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Riggs DW, Baumgartner KB, Baumgartner R, Boone S, Judd SE, Bhatnagar A. Long-term exposure to air pollution and risk of stroke by ecoregions: The REGARDS study. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2024; 345:123367. [PMID: 38280465 PMCID: PMC10996890 DOI: 10.1016/j.envpol.2024.123367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 01/11/2024] [Accepted: 01/14/2024] [Indexed: 01/29/2024]
Abstract
Several cohort studies have found associations between long-term exposure to air pollution and stroke risk. However, it is unclear whether the surrounding ecology may modify these associations. This study evaluates associations of air pollution with stroke risk by ecoregions, which are areas of similar type, quality, and quantity of environmental resources in the REasons for Geographic and Racial Differences in Stroke (REGARDS) study. We assessed the incidence of stroke in 26,792 participants (45+ yrs) from the REGARDS study, a prospective cohort recruited across the contiguous United States. One-yr and 3-yr means of PM2.5, PM10, O3, NO2, SO2, and CO were estimated at baseline using data from the Center for Air, Climate, & Energy Solution, and assigned to participants at the census block group level. Incident stroke was ascertained through September 30, 2020. Relations of air pollutants with the risk of incident stroke were estimated using Cox proportional hazards models, adjusting for relevant demographics, behavioral risk factors, and neighborhood urbanicity. Models were stratified by EPA designated ecoregions. A 5.4 μg/m3 (interquartile range) increase in 1-yr PM10 was associated with a hazard ratio (95 %CI) for incident stroke of 1.07 (1.003, 1.15) in the overall study population. We did not find evidence of positive associations for PM2.5, O3, NO2, SO2, and CO in the fully adjusted models. In our ecoregion-specific analysis, associations of PM2.5 with stroke were stronger in the Great Plains ecoregion (HR = 1.44) than other ecoregions, while associations for PM10 were strongest in the Eastern Temperate Forests region (HR = 1.15). The associations between long-term exposure to air pollution and risk of stroke varied by ecoregion. Our results suggests that the type, quality, and quantity of the surrounding ecology can modify the effects of air pollution on risk of stroke.
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Affiliation(s)
- Daniel W Riggs
- Christina Lee Brown Envirome Institute, University of Louisville, Louisville, KY, United States; Department of Epidemiology and Population Health, University of Louisville, Louisville, KY, United States.
| | - Kathy B Baumgartner
- Department of Epidemiology and Population Health, University of Louisville, Louisville, KY, United States
| | - Richard Baumgartner
- Department of Epidemiology and Population Health, University of Louisville, Louisville, KY, United States
| | - Stephanie Boone
- Department of Epidemiology and Population Health, University of Louisville, Louisville, KY, United States
| | - Suzanne E Judd
- Department of Biostatistics, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Aruni Bhatnagar
- Christina Lee Brown Envirome Institute, University of Louisville, Louisville, KY, United States
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Bailey RR, Miner N. Differences in health characteristics and health behaviors between rural and non-rural community-dwelling stroke survivors aged ≥65 years in the USA. BRAIN IMPAIR 2023; 24:521-528. [PMID: 38167358 DOI: 10.1017/brimp.2022.17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVES To examine differences in health characteristics and health behaviors between rural and non-rural stroke survivors in the USA. METHODS Data were extracted from the 2017 and 2019 Behavioral Risk Factor Surveillance System (BRFSS) to compare prevalences of health characteristics (i.e., diabetes, disability, poor health, high cholesterol, hypertension, no health care coverage, weight status) and health behaviors (i.e., fruit consumption, vegetable consumption, physical inactivity, high alcohol consumption, smoking) among community-dwelling stroke survivors, stratified by rural status (i.e., rural vs. non-rural). Logistic regression was used to calculate odds ratios (ORs) for health characteristics and health behaviors to examine the association of rural status with each variable of interest (reference group=non-rural). RESULTS Data from 14,599 respondents (rural: n = 5,039; non-rural: n = 9,560) were available for analysis. The majority of respondents were female (61.4%), non-Hispanic white (83.2%), previously married (56.1%), had at least some college education (55.2%), and had an annual household income ≥USD $25,000 (56.9%). Prevalences of disability, poor health, weekly aerobic exercise, and smoking were higher among rural respondents compared to non-rural respondents. Logistic regression showed increased odds (odds ratio range: 1.1-1.2) for these variables among rural respondents; however, odds ratios were attenuated after controlling for sociodemographic and health characteristics. CONCLUSIONS We did not find evidence of differences in the investigated health characteristics and health behaviors between rural and non-rural community-dwelling stroke survivors in the USA. Additional research is needed to confirm these findings and to identify alternative sociodemographic and health factors that may differ between rural and non-rural community-dwelling stroke survivors.
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Affiliation(s)
- Ryan R Bailey
- Department of Occupational and Recreational Therapies, College of Health, University of Utah, 520 Wakara Way, Salt Lake City, UT, 84108, USA
| | - Natalie Miner
- Department of Occupational and Recreational Therapies, College of Health, University of Utah, 520 Wakara Way, Salt Lake City, UT, 84108, USA
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Ding X, Ding R, Chen L, Jiao Y, Xu J, Zhang G, Wang Q, Xie J, Gao Y, Yang X. The Epidemic Characteristics of Stroke Death from 2012 to 2021 in Chongqing, China. Cerebrovasc Dis 2023; 53:198-204. [PMID: 37437549 DOI: 10.1159/000531488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 05/29/2023] [Indexed: 07/14/2023] Open
Abstract
INTRODUCTION Stroke has become a major disease that threatens the global population's health and is a major public health problem that needs to be solved in China. Therefore, it is essential to analyze the trend of the mortality of stroke and its epidemic characteristic of stroke death. METHODS Death cases of stroke were reported to the national death registry system by the medical staff of all medical institutions, and the population data every year were obtained from District or County's Statistic Bureau in Chongqing. They were analyzed to calculate the mortality, age-standardized mortality rate by Chinese standardization population (ASMRC), age-specific mortality, proportion, and annual percent of change (APC) according to the ICD-10 code. ASMRC was based on the standard population of the 6th census in China, 2010. The stroke mortality of each subgroup was compared using the χ2 test. Trend analysis was presented by APC. RESULTS The crude mortality of stroke increased from 96.29 per 100,000 in 2012 to 115.93 per 100,000 significantly, with the APC of 2.02% (t = 2.82, p = 0.022) in Chongqing. ASMRC of stroke was 56.47 per 100,000 in 2012 and 54.70 per 100,000 in 2021, and its trend change was stable (APC = -0.01, t = 0.07, p = 0.947). The crude mortality of stroke in males was higher than that in females every year (p < 0.05). The death proportion of intracerebral hemorrhage dwindled from 60.53% in 2012 to 49.88% in 2021, whereas the death proportion of ischemic stroke increased from 20.92% in 2012 to 39.96% in 2021. The average age of stroke death was delayed from 73.43 years old in 2012 to 76.52 years old in 2021 significantly (t = 18.12, p < 0.001). The percentage of stroke death at home increased from 75.23% in 2012 to 79.23% in 2021, while the percentage of stroke death at hospitals decreased from 17.89% in 2012 to 15.89% in 2021. CONCLUSION The crude mortality of stroke surged, and intracerebral hemorrhage was the main death cause of all subtypes. The mortality of stroke in males and rural residents was higher than that in females and urban residents. Most stroke deaths occurred at home. Male and rural residents were crucial populations for stroke prevention and control. There should be improved medical resources in rural areas and enhanced capability of stroke diagnosis and treatment.
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Affiliation(s)
- Xianbin Ding
- Chongqing Municipal Center for Disease Control and Prevention, Chongqing, China
| | - Rui Ding
- First Medical College, Chongqing Medical University, Chongqing, China
| | - Liling Chen
- Chongqing Municipal Center for Disease Control and Prevention, Chongqing, China
| | - Yan Jiao
- Chongqing Municipal Center for Disease Control and Prevention, Chongqing, China
| | - Jie Xu
- Chongqing Municipal Center for Disease Control and Prevention, Chongqing, China
| | - Guiting Zhang
- Chongqing Municipal Center for Disease Control and Prevention, Chongqing, China
| | - Qiuting Wang
- Medical and Social Development Research Center, School of Public Health and Management, Chongqing Medical University, Chongqing, China
| | - Jiaxi Xie
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Yang Gao
- Chongqing Municipal Center for Disease Control and Prevention, Chongqing, China
| | - Xianxian Yang
- Chongqing Municipal Center for Disease Control and Prevention, Chongqing, China
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Liu X, Zhang Z, Lin B, Guo Y, Mei Y, Ping Z, Wang W, Jiang H, Wang S, Zhang C, Chen S, Zhang Q. Relationship between perceptions of recurrence risk and depression state among first-episode ischemic stroke patients in rural areas: The mediating role of coping style. Nurs Open 2023; 10:4515-4525. [PMID: 37014075 PMCID: PMC10277436 DOI: 10.1002/nop2.1695] [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: 08/14/2022] [Revised: 01/05/2023] [Accepted: 02/14/2023] [Indexed: 04/05/2023] Open
Abstract
AIMS To investigate the relationship between stroke survivors' perceptions of recurrence risk, coping styles and depression state, and the role coping styles play in mediating that relationship. DESIGN A cross-sectional descriptive study. METHODS From one hospital in Huaxian, China, 320 stroke survivors were randomly selected as a convenience sample. In this research, the Simplified Coping Style Questionnaire, the Patient Health Questionnaire-9 and the Stroke Recurrence Risk Perception Scale were all used. Structural equation modelling and correlation analysis were used to analyse the data. This research followed the EQUATOR and STROBE checklists. RESULTS There were 278 valid survey responses. There were mild to severe depressive symptoms in 84.8% of stroke survivors. In stroke survivors, there was a significant negative relationship (p < 0.01) between the positive coping of perceptions of recurrence risk and their depression state. Recurrence risk perception's impact on depression state was partly mediated, according to mediation studies, by coping style, with the mediation effect accounting for 44.92% of the overall effect. CONCLUSIONS The connection between perceptions of recurrence risk and depression state was mediated by the coping mechanisms of stroke survivors. A lower degree of depression state among survivors was connected with positive coping to the beliefs of recurrence risk.
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Affiliation(s)
- Xueting Liu
- Nursing and Health School, Zhengzhou University, Zhengzhou City, Henan Province, China
| | - Zhenxiang Zhang
- Nursing and Health School, Zhengzhou University, Zhengzhou City, Henan Province, China
| | - Beilei Lin
- Nursing and Health School, Zhengzhou University, Zhengzhou City, Henan Province, China
- Academic of Medical Science, Zhengzhou University, Zhengzhou City, Henan Province, China
| | - Yunfei Guo
- Henan Provincial People's Hospital, Zhengzhou University People's Hospital, Zhengzhou City, China
| | - Yongxia Mei
- Nursing and Health School, Zhengzhou University, Zhengzhou City, Henan Province, China
| | - Zhiguang Ping
- School of Public Health, Zhengzhou University, Zhengzhou City, China
| | - Wenna Wang
- Nursing and Health School, Zhengzhou University, Zhengzhou City, Henan Province, China
| | - Hu Jiang
- Nursing and Health School, Zhengzhou University, Zhengzhou City, Henan Province, China
| | - Shaoyang Wang
- The Second Affiliated Hospital, Zhengzhou University, Zhengzhou City, China
| | - Chunhui Zhang
- Nursing and Health School, Zhengzhou University, Zhengzhou City, Henan Province, China
| | - Suyan Chen
- Nursing and Health School, Zhengzhou University, Zhengzhou City, Henan Province, China
| | - Qiushi Zhang
- Nursing and Health School, Zhengzhou University, Zhengzhou City, Henan Province, China
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Ren H, Guo YF, Zhang ZX, Lin BL, Mei YX, Wang WN, Luan WY, Zhang XY, Liang LL, Xue LH. Perception of recurrent risk versus objective measured risk of ischemic stroke in first-ever stroke patients from a rural area in China: A cross-sectional study. PATIENT EDUCATION AND COUNSELING 2023; 107:107586. [PMID: 36495680 DOI: 10.1016/j.pec.2022.107586] [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: 06/07/2022] [Revised: 11/22/2022] [Accepted: 11/30/2022] [Indexed: 06/17/2023]
Abstract
OBJECTIVE Risk perception is critical to the formation of individual health prevention behaviors. A long-term accurate perception of stroke recurrent risks is imperative for stroke secondary prevention. This study aims to explore the level of recurrence risk perceptions and the influential factors of inaccuracy between perceived and objective risk in first-ever ischemic stroke patients from a rural area. METHODS From May to November 2020, 284 first-ever ischemic stroke patients were conveniently recruited in a rural area of Henan Province, China. Perceived risk was measured based on self-reported using a numerical rating scale, whereas the objective risk was measured by the Essen Stroke Risk Score. Patients' perceived risk was compared with their objective risk and categorized as "Accurate," "Underestimated," and "Overestimated." The influencing factors of inaccuracy were further evaluated using multivariate regression analyses. RESULTS 46% of the participants underestimated their stroke risk, while 15.9% overestimated their risks. Patients who were younger (≤65 years), didn't worry about recurrent stroke, and had a low actual recurrent risk were more likely to underestimate their recurrent risk. Patients who were employed, had lower independence, and had greater anxiety were more likely to overestimate their recurrent risk. CONCLUSIONS The majority of participants were unable to accurately perceive their own risk of stroke recurrence. Patients' age, working status, worry about recurrent stroke, actual recurrent risk, level of dependence, and anxiety played a role in perception inaccuracy. PRACTICE IMPLICATIONS The findings could help healthcare providers gain a better understanding of the level and accuracy of recurrence risk perceptions among first-ever stroke patients in the rural area. Future counseling on the perceived risk of stroke recurrence and individual objective risk assessment could be conducted to help patients better understand their risk of recurrence. Individualized risk communication and multidisciplinary teamwork can be developed to improve the accuracy of recurrence risk perceptions and health behaviors.
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Affiliation(s)
- Hui Ren
- School of Nursing and Health, Zhengzhou University, No. 100 Science Avenue of Zhengzhou City, Henan, PR China.
| | - Yun-Fei Guo
- Henan provincial people's Hospital, Zhengzhou, Henan, PR China.
| | - Zhen-Xiang Zhang
- School of Nursing and Health, Zhengzhou University, No. 100 Science Avenue of Zhengzhou City, Henan, PR China.
| | - Bei-Lei Lin
- School of Nursing and Health, Zhengzhou University, No. 100 Science Avenue of Zhengzhou City, Henan, PR China.
| | - Yong-Xia Mei
- School of Nursing and Health, Zhengzhou University, No. 100 Science Avenue of Zhengzhou City, Henan, PR China.
| | - Wen-Na Wang
- School of Nursing and Health, Zhengzhou University, No. 100 Science Avenue of Zhengzhou City, Henan, PR China.
| | - Wen-Yan Luan
- School of Nursing and Health, Zhengzhou University, No. 100 Science Avenue of Zhengzhou City, Henan, PR China.
| | - Xin-Yue Zhang
- School of Nursing and Health, Zhengzhou University, No. 100 Science Avenue of Zhengzhou City, Henan, PR China.
| | - Li-Li Liang
- Nanyang University of Technology, Nanyang, PR China.
| | - Li-Hong Xue
- Huaxian People's Hospital, Anyang, Henan, PR China.
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Ding Z, Zhang L, Niu M, Zhao B, Liu X, Huo W, Hou J, Mao Z, Wang Z, Wang C. Stroke prevention in rural residents: development of a simplified risk assessment tool with artificial intelligence. Neurol Sci 2023; 44:1687-1694. [PMID: 36653543 DOI: 10.1007/s10072-023-06610-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Accepted: 01/08/2023] [Indexed: 01/20/2023]
Abstract
BACKGROUND Limited studies have focused on the risk assessment of stroke in rural regions. Moreover, the application of artificial intelligence in stroke risk scoring system is still insufficient. This study aims to develop a simplified and visualized risk score with good performance and convenience for rural stroke risk assessment, which is combined with a machine learning (ML) algorithm. METHODS Participants of the Henan Rural Cohort were enrolled in this study. The total participants (n = 38,322) were randomly split into a train set and a test set in the ratio of 7:3. An ML algorithm was used to select variables and the logistic regression was then applied to construct the scoring system. The C-statistic and the Brier score (BS) were used to evaluate the discrimination and calibration. The Framingham stroke risk profile (FSRP) and the self-reported stroke risk function (SRSRF) were chosen to be compared. RESULTS The Rural Stroke Risk Score (RSRS) was produced in this study, including age, drinking status, triglyceride, type 2 diabetes mellitus, hypertension, waist circumference, and family history of stroke. On validation, the C-statistic was 0.757 (95% CI 0.749-0.765) and the BS was 0.058 in the test set. In addition, the discrimination of RSRS was 6.02% and 7.34% higher than that of the FSRP and SRSRF, respectively. CONCLUSIONS A well-performed scoring system for assessing stroke risk in rural residents was developed in this study. This risk score would facilitate stroke screening and the prevention of cardiovascular disease in economically underdeveloped areas.
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Affiliation(s)
- Zhongao Ding
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Henan, 450001, Zhengzhou, People's Republic of China
| | - Liying Zhang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Henan, 450001, Zhengzhou, People's Republic of China
- Department of Software Engineering, School of Computer and Artificial Intelligence, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Miaomiao Niu
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Henan, 450001, Zhengzhou, People's Republic of China
| | - Bo Zhao
- Department of Statistics, University of Illinois at Urbana-Champaign, Champaign, IL, USA
| | - Xiaotian Liu
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Henan, 450001, Zhengzhou, People's Republic of China
| | - Wenqian Huo
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Henan, 450001, Zhengzhou, People's Republic of China
| | - Jian Hou
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Henan, 450001, Zhengzhou, People's Republic of China
| | - Zhenxing Mao
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Henan, 450001, Zhengzhou, People's Republic of China
| | - Zhenfei Wang
- Department of Software Engineering, School of Computer and Artificial Intelligence, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Chongjian Wang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Henan, 450001, Zhengzhou, People's Republic of China.
- NHC Key Laboratory of Prevention and Treatment of Cerebrovascular Diseases, Zhengzhou, Henan, People's Republic of China.
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Ariss RW, Minhas AMK, Lang J, Ramanathan PK, Khan SU, Kassi M, Warraich HJ, Kolte D, Alkhouli M, Nazir S. Demographic and Regional Trends in Stroke-Related Mortality in Young Adults in the United States, 1999 to 2019. J Am Heart Assoc 2022; 11:e025903. [PMID: 36073626 DOI: 10.1161/jaha.122.025903] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background Despite improvements in the management and prevention of stroke, increasing hospitalizations for stroke and stagnant mortality rates have been described in young adults. However, there is a paucity of contemporary national mortality estimates in young adults. Methods and Results Trends in mortality related to stroke in young adults (aged 25-64 years) were assessed using the Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research database. Age-adjusted mortality rates per 100 000 people with associated annual percentage change were calculated. Joinpoint regression was used to assess the trends in the overall sample and different demographic (sex, race and ethnicity, and age) and geographical (state, urban-rural, and regional) subgroups. Between 1999 and 2019, a total of 566 916 stroke-related deaths occurred among young adults. After the initial decline in mortality in the overall population, age-adjusted mortality rate increased from 2013 to 2019 with an associated annual percentage change of 1.5 (95% CI, 1.1-2.0). Mortality rates were higher in men versus women and in non-Hispanic Black people versus individuals of other races and ethnicities. Non-Hispanic American Indian or Alaskan Native people had a marked increase in stroke-related mortality (annual percentage change 2010-2019: 3.3). Furthermore, rural (nonmetropolitan) counties experienced the greatest increase in mortality (annual percentage change 2012-2019: 3.1) compared with urban (metropolitan) counties. Conclusions Following the initial decline in stroke-related mortality, young adults have experienced increasing mortality rates from 2013 to 2019, with considerable differences across demographic groups and regions.
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Affiliation(s)
- Robert W Ariss
- Division of Cardiovascular Medicine University of Toledo Medical Center Toledo OH.,ProMedica Heart and Vascular Institute, ProMedica Toledo Hospital Toledo OH.,Department of Medicine Brigham and Women's Hospital, Harvard Medical School Boston MA
| | | | - Jacob Lang
- Division of Cardiovascular Medicine University of Toledo Medical Center Toledo OH
| | - P Kasi Ramanathan
- ProMedica Heart and Vascular Institute, ProMedica Toledo Hospital Toledo OH
| | - Safi U Khan
- Department of Cardiology Houston Methodist DeBakey Heart and Vascular Center Houston TX
| | - Mahwash Kassi
- Department of Cardiology Houston Methodist DeBakey Heart and Vascular Center Houston TX
| | - Haider J Warraich
- Division of Cardiovascular Medicine Brigham and Women's Hospital Boston MA.,Cardiology Section, Department of Medicine VA Boston Healthcare System Boston MA
| | - Dhaval Kolte
- Cardiology Division Massachusetts General Hospital and Harvard Medical School Boston MA
| | | | - Salik Nazir
- Division of Cardiovascular Medicine University of Toledo Medical Center Toledo OH.,ProMedica Heart and Vascular Institute, ProMedica Toledo Hospital Toledo OH.,Section of Cardiology Baylor College of Medicine Houston TX
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Stroke Risk Prediction with Machine Learning Techniques. SENSORS 2022; 22:s22134670. [PMID: 35808172 PMCID: PMC9268898 DOI: 10.3390/s22134670] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 06/16/2022] [Accepted: 06/20/2022] [Indexed: 01/25/2023]
Abstract
A stroke is caused when blood flow to a part of the brain is stopped abruptly. Without the blood supply, the brain cells gradually die, and disability occurs depending on the area of the brain affected. Early recognition of symptoms can significantly carry valuable information for the prediction of stroke and promoting a healthy life. In this research work, with the aid of machine learning (ML), several models are developed and evaluated to design a robust framework for the long-term risk prediction of stroke occurrence. The main contribution of this study is a stacking method that achieves a high performance that is validated by various metrics, such as AUC, precision, recall, F-measure and accuracy. The experiment results showed that the stacking classification outperforms the other methods, with an AUC of 98.9%, F-measure, precision and recall of 97.4% and an accuracy of 98%.
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Higgins ST. Behavior change, health, and health disparities 2021: Rural addiction and health. Prev Med 2021; 152:106834. [PMID: 34626647 PMCID: PMC9258004 DOI: 10.1016/j.ypmed.2021.106834] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 10/04/2021] [Indexed: 10/20/2022]
Abstract
This Special Issue of Preventive Medicine (PM) is the 8th in a series on behavior change, health, and health disparities. This is a topic of critical importance to improving U.S. population health. There is broad consensus that personal behavior patterns or lifestyle such as substance abuse, poor food choices, physical inactivity, and non-adherence with medical regimens are among the most important modifiable causes of chronic disease and premature death and contributors to recent decreases in U.S. longevity. While no U.S region is free of these problems, they disproportionately impact rural communities. As in prior Special Issues in this series, we devote considerable space to the ongoing U.S. opioid epidemic while also examining selected issues in rural health disparities involving tobacco use, cancer, and cardiovascular disease. Across each of these topics we have recruited contributions from accomplished investigators, clinicians, and policymakers to acquaint readers with recent advances while also noting knowledge gaps and unresolved challenges.
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Affiliation(s)
- Stephen T Higgins
- Vermont Center on Behavior and Health, Departments of Psychiatry and Psychological Science, University of Vermont, USA.
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