Key Points
Question
Are population-level social factors associated with coronavirus disease 2019 (COVID-19) incidence and mortality?
Findings
In this cross-sectional study including 4 289 283 COVID-19 cases and 147 074 COVID-19 deaths, county-level sociodemographic risk factors as assessed by the Social Vulnerability Index were associated with greater COVID-19 incidence and mortality.
Meaning
These findings suggest that to address inequities in the burden of the COVID-19 pandemic, these sociodemographic risk factors and their root causes must be addressed.
Preventive care utilization was found to be higher in women than in men. The gender disparity issue needs to be explored in greater detail to understand these differences.
Emotional abuse during childhood contributed more than physical or sexual abuse to the development of migraine. There is a dose-response relationship with increasing number of abuse types associated with rising odds of migraine. In addition, the relationship between the frequency of emotional abuse and the odds of migraine follows a U-shape pattern.
The adipose tissue extracellular matrix (ECM) regulates adipocyte cellular metabolism and is altered in obesity and type 2 diabetes, but mechanisms underlying ECM-adipocyte metabolic crosstalk are poorly defined. Advanced glycation end-product (AGE) formation is increased in diabetes. AGE alter tissue function via direct effects on ECM and by binding scavenger receptors on multiple cell types and signaling through Rho GTPases. Our goal was to determine the role and underlying mechanisms of AGE in regulating human ECM-adipocyte metabolic crosstalk. Visceral adipocytes from diabetic and non-diabetic humans with obesity were studied in 2D and 3D-ECM culture systems. AGE is increased in adipose tissue from diabetic compared to non-diabetic subjects. Glycated collagen 1 and AGE-modified ECM regulate adipocyte glucose uptake and expression of AGE scavenger receptors and Rho signaling mediators, including the DIAPH1 gene, which encodes the human Diaphanous 1 protein (hDia1). Notably, inhibition of hDia1, but not scavenger receptors RAGE or CD36, attenuated AGE-ECM inhibition of adipocyte glucose uptake. These data demonstrate that AGE-modification of ECM contributes to adipocyte insulin resistance in human diabetes, and implicate hDia1 as a potential mediator of AGE-ECM-adipocyte metabolic crosstalk.
IMPORTANCEThe association of the COVID-19 pandemic with the quality of ambulatory care is unknown. Hospitalizations for ambulatory care-sensitive conditions (ACSCs) are a well-studied measure of the quality of ambulatory care; however, they may also be associated with other patientlevel and system-level factors. OBJECTIVE To describe trends in hospital admissions for ACSCs in the prepandemic period (March 2019 to February 2020) compared with the pandemic period (March 2020 to February 2021). DESIGN, SETTING, AND PARTICIPANTS This cross-sectional study of adults enrolled in a commercial health maintenance organization in Michigan included 1 240 409 unique adults (13 011 176 person-months) in the prepandemic period and 1 206 361 unique adults (12 759 675 person-months) in the pandemic period.
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