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Rohde JA, Muro AH, D'Angelo H. Characteristics of and engagement with URL resources shared among online vaping communities on Reddit. Tob Control 2024:tc-2023-058533. [PMID: 39153862 DOI: 10.1136/tc-2023-058533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 07/29/2024] [Indexed: 08/19/2024]
Abstract
INTRODUCTION Reddit is a popular social media platform for sharing information about vaping. Little is known about the types of external resources that Reddit users in vaping communities share and engage with. METHODS We analysed 2315 posts containing uniform resource locators (URLs) published to vaping communities on Reddit between November 2021 and October 2022. We coded URLs into eight mutually exclusive domain types. A mixed-effects Poisson regression model examined whether domain type was associated with user engagement (ie, number of unique commenters). RESULTS Posts contained links to social media (35%), image hosting (31%), vaping-related commerce (19%), eJuice (12%), general vaping (6%), news (2%) and research (1%) URL domains. There were 237 unique vaping-related commerce domains (eg, ziipstock.com). The average number of commenters per post was 5.43 (SD=8.04). The rate of commenters was higher for posts sharing research (adjusted rate ratio (aRR) 1.74, 95% CI 1.28 to 2.36) and news (aRR 1.56, 95% CI 1.02 to 2.38) domains compared with vape-related commerce domains. CONCLUSION Reddit users in vaping communities share and interact with a variety of external resources. The >200 different vaping-related commerce domains in our sample speak to the breadth and availability of websites that Reddit users (perhaps even those underage) may be using to browse and purchase vaping devices.
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Affiliation(s)
- Jacob A Rohde
- Consumer Behavior Research Program, Center for Communication & Media Impact, RTI International, Durham, NC, USA
| | - Abigail H Muro
- Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD, USA
| | - Heather D'Angelo
- Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD, USA
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Zhang J, Peng M, Li J, Li L, Bai X, Thabane L, Yh Lip G, Van Spall HG, Li G. Enrollment of Black, Indigenous and People of Color (BIPOC) and female participants in the US diabetes trials spanning 2000 to 2020: A chronological survey. Diabetes Metab Syndr 2024; 18:103074. [PMID: 39033649 DOI: 10.1016/j.dsx.2024.103074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 07/11/2024] [Accepted: 07/14/2024] [Indexed: 07/23/2024]
Abstract
AIMS Little is known about the enrollment practice of both Black, Indigenous and People of Color (BIPOC) and females in the US diabetes trials. We aimed to perform a chronological survey to evaluate the enrollment of BIPOC and female participants in the US diabetes randomized controlled trials (RCTs) over the past two decades. METHODS We searched databases to systematically include the US diabetes RCTs from 2000 January 1st to 2020 December 31st. Primary outcome was the adequate enrollment of both BIPOC and females, defined by the participation to prevalence ratio (PPR) > 0.8. We tested the temporal trend in adequate enrollment over time and used logistic regression analysis to explore the relationship between adequate enrollment and trial characteristics. RESULTS A total of 69 US diabetes trials were included for analyses, with a median BIPOC and female enrollment percentage of 29.0 % and 45.4 % respectively. There were 22 (31.9 %) trials with adequate enrollment of both BIPOC and females. No significant trend of adequate enrollment percentage of BIPOC and females over time was observed (P = 0.16). Of trial types, those with medication interventions were significantly related to decreased odds of adequate enrollment, when compared to trials with non-drug interventions (odds ratio = 0.29, 95 % confidence interval: 0.11-0.84). CONCLUSIONS Less than one third of the US diabetes trials adequately enrolled both BIPOC and females over the past two decades, and no temporal improvement in BIPOC and female participant enrollment was observed. These results highlight the need for more endeavors to mitigate inadequate representation regarding BIPOC and female enrollment in diabetes trials.
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Affiliation(s)
- Jingyi Zhang
- Center for Clinical Epidemiology and Methodology (CCEM), The Affiliated Guangdong Second Provincial General Hospital of Jinan University, Guangzhou, China
| | - Miaoguan Peng
- Department of Endocrinology, Guangdong Provincial Key Laboratory of Major Obstetric Diseases, Guangdong Provincial Clinical Research Center for Obstetrics and Gynecology, Guangdong-Hong Kong-Macao Greater Bay Area Higher Education Joint Laboratory of Maternal-Fetal Medicine, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510150, China
| | - Jianfeng Li
- Department of Epidemiology and Health Statistics, School of Public Health, Guangdong Medical University, Dongguan, China
| | - Likang Li
- Center for Clinical Epidemiology and Methodology (CCEM), The Affiliated Guangdong Second Provincial General Hospital of Jinan University, Guangzhou, China
| | - Xuerui Bai
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China
| | - Lehana Thabane
- Father Sean O'Sullivan Research Centre, St Joseph's Healthcare Hamilton, Hamilton, ON, Canada; Faculty of Health Sciences, University of Johannesburg, Johannesburg, South Africa; Department of Health Research Methods, Evidence, and Impact (HEI), McMaster University, Hamilton, ON, Canada
| | - Gregory Yh Lip
- Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital, Liverpool, United Kingdom; Danish Center for Health Services Research, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Harriette Gc Van Spall
- Department of Health Research Methods, Evidence, and Impact (HEI), McMaster University, Hamilton, ON, Canada; Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - Guowei Li
- Center for Clinical Epidemiology and Methodology (CCEM), The Affiliated Guangdong Second Provincial General Hospital of Jinan University, Guangzhou, China; Father Sean O'Sullivan Research Centre, St Joseph's Healthcare Hamilton, Hamilton, ON, Canada.
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Macrì M, D’Albis G, D’Albis V, Antonacci A, Abbinante A, Stefanelli R, Pegreffi F, Festa F. Periodontal Health and Its Relationship with Psychological Stress: A Cross-Sectional Study. J Clin Med 2024; 13:2942. [PMID: 38792482 PMCID: PMC11122378 DOI: 10.3390/jcm13102942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2024] [Revised: 05/03/2024] [Accepted: 05/10/2024] [Indexed: 05/26/2024] Open
Abstract
Background: Studies suggest that chronic psychological stress can lead to oral health deterioration, alter the immune response, and possibly contribute to increased inflammation, which can impact the physiological healing of periodontal tissues. This cross-sectional study seeks to assess and improve clinical understanding regarding the relationship between perceived stress, mindfulness, and periodontal health. Methods: A total of 203 people were analyzed from December 2022 to June 2023. The Periodontal Screening and Recording (PSR) score and Gingival Bleeding Index (GBI), and Plaque Control Record (PCR) of every patient were registered. Subsequently, participants completed the Sheldon Cohen Perceived Stress Scale (PSS) and the Mindfulness Awareness Attention Scale (MAAS) questionnaires. The collected data underwent statistical analysis, encompassing the evaluation of correlations and dependencies. Applying Welch's t-test to assess the relationship between MAAS and the variable indicating the presence or absence of periodontitis, a noteworthy p-value of 0.004265 was obtained. Results: This underscores a significant distinction in MAAS scores between patients affected by periodontitis and those unaffected by the condition. Additionally, Pearson correlations were computed for GBI and perceived stress, PCR and perceived stress, PCR and MAAS. The resulting p-values of 2.2-16, 3.925-8, and 2.468-8, respectively, indicate a statistically significant correlation in each instance. Conclusions: These findings contribute valuable insights into the interconnectedness of these variables, emphasizing the significance of their associations in the study context. Despite the limitations, the findings of this study suggest a significant relationship between psychological stress, mindfulness, and periodontal tissue health. Clinical trials are necessary to incorporate the assessment of a patient's psychological status as a new valuable tool in the management of periodontal health.
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Affiliation(s)
- Monica Macrì
- Department of Innovative Technologies in Medicine & Dentistry, University “G. D’Annunzio” of Chieti-Pescara, 66100 Chieti, Italy
| | - Giuseppe D’Albis
- Department of Innovative Technologies in Medicine & Dentistry, University “G. D’Annunzio” of Chieti-Pescara, 66100 Chieti, Italy
| | - Vincenzo D’Albis
- Department of Innovative Technologies in Medicine & Dentistry, University “G. D’Annunzio” of Chieti-Pescara, 66100 Chieti, Italy
| | - Anna Antonacci
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70121 Bari, Italy
| | - Antonia Abbinante
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70121 Bari, Italy
| | - Riccardo Stefanelli
- Department for Life Quality Studies, University of Bologna, 40064 Bologna, Italy
| | - Francesco Pegreffi
- Department for Life Quality Studies, University of Bologna, 40064 Bologna, Italy
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 Urbino, Italy
| | - Felice Festa
- Department of Innovative Technologies in Medicine & Dentistry, University “G. D’Annunzio” of Chieti-Pescara, 66100 Chieti, Italy
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Bloom BE, Joseph R, Ulibarri MD, Reed E, Ulloa EC. Factors Associated with Engaging in Bystander Intervention Behavior Among College Students. JOURNAL OF INTERPERSONAL VIOLENCE 2024; 39:1731-1759. [PMID: 38014681 DOI: 10.1177/08862605231212170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2023]
Abstract
Sexual violence (SV) is a well-documented and highly prevalent issue on college campuses that disproportionately impacts women, students of color, and students who identify as lesbian, gay, bisexual, transgender, queer (LGBTQ). In recent years, bystander intervention programming has emerged as a promising prevention strategy for colleges due to its success in preventing SV before it occurs using community involvement; however, little consideration has been given to the power, status, or position that a bystander has when deciding whether to intervene and weighing the potential consequences of their actions. In order to inform university campus bystander intervention programming and increase its effectiveness, more work is needed to understand specific student characteristics (e.g., race/ethnicity, gender identity, sexual orientation, history of SV) that may be associated with engaging in bystander behavior in SV risk situations. Using cross-sectional data from a large west-coast university, 592 students were surveyed about their SV-related experiences. Poisson regression models were utilized to determine the relative risk of engaging in bystander behavior by sociodemographic identities and history of SV victimization. Our fully adjusted model indicated that experiencing attempted and completed sexual assault was associated with engaging in bystander behavior; belonging to specific minority groups was differentially associated with engaging in bystander behavior, as was belonging to a minority group and having a history of SV. Personal histories, identities, and power inequity matter when deciding to engage in bystander behavior. Additional research is needed to create more well-rounded and population-specific bystander intervention programs that are inclusive of diverse student voices and experiences.
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Affiliation(s)
- Brittnie E Bloom
- San Diego State University, CA, USA
- University of California San Diego, USA
| | - Renee Joseph
- Alliant International University, San Diego, CA, USA
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5
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Eduvirgem J, Bressan J, Hermsdorff HHM, Montenegro LC, Brandão ML, Neves AAT, da Silva LSA, Gerake-Dias TA, Pimenta AM. Risk and protective factors for Long COVID in Brazilian adults (CUME Study). Front Med (Lausanne) 2024; 11:1344011. [PMID: 38455472 PMCID: PMC10919220 DOI: 10.3389/fmed.2024.1344011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Accepted: 02/05/2024] [Indexed: 03/09/2024] Open
Abstract
Background Most people recover from COVID-19, however, between 5 to 20% have experienced new, recurring, or continuous health problems four or more weeks after being infected, a phenomenon called Long COVID, and whose reasons for its manifestation are incipient. Our objective was to analyse the risk and protective factors for Long COVID in Brazilian adults participating in the CUME Study. Methods The CUME Study is a prospective cohort conducted with graduates from federal universities in the State of Minas Gerais, Brazil. In this study, 390 participants who answered the baseline questionnaire in 2016 and the third follow-up questionnaire in 2022 (which contained a block of questions about occurrence of COVID-19 and Long COVID) were included. The diagnosis of Long COVID was based on self-reporting of persistence of signs and symptoms of COVID-19 between 30 days and 6 months after remission of the disease. To estimate the risk and protective factors for Long COVID, a hierarchical multivariate statistical analysis was conducted using the Poisson regression technique. Results Long COVID was observed in 48.9% of the participants. The following characteristics were identified as risk factors for the outcome: female sex (RR = 1.56; 95% CI = 1.22-1.99); prior diagnosis of hypertension (RR = 1.46; 95% CI = 1.19-1.80); having contracted COVID-19 in the first (RR =1.38; 95% CI = 1.07-1.79) or in the second waves (RR = 1.33; 95% CI = 1.07-1.65) of the pandemic period; and having presented three or more signs and symptoms during the acute phase of COVID-19 (RR = 2.99; 95% CI = 1.08-8.24). On the other hand, having a doctoral/postdoctoral educational level (RR = 0.69; 95% CI = 0.50-0.94) was identified as a protective factor for the outcome. Conclusion Health system managers and healthcare professionals should be aware of the socioeconomic profile and disease history of patients who have had COVID-19 because women, people with a prior diagnosis of hypertension, and those who manifested multiple signs and symptoms of COVID-19 during the acute phase of the disease were at greater risk of developing Long COVID.
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Affiliation(s)
- Júlio Eduvirgem
- Posgraduate Program in Nursing, Universidade Federal do Paraná, Curitiba, Paraná, Brazil
| | - Josefina Bressan
- Department of Nutrition and Health, Universidade Federal de Viçosa, Viçosa, Minas Gerais, Brazil
| | | | | | - Marlise Lima Brandão
- Posgraduate Program in Nursing, Universidade Federal do Paraná, Curitiba, Paraná, Brazil
| | | | | | | | - Adriano Marçal Pimenta
- Posgraduate Program in Nursing, Universidade Federal do Paraná, Curitiba, Paraná, Brazil
- Department of Nursing, Universidade Federal do Paraná, Curitiba, Paraná, Brazil
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Orero L, Omondi EO, Omolo BO. A Bayesian model for predicting monthly fire frequency in Kenya. PLoS One 2024; 19:e0291800. [PMID: 38271480 PMCID: PMC10810550 DOI: 10.1371/journal.pone.0291800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Accepted: 09/06/2023] [Indexed: 01/27/2024] Open
Abstract
This study presents a comprehensive analysis of historical fire and climatic data to estimate the monthly frequency of vegetation fires in Kenya. This work introduces a statistical model that captures the behavior of fire count data, incorporating temporal explanatory factors and emphasizing the predictive significance of maximum temperature and rainfall. By employing Bayesian approaches, the paper integrates literature information, simulation studies, and real-world data to enhance model performance and generate more precise prediction intervals that encompass actual fire counts. To forecast monthly fire occurrences aggregated from the Moderate Resolution Imaging Spectroradiometer (MODIS) data in Kenya (2000-2018), the study utilizes maximum temperature and rainfall values derived from global GeoTiff (.tif) files sourced from the WorldClim database. The evaluation of the widely used Negative Binomial (NB) model and the proposed Bayesian Negative Binomial (BNB) model reveals the superiority of the latter in accounting for seasonal patterns and long-term trends. The simulation results demonstrate that the BNB model outperforms the NB model in terms of Root Mean Square Error (RMSE), and Mean Absolute Scaled Error (MASE) on both training and testing datasets. Furthermore, when applied to real data, the Bayesian Negative Binomial model exhibits better performance on the test dataset, showcasing lower RMSE (163.22 vs. 166.67), lower MASE (1.12 vs. 1.15), and reduced bias (-2.52% vs. -2.62%) compared to the NB model. The Bayesian model also offers prediction intervals that closely align with actual predictions, indicating its flexibility in forecasting the frequency of monthly fires. These findings underscore the importance of leveraging past data to forecast the future behavior of the fire regime, thus providing valuable insights for fire control strategies in Kenya. By integrating climatic factors and employing Bayesian modeling techniques, the study contributes to the understanding and prediction of vegetation fires, ultimately supporting proactive measures in mitigating their impact.
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Affiliation(s)
- Levi Orero
- Institute of Mathematical Sciences, Strathmore University, Nairobi, Kenya
| | - Evans Otieno Omondi
- Institute of Mathematical Sciences, Strathmore University, Nairobi, Kenya
- African Population and Health Research Center (APHRC), Nairobi, Kenya
| | - Bernard Oguna Omolo
- Institute of Mathematical Sciences, Strathmore University, Nairobi, Kenya
- Division of Mathematics & Computer Science, University of South Carolina – Upstate, Spartanburg, SC, United States of America
- School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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Zhang J, Zhang Z, Zhang R, Yang C, Zhang X, Chang S, Chen Q, Rossi V, Zhao L, Xiao J, Xin M, Du J, Guo W, Hu Z, Liu J, Peng H, Ni Z, Sun Q, Yao Y. Type I MADS-box transcription factor TaMADS-GS regulates grain size by stabilizing cytokinin signalling during endosperm cellularization in wheat. PLANT BIOTECHNOLOGY JOURNAL 2024; 22:200-215. [PMID: 37752705 PMCID: PMC10754016 DOI: 10.1111/pbi.14180] [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: 05/03/2023] [Revised: 09/01/2023] [Accepted: 09/09/2023] [Indexed: 09/28/2023]
Abstract
Grain size is one of the important traits in wheat breeding programs aimed at improving yield, and cytokinins, mainly involved in cell division, have a positive impact on grain size. Here, we identified a novel wheat gene TaMADS-GS encoding type I MADS-box transcription factor, which regulates the cytokinins signalling pathway during early stages of grain development to modulate grain size and weight in wheat. TaMADS-GS is exclusively expressed in grains at early stage of seed development and its knockout leads to delayed endosperm cellularization, smaller grain size and lower grain weight. TaMADS-GS protein interacts with the Polycomb Repressive Complex 2 (PRC2) and leads to repression of genes encoding cytokinin oxidase/dehydrogenases (CKXs) stimulating cytokinins inactivation by mediating accumulation of the histone H3 trimethylation at lysine 27 (H3K27me3). Through the screening of a large wheat germplasm collection, an elite allele of the TaMADS-GS exhibits higher ability to repress expression of genes inactivating cytokinins and a positive correlation with grain size and weight, thus representing a novel marker for breeding programs in wheat. Overall, these findings support the relevance of TaMADS-GS as a key regulator of wheat grain size and weight.
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Affiliation(s)
- Jianing Zhang
- Frontiers Science Center for Molecular Design Breeding, Key Laboratory of Crop Heterosis and Utilization (MOE), and Beijing Key Laboratory of Crop Genetic ImprovementChina Agricultural UniversityBeijingChina
| | - Zhaoheng Zhang
- Frontiers Science Center for Molecular Design Breeding, Key Laboratory of Crop Heterosis and Utilization (MOE), and Beijing Key Laboratory of Crop Genetic ImprovementChina Agricultural UniversityBeijingChina
| | - Ruijie Zhang
- Frontiers Science Center for Molecular Design Breeding, Key Laboratory of Crop Heterosis and Utilization (MOE), and Beijing Key Laboratory of Crop Genetic ImprovementChina Agricultural UniversityBeijingChina
| | - Changfeng Yang
- Frontiers Science Center for Molecular Design Breeding, Key Laboratory of Crop Heterosis and Utilization (MOE), and Beijing Key Laboratory of Crop Genetic ImprovementChina Agricultural UniversityBeijingChina
| | - Xiaobang Zhang
- Frontiers Science Center for Molecular Design Breeding, Key Laboratory of Crop Heterosis and Utilization (MOE), and Beijing Key Laboratory of Crop Genetic ImprovementChina Agricultural UniversityBeijingChina
| | - Siyuan Chang
- Frontiers Science Center for Molecular Design Breeding, Key Laboratory of Crop Heterosis and Utilization (MOE), and Beijing Key Laboratory of Crop Genetic ImprovementChina Agricultural UniversityBeijingChina
| | - Qian Chen
- Frontiers Science Center for Molecular Design Breeding, Key Laboratory of Crop Heterosis and Utilization (MOE), and Beijing Key Laboratory of Crop Genetic ImprovementChina Agricultural UniversityBeijingChina
| | - Vincenzo Rossi
- Council for Agricultural Research and EconomicsResearch Centre for Cereal and Industrial CropsBergamoItaly
| | - Long Zhao
- Key Laboratory of Plant Cell and Chromosome Engineering, Institute of Genetics and Developmental BiologyChinese Academy of SciencesBeijingChina
| | - Jun Xiao
- Key Laboratory of Plant Cell and Chromosome Engineering, Institute of Genetics and Developmental BiologyChinese Academy of SciencesBeijingChina
| | - Mingming Xin
- Frontiers Science Center for Molecular Design Breeding, Key Laboratory of Crop Heterosis and Utilization (MOE), and Beijing Key Laboratory of Crop Genetic ImprovementChina Agricultural UniversityBeijingChina
| | - Jinkun Du
- Frontiers Science Center for Molecular Design Breeding, Key Laboratory of Crop Heterosis and Utilization (MOE), and Beijing Key Laboratory of Crop Genetic ImprovementChina Agricultural UniversityBeijingChina
| | - Weilong Guo
- Frontiers Science Center for Molecular Design Breeding, Key Laboratory of Crop Heterosis and Utilization (MOE), and Beijing Key Laboratory of Crop Genetic ImprovementChina Agricultural UniversityBeijingChina
| | - Zhaorong Hu
- Frontiers Science Center for Molecular Design Breeding, Key Laboratory of Crop Heterosis and Utilization (MOE), and Beijing Key Laboratory of Crop Genetic ImprovementChina Agricultural UniversityBeijingChina
| | - Jie Liu
- Frontiers Science Center for Molecular Design Breeding, Key Laboratory of Crop Heterosis and Utilization (MOE), and Beijing Key Laboratory of Crop Genetic ImprovementChina Agricultural UniversityBeijingChina
| | - Huiru Peng
- Frontiers Science Center for Molecular Design Breeding, Key Laboratory of Crop Heterosis and Utilization (MOE), and Beijing Key Laboratory of Crop Genetic ImprovementChina Agricultural UniversityBeijingChina
| | - Zhongfu Ni
- Frontiers Science Center for Molecular Design Breeding, Key Laboratory of Crop Heterosis and Utilization (MOE), and Beijing Key Laboratory of Crop Genetic ImprovementChina Agricultural UniversityBeijingChina
| | - Qixin Sun
- Frontiers Science Center for Molecular Design Breeding, Key Laboratory of Crop Heterosis and Utilization (MOE), and Beijing Key Laboratory of Crop Genetic ImprovementChina Agricultural UniversityBeijingChina
| | - Yingyin Yao
- Frontiers Science Center for Molecular Design Breeding, Key Laboratory of Crop Heterosis and Utilization (MOE), and Beijing Key Laboratory of Crop Genetic ImprovementChina Agricultural UniversityBeijingChina
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Scott DAR, Renelle A, Niederer RL. Methodological and statistical considerations: Batch-dependent adverse effects of COVID-19 vaccines. Eur J Clin Invest 2023; 53:e14073. [PMID: 37548000 DOI: 10.1111/eci.14073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 07/09/2023] [Accepted: 07/18/2023] [Indexed: 08/08/2023]
Affiliation(s)
- Daniel Andrew Richard Scott
- Department of Ophthalmology, Greenlane Clinical Centre, Te Whatu Ora Health New Zealand, Auckland, New Zealand
- Department of Ophthalmology, University of Auckland, Auckland, New Zealand
| | - Amy Renelle
- Department of Mathematics, University of Waikato, Hamilton, New Zealand
| | - Rachael Louise Niederer
- Department of Ophthalmology, Greenlane Clinical Centre, Te Whatu Ora Health New Zealand, Auckland, New Zealand
- Department of Ophthalmology, University of Auckland, Auckland, New Zealand
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Langenberger B, Steinbeck V, Schöner L, Busse R, Pross C, Kuklinski D. Exploring treatment effect heterogeneity of a PROMs alert intervention in knee and hip arthroplasty patients: A causal forest application. Comput Biol Med 2023; 163:107118. [PMID: 37392619 DOI: 10.1016/j.compbiomed.2023.107118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 05/24/2023] [Accepted: 05/30/2023] [Indexed: 07/03/2023]
Abstract
Patient reported outcome measures (PROMs) experience an uptake in use for hip (HA) and knee arthroplasty (KA) patients. As they may be used for patient monitoring interventions, it remains unclear whether their use in HA/KA patients is effective, and which patient groups benefit the most. Nonetheless, knowledge about treatment effect heterogeneity is crucial for decision makers to target interventions towards specific subgroups that benefit to a greater extend. Therefore, we evaluate the treatment effect heterogeneity of a remote PROM monitoring intervention that includes ∼8000 HA/KA patients from a randomized controlled trial conducted in nine German hospitals. The study setting gave us the unique opportunity to apply a causal forest, a recently developed machine learning method, to explore treatment effect heterogeneity of the intervention. We found that among both HA and KA patients, the intervention was especially effective for patients that were female, >65 years of age, had a blood pressure disease, were not working, reported no backpain and were adherent. When transferring the study design into standard care, policy makers should make use of the knowledge obtained in this study and allocate the treatment towards subgroups for which the treatment is especially effective.
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Santos-Burgoa C, Garcia-Meza A, Talayero MJ, Kuenster N, Goldman Hawes AS, Andrade E. Total Excess Mortality Surveillance for Real-Time Decision-Making in Disasters and Crises. Disaster Med Public Health Prep 2023; 17:e350. [PMID: 36912748 DOI: 10.1017/dmp.2023.15] [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: 03/14/2023]
Abstract
Crises such as Hurricane Maria and the coronavirus disease 2019 (COVID-19) pandemic have revealed that untimely reporting of the death toll results in inadequate interventions, impacts communication, and fuels distrust on response agencies. Delays in establishing mortality are due to the contested definition of deaths attributable to a disaster and lack of rapid collection of vital statistics data from inadequate health system infrastructure. Readily available death counts, combined with geographic, demographic, and socioeconomic data, can serve as a baseline to build a continuous mortality surveillance system. In an emergency setting, real-time Total, All-cause, Excess Mortality (TEM) can be a critical tool, granting authorities timely information ensuring a targeted response and reduce disaster impact. TEM measurement can identify spikes in mortality, including geographic disparities and disproportionate deaths in vulnerable populations. This study recommends that measuring total, all-cause, excess mortality as a first line of response should become the global standard for measuring disaster impact.
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Semovski V, King C, Lapshina N, Stewart SL. A cross-sectional examination of service complexity in youths with co-occurring autism spectrum disorder and psychiatric or medical diagnoses across service sectors. Front Psychol 2023; 13:1027373. [PMID: 36817386 PMCID: PMC9930473 DOI: 10.3389/fpsyg.2022.1027373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 11/28/2022] [Indexed: 02/04/2023] Open
Abstract
Introduction Autism spectrum disorder (ASD) is a heterogeneous, life-long, and complex condition. Youth diagnosed with ASD require several supports addressing core symptoms associated with the disorder, but also those resulting from co-occurring mental and physical health conditions. As a result, their care is overseen by numerous professionals spanning various service sectors, but communication between sectors is hindered due to the absence of a standardized assessment system to identify and triage youth to services. A paucity of information surrounding this population's service use lingers and a siloed delivery system persists. Methods Using archival data collected from 1,020 youth between 12 and 18 years of age, this study explored service complexity among autistic youth with and without psychiatric and medical co-occurring conditions in Ontario, Canada. In doing so, a negative binomial regression was utilized to investigate which predisposing, enabling, and need variables were associated with service complexity. Results Results revealed that experiencing financial difficulties was not associated with service complexity. However, age, sex, caregiver distress, comorbidity, intellectual disability, and evaluated health status were significant predictors. More specifically, female youth and youth with distressed caregivers had greater mental health service complexity scores. Additionally, youth diagnosed with two or more conditions in addition to ASD who required longer durations of programming, controlling for other predictors, had greater mental health service complexity scores. Yet, youth with an intellectual disability had lower service complexity scores. Discussion Clinical implications of this study are discussed to inform future investments into mental health efforts for autistic youth.
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Weatherton M, Schussler EE. Demographics Matter: Non-white and White Life Science Graduate Students Perceive and Use Resources Differently. CBE LIFE SCIENCES EDUCATION 2022; 21:ar79. [PMID: 36256470 PMCID: PMC9727622 DOI: 10.1187/cbe.22-06-0112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 09/15/2022] [Accepted: 09/22/2022] [Indexed: 06/16/2023]
Abstract
Many studies and interventions have been conducted to combat differential academic outcomes between majority and minoritized student populations in science, technology, engineering, and mathematics (STEM) higher education; however, few studies have examined resource use as a factor impacting these differences. Resource use is critical to success in myriad fields, and we posit that understanding resource use in graduate education, including the use and perception of resources, may be important in understanding differential outcomes and success among STEM graduate students. We employed a national survey of life science graduate students (N = 534) to describe student resource use outcomes and how these outcomes may be related to student demographic characteristics. The survey collected data on the following resource use outcomes: what resources students use, how often they use them, and how useful they perceive them to be. Academic stipend was the most frequently used resource and was perceived to be the most useful resource. Analysis of variance modeling and Tukey post hoc tests indicated that year in program, racial identity, gender identity, and college generation status all impacted student frequency of use or perception of usefulness for some resources, with the greatest differentials between white and non-white students. We conclude with recommendations for policy, practice, and future research.
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Affiliation(s)
- Maryrose Weatherton
- Department of Ecology and Evolutionary Biology, University of Tennessee, Knoxville, TN 37996
| | - Elisabeth E. Schussler
- Department of Ecology and Evolutionary Biology, University of Tennessee, Knoxville, TN 37996
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Szakmar E, Munster C, El-Shibiny H, Jermendy A, Inder T, El-Dib M. Hypocapnia in early hours of life is associated with brain injury in moderate to severe neonatal encephalopathy. J Perinatol 2022; 42:892-897. [PMID: 35461333 DOI: 10.1038/s41372-022-01398-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Revised: 04/04/2022] [Accepted: 04/08/2022] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To evaluate the association between hypocapnia within the first 24 h of life and brain injury assessed by a detailed MRI scoring system in infants receiving therapeutic hypothermia (TH) for neonatal encephalopathy (NE) stratified by the stage of NE. STUDY DESIGN This retrospective cohort study included infants who received TH for mild to severe NE. RESULTS 188 infants were included in the study with 48% having mild and 52% moderate-severe NE. Infants with moderate-severe NE spent more time in hypocapnia (PCO2 ≤ 35 mmHg) and presented with more severe brain injury on MRI compared to mild cases. The MRI injury score increased by 6% for each extra hour spent in hypocapnic range in infants with moderate-severe NE. There was no association between hypocapnia and injury scores in mild cases. CONCLUSION In infants with moderate-severe NE, the hours spent in hypocapnia was an independent predictor of brain injury.
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Affiliation(s)
- Eniko Szakmar
- Department of Pediatric Newborn Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States.,1st Department of Pediatrics, Semmelweis University, Budapest, Hungary
| | - Chelsea Munster
- Department of Pediatric Newborn Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States
| | - Hoda El-Shibiny
- Department of Pediatric Newborn Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States
| | - Agnes Jermendy
- 1st Department of Pediatrics, Semmelweis University, Budapest, Hungary
| | - Terrie Inder
- Department of Pediatric Newborn Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States
| | - Mohamed El-Dib
- Department of Pediatric Newborn Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States.
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Menni C, May A, Polidori L, Louca P, Wolf J, Capdevila J, Hu C, Ourselin S, Steves CJ, Valdes AM, Spector TD. COVID-19 vaccine waning and effectiveness and side-effects of boosters: a prospective community study from the ZOE COVID Study. THE LANCET INFECTIOUS DISEASES 2022; 22:1002-1010. [PMID: 35405090 PMCID: PMC8993156 DOI: 10.1016/s1473-3099(22)00146-3] [Citation(s) in RCA: 182] [Impact Index Per Article: 91.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 02/18/2022] [Accepted: 02/18/2022] [Indexed: 12/11/2022]
Abstract
Background With the surge of new SARS-CoV-2 variants, countries have begun offering COVID-19 vaccine booster doses to high-risk groups and, more recently, to the adult population in general. However, uncertainty remains over how long primary vaccination series remain effective, the ideal timing for booster doses, and the safety of heterologous booster regimens. We aimed to investigate COVID-19 primary vaccine series effectiveness and its waning, and the safety and effectiveness of booster doses, in a UK community setting. Methods We used SARS-CoV-2 positivity rates in individuals from a longitudinal, prospective, community-based study (ZOE COVID Study), in which data were self-reported through an app, to assess the effectiveness of three COVID-19 vaccines (ChAdOx1 nCov19 [Oxford-AstraZeneca], BNT162b2 [Pfizer-BioNtech], and mRNA1273 [Moderna]) against infection in the 8 months after completion of primary vaccination series. In individuals receiving boosters, we investigated vaccine effectiveness and reactogenicity, by assessing 16 self-reported systemic and localised side-effects. We used multivariate Poisson regression models adjusting for confounders to estimate vaccine effectiveness. Findings We included 620 793 participants who received two vaccine doses (204 731 [33·0%] received BNT162b2, 405 239 [65·3%] received ChAdOx1 nCoV-19, and 10 823 [1·7%] received mRNA-1273) and subsequently had a SARS-CoV-2 test result between May 23 (chosen to exclude the period of alpha [B.1.1.7] variant dominance) and Nov 23, 2021. 62 172 (10·0%) vaccinated individuals tested positive for SARS-CoV-2 and were compared with 40 345 unvaccinated controls (6726 [16·7%] of whom tested positive). Vaccine effectiveness waned after the second dose: at 5 months, BNT162b2 effectiveness was 82·1% (95% CI 81·3–82·9), ChAdOx1 nCoV-19 effectiveness was 75·7% (74·9–76·4), and mRNA-1273 effectiveness was 84·3% (81·2–86·9). Vaccine effectiveness decreased more among individuals aged 55 years or older and among those with comorbidities. 135 932 individuals aged 55 years or older received a booster (2123 [1·6%] of whom tested positive). Vaccine effectiveness for booster doses in 0–3 months after BNT162b2 primary vaccination was higher than 92·5%, and effectiveness for heterologous boosters after ChAdOx1 nCoV-19 was at least 88·8%. For the booster reactogenicity analysis, in 317 011 participants, the most common systemic symptom was fatigue (in 31 881 [10·1%] participants) and the most common local symptom was tenderness (in 187 767 [59·2%]). Systemic side-effects were more common for heterologous schedules (32 632 [17·9%] of 182 374) than for homologous schedules (17 707 [13·2%] of 134 637; odds ratio 1·5, 95% CI 1·5–1·6, p<0·0001). Interpretation After 5 months, vaccine effectiveness remained high among individuals younger than 55 years. Booster doses restore vaccine effectiveness. Adverse reactions after booster doses were similar to those after the second dose. Homologous booster schedules had fewer reported systemic side-effects than heterologous boosters. Funding Wellcome Trust, ZOE, National Institute for Health Research, Chronic Disease Research Foundation, National Institutes of Health, Medical Research Council
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Hassanin S, Kshirsagar RS, Steele TO, Liang J. A Geospatial Analysis of the Rhinologist Workforce in the United States. Am J Rhinol Allergy 2022; 36:459-464. [PMID: 35098735 DOI: 10.1177/19458924221075887] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Six percent of practicing otolaryngologists identified by the American Academy of Otolaryngology - Head and Neck Surgery (AAO-HNS) are rhinologists. This is the first study to investigate both the distribution of rhinologists in the United States and the sociodemographic characteristics that may predict their practice locations. OBJECTIVE We aim to describe the geospatial distribution of the rhinology workforce and analyze sociodemographic characteristics associated with practice distribution. METHODS We conducted a cross-sectional study of 662 rhinologists queried from the 2020 American Rhinologic Society (ARS) database. Rhinologist practice addresses were compared with ZIP code tabulation area (ZCTA) sociodemographic data from the 2010 US Census Bureau and from the 2014 to 2018 American Community Surveys. Geospatial mapping and multivariate statistics were employed to visualize rhinologist practice locations and analyze which community characteristics were associated with greater densities of rhinologists in ZCTAs. RESULTS The largest and smallest densities of rhinologists were in coastal areas and in the Central and Midwestern US, respectively. Population characteristics that significantly predicted a higher number of practicing rhinologists included: greater percentage of non-citizens and greater educational attainment (p < 0.001). Population characteristics that significantly predicted a lower number of practicing rhinologists included: greater percentage of self-identified white/Caucasians, median household income, and greater percentage of population aged 65 or older (p < 0.001). CONCLUSION Disparities in healthcare access in the US is evident and applies to rhinologic subspecialty care. Through visual geospatial analysis, we demonstrate the distribution of rhinologists and the population characteristics that may be predictive of whether patients have access to rhinological care.
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Affiliation(s)
- Samir Hassanin
- Kaiser Permanente Oakland Medical Center, Oakland, CA, USA
- Rutgers Robert Wood Johnson Medical School, Piscataway, NJ, USA
| | - Rijul S Kshirsagar
- University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA, USA
| | | | - Jonathan Liang
- Kaiser Permanente Oakland Medical Center, Oakland, CA, USA
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Zaborskis A, Kavaliauskienė A, Eriksson C, Klemera E, Dimitrova E, Melkumova M, Husarova D. Family Support as Smoking Prevention during Transition from Early to Late Adolescence: A Study in 42 Countries. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:12739. [PMID: 34886464 PMCID: PMC8656923 DOI: 10.3390/ijerph182312739] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 11/21/2021] [Accepted: 11/28/2021] [Indexed: 11/16/2022]
Abstract
Family support has a beneficial impact on protecting health-risk behaviour in adolescents. This study aimed to explore whether family support is associated with risk of smoking during transition from early (11 years) to late (15 years) adolescence across 42 countries. The data from the cross-national Health Behaviour in School-aged Children (HBSC) study in 2017/2018 were employed (N = 195,966). Family support was measured using the four-item Family dimension of the Multidimensional Scale of Perceived Social Support (sum score 20 or more was categorised as high family support). Smoking was defined as a reported cigarette smoking at least 1-2 days in the last 30 days. The association between smoking and family support was assessed using a prevalence ratio (PR) obtained from the multivariate Poisson regression. Over two thirds of adolescents reported high levels of support from their family. Family support was found to significantly decrease with age in most of the countries, with the boys reported high level of family support more often than girls. The adolescents who reported having low family support also were more likely to smoke compared to their peers who reported having high family support (PR = 1.81; 95% CI: 1.71-1.91 in boys, and PR = 2.19; 95% CI: 2.08-2.31 in girls). The countries with a stronger effect of family support in reducing smoking risk indicated lower rates of adolescent smoking as well as lower increases in the cigarette smoking prevalence during the age period from 11 to 15 years. This study reinforces the need for family support, which is an important asset helping adolescents to overcome the risk of smoking during their transition from early to late adolescence.
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Affiliation(s)
- Apolinaras Zaborskis
- Faculty of Public Health, Medical Academy, Lithuanian University of Health Sciences, LT-44307 Kaunas, Lithuania
| | - Aistė Kavaliauskienė
- Faculty of Odontology, Medical Academy, Lithuanian University of Health Sciences, LT-44307 Kaunas, Lithuania;
| | - Charli Eriksson
- Department of Public Health Sciences, Stockholm University, SE-10691 Stockholm, Sweden;
| | - Ellen Klemera
- Centre for Health Services Studies, Division of Low, Society and Social Justice, University of Kent, Canterbury CT2 7NS, UK;
| | - Elitsa Dimitrova
- Institute for Population and Human Studies, Bulgarian Academy of Sciences & Plovdiv University Paisii Hilendarski, 1000 Sofia, Bulgaria;
| | - Marina Melkumova
- Arabkir Medical Centre-Institute of Child and Adolescent Health, National Institute of Health, Yerevan 0014, Armenia;
| | - Daniela Husarova
- Department of Health Psychology and Methodology Research, Faculty of Medicine, Pavol Jozef Šafárik University in Košice, 04011 Kosice, Slovakia;
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The Effect of Geometric Road Conditions on Safety Performance of Abu Dhabi Road Intersections. SAFETY 2021. [DOI: 10.3390/safety7040073] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Abu Dhabi’s government has taken several initiatives to improve the safety of the city’s highways, such as reducing traffic accident occurrence, red light violations, and property damage associated with traffic accidents. However, the intersections are still associated with many severe accidents, property damage associated with accidents, and red light violations. To help authorities pinpoint the major contributors to the deterioration of the safety performance of the signalized junctions, this study employed a negative binomial regression model to investigate the effect of geometric road conditions (in terms of the number of lanes of streets found in four-leg, three-leg, and different types of intersection) on property damage, red light violations, and severe accidents as safety performance indicators. The research found that, in both three-leg and four-leg intersections, most accidents and traffic light violations occur when minor streets pass through the intersection. This can be solved by converting these minor streets into major streets by increasing the number of lanes. This way, the capability of the minor street’s handling of increased traffic from the major streets significantly increases. The results also show that traffic speed is a major contributor to safety performance deterioration in these intersections. This can be solved by posting speed limits at these intersections. Results have also shown that, in Direction 1, when the main street passes through the intersection, the property damage type of accident is significantly high. This may be due to the presence of a potentially hazardous property or road design flaws on that side of the road. This effect needs further investigation to determine the hazardous property or the road design flaws causing these accidents.
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Slabšinskienė E, Gorelik A, Kavaliauskienė A, Zaborskis A. Burnout, lifestyle and relaxation among dentists in Lithuania: a cross-sectional study. BMC Health Serv Res 2021; 21:1098. [PMID: 34654421 PMCID: PMC8520307 DOI: 10.1186/s12913-021-07074-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Accepted: 09/22/2021] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND The aim of this study was to estimate the association of burnout level with lifestyle and relaxation among dentists in Lithuania. A better understanding of this association could help in the development of targeted interventions to prevent burnout among these professionals. METHODS The survey was conducted among practising dentists (N = 380) using the Maslach Burnout Inventory (MBI) and an authors' proposed scale to measure lifestyle and relaxation. Poisson regression was applied to examine the association between variables. RESULTS Regular cigarette smoking among dentists in Lithuania was 16.8 % and alcohol consumption was 31.3 %. Some forms of active relaxation were also common: regular playing sports (57.9 %), and spending time in nature (61.4 %). Emotional exhaustion (EE) and depersonalization (DP) burnout dimensions were negatively related to the regular use of illegal substances, alcohol, medication and smoking, while personal achievement (PA) was negatively related to smoking only. Dentists who regularly exercised had significantly lower EE and DP sum scores, and better assessments of PA. There were also positive relationships of EE, DP and PA sum scores with the variables of relaxation (e.g., spending time with family or friends, visiting a theatre, engaging in art, listening to music). CONCLUSIONS It was concluded that the burnout dimensions are negatively associated with unhealthy lifestyle factors and positively associated with active relaxation among dentists in Lithuania. Therefore, burnout prevention should target specific lifestyle and relaxation improvement strategies.
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Affiliation(s)
- Eglė Slabšinskienė
- Medical Academy, Faculty of Odontology, Department of Oral Health and Pediatric Dentistry, Lithuanian University of Health Sciences, Kaunas, Lithuania.
- Academy of Medicine, Faculty of Odontology, Department of Oral Health and Pediatric Dentistry, Lithuanian University of Health Sciences, J.Luksos-Daumanto street, 6, LT-50106, Kaunas, Lithuania.
| | - Andrej Gorelik
- Medical Academy, Faculty of Odontology, Department of Oral Health and Pediatric Dentistry, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Aistė Kavaliauskienė
- Medical Academy, Faculty of Odontology, Department of Orthodontics, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Apolinaras Zaborskis
- Medical Academy, Faculty of Public Health, Department of Preventive Medicine, Lithuanian University of Health Sciences, Kaunas, Lithuania
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Speer CG, Rendos NK, Davis CE, Au B, Manway JM, Burns PR. Reoperation, reamputation, and new ulceration following complete or partial toe amputation among diabetic and non-diabetic patients. Diabetes Res Clin Pract 2021; 179:109008. [PMID: 34411621 DOI: 10.1016/j.diabres.2021.109008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 07/19/2021] [Accepted: 08/11/2021] [Indexed: 01/22/2023]
Abstract
AIMS To compare the number of reoperations, reamputations, and new ulcers following toe amputation in diabetic and non-diabetic patients with sub-group analysis on index amputation level. METHODS One-hundred sixteen patients with a complete (CTA) or partial (PTA) toe amputation and minimum of 12-month (12 M) follow-up were identified in electronic medical records. The number of reoperations and reamputations, number and location of new ulcers, and final amputation level of the ipsilateral extremity were compared between diabetic and non-diabetic patients and between those with CTA and PTA at 12 M and final follow-up (FFU). RESULTS Diabetic patients had significantly more reoperations, reamputations, and new ulcers than non-diabetic patients at 12 M and FFU. There were no differences in reoperations, reamputations, or new ulcer location between CTA and PTA; however, patients with PTA developed more new ulcers at 12 M and FFU and were more likely to have a distal final amputation level compared to those with CTA. CONCLUSIONS Diabetic patients required significantly more reoperations and reamputations following a toe amputation and developed more new ulcers than non-diabetic patients regardless of index amputation level. These high rates among diabetic patients highlight the complications encountered following toe amputation and emphasize the need for close, multi-disciplinary care.
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Affiliation(s)
- Carl G Speer
- Emerald Coast Foot and Ankle Center, 8333 N Davis Highway, Suite 6E, Pensacola, FL, 32514, United States; Podiatric Medicine and Surgery Residency Program, University of Pittsburgh Medical Center, 1400 Locust Street, Pittsburgh, PA 15219, United States.
| | - Nicole K Rendos
- Division of Physical Therapy, Department of Rehabilitation Medicine, Emory University School of Medicine, 1441 Clifton Road NE, Atlanta, GA 30322, United States.
| | - Calvin E Davis
- Podiatric Medicine and Surgery Residency Program, University of Pittsburgh Medical Center, 1400 Locust Street, Pittsburgh, PA 15219, United States.
| | - Brian Au
- Podiatric Medicine and Surgery Residency Program, University of Pittsburgh Medical Center, 1400 Locust Street, Pittsburgh, PA 15219, United States.
| | - Jeffrey M Manway
- Podiatric Medicine and Surgery Residency Program, University of Pittsburgh Medical Center, 1400 Locust Street, Pittsburgh, PA 15219, United States.
| | - Patrick R Burns
- Podiatric Medicine and Surgery Residency Program, University of Pittsburgh Medical Center, 1400 Locust Street, Pittsburgh, PA 15219, United States.
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Slabšinskienė E, Kavaliauskienė A, Žemaitienė M, Vasiliauskienė I, Zaborskis A. Dental Fear and Associated Factors among Children and Adolescents: A School-Based Study in Lithuania. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18168883. [PMID: 34444632 PMCID: PMC8395053 DOI: 10.3390/ijerph18168883] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 08/19/2021] [Accepted: 08/20/2021] [Indexed: 12/12/2022]
Abstract
Dental fear is a challenging problem in dentistry and many contributing factors have been identified. Although this problem among children and adolescents has been studied in the literature for a long time, few such studies have been conducted in Lithuania. This study aimed to evaluate the prevalence of dental fear and examine its association with gender, age and several psychological and social factors among children and adolescents in Lithuania. The cross-sectional survey included a randomly selected sample (n = 1590) of children aged 11-14 and adolescents aged 15-18. The data were supplemented by interviewing the parents of these subjects (n = 1399). Dental fear was measured with a single five-score question. The data collection also included questions on oral health, socioeconomic status, oral health-related quality of life and self-esteem. Poisson regression analysis was used to assess the association between perception of dental fear and potential predictor variables. It was found that 32.2% (95% CI: 29.9-34.4%) of children and adolescents reported no fear of dental treatment, 12.5% (10.8-14.2%) of their peers were highly afraid of dental treatment, and other subjects assessed their dental fear gradually. Girls reported greater dental fear scores than boys, but the level of dental fear did not depend on the age. We identified the groups of subjects by gender and age, and a higher level of dental fear was significantly associated with untreated caries experience, a delay in the age of the subject's first visit to the dentist, low self-esteem, low oral health-related quality of life, low overall life satisfaction and low family affluence. The results also suggested that dental fear could originate from previous toothache, dentists' actions, high sensitivity in the child and poor psychological readiness for treatment. It was concluded that dental fear among Lithuanian children and adolescents is a common problem that is associated with gender and several dental, psychological and social factors. The findings indicate that school-based health policies, paediatric dentists and parents should be encouraged to focus on the psychosocial factors associated with dental fear because most of them can be prevented.
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Affiliation(s)
- Eglė Slabšinskienė
- Department of Oral Health and Paediatric Dentistry, Medical Academy, Lithuanian University of Health Sciences, LT-44307 Kaunas, Lithuania; (M.Ž.); (I.V.)
- Correspondence: ; Tel.: +37-037-388-192
| | - Aistė Kavaliauskienė
- Department of Orthodontics, Faculty of Odontology, Medical Academy, Lithuanian University of Health Sciences, LT-44307 Kaunas, Lithuania;
| | - Miglė Žemaitienė
- Department of Oral Health and Paediatric Dentistry, Medical Academy, Lithuanian University of Health Sciences, LT-44307 Kaunas, Lithuania; (M.Ž.); (I.V.)
| | - Ingrida Vasiliauskienė
- Department of Oral Health and Paediatric Dentistry, Medical Academy, Lithuanian University of Health Sciences, LT-44307 Kaunas, Lithuania; (M.Ž.); (I.V.)
| | - Apolinaras Zaborskis
- Department of Preventive Medicine & Health Research Institute, Faculty of Public Health, Medical Academy, Lithuanian University of Health Sciences, LT-44307 Kaunas, Lithuania;
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Liao R, Liu Y, Peng S, Feng XL. Factors affecting health care users' first contact with primary health care facilities in north eastern China, 2008-2018. BMJ Glob Health 2021; 6:bmjgh-2020-003907. [PMID: 33597277 PMCID: PMC7893657 DOI: 10.1136/bmjgh-2020-003907] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 01/03/2021] [Accepted: 01/26/2021] [Indexed: 12/15/2022] Open
Abstract
Background China set out the vision to establishing a hierarchical medical system, with primary health care (PHC) facilities serving health care users’ first contact. Common ailments were listed, supported by a series of auxiliary policy measures. We aim to assess whether these policies were effective to prompt users’ preference to PHCs within these contexts. Methods Using data from three waves of National Health Service Survey, we examined trends in care users’ first contact with PHC facilities in Jilin, a north eastern province, during 2008–2018. We analysed trends and factors affecting care users’ choices, stratified by type of diseases and urban–rural settings. Results From 38 823 respondents, the survey identified 3302 health care users who sought outpatient care. 54.92% and 82.49% with diseases recommended to PHC, in urban and rural Jilin, respectively, contacted PHC facilities first. While 33.51% and 61.19% with diseases not recommended to PHC did so. Care users’ first contact with PHC facilities followed an inverse U shape during 2008–2018. Such trends were more profound among care users with hypertension and/or diabetes. Neither social health insurance coverage nor contracting with family doctors was associated with care users’ first contacts. Only 1.25% care users had referral experiences. Low perceived quality was the main barrier to choose PHC facilities. Conclusion Health care users sought PHC in a chaotic manner in Jilin. None of the recent efforts seemed effective in prompting their preference to PHC facilities. Without levering quality of PHC, an effective hierarchical medical system could be hardly forged in China.
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Affiliation(s)
- Ran Liao
- Department of Health Policy and Management, School of Public Health, Peking University, Beijing, China
| | - Yaqian Liu
- Department of Health Policy and Management, School of Public Health, Peking University, Beijing, China
| | - Shunzhuang Peng
- Department of Health Policy and Management, School of Public Health, Peking University, Beijing, China
| | - Xing Lin Feng
- Department of Health Policy and Management, School of Public Health, Peking University, Beijing, China
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Mao W, Wu B, Chi I, Yang W, Dong X. Acculturation and Subsequent Oral Health Problems Among Foreign-Born Older Chinese Americans: Does Neighborhood Disorder Matter? Res Aging 2021; 44:231-240. [PMID: 34002640 DOI: 10.1177/01640275211018785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES To investigate the relationship between acculturation and subsequent oral health problems in older Chinese Americans and to further test the moderating role of neighborhood disorder in such a relationship. METHODS The working sample included 2,706 foreign-born community-dwelling older Chinese Americans aged 60 years or older who participated in the Population Study of Chinese Elderly in Chicago at baseline between 2011 and 2013 and the 2-year follow-up between 2013 and 2015. Stepwise Poisson regressions with lagged dependent variable were conducted. RESULTS Behavioral acculturation was protective against subsequent oral health problems, and the protective role was stronger among individuals reporting lower levels of neighborhood disorder. Residence in Chinatown was associated with an increase in the risk of subsequent oral health problems. DISCUSSION To reduce oral health symptoms and related burdens, it is important to consider, in practice and policy, the role of acculturation and the neighborhood on subsequent oral health outcomes.
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Affiliation(s)
- Weiyu Mao
- School of Social Work, University of Nevada, Reno, NV, USA
| | - Bei Wu
- Rory Meyers College of Nursing, New York University, NY, USA
| | - Iris Chi
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, USA
| | - Wei Yang
- School of Community Health Sciences, University of Nevada, Reno, NV, USA
| | - XinQi Dong
- Institute for Health, Health Care Policy and Aging Research, Rutgers University, New Brunswick, NJ, USA
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Burnout and Its Relationship with Demographic and Job-Related Variables among Dentists in Lithuania: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18083968. [PMID: 33918738 PMCID: PMC8069627 DOI: 10.3390/ijerph18083968] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 04/03/2021] [Accepted: 04/07/2021] [Indexed: 12/21/2022]
Abstract
Although burnout has been described as a serious hazard for personal and professional lives and has been surveyed among dentists in many countries, no study has been published regarding burnout among dentists in Lithuania. This study aimed to evaluate the burnout level among Lithuanian dentists and its association with demographic variables, job satisfaction, and other job-related variables. The data were collected among dentists online or during professional conferences while using an anonymous questionnaire (n = 380). The Maslach Burnout Inventory (MBI) was used to evaluate the burnout level. A Poisson regression was applied for the analysis of relationships between variables. We observed that 42.3% of the respondents had a high emotional exhaustion (EE) (95% confidence interval (CI): 37.4-42.3%), while 18.7% (95% CI: 15.0-22.9%) and 28,2% (95% CI: 23.4-32.6%) had high depersonalization (DP) and low personal accomplishment (PA), respectively. Nonetheless, 15.3% (95% CI: 11.8-18.9%) of the study population experienced a high level of overall burnout. An original job satisfaction index was elaborated. It was significantly associated with sum scores of all burnout dimensions: with the EE sum score (Ratio of Sum Score Means (RSSM) 1.54; 95% CI: 1.46-1.62), DP sum score (RSSM 1.59; 95% CI: 1.45-1.74), and PA sum score (RSSM 0.88; 95% CI: 0.84-0.92). It was concluded that Lithuanian dentists can be characterised by high burnout intensity and high prevalence of burnout, being especially evident in emotional exhaustion. The dentist with low job satisfaction appeared to be the most vulnerable to all burnout dimensions.
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Berger M, Tutz G. Transition models for count data: a flexible alternative to fixed distribution models. STAT METHOD APPL-GER 2021. [DOI: 10.1007/s10260-021-00558-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
AbstractA flexible semiparametric class of models is introduced that offers an alternative to classical regression models for count data as the Poisson and Negative Binomial model, as well as to more general models accounting for excess zeros that are also based on fixed distributional assumptions. The model allows that the data itself determine the distribution of the response variable, but, in its basic form, uses a parametric term that specifies the effect of explanatory variables. In addition, an extended version is considered, in which the effects of covariates are specified nonparametrically. The proposed model and traditional models are compared in simulations and by utilizing several real data applications from the area of health and social science.
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Patton MP, Moore L, Farhat I, Tardif PA, Gonthier C, Belcaid A, Lauzier F, Turgeon A, Clément J. Inter-hospital variation in surgical intensity for trauma admissions: A multicentre cohort study. Int J Clin Pract 2020; 74:e13613. [PMID: 32683730 DOI: 10.1111/ijcp.13613] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Accepted: 07/08/2020] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Guidelines for injury care are increasingly moving away from surgical management towards less invasive procedures but there is a knowledge gap on how these recommendations are influencing practice. We aimed to assess inter-hospital variation in surgical intensity for injury admissions and evaluate the correlation between hospital surgical intensity and mortality/complications. METHODS We included adults admitted for major trauma between 2006 and 2016 in a Canadian provincial trauma system. Analyses were stratified for orthopaedic (n = 16 887), neurological (n = 12 888) and torso injuries (n = 9816). Surgical intensity was quantified with the number of surgical procedures <72 hours. Inter-hospital variation was assessed with the intra-class correlation coefficient (ICC). We assessed the correlation between the risk-adjusted mean number of surgical procedures and risk-adjusted incidence of mortality and complications using Pearson correlation coefficients (r). RESULTS Moderate inter-hospital variation was observed for orthopaedic surgery (ICC = 14.0%) whereas variation was low for torso surgery (ICC = 2.7%) and neurosurgery (ICC = 0.8%). Surgical intensity was negatively correlated with hospital mortality for torso injury (r = -.32, P = .02) and neurotrauma (r = -.65, P = .08). A strong positive correlation was observed with hospital complications for orthopaedic injuries (r = .36, P = .006) whereas the opposite was observed for neurotrauma (r = -.71, P = .05). CONCLUSIONS Results should be interpreted with caution as they may be a result of residual confounding. However, they may suggest that there are opportunities for quality improvement in surgical care for injury admissions, particularly for orthopaedic injuries. Moving forward, we should aim to prospectively evaluate adherence to guidelines on non-operative management and their impact on mortality and morbidity.
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Affiliation(s)
- Marie-Pier Patton
- Department of Social and Preventive Medicine, Université Laval, Québec, QC, Canada
- Axe Santé des Populations et Pratiques Optimales en Santé (Population Health and Optimal Health Practices Research Unit), Traumatologie - Urgence - Soins intensifs (Trauma - Emergency - Critical Care Medicine), Centre de Recherche du CHU de Québec (Hôpital de l'Enfant-Jésus), Université Laval, Québec, QC, Canada
| | - Lynne Moore
- Department of Social and Preventive Medicine, Université Laval, Québec, QC, Canada
- Axe Santé des Populations et Pratiques Optimales en Santé (Population Health and Optimal Health Practices Research Unit), Traumatologie - Urgence - Soins intensifs (Trauma - Emergency - Critical Care Medicine), Centre de Recherche du CHU de Québec (Hôpital de l'Enfant-Jésus), Université Laval, Québec, QC, Canada
| | - Imen Farhat
- Department of Social and Preventive Medicine, Université Laval, Québec, QC, Canada
- Axe Santé des Populations et Pratiques Optimales en Santé (Population Health and Optimal Health Practices Research Unit), Traumatologie - Urgence - Soins intensifs (Trauma - Emergency - Critical Care Medicine), Centre de Recherche du CHU de Québec (Hôpital de l'Enfant-Jésus), Université Laval, Québec, QC, Canada
| | - Pier-Alexandre Tardif
- Department of Social and Preventive Medicine, Université Laval, Québec, QC, Canada
- Axe Santé des Populations et Pratiques Optimales en Santé (Population Health and Optimal Health Practices Research Unit), Traumatologie - Urgence - Soins intensifs (Trauma - Emergency - Critical Care Medicine), Centre de Recherche du CHU de Québec (Hôpital de l'Enfant-Jésus), Université Laval, Québec, QC, Canada
| | - Catherine Gonthier
- Institut national d'excellence en santé et en services sociaux (INESSS), Québec, QC, Canada
| | - Amina Belcaid
- Institut national d'excellence en santé et en services sociaux (INESSS), Québec, QC, Canada
| | - François Lauzier
- Axe Santé des Populations et Pratiques Optimales en Santé (Population Health and Optimal Health Practices Research Unit), Traumatologie - Urgence - Soins intensifs (Trauma - Emergency - Critical Care Medicine), Centre de Recherche du CHU de Québec (Hôpital de l'Enfant-Jésus), Université Laval, Québec, QC, Canada
- Department of Medicine, Université Laval, Québec, QC, Canada
- Division of Critical Care, Departement of Anesthesiology and Critical Care, Université Laval, Québec, QC, Canada
| | - Alexis Turgeon
- Axe Santé des Populations et Pratiques Optimales en Santé (Population Health and Optimal Health Practices Research Unit), Traumatologie - Urgence - Soins intensifs (Trauma - Emergency - Critical Care Medicine), Centre de Recherche du CHU de Québec (Hôpital de l'Enfant-Jésus), Université Laval, Québec, QC, Canada
- Department of Medicine, Université Laval, Québec, QC, Canada
| | - Julien Clément
- Departement of Surgery, Université Laval, Québec, QC, Canada
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Loyola S, Sanchez JF, Maguiña E, Canal E, Castillo R, Bernal M, Meza Y, Tilley DH, Oswald WE, Heitzinger K, Lescano AG, Rocha CA. Fecal Contamination of Drinking Water Was Associated with Diarrheal Pathogen Carriage among Children Younger than 5 Years in Three Peruvian Rural Communities. Am J Trop Med Hyg 2020; 102:1279-1285. [PMID: 32207402 DOI: 10.4269/ajtmh.19-0337] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Drinking water contamination is a frequent problem in developing countries and could be associated with bacterial pathogen carriage in feces. We evaluated the association between the risk of drinking water and bacterial carrier status in children younger than 5 years in a cross-sectional study conducted in 199 households from three Peruvian rural communities. Fecal samples from children were screened for pathogenic Aeromonas, Campylobacter, and Vibrio species, as well as for Enterobacteriaceae, including pathogenic Escherichia coli. The drinking water risk was determined using E. coli as an indicator of contamination. Nineteen (9.5%) children were colonized with pathogens and classified as carriers, all without diarrhea symptoms. Of 199 drinking water samples, 38 (19.1%) were classified as very high risk because of high fecal contamination (> 100 E. coli/100 mL). Shared-use water sources, daily washing of containers, and washing using only water were associated with higher prevalence of bacterial carriage, whereas there was no association between households reporting boiling and chlorination of water and carrier status. The prevalence of carriage in children exposed to very high-risk water was 2.82 (95% CI: 1.21-6.59) times the prevalence of those who consumed less contaminated water, adjusted by the water source and daily washing. Our results suggest that household drinking water plays an important role in the generation of carriers with diarrheal pathogens. Our findings also highlight the importance of interventions to ensure the safety of drinking water. Further studies are needed to validate the observed association and determine its significance with respect to diarrhea in the community.
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Affiliation(s)
- Steev Loyola
- School of Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru.,U.S. Naval Medical Research Unit No. 6, Lima, Peru
| | - Juan F Sanchez
- Emerge, Emerging Diseases and Climate Change Research Unit, School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru.,U.S. Naval Medical Research Unit No. 6, Lima, Peru
| | | | | | | | | | | | | | - William E Oswald
- Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | | | - Andres G Lescano
- Emerge, Emerging Diseases and Climate Change Research Unit, School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru.,U.S. Naval Medical Research Unit No. 6, Lima, Peru
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Bishop MR, Diaz Perez KK, Sun M, Ho S, Chopra P, Mukhopadhyay N, Hetmanski JB, Taub MA, Moreno-Uribe LM, Valencia-Ramirez LC, Restrepo Muñeton CP, Wehby G, Hecht JT, Deleyiannis F, Weinberg SM, Wu-Chou YH, Chen PK, Brand H, Epstein MP, Ruczinski I, Murray JC, Beaty TH, Feingold E, Lipinski RJ, Cutler DJ, Marazita ML, Leslie EJ. Genome-wide Enrichment of De Novo Coding Mutations in Orofacial Cleft Trios. Am J Hum Genet 2020; 107:124-136. [PMID: 32574564 PMCID: PMC7332647 DOI: 10.1016/j.ajhg.2020.05.018] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Accepted: 05/26/2020] [Indexed: 01/05/2023] Open
Abstract
Although de novo mutations (DNMs) are known to increase an individual's risk of congenital defects, DNMs have not been fully explored regarding orofacial clefts (OFCs), one of the most common human birth defects. Therefore, whole-genome sequencing of 756 child-parent trios of European, Colombian, and Taiwanese ancestry was performed to determine the contributions of coding DNMs to an individual's OFC risk. Overall, we identified a significant excess of loss-of-function DNMs in genes highly expressed in craniofacial tissues, as well as genes associated with known autosomal dominant OFC syndromes. This analysis also revealed roles for zinc-finger homeobox domain and SOX2-interacting genes in OFC etiology.
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Affiliation(s)
- Madison R. Bishop
- Department of Human Genetics, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Kimberly K. Diaz Perez
- Department of Human Genetics, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Miranda Sun
- Department of Comparative Biosciences, School of Veterinary Medicine, University of Wisconsin, Madison, WI 53706, USA
| | - Samantha Ho
- Department of Human Genetics, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Pankaj Chopra
- Department of Human Genetics, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Nandita Mukhopadhyay
- Department of Oral Biology, University of Pittsburgh School of Dental Medicine, Pittsburgh, PA 15219, USA
| | - Jacqueline B. Hetmanski
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA
| | - Margaret A. Taub
- Department of Biostatistics, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA
| | - Lina M. Moreno-Uribe
- Department of Orthodontics, College of Dentistry, University of Iowa, Iowa City, IA 52242, USA
| | | | | | - George Wehby
- Department of Health Management and Policy, College of Public Health, University of Iowa, Iowa City, IA 52242, USA
| | - Jacqueline T. Hecht
- Department of Pediatrics, McGovern Medical School and School of Dentistry, UT Health at Houston, Houston, TX 77030, USA
| | | | - Seth M. Weinberg
- Department of Oral Biology, University of Pittsburgh School of Dental Medicine, Pittsburgh, PA 15219, USA,Department of Human Genetics, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA 15219, USA
| | - Yah Huei Wu-Chou
- Department of Medical Research, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Philip K. Chen
- Craniofacial Centre, Taipei Medical University Hospital and Taipei Medical University, Taipei, Taiwan
| | - Harrison Brand
- Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
| | - Michael P. Epstein
- Department of Human Genetics, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Ingo Ruczinski
- Department of Biostatistics, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA
| | - Jeffrey C. Murray
- Department of Pediatrics, Carver College of Medicine, University of Iowa, Iowa City, IA 52242, USA
| | - Terri H. Beaty
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA
| | - Eleanor Feingold
- Department of Human Genetics, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA 15219, USA
| | - Robert J. Lipinski
- Department of Comparative Biosciences, School of Veterinary Medicine, University of Wisconsin, Madison, WI 53706, USA
| | - David J. Cutler
- Department of Human Genetics, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Mary L. Marazita
- Department of Oral Biology, University of Pittsburgh School of Dental Medicine, Pittsburgh, PA 15219, USA,Department of Human Genetics, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA 15219, USA
| | - Elizabeth J. Leslie
- Department of Human Genetics, Emory University School of Medicine, Atlanta, GA 30322, USA,Corresponding author
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Kavaliauskienė A, Šidlauskas A, Žemaitienė M, Slabšinskienė E, Zaborskis A. Relationships of Dental Caries and Malocclusion with Oral Health-Related Quality of Life in Lithuanian Adolescents Aged 15 to 18 Years: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17114072. [PMID: 32521600 PMCID: PMC7311969 DOI: 10.3390/ijerph17114072] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Revised: 06/01/2020] [Accepted: 06/02/2020] [Indexed: 11/16/2022]
Abstract
There is a lack of evidence of the moderating effects of caries lesions and malocclusions on oral health-related quality of life (OHRQoL) among older adolescents. This study aimed to evaluate the relationship of dental caries and malocclusion with OHRQoL among Lithuanian adolescents aged 15 to 18 years. A survey in a representative sample of adolescents included a clinical examination to assess dental health status using the DMFT (Decayed, Missing, and Filled Permanent Teeth) index, and malocclusion using the Index of Complexity, Outcome, and Need (ICON). The Child Perceptions Questionnaire (CPQ) was used to evaluate respondents’ OHRQoL. Negative binomial regression was fitted to associate the clinical variables with the CPQ scores. A total of 600 adolescents were examined. The overall mean DMFT score was 2.7. A need for orthodontic treatment was detected among 27.7% of adolescents. Subjects with caries lesions (DMFT > 3) had higher CPQ scores in the domains of functional limitations and social wellbeing (relative risks were 1.35 (95% confidence interval: 1.09–1.67) and 1.30 (1.03–1.64), respectively), while subjects with a need for orthodontic treatment (ICON > 43) had higher CPQ scores in the domains of emotional wellbeing and social wellbeing (relative risks were 1.81 (1.40–2.22), and 1.69 (1.34–2.14), respectively). It was concluded that both dental caries and malocclusion have negative relationships with OHRQoL in adolescents above 15 years, but their effects occur differently in each OHRQoL domain.
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Affiliation(s)
- Aistė Kavaliauskienė
- Department of Orthodontics, Faculty of Odontology, Medical Academy, Lithuanian University of Health Sciences, A.Mickevičiaus 9, LT-44307 Kaunas, Lithuania; (A.K.); (A.Š.)
| | - Antanas Šidlauskas
- Department of Orthodontics, Faculty of Odontology, Medical Academy, Lithuanian University of Health Sciences, A.Mickevičiaus 9, LT-44307 Kaunas, Lithuania; (A.K.); (A.Š.)
| | - Miglė Žemaitienė
- Department of Oral Health and Paediatric Dentistry, Medical Academy, Lithuanian University of Health Sciences, A.Mickevičiaus 9, LT-44307 Kaunas, Lithuania; (M.Ž.); (E.S.)
| | - Eglė Slabšinskienė
- Department of Oral Health and Paediatric Dentistry, Medical Academy, Lithuanian University of Health Sciences, A.Mickevičiaus 9, LT-44307 Kaunas, Lithuania; (M.Ž.); (E.S.)
| | - Apolinaras Zaborskis
- Department of Preventive Medicine & Health Research Institute, Faculty of Public Health, Medical Academy, Lithuanian University of Health Sciences, A.Mickevičiaus 9, LT-44307 Kaunas, Lithuania
- Correspondence: ; Tel.: +370-3724-2920
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McGee BT, Higgins MK, Phillips V, Butler J. Prescription drug spending and hospital use among Medicare beneficiaries with heart failure. Res Social Adm Pharm 2020; 16:1452-1458. [PMID: 31953113 DOI: 10.1016/j.sapharm.2019.12.019] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Accepted: 12/20/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND Heart failure (HF) is a common cause of hospitalization in Medicare. Optimal medication adherence lowers hospitalization risk in HF patients. Although out-of-pocket spending can adversely affect adherence to HF medications, it is unknown whether medication spending ultimately increases hospital use for Medicare beneficiaries with HF. OBJECTIVE To examine the association between out-of-pocket medication payments and HF-related hospital use among Medicare Part D subscribers. METHODS Retrospective analysis of the 2010-12 Medicare Current Beneficiary Survey. The sample comprised community-dwelling respondents with fee-for-service Medicare, continuous Part D coverage, and self-reported HF (n = 819 participant-year records). The effects of average out-of-pocket payment for a 30-day HF-related prescription on odds and frequency of hospitalization and total inpatient days attributable to HF were estimated. Design-adjusted models adjusted for sociodemographic and health status variables, survey year and censoring, and included a pre-specified interaction of out-of-pocket payment with Medicaid co-eligibility. RESULTS The interaction term was statistically significant in all the models. For beneficiaries without Medicaid, average out-of-pocket payment per prescription was not significantly associated with odds of HF-related hospitalization (odds ratio = 1.01, 95% CI = 0.98-1.05, P = .399). The association between out-of-pocket payment and hospitalization frequency was statistically significant (incidence rate ratio [IRR] = 1.02, 95% CI = 1.00-1.05, P = .048), as was the association between out-of-pocket payment and total inpatient days (IRR = 1.04, 95% CI = 1.00-1.08, P = .041). For Medicaid co-eligible beneficiaries, the validity of model estimates is limited, because the range of actual out-of-pocket payments was negligible. CONCLUSIONS Fee-for-service Medicare beneficiaries with Part D, self-reported HF, and no supplemental Medicaid tolerated out-of-pocket medication payments without elevated risk of HF-related hospital use, but medication spending modestly increased hospital use intensity. Therefore, Part D plans with higher out-of-pocket requirements for essential HF medications may warrant additional scrutiny.
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Affiliation(s)
- Blake Tyler McGee
- Laney Graduate School, Emory University, 201 Dowman Dr. NW, Atlanta, GA, 30322, USA.
| | - Melinda K Higgins
- Nell Hodgson Woodruff School of Nursing, Emory University, 1520 Clifton Rd. NW, Atlanta, GA, 30322, USA.
| | - Victoria Phillips
- Rollins School of Public Health, Emory University, 1518 Clifton Rd. NW, Atlanta, GA, 30322, USA.
| | - Javed Butler
- Department of Medicine, University of Mississippi, 2500 N State St. Jackson, MS, 39216, USA.
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Family Affluence Based Inequality in Oral Health-Related Quality of Life in a Population of Lithuanian Adolescents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16122106. [PMID: 31197104 PMCID: PMC6616952 DOI: 10.3390/ijerph16122106] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Revised: 06/10/2019] [Accepted: 06/12/2019] [Indexed: 12/22/2022]
Abstract
Background: The social inequalities in oral health have had increasing attention in recent years. The present study aimed to explore the impact of family affluence on Oral Health-Related Quality of Life (OHRQoL) among Lithuanian adolescents aged 11–18 years. Methods: The cross-sectional, population-based study included a representative sample of 881 adolescents aged 11–18 years (mean = 15.55; SD = 1.51) randomly selected from 20 schools in Lithuania. The schoolchildren completed questionnaires to evaluate their OHRQoL using a Lithuanian version of the Child Perceptions Questionnaire (CPQ). The adolescents’ family affluence was indirectly assessed by inquiring whether they possessed various modern life items. In dental examination, the severity of malocclusion was predetermined by the Index of Complexity, Outcome, and Need (ICON). The relationship among variables was examined employing the negative binomial regression and the path analysis. Results: The sum score of CPQ as a whole and the sum scores of all four domains were significantly associated with family affluence, indicating higher OHRQoL among adolescents from more affluent families. The severity of malocclusion had a significant association with emotional and social well-being domains of OHRQoL only. Conclusion: This study evidences the family affluence based inequality in OHRQoL among Lithuanian adolescents.
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Romero-Sandoval N, Alcázar DD, Pastor J, Martín M. Ecuadorian infant mortality linked to socioeconomic factors during the last 30 years. REVISTA BRASILEIRA DE SAÚDE MATERNO INFANTIL 2019. [DOI: 10.1590/1806-93042019000200003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Abstract Objectives: to analyze the difference among geographical units and the evolution of infant mortality rate (IMR) based on Ecuadorian censuses (1990-2001-2010). Methods: artificial Neural Network analyzed the impact of sociodemographic factors over the variability of IMR. Poisson regression analyzed the variation of the standardized IMR (sIMR). Results: the decrease in the national IMR was 63.8%; however, 42.8% provinces showed an increase in 2001-2010. The variability was explained mainly by illiteracy decrease. The adjusted RR between provincial sIMR with illiteracy and poverty revealed a trend towards the unit. Conclusions: the variation of IMR reflects a complex interaction of the sociodemographic factors.
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Characterization of EIAV env Quasispecies during Long-Term Passage In Vitro: Gradual Loss of Pathogenicity. Viruses 2019; 11:v11040380. [PMID: 31022927 PMCID: PMC6520696 DOI: 10.3390/v11040380] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Revised: 04/08/2019] [Accepted: 04/17/2019] [Indexed: 01/12/2023] Open
Abstract
As the only widely used live lentiviral vaccine, the equine infectious anima virus (EIAV) attenuated vaccine was developed by in vitro passaging of a virulent strain for 121 generations. In our previous study, we observed that the attenuated vaccine was gradually selected under increased environmental pressure at the population level (termed a quasispecies). To further elucidate the potential correlation between viral quasispecies evolution and pathogenesis, a systematic study was performed by sequencing env using several methods. Some key mutations were identified within Env, and we observed that increased percentages of these mutations were accompanied by an increased passage number and attenuated virulence. Phylogenetic analysis revealed that env mutations related to the loss of virulence might have occurred evolutionarily. Among these mutations, deletion of amino acid 236 in the V4 region of Env resulted in the loss of one N-glycosylation site that was crucial for virulence. Notably, the 236-deleted sequence represented a "vaccine-specific" mutation that was also found in wild EIAVLN40 strains based on single genome amplification (SGA) analysis. Therefore, our results suggest that the EIAV attenuated vaccine may originate from a branch of quasispecies of EIAVLN40. Generally, the presented results may increase our understanding of the attenuation mechanism of the EIAV vaccine and provide more information about the evolution of other lentiviruses.
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Doyle JR, Bottomley PA. The relative age effect in European elite soccer: A practical guide to Poisson regression modelling. PLoS One 2019; 14:e0213988. [PMID: 30943241 PMCID: PMC6447143 DOI: 10.1371/journal.pone.0213988] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Accepted: 03/05/2019] [Indexed: 11/19/2022] Open
Abstract
Many disciplines of scholarship are interested in the Relative Age Effect (RAE), whereby age-banding confers advantages on older members of the cohort over younger ones. Most research does not test this relationship in a manner consistent with theory (which requires a decline in frequency across the cohort year), instead resorting to non-parametric, non-directional approaches. In this article, the authors address this disconnect, provide an overview of the benefits associated with Poisson regression modelling, and two managerially useful measures for quantifying RAE bias, namely the Indices of Discrimination and Wastage. In a tutorial-like exposition, applications and extensions of this approach are illustrated using data on professional soccer players competing in the top two tiers of the "Big Five" European football leagues in the search to identify paragon clubs, leagues, and countries from which others may learn to mitigate this form of age-discrimination in the talent identification process. As with OLS regression, Poisson regression may include more than one independent variable. In this way we test competing explanations of RAE; control for unwanted sources of covariation; model interaction effects (that different clubs and countries may not all be subject to RAE to the same degree); and test for non-monotonic versions of RAE suggested in the literature.
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Affiliation(s)
- John R. Doyle
- Business School, Cardiff University, Cardiff, Wales, United Kingdom
| | - Paul A. Bottomley
- Business School, Cardiff University, Cardiff, Wales, United Kingdom
- * E-mail:
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Khatun W, Alam A, Rasheed S, Huda TM, Dibley MJ. Exploring the intergenerational effects of undernutrition: association of maternal height with neonatal, infant and under-five mortality in Bangladesh. BMJ Glob Health 2018; 3:e000881. [PMID: 30498585 PMCID: PMC6254740 DOI: 10.1136/bmjgh-2018-000881] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Revised: 08/16/2018] [Accepted: 08/20/2018] [Indexed: 12/11/2022] Open
Abstract
Background Global or regional evidence showed maternal height as a strong predictor of child survival. However, there is limited information that confirms the intergenerational effect of short maternal height on the risk of offspring mortality in Bangladesh. Therefore, this study aimed to examine the association of maternal height with neonatal, infant and under-five mortality in Bangladesh. Methods It was a pooled analysis of data from four rounds of Bangladesh Demographic and Health Surveys 2004, 2007, 2011 and 2014. We included singleton children aged 0-59 months born to mothers aged 15-49 years (n = 29 698). Mothers were interviewed to collect data on maternal and child characteristics, and socio-demographic information. Maternal height was measured using an adjustable measuring board calibrated in millimetres. We used STATA V.14.2 and adjusted for the cluster sampling design. Multivariate 'Modified Poisson Regression' was performed using stepwise backward elimination procedures to examine the association between maternal height and child death. Results In the adjusted model, every 1 cm increase maternal height was associated with a reduced risk of neonatal mortality (relative risk (RR) = 0.973, 95% CI 0.960 to 0.986), infant mortality (RR = 0.980, 95% CI 0.969 to 0.991) and under-five mortality (RR = 0.982, 95% CI 0.972 to 0.992). Children of the shortest mothers (height<145 cm) had 1.73 times greater risk of neonatal mortality, about 1.60 times greater risk of infant mortality and 1.48 times greater risk of under-five mortality compared with those of tall mothers (height≥155 cm). Among the children of the shortest mothers (height<145 cm), the absolute probabilities for neonatal, infant and under-five mortality were 4.4%, 6.0% and 6.5%, respectively, while for the children of the tall mothers (height≥ 155 cm), the absolute probabilities for neonatal, infant and under-five mortality were 2.6%, 3.7 %, and 4.4%, respectively. Conclusion These findings suggest a robust intergenerational linkage between short maternal height and the risk of neonatal, infant and under-five mortally in Bangladesh.
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Affiliation(s)
- Wajiha Khatun
- Sydney School of Public Health, University of Sydney, Sydney, New South Wales, Australia
| | - Ashraful Alam
- Sydney School of Public Health, University of Sydney, Sydney, New South Wales, Australia
| | - Sabrina Rasheed
- International Centre for Diarrhoeal Disease Research Bangladesh, Dhaka, Bangladesh
| | - Tanvir M Huda
- Sydney School of Public Health, University of Sydney, Sydney, New South Wales, Australia
| | - Michael J Dibley
- Sydney School of Public Health, University of Sydney, Sydney, New South Wales, Australia
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Alkandari O, Nguyen L, Hebert D, Langlois V, Jawa NA, Parekh RS, Robinson LA. Acute Kidney Injury in Children with Kidney Transplantation. Clin J Am Soc Nephrol 2018; 13:1721-1729. [PMID: 30242029 PMCID: PMC6237068 DOI: 10.2215/cjn.02440218] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Accepted: 08/08/2018] [Indexed: 12/29/2022]
Abstract
BACKGROUND AND OBJECTIVES AKI is associated with progression of CKD. Little is known about AKI after kidney transplantation in pediatric recipients. We aim to describe the epidemiology, risk factors, consequences, and outcomes of AKI in this population. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS We performed a retrospective longitudinal analysis of pediatric kidney transplant recipients followed at The Hospital for Sick Children (Toronto, Canada) from 2001 to 2012. AKI was defined as an increase in serum creatinine ≥1.5 times baseline, and a rise of serum creatinine ≥1.25 but <1.5 times baseline defined subacute AKI. RESULTS Of 179 children, 122 were eligible for analysis. At baseline (3 months post-transplant), median age of the children was 13 years old (interquartile range, 9-16 years old), and 53% had CKD stage 2. Congenital anomalies of the kidney and urinary tract accounted for 46% of children. Over the study period (12 years), the incidence of AKI was 37% (n=45 children), and 65% (79 children) experienced subacute AKI. Twenty-seven percent (33 children) did not develop AKI or subacute AKI. The main causes of AKI were infections other than urinary tract infections, rejection, and urinary tract infections. In a multivariable Poisson regression analysis, independent risk factors for AKI included younger age, girls, grafts from deceased donors, and lower baseline eGFR. AKI was significantly associated with lower long-term GFR and graft loss independent of rejection episodes. Moreover, subacute AKI was associated with progression of CKD. CONCLUSIONS AKI and subacute AKI were common after pediatric kidney transplantation, and they were associated with graft loss, lower eGFR, and more rapid progression of CKD.
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Affiliation(s)
- Omar Alkandari
- Division of Pediatric Nephrology, Mubarak Al-Kabeer Hospital and Hamid Al-Essa Organ Transplant Center, Jabriya, Kuwait
| | - Lieuko Nguyen
- Division of Pediatric Nephrology, Rady Children’s Hospital, San Diego, California
| | - Diane Hebert
- Division of Nephrology, The Hospital for Sick Children, Toronto, Ontario, Canada
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Valerie Langlois
- Division of Nephrology, The Hospital for Sick Children, Toronto, Ontario, Canada
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Natasha A. Jawa
- Division of Nephrology, The Hospital for Sick Children, Toronto, Ontario, Canada
- SickKids Research Institute, Toronto, Ontario, Canada; and
| | - Rulan S. Parekh
- Division of Nephrology, The Hospital for Sick Children, Toronto, Ontario, Canada
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- SickKids Research Institute, Toronto, Ontario, Canada; and
- Division of Nephrology, University Health Network, Toronto, Ontario, Canada
| | - Lisa A. Robinson
- Division of Nephrology, The Hospital for Sick Children, Toronto, Ontario, Canada
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- SickKids Research Institute, Toronto, Ontario, Canada; and
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Kavaliauskienė A, Šidlauskas A, Zaborskis A. Relationship Between Orthodontic Treatment Need and Oral Health-Related Quality of Life among 11⁻18-Year-Old Adolescents in Lithuania. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15051012. [PMID: 29772849 PMCID: PMC5982051 DOI: 10.3390/ijerph15051012] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Revised: 05/10/2018] [Accepted: 05/15/2018] [Indexed: 12/13/2022]
Abstract
The aim was to examine the relationship between orthodontic treatment need and Oral Health-Related Quality of Life (OHRQoL) among Lithuanian adolescents aged 11–18 across gender and age groups. A representative cross-sectional study of 911 adolescents aged 11–18 (mean (M) = 15.53; Standard Deviation (SD) = 1.52) was conducted in 26 public schools. The schoolchildren completed the Child Perceptions Questionnaire to evaluate their OHRQoL. The Index of Orthodontic Treatment Need (IOTN) was used to evaluate the severity of malocclusion. The strength of association between variables was evaluated via negative binomial regression estimating the ratio of sum score means (RSSM). A worse OHRQoL score was associated with a higher grade of IOTN; however, only the Emotional and Social wellbeing domains were significantly affected by malocclusion (RSSM = 1.158; 95% Confidence Interval (CI): 1.083–1.237 and RSSM = 1.205; 95% CI: 1.114–1.304, respectively). The significant association was identified only among females (RSSM = 1.264; 95% CI: 1.176–1.359). A significant association was observed in all age groups for Emotional and Social well-being domains but only in the oldest age group for Oral Symptoms and Functional Limitations domains. Conclusions: Malocclusion has a negative impact on the OHRQoL of young people with emotional and social aspects being the most affected. Girls and older adolescents suffered from malocclusion more than boys and their younger counterparts.
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Affiliation(s)
- Aistė Kavaliauskienė
- Department of Orthodontics, Faculty of Odontology, Medical Academy, Lithuanian University of Health Sciences, A.Lukšos-Daumanto Street 6, LT-50106 Kaunas, Lithuania.
| | - Antanas Šidlauskas
- Department of Orthodontics, Faculty of Odontology, Medical Academy, Lithuanian University of Health Sciences, A.Lukšos-Daumanto Street 6, LT-50106 Kaunas, Lithuania.
| | - Apolinaras Zaborskis
- Department of Preventive Medicine & Health Research Institute, Faculty of Public Health, Medical Academy, Lithuanian University of Health Sciences, Tilžės Street 18, LT-47181 Kaunas, Lithuania.
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Workie DL, Zike DT, Fenta HM, Mekonnen MA. Weighted log-linear models for service delivery points in Ethiopia: a case of modern contraceptive users at health facilities. Reprod Health 2018; 15:78. [PMID: 29747681 PMCID: PMC5946447 DOI: 10.1186/s12978-018-0520-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Accepted: 05/02/2018] [Indexed: 11/10/2022] Open
Abstract
Background Ethiopia is among countries with low contraceptive usage prevalence rate and resulted in high total fertility rate and unwanted pregnancy which intern affects the maternal and child health status. This study aimed to investigate the major factors that affect the number of modern contraceptive users at service delivery point in Ethiopia. Methods The Performance Monitoring and Accountability2020/Ethiopia data collected between March and April 2016 at round-4 from 461 eligible service delivery points were in this study. The weighted log-linear negative binomial model applied to analyze the service delivery point’s data. Results Fifty percent of service delivery points in Ethiopia given service for 61 modern contraceptive users with the interquartile range of 0.62. The expected log number of modern contraceptive users at rural was 1.05 (95% Wald CI: − 1.42 to − 0.68) lower than the expected log number of modern contraceptive users at urban. In addition, the expected log count of modern contraceptive users at others facility type was 0.58 lower than the expected log count of modern contraceptive users at the health center. The numbers of nurses/midwives were affecting the number of modern contraceptive users. Since, the incidence rate of modern contraceptive users increased by one due to an additional nurse in the delivery point. Conclusion Among different factors considered in this study, residence, region, facility type, the number of days per week family planning offered, the number of nurses/midwives and number of medical assistants were to be associated with the number of modern contraceptive users. Thus, the Government of Ethiopia would take immediate steps to address causes of the number of modern contraceptive users in Ethiopia.
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Affiliation(s)
- Demeke Lakew Workie
- Statistics Department, Science College, Bahir Dar University, Bahir Dar, Ethiopia.
| | - Dereje Tesfaye Zike
- Statistics Department, Science College, Bahir Dar University, Bahir Dar, Ethiopia
| | - Haile Mekonnen Fenta
- Statistics Department, Science College, Bahir Dar University, Bahir Dar, Ethiopia
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Change in college students' perceived parental permissibility of alcohol use and its relation to college drinking. Addict Behav 2018; 76:275-280. [PMID: 28886576 DOI: 10.1016/j.addbeh.2017.08.025] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2017] [Revised: 07/11/2017] [Accepted: 08/28/2017] [Indexed: 11/24/2022]
Abstract
College students who perceive their parents to hold permissive views about their alcohol use engage in heavier drinking. However, few studies have assessed perceived parental permissibility of alcohol use (PPP) longitudinally across the later college years, and few have assessed variation in changes in PPP and whether or not these changes differentially predict drinking. This study assessed whether PPP changed across college and used two approaches to determine whether PPP predicted binge drinking frequency and peak drinking. Data on college students' daily lives and risk behaviors were collected from 687 students (51% female) in a large university in the Northeast United States over four years. Perceived parental permissibility of alcohol use increased from the last year of high school through the third year of college with males reporting significantly higher PPP by the third year of college. From 12th grade through the third year of college, between-person differences in mean PPP were positively associated with binge drinking frequency and peak drinking, and patterns of PPP change differentially predicted both drinking outcomes through fourth year. These findings suggest that PPP is a dynamic construct that may evidence important developmental changes across college and the transition to adulthood. More broadly, the results indicate that aspects of the parent-child relationship continue to change after high school and may be important as they are linked with college student risk behaviors.
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Rehn M, Weaver AE, Eshelby S, Røislien J, Lockey DJ. Pre-hospital transfusion of red blood cells in civilian trauma patients. Transfus Med 2017; 28:277-283. [PMID: 29067785 DOI: 10.1111/tme.12483] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Revised: 09/29/2017] [Accepted: 10/02/2017] [Indexed: 12/27/2022]
Abstract
INTRODUCTION The current management of severely injured patients includes damage control resuscitation strategies that minimise the use of crystalloids and emphasise earlier transfusion of red blood cells (RBC) to prevent coagulopathy. In 2012, London's air ambulance (LAA) became the first UK civilian pre-hospital service to routinely carry RBC to the trauma scene. OBJECTIVE To investigate the effect of pre-hospital RBC transfusion (phRTx) on overall blood product consumption. METHODS A retrospective trauma database study compares before implementation with after implementation of phRTx in exsanguinating trauma patients transported directly to one major trauma centre. Pre-hospital deaths were excluded. Univariate and multivariate Poisson regression analyses on data subject to multiple imputation were conducted. RESULTS We included 137 and 128 patients in the before and after the implementation of phRTx groups, respectively. LAA transfused 304 RBC units (median 2, inter quartile range 1-3). We found a significant reduction in total RBC usage and reduced early use of platelets and fresh-frozen plasma (FFP) after the implementation of phRTx in both univariate (P < 0·001) and multivariate analyses (P < 0·001). No immediate adverse transfusion reactions were identified. CONCLUSION Pre-hospital trauma transfusion practice is feasible and associated with overall reduced RBC, platelets and FFP consumption.
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Affiliation(s)
- M Rehn
- London's Air Ambulance, Royal London Hospital, London, UK.,The Norwegian Air Ambulance Foundation, Drøbak, Norway.,Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
| | - A E Weaver
- London's Air Ambulance, Royal London Hospital, London, UK
| | - S Eshelby
- Croydon University Hospital, Croydon Healthcare Trust, London, UK
| | - J Røislien
- The Norwegian Air Ambulance Foundation, Drøbak, Norway.,Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
| | - D J Lockey
- London's Air Ambulance, Royal London Hospital, London, UK.,Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
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Nazareth JV, de Souza KV, Beinner MA, Barra JS, Brüggemann OM, Pimenta AM. Special attention to women experiencing high-risk pregnancy: Delivery, care assistance and neonatal outcomes in two Brazilian maternity wards. Midwifery 2017; 53:42-48. [PMID: 28750275 DOI: 10.1016/j.midw.2017.07.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2016] [Revised: 06/01/2017] [Accepted: 07/15/2017] [Indexed: 11/18/2022]
Abstract
BACKGROUND To compare two care models of high-risk pregnant women--a House for Pregnant Women, staffed by nurse-midwives, versus a traditional care model in a hospital maternity ward. DESIGN This was across-sectional study conducted in two reference maternity hospitals for high-risk pregnancies, in Belo Horizonte, Minas Gerais, Brazil. The sample consisted of 312 high-risk pregnant women consecutively admitted from January 1st to December 31st, 2010, either to the House for Pregnant Women (n=247), or the hospital maternity ward (n=65). Gestational ages varied from 22 weeks to 36 weeks and six days. We measured individual, demographic, obstetric, labour and delivery variables, and newborn characteristics. For data analysis, we used descriptive, bivariate and multivariate statistics using Poisson regression, with a 5% significance level. FINDINGS At the conventional hospital maternity ward, more women had six or more antenatal exams, greater frequencies of diagnosis related to blood pressure, and a greater number of women underwent either a C-section or a vaginal delivery with an episiotomy and analgesia. At the House for Pregnant Women, the majority of the hospitalizations were related to preterm labour and premature rupture of membranes. There were no statistical differences in the newborn characteristics. KEY CONCLUSIONS The House for Pregnant Women care model, utilizing midwives was less interventionist, yet with results as favorable as in a conventional maternity hospital setting.
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Affiliation(s)
| | | | - Mark Anthony Beinner
- School of Nursing, Universidade Federal de Minas Gerais - UFMG, Belo Horizonte, Brazil.
| | - Juliana Silva Barra
- School of Medicine, Universidade Federal de Minas Gerais - UFMG, Belo Horizonte, Brazil
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Baumann E, Czerwinski F, Reifegerste D. Gender-Specific Determinants and Patterns of Online Health Information Seeking: Results From a Representative German Health Survey. J Med Internet Res 2017; 19:e92. [PMID: 28377367 PMCID: PMC5395693 DOI: 10.2196/jmir.6668] [Citation(s) in RCA: 76] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2016] [Revised: 12/07/2016] [Accepted: 02/14/2017] [Indexed: 11/13/2022] Open
Abstract
Background Online health information-seeking behavior (OHISB) is currently a widespread and common behavior that has been described as an important prerequisite of empowerment and health literacy. Although demographic factors such as socioeconomic status (SES), age, and gender have been identified as important determinants of OHISB, research is limited regarding the gender-specific motivational determinants of OHISB and differences between women and men in the use of online resources for health information purposes. Objective The aim of this study was to identify gender-specific determinants and patterns of OHISB by analyzing data from a representative German sample of adults (N=1728) with special attention to access and frequency of use as well as topics and sources of OHISB. Methods We employed a 2-step analysis, that is, after exploring differences between users and nonusers of online health information using logistic regression models, we highlighted gender-specific determinants of the frequency of OHISB by applying zero-truncated negative binomial models. Results Age (odds ratio, OR for females=0.97, 95% CI 0.96-0.99) and degree of satisfaction with one’s general practitioner (GP) (OR for males=0.73, 95% CI 0.57-0.92) were gender-specific determinants of access to OHISB. Regarding the frequency of OHISB, daily Internet use (incidence rate ratio, IRR=1.67, 95% CI 1.19-2.33) and a strong interest in health topics (IRR=1.45, 95% CI 1.19-1.77) were revealed to be more important predictors than SES (IRR for high SES=1.25, 95% CI 0.91-1.73). Conclusions Users indicate that the Internet seems to be capable of providing a valuable source of informational support and patient empowerment. Increasing the potential value of the Internet as a source for health literacy and patient empowerment requires need-oriented and gender-specific health communication efforts, media, and information strategies.
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Affiliation(s)
- Eva Baumann
- Hanover Center for Health Communication, Department of Journalism and Communication Research, Hanover University of Music, Drama, and Media, Hanover, Germany
| | - Fabian Czerwinski
- Hanover Center for Health Communication, Department of Journalism and Communication Research, Hanover University of Music, Drama, and Media, Hanover, Germany
| | - Doreen Reifegerste
- Hanover Center for Health Communication, Department of Journalism and Communication Research, Hanover University of Music, Drama, and Media, Hanover, Germany
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Tracas A, Bazzi AR, Artamonova I, Rangel MG, Staines H, Ulibarri MD. Changes in Condom Use Over Time Among Female Sex Workers and Their Male Noncommercial Partners and Clients. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2016; 28:312-24. [PMID: 27427926 PMCID: PMC5356484 DOI: 10.1521/aeap.2016.28.4.312] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Female sex workers (FSWs) often report inconsistent condom use with clients and noncommercial male partners, yet changes in condom use with various partner types during participation in observation studies remains underexplored. This longitudinal study of 214 FSWs and their male, noncommercial partners in the Mexico-U.S. border region, where HIV prevalence among FSWs continues to be high, utilized negative binomial regressions to examine changes in condom use with intimate partners and clients (regular and nonregular) over 24 months. Condom use decreased over time among couples in Ciudad Juarez, but there was no change in condom use among couples in Tijuana. FSWs' condom use with regular and nonregular clients significantly increased over time, which is consistent with previous research finding behavioral changes when participating in observational studies. Findings suggest the need for continued efforts to promote condom use among FSWs and their noncommercial male partners in addition to clients.
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Affiliation(s)
- Ashley Tracas
- Department of Psychology, San Diego State University, San Diego, California
| | - Angela Robertson Bazzi
- Department of Community Health Sciences, School of Public Health, Boston University, Boston, Massachusetts
| | - Irina Artamonova
- Division of Global Public Health, School of Medicine, University of California, San Diego, La Jolla, California
| | - M Gudelia Rangel
- Comisión de Salud Fronteriza México-Estado Unidos, Tijuana, Baja California, México
| | - Hugo Staines
- Departamento de Ciencias Médicas, Universidad Autónoma de Ciudad Juárez, Ciudad Juárez, Chihuahua, México
| | - Monica D Ulibarri
- Department of Psychiatry, University of California, San Diego, La Jolla
- California School of Professional Psychology, Alliant International University, San Diego, California
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Peckham EC, Scheurer ME, Danysh HE, Lubega J, Langlois PH, Lupo PJ. Residential Radon Exposure and Incidence of Childhood Lymphoma in Texas, 1995-2011. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2015; 12:12110-26. [PMID: 26404336 PMCID: PMC4626958 DOI: 10.3390/ijerph121012110] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/04/2015] [Revised: 09/11/2015] [Accepted: 09/21/2015] [Indexed: 12/23/2022]
Abstract
There is warranted interest in assessing the association between residential radon exposure and the risk of childhood cancer. We sought to evaluate the association between residential radon exposure and the incidence of childhood lymphoma in Texas. The Texas Cancer Registry (n = 2147) provided case information for the period 1995–2011. Denominator data were obtained from the United States Census. Regional arithmetic mean radon concentrations were obtained from the Texas Indoor Radon Survey and linked to residence at diagnosis. Exposure was assessed categorically: ≤25th percentile (reference), >25th to ≤50th percentile, >50th to ≤75th percentile, and >75th percentile. Negative binomial regression generated adjusted incidence rate ratios (aIRR) and 95% confidence intervals (CI). We evaluated lymphoma overall and by subtype: Hodgkin (HL; n = 1248), Non-Hodgkin excluding Burkitt (non-BL NHL; n = 658), Burkitt (BL; n = 241), and Diffuse Large B-cell (DLBCL; n = 315). There was no evidence that residential radon exposure was positively associated with lymphoma overall, HL, or BL. Areas with radon concentrations >75th percentile had a marginal increase in DLBCL incidence (aIRR = 1.73, 95% CI: 1.03–2.91). In one of the largest studies of residential radon exposure and the incidence of childhood lymphoma, we found little evidence to suggest a positive or negative association; an observation consistent with previous studies.
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Affiliation(s)
- Erin C Peckham
- Department of Pediatrics, Section of Hematology-Oncology, Baylor College of Medicine, One Baylor Plaza, MS BCM305, Houston, TX 77030, USA.
| | - Michael E Scheurer
- Department of Pediatrics, Section of Hematology-Oncology, Baylor College of Medicine, One Baylor Plaza, MS BCM305, Houston, TX 77030, USA.
| | - Heather E Danysh
- Department of Pediatrics, Section of Hematology-Oncology, Baylor College of Medicine, One Baylor Plaza, MS BCM305, Houston, TX 77030, USA.
| | - Joseph Lubega
- Department of Pediatrics, Section of Hematology-Oncology, Baylor College of Medicine, One Baylor Plaza, MS BCM305, Houston, TX 77030, USA.
| | - Peter H Langlois
- Birth Defects Epidemiology and Surveillance Branch, Texas Department of State Health Services, MC 1964, P.O. Box 149347, Austin, TX 78714-9347, USA.
| | - Philip J Lupo
- Department of Pediatrics, Section of Hematology-Oncology, Baylor College of Medicine, One Baylor Plaza, MS BCM305, Houston, TX 77030, USA.
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Payne EH, Hardin JW, Egede LE, Ramakrishnan V, Selassie A, Gebregziabher M. Approaches for dealing with various sources of overdispersion in modeling count data: Scale adjustment versus modeling. Stat Methods Med Res 2015; 26:1802-1823. [DOI: 10.1177/0962280215588569] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Overdispersion is a common problem in count data. It can occur due to extra population-heterogeneity, omission of key predictors, and outliers. Unless properly handled, this can lead to invalid inference. Our goal is to assess the differential performance of methods for dealing with overdispersion from several sources. We considered six different approaches: unadjusted Poisson regression (Poisson), deviance-scale-adjusted Poisson regression (DS-Poisson), Pearson-scale-adjusted Poisson regression (PS-Poisson), negative-binomial regression (NB), and two generalized linear mixed models (GLMM) with random intercept, log-link and Poisson (Poisson-GLMM) and negative-binomial (NB-GLMM) distributions. To rank order the preference of the models, we used Akaike's information criteria/Bayesian information criteria values, standard error, and 95% confidence-interval coverage of the parameter values. To compare these methods, we used simulated count data with overdispersion of different magnitude from three different sources. Mean of the count response was associated with three predictors. Data from two real-case studies are also analyzed. The simulation results showed that NB and NB-GLMM were preferred for dealing with overdispersion resulting from any of the sources we considered. Poisson and DS-Poisson often produced smaller standard-error estimates than expected, while PS-Poisson conversely produced larger standard-error estimates. Thus, it is good practice to compare several model options to determine the best method of modeling count data.
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Affiliation(s)
- Elizabeth H Payne
- Department of Public Health Sciences – Biostatistics, Medical University of South Carolina, Charleston, SC, USA
- Health Equity and Rural Outreach Innovation Center (HEROIC), Ralph H. Johnson Department of Veterans Affairs Medical Center, Charleston, SC, USA
| | - James W Hardin
- Division of Biostatistics, Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, SC, USA
| | - Leonard E Egede
- Department of Public Health Sciences – Biostatistics, Medical University of South Carolina, Charleston, SC, USA
- Health Equity and Rural Outreach Innovation Center (HEROIC), Ralph H. Johnson Department of Veterans Affairs Medical Center, Charleston, SC, USA
| | - Viswanathan Ramakrishnan
- Department of Public Health Sciences – Biostatistics, Medical University of South Carolina, Charleston, SC, USA
| | - Anbesaw Selassie
- Department of Public Health Sciences – Biostatistics, Medical University of South Carolina, Charleston, SC, USA
| | - Mulugeta Gebregziabher
- Department of Public Health Sciences – Biostatistics, Medical University of South Carolina, Charleston, SC, USA
- Health Equity and Rural Outreach Innovation Center (HEROIC), Ralph H. Johnson Department of Veterans Affairs Medical Center, Charleston, SC, USA
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Hånell A, Greer JE, McGinn MJ, Povlishock JT. Traumatic brain injury-induced axonal phenotypes react differently to treatment. Acta Neuropathol 2015; 129:317-32. [PMID: 25528329 DOI: 10.1007/s00401-014-1376-x] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2014] [Revised: 12/12/2014] [Accepted: 12/13/2014] [Indexed: 11/25/2022]
Abstract
Injured axons with distinct morphologies have been found following mild traumatic brain injury (mTBI), although it is currently unclear whether they reflect varied responses to the injury or represent different stages of progressing pathology. This complicates evaluation of therapeutic interventions targeting axonal injury. To address this issue, we assessed axonal injury over time within a well-defined axonal population, while also evaluating mitochondrial permeability transition as a therapeutic target. We utilized mice expressing yellow fluorescent protein (YFP) in cortical neurons which were crossed with mice which lacked Cyclophilin D (CypD), a positive regulator of mitochondrial permeability transition pore opening. Their offspring were subjected to mTBI and the ensuing axonal injury was assessed using YFP expression and amyloid precursor protein (APP) immunohistochemistry, visualized by confocal and electron microscopy. YFP(+) axons initially developed a single, APP(+), focal swelling (proximal bulb) which progressed to axotomy. Disconnected axonal segments developed either a single bulb (distal bulb) or multiple bulbs (varicosities), which were APP(-) and whose ultrastructure was consistent with ongoing Wallerian degeneration. CypD knock-out failed to reduce proximal bulb formation but decreased the number of distal bulbs and varicosities, as well as a population of small, APP(+), callosal bulbs not associated with YFP(+) axons. The observation that YFP(+) axons contain several pathological morphologies points to the complexity of traumatic axonal injury. The fact that CypD knock-out reduced some, but not all, subtypes highlights the need to appropriately characterize injured axons when evaluating potential neuroprotective strategies.
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Affiliation(s)
- Anders Hånell
- Department of Anatomy and Neurobiology, Medical College of Virginia Campus of Virginia Commonwealth University, Post Office Box 980709, Richmond, VA, 23298-0709, USA
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