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Background We aimed to determine if pre-existing immunocompromising conditions (ICCs) were associated with the presentation or outcome of patients with acute coronavirus disease 2019 (COVID-19) admitted for pediatric intensive care. Methods Fifty-five hospitals in 30 US states reported cases through the Overcoming COVID-19 public health surveillance registry. Patients <21 years admitted 12 March 2020–30 December 2021 to the pediatric intensive care unit (PICU) or high-acuity unit for acute COVID-19 were included. Results Of 1274 patients, 105 (8.2%) had an ICC, including 33 (31.4%) hematologic malignancies, 24 (22.9%) primary immunodeficiencies and disorders of hematopoietic cells, 19 (18.1%) nonmalignant organ failure with solid-organ transplantation, 16 (15.2%) solid tumors, and 13 (12.4%) autoimmune disorders. Patients with ICCs were older, had more underlying renal conditions, and had lower white blood cell and platelet counts than those without ICCs, but had similar clinical disease severity upon admission. In-hospital mortality from COVID-19 was higher (11.4% vs 4.6%, P =.005) and hospitalization was longer (P =.01) in patients with ICCs. New major morbidities upon discharge were not different between those with and without ICC (10.5% vs 13.9%, P =.40). In patients with ICCs, bacterial coinfection was more common in those with life-threatening COVID-19. Conclusions In this national case series of patients <21 years of age with acute COVID-19 admitted for intensive care, existence of a prior ICCs were associated with worse clinical outcomes. Reassuringly, most patients with ICCs hospitalized in the PICU for severe acute COVID-19 survived and were discharged home without new severe morbidities. [ABSTRACT FROM AUTHOR]

Agropastoralism and international labor migration are livelihood strategies that are interconnected as dominant ways of life across rural Kyrgyzstan. A prevalent rural livelihood strategy—agropastoralism—is closely tied to agrarian semi‐nomadic ways of life that link families and communities to the surrounding mountain environment. Another livelihood strategy—international labor migration—links or telecouples communities and income streams to transnational family structures, international labor markets, and distant economies. This article examines four hypothetical relationships between key elements of these two livelihood strategies. The relationship between remittances, pasture access, and livestock holdings is examined by analyzing 1,815 household surveys from southern rural Kyrgyzstan. We find remittances and livestock holdings have a significant positive relationship when a household is receiving a large amount of remittances, but not when the remittances received are modest. We also find that access to more distant, productive pastures is positively associated with the receipt of any amount of remittances. These findings demonstrate the ways in which migration and remittances can impact livestock management and agropastoral livelihoods at different levels of remittance reception. [ABSTRACT FROM AUTHOR]

Multisystem inflammatory syndrome in children (MIS-C) evolves in some pediatric patients following acute infection with SARS-CoV-2 by hitherto unknown mechanisms. Whereas acute-COVID-19 severity and outcomes were previously correlated with Notch4 expression on Tregs, here, we show that Tregs in MIS-C were destabilized through a Notch1-dependent mechanism. Genetic analysis revealed that patients with MIS-C had enrichment of rare deleterious variants affecting inflammation and autoimmunity pathways, including dominant-negative mutations in the Notch1 regulators NUMB and NUMBL leading to Notch1 upregulation. Notch1 signaling in Tregs induced CD22, leading to their destabilization in a mTORC1dependent manner and to the promotion of systemic inflammation. These results identify a Notch1/CD22 signaling axis that disrupts Treg function in MIS-C and point to distinct immune checkpoints controlled by individual Treg Notch receptors that shape the inflammatory outcome in SARS-CoV-2 infection., Introduction COVID-19, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has resulted in massive morbidity and mortality worldwide (1, 2). Acute infection is associated in some individuals with [...]

This article provides a systematic review of the quantitative social science research on broadband Internet technology in rural areas. Specifically, we summarize the literature on 1) rural broadband availability and adoption behaviors and 2) the implications of these behaviors for rural businesses, public policy initiatives, and regional development. In the studies reviewed, rural areas suffer from both lower availability and lower adoption rates compared to their urban counterparts. However, researchers disagree on whether supply frictions inherent to rural areas or heterogeneous demand and adoption behaviors are the major cause of this outcome. Researchers widely agree that high-speed Internet improves economic outcomes of rural areas, whether it is through increases in business activity or in more general economic development measures (e.g. productivity, jobs, income). Impact evaluations of rural broadband policy initiatives produced mixed results, highlighting the need for a better understanding of agents' incentives. This review points to four areas for future research. One, assessments of the long-term impact of broadband on rural economies. Two, analyses of the net effect of broadband on economic development outcomes (e.g. migrants, job creation). Three, assessments of economic development impacts associated with broadband speed. Four, assessments of the efficacy of broadband policies. [ABSTRACT FROM AUTHOR]

Pediatric COVID-19 vaccination is effective in preventing COVID-19–related hospitalization, but duration of protection of the original monovalent vaccine during SARS-CoV-2 Omicron predominance merits evaluation, particularly given low coverage with updated COVID-19 vaccines. During December 19, 2021–October 29, 2023, the Overcoming COVID-19 Network evaluated vaccine effectiveness (VE) of ≥2 original monovalent COVID-19 mRNA vaccine doses against COVID-19–related hospitalization and critical illness among U.S. children and adolescents aged 5–18 years, using a case-control design. Too few children and adolescents received bivalent or updated monovalent vaccines to separately evaluate their effectiveness. Most case-patients (persons with a positive SARS-CoV-2 test result) were unvaccinated, despite the high frequency of reported underlying conditions associated with severe COVID-19. VE of the original monovalent vaccine against COVID-19–related hospitalizations was 52% (95% CI = 33%–66%) when the most recent dose was administered <120 days before hospitalization and 19% (95% CI = 2%–32%) if the interval was 120–364 days. VE of the original monovalent vaccine against COVID-19–related hospitalization was 31% (95% CI = 18%–43%) if the last dose was received any time within the previous year. VE against critical COVID-19–related illness, defined as receipt of noninvasive or invasive mechanical ventilation, vasoactive infusions, extracorporeal membrane oxygenation, and illness resulting in death, was 57% (95% CI = 21%–76%) when the most recent dose was received <120 days before hospitalization, 25% (95% CI = –9% to 49%) if it was received 120–364 days before hospitalization, and 38% (95% CI = 15%–55%) if the last dose was received any time within the previous year. VE was similar after excluding children and adolescents with *These senior authors contributed equally to this report. documented immunocompromising conditions. Because of the low frequency of children who received updated COVID-19 vaccines and waning effectiveness of original monovalent doses, these data support CDC recommendations that all children and adolescents receive updated COVID-19 vaccines to protect against severe COVID-19. [ABSTRACT FROM AUTHOR]

Numerous studies have examined the effects of climate change on many aspects of both human health and violence. Fewer studies have investigated the links between climate change and intimate partner violence (IPV). We expand on this literature by examining the association between climate variability and IPV, including physical, sexual, and psychological forms of violence. We examine both direct associations and potential mediation via water insecurity, in a sample of women from 15 sub-Saharan African countries. Our results suggest there is a direct effect of climate variability on IPV but also that this effect is mediated through water insecurity. These results contribute to the literature by highlighting pathways through which climate change may affect IPV, including water insecurity, and changes in soil moisture and precipitation. Our findings are important for policy makers and international development organizations as they indicate specific areas where improvements to water insecurity can help reduce the incidence of IPV globally. [ABSTRACT FROM AUTHOR]

Automation continues to be a disruptive force in the workforce. In particular, new automated technologies are projected to replace many mid-skill jobs, potentially displacing millions of workers. Career planning agencies and other organizations can help support workers if they are able to effectively identify optimal transition occupations for displaced workers. We drew upon the 24.2 Occupational Information Network (O*NET) Database to conduct two related studies that identify alternate occupations for truck drivers, who are at risk of job loss due to the adoption of autonomous vehicles. In Study 1, we statistically compared the jobs that we identified based on different search methods using O*NET classifications based on their similarity to the knowledge, skills, values, and interests held by truck drivers. In Study 2, we conducted a survey of truck drivers to evaluate their perceptions of the occupations identified as objectively similar to their occupation. Results indicate that optimal transition occupations may be identified by searching for occupations that share skills as well as the same work activities/industry as a given occupation. These findings hold further implications for career planning organizations and policymakers to ease workforce disruption due to automation. [ABSTRACT FROM AUTHOR]

Older adults' smartphone use has been shown to be a double-edged sword, linked to health and social benefits but also creating vulnerabilities. Similarly, the use of smartphones and other information and communication technologies (ICTs) in organizations also affords workers advantages, such as increased flexibility, while exposing them to risks such as exhaustion and distress. This research examines older workers' smartphone use and identifies a contextual characteristic that may buffer the negative implications of smartphone use for work purposes. Following the job demands–resources (JD-R) model, we hypothesized that older workers' daily work-related smartphone use is positively related to their experienced stress and negatively related to their mood, and that these relationships would be attenuated by work scheduling autonomy. We conducted an experience sampling method (ESM) study with a sample of 38 workers (ages 50–64) who completed daily measures over 8 days, and tracked their smartphone use objectively using screenshots of time spent using various apps. Contrary to our expectations, smartphone use was not significantly related to stress or mood. There were significant cross-level interactions, such that smartphone use for work was negatively related to experienced stress and positively related to a positive mood for those with lower levels of scheduling autonomy. We interpret these findings and discuss the effects that technology use for work may have on older workers' well-being through the lens of the JD-R model. Our results suggest that ICT use in the workplace combined with work scheduling autonomy may not be advantageous for workers' well-being. [ABSTRACT FROM AUTHOR]

Background: The fast-changing labor market highlights the need for an in-depth understanding of occupational mobility impacted by technological change. However, we lack a multidimensional classification scheme that considers similarities of occupations comprehensively, which prevents us from predicting employment trends and mobility across occupations. This study fills the gap by examining employment trends based on similarities between occupations. Method: We first demonstrated a new method that clusters 756 occupation titles based on knowledge, skills, abilities, education, experience, training, activities, values, and interests. We used the Principal Component Analysis to categorize occupations in the Standard Occupational Classification, which is grouped into a four-level hierarchy. Then, we paired the occupation clusters with the occupational employment projections provided by the U.S. Bureau of Labor Statistics. We analyzed how employment would change and what factors affect the employment changes within occupation groups. Particularly, we specified factors related to technological changes. Results: The results reveal that technological change accounts for significant job losses in some clusters. This poses occupational mobility challenges for workers in these jobs at present. Job losses for nearly 60% of current employment will occur in low-skill, low-wage occupational groups. Meanwhile, many mid-skilled and highly skilled jobs are projected to grow in the next ten years. Conclusion: Our results demonstrate the utility of our occupational classification scheme. Furthermore, it suggests a critical need for skills upgrading and workforce development for workers in declining jobs. Special attention should be paid to vulnerable workers, such as older individuals and minorities. [ABSTRACT FROM AUTHOR]