Multiple Substance Use Disorders and Self-Reported Cognitive Function in U.S. Adults: Associations and Sex-Differences in a Nationally Representative Sample

Polysubstance use is a growing public health concern that has been associated with poor clinical outcomes. Compared to single-drug users, this population suffers greater deficits in cognitive function, which hinder treatment success and recovery. Despite its high prevalence and poor prognosis, epidemiological research on polysubstance use and accompanying cognitive profile is lacking. We investigated associations between numbers of past-year co-occurring substance use disorders (SUDs) and self-reported cognitive function using data from the National Epidemiologic Survey for Alcohol and Related Conditions III (NESARC-III). Regression analyses revealed a significant negative association between cognitive scores and numbers of past-year SUDs, which was moderated by sex. After adjusting for confounding variables, greater numbers of SUDs were associated with declining self-reported cognitive function, and this relationship was stronger among females. Our findings expand on current literature on cognitive impairments among polysubstance users and provide a novel, nuanced description of this relationship among the general population. We highlight the need for targeted and individualized treatment approaches in order to improve outcomes in this population.

Latent Class Patterns of Adverse Childhood Experiences and Their Relationship to Veteran Status and Sex in the National Epidemiologic Survey of Alcohol and Related Conditions Wave III

ABSTRACT Introduction Adverse childhood experiences (ACEs) are associated with poor psychosocial and health outcomes in adulthood. Veterans and females experience ACEs disproportionately. A greater understanding of this disparity may be achieved by examining the relationship between distinct ACE patterns and these demographic characteristics. Therefore, this study examined distinct ACE patterns and their association with Veteran status, sex, and other demographics in a nationally representative sample of U.S. adults to inform interventions tailored to ACE patterns experienced by specific groups. Materials and Methods Latent class analysis (LCA) was conducted with data from the National Epidemiologic Survey of Alcohol and Related Conditions-III, a nationally representative structured diagnostic interview conducted from 2012-2013. The target population was the noninstitutionalized adult population living in the USA. The analytic sample was 36,190 (mean age 46.5 years; 48.1% male). Of these participants, 3,111 were Veterans. Data were analyzed between September 2020 and January 2021. Results Latent class analysis revealed a four-class solution: (1) “Low adversity” (75.3%); (2) “Primarily household dysfunction” (9.0%); (3) “Primarily maltreatment” (10.7%); and (4) “Multiple adversity types” (5.1%). Compared to “Low adversity,” members in the other classes were more likely to be Veterans (odds ratio (OR)C2vC1 = 1.33, ORC3vC1 = 1.55, ORC4vC1 = 1.98) and female (ORC2vC1 = 1.58, ORC3vC1 = 1.22, ORC4vC1 = 1.65). While lower education and income were also related to higher adversity class membership, Veteran status and sex were the strongest predictors, even when controlling for education and income. Conclusions Distinct and meaningful patterns of ACEs identified in this study highlight the need for routine ACE screenings in Veterans and females. As in the current study, operationalizing and clustering ACEs can inform screening measures and trauma-informed interventions in line with personalized medicine. Future work can test if classes are differentially associated with health outcomes.

A Novel Gonadotropic Microsporidian Parasite (Microsporidium clinchi n. sp.) Infecting a Declining Population of Pheasantshell Mussels (Actinonaias pectorosa) (Unioinidae) from the Clinch River, USA

Freshwater mussels of the order Unionida are among the most endangered animal groups globally, but the causes of their population decline are often enigmatic, with little known about the role of disease. In 2018, we collected wild adult pheasantshell (Actinonaias pectorosa) and mucket (Actinonaias ligamentina) during an epidemiologic survey investigating an ongoing mussel mass mortality event in the Clinch River, Virginia and Tennessee, USA. Histopathology and transmission electron microscopy showed a novel microsporidian parasite primarily infecting the ovary of pheasantshell. Sequencing of the small subunit rRNA gene produced a 1333 bp sequence with the greatest similarity to Pseudonosema cristatellae (AF484694.1; 86.36%; e-value = 0), a microsporidium infecting the freshwater bryozoan (Cristatella mucedo). Microsporidia were observed in 65% (17/26) of the examined female pheasantshell (A. pectorosa) and in no (0/2) female muckets (A. ligamentina) and occurred at mortality and non-mortality sites. Our findings indicate that a novel parasite, Microsporidium clinchi n. sp., is present in pheasantshell in the Clinch River, and while likely not a cause of mass mortality, could reduce fecundity and recruitment in this declining population and threaten the success of reintroductions. Surveillance of M. clinchi n. sp. and evaluation of broodstock and their progeny for microsporidia would therefore be prudent.

Evaluation of Water, Sanitation, and Hygiene, Behavioral Aspects, Household State for the Diarrhea Prevalence among Students in the Valley of Sinabung Volcano, North Sumatera, Indonesia

Diarrhea stands as a result of the inter-variable relationships, including behavior, environmental aspect, and household states. The study aimed to conduct an epidemiologic survey of diarrhea prevalence and several existing risk factors of diarrhea. A community-based surveillance and in-depth interview were conducted following the JMP ladder service for WASH and government regulation and it enrolled 135 children of a public primary school, SDN 040494, and households in the Valley of Sinabung Volcano, North Sumatera, Indonesia between June and October 2019. There were only two lowest categories of each WASH (Water, Sanitation and Hygiene) indicator. Multivariate analysis has also demonstrated a high likelihood of diarrhea among the population in limited settings for hygiene (p-value 0.012, AOR 7.892 95%CI 2.485, 25.064) and low daily income (p-value 0.015, AOR 3.079 95%CI 1.148, 8.260). Improvement of hygienic practices is mandatory as well as preventing volcanic eruption implications to the economy of the local community.

Fowl adenovirus strains 1/A and 11/D isolated from birds with reovirus infection

Inclusion body hepatitis (IBH) is, in some cases, a fatal disease affecting fowl by adenovirus strains which are subdivided into 5 species (A-E). In the current study, we investigated sequences from the Loop L1 region of the hexon gene of sequences of adenovirus field stains 1/A and 11/D isolated from a poultry flock co-infected with IBH and avian reoviruses ARVs. In early 2021, an epidemiologic survey highlighted the coinfection adenoviruses with other viruses (orthoreovirus infection) as being particularly deleterious within the poultry industry. Here, we investigated the Loop L1 HVR1-4 region of the hexon gene with relative synonymous codon usage (RSCU) designation and RSCU inclusive of all the mutations. These are the first results that have been presented on fowl adenovirus species A and D with simultaneous reovirus infection in 38-days old broiler chickens in Poland.