Human mobility data and machine learning reveal geographic differences in alcohol sales and alcohol outlet visits across U.S. states during COVID-19

As many U.S. states implemented stay-at-home orders beginning in March 2020, anecdotes reported a surge in alcohol sales, raising concerns about increased alcohol use and associated ills. The surveillance report from the National Institute on Alcohol Abuse and Alcoholism provides monthly U.S. alcohol sales data from a subset of states, allowing an investigation of this potential increase in alcohol use. Meanwhile, anonymized human mobility data released by companies such as SafeGraph enables an examination of the visiting behavior of people to various alcohol outlets such as bars and liquor stores. This study examines changes to alcohol sales and alcohol outlet visits during COVID-19 and their geographic differences across states. We find major increases in the sales of spirits and wine since March 2020, while the sales of beer decreased. We also find moderate increases in people’s visits to liquor stores, while their visits to bars and pubs substantially decreased. Noticing a significant correlation between alcohol sales and outlet visits, we use machine learning models to examine their relationship and find evidence in some states for likely panic buying of spirits and wine. Large geographic differences exist across states, with both major increases and decreases in alcohol sales and alcohol outlet visits.

The Causal Effects of Place on Health and Longevity

Life expectancy varies substantially across local regions within a country, raising conjectures that place of residence affects health. However, population sorting and other confounders make it difficult to disentangle the effects of place on health from other geographic differences in life expectancy. Recent studies have overcome such challenges to demonstrate that place of residence substantially influences health and mortality. Whether policies that encourage people to move to places that are better for their health or that improve areas that are detrimental to health are desirable depends on the mechanisms behind place effects, yet these mechanisms remain poorly understood.

Geographic Differences in Rates of Primary Total Knee Arthroplasty In Young and Older Adults: A Comparison of Three U.S. States

Objective Rates of total knee arthroplasty (TKA) among Medicare beneficiaries (adults age 65 and older) vary across the United States, with higher rates in the Midwest and West than in the South. It is not known if similar variation is present among younger patients, or if findings in Medicare reflect selective postponement of TKA in some regions. Methods Data on all primary TKA performed in adults age 20 or older in three states (Iowa, Utah, and Florida) in 2016 were obtained from state inpatient databases. Rates of TKA were computed based on population census data. Age-, sex-, and race-standardized rates were compared between Iowa and Florida and between Utah and Florida among adults age 20 to 64 years and adults age 65 and older. Results There were 10074, 8954, and 43908 primary TKA in Iowa, Utah, and Florida, respectively. Standardized rates were higher in Iowa and Utah than in Florida both among adults age 20 to 64 (Iowa:Florida rate ratio1.89 (95% confidence interval (CI) 1.79, 1.99); Utah:Florida rate ratio 2.31 (95% CI 2.18, 2.45)) and among those age 65 or older (Iowa:Florida rate ratio 1.41 (95% confidence interval (CI) 1.35, 1.47); Utah:Florida rate ratio 1.77 (95% CI 1.70, 1.85)). Results were similar in sensitivity analyses limited to white patients, urban residents, and those with a diagnosis of knee osteoarthritis. Conclusion TKA rates were higher in Iowa and Utah than in Florida among both younger adults and those age 65 and older, indicating geographic differences are not specific to elderly patients.

Analysis of the regional distribution of road traffic mortality and associated factors in Japan

Background Regional differences in road traffic (RT) mortality among municipalities have not been revealed in Japan. Further, the association between RT mortality and regional socioeconomic characteristics has not been investigated. We analyzed geographic differences in RT mortality and its associated factors using the Vital Statistics in Japan. Methods We used data on RT mortality by sex and municipality in Japan from 2013 to 2017. We calculated the standardized mortality ratio (SMR) of RT for each municipality by sex using an Empirical Bayes method. The SMRs were mapped onto a map of Japan to show the geographic differences. In addition, an ecological study investigated the municipal characteristics associated with the SMR using demographic socioeconomic, medical, weather, and vehicular characteristics as explanatory variables. The ecological study used a spatial statistical model. Results The mapping revealed that the number of municipalities with a high SMR of RT (SMR > 2) was larger in men than in women. In addition, SMRs of capital areas (Kanagawa and Tokyo prefectures) tended to be low in men and women. The regression analysis revealed that population density was negatively associated with the SMR in men and women, and the degree of the association was the largest among explanatory variables. In contrast, there was a positive association between the proportion of non-Japanese persons and SMR. The proportions of lower educational level (elementary school or junior high school graduates), agriculture, forestry, and fisheries workers, service workers, and blue-collar workers were positively associated with the SMR in men. The proportion of unemployed persons was negatively associated with the SMR in men. Conclusions Socioeconomic characteristics are associated with geographic differences in RT mortality particularly in men. The results suggested preventive measures targeted at men of low socioeconomic status and non-Japanese persons are needed to decrease RT mortality further.

Development and Application of a gp60-Based Subtyping Tool for Cryptosporidium bovis

Cryptosporidium bovis is a common enteric pathogen in bovine animals. The research on transmission characteristics of the pathogen is hampered by the lack of subtyping tools. In this study, we retrieve the nucleotide sequence of the 60 kDa glycoprotein (GP60) from the whole genome sequences of C. bovis we obtained previously and analyze its sequence characteristics. Despite a typical structure of the GP60 protein, the GP60 of C. bovis had only 19.3–45.3% sequence identity to those of other Cryptosporidium species. On the basis of the gene sequence, a subtype typing tool was developed for C. bovis and used in the analysis of 486 C. bovis samples from dairy cattle, yaks, beef cattle, and water buffalos from China. Sixty-eight sequence types were identified from 260 subtyped samples, forming six subtype families, namely XXVIa to XXVIf. The mosaic sequence patterns among subtype families and the 121 potential recombination events identified among the sequences both suggest the occurrence of genetic recombination at the locus. No obvious host adaptation and geographic differences in the distribution of subtype families were observed. Most farms with more extensive sampling had more than one subtype family, and the dominant subtype families on a farm appeared to differ between pre- and post-weaned calves, indicating the likely occurrence of multiple episodes of C. bovis infections. There was an association between XXVId infection and occurrence of moderate diarrhea in dairy cattle. The subtyping tool developed and the data generated in the study might improve our knowledge of the genetic diversity and transmission of C. bovis.

Correlation between α1-Antitrypsin Deficiency and SARS-CoV-2 Infection: Epidemiological Data and Pathogenetic Hypotheses

The most common hereditary disorder in adults, α1-antitrypsin deficiency (AATD), is characterized by reduced plasma levels or the abnormal functioning of α1-antitrypsin (AAT), a major human blood serine protease inhibitor, which is encoded by the SERine Protein INhibitor-A1 (SERPINA1) gene and produced in the liver. Recently, it has been hypothesized that the geographic differences in COVID-19 infection and fatality rates may be partially explained by ethnic differences in SERPINA1 allele frequencies. In our review, we examined epidemiological data on the correlation between the distribution of AATD, SARS-CoV-2 infection, and COVID-19 mortality rates. Moreover, we described shared pathogenetic pathways that may provide a theoretical basis for our epidemiological findings. We also considered the potential use of AAT augmentation therapy in patients with COVID-19.

Differences in Mortality Rates of Gunshot Victims: The Influence of Neighborhood Social Processes

Firearm violence is considered a public health crisis in the United States. Firearm violence spatially concentrates within neighborhoods and is associated with community factors; however, little is understood about the geographic differences in gunshot wound mortality and associated neighborhood social processes. Applying a public health approach through the Haddon’s Matrix, the results demonstrate systematic differences in social and physical features associated with gunshot mortality. These findings have important implications to improve neighborhood physical and social conditions, police transporting gunshot victims, and police-public health partnerships to improve data collection on nonfatal shootings and shots fired.