Explore the vast range of titles available.

BackgroundAlthough preventable, adverse childhood experiences (ACEs) can result in lifelong health harms. Current surveillance data on adults’ exposure to ACEs are either unavailable or incomplete for many U.S. states.MethodsCurrent estimates of the proportion of U.S. adults with past ACEs exposures were obtained by analysing individual-level data from 2019 to 2020 Behavioural Risk Factor Surveillance System―annual nationally representative survey of noninstitutionalized adults aged 18+years. Standardised questions measuring ACEs exposures (presence of household member with mental illness, substance abuse, or incarceration; parental separation; witnessing intimate partner violence; experiencing physical, emotional, or sexual abuse during childhood) were categorised into 0, 1, 2–3, or 4+ACEs and reported by sociodemographic group in each state. Missing ACEs responses (state did not offer ACEs questions or offered to only some respondents; respondent skipped questions) were modelled through multilevel mixed-effects logistic (MMEL) and jackknifed MMEL regressions.ResultsIn 2019–2020, an estimated 62.8% of U.S. adults had past exposure to 1+ACEs (range: 54.9% in Connecticut; 72.5% in Maine), including 22.4% of adults who were exposed to 4+ACEs (range: 11.9% in Connecticut; 32.8% in Nevada). At the national and state levels, exposure to 4+ACEs was highest among adults aged 18–34 years, those who did not graduate from high school, or adults who did not have a healthcare provider. Racial/ethnic distribution of adults exposed to 4+ACEs varied by age and state.ConclusionsACEs are common but not equally distributed. ACEs exposures estimated by state and sociodemographic group can help decisionmakers focus public health interventions on populations disproportionately impacted in their area.

To estimate the cost of establishing and operating a comprehensive syringe service program (SSP) free to clients in the United States. We identified the major cost components of a comprehensive SSP: (one-time start-up cost, and annual costs associated with personnel, operations, and prevention/medical services) and estimated the anticipated total costs (2016 US dollars) based on program size (number of clients served each year) and geographic location of the service (rural, suburban, and urban). The estimated costs ranged from $0.4 million for a small rural SSP (serving 250 clients) to $1.9 million for a large urban SSP (serving 2,500 clients), of which 1.6% and 0.8% is the start-up cost of a small rural and large urban SSP, respectively. Cost per syringe distributed varied from $3 (small urban SSP) to $1 (large rural SSP), and cost per client per year varied from $2000 (small urban SSP) to $700 (large rural SSP). Estimates of the cost of SSPs in the United States vary by number of clients served and geographic location of service. Accurate costing can be useful for planning programs, developing policy, allocating funds for establishing and supporting SSPs, and providing data for economic evaluation of SSPs.

The United States is in the midst of unprecedented person-to-person hepatitis A outbreaks. By using Healthcare Cost and Utilization Project data, we estimated the average costs per hepatitis A-related hospitalization in 2017. These estimates can guide investment in outbreak prevention efforts to stop the spread of this vaccine-preventable disease.

This study focused on evaluating the antioxidant properties of Octhochloa compressa , a Cholistani medicinal plant and to explore the interaction of its active phytochemical constituents with the biological macromolecule NADPH oxidase (PDB ID: 2CDU). Six different non-polar to polar solvent extracts were evaluated for their antioxidant activity using DPPH and FRAP assays. The key metabolites were then subjected to molecular docking against NADPH oxidase, density functional theory (DFT) and molecular dynamics (MD) simulations to validate the ligand-protein stability and conformational dynamics. The methanol extract revealed significantly highest scavenging potential (IC 50  = 110 ± 2.34 µg/mL) in DPPH assay and displayed the greatest amount of total phenolic (97.34 ± 3.34 mg GAE/g) and flavonoid (98.72 ± 2.46 µg CE/g) contents. Phytochemical profiling of the methanol extract identified 43 major bioactive compounds by using HPLC and GC-MS. Silico molecular docking of selected metabolites (lignan, oxindole, apigenin, anthocyanin, acridone) with NADPH oxidase revealed stable interactions, with binding energies ranging from − 6.060 to -6.654 kcal/mol. DFT analysis revealed dipole moments of 1.36–7.52 D and HOMO–LUMO gaps of 3.15–11.74 eV with anthocyanin and apigenin, predicted as the most reactive ligands. MD simulations further confirmed these findings, as the representative 2CDU–ligand complex rapidly equilibrated and maintained the stability across 1 ns and 10 ns trajectories (RMSD ~ 0.2 nm, Rg 2.38–2.46 nm), with persistent non-covalent interactions (− 300 to − 400 kJ/mol) and well-defined free energy minima, validating favorable and thermo-dynamically stable binding. Collectively, these results suggest that O. compressa is a rich source of anti-oxidants phyto-metabolites, capable of interacting with NADPH oxidase, emphasizing its role in the management of disorders related to oxidative stress.

Adverse childhood experiences (ACEs) are defined as preventable, potentially traumatic events that occur among persons aged <18 years and are associated with numerous negative outcomes; data from 25 states indicate that ACEs are common among U.S. adults (1). Disparities in ACEs are often attributable to social and economic environments in which some families live (2,3). Understanding the prevalence of ACEs, stratified by sociodemographic characteristics, is essential to addressing and preventing ACEs and eliminating disparities, but population-level ACEs data collection has been sporadic (1). Using 2011-2020 Behavioral Risk Factor Surveillance System (BRFSS) data, CDC provides estimates of ACEs prevalence among U.S. adults in all 50 states and the District of Columbia, and by key sociodemographic characteristics. Overall, 63.9% of U.S. adults reported at least one ACE; 17.3% reported four or more ACEs. Experiencing four or more ACEs was most common among females (19.2%), adults aged 25-34 years (25.2%), non-Hispanic American Indian or Alaska Native (AI/AN) adults (32.4%), non-Hispanic multiracial adults (31.5%), adults with less than a high school education (20.5%), and those who were unemployed (25.8%) or unable to work (28.8%). Prevalence of experiencing four or more ACEs varied substantially across jurisdictions, from 11.9% (New Jersey) to 22.7% (Oregon). Patterns in prevalence of individual and total number of ACEs varied by jurisdiction and sociodemographic characteristics, reinforcing the importance of jurisdiction and local collection of ACEs data to guide targeted prevention and decrease inequities. CDC has released prevention resources, including Preventing Adverse Childhood Experiences: Leveraging the Best Available Evidence, to help provide jurisdictions and communities with the best available strategies to prevent violence and other ACEs, including guidance on how to implement those strategies for maximum impact (4-6).

The Youth Risk Behavior Survey (YRBS) among high school students includes standard questions about sexual identity and sex of sexual contacts, but these questions are not consistently included in every state that conducts the survey. This study aimed to develop and apply a method to predict state-level proportions of high school students identifying as lesbian, gay, or bisexual (LGB) or reporting any same-sex sexual contacts in those states that did not include these questions in their 2017 YRBS. We used state-level high school YRBS data from 2013, 2015, and 2017. We defined two primary outcomes relating to self-reported LGB identity and reported same-sex sexual contacts. We developed machine learning models to predict the two outcomes based on other YRBS variables, and comparing different modeling approaches. We used a leave-one-out cross-validation approach and report results from best-performing models. Modern ensemble models outperformed traditional linear models at predicting state-level proportions for the two outcomes, and we identified prediction methods that performed well across different years and prediction tasks. Predicted proportions of respondents reporting LGB identity in states that did not include direct measurement ranged between 9.4% and 12.9%. Predicted proportions of respondents reporting any same-sex contacts, where not directly observed, ranged between 7.0% and 10.4%. Comparable population estimates of sexual minority adolescents can raise awareness among state policy makers and the public about what proportion of youth may be exposed to disparate health risks and outcomes associated with sexual minority status. This information can help decision makers in public health and education agencies design, implement and evaluate community and school interventions to improve the health of LGB youth.

Diabetes can lead to various health complications but can be managed with medication, diet, lifestyle changes, and certain medicinal plants with antidiabetic properties. Octhochloa compressa, a plant native to arid regions with a history of medicinal use, is being comprehensively examined for the first time using in vitro, in silico , and in vivo approaches to evaluate its efficacy in combating diabetes. In vitro α-glucosidase inhibition assays were performed using aqueous, methanol, n -butanol, ethyl acetate, n -hexane, and dichloromethane extracts. The ethyl acetate (EtAc) and methanol (MetOH) extracts showed the strongest inhibition with IC 50 values of 190.6 ± 1.19 μg/mL and 281.0 ± 0.98 μg/mL, respectively. In vivo , the anti-diabetic activity of aqueous, MetOH, and EtAc extracts was assessed at 250, 500, and 750 mg/kg body weight in alloxan-induced hyperglycemic rabbits (blood glucose >250 mg/dL). A 30-day study revealed that EtAc extract at 500 mg/kg significantly reduced glucose levels from 328.38 ± 0.86 mg/dL to 121.61 ± 1.28 mg/dL (P < 0.001), along with notable improvements in serum bilirubin, lipid profile, creatinine, ALT, and AST levels compared to the negative control. Histopathological analysis showed no toxic effects on liver, kidney, or adrenal tissues. HPLC analysis of the potent EtAc extract identified bioactive compounds, and in silico docking revealed that tannins, gallic acid, coumarin, oxindole, and xanthone formed stable complexes with α-glucosidase (PDB ID: 3W37), with docking scores of −7.91, −6.59, −6.34, −6.33, and −6.07 kcal/mol, respectively. These findings suggest that O. compressa contains active compounds with significant anti-diabetic properties and minimal toxicity, making it a promising candidate for diabetes management and its complications. Future research should isolate and characterize key bioactive compounds and validate their mechanisms, safety, and clinical efficacy to advance O. compressa as a potential antidiabetic therapy.

BACKGROUNDNational trends in syphilis rates among females delivering newborns are not well characterized. We assessed 2010–2014 trends in syphilis diagnoses documented on discharge records and associated factors among females who have given birth in US hospitals. METHODSWe calculated quarterly trends in syphilis rates (per 100,000 deliveries) by using International Classification of Diseases, Ninth Revision, Clinical Modification codes on delivery discharge records from the National Inpatient Sample. Changes in trends were determined by using Joinpoint software. We estimated relative risks (RR) to assess the association of syphilis diagnoses with race/ethnicity, age, insurance status, household income, and census region. RESULTSOverall, estimated syphilis rates decreased during 2010–2012 at 1.0% per quarter (P < 0.001) and increased afterward at 1.8% (P < 0.001). The syphilis rate increase was statistically significant across all sociodemographic groups and all US regions, with substantial increases identified among whites (35.2% per quarter; P < 0.001) and Medicaid recipients (15.1%; P < 0.001). In 2014, the risk of syphilis diagnosis was greater among blacks (RR, 13.02; 95% confidence interval [CI], 9.46–17.92) or Hispanics (RR, 4.53; 95% CI, 3.19–6.42), compared with whites; Medicaid recipients (RR, 4.63; 95% CI, 3.38–6.33) or uninsured persons (RR, 2.84; 95% CI, 1.74–4.63), compared with privately insured patients; females with the lowest household income (RR, 5.32; 95% CI, 3.55–7.97), compared with the highest income; and females in the South (RR, 2.42; 95% CI, 1.66–3.53), compared with the West. CONCLUSIONSIncreasing syphilis rates among pregnant females of all backgrounds reinforce the importance of prenatal screening and treatment.

Positive childhood experiences (PCEs) promote optimal health and mitigate the effects of adverse childhood experiences, but PCE prevalence in the United States is not well-known. Using Behavioral Risk Factor Surveillance System data, this study describes the prevalence of individual and cumulative PCEs among adults residing in four states: Kansas (2020), Montana (2019), South Carolina (2020), and Wisconsin (2015). Cumulative PCE scores were calculated by summing affirmative responses to seven questions. Subscores were created for family-related (three questions) and community-related (four questions) PCEs. The prevalence of individual PCEs varied from 59.5% (enjoyed participating in community traditions) to 90.5% (adult in respondents' household made them feel safe), and differed significantly by race and ethnicity, age, and sexual orientation. Fewer non-Hispanic Black or African American (49.2%), non-Hispanic Alaska Native or American Indian (37.7%), and Hispanic or Latino respondents (38.9%) reported 6-7 PCEs than did non-Hispanic White respondents (55.2%). Gay or lesbian, and bisexual respondents were less likely than were straight respondents to report 6-7 PCEs (38.1% and 27.4% versus 54.7%, respectively). A PCE score of 6-7 was more frequent among persons with higher income and education. Improved understanding of the relationship of PCEs to adult health and well-being and variation among population subgroups might help reduce health inequities.

Objectives The risk of mother-to-child HIV transmission can be reduced to ≤0.5% if the mother’s HIV status is known before delivery. This study describes 2006-2014 trends in diagnosed HIV infection documented on delivery discharge records and associated sociodemographic characteristics among women who gave birth in US hospitals. Methods We analyzed data from the 2006-2014 National Inpatient Sample and identified delivery discharges and women with diagnosed HIV infection by using International Classification of Diseases, Ninth Revision, Clinical Modification codes. We used a generalized linear model with log link and binomial distribution to assess trends and the association of sociodemographic characteristics with an HIV diagnosis on delivery discharge records. Results During 2006-2014, an HIV diagnosis was documented on approximately 3900-4400 delivery discharge records annually. The probability of having an HIV diagnosis on delivery discharge records decreased 3% per year (adjusted relative risk [aRR] = 0.97; 95% CI, 0.94-0.99), with significant declines identified among white women aged 25-34 (aRR = 0.93; 95% CI, 0.88-0.97) or those using Medicaid (aRR = 0.93; 95% CI, 0.90-0.97); among black women aged 25-34 (aRR = 0.95; 95% CI, 0.92-0.99); and among privately insured women who were black (aRR = 0.96; 95% CI, 0.92-0.99), Hispanic (aRR = 0.92; 95% CI, 0.86-0.98), or aged 25-34 (aRR = 0.96; 95% CI, 0.92-0.99). The probability of having an HIV diagnosis on delivery discharge records was greater for women who were black (aRR = 8.45; 95% CI, 7.56-9.44) or Hispanic (aRR = 1.56; 95% CI, 1.33-1.83) than white; for women aged 25-34 (aRR = 2.33; 95% CI, 2.12-2.55) or aged ≥35 (aRR = 3.04; 95% CI, 2.79-3.31) than for women aged 13-24; and for Medicaid recipients (aRR = 2.70; 95% CI, 2.45-2.98) or the uninsured (aRR = 1.87; 95% CI, 1.60-2.19) than for privately insured patients. Conclusion During 2006-2014, the probability of having an HIV diagnosis declined among select sociodemographic groups of women delivering neonates. High-impact prevention efforts tailored to women remaining at higher risk for HIV infection can reduce the risk of mother-to-child HIV transmission.