Fine particulate matter (PM _2.5 ) exposure can induce immune system pathology via epigenetic modification, affecting pregnancy outcomes. Our study investigated the association between PM _2.5 exposure and immune response, as well as epigenetic changes using high-dimensional epigenetic landscape profiling using cytometry by time-of-flight (EpiTOF) at the single cell. We found statistically significant associations between PM _2.5 exposure and levels of certain cytokines [interleukin-1RA (IL-1RA), IL-8/CXCL8, IL-18, and IL-27)] and histone posttranslational modifications (HPTMs) in immune cells (HPTMs: H3K9ac, H3K23ac, H3K27ac, H2BK120ub, H4K20me1/3, and H3K9me1/2) among pregnant and nonpregnant women. The cord blood of neonates with high maternal PM _2.5 exposure showed lower IL-27 than those with low exposure. Furthermore, PM _2.5 exposure affects the co-modification profiles of cytokines between pregnant women and their neonates, along with HPTMs in each immune cell type between pregnant and nonpregnant women. These modifications in specific histones and cytokines could indicate the toxicological mechanism of PM _2.5 exposure in inflammation, inflammasome pathway, and pregnancy complications.

Low-income, rural children are at a greater risk for poor dietary intake. Schools offer a venue to deliver appropriate interventions. Our aim was to evaluate the implementation and effectiveness of Healthy Schools, Healthy Students (HSHS). We conducted a mixed-methods evaluation using a cluster-randomized trial design with 20 schools in a rural, Midwestern state. HSHS included education sessions, cafeteria coaching and taste testing. We interviewed implementers (n = 13) and nutrition educators (n = 8), conducted six focus groups with cafeteria coaches, and surveyed fourth graders (n = 1057) about their nutrition knowledge, attitudes toward and preferences for fruits and vegetables (F&V), F&V consumption and MyPlate awareness. We used multi-level linear models to estimate the intervention effect and qualitative data were coded. There were very few challenges to implementation. HSHS participation was positively associated with knowledge, attitudes toward F&V, preferences for vegetables from the taste tests, MyPlate awareness and vegetable consumption. HSHS was viewed as beneficial and easy to deliver, suggesting this type of intervention could be widely implemented. Improving knowledge and attitudes through nutrition education and preferences through taste testing have the potential to improve dietary intake among rural students. Low-cost nutrition interventions can be successfully implemented in rural elementary schools with positive outcomes.

Extreme heat (EH) is a leading cause of weather-related fatalities in the United States. In Massachusetts, average temperatures have increased by 1.9 °C since the 20th century, higher than the global average increase of 1.1 °C. EH disproportionately impacts communities, exacerbating social inequities. This study examined the risks of heat-related hospitalizations in each small area of the Greater Boston Metropolitan Area using Medicare data (2000–2016). EH events included daily heat index (HI), days with an HI above the 90th percentile, and heat waves (≥2 consecutive EH days). We applied a case-crossover design to estimate area-specific associations between EH and hospitalizations and assessed effect modifications by an individual (age ≥85, sex, Medicaid dual eligibility) and ZIP-code characteristics (green space, poverty, educational attainment, and household income). Results were pooled using random effects meta-analysis. Area-specific analysis revealed higher hospitalization risks in Boston compared with surrounding areas. Pooled results indicated heat-related hospitalizations increased by 9.0% (95% CI = 5.7, 12.3) per 10 °C rise in HI, 14.4% (95% CI = 8.8, 20.3) on EH days, and 17.9% (95% CI = 11.1, 25.1) during heat waves. Risks were more pronounced in Boston, and some indications of elevated risk among males and residents in low-income, low-education areas. These findings underscore that heat-related health risks may be different across the level of geographic units and suggest the need for targeted public health strategies to mitigate the impacts of EH.