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Andrews L, Benken S, Tan X, Wenzler E. Pharmacokinetics and dialytic clearance of apixaban during in vitro continuous renal replacement therapy. BMC Nephrol 2021; 22:45. [PMID: 33516188 PMCID: PMC7847018 DOI: 10.1186/s12882-021-02248-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Accepted: 01/19/2021] [Indexed: 12/26/2022] Open
Abstract
Background To evaluate the transmembrane clearance (CLTM) of apixaban during modeled in vitro continuous renal replacement therapy (CRRT), assess protein binding and circuit adsorption, and provide initial dosing recommendations. Methods Apixaban was added to the CRRT circuit and serial pre-filter bovine blood samples were collected along with post-filter blood and effluent samples. All experiments were performed in duplicate using continuous veno-venous hemofiltration (CVVH) and hemodialysis (CVVHD) modes, with varying filter types, flow rates, and point of CVVH replacement fluid dilution. Concentrations of apixaban and urea were quantified via liquid chromatography-tandem mass spectrometry. Plasma pharmacokinetic parameters for apixaban were estimated via noncompartmental analysis. CLTM was calculated via the estimated area under the curve (AUC) and by the product of the sieving/saturation coefficient (SC/SA) and flow rate. Two and three-way analysis of variance (ANOVA) models were built to assess the effects of mode, filter type, flow rate, and point of dilution on CLTM by each method. Optimal doses were suggested by matching the AUC observed in vitro to the systemic exposure demonstrated in Phase 2/3 studies of apixaban. Linear regression was utilized to provide dosing estimations for flow rates from 0.5–5 L/h. Results Mean adsorption to the HF1400 and M150 filters differed significantly at 38 and 13%, respectively, while mean (± standard deviation, SD) percent protein binding was 70.81 ± 0.01%. Effect of CVVH point of dilution did not differ across filter types, although CLTM was consistently significantly higher during CRRT with the HF1400 filter compared to the M150. The three-way ANOVA demonstrated improved fit when CLTM values calculated by AUC were used (adjusted R2 0.87 vs. 0.52), and therefore, these values were used to generate optimal dosing recommendations. Linear regression revealed significant effects of filter type and flow rate on CLTM by AUC, suggesting doses of 2.5–7.5 mg twice daily (BID) may be needed for flow rates ranging from 0.5–5 L/h, respectively. Conclusion For CRRT flow rates most commonly employed in clinical practice, the standard labeled 5 mg BID dose of apixaban is predicted to achieve target systemic exposure thresholds. The safety and efficacy of these proposed dosing regimens warrants further investigation in clinical studies. Supplementary Information The online version contains supplementary material available at 10.1186/s12882-021-02248-7.
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Affiliation(s)
- Lauren Andrews
- College of Pharmacy, University of Illinois at Chicago, 833 South Wood Street, Room 164 (M/C 886),, Chicago, IL, 60612, USA
| | - Scott Benken
- College of Pharmacy, University of Illinois at Chicago, 833 South Wood Street, Room 164 (M/C 886),, Chicago, IL, 60612, USA
| | - Xing Tan
- College of Pharmacy, University of Illinois at Chicago, 833 South Wood Street, Room 164 (M/C 886),, Chicago, IL, 60612, USA
| | - Eric Wenzler
- College of Pharmacy, University of Illinois at Chicago, 833 South Wood Street, Room 164 (M/C 886),, Chicago, IL, 60612, USA.
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Zhang Q, Han J, Zhang Y, Li C, Chen P, Zhang J, Zeng K. Study on the psychological health and related risk factors in 245 patients with psoriasis in Inner Mongolia. PSYCHOL HEALTH MED 2019; 24:769-780. [PMID: 30784297 DOI: 10.1080/13548506.2019.1574352] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
To investigate the psychological health and related risk factors in patients suffering from psoriasis. A total of 245 inpatients and outpatients with psoriasis were selected from January 2014 to December 2015. Patients with psoriasis were assessed a homemade questionnaire as well as the Psoriasis Area and Severity Index (PASI), Selfrating Anxiety Scale, Self-rating Depression Scale, Trait Coping Style Questionnaire and Social Avoidance and Distress Scale.Differences in sex, age, marital status, type of medical payment, occupation, economic situation, disease severity, and type of psychological state of psoriasis patients were significant, there was no significant difference in psychological health between psoriasis patients with different levels of educational attainment. Scores for anxiety, depression, social avoidance, and social distress were positively correlated with disease severity and negative-coping scores, but a significant negative correlation was observed with scores for social support and positive coping. Stepwise regression analysis of factors influencing psychological health showed that total social support and negative-coping scores could explain 65.2% of the variation. Patients with psoriasis can suffer from anxiety, depression, social distress, and social avoidance. Physicians should pay greater attention to deterioration in mental health of psoriasis patients.
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Affiliation(s)
- Qiang Zhang
- a Department of Dermatology , Nanfang Hospital of Southern Medical University , Guangdong , China
| | - Jianwen Han
- a Department of Dermatology , Nanfang Hospital of Southern Medical University , Guangdong , China
| | - Yan Zhang
- a Department of Dermatology , Nanfang Hospital of Southern Medical University , Guangdong , China
| | - Changxing Li
- a Department of Dermatology , Nanfang Hospital of Southern Medical University , Guangdong , China
| | - Pingjiao Chen
- a Department of Dermatology , Nanfang Hospital of Southern Medical University , Guangdong , China
| | - Jing Zhang
- a Department of Dermatology , Nanfang Hospital of Southern Medical University , Guangdong , China
| | - Kang Zeng
- a Department of Dermatology , Nanfang Hospital of Southern Medical University , Guangdong , China
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Anderson RT, Peres LC, Camacho F, Bandera EV, Funkhouser E, Moorman PG, Paddock LE, Peters ES, Abbott SE, Alberg AJ, Barnholtz-Sloan J, Bondy M, Cote ML, Schwartz AG, Terry P, Schildkraut JM. Individual, Social, and Societal Correlates of Health-Related Quality of Life Among African American Survivors of Ovarian Cancer: Results from the African American Cancer Epidemiology Study. J Womens Health (Larchmt) 2019; 28:284-293. [PMID: 30307782 PMCID: PMC6909765 DOI: 10.1089/jwh.2018.7025] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVE While the incidence of epithelial ovarian cancer (EOC) is lower among African American (AA) women compared with European American (EA) women, AA women have markedly worse outcomes. In this study, we describe individual, social, and societal factors in health-related quality of life (HRQL) in AA women diagnosed with EOC in the African American Cancer Epidemiology Study (AACES) that we hypothesize may influence a patient's capacity to psychosocially adjust to a diagnosis of cancer. METHODS There were 215 invasive EOC cases included in the analysis. HRQL was measured using the SF-8 component scores for physical (PCS) and mental (MCS) health. We used least squares regression to test the effects of individual dispositional factors (optimism and trait anxiety); social level (perceived social support); and societal-level factors (SES defined as low family income and low educational attainment, and perceived discrimination) on HRQL, while adjusting for patient age, tumor stage, body mass index, and comorbidity. Mediation analysis was applied to test whether social support and physical activity buffer impacts of EOC on HRQL. RESULTS Optimism, trait anxiety, social support, poverty, and past perceived discrimination were significantly associated with HRQL following diagnosis of EOC. Specifically, higher family income, lower phobic anxiety, and higher social support were associated with better wellbeing on the MCS and PCS (p < 0.01). Higher perceived discrimination was associated with both lower MCS and PCS, whereas higher optimism was associated with higher MCS. Physical activity (MET-min/week) and social support displayed significant overall mediation for effects of SES on MCS and PCS, but not for trait anxiety. CONCLUSIONS Both pre- and postdiagnosis characteristics of AA women with EOC are important predictors of HRQL after cancer diagnosis. Individual, social, and societal-level factors each contribute to HRQL status with EOC and should be assessed.
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Affiliation(s)
- Roger T. Anderson
- Department of Public Health Sciences, University of Virginia, Charlottesville, Virginia
| | - Lauren C. Peres
- Department of Public Health Sciences, University of Virginia, Charlottesville, Virginia
| | - Fabian Camacho
- Department of Public Health Sciences, University of Virginia, Charlottesville, Virginia
| | - Elisa V. Bandera
- Department of Population Science, Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey
| | - Ellen Funkhouser
- Division of Preventive Medicine, University of Alabama at Birmingham, Birmingham, Alabama
| | - Patricia G. Moorman
- Department of Community and Family Medicine, Duke University Medical Center, Durham, North Carolina
| | - Lisa E. Paddock
- Cancer Surveillance Research Program, New Jersey State Cancer Registry, Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey
| | - Edward S. Peters
- Epidemiology Program, Louisiana State University Health Sciences Center, School of Public Health, New Orleans, Louisiana
| | - Sarah E. Abbott
- Department of Public Health Sciences, University of Virginia, Charlottesville, Virginia
| | - Anthony J. Alberg
- Department of Epidemiology, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
- Department of Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
| | - Jill Barnholtz-Sloan
- Case Comprehensive Cancer Center, Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Melissa Bondy
- Cancer Prevention and Population Sciences Program, Baylor College of Medicine, Houston, Texas
| | - Michele L. Cote
- Karmanos Cancer Institute Population Studies and Disparities Research Program, Department of Oncology, Wayne State University, Detroit, Michigan
| | - Ann G. Schwartz
- Karmanos Cancer Institute Population Studies and Disparities Research Program, Department of Oncology, Wayne State University, Detroit, Michigan
| | - Paul Terry
- Department of Medicine, University of Tennessee Medical Center-Knoxville, Knoxville, Tennessee
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Richter VC, Coelho M, Arantes EDC, Dessotte CAM, Schmidt A, Dantas RAS, Rossi LA, Furuya RK. Health status and mental health in patients after percutaneous coronary intervention. Rev Bras Enferm 2015; 68:589-95, 676-82. [PMID: 26422040 DOI: 10.1590/0034-7167.2015680415i] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE to assess the association between perceived health status and the mental health of patients submitted to percutaneous coronary intervention after hospital discharge. METHOD a quantitative and cross-sectional study involving 101 participants. The following instruments were used: a sociodemographic and clinical characterization instrument, the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36), and the Hospital Anxiety and Depression Scale (HADS). Participants were divided into three groups: no anxiety and no depression (G1); anxiety or depression (G2); and both (G3). The ANOVA test was used for the intergroup comparison of means on the SF-36 domains. RESULTS There was an association between perceived health status and mental health. The participants in G1 presented higher scores in all SF-36 domains in comparison with participants in G2 and G3. CONCLUSION Participants with no anxiety and depression presented better-perceived health status in comparison with those with anxiety or depression, or both.
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Affiliation(s)
- Vitor Cesar Richter
- Curso de Enfermagem, Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, BR
| | - Mariana Coelho
- Curso de Enfermagem, Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, BR
| | - Eliana de Cássia Arantes
- Programa de Pós-Graduação em Enfermagem Fundamental, Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, BR
| | - Carina Aparecida Marosti Dessotte
- Departamento de Enfermagem Geral e Especializada, Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, BR
| | - André Schmidt
- Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, BR
| | - Rosana Aparecida Spadoti Dantas
- Departamento de Enfermagem Geral e Especializada, Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, BR
| | - Lídia Aparecida Rossi
- Departamento de Enfermagem Geral e Especializada, Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, BR
| | - Rejane Kiyomi Furuya
- Programa de Pós-Graduação Interunidades de Doutoramento em Enfermagem, Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, BR
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Furuya RK, Costa EDCA, Coelho M, Richter VC, Dessotte CAM, Schmidt A, Dantas RAS, Rossi LA. [Anxiety and depression among men and women who underwent percutaneous coronary intervention]. Rev Esc Enferm USP 2014; 47:1333-7. [PMID: 24626358 DOI: 10.1590/s0080-623420130000600012] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2012] [Accepted: 09/27/2013] [Indexed: 11/22/2022] Open
Abstract
A descriptive, cross-sectional, correlational study aimed to investigate the association of sex and the presence of anxiety and depression after hospital discharge in patients who underwent percutaneous coronary intervention (PCI). Fifty-nine patients undergoing PCI and receiving outpatient treatment in the first seven months after hospital discharge were evaluated. To assess the symptoms of anxiety and depression the Hospital Anxiety and Depression Scale (HADS) was used. To test the possible associations between the variables anxiety, depression and sex the Chi-square test was used with a significance level of 5%. The results indicated a greater number of women with depression and the association between the variables sex and depression was statistically significant. In relation to anxiety, cases were more frequent in males and the association between the variables sex and anxiety was not statistically significant.
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Affiliation(s)
- Rejane Kiyomi Furuya
- Escola de Enfermagem, Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo, Brasil, Ribeirão PretoSP, Enfermeira. Doutoranda, Programa Interunidades, Escola de Enfermagem , Escola de Enfermagem de Ribeirão Preto , Universidade de São Paulo , Ribeirão Preto , SP , Brasil
| | - Eliana de Cássia Arantes Costa
- Universidade de Franca, Brasil, SP, Terapeuta Ocupacional. Especialista em Saúde Pública, Universidade de Franca , SP , Brasil
| | - Mariana Coelho
- Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo, Brasil, Ribeirão PretoSP, Graduanda em Enfermagem, Escola de Enfermagem de Ribeirão Preto , Universidade de São Paulo , Ribeirão Preto , SP , Brasil
| | - Vitor César Richter
- Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo, Brasil, Ribeirão PretoSP, Graduando em Enfermagem, Escola de Enfermagem de Ribeirão Preto , Universidade de São Paulo , Ribeirão Preto , SP , Brasil
| | - Carina Aparecida Marosti Dessotte
- Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo, Brasil, Ribeirão PretoSP, Enfermeira. Doutora em Enfermagem, Escola de Enfermagem de Ribeirão Preto , Universidade de São Paulo , Ribeirão Preto , SP , Brasil
| | - André Schmidt
- Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Brasil, Ribeirão PretoSP, Médico. Professor Doutor, Faculdade de Medicina de Ribeirão Preto , Universidade de São Paulo , Ribeirão Preto , SP , Brasil
| | - Rosana Aparecida Spadoti Dantas
- Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo, Brasil, Ribeirão PretoSP, Enfermeira. Professora Associada, Escola de Enfermagem de Ribeirão Preto , Universidade de São Paulo , Ribeirão Preto , SP , Brasil
| | - Lídia Aparecida Rossi
- Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo, Brasil, Ribeirão PretoSP, Enfermeira. Professora Titular, Escola de Enfermagem de Ribeirão Preto , Universidade de São Paulo , Ribeirão Preto , SP , Brasil
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Relation of depression, anxiety, and quality of life with outcome after percutaneous transluminal coronary angioplasty. ScientificWorldJournal 2013; 2013:465979. [PMID: 24319368 PMCID: PMC3844159 DOI: 10.1155/2013/465979] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2013] [Accepted: 09/26/2013] [Indexed: 11/18/2022] Open
Abstract
Background. Despite, increasing number of percutaneous transluminal coronary angioplasty (PTCA) being performed, there is a paucity of Indian studies on the psychological effects of PTCA. Aim. To study the relation of anxiety, depression, and health related quality of life with outcome after PTCA. Methods. A total of 35 patients undergoing PTCA were included in the present project with their informed consent. All patients filled a specially designed proforma, the Hospital Anxiety and Depression Scale, Coronary Scale, Seattle Angina Questionnaire, and a health related quality of life measure (EQ 5D) one day before undergoing PTCA. Three days after PTCA patients were reassessed with the Hospital anxiety & depression scale, Seattle angina questionnaire and the EQ 5D. Results. Analysis showed that 46% had significant anxiety and 32.1% had significant depression before PTCA. Following successful PTCA, none of the patients had significant anxiety, and only 2 (3.6%) had significant depression. On the Seattle Angina Questionnaire, physical limitation reduced from 67.9 to 48. Disease perception improved from 21.2 to 37.1. On the EQ5D, the health status improved from 42.7 before PTCA to 78.7 after PTCA. Conclusion. Successful PTCA resulted in significant reduction in anxiety, depression, and physical limitation and improvement in disease perception and health status.
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Cassar S, Baldacchino DR. Quality of life after percutaneous coronary intervention: part 2. ACTA ACUST UNITED AC 2012; 21:1125-30. [DOI: 10.12968/bjon.2012.21.19.1125] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
| | - Donia R Baldacchino
- Faculty of Health Sciences, University of Malta, Malta; Visiting Fellow, University of Glamorgan, Wales; Adjunct Faculty Member, Johns Hopkins University, Baltimore
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Janowski K, Steuden S, Pietrzak A, Krasowska D, Kaczmarek L, Gradus I, Chodorowska G. Social support and adaptation to the disease in men and women with psoriasis. Arch Dermatol Res 2012; 304:421-32. [PMID: 22456752 PMCID: PMC3401292 DOI: 10.1007/s00403-012-1235-3] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2011] [Revised: 03/13/2012] [Accepted: 03/15/2012] [Indexed: 02/08/2023]
Abstract
Social support was shown to be an important factor buffering negative effects of stress in a range of clinical populations. Little is known, however, about the role of social support in the population of patients with psoriasis although strong psychosocial stress has been implicated in this disease. The objective of this study was to evaluate the association between social support and selected indices of adaptation to life with the disease, including health-related quality of life, depressive symptoms and acceptance of life with the disease, in a sample of patients with psoriasis. Additionally, gender differences in these relationships were analyzed. One-hundred-four patients with psoriasis completed psychological tests measuring disease-related social support, health-related quality of life, depressive symptoms and acceptance of life with the disease. Psoriasis severity was assessed by Psoriasis Area and Severity Index. The patients reporting higher social support levels had significantly higher quality of life, lower depression levels, and higher acceptance of life with the disease. The strengths of these effects, however, were different in women and men. Higher social support was slightly more closely associated with better acceptance of life with the disease in men than in women. However, higher social support was more closely associated to lower depression and better quality of life in women than in men. Among different types of social support, tangible support was found to be the best predictor for the all adaptation indices. Effects of social support perceived by psoriasis patients on adaptation to the disease may be gender-related and exact pathways of these effects may depend on the type on the dimension of social support and the selected type of adaptation indicator. Tangible support seems the most important type of support contributing to better adaptation in both women and men with psoriasis.
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Affiliation(s)
- Konrad Janowski
- Department of Psychology, University of Finance and Management in Warsaw, Poland.
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Ford ES, Mokdad AH, Li C, McGuire LC, Strine TW, Okoro CA, Brown DW, Zack MM. Gender Differences in Coronary Heart Disease and Health-Related Quality of Life: Findings from 10 States from the 2004 Behavioral Risk Factor Surveillance System. J Womens Health (Larchmt) 2008; 17:757-68. [DOI: 10.1089/jwh.2007.0468] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Earl S. Ford
- Division of Adult and Community Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Ali H. Mokdad
- Division of Adult and Community Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Chaoyang Li
- Division of Adult and Community Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Lisa C. McGuire
- Division of Adult and Community Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Tara W. Strine
- Division of Adult and Community Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Catherine A. Okoro
- Division of Adult and Community Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - David W. Brown
- Division of Adult and Community Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Matthew M. Zack
- Division of Adult and Community Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
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