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Santinello B, Sun R, Amjad A, Hoyt SJ, Ouyang L, Courret C, Drennan R, Leo L, Larracuente AM, Core LM, O’Neill RJ, Mellone BG. A centromere-derived retroelement RNA localizes in cis and is a core element of the transcriptional landscape of Drosophila centromeres. bioRxiv 2024:2024.01.14.574223. [PMID: 38293134 PMCID: PMC10827089 DOI: 10.1101/2024.01.14.574223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2024]
Abstract
Centromeres are essential chromosomal landmarks that dictate the point of attachment between chromosomes and spindle microtubules during cell division. The stable transmission of the centromere site through generations is ensured by a unique chromatin containing the histone H3 variant CENP-A. Previous studies have highlighted the impact of transcription on promoting CENP-A deposition. However, the specific sequences undergoing this transcription and their contribution to centromere function in metazoan systems remain elusive. In this study, we unveil the centromeric transcriptional landscape and explore its correlation with CENP-A in D. melanogaster, currently the only in vivo model with assembled centromeres. We find that the centromere-enriched retroelement G2/Jockey-3 (hereafter referred to as Jockey-3) is a major driver of centromere transcription, producing RNAs that localize to all mitotic centromeres, with the Y centromere showing the most transcription. Taking advantage of the polymorphism of Jockey-3, we show that these RNAs remain associated with their cognate DNA sequences in cis. Using a LacI/lacO system to generate de novo centromeres, we find that Jockey-3 transcripts do not localize to ectopic sites, suggesting they are unlikely to function as non-coding RNAs with a structural role at centromeres. At de novo centromeres on the lacO array, the presence of CENP-A augments the detection of exogenous lacO-derived transcripts specifically in metaphase. We propose that Jockey-3 contributes to the epigenetic maintenance of the centromere by promoting chromatin transcription, while inserting in a region that permits its continuous transmission. Given the conservation of retroelements as centromere components across taxa, our findings have broad implications in understanding this widespread association.
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Affiliation(s)
- B Santinello
- Department of Molecular and Cell Biology, University of Connecticut, Storrs, CT, US
| | - R Sun
- Department of Molecular and Cell Biology, University of Connecticut, Storrs, CT, US
| | - A Amjad
- Department of Molecular and Cell Biology, University of Connecticut, Storrs, CT, US
| | - SJ Hoyt
- Department of Molecular and Cell Biology, University of Connecticut, Storrs, CT, US
| | - L Ouyang
- Department of Molecular and Cell Biology, University of Connecticut, Storrs, CT, US
| | - C Courret
- Department of Biology, University of Rochester, Rochester, NY, US
| | - R Drennan
- Department of Molecular and Cell Biology, University of Connecticut, Storrs, CT, US
| | - L Leo
- Department of Molecular and Cell Biology, University of Connecticut, Storrs, CT, US
- Dipartimento di Biologia e Biotecnologie “Charles Darwin”, “Sapienza” University of Rome, 00185 Rome, Italy
- Present address: RNA editing Lab, Onco-Haematology Department, Genetics and Epigenetics of Pediatric Cancers, Bambino Gesù Children Hospital, IRCCS, 00146 Rome, Italy
| | - AM Larracuente
- Department of Biology, University of Rochester, Rochester, NY, US
| | - LM Core
- Department of Molecular and Cell Biology, University of Connecticut, Storrs, CT, US
- Institute for Systems Genomics, University of Connecticut, Storrs CT, US
| | - RJ O’Neill
- Department of Molecular and Cell Biology, University of Connecticut, Storrs, CT, US
- Institute for Systems Genomics, University of Connecticut, Storrs CT, US
- Department of Genetics and Genome Sciences, UConn Health, Farmington, CT, US
| | - BG Mellone
- Department of Molecular and Cell Biology, University of Connecticut, Storrs, CT, US
- Institute for Systems Genomics, University of Connecticut, Storrs CT, US
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Peng X, Wang BY, Li XY, Li YW, Lu Y, Wu GH, Ouyang L, Zou HC. [Utilization of sexual and reproductive health services and its correlates among community- based older adults in Chongqing]. Zhonghua Liu Xing Bing Xue Za Zhi 2023; 44:1880-1885. [PMID: 38129143 DOI: 10.3760/cma.j.cn112338-20230519-00315] [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] [Grants] [Subscribe] [Scholar Register] [Indexed: 12/23/2023]
Abstract
Objective: To investigate the utilization of sexual health services among community-based older adults in Chongqing and explore its potential correlates. Methods: A cross-sectional survey using multistage sampling among community-based older adults aged ≥50 years was conducted in Chongqing between June 2020 and December 2022. A questionnaire including information on demographic characteristics, general health, sexual health status, and sexual health services utilization was collected. Sexual health and reproductive services utilization was defined as having ever been tested for human immunodeficiency virus (HIV), or having had a male/gynecological reproductive health examination in the past year. Logistic regression was used to examine the correlates of the utilization of sexual health services. Results: A total of 794 community-based older adults participated in the study (482 were male, and 312 were female). The mean age was (62.8±8.2) years. The proportion of HIV testing was 18.0%, and the proportion of reproductive health examination was 10.1% among community-based older adults. The results of multivariate logistic regression analysis showed that the age group of 60-69 years (aOR=0.37, 95%CI: 0.18-0.76), female (aOR=11.34, 95%CI: 5.71-22.52), monthly income ≥5 000 yuan (aOR=3.05, 95%CI: 1.01-9.27), being sexual activity (aOR=4.99, 95%CI: 2.23-11.15) was significantly associated with had a reproductive health examination in the past year. Conclusions: The proportion of sexual health services utilization among older adults was low. Older sexual health education should be further strengthened, the close relationship between older adults should be correctly guided and dealt with, and the sexual health services suitable for the older population should be formulated.
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Affiliation(s)
- X Peng
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen 518107, China
| | - B Y Wang
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen 518107, China
| | - X Y Li
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen 518107, China
| | - Y W Li
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen 518107, China
| | - Y Lu
- School of Public Health, the Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang 550025, China
| | - G H Wu
- Chongqing Center for Disease Control and Prevention, Chongqing 400042, China
| | - L Ouyang
- Chongqing Center for Disease Control and Prevention, Chongqing 400042, China
| | - H C Zou
- School of Public Health, Fudan University, Shanghai 200032, China
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Lu Y, Peng X, Li XY, Fu LW, Tian T, Wang BY, Ouyang L, Wu GH, Zou HC. [Condom use and its correlates among community-based older adults in Chongqing]. Zhonghua Liu Xing Bing Xue Za Zhi 2023; 44:1886-1892. [PMID: 38129144 DOI: 10.3760/cma.j.cn112338-20230519-00317] [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] [Grants] [Subscribe] [Scholar Register] [Indexed: 12/23/2023]
Abstract
Objective: To understand the current status of condom use and its correlates among community-based older adults in Chongqing, China. Methods: Cross-sectional study based on a multistage sampling method was conducted in Chongqing from June 2020 to December 2022. The estimated sample size was 735. Through face-to-face interviews, the investigators collected the sociodemographic characteristics, sexual behavior characteristics, awareness of AIDS prevention knowledge, etc. A multivariable logistic regression model was used to explore the correlates of condom use during the last sexual behavior among the participants. Results: A total of 761 participants were included in this study, with 476 males and 285 females, whose average age was (63.8±8.2) years old, mainly in the age group of 60-69 years (44.5%). Among the participants, the rate of condom use during the last sexual behavior was 9.7%. The multivariable logistic regression analysis indicated that correlates of condom use during the last sexual behavior included urban household registration (aOR=2.34, 95%CI: 1.12-4.89), monthly income of 1 000-4 999 Yuan, and 5 000 Yuan and above (aOR=4.49, 95%CI: 1.31-15.41; aOR=16.33, 95%CI: 4.30-62.00), self-assessed sexual behavior risk as very risky/relatively risky (aOR=3.97, 95%CI: 1.40-11.31), awareness of AIDS prevention knowledge (aOR=0.36, 95%CI: 0.21-0.62). Conclusions: The rate of condom use among community-based older adults in Chongqing is low. Comprehensive intervention measures should be taken in combination with the characteristics and needs of community-based older adults to improve awareness of AIDS prevention knowledge and perception of AIDS risk and promote condom use among this population.
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Affiliation(s)
- Y Lu
- School of Public Health, the Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang 550025, China
| | - X Peng
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen 518107, China
| | - X Y Li
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen 518107, China
| | - L W Fu
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen 518107, China
| | - T Tian
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen 518107, China
| | - B Y Wang
- School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen 518107, China
| | - L Ouyang
- Chongqing Center for Disease Control and Prevention, Chongqing 400042, China
| | - G H Wu
- Chongqing Center for Disease Control and Prevention, Chongqing 400042, China
| | - H C Zou
- School of Public Health, Fudan University, Shanghai 200032, China
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Chen J, Ouyang L, Goodman DA, Okoroh EM, Romero L, Ko JY, Cox S. Association of Medicaid Expansion Under the Affordable Care Act With Medicaid Coverage in the Prepregnancy, Prenatal, and Postpartum Periods. Womens Health Issues 2023; 33:582-591. [PMID: 37951662 PMCID: PMC11018307 DOI: 10.1016/j.whi.2023.08.002] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Revised: 08/01/2023] [Accepted: 08/08/2023] [Indexed: 11/14/2023]
Abstract
INTRODUCTION We evaluated how the Affordable Care Act (ACA) Medicaid eligibility expansion affected perinatal insurance coverage patterns for Medicaid-enrolled beneficiaries who gave birth overall and by race/ethnicity. We also examined state-level heterogeneous impacts. METHODS Using the 2011-2013 Medicaid Analytic eXtract and the 2016-2018 Transformed Medicaid Statistical Information System Analytic File databases, we identified 1.4 million beneficiaries giving birth in 2012 (pre-ACA expansion cohort) and 1.5 million in 2017 (post-ACA expansion cohort). We constructed monthly coverage rates for the two cohorts by state Medicaid expansion status and obtained difference-in-differences estimates of the association of Medicaid expansion with coverage overall and by race/ethnicity group (non-Hispanic White, non-Hispanic Black, and Hispanic). To explore state-level heterogeneous impacts, we divided the expansion and non-expansion states into groups based on the differences in the income eligibility limits for low-income parents in each state between 2012 and 2017. RESULTS Medicaid expansion was associated with 13 percentage points higher coverage in the 9 to 12 months before giving birth, and 11 percentage points higher coverage at 6 to 12 months postpartum. Hispanic birthing individuals had the greatest relative increases in coverage, followed by non-Hispanic White and non-Hispanic Black individuals. In Medicaid expansion states, those who experienced the greatest increases in income eligibility limits for low-income parents generally saw the greatest increases in coverage. In non-expansion states, there was less heterogeneity between state groupings. CONCLUSIONS Pregnancy-related Medicaid eligibility did not have major changes in the 2010s. However, states' adoption of ACA Medicaid expansion after 2012 was associated with increased Medicaid coverage before, during, and after pregnancy. The increases varied by race/ethnicity and across states.
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Affiliation(s)
- Jiajia Chen
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), Centers for Disease Control and Prevention (CDC), Atlanta, Georgia; Mathematica, Atlanta, Georgia.
| | - Lijing Ouyang
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), Centers for Disease Control and Prevention (CDC), Atlanta, Georgia
| | - David A Goodman
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), Centers for Disease Control and Prevention (CDC), Atlanta, Georgia
| | - Ekwutosi M Okoroh
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), Centers for Disease Control and Prevention (CDC), Atlanta, Georgia
| | - Lisa Romero
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), Centers for Disease Control and Prevention (CDC), Atlanta, Georgia
| | - Jean Y Ko
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), Centers for Disease Control and Prevention (CDC), Atlanta, Georgia
| | - Shanna Cox
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), Centers for Disease Control and Prevention (CDC), Atlanta, Georgia
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Liu T, Ouyang L, Walker WO, Wiener JS, Woodward J, Castillo J, Wood HM, Tanaka ST, Adams R, Smith KA, O'Neil J, Williams TR, Ward EA, Bowman RM, Riley C. Education and employment as young adults living with spina bifida transition to adulthood in the USA: A study of the National Spina Bifida Patient Registry. Dev Med Child Neurol 2023; 65:821-830. [PMID: 36385606 PMCID: PMC10415865 DOI: 10.1111/dmcn.15456] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 10/06/2022] [Accepted: 10/12/2022] [Indexed: 11/18/2022]
Abstract
AIM To describe the education and employment transition experience of young adults with spina bifida (YASB) and investigate factors associated with employment. METHOD We queried education and employment data from the US National Spina Bifida Patient Registry from 2009 to 2019. We applied generalized estimating equations models to analyze sociodemographic and disease-related factors associated with employment. RESULTS A total of 1909 participants (850 males, 1059 females) aged 18 to 26 years contributed 4379 annual visits. Nearly 84% had myelomeningocele and, at last visit, the median age was 21 years (mean 21 years 5 months, SD 2 years 10 months). A total of 41.8% had at least some post-high school education, and 23.9% were employed. In a multivariable regression model, employment was significantly associated with education level, lower extremity functional level, bowel continence, insurance, and history of non-shunt surgery. This large, national sample of YASB demonstrated low rates of post-secondary education attainment and employment and several potentially modifiable factors associated with employment. INTERPRETATION Specific sociodemographic, medical, and functional factors associated with employment are important for clinicians to consider when facilitating transition for YASB into adulthood. Additional research is needed to understand the impact of cognitive functioning and social determinants of health on transition success in YASB. WHAT THIS PAPER ADDS There were low education attainment and employment rates in a large sample of young adults with spina bifida. Specific sociodemographic, medical, and functional factors are associated with employment. Some employment-associated factors, such as continence and self-management skills, are modifiable.
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Affiliation(s)
- Tiebin Liu
- Birth Defects Monitoring and Research Branch, Division of Birth Defects and Infant Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Georgia, Atlanta, USA
| | - Lijing Ouyang
- Birth Defects Monitoring and Research Branch, Division of Birth Defects and Infant Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Georgia, Atlanta, USA
| | - William O. Walker
- Division of Developmental Medicine, Seattle Children's Hospital, Seattle, Washington, USA
- University of Washington School of Medicine, Seattle, Washington, USA
| | - John S. Wiener
- Division of Urology, Duke University Medical Center, Durham, North Carolina, USA
| | - Jason Woodward
- Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Jonathan Castillo
- Division of Developmental Pediatrics, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas, USA
| | - Hadley M. Wood
- Cleveland Clinic, Glickman Urological and Kidney Institute, Cleveland, Ohio, USA
| | - Stacy T. Tanaka
- Department of Urology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Richard Adams
- University of Texas Southwestern Medical Center; Scottish Rite for Children, Dallas, Texas, USA
| | - Kathryn A. Smith
- Children's Hospital Los Angeles, Los Angeles, California, USA
- Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Joseph O'Neil
- Riley Hospital for Children, Indianapolis, Indiana, USA
| | - Tonya R. Williams
- Birth Defects Monitoring and Research Branch, Division of Birth Defects and Infant Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Georgia, Atlanta, USA
| | - Elisabeth A. Ward
- Birth Defects Monitoring and Research Branch, Division of Birth Defects and Infant Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Georgia, Atlanta, USA
- Universal Consulting Services, Inc, Consultant to Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Robin M. Bowman
- Ann and Robert H Lurie Children's Hospital of Chicago, Chicago, Illinois, USA
| | - Catharine Riley
- Birth Defects Monitoring and Research Branch, Division of Birth Defects and Infant Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Georgia, Atlanta, USA
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Ouyang L, Cox S, Xu L, Robbins CL, Ko JY. Mental health and substance use disorders at delivery hospitalization and readmissions after delivery discharge. Drug Alcohol Depend 2023; 247:109864. [PMID: 37062248 DOI: 10.1016/j.drugalcdep.2023.109864] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 03/20/2023] [Accepted: 04/01/2023] [Indexed: 04/18/2023]
Abstract
BACKGROUND The objective was to assess mental health and substance use disorders (MSUD) at delivery hospitalization and readmissions after delivery discharge. METHODS This is a population-based retrospective cohort study of persons who had a delivery hospitalization during January to September in the 2019 Nationwide Readmissions Database. We calculated 90-day readmission rates for MSUD and non-MSUD, overall and stratified by MSUD status at delivery. We used multivariable logistic regressions to assess the associations of MSUD type, patient, clinical, and hospital factors at delivery with 90-day MSUD readmissions. RESULTS An estimated 11.8% of the 2,697,605 weighted delivery hospitalizations recorded MSUD diagnoses. The 90-day MSUD and non-MSUD readmission rates were 0.41% and 2.9% among delivery discharges with MSUD diagnoses, compared to 0.047% and 1.9% among delivery discharges without MSUD diagnoses. In multivariable analysis, schizophrenia, bipolar disorder, stimulant-related disorders, depressive disorders, trauma- and stressor-related disorders, alcohol-related disorders, miscellaneous mental and behavioral disorders, and other specified substance-related disorders were significantly associated with increased odds of MSUD readmissions. Three or more co-occurring MSUDs (vs one MSUD), Medicare or Medicaid (vs private) as the primary expected payer, lowest (vs highest) quartile of median household income at residence zip code level, decreasing age, and longer length of stay at delivery were significantly associated with increased odds of MSUD readmissions. CONCLUSION Compared to persons without MSUD at delivery, those with MSUD had higher MSUD and non-MSUD 90-day readmission rates. Strategies to address MSUD readmissions can include improved postpartum MSUD follow-up management, expanded Medicaid postpartum coverage, and addressing social determinants of health.
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Affiliation(s)
- Lijing Ouyang
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Shanna Cox
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Likang Xu
- National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Cheryl L Robbins
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Jean Y Ko
- National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA
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Whitehead N, Erickson SW, Cai B, McDermott S, Peay H, Howard JF, Ouyang L. Sources of variation in estimates of Duchenne and Becker muscular dystrophy prevalence in the United States. Orphanet J Rare Dis 2023; 18:65. [PMID: 36949506 PMCID: PMC10031951 DOI: 10.1186/s13023-023-02662-0] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Accepted: 03/11/2023] [Indexed: 03/24/2023] Open
Abstract
BACKGROUND Direct estimates of rare disease prevalence from public health surveillance may only be available in a few catchment areas. Understanding variation among observed prevalence can inform estimates of prevalence in other locations. The Muscular Dystrophy Surveillance, Tracking, and Research Network (MD STARnet) conducts population-based surveillance of major muscular dystrophies in selected areas of the United States. We identified sources of variation in prevalence estimates of Duchenne and Becker muscular dystrophy (DBMD) within MD STARnet from published literature and a survey of MD STARnet investigators, then developed a logic model of the relationships between the sources of variation and estimated prevalence. RESULTS The 17 identified sources of variability fell into four categories: (1) inherent in surveillance systems, (2) particular to rare diseases, (3) particular to medical-records-based surveillance, and (4) resulting from extrapolation. For the sources of uncertainty measured by MD STARnet, we estimated each source's contribution to the total variance in DBMD prevalence. Based on the logic model we fit a multivariable Poisson regression model to 96 age-site-race/ethnicity strata. Age accounted for 74% of the variation between strata, surveillance site for 6%, race/ethnicity for 3%, and 17% remained unexplained. CONCLUSION Variation in estimates derived from a non-random sample of states or counties may not be explained by demographic differences alone. Applying these estimates to other populations requires caution.
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Affiliation(s)
- Nedra Whitehead
- Social, Statistical, and Environmental Sciences, RTI International, 2987 Clairmont Road NE, Atlanta, GA, USA.
| | - Stephen W Erickson
- Social, Statistical, and Environmental Sciences, RTI International, Research Triangle Park, NC, USA
| | - Bo Cai
- Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Suzanne McDermott
- Department of Environmental, Occupational, and Geospatial Health Sciences, City University of New York Graduate School of Public Health and Health Policy, New York, NY, USA
| | - Holly Peay
- Social, Statistical, and Environmental Sciences, RTI International, Research Triangle Park, NC, USA
| | - James F Howard
- Department of Neurology, The University of North Carolina, Chapel Hill, NC, USA
| | - Lijing Ouyang
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA
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Abimbola TO, Van Handel M, Tie Y, Ouyang L, Nelson N, Weiser J. Cost-effectiveness of expanded hepatitis A vaccination among adults with diagnosed HIV, United States. PLoS One 2023; 18:e0282972. [PMID: 36930611 PMCID: PMC10022807 DOI: 10.1371/journal.pone.0282972] [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] [Received: 05/04/2022] [Accepted: 02/21/2023] [Indexed: 03/18/2023] Open
Abstract
Hepatitis A virus can cause severe and prolonged illness in persons with HIV (PWH). In July 2020, the Advisory Committee on Immunization Practices (ACIP) expanded its recommendation for hepatitis A vaccination to include all PWH aged ≥1 year. We used a decision analytic model to estimate the value of vaccinating a cohort of adult PWH aged ≥20 years with diagnosed HIV in the United States using a limited societal perspective. The model compared 3 scenarios over an analytic horizon of 1 year: no vaccination, current vaccine coverage, and full vaccination. We incorporated the direct medical costs and nonmedical costs (i.e., public health costs and productivity loss). We estimated the total number of infections averted, cost to vaccinate, and incremental cost per case averted. Full implementation of the ACIP recommendation resulted in 775 to 812 fewer adult cases of hepatitis A in 1 year compared with the observed vaccination coverage. The incremental cost-effectiveness ratio for the full vaccination scenario was $48,000 for the 2-dose single-antigen hepatitis A vaccine and $130,000 for the 3-dose combination hepatitis A and hepatitis B vaccine per case averted, compared with the observed vaccination scenario. Depending on type of vaccine, full hepatitis A vaccination of PWH could lead to ≥80% reduction in the number of cases and $48,000 to $130,000 in additional cost per case averted. Data on hepatitis A health outcomes and costs specific to PWH are needed to better understand the longer-term costs and benefits of the 2020 ACIP recommendation.
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Affiliation(s)
- Taiwo O. Abimbola
- National Center for HIV, Viral Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
- * E-mail:
| | - Michelle Van Handel
- National Center for HIV, Viral Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Yunfeng Tie
- Division of HIV Prevention, National Center for HIV, Viral Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Lijing Ouyang
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Noele Nelson
- Division of Viral Hepatitis, National Center for HIV, Viral Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - John Weiser
- Division of HIV Prevention, National Center for HIV, Viral Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
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Ford ND, Cox S, Ko JY, Ouyang L, Romero L, Colarusso T, Ferre CD, Kroelinger CD, Hayes DK, Barfield WD. Hypertensive Disorders in Pregnancy and Mortality at Delivery Hospitalization - United States, 2017-2019. MMWR Morb Mortal Wkly Rep 2022; 71:585-591. [PMID: 35482575 PMCID: PMC9098235 DOI: 10.15585/mmwr.mm7117a1] [Citation(s) in RCA: 89] [Impact Index Per Article: 44.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Hypertensive disorders in pregnancy (HDPs), defined as prepregnancy (chronic) or pregnancy-associated hypertension, are common pregnancy complications in the United States.* HDPs are strongly associated with severe maternal complications, such as heart attack and stroke (1), and are a leading cause of pregnancy-related death in the United States.† CDC analyzed nationally representative data from the National Inpatient Sample to calculate the annual prevalence of HDP among delivery hospitalizations and by maternal characteristics, and the percentage of in-hospital deaths with an HDP diagnosis code documented. During 2017-2019, the prevalence of HDP among delivery hospitalizations increased from 13.3% to 15.9%. The prevalence of pregnancy-associated hypertension increased from 10.8% in 2017 to 13.0% in 2019, while the prevalence of chronic hypertension increased from 2.0% to 2.3%. Prevalence of HDP was highest among delivery hospitalizations of non-Hispanic Black or African American (Black) women, non-Hispanic American Indian and Alaska Native (AI/AN) women, and women aged ≥35 years, residing in zip codes in the lowest median household income quartile, or delivering in hospitals in the South or the Midwest Census regions. Among deaths that occurred during delivery hospitalization, 31.6% had any HDP documented. Clinical guidance for reducing complications from HDP focuses on prompt identification and preventing progression to severe maternal complications through timely treatment (1). Recommendations for identifying and monitoring pregnant persons with hypertension include measuring blood pressure throughout pregnancy,§ including self-monitoring. Severe complications and mortality from HDP are preventable with equitable implementation of strategies to identify and monitor persons with HDP (1) and quality improvement initiatives to improve prompt treatment and increase awareness of urgent maternal warning signs (2).
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Conway KM, Grosse SD, Ouyang L, Street N, Romitti PA. Direct costs of adhering to selected Duchenne muscular dystrophy care considerations: estimates from a Midwestern state. Muscle Nerve 2022; 65:574-580. [PMID: 35064961 PMCID: PMC9109677 DOI: 10.1002/mus.27505] [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: 11/26/2020] [Revised: 01/12/2022] [Accepted: 01/15/2022] [Indexed: 11/10/2022]
Abstract
INTRODUCTION/AIMS The multidisciplinary Duchenne muscular dystrophy (DMD) Care Considerations were developed to standardize care and improve outcomes. We provide cumulative cost estimates for selected key preventive (i.e., excluding new molecular therapies and acute care) elements of the care considerations in eight domains (neuromuscular, rehabilitation, respiratory, cardiac, orthopedic, gastrointestinal, endocrine, psychosocial management) independent of completeness of uptake or provision of non-preventive care. METHODS We used de-identified insurance claims data from a large Midwestern commercial health insurer during 2018. We used Current Procedural Terminology and National Drug codes to extract unit costs for clinical encounters representing key preventive elements of the DMD Care Considerations. We projected per-patient cumulative costs from ages 5 to 25 years for these elements by multiplying a schedule of recommended frequencies of preventive services by unit costs in 2018 US dollars. RESULTS Assuming a diagnosis at age 5 years, independent ambulation until age 11, and survival until age 25, we estimated 670 billable clinical events. The 20-year per-patient cumulative cost was $174,701 with prednisone ($2.3 million with deflazacort) and an expected total of $12,643 ($29,194) for out-of-pocket expenses associated with those events and medications. DISCUSSION Standardized monitoring of disease progression and treatments may reduce overall costs of illness. Costs associated with these services would be needed to quantify potential savings. Our approach demonstrates a method to estimate costs associated with implementation of preventive care schedules.
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Affiliation(s)
- Kristin M Conway
- Department of Epidemiology, College of Public Health, The University of Iowa, Iowa City, Iowa
| | - Scott D Grosse
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Lijing Ouyang
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Natalie Street
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Paul A Romitti
- Department of Epidemiology, College of Public Health, The University of Iowa, Iowa City, Iowa
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11
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Chen J, Ferre C, Ouyang L, Mohamoud Y, Barfield W, Cox S. Changes and geographic variation in rates of preterm birth and stillbirth during the prepandemic period and COVID-19 pandemic, according to health insurance claims in the United States, April-June 2019 and April-June 2020. Am J Obstet Gynecol MFM 2021; 4:100508. [PMID: 34656730 PMCID: PMC8516120 DOI: 10.1016/j.ajogmf.2021.100508] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 09/29/2021] [Accepted: 10/10/2021] [Indexed: 11/17/2022]
Affiliation(s)
- Jiajia Chen
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 4770 Buford Hwy NE, MS S107-2, Atlanta, GA 30341.
| | - Cynthia Ferre
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 4770 Buford Hwy NE, MS S107-2, Atlanta, GA 30341
| | - Lijing Ouyang
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 4770 Buford Hwy NE, MS S107-2, Atlanta, GA 30341
| | - Yousra Mohamoud
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 4770 Buford Hwy NE, MS S107-2, Atlanta, GA 30341
| | - Wanda Barfield
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 4770 Buford Hwy NE, MS S107-2, Atlanta, GA 30341
| | - Shanna Cox
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 4770 Buford Hwy NE, MS S107-2, Atlanta, GA 30341
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12
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Soelaeman RH, Smith MG, Sahay K, Tilford JM, Goodenough D, Paramsothy P, Ouyang L, Oleszek J, Grosse SD. Labor market participation and productivity costs for female caregivers of minor male children with Duchenne and Becker muscular dystrophies. Muscle Nerve 2021; 64:717-725. [PMID: 34605048 DOI: 10.1002/mus.27429] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 08/13/2020] [Revised: 09/22/2021] [Accepted: 09/28/2021] [Indexed: 01/14/2023]
Abstract
INTRODUCTION/AIMS Duchenne and Becker muscular dystrophies (DBMD) are X-linked neuromuscular disorders characterized by progressive muscle weakness, leading to decreased mobility and multisystem complications. We estimate productivity costs attributable to time spent by a parent caring for a male child under the age of 18 y with DBMD, with particular focus on female caregivers of boys with Duchenne muscular dystrophy (DMD) who have already lost ambulation. METHODS Primary caregivers of males with DBMD in the Muscular Dystrophy Surveillance and Research Tracking Network (MD STARnet) were surveyed during 2011-2012 on family quality of life measures, including labor market outcomes. Of 211 respondents, 96 female caregivers of boys with DBMD were matched on state, year of survey, respondent's age, child's age, and number of minor children with controls constructed from Current Population Survey extracts. Regression analysis was used to estimate labor market outcomes and productivity costs. RESULTS Caregivers of boys with DBMD worked 296 h less per year on average than caregivers of unaffected children, translating to a $8816 earnings loss in 2020 U.S. dollars. Caregivers of boys with DMD with ≥4 y of ambulation loss had a predicted loss in annualized earnings of $23,995, whereas caregivers of boys with DBMD of the same ages who remained ambulatory had no loss of earnings. DISCUSSION Female caregivers of non-ambulatory boys with DMD face additional household budget constraints through income loss. Failure to include informal care costs in economic studies could understate the societal cost-effectiveness of strategies for managing DMD that might prolong ambulation.
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Affiliation(s)
- Rieza H Soelaeman
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Michael G Smith
- Department of Health Services Management and Policy, College of Public Health, East Tennessee State University, Johnson City, Tennessee, USA
| | | | - J Mick Tilford
- Department of Health Policy and Management, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Dana Goodenough
- Oak Ridge Institute for Science and Education, Oak Ridge, Tennessee, USA
| | - Pangaja Paramsothy
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Lijing Ouyang
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Joyce Oleszek
- Department of Physical Medicine and Rehabilitation, University of Colorado School of Medicine, Aurora, Colorado, USA.,Children's Hospital Colorado, Aurora, Colorado, USA
| | - Scott D Grosse
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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13
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Chu DI, Liu T, Patel P, Routh JC, Ouyang L, Baum MA, Cheng EY, Yerkes EB, Isakova T. Kidney Function Surveillance in the National Spina Bifida Patient Registry: A Retrospective Cohort Study. J Urol 2020; 204:578-586. [PMID: 32141805 PMCID: PMC7415638 DOI: 10.1097/ju.0000000000001010] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [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] [Accepted: 02/20/2020] [Indexed: 11/26/2022]
Abstract
PURPOSE Chronic kidney disease affects 25% to 50% of patients with spina bifida. Guidelines recommend kidney function surveillance in these patients but practice patterns are unknown. Variations in kidney function surveillance were assessed in patients with spina bifida based on the hypothesis that the treating clinic and spina bifida type would be associated with kidney function surveillance. MATERIALS AND METHODS A retrospective cohort study was conducted of U.S. patients in the National Spina Bifida Patient Registry from 2013 to 2018. Followup was anchored at the 2013 visit. Participants with either an outcome event within 2 years of followup or more than 2 years of followup without an outcome event were included. Primary outcome was kidney function surveillance, defined as at least 1 renal ultrasound and serum creatinine within 2 years of followup. Primary exposures were clinic and spina bifida type, which were analyzed with covariates including sociodemographic and clinical characteristics in logistic regression models for their association with the outcome. Sensitivity analyses were performed using different kidney function surveillance definitions. RESULTS Of 8,351 patients 5,445 were included with a median followup of 3.0 years. Across 23 treating clinics kidney function surveillance rates averaged 62% (range 6% to 100%). In multivariable models kidney function surveillance was associated with treating clinic, younger patient age, functional lesion level, nonambulatory status and prior bladder augmentation. Treating clinic remained a significant predictor of kidney function surveillance in all sensitivity analyses. CONCLUSIONS Within the National Spina Bifida Patient Registry wide variation exists in practice of kidney function surveillance across treating clinics despite adjustment for key patient characteristics.
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Affiliation(s)
- David I. Chu
- Division of Urology, Ann & Robert H. Lurie Children’s Hospital of Chicago
- Center for Healthcare Studies, Institute for Public Health and Medicine, Feinberg School of Medicine at Northwestern University
| | - Tiebin Liu
- Centers for Disease Control and Prevention
| | - Priya Patel
- Oak Ridge Institute for Science and Education (ORISE), Oak Ridge, Tennessee
| | | | | | | | - Earl Y. Cheng
- Division of Urology, Ann & Robert H. Lurie Children’s Hospital of Chicago
| | | | - Tamara Isakova
- Division of Nephrology and Hypertension, Feinberg School of Medicine at Northwestern University
- Center for Translational Metabolism and Health, Institute for Public Health and Medicine, Feinberg School of Medicine at Northwestern University
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He M, Chen X, Luo M, Ouyang L, Xie L, Huang Z, Liu A. Suppressor of cytokine signaling 1 inhibits the maturation of dendritic cells involving the nuclear factor kappa B signaling pathway in the glioma microenvironment. Clin Exp Immunol 2020; 202:47-59. [PMID: 32516488 DOI: 10.1111/cei.13476] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [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: 11/22/2019] [Revised: 04/22/2020] [Accepted: 05/24/2020] [Indexed: 12/30/2022] Open
Abstract
Recurrence and diffuse infiltration challenge traditional therapeutic strategies for malignant glioma. Immunotherapy appears to be a promising approach to obtain long-term survival. Dendritic cells (DCs), the most specialized and potent antigen-presenting cells (APCs), play an important part in initiating and amplifying both the innate and adaptive immune responses against cancer cells. However, cancer cells can escape from immune surveillance by inhibiting maturation of DCs. Until the present, molecular mechanisms of maturation inhibition of DCs in the tumor microenvironment (TME) have not been fully revealed. Our study showed that pretreatment with tumor-conditioned medium (TCM) collected from supernatant of primary glioma cells significantly suppressed the maturation of DCs. TCM pretreatment significantly changed the morphology of DCs, TCM decreased the expression levels of CD80, CD83, CD86 and interleukin (IL)-12p70, while it increased the expression levels of IL-10, transforming growth factor (TGF)-β and IL-6. RNA-Seq showed that TCM pretreatment significantly increased the gene expression level of suppressor of cytokine signaling 1 (SOCS1) in DCs. suppressor of cytokine signaling 1 (SOCS1) knock-down significantly antagonized the maturation inhibition of DCs by TCM, which was demonstrated by the restoration of maturation markers. TCM pretreatment also significantly suppressed T cell viability and T helper type 1 (Th1) response, and SOCS1 knock-down significantly antagonized this suppressive effect. Further, TCM pretreatment significantly suppressed p65 nuclear translocation and transcriptional activity in DCs, and SOCS1 knock-down significantly attenuated this suppressive effect. In conclusion, our research demonstrates that TCM up-regulate SOCS1 to suppress the maturation of DCs via the nuclear factor-kappa signaling pathway.
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Affiliation(s)
- M He
- Department of Neurosurgery, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - X Chen
- Department of Neurosurgery, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - M Luo
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China.,Department of Oncology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - L Ouyang
- Department of Neurosurgery, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - L Xie
- Department of Neurosurgery, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Z Huang
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China.,Department of Neurosurgery, The Eighth Affiliated Hospital, Sun Yat-Sen University, Shenzhen, China
| | - A Liu
- Department of Neurosurgery, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
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15
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Gebretsadik T, Cooper WO, Ouyang L, Thibadeau J, Markus T, Cook J, Tesfaye S, Mitchel EF, Newsome K, Carroll KN. Rates of hospitalization for urinary tract infections among medicaid-insured individuals by spina bifida status, Tennessee 2005-2013. Disabil Health J 2020; 13:100920. [PMID: 32402791 DOI: 10.1016/j.dhjo.2020.100920] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 09/26/2019] [Revised: 03/23/2020] [Accepted: 03/25/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND Individuals with spina bifida are at increased risk for urinary tract infection (UTI), however there are few population-based investigations of the burden of UTI hospitalizations. OBJECTIVE We assessed rates and risk factors for UTI hospitalization in individuals with and without spina bifida. METHODS We conducted a retrospective cohort study to estimate rates of UTI hospitalization by spina bifida status. We included individuals enrolled in Tennessee Medicaid who lived in one of the Emerging Infections Program's Active Bacterial Surveillance counties between 2005 and 2013. Spina bifida was primarily defined and UTI hospitalizations were identified using International Classification of Diseases, Ninth Revision diagnoses. We also studied a subset without specific health conditions potentially associated with UTI. We used Poisson regression to calculate rate ratios (RR) of UTIs for individuals with versus without spina bifida, adjusting for race, sex and age group. RESULTS Over the 9-years, 1,239,362 individuals were included and 2,493 met criteria for spina bifida. Individuals with spina bifida had over a four-fold increased rate of UTI hospitalization than those without spina bifida-in the overall study population and in the subset without specific, high-risk conditions (adjusted rate ratios: 4.41, 95% confidence intervals: 3.03, 6.43) and (4.87, 95% CI: 2.99, 7.92), respectively. We detected differences in rates of UTI hospitalization by race and sex in individuals without spina bifida that were not seen among individuals with spina bifida. CONCLUSIONS Individuals with spina bifida had increased rates of UTI hospitalizations, and associated demographic patterns differed from those without spina bifida.
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Affiliation(s)
- Tebeb Gebretsadik
- Department of Biostatistics, 2525 West End, Suite, 1100, Vanderbilt School of Medicine, Nashville, TN, USA
| | - William O Cooper
- Division of General Pediatrics, Department of Pediatrics, 2146, Belcourt Ave., Vanderbilt University Medical Center, Nashville, TN, USA
| | - Lijing Ouyang
- Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Judy Thibadeau
- Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Tiffanie Markus
- Department of Health Policy, 2525 West End Ave., Suite 1200, 1275, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Jessica Cook
- Division of General Pediatrics, Department of Pediatrics, 2146, Belcourt Ave., Vanderbilt University Medical Center, Nashville, TN, USA
| | - Sarah Tesfaye
- Division of General Pediatrics, Department of Pediatrics, 2146, Belcourt Ave., Vanderbilt University Medical Center, Nashville, TN, USA
| | - Edward F Mitchel
- Department of Health Policy, 2525 West End Ave., Suite 1200, 1275, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Kimberly Newsome
- Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Kecia N Carroll
- Division of General Pediatrics, Department of Pediatrics, 2146, Belcourt Ave., Vanderbilt University Medical Center, Nashville, TN, USA.
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16
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Xu CS, Wu MT, Ouyang L, Cai ZS, Ren Y, Lu SF, Shi WZ. Preparation and Properties of Polyaminosiloxane Modified Polyester Waterborne Polyurethane. INT POLYM PROC 2020. [DOI: 10.3139/217.3842] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Abstract
In this study, a organosilicon modified waterborne polyurethane (WPU) is synthesized with polyethylene glycol 1,4-butanediol adipate ester diol (PBA) to form the soft segment, dimethylolpropionic acid (DMPA) as the hydrophilic chain extender, and isophorone diisocyanate as the hard segment to synthesize the WPU prepolymer, and aminoethyl aminopropyl dimethicone (AEAPS) as the graft chain extender. The properties of the formed WPU films are then characterized by using Fourier transform infrared spectrometry, thermogravimetric analysis, X-ray diffraction, and dynamic mechanical analysis. It is found that when the amount of AEAPS in the WPU is increased from 0 to 30 wt%, the particle size of the AEAPS modified WPU emulsion is increased from 84.8 nm to 271.9 nm and maintained high centrifugal stability. Moreover, the water absorption of the WPU film is reduced from 43.4% to 24.1%, and the hardness is enhanced from 3H to 5H, while the glass-transition temperature (Tg) of the soft segment of the modified WPU shifts from -37.4 °C to -44.3 °C, and the Tg of the hard segment shifts from 73.6 °C to 118.1 °C. Therefore, the overall performance of AEAPS modified WPU is improved.
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Affiliation(s)
- C.-S. Xu
- School of Textile Science and Engineering , Xi'an Polytechnic University, Xi'an, Shaanxi , PRC
| | - M.-T. Wu
- School of Textile Science and Engineering , Xi'an Polytechnic University, Xi'an, Shaanxi , PRC
| | - L. Ouyang
- Xi'an Wanzi Fine Chemical Technology Co. , Ltd., Xi'an , PRC
| | - Z.-S. Cai
- College of Chemistry , Chemical Engineering and Biotechnology, Donghua University, Shanghai , PRC
| | - Y. Ren
- School of Textile Science and Engineering , Xi'an Polytechnic University, Xi'an, Shaanxi , PRC
| | - S.-F. Lu
- School of Textile Science and Engineering , Xi'an Polytechnic University, Xi'an, Shaanxi , PRC
| | - W.-Z. Shi
- School of Textile Science and Engineering , Xi'an Polytechnic University, Xi'an, Shaanxi , PRC
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17
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Thibadeau J, Walker WO, Castillo J, Dicianno BE, Routh JC, Smith KA, Ouyang L. Philosophy of care delivery for spina bifida. Disabil Health J 2020; 13:100883. [PMID: 31928964 PMCID: PMC7477785 DOI: 10.1016/j.dhjo.2019.100883] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [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: 03/01/2019] [Revised: 12/06/2019] [Accepted: 12/17/2019] [Indexed: 02/07/2023]
Abstract
The multidisciplinary model (MCM) is described as one that utilizes skills and experience from practitioners belonging to various disciplines, each treating patients from a specific clinical perspective.1 The Spina Bifida Association (SBA) supports and recommends that clinical care for people with Spina Bifida (SB) be provided in specialty clinics of which the MCM is an example; that care be coordinated; and that there be a plan for transitional care.2 This paper explores the challenges the MCM faces with a transitioning and aging population in a care system that calls for a positive patient experience, engaged health care professionals, desired outcomes, with consideration of cost.
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Affiliation(s)
- Judy Thibadeau
- Spina Bifida Association, 1600 Wilson Blvd., Suite 800, Arlington, VA, 22209, USA.
| | - William O Walker
- Chief, Division of Developmental Medicine, Seattle Children's Hospital, Robert A. Aldrich Professor, Department of Pediatrics, University of Washington School of Medicine, USA
| | - Jonathan Castillo
- Developmental-Behavioral Pediatrics, Texas Children's Hospital, Baylor College of Medicine, USA
| | - Brad E Dicianno
- University of Pittsburgh School of Medicine, Department of Physical Medicine and Rehabilitation, Pittsburgh, PA, USA; Human Engineering Research Laboratories, VA Pittsburgh Healthcare System, Pittsburgh, PA, USA
| | | | - Kathryn A Smith
- USC University Center for Excellence in Developmental Disabilities, Spina Bifida Program, Children's Hospital Los Angeles, Clinical Pediatrics, Keck School of Medicine, University of Southern California, USA
| | - Lijing Ouyang
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, USA
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18
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Do TQN, Riley C, Paramsothy P, Ouyang L, Bolen J, Grosse SD. Fragile X Syndrome-Associated Emergency Department Visits in the United States, 2006-2011. Am J Intellect Dev Disabil 2020; 125:103-108. [PMID: 32058813 PMCID: PMC7305836 DOI: 10.1352/1944-7558-125.2.103] [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] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Using national data, we examined emergency department (ED) encounters during 2006-2011 for which a diagnosis code for fragile X syndrome (FXS) was present (n = 7,217). Almost half of ED visits coded for FXS resulted in hospitalization, which is much higher than for ED visits not coded for FXS. ED visits among females coded for FXS were slightly more likely to result in hospitalization. These findings underscore the importance of surveillance systems that could accurately identify individuals with FXS, track healthcare utilization and co-occurring conditions, and monitor quality of care in order to improve care and reduce FXS-associated morbidity.
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Affiliation(s)
- Thuy Quynh N Do
- Thuy Quynh N. Do, Catharine Riley, Pangaja Paramsothy, Lijing Ouyang, Julie Bolen, and Scott D. Grosse, Centers for Disease Control and Prevention, National Center on Birth Defects and Developmental Disabilities
| | - Catharine Riley
- Thuy Quynh N. Do, Catharine Riley, Pangaja Paramsothy, Lijing Ouyang, Julie Bolen, and Scott D. Grosse, Centers for Disease Control and Prevention, National Center on Birth Defects and Developmental Disabilities
| | - Pangaja Paramsothy
- Thuy Quynh N. Do, Catharine Riley, Pangaja Paramsothy, Lijing Ouyang, Julie Bolen, and Scott D. Grosse, Centers for Disease Control and Prevention, National Center on Birth Defects and Developmental Disabilities
| | - Lijing Ouyang
- Thuy Quynh N. Do, Catharine Riley, Pangaja Paramsothy, Lijing Ouyang, Julie Bolen, and Scott D. Grosse, Centers for Disease Control and Prevention, National Center on Birth Defects and Developmental Disabilities
| | - Julie Bolen
- Thuy Quynh N. Do, Catharine Riley, Pangaja Paramsothy, Lijing Ouyang, Julie Bolen, and Scott D. Grosse, Centers for Disease Control and Prevention, National Center on Birth Defects and Developmental Disabilities
| | - Scott D Grosse
- Thuy Quynh N. Do, Catharine Riley, Pangaja Paramsothy, Lijing Ouyang, Julie Bolen, and Scott D. Grosse, Centers for Disease Control and Prevention, National Center on Birth Defects and Developmental Disabilities
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19
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Zhang J, Li H, Chen Q, Wu C, Pan H, Pan Y, Zheng J, Wen J, Ouyang L, Zhou C. P2.12-22 Risk Factors for BM Incidence in SCLC: A Predictive Model for SCLC Patients on Brain Metastasis. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.1767] [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: 10/25/2022]
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Abstract
OBJECTIVE Research has not examined the use of health care by patients with myotonic muscular dystrophy (MMD), but it would provide insights into this population, which is prone to comorbidities and high service needs. This study is an analysis of this understudied subgroup, using a unique linked dataset to examine the characteristics and healthcare utilization patterns for people with MMD. METHODS This analysis used 3 South Carolina datasets (2009-2014). The subjects included individuals with at least 1 encounter with an International Classification of Diseases, Ninth Revision, Clinical Modification code of 359.21. The variables included sex, race, visit type, payer, and diagnoses. The analyses examined characteristics and number of encounters. RESULTS The subjects were predominately female, white, and 45 to 64 years old. A total of 44.6% of the study population had at least 1 inpatient visit, whereas 64.2% had at least 1 emergency department visit. A majority of the subjects had at least 1 office visit (55.0%), and most (85.3%) did not have a home health encounter. CONCLUSIONS Investigation of the reasons for these inpatient and emergency department encounters may be helpful in identifying ways to deliver high-quality care.
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Affiliation(s)
- Kevin J Bennett
- From the Department of Family and Preventive Medicine, University of South Carolina, Columbia, the Department of Preventive Medicine, University of Mississippi Medical Center School of Medicine and John D. Bower School of Population Health, Jackson, and the National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Joshua R Mann
- From the Department of Family and Preventive Medicine, University of South Carolina, Columbia, the Department of Preventive Medicine, University of Mississippi Medical Center School of Medicine and John D. Bower School of Population Health, Jackson, and the National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Lijing Ouyang
- From the Department of Family and Preventive Medicine, University of South Carolina, Columbia, the Department of Preventive Medicine, University of Mississippi Medical Center School of Medicine and John D. Bower School of Population Health, Jackson, and the National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia
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21
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Bennett KJ, Mann JR, Ouyang L. 30-day all-cause readmission rates among a cohort of individuals with rare conditions. Disabil Health J 2019; 12:203-208. [PMID: 30227990 PMCID: PMC6414271 DOI: 10.1016/j.dhjo.2018.08.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [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: 03/31/2018] [Revised: 08/30/2018] [Accepted: 08/31/2018] [Indexed: 11/24/2022]
Abstract
BACKGROUND There is a need to examine health care utilization of individuals with the rare conditions muscular dystrophies, spina bifida, and fragile X syndrome. These individuals have a greater need for health care services, particularly inpatient admissions. Prior studies have not yet assessed 30-day all-cause readmission rates. OBJECTIVE To estimate 30-day hospital readmission rates among individuals with three rare conditions. HYPOTHESIS Rare conditions patients will have a higher 30-day all-cause readmission rate than those without. METHODS Data from three sources (2007-2014) were combined for this case-control analysis. A cohort of individuals with one of the three conditions was matched (by age in 5 year age groups, gender, and race) to a comparison group without a rare condition. Inpatient utilization and 30-day all-cause readmission rates were compared between the two groups. Logistic regression analyses compared the odds of a 30-day all-cause readmission across the two groups, controlling for key covariates. RESULTS A larger proportion in the rare condition group had at least one inpatient visit (46.1%) vs. the comparison group (23.6%), and a higher 30-day all-cause readmission rate (Spina Bifida-46.7%, Muscular Dystrophy-39.7%, and Fragile X Syndrome-35.8%) than the comparison group (13.4%). Logistic regression results indicated that condition status contributed significantly to differences in readmission rates. CONCLUSIONS Higher rates of inpatient utilization and 30-day all-cause readmission among individuals with rare conditions vs. those without are not surprising, given the medical complexity of these individuals, and indicates an area where unfavorable outcomes may be improved with proper care coordination and post discharge care.
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Affiliation(s)
- Kevin J Bennett
- University of South Carolina, Department of Family and Preventive Medicine, Columbia, SC, USA.
| | - Joshua R Mann
- University of Mississippi Medical Center School of Medicine and John D. Bower School of Population Health, Department of Preventive Medicine, Jackson, MS, USA
| | - Lijing Ouyang
- Centers for Disease Control and Prevention, National Center on Birth Defects and Developmental Disabilities, Atlanta, GA, USA
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Wang Y, Ouyang L, Dicianno BE, Beierwaltes P, Valdez R, Thibadeau J, Bolen J. Differences in Length of Stay and Costs Between Comparable Hospitalizations of Patients With Spina Bifida With or Without Pressure Injuries. Arch Phys Med Rehabil 2019; 100:1475-1481. [PMID: 30684491 DOI: 10.1016/j.apmr.2018.12.033] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [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: 02/13/2018] [Revised: 12/17/2018] [Accepted: 12/31/2018] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To estimate differences in the length of stay and costs for comparable hospitalizations of patients with spina bifida (SB) with and without pressure injuries. DESIGN Retrospective, cross-sectional, observational study. SETTING Nationwide Inpatient Sample from years 2010-2014. PARTICIPANTS Hospitalizations of patients with SB (N=7776). Hospitalizations among patients with SB and pressure injuries (n=3888) were matched to hospitalizations among patients with SB but without pressure injuries (n=3888). INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES Differences in length of stay and total costs between the 2 groups. RESULTS After successful matching, multivariate modeling of costs and length of stay on matched sample showed that hospitalizations with pressure injuries had an increased 1.2 inpatient days and excess average costs of $1182 in 2014 dollars. CONCLUSIONS The estimated average cost of hospitalization increased by 10%, and the estimated average length of stay increased by 24% in the presence of pressure injuries among hospitalized patients with SB, compared with their peers without these injuries. These results highlight the substantial morbidity associated with pressure injuries, which are potentially preventable before or during hospitalizations among persons with SB.
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Affiliation(s)
- Yinding Wang
- Rare Disorders and Health Outcomes Team, Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA; McKing Consulting Corporation, Atlanta, GA
| | - Lijing Ouyang
- Rare Disorders and Health Outcomes Team, Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA.
| | - Brad E Dicianno
- Department of Physical Medicine and Rehabilitation, School of Medicine, University of Pittsburgh, Pittsburgh, PA
| | - Patricia Beierwaltes
- School of Nursing, College of Allied Health & Nursing, Minnesota State University, Mankato, MN
| | - Rodolfo Valdez
- Rare Disorders and Health Outcomes Team, Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA
| | | | - Julie Bolen
- Rare Disorders and Health Outcomes Team, Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA
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Ouyang L, Wang Y, Valdez R, Johnson N, Gutmann L, Street N, Bolen J. Gender difference in clinical conditions among hospitalized adults with myotonic dystrophy. Muscle Nerve 2019; 59:348-353. [PMID: 30575975 DOI: 10.1002/mus.26402] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [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: 06/27/2018] [Revised: 11/30/2018] [Accepted: 12/15/2018] [Indexed: 01/22/2023]
Abstract
INTRODUCTION In this study we examined gender differences in adult hospitalizations with myotonic dystrophy (DM). METHODS From the Nationwide Inpatient Sample (NIS) 2010-2014, we identified 1,891 adult hospitalizations with a DM diagnosis and constructed a comparison group of hospitalizations without DM using propensity score matching. We calculated relative risk by gender for 44 clinical diagnoses that each accounted for at least 5% of DM hospitalizations. RESULTS Hospitalizations with DM were longer (4.8 vs. 4.1 days, P < 0.0001) and more costly ($13,241 vs. $11,458, P < 0.0001) than those without DM. More than half (25 of 44) of the conditions co-occurring with DM hospitalizations did not differ in their relative risks by gender. For those that differed by gender, only 5 were specific to DM, compared with hospitalizations without DM. DISCUSSION Our findings highlight the importance of comprehensive and coordinated care for DM rather than gender-oriented care in the inpatient setting. Muscle Nerve 59:348-353, 2019.
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Affiliation(s)
- Lijing Ouyang
- Rare Disorders and Health Outcomes Team, Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, 1600 Clifton Road, MS E-88, Atlanta, Georgia 30329, USA
| | - Yinding Wang
- Rare Disorders and Health Outcomes Team, Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, 1600 Clifton Road, MS E-88, Atlanta, Georgia 30329, USA
| | - Rodolfo Valdez
- Rare Disorders and Health Outcomes Team, Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, 1600 Clifton Road, MS E-88, Atlanta, Georgia 30329, USA
| | - Nicholas Johnson
- Department of Neurology, Virginia Commonwealth University, Virginia, USA
| | - Laurie Gutmann
- Department of Neurology, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
| | - Natalie Street
- Rare Disorders and Health Outcomes Team, Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, 1600 Clifton Road, MS E-88, Atlanta, Georgia 30329, USA
| | - Julie Bolen
- Rare Disorders and Health Outcomes Team, Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, 1600 Clifton Road, MS E-88, Atlanta, Georgia 30329, USA
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Li YH, Shi CY, Duan FQ, Pang Y, Li HB, Zhang LQ, Liu ZH, Ouyang L, Yue CY, Xie MC, Jiang ZJ, Xiao Y. [A clinical analysis of 10 cases with cardiac lymphoma]. Zhonghua Xue Ye Xue Za Zhi 2018; 38:102-106. [PMID: 28279032 PMCID: PMC7354164 DOI: 10.3760/cma.j.issn.0253-2727.2017.02.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
目的 分析心脏淋巴瘤的发病情况、临床特征、治疗效果及预后。 方法 收集2000年1月至2016年6月期间确诊并有心脏累及的10例淋巴瘤患者的资料,对患者的一般资料、临床表现、病理诊断、实验室检查、心脏累及方式、心脏并发症、治疗方式、疗效及预后进行分析。 结果 3 918例淋巴瘤患者中,心脏累及者10例,其中原发性心脏淋巴瘤(PCL)1例(主要累及左右心房,以心肌内多发结节包块为主),继发性心脏淋巴瘤(SCL)9例(主要为心包包块,其中出现心包积液5例,心肌肿块2例)。男性6例,女性4例,中位年龄55(19~88)岁,主要临床表现为呼吸困难7例,胸痛5例,乏力、水肿各2例。病理类型包括弥漫大B细胞淋巴瘤(DLBCL)7例,T淋巴母细胞淋巴瘤、霍奇金淋巴瘤、Burkitt淋巴瘤各1例。心脏并发症包括充血性心力衰竭7例,心律失常4例(主要为窦性心动过速、心房颤动和房室传导阻滞)。除1例高龄、一般状况差未接受治疗外,其余9例患者均接受治疗(单纯化疗4例,化疗联合放疗5例)。中位随访时间为9(1~28)个月。1例PCL患者化疗后获部分缓解(PR),无进展生存(PFS)期为6个月,总生存(OS)期为21个月。SCL患者中6例起病累及心脏者,治疗后1例获完全缓解,5例获PR,中位PFS期为5个月,中位OS期为19个月;3例病情进展累及心脏者,2例治疗后获PR,1例未治疗者死亡,中位PFS期为4个月,OS因数据截尾,未能获得。 结论 心脏淋巴瘤为少见类型,DLBCL为最常见类型,呼吸困难、胸痛为最常见临床表现,并易出现充血性心力衰竭和心律失常,治疗以系统化疗为主,总体预后差。
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Affiliation(s)
- Y H Li
- Department of Hematology, Guangzhou Military Command Guangzhou General Hospital, Guangzhou 510010, China
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Guo W, Li Y, Zhou N, Wu GH, Chang WH, Huan XP, Hui S, Tong X, Guo Y, Yu MH, Lu RR, Ouyang L, Dong LF, Li H, Li JJ, Liu XY, Liu YL, Luo C, Wei XL, Huang XD, Cui Y. [Risk factors related to HIV new infections among men who have sex with men in a cohort study]. Zhonghua Liu Xing Bing Xue Za Zhi 2018; 39:16-20. [PMID: 29374888 DOI: 10.3760/cma.j.issn.0254-6450.2018.01.003] [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] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objectives: To analyze and understand the risk factors related to HIV new infections among men who have sex with men (MSM). Methods: A longitudinal observational study among MSM was conducted to collect information on HIV related behaviors and sero-conversion. Univariate and multivariate generalized estimating equations (GEE) were used to discuss the risk factors for HIV new infection. Results: A total number of 4 305 MSM were followed during 2013-2015. Among those self-reported MSM who are seeking partners on the Interner tended to have higher proportion on receptive anal intercourse and consistent condom use during anal intercourse than the subgroups seeking their partners in gay bars or bathrooms. HIV incidence among followed MSM during the study period appeared as 4.3/100 person years, with adjusted RR (aRR) of HIV infection for receptive anal intercourse as group 2.20 (95% CI: 1.49-3.24) times than that of insertion anal intercourse group. Those who used rush-poppers (aRR=1.55, 95% CI: 1.10-2.17), unprotected anal intercourse (aRR=2.24, 95%CI: 1.62-3.08), and those with syphilis infection (aRR=2.95, 95%CI: 2.00-4.35) were also risk factors for HIV new infections. After controlling other factors, the relationship between the ways of seeking partners and HIV new infection was not statistical significant. Conclusion: Risk factors for HIV new infection among MSM appeared complex and interactive, suggesting that further studies are needed to generate tailored strategies for the prevention of HIV epidemic among MSM population.
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Affiliation(s)
- W Guo
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206
| | - Y Li
- Center for Disease Control and Prevention in Heilongjiang Province, Harbin 150036
| | - N Zhou
- Center for Disease Control and Prevention in Tianjin, Tianjin 300011
| | - G H Wu
- Center for Disease Control and Prevention in Chongqing, Chong qing 400042
| | - W H Chang
- Center for Disease Control and Prevention in Shaanxi Province. Xi'an 710054
| | - X P Huan
- Center for Disease Control and Prevention in Jiangsu Province, Nanjing 210009
| | - S Hui
- Center for Disease Control and Prevention in Heilongjiang Province, Harbin 150036
| | - X Tong
- Center for Disease Control and Prevention in Heilongjiang Province, Harbin 150036
| | - Y Guo
- Center for Disease Control and Prevention in Tianjin, Tianjin 300011
| | - M H Yu
- Center for Disease Control and Prevention in Tianjin, Tianjin 300011
| | - R R Lu
- Center for Disease Control and Prevention in Chongqing, Chong qing 400042
| | - L Ouyang
- Center for Disease Control and Prevention in Chongqing, Chong qing 400042
| | - L F Dong
- Center for Disease Control and Prevention in Shaanxi Province. Xi'an 710054
| | - H Li
- Center for Disease Control and Prevention in Shaanxi Province. Xi'an 710054
| | - J J Li
- Center for Disease Control and Prevention in Jiangsu Province, Nanjing 210009
| | - X Y Liu
- Center for Disease Control and Prevention in Jiangsu Province, Nanjing 210009
| | - Y L Liu
- Center for Disease Control and Prevention at Harbin City, Harbin 150056
| | - C Luo
- Center for Disease Control and Prevention at Harbin City, Harbin 150056
| | - X L Wei
- Center for Disease Control and Prevention at Xi'an City, Xi'an 710054
| | - X D Huang
- Center for Disease Control and Prevention at Xi'an City, Xi'an 710054
| | - Y Cui
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206
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Bennett KJ, Mann J, Ouyang L. Utilizing Combined Claims and Clinical Datasets for Research Among Potential Cases of Rare Diseases. Int J Healthc Inf Syst Inform 2018; 13:1-12. [PMID: 32913425 DOI: 10.4018/ijhisi.2018040101] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
With data quality issues with administrative claims and medically derived datasets, a dataset derived from a combination of sources may be more effective for research. The purposes of this article is to link an EMR-based data warehouse with state administrative data to study individuals with rare diseases; to describe and compare their characteristics; and to explore research with the data. These methods included subjects with diagnosis codes for one of three rare diseases from the years 2009-2014; Spina Bifida, Muscular Dystrophy, and Fragile X Syndrome. The results from the combined data provides additional information that each dataset, by itself, would not contain. The simultaneous examination of data such as race/ethnicity, physician and other outpatient visit data, charges and payments, and overall utilization was possible in the combined dataset. It is also discussed that combining such datasets can be a useful tool for the study of populations with rare diseases.
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Affiliation(s)
| | - Joshua Mann
- University of Mississippi Medical Center, Jackson, MS, USA
| | - Lijing Ouyang
- Centers for Disease Control & Prevention, Atlanta, GA, USA
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Abstract
PURPOSE Recent studies have revealed that the lack of continuity in preparing patients with spina bifida to transition into adult-centered care may have detrimental health consequences. We sought to describe current practices of transitional care services offered at spina bifida clinics in the US. METHODS Survey design followed the validated transitional care survey by the National Cystic Fibrosis center. Survey was amended for spina bifida. Face validity was completed. Survey was distributed to registered clinics via the Spina Bifida Association. Results were analyzed via descriptive means. RESULTS Total of 34 clinics responded. Over 90 characteristics were analyzed per clinic. The concept of transition is discussed with most patients. Most clinics discuss mobility, bowel and bladder management, weight, and education plans consistently. Most do not routinely evaluate their process or discuss insurance coverage changes with patients. Only 30% communicate with the adult providers. Sexuality, pregnancy and reproductive issues are not readily discussed in most clinics. Overall clinics self-rate themselves as a 5/10 in their ability to provide services for their patients during transition. CONCLUSIONS Characteristics of current transitional care services and formal transitional care programs at US clinics show wide variances in what is offered to patients and families.
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Affiliation(s)
| | - Judy Thibadeau
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Sara Struwe
- Spina Bifida Association, Arlington, VA, USA
| | - Lisa Ramen
- Spina Bifida Association, Arlington, VA, USA
| | - Lijing Ouyang
- Centers for Disease Control and Prevention, Atlanta, GA, USA
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Liu T, Ouyang L, Thibadeau J, Wiener JS, Routh JC, Castillo H, Castillo J, Freeman KA, Sawin KJ, Smith K, Van Speybroeck A, Valdez R. Longitudinal Study of Bladder Continence in Patients with Spina Bifida in the National Spina Bifida Patient Registry. J Urol 2017; 199:837-843. [PMID: 29132982 DOI: 10.1016/j.juro.2017.11.048] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [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: 11/06/2017] [Indexed: 11/25/2022]
Abstract
PURPOSE Achieving bladder continence in individuals with spina bifida is a lifetime management goal. We investigated bladder continence status through time and factors associated with this status in patients with spina bifida. MATERIALS AND METHODS We used National Spina Bifida Patient Registry data collected from 2009 through 2015 and applied generalized estimating equation models to analyze factors associated with bladder continence status. RESULTS This analysis included 5,250 participants with spina bifida in a large, multi-institutional patient registry who accounted for 12,740 annual clinic visit records during the study period. At last followup mean age was 16.6 years, 22.4% of participants had undergone bladder continence surgery, 92.6% used some form of bladder management and 45.8% reported bladder continence. In a multivariable regression model the likelihood of bladder continence was significantly greater in those who were older, were female, were nonHispanic white, had a nonmyelomeningocele diagnosis, had a lower level of lesion, had a higher mobility level and had private insurance. Continence surgery history and current management were also associated with continence independent of all other factors (adjusted OR and 95% CI 1.9, 1.7-2.1 and 3.8, 3.2-4.6, respectively). The association between bladder management and continence was stronger for those with a myelomeningocele diagnosis (adjusted OR 4.6) than with nonmyelomeningocele (adjusted OR 2.8). CONCLUSIONS In addition to demographic, social and clinical factors, surgical intervention and bladder management are significantly and independently associated with bladder continence status in individuals with spina bifida. The association between bladder management and continence is stronger in those with myelomeningocele.
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Affiliation(s)
- Tiebin Liu
- Rare Disorders and Health Outcomes Team, Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Lijing Ouyang
- Rare Disorders and Health Outcomes Team, Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Judy Thibadeau
- Rare Disorders and Health Outcomes Team, Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - John S Wiener
- Duke University Medical Center, Durham, North Carolina
| | | | | | | | | | - Kathleen J Sawin
- Children's Hospital of Wisconsin and University of Wisconsin, Milwaukee, Wisconsin
| | - Kathryn Smith
- Children's Hospital Los Angeles, Los Angeles, California
| | | | - Rodolfo Valdez
- Rare Disorders and Health Outcomes Team, Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia
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He HJ, Lyu P, Luan RS, Liao QH, Chang ZJ, Li Y, Ouyang L, Yang J. [Influence of sociocultural factors on HIV transmission among men who have sex with men: a qualitative study]. Zhonghua Yu Fang Yi Xue Za Zhi 2017; 50:858-862. [PMID: 27686762 DOI: 10.3760/cma.j.issn.0253-9624.2016.10.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To understand how social and cultural factors influence sexual perceptions, sexual practices, and HIV transmission among men who have sex with men at selected sites in China. Methods: Qualitative methodology was used and face to face, semi-structured, in-depth interviews conducted from April 2013 to October 2015 in Sichuan, Jiangxi, Henan, Heilongjiang provinces and Chongqing municipality of China. Results: A total of 184 men who have sex with men participated in the interviews. Forty-eight originated from Henan Province, and 12, 50, 47, and 27 from Jiangxi, Heilongjiang, Sichuan provinces and Chongqing municipality, respectively. A total of 122 participants(66.3%)were under 30 years of age, 111 were college graduates(61.3%), 140 were unmarried(76.5%), and 74 were HIV positive(40.2%). Among interviewees, 6%(11 MSM)were employed at nongovernmental organizations. The main findings revealed that: Owing to sociocultural influences and social norms, most homosexual men concealed their sexual orientation and married females so as to fulfill their family obligation; this may encourage HIV transmission from a high-risk population to the general population; the main features of male homosexual behaviors, as well as those of the associated community and subculture, included hedonism, less concern about health, drug abuse, encouraging of high risk behaviors among men who have sex with men, and negative attitudes regarding HIV prevention; subgroups among MSM were found to have differential HIV transmission risk behaviors, with young men more vulnerable to infection with HIV. Conclusion: Sociocultural factors, including external socioenvironmental circumstances and internal MSM community subcultures, have adverse impacts on HIV transmission among men who have sex with men. Because there were varied behavior modes and HIV transmission risks among MSM subgroups, further study focusing on MSM subgroups is imperative, to provide a basis for more targeted and effective prevention strategies.
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Affiliation(s)
- H J He
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
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Li B, Shen C, Ouyang L, Yang M, Zhou L, Jiang S, Jia X. WE-FG-207B-03: Multi-Energy CT Reconstruction with Spatial Spectral Nonlocal Means Regularization. Med Phys 2016. [DOI: 10.1118/1.4957948] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Chen X, Ouyang L, Yan H, Jia X, Zhang Y, Wang J. WE-AB-207A-09: Optimization of the Design of a Moving Blocker for Cone-Beam CT Scatter Correction: Experimental Evaluation. Med Phys 2016. [DOI: 10.1118/1.4957762] [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: 11/07/2022] Open
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Ouyang L, Folkerts M, Hrycushko B, Lamphier R, Lee H, Yan Y, Jiang S, Timmerman R, Desai N, Abulrahman R, Gu X. TH-EF-BRB-11: Volumetric Modulated Arc Therapy for Total Body Irradiation. Med Phys 2016. [DOI: 10.1118/1.4958257] [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: 11/07/2022] Open
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Cai B, McDermott S, Wang Y, Royer JA, Mann JR, Hardin JW, Ozturk O, Ouyang L. Skin Ulcers and Mortality Among Adolescents and Young Adults With Spina Bifida in South Carolina During 2000-2010. J Child Neurol 2016; 31:370-7. [PMID: 26239488 PMCID: PMC4740267 DOI: 10.1177/0883073815596611] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [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: 02/07/2015] [Accepted: 05/22/2015] [Indexed: 12/28/2022]
Abstract
The authors investigated 48 deaths (7% death rate) among 690 adolescents and young adults with spina bifida in South Carolina during 2000-2010. The authors used Medicaid and other administrative data and a retrospective cohort design that included people with spina bifida identified using ICD-9 codes. Cox regression models with time-dependent and time-invariant covariates, and Kaplan-Meier survival curves were constructed. The authors found that 21.4% of the study group had a skin ulcer during the study period and individuals with skin ulcers had significantly higher mortality than those without ulcers (P < .0001). People who had their first skin ulcer during adolescence had higher mortality than those who had the first skin ulcer during young adulthood (P = .0002; hazard ratio = 10.70, 95% confidence interval for hazard ratio: 3.01, 38.00) and those without skin ulcers, controlling for other covariates. This study showed that age at which individuals first had a skin ulcer was associated with mortality.
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Affiliation(s)
- Bo Cai
- Department of Epidemiology and Biostatistics, University of South Carolina Arnold School of Public Health, Columbia, SC, USA
| | - Suzanne McDermott
- Department of Epidemiology and Biostatistics, University of South Carolina Arnold School of Public Health, Columbia, SC, USA
| | - Yinding Wang
- Department of Epidemiology and Biostatistics, University of South Carolina Arnold School of Public Health, Columbia, SC, USA
| | - Julie A Royer
- Division of Research and Statistics, South Carolina Revenue and Fiscal Affairs, Columbia, SC, USA
| | - Joshua R Mann
- Department of Family and Preventive Medicine, University of South Carolina School of Medicine, Columbia, SC, USA
| | - James W Hardin
- Department of Epidemiology and Biostatistics, University of South Carolina Arnold School of Public Health, Columbia, SC, USA
| | - Orgul Ozturk
- Department of Economics, University of South Carolina, Moore School of Business, Columbia, SC, USA
| | - Lijing Ouyang
- Centers for Disease Control and Prevention, National Center on Birth Defects and Developmental Disabilities, Atlanta, GA, USA
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Affiliation(s)
- Rodolfo Valdez
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, 1600 Clifton Rd NE, Mailstop E-88, Atlanta, GA 30333.
| | - Lijing Ouyang
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Julie Bolen
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia
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Ouyang L, Folkerts M, Lee H, Ramirez E, Timmerman R, Abdulrahman R, Jiang S, Gu X. SU-E-T-812: Volumetric Modulated Arc Therapy-Total Body Irradiation (VMAT-TBI) V.s. Conventional Extended SSD-TBI (cTBI): A Dosimetric Comparisom. Med Phys 2015. [DOI: 10.1118/1.4925176] [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: 11/07/2022] Open
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Webster M, Ouyang L, Folkerts M, Tian Z, Jia X, Jiang S, Gu X. SU-E-T-253: Development of a GDPM Monte Carlo Based Quality Assurance Tool for Cyberknife. Med Phys 2015. [DOI: 10.1118/1.4924615] [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: 11/07/2022] Open
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37
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Zhao C, Ouyang L, Wang J, Jin M. SU-E-I-08: Investigation of Deconvolution Methods for Blocker-Based CBCT Scatter Estimation. Med Phys 2015. [DOI: 10.1118/1.4924005] [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: 11/07/2022] Open
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Folkerts M, Ouyang L, Jia X, Jiang S, Gu X. SU-E-T-689: Semi-Automated GPU-Based Monte Carlo Dose Calculation for Total Body Irradiation. Med Phys 2015. [DOI: 10.1118/1.4925052] [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: 11/07/2022] Open
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McDermott S, Hardin JW, Royer JA, Mann JR, Tong X, Ozturk OD, Ouyang L. Emergency department and inpatient hospitalizations for young people with fragile X syndrome. Am J Intellect Dev Disabil 2015; 120:230-243. [PMID: 25928435 PMCID: PMC4491920 DOI: 10.1352/1944-7558-120.3.230] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
We compared hospital encounters between adolescents and young adults with fragile X syndrome (FXS) to peers with intellectual disability (ID) from other causes, autism spectrum disorder (ASD), and a comparison group without these conditions matched by gender, age, and insurance coverage. Those with FXS, ASD, or ID were more likely to have had hospital encounters. In terms of age groups, we found mental illness hospitalizations decreased during adulthood as compared to adolescence for those with FXS, and we found that for conditions unrelated to FXS (e.g., respiratory, genitourinary, gastroenteritis, and pneumonia) adolescents had higher rates of hospitalization compared to their peers with FXS, ID, or ASD. We analyzed epilepsy, common among people with FXS and designated as an ambulatory care sensitive condition that can be treated outside the hospital, and found that people with FXS, ID, and ASD had higher odds of hospitalization due to epilepsy in both age groups than did the comparison group.
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Deroche CB, Holland MM, McDermott S, Royer JA, Hardin JW, Mann JR, Salzberg D, Ozturk O, Ouyang L. Development of a tool to describe overall health, social independence and activity limitation of adolescents and young adults with disability. Res Dev Disabil 2015; 38:288-300. [PMID: 25577179 PMCID: PMC4591546 DOI: 10.1016/j.ridd.2014.12.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/20/2014] [Accepted: 12/08/2014] [Indexed: 06/04/2023]
Abstract
There is a need for research that focuses on the correlation between self-perceived quality of life (QoL) and the health outcomes of adolescents with disability transitioning to adulthood. To better understand the transition experience of adolescents and young adults with disability, we developed a questionnaire to assess the impact of disability on QoL. We recruited 174 participants who were 15-24 years old and diagnosed with Fragile X syndrome (FXS), spina bifida (SB) or muscular dystrophy (MD) and conducted an exploratory factor analysis to identify factors that characterize QoL. Five factors emerged: emotional health, physical health, independence, activity limitation, and community participation. To validate the tool, we linked medical claims and other administrative data records and examined the association of the factor scores with health care utilization and found the questionnaire can be utilized among diverse groups of young people with disability.
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Affiliation(s)
- Chelsea B Deroche
- University of South Carolina, Arnold School of Public Health, Department of Epidemiology and Biostatistics, 915 Greene Street, Columbia, SC 29208, United States.
| | - Margaret M Holland
- University of South Carolina, Arnold School of Public Health, Department of Epidemiology and Biostatistics, 915 Greene Street, Columbia, SC 29208, United States.
| | - Suzanne McDermott
- University of South Carolina, Arnold School of Public Health, Department of Epidemiology and Biostatistics, 915 Greene Street, Columbia, SC 29208, United States.
| | - Julie A Royer
- Revenue and Fiscal Affairs Office, Health and Demographics, Blanding Street, Columbia, SC 29201, United States.
| | - James W Hardin
- University of South Carolina, Arnold School of Public Health, Department of Epidemiology and Biostatistics, 915 Greene Street, Columbia, SC 29208, United States.
| | - Joshua R Mann
- University of South Carolina, School of Medicine, Department of Family and Preventive Medicine, 3209 Colonial Drive, Columbia, SC 29203, United States.
| | - Deborah Salzberg
- University of South Carolina, Arnold School of Public Health, Department of Epidemiology and Biostatistics, 915 Greene Street, Columbia, SC 29208, United States.
| | - Orgul Ozturk
- University of South Carolina, Moore School of Business, Department of Economics, 1705 College Street, Columbia, SC 29208, United States.
| | - Lijing Ouyang
- Centers for Disease Control and Prevention, National Center on Birth Defects and Developmental Disabilities, 1600 Clifton Road, Atlanta, GA 30333, United States.
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Ouyang L, Luo Y, Tian M, Zhang SY, Lu R, Wang JH, Kasimu R, Li X. Plant natural products: from traditional compounds to new emerging drugs in cancer therapy. Cell Prolif 2015; 47:506-15. [PMID: 25377084 DOI: 10.1111/cpr.12143] [Citation(s) in RCA: 75] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2014] [Accepted: 07/03/2014] [Indexed: 02/05/2023] Open
Abstract
Natural products are chemical compounds or substances produced naturally by living organisms. With the development of modern technology, more and more plant extracts have been found to be useful to medical practice. Both micromolecules and macromolecules have been reported to have the ability to inhibit tumour progression, a novel weapon to fight cancer by targeting its 10 characteristic hallmarks. In this review, we focus on summarizing plant natural compounds and their derivatives with anti-tumour properties, into categories, according to their potential therapeutic strategies against different types of human cancer. Taken together, we present a well-grounded review of these properties, hoping to shed new light on discovery of novel anti-tumour therapeutic drugs from known plant natural sources.
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Affiliation(s)
- L Ouyang
- State Key Laboratory of Biotherapy and Department of Urology, West China Hospital, Sichuan University, Chengdu, 610041, China
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Wang SY, Fu LL, Zhang SY, Tian M, Zhang L, Zheng YX, Wang JH, Huang J, Ouyang L. In silico analysis and experimental validation of active compounds from fructus Schisandrae chinensis in protection from hepatic injury. Cell Prolif 2014; 48:86-94. [PMID: 25521411 DOI: 10.1111/cpr.12157] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2014] [Accepted: 09/10/2014] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVES The aim of this study was to explore mechanisms by which fructus Schisandrae chinensis (Wuweizi) is able to reveal its protective capacity against hepatocyte injury. MATERIALS AND METHODS Identification of candidate small molecular compounds was performed by text-mining, extraction and isolation, reverse-docking, network construction, molecular docking and molecular dynamics (MD) simulation. In vitro cytological examination and western blotting were used to validate efficacy of selected compounds. RESULTS We analyzed chemical composition of fructus Schisandrae chinensis and constructed protein-protein networks of key targets. Networks of miRNA-protein were constructed. Molecular docking and MD simulation results supported good interaction between selected compound 11/12 and GBA3/SHBG. Further in vitro examination divulged molecular mechanisms involved. CONCLUSIONS In silico analysis and experimental validation together demonstrated that compound 11/12 of fructus Schisandrae chinensis targetted GBA3/SHBG in hepatocytes. Hopefully this will shed light on exploration of its complex molecular mechanisms.
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Affiliation(s)
- S Y Wang
- School of Traditional Chinese Materia Medica, Shenyang Pharmaceutical University, Shenyang, 110016, China
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44
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Jiang QL, Zhang S, Tian M, Zhang SY, Xie T, Chen DY, Chen YJ, He J, Liu J, Ouyang L, Jiang X. Plant lectins, from ancient sugar-binding proteins to emerging anti-cancer drugs in apoptosis and autophagy. Cell Prolif 2014; 48:17-28. [PMID: 25488051 DOI: 10.1111/cpr.12155] [Citation(s) in RCA: 78] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2014] [Accepted: 08/28/2014] [Indexed: 02/06/2023] Open
Abstract
Ubiquitously distributed in different plant species, plant lectins are highly diverse carbohydrate-binding proteins of non-immune origin. They have interesting pharmacological activities and currently are of great interest to thousands of people working on biomedical research in cancer-related problems. It has been widely accepted that plant lectins affect both apoptosis and autophagy by modulating representative signalling pathways involved in Bcl-2 family, caspase family, p53, PI3K/Akt, ERK, BNIP3, Ras-Raf and ATG families, in cancer. Plant lectins may have a role as potential new anti-tumour agents in cancer drug discovery. Thus, here we summarize these findings on pathway- involved plant lectins, to provide a comprehensive perspective for further elucidating their potential role as novel anti-cancer drugs, with respect to both apoptosis and autophagy in cancer pathogenesis, and future therapy.
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Affiliation(s)
- Q-L Jiang
- State Key Laboratory of Biotherapy & Collaborative Innovation Center of Biotherapy, Department of Dermatology, Department of Emergency Medicine, West China Hospital, Sichuan University, Chengdu, 610041, China; School of Pharmacy and The First Affiliated Hospital of Chengdu Medical College, Chengdu Medical College, Chengdu, Sichuan, 610500, China; Sichuan Province College Key Laboratory of Structure-Specific Small Molecule Drugs, Chengdu Medical College, Chengdu, Sichuan, 610500, China
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Tong XP, Chen Y, Zhang SY, Xie T, Tian M, Guo MR, Kasimu R, Ouyang L, Wang JH. Key autophagic targets and relevant small-molecule compounds in cancer therapy. Cell Prolif 2014; 48:7-16. [PMID: 25474301 DOI: 10.1111/cpr.12154] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2014] [Accepted: 08/31/2014] [Indexed: 02/05/2023] Open
Abstract
Autophagy is a highly conserved lysosomal degradation process which can recycle unnecessary or dysfunctional cell organelles and proteins, thereby playing a crucial regulatory role in cell survival and maintenance. It has been widely accepted that autophagy regulates various pathological processes, among which cancer attracts much attention. Autophagy may either promote cancer cell survival by providing energy during unfavourable metabolic circumstance or can induce individual cancer cell death by preventing necrosis and increasing genetic instability. Thus, dual roles of autophagy may determine the destiny of cancer cells and make it an attractive target for small-molecule drug discovery. Collectively, key autophagy-related elements as potential targets, oncogenes mTORC1, class I PI3K and AKT, as well as tumour suppressor class III PI3K, Beclin-1 and p53, have been discussed. In addition, some small molecule drugs, such as rapamycin and its derivatives, rottlerin, PP242 and AZD8055 (targeting PI3K/AKT/mTORC1), spautin-1, and tamoxifen, as well as oridonin and metformin (targeting p53), can modulate autophagic pathways in different types of cancer. All these data will shed new light on targeting the autophagic process for cancer therapy, using small-molecule compounds, to fight cancer in the near future.
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Affiliation(s)
- X-P Tong
- State Key Laboratory of Biotherapy & Collaborative Innovation Center of Biotherapy, West China Hospital, Sichuan University, Chengdu, 610041, China; School of Pharmacy, China Pharmaceutical University, Nanjing, 211198, China
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Chen Y, He J, Tian M, Zhang SY, Guo MR, Kasimu R, Wang JH, Ouyang L. UNC51-like kinase 1, autophagic regulator and cancer therapeutic target. Cell Prolif 2014; 47:494-505. [PMID: 25327638 DOI: 10.1111/cpr.12145] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2014] [Accepted: 08/12/2014] [Indexed: 02/05/2023] Open
Abstract
Autophagy, the cell process of self-digestion, plays a pivotal role in maintaining energy homoeostasis and protein synthesis. When required, it causes degradation of long-lived proteins and damaged organelles, indicating that it may play a dual role in cancer, by both protecting against and promoting cell death. The autophagy-related gene (Atg) family, with more than 35 members, regulates multiple stages of the process. Serine/threonine protein kinase Atg1 in yeast, for example, can interact with other ATG gene products, functioning in autophagosome formation. One mammalian homologue of Atg1, UNC-51-like kinase 1 (ULK1) and its related complex ULK1-mAtg13-FIP200 can mediate autophagy under nutrient-deprived conditions, by protein-protein interactions and post-translational modifications. Although specific mechanisms of how ULK1 and its complex transduces upstream signals to the downstream central autophagy pathways is not fully understood, past studies have indicated that ULK1 can both suppress and promote tumour growth under different conditions. Here, we summarize some properties of ULK1 which can regulate autophagy in cancer, which may shed new light on future cancer therapy strategies, utilizing ULK1 as a potential new target.
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Affiliation(s)
- Y Chen
- State Key Laboratory of Biotherapy & Collaborative Innovation Center of Biotherapy, Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu, 610041, China
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Wang J, Dang J, Ouyang L, Gu X, Pan T. Clinical Evaluation of a Novel 4D-CBCT Reconstruction Scheme Based on Simultaneous Motion Estimation and Image Reconstruction. Int J Radiat Oncol Biol Phys 2014. [DOI: 10.1016/j.ijrobp.2014.05.747] [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: 11/30/2022]
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Ouyang L, Bolen J, Valdez R, Joseph D, Baum MA, Thibadeau J. Characteristics and survival of patients with end stage renal disease and spina bifida in the United States renal data system. J Urol 2014; 193:558-64. [PMID: 25167993 DOI: 10.1016/j.juro.2014.08.092] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [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] [Accepted: 08/18/2014] [Indexed: 11/18/2022]
Abstract
PURPOSE We describe the characteristics, treatments and survival of patients with spina bifida in whom end stage renal disease developed from 2004 through 2008 in the United States Renal Data System. MATERIALS AND METHODS We used ICD-9-CM code 741.* to identify individuals with spina bifida using hospital inpatient data from 1977 to 2010, and physician and facility claims from 2004 to 2008. We constructed a 5:1 comparison group of patients with end stage renal disease without spina bifida matched by age at first end stage renal disease service, gender and race/ethnicity. We assessed the risk of mortality and of renal transplantation while on dialysis using multivariate cause specific proportional hazards survival analysis. We also compared survival after the first renal transplant from the first end stage renal disease service to August 2011. RESULTS We identified 439 patients with end stage renal disease and spina bifida in whom end stage renal disease developed at an average younger age than in patients without spina bifida (41 vs 62 years, p <0.001) and in whom urological issues were the most common primary cause of end stage renal disease. Compared to patients with end stage renal disease without spina bifida those who had spina bifida showed a similar mortality hazard on dialysis and after transplantation. However, patients with end stage renal disease without spina bifida were more likely to undergo renal transplantation than patients with spina bifida (HR 1.51, 95% CI 1.13-2.03). Hospitalizations related to urinary tract infections were positively associated with the risk of death on dialysis in patients with end stage renal disease and spina bifida (HR 1.42, 95% CI 1.33-1.53). CONCLUSIONS Spina bifida was not associated with increased mortality in patients with end stage renal disease on dialysis or after renal transplantation. Proper urological and bladder management is imperative in patients with spina bifida, particularly in adults.
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Affiliation(s)
- Lijing Ouyang
- Rare Disorders and Health Outcomes Team, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Bethesda, Maryland.
| | - Julie Bolen
- Rare Disorders and Health Outcomes Team, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Bethesda, Maryland
| | - Rodolfo Valdez
- Rare Disorders and Health Outcomes Team, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Bethesda, Maryland
| | - David Joseph
- Department of Urology, School of Medicine, University of Alabama at Birmingham, Birmingham
| | - Michelle A Baum
- Division of Nephrology, Harvard Medical School, Boston Children's Hospital, Boston, Massachusetts
| | - Judy Thibadeau
- Rare Disorders and Health Outcomes Team, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Bethesda, Maryland
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Royer JA, Hardin JW, McDermott S, Ouyang L, Mann JR, Ozturk OD, Bolen J. Use of state administrative data sources to study adolescents and young adults with rare conditions. J Gen Intern Med 2014; 29 Suppl 3:S732-8. [PMID: 25029984 PMCID: PMC4124125 DOI: 10.1007/s11606-014-2925-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [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: 12/14/2022]
Abstract
BACKGROUND Effective care of young people with rare conditions requires ongoing coordinated medical treatment as well as educational and social support services. However, information on treatment is often lacking due to limited data. South Carolina has a repository of comprehensive health and human service data with which individuals may be tracked across the data systems of multiple state agencies and organizations. OBJECTIVE To develop a method for studying health care of young persons with rare conditions using this repository. METHODS We identified individuals aged 15 to 24 years diagnosed during 2000-2010 with Fragile X syndrome (FXS), spina bifida (SB), or muscular dystrophy (MD) using a series of algorithms. ICD-9-CM codes were used to initially identify the cohort from medical billing data. Demographics, medical care, employment, education, and socioeconomic status data were then extracted from linked administrative sources. RESULTS We identified 1,040 individuals with these rare conditions: 125 with FXS, 695 with SB, and 220 with MD. The vast majority of the cases (95%) were identified in the Medicaid database. Half of the cohort was male, with a higher percentage in the FXS and MD groups. Sixty-two percent of the cohort was enrolled in the last year of high school. Over half of the cohort received support services from the state's disability and special-needs agency; 16% received food assistance. Thirty-eight percent were employed at some point during the study period. Forty-nine individuals with SB and 56 with MD died during the study period. CONCLUSIONS We used a linked statewide data system to study rare conditions. Strengths include the diversity of information, rigorous identification strategies, and access to longitudinal data. Despite limitations inherent to administrative data, we found that linked state data systems are valuable resources for investigating important public health questions on rare conditions.
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Affiliation(s)
- J. A. Royer
- />Division of Research and Statistics, South Carolina Budget and Control Board, 1919 Blanding Street, Columbia, SC 29201 USA
| | - J. W. Hardin
- />Department of Epidemiology and Biostatistics, University of South Carolina Arnold School of Public Health, 800 Sumter Street, Columbia, SC 29208 USA
| | - S. McDermott
- />Department of Epidemiology and Biostatistics, University of South Carolina Arnold School of Public Health, 800 Sumter Street, Columbia, SC 29208 USA
| | - L. Ouyang
- />Centers for Disease Control and Prevention National Center on Birth Defects and Developmental Disabilities, Atlanta, GA USA
| | - J. R. Mann
- />Department of Family and Preventive Medicine, University of South Carolina School of Medicine, 3209 Colonial Drive, Columbia, SC 29203 USA
| | - O. D. Ozturk
- />Moore School of Business, Department of Economics, University of South Carolina, Columbia, SC 29208 USA
| | - J. Bolen
- />Centers for Disease Control and Prevention National Center on Birth Defects and Developmental Disabilities, Atlanta, GA USA
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Ouyang L, Grosse SD, Riley C, Bolen J, Bishop E, Raspa M, Bailey DB. A comparison of family financial and employment impacts of fragile X syndrome, autism spectrum disorders, and intellectual disability. Res Dev Disabil 2014; 35:1518-27. [PMID: 24755230 PMCID: PMC4491950 DOI: 10.1016/j.ridd.2014.04.009] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/17/2013] [Revised: 03/25/2014] [Accepted: 04/01/2014] [Indexed: 05/17/2023]
Abstract
This study compares the family financial and employment impacts of having a child with fragile X syndrome (FXS), autism spectrum disorder (ASD), or intellectual disabilities (ID). Data from a 2011 national survey of families of children with FXS were matched with data from the National Survey of Children with Special Health Care Needs 2009-2010 to form four analytic groups: children with FXS (n=189), children with special health care needs with ASD only (n=185), ID only (n=177), or both ASD and ID (n=178). Comparable percentages of parents of children with FXS (60%) and parents of children with both ASD and ID (52%) reported that their families experienced a financial burden as a result of the condition, both of which were higher than the percentages of parents of children with ASD only (39%) or ID only (29%). Comparable percentages of parents of children with FXS (40%) and parents of children with both ASD and ID (46%) reported quitting employment because of the condition, both of which were higher than the percentages of parents of children with ID only (25%) or ASD only (25%). In multivariate analyses controlling for co-occurring conditions and functional difficulties and stratified by age, adjusted odds ratios for the FXS group aged 12-17 years were significantly elevated for financial burden (2.73, 95% CI 1.29-5.77), quitting employment (2.58, 95% CI 1.18-5.65) and reduced hours of work (4.34, 95% CI 2.08-9.06) relative to children with ASD only. Among children aged 5-11 years, the adjusted odds ratios for the FXS group were elevated but statistically insignificant for financial burden (1.63, 95% CI 0.85-3.14) and reducing hours of work (1.34, 95% CI 0.68-2.63) relative to children with ASD only. Regardless of condition, co-occurring anxiety or seizures, limits in thinking, reasoning, or learning ability, and more irritability were significantly associated with more caregiver financial and employment impacts. Proper management of anxiety or seizures and functional difficulties of children with FXS or other developmental disabilities may be important in alleviating adverse family caregiver impacts.
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Affiliation(s)
- Lijing Ouyang
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, United States.
| | - Scott D Grosse
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, United States
| | - Catharine Riley
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, United States
| | - Julie Bolen
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, United States
| | - Ellen Bishop
- RTI International, Research Triangle Park, NC, United States
| | - Melissa Raspa
- RTI International, Research Triangle Park, NC, United States
| | - Donald B Bailey
- RTI International, Research Triangle Park, NC, United States
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