Aftershocks: Home Loss and Long-Term Health after the 2011 Great East Japan Earthquake

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From hurricanes to earthquakes, natural disasters affect survivors in innumerable ways, including adverse effects on mental¹ and physical² health. Only a few studies have been able to assess a consistent set of health indicators both before and after a disaster due to the unpredictability of such events. However, in a study recently published in Environmental Health Perspectives,³ a team of researchers was able to use preexisting data from the Japan Gerontological Evaluation Study to assess a wide array of health and well-being outcomes before and up to 9 years after the 2011 Great East Japan Earthquake.The authors used data from a cohort of older individuals who came from the city of Iwanuma. The tsunami that followed the earthquake killed more than 180 people in Iwanuma, inundated nearly half the city, and destroyed 5,542 houses. Most of the 2,167 individuals in the current study sustained some degree of damage to their homes during the 2011 disaster; 4% suffered a complete home loss.Open in a separate windowThe Great East Japan Earthquake and related tsunami completely destroyed 122,000 dwellings in all and damaged another 1 million, according to estimates from 2021.⁵ Image: © Gallo Images/Contributor via Getty Images.The study examined the longitudinal associations between complete home loss specifically and 34 health indicators categorized as physical health, mental health (e.g., symptoms of depression or posttraumatic stress), health behaviors/sleep (e.g., dozing off during the day), social well-being (participation in society), cognitive social capital (perceptions about social relations in the community), subjective well-being (happiness and life satisfaction), and prosocial or altruistic behaviors (e.g., sharing). This “outcome-wide” framework—namely, assessing the relationship between a single exposure and multiple outcomes—is a relatively new approach.⁴“Epidemiologic research on disaster survivors has focused on mental health problems as an outcome,” says lead author Koichiro Shiba, a postdoctoral research fellow at the Harvard T.H. Chan School of Public Health. “We know little about how a disaster influences key aspects of human well-being that cannot be captured by looking at mental health alone. This knowledge gap motivated us to employ the outcome-wide framework to examine the relationship between the disaster experience and well-being.”After 9 years, complete home loss was associated with increased symptoms of posttraumatic stress, depression, and hopelessness. People who lost their homes were also more likely to experience daytime sleepiness along with lower levels of trust in the community, community attachment, perceptions of mutual help in the community, and prosociality. The researchers saw more modest associations between complete home loss and having more chronic conditions, higher body mass index, and decreased happiness. Home loss was not associated with the remaining indicators.“The most surprising result to me was the strong association between home loss and decreased social capital; it is notable that the association persisted even nine years after the disaster,” Shiba says. “By that time, buildings in the flooded area had been rebuilt and people had already moved out of the temporary shelters and lived in permanent housing. It is difficult and takes time to reconstruct social capital once it is destroyed, highlighting the importance of efforts to preserve preexisting social capital.”“This is an excellent piece of scholarship. The longevity of the disruptive effect is astonishing: 9 years post-event, participants are still experiencing distress related to the earthquake event,” says Katie E. Cherry, the Emogene Pliner Distinguished Professor of Aging Studies at Louisiana State University and author The Other Side of Suffering, which covers her research on survivor recovery after Hurricanes Katrina and Rita. “Most important from a methodological point of view is the authors’ use of a prospective design,” she says, explaining that the availability of pre-event data allowed for a cleaner assessment of earthquake exposure effects.“It’s nice to see the authors’ inclusion of social capital and mental health consequences as outcome variables,” Cherry adds. Yet she found the notion of cognitive social capital to be conceptually ambiguous. The authors included in that term trust and mutual help in the community, as well as community attachment. “There is a large [body of] literature on social capital, which is a well-established social science construct,” Cherry says. “To my knowledge, there may be a dimension of social capital that is cognitive, but I am not aware of a ‘cognitive social capital.’”“Although we intuitively understand that losing a home during a natural hazard or disaster is incredibly harmful, this study has used extensive quantitative data from more than 2,000 survivors over a decade to show how broadly damaging it can be,” says Daniel Aldrich, a professor of political science and public policy at Northeastern University. “It is not just the loss of one’s physical property that changes one’s life. It is also the forced relocation that follows which pulls people away from their pre-disaster family, neighbors, and friends. In short, they lose their social networks, and these networks are powerful determinants of social and mental health.”     

Altered Regulation of mRNA and miRNA Expression in Epithelial and Stromal Tissue of Keratoconus Corneas

PurposeEvaluation of mRNA and microRNA (miRNA) expression in epithelium and stroma of patients with keratoconus.MethodsThe epithelium and stroma of eight corneas of eight patients with keratoconus and eight corneas of eight non-keratoconus healthy controls were studied separately. RNA was extracted, and mRNA and miRNA analyses were performed using microarrays. Differentially expressed mRNAs and miRNAs in epithelial and stromal keratoconus samples compared to healthy controls were identified. Selected genes and miRNAs were further validated using RT-qPCR.ResultsWe discovered 170 epithelial and 1498 stromal deregulated protein-coding mRNAs in KC samples. In addition, in epithelial samples 180 miRNAs and in stromal samples 379 miRNAs were significantly deregulated more than twofold compared to controls. Pathway analysis revealed enrichment of metabolic and axon guidance pathways for epithelial cells and enrichment of metabolic, mitogen-activated protein kinase (MAPK), and focal adhesion pathways for stromal cells.ConclusionsThis study demonstrates significant differences in the expression and regulation of mRNAs and miRNAs in the epithelium and stroma of Patients with KC. Also, in addition to the well-known target candidates, we were able to identify further genes and miRNAs that may be associated with keratoconus. Signaling pathways influencing metabolic changes and cell contacts are affected in epithelial and stromal cells of patients with keratoconus.     

Vital Signs: Drug Overdose Deaths,by Selected Sociodemographic and Social Determinants of Health Characteristics — 25 States and the District of Columbia, 2019–2020

Introduction: Drug overdose deaths increased approximately 30% from 2019 to 2020 in the United States. Examining rates by demographic and social determinants of health characteristics can identify disproportionately affected populations and inform strategies to reduce drug overdose deaths.Methods: Data from the State Unintentional Drug Overdose Reporting System (SUDORS) were used to analyze overdose death rates from 2019 to 2020 in 25 states and the District of Columbia. Rates were examined by race and ethnicity and county-level social determinants of health (e.g., income inequality and treatment provider availability).Results: From 2019 to 2020, drug overdose death rates increased by 44% and 39% among non-Hispanic Black (Black) and non-Hispanic American Indian or Alaska Native (AI/AN) persons, respectively. Significant disparities were found across sex, age, and racial and ethnic subgroups. In particular, the rate in 2020 among Black males aged ≥65 years (52.6 per 100,000) was nearly seven times that of non-Hispanic White males aged ≥65 years (7.7). A history of substance use was frequently reported. Evidence of previous substance use treatment was lowest for Black persons (8.3%). Disparities in overdose deaths, particularly among Black persons, were larger in counties with greater income inequality. Opioid overdose rates in 2020 were higher in areas with more opioid treatment program availability compared with areas with lower opioid treatment availability, particularly among Black (34.3 versus 16.6) and AI/AN (33.4 versus 16.2) persons.Conclusions and Implications for Public Health Practice: Health disparities in overdose rates continue to worsen, particularly among Black and AI/AN persons; social determinants of health, such as income inequality, exacerbate these inequities. Implementation of available, evidence-based, culturally responsive overdose prevention and response efforts that address health disparities impacting disproportionately affected populations are urgently needed.     

Targeted Mutations in the Fusion Peptide Region of La Crosse Virus Attenuate Neuroinvasion and Confer Protection against Encephalitis

La Crosse virus (LACV) is a major cause of pediatric encephalitis and aseptic meningitis in the Midwestern, Mid-Atlantic, and Southern United States, where it is an emerging pathogen. The LACV Gc glycoprotein plays a critical role in the neuropathogenesis of LACV encephalitis as the putative virus attachment protein. Previously, we identified and experimentally confirmed the location of the LACV fusion peptide within Gc and generated a panel of recombinant LACVs (rLACVs) containing mutations in the fusion peptide as well as the wild-type sequence. These rLACVs retained their ability to cause neuronal death in a primary embryonic rat neuronal culture system, despite decreased replication and fusion phenotypes. To test the role of the fusion peptide in vivo, we tested rLACVs in an age-dependent murine model of LACV encephalitis. When inoculated directly into the CNS of young adult mice (P28), the rLACV fusion peptide mutants were as neurovirulent as the rLACV engineered with a wild-type sequence, confirming the results obtained in tissue culture. In contrast, the fusion peptide mutant rLACVs were less neuroinvasive when suckling (P3) or weanling (P21) mice were inoculated peripherally, demonstrating that the LACV fusion peptide is a determinant of neuroinvasion, but not of neurovirulence. In a challenge experiment, we found that peripheral challenge of weanling (P21) mice with fusion peptide mutant rLACVs protected from a subsequent WT-LACV challenge, suggesting that mutations in the fusion peptide are an attractive target for generating live-attenuated virus vaccines. Importantly, the high degree of conservation of the fusion peptide amongst the Bunyavirales and, structurally, other arboviruses suggests that these findings are broadly applicable to viruses that use a class II fusion mechanism and cause neurologic disease.     

Integrated decision strategies for skin sensitization hazard

One of the top priorities of the Interagency Coordinating Committee for the Validation of Alternative Methods (ICCVAM) is the identification and evaluation of non‐animal alternatives for skin sensitization testing. Although skin sensitization is a complex process, the key biological events of the process have been well characterized in an adverse outcome pathway (AOP) proposed by the Organisation for Economic Co‐operation and Development (OECD). Accordingly, ICCVAM is working to develop integrated decision strategies based on the AOP using in vitro, in chemico and in silico information. Data were compiled for 120 substances tested in the murine local lymph node assay (LLNA), direct peptide reactivity assay (DPRA), human cell line activation test (h‐CLAT) and KeratinoSens assay. Data for six physicochemical properties, which may affect skin penetration, were also collected, and skin sensitization read‐across predictions were performed using OECD QSAR Toolbox. All data were combined into a variety of potential integrated decision strategies to predict LLNA outcomes using a training set of 94 substances and an external test set of 26 substances. Fifty‐four models were built using multiple combinations of machine learning approaches and predictor variables. The seven models with the highest accuracy (89–96% for the test set and 96–99% for the training set) for predicting LLNA outcomes used a support vector machine (SVM) approach with different combinations of predictor variables. The performance statistics of the SVM models were higher than any of the non‐animal tests alone and higher than simple test battery approaches using these methods. These data suggest that computational approaches are promising tools to effectively integrate data sources to identify potential skin sensitizers without animal testing. Published 2016. This article has been contributed to by US Government employees and their work is in the public domain in the USA.     

Getting the most out of your IP--patent management along its life cycle

Effectively managing and optimizing the value of the patent portfolio is a major challenge for many firms, especially those in knowledge intensive industries, such as the pharmaceutical, biotechnological and chemical industry. However, insights on effective patent portfolio strategies are rare. Therefore, in this article we investigate in detail how firms successfully manage and optimize their patent portfolios to increase their overall competitiveness. We discover that successful patent portfolio management is rooted in managing the patents along their life cycles. Based on the findings of ten case studies, we develop a holistic patent life cycle management model reflecting five distinctive phases of patent management: explore, generate, protect, optimize and decline. We conclude with how our findings can be used in practice.     

Food Insecurity and Depression among US Adults: NHANES 2005–2016

A growing body of evidence suggests that food insecurity is associated with adverse mental health outcomes such as depression and anxiety. In this study, the relationship between food insecurity and depression was examined using data from the 2005–2016 National Health and Nutrition Examination Survey (NHANES). Food insecurity was assessed with the 18-item United States Food Security Survey Module with zero affirmative responses indicating high food security, 1 or 2 affirmative responses indicating marginal food security, and ≥3 affirmative responses indicating food insecurity. Depression was assessed with the Patient Health Questionnaire-9 with scores ≥10 indicating depression. Data were analyzed from 28,448 adult participants aged 20 or older. Food insecurity was present in 19.2% of the sample population (n = 5452). Food security status was significantly associated with gender, race, education level, marital status, smoking status, and BMI (Rao-Scott chi-square, p < 0.05). Fully food secure and very low food security adults experienced depression at a rate of 5.1% and 25.8%, respectively (Rao-Scott chi-square, p < 0.0001). Participants with very low food security had a significantly greater odds of depression than food secure adults, OR = 3.50 (95% CI: 2.98, 4.12). These findings suggest that food insecurity is a significant risk factors for depression in US adults over 20 years of age. To address this issue in our citizenry, police initiatives and public health interventions addressing both food access and mental health should be prioritized.