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Rishi P, Sharma P, Jain S, Jain A, Kumar P, Shetty D. Correlation of palatal anatomic characteristics with dermatoglyphic heterogeneity in different growth patterns. Morphologie 2024; 108:100775. [PMID: 38518579 DOI: 10.1016/j.morpho.2024.100775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Revised: 03/01/2024] [Accepted: 03/04/2024] [Indexed: 03/24/2024]
Abstract
AIM AND OBJECTIVE The study aimed to explore the correlation between dermatoglyphic patterns and quantitative palatal anatomic variables in individuals with different growth patterns. MATERIALS AND METHOD A cross-sectional study was conducted involving 126 healthy patients aged 17-25 years. Participants were divided into three groups based on growth patterns: average, vertical, and horizontal. Dermatoglyphic patterns were recorded using an optical fingerprint sensor, and palatal characteristics were measured using digital software. Palatal characteristics, including intercanine width, intermolar width, and palatal depth, were measured using digital software. The results were statistically analyzed. RESULTS Significant differences were observed in ridge counts among the three growth patterns. The average growth pattern showed lower ridge counts compared to the vertical and horizontal growth patterns. Dermatoglyphic patterns, such as double loops and tented arches, were significantly higher in the horizontal growth pattern. Weak correlations were found between certain dermatoglyphic patterns and palatal characteristics, with simple arch patterns showing a negative correlation with inter-canine width and symmetrical whorl patterns showing a positive correlation with palatal depth. Loop patterns, spiral patterns, double loop patterns, symmetrical whorl, and simple arch patterns were significant predictors of growth patterns. CONCLUSION This study revealed distinct dermatoglyphic patterns and ridge counts among individuals with different growth patterns. Weak correlations were observed between dermatoglyphic patterns and palatal characteristics. However, the predictive value of dermatoglyphics for skeletal malocclusion requires further investigation. Understanding the relationships between dermatoglyphic patterns and craniofacial growth can provide valuable insights into genetic and developmental factors affecting dental and orthodontic conditions.
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Affiliation(s)
- P Rishi
- Department of Orthodontics & Dentofacial Orthopaedics, I.T.S. Center for Dental Studies and Research, Muradnagar, 201206 Ghaziabad, UP, India
| | - P Sharma
- Department of Orthodontics & Dentofacial Orthopaedics, I.T.S. Center for Dental Studies and Research, Muradnagar, 201206 Ghaziabad, UP, India
| | - S Jain
- Department of Orthodontics & Dentofacial Orthopaedics, I.T.S. Center for Dental Studies and Research, Muradnagar, 201206 Ghaziabad, UP, India.
| | - A Jain
- Independent consultant, Delhi, India
| | - P Kumar
- Department of Orthodontics & Dentofacial Orthopaedics, I.T.S. Center for Dental Studies and Research, Muradnagar, 201206 Ghaziabad, UP, India
| | - D Shetty
- Department of Orthodontics & Dentofacial Orthopaedics, I.T.S. Center for Dental Studies and Research, Muradnagar, 201206 Ghaziabad, UP, India
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Zhu S, Quint J, León TM, Sun M, Li NJ, Tenforde MW, Jain S, Schechter R, Hoover C, Murray EL. Interim Influenza Vaccine Effectiveness Against Laboratory-Confirmed Influenza - California, October 2023-January 2024. MMWR Morb Mortal Wkly Rep 2024; 73:175-179. [PMID: 38421946 PMCID: PMC10907038 DOI: 10.15585/mmwr.mm7308a4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/02/2024]
Abstract
Surveillance data can provide rapid, within-season influenza vaccine effectiveness (VE) estimates to guide public health recommendations. Mandatory reporting of influenza vaccine administration to California's immunization information registry began January 1, 2023, and mandatory reporting of all influenza laboratory test results, including negative results, was instituted in California on June 15, 2023. These data, collected by the California Department of Public Health during October 1, 2023-January 31, 2024, were used to calculate interim influenza VE against laboratory-confirmed influenza by comparing the odds of vaccination among case-patients (persons who received a positive influenza laboratory test result) and control patients (those who received a negative influenza laboratory test result). VE was calculated as 1 - adjusted odds ratio using mixed-effects logistic regression, with age, race, and ethnicity as fixed effects and specimen collection week and county as random effects. Overall, during October 1, 2023-January 31, 2024, estimated VE was 45% among persons aged ≥6 months, 56% among children and adolescents aged 6 months-17 years, 48% among adults aged 18-49 years, 36% among those aged 50-64 years, and 30% among those aged ≥65 years. Consistent with some previous influenza seasons, influenza vaccination provided moderate protection against laboratory-confirmed influenza among infants, children, adolescents, and adults. All persons aged ≥6 months without a contraindication to vaccination should receive annual influenza vaccination to reduce influenza illness, severe influenza, and strain on health care resources. Influenza vaccination remains the best way to prevent influenza.
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Walls GM, O'Connor J, Harbinson M, Duane F, McCann C, McKavanagh P, Johnston DI, Giacometti V, McAleese J, Hounsell AR, Cole AJ, Butterworth KT, McGarry CK, Hanna GG, Jain S. The Association of Incidental Radiation Dose to the Heart Base with Overall Survival and Cardiac Events after Curative-intent Radiotherapy for Non-small Cell Lung Cancer: Results from the NI-HEART Study. Clin Oncol (R Coll Radiol) 2024; 36:119-127. [PMID: 38042669 DOI: 10.1016/j.clon.2023.11.029] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 10/10/2023] [Accepted: 11/06/2023] [Indexed: 12/04/2023]
Abstract
AIMS Cardiac disease is a dose-limiting toxicity in non-small cell lung cancer radiotherapy. The dose to the heart base has been associated with poor survival in multiple institutional and clinical trial datasets using unsupervised, voxel-based analysis. Validation has not been undertaken in a cohort with individual patient delineations of the cardiac base or for the endpoint of cardiac events. The purpose of this study was to assess the association of heart base radiation dose with overall survival and the risk of cardiac events with individual heart base contours. MATERIALS AND METHODS Patients treated between 2015 and 2020 were reviewed for baseline patient, tumour and cardiac details and both cancer and cardiac outcomes as part of the NI-HEART study. Three cardiologists verified cardiac events including atrial fibrillation, heart failure and acute coronary syndrome. Cardiac substructure delineations were completed using a validated deep learning-based autosegmentation tool and a composite cardiac base structure was generated. Cox and Fine-Gray regressions were undertaken for the risk of death and cardiac events. RESULTS Of 478 eligible patients, most received 55 Gy/20 fractions (96%) without chemotherapy (58%), planned with intensity-modulated radiotherapy (71%). Pre-existing cardiovascular morbidity was common (78% two or more risk factors, 46% one or more established disease). The median follow-up was 21.1 months. Dichotomised at the median, a higher heart base Dmax was associated with poorer survival on Kaplan-Meier analysis (20.2 months versus 28.3 months; hazard ratio 1.40, 95% confidence interval 1.14-1.75, P = 0.0017) and statistical significance was retained in multivariate analyses. Furthermore, heart base Dmax was associated with pooled cardiac events in a multivariate analysis (hazard ratio 1.75, 95% confidence interval 1.03-2.97, P = 0.04). CONCLUSIONS Heart base Dmax was associated with the rate of death and cardiac events after adjusting for patient, tumour and cardiovascular factors in the NI-HEART study. This validates the findings from previous unsupervised analytical approaches. The heart base could be considered as a potential sub-organ at risk towards reducing radiation cardiotoxicity.
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Affiliation(s)
- G M Walls
- Cancer Centre Belfast City Hospital, Belfast Health & Social Care Trust, Belfast, UK; Patrick G Johnston Centre for Cancer Research, Queen's University Belfast, Belfast, UK.
| | - J O'Connor
- Patrick G Johnston Centre for Cancer Research, Queen's University Belfast, Belfast, UK
| | - M Harbinson
- Department of Cardiology, Belfast Health & Social Care Trust, Belfast, UK; Wellcome-Wolfson Institute for Experimental Medicine, Queen's University Belfast, Belfast, UK
| | - F Duane
- St. Luke's Radiation Oncology Network, St. Luke's Hospital, Dublin, Ireland; Trinity St James's Cancer Institute, St. James's Hospital, Dublin, Ireland
| | - C McCann
- Department of Cardiology, Belfast Health & Social Care Trust, Belfast, UK
| | - P McKavanagh
- Department of Cardiology, Ulster Hospital, South Eastern Health & Social Care Trust, Dundonald, UK
| | - D I Johnston
- Cancer Centre Belfast City Hospital, Belfast Health & Social Care Trust, Belfast, UK
| | - V Giacometti
- Patrick G Johnston Centre for Cancer Research, Queen's University Belfast, Belfast, UK
| | - J McAleese
- Cancer Centre Belfast City Hospital, Belfast Health & Social Care Trust, Belfast, UK
| | - A R Hounsell
- Cancer Centre Belfast City Hospital, Belfast Health & Social Care Trust, Belfast, UK; Patrick G Johnston Centre for Cancer Research, Queen's University Belfast, Belfast, UK
| | - A J Cole
- Cancer Centre Belfast City Hospital, Belfast Health & Social Care Trust, Belfast, UK; Patrick G Johnston Centre for Cancer Research, Queen's University Belfast, Belfast, UK
| | - K T Butterworth
- Patrick G Johnston Centre for Cancer Research, Queen's University Belfast, Belfast, UK
| | - C K McGarry
- Cancer Centre Belfast City Hospital, Belfast Health & Social Care Trust, Belfast, UK; Patrick G Johnston Centre for Cancer Research, Queen's University Belfast, Belfast, UK
| | - G G Hanna
- Cancer Centre Belfast City Hospital, Belfast Health & Social Care Trust, Belfast, UK; Patrick G Johnston Centre for Cancer Research, Queen's University Belfast, Belfast, UK
| | - S Jain
- Cancer Centre Belfast City Hospital, Belfast Health & Social Care Trust, Belfast, UK; Patrick G Johnston Centre for Cancer Research, Queen's University Belfast, Belfast, UK
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Redmond KM, Turner PG, Cole A, Jain S, Prise KM, O'Sullivan JM. A potential biomarker of radiosensitivity in metastatic hormone sensitive prostate cancer patients treated with combination external beam radiotherapy and radium-223. Radiother Oncol 2024; 191:110063. [PMID: 38135185 DOI: 10.1016/j.radonc.2023.110063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 12/13/2023] [Accepted: 12/13/2023] [Indexed: 12/24/2023]
Abstract
PURPOSE The ADRRAD trial reported the safety and feasibility of the combination of external beam radiotherapy and radium-223 in the treatment of de novo bone metastatic prostate. This study aimed to determine if any biomarkers predictive of response to these treatments could be identified. EXPERIMENTAL DESIGN 30 patients with newly diagnosed bone metastatic hormone sensitive prostate cancer were recruited to the ADRRAD trial. Blood samples were taken pre-treatment, before cycles 2 to 6 of radium-223, and 8 weeks and 6 months after treatment. Mononuclear cells were isolated and DNA damage was assessed at all timepoints. RESULTS DNA damage was increased in all patients during treatment, with bigger increases in foci observed in patients who relapsed late compared to those who relapsed early. Increases in DNA damage during the radium-223 only cycles of treatment were specifically related to response in these patients. Analysis of hematology counts also showed bigger decreases in red blood cell and hemoglobin counts in patients who experienced later biochemical relapse. CONCLUSIONS While some patients responded to this combination treatment, others relapsed within one year of treatment initiation. This study identifies a biomarker based approach that may be useful in predicting which patients will respond to treatment, by monitoring both increases in DNA damage above baseline levels in circulating lymphocytes and decreases in red blood cell and hemoglobin counts during treatment.
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Affiliation(s)
- K M Redmond
- The Patrick G Johnston Centre for Cancer Research, Queen's University Belfast, 97 Lisburn Road, Belfast BT9 7AE, United Kingdom.
| | - P G Turner
- Northern Ireland Cancer Centre, Belfast Health and Social Care Trust, Belfast, Northern Ireland, United Kingdom
| | - A Cole
- The Patrick G Johnston Centre for Cancer Research, Queen's University Belfast, 97 Lisburn Road, Belfast BT9 7AE, United Kingdom; Northern Ireland Cancer Centre, Belfast Health and Social Care Trust, Belfast, Northern Ireland, United Kingdom
| | - S Jain
- The Patrick G Johnston Centre for Cancer Research, Queen's University Belfast, 97 Lisburn Road, Belfast BT9 7AE, United Kingdom; Northern Ireland Cancer Centre, Belfast Health and Social Care Trust, Belfast, Northern Ireland, United Kingdom
| | - K M Prise
- The Patrick G Johnston Centre for Cancer Research, Queen's University Belfast, 97 Lisburn Road, Belfast BT9 7AE, United Kingdom
| | - J M O'Sullivan
- The Patrick G Johnston Centre for Cancer Research, Queen's University Belfast, 97 Lisburn Road, Belfast BT9 7AE, United Kingdom; Northern Ireland Cancer Centre, Belfast Health and Social Care Trust, Belfast, Northern Ireland, United Kingdom
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Jain S, Higashi RT, Salmeron C, Bhavan K. The Intersection of Childcare and Health Among Women at a U.S. Safety-Net Health System During the COVID-19 Pandemic: A Qualitative Study. Health Equity 2024; 8:32-38. [PMID: 38250304 PMCID: PMC10797167 DOI: 10.1089/heq.2023.0068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/19/2023] [Indexed: 01/23/2024] Open
Abstract
Introduction Lack of childcare has been linked to missed health care appointments for adult women, especially for lower-income women. The COVID-19 pandemic created additional stressors for many low-income families that already struggled to meet childcare and health care needs. By exploring the experiences of women who were referred for childcare services at a U.S. safety-net health system, we aimed to understand the challenges women faced in managing their health and childcare needs during the COVID-19 pandemic. Methods We conducted semistructured interviews with participants in Dallas County, TX between August 2021 and February 2022. All participants were referred from women's health clinics at the county's safety-net hospital system to an on-site drop-off childcare center by hospital staff who identified lack of childcare as a barrier to health care access. Participants were the primary caregiver for at least one child ≤age 13. Interviews were conducted in English or Spanish. We analyzed data using thematic content analysis. Results We interviewed 22 participants (mean age 34); participants were adult women, had on average 3 children, and primarily identified as Hispanic or African American. Three interrelated themes emerged: disruptions in access, competing priorities, and exacerbated psychological distress. Conclusions Findings demonstrate how low-income women with young children in a safety-net health system struggle to address their own health needs amid childcare and other household demands. Our study advances our understanding of childcare as a social domain of health, a necessary step to inform how we build structural support systems and drive policy interventions.
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Affiliation(s)
- Seema Jain
- HonorHealth Internal Medicine Residency, Phoenix, Arizona, USA
| | - Robin T. Higashi
- The University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | | | - Kavita Bhavan
- The University of Texas Southwestern Medical Center, Dallas, Texas, USA
- Parkland Health and Hospital System, Dallas, Texas, USA
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Han E, Nabity SA, Dasgupta-Tsinikas S, Guevara RE, Moore M, Kadakia A, Henry H, Cilnis M, Buhain S, Chitnis A, Chakrabarty M, Ky A, Nguyen Q, Low J, Jain S, Higashi J, Barry PM, Flood J. Tuberculosis Diagnostic Delays and Treatment Outcomes among Patients with COVID-19, California, USA, 2020. Emerg Infect Dis 2024; 30:136-140. [PMID: 38147063 PMCID: PMC10756354 DOI: 10.3201/eid3001.230924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2023] Open
Abstract
We assessed tuberculosis (TB) diagnostic delays among patients with TB and COVID-19 in California, USA. Among 58 persons, 43% experienced TB diagnostic delays, and a high proportion (83%) required hospitalization for TB. Even when viral respiratory pathogens circulate widely, timely TB diagnostic workup for at-risk persons remains critical for reducing TB-related illness.
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Affiliation(s)
| | | | - Shom Dasgupta-Tsinikas
- California Department of Public Health, Richmond, California, USA (E. Han, S.A. Nabity, H. Henry, M. Cilnis, S. Jain, P.M. Barry, J. Flood)
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA (S.A. Nabity, M. Moore)
- Los Angeles County Department of Public Health, Los Angeles, California, USA (S. Dasgupta-Tsinikas, R.E. Guevara, J. Higashi)
- San Diego County Health and Human Services Agency, San Diego, California, USA (M. Moore, A. Kadakia)
- Alameda County Public Health Department, San Leandro, California, USA (S. Buhain, A. Chitnis)
- Sacramento County Health Services, Sacramento, California, USA (M. Chakrabarty)
- Santa Clara County Public Health Department, San Jose, California, USA (A. Ky)
- Orange County Health Care Agency, Santa Ana, California, USA (Q. Nguyen, J. Low)
| | - Ramon E. Guevara
- California Department of Public Health, Richmond, California, USA (E. Han, S.A. Nabity, H. Henry, M. Cilnis, S. Jain, P.M. Barry, J. Flood)
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA (S.A. Nabity, M. Moore)
- Los Angeles County Department of Public Health, Los Angeles, California, USA (S. Dasgupta-Tsinikas, R.E. Guevara, J. Higashi)
- San Diego County Health and Human Services Agency, San Diego, California, USA (M. Moore, A. Kadakia)
- Alameda County Public Health Department, San Leandro, California, USA (S. Buhain, A. Chitnis)
- Sacramento County Health Services, Sacramento, California, USA (M. Chakrabarty)
- Santa Clara County Public Health Department, San Jose, California, USA (A. Ky)
- Orange County Health Care Agency, Santa Ana, California, USA (Q. Nguyen, J. Low)
| | - Marisa Moore
- California Department of Public Health, Richmond, California, USA (E. Han, S.A. Nabity, H. Henry, M. Cilnis, S. Jain, P.M. Barry, J. Flood)
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA (S.A. Nabity, M. Moore)
- Los Angeles County Department of Public Health, Los Angeles, California, USA (S. Dasgupta-Tsinikas, R.E. Guevara, J. Higashi)
- San Diego County Health and Human Services Agency, San Diego, California, USA (M. Moore, A. Kadakia)
- Alameda County Public Health Department, San Leandro, California, USA (S. Buhain, A. Chitnis)
- Sacramento County Health Services, Sacramento, California, USA (M. Chakrabarty)
- Santa Clara County Public Health Department, San Jose, California, USA (A. Ky)
- Orange County Health Care Agency, Santa Ana, California, USA (Q. Nguyen, J. Low)
| | - Ankita Kadakia
- California Department of Public Health, Richmond, California, USA (E. Han, S.A. Nabity, H. Henry, M. Cilnis, S. Jain, P.M. Barry, J. Flood)
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA (S.A. Nabity, M. Moore)
- Los Angeles County Department of Public Health, Los Angeles, California, USA (S. Dasgupta-Tsinikas, R.E. Guevara, J. Higashi)
- San Diego County Health and Human Services Agency, San Diego, California, USA (M. Moore, A. Kadakia)
- Alameda County Public Health Department, San Leandro, California, USA (S. Buhain, A. Chitnis)
- Sacramento County Health Services, Sacramento, California, USA (M. Chakrabarty)
- Santa Clara County Public Health Department, San Jose, California, USA (A. Ky)
- Orange County Health Care Agency, Santa Ana, California, USA (Q. Nguyen, J. Low)
| | - Hannah Henry
- California Department of Public Health, Richmond, California, USA (E. Han, S.A. Nabity, H. Henry, M. Cilnis, S. Jain, P.M. Barry, J. Flood)
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA (S.A. Nabity, M. Moore)
- Los Angeles County Department of Public Health, Los Angeles, California, USA (S. Dasgupta-Tsinikas, R.E. Guevara, J. Higashi)
- San Diego County Health and Human Services Agency, San Diego, California, USA (M. Moore, A. Kadakia)
- Alameda County Public Health Department, San Leandro, California, USA (S. Buhain, A. Chitnis)
- Sacramento County Health Services, Sacramento, California, USA (M. Chakrabarty)
- Santa Clara County Public Health Department, San Jose, California, USA (A. Ky)
- Orange County Health Care Agency, Santa Ana, California, USA (Q. Nguyen, J. Low)
| | - Martin Cilnis
- California Department of Public Health, Richmond, California, USA (E. Han, S.A. Nabity, H. Henry, M. Cilnis, S. Jain, P.M. Barry, J. Flood)
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA (S.A. Nabity, M. Moore)
- Los Angeles County Department of Public Health, Los Angeles, California, USA (S. Dasgupta-Tsinikas, R.E. Guevara, J. Higashi)
- San Diego County Health and Human Services Agency, San Diego, California, USA (M. Moore, A. Kadakia)
- Alameda County Public Health Department, San Leandro, California, USA (S. Buhain, A. Chitnis)
- Sacramento County Health Services, Sacramento, California, USA (M. Chakrabarty)
- Santa Clara County Public Health Department, San Jose, California, USA (A. Ky)
- Orange County Health Care Agency, Santa Ana, California, USA (Q. Nguyen, J. Low)
| | - Sonal Buhain
- California Department of Public Health, Richmond, California, USA (E. Han, S.A. Nabity, H. Henry, M. Cilnis, S. Jain, P.M. Barry, J. Flood)
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA (S.A. Nabity, M. Moore)
- Los Angeles County Department of Public Health, Los Angeles, California, USA (S. Dasgupta-Tsinikas, R.E. Guevara, J. Higashi)
- San Diego County Health and Human Services Agency, San Diego, California, USA (M. Moore, A. Kadakia)
- Alameda County Public Health Department, San Leandro, California, USA (S. Buhain, A. Chitnis)
- Sacramento County Health Services, Sacramento, California, USA (M. Chakrabarty)
- Santa Clara County Public Health Department, San Jose, California, USA (A. Ky)
- Orange County Health Care Agency, Santa Ana, California, USA (Q. Nguyen, J. Low)
| | - Amit Chitnis
- California Department of Public Health, Richmond, California, USA (E. Han, S.A. Nabity, H. Henry, M. Cilnis, S. Jain, P.M. Barry, J. Flood)
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA (S.A. Nabity, M. Moore)
- Los Angeles County Department of Public Health, Los Angeles, California, USA (S. Dasgupta-Tsinikas, R.E. Guevara, J. Higashi)
- San Diego County Health and Human Services Agency, San Diego, California, USA (M. Moore, A. Kadakia)
- Alameda County Public Health Department, San Leandro, California, USA (S. Buhain, A. Chitnis)
- Sacramento County Health Services, Sacramento, California, USA (M. Chakrabarty)
- Santa Clara County Public Health Department, San Jose, California, USA (A. Ky)
- Orange County Health Care Agency, Santa Ana, California, USA (Q. Nguyen, J. Low)
| | - Melony Chakrabarty
- California Department of Public Health, Richmond, California, USA (E. Han, S.A. Nabity, H. Henry, M. Cilnis, S. Jain, P.M. Barry, J. Flood)
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA (S.A. Nabity, M. Moore)
- Los Angeles County Department of Public Health, Los Angeles, California, USA (S. Dasgupta-Tsinikas, R.E. Guevara, J. Higashi)
- San Diego County Health and Human Services Agency, San Diego, California, USA (M. Moore, A. Kadakia)
- Alameda County Public Health Department, San Leandro, California, USA (S. Buhain, A. Chitnis)
- Sacramento County Health Services, Sacramento, California, USA (M. Chakrabarty)
- Santa Clara County Public Health Department, San Jose, California, USA (A. Ky)
- Orange County Health Care Agency, Santa Ana, California, USA (Q. Nguyen, J. Low)
| | - Ann Ky
- California Department of Public Health, Richmond, California, USA (E. Han, S.A. Nabity, H. Henry, M. Cilnis, S. Jain, P.M. Barry, J. Flood)
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA (S.A. Nabity, M. Moore)
- Los Angeles County Department of Public Health, Los Angeles, California, USA (S. Dasgupta-Tsinikas, R.E. Guevara, J. Higashi)
- San Diego County Health and Human Services Agency, San Diego, California, USA (M. Moore, A. Kadakia)
- Alameda County Public Health Department, San Leandro, California, USA (S. Buhain, A. Chitnis)
- Sacramento County Health Services, Sacramento, California, USA (M. Chakrabarty)
- Santa Clara County Public Health Department, San Jose, California, USA (A. Ky)
- Orange County Health Care Agency, Santa Ana, California, USA (Q. Nguyen, J. Low)
| | - Quy Nguyen
- California Department of Public Health, Richmond, California, USA (E. Han, S.A. Nabity, H. Henry, M. Cilnis, S. Jain, P.M. Barry, J. Flood)
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA (S.A. Nabity, M. Moore)
- Los Angeles County Department of Public Health, Los Angeles, California, USA (S. Dasgupta-Tsinikas, R.E. Guevara, J. Higashi)
- San Diego County Health and Human Services Agency, San Diego, California, USA (M. Moore, A. Kadakia)
- Alameda County Public Health Department, San Leandro, California, USA (S. Buhain, A. Chitnis)
- Sacramento County Health Services, Sacramento, California, USA (M. Chakrabarty)
- Santa Clara County Public Health Department, San Jose, California, USA (A. Ky)
- Orange County Health Care Agency, Santa Ana, California, USA (Q. Nguyen, J. Low)
| | - Julie Low
- California Department of Public Health, Richmond, California, USA (E. Han, S.A. Nabity, H. Henry, M. Cilnis, S. Jain, P.M. Barry, J. Flood)
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA (S.A. Nabity, M. Moore)
- Los Angeles County Department of Public Health, Los Angeles, California, USA (S. Dasgupta-Tsinikas, R.E. Guevara, J. Higashi)
- San Diego County Health and Human Services Agency, San Diego, California, USA (M. Moore, A. Kadakia)
- Alameda County Public Health Department, San Leandro, California, USA (S. Buhain, A. Chitnis)
- Sacramento County Health Services, Sacramento, California, USA (M. Chakrabarty)
- Santa Clara County Public Health Department, San Jose, California, USA (A. Ky)
- Orange County Health Care Agency, Santa Ana, California, USA (Q. Nguyen, J. Low)
| | - Seema Jain
- California Department of Public Health, Richmond, California, USA (E. Han, S.A. Nabity, H. Henry, M. Cilnis, S. Jain, P.M. Barry, J. Flood)
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA (S.A. Nabity, M. Moore)
- Los Angeles County Department of Public Health, Los Angeles, California, USA (S. Dasgupta-Tsinikas, R.E. Guevara, J. Higashi)
- San Diego County Health and Human Services Agency, San Diego, California, USA (M. Moore, A. Kadakia)
- Alameda County Public Health Department, San Leandro, California, USA (S. Buhain, A. Chitnis)
- Sacramento County Health Services, Sacramento, California, USA (M. Chakrabarty)
- Santa Clara County Public Health Department, San Jose, California, USA (A. Ky)
- Orange County Health Care Agency, Santa Ana, California, USA (Q. Nguyen, J. Low)
| | - Julie Higashi
- California Department of Public Health, Richmond, California, USA (E. Han, S.A. Nabity, H. Henry, M. Cilnis, S. Jain, P.M. Barry, J. Flood)
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA (S.A. Nabity, M. Moore)
- Los Angeles County Department of Public Health, Los Angeles, California, USA (S. Dasgupta-Tsinikas, R.E. Guevara, J. Higashi)
- San Diego County Health and Human Services Agency, San Diego, California, USA (M. Moore, A. Kadakia)
- Alameda County Public Health Department, San Leandro, California, USA (S. Buhain, A. Chitnis)
- Sacramento County Health Services, Sacramento, California, USA (M. Chakrabarty)
- Santa Clara County Public Health Department, San Jose, California, USA (A. Ky)
- Orange County Health Care Agency, Santa Ana, California, USA (Q. Nguyen, J. Low)
| | - Pennan M. Barry
- California Department of Public Health, Richmond, California, USA (E. Han, S.A. Nabity, H. Henry, M. Cilnis, S. Jain, P.M. Barry, J. Flood)
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA (S.A. Nabity, M. Moore)
- Los Angeles County Department of Public Health, Los Angeles, California, USA (S. Dasgupta-Tsinikas, R.E. Guevara, J. Higashi)
- San Diego County Health and Human Services Agency, San Diego, California, USA (M. Moore, A. Kadakia)
- Alameda County Public Health Department, San Leandro, California, USA (S. Buhain, A. Chitnis)
- Sacramento County Health Services, Sacramento, California, USA (M. Chakrabarty)
- Santa Clara County Public Health Department, San Jose, California, USA (A. Ky)
- Orange County Health Care Agency, Santa Ana, California, USA (Q. Nguyen, J. Low)
| | - Jennifer Flood
- California Department of Public Health, Richmond, California, USA (E. Han, S.A. Nabity, H. Henry, M. Cilnis, S. Jain, P.M. Barry, J. Flood)
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA (S.A. Nabity, M. Moore)
- Los Angeles County Department of Public Health, Los Angeles, California, USA (S. Dasgupta-Tsinikas, R.E. Guevara, J. Higashi)
- San Diego County Health and Human Services Agency, San Diego, California, USA (M. Moore, A. Kadakia)
- Alameda County Public Health Department, San Leandro, California, USA (S. Buhain, A. Chitnis)
- Sacramento County Health Services, Sacramento, California, USA (M. Chakrabarty)
- Santa Clara County Public Health Department, San Jose, California, USA (A. Ky)
- Orange County Health Care Agency, Santa Ana, California, USA (Q. Nguyen, J. Low)
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Sud R, Banerjee A, Viswanath B, Purushottam M, Jain S. Non-synaptic mechanisms of antipsychotics may be key to their actions. Schizophr Res 2023; 261:128-129. [PMID: 37717511 DOI: 10.1016/j.schres.2023.09.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 08/09/2023] [Accepted: 09/04/2023] [Indexed: 09/19/2023]
Affiliation(s)
- R Sud
- Molecular Genetics Lab, Department of Psychiatry, NIMHANS, Bangalore, India
| | - A Banerjee
- Molecular Genetics Lab, Department of Psychiatry, NIMHANS, Bangalore, India
| | - B Viswanath
- Molecular Genetics Lab, Department of Psychiatry, NIMHANS, Bangalore, India.
| | - M Purushottam
- Molecular Genetics Lab, Department of Psychiatry, NIMHANS, Bangalore, India
| | - S Jain
- Molecular Genetics Lab, Department of Psychiatry, NIMHANS, Bangalore, India.
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8
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Gebreegziabher E, Bui D, Cummings KJ, Beckman J, Frederick M, Nguyen A, Chan E, Gibb K, Rodriguez A, Wong J, Majka C, Jain S, Vergara X. Temporal assessment of disparities in California COVID-19 mortality by industry: a population-based retrospective cohort study. Ann Epidemiol 2023; 87:S1047-2797(23)00169-2. [PMID: 37714416 DOI: 10.1016/j.annepidem.2023.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 08/28/2023] [Accepted: 09/09/2023] [Indexed: 09/17/2023]
Abstract
PURPOSE To assess changes in the COVID-19 mortality rate and disparities over variants or waves by industry. METHODS We identified COVID-19 deaths that occurred between January 2020 and May 2022 among California workers aged 18-64 years using death certificates, and estimated Californians at risk using the Current Population Survey. The waves in deaths were wave 1: March-June 2020, wave 2: July-November 2020, wave 3/Epsilon and Alpha variants: December 2020-May 2021, wave 4/Delta variant: June 2021-January 2022, and wave 5/Omicron variant: February-May 2022. We used Poisson regression to generate wave-specific mortality rate ratios (MRR) and included an interaction term between industry and wave in different models to assess significance of the change in MRR. RESULTS In all waves of the pandemic, healthcare, other services, manufacturing, transportation, and retail trade industries had higher mortality rates than the professional, scientific, and technical industry. The healthcare industry had the highest relative rate earlier in the pandemic, while other services, utilities, and accommodation and food services industries had substantial increases in MRR in later waves. CONCLUSIONS Industries that consistently had disproportionate COVID-19 mortality may have benefitted from protections that consider workers' increased exposure and vulnerability to severe outcomes.
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Affiliation(s)
- Elisabeth Gebreegziabher
- Occupational Health Branch, California Department of Public Health, Richmond; Heluna Health, City of Industry, CA.
| | - David Bui
- Occupational Health Branch, California Department of Public Health, Richmond; Heluna Health, City of Industry, CA.
| | - Kristin J Cummings
- Occupational Health Branch, California Department of Public Health, Richmond.
| | - John Beckman
- Occupational Health Branch, California Department of Public Health, Richmond; Public Health Institute, Oakland, CA.
| | - Matthew Frederick
- Occupational Health Branch, California Department of Public Health, Richmond; Public Health Institute, Oakland, CA.
| | - Alyssa Nguyen
- Infectious Diseases Branch, California Department of Public Health, Richmond.
| | - Elena Chan
- Occupational Health Branch, California Department of Public Health, Richmond; Public Health Institute, Oakland, CA.
| | - Kathryn Gibb
- Occupational Health Branch, California Department of Public Health, Richmond; Public Health Institute, Oakland, CA.
| | - Andrea Rodriguez
- Occupational Health Branch, California Department of Public Health, Richmond; Public Health Institute, Oakland, CA.
| | - Jessie Wong
- Occupational Health Branch, California Department of Public Health, Richmond; Public Health Institute, Oakland, CA.
| | - Claire Majka
- Occupational Health Branch, California Department of Public Health, Richmond; Public Health Institute, Oakland, CA.
| | - Seema Jain
- Infectious Diseases Branch, California Department of Public Health, Richmond.
| | - Ximena Vergara
- Occupational Health Branch, California Department of Public Health, Richmond; Heluna Health, City of Industry, CA.
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9
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Sankar J, Prasad CB, Mathew J, Dhir V, Jain S. Erosive hand osteoarthritis. QJM 2023; 116:871-872. [PMID: 37267217 DOI: 10.1093/qjmed/hcad114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Indexed: 06/04/2023] Open
Affiliation(s)
- J Sankar
- Department of Internal Medicine, Clinical Immunology and Rheumatology Unit, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India.
| | - C B Prasad
- Department of Internal Medicine, Clinical Immunology and Rheumatology Unit, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India.
| | - J Mathew
- Department of Internal Medicine, Clinical Immunology and Rheumatology Unit, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India.
| | - V Dhir
- Department of Internal Medicine, Clinical Immunology and Rheumatology Unit, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India.
| | - S Jain
- Department of Internal Medicine, Clinical Immunology and Rheumatology Unit, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India.
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Gohil B, Tan N, Jolly R, Yadav N, Jain S. 25 The efficacy of pre-operative multidisciplinary meetings for surgical management of strabismus. BMJ Open Ophthalmol 2023; 8:A9. [PMID: 37798004 DOI: 10.1136/bmjophth-2023-biposa.25] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/07/2023] Open
Abstract
Informal discussion regarding surgical management plans between strabismus surgeons is common but this limits potentially valuable multi-disciplinary input and learning opportunities. We evaluate the effectiveness of virtual multidisciplinary meetings to provide a platform for discussion of pre-operative strabismus surgical cases.Weekly virtual MS Teams meetings are held on Monday mornings for one hour, attended by the three paediatric consultants, paediatric fellow, all trainees on the paediatric firm and orthoptists. The meetings are recorded and available for reference to the content and for those not present.Presentations for upcoming surgery cases are prepared and presented by the fellow, with discussion from participants regarding examination findings and surgical options. Cases are anonymised to allow multicentre collaboration. The agreed management plan is documented in the patient's medical notes, and outcomes of challenging cases are discussed.The management plan is formalised during the MDT. Where required, additional tests are arranged. There are opportunities for all participants to constructively challenge decisions. Trainees of all levels are actively engaged by presenting, listening to the rationale behind surgical plans, with the opportunity to ask and respond to questions.Patients are informed that their case has been presented in the MDT to obtain multiple opinions, which gives them additional confidence. Orthoptists can see the impact of the measurements they provide, and how differing tests can change management plans.This MDT has been a positive change to our surgical strabismus patient pathway. Knowledge and teamwork have been strengthened using this innovative virtual discussion method.
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Affiliation(s)
- B Gohil
- Royal Free London NHS Foundation Trust
| | - N Tan
- Royal Free London NHS Foundation Trust
| | - R Jolly
- Royal Free London NHS Foundation Trust
| | - N Yadav
- Royal Free London NHS Foundation Trust
| | - S Jain
- Royal Free London NHS Foundation Trust
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11
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Walls G, Johnston D, Harbsinson M, McCann C, McKavanagh P, Giacometti V, McAleese J, Cole A, Butterworth K, McGarry C, Jain S, Hanna GG. Simulation CT Features and Radiation Cardiotoxicity in Non-Small Cell Lung Cancer. Int J Radiat Oncol Biol Phys 2023; 117:e69. [PMID: 37786027 DOI: 10.1016/j.ijrobp.2023.06.799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Radiation cardiotoxicity is a significant clinical dilemma in non-small cell lung cancer (NSCLC) radiation therapy (RT). Baseline cardiovascular (CV) status may influence the risk of cardiotoxicity, and may be ascertainable from the appearance of the heart on simulation computed tomography (CT). We examined the association of CT features with incidental heart dose and risk of cardiac events in NSCLC. MATERIALS/METHODS Patients treated with curative-intent RT between 2015 and 2020 at a regional center were identified. Clinical notes were interrogated for baseline patient and CV health details, and follow-up CV events. Cardiac events were verified by a cardiologist. A deep learning-based auto-segmentation tool was applied, allowing extraction of a pre-specified list of volume parameters in a programming environment. CAC was graded as none, mild, moderate and severe in patients with a non-contrast scan. The craniocaudal relationship of the PTV and heart (Feng atlas) were annotated. RESULTS A total of 478 patients were included, with a median age of 70 and Charlson Index of 5. The median mean heart dose was 6.3 Gy (IQR 2.7-11.4). The median lung V20 was 20.0% (IQR 14.8-27.1). Cardiovascular risk factors were common, with most patients having 2 (39%) or 3 (31%). A history of previous cardiac events was common, including myocardial infarction (14%), arrhythmia (11%) or heart failure (9%). A total of 6.9% and 7.1% patients developed a new atrial arrhythmia (AA) or heart failure (HF) after completing RT. The volume metrics with the highest AUC for AA and HF events were the left atrium (LA) (AUC 0.67, p = 0.0002) and left ventricle:right ventricle (LV:RV) ratio (AUC 0.66, p = 0.0021). Kaplan-Meier analysis for cardiac events dichotomizing at the optimal cut-point for maximum sensitivity and specificity demonstrated significantly different rates for both AA (LA 109cc, HR 3.35, 95% CI 1.64-6.83, p = 0.0009) and HF (LV:RV ratio 1.61, HR 2.37, 95% CI 1.19-4.74, p = 0.0143). Only 2 patients with non-contrast scans developed a myocardial infarction, both had mild CAC. The incidence of pooled cardiac events was not significantly different between patients with no (n = 2/21, 9.5%), mild (n = 10/38, 26.3%), moderate (n = 8/53, 15.1%) and severe (n = 7/24, 29.2%) CAC (p = 0.3916). Where the inferior border of the PTV was above the superior border of the heart, mean heart dose was significantly lower than compared with overlap of levels (1.9 Gy v 9.7 Gy, p<0.0001), and this was true for 3DCRT (n = 139, p<0.001), IMRT (n = 94, p<0.001) and VMAT (n = 145, p<0.001) patients. CONCLUSION LA volume and LV:RV volume ratio are predictive for the development of AA and HF respectively. CAC grade did not differentiate patients by risk of cardiac events. Where the craniocaudal level of the PTV doesn't overlap with the level of the heart, the cardiac dose is likely to be very low. Several simulation CT features are associated with cardiac events following treatment for NSCLC and prospective evidence of cardiac risk could enable medical optimization prior to RT.
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Affiliation(s)
- G Walls
- Patrick G Johnston Centre for Cancer Research, Belfast, United Kingdom
| | - D Johnston
- Belfast Health & Social Care Trust, Belfast, United Kingdom
| | - M Harbsinson
- Belfast Health & Social Care Trust, Belfast, United Kingdom
| | - C McCann
- Belfast Health & Social Care Trust, Belfast, United Kingdom
| | - P McKavanagh
- South Eastern Health & Social Care Trust, Belfast, United Kingdom
| | - V Giacometti
- Patrick G Johnston Centre for Cancer Research, Belfast, United Kingdom
| | - J McAleese
- Belfast Health & Social Care Trust, Belfast, United Kingdom
| | - A Cole
- Patrick G Johnston Centre for Cancer Research, Belfast, United Kingdom
| | - K Butterworth
- Patrick G Johnston Centre for Cancer Research, Belfast, United Kingdom
| | - C McGarry
- Patrick G Johnston Centre for Cancer Research, Belfast, United Kingdom
| | - S Jain
- Patrick G Johnston Centre for Cancer Research, Belfast, United Kingdom
| | - G G Hanna
- Patrick G Johnston Centre for Cancer Research, Belfast, United Kingdom
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12
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Jain S, Padhi S, Patel M G, Malathi H, Kumar B, Madaan S. AN INCREASED RISK OF HORMONAL DISORDERS, PRIMARILY DIABETES, IN INDIVIDUALS WITH Β -THALASSEMIA MAJOR: A RETROSPECTIVE ANALYSIS. Georgian Med News 2023:179-185. [PMID: 38096537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
β-Thalassemia major is an inherited blood condition marked by a serious anemia and a lifetime need for blood transfusions. The effects of β-thalassemia major on endocrine health, notably the risk of diabetes, remain largely unstudied, despite the fact that its haematological components are established. The purpose of this systematic analysis was to examine the incidence of reduced metabolism of glucose in β--thalassemia major. The articles were under the inclusion requirements, after which the data was retrieved. The main outcome was determined to be every prevalence (P) of DM (diabetes mellitus) in β-thalassemia major. In order to examine the percentage of aberrant glucose metabolism (GM) with individuals among β-thalassemia major, the P with the 95% CI (Confidence Interval) was utilized. In this retrospective investigation, we looked at a cohort of people with β-thalassemia major diagnoses to determine the incidence and risk of hormonal diseases, particularly diabetes. A specialist thalassemia facility treated 315 individuals with β-thalassemia major, and their medical records were examined. Age, gender, age at which a main diagnosis of β-thalassemia was made, the length of transfusion treatment, and concomitant diseases were gathered as part of the demographic and clinical data. Our research, which included 17 studies and 1500 cases altogether, showed that with β -thalassemia major had a considerably greater frequency of diabetes than people in general. With a mean beginning age of 30 years, diabetes was identified in 28% of the research cohort's participants. The combined meta-analysis showed that each year had a rather stable level of DM P in β-thalassemia major. In people with major β-thalassemia, the P of impaired fasting glucose (IFG), DM, and impaired glucose tolerance (IGT) was 17.22% (95% CI: 8.44%-26.02%), (6.57 (95% CI: 5.31%- 7.79%) and 12.47 % (95% CI: 5.97%-18.95%), respectively. Our research suggests that people with β-thalassemia major have a high chance of acquiring diabetes, particularly if they get extended transfusion treatment. For prompt diagnosis and care, early detection of diabetes and other hormonal problems in this group is crucial. In β-thalassemia major, there is a high frequency of endocrine problems, including improper GM. To stop growth and endocrine issues, treatment and preventative measures can be required.
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Affiliation(s)
- S Jain
- 1Department of Anatomy, TMMC&RC, Teerthanker Mahaveer University, Moradabad, Uttar Pradesh, India
| | - S Padhi
- 2Department of Pharmacy, Noida Institute of Engineering and Technology (Pharmacy Institute), Uttar Pradesh, India
| | - G Patel M
- 3Department of Community Medicine, Parul University, PO Limda, Tal. Waghodia, District Vadodara, Gujarat, India
| | - H Malathi
- 4Department of Life Sciences, School of Sciences, JAIN (Deemed-to-be University), Karnataka, India
| | - B Kumar
- 5School of Pharmacy & Research, Dev Bhoomi Uttarakhand University, Dehradun, India
| | - Sh Madaan
- 6Department of Allied Healthcare and Sciences, Vivekananda Global University, Jaipur, India
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Hogg G, Joshi S, Mason H, O'Byrne C, Jain S. 17 Development of a questionnaire to study fear and anxiety factors affecting patients and their families undergoing strabismus surgery. BMJ Open Ophthalmol 2023; 8:A6. [PMID: 37798008 DOI: 10.1136/bmjophth-2023-biposa.17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/07/2023] Open
Abstract
Patients and their Families undergoing Strabismus Surgery. The aim of this study was to develop a questionnaire to identify perioperative fear and anxiety factors affecting pediatric strabismus surgery patients.First, we reviewed the literature to determine precipitants of fears and anxieties experienced by pediatric patients. Subsequently, we developed a questionnaire for pediatric patients undergoing strabismus surgery. This was a two part questionnaire, consisting of a 16-piece section for patients and a 22-piece section for parents. Finally, we piloted this questionnaire to validate its clinical use.Common anxiety factors for children include pain, minor clinical procedures requiring needles, separation from parents and engaging with medical professionals. We used this information to develop a two part questionnaire for patients and parents. The questionnaire elicited positive and negative aspects of the patient journey, corroborated fears reported in the literature, and identified anxiety inducing factors specific to strabismus patients.There is a lack of evidence regarding fear and anxiety specific to pediatric ophthalmology surgeries. Strabismus surgery carries unique fear inducing factors. Interventions which may alleviate the stress of pediatric surgery, therefore greatly benefit patient experience and surgical outcomes, and should be considered in the care of pediatric patients. Patient educational material is known to provide a sense of control to patients, helping to alleviate such fear.Evidenced by the literature and the pilot questionnaire, there still exists anxiety inducing factors in pediatric surgery. Investigation into patient fears regarding pediatric strabismus surgery is needed to better understand how clinical staff can support patients perioperatively.
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Affiliation(s)
- G Hogg
- Royal Free Hospital NHS Foundation Trust, London, UK
| | - S Joshi
- Royal Free Hospital NHS Foundation Trust, London, UK
| | - H Mason
- Royal Free Hospital NHS Foundation Trust, London, UK
| | - C O'Byrne
- Royal Free Hospital NHS Foundation Trust, London, UK
| | - S Jain
- Royal Free Hospital NHS Foundation Trust, London, UK
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14
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Arnold SR, Jain S, Dansie D, Kan H, Williams DJ, Ampofo K, Anderson EJ, Grijalva CG, Bramley AM, Pavia AT, Edwards KM, Nolan VG, McCullers JA, Kaufman RA. Association of Radiology Findings with Etiology of Community Acquired Pneumonia among Children. J Pediatr 2023; 261:113333. [PMID: 36736585 DOI: 10.1016/j.jpeds.2023.01.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 01/24/2023] [Accepted: 01/24/2023] [Indexed: 02/05/2023]
Abstract
OBJECTIVE To evaluate the association between consolidation on chest radiograph and typical bacterial etiology of childhood community acquired pneumonia (CAP) in the Etiology of Pneumonia in the Community study. STUDY DESIGN Hospitalized children <18 years of age with CAP enrolled in the Etiology of Pneumonia in the Community study at 3 children's hospitals between January 2010 and June 2012 were included. Testing of blood and respiratory specimens used multiple modalities to identify typical and atypical bacterial, or viral infection. Study radiologists classified chest radiographs (consolidation, other infiltrates [interstitial and/or alveolar], pleural effusion) using modified World Health Organization pneumonia criteria. Infiltrate patterns were compared according to etiology of CAP. RESULTS Among 2212 children, there were 1302 (59%) with consolidation with or without other infiltrates, 910 (41%) with other infiltrates, and 296 (13%) with pleural effusion. In 1795 children, at least 1 pathogen was detected. Among these patients, consolidation (74%) was the most frequently observed pattern (74% in typical bacterial CAP, 58% in atypical bacterial CAP, and 54% in viral CAP). Positive and negative predictive values of consolidation for typical bacterial CAP were 12% (95% CI 10%-15%) and 96% (95% CI 95%-97%) respectively. In a multivariable model, typical bacterial CAP was associated with pleural effusion (OR 7.3, 95% CI 4.7-11.2) and white blood cell ≥15 000/mL (OR 3.2, 95% CI 2.2-4.9), and absence of wheeze (OR 0.5, 95% CI 0.3-0.8) or viral detection (OR 0.2, 95% CI 0.1-0.4). CONCLUSIONS Consolidation predicted typical bacterial CAP poorly, but its absence made typical bacterial CAP unlikely. Pleural effusion was the best predictor of typical bacterial infection, but too uncommon to aid etiology prediction.
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Affiliation(s)
- Sandra R Arnold
- Department of Pediatrics, University of Tennessee Health Sciences Center, Memphis, TN.
| | - Seema Jain
- Centers for Disease Control and Prevention, Atlanta, GA
| | - David Dansie
- Department of Radiology, University of Utah Health Science Center, Salt Lake City, UT
| | - Herman Kan
- Department of Radiology, Vanderbilt University School of Medicine, Nashville, TN; Department of Radiology, Baylor College of Medicine, Houston, TX
| | - Derek J Williams
- Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, TN
| | - Krow Ampofo
- Department of Pediatrics, University of Utah Health Science Center, Salt Lake City, UT
| | - Evan J Anderson
- Departments of Pediatrics and Medicine, Emory University School of Medicine, Atlanta, GA
| | - Carlos G Grijalva
- Department of Health Policy, Vanderbilt University Medical Center, Nashville, TN
| | | | - Andrew T Pavia
- Department of Pediatrics, University of Utah Health Science Center, Salt Lake City, UT
| | - Kathryn M Edwards
- Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, TN
| | - Vikki G Nolan
- Division of Epidemiology, School of Public Health, University of Memphis, Memphis, TN
| | - Jonathan A McCullers
- Department of Pediatrics, University of Tennessee Health Sciences Center, Memphis, TN; Department of Infectious Diseases, St. Jude Children's Research Hospital, Memphis, TN
| | - Robert A Kaufman
- Department of Diagnostic Imaging, St. Jude Children's Research Hospital, Memphis, TN
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15
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Walls G, O'Connor J, Harbsinson M, Duane FK, McCann C, McKavanagh P, Johnston D, Giacometti V, McAleese J, Hounsell A, Cole A, Butterworth K, McGarry C, Hanna GG, Jain S. Patient-Level and Endpoint-Specific Clinico-Dosimetric Analysis of the Cardiac Base as a Mediator of Radiation Cardiotoxicity in Non-Small Cell Lung Cancer. Int J Radiat Oncol Biol Phys 2023; 117:e69-e70. [PMID: 37786026 DOI: 10.1016/j.ijrobp.2023.06.800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Cardiac disease is a dose-limiting toxicity in non-small cell lung cancer (NSCLC) radiation therapy. Radiation dose to the cardiac base is associated with poor overall survival in several clinical studies, but has not been validated in a non-dose escalated cohort, or with individual patient delineations. In this study we examined the impact of cardiac base dose on overall survival (OS) and cardiac events (CEs), and interrogated the relationships of the substructures comprising the heart base with OS and CEs. MATERIALS/METHODS Patients with stage I-III NSCLC treated with curative-intent radiation therapy between 2015 and 2020 at a regional cancer center were identified. Clinical notes were examined for baseline patient, tumor and cardiac details, and both cancer and cardiac outcomes. Three cardiologists verified CEs. Cardiac delineations were completed using a validated deep learning-based autosegmentation tool. Cox and Fine and Gray regressions were undertaken for the risk of death and CEs respectively, accounting for pre-specified evidence-based dose metrics and clinically relevant cardiac covariates. RESULTS Most patients received 55 Gy/20# (n = 461/478, 96%) without chemotherapy (58%), planned with VMAT (51%) or IMRT (20%). Pre-existing cardiovascular morbidity was common, with 78% having ≥2 risk factors, and 46% having >1 established cardiac disease. The median follow-up was 21.1 months. Dichotomized at the median, higher heart base Dmax was associated with poorer survival on Kaplan-Meier analysis (21.6 months (95% CI 19.3-24.9) versus 29.4 months (95% CI 21.6-36.6), p = 0.021), and remained significant when statistically compared in published multivariate models. In a multivariate analysis for pooled acute CEs, heart base Dmax was associated with CEs (HR 1.75, 95% CI 1.01-1.06, p = 0.04), but this was not the case for individual CEs. Using Fine and Gray models to account for the competing risk of death, left main coronary maximum dose was associated with atrial fibrillation (p = 0.024), proximal right coronary artery V15 (p = 0.023) and mean dose (p = 0.032), and the right atrium mean dose (p = 0.029) were associated with heart failure. No dose-volume metrics were significantly associated with acute coronary syndrome. None of the constituent base substructures dose were significantly associated with death. CONCLUSION Dose to the heart base was associated with increased mortality and an increased pooled cardiac event rate. Accounting for endpoint-specific clinical covariates, only select constituent substructures of the heart base were associated with CEs and no substructures were independently associated with survival. Together, these findings are suggestive of possible interplay between the constituent base substructures in their mediation of radiation cardiotoxicity.
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Affiliation(s)
- G Walls
- Patrick G Johnston Centre for Cancer Research, Belfast, United Kingdom
| | - J O'Connor
- Patrick G Johnston Centre for Cancer Research, Belfast, United Kingdom
| | - M Harbsinson
- Belfast Health & Social Care Trust, Belfast, United Kingdom
| | - F K Duane
- Trinity St James's Cancer Institute, St James's Hospital, Dublin, Ireland
| | - C McCann
- Belfast Health & Social Care Trust, Belfast, United Kingdom
| | - P McKavanagh
- South Eastern Health & Social Care Trust, Belfast, United Kingdom
| | - D Johnston
- Belfast Health & Social Care Trust, Belfast, United Kingdom
| | - V Giacometti
- Patrick G Johnston Centre for Cancer Research, Belfast, United Kingdom
| | - J McAleese
- Belfast Health & Social Care Trust, Belfast, United Kingdom
| | - A Hounsell
- Patrick G Johnston Centre for Cancer Research, Belfast, United Kingdom
| | - A Cole
- Patrick G Johnston Centre for Cancer Research, Belfast, United Kingdom
| | - K Butterworth
- Patrick G Johnston Centre for Cancer Research, Belfast, United Kingdom
| | - C McGarry
- Patrick G Johnston Centre for Cancer Research, Belfast, United Kingdom
| | - G G Hanna
- Patrick G Johnston Centre for Cancer Research, Belfast, United Kingdom
| | - S Jain
- Patrick G Johnston Centre for Cancer Research, Belfast, United Kingdom
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16
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Jain S, Mahajan A, Patil PM, Bhandarkar P, Khajanchi M. Trends of surgical-care delivery during the COVID-19 pandemic: A multi-centre study in India (IndSurg Collaboration). J Postgrad Med 2023; 69:198-204. [PMID: 37449588 PMCID: PMC10846812 DOI: 10.4103/jpgm.jpgm_485_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 10/18/2022] [Accepted: 11/24/2022] [Indexed: 07/18/2023] Open
Abstract
Context The COVID-19 pandemic and subsequent lockdowns adversely affected global healthcare services to varying extents. To accommodate its added burden, emergency services were affected along-with elective surgeries. Aims To quantify and analyze the trends of essential surgeries and bellwether procedures during the waxing and waning of the pandemic, across various hospitals in India. Settings and Design Multi-centric retrospective study. Methods and Material A research consortium led by World Health Organization (WHO) Collaboration Center (WHOCC) for Research in Surgical Care Delivery in Low-and Middle-Income countries, India, conducted this study with 5 centers. All surgeries performed during April 2020 (Wave I), November 2020 (Recovery I), and April 2021 (Wave II) were compared with those performed in April 2019 (pre-pandemic period). Statistical Analysis Used Microsoft Excel 2019 and SPSS Version 20. Results The total number of surgeries reduced by 77% during Wave I, which improved to a 52% reduction in Recovery I compared to the pre-pandemic period. However, surgeries were reduced again during Wave II to 68%, but the reduction was less compared to Wave I. Emergency and essential surgeries were affected along with the elective ones but to a lesser extent. Conclusions The present study has quantified the effects of the pandemic on surgical-care delivery across a timeline and documented a reduction in overall surgical volumes during the peaks of the pandemic (Wave I and II) with minimal improvement as the surge of COVID-19 cases declined (Recovery II). The surgical volumes improved during the second wave compared to the first one which may be attributable to better preparedness. Cesarean sections were affected the least.
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Affiliation(s)
- S Jain
- Dayanand Medical College and Hospital, Ludhiana, Punjab, India
| | - A Mahajan
- Government Medical College, Amritsar, Punjab, India
| | - PM Patil
- Department of Biostatistics, BARC Hospital, Mumbai, Maharashtra, India
| | - P Bhandarkar
- Department of Biostatistics, BARC Hospital, Mumbai, Maharashtra, India
| | - M Khajanchi
- Department of Surgery, Seth G.S. Medical College and K.E.M Hospital, Mumbai, Maharashtra, India
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Jain S, Cetnar A, Woollard J, Gupta N, Blakaj D, Chakravarti A, Ayan AS. Pulse parameter optimizer: an efficient tool for achieving prescribed dose and dose rate with electron FLASH platforms. Phys Med Biol 2023; 68:19NT01. [PMID: 37735967 DOI: 10.1088/1361-6560/acf63e] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 09/01/2023] [Indexed: 09/23/2023]
Abstract
Purpose. Commercial electron FLASH platforms deliver ultra-high dose rate doses at discrete combinations of pulse parameters including pulse width (PW), pulse repetition frequency (PRF) and number of pulses (N), which dictate unique combinations of dose and dose rates. Additionally, collimation, source to surface distance, and airgaps also vary the dose per pulse (DPP). Currently, obtaining pulse parameters for the desired dose and dose rate is a cumbersome manual process involving creating, updating, and looking up values in large spreadsheets for every treatment configuration. This work presents a pulse parameter optimizer application to match intended dose and dose rate precisely and efficiently.Methods. Dose and dose rate calculation methods have been described for a commercial electron FLASH platform. A constrained optimization for the dose and dose rate cost function was modelled as a mixed integer problem in MATLAB (The MathWorks Inc., Version9.13.0 R2022b, Natick, Massachusetts). The beam and machine data required for the application were acquired using GafChromic film and alternating current current transformers (ACCTs). Variables for optimization included DPP for every collimator, PW and PRF measured using ACCT and airgap factors.Results. Using PW, PRF,Nand airgap factors as parameters, a software was created to optimize dose and dose rate, reaching the closest match if exact dose and dose rates are not achievable. Optimization took 20 s or less to converge to results. This software was validated for accuracy of dose calculation and precision in matching prescribed dose and dose rate.Conclusion. A pulse parameter optimization application was built for a commercial electron FLASH platform to increase efficiency in dose, dose rate, and pulse parameter prescription process. Automating this process reduces safety concerns associated with manual look up and calculation of these parameters, especially when many subjects at different doses and dose rates are to be safely managed.
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Affiliation(s)
- S Jain
- The Department of Radiation Oncology, The Ohio State University Wexner Medical Center, United States of America
| | - A Cetnar
- The Department of Radiation Oncology, The Ohio State University Wexner Medical Center, United States of America
| | - J Woollard
- The Department of Radiation Oncology, The Ohio State University Wexner Medical Center, United States of America
| | - N Gupta
- The Department of Radiation Oncology, The Ohio State University Wexner Medical Center, United States of America
| | - D Blakaj
- The Department of Radiation Oncology, The Ohio State University Wexner Medical Center, United States of America
| | - A Chakravarti
- The Department of Radiation Oncology, The Ohio State University Wexner Medical Center, United States of America
| | - A S Ayan
- The Department of Radiation Oncology, The Ohio State University Wexner Medical Center, United States of America
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18
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Park HJ, Tan ST, León TM, Jain S, Schechter R, Lo NC. Predicting the Public Health Impact of Bivalent Vaccines and Nirmatrelvir-Ritonavir Against Coronavirus Disease 2019. Open Forum Infect Dis 2023; 10:ofad415. [PMID: 37674629 PMCID: PMC10478155 DOI: 10.1093/ofid/ofad415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Accepted: 07/28/2023] [Indexed: 09/08/2023] Open
Abstract
Background Uptake of coronavirus disease 2019 (COVID-19) bivalent vaccines and the oral medication nirmatrelvir-ritonavir (Paxlovid) has remained low across the United States. Assessing the public health impact of increasing uptake of these interventions in key risk groups can guide further public health resources and policy and determine what proportion of severe COVID-19 is avertable with these interventions. Methods This modeling study used person-level data from the California Department of Public Health on COVID-19 cases, hospitalizations, deaths, and vaccine administration from 23 July 2022 to 23 January 2023. We used a quasi-Poisson regression model calibrated to recent historical data to predict future COVID-19 outcomes and modeled the impact of increasing uptake (up to 70% coverage) of bivalent COVID-19 vaccines and nirmatrelvir-ritonavir during acute illness in different risk groups. Risk groups were defined by age (≥50, ≥65, ≥75 years) and vaccination status (everyone, primary series only, previously vaccinated). We predicted the number of averted COVID-19 cases, hospitalizations, and deaths and number needed to treat (NNT). Results The model predicted that increased uptake of bivalent COVID-19 boosters and nirmatrelvir-ritonavir (up to 70% coverage) in all eligible persons could avert an estimated 15.7% (95% uncertainty interval [UI], 11.2%-20.7%; NNT: 17 310) and 23.5% (95% UI, 13.1%-30.0%; NNT: 67) of total COVID-19-related deaths, respectively. In the high-risk group of persons ≥65 years old alone, increased uptake of bivalent boosters and nirmatrelvir-ritonavir could avert an estimated 11.9% (95% UI, 8.4%-15.1%; NNT: 2757) and 22.8% (95% UI, 12.7%-29.2%; NNT: 50) of total COVID-19-related deaths, respectively. Conclusions These findings suggest that prioritizing uptake of bivalent boosters and nirmatrelvir-ritonavir among older age groups (≥65 years) would be most effective (based on NNT) but would not address the entire burden of severe COVID-19.
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Affiliation(s)
- Hailey J Park
- Division of Infectious Diseases and Geographic Medicine, Department of Medicine, Stanford University, Stanford, California, USA
| | - Sophia T Tan
- Division of Infectious Diseases and Geographic Medicine, Department of Medicine, Stanford University, Stanford, California, USA
| | - Tomás M León
- California Department of Public Health, Richmond, California, USA
| | - Seema Jain
- California Department of Public Health, Richmond, California, USA
| | - Robert Schechter
- California Department of Public Health, Richmond, California, USA
| | - Nathan C Lo
- Division of Infectious Diseases and Geographic Medicine, Department of Medicine, Stanford University, Stanford, California, USA
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Rabe A, Ravuri S, Burnor E, Steele JA, Kantor RS, Choi S, Forman S, Batjiaka R, Jain S, León TM, Vugia DJ, Yu AT. Correlation between wastewater and COVID-19 case incidence rates in major California sewersheds across three variant periods. J Water Health 2023; 21:1303-1317. [PMID: 37756197 PMCID: wh_2023_173 DOI: 10.2166/wh.2023.173] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/29/2023]
Abstract
Monitoring for COVID-19 through wastewater has been used for adjunctive public health surveillance, with SARS-CoV-2 viral concentrations in wastewater correlating with incident cases in the same sewershed. However, the generalizability of these findings across sewersheds, laboratory methods, and time periods with changing variants and underlying population immunity has not been well described. The California Department of Public Health partnered with six wastewater treatment plants starting in January 2021 to monitor wastewater for SARS-CoV-2, with analyses performed at four laboratories. Using reported PCR-confirmed COVID-19 cases within each sewershed, the relationship between case incidence rates and wastewater concentrations collected over 14 months was evaluated using Spearman's correlation and linear regression. Strong correlations were observed when wastewater concentrations and incidence rates were averaged (10- and 7-day moving window for wastewater and cases, respectively, ρ = 0.73-0.98 for N1 gene target). Correlations remained strong across three time periods with distinct circulating variants and vaccination rates (winter 2020-2021/Alpha, summer 2021/Delta, and winter 2021-2022/Omicron). Linear regression revealed that slopes of associations varied by the dominant variant of concern, sewershed, and laboratory (β = 0.45-1.94). These findings support wastewater surveillance as an adjunctive public health tool to monitor SARS-CoV-2 community trends.
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Affiliation(s)
- Angela Rabe
- California Department of Public Health COVID-19 Detection, Investigation, Surveillance, Clinical, and Outbreak Response, California Department of Public Health, Richmond and Sacramento, CA, USA; These first authors contributed equally to this manuscript. E-mail:
| | - Sindhu Ravuri
- California Department of Public Health COVID-19 Detection, Investigation, Surveillance, Clinical, and Outbreak Response, California Department of Public Health, Richmond and Sacramento, CA, USA; These first authors contributed equally to this manuscript
| | - Elisabeth Burnor
- California Department of Public Health COVID-19 Detection, Investigation, Surveillance, Clinical, and Outbreak Response, California Department of Public Health, Richmond and Sacramento, CA, USA
| | - Joshua A Steele
- Southern California Coastal Water Research Project (SCCWRP), Department of Microbiology, Costa Mesa, CA, USA
| | - Rose S Kantor
- Department of Civil and Environmental Engineering, University of California, Berkeley, CA, USA
| | - Samuel Choi
- Orange County Sanitation District, Fountain Valley, CA, USA
| | - Stanislav Forman
- Zymo Research Corp. Department of Sample Collection and Nucleic Acid Purification, Zymo Research Corp., Irvine, CA, USA
| | - Ryan Batjiaka
- San Francisco Public Utilities Commission, San Francisco, CA, USA
| | - Seema Jain
- California Department of Public Health COVID-19 Detection, Investigation, Surveillance, Clinical, and Outbreak Response, California Department of Public Health, Richmond and Sacramento, CA, USA
| | - Tomás M León
- California Department of Public Health COVID-19 Detection, Investigation, Surveillance, Clinical, and Outbreak Response, California Department of Public Health, Richmond and Sacramento, CA, USA
| | - Duc J Vugia
- California Department of Public Health COVID-19 Detection, Investigation, Surveillance, Clinical, and Outbreak Response, California Department of Public Health, Richmond and Sacramento, CA, USA
| | - Alexander T Yu
- California Department of Public Health COVID-19 Detection, Investigation, Surveillance, Clinical, and Outbreak Response, California Department of Public Health, Richmond and Sacramento, CA, USA
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20
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Khan P, Venkatesh S, Parveen R, Mishra P, Jain S, Agarwal N. Longitudinal efficacy of Ertugliflozin in type 2 diabetes mellitus: a meta-analysis of randomized controlled trials. Expert Opin Pharmacother 2023; 24:2199-2210. [PMID: 37955156 DOI: 10.1080/14656566.2023.2279100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 05/30/2023] [Indexed: 11/14/2023]
Abstract
INTRODUCTION Ertugliflozin, a sodium-glucose cotransporter-2 inhibitor, seems to improve glycemic control in type 2 diabetes mellitus (T2DM). We aim to evaluate the efficacy of Ertugliflozin across multiple time intervals (18, 26, and 52 weeks) in T2DM patients. METHODS A literature search was conducted on electronic databases. Data was extracted from eligible studies at both 5 mg and 15 mg doses in monotherapy and as add-on therapy. Cochrane RevMan was used to perform the meta-analysis. RESULTS Ertugliflozin, at both 5 mg and 15 mg doses, demonstrated a significant improvement in HbA1c levels at 18 weeks 5 mg [P = 0.00001], 15 mg [P = 0.05], and at 26 weeks in monotherapy 5 mg [P = 0.006], monotherapy 15 mg [P = 0.006], 5 mg as add-on therapy [P = 0.00001], 15 mg add-on therapy [P = 0.00001] respectively. At 52 weeks, the reduction in HbA1c was significant in 15 mg add-on therapy [P = 0.0001]. Additionally, ertugliflozin as an add-on therapy also led to a significant reduction in FPG, body weight, and systolic blood pressure. CONCLUSION Ertugliflozin showed clinical efficacy in improving glycemic control, fasting plasma glucose, body weight, and systolic blood pressure in T2DM patients over the studied time intervals compared to placebo.
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Affiliation(s)
- Parvej Khan
- Department for Translational and Clinical Research, School of Chemical and Life Sciences, Jamia Hamdard, New Delhi, India
| | | | - Rizwana Parveen
- Department for Translational and Clinical Research, School of Chemical and Life Sciences, Jamia Hamdard, New Delhi, India
| | - Pinki Mishra
- Department for Translational and Clinical Research, School of Chemical and Life Sciences, Jamia Hamdard, New Delhi, India
| | - Seema Jain
- Department of Pharmacology, University College of Medical Sciences and GTB Hospital, New Delhi, India
| | - Nidhi Agarwal
- Department for Translational and Clinical Research, School of Chemical and Life Sciences, Jamia Hamdard, New Delhi, India
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21
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Jain S, Mohanachandran J, Mohan R. Outcomes and complications of Titanium elastic nailing for forearm bones fracture in children: our experience in a district general hospital in the United Kingdom. Acta Orthop Belg 2023; 89:539-546. [PMID: 37935240 DOI: 10.52628/89.3.12032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2023]
Abstract
Intramedullary Titanium elastic nailing (TENS) is successfully used for irreducible and displaced forearm bone fractures in children. The purpose of this study was to report the potential complications and functional outcomes associated with paediatric forearm fractures treated with TENS nails. We retrospectively reviewed 65 children with displaced forearm bone fractures treated by TENS nailing with a mean follow-up of 5.84 months (4-12). Data detailing patient demographics, fracture characteristics, associated fractures, injury surgery interval, grade of the operating surgeon, methods of fixation, time to union, the timing of removal of the nail, and complications were collected and analysed. The mean age in our study was 9.13 years. 92% had fractures of both radius and ulna, 83.3% had fixation of both bones, and 16.7% had single bone fixation only. Open reduction was required in 38.5% of cases. The average time to fracture union was 10.34 weeks (6-20). The average time of implant removal was 20.12 weeks (9-32). We observed an overall complication rate of 41.5%. We noted a higher (56% vs 32.5%, p=0.059) complication rate in open reduction cases. According to the Price criteria, we had excellent to good results in over 98% of patients despite a slightly higher complication rate. Titanium elastic nailing is a safe, reliable method of internal fixation for irreducible or unstable fractures of both bones of the forearm in children. Open reduction of fracture was associated with higher complications. Despite higher overall complications, we noted excellent functional results in most cases.
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22
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Phillips S, Jones I, Sondermyer-Cooksey G, Yu AT, Heaney AK, Zhou B, Bhattachan A, Weaver AK, Campo SK, Mgbara W, Wagner R, Taylor J, Lettenmaier D, Okin GS, Jain S, Vugia D, Remais JV, Head JR. Association between wildfires and coccidioidomycosis incidence in California, 2000-2018: a synthetic control analysis. Environ Epidemiol 2023; 7:e254. [PMID: 37545805 PMCID: PMC10402968 DOI: 10.1097/ee9.0000000000000254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 05/04/2023] [Indexed: 08/08/2023] Open
Abstract
The frequency and severity of wildfires in the Western United States have increased over recent decades, motivating hypotheses that wildfires contribute to the incidence of coccidioidomycosis, an emerging fungal disease in the Western United States with sharp increases in incidence observed since 2000. While coccidioidomycosis outbreaks have occurred among wildland firefighters clearing brush, it remains unknown whether fires are associated with an increased incidence among the general population. Methods We identified 19 wildfires occurring within California's highly endemic San Joaquin Valley between 2003 and 2015. Using geolocated surveillance records, we applied a synthetic control approach to estimate the effect of each wildfire on the incidence of coccidioidomycosis among residents that lived within a hexagonal buffer of 20 km radii surrounding the fire. Results We did not detect excess cases due to wildfires in the 12 months (pooled estimated percent change in cases: 2.8%; 95% confidence interval [CI] = -29.0, 85.2), 13-24 months (7.9%; 95% CI = -27.3, 113.9), or 25-36 months (17.4%; 95% CI = -25.1, 157.1) following a wildfire. When examined individually, we detected significant increases in incidence following three of the 19 wildfires, all of which had relatively large adjacent populations, high transmission before the fire, and a burn area exceeding 5,000 acres. Discussion We find limited evidence that wildfires drive increases in coccidioidomycosis incidence among the general population. Nevertheless, our results raise concerns that large fires in regions with ongoing local transmission of Coccidioides may be associated with increases in incidence, underscoring the need for field studies examining Coccidioides spp. in soils and air pre- and post-wildfires.
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Affiliation(s)
- Sophie Phillips
- Department of Statistics, University of California, Los Angeles, Los Angeles, California
| | - Isabel Jones
- Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, Berkeley, California
| | | | - Alexander T. Yu
- Infectious Diseases Branch, California Department of Public Health, Richmond, California
| | - Alexandra K. Heaney
- Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, Berkeley, California
| | - Bo Zhou
- Department of Geography, University of California, Los Angeles, Los Angeles, California
| | | | - Amanda K. Weaver
- Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, Berkeley, California
| | - Simon K. Campo
- Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, Berkeley, California
| | - Whitney Mgbara
- Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, Berkeley, California
| | - Robert Wagner
- Department of Plant and Microbial Biology, College of Natural Resources, University of California, Berkeley, Berkeley, California
| | - John Taylor
- Department of Plant and Microbial Biology, College of Natural Resources, University of California, Berkeley, Berkeley, California
| | - Dennis Lettenmaier
- Department of Geography, University of California, Los Angeles, Los Angeles, California
| | - Gregory S. Okin
- Department of Geography, University of California, Los Angeles, Los Angeles, California
| | - Seema Jain
- Infectious Diseases Branch, California Department of Public Health, Richmond, California
| | - Duc Vugia
- Infectious Diseases Branch, California Department of Public Health, Richmond, California
| | - Justin V. Remais
- Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, Berkeley, California
| | - Jennifer R. Head
- Department of Statistics, University of California, Los Angeles, Los Angeles, California
- Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, Berkeley, California
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23
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Jain S, Patel K, Ganapathy K, Khan F, Sahu S, Singh A. LAPAROSCOPIC APPROACH TO A GIANT RUPTURED SPLENIC CYST: A CHALLENGING CASE REPORT. Georgian Med News 2023:280-283. [PMID: 37805912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 10/09/2023]
Abstract
Splenic cysts are rare; their absence of an epithelial wall determines whether they're real cysts or pseudocysts. Spontaneous nonparasitic actual tumors are those that develop early in life at the anterior pole of the splenic and are typically epidermoid, dermoid, or endodermal. Surgical therapy is suggested for symptomatic, large (more than 5 cm) cysts or complicated. Inhaling splenic excision is a substitute for surgery, depending on the quantity, location, connection to the hilus, and dimension of the tumors. With an emphasis on less invasive treatments that preserve the spleen, laparoscopic methods have already established themselves as the accepted method for treating numerous disorders, including splenic cysts. They describe the effective decapsulation of a massive epidermoid spleen tumor under a prolonged, partially endoscopic technique. Laparoscopy, an operation commonly referred to as surgery with minimally invasive or keyhole surgery, is a technique that makes many tiny incisions in the belly to carry out different surgical procedures.
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Affiliation(s)
- S Jain
- 1Department of General Surgery, Jaipur National University, Jaipur, India
| | - K Patel
- 2Department of Gynecology, Parul University, PO Limda, Tal. Waghodia, District Vadodara, Gujarat, India
| | - K Ganapathy
- 3Department of Biotechnology, School of Sciences, JAIN (Deemed-to-be University), Karnataka, India
| | - F Khan
- 4Department of Nursing, IIMT University, Meerut, Uttar Pradesh, India
| | - S Sahu
- 5Department of Ayurveda, Sanskriti University, Mathura, Uttar Pradesh, India
| | - A Singh
- 6Department of General Surgery, Teerthanker Mahaveer University, Moradabad, Uttar Pradesh, India
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Bayetti C, Bakhshi P, Davar B, Khemka GC, Kothari P, Kumar M, Kwon W, Mathias K, Mills C, Montenegro CR, Trani JF, Jain S. Critical reflections on the concept and impact of "scaling up" in Global Mental Health. Transcult Psychiatry 2023; 60:602-609. [PMID: 37491885 PMCID: PMC7615199 DOI: 10.1177/13634615231183928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/27/2023]
Abstract
The field of Global Mental Health (GMH) aims to address the global burden of mental illness by focusing on closing the "treatment gap" faced by many low- and middle-income countries (LMICs). To increase access to services, GMH prioritizes "scaling up" mental health services, primarily advocating for the export of Western centred and developed biomedical and psychosocial "evidence-based" approaches to the Global South. While this emphasis on scalability has resulted in the increased availability of mental health services in some LMICs, there have been few critical discussions of this strategy. This commentary critically appraises the scalability of GMH by questioning the validity and sustainability of its approach. We argue that the current approach emphasizes the development of mental health services and interventions in "silos," focusing on the treatment of mental illnesses at the exclusion of a holistic and contextualized approach to people's needs. We also question the opportunities that the current approach to GMH offers for the growth of mental health programmes of local NGOs and investigate the potential pitfalls that scalability may have on NGOs' impact and ability to innovate. This commentary argues that any "scaling up" of mental health services must place sustainability at the core of its mission by favouring the growth and development of local solutions and wider forms of support that prioritize social inclusion and long-lasting mental health recovery.
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Affiliation(s)
- C Bayetti
- Brown School, Washington University in St Louis, St Louis, MO, USA
| | - P Bakhshi
- School of Occupational Therapy, Washington University in St Louis, MO, USA
| | - B Davar
- Executive Director, Transforming Communities for Inclusion (TCI) Managing Trustee, Bapu Trust for Research on Mind & Discourse, Pune, Maharashtra, India
| | - G C Khemka
- Brown School, Washington University in St Louis, St Louis, MO, USA
| | - P Kothari
- Iswar Sankalpa (NGO), Kolkata, West Bengal, India
| | - M Kumar
- Founder & Clinical Director, MHAT, India
| | - W Kwon
- University of Edinburgh Business School, Edinburgh, Scotland
| | - K Mathias
- Burans, Herbertpur Christian Hospital, Dehradun, India
- Faculty of Health, University of Canterbury, Christchurch, New Zealand
| | - C Mills
- School of Health and Psychological Sciences, City, University of London
| | - C R Montenegro
- Wellcome Centre for Cultures and Environments of Health, University of Exeter, UK
- School of Nursing, Pontificia Universidad Católica de Chile, Chile
| | - J F Trani
- Brown School, Washington University in St Louis, St Louis, MO, USA
| | - S Jain
- School of Social and Political Science, The University of Edinburgh, UK
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25
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Park HJ, Tan ST, León TM, Jain S, Schechter R, Lo NC. Predicting the public health impact of bivalent vaccines and nirmatrelvir-ritonavir against COVID-19. medRxiv 2023:2023.05.18.23289533. [PMID: 37292707 PMCID: PMC10246024 DOI: 10.1101/2023.05.18.23289533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Background Uptake of COVID-19 bivalent vaccines and oral medication nirmatrelvir-ritonavir (Paxlovid) has remained low across the United States. Assessing the public health impact of increasing uptake of these interventions in key risk groups can guide further public health resources and policy. Methods This modeling study used person-level data from the California Department of Public Health on COVID-19 cases, hospitalizations, deaths, and vaccine administration from July 23, 2022 to January 23, 2023. We modeled the impact of additional uptake of bivalent COVID-19 vaccines and nirmatrelvir-ritonavir during acute illness in different risk groups defined by age (50+, 65+, 75+ years) and vaccination status (everyone, primary series only, previously vaccinated). We predicted the number of averted COVID-19 cases, hospitalizations, and deaths and number needed to treat (NNT). Results For both bivalent vaccines and nirmatrelvir-ritonavir, the most efficient strategy (based on NNT) for averting severe COVID-19 was targeting the 75+ years group. We predicted that perfect coverage of bivalent boosters in the 75+ years group would avert 3,920 hospitalizations (95%UI: 2,491-4,882; 7.8% total averted; NNT 387) and 1,074 deaths (95%UI: 774-1,355; 16.2% total averted; NNT 1,410). Perfect uptake of nirmatrelvir-ritonavir in the 75+ years group would avert 5,644 hospitalizations (95%UI: 3,947-6,826; 11.2% total averted; NNT 11) and 1,669 deaths (95%UI: 1,053-2,038; 25.2% total averted; NNT 35). Conclusions These findings suggest prioritizing uptake of bivalent boosters and nirmatrelvir-ritonavir among the oldest age groups would be efficient and have substantial public health impact in reducing the burden of severe COVID-19, but would not address the entire burden of severe COVID-19.
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Affiliation(s)
- Hailey J. Park
- Division of HIV, Infectious Diseases, and Global Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Sophia T. Tan
- Division of HIV, Infectious Diseases, and Global Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Tomás M. León
- California Department of Public Health, Richmond, CA, USA
| | - Seema Jain
- California Department of Public Health, Richmond, CA, USA
| | | | - Nathan C. Lo
- Division of HIV, Infectious Diseases, and Global Medicine, University of California, San Francisco, San Francisco, CA, USA
- Department of Medicine, University of California, San Francisco, San Francisco, CA, USA
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Jain S, Shahan K, Bowen M, Pruitt SL. Dietary intake of individuals receiving Supplemental Nutrition Assistance Program and food pantry assistance in North Texas. Public Health Nutr 2023; 26:1082-1087. [PMID: 35321780 PMCID: PMC10346013 DOI: 10.1017/s136898002200074x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 03/07/2022] [Accepted: 03/21/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Food pantries and the Supplemental Nutrition Assistance Program (SNAP) are widely available resources for individuals facing food insecurity, yet the dietary quality of individuals using both programmes is not well characterised. We describe the dietary intake of individuals in North Texas who use both food pantries and SNAP to identify nutritional gaps and opportunities to improve food assistance programmes. DESIGN We analysed baseline data from a randomised controlled trial examining food security and dietary intake. At baseline, we administered the validated, 26-item Dietary Screener Questionnaire (DSQ). We calculated descriptive statistics for dietary intake variables and compared with the 2020-2025 Dietary Guidelines for Americans recommended intake values. SETTING Two large food pantries in Dallas County, TX. PARTICIPANTS Eligible participants were English or Spanish speaking adults receiving SNAP benefits who had used the food pantry within the last 4 months. RESULTS We analysed baseline DSQ data from 320 participants (mean age 47 years; 90% female; 45% Black or African American; 37% Hispanic or Latino). Despite receiving SNAP benefits and food pantry assistance, most participants did not meet the minimum recommended intake values for fruits (88.4%), vegetables (97.4%), fibre (90·7%), whole grains (99·7%), dairy products (98·4%) and Ca (83·4%). Furthermore, 73·2% of participants exceeded the maximum recommended intake for added sugar. Still, the gap between median daily intake and recommended daily intake could be partially bridged with food obtained through current food assistance programmes. CONCLUSIONS Multilevel, coordinated approaches within both SNAP and food pantry networks are needed to improve diet quality in individuals receiving food assistance.
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Affiliation(s)
- Seema Jain
- Internal Medicine, The University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, E1, Dallas, TX75390, USA
| | - Kathryn Shahan
- Population and Data Sciences, The University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Michael Bowen
- Internal Medicine, The University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, E1, Dallas, TX75390, USA
- Population and Data Sciences, The University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Sandi L Pruitt
- Population and Data Sciences, The University of Texas Southwestern Medical Center, Dallas, TX, USA
- Harold C. Simmons Cancer Center, The University of Texas Southwestern Medical Center, Dallas, TX, USA
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27
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White LA, McCorvie R, Crow D, Jain S, León TM. Assessing the accuracy of California county level COVID-19 hospitalization forecasts to inform public policy decision making. BMC Public Health 2023; 23:782. [PMID: 37118796 PMCID: PMC10141909 DOI: 10.1186/s12889-023-15649-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 04/11/2023] [Indexed: 04/30/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic has highlighted the role of infectious disease forecasting in informing public policy. However, significant barriers remain for effectively linking infectious disease forecasts to public health decision making, including a lack of model validation. Forecasting model performance and accuracy should be evaluated retrospectively to understand under which conditions models were reliable and could be improved in the future. METHODS Using archived forecasts from the California Department of Public Health's California COVID Assessment Tool ( https://calcat.covid19.ca.gov/cacovidmodels/ ), we compared how well different forecasting models predicted COVID-19 hospitalization census across California counties and regions during periods of Alpha, Delta, and Omicron variant predominance. RESULTS Based on mean absolute error estimates, forecasting models had variable performance across counties and through time. When accounting for model availability across counties and dates, some individual models performed consistently better than the ensemble model, but model rankings still differed across counties. Local transmission trends, variant prevalence, and county population size were informative predictors for determining which model performed best for a given county based on a random forest classification analysis. Overall, the ensemble model performed worse in less populous counties, in part because of fewer model contributors in these locations. CONCLUSIONS Ensemble model predictions could be improved by incorporating geographic heterogeneity in model coverage and performance. Consistency in model reporting and improved model validation can strengthen the role of infectious disease forecasting in real-time public health decision making.
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Affiliation(s)
- Lauren A White
- California Department of Public Health, Richmond, CA, USA.
| | - Ryan McCorvie
- California Department of Public Health, Richmond, CA, USA
| | - David Crow
- California Department of Public Health, Richmond, CA, USA
| | - Seema Jain
- California Department of Public Health, Richmond, CA, USA
| | - Tomás M León
- California Department of Public Health, Richmond, CA, USA
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28
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Adejuyigbe EA, Agyeman I, Anand P, Anyabolu HC, Arya S, Assenga EN, Badhal S, Brobby NW, Chellani HK, Chopra N, Debata PK, Dube Q, Dua T, Gadama L, Gera R, Hammond CK, Jain S, Kantumbiza F, Kawaza K, Kija EN, Lal P, Mallewa M, Manu MK, Mehta A, Mhango T, Naburi HE, Newton S, Nyanor I, Nyako PA, Oke OJ, Patel A, Phlange-Rhule G, Sehgal R, Singhal R, Wadhwa N, Yiadom AB. Evaluation of the impact of continuous Kangaroo Mother Care (KMC) initiated immediately after birth compared to KMC initiated after stabilization in newborns with birth weight 1.0 to < 1.8 kg on neurodevelopmental outcomes: Protocol for a follow-up study. Trials 2023; 24:265. [PMID: 37038239 PMCID: PMC10088121 DOI: 10.1186/s13063-023-07192-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 02/20/2023] [Indexed: 04/12/2023] Open
Abstract
BACKGROUND Preterm birth or low birth weight is the single largest cause of death in newborns, however this mortality can be reduced through newborn care interventions, including Kangaroo Mother Care (KMC). Previously, a multi-country randomized controlled trial, coordinated by the World Health Organization (WHO), reported a significant survival advantage with initiation of continuous KMC immediately after birth compared with initiation of continuous KMC a few days after birth when the baby is considered clinically stable. Whether the survival advantage would lead to higher rates of neurodevelopmental morbidities, or the immediate KMC will also have a beneficial effect on cognitive development also, has not been investigated. We therefore propose to test the hypothesis that low-birth-weight infants exposed to immediate KMC will have lower rates of neurodevelopmental impairment in comparison to traditional KMC-treated infants, by prospectively following up infants already enrolled in the immediate KMC trial for the first 2 years of life, and assessing their growth and neurodevelopment. METHODS This prospective cohort study will enroll surviving neonates from the main WHO immediate KMC trial. The main trial as well as this follow-up study are being conducted in five low- and middle-income countries in South Asia and sub-Saharan Africa. The estimated sample size for comparison of the risk of neurodevelopmental impairment is a total of 2200 children. The primary outcome will include rates of cerebral palsy, hearing impairment, vision impairment, mental and motor development, and epilepsy and will be assessed by the age of 3 years. The analysis will be by intention to treat. DISCUSSION Immediate KMC can potentially reduce low-birth-weight-associated complications such as respiratory disease, hypothermia, hypoglycemia, and infection that can result in impaired neurocognitive development. Neuroprotection may also be mediated by improved physiological stabilization that may lead to better maturation of neural pathways, reduced risk of hypoxia, positive parental impact, improved sleep cycles, and improved stress responses. The present study will help in evaluating the overall impact of KMC by investigating the long-term effect on neurodevelopmental impairment in the survivors. TRIAL REGISTRATION Clinical Trials Registry-India CTRI/2019/11/021899. Registered on 06 November 2019. Trials registration of parent trial: ACTRN12618001880235; Clinical Trials Registry-India: CTRI/2018/08/015369.
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Affiliation(s)
- E A Adejuyigbe
- Department of Paediatrics and Child Health, Obafemi Awolowo University, Ile-Ife, 220005, Nigeria
| | - I Agyeman
- Komfo Anokye Teaching Hospital, P.O. Box 1934, Adum, Kumasi, Ghana
| | - P Anand
- Department of Pediatrics, Vardhman Mahavir Medical College and Safdarjung Hospital, Ansari Nagar, New Delhi, 110029, India
| | - H C Anyabolu
- Department of Paediatrics and Child Health, Obafemi Awolowo University, Ile-Ife, 220005, Nigeria
| | - S Arya
- Department of Pediatrics, Vardhman Mahavir Medical College and Safdarjung Hospital, Ansari Nagar, New Delhi, 110029, India
| | - E N Assenga
- Department of Paediatrics and Child Health, School of Medicine, Muhimbili University of Health and Allied Sciences, Dar Es Salaam, 255, Tanzania
| | - S Badhal
- Vardhman Mahavir Medical College and Safdarjung Hospital, Ansari Nagar, New Delhi, 110029, India
| | - N W Brobby
- Department of Child Health, Komfo Anokye Teaching Hospital, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - H K Chellani
- Department of Pediatrics, Vardhman Mahavir Medical College and Safdarjung Hospital, Ansari Nagar, New Delhi, 110029, India.
| | - N Chopra
- Department of Pediatrics, Vardhman Mahavir Medical College and Safdarjung Hospital, Ansari Nagar, New Delhi, 110029, India
| | - P K Debata
- Department of Pediatrics, Vardhman Mahavir Medical College and Safdarjung Hospital, Ansari Nagar, New Delhi, 110029, India
| | - Q Dube
- Queen Elizabeth Central Hospital, Blantyre, Malawi
| | - T Dua
- Department of Mental Health and Substance Use, World Health Organization, Geneva, Switzerland
| | - L Gadama
- Department of Obstetrics and Gynaecology, Kamuzu University of Health Sciences, Blantyre, Malawi
| | - R Gera
- Department of Pediatrics, Vardhman Mahavir Medical College and Safdarjung Hospital, Ansari Nagar, New Delhi, 110029, India
| | - C K Hammond
- Department of Child Health, Komfo Anokye Teaching Hospital, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - S Jain
- Vardhman Mahavir Medical College and Safdarjung Hospital, Ansari Nagar, New Delhi, 110029, India
| | - F Kantumbiza
- Department of Paediatrics and Child Health, Kamuzu University of Health Sciences, Blantyre, Malawi
| | - K Kawaza
- Department of Paediatrics and Child Health, Kamuzu University of Health Sciences, Blantyre, Malawi
| | - E N Kija
- Department of Paediatrics and Child Health, School of Medicine, Muhimbili University of Health and Allied Sciences, Dar Es Salaam, 255, Tanzania
| | - P Lal
- Atal Bihari Vajpayee Institute of Medical Sciences &, Dr Ram Manohar Lohia Hospital, New Delhi, 110001, India
| | - M Mallewa
- Department of Paediatrics and Child Health, Kamuzu University of Health Sciences, Blantyre, Malawi
| | - M K Manu
- Komfo Anokye Teaching Hospital, P.O. Box 1934, Adum, Kumasi, Ghana
| | - A Mehta
- Vardhman Mahavir Medical College and Safdarjung Hospital, Ansari Nagar, New Delhi, 110029, India
| | - T Mhango
- Department of Paediatrics and Child Health, Kamuzu University of Health Sciences, Blantyre, Malawi
| | - H E Naburi
- Department of Paediatrics and Child Health, School of Medicine, Muhimbili University of Health and Allied Sciences, Dar Es Salaam, 255, Tanzania
| | - S Newton
- School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - I Nyanor
- Research and Development, Komfo Anokye Teaching Hospital, P.O. Box 1934, Adum, Kumasi, Ghana
| | - P A Nyako
- Department of Psychiatry, Child And Adolescent Mental Health, Komfo Anokye Teaching Hospital, P.O. Box 1934, Adum, Kumasi, Ghana
| | - O J Oke
- Department of Paediatrics and Child Health, Obafemi Awolowo University, Ile-Ife, 220005, Nigeria
| | - A Patel
- Department of Mental Health and Substance Use, World Health Organization, Geneva, Switzerland
- Division of Epilepsy & Clinical Neurophysiology, Boston Children's Hospital, Harvard Medical School, Boston, USA
| | - G Phlange-Rhule
- Clinical Development Services Agency (CDSA), Translational Health Science and Technology Institute (THSTI), NCR Biotech Science Cluster, PO Box #04, Faridabad, 121001, India
| | - R Sehgal
- Department of Pediatrics, Vardhman Mahavir Medical College and Safdarjung Hospital, Ansari Nagar, New Delhi, 110029, India
| | - R Singhal
- Translational Health Science and Technology Institute (THSTI), NCR Biotech Science Cluster, PO Box #04, 121001, Faridabad, India
| | - N Wadhwa
- Faridabad-Gurgaon Expressway, Translational Health Science and Technology Institute, NCR Biotech Science Cluster, 3Rd MilestonePost Box #04, Faridabad, Haryana, 121001, India.
| | - A B Yiadom
- Department of Child Health, Komfo Anokye Teaching Hospital, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
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Bangaru S, Uppalapati S, Palluri S, Ram K, Sudheendra K, Jain S, Johnson K, Hynes D, Madhushankar A, Grinstein J, Pinney S, Onsager D, Rodgers D, Jeevanandam V. A Less Restrictive Approach to Procuring Organs is Not an Indicator of Prognostic Survival in Heart Transplantation: A Retrospective Analysis of 118 Adult Heart Transplant Centers from 2020 to 2022. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
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30
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Ochoa E, Jain S, Rodgers D, de Matos SN, Uppalapati S, Bangaru S, Johnson K, Sudheendra K, Ram K, Hynes D, Sorensen K, Paluri S, Madhushankar A, Jeevanandam V. As Comfortable as a Pillow: The Superiority of the Sternasafe® Device Over the Standard of Care. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
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31
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Paluri S, Siddiqi U, Rodgers D, Uppalapati S, Bangaru S, Ram K, Sorensen K, Sudheendra K, Madhushankar A, Johnson K, Hynes D, Jain S, Jeevanandam V. A Probable Winner in the Race for the Best Cardiac Preservation Solution: A Single-Center's Experience. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
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32
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Uppalapati S, Rodgers D, Paluri S, Ram K, Jain S, Sorensen K, Bangaru S, Madhushankar A, Sudheendra K, Johnson K, Hynes D, Grinstein J, Kalathiya R, Jeevanandam V. Changes in Echocardiographic Parameters after Transcatheter Aortic Valve Replacement in Patients with a Left Ventricular Assist Device: A Case Series. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
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33
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Sorensen K, Rodgers D, Uppalapati SC, Siddiqi U, Jain S, Paluri S, Madhushanka A, Sudheendra K, Johnson K, Bangaru S, Ram K, Hynes D, Ozcan C, Lee L, Kim G, Jeevanandam V. A Retrospective Study on Gender, LAA Morphology and Stroke Risk. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
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34
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Bangaru S, Uppalapati S, Palluri S, Ram K, Madhushankar A, Johnson K, Hynes D, Jain S, Sudheendra K, Rodgers D, Jeevanandam V, Onsager D. Continuous Temperature Measurements in Donor Hearts During Cold Organ Procurement. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
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35
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Prasad CB, Sankar J, Dhir V, Jain S. Trolley-track sign in ankylosing spondylitis. QJM 2023; 116:231-232. [PMID: 36308443 DOI: 10.1093/qjmed/hcac247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Accepted: 10/24/2022] [Indexed: 11/09/2022] Open
Affiliation(s)
- C B Prasad
- Clinical Immunology and Rheumatology Unit, Department of Internal Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India
| | - J Sankar
- Clinical Immunology and Rheumatology Unit, Department of Internal Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India
| | - V Dhir
- Clinical Immunology and Rheumatology Unit, Department of Internal Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India
| | - S Jain
- Clinical Immunology and Rheumatology Unit, Department of Internal Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India
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Andrejko KL, Myers JF, Fukui N, Nelson L, Zhao R, Openshaw J, Watt JP, Jain S, Lewnard JA, Pry JM. Real-world uptake of COVID-19 vaccination among individuals expressing vaccine hesitancy: A registry-linkage study. Vaccine 2023; 41:1649-1656. [PMID: 36746740 PMCID: PMC9889259 DOI: 10.1016/j.vaccine.2023.01.066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 01/09/2023] [Accepted: 01/27/2023] [Indexed: 02/04/2023]
Abstract
INTRODUCTION Uptake of COVID-19 vaccination remains suboptimal in the United States and other settings. Though early reports indicated that a strong majority of people were interested in receiving the COVID-19 vaccine, the association between vaccine intention and uptake is not yet fully understood. Ourobjective was todescribe predictors of vaccine uptake, and estimate the sensitivity, specificity, and predictive values of self-reported COVID-19 vaccine status compared to a comprehensive statewide COVID-19 vaccine registry. METHODS A cohort of California residents that received a molecular test for SARS-CoV-2 infection during 24 February-5 December 2021 were enrolled in a telephone-administered survey. Survey participants were matched with records in a statewide immunization registry. Cox proportional hazards model were used to compare time to vaccination among those unvaccinated at survey enrollment by self-reported COVID-19 vaccination intention. RESULTS Among 864 participants who were unvaccinated at the time of interview, 272 (31%) had documentation of receipt of COVID-19 vaccination at a later date; including 194/423 (45.9%) who had initially reported being willing to receive vaccination, 41/185 (22.2%) who reported being unsure about vaccination, and 37/278 (13.3%) who reported unwillingness to receive vaccination.Adjusted hazard ratios (aHRs) for registry-confirmed COVID-19 vaccination were 0.49 (95% confidence interval: 0.32-0.76) and 0.21 (0.12-0.36) for participants expressing uncertainty and unwillingness to receive vaccination, respectively, as compared with participants who reported being willing to receive vaccination. Time to vaccination was shorter among participants from higher-income households (aHR = 3.30 [2.02-5.39]) and who reported co-morbidities or immunocompromising conditions (aHR = 1.54 [1.01-2.36]).Sensitivity of self-reported COVID-19 vaccination status was 82% (80-85%) overall, and 98% (97-99%) among those referencing vaccination records; specificity was 87% (86-89%). CONCLUSION Willingness to receive COVID-19 vaccination was an imperfect predictor of real-world vaccine uptake. Improved messaging about COVID-19 vaccination regardless of previous SARS-CoV-2 infection status may help improve uptake.
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Affiliation(s)
- Kristin L Andrejko
- California Department of Public Health, Richmond, CA, United States; Division of Epidemiology and Biostatistics, School of Public Health, University of California, Berkeley, CA, United States
| | - Jennifer F Myers
- California Department of Public Health, Richmond, CA, United States
| | - Nozomi Fukui
- California Department of Public Health, Richmond, CA, United States
| | - Lauren Nelson
- California Department of Public Health, Richmond, CA, United States
| | - Rui Zhao
- California Department of Public Health, Richmond, CA, United States
| | - John Openshaw
- California Department of Public Health, Richmond, CA, United States
| | - James P Watt
- California Department of Public Health, Richmond, CA, United States
| | - Seema Jain
- California Department of Public Health, Richmond, CA, United States
| | - Joseph A Lewnard
- Division of Epidemiology and Biostatistics, School of Public Health, University of California, Berkeley, CA, United States; Division of Infectious Diseases & Vaccinology, School of Public Health, University of California, Berkeley, CA, United States; Center for Computational Biology, College of Engineering, University of California, Berkeley, CA, United States.
| | - Jake M Pry
- California Department of Public Health, Richmond, CA, United States; Department of Public Health Sciences, School of Medicine, University of California, Davis, CA, United States.
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Meza E, Cummings KJ, Vergara XP, Lai KW, Lim E, Lamba K, Kamali A, Bibbins-Domingo K, Jain S, Mehrotra ML. Evaluating the association between in-person work and the risk of SARS-CoV-2 infection through June 2021. Am J Ind Med 2023; 66:222-232. [PMID: 36645337 DOI: 10.1002/ajim.23458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 12/09/2022] [Accepted: 12/27/2022] [Indexed: 01/17/2023]
Abstract
OBJECTIVES Recent studies have evaluated COVID-19 outbreaks and excess mortality by occupation sectors. Studies on SARS-CoV-2 infection across occupation and occupation-related factors remain lacking. In this study, we estimate the effect of in-person work on SARS-CoV-2 infection risk and describe SARS-CoV-2 seroprevalence among working adults. METHODS We used Wave 1 data (May to June 2021) from CalScope, a population-based seroprevalence study in California. Occupation data were coded using the National Institute for Occupational Safety and Health Industry and Occupation Computerized Coding System. Dried blood spot specimens were tested for antibodies to establish evidence of prior infection. We estimated the causal effect of in-person work on SARS-CoV-2 infection risk using the g-formula and describe SARS-CoV-2 seroprevalence across occupation-related factors. RESULTS Among 4335 working adults, 53% worked in person. In-person work was associated with increased risk of prior SARS-CoV-2 infection (risk difference: 0.03; [95% CI: 0.02-0.04]) compared with working remotely. Workers that reported job loss or who were without medical insurance had higher evidence of prior infection. Amongst in-person workers, evidence of prior infection was highest within farming, fishing, and forestry (55%; [95% CI: 26%-81%]); installation, maintenance, and repair (23%; [12%-39%]); building and grounds cleaning and maintenance (23%; [13%-36%]); food preparation and serving related (22% [13%-35%]); and healthcare support (22%; [13%-34%]) occupations. Workers who identified as Latino, reported a household income of <$25K, or who were without a bachelor's degree also had higher evidence of prior infection. CONCLUSIONS SARS-CoV-2 infection risk varies by occupation. Future vaccination strategies may consider prioritizing in-person workers.
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Affiliation(s)
- Erika Meza
- California Department of Public Health, Richmond, California, USA.,Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California, USA
| | | | - Ximena P Vergara
- California Department of Public Health, Richmond, California, USA.,Heluna Health, City of Industry, California, USA
| | - Kristina W Lai
- California Department of Public Health, Richmond, California, USA
| | - Esther Lim
- California Department of Public Health, Richmond, California, USA
| | - Katherine Lamba
- California Department of Public Health, Richmond, California, USA
| | - Amanda Kamali
- California Department of Public Health, Richmond, California, USA
| | - Kirsten Bibbins-Domingo
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California, USA
| | - Seema Jain
- California Department of Public Health, Richmond, California, USA
| | - Megha L Mehrotra
- California Department of Public Health, Richmond, California, USA
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Jain S, Menon D, Mitchell T, Kerr J, Bassi V, West R, Pandit H. A cost analysis of treating postoperative periprosthetic femoral fractures following hip replacement surgery in a UK tertiary referral centre. Injury 2023; 54:698-705. [PMID: 36470768 DOI: 10.1016/j.injury.2022.11.058] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 11/21/2022] [Accepted: 11/27/2022] [Indexed: 11/30/2022]
Abstract
AIM This study aims to evaluate costs associated with periprosthetic femoral fracture (PFF) treatment at a UK tertiary referral centre. METHODS This study included 128 consecutive PFFs admitted from 02/04/2014-19/05/2020. Financial data were provided by Patient Level Information and Costing Systems. Primary outcomes were median cost and margin. Secondary outcomes were length of stay, blood transfusion, critical care, 30-day readmission, 2-year local complication, 2-year systemic complication, 2-year reoperation and 30-day mortality rates. Statistical comparisons were made between treatment type. Statistical significance was set at p<0.05. RESULTS Across the cohort, median cost was £15,644.00 (IQR £11,031.00-£22,255.00) and median loss was £3757.50 (£599.20-£8296.20). The highest costs were ward stay (£3994.00, IQR £1,765.00-£7,013.00), theatre utilisation (£2962.00, IQR £0.00-£4,286.00) and overheads (£1705.10, IQR £896.70-£2432.20). Cost (£17,455.00 [IQR, £13,194.00-£23,308.00] versus £7697.00 [IQR £3871.00-£10,847.00], p<0.001) and loss (£4890.00 [IQR £1308.00-£10,009.00] versus £1882.00 [IQR £313.00-£3851.00], p = 0.02) were greater in the operative versus the nonoperative group. There was no difference in cost (£17,634.00 [IQR £12,965.00-£22,958.00] versus £17,399.00 [IQR £13,394.00-£23,404.00], p = 0.98) or loss (£5374.00 [IQR £1950.00-£10,143.00] versus £3860.00 [IQR -£95.50-£7601.00], p = 0.21) between the open reduction and internal fixation (ORIF) and revision groups. More patients required blood transfusion in the operative versus the nonoperative group (17 [17.9%] versus 0 [0.0%], p = 0.009). There was no difference in any clinical outcome between the ORIF and revision groups (p>0.05). CONCLUSION PFF treatment costs are high with inadequate reimbursement from NHS tariff. Work is needed to address this disparity and reduce hospital costs. Cost should not be used to decide between ORIF and revision surgery.
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Affiliation(s)
- S Jain
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Chapeltown Road, Leeds LS7 4SA, United Kingdom; Chapel Allerton Hospital, Leeds Teaching Hospitals NHS Trust, Chapeltown Road, Leeds LS7 4SA, United Kingdom.
| | - D Menon
- Chapel Allerton Hospital, Leeds Teaching Hospitals NHS Trust, Chapeltown Road, Leeds LS7 4SA, United Kingdom
| | - T Mitchell
- Patient Level Information and Costing Systems (PLICS) department, Leeds Teaching Hospitals NHS Trust, Beckett Street, Leeds LS9 7TF, United Kingdom
| | - J Kerr
- Patient Level Information and Costing Systems (PLICS) department, Leeds Teaching Hospitals NHS Trust, Beckett Street, Leeds LS9 7TF, United Kingdom
| | - V Bassi
- Patient Level Information and Costing Systems (PLICS) department, Leeds Teaching Hospitals NHS Trust, Beckett Street, Leeds LS9 7TF, United Kingdom
| | - R West
- Leeds Institute of Health Sciences, University of Leeds, Leeds LS2 9TJ, United Kingdom
| | - H Pandit
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Chapeltown Road, Leeds LS7 4SA, United Kingdom; Chapel Allerton Hospital, Leeds Teaching Hospitals NHS Trust, Chapeltown Road, Leeds LS7 4SA, United Kingdom
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Al-Omari L, Williams M, Fuenmayor MEF, Jain S. Case report – identical twins in the neonatal intensive care unit with hiatal hernias. Am J Med Sci 2023. [DOI: 10.1016/s0002-9629(23)00047-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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Andrejko KL, Pry JM, Myers JF, Mehrotra M, Lamba K, Lim E, Fukui N, DeGuzman JL, Openshaw J, Watt J, Jain S, Lewnard JA, Covid-Case-Control Study Team OBOTC. Waning of two-dose BNT162b2 and mRNA-1273 vaccine effectiveness against symptomatic SARS-CoV-2 infection is robust to depletion-of-susceptibles bias. Am J Epidemiol 2023:7000826. [PMID: 36702469 DOI: 10.1093/aje/kwad017] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 10/10/2022] [Indexed: 01/28/2023] Open
Abstract
Concerns about the duration of protection conferred by COVID-19 vaccines have arisen in postlicensure evaluations. "Depletion of susceptibles" bias driven by differential accrual of infection among vaccinated and unvaccinated individuals may obscure vaccine effectiveness (VE) estimates, hindering interpretation. We enrolled California residents who received molecular SARS-CoV-2 tests in a matched, test-negative design case-control study to estimate VE of mRNA-based COVID-19 vaccines between 23 February and 5 December 2021. We analyzed waning protection following two vaccine doses using conditional logistic regression models. Additionally, we used data from a population-based serological study to adjust for "depletion-of-susceptibles" bias and estimated VE for 3 doses, by time since second dose receipt. Pooled VE of BNT162b2 and mRNA-1273 against symptomatic SARS-CoV-2 infection was 91.3% (95% confidence interval: 83.8-95.4%) at 14 days after second-dose receipt and declined to 50.8% (31.2-75.6%) at 7 months. Adjusting for depletion-of-susceptibles, we estimated VE of 53.2% (23.6-71.2%) at 7 months after primary mRNA vaccination series. A booster dose of BN162b2 or mRNA-1273 increased VE to 95.0% (82.8-98.6%). These findings confirm that observed waning of protection is not attributable to epidemiologic bias and support ongoing efforts to administer additional vaccine doses to mitigate burden of COVID-19.
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Affiliation(s)
- Kristin L Andrejko
- Division of Epidemiology and Biostatistics, School of Public Health, University of California, Berkeley, California, United States.,California Department of Public Health, Richmond, California, United States
| | - Jake M Pry
- California Department of Public Health, Richmond, California, United States
| | - Jennifer F Myers
- California Department of Public Health, Richmond, California, United States
| | - Megha Mehrotra
- California Department of Public Health, Richmond, California, United States
| | - Katherine Lamba
- California Department of Public Health, Richmond, California, United States
| | - Esther Lim
- California Department of Public Health, Richmond, California, United States
| | - Nozomi Fukui
- California Department of Public Health, Richmond, California, United States
| | | | - John Openshaw
- California Department of Public Health, Richmond, California, United States
| | - James Watt
- California Department of Public Health, Richmond, California, United States
| | - Seema Jain
- California Department of Public Health, Richmond, California, United States
| | - Joseph A Lewnard
- Division of Epidemiology and Biostatistics, School of Public Health, University of California, Berkeley, California, United States.,Division of Infectious Diseases & Vaccinology, School of Public Health, University of California, Berkeley, California, United States.,Center for Computational Biology, College of Engineering, University of California, Berkeley, California, United States
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Roy A, Sharma S, Sharma B, Nag TC, Katyal J, Gupta YK, Jain S. 1147 MORPHO-FUNCTIONAL EVALUATION OF 3MG/KG ICV-STZ RAT SHOWED SPORADIC ALZHEIMER'S LIKE PATHOLOGY WITH PROGRESSIVE DEMENTIA. Age Ageing 2023. [DOI: 10.1093/ageing/afac322.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
Abstract
Background
Intracerebroventricular streptozotocin (ICV-STZ) injection is among the best animal models to simulate sporadic Alzheimer’s disease (sAD). Abnormality in brain insulin signalling, neurodegeneration, neuroinflammation, cholinergic damage, mitochondrial dysfunction, genetic abnormality, respiratory problem, oxidative stress, gliosis, sleep disturbances are associated with cognitive abnormalities seen in ICV-STZ injected rats. Available experimental evidence has used varying doses of STZ (<1 to 3mg/kg) and studied its effect for different study durations, ranging from 14-21 (short), 30-42 (mild), 90-105 (moderate) and 250-270 (long) days. These studies indicated that 3mg/kg of body-weight is the optimum dose for inducing sAD in the rodents. However, studies on the pathological process with related the morphological and functional abnormalities reported were illusive.
Objective/Method
Hence in the present study, we have investigated the morpho-functional changes after 3mg/kg ICV-STZ treatment with a follow-up of two months in 54 male Wistar rats (ethical no. 937/IAEC/PhD-2016).
Results
Exhibited a spatial, episodic and avoidance memory decline and increase in anxiety (p<0.05) in ICV-STZ group progressively with time from 15th day to 60th day post-injection. Morphometry showed hippocampal atrophy with CA1, CA3 layer thinning (p ≤0.01) and loss of neurons (p<0.0001) associated with third ventricular enlargement (p= 0.007) in ICV-STZ rats versus sham, along-with extracellular amyloid plaque in AD rats with Congored staining. In addition, spine morphometry with Golgi-Cox impregnation of mossy fibre showed a reduction of spine density in AD group versus control and sham group (p<0.0001). Finally, immunohistochemistry of GSK3ß, PI3K and mtCOX-1 antigen in coronal sections revealed an increase in mean intensity of GSK3ß and decrease in PI3K and mtCox-1 in brain areas associated with limbic system in ICV-STZ group on 60th day.
Conclusion
These findings suggest progressive dementia and anxiety in 3mg/kg STZ treated rats, which may be due to hippocampal atrophy, amyloidopathy, ventricular enlargement, synaptic dysfunction and deficits in energy homeostasis of brain.
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Affiliation(s)
- A Roy
- All India Institute of Medical Sciences , New Delhi
| | - S Sharma
- Indian Institute of Technology , Delhi
| | - B Sharma
- All India Institute of Medical Sciences , New Delhi
| | - T C Nag
- All India Institute of Medical Sciences , New Delhi
| | - J Katyal
- All India Institute of Medical Sciences , New Delhi
| | - Y K Gupta
- Translational Health Sciences and Technology Institute , Delhi
| | - S Jain
- All India Institute of Medical Sciences , New Delhi
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Roy A, Kumar A, Kakkadi V, Nag TC, Katyal J, Gupta YK, Jain S. 1145 RTMS TREATMENT IMPROVED COGNITIVE DYSFUNCTION THROUGH ADULT NEUROGENESIS IN ICV-STZ RAT MODEL OF SPORADIC ALZHEIMER'S DISEASE. Age Ageing 2023. [DOI: 10.1093/ageing/afac322.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
Abstract
Background
Intracerebroventricular streptozotocin injection at 3mg/kg of b/w causes phenotypes similar to that of sporadic Alzheimer’s disease (sAD) from 14th day post-injection. On the other hand, the body of evidence indicated that impairment in the sAD is the major contributor for cognitive decline. Taken together, we tested the adult neurogenesis hypothesis in streptozotocin model of sAD in female Wistar rats after extremely low magnetic stimulation (MF: 17.96, 50Hz, 2hr/day, 21days).
Method
33 rats were randomly divided into three groups viz. Sham+MF, AD and AD+MF. Consequently, animals were first induced AD with stereotaxic manipulation and then they were exposed to low frequency magnetic field stimulation, followed by terminal cognitive behavioural tasks brain tissue being isolated for both biochemical and subcellular expression experiments (ethical no. 12/IAEC-1/2017).
Results
Showed reduction in latency to the goal quadrant (p= 0.002) and transfer latency (p= 0.045) in AD+MF group versus AD. Even, Dirichlet distribution of time spent in 4 quadrants indicated un-uniform in all the groups except AD group (p= 0.067, LRS= 7.35). Further, cell count in CA3 and DG exhibited increase in cell density in AD+MF group (p<0.05). However, we found significant reduction in SOD1 activity after MF treatment (p= 0.035) but no change in GSH level in hippocampus and frontal cortex. Interestingly, these changes in AD+MF animals are associated with increase in density of BrdU+/Nestin+ cells in granular layer (p= 0.002) and hilus region (p= 0.0005) of DG along with increase in expression of L-type Ca2+ channels as compared to AD group.
Conclusion
This experimental evidence suggests that non-invasive brain stimulation can promote adult neurogenesis by activating L-type ca2+ channels in the hilus, which intern helps in retention of long-term memory even after sAD.
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Affiliation(s)
- A Roy
- All India Institute of Medical Sciences , New Delhi
| | - A Kumar
- All India Institute of Medical Sciences , New Delhi
| | - V Kakkadi
- All India Institute of Medical Sciences , New Delhi
| | - T C Nag
- All India Institute of Medical Sciences , New Delhi
| | - J Katyal
- All India Institute of Medical Sciences , New Delhi
| | - Y K Gupta
- Translational Health Sciences and Technology Institute , Delhi
| | - S Jain
- All India Institute of Medical Sciences , New Delhi
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Jain S, Grover S, Narang S, Gupta R, Garg S, Sharma D. Evaluation of cognitive function, serum 25-hydroxyvitamin D, and Vitamin D binding protein levels in chronic obstructive pulmonary disease: A case–control study. Int J Non-Commun Dis 2023. [DOI: 10.4103/jncd.jncd_70_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/30/2023] Open
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Grover S, Jain S. Current Trends in the Animal Models for Screening of Nootropic Agents: A Systematic Review. Curr Rev Clin Exp Pharmacol 2023; 18:255-269. [PMID: 35469584 DOI: 10.2174/2772432817666220425121323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 01/31/2022] [Accepted: 02/17/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND Deficits in cognitive functions are observed in various diseases. The term "nootropics" refers to the compounds that increase mental functions, including memory, motivation, concentration and attention. Given the complexity and vastness of the processes involved in cognition, developing an appropriate animal model for the screening of nootropic agents still remains a daunting task. OBJECTIVES This review attempts to elicit the current trends in the animal models being used for screening of nootropic agents and effectively use this knowledge to improve prospects embarking on this area of research. METHODS Electronic searches were carried out on PubMed using the keywords "nootropic agents"[MeSH Term] OR "nootropic drugs" [MeSH Term] AND "animal model" [MeSH Term] OR "animal model, experimental" [MeSH Term]. All relevant studies from 2016 to 31st August, 2021, were then reviewed to meet the stated objective. RESULTS The most commonly used disease model for screening of nootropic agents was found to be the animal model of Alzheimer's disease. Disease models of vascular dementia or stroke, depression or anxiety, schizophrenia, epilepsy or seizure, diabetes and traumatic brain injury, among others, have also been used. There exists a wide variety of behavioral tests to assess cognition. CONCLUSION Since a variety of etiologies can affect cognitive processes. Hence, a nootropic agent may be screened in a variety of disease models. The most widely used and appropriate method to assess cognition would be by combining the behavioral and biochemical assays so that a more comprehensive profile of the nootropic effects of a drug can be elicited.
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Affiliation(s)
- Shubhima Grover
- Department of Pharmacology, University College of Medical Sciences and GTB Hospital, New Delhi, India
| | - Seema Jain
- Department of Pharmacology, University College of Medical Sciences and GTB Hospital, New Delhi, India
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Dunajcik A, Haire K, Thomas JD, Moriarty LF, Springer Y, Villanueva JM, MacNeil A, Silk B, Nemhauser JB, Byrkit R, Taylor M, Queen K, Tong S, Lee J, Batra D, Paden C, Henderson T, Kunkes A, Ojo M, Firestone M, Martin Webb L, Freeland M, Brown CM, Williams T, Allen K, Kauerauf J, Wilson E, Jain S, McDonald E, Silver E, Stous S, Wadford D, Radcliffe R, Marriott C, Owes JP, Bart SM, Sosa LE, Oakeson K, Wodniak N, Shaffner J, Brown Q, Westergaard R, Salinas A, Hallyburton S, Ogale Y, Offutt-Powell T, Bonner K, Tubach S, Van Houten C, Hughes V, Reeb V, Galeazzi C, Khuntia S, McGee S, Hicks JT, Dinesh Patel D, Krueger A, Hughes S, Jeanty F, Wang JC, Lee EH, Assanah-Deane T, Tompkins M, Dougherty K, Naqvi O, Donahue M, Frederick J, Abdalhamid B, Powers AM, Anderson M. Travel history among persons infected with SARS-CoV-2 variants of concern in the United States, December 2020-February 2021. PLOS Glob Public Health 2023; 3:e0001252. [PMID: 36989218 DOI: 10.1371/journal.pgph.0001252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 02/16/2023] [Indexed: 03/30/2023]
Abstract
The first three SARS-CoV-2 phylogenetic lineages classified as variants of concern (VOCs) in the United States (U.S.) from December 15, 2020 to February 28, 2021, Alpha (B.1.1.7), Beta (B.1.351), and Gamma (P.1) lineages, were initially detected internationally. This investigation examined available travel history of coronavirus disease 2019 (COVID-19) cases reported in the U.S. in whom laboratory testing showed one of these initial VOCs. Travel history, demographics, and health outcomes for a convenience sample of persons infected with a SARS-CoV-2 VOC from December 15, 2020 through February 28, 2021 were provided by 35 state and city health departments, and proportion reporting travel was calculated. Of 1,761 confirmed VOC cases analyzed, 1,368 had available data on travel history. Of those with data on travel history, 1,168 (85%) reported no travel preceding laboratory confirmation of SARS-CoV-2 and only 105 (8%) reported international travel during the 30 days preceding a positive SARS-CoV-2 test or symptom onset. International travel was reported by 92/1,304 (7%) of persons infected with the Alpha variant, 7/55 (22%) with Beta, and 5/9 (56%) with Gamma. Of the first three SARS-CoV-2 lineages designated as VOCs in the U.S., international travel was common only among the few Gamma cases. Most persons infected with Alpha and Beta variant reported no travel history, therefore, community transmission of these VOCs was likely common in the U.S. by March 2021. These findings underscore the importance of global surveillance using whole genome sequencing to detect and inform mitigation strategies for emerging SARS-CoV-2 VOCs.
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Affiliation(s)
- Alicia Dunajcik
- Centers for Disease Control and Prevention (CDC), COVID-19 Response Team, Atlanta, Georgia, United States of America
| | - Kambria Haire
- Centers for Disease Control and Prevention (CDC), COVID-19 Response Team, Atlanta, Georgia, United States of America
| | - Jennifer D Thomas
- Centers for Disease Control and Prevention (CDC), COVID-19 Response Team, Atlanta, Georgia, United States of America
| | - Leah F Moriarty
- Centers for Disease Control and Prevention (CDC), COVID-19 Response Team, Atlanta, Georgia, United States of America
| | - Yuri Springer
- Centers for Disease Control and Prevention (CDC), COVID-19 Response Team, Atlanta, Georgia, United States of America
| | - Julie M Villanueva
- Centers for Disease Control and Prevention (CDC), COVID-19 Response Team, Atlanta, Georgia, United States of America
| | - Adam MacNeil
- Centers for Disease Control and Prevention (CDC), COVID-19 Response Team, Atlanta, Georgia, United States of America
| | - Benjamin Silk
- Centers for Disease Control and Prevention (CDC), COVID-19 Response Team, Atlanta, Georgia, United States of America
| | - Jeffrey B Nemhauser
- Centers for Disease Control and Prevention (CDC), COVID-19 Response Team, Atlanta, Georgia, United States of America
| | - Ramona Byrkit
- Centers for Disease Control and Prevention (CDC), COVID-19 Response Team, Atlanta, Georgia, United States of America
| | - Melanie Taylor
- Centers for Disease Control and Prevention (CDC), COVID-19 Response Team, Atlanta, Georgia, United States of America
| | - Krista Queen
- Centers for Disease Control and Prevention (CDC), COVID-19 Response Team, Atlanta, Georgia, United States of America
| | - Suxiang Tong
- Centers for Disease Control and Prevention (CDC), COVID-19 Response Team, Atlanta, Georgia, United States of America
| | - Justin Lee
- Centers for Disease Control and Prevention (CDC), COVID-19 Response Team, Atlanta, Georgia, United States of America
| | - Dhwani Batra
- Centers for Disease Control and Prevention (CDC), COVID-19 Response Team, Atlanta, Georgia, United States of America
| | - Clinton Paden
- Centers for Disease Control and Prevention (CDC), COVID-19 Response Team, Atlanta, Georgia, United States of America
| | - Tiffany Henderson
- Michigan Department of Health and Human Services, Lansing, Michigan, United States of America
| | - Audrey Kunkes
- Georgia Department of Health, Atlanta, Georgia, United States of America
| | - Mojisola Ojo
- New Jersey Department of Health, Trenton, New Jersey, United States of America
| | - Melanie Firestone
- Minnesota Department of Health, St. Paul, Minnesota, United States of America
- Epidemic Intelligence Service, CDC, Atlanta, Georgia, United States of America
| | - Lindsey Martin Webb
- Colorado Department of Public Health and Environment, Denver, Colorado, United States of America
| | - Melissa Freeland
- Texas Department of State Health Services, Austin, Texas, United States of America
| | - Catherine M Brown
- Massachusetts Department of Public Health, Boston, Massachusetts, United States of America
| | - Thelonious Williams
- Maryland Department of Health, Baltimore, Maryland, United States of America
- CDC Foundation, Atlanta, Georgia, United States of America
| | - Krisandra Allen
- Washington State Department of Health, Shoreline, Washington, United States of America
| | - Judy Kauerauf
- Illinois Department of Public Health, Springfield, Illinois, United States of America
| | - Erica Wilson
- North Carolina Department of Health and Human Services, Raleigh, North Carolina, United States of America
| | - Seema Jain
- California Department of Public Health, Richmond, California, United States of America
| | - Eric McDonald
- San Diego County Health and Human Services Agency, San Diego, California, United States of America
| | - Elana Silver
- California Department of Public Health, Richmond, California, United States of America
| | - Sarah Stous
- San Diego County Health and Human Services Agency, San Diego, California, United States of America
| | - Debra Wadford
- California Department of Public Health, Richmond, California, United States of America
| | - Rachel Radcliffe
- South Carolina Department of Health and Environmental Control, Columbia, South Carolina, United States of America
| | - Chandra Marriott
- Pennsylvania Department of Health, Pittsburgh, Pennsylvania, United States of America
| | - Jennifer P Owes
- Alabama Department of Public Health, Montgomery, Alabama, United States of America
| | - Stephen M Bart
- Epidemic Intelligence Service, CDC, Atlanta, Georgia, United States of America
- Connecticut Department of Public Health, Hartford, Connecticut, United States of America
| | - Lynn E Sosa
- Connecticut Department of Public Health, Hartford, Connecticut, United States of America
| | - Kelly Oakeson
- Utah Department of Health, Salt Lake City, Utah, United States of America
| | - Natalie Wodniak
- Virginia Department of Health, Richmond, Virginia, United States of America
| | - Julia Shaffner
- Centers for Disease Control and Prevention (CDC), COVID-19 Response Team, Atlanta, Georgia, United States of America
- Tennessee Department of Health, Nashville, Tennessee, United States of America
| | - Quanta Brown
- Ohio Department of Health, Columbus, Ohio, United States of America
| | - Ryan Westergaard
- Wisconsin Department of Health Services, Madison, Wisconsin, United States of America
| | - Andrea Salinas
- Louisiana Department of Health, New Orleans, Louisiana, United States of America
| | - Sara Hallyburton
- Indiana Department of Health, Indianapolis, Indiana, United States of America
| | - Yasmin Ogale
- Delaware Division of Public Health, Dover, Delaware, United States of America
| | | | - Kimberly Bonner
- Epidemic Intelligence Service, CDC, Atlanta, Georgia, United States of America
- Oregon Health Authority, Portland, Oregon, United States of America
| | - Sheri Tubach
- Kansas Department of Health and Environment, Topeka, Kansas, United States of America
| | - Clay Van Houten
- Wyoming Department of Health, Cheyenne, Wyoming, United States of America
| | - Victoria Hughes
- Southern Nevada Health District, Las Vegas, Nevada, United States of America
| | - Valerie Reeb
- Iowa Department of Public Health, Des Moines, Iowa, United States of America
| | - Chris Galeazzi
- Iowa Department of Public Health, Des Moines, Iowa, United States of America
| | - Shreya Khuntia
- District of Columbia Department of Health (DC Health), Washington, DC, United States of America
| | - Sasha McGee
- District of Columbia Department of Health (DC Health), Washington, DC, United States of America
| | - Joseph T Hicks
- Epidemic Intelligence Service, CDC, Atlanta, Georgia, United States of America
- New Mexico Department of Health, Santa Fe, New Mexico, United States of America
| | - Dimple Dinesh Patel
- Kentucky Department for Public Health, Frankfort, Kentucky, United States of America
| | - Anna Krueger
- Maine Center for Disease Control and Prevention, Augusta, Maine, United States of America
| | - Scott Hughes
- New York City Department of Health and Mental Hygiene, New York City, New York, United States of America
| | - Fabiana Jeanty
- New York City Department of Health and Mental Hygiene, New York City, New York, United States of America
| | - Jade C Wang
- New York City Department of Health and Mental Hygiene, New York City, New York, United States of America
| | - Ellen H Lee
- New York City Department of Health and Mental Hygiene, New York City, New York, United States of America
| | - Tracey Assanah-Deane
- New York City Department of Health and Mental Hygiene, New York City, New York, United States of America
| | - Megan Tompkins
- Alaska Department of Health and Social Services, Anchorage, Alaska, United States of America
| | - Kendra Dougherty
- Oklahoma State Department of Health, Oklahoma City, Oklahoma, United States of America
| | - Ozair Naqvi
- Oklahoma State Department of Health, Oklahoma City, Oklahoma, United States of America
| | - Matthew Donahue
- Nebraska Department of Health and Human Services, Lincoln, Nebraska, United States of America
| | - Justin Frederick
- Douglas County Health Department, Omaha, Nebraska, United States of America
| | - Baha Abdalhamid
- Nebraska Public Health Lab, Lincoln, Nebraska, United States of America
| | - Ann M Powers
- Centers for Disease Control and Prevention (CDC), COVID-19 Response Team, Atlanta, Georgia, United States of America
| | - Mark Anderson
- Centers for Disease Control and Prevention (CDC), COVID-19 Response Team, Atlanta, Georgia, United States of America
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Jeancolas C, Singh A, Jain S, Krishna S, Nghe P. An interdisciplinary effort to understand chemical organizations at the origin of life. iScience 2022; 26:105834. [PMID: 36619971 PMCID: PMC9813777 DOI: 10.1016/j.isci.2022.105834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
This backstory features the perspectives of three group leaders of a Franco-Indian collaboration on the origin of life, involving efforts to engineer evolvable chemical systems. The researchers explain how they overcame the difficulties to bring empiricist and theorist cultures together and the importance of such synergy for the future of origin of life research.
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Affiliation(s)
- C. Jeancolas
- Laboratoire Biophysique et Évolution, UMR Chimie Biologie Innovation 8231, ESPCI Paris, Université PSL, CNRS, Paris, France,Department of Philosophy, Durham University, Durham, UK
| | - A.Y. Singh
- Department of Physics and Astrophysics, University of Delhi, Delhi, India
| | - S. Jain
- Department of Physics and Astrophysics, University of Delhi, Delhi, India,Corresponding author
| | - S. Krishna
- Simons Centre for the Study of Living Machines, National Centre for Biological Sciences, Tata Institute of Fundamental Research, Bangalore, India,Corresponding author
| | - P. Nghe
- Simons Centre for the Study of Living Machines, National Centre for Biological Sciences, Tata Institute of Fundamental Research, Bangalore, India,Corresponding author
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Jain S, Singla C, Toor S, Bhatti DJ, Gupta P. Management of dog bite wounds: Our protocol and experience with early surgical intervention. Ambulatornaya khirurgiya 2022. [DOI: 10.21518/1995-1477-2022-19-2-128-133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Dog bites injuries are a significant cause of morbidity and mortality. Conventionally, it was suggested to leave the wounds open due to probable increased risk of infections and occurrence of rabies with suturing.Recent publications indicate that primary closure does not necessarily affect the chances of infection but definitely helps in improving the quality of scar. We are presenting our experience and protocol for primary closure of all dog bite wounds. From March 2020 to February 2021, 10 consecutive patients of all ages coming to the emergency of our hospital with category 3 dog bite that penetrated the epidermis and dermis and presenting within 48 hours of injury were included. Every patient was administered first dose of anti rabies vaccine (ARV) (zero dose) for active immunisation and was also given injection tetanus intramuscularly. Mean age of patients in our study was 20.9 with range from 2 years to 90 years. Only 2/10 patients developed infections which were managed conservatively with drainage of abscess and antibiotics. Rest all patients recovered without complications. Primary closure of dog bite wounds when associated with debridement, sufficient irrigation, povidine iodine cleansing and antibiotic administration resulted in improved cosmetic appearance without increase in the rate of infection.
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Affiliation(s)
- S. Jain
- Guru Gobind Singh Medical College and Hospital
| | - C. Singla
- Guru Gobind Singh Medical College and Hospital
| | - S. Toor
- Guru Gobind Singh Medical College and Hospital
| | | | - P. Gupta
- Guru Gobind Singh Medical College and Hospital
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Gautam SR, Jain S, Rana P, Banerjee B, Kumari P. Protective Effects of N-Acetylcysteine on Dipentyl Phthalate Induced Cognitive Dysfunction and Brain Oxidative Stress in Mice. PBR 2022. [DOI: 10.18502/pbr.v8i3.11032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background: Dipentyl phthalate (DPeP) is a plasticizer compound commonly used in polyvinylchloride plastic to enhance softness and flexibility. They are not bound covalently to plastic polymers; therefore, they can dissolve into the environment and adversely affect the health of humans and animals.
Objectives: The aim of this study was to investigate the effect of DPeP on cognition and protective effects of N-acetylcysteine (NAC) on DPeP induced alteration in cognitive behaviour and oxidative stress markers in mice.
Methods: Mice were orally treated with 2 doses (33 mg/kg and 100 mg/kg) of DPeP for 28 days. Cognitive functions were assessed using spatial navigation tasks on the Morris water maze and the step-down latency in the passive avoidance apparatus. Oxidative stress was assessed by examining the levels of malondialdehyde, glutathione, ferric reducing antioxidant power, and 8-hydroxy-deoxyguanosine levels in the whole brain of mice.
Results: There was a significant increase in latency in spatial navigation tasks and a significant decline in the step-down latency in passive avoidance apparatus in the DPeP-treated group compared to the control groups. There was also a significant increase in the levels of oxidative stress following DPeP administration as seen with the rise in the levels of malondialdehyde, 8-hydroxy-deoxyguanosine, and a fall in glutathione and ferric reducing antioxidant power levels.
Conclusion: The present study demonstrated that DPeP adversely affects learning and memory functions in mice by oxidative stress-mediated neuronal damage. These effects were attenuated by pretreatment with N-acetylcysteine.
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Jain S, Kumar L, Babu S, Sadhoo A, Ravindran G, Rajan S. Correlation of arterial PaCO 2 to end tidal CO 2 in children undergoing laparoscopic abdominal surgery: An observational study. J Anaesthesiol Clin Pharmacol 2022; 38:640-645. [PMID: 36778836 PMCID: PMC9912885 DOI: 10.4103/joacp.joacp_581_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2020] [Revised: 03/23/2021] [Accepted: 04/14/2021] [Indexed: 12/31/2022] Open
Abstract
Background and Aims The reliability of end tidal carbon dioxide (ETCO2) as a measure of arterial carbon dioxide (PaCO2) in pediatric laparoscopy is unclear. We evaluated the correlation of arterial to end tidal P(a-ET) CO2 during pediatric laparoscopy at two hours of pneumoperitoneum as the primary objective. We also compared P(a-ET) CO2 and alveolar to arterial oxygen gradient P(A-a) O2 and haemodynamics at fixed time points during surgery. Material and Methods A cross-sectional study was conducted in 25 children undergoing laparoscopic abdominal surgery. Arterial blood gases were drawn at T0, baseline, T10: ten minutes, T1h: 1 hour, T2h: 2 hours of pnuemoperitoneum and T 10d: 10 mins after deflation. The P(a-ET) CO2, P(A-a) O2, were measured from the blood gas and ETCO2 and FiO2 values on the monitor. The Pearson's correlation coefficient, the Wilcoxon rank test and Chi square test were used for statistical analysis. Results At T2h moderate correlation of P(a-ET) CO2 (r = 0.605, P = 0.001) with 40% children documenting accurate P(a-ET) CO2, -1 to +1 mm Hg was seen. Moderate correlation was also seen at T0, T10, T 10d but poor correlation at T 1h. The P(A-a) O2 increased progressively with surgery and did not correlate with P(a-ET) CO2. Heart rate was stable, but systolic blood pressures at T 10 and diastolic at T10, T 1h, T 2h were higher than baseline. Conclusion Moderate correlation was seen between PaCO2 and ETCO2 at 2 h of pnuemoperitoneum and at T0, T 10, and T 10d. P(A-a) O2 increased with surgery but did not correlate with P(a-ET) CO2.
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Affiliation(s)
- S. Jain
- Department of Anaesthesiology, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India
| | - L. Kumar
- Department of Anaesthesiology, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India
| | - S.C. Babu
- Department of Anaesthesiology, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India
| | - A. Sadhoo
- Department of Anaesthesiology, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India
| | - G.C. Ravindran
- Department of Biostatistics, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India
| | - S. Rajan
- Department of Anaesthesiology, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India
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Head JR, Sondermeyer-Cooksey G, Heaney AK, Yu AT, Jones I, Bhattachan A, Campo SK, Wagner R, Mgbara W, Phillips S, Keeney N, Taylor J, Eisen E, Lettenmaier DP, Hubbard A, Okin GS, Vugia DJ, Jain S, Remais JV. Effects of precipitation, heat, and drought on incidence and expansion of coccidioidomycosis in western USA: a longitudinal surveillance study. Lancet Planet Health 2022; 6:e793-e803. [PMID: 36208642 PMCID: PMC10189771 DOI: 10.1016/s2542-5196(22)00202-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 08/22/2022] [Accepted: 08/23/2022] [Indexed: 05/20/2023]
Abstract
BACKGROUND Drought is an understudied driver of infectious disease dynamics. Amidst the ongoing southwestern North American megadrought, California (USA) is having the driest multi-decadal period since 800 CE, exacerbated by anthropogenic warming. In this study, we aimed to examine the influence of drought on coccidioidomycosis, an emerging infectious disease in southwestern USA. METHODS We analysed California census tract-level surveillance data from 2000 to 2020 using generalised additive models and distributed monthly lags on precipitation and temperature. We then developed an ensemble prediction algorithm of incident cases of coccidioidomycosis per census tract to estimate the counterfactual incidence that would have occurred in the absence of drought. FINDINGS Between April 1, 2000, and March 31, 2020, there were 81 448 reported cases of coccidioidomycosis throughout California. An estimated 1467 excess cases of coccidioidomycosis were observed in California in the 2 years following the drought that occurred between 2007 and 2009, and an excess 2649 drought-attributable cases of coccidioidomycosis were observed in the 2 years following the drought that occurred between 2012 and 2015. These increased numbers of cases more than offset the declines in cases that occurred during drought. An IQR increase in summer temperatures was associated with 2·02 (95% CI 1·84-2·22) times higher incidence in the following autumn (September to November), and an IQR increase in precipitation in the winter was associated with 1·45 (1·36-1·55) times higher incidence in the autumn. The effect of winter precipitation was 36% (25-48) stronger when preceded by two dry, rather than average, winters. Incidence in arid counties was most sensitive to precipitation fluctuations, while incidence in wetter counties was most sensitive to temperature. INTERPRETATION In California, multi-year cycles of dry conditions followed by a wet winter increases transmission of coccidioidomycosis, especially in historically wetter areas. With anticipated increasing frequency of drought in southwestern USA, continued expansion of coccidioidomycosis, along with more intense seasons, is expected. Our results motivate the need for heightened precautions against coccidioidomycosis in seasons that follow major droughts. FUNDING National Institutes of Health.
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Affiliation(s)
- Jennifer R Head
- Division of Epidemiology, University of California, Berkeley, Berkeley, CA, USA; Division of Environmental Health Sciences, University of California, Berkeley, Berkeley, CA, USA
| | | | - Alexandra K Heaney
- Division of Environmental Health Sciences, University of California, Berkeley, Berkeley, CA, USA
| | - Alexander T Yu
- Infectious Disease Branch, California Department of Public Health, Richmond, CA, USA
| | - Isabel Jones
- Division of Environmental Health Sciences, University of California, Berkeley, Berkeley, CA, USA
| | | | - Simon K Campo
- Division of Environmental Health Sciences, University of California, Berkeley, Berkeley, CA, USA
| | - Robert Wagner
- Department of Plant and Microbial Biology, University of California, Berkeley, Berkeley, CA, USA
| | - Whitney Mgbara
- Department of Environmental Science, Policy, and Management, University of California, Berkeley, Berkeley, CA, USA
| | - Sophie Phillips
- College of Letters and Science, University of California, Berkeley, Berkeley, CA, USA
| | - Nicole Keeney
- Division of Environmental Health Sciences, University of California, Berkeley, Berkeley, CA, USA
| | - John Taylor
- Department of Plant and Microbial Biology, University of California, Berkeley, Berkeley, CA, USA
| | - Ellen Eisen
- Division of Environmental Health Sciences, University of California, Berkeley, Berkeley, CA, USA
| | | | - Alan Hubbard
- Division of Biostatistics, University of California, Berkeley, Berkeley, CA, USA
| | - Gregory S Okin
- Department of Geography, University of California, Berkeley, Berkeley, CA, USA
| | - Duc J Vugia
- Infectious Disease Branch, California Department of Public Health, Richmond, CA, USA
| | - Seema Jain
- Infectious Disease Branch, California Department of Public Health, Richmond, CA, USA
| | - Justin V Remais
- Division of Environmental Health Sciences, University of California, Berkeley, Berkeley, CA, USA.
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