In the 1930s, maps created by the federal Home Owners’ Loan Corporation (HOLC) nationalized residential racial segregation via “redlining,” whereby HOLC designated and colored in red areas they deemed to be unsuitable for mortgage lending on account of their black, foreign-born, or low-income residents. We used the recently digitized HOLC redlining maps for 28 municipalities in Massachusetts to analyze Massachusetts Cancer Registry data for late stage at diagnosis for cervical, breast, lung, and colorectal cancer (2001–2015). Multivariable analyses indicated that, net of age, sex/gender, and race/ethnicity, residing in a previously HOLC-redlined area imposed an elevated risk for late stage at diagnosis, even for residents of census tracts with present-day economic and racial privilege, whereas the best historical HOLC grade was not protective for residents of census tracts without such current privilege. For example, a substantially elevated risk of late stage at diagnosis occurred among men with lung cancer residing in currently privileged areas that had been redlined (risk ratio = 1.17, 95% confidence interval: 1.06, 1.29), whereas such risk was attenuated among men residing in census tracts lacking such current privilege (risk ratio = 1.01, 95% confidence interval: 0.94, 1.08). Research on historical redlining as a structural driver of health inequities is warranted.

Sampling of agricultural and natural environments in two US states (Colorado and Florida) yielded 18 Listeria-like isolates that could not be assigned to previously described species using traditional methods. Using whole-genome sequencing and traditional phenotypic methods, we identified five novel species, each with a genome-wide average blast nucleotide identity (ANIb) of less than 85 % to currently described species. Phylogenetic analysis based on 16S rRNA gene sequences and amino acid sequences of 31 conserved loci showed the existence of four well-supported clades within the genus Listeria ; (i) a clade representing Listeria monocytogenes , L. marthii , L. innocua , L. welshimeri , L. seeligeri and L. ivanovii , which we refer to as Listeria sensu stricto, (ii) a clade consisting of Listeria fleischmannii and two newly described species, Listeria aquatica sp. nov. (type strain FSL S10-1188T = DSM 26686T = LMG 28120T = BEI NR-42633T) and Listeria floridensis sp. nov. (type strain FSL S10-1187T = DSM 26687T = LMG 28121T = BEI NR-42632T), (iii) a clade consisting of Listeria rocourtiae , L. weihenstephanensis and three novel species, Listeria cornellensis sp. nov. (type strain TTU A1-0210T = FSL F6-0969T = DSM 26689T = LMG 28123T = BEI NR-42630T), Listeria grandensis sp. nov. (type strain TTU A1-0212T = FSL F6-0971T = DSM 26688T = LMG 28122T = BEI NR-42631T) and Listeria riparia sp. nov. (type strain FSL S10-1204T = DSM 26685T = LMG 28119T = BEI NR- 42634T) and (iv) a clade containing Listeria grayi . Genomic and phenotypic data suggest that the novel species are non-pathogenic.

In this study, we report a whole-genome single nucleotide polymorphism (SNP)-based evolutionary approach to study the epidemiology of a multistate outbreak of Salmonella enterica subsp. enterica serovar Montevideo. This outbreak included 272 cases that occurred in 44 states between July 2009 and April 2010. A case-control study linked the consumption of salami made with contaminated black and red pepper to the outbreak. We sequenced, on the SOLiD System, 47 isolates with XbaI PFGE pattern JIXX01.0011, a common pulsed-field gel electrophoresis (PFGE) pattern associated with isolates from the outbreak. These isolates represented 20 isolates collected from human sources during the period of the outbreak and 27 control isolates collected from human, food, animal, and environmental sources before the outbreak. Based on 253 high-confidence SNPs, we were able to reconstruct a tip-dated molecular clock phylogeny of the isolates and to assign four human isolates to the actual outbreak. We developed an SNP typing assay to rapidly discriminate between outbreak-related cases and non-outbreak-related cases and tested this assay on an extended panel of 112 isolates. These results suggest that only a very small percentage of the human isolates with the outbreak PFGE pattern and obtained during the outbreak period could be attributed to the actual pepper-related outbreak (20%), while the majority (80%) of the putative cases represented background cases. This study demonstrates that next-generation-based SNP typing provides the resolution and accuracy needed for outbreak investigations of food-borne pathogens that cannot be distinguished by currently used subtyping methods.Whole-genome sequencing has been demonstrated to provide a high-resolution view of the epidemiology and microevolution of pathogenic bacteria, such as the transmission (13) and phylogeography (12) of methicillin-resistant Staphylococcus aureus and the role of recombination in the evolution of Streptococcus pneumoniae lineages (6). The use of genome sequencing methods to investigate outbreaks of food-borne bacterial diseases is relatively new and holds great promise, as it can help to identify the temporal, geographical, and evolutionary origin of an outbreak. At the same time, whole-genome data can be used to rapidly develop single nucleotide polymorphism (SNP) assays that can be used to clarify the epidemiology of an outbreak and discriminate between outbreak-related and sporadic clinical cases during and after the period of the outbreak.

BackgroundIdiopathic pulmonary fibrosis (IPF) is a debilitating condition with significant morbidity and poor survival. Since 2010, there has been increased activity in the development of treatments that aim to delay progression of the disease.ObjectiveOur study involves a comprehensive review of the literature for evidence on health-related quality of life (HRQoL), healthcare resource use (HCRU) and costs, and an assessment of the burden of illness of the condition.MethodsWe carried out a systematic literature review (SLR) to identify economic evaluations and HRQoL studies. We searched EMBASE, MEDLINE and MEDLINE In Process for relevant studies from database origins to April 2017. Alongside the presentation of the study characteristics and the available evidence, we carried out a qualitative comparison using reference population estimates for HRQoL and national health expenditure for costs.ResultsOur search identified a total of 3241 records. After removing duplicates and not relevant articles, we analysed 124 publications referring to 88 studies published between 2000 and 2017. Sixty studies were HRQoL and 28 were studies on costs or HCRU. We observed an exponential growth of publications in the last 3–5 years, with the majority of the studies conducted in Europe and North America. Among the HRQoL studies, and despite regional differences, there was some agreement between estimates on the absolute and relative level of HRQoL for patients with IPF compared with the general population. Regarding costs, after adjustments for the cost years and currency, the suggested annual per capita cost of patients with IPF in North America was estimated around US$20,000, 2.5–3.5 times higher than the national healthcare expenditure. Additionally, studies that analysed patients with IPF alongside a matched control cohort suggested a significant increase in resource use and cost.ConclusionThe reviewed evidence indicates that IPF has considerable impact on HRQoL, relative to the general population levels. Furthermore, in studies of cost and resource use, most estimates of the burden were consistent in suggesting an excess cost for patients with IPF compared with a control cohort or the national health expenditure. This confirms IPF as a growing threat for public health worldwide, with considerable impact to the patients and healthcare providers.Electronic supplementary materialThe online version of this article (10.1007/s40273-018-0631-8) contains supplementary material, which is available to authorized users.

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