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As the COVID-19 pandemic moved beyond the initial heavily impacted and urbanized Northeast region of the United States, hotspots of cases in other urban areas ensued across the country in early 2020. In South Carolina, the spatial and temporal patterns were different, initially concentrating in small towns within metro counties, then diffusing to centralized urban areas and rural areas. When mitigation restrictions were relaxed, hotspots reappeared in the major cities. This paper examines the county-scale spatial and temporal patterns of confirmed cases of COVID-19 for South Carolina from March 1 st —September 5 th , 2020. We first describe the initial diffusion of the new confirmed cases per week across the state, which remained under 2,000 cases until Memorial Day weekend (epi week 23) then dramatically increased, peaking in mid-July (epi week 29), and slowly declining thereafter. Second, we found significant differences in cases and deaths between urban and rural counties, partially related to the timing of the number of confirmed cases and deaths and the implementation of state and local mitigations. Third, we found that the case rates and mortality rates positively correlated with pre-existing social vulnerability. There was also a negative correlation between mortality rates and county resilience patterns, as expected, suggesting that counties with higher levels of inherent resilience had fewer deaths per 100,000 population.

This study investigates evacuation behaviors associated with Hurricane Matthew in October of 2016. It assesses factors influencing evacuation decisions and evacuation departure times for Florida, Georgia, and South Carolina from an online survey of respondents. Approximately 62% of the Florida sample, 77% of the Georgia sample, and 67% of the South Carolina sample evacuated. Logistic regression analysis of the departures in the overall time period identified variability in evacuation timing, primarily dependent on prior experience, receipt of an evacuation order, and talking with others about the evacuation order. However, using four logistic regressions to analyze differences in departure times by day shows that the only significant variable across the three main days of evacuation was our proxy variable for evacuation-order times. Depending on the day, other variables of interest include number of household vehicles, previous hurricane experience, and receipt of an evacuation order. Descriptive results show that many variables are considered in the decision to evacuate, but results from subsequent analyses, and respondents’ comments about their experiences, highlight that evacuation orders are the primary triggering variable for when residents left.

Over the last few decades, the United States has been fighting the high school dropout epidemic that reaches every corner of our nation. Research shows that ninth grade is the pivotal year in school that determines whether you finish high school, dropout, or lack enough credits to graduate on-time. The transition from middle school to high school presents challenges for many incoming freshmen, which is why schools are implementing freshman transition programs that will address the needs of incoming ninth graders, prepare them for high school and beyond. This meta-synthesis study explored freshman transition programs and best practices for ensuring successful completion for incoming freshmen students in U.S. public high schools. The study was designed to create a catalog for educators to use as a reference of successful transition programs and best practices that other schools have already implemented and were found to elicit positive effects. Fifty articles were chosen based on inclusion and exclusion words, then a list was created. The researcher felt two different formats highlighting various information might be useful for educators. Findings included positive and negative implementation outcomes; however, the positive do outweigh the negative. Furthermore, it was discovered that numerous characteristics can be added to a transition program to increase the effectiveness. The theoretical framework of Self-Determination Theory proved to support the idea of educators developing strong, positive relationships with students in order to improve academics, attendance, and even decrease discipline issues. All of these efforts not only increase a freshman’s first year of high school but puts them on the right path for graduation and their future.

During a hurricane, an individual’s risk perception does not remain static. Spatial and temporal variations of a hurricane will shift perceptions of risk, and complicating this dynamic are information-seeking processes increasingly reliant on the individual’s self-motivated interpretation of information sources. Initial evacuation resistance or willingness could change even after evacuations are ordered, affecting evacuation preferences and departure times. Because Hurricane Matthew’s continually shifting track had virtually nonstop coverage, evacuation decisions were also being modified as residents either grew more or less certain of their safety. This research investigates the evacuation behaviors associated with Hurricane Matthew in October of 2016. It assesses the relationships between selected variables acquired from an online survey and evacuation departure times – generally speaking, the differences in evacuation behaviors between Florida, Georgia, and South Carolina survey respondents. Descriptive statistics are provided for several variables of interest, followed by spatiotemporal analysis of evacuation departures using Esri ArcGIS® software’s space-time pattern mining tools. To assess the relationship of a subset of variables and evacuation during the entire study period (5 days), a binary logit model is estimated, and subsequently, to investigate the relationship of several variables and evacuation by day, four additional binary logit models are estimated and discussed. Results indicate that approximately 62% of the Florida sample, 77% of the Georgia sample, and 67% of the South Carolina sample evacuated. Under the logistic model analyzing the overall time period, an observed evacuation depended on not having prior hurricane experience, having received an evacuation order, an increased level of communication about the evacuation order, believing one lived in an evacuation zone, not knowing if one lived in an evacuation zone, having fewer pets in the household, and higher household income in 2015. However, the state (FL, GA, SC) was the only variable which was significant for each of the four days’ logistic regressions. Essentially, for each day, there were consistent differences in evacuation between the states. Some of the results concerning the influence of some variables on evacuation behavior have been confirmed in past research, while others continue to emphasize the case-specific nature of every hurricane event through inconsistently influential variables. The descriptive results provided makes clear that a number of variables are taken into consideration in a household’s decision to evacuate, but the results from the subsequent analyses highlights that an authoritative evacuation order is the primary triggering variable. The results also show the significance of the state variable on coordinating an evacuation at the household level, which stresses the criticality of recommending protective action in a timely manner.

Micronutrient deficiencies are a public health concern worldwide negatively affecting maternal and child health outcomes. The primary underlying causes of micronutrient deficiencies are insufficient intake and poor bioavailability of micronutrients. However, reliable data on micronutrient intakes are sparse. The objectives of this study were to identify the key local food sources providing the majority of micronutrients and assess the adequacy and determinants of micronutrient intakes. The study used data from a survey of 4,983 rural women of reproductive age (WRA) participating in a preconception micronutrient supplementation trial in Vietnam. Micronutrient intakes were assessed using a validated 107-item semi-quantitative food-frequency questionnaire. Multivariate linear and logistic regression analyses were used to examine the association between socioeconomic status and micronutrient intakes. Starchy staples were the main source of iron and zinc (37% and 54%, respectively) with only a small proportion from meat (10% and 18%, respectively). The primary source of folate and vitamin A were vegetables; vitamin B12 came from meat and eggs. The proportion of the population with intakes below the estimated average requirement was 25% for iron, 16% for zinc, 54% for folate, 64% for vitamin B12 and 27% for vitamin A. Socioeconomic status was the main determinant of micronutrient intakes. WRA in the highest quintile consumed 26% more iron, 19% more zinc, 36% more folate, 82% more vitamin B12 and 47% more vitamin A compared to those in the lowest quintile. Women in the upper quintiles of SES were more likely to obtain nutrients from more nutritious and higher bioavailable foods than those in the lowest quintile. Underprivileged women were at increased risk for insufficient micronutrient intakes due to poor diet quality. Targeted efforts to promote the consumption of local nutrient rich foods along with educational programs and social development are needed.

Angiopoietin-like 3 (ANGPTL3) inhibits endothelial lipase and lipoprotein lipase. Injection of antisense oligonucleotides targeting ANGPTL3 messenger RNA effects a reduction of atherogenic lipoproteins in humans and mice and a slowing of progression of atherosclerosis in mice.

Background Impaired cerebrovascular reactivity (CVR) is one feature of post cardiac arrest encephalopathy. We studied the incidence and features of CVR by near infrared spectroscopy (NIRS) and associations with outcome and biomarkers of brain injury. Methods A post-hoc analysis of 120 comatose OHCA patients continuously monitored with NIRS and randomised to low- or high-normal oxygen, carbon dioxide and mean arterial blood pressure (MAP) targets for 48 h. The tissue oximetry index (TO x ) generated by the moving correlation coefficient between cerebral tissue oxygenation measured by NIRS and MAP was used as a dynamic index of CVR with TO x  > 0 indicating impaired reactivity and TO x  > 0.3 used to delineate the lower and upper MAP bounds for disrupted CVR. TO x was analysed in the 0–12, 12–24, 24–48 h time-periods and integrated over 0–48 h. The primary outcome was the association between TO x and six-month functional outcome dichotomised by the cerebral performance category (CPC1-2 good vs. 3–5 poor). Secondary outcomes included associations with MAP bounds for CVR and biomarkers of brain injury. Results In 108 patients with sufficient data to calculate TO x , 76 patients (70%) had impaired CVR and among these, chronic hypertension was more common (58% vs. 31%, p  = 0.002). Integrated TO x for 0–48 h was higher in patients with poor outcome than in patients with good outcome (0.89 95% CI [− 1.17 to 2.94] vs. − 2.71 95% CI [− 4.16 to − 1.26], p  = 0.05). Patients with poor outcomes had a decreased upper MAP bound of CVR over time ( p  = 0.001), including the high-normal oxygen ( p  = 0.002), carbon dioxide ( p  = 0.012) and MAP ( p  = 0.001) groups. The MAP range of maintained CVR was narrower in all time intervals and intervention groups ( p  < 0.05). NfL concentrations were higher in patients with impaired CVR compared to those with intact CVR (43 IQR [15–650] vs 20 IQR [13–199] pg/ml, p  = 0.042). Conclusion Impaired CVR over 48 h was more common in patients with chronic hypertension and associated with poor outcome. Decreased upper MAP bound and a narrower MAP range for maintained CVR were associated with poor outcome and more severe brain injury assessed with NfL. Trial registration ClinicalTrials.gov, NCT02698917 .

Background The rising prevalence of maternal obesity presents a significant health concern because of the possible implications for obstetric complications and neonatal outcomes. Understanding the impact of obesity on placental structure and function as well as fetal growth and infant outcomes is important to improve the care of these potentially high-risk pregnancies. This study aimed to determine the effect of elevated maternal BMI on histopathologic patterns of placental injury and its consequences on fetal growth. Methods Data were collected from an ongoing cohort of maternal-infant dyads in the UCSD Obstetric Registry spanning 2011–2020. Maternal characteristics, including BMI, hypertensive disease and diabetes, placental gross and histopathology, and infant characteristics, including sex and birthweight, were recorded and analyzed. ANOVA and chi-square tests were used in initial analyses, followed by log-binomial and linear regression models adjusted for relevant confounders to determine associations between maternal BMI, specific patterns of placental injury, and infant birthweight percentiles. Results Among 1366 maternal-infant dyads, placentas from mothers with overweight and obesity were heavier and demonstrated higher adjusted relative risks of chronic villitis (CV), decidual vasculopathy, intervillous thrombosis, and normoblastemia. Placental efficiency, determined by fetal-placental weight ratio, was decreased with increasing BMI. Maternal obesity was associated with higher rates of preterm birth and higher birthweight percentiles. Multiple placental lesions, including maternal (MVM) and fetal vascular malperfusion (FVM), exhibited significant effects on birthweight percentiles; however, only MVM showed a differential effect based on maternal obesity. Conclusions Presence of obesity in pregnancy is associated with increased rates of placental patterns of injury, decreased placental efficiency, and increased birthweight percentiles. While placental lesions, such as CV, have the potential to negatively impact fetal growth, the resulting birthweight percentiles demonstrate a more complex relationship between maternal obesity and fetal growth, that likely involves placental and fetal adaptation to the altered in utero environment.

Magnetic resonance imaging (MRI) is a powerful tool for visualizing traumatic brain injury(TBI)-related lesions. Trauma-induced encephalomalacia is frequently identified by its hyperintense appearance on fluid-attenuated inversion recovery (FLAIR) sequences. In addition to parenchymal lesions, TBI commonly results in cerebral microvascular injury, but its anatomical relationship to parenchymal encephalomalacia is not well characterized. The current study utilized a multi-modal MRI protocol to assess microstructural tissue integrity (by mean diffusivity [MD] and fractional aniosotropy [FA]) and altered vascular function (by cerebral blood flow [CBF] and cerebral vascular reactivity [CVR]) within regions of visible encephalomalacia and normal appearing tissue in 27 chronic TBI (minimum 6 months post-injury) subjects. Fifteen subjects had visible encephalomalacias whereas 12 did not have evident lesions on MRI. Imaging from 14 age-matched healthy volunteers were used as controls. CBF was assessed by arterial spin labeling (ASL) and CVR by measuring the change in blood-oxygen-level–dependent (BOLD) MRI during a hypercapnia challenge. There was a significant reduction in FA, CBF, and CVR with a complementary increase in MD within regions of FLAIR-visible encephalomalacia (p < 0.05 for all comparisons). In normal-appearing brain regions, only CVR was significantly reduced relative to controls (p < 0.05). These findings indicate that vascular dysfunction represents a TBI endophenotype that is distinct from structural injury detected using conventional MRI, may be present even in the absence of visible structural injury, and persists long after trauma. CVR may serve as a useful diagnostic and pharmacodynamic imaging biomarker of traumatic microvascular injury.

Pálinka is a traditional fruit spirit and a kind of gastronomic heritage in Hungary. In Pálinka production, fermentation is one of the most important processes affecting the quality and yield of spirits. Based on single-factor and three-factor influence level tests by following the Plackett–Burman design, the fermentation process from sour cherry juice concentrate and Saccharomyces cerevisiae by using Response Surface Methodology (RSM) coupled with the central composite rotatable design was investigated to optimize fermentation conditions through three variables in a defined range of temperature (15–25 °C), pH (2.75–3.75), and total soluble solid (18–30 °Brix). After eight fermentation days, production yields of alcohol and volatile compounds were a maximum of 9.02% v/v and 337.37 mg/L at an optimized temperature of 24.71 °C, pH of 3.25, and total soluble solid of 22.49 °Brix. The GC-FID analysis results showed 1-propanol, 2-methyl-1-propanol, 2-methyl-1-butanol, 3-methyl-1-butanol, and ethyl acetate were considered the major aroma compound in the cherry spirits. These results provided important information in serving the basic to develop standard fruit spirits production from sour cherry.