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The article examines longitudinal trends in body mass index (BMI) among children and adolescents aged 2–19 years before and during the COVID-19 pandemic in the United States. The study shows that during the COVID-19 pandemic, there was a significant increase in BMI among this age group, particularly among those with overweight or obesity, emphasizing the need for efforts to prevent excess weight gain and promote healthy behaviors during public health emergencies.

The jasmonic acid cascade plays a pivotal role in induced plant resistance to herbivores. There have been a number of investigations into the potential uses of derivatives of this hormone for pest management. Understanding the phenotypic plasticity of plant defense traits interactions in agricultural systems may facilitate the development of novel and improved management practices, which is desirable as management of insects in most agricultural systems is currently heavily reliant on insecticides. The rice water weevil (RWW), Lissorhoptrus oryzophilus Kuschel, is a pest of rice, Oryza sativa, in the southern U.S. and globally. The effects of the jasmonic acid derivative, methyl jasmonate (MJ), on induced defenses to RWW in rice, and the potential costs of MJ-induced resistance to plant growth and fitness, were tested in a series of field and greenhouse trials. It was hypothesized that seed treatments with MJ would reduce densities of larval RWW. A second hypothesis was that MJ seed treatments would alter emergence, biomass accumulation, and yield of rice. The final hypothesis was that induction of plant resistance to the RWW would diminish as the time from seed treatment increased. In order to investigate these hypotheses, RWW densities were determined in greenhouse and field trials. Plant growth was measured in the field by assessing plant emergence, root and shoot biomass, time of heading, and yield (grain mass). Results indicated that MJ seed treatments induced resistance to RWW, although this effect decayed over time. Additionally, there were costs to plant growth and fitness; emergence and heading were delayed and biomass was reduced. Importantly, however, yields on a per-plant were not significantly reduced by MJ treatment. Overall, these results are promising and show the potential for the use of jasmonate elicitors as part of a pest management program in rice. [ABSTRACT FROM AUTHOR]

Simple Summary: Mass rearing the air potato beetle, Lilioceris cheni, is a vital contribution to the integrated pest management of the invasive air potato vine. Here, the authors report on the production, distribution, and advancements of a mass rearing method. It was determined that adults are most successful on a diet of fresh air potato leaf. Although to reduce the amount of leaf tissue needed for overwintering populations, they can survive on artificial diet for several months and can be starved for several days to two weeks depending on previous diet. Larvae cannot survive continuously on artificial diet. This information allows those mass rearing beetles to reduce the amount of tissue grown at points in the annual cycle and shows that adult beetles can survive starvation while being distributed or for short periods after release. It also indicates that fresh air potato vine must be available in at least small quantities year-round. This information will assist those attempting to mass rear and distribute the beetle. The air potato beetle, Lilioceris cheni Gressitt and Kimoto (Coleoptera:Chrysomelidae), is a successful biological control agent of the air potato vine, Dioscorea bulbifera L. (Dioscoreales: Dioscoreaceae), in the southern United States. Lilioceris cheni is currently being mass-reared by the Florida Department of Agriculture and Consumer Services Division of Plant Industry (FDACS-DPI) for biological control releases and research. The facility rears and releases over 50,000 adult beetles annually at approximately 1000 different locations. In addition to data on beetle production and distribution, studies on alternative larval and adult diets are described. Adults fed bulbils as the sole food source had reduced life spans compared with beetles given fresh air potato leaves. Adults survived without air potato leaves or bulbils for several days to two weeks depending on availability of leaves at emergence. Larvae did not survive on a modified artificial Colorado potato beetle diet containing fresh air potato vine leaves. Adults survived while consuming artificial diet but ceased oviposition. They, however, resumed egg laying less than one week after being returned to a diet of fresh air potato vine leaves. [ABSTRACT FROM AUTHOR]

Objective: Bone stress injuries (BSIs) in trabecular-rich bone are associated with greater biological risk factors compared with cortical-rich bone. We hypothesized that female runners with high Female Athlete Triad (Triad)-related risk would be at greater risk for trabecular-rich BSIs than runners with low Triad-related risk. Design: Prospective cohort study. Setting: Two NCAA institutions. Participants: Female runners were followed prospectively for up to 5 years. Intervention: The intervention consisted of team nutrition presentations focused on optimizing energy availability plus individualized nutrition sessions. Triad Cumulative Risk Assessment (CRA) categories were assigned yearly based on low-energy availability, menstrual status, age of menarche, low body mass index, low bone mineral density, and prior BSI. Main Outcome Measures: The outcome was the annual incidence of trabecular- and cortical-rich BSI. Generalized Estimating Equations (GEE, to account for the correlated nature of the observations) with a Poisson distribution and log link were used for statistical modeling. Results: Cortical-rich BSI rates were higher than trabecular-rich BSI rates (0.32 vs 0.13 events per person-year). Female runners with high Triad-related risk had a significantly higher incidence rate ratio of trabecular-rich BSI (RR: 4.40, P = 0.025) and cortical-rich BSI (RR: 2.87, P = 0.025) than women with low Triad-related risk. Each 1 -point increase in Triad CRA score was associated with a significant 26% increased risk of trabecular-rich BSI (P = 0.0007) and a nonsignificant 14% increased risk of cortical-rich BSI (P = 0.054). Conclusions: Increased Triad CRA scores were strongly associated with increased risk for trabecular-rich BSI. Incorporating Triad CRA scores in clinical care could guide BSI prevention. [ABSTRACT FROM AUTHOR]

Importance: Universal screening to identify unfavorable lipid levels is recommended for US children aged 9 to 11 years and adolescents aged 17 to 21 years (hereafter, young adults); however, screening benefits in these individuals have been questioned. Current use of lipid screening and prevalence of elevated lipid measurements among US youths is not well understood., Objective: To investigate the prevalence of ambulatory pediatric lipid screening and elevated or abnormal lipid measurements among US screened youths by patient characteristic and test type., Design, Setting, and Participants: This cross-sectional study used data from the IQVIA Ambulatory Electronic Medical Record database and included youths aged 9 to 21 years with 1 or more valid measurement of height and weight during the observation period (2018-2021). Body mass index (BMI) was calculated and categorized using standard pediatric BMI percentiles (9-19 years) and adult BMI categories (≥20 years). The data were analyzed from October 6, 2022, to January 18, 2023., Main Outcomes and Measures: Lipid measurements were defined as abnormal if 1 or more of the following test results was identified: total cholesterol (≥200 mg/dL), low-density lipoprotein cholesterol (≥130 mg/dL), very low-density lipoprotein cholesterol (≥31 mg/dL), non-high-density lipoprotein cholesterol (≥145 mg/dL), and triglycerides (≥100 mg/dL for children aged 9 years or ≥130 mg/dL for patients aged 10-21 years). After adjustment for age group, sex, race and ethnicity, and BMI category, adjusted prevalence ratios (aPRs) and 95% CIs were calculated., Results: Among 3 226 002 youths (23.9% aged 9-11 years, 34.8% aged 12-16 years, and 41.3% aged 17-21 years; 1 723 292 females [53.4%]; 60.0% White patients, 9.5% Black patients, and 2.4% Asian patients), 11.3% had 1 or more documented lipid screening tests. The frequency of lipid screening increased by age group (9-11 years, 9.0%; 12-16 years, 11.1%; 17-21 years, 12.9%) and BMI category (range, 9.2% [healthy weight] to 21.9% [severe obesity]). Among those screened, 30.2% had abnormal lipid levels. Compared with youths with a healthy weight, prevalence of an abnormal result was higher among those with overweight (aPR, 1.58; 95% CI, 1.56-1.61), moderate obesity (aPR, 2.16; 95% CI, 2.14-2.19), and severe obesity (aPR, 2.53; 95% CI, 2.50-2.57)., Conclusions and Relevance: In this cross-sectional study of prevalence of lipid screening among US youths aged 9 to 21 years, approximately 1 in 10 were screened. Among them, abnormal lipid levels were identified in 1 in 3 youths overall and 1 in 2 youths with severe obesity. Health care professionals should consider implementing lipid screening among children aged 9 to 11 years, young adults aged 17 to 21 years, and all youths at high cardiovascular risk.

Introduction: Surveillance modernization efforts emphasize the potential use of electronic health record (EHR) data to inform public health surveillance and prevention. However, EHR data streams vary widely in their completeness, accuracy, and representativeness., Methods: We developed a validation process for the Multi-State EHR-Based Network for Disease Surveillance (MENDS) pilot project to identify and resolve data quality issues that could affect chronic disease prevalence estimates. We examined MENDS validation processes from December 2020 through August 2023 across 5 data-contributing organizations and outlined steps to resolve data quality issues., Results: We identified gaps in the EHR databases of data contributors and in the processes to extract, map, integrate, and analyze their EHR data. Examples of source-data problems included missing data on race and ethnicity and zip codes. Examples of data processing problems included duplicate or missing patient records, lower-than-expected volumes of data, use of multiple fields for a single data type, and implausible values., Conclusion: Validation protocols identified critical errors in both EHR source data and in the processes used to transform these data for analysis. Our experience highlights the value and importance of data validation to improve data quality and the accuracy of surveillance estimates that use EHR data. The validation process and lessons learned can be applied broadly to other EHR-based surveillance efforts.

Introduction: Improving hypertension control is a national priority. Electronic health record data have the potential to augment traditional surveillance systems. This study aimed to assess hypertension prevalence and control at the state level using a previously established electronic health record-based phenotype for hypertension., Methods: Adult patients (N=11,031,368) were included from the IQVIA ambulatory electronic medical record-U.S. 2019 data set. IQVIA ambulatory electronic medical record comprises electronic health records from >100,000 providers and includes patients from every U.S. state and Washington DC. Authors compared hypertension prevalence and control estimates against those from the Behavioral Risk Factor Surveillance System 2019. Results were age-standardized and stratified by state and sociodemographic characteristics. Statistical analyses were conducted in 2022-2023., Results: IQVIA ambulatory electronic medical record-U.S. patients had a median age of 55 years, and 56.7% were women. Overall age-standardized hypertension prevalence was higher in IQVIA ambulatory electronic medical record-U.S. (35.0%) than in the Behavioral Risk Factor Surveillance System (29.7%), however, state-level geographic patterns were similar, with the highest burden in the South and Appalachia. Similar patterns were also observed by sociodemographic characteristics in both data sets: hypertension prevalence was higher in older age groups (than younger), men (than women), and Black patients (than other races). Hypertension control varied widely across states: among states with >1% data coverage, control rates were lowest in Nevada (51.1%), Washington DC (52.0%), and Mississippi (55.2%); highest in Kansas (73.4%), New Jersey (72.3%), and Iowa (71.9%)., Conclusions: This study provided the first-ever estimates of hypertension control for all states and Washington DC. Electronic health record-based surveillance could support hypertension prevention and control efforts at the state level., (Published by Elsevier Inc.)

Context: Electronic health record (EHR) data can potentially make chronic disease surveillance more timely, actionable, and sustainable. Although use of EHR data can address numerous limitations of traditional surveillance methods, timely surveillance data with broad population coverage require scalable systems. This report describes implementation, challenges, and lessons learned from the Multi-State EHR-Based Network for Disease Surveillance (MENDS) to help inform how others work with EHR data to develop distributed networks for surveillance., Program: Funded by the Centers for Disease Control and Prevention (CDC), MENDS is a data modernization demonstration project that aims to develop a timely national chronic disease sentinel surveillance system using EHR data. It facilitates partnerships between data contributors (health information exchanges, other data aggregators) and data users (state and local health departments). MENDS uses query and visualization software to track local emerging trends. The program also uses statistical and geospatial methods to generate prevalence estimates of chronic disease risk measures at the national and local levels. Resulting data products are designed to inform public health practice and improve the health of the population., Implementation: MENDS includes 5 partner sites that leverage EHR data from 91 health system and clinic partners and represents approximately 10 million patients across the United States. Key areas of implementation include governance, partnerships, technical infrastructure and support, chronic disease algorithms and validation, weighting and modeling, and workforce education for public health data users., Discussion: MENDS presents a scalable distributed network model for implementing national chronic disease surveillance that leverages EHR data. Priorities as MENDS matures include producing prevalence estimates at various geographic and subpopulation levels, developing enhanced data sharing and interoperability capacity using international data standards, scaling the network to improve coverage nationally and among underrepresented geographic areas and subpopulations, and expanding surveillance of additional chronic disease measures and social determinants of health., Competing Interests: The authors declare that they have no conflicts of interest.

Introduction: The national and state economic burden of the opioid crisis is substantial. This study estimated the number of hospitalizations associated with opioid use disorder (OUD) or opioid misuse (OM) and the cost of those hospitalizations at Denver Health (DH) Medical Center, a large, urban safety-net hospital., Methods: For 2017, direct inpatient medical costs for hospitalizations associated with OUD or OM at DH Medical Center were estimated and categorized by group and insurance type. Data were from the DH electronic health records database that included charge data. Hospitalizations associated with OUD or OM were identified using diagnostic codes and an expanded set of inclusion criteria including diagnostic codes, opioid withdrawal assessments, opioid-related admission notes, and medication prescriptions to treat OUD. Costs were estimated using cost-to-charge ratios specific to DH., Results: During 2017, 220 hospitalizations, $9,834,979 in total charges, $3,690,724 in estimated total costs, and $2,115,990 in total reimbursements were identified using diagnostic codes. Using the most expansive set of inclusion criteria, 739 hospitalizations, $35,033,157 in total charges, $13,346,099 in estimated total costs, and $7,020,877 in total reimbursements were identified. Of the 739 hospitalizations, Medicaid covered 546 hospitalizations (74 %), the largest proportion of total reimbursement (65 %), with estimated total costs of $10,135,048 (77 %)., Conclusions: Our study identified considerable costs for hospitalizations associated with OUD or OM for DH. Estimating costs for hospitalizations associated with OUD or OM through use of expanded inclusion methodology can guide future program planning to allocate resources efficiently for hospitals such as DH Medical Center., (Published by Elsevier B.V.)