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Petrocelli M, Ruggiero F, Allegri D, Cutrupi S, Baietti AM, Salzano G, Maglitto F, Manfuso A, Copelli C, Barca I, Cristofaro MG, Galvano F, Loche VP, Gemini P, Tewfik K, Burlini D, Bernardi M, Bianchi FA, Catanzaro S, Ascani G, Consorti G, Balercia P, Braconi A, Scozzaro C, Catalfamo L, De Rinaldis D, De Ponte FS, Tarabbia F, Biglioli F, Giovacchini F, Tullio A, Cama A, Di Emidio P, Ferrari S, Perlangeli G, Rossi MB, Biglio A, De Riu G, Califano L, Vaira LA. Changes in hospital admissions for facial fractures during and after COVID 19 pandemic: national multicentric epidemiological analysis on 2938 patients. Oral Maxillofac Surg 2024; 28:753-759. [PMID: 38093155 DOI: 10.1007/s10006-023-01201-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 12/07/2023] [Indexed: 06/04/2024]
Abstract
PURPOSE The objective of this multicenter study was to examine the differences in maxillo-facial fractures epidemiology across the various phases of the SARS-CoV-2 pandemic. METHODS This is a retrospective study on patients who underwent surgery for facial bone fractures in 18 maxillo-facial surgery departments in Italy, spanning from June 23, 2019, to February 23, 2022. Based on the admission date, the data were classified into four chronological periods reflecting distinct periods of restrictions in Italy: pre-pandemic, first wave, partial restrictions, and post-pandemic. Epidemiological differences across the groups were analysed. RESULTS The study included 2938 patients. A statistically significant difference in hospitalization causes was detected between the pre-pandemic and first wave groups (p = 0.005) and between the pre-pandemic and partial restriction groups (p = 0.002). The differences between the pre- and post-pandemic groups were instead not significant (p = 0.106). Compared to the pre-pandemic period, the number of patients of African origin was significantly higher during the first wave and the post-pandemic period. No statistically significant differences were found across the periods concerning gender, age, fracture type, treatment approach, and hospital stay duration CONCLUSIONS: The COVID-19 pandemic brought about significant changes in fracture epidemiology, influenced by the restrictive measures enforced by the government in Italy. Upon the pandemic's conclusion, the fracture epidemiology returned to the patterns observed in the pre-pandemic period.
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Affiliation(s)
- Marzia Petrocelli
- Oral and Maxillo-Facial Unit AUSL Bologna Bellaria-Maggiore Hospital, Bologna, Italy
| | - Federica Ruggiero
- Oral and Maxillo-Facial Unit AUSL Bologna Bellaria-Maggiore Hospital, Bologna, Italy
| | - Davide Allegri
- Department of Clinical Governance and Quality, AUSL Bologna Bellaria-Maggiore Hospital, Bologna, Italy
| | | | - Anna Maria Baietti
- Oral and Maxillo-Facial Unit AUSL Bologna Bellaria-Maggiore Hospital, Bologna, Italy
| | - Giovanni Salzano
- Maxillo-facial Surgery Unit, University Hospital of Naples "Federico II,", Naples, Italy
| | - Fabio Maglitto
- Maxillo-Facial Surgery Unit, University of Bari "Aldo Moro,", Bari, Italy
| | - Alfonso Manfuso
- Maxillo-Facial Surgery Unit, University of Bari "Aldo Moro,", Bari, Italy
| | - Chiara Copelli
- Maxillo-Facial Surgery Unit, University of Bari "Aldo Moro,", Bari, Italy
| | - Ida Barca
- Department of Experimental and Clinical Medicine, Unit of Maxillofacial Surgery, Magna Graecia University, Catanzaro, Italy
| | - Maria Giulia Cristofaro
- Department of Experimental and Clinical Medicine, Unit of Maxillofacial Surgery, Magna Graecia University, Catanzaro, Italy
| | - Francesca Galvano
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Rome, Italy
| | | | - Paolo Gemini
- Maxillofacial Surgery Unit, ARNAS Brotzu, Cagliari, Italy
| | - Karim Tewfik
- Pediatric Maxillo-Facial Surgery Unit, Children's Hospital of Brescia - ASST Spedali Civili, Brescia, Italy
| | - Dante Burlini
- Pediatric Maxillo-Facial Surgery Unit, Children's Hospital of Brescia - ASST Spedali Civili, Brescia, Italy
| | - Marco Bernardi
- Maxillo-Facial Surgery Unit, ASO Santa Croce e Carle, Cuneo, Italy
| | | | - Susanna Catanzaro
- Department of Maxillo-Facial Surgery, Spirito Santo Hospital, Pescara, Italy
| | - Giuliano Ascani
- Department of Maxillo-Facial Surgery, Spirito Santo Hospital, Pescara, Italy
| | - Giuseppe Consorti
- Maxillo-Facial Surgery Unit, Marche University Hospital, Ancona, Italy
| | - Paolo Balercia
- Maxillo-Facial Surgery Unit, Marche University Hospital, Ancona, Italy
| | - Andrea Braconi
- Maxillo-Facial Surgery Unit, A.R.N.A.S. Civico di Cristina Bonfratelli Hospital, Palermo, Italy
| | - Calogero Scozzaro
- Maxillo-Facial Surgery Unit, A.R.N.A.S. Civico di Cristina Bonfratelli Hospital, Palermo, Italy
| | - Luciano Catalfamo
- UOC of Maxillofacial Surgery, Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
| | - Danilo De Rinaldis
- UOC of Maxillofacial Surgery, Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
| | - Francesco Saverio De Ponte
- UOC of Maxillofacial Surgery, Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
| | - Filippo Tarabbia
- Head and Neck Department, Operative Unit of Maxillo-Facial Surgery, San Paolo Hospital of Milan, Milan, Italy
| | - Federico Biglioli
- Head and Neck Department, Operative Unit of Maxillo-Facial Surgery, San Paolo Hospital of Milan, Milan, Italy
| | | | - Antonio Tullio
- Maxillo-Facial Surgery Unit, Perugia Hospital, Perugia, Italy
| | - Antonia Cama
- Oral and Maxillo-Facial Unit, ASL Teramo - G. Mazzini Hospital, Teramo, Italy
| | - Paolo Di Emidio
- Oral and Maxillo-Facial Unit, ASL Teramo - G. Mazzini Hospital, Teramo, Italy
| | - Silvano Ferrari
- Head and Neck Department, University Hospital of Parma, Parma, Italy
| | | | - Maria Beatrice Rossi
- Maxillo-Facial Surgery, Surgical Sciences Department, University of Turin, Città della Salute e della Scienza Hospital, Turin, Italy
| | - Andrea Biglio
- Head and Neck Department, Operative Unit of Maxillo-Facial Surgery, San Paolo Hospital of Milan, Milan, Italy
- Maxillofacial Surgery Operative Unit, Department of Medicine, Surgery and Pharmacy, University of Sassari, Viale San Pietro 43B, 07100, Sassari, Italy
| | - Giacomo De Riu
- Maxillofacial Surgery Operative Unit, Department of Medicine, Surgery and Pharmacy, University of Sassari, Viale San Pietro 43B, 07100, Sassari, Italy
| | - Luigi Califano
- Maxillo-facial Surgery Unit, University Hospital of Naples "Federico II,", Naples, Italy
| | - Luigi Angelo Vaira
- Maxillofacial Surgery Operative Unit, Department of Medicine, Surgery and Pharmacy, University of Sassari, Viale San Pietro 43B, 07100, Sassari, Italy.
- Biomedical Science Department, PhD School of Biomedical Science, University of Sassari, Sassari, Italy.
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Lacy A, Khan MM, Deb Nath N, Das P, Igoe M, Lenhart S, Lloyd AL, Lanzas C, Odoi A. Geographic disparities and predictors of COVID-19 vaccination in Missouri: a retrospective ecological study. Front Public Health 2024; 12:1329382. [PMID: 38528866 PMCID: PMC10961407 DOI: 10.3389/fpubh.2024.1329382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Accepted: 02/23/2024] [Indexed: 03/27/2024] Open
Abstract
Background Limited information is available on geographic disparities of COVID-19 vaccination in Missouri and yet this information is essential for guiding efforts to improve vaccination coverage. Therefore, the objectives of this study were to (a) investigate geographic disparities in the proportion of the population vaccinated against COVID-19 in Missouri and (b) identify socioeconomic and demographic predictors of the identified disparities. Methods The COVID-19 vaccination data for time period January 1 to December 31, 2021 were obtained from the Missouri Department of Health. County-level data on socioeconomic and demographic factors were downloaded from the 2020 American Community Survey. Proportions of county population vaccinated against COVID-19 were computed and displayed on choropleth maps. Global ordinary least square regression model and local geographically weighted regression model were used to identify predictors of proportions of COVID-19 vaccinated population. Results Counties located in eastern Missouri tended to have high proportions of COVID-19 vaccinated population while low proportions were observed in the southernmost part of the state. Counties with low proportions of population vaccinated against COVID-19 tended to have high percentages of Hispanic/Latino population (p = 0.046), individuals living below the poverty level (p = 0.049), and uninsured (p = 0.015) populations. The strength of association between proportion of COVID-19 vaccinated population and percentage of Hispanic/Latino population varied by geographic location. Conclusion The study findings confirm geographic disparities of proportions of COVID-19 vaccinated population in Missouri. Study findings are useful for guiding programs geared at improving vaccination coverage and uptake by targeting resources to areas with low proportions of vaccinated individuals.
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Affiliation(s)
- Alexanderia Lacy
- Department of Mathematics, University of Tennessee, Knoxville, TN, United States
| | - Md Marufuzzaman Khan
- Department of Public Health, University of Tennessee, Knoxville, TN, United States
| | - Nirmalendu Deb Nath
- Department of Biomedical and Diagnostics Sciences, University of Tennessee, Knoxville, TN, United States
| | - Praachi Das
- Biomathematics Graduate Program, North Carolina State University, Raleigh, NC, United States
| | - Morganne Igoe
- Department of Mathematics, University of Tennessee, Knoxville, TN, United States
| | - Suzanne Lenhart
- Department of Mathematics, University of Tennessee, Knoxville, TN, United States
| | - Alun L. Lloyd
- Biomathematics Graduate Program, North Carolina State University, Raleigh, NC, United States
| | - Cristina Lanzas
- Department of Population Health and Pathobiology and Comparative Medicine Institute, North Carolina State University, Raleigh, NC, United States
| | - Agricola Odoi
- Department of Biomedical and Diagnostics Sciences, University of Tennessee, Knoxville, TN, United States
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Patwary AL, Haque AM, Mahdinia I, Khattak AJ. Investigating transportation safety in disadvantaged communities by integrating crash and Environmental Justice data. ACCIDENT; ANALYSIS AND PREVENTION 2024; 194:107366. [PMID: 37924566 DOI: 10.1016/j.aap.2023.107366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 10/03/2023] [Accepted: 10/24/2023] [Indexed: 11/06/2023]
Abstract
Recent efforts to identify disadvantaged communities (DACs) on a census tract level have evoked possibilities of attaining transportation justice and vision zero goals in these areas. To identify DACs, the United States Department of Transportation (USDOT) has developed six comprehensive indicators: economy, environment, equity, health, resilience, and transportation access. The indicators are used to explore the associations between DACs (in 71,728 census tracts) and five years of fatal crashes, providing a comprehensive understanding of safety risks. Specifically, using data on DACs and linking it with census and crash data, this study aims to understand the complex connections between safety (captured through fatal crashes) and disadvantages that communities confront due to a convergence of multiple challenges and burdens using Zero-Hurdle Negative Binomial models. The results reveal that health, resilience, and transportation-disadvantaged tracts are associated with more fatal crashes. The study also found the presence of a higher percentage of the population with bachelor's degrees and increased use of public transportation are correlated with fewer fatal crashes. Also, a higher fatal crash rate is observed in disadvantaged census tracts where a high proportion of the Hawaiian or other Pacific Islander, and American Indian or Alaska Native populations live. This implies that targeted interventions can be explored further in tracts that show high correlations with fatal crashes. The findings contribute to traffic safety by highlighting the risks in DACs, which can help design and implement traffic safety interventions. The insights gained from this study can inform decision-making and help to guide the development of more equitable traffic safety programs in disadvantaged communities.
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Affiliation(s)
- A Latif Patwary
- Department of Civil and Environmental Engineering, University of Tennessee Knoxville, Knoxville, TN 37996, USA.
| | - Antora Mohsena Haque
- Department of Civil and Environmental Engineering, University of Tennessee Knoxville, Knoxville, TN 37996, USA.
| | - Iman Mahdinia
- Safe Transportation Research & Education Center, The University of California Berkeley, CA 94704, USA.
| | - Asad J Khattak
- Department of Civil and Environmental Engineering, University of Tennessee Knoxville, Knoxville, TN 37996, USA.
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Deb Nath N, Khan MM, Schmidt M, Njau G, Odoi A. Geographic disparities and temporal changes of COVID-19 incidence risks in North Dakota, United States. BMC Public Health 2023; 23:720. [PMID: 37081453 PMCID: PMC10116449 DOI: 10.1186/s12889-023-15571-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 03/30/2023] [Indexed: 04/22/2023] Open
Abstract
BACKGROUND COVID-19 is an important public health concern due to its high morbidity, mortality and socioeconomic impact. Its burden varies by geographic location affecting some communities more than others. Identifying these disparities is important for guiding health planning and service provision. Therefore, this study investigated geographical disparities and temporal changes of the percentage of positive COVID-19 tests and COVID-19 incidence risk in North Dakota. METHODS COVID-19 retrospective data on total number of tests and confirmed cases reported in North Dakota from March 2020 to September 2021 were obtained from the North Dakota COVID-19 Dashboard and Department of Health, respectively. Monthly incidence risks of the disease were calculated and reported as number of cases per 100,000 persons. To adjust for geographic autocorrelation and the small number problem, Spatial Empirical Bayesian (SEB) smoothing was performed using queen spatial weights. Identification of high-risk geographic clusters of percentages of positive tests and COVID-19 incidence risks were accomplished using Tango's flexible spatial scan statistic. ArcGIS was used to display and visiualize the geographic distribution of percentages of positive tests, COVID-19 incidence risks, and high-risk clusters. RESULTS County-level percentages of positive tests and SEB incidence risks varied by geographic location ranging from 0.11% to 13.67% and 122 to 16,443 cases per 100,000 persons, respectively. Clusters of high percentages of positive tests were consistently detected in the western part of the state. High incidence risks were identified in the central and south-western parts of the state, where significant high-risk spatial clusters were reported. Additionally, two peaks (August 2020-December 2020 and August 2021-September 2021) and two non-peak periods of COVID-19 incidence risk (March 2020-July 2020 and January 2021-July 2021) were observed. CONCLUSION Geographic disparities in COVID incidence risks exist in North Dakota with high-risk clusters being identified in the rural central and southwest parts of the state. These findings are useful for guiding intervention strategies by identifying high risk communities so that resources for disease control can be better allocated to communities in need based on empirical evidence. Future studies will investigate predictors of the identified disparities so as to guide planning, disease control and health policy.
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Affiliation(s)
- Nirmalendu Deb Nath
- Department of Biomedical and Diagnostic Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, TN, USA
| | - Md Marufuzzaman Khan
- Department of Public Health, College of Education, Health, and Human Sciences, University of Tennessee, Knoxville, TN, USA
| | - Matthew Schmidt
- North Dakota Department of Health and Human Services, Special Projects and Health Analytics, Bismarck, ND, USA
| | - Grace Njau
- North Dakota Department of Health and Human Services, Special Projects and Health Analytics, Bismarck, ND, USA
| | - Agricola Odoi
- Department of Biomedical and Diagnostic Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, TN, USA.
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Patwary AL, Khattak AJ. Crash harm before and during the COVID-19 pandemic: Evidence for spatial heterogeneity in Tennessee. ACCIDENT; ANALYSIS AND PREVENTION 2023; 183:106988. [PMID: 36724654 PMCID: PMC9874053 DOI: 10.1016/j.aap.2023.106988] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 09/19/2022] [Accepted: 01/23/2023] [Indexed: 05/05/2023]
Abstract
Major concerns have been raised about road safety during the COVID-19 pandemic in the US, as the crash fatalities have increased, despite the substantial reduction in traffic. However, a comprehensive analysis of safety-critical events on roadways based on a broader set of traffic safety metrics and their correlates is needed. In addition to fatalities, this study uses changes in total crashes and total monetary harm as additional measures of safety. A comprehensive and unique time-series database of crashes and socio-economic variables is created at the county level in Tennessee. Statistics show that while fatal crashes increase by 8.2%, total crashes decrease by 15.3%, and the total harm cost is lower by about $1.76 billion during COVID-19 (2020) compared with pre-COVID-19 conditions (2019). Several models, including generalized least squares linear, Poisson, and geographically weighted regression models using the differences between 2020 and 2019 values, are estimated to rigorously quantify the correlates of fatalities, crashes, and crash harm. The results indicate that compared to the pre-pandemic periods, fatal crashes that occurred during the pandemic are associated with more speeding & reckless behaviors and varied across jurisdictions. Fatal crashes are more likely to happen on interstates and dark-not-lighted roads and involve commercial trucks. These same factors largely contribute to crash harm. In addition, a greater number of long trips per person not staying home during COVID-19 is found to be associated with more crashes and crash harm. These results can inform policymaking to strengthen traffic law enforcement through appropriate countermeasures, such as the placement of warning signs and the reduction of the speed limit in hotspots.
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Affiliation(s)
- A Latif Patwary
- Department of Civil and Environmental Engineering, University of Tennessee, Knoxville, TN 37996, USA
| | - Asad J Khattak
- Department of Civil and Environmental Engineering, University of Tennessee, Knoxville, TN 37996, USA.
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Mohammadnazar A, Patwary AL, Moradloo N, Arvin R, Khattak AJ. Incorporating driving volatility measures in safety performance functions: Improving safety at signalized intersections. ACCIDENT; ANALYSIS AND PREVENTION 2022; 178:106872. [PMID: 36274543 DOI: 10.1016/j.aap.2022.106872] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 09/22/2022] [Accepted: 10/08/2022] [Indexed: 06/16/2023]
Abstract
About 40 percent of motor vehicle crashes in the US are related to intersections. To deal with such crashes, Safety Performance Functions (SPFs) are vital elements of the predictive methods used in the Highway Safety Manual. The predictions of crash frequencies and potential reductions due to countermeasures are based on exposure and geometric variables. However, the role of driving behavior factors, e.g., hard accelerations and declarations at intersections, which can lead to crashes, are not explicitly treated in SPFs. One way to capture driving behavior is to harness connected vehicle data and quantify performance at intersections in terms of driving volatility measures, i.e., rapid changes in speed and acceleration. According to recent studies, driving volatility is typically associated with higher risk and safety-critical events and can serve as a surrogate for driving behavior. This study incorporates driving volatility measures in the development of SPFs for four-leg signalized intersections. The Safety Pilot Model Deployment (SPMD) data containing over 125 million Basic Safety Messages generated by over 2,800 connected vehicles are harnessed and linked with the crash, traffic, and geometric data belonging to 102 signalized intersections in Ann Arbor, Michigan. The results show that including driving volatility measures in SPFs can reduce model bias and significantly enhances the models' goodness-of-fit and predictive performance. Technically, the best results were obtained by applying Bayesian hierarchical Negative Binomial Models, which account for spatial correlation between signalized intersections. The results of this study have implications for practitioners and transportation agencies about incorporating driving behavior factors in the development of SPFs for greater accuracy and measures that can potentially reduce volatile driving.
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Affiliation(s)
- Amin Mohammadnazar
- Department of Civil & Environmental Engineering, The University of Tennessee, Knoxville, USA
| | - A Latif Patwary
- Department of Civil & Environmental Engineering, The University of Tennessee, Knoxville, USA
| | - Nastaran Moradloo
- Department of Civil & Environmental Engineering, The University of Tennessee, Knoxville, USA
| | - Ramin Arvin
- Department of Civil & Environmental Engineering, The University of Tennessee, Knoxville, USA
| | - Asad J Khattak
- Department of Civil & Environmental Engineering, The University of Tennessee, Knoxville, USA.
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