JHU Open Access Research
Permanent URI for this collection
This collection contains research from scholars across all the schools at The Johns Hopkins University
Browse
Recent Submissions
Item Detection of ultrashort-chain and other per- and polyfluoroalkyl substances (PFAS) in U.S. bottled water(Elsevier BV)Per- and polyfluoroalkyl substances (PFAS) are compounds of emerging concern due to their persistence in the global water cycle and detection in drinking water sources. However, PFAS have been poorly studied in bottled water, especially in the United States. This study investigated the occurrence of PFAS and related factors in 101 uniquely labelled bottled water products for sale in the U.S. Products were screened for 32 target PFAS by solid phase extraction-liquid chromatography-tandem mass spectrometry (SPE-LC-MS/MS). Fifteen of 32 measured analytes were detected, consisting primarily of C3-C10 perfluorocarboxylic acids (PFCA) and C3-C6 and C8 perfluorosulfonic acids (PFSA). PFAS were detected above method detection limits in 39/101 tested products. The Σ32PFAS concentrations detected were 0.17–18.87 ng/L with a median of 0.98 ng/L; 97% of samples were below 5 ng/L. PFCA (83%) and short-chain perfluoroalkyl acids (PFAA) containing 5 or less CF2 groups (67%) were more prevalent on a mass basis than PFSA and longer-chain PFAA, respectively. Ultrashort-chain PFPrA, measured for the first time in bottled water, accounted for the greatest individual fraction of detected PFAS mass (42%) and was found almost exclusively in products labeled as Spring water. Purified water products contained significantly less PFAS than Spring water products, which was attributed to the use of reverse osmosis (RO) treatment in the majority of Purified waters (25/35) compared to Spring waters (1/45). RO-treated products contained significantly lower Σ32PFAS, long-chain, short-chain, and PFPrA concentrations than products without RO. Although no enforceable PFAS regulations exist for bottled water in the U.S., the finding that some products approach levels of concern justify a framework for monitoring PFAS in bottled water production.Item Deletion of Pkd1 in renal stromal cells causes defects in the renal stromal compartment and progressive cystogenesis in the kidney(Springer Science and Business Media LLC)Item Pediatric outpatient utilization by differing Medicaid payment models in the United States(Springer Science and Business Media LLC)Item The Effects of Social Rank and Neighborhood and School Environment on Adolescent Depression and Suicidal Ideation: A Structural Equation Modeling Approach(Springer Science and Business Media LLC)Item Crystalglobulin-associated nephropathy presenting as MGRS in a case of monoclonal B-cell lymphocytosis: a case report(Springer Science and Business Media LLC)Abstract Background Crystalglobulin-associated nephropathy (CAN), a rare subtype of monoclonal gammopathy, usually associated with multiple myeloma and occasionally monoclonal gammopathy of uncertain significance (MGUS), is characterized by occluding monoclonal pseudothrombi within renal glomerular capillaries and/or interstitial arterioles. Ultrastructurally, these pseudothrombi are unique for having a crystalline substructure. We describe a case of an adult patient with monoclonal B-cell lymphocytosis (MBL) and acute renal failure whose kidney biopsy revealed a rare diagnosis of CAN. Case presentation A 63-year old male presented with a 2-month history of edema, arthralgia and malaise. He had acute kidney injury with hematoproteinuria on urine analysis. Serum and urine protein electrophoresis were both negative. A renal biopsy however revealed features of CAN. Organomegaly, bone pain and lymphadenopathy were absent. A repeat serum electrophoresis was positive for IgA kappa and a free light chain assay showed elevated free kappa light chains. Flow cytometry done subsequently revealed a diagnosis of MBL, chronic lymphocytic leukemia (CLL) type. Conclusion CAN in association with MBL/CLL has not been previously described in literature, and our case highlights yet another instance of monoclonal gammopathy of renal significance (MGRS) where a small B-cell clone resulted in extensive renal pathology without systemic manifestations.Item Risk Factors for Seclusion in Children and Adolescents Inpatient Psychiatry: The Role of Demographic Characteristics, Clinical Severity, Life Experiences and Diagnoses(Springer Science and Business Media LLC)Item Biocultural Lactation: Integrated Approaches to Studying Lactation Within and Beyond Anthropology(Annual Reviews)This review examines anthropological contributions over the past decade into the biocultural processes and practices of lactation via the analytical pillars of colonialism, racial capitalism, and medicalization. The nexus of these three processes has been foundational to the profound disruption and decline of breastfeeding in the mid-twentieth century and is still impacting ongoing efforts to restore and facilitate breastfeeding. Anthropologists have helped expose and challenge biocapitalist, medicalized conceptualizations of lactation that undermine breastfeeding often even when they claim to support it. Moreover, they have highlighted how ethnocentric cultural ideologies shape biomedical categories of “normal” infant feeding and lactation and have demonstrated the variability of these processes and practices. While these efforts have yielded important interventions into anthropology and a range of other disciplines, significant work remains to integrate efforts across the subfields and to challenge racist, oppressive systems that continue to shape both the study and the practice of lactation. Expected final online publication date for the Annual Review of Anthropology, Volume 52 is October 2023. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.Item Combating Stigma in the Era of Monkeypox—Is History Repeating Itself?(Ovid Technologies (Wolters Kluwer Health))Men who have sex with men (MSM) and people with HIV (PWH) perceive, internalize, and experience significant stigma from family members, health care providers, and community members because of their sexual behaviors. The current monkeypox (MPX) outbreak is affecting both communities. The pandemic has spread to 89 countries with more than 31,000 confirmed cases, and global agencies are concerned about how the disease is portrayed in the media. This article will introduce MPX and its associated stigmas, providing a brief theoretical perspective on adaptive behaviors and nursing interventions to mitigate stigma. This is followed by a case-based description of the current experiences of an MSM with MPX. We will discuss stigma prevention strategies from an adaptation and mitigation perspective. We conclude with how nurses can contribute to stigma prevention for individuals with MPX.Item Development of a Stata Command for Pediatric Risk of Mortality Calculation(Ovid Technologies (Wolters Kluwer Health))Item A systematic review and psychometric appraisal of instruments measuring tuberculosis stigma in Sub-Saharan Africa.(American Psychological Association (APA))Tuberculosis (TB) stigma is one barrier to TB testing, treatment uptake, and treatment completion. Therefore, stigma measurement must be approached through rigorous scientific methodology in order to accurately and reliably estimate the impact of TB stigma on treatment outcomes. The aim of this systematic review is to evaluate the methods and instruments used to measure TB stigma and interrogate strategies used to culturally validate measures of TB stigma in global research. Two reviewers used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) method to extract and analyze the existing body of literature on TB stigma in Sub-Saharan Africa. A thorough search was performed using three databases generating 2,302 independent studies. After the systematic screening, this review includes 28 studies. Of those studies, 13 used a psychometrically validated instrument while 15 used informal questionnaires or proxy variables to measure stigma. The psychometric appraisal was limited due to the number of studies that measured stigma using unvalidated questionnaires or proxy variables. The Patient and Community Perceptions of TB scales validated by Van Rie et al. were the most commonly used instruments to measure TB stigma; additionally, many instruments were not culturally or linguistically validated in Sub-Saharan Africa. Our appraisal emphasizes the need for reliable and valid instruments to measure TB stigma in low- and middle-income countries most affected by TB.Item A Choice Too Far: Transit Difficulty and Early High School Transfer(American Educational Research Association (AERA))The challenge of a long and difficult commute to school each day is likely to wear on students, leading some to change schools. We used administrative data from approximately 3,900 students in the Baltimore City Public School System in 2014–2015 to estimate the relationship between travel time on public transportation and school transfer during the ninth grade. We show that students who have relatively more difficult commutes are more likely to transfer than peers in the same school with less difficult commutes. Moreover, we found that when these students change schools, their newly enrolled school is substantially closer to home, requires fewer vehicle transfers, and is less likely to have been included among their initial set of school choices.Item Mouse PVRIG Has CD8+ T Cell–Specific Coinhibitory Functions and Dampens Antitumor Immunity(American Association for Cancer Research (AACR))A limitation to antitumor immunity is the dysfunction of T cells in the tumor microenvironment, in part due to upregulation of coinhibitory receptors such as PD-1. Here, we describe that poliovirus receptor-related immunoglobulin domain protein (PVRIG) acts as a coinhibitory receptor in mice. Murine PVRIG interacted weakly with poliovirus receptor (PVR) but bound poliovirus receptor-like 2 (PVRL2) strongly, making the latter its principal ligand. As in humans, murine NK and NKT cells constitutively expressed PVRIG. However, when compared with humans, less PVRIG transcript and surface protein was detected in murine CD8+ T cells ex vivo However, activated CD8+ T cells upregulated PVRIG expression. In the mouse tumor microenvironment, infiltrating CD8+ T cells expressed PVRIG whereas its ligand, PVRL2, was detected predominantly on myeloid cells and tumor cells, mirroring the expression pattern in human tumors. PVRIG-deficient mouse CD8+ T cells mounted a stronger antigen-specific effector response compared with wild-type CD8+ T cells during acute Listeria monocytogenes infection. Furthermore, enhanced CD8+ T-cell effector function inhibited tumor growth in PVRIG-/- mice compared with wild-type mice and PD-L1 blockade conferred a synergistic antitumor response in PVRIG-/- mice. Therapeutic intervention with antagonistic anti-PVRIG in combination with anti-PD-L1 reduced tumor growth. Taken together, our results suggest PVRIG is an inducible checkpoint receptor and that targeting PVRIG-PVRL2 interactions results in increased CD8+ T-cell function and reduced tumor growth.Item Economic Benefits of Immunization for 10 Pathogens in 94 Low- and Middle-Income Countries From 2011 to 2030 Using Cost-of-Illness and Value-of-Statistical-Life Approaches(Elsevier BV)Objectives Vaccination has prevented millions of deaths and cases of disease in low- and middle-income countries (LMICs). During the Decade of Vaccines (2011-2020), international organizations, including the World Health Organization and Gavi, the Vaccine Alliance, focused on new vaccine introduction and expanded coverage of existing vaccines. As Gavi, other organizations, and country governments look to the future, we aimed to estimate the economic benefits of immunization programs made from 2011 to 2020 and potential gains in the future decade. Methods We used estimates of cases and deaths averted by vaccines against 10 pathogens in 94 LMICs to estimate the economic value of immunization. We applied 3 approaches—cost of illness averted (COI), value of statistical life (VSL), and value of statistical life-year (VSLY)—to estimate observable and unobservable economic benefits between 2011 and 2030. Results From 2011 to 2030, immunization would avert $1510.4 billion ($674.3-$2643.2 billion) (2018 USD) in costs of illness in the 94 modeled countries, compared with the counterfactual of no vaccination. Using the VSL approach, immunization would generate $3436.7 billion ($1615.8-$5657.2 billion) in benefits. Applying the VSLY approach, $5662.7 billion ($2547.2-$9719.4) in benefits would be generated. Conclusion Vaccination has generated significant economic benefits in LMICs in the past decade. To reach predicted levels of economic benefits, countries and international donor organizations need to meet coverage projections outlined in the Gavi Operational Forecast. Estimates generated using the COI, VSL, or VSLY approach may be strategically used by donor agencies, decision makers, and advocates to inform investment cases and advocacy campaigns.Item The anthropology of health systems: A history and review(Elsevier BV)Ethnographies of health systems are a theoretically rich and rapidly growing area within medical anthropology. Critical ethnographic work dating back to the 1950s has taken policymakers and health staff as points of entry into the power structures that run through the global health enterprise. In the last decade, there has been a surge of ethnographic work on health systems. We conceptualize the anthropology of health systems as a field; review the history of this body of knowledge; and outline emergent literatures on policymaking, HIV, hospitals, Community Health Workers, health markets, pharmaceuticals, and metrics. High-quality ethnographic work is an excellent way to understand the complex systems that shape health outcomes, and provides a critical vantage point for thinking about global health policy and systems. As theory in this space develops and deepens, we argue that anthropologists should look beyond the discipline to think through what their work does and why it matters.Item Sarcoidosis in Native and Transplanted Kidneys: Incidence, Pathologic Findings, and Clinical Course(Public Library of Science (PLoS))Item Acute Tubular Injury in a Woman with Placental Abruption(Austin Publishing Group)Here we report the case of a young woman who developed acute renal failure following prolonged cesarean section delivery. The surgical procedure was complicated by placental abruption and uterine leiomyomata. A kidney biopsy for persistent renal failure revealed acute tubular injury from an unexpected source.