical results highlight the effectiveness of a carefully planned preprocessing workflow as demonstrated in the context of more highly concentrated variable lists, improved correlational distributions, and enhanced downstream analytics for latent relationship discovery. The nascent field of exposome science can be characterized by the need to analyze and interpret a complex confluence of highly inhomogeneous spatial and temporal data, which may present formidable challenges to even the most powerful analytical tools. A systematic approach to preprocessing can therefore provide an essential first step in the application of modern computer and data science methods.

This article explains the importance of a communities of practice (CoP) model for continually aligning medical education and clinical transformation with contemporary health issues. It describes the evolution and advantages of using CoP as a model for transforming medical education and clinical practice and applies the CoP methodology to addressing the changing needs of socially vulnerable populations (LGBTQ [lesbian, gay, bisexual, transgender, and queer/questioning], persons experiencing homelessness, and migrant farm workers). In conclusion, this article describes CoP-led activities, achievements, and value creation in medical education by the National Center for Medical Education Development and Research established at the Meharry Medical College.

Background: Social habits such as tobacco use, alcohol consumption, and chemically contaminated diet contribute to poor oral health. Intimate Partner Violence (IPV) is a global public health epidemic which can exacerbate the prevalence of health conditions affecting a victim's lifespan. This study investigates using saliva as a biomarker for detecting levels of benzo(a)pyrene [B(a)P]; a toxicant present in cigarette smoke and barbecued meat in a population of IPV thorn female patients.Methods: A cross-sectional IRB-approved study utilized 63 female participants (37 African Americans [AA], and 26 non-African Americans [NAA]), who provided consent for the study. Participants submitted samples of saliva, as well as questionnaires about demographics, health history, and a well-validated (IPV) screen.Results: The prevalence of IPV was greater in AA compared to NAA. While the concentrations of PAHs/B(a)P detected in saliva of IPV samples in NAA were generally within the range of B(a)P reported for saliva from elsewhere, the concentrations were high in some IPV positive samples. Among the B(a)P metabolites, the concentrations of B(a)P 7,8-diol, B(a)P 3,6-and 6,12-dione metabolites were greater than the other metabolite in both AA and non AA groups who were positive.Conclusion: Our study supports the use of saliva as a potential "diagnostic rheostat" to identify toxicants that may exacerbate/precipitate systemic disease in female victims of IPV. In addition, our study is the first to report that IPV may precipitate the accumulation of B(a)P in oral cavity that can alter inflammatory cascades and increase risk of poor health outcomes in this population of patients.

Purpose: Providing inclusive and comprehensive gender-affirming care is critical to reducing health disparities (gaps in care) experienced by sexual and gender minorities (SGM). Currently, little is known about how medical students and residents are being trained to address the health needs of SGM persons or of the most effective methods.Methods: We conducted a systematic review of the research literature from 2000 to 2020 on the effectiveness of teaching medical students and residents on knowledge, attitudes, and skills in addressing the health of SGM persons and the strength of the research sample, design, and methods used.Results: We identified a total of 36 articles that assessed the impact of medical student and resident education on knowledge, comfort, attitudes, confidence, and skills in working with SGM patients. All studies utilized quasi-experimental designs, and found efficacious results. No study examined the impact of training on patient outcomes.Conclusion: Future studies will need to be powered and designed to assess the impact of training on patient outcomes.

BackgroundLiterature presents limited information on histological subtypes and their association with other factors influencing the survival of melanoma patients. To explore the risk of death due to melanoma associated with histological subtypes, this retrospective study used the Surveillance, Epidemiology, and End Results program (SEER) data from 1998 to 2019.MethodsA total of 27,532 patients consisting of 15,527 males and 12,005 females. The Hypertabastic Accelerated Failure Time model was used to analyze the impact of histology on the survival of patients with cutaneous or mucosal melanoma.ResultsThe median survival time (MST) for cutaneous patients was 149 months, whereas those diagnosed with mucosal melanoma was 34 months. Nodular melanoma had a hazard ratio of 3.40 [95% CI: (2.94, 3.94)] compared to lentigo maligna melanoma. Across all histological subtypes, females had a longer MST, when compared to males. The hazard ratio (HR) of distant to localized melanoma was 9.56 [95% CI: (7.58, 12.07)].ConclusionsKnowledge of patients' histological subtypes and their hazard assessment would enable clinicians and healthcare providers to perform personalized treatment, resulting in a lower risk of complication and higher survivability of melanoma patients. Significant factors were stage of the disease, age, histology, sex, and income. Focus should be placed on high-risk populations with severe and aggressive histological subtypes. Programs that emphasize preventive measures such as awareness, education, and early screening could reduce risk.

Background: Increases in fatal synthetic opioid overdoses over the past 8 years have left states scrambling for effective means to curtail these deaths. Many states have implemented policies and increased service capacity to address this rise. To better understand the effectiveness of policy level interventions we estimated the impact of the presence of naloxone access laws (NALs) on synthetic opioid fatalities at the state level. Methods: A multivariable longitudinal linear mixed model with a random intercept was used to determine the relationship between the presence of NALs and synthetic opioid overdose death rates, while controlling for, Good Samaritan laws, opioid prescription rate, and capacity for medication for opioid use disorder (MOUD), utilizing a quadratic time trajectory. Data for the study was collected from the National Vital Statistics System using multiple cause-of-death mortality files linked to drug overdose deaths. Results: The presence of an NAL had a significant (univariate P-value = .013; multivariable p-value = .010) negative relationship to fentanyl overdose death rates. Other significant controlling variables were quadratic time (univariate and multivariable P-value < .001), MOUD (univariate P-value < .001; multivariable P-value = .009), and Good Samaritan Law (univariate P-value = .033; multivariable P-value = .018). Conclusion: Naloxone standing orders are strongly related to fatal synthetic opioid overdose reduction. The effect of NALs, MOUD treatment capacity, and Good Samaritan laws all significantly influenced the synthetic opioid overdose death rate. The use of naloxone should be a central part of any state strategy to reduce overdose death rate.

The exposome refers to all of the internal and external life-long exposures that an individual experiences. These exposures, either acute or chronic, are associated with changes in metabolism that will positively or negatively influence the health and well-being of individuals. Nutrients and other dietary compounds modulate similar biochemical processes and have the potential in some cases to counteract the negative effects of exposures or enhance their beneficial effects. We present herein the concept of Nutritional Pharmacology/Toxicology which uses high-information metabolomics workflows to identify metabolic targets associated with exposures. Using this information, nutritional interventions can be designed toward those targets to mitigate adverse effects or enhance positive effects. We also discuss the potential for this approach in precision nutrition where nutrients/diet can be used to target gene-environment interactions and other subpopulation characteristics. Deriving these “nutrient cocktails” presents an opportunity to modify the effects of exposures for more beneficial outcomes in public health.

BACKGROUND:The objective of the study was to measure the risk of death due to COVID-19 in relation to individuals' characteristics, and severity of their disease during the dominant periods of Alpha, Delta, and Omicron variants have influenced mortality rates.METHODS:This study was conducted using COVID-19 Centers for Disease Control and Prevention (CDC) Case Surveillance Public Data Taskforce for 57 states, and United States territories between January 1, 2020 and March 20, 2022. Multivariable binary Hyperbolastic regression of type I was used to analyzes the data.RESULTS:Seniors and ICU-admitted patients had the highest risk of death. For each additional percent increase in fully vaccinated individuals, the odds of death deceased by 1%. The odds of death prior to vaccine availability, compared to post vaccine availability, was 1.27. When comparing the time periods each variant was dominant, the odds of death was 3.45-fold higher during Delta compared to Alpha. All predictor variables had P-values ≤.001.CONCLUSION:There was a noticeable difference in the odds of death among subcategories of age, race/ethnicity, sex, PMCs, hospitalization, ICU, vaccine availability, variant, and percent of fully vaccinated individuals.

Background: Currently, the capacity to provide buprenorphine treatment (BT) is not sufficient to treat the growing number of people in the United States with opioid use disorder (OUD). We sought to examine participant retention in care rates of primary care delivered BT programs and to describe factors associated with retention/attrition for participants receiving BT in this setting.Objectives: A PRISMA-guided search of various databases was performed to identify the articles focusing on efficacy of BT treatment and OUD.Method: A systematic literature search identified 15 studies examining retention in care in the primary care setting between 2002 and 2020. Random effects meta-regression were used to identify retention rates across studies.Results: Retention rates decreased across time with a mean 0.52 rate at one year. Several factors were found to be related to retention, including: race, use of other drugs, receipt of counseling, and previous treatment with buprenorphine.Conclusions: While we only investigate BT through primary care, our findings indicate retention rates are equivalent to the rates reported in the specialty care literature. More work is needed to examine factors that may impact primary care delivered BT specifically and differentiate participants that may benefit from care delivered in specialty over primary care as well as the converse.

This overview discusses the role of imprinting in the development of an organism, and how exposure to environmental chemicals during fetal development leads to the physiological and biochemical changes that can have adverse lifelong effects on the health of the offspring. There has been a recent upsurge in the use of chemical products in everyday life. These chemicals include industrial byproducts, pesticides, dietary supplements, and pharmaceutical products. They mimic the natural estrogens and bind to estradiol receptors. Consequently, they reduce the number of receptors available for ligand binding. This leads to a faulty signaling in the neuroendocrine system during the critical developmental process of ‘imprinting’. Imprinting causes structural and organizational differentiation in male and female reproductive organs, sexual behavior, bone mineral density, and the metabolism of exogenous and endogenous chemical substances. Several studies conducted on animal models and epidemiological studies provide profound evidence that altered imprinting causes various developmental and reproductive abnormalities and other diseases in humans. Altered metabolism can be measured by various endpoints such as the profile of cytochrome P-450 enzymes (CYP450’s), xenobiotic metabolite levels, and DNA adducts. The importance of imprinting in the potentiation or attenuation of toxic chemicals is discussed.