Issue 41, October 15, 2012
Vol. 4, Issue: 41, 10/15/12
The report consists of three components:
- CDC-authored publications
- Key scientific articles in featured topic areas (this week featuring articles related to CDC’s Public Health Grand Rounds on reducing U. S. infant mortality)
- Public health articles noted in the media
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Key Scientific Articles in Featured Topic Areas
Subject matter experts decide what topic to feature, and articles are selected from the last 3 to 6 months of published literature. Key topic coincides monthly with other CDC products (e.g. Vital Signs).
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Maternal and Child Health
- A statewide initiative to reduce inappropriate scheduled births at 36(0/7)-38(6/7) weeks’ gestationexternal icon
Donovan EF, Lannon C, Bailit J, Rose B, Iams JD, Byczkowski T, Ohio Perinatal Quality Collaborative Writing Committee.
Am J Obstet Gynecol. 2010 Mar;202(3):243 e1-8.
- Infant morbidity and mortality attributable to prenatal smoking in the U.Sexternal icon
Dietz PM, England LJ, Shapiro-Mendoza CK, Tong VT, Farr SL, Callaghan WM.
Am J Prev Med. 2010 Jul;39(1):45-52.
- Perinatal regionalization for very low-birth-weight and very preterm infants: a meta-analysisexternal icon
Lasswell SM, Barfield WD, Rochat RW, Blackmon L.
JAMA. 2010 Sep 1;304(9):992-1000.
- Behind international rankings of infant mortality: how the United States compares with Europeexternal icon
MacDorman MF, Mathews TJ.
NCHS Data Brief. 2009 Nov(23):1-8.
- Understanding racial and ethnic disparities in U.S. infant mortality ratesexternal icon
MacDorman MF, Mathews TJ.
NCHS Data Brief. 2011 Sep(74):1-8.
- Disparities in perinatal medicine: preterm birth, stillbirth, and infant mortalityexternal icon
Spong CY, Iams J, Goldenberg R, Hauck FR, Willinger M.
Obstet Gynecol. 2011 Apr;117(4):948-55.
- Sudden infant death syndrome: an updateexternal icon
Moon RY, Fu L.
Pediatr Rev. 2012 Jul;33(7):314-20.
- The contribution of preterm birth to infant mortality rates in the United Statesexternal icon
Callaghan WM, MacDorman MF, Rasmussen SA, Qin C, Lackritz EM.
Pediatrics. 2006 Oct;118(4):1566-73.
- SIDS and other sleep-related infant deaths: expansion of recommendations for a safe infant sleeping environmentexternal icon
Moon R, Task Force on Sudden Infant Death Syndrome.
Pediatrics. 2011 Nov;128(5):1030-9.
- Levels of neonatal careexternal icon
Committee on Fetus and Newborn.
Pediatrics. 2012 Sep;130(3):587-97.
- US infant mortality trends attributable to accidental suffocation and strangulation in bed from 1984 through 2004: are rates increasing?external icon
Shapiro-Mendoza CK, Kimball M, Tomashek KM, Anderson RN, Blanding S.
Pediatrics. 2009 Feb;123(2):533-9.
- Race and ethnic disparities in fetal mortality, preterm birth, and infant mortality in the United States: an overviewexternal icon
MacDorman MF.
Semin Perinatol. 2011 Aug;35(4):200-8.
- A statewide initiative to reduce inappropriate scheduled births at 36(0/7)-38(6/7) weeks’ gestationexternal icon
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CDC Authored Articles
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Chronic Diseases and Conditions
- Tackling the global diabetes burden: will screening help?external icon
Engelgau MM, Gregg EW.
Lancet. 2012 Oct 3.
- Chronic medical conditions as risk factors for herpes zosterexternal icon
Joesoef RM, Harpaz R, Leung J, Bialek SR.
Mayo Clin Proc. 2012 Oct;87(10):961-7.
- Parkinson’s disease among American Indians and Alaska Natives: a nationwide prevalence studyexternal icon
Gordon PH, Mehal JM, Holman RC, Rowland AS, Cheek JE.
Mov Disord. 2012 Sep 15;27(11):1456-9.
- Population-based study of risk factors for coronary heart disease among HIV-infected personsexternal icon
Oh JY, Greene K, He H, Schafer S, Hedberg K.
Open AIDS J. 2012 ;6:177-80.
- Tackling the global diabetes burden: will screening help?external icon
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Communicable Diseases
- Constant transmission properties of variant Creutzfeldt-Jakob disease in 5 countriesexternal icon
Diack AB, Ritchie D, Bishop M, Pinion V, Brandel JP, Haik S, Tagliavini F, Van Duijn C, Belay ED, Gambetti P, Schonberger LB, Piccardo P, Will RG, Manson JC.
Emerg Infect Dis. 2012 Oct;18(10):1574-9.
- Hand, foot, and mouth disease caused by Coxsackievirus A6external icon
Flett K, Youngster I, Huang J, McAdam A, Sandora TJ, Rennick M, Smole S, Rogers SL, Nix WA, Oberste MS, Gellis S, Ahmed AA.
Emerg Infect Dis. 2012 Oct;18(10):1702-4.
- Tuberculosis among healthcare workers, United States, 1995-2007external icon
Lambert LA, Pratt RH, Armstrong LR, Haddad MB.
Infect Control Hosp Epidemiol. 2012 Nov;33(11):1126-32.
- So many questions, so little timeexternal icon
Donis RO, Cox NJ.
J Infect Dis. 2012 Oct 4.
- Human papillomavirus genotypes in high grade cervical lesions in the United Statesexternal icon
Hariri S, Unger ER, Powell SE, Bauer HM, Bennett NM, Bloch KC, Niccolai LM, Schafer S, Steinau M, Markowitz LE.
J Infect Dis. 2012 Oct 8.
- Use of and adherence to antiretroviral therapy in a large U.S. sample of HIV-infected adults in care, 2007-2008external icon
Beer L, Heffelfinger J, Frazier E, Mattson C, Roter B, Barash E, Buskin S, Rime T, Valverde E.
Open AIDS J. 2012 ;6:213-23.
- Using HIV surveillance data to monitor missed opportunities for linkage and engagement in HIV medical careexternal icon
Bertolli J, Shouse RL, Beer L, Valverde E, Fagan J, Jenness SM, Wogayehu A, Johnson C, Neaigus A, Hillman D, Courogen M, Brady KA, Bolden B.
Open AIDS J. 2012 ;6:131-41.
- Assessing the assumptions of respondent-driven sampling in the National HIV Behavioral Surveillance System among injecting drug usersexternal icon
Lansky A, Drake A, Wejnert C, Pham H, Cribbin M, Heckathorn DD.
Open AIDS J. 2012 ;6:77-82.
- Constant transmission properties of variant Creutzfeldt-Jakob disease in 5 countriesexternal icon
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Disaster Control and Emergency Services
- National surveillance for radiological exposures and intentional potassium iodide and iodine product ingestions in the United States associated with the 2011 Japan radiological incidentexternal icon
Law RK, Schier JG, Martin CA, Olivares DE, Thomas RG, Bronstein AC, Chang AS.
Clin Toxicol (Phila). 2012 Oct 8.
- National surveillance for radiological exposures and intentional potassium iodide and iodine product ingestions in the United States associated with the 2011 Japan radiological incidentexternal icon
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Disease Reservoirs and Vectors
- Rickettsia parkeri and Candidatus Rickettsia andeanae in Gulf Coast ticks, Mississippi, USAexternal icon
Ferrari FA, Goddard J, Paddock CD, Varela-Stokes AS.
Emerg Infect Dis. 2012 Oct;18(10):1705-7.
- Anthroponotic enteric parasites in monkeys in public park, Chinaexternal icon
Ye J, Xiao L, Ma J, Guo M, Liu L, Feng Y.
Emerg Infect Dis. 2012 Oct;18(10):1640-3.
- Seasonal pulses of Marburg virus circulation in juvenile Rousettus aegyptiacus bats coincide with periods of increased risk of human infectionexternal icon
Amman BR, Carroll SA, Reed ZD, Sealy TK, Balinandi S, Swanepoel R, Kemp A, Erickson BR, Comer JA, Campbell S, Cannon DL, Khristova ML, Atimnedi P, Paddock CD, Kent Crockett RJ, Flietstra TD, Warfield KL, Unfer R, Katongole-Mbidde E, Downing R, Tappero JW, Zaki SR, Rollin PE, Ksiazek TG, Nichol ST, Towner JS.
PLoS Pathog. 2012 Oct;8(10):e1002877.
- Rickettsia parkeri and Candidatus Rickettsia andeanae in Gulf Coast ticks, Mississippi, USAexternal icon
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Environmental Health
- Analysis of selected maternal exposures and non-syndromic atrioventricular septal defects in the National Birth Defects Prevention Study, 1997-2005external icon
Patel SS, Burns TL, Botto LD, Riehle-Colarusso TJ, Lin AE, Shaw GM, Romitti PA.
Am J Med Genet A. 2012 Oct;158A(10):2447-2455.
- Climbing the evidentiary hierarchy for environmental infection controlexternal icon
McDonald LC, Arduino M.
Clin Infect Dis. 2012 Oct 5.
- Preventing maritime transfer of toxigenic Vibrio choleraeexternal icon
Cohen NJ, Slaten DD, Marano N, Tappero JW, Wellman M, Albert RJ, Hill VR, Espey D, Handzel T, Henry A, Tauxe RV.
Emerg Infect Dis. 2012 Oct;18(10):1680-2.
- Risk reduction assessment of waterborne Salmonella and Vibrio by a chlorine contact disinfectant point-of-use deviceexternal icon
Coulliette AD, Enger KS, Weir MH, Rose JB.
Int J Hyg Environ Health. 2012 Oct 4.
- The food-water nexus: irrigation water quality, risks to food safety, and the need for a systems-based preventive approach
Gelting RJ, Baloch MA.
J Environ Health. 2012 ;75(3):40-41.
- From conversation to action: implementation of the National Conversation on Public Health and Chemical Exposures
Nielsen JA.
J Environ Health. 2012 ;75(3):38-39.
- Consumption of pesticide-treated wheat seed by a rural population in Malawiexternal icon
Schier JG, Sejvar JJ, Lutterloh E, Likaka A, Katsoudas E, Karaseva YD, Tippett Barr B, Redwood Y, Monroe S.
J Expo Sci Environ Epidemiol. 2012 Oct 10.
- Analysis of selected maternal exposures and non-syndromic atrioventricular septal defects in the National Birth Defects Prevention Study, 1997-2005external icon
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Epidemiology and Surveillance
- Time-series analyses of count data to estimate the burden of seasonal infectious diseasesexternal icon
Thompson WW, Ridenhour BL, Barile JP, Shay DK.
Epidemiology. 2012 Nov;23(6):839-42.
- Prostate cancer screening practices of African-American and non-African-American US primary care physicians: a cross-sectional surveyexternal icon
Richards TB, Rim SH, Hall IJ, Richardson LC, Ross LE.
Int J Gen Med. 2012 ;5:775-80.
- Chest radiography for tuberculosis screening is back on the agenda [Editorial]external icon
Iademarco MF, O’Grady J, Lonnroth K.
Int J Tuberc Lung Dis. 2012 Nov;16(11):1421-2.
- Piloting a system for behavioral surveillance among heterosexuals at increased risk of HIV in the United Statesexternal icon
DiNenno EA, Oster AM, Sionean C, Denning P, Lansky A.
Open AIDS J. 2012 ;6:169-76.
- Enhanced collection of laboratory data in HIV surveillance smong 5 states with confidential name-based HIV infection reporting, 2005-2006external icon
Gray KM, Kajese T, Crandell-Alden E, Anderson BJ, Wendell D, Crutchfield A, Jackson T, Hall HI.
Open AIDS J. 2012 ;6:90-7.
- Internet-based methods may reach higher-risk men who have sex with men not reached through venue-based samplingexternal icon
Sanchez T, Smith A, Denson D, Dinenno E, Lansky A.
Open AIDS J. 2012 ;6:83-9.
- A national case-control study identifies human socio-economic status and activities as risk factors for tick-borne encephalitis in Polandexternal icon
Stefanoff P, Rosinska M, Samuels S, White DJ, Morse DL, Randolph SE.
PLoS One. 2012 ;7(9):e45511.
- Time-series analyses of count data to estimate the burden of seasonal infectious diseasesexternal icon
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Food Safety
- Multistate outbreak of Escherichia coli O157:H7 infections associated with in-store sampling of an aged raw-milk Gouda cheese, 2010external icon
McCollum JT, Williams NJ, Beam SW, Cosgrove S, Ettestad PJ, Ghosh TS, Kimura AC, Nguyen L, Stroika SG, Vogt RL, Watkins AK, Weiss JR, Williams IT, Cronquist A.
J Food Prot. 2012 Oct;75(10):1759-65.
- Multistate outbreak of Escherichia coli O157:H7 infections associated with in-store sampling of an aged raw-milk Gouda cheese, 2010external icon
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Genetics and Genomics
- Genetic diversity among Clostridium botulinum strains harboring bont/A2 and bont/A3 genesexternal icon
Luquez C, Raphael BH, Joseph LA, Meno SR, Fernandez RA, Maslanka SE.
Appl Environ Microbiol. 2012 Oct 5.
- Genetic diversity among Clostridium botulinum strains harboring bont/A2 and bont/A3 genesexternal icon
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Health Behavior and Risk
- Risk behaviors and STI prevalence among people with HIV in El Salvadorexternal icon
Paz-Bailey G, Shah N, Creswell J, Guardado M, Nieto A, Estrada M, Cedillos R, Pascale J, Monterroso E.
Open AIDS J. 2012 ;6:205-12.
- Risk behaviors and STI prevalence among people with HIV in El Salvadorexternal icon
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Immunity and Immunization
- Adverse events following a third dose of measles, mumps, and rubella vaccine in a mumps outbreakexternal icon
Abedi GR, Mutuc JD, Lawler J, Leroy ZC, Hudson JM, Blog DS, Schulte CR, Rausch-Phung E, Ogbuanu IU, Gallagher K, Kutty PK.
Vaccine. 2012 Oct 3.
- Immunogenicity and safety of a new meningococcal A conjugate vaccine in Indian children aged 2-10 years: a phase II/III double-blind randomized controlled trialexternal icon
Hirve S, Bavdekar A, Pandit A, Juvekar S, Patil M, Preziosi MP, Tang Y, Marchetti E, Martellet L, Findlow H, Elie C, Parulekar V, Plikaytis B, Borrow R, Carlone G, Kulkarni PS, Goel A, Suresh K, Beri S, Kapre S, Jadhav S, Preaud JM, Viviani S, Laforce FM.
Vaccine. 2012 Oct 5;30(45):6456-60.
- WHO recommendations for the viruses to be used in the 2012 Southern Hemisphere influenza vaccine: epidemiology, antigenic and genetic characteristics of influenza A(H1N1)pdm09, A(H3N2) and B influenza viruses collected from February to September 2011external icon
Klimov AI, Garten R, Russell C, Barr IG, Besselaar TG, Daniels R, Engelhardt OG, Grohmann G, Itamura S, Kelso A, McCauley J, Odagiri T, Smith D, Tashiro M, Xu X, Webby R, Wang D, Ye Z, Yuelong S, Zhang W, Cox N.
Vaccine. 2012 Oct 5;30(45):6461-71.
- Adverse events following a third dose of measles, mumps, and rubella vaccine in a mumps outbreakexternal icon
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Laboratory Sciences
- Endolysins of Bacillus anthracis bacteriophages recognize unique carbohydrate epitopes of vegetative cell wall polysaccharides with high affinity and selectivityexternal icon
Mo KF, Li X, Li H, Low LY, Quinn CP, Boons GJ.
J Am Chem Soc. 2012 Sep 19;134(37):15556-62.
- Characterization of Corynebacterium species in macaquesexternal icon
Venezia J, Cassiday PK, Marini RP, Shen Z, Buckley EM, Peters Y, Taylor N, Dewhirst FE, Tondella ML, Fox JG.
J Med Microbiol. 2012 Oct;61(Pt 10):1401-8.
- Brain organochlorines and Lewy pathology: the Honolulu-Asia Aging Studyexternal icon
Ross GW, Duda JE, Abbott RD, Pellizzari E, Petrovitch H, Miller DB, O’Callaghan JP, Tanner CM, Noorigian JV, Masaki K, Launer L, White LR.
Mov Disord. 2012 Sep 15;27(11):1418-24.
- Endolysins of Bacillus anthracis bacteriophages recognize unique carbohydrate epitopes of vegetative cell wall polysaccharides with high affinity and selectivityexternal icon
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Maternal and Child Health
- Cytokines and posthemorrhagic ventricular dilation in premature infantsexternal icon
Ambalavanan N, Carlo WA, McDonald SA, Das A, Schendel DE, Thorsen P, Hougaard DM, Skogstrand K, Higgins RD.
Am J Perinatol. 2012 Oct;29(9):731-740.
- Legacy for Childrenexternal icon
Perou R, Elliott MN, Visser SN, Claussen AH, Scott KG, Beckwith LH, Howard J, Katz LF, Smith C.
BMC Public Health. 2012 Aug 23;12(1):691.
- Severe maternal morbidity among delivery and postpartum hospitalizations in the United Statesexternal icon
Callaghan WM, Creanga AA, Kuklina EV.
Obstet Gynecol. 2012 Oct 5.
- Cytokines and posthemorrhagic ventricular dilation in premature infantsexternal icon
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Nutritional Sciences
- Let’s move salad bars to schools: a public-private partnership to increase student fruit and vegetable consumptionexternal icon
Harris DM, Seymour J, Grummer-Strawn L, Cooper A, Collins B, DiSogra L, Marshall A, Evans N.
Child Obes. 2012 Aug;8(4):294-7.
- Food insecurity is associated with obesity among US adults in 12 statesexternal icon
Pan L, Sherry B, Njai R, Blanck HM.
J Acad Nutr Diet. 2012 Sep;112(9):1403-9.
- Factors associated with low water intake among US high school students-National Youth Physical Activity and Nutrition Study, 2010external icon
Park S, Blanck HM, Sherry B, Brener N, O’Toole T.
J Acad Nutr Diet. 2012 Sep;112(9):1421-7.
- Let’s move salad bars to schools: a public-private partnership to increase student fruit and vegetable consumptionexternal icon
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Occupational Safety and Health
- Toward developing a new occupational exposure metric approach for characterization of diesel aerosols
Cauda EG, Ku BK, Miller AL, Barone TL.
Aerosol Sci Technol. 2012 01 Dec;46(12):1370-1381.
- Workplace safety equals patient safetyexternal icon
Spratt D, Cowles CE, Berguer R, Dennis V, Waters TR, Rodriguez M, Spry C, Groah L.
AORN J. 2012 Sep;96(3):235-44.
- Associations of long-term shift work with waking salivary cortisol concentration and patterns among police officersexternal icon
Fekedulegn D, Burchfiel CM, Violanti JM, Hartley TA, Charles LE, Andrew ME, Miller DB.
Ind Health. 2012 Oct 8.
- Needlestick injuries among employees at a nationwide retail pharmacy chain, 2000-2011external icon
de Perio MA.
Infect Control Hosp Epidemiol. 2012 Nov;33(11):1156-8.
- A critical evaluation of material safety data sheets (MSDSs) for engineered nanomaterials
Eastlake A, Hodson L, Geraci C, Crawford C.
J Chem Health Saf. 2012 ;19(5):1-8.
- Employer perceptions of stress and resilience interventionexternal icon
Spangler NW, Koesten J, Fox MH, Radel J.
J Occup Environ Med. 2012 Oct 8.
- Toward developing a new occupational exposure metric approach for characterization of diesel aerosols
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Public Health Law
- Tattooing regulations in U.S. states, 2011
Carlson VP, Lehman EJ, Armstrong M.
J Environ Health. 2012 ;75(3):30-37.
- Tattooing regulations in U.S. states, 2011
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Reproductive Health
- Adaptation of the World Health Organization’s Selected Practice Recommendations for Contraceptive Use for the United Statesexternal icon
Curtis KM, Tepper NK, Jamieson DJ, Marchbanks PA.
Contraception. 2012 Oct 4.
- Treatment of unscheduled bleeding in women using extended- or continuous-use combined hormonal contraception: a systematic reviewexternal icon
Godfrey EM, Whiteman MK, Curtis KM.
Contraception. 2012 Oct 5.
- How does the number of oral contraceptive pill packs dispensed or prescribed affect continuation and other measures of consistent and correct use? A systematic reviewexternal icon
Steenland MW, Rodriguez MI, Marchbanks PA, Curtis KM.
Contraception. 2012 Oct 4.
- Use of a checklist to rule out pregnancy: a systematic reviewexternal icon
Tepper NK, Marchbanks PA, Curtis KM.
Contraception. 2012 Oct 4.
- Retention of intrauterine devices in women who acquire pelvic inflammatory disease: a systematic reviewexternal icon
Tepper NK, Steenland MW, Gaffield ME, Marchbanks PA, Curtis KM.
Contraception. 2012 Oct 4.
- Hemoglobin measurement prior to initiating copper intrauterine devices: a systematic reviewexternal icon
Tepper NK, Steenland MW, Marchbanks PA, Curtis KM.
Contraception. 2012 Oct 4.
- Laboratory screening prior to initiating contraception: a systematic reviewexternal icon
Tepper NK, Steenland MW, Marchbanks PA, Curtis KM.
Contraception. 2012 Oct 4.
- Patient understanding of oral contraceptive pill instructions related to missed pills: a systematic reviewexternal icon
Zapata LB, Steenland MW, Brahmi D, Marchbanks PA, Curtis KM.
Contraception. 2012 Oct 4.
- Adaptation of the World Health Organization’s Selected Practice Recommendations for Contraceptive Use for the United Statesexternal icon
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Statistics as Topic
- Estimation with vanishing baseline riskexternal icon
Park RM.
Epidemiology. 2012 Nov;23(6):937-8.
- Estimation with vanishing baseline riskexternal icon
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Zoonoses
- Complete genome sequence of Ikoma lyssavirusexternal icon
Marston DA, Ellis RJ, Horton DL, Kuzmin IV, Wise EL, McElhinney LM, Banyard AC, Ngeleja C, Keyyu J, Cleaveland S, Lembo T, Rupprecht CE, Fooks AR.
J Virol. 2012 Sep;86(18):10242-3.
- Complete genome sequence of Ikoma lyssavirusexternal icon
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Public Health Articles Noted in the Media
Articles about important public health topics that have been mentioned in the press.
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MMWR in the Media
- Geographic differences in HIV infection among Hispanics or Latinos – 46 states and Puerto Rico, 2010
MMWR Morb Mortal Wkly Rep. 2012 Oct 12;61(40):805-10.
- Geographic differences in HIV infection among Hispanics or Latinos – 46 states and Puerto Rico, 2010
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Chronic Diseases and Conditions
- Age at stroke: temporal trends in stroke incidence in a large, biracial populationexternal icon
Kissela BM, Khoury JC, Alwell K, Moomaw CJ, Woo D, Adeoye O, Flaherty ML, Khatri P, Ferioli S, De Los Rios La Rosa F, Broderick JP, Kleindorfer DO.
Neurology. 2012 Oct 10.
- Age at stroke: temporal trends in stroke incidence in a large, biracial populationexternal icon
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Nutritional Sciences
- Consumption of diet drinks in the United States, 2009-2010pdf icon
Fakhouri TH, Kit BK, Ogden CL.
NCHS Data Brief. 2012 Oct(109):1-7.
- Consumption of diet drinks in the United States, 2009-2010pdf icon
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Vital Statistics
- Births: preliminary data for 2011pdf icon
Hamilton BE, Martin JA, Ventura SJ.
Natl Vital Stat Rep. 2012 Oct 3;61(5):1-29.
- Deaths: preliminary data for 2011pdf icon
Hoyert D, Xu J.
Natl Vital Stat Rep. 2012 Oct 10;61(6):1-64.
- Births: preliminary data for 2011pdf icon
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CDC Science Clips Production Staff:
- John Iskander, MD MPH, Editor
- Rebecca Satterthwaite, MS, Librarian
- Gail Bang, MLIS, Librarian
- Deidre Thomas, MLS, Librarian
- Kathleen Connick, MSLS, Librarian
- Joseph Dunlap, Web Developer
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DISCLAIMER: Articles listed in the CDC Science Clips are selected by the Stephen B. Thacker CDC Library to provide current awareness of the public health literature. An article’s inclusion does not necessarily represent the views of the Centers for Disease Control and Prevention nor does it imply endorsement of the article’s methods or findings. CDC and DHHS assume no responsibility for the factual accuracy of the items presented. The selection, omission, or content of items does not imply any endorsement or other position taken by CDC or DHHS. Opinion, findings and conclusions expressed by the original authors of items included in the Clips, or persons quoted therein, are strictly their own and are in no way meant to represent the opinion or views of CDC or DHHS. References to publications, news sources, and non-CDC Websites are provided solely for informational purposes and do not imply endorsement by CDC or DHHS.