BACKGROUND: Neonatal and early-life gut microbiome changes are associated with altered cardiometabolic and immune development. In this study, we explored Cesarean delivery effects on the gut microbiome in our high-risk, under-resourced Bronx, NY population.
RESULTS: Fecal samples from the Bronx MomBa Health Study (Bronx MomBa Health Study) were categorized by delivery mode (vaginal/Cesarean) and analyzed via 16 S rRNA gene sequencing at four timepoints over the first two years of life. Bacteroidota organisms, which have been linked to decreased risk for obesity and type 2 diabetes, were relatively reduced by Cesarean delivery, while Firmicutes organisms were increased. Organisms belonging to the Enterococcus genus, which have been tied to aberrant immune cell development, were relatively increased in the Cesarean delivery microbiomes.
CONCLUSIONS: Due to their far-reaching impact on cardiometabolic and immune functions, Cesarean deliveries in high-risk patient populations should be carefully considered.

Sero-monitoring provides context to the epidemiology of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections and changes in population immunity following vaccine introduction. Here, we describe results of a cross-sectional hospital-based study of anti-spike seroprevalence in New York City (NYC) from February 2020 to July 2022, and a follow-up period from August 2023 to October 2023. Samples from 55,092 individuals, spanning five epidemiological waves were analyzed. Prevalence ratios (PR) were obtained using Poisson regression. Anti-spike antibody levels increased gradually over the first two waves, with a sharp increase during the 3rd wave coinciding with SARS-CoV-2 vaccination in NYC resulting in seroprevalence levels >90% by July 2022. Our data provide insights into the dynamic changes in immunity occurring in a large and diverse metropolitan community faced with a new viral pathogen and reflects the patterns of antibody responses as the pandemic transitions into an endemic stage.

Urban street trees offer cities critical environmental and social benefits. In New York City (NYC), a decadal census of every street tree is conducted to help understand and manage the urban forest. However, it has previously been impossible to analyze growth of an individual tree because of uncertainty in tree location. This study overcomes this limitation using a three-step alignment process for identifying individual trees with ZIP Codes, address, and species instead of map coordinates. We estimated individual growth rates for 126,362 street trees (59 species and 19% of 2015 trees) using the difference between diameter at breast height (DBH) from the 2005 and 2015 tree censuses. The tree identification method was verified by locating and measuring the DBH of select trees and measuring a set of trees annually for over 5 years. We examined determinants of tree growth rates and explored their spatial distribution. In our newly created NYC tree growth database, fourteen species have over 1000 unique trees. The three most abundant tree species vary in growth rates; London Planetree (n = 32,056, 0.163 in/yr) grew the slowest compared to Honeylocust (n = 15,967, 0.356 in/yr), and Callery Pear (n = 15,902, 0.334 in/yr). Overall, Silver Linden was the fastest growing species (n = 1,149, 0.510 in/yr). Ordinary least squares regression that incorporated biological factors including size and the local urban form indicated that species was the major factor controlling growth rates, and tree stewardship had only a small effect. Furthermore, tree measurements by volunteer community scientists were as accurate as those made by NYC staff. Examining city wide patterns of tree growth indicates that areas with a higher Social Vulnerability Index have higher than expected growth rates. Continued efforts in street tree planting should utilize known growth rates while incorporating community voices to better provide long-term ecosystem services across NYC.

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UNASSIGNED: A nonadjuvanted bivalent respiratory syncytial virus (RSV) prefusion F (RSVpreF [Pfizer]) protein subunit vaccine was newly approved and recommended for pregnant individuals at 32 0/7 to 36 6/7 weeks\' gestation during the 2023 to 2024 RSV season; however, clinical vaccine data are lacking.
UNASSIGNED: To evaluate the association between prenatal RSV vaccination status and perinatal outcomes among patients who delivered during the vaccination season.
UNASSIGNED: This retrospective observational cohort study was conducted at 2 New York City hospitals within 1 health care system among patients who gave birth to singleton gestations at 32 weeks\' gestation or later from September 22, 2023, to January 31, 2024.
UNASSIGNED: Prenatal RSV vaccination with the RSVpreF vaccine captured from the health system\'s electronic health records.
UNASSIGNED: The primary outcome is preterm birth (PTB), defined as less than 37 weeks\' gestation. Secondary outcomes included hypertensive disorders of pregnancy (HDP), stillbirth, small-for-gestational age birth weight, neonatal intensive care unit (NICU) admission, neonatal respiratory distress with NICU admission, neonatal jaundice or hyperbilirubinemia, neonatal hypoglycemia, and neonatal sepsis. Logistic regression models were used to estimate odds ratios (ORs), and multivariable logistic regression models and time-dependent covariate Cox regression models were performed.
UNASSIGNED: Of 2973 pregnant individuals (median [IQR] age, 34.9 [32.4-37.7] years), 1026 (34.5%) received prenatal RSVpreF vaccination. Fifteen patients inappropriately received the vaccine at 37 weeks\' gestation or later and were included in the nonvaccinated group. During the study period, 60 patients who had evidence of prenatal vaccination (5.9%) experienced PTB vs 131 of those who did not (6.7%). Prenatal vaccination was not associated with an increased risk for PTB after adjusting for potential confounders (adjusted OR, 0.87; 95% CI, 0.62-1.20) and addressing immortal time bias (hazard ratio [HR], 0.93; 95% CI, 0.64-1.34). There were no significant differences in pregnancy and neonatal outcomes based on vaccination status in the logistic regression models, but an increased risk of HDP in the time-dependent model was seen (HR, 1.43; 95% CI, 1.16-1.77).
UNASSIGNED: In this cohort study of pregnant individuals who delivered at 32 weeks\' gestation or later, the RSVpreF vaccine was not associated with an increased risk of PTB and perinatal outcomes. These data support the safety of prenatal RSVpreF vaccination, but further investigation into the risk of HDP is warranted.

UNASSIGNED: Our study explores how New York City (NYC) communities of various socioeconomic strata were uniquely impacted by the COVID-19 pandemic.
UNASSIGNED: New York City ZIP codes were stratified into three bins by median income: high-income, middle-income, and low-income. Case, hospitalization, and death rates obtained from NYCHealth were compared for the period between March 2020 and April 2022.
UNASSIGNED: COVID-19 transmission rates among high-income populations during off-peak waves were higher than transmission rates among low-income populations. Hospitalization rates among low-income populations were higher during off-peak waves despite a lower transmission rate. Death rates during both off-peak and peak waves were higher for low-income ZIP codes.
UNASSIGNED: This study presents evidence that while high-income areas had higher transmission rates during off-peak periods, low-income areas suffered greater adverse outcomes in terms of hospitalization and death rates. The importance of this study is that it focuses on the social inequalities that were amplified by the pandemic.

The Phylum Cressdnaviricota consists of a large number of circular Rep-encoding single-stranded (CRESS)-DNA viruses. Recently, metagenomic analyzes revealed their ubiquitous distribution in a diverse range of eukaryotes. Data relating to CRESS-DNA viruses in humans remains scarce. Our study investigated the presence and genetic diversity of CRESS-DNA viruses in human vaginal secretions. Vaginal swabs were collected from 28 women between 29 and 43 years old attending a fertility clinic in New York City. An exploratory metagenomic analysis was performed and detection of CRESS-DNA viruses was confirmed through analysis of near full-length sequences of the viral isolates. A phylogenetic tree was based on the REP open reading frame sequences of the CRESS-DNA virus genome. Eleven nearly complete CRESS-DNA viral genomes were identified in 16 (57.1%) women. There were no associations between the presence of these viruses and any demographic or clinical parameters. Phylogenetic analysis indicated that one of the sequences belonged to the genus Gemycircularvirus within the Genomoviridae family, while ten sequences represented previously unclassified species of CRESS-DNA viruses. Novel species of CRESS-DNA viruses are present in the vaginal tract of adult women. Although they be transient commensal agents, the potential clinical implications for their presence at this site cannot be dismissed.

OBJECTIVE: The objective of this study was to assess purchasing, intake, and weight after discounting fruits and vegetables (F&V) and noncaloric beverages in New York City supermarkets.
METHODS: A 16-week randomized controlled trial was conducted with a 4-week baseline, an 8-week intervention with 50% discounts on F&V and noncaloric beverages, and a 4-week follow-up. Purchasing was tracked via loyalty cards, and intake was tracked via 24-h dietary recalls. Weights were measured at five in-person visits.
RESULTS: Data from 67 participants were analyzed (38 in the experimental group; 29 in the control group). F&V and noncaloric beverage weekly purchasing was greater in the experimental than the control group (mean difference [SD], $4.64 [$1.44], p < 0.0001; $0.53 [$0.39], p = 0.008) during intervention, with F&V purchasing remaining greater in the experimental versus control group during follow-up (p = 0.005). F&V intake was greater for the experimental than the control group during intervention (142 [105] g/day; p = 0.009) and follow-up (p = 0.001). Although no difference in noncaloric beverage consumption was observed between groups, there was lower alcohol intake in the experimental than the control group during follow-up (-85.8 [60.2] g/day; p = 0.004). The experimental group lost weight compared with the control group (-1.33 [0.92] kg; p = 0.006 intervention and p = 0.106 follow-up). No differences in nutrient composition or high energy-dense product consumption were found.
CONCLUSIONS: A 50% discount on F&V and noncaloric beverages promoted increased purchasing and intake of F&V and induced weight loss.

On 11 September 2001, attacks on the World Trade Center (WTC) killed nearly three thousand people and exposed hundreds of thousands of rescue and recovery workers, passersby, area workers, and residents to varying amounts of dust and smoke. Former New York City Mayor Rudy Giuliani ordered the emergency evacuation of Lower Manhattan below Canal Street, but not all residents evacuated. Previous studies showed that those who did not evacuate had a higher incidence of newly diagnosed asthma. Among the 71,424 who enrolled in the WTC Health Registry in 2003-2004, we evaluated the bivariate association of educational attainment, household income, and race or ethnicity with reported evacuation on or after 9/11/01. We used log binomial regression to assess the relative risks of not evacuating from their home following the 9/11 attacks, adjusting for age, gender, and marital status. Out of a total of 11,871 enrollee residents of Lower Manhattan, 7345 or 61.79% reported evacuating their home on or after 9/11. In a fully adjusted model, the estimated relative risk for not evacuating was elevated for those who identified as non-Hispanic Black, Asian/Pacific Islander, and Hispanic residents compared to non-Hispanic White residents. Residents with a high school diploma/GED had an elevated estimated risk compared to those with at least a bachelor\'s degree. Those with lower household incomes had an elevated estimated risk compared to those with the highest income category. These significant inequities will need to be prevented in future disasters.

This Introduction to NPCC4 provides an overview of the first three NPCC Reports and contextualizes NPCC4\'s deliberate decision to address justice, equity, diversity, and inclusion in its collective work and in its own practices, procedures, and methods of assessment. Next, it summarizes the assessment process, including greater emphasis on sustained assessment. Finally, it introduces the NPCC4 chapters and their scope.