Journal articles: 'Westchester county (n.y.)'

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Usiak, Shauna, Laurie DiFilippo, Meredith Frattellone, Mary Kincart, and Christine Kerr. "400. Secondary Infections in COVID-19 Patients Receiving Tocilizumab in a Community Hospital." Open Forum Infectious Diseases 7, Supplement_1 (2020): S268. http://dx.doi.org/10.1093/ofid/ofaa439.595.

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Abstract Background Secondary bacterial/fungal infection in patients with pandemic strains of Influenza has been well documented in the literature. Little is known about the development of secondary bacterial or fungal infections in patients with COVID-19. Additionally, COVID patients receiving tocilizumab as treatment may be at higher risk for developing a secondary infection due to theoretical risk of immunosuppression. Table 1 Table 2 Methods A retrospective analysis of all COVID positive patients admitted to a 128 bed community hospital in Westchester County, NY from March 1 – May 31, 2020. The data was analyzed to determine incidence of secondary infections based on positive cultures in patients and further stratified based on receipt of tocilizumab. Results Out of 445 COVID positive patients reviewed, 69 (15.5%) had positive bacterial/fungal cultures. Average age of the patient population reviewed was 64 (range 1 – 106) and 60% of the patients were male. As of May 31, 2020, 114 of the patients had expired, 281 were discharged, 23 were transferred, and 27 were still admitted to the hospital. Of the 445 total patients, 42 received at least 1 dose of tocilizumab. Out of those patients, 6 patients (14.3%) had subsequent positive cultures. (Table 1) This was not statistically significant (p = 0.8185). Most common positive specimens were in urine (n=38), blood (n=33), and respiratory specimens (n=20). Most commonly found co-pathogens were Escherichia coli (n=22), Coagulase-negative staphylococci (n=11), and Pseudomonas aeruginosa (n=9). Of the 69 patients with positive cultures, 27 received ICU level of care. (Table 2) Conclusion A small retrospective study found that the incidence of bacterial or fungal co-infection for COVID positive patients was high but did not find receipt of tocilizumab was associated with secondary infections. This suggests areas for future study and further investigation as hospitals consider use of immunomodulatory therapies in the treatment of COVID-19. Disclosures All Authors: No reported disclosures

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Bromberg, MD, FACS, Warren D., Tracey Emanuel, MSN, RN, FNP-BC, Valerie Zeller, MA, RN, et al. "Assessment of post-operative opioid prescribing practices in a community hospital ambulatory surgical center." Journal of Opioid Management 17, no. 3 (2021): 241–49. http://dx.doi.org/10.5055/jom.2021.0634.

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Objective: To evaluate the prescribing practices and opioid consumption in an ambulatory setting to inform the development of evidence-based guidelines.Design: A prospective study of adults undergoing outpatient open and laparoscopic surgeries over 3 months. One week after discharge, a telephonic interview quantified the number of opioids prescribed and consumed, degree of pain control and satisfaction, and whether additional pain medication was requested. Setting: Community hospital ambulatory surgery center in Westchester County, New York.Participants: This study included 304 adults undergoing a variety of procedures by surgeons from multiple specialties.Main outcome measures: Quantify surgeons’ postoperative opioid prescribing compared with patient opioid consumption.Results: Eighty-one percent (N = 245) responded to the survey, of which 64 percent were prescribed opioids. Males and females were equally represented with the mean age of 59.4 years. Of those prescribed opioids, 92 percent filled the prescription. The most commonly prescribed opioids reported by the patients that filled their prescription (N = 145) were oxycodone (36.5 percent), oxycodone/acetaminophen (28.9 percent), and tramadol (22.7 percent). The mean number of opioid pills prescribed was 20 and the mean consumption was 6.7 pills, resulting in an average of 13 retained pills. Only 3.8 percent of the patients prescribed opioids at discharge called their provider for additional analgesia. Despite the low opioid consumption patients reported high satisfaction (4.5 on scale of 0-5) with pain control. Only 10.4 percent reported that the surgeon recommended an over the counter (OTC) analgesic option. There was variability in the amount of opioids prescribed within each surgical category.Conclusions: One week after outpatient surgery, patients consumed one-third of physician-prescribed opioids, yet they reported high pain management satisfaction. Our study will inform the development of a patient-centered interdisciplinary perioperative education program to more effectively tailor multimodal pain management in ambulatory surgical patients and collaterally reduce the number of retained opioids.

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Hoefer, Dina, Patricia S. Ruppert, Elizabeth Rausch-Phung, et al. "LB15. Measles Outbreak in New York State (NYS) Outside of New York City, 2018–2019." Open Forum Infectious Diseases 6, Supplement_2 (2019): S999—S1000. http://dx.doi.org/10.1093/ofid/ofz415.2498.

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Abstract Background The United States is experiencing one of the largest and longest measles outbreaks since elimination was declared in 2000 and is at risk of losing this status. Most cases occurring in NYS were reported in undervaccinated communities. Methods We included all confirmed NYS measles cases (excluding NYC) from outbreak counties from October 1, 2018 to July 25, 2019. We used the CSTE measles case definition requiring an acute febrile rash illness and either laboratory confirmation or direct epidemiologic linkage to a lab-confirmed case. For each case, demographic and clinical characteristics were obtained. A medical record review was completed for those reported to have an encounter at a hospital, emergency department, or urgent care center. Results There were 371 cases of measles reported, including 11 internationally imported cases. Most occurred in Rockland county (n = 283); followed by Orange (n = 55), Westchester (n = 18), Sullivan (n = 14) and Greene (n = 1) (Figures 1 and 2). The median age was 5.5 years; 79% of all cases occurred among children younger than 18 years of age (Figure 3). Most cases (79%) had not received any doses of measles vaccine. Of the 371 cases, 263 (71%) were children who had received 0 doses of measles, mumps, rubella vaccine (MMR), 218 (83%) of whom were over 1 year of age (Table 1). There have been no deaths or documented cases of encephalitis. Twenty-eight (8%) patients were diagnosed with pneumonia and 25 (7%) patients were hospitalized. Among 17 hospitalized children, 5 (29%) were admitted to the intensive care unit (ICU) (ages 1 day to 7 years). There were two preterm births at 34 and 25 weeks gestation to women with measles while pregnant. During October 1, 2018–July 31, 2019, providers in outbreak counties vaccinated 72,465 individuals with MMR, a 46% increase from the same period the year prior. Conclusion Unvaccinated children were identified as the largest group affected and experienced severe complications; nearly 30% of hospitalized children were admitted to an ICU. These data support the critical need for continued education and outreach on the risks of measles and the value of vaccination to prevent continued circulation in undervaccinated communities and potential further cases of severe disease. Disclosures Kirsten St. George, MAppSc, PhD, Akonni Biosystems (Other Financial or Material Support), ThermoFisher (Grant/Research Support), Zeptometrix (Other Financial or Material Support, royalty generating collaborative agreement); others, no disclosures reported..

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Jackson, Debra. "Westchester County, New York: Harnessing micropolitics in a learning community." School Leadership & Management 19, no. 2 (1999): 205–7. http://dx.doi.org/10.1080/13632439969221.

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Kumaraswami, Sangeeta, Tana S. Pradhan, Sorana Vrabie-Wolf, et al. "Response of an Obstetric Unit during the Coronavirus Disease of 2019 (COVID-19) Pandemic: Experiences from a Tertiary Care Center." American Journal of Perinatology Reports 10, no. 03 (2020): e281-e287. http://dx.doi.org/10.1055/s-0040-1716731.

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Abstract Objective To describe our experiences in preparing our obstetric unit in Westchester County, New York, during the COVID-19 (coronavirus disease of 2019) pandemic. We focus on describing our timeline, continuously evolving actions, observations, and challenges. Methods With guidance from the New York State Department of Health (NYSDOH), our institutional epidemiologist, and key multidisciplinary faculty members, we evaluated emerging national data as well as expert opinions to identify issues and challenges to create action plans. Results We created and modified policies for our patients presenting for obstetrical care on the labor and delivery unit to accommodate their unique needs during this pandemic. Conclusion The COVID-19 pandemic has posed many unique challenges. Balancing communication, risks of infection to providers, patient autonomy and rights, and resources for testing and personal protective equipment were among the valuable lessons learnt. We have shared our experiences and described our observations and challenges in Westchester County, New York.

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Chung, Heeja Hahn. "User-Friendly Audiovisual Material Cataloging at Westchester County Public Library System." Cataloging & Classification Quarterly 31, no. 3-4 (2001): 313–25. http://dx.doi.org/10.1300/j104v31n03_08.

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Williams, C. L., A. S. Curran, A. C. Lee, and V. O. Sousa. "Lyme disease: epidemiologic characteristics of an outbreak in Westchester County, NY." American Journal of Public Health 76, no. 1 (1986): 62–65. http://dx.doi.org/10.2105/ajph.76.1.62.

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Cooper, John. "Legislation to Protect and Replace Trees on Private Land: Ordinances in Westchester County, New York." Arboriculture & Urban Forestry 22, no. 6 (1996): 270–78. http://dx.doi.org/10.48044/jauf.1996.041.

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As the density of development has increased in New York City and its northern suburbs over the past 2 decades, there has been increased concern about the preservation of trees on private land. This paper presents a snapshot of how these ordinances have developed, the present situation, and the future of this area of regulation. Many of the 41 town or villages in Westchester County, New York, have some form of tree preservation ordinance. (Westchester County is an affluent suburban area immediately north of New York City, and has seen its population more than double in the past 20 years.) Important features of these ordinances include the types of private property or subdivisions covered by the regulations, use of the concept of clear-cutting protection, tree classification and coverage, tree density, and enforcement mechanisms. Three types of ordinance can be differentiated. In the first type, large lot sizes are regulated, while the second type, demonstrates a variety of concerns about tree size and type. These ordinances are generally too weak to substantially protect private trees. The third type of ordinance, more recent in passage (or amendment), contains sufficient detail for strong enforcement in the areas of concern. A set of model regulations is recommended for all ordinances that control trees on private land.

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Mensz, Jan. "Citizen Police: Using the Qui Tam Provision of the False Claims Act to Promote Racial and Economic Integration in Housing." University of Michigan Journal of Law Reform, no. 43.4 (2010): 1137. http://dx.doi.org/10.36646/mjlr.43.4.citizen.

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Economic and racial integration in housing remains elusive more than forty years after the passage of the Fair Housing Act. Recalcitrant municipal governments and exclusionary zoning ordinances have played a large role in maintaining and exacerbating segregated housing patterns. After discussing some of the persistent causes of segregated housing patterns, this Note presents a novel approach to enforcing the Fair Housing Act and the "affirmatively furthering fair housing" requirement on recipients of federal housing grants. This Note presents a citizen suit that emerged from the Southern District of New York in Anti-Discrimination Center v. Westchester County, where a private plaintiff successfully used the False Claims Act to enforce the Westchester County's obligations to overcome impediments to racial integration. This Note concludes by arguing for specific reforms, regional coordination, and inclusionary zoning policies that recipients of federal funds should adopt as part of a truly integrated fair housing policy.

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Morse, A. R., E. Trief, and J. Joseph. "Vision Screening: A Study of 297 Head Start Children." Journal of Visual Impairment & Blindness 81, no. 5 (1987): 200–203. http://dx.doi.org/10.1177/0145482x8708100507.

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Vision assessments were provided to 297 Head Start children in nine Westchester County, New York programs. An optometrist and an orthoptist administered a protocol which included retinoscopy, visual acuity, fly, cover, motility and convergence tests. Sixty-three children (21.2%) were referred for further evaluation. The visual deficits detected by this screening included decreased acuity, strabismus combined with decreased acuity, astigmatism, and nonspecific visual problems. The protocol used provided a thorough evaluation of the visual system and required only seven minutes per patient.

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Long, Sharon K., Jennifer King, and Teresa A. Coughlin. "The Implications of Unmet Need for Future Health Care Use: Findings for a Sample of Disabled Medicaid Beneficiaries in New York." INQUIRY: The Journal of Health Care Organization, Provision, and Financing 42, no. 4 (2005): 413–20. http://dx.doi.org/10.5034/inquiryjrnl_42.4.413.

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Using survey data linked with Medicaid claims data, this study examines the consequences of unmet need for future health care use for a sample of disabled Medicaid beneficiaries in Westchester County, New York. Among other things, we find that individuals reporting unmet need in 1999 were more likely to use emergency room and hospital care in 2000 than those not reporting unmet need. Addressing the barriers to care that underlie unmet need could generate cost savings to Medicaid and provide better health outcomes for program beneficiaries.

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Godfrey, Jodi. "Eat Well, Be Well Nutrition Education Program: Westchester and Lower Putnam County, New York." Childhood Obesity 6, no. 6 (2010): 350–52. http://dx.doi.org/10.1089/chi.2010.0610.lbfew.

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MINOMO, Toshitaro. "A study on the distribution of parks founded to the parksystem in Westchester county." Journal of the Japanese Institute of Landscape Architects 50, no. 5 (1986): 251–56. http://dx.doi.org/10.5632/jila1934.50.5_251.

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Maupin, Gary O., Durland Fish, Jodie Zultowsky, Eduardo G. Campos, and Joseph Piesman. "Landscape Ecology of Lyme Disease in a Residential Area of Westchester County, New York." American Journal of Epidemiology 133, no. 11 (1991): 1105–13. http://dx.doi.org/10.1093/oxfordjournals.aje.a115823.

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Kim, Sung Bok. "The Limits of Politicization in the American Revolution: The Experience of Westchester County, New York." Journal of American History 80, no. 3 (1993): 868. http://dx.doi.org/10.2307/2080407.

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Hosler, Akiko S., and Thomas A. Melnik. "Prevalence of Diagnosed Diabetes and Related Risk Factors: Japanese Adults in Westchester County, New York." American Journal of Public Health 93, no. 8 (2003): 1279–81. http://dx.doi.org/10.2105/ajph.93.8.1279.

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Picciano, Anthony G. "Computers, city and suburb: A study of New York City and Westchester County public schools." Urban Review 23, no. 3 (1991): 191–206. http://dx.doi.org/10.1007/bf01108428.

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Alderisio, K. A., and N. DeLuca. "Seasonal Enumeration of Fecal Coliform Bacteria from the Feces of Ring-Billed Gulls (Larus delawarensis) and Canada Geese (Branta canadensis)." Applied and Environmental Microbiology 65, no. 12 (1999): 5628–30. http://dx.doi.org/10.1128/aem.65.12.5628-5630.1999.

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ABSTRACT Water suppliers have often implicated roosting birds for fecal contamination of their surface waters. Geese and gulls have been the primary targets of this blame although literature documenting the fecal coliform content of these birds is quite limited. To determine the actual fecal coliform concentrations of these birds, fecal samples from 249 ring-billed gulls and 236 Canada geese in Westchester County, N.Y., were analyzed over a 2-year period. Results indicate that gull feces contain a greater average concentration of fecal coliform bacteria per gram (3.68 × 108) than do goose feces (1.53 × 104); however, average fecal sample weights of the geese were more than 15 times higher than those of the gulls.

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Baby-Collin, Virginie. "Disparités socio-spatiales et ségrégations ethniques dans la banlieue new-yorkaise. L'exemple du riche Westchester County." L'Information géographique 76, no. 4 (2012): 143. http://dx.doi.org/10.3917/lig.764.0143.

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FALCO, RICHARD C., and DURLAND FISH. "PREVALENCE OF IXODES DAMMINI NEAR THE HOMES OF LYME DISEASE PATIENTS IN WESTCHESTER COUNTY, NEW YORK." American Journal of Epidemiology 127, no. 4 (1988): 826–30. http://dx.doi.org/10.1093/oxfordjournals.aje.a114865.

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Fusco, Nicole A., Anthony Zhao, and Jason Munshi-South. "Urban forests sustain diverse carrion beetle assemblages in the New York City metropolitan area." PeerJ 5 (March 15, 2017): e3088. http://dx.doi.org/10.7717/peerj.3088.

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Urbanization is an increasingly pervasive form of land transformation that reduces biodiversity of many taxonomic groups. Beetles exhibit a broad range of responses to urbanization, likely due to the high functional diversity in this order. Carrion beetles (Order: Coleoptera, Family: Silphidae) provide an important ecosystem service by promoting decomposition of small-bodied carcasses, and have previously been found to decline due to forest fragmentation caused by urbanization. However, New York City (NYC) and many other cities have fairly large continuous forest patches that support dense populations of small mammals, and thus may harbor relatively robust carrion beetle communities in city parks. In this study, we investigated carrion beetle community composition, abundance and diversity in forest patches along an urban-to-rural gradient spanning the urban core (Central Park, NYC) to outlying rural areas. We conducted an additional study comparing the current carrion beetle community at a single suburban site in Westchester County, NY that was intensively surveyed in the early 1970’s. We collected a total of 2,170 carrion beetles from eight species at 13 sites along this gradient. We report little to no effect of urbanization on carrion beetle diversity, although two species were not detected in any urban parks.Nicrophorus tomentosuswas the most abundant species at all sites and seemed to dominate the urban communities, potentially due to its generalist habits and shallower burying depth compared to the other beetles surveyed. Variation between species body size, habitat specialization, and % forest area surrounding the surveyed sites also did not influence carrion beetle communities. Lastly, we found few significant differences in relative abundance of 10 different carrion beetle species between 1974 and 2015 at a single site in Westchester County, NY, although two of the rare species in the early 1970’s were not detected in 2015. These results indicate that NYC’s forested parks have the potential to sustain carrion beetle communities and the ecosystem services they provide.

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Wright, Daniel, and John Moran. "Effect of Atrinal (Dikegulac) on the Growth of Plane Tree, Red Maple, and Norway Maple in New York." Arboriculture & Urban Forestry 14, no. 5 (1988): 121–24. http://dx.doi.org/10.48044/jauf.1988.029.

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Three hundred trees under utility electric lines were selected in 1984 in the communities of Yonkers, White Plains, and New Castle in Westchester County, New York to test the effectiveness of Atrinal (dikegulac) in controlling tree regrowth following trimming. Atrinal was applied to plane trees, red maples, and Norway maples by trunk injection after trimming. During the first growing season after Atrinal treatment, the average sprout length reduction was 48.3% for plane tree; 23.9% for red maple; and 33.3% for Norway maple. In 1984, Atrinal injection reduced the average length of longest wound sprouts for plane tree 53.6%; red maple 41.2%; and Norway maple 29.1%. The variability in tree regrowth noted among species may be due to different uptake rates of Atrinal, amount of crown removal, climatic factors, and tree health prior to treatment.

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Chang, Yung-Fu, Vesna Novosel, Chao-Fu Chang, Jong Bae Kim, Sang J. Shin, and Donald H. Lein. "Detection of Human Granulocytic Ehrlichiosis Agent and Borrelia Burgdorferi in Ticks by Polymerase Chain Reaction." Journal of Veterinary Diagnostic Investigation 10, no. 1 (1998): 56–59. http://dx.doi.org/10.1177/104063879801000110.

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Adult ixodid ticks were collected from Westchester County, New York, and Ipswich, Massachusetts, to determine the presence of infection with a human granulocytic ehrlichiosis (HGE) agent by using the polymerase chain reaction (PCR). The presence of Borrelia burgdorferi in ticks collected from New York was also determined by PCR. Of the 229 ticks from New York and 47 ticks from Massachusetts, 9% (22/229) and 25% (12/47) of ticks contained HGE agent, respectively. Fifty-four percent (123/229) of the ticks collected from New York were B. burgdorferi positive; 4% (9/229) of these ticks contained both HGE agent and B. burgdorferi. This finding indicates that animals with Lyme borreliosis may be also exposed to the etiologic agent of HGE. More extensive laboratory diagnosis may be necessary when multiple tick-borne diseases are suspected in animals.

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Redkey, Elizabeth. "Freedom Journey: Black Civil War Soldiers and The Hills Community, Westchester County, New York by Edythe Ann Quinn." New York History 98, no. 1 (2017): 153–55. http://dx.doi.org/10.1353/nyh.2017.0043.

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Nagy, Christopher M., and Robert F. Rockwell. "Occupancy patterns of Megascops asio in urban parks of New York City and southern Westchester County, NY, USA." Journal of Natural History 47, no. 31-32 (2013): 2135–49. http://dx.doi.org/10.1080/00222933.2013.770100.

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Washington, Eric Michael. "Freedom Journey: Black Civil War Soldiers and The Hills Community, Westchester County, New York by Edythe Ann Quinn." Civil War History 62, no. 3 (2016): 337–38. http://dx.doi.org/10.1353/cwh.2016.0061.

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Seeber, Leonardo, and Nancye Dawers. "Characterization of an Intraplate Seismogenic Fault in the Manhattan Prong, Westchester Co., N. Y." Seismological Research Letters 60, no. 2 (1989): 71–78. http://dx.doi.org/10.1785/gssrl.60.2.71.

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Abstract A close correlation in location, orientation and sense of slip is found between the Dobbs Ferry fault zone (DFFZ) and the 1985 Ardsley earthquake rupture (mb =4.0) in southern Westchester Co., N.Y. A 3 km portion of the DFFZ that had been previously recognized by Hall is now traced for 8 km from the Hudson River to Cameron’s Line. Detailed mapping reveals a northwest trending zone of intense fracturing and faulting associated with a set of aligned linear valleys. The fault zone is a tabular zone of discontinuous faults and fractures rather than a single through-going fault, and cumulative offset across it is very small, considering size and age of the structure. Fractures range from purely extensional joints, to small-displacement slickensided microfaults, to brittle faults with measurable offset, breccia, and gouge. Mesoscopic structural data argue for predominantly left-lateral motion on the DFFZ. Sinistral motion also predominated in the 1985 earthquake sequence. The accumulated displacement on the DFFZ shown by offset Paleozoic-age markers, however, is right-lateral (20–30m). Other northwest-striking brittle faults in the Manhattan Prong exhibit similar right-lateral offsets. This discrepancy along with other data suggest a multi-phase evolution, probably including a plate-boundary phase coinciding with Mesozoic rifting and a presently active intraplate phase. The more recent left-lateral phase probably involved fault formation from preexisting (Late Paleozoic-Mesozoic ?) joints. Preliminary results of this study have immediate application to earthquake hazard analysis and broad implications regarding intraplate seismogenesis. Firstly, faults with little or no accumulated displacement (“low-displacement faults”) can be the source of significant earthquakes. Thus, rates and recency of displacement on faults need to be reevaluated as criteria for earthquake potential. Secondly, the structural setting of intraplate seismogenic faults may provide a basis for segmentation, leading to limits on the maximum characteristic size of earthquakes, which could be much smaller than magnitude estimates derived from a single rupture of the entire fault.

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Zeng, Chengbo, and Yunyu Xiao. "429. County-level predictors of COVID-19 testing across the 62 counties in New York State: A comparison across machine learning algorithms." Open Forum Infectious Diseases 7, Supplement_1 (2020): S281. http://dx.doi.org/10.1093/ofid/ofaa439.623.

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Abstract Background More than 360,000 people infected with COVID-19 in New York State (NYS) by the end of May 2020. Although expanded testing could effectively control statewide COVID-19 outbreak, the county-level factors predicting the number of testing are unknown. Accurately identifying the county-level predictors of testing may contribute to more effective testing allocation across counties in NYS. This study leveraged multiple public datasets and machine learning algorithms to construct and compare county-level prediction models of COVID-19 testing in NYS. Methods Testing data by May 15th was extracted from the Department of Health in NYS. A total of 28 county-level predictors derived from multiple public datasets (e.g., American Community Survey and US Health Data) were used to construct the prediction models. Three machine learning algorithms, including generalized linear regression with the least absolute shrinkage and selection operator(LASSO), ridge regression, and regression tree, were used to identify the most important county-level predictors, adjusting for prevalence and incidence. Model performances were assessed using the mean square error (MSE), with smaller MSE indicating a better model performance. Results The testing rate was 70.3 per 1,000 people in NYS. Counties (Rockland and Westchester) closed to the epicenter had high testing rates while counties (Chautauqua and Clinton) located at the boundary of NYS and were far away from the epicenter had low testing rates. The MSEs of linear regression with the LASSO penalty, ridge regression, and regression tree was 123.60, 40.59, and 298.0, respectively. Ridge regression was selected as the final model and revealed that the mental health provider rate was positively associated with testing (β=5.11, p=.04) while the proportion of religious adherents (β=-3.91, p=.05) was inversely related to the variation of testing rate across counties. Conclusion This study identified healthcare resources and religious environment as the strongest predictor of spatial variations of COVID-19 testing across NYS. Structural or policy efforts should address the spatial variations and target the relevant county-level predictors to promote statewide testing. Disclosures All Authors: No reported disclosures

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Rahman, Nishad, Kayla Guidry, Elizabeth Brining, et al. "Community Hospital Response to COVID-19 Outbreak." Western Journal of Emergency Medicine 23, no. 2 (2022): 129–33. http://dx.doi.org/10.5811/westjem.2021.9.52294.

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Since early 2020, the world has been living through coronavirus disease 2019 (COVID-19). Westchester County, New York, was one of the hardest and earliest hit places in the United States. Working within a community emergency department amid the rise of a highly infectious disease such as COVID-19 presented many challenges, including appropriate isolation, adequate testing, personnel shortages, supply shortfalls, facility changes, and resource allocation. Here we discuss our process in navigating these complexities, including the practice changes implemented within our institution to counter these unprecedented issues. These adjustments included establishing three outdoor tents to serve as triage areas; creating overflow intensive care units through conversion of areas that had previously served as the ambulatory surgery unit, post-anesthesia care unit, and endoscopy suite; increasing critical care staff to meet unprecedented need; anticipating and adapting to medical supply shortages; and adjusting resident physician roles to meet workflow requirements. By analyzing and improving upon the processes delineated below, our healthcare system should be better prepared for future pandemics.

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Garmendia, Antonio E., Herbert J. Van Kruiningen, Richard A. French, et al. "Recovery and Identification of West Nile Virus from a Hawk in Winter." Journal of Clinical Microbiology 38, no. 8 (2000): 3110–11. http://dx.doi.org/10.1128/jcm.38.8.3110-3111.2000.

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West Nile virus was recovered from the brain of a red-tailed hawk that died in Westchester County, N.Y., in February 2000. Multiple foci of glial cells, lymphocytes, and a few pyknotic nuclei were observed in the brain. Three to 4 days after inoculation of Vero cells with brain homogenates, cytopathic changes were detected. The presence of West Nile virus antigen in fixed cells or cell lysates was revealed by fluorescent antibody testing or enzyme-linked immunosorbent assay, respectively. Furthermore, Reverse transcriptase-PCR with primers specific for the NS3 gene of West Nile virus resulted in an amplicon of the expected size (470 bp). Electron microscopy of thin sections of infected Vero cells revealed the presence of viral particles approximately 40 nm in diameter, within cytoplasmic vesicles. The demonstration of infection with the West Nile virus in the dead of the winter, long after mosquitoes ceased to be active, is significant in that it testifies to the survival of the virus in the region beyond mosquito season and suggests another route of transmission: in this case, prey to predator.

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O’Callaghan, Kevin P., Kyle Winser, Vaidehi Mehta, et al. "434. Tracking COVID-19 in Real Time: Leveraging Public Data Sources to Inform Infection Prevention Practices." Open Forum Infectious Diseases 7, Supplement_1 (2020): S285. http://dx.doi.org/10.1093/ofid/ofaa439.628.

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Abstract Background Global spread of SARS-CoV-2 led to an urgent need for data on national and regional prevalence to inform public health policy. Healthcare systems were also in need of data to develop best practices around defining patient risk. We describe a data analytics tool developed at our institution which uses public data sources to track county-level prevalence of COVID-19 so as to delineate risk for individual patients. Methods We investigated a number of data sources tracking COVID-19 case counts, assessing for (1) frequency of updates, (2) granularity of geographic detail (optimally to zip-code or county) and (3) completeness of the data. We chose the Johns Hopkins University CSSE COVID-19 data set. This contains counts of new diagnoses per day by county using Federal Information Processing System (FIPS) codes. The dataset is updated daily with adjustments made for backdated corrections. We developed a data analytics tool which allowed for direct comparison of county period prevalence. We developed a metric of 10-day rolling period prevalence calculated as a total case count from the preceding 10 days, divided by county population from 2018 American Community Survey (ACS) estimates. Results Benchmarking against local (peak of 3.12 cases per 1,000 persons) and regional prevalence, we set 6 cases/1,000 persons as the threshold for a Geographic Region with Widespread Community Transmission (GReWCoT). Counties have to reach this threshold for at least 4 out of 7 days within the period 3 to 10 days prior to the evaluation, to adjust for bulking of test results and delayed reporting. We used the analytics tool to support a semimonthly review of geographic regions, and made specific recommendations for patients from qualifying regions including use of modified enhanced precautions (including surgical mask and eye protection), as well as restricted visitation of caregivers. Figure 1. Epidemic curves for 10-day rolling period prevalence of COVID-19 in the Mid-Atlantic Region: Philadelphia County, PA Figure 2. Epidemic curves for 10-day rolling period prevalence of COVID-19 in the Mid-Atlantic Region: Westchester County, NY Figure 3. Epidemic curves for 10-day rolling period prevalence of COVID-19 in the Mid-Atlantic Region: Bergen County, NJ Conclusion This approach allowed for a nuanced investigation of COVID-19 prevalence in real-time, and provided support for risk stratification of patients throughout our large catchment area. The dashboard was shared on an inward-facing site to support staff messaging about regions of increased risk. Next steps include leveraging international data to inform a similar approach to international travel for our patients and staff. Disclosures All Authors: No reported disclosures

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Schwartz, Brian S., Gilda Foreseter, Gary P. Wormser, Durland Fish, James E. Childs, and Robert B. Nadelman. "Entomologic and Demographic Correlates of Anti-Tick Saliva Antibody in a Prospective Study of Tick Bite Subjects in Westchester County, New York." American Journal of Tropical Medicine and Hygiene 48, no. 1 (1993): 50–57. http://dx.doi.org/10.4269/ajtmh.1993.48.50.

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Aguero-Rosenfeld, M. E., L. Donnarumma, L. Zentmaier, et al. "Seroprevalence of Antibodies That React with Anaplasma phagocytophila, the Agent of Human Granulocytic Ehrlichiosis, in Different Populations in Westchester County, New York." Journal of Clinical Microbiology 40, no. 7 (2002): 2612–15. http://dx.doi.org/10.1128/jcm.40.7.2612-2615.2002.

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Nickols, David, Gerard C. Moerschell, and Michael V. Broder. "The first DAF water treatment plant in the United States." Water Science and Technology 31, no. 3-4 (1995): 239–46. http://dx.doi.org/10.2166/wst.1995.0533.

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The Millwood Water Treatment Plant in Westchester County, about 60 kilometres (35 miles) north of New York City, was commissioned in August 1993. This plant is the first dissolved air flotation (DAF) plant in the United States which uses the DAF technology and concepts that have become the industry standards in Europe and Australia. The $19-million plant was built to treat a previously unfiltered supply, to meet the requirements of the new federal Surface Water Treatment Rule. This paper describes the project in its entirety: starting from the planning, pilot testing, and process selection; proceeding to the means of overcoming resistance to a “new” process and obtaining regulatory body approvals; and outlining the design, process criteria, construction, and start-up of the plant. Operating results are also presented. The plant treats soft, slightly colored, generally low turbidity water which experiences occasional turbidity spikes of 100 NTU or more. The treatment process comprises two-stage mixing, three-stage flocculation, dissolved air flotation, ozonation for primary disinfection, dual-media filtration, and post-treatment with chlorine, sodium hydroxide, orthophosphate and fluoride. Flotation sludge is dewatered in on-site freeze/thaw lagoons for off-site disposal in a landfill.

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Chang, Yung-Fu, Sean P. McDonough, Chao-Fu Chang, Kwang-Soon Shin, William Yen, and Thomas Divers. "Human Granulocytic Ehrlichiosis Agent Infection in a Pony Vaccinated with a Borrelia burgdorferi Recombinant OspA Vaccine and Challenged by Exposure to Naturally Infected Ticks." Clinical Diagnostic Laboratory Immunology 7, no. 1 (2000): 68–71. http://dx.doi.org/10.1128/cdli.7.1.68-71.2000.

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ABSTRACT A pony was vaccinated with recombinant OspA vaccine (rOspA) and then exposed 3 months later to Borrelia burgdorferi-infected ticks (Ixodes scapularis) collected in Westchester County, N.Y. At 2 weeks after tick exposure, the pony developed a high fever (105°F). Buffy coat smears showed that 20% of neutrophils contained ehrlichial inclusion bodies (morulae). Flunixin Meglumine (1 g daily) was given for 2 days, and the body temperature returned to normal. PCR for ehrlichial DNA was performed on blood samples for 10 consecutive days beginning when the pony was first febrile. This pony was monitored for another 3.5 months but developed no further clinical signs. The 44-kDa immunodominant human granulocytic ehrlichiosis antigen gene was amplified by PCR and cloned into a pCR2.1 vector. DNA sequence analysis of this gene showed it was only 8 bp different (99% identity) from the results reported by others (J.W. Ijdo et al., Infect. Immun. 66:3264–3269, 1998). Western blot analysis, growth inhibition assays, and repeated attempts to isolate B. burgdorferi all demonstrated the pony was protected against B. burgdorferi infection. These results highlight the potential for ticks to harbor and transmit several pathogens simultaneously, which further complicates the diagnosis and vaccination of these emerging tick-borne diseases.

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Taber, Timothy, Robert Butterworth, Scott Sellers, et al. "INTEGRATION OF COMPUTERIZED O&M MANUALS AND COMPUTERIZED MAINTENANCE MANAGEMENT SYSTEMS TO IMPROVE PERFORMANCE AT SEVEN WASTEWATER TREATMENT PLANTS IN WESTCHESTER COUNTY, NEW YORK." Proceedings of the Water Environment Federation 2001, no. 8 (2001): 313–30. http://dx.doi.org/10.2175/193864701790861938.

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Thompson, H. D. "THE PALISADES RIDGE IN ROCKLAND COUNTY, N. Y." Annals of the New York Academy of Sciences 80, no. 4 (2006): 1106–26. http://dx.doi.org/10.1111/j.1749-6632.1959.tb49283.x.

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Cannizzaro, Andrew G., Donna Balding, Michael Stine, and Thomas R. Sawicki. "A new syntopic species of Stygobromus Cope, 1872 (Amphipoda: Crangonyctidae) from groundwaters in Georgia and Florida, USA, with notes on S. floridanus Holsinger & Sawicki, 2016." Journal of Crustacean Biology 39, no. 4 (2019): 407–18. http://dx.doi.org/10.1093/jcbiol/ruz034.

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Abstract Stygobromus doughertyensis n. sp. is described from groundwater habitats in Jackson County, Florida and Dougherty County, Georgia, USA using both morphological and molecular methods. This species occurs syntopically with the morphologically similar S. floridanus, which is newly recorded in Jackson County. The occurrence of S. floridanus in Jackson County marks a range extension for this species, which was described from two caves in Washington County, Florida. The description of S. doughertyensis n. sp. brings the number of described species in the genus Stygobromus to 142 and marks the second species of Stygobromus to be described from the Floridan aquifer.

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Ceciliah, Wambogo N., Orago S. S. Alloys, and Oyore P. John. "Factors associated with the occurrence of asymptomatic bacteriuria among pregnant women in Embakasi Central Sub-County, Nairobi County." International Journal Of Community Medicine And Public Health 9, no. 5 (2022): 2043. http://dx.doi.org/10.18203/2394-6040.ijcmph20221219.

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Background: Asymptomatic bacteriuria (ASB) complications are the second leading cause of death in pregnant women globally, trailing only anaemia. Despite the fact that urinary tract infection (UTI) has been a threat to public health in Nairobi for the past five years, especially in the Embakasi Central sub-county, no studies on the occurrence of ASB and related factors have been conducted in Nairobi County.Methods: A descriptive cross-sectional analytical design study was conducted in five wards of Embakasi central sub-county, Nairobi County, Kenya. A questionnaire and routine urine microscopy were used to collect data from 369 expectant women attending ANC in selected facilities. independent t test and chi-square tests were between the independent and dependent variables at p≤0.05.Results: The respondents were 26 years old on average, majority of the women had attained secondary education (46.7%, n=172), were married (66%, n=241) and professed Christianity (72.2%, n=265). The proportion of women in employment (52%, n=192) was slightly higher than the unemployed (48%, n=175). The occurrence of ASB was significantly higher in first trimester as compared to the other trimesters (p=0.000). Also, the occurrence of ASB differed significantly by religion (p=0.002) and by employment status (p=0.003). Most of the expectant mothers had heard of ASB, mainly from health care workers (58.9%, n=119) or the media (31.7%, n=64). ASB was more likely to occur in women who had never heard of ASB (p=0.000).Conclusions: The prevalence of ASB is relatively higher than the rest of the African continent. Knowledge levels, religion, family sizes, trimester of pregnancy and employment status were strongly linked to ASB. Consequently, a number of interventions and policy recommendations have been made in this paper.

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BELOUSOV, IGOR A., ILYA I. KABAK, and HONGBIN LIANG. "New species of the tribe Trechini from China (Coleoptera: Carabidae)." Zootaxa 4656, no. 1 (2019): 143–52. http://dx.doi.org/10.11646/zootaxa.4656.1.7.

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Two new species of the tribe Trechini Bonelli, 1810 are described from the Hengduan Mountains in Sichuan and Yunnan provinces, China: Agonotrechus spinangulus sp. n. (from the Kangwu Pass, Liziping Town, Muli County, southern Sichuan) and Sinotrechiama yunnanus sp. n. (from the Xiaobaicaoling Pass, Santai Town, Dayao County, Yunnan). A new collecting site (Yizi Pass between Meigu County and Ebian County, Sichuan) is provided with some data on morphological variation for one more species, Protrechiama crassipes (Uéno, 1997), known so far only from the two female specimens of the type series. These new findings significantly expand our knowledge of the above three genera. Sinotrechiama yunnanus sp. n. is the first member of the genus found outside of Sichuan Province.

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Fetisenko, Ol’ga Leonidovna. "K. N. LEONTIEV: DOCTOR, WRITER, PATIENT." Russkaya literatura 3 (2022): 27–34. http://dx.doi.org/10.31860/0131-6095-2022-3-27-34.

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The article outlines the legacy of K. N. Leontiev, a well-known writer and philosopher, who served as a military doctor during the Crimean War and worked as a private practitioner for five years after. It deals with the plethora of «medical» themes in his fi ction and his memoir-autobiographical prose, as well as with the use of the relevant imagery in his historiosophic writings. A number of previously unknown facts of the writer’s biography are introduced to the academic community for the fi rst time, e. g. the permission to practice medicine he received in 1876 from the Meshchovskaya County Medical Board, his unsuccessful attempt to take the position of a zemstvo doctor in the same county in 1877, at a time when the author of «Byzantium and Slavyanism» seemed to have long abandoned his «professional path».

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Hassan, Abdurrahman Ahmed, and Wilson Muna. "Fiscal Transfer n Intergovernmental Relations: A Case of Wajir County, Kenya." International Journal of Current Aspects 6, no. 3 (2022): 161–74. http://dx.doi.org/10.35942/ijcab.v6i3.286.

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The declaration of the constitution 2010 was proposed to change the predominant socio-political plan in Kenya. The constitution expects to achieve fiscal changes by evenhanded dispersion of assets to advance improvement strategies and administrations that are customized to local needs. Different laws and strategies, for example, the Public Finance Management Act of 2012 and the County Government Act of 2012 means to ensure, advance and authorize the execution of these standards in the 47 counties Regardless of all these changes, fiscal transfer has been facing challenging issues in the devolution cycle in Kenya, creating broad discussions among different partners especially between the devolved units and national government. This study aimed at exploring the effects of fiscal transfers on intergovernmental relations in Wajir County, with the aim of providing sustainable recommendations on the research topic at hand. The study objectives were to assess the impacts of the amount allocated, timely disbursement, procedure of and national government fiscal control measures on intergovernmental relations in Kenya. This study depends on the theory of fiscal decentralization by that analyzes the channels through which fiscal decentralization influences intergovernmental relations and the fiscal control theory. The survey utilized descriptive research design and target targeted region government officials and chosen officials from Wajir County and the staff of Wajir County. The primary data was collected using semi-structured questionnaires and analyzed both qualitatively and quantitatively. Quantitative data was analyzed using clear measurements which incorporated; rates, frequencies, mean and standard deviation. For qualitative data, it got analyzed using thematic analysis. The study found out that resource allocated, timely disbursement of resources and procedure of allocation of resources significantly affected fiscal transfers on intergovernmental relations in Wajir County. On the other hand, national government fiscal control measures had an insignificant effect on the intergovernmental relations in Wajir County. The study recommends that county governments and the national government should look for ways of ensuring adherence to policies and also come up with mechanisms of developing new policies regularly, Resource allocation to various activities should be enhanced and that the health departments should allocate significant amounts to non- recurrent expenditure, amount of resources should be improved through regular trainings and Governance structures should be established with a clear chain of command and they should incorporate all the stakeholders involved.

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Dong, Xiawei, Thomas Talhelm, and Xiaopeng Ren. "Teens in Rice County Are More Interdependent and Think More Holistically Than Nearby Wheat County." Social Psychological and Personality Science 10, no. 7 (2018): 966–76. http://dx.doi.org/10.1177/1948550618808868.

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China’s smallest province Ningxia sits in North Central China. Surrounded by herding cultures to the north and wheat farmers to the south, Qingtongxia is a small outpost of rice farming fed by the Yellow River. We test the hypothesis that rice-farming cultures are more interdependent by comparing high school students from Qingtongxia ( N = 190) to students in a nearby wheat district, Yuanzhou ( N = 223). Comparing two nearby counties provides a natural test case that controls for third variables. Students in the rice county thought more holistically, treated a close friend better than a stranger, and showed lower implicit individualism. Students in the rice area showed more relative perception than students from the wheat areas on the practice trials of the framed line task, but differences were nonsignificant on the main trials. Differences between teenagers—born after the year 2000—suggest that rice–wheat differences continue among China’s next generation.

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44

Kennedy, George L. "New Cretaceous and Tertiary Pholadidae (Mollusca: Bivalvia) from California." Journal of Paleontology 67, no. 3 (1993): 397–404. http://dx.doi.org/10.1017/s0022336000036878.

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Cretaceous and early Tertiary Pholadidae (Mollusca: Bivalvia) from the Pacific Slope of North America are rare and only poorly known. Three new species, each the earliest known Pacific Slope representative of its respective genus, are described: Barnea (Anchomasa) saulae n. sp. (Pholadinae) from the Upper Cretaceous (Coniacian and Santonian) Redding Formation near Redding, uppermost Sacramento Valley, Shasta County, northern California; Chaceia fulcherae n. sp. (Martesiinae) from three widely separated areas of outcrop represented by 1) the middle Miocene (“Temblor”) Temblor Formation near Oil City and in Jasper Canyon, western Fresno County, central California, 2) the middle Miocene (“Temblor”) Topanga(?) Group in the northern Santa Ana Mountains, Orange County, southern California, and 3) the upper Miocene (Wishkahan) Montesano Formation on the Middle Fork of the Satsop River, Mason County, western Washington; and Netastoma squiresi n. sp. (Jouannetiinae) from the lowest Eocene (uppermost “Meganos”) part of the Santa Susana Formation north of Simi Valley in the Santa Susana Mountains, Ventura County, southern California.

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45

Muma, Benedict M., Justus O. Osero, and Caroline M. Kanini. "Risk factors associated with the prevalence of Helicobacter pylori among community members in Kibwezi West Sub-County, Makueni County." International Journal Of Community Medicine And Public Health 9, no. 5 (2022): 2049. http://dx.doi.org/10.18203/2394-6040.ijcmph20221220.

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Background: Helicobacter pylori are gram-negative pathogens that live in the digestive tract and are linked to intestinal ulcers, stomach open wounds, prolonged inflammation, stomach malignancy, and a variety of extra-gastric problems. Close to half of the world's populace is afflicted. The principal focus of the investigation sought to establish the extent of Helicobacter pylori infection in Kibwezi West Sub-County and socioeconomic parameters that drive it.Methods: Purposeful selection, cluster selection, and simple random sampling strategies were utilized in the study's analytic cross-sectional architecture. Participants ranged from 18 to 70 years old, and their stool samples (344) were analyzed using the concept of immunochromatography in vitro to determine the antigens of Helicobacter pylori in stool. At p≤0.05, Chi2 tests were conducted between independent and dependent variables.Results: A number of 344 residents of Kibwezi West Sub-County were surveyed, with a response rate of 100% (344). The majority of those sampled were aged below 58 years (90.1%, n=310), married (81%, n=280), female (75%, n=259), and practicing Christians (84%, n=288). The H. pylori test results indicated 32% (n=109) tested positive, with 68% (n=225) returning negative results. The statistical significance of education level (p=0.024), source of drinking water (p=0.001), and diabetic status (p=0.010) was confirmed.Conclusions: The extent of H. pylori is lower than reported throughout Kenyan studies, including the Kenya health information system. Infection with H. pylori was strongly linked to education, drinking water source, and diabetes. This study proposes a number of intervention strategies.

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Su, Dai, Yingchun Chen, Hongxia Gao, et al. "Does County-Level Medical Centre Policy Influence the Health Outcomes of Patients with Trauma Transported by the Emergency Medical Service System? An Integrated Emergency Model in Rural China." International Journal of Environmental Research and Public Health 16, no. 1 (2019): 133. http://dx.doi.org/10.3390/ijerph16010133.

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This study aimed to assess the effect of the county-level medical centre policy on the health outcomes of trauma patients transported by emergency medical service (EMS) system in rural China. The methodology involved the use of electronic health records (EHRs, after 2016) of patients with trauma conditions such as head injury (n = 1931), chest (back) injury (n = 466), abdominal (waist) injury (n = 536), and limb injury (n = 857) who were transported by EMS to the county-level trauma centres of Huining County and Huan County in Gansu, China. Each patient was matched with a counterpart to a county-level trauma centre hospital by propensity score matching. Cox proportional hazard models were used to estimate the hazard ratios (HRs) of such patients in different hospitals. The HRs of all patients with the abovementioned traumatic conditions transported by EMS to county-level trauma centre hospitals were consistently higher than those transported by EMS to traditional hospitals after adjusting for numerous potential confounders. Higher HRs were associated with all patients with trauma (HR = 1.249, p < 0.001), head injury (HR = 1.416, p < 0.001), chest (back) injury (HR = 1.112, p = 0.560), abdominal (waist) injury (HR = 1.273, p = 0.016), and limb injury (HR = 1.078, p = 0.561) transported by EMS to the county-level trauma centre hospitals. Our study suggests that the construction of county-level medical centre provides an effective strategy to improve the health outcomes of EMS-transported trauma patients in Gansu, China. Policy makers can learn from the experience and improve the health outcomes of such patients through a personalised trauma treatment system and by categorizing the regional trauma centre.

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Collica-Cox, Kimberly, and Louis Molina. "A Case Study of the Westchester County New York’s Jail Response to COVID-19: Controlling COVID while Balancing Service Needs for the Incarcerated-A National Model for Jails." Victims & Offenders 15, no. 7-8 (2020): 1305–16. http://dx.doi.org/10.1080/15564886.2020.1820923.

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48

Middleton, Beth A., Evelyn Anemaet, Tracy Elsey Quirk, and Nicholas P. Tippery. "Nymphoides humboldtiana (Menyanthaceae) in Florida (U.S.A.) verified by DNA data." Journal of the Botanical Research Institute of Texas 12, no. 1 (2018): 257–63. http://dx.doi.org/10.17348/jbrit.v12.i1.934.

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Certain Nymphoides populations in Florida, U.S.A., previously identified as the non-native N. indica (L.) Kuntze, are actually N. humboldtiana (Kunth) Kuntze, as verified using nuclear and plastid DNA data. These new records of N. humboldtiana in Florida are the only known localities in the U.S.A. outside of Uvalde County, Texas. Nymphoides humboldtiana is native to Texas, México, the Caribbean, and Central and South America. The newly identified Florida populations found near the city of Tampa in Manatee County (Ward Lake and Braden River) and Fort Walton Beach in Okaloosa County (Bass Lake) are presumed to be native. Nymphoides humboldtiana and N. indica share many superficial similarities, most notably white petals with ciliate hairs. Our findings suggest that certain morphologically-determined populations of N. indica in the U.S.A. may be incorrectly identified. Such populations might be re-examined using DNA methods to avoid any management actions against N. humboldtiana.

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LI, DE-WEI, GUO-QUAN WANG, and SUI-GAI WEI. "A new genus and three new species of Phyllocoptinae (Acari: Eriophyidae) from South China." Zootaxa 1587, no. 1 (2007): 53–59. http://dx.doi.org/10.11646/zootaxa.1587.1.4.

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In this paper, a new genus and three new species of eriophyid mites from Heng County and Longlin County, Guangxi Zhuang Autonomous Region, South China are described and illustrated: Calpentaconvexus eyrei n. gen. and n. sp. infesting Castanopsis eyrei (Champ. ex Benth.) Tutch. (Fagaceae); Phyllocoptruta subcoriaceae n. sp. infesting Embelia subcoriacea Mez. (Myrsinaceae) and Petanovicia discolor n. sp. infesting Sapium discolor (Champ. ex Benth.) Muell.-Arg. (Euphorbiaceae). A key to species of Phyllocoptruta from China is provided.

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Van Harten, Argonde C., Heather J. Wiste, Stephen D. Weigand, et al. "CSF biomarkers in Olmsted County." Neurology 95, no. 3 (2020): e256-e267. http://dx.doi.org/10.1212/wnl.0000000000009874.

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ObjectiveWe studied interrelationships between CSF biomarkers and associations with APOE ε4 genotype, demographic variables, vascular variables, and clinical diagnosis in Olmsted County, Minnesota.MethodsWe included 774 Mayo Clinic Study of Aging participants (693 cognitively unimpaired [CU]; 71 with mild cognitive impairment [MCI]). CSF β-amyloid 42 (Aβ42), total tau (t-tau), and hyperphosphorylated tau (p-tau) were analyzed using Aβ42 CSF, t-tau CSF, and p-tau (181P) CSF electrochemiluminescence immunoassays. Bivariate mixture models were used to evaluate latent classes. We used linear regression models to evaluate independent associations of APOE ε4, demographic factors, cardiovascular risk, and diagnosis with CSF biomarker levels. Results were weighted back to the Olmsted County population.ResultsInterrelationships between CSF Aβ42 and p-tau/t-tau were consistent with 2 latent classes in the general population. In subgroup 1 (n = 547 [71%]), we found a strong positive correlation between Aβ42 and p-tau (ρ = 0.81), while the correlation was much smaller in group 2 (ρ = 0.26, n = 227 [29%]). Group 2 was associated with older age, APOE ε4 genotype, a diagnosis of MCI, and elevated amyloid PET. Overall, APOE ε4 genotype and MCI were associated with Aβ42, while age was associated with p-tau/t-tau. There were no associations with sex, education, or vascular risk.ConclusionWe hypothesize the population without dementia can be subdivided into participants with and without biological Alzheimer disease (AD) based on the combination of CSF Aβ42 and p-tau/t-tau (represented also by the p-tau/t-tau/Aβ42 ratio). In those without biological AD, common factors such as CSF dynamics may cause a positive correlation between CSF Aβ42 and p-tau/t-tau, while AD leads to dissociation of these proteins.

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Journal articles on the topic 'Westchester county (n.y.)'

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