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Sullivan PS, DuBose SN, Castel AD, Hoover KW, Juhasz M, Guest JL, Le G, Whitby S, Siegler AJ. Equity of PrEP uptake by race, ethnicity, sex and region in the United States in the first decade of PrEP: a population-based analysis. Lancet Reg Health Am 2024; 33:100738. [PMID: 38659491 PMCID: PMC11041841 DOI: 10.1016/j.lana.2024.100738] [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] [Figures] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 03/25/2024] [Accepted: 03/27/2024] [Indexed: 04/26/2024]
Abstract
Background PrEP was approved for HIV prevention in the US in 2012; uptake has been slow. We describe relative equity with the PrEP Equity Ratio (PER), a ratio of PrEP-to-Need Ratios (PnRs). Methods We used commercial pharmacy data to enumerate PrEP users by race and ethnicity, sex, and US Census region from 2012 to 2021. We report annual race and ethnicity-, sex-, and region-specific rates of PrEP use and PnR, a metric of PrEP equity, to assess trends. Findings PrEP use increased for Black, Hispanic and White Americans from 2012 to 2021. By 2021, the rate of PrEP use per population was similar in Black and White populations but slightly lower among Hispanic populations. PnR increased from 2012 to 2021 for all races and ethnicities and regions; levels of PrEP use were inconsistent across regions and highly inequitable by race, ethnicity, and sex. In all regions, PnR was highest for White and lowest for Black people. Inequity in PrEP use by race and ethnicity, as measured by the PER, grew early after availability of PrEP and persisted at a level substantially below equitable PrEP use. Interpretation From 2012 to 2021, PrEP use increased among Americans, but PrEP equity for Black and Hispanic Americans decreased. The US South lagged all regions in equitable PrEP use. Improved equity in PrEP use will be not only just, but also impactful on the US HIV epidemic; persons most at-risk of acquiring HIV should have the highest levels of access to PrEP. Prevention programs should be guided by PrEP equity, not PrEP equality. Funding National Institutes of Health, Gilead Sciences.
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Affiliation(s)
| | | | - Amanda D. Castel
- The George Washington University Milken Institute School of Public Health, Washington, DC, USA
| | - Karen W. Hoover
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | - Jodie L. Guest
- Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Gordon Le
- Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Shamaya Whitby
- Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Aaron J. Siegler
- Rollins School of Public Health, Emory University, Atlanta, GA, USA
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Tambalis KD, Panagiotakos DB, Sidossis LS. Dietary habits among 177091 Greek schoolchildren by age, sex, weight status, region, and living area. A cross-sectional study. Hellenic J Cardiol 2024:S1109-9666(24)00079-4. [PMID: 38636777 DOI: 10.1016/j.hjc.2024.04.004] [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: 02/05/2024] [Revised: 03/19/2024] [Accepted: 04/13/2024] [Indexed: 04/20/2024] Open
Abstract
BACKGROUND This study aimed to investigate the dietary habits, from early childhood to adolescence, among participants from all regions of the country and living areas (rural/urban) and to assess potential associations between dietary habits and obesity, in both sexes. METHODS Population data were derived from a cross-sectional, health survey on a representative sample of 177091 children aged 6 to 18 years. Dietary habits were considered via a self-completed questionnaire (KIDMED index). Trained investigators assessed anthropometric data. RESULTS KIDMED scores were 6.7±2.4 and 6.8±2.3 for boys and girls, respectively, while a percentage of almost 10% of the total study population had insufficient dietary habits. Dietary habits peaked around age 11 and then gradually worsened until the end of adolescence, among both sexes, with an annual trend equal to -0.28±0.02 (p<0.001), for boys and 0.31±0.03, (p<0.001), for girls. Overweight/obese schoolchildren presented higher percentages in all unhealthy dietary habits (e.g. skipping breakfast, going often to a fast-food restaurant, and consuming a lot of sweets) than normal-weight ones (all p-values<0.001). Dietary habits did not noteworthy differ by area of living, i.e. urban versus rural, of participants, in both sexes. Also, no noticeable differences in the values of the KIDMED index were found among all regions of Greece, with the highest values in Attica and Crete, in both sexes. CONCLUSIONS As Greek schoolchildren do not fully adopt the traditional cardio-protective Mediterranean diet, it could be helpful to provide certain recommendations, especially for adolescents, to decrease the risk for future adverse health consequences.
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Affiliation(s)
- Konstantinos D Tambalis
- Department of Physical Education and Sport Science, National and Kapodistrian University of Athens, Greece.
| | - Demosthenes B Panagiotakos
- Department of Nutrition and Dietetics, School of Health Science & Education, Harokopio University, Athens, Greece
| | - Labros S Sidossis
- Department of Kinesiology and Health, Rutgers University, New Brunswick, NJ 08901, USA
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Zhao YC, Sun ZH, Xiao MX, Li JK, Liu HY, Cai HL, Cao W, Feng Y, Zhang BK, Yan M. Analyzing the correlation between quinolone-resistant Escherichia coli resistance rates and climate factors: A comprehensive analysis across 31 Chinese provinces. Environ Res 2024; 245:117995. [PMID: 38145731 DOI: 10.1016/j.envres.2023.117995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Revised: 11/27/2023] [Accepted: 12/18/2023] [Indexed: 12/27/2023]
Abstract
BACKGROUND The increasing problem of bacterial resistance, particularly with quinolone-resistant Escherichia coli (QnR eco) poses a serious global health issue. METHODS We collected data on QnR eco resistance rates and detection frequencies from 2014 to 2021 via the China Antimicrobial Resistance Surveillance System, complemented by meteorological and socioeconomic data from the China Statistical Yearbook and the China Meteorological Data Service Centre (CMDC). Comprehensive nonparametric testing and multivariate regression models were used in the analysis. RESULT Our analysis revealed significant regional differences in QnR eco resistance and detection rates across China. Along the Hu Huanyong Line, resistance rates varied markedly: 49.35 in the northwest, 54.40 on the line, and 52.30 in the southeast (P = 0.001). Detection rates also showed significant geographical variation, with notable differences between regions (P < 0.001). Climate types influenced these rates, with significant variability observed across different climates (P < 0.001). Our predictive model for resistance rates, integrating climate and healthcare factors, explained 64.1% of the variance (adjusted R-squared = 0.641). For detection rates, the model accounted for 19.2% of the variance, highlighting the impact of environmental and healthcare influences. CONCLUSION The study found higher resistance rates in warmer, monsoon climates and areas with more public health facilities, but lower rates in cooler, mountainous, or continental climates with more rainfall. This highlights the strong impact of climate on antibiotic resistance. Meanwhile, the predictive model effectively forecasts these resistance rates using China's diverse climate data. This is crucial for public health strategies and helps policymakers and healthcare practitioners tailor their approaches to antibiotic resistance based on local environmental conditions. These insights emphasize the importance of considering regional climates in managing antibiotic resistance.
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Affiliation(s)
- Yi-Chang Zhao
- The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, PR China; Department of Pharmacy, The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, PR China; International Research Center for Precision Medicine, Transformative Technology and Software Services, Hunan, PR China
| | - Zhi-Hua Sun
- International Research Center for Precision Medicine, Transformative Technology and Software Services, Hunan, PR China; China Pharmaceutical University, Nanjing, Jiangsu, 210009, PR China
| | - Ming-Xuan Xiao
- International Research Center for Precision Medicine, Transformative Technology and Software Services, Hunan, PR China; China Pharmaceutical University, Nanjing, Jiangsu, 210009, PR China
| | - Jia-Kai Li
- The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, PR China; Department of Pharmacy, The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, PR China; International Research Center for Precision Medicine, Transformative Technology and Software Services, Hunan, PR China
| | - Huai-Yuan Liu
- International Research Center for Precision Medicine, Transformative Technology and Software Services, Hunan, PR China; China Pharmaceutical University, Nanjing, Jiangsu, 210009, PR China
| | - Hua-Lin Cai
- The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, PR China; Department of Pharmacy, The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, PR China; International Research Center for Precision Medicine, Transformative Technology and Software Services, Hunan, PR China
| | - Wei Cao
- The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, PR China; Department of Medical Laboratory, The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, PR China
| | - Yu Feng
- China Pharmaceutical University, Nanjing, Jiangsu, 210009, PR China
| | - Bi-Kui Zhang
- The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, PR China; Department of Pharmacy, The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, PR China; International Research Center for Precision Medicine, Transformative Technology and Software Services, Hunan, PR China.
| | - Miao Yan
- The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, PR China; Department of Pharmacy, The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, PR China; International Research Center for Precision Medicine, Transformative Technology and Software Services, Hunan, PR China.
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Jung YS, Kim YE, Ock M, Yoon SJ. Trends in Healthy Life Expectancy (HALE) and Disparities by Income and Region in Korea (2008-2020): Analysis of a Nationwide Claims Database. J Korean Med Sci 2024; 39:e46. [PMID: 38374624 PMCID: PMC10876431 DOI: 10.3346/jkms.2024.39.e46] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 12/06/2023] [Indexed: 02/21/2024] Open
Abstract
BACKGROUND Healthy life expectancy is a well-recognized indicator for establishing health policy goals used in Korea's Health Plan. This study aimed to explore Koreans' healthy life expectancy and its gender, income, and regional disparities from 2008 to 2020. METHODS This study was conducted on the entire population covered by health insurance and medical aid program in Korea. The incidence-based "years lived with disability" for 260 disease groups by gender, income level, and region was calculated employing the methodology developed in the Korean National Burden of Disease Study, and it was used as the number of healthy years lost to calculate health-adjusted life expectancy (HALE). RESULTS Koreans' HALE increased from 68.89 years in 2008 to 71.82 years in 2020. Although the gender disparity in HALE had been decreasing, it increased to 4.55 years in 2020. As of 2020, 5.90 years out of 8.67 years of the income disparity (Q5-Q1) in HALE were due to the disparity between Q1 and Q2, the low-income groups. Income and regional disparities in HALE exhibited an increasing trend, and these disparities were higher in men than in women. CONCLUSION A subgroup with a low health level was identified through the HALE results, and it was confirmed that improving the health level of this population can reduce health inequalities and improve health at the national level. Further exploration of the HALE calculation methodology may help in the development of effective policies such as prioritizing interventions for health risk factors.
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Affiliation(s)
- Yoon-Sun Jung
- Artificial Intelligence and Big-Data Convergence Center, Gil Medical Center, Gachon University College of Medicine, Incheon, Korea
| | - Young-Eun Kim
- Department of Big Data Strategy, National Health Insurance Service, Wonju, Korea
| | - Minsu Ock
- Department of Preventive Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
- Department of Preventive Medicine, University of Ulsan College of Medicine, Seoul, Korea
| | - Seok-Jun Yoon
- Department of Preventive Medicine, Korea University College of Medicine, Seoul, Korea.
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Chidiac O, AlMukdad S, Harfouche M, Harding-Esch E, Abu-Raddad LJ. Epidemiology of gonorrhoea: systematic review, meta-analyses, and meta-regressions, World Health Organization European Region, 1949 to 2021. Euro Surveill 2024; 29:2300226. [PMID: 38426239 PMCID: PMC10986664 DOI: 10.2807/1560-7917.es.2024.29.9.2300226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 11/08/2023] [Indexed: 03/02/2024] Open
Abstract
BackgroundEpidemiology of Neisseria gonorrhoeae (NG) infection remains inadequately understood.AimWe aimed to characterise NG epidemiology in Europe.MethodsWe used Cochrane and PRISMA guidelines to systematically review, report, synthesise and analyse NG prevalence data from 1949 to 30 September 2021. Random-effects meta-analyses estimated pooled prevalence. Meta-regression analyses investigated associations and sources of heterogeneity.ResultsThe 844 included publications yielded 1,573 prevalence measures. Pooled prevalence of current urogenital infection was 1.0% (95% CI: 0.7-1.2%) among general populations, 3.2% (95% CI: 1.8-4.8%) among female sex workers, 4.9% (95% CI: 4.2-5.6%) among sexually transmitted infection clinic attendees and 12.1% (95% CI: 8.8-15.8%) among symptomatic men. Among men who have sex with men, pooled prevalence was 0.9% (95% CI: 0.5-1.4%), 5.6% (95% CI: 3.6-8.1%), and 3.8% (95% CI: 2.5-5.4%), respectively, for current urogenital, anorectal or oropharyngeal infection. Current urogenital, anorectal or oropharyngeal infection was 1.45-fold (95% CI: 1.19-1.77%), 2.75-fold (95% CI: 1.89-4.02%) and 2.64-fold (95% CI: 1.77-3.93%) higher among men than women. Current urogenital infection declined 0.97-fold (95% CI: 0.96-0.98%) yearly, but anorectal and oropharyngeal infection increased (1.02-fold; 95% CI: 1.01-1.04% and 1.02-fold; 95% CI: 1.00-1.04%), respectively.ConclusionsNeisseria gonorrhoeae epidemiology in Europe has distinct and contrasting epidemiologies for vaginal sex transmission in heterosexual sex networks vs anal and oral sex transmission in MSM sexual networks. Increased transmission may facilitate drug-resistant strain emergence. Europe is far from achieving the World Health Organization target of 90% incidence reduction by 2030.
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Affiliation(s)
- Omar Chidiac
- Infectious Disease Epidemiology Group, Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation - Education City, Doha, Qatar
- These authors contributed equally to this work and share first authorship
| | - Sawsan AlMukdad
- Infectious Disease Epidemiology Group, Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation - Education City, Doha, Qatar
- World Health Organization Collaborating Centre for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis, Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation - Education City, Doha, Qatar
- These authors contributed equally to this work and share first authorship
| | - Manale Harfouche
- Infectious Disease Epidemiology Group, Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation - Education City, Doha, Qatar
- World Health Organization Collaborating Centre for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis, Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation - Education City, Doha, Qatar
- These authors contributed equally to this work and share first authorship
| | - Emma Harding-Esch
- Clinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK
| | - Laith J Abu-Raddad
- Infectious Disease Epidemiology Group, Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation - Education City, Doha, Qatar
- World Health Organization Collaborating Centre for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis, Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation - Education City, Doha, Qatar
- Department of Population Health Sciences, Weill Cornell Medicine, Cornell University, New York, New York, USA
- Department of Public Health, College of Health Sciences, QU Health, Qatar University, Doha, Qatar
- College of Health and Life Sciences, Hamad bin Khalifa University, Doha, Qatar
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Rey-Brandariz J, Ruano-Ravina A, Santiago-Pérez MI, Varela-Lema L, Guerra-Tort C, Montes A, Piñeiro M, Rábade C, Pérez-Ríos M. Evolution of smoking prevalence in Spain and its 17 autonomous regions (1987-2020). Med Clin (Barc) 2024:S0025-7753(23)00715-7. [PMID: 38184463 DOI: 10.1016/j.medcli.2023.11.015] [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: 10/06/2023] [Revised: 11/22/2023] [Accepted: 11/28/2023] [Indexed: 01/08/2024]
Abstract
BACKGROUND AND OBJECTIVES Continuous monitoring of smoking prevalence is essential to understand the evolution of the tobacco epidemic in a population. The objective of this study was to analyze the evolution of smoking prevalence in Spain and its 17 Autonomous Regions (ARs) in population ≥15 years during the period 1987-2020. METHODS Tobacco consumption data were derived from the National Health Survey of Spain and the European Health Survey in Spain. A smoker was defined as a person who smoked at the time of the survey. The trend in prevalences by sex in Spain and its ARs was analyzed by applying joinpoint models. Age-standardized prevalences were calculated for Spain by applying the direct method. RESULTS In Spain, the prevalence of consumption decreased 29 percentage points in men and 4.5 in women between 1987-2020. In men, the smoking prevalence decreased in all the ARs and the absolute change varied between -19.5% in the Balearic Islands and -33.9% in Andalusia. In women, the evolution of smoking prevalence differed between ARs. The absolute change varied between -15.4% in Basque Country and 0.5% in Andalusia. CONCLUSIONS The number of men and women smokers has decreased in Spain between 1987-2020. Different patterns of evolution of the prevalence of consumption are observed among the ARs, especially among women. This reinforces the need for policies adapted to more local contexts and that take into account the gender perspective.
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Affiliation(s)
- Julia Rey-Brandariz
- Área de Medicina Preventiva y Salud Pública, Universidade de Santiago de Compostela, Santiago de Compostela, A Coruña, España; CIBER en Epidemiología y Salud Pública/CIBERESP, España
| | - Alberto Ruano-Ravina
- Área de Medicina Preventiva y Salud Pública, Universidade de Santiago de Compostela, Santiago de Compostela, A Coruña, España; CIBER en Epidemiología y Salud Pública/CIBERESP, España; Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), Santiago de Compostela, A Coruña, España
| | - María Isolina Santiago-Pérez
- Servicio de Epidemiología, Dirección General de Salud Pública, Xunta de Galicia, Santiago de Compostela, A Coruña, España
| | - Leonor Varela-Lema
- Área de Medicina Preventiva y Salud Pública, Universidade de Santiago de Compostela, Santiago de Compostela, A Coruña, España; CIBER en Epidemiología y Salud Pública/CIBERESP, España; Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), Santiago de Compostela, A Coruña, España.
| | - Carla Guerra-Tort
- Área de Medicina Preventiva y Salud Pública, Universidade de Santiago de Compostela, Santiago de Compostela, A Coruña, España
| | - Agustín Montes
- Área de Medicina Preventiva y Salud Pública, Universidade de Santiago de Compostela, Santiago de Compostela, A Coruña, España; CIBER en Epidemiología y Salud Pública/CIBERESP, España; Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), Santiago de Compostela, A Coruña, España
| | - María Piñeiro
- CIBER en Epidemiología y Salud Pública/CIBERESP, España; Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), Santiago de Compostela, A Coruña, España
| | - Carlos Rábade
- Servicio de Neumología. Complejo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, A Coruña, España
| | - Mónica Pérez-Ríos
- Área de Medicina Preventiva y Salud Pública, Universidade de Santiago de Compostela, Santiago de Compostela, A Coruña, España; CIBER en Epidemiología y Salud Pública/CIBERESP, España; Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), Santiago de Compostela, A Coruña, España
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Rhubart D, Santos A. Research Note Showing That the Rural Mortality Penalty Varies by Region, Race, and Ethnicity in the United States, 1999-2016. Demography 2023; 60:1699-1709. [PMID: 38015809 PMCID: PMC10796192 DOI: 10.1215/00703370-11078239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2023]
Abstract
This research note presents a new perspective on the rural mortality penalty in the United States. While previous work has documented a growing rural mortality penalty, there has been a lack of attention to heterogeneity in trends at the intersection of region, race, and ethnicity. We use age-adjusted mortality rates from the Centers for Disease Control and Prevention to examine the rural mortality penalty by region, race, and ethnicity for 1999-2016 (N = 44,792,050 deaths) and stratify by 2006 National Center for Health Statistics metropolitan-nonmetropolitan classifications. We find substantial variation at the intersection of region, race, and ethnicity, revealing heterogeneity in the rural penalty and-in some cases-a rural mortality advantage. For the Black/African American population, the rural mortality penalty is observed only in the South. On the other hand, for Hispanic/Latino populations, a small but persistent rural mortality penalty is present only in the South and the West. There is a rural mortality penalty in all regions for White and American Indian/Alaska Native populations. However, for the latter, there is substantial variation in the magnitude of the penalty by region of residence. This research documents heterogeneous patterns when the rural mortality penalty is analyzed by region, race, and ethnicity in the United States.
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Affiliation(s)
- Danielle Rhubart
- Department of Biobehavioral Health, The Pennsylvania State University, State College, PA, USA
| | - Alexis Santos
- Department of Human Development and Family Studies, The Pennsylvania State University, State College, PA, USA
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Pinki F, Costello DA, Stewart G. Regional investigation of UT-B urea transporters in the rat brain. Biochem Biophys Rep 2023; 36:101563. [PMID: 37929290 PMCID: PMC10624589 DOI: 10.1016/j.bbrep.2023.101563] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Revised: 10/16/2023] [Accepted: 10/19/2023] [Indexed: 11/07/2023] Open
Abstract
Recent studies have reported increased levels of urea in the aging brain and various neurological disorders. Additionally, these diseased tissues also have increased expression of the UT-B transporter that regulates urea transport in the brain. However, little is known regarding the actual UT-B protein distribution across the brain in either normal or diseased states. This current study investigated UT-B protein abundance across three regions of the rat brain - anterior, posterior and cerebellum. Endpoint RT-PCR experiments showed that there were no regional differences in UT-B RNA expression (NS, N = 3, ANOVA), whilst Western blotting confirmed no difference in the abundance of a 35 kDa UT-B protein (NS, N = 3-4, ANOVA). In contrast, there was a significant variation in a non-UT-B 100 kDa protein (P < 0.001, N = 3-4, ANOVA), which was also detected by anti-UT-B antibodies. Using the C6 rat astrocyte cell line, Western blot analysis showed that 48-h incubation in either 5 mM or 10 mM significantly increased a 30-45 kDa UT-B protein signal (P < 0.05, N = 3, ANOVA). Furthermore, investigation of compartmentalized C6 protein samples showed the 30-45 kDa signal in the membrane fraction, whilst the 100 kDa non-UT-B signal was predominantly in the cytosolic fraction. Finally, immunolocalization studies gave surprisingly weak detection of rat UT-B, except for strong staining of red blood cells in the cerebellum. In conclusion, this study confirmed that RNA expression and protein abundance of UT-B were equal across all regions of the rat brain, suggesting that urea levels were also similar. However, it also highlighted some of the technical challenges of studying urea transporters at the protein level.
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Affiliation(s)
- Farhana Pinki
- UCD School of Biology and Environmental Science, University College Dublin, Dublin 4, Ireland
| | - Derek A Costello
- UCD School of Biomolecular and Biomedical Science, University College Dublin, Dublin 4, Ireland
- UCD Conway Institute, University College Dublin, Dublin 4, Ireland
| | - Gavin Stewart
- UCD School of Biology and Environmental Science, University College Dublin, Dublin 4, Ireland
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Erhardsson M, Ljung Faxén U, Venkateshvaran A, Svedlund S, Saraste A, Lagerström Fermer M, Gan L, Shah SJ, Tromp J, SP Lam C, Lund LH, Hage C. Regional differences and coronary microvascular dysfunction in heart failure with preserved ejection fraction. ESC Heart Fail 2023; 10:3729-3734. [PMID: 37920127 PMCID: PMC10682847 DOI: 10.1002/ehf2.14569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Revised: 09/05/2023] [Accepted: 10/02/2023] [Indexed: 11/04/2023] Open
Abstract
AIMS In heart failure with preserved ejection fraction (HFpEF), regional heterogeneity of clinical phenotypes is increasingly recognized, with coronary microvascular dysfunction (CMD) potentially being a common shared feature. We sought to determine the regional differences in clinical characteristics and prevalence of CMD in HFpEF. METHODS AND RESULTS We analysed clinical characteristics and CMD in 202 patients with stable HFpEF (left ventricular ejection fraction ≥40%) in Finland, Singapore, Sweden, and United States in the multicentre PROMIS-HFpEF study. Patients with unrevascularized macrovascular coronary artery disease were excluded. CMD was assessed using Doppler echocardiography and defined as coronary flow reserve (adenosine-induced vs. resting flow) < 2.5. Patients from Singapore had the lowest body mass index yet highest prevalence of hypertension, dyslipidaemia, and diabetes; patients from Finland and Sweden were oldest, with the most atrial fibrillation, chronic kidney disease, and high smoking rates; and those from United States were youngest and most obese. The prevalence of CMD was 88% in Finland, 80% in Singapore, 77% in Sweden, and 59% in the United States; however, non-significant after adjustment for age, sex, N-terminal pro-brain natriuretic peptide, smoking, left atrial reservoir strain, and atrial fibrillation. Associations between CMD and clinical characteristics did not differ based on region (interaction analysis). CONCLUSIONS Despite regional differences in clinical characteristics, CMD was present in the majority of patients with HFpEF across different regions of the world with the lowest prevalence in the United States. This difference was explained by differences in patient characteristics. CMD could be a common therapeutic target across regions.
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Affiliation(s)
- Mikael Erhardsson
- Department of Medicine, Cardiology UnitKarolinska InstitutetStockholmSweden
| | - Ulrika Ljung Faxén
- Department of Medicine, Cardiology UnitKarolinska InstitutetStockholmSweden
- Karolinska University Hospital, Perioperative Medicine and Intensive CareStockholmSweden
| | | | - Sara Svedlund
- Department of Clinical Physiology, Institute of Medicine, Sahlgrenska University HospitalUniversity of GothenburgGothenburgSweden
| | - Antti Saraste
- Heart CenterTurku University Hospital, University of TurkuTurkuFinland
| | | | - Li‐Ming Gan
- Ribocure Pharmaceuticals AB, Sweden, Suzhou Ribo Life Science Co. Ltd.China
- Department of Cardiology, Department of Molecular and Clinical Medicine, Institute of MedicineSahlgrenska Academy at the University of GothenburgGothenburgSweden
| | - Sanjiv J. Shah
- Division of Cardiology, Department of MedicineNorthwestern University Feinberg School of MedicineChicagoILUSA
| | - Jasper Tromp
- Saw Swee Hock School of Public HealthNational University of Singapore & the National University Health SystemSingaporeSingapore
- Duke‐NUS Medical SchoolSingaporeSingapore
- National Heart Centre Singapore, Duke‐National University of SingaporeSingaporeSingapore
| | - Carolyn SP Lam
- National Heart Centre Singapore, Duke‐National University of SingaporeSingaporeSingapore
- University Medical Centre GroningenGroningenthe Netherlands
| | - Lars H. Lund
- Department of Medicine, Cardiology UnitKarolinska InstitutetStockholmSweden
- Karolinska University Hospital, Heart and Vascular ThemeStockholmSweden
| | - Camilla Hage
- Department of Medicine, Cardiology UnitKarolinska InstitutetStockholmSweden
- Karolinska University Hospital, Heart and Vascular ThemeStockholmSweden
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Orfali SM, Alrumikhan AS, Assal NA, Alrusayes AM, Natto ZS. Prevalence and severity of dental caries in school children in Saudi Arabia: A nationwide cross-sectional study. Saudi Dent J 2023; 35:969-974. [PMID: 38107051 PMCID: PMC10724354 DOI: 10.1016/j.sdentj.2023.09.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Revised: 09/18/2023] [Accepted: 09/19/2023] [Indexed: 12/19/2023] Open
Abstract
Aim This nationwide study assessed the prevalence and severity of dental caries in 6-, 12-, and 15-year-old school children across Saudi Arabia. This study examined differences between genders and among regions regarding the mean values of decayed, missing, and filled teeth (dmft/DMFT), the care index (CI), and the significant caries index (SiC index). Materials and methods Data from 19,870 participants, 10,435 males and 9435 females, were collected using stratified multistage cluster random sampling. The survey team divided Saudi Arabia into five regions (northern, eastern, western, southern, and middle). To represent each respective region, a large city, two random towns (peri-urban), and four random rural areas were selected for surveying. Lastly, the sampling technique was applied by choosing random schools and random classes within the selected schools. Dental caries were assessed using the dmft/DMFT score, CI, and the top 30% and 10% of the sample dmft/DMFT scores (SiC30 and SiC10, respectively). Results The overall prevalence of caries was 65.6%, with 72.1 occurring in primary teeth and 61.7% in permanent teeth. The percentages of individuals with missing teeth and filled teeth were 9.0% and 20.5%, respectively. The mean dmft was 3.93 ± 3.60, while the mean DMFT was 2.42 ± 2.52; most of the DMFT components were significantly higher in females than males, while the dmft components were higher in males. The northern region had the highest and worst DMFT/dmft ratios of the five regions. The mean SiC30 and SiC10 values were significantly higher than the overall average DMFT/dmft values (P < 0.001). Conclusion Dental caries remain a public health challenge among school children in Saudi Arabia. The SiC and CI analysis indicated that caries management had a high overall efficacy, but that certain groups of the population may need targeted management in the future.
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Affiliation(s)
- Saud M. Orfali
- Therapeutic service agency, General director of Dentistry, Ministry of Health, Saudi Arabia
| | | | - Nader A. Assal
- General Directorate of Dentistry, Ministry of Health, Saudi Arabia
| | | | - Zuhair S. Natto
- Department of Dental Public Health, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
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11
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Akçaalan S, Akkaya M, Dogan M, Valdivielso AA, Zeiton MA, Mohammad HR, Sangaletti R, Benazzo F, Kara S, Gehrke T, Citak M. Do age, gender, and region affect tibial slope? A multi-center study. Arch Orthop Trauma Surg 2023; 143:6983-6991. [PMID: 37438581 DOI: 10.1007/s00402-023-04976-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 06/26/2023] [Indexed: 07/14/2023]
Abstract
INTRODUCTION Tibial slope is a parameter that is important to recognize in knee kinematics and knee surgery. A very wide range of values governing posterior tibial slope exist in the literature. This study is based on the hypothesis that age, gender and region may have an effect on the tibial slope. MATERIALS AND METHODS A total of 1800 lateral knee radiographies from five different countries [Turkey, Germany, Italy, Spain, and the United Kingdom (UK)] were utilized to measure the native posterior tibial slope. Participants were categorized in deciles with each decade of age after 40 years determined as a separate age group. Accordingly, four different age categories were formed in total, namely, the 40- to 49-, 50- to 59-, 60-69, and 70- to 79-year-old groups. Patients with severe knee osteoarthritis, those with a history of arthroscopic and open surgery around the knee, and those with severe morbid obesity and those outside the specified age group were excluded from the study. The angle between the line tangential to the medial tibial plateau and the proximal anatomical axis of the tibia was measured. RESULTS The tibial slope values of both males and females in the Turkish population were found to be higher than those in other populations. It was observed that tibial slope values increased with age in females in all populations, except for those in the Spanish and UK populations. In the male population, it was found that tibial slope values increased with age in all populations except in the Spanish population. CONCLUSIONS Region, age, and gender affect tibial slope in different populations in various ways. Our study shows that the region an individual lives in and living conditions affect the tibial slope.
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Affiliation(s)
- Serhat Akçaalan
- Orthopedics and Traumatology Clinics, Kirikkale Yuksek Ihtısas Hospital, Bağlarbaşı, Ahmet Ay Caddesi, 71300, Merkez/Kırıkkale, Turkey.
| | - Mustafa Akkaya
- Orthopedics and Traumatology Department, Ankara Yıldırım Beyazıt University School of Medicine, Ankara, Turkey
| | - Metin Dogan
- Orthopedics and Traumatology Department, Ankara Yıldırım Beyazıt University School of Medicine, Ankara, Turkey
| | - Ainhoa Alvarez Valdivielso
- Orthopaedic Surgery and Traumatology Service, Hospital Universitari Son Espases, Palma de Mallorca, Spain
| | - Moez Asaid Zeiton
- Orthopedics and Traumatology Department, Royal Bolton Hospital, Minerva Rd, Farnworth, Bolton, United Kingdom
| | - Hasan Raza Mohammad
- Orthopedics and Traumatology Department, Royal Bolton Hospital, Minerva Rd, Farnworth, Bolton, United Kingdom
| | - Rudy Sangaletti
- Sezione di Chirurgia Protesica ad Indirizzo Robotico - Unità di Traumatologia dello Sport, U.O.C Ortopedia e Traumatologia, Fondazione Poliambulanza, Via Bissolati 57, 25124, Brescia, Italy
| | - Francesco Benazzo
- Sezione di Chirurgia Protesica ad Indirizzo Robotico - Unità di Traumatologia dello Sport, U.O.C Ortopedia e Traumatologia, Fondazione Poliambulanza, Via Bissolati 57, 25124, Brescia, Italy
- IUSS, Istituto di Studi Superiori, Pavia, Italy
| | - Seher Kara
- Helios ENDO-Klinik, Holstenstr, Hamburg, Germany
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Denke C, Jaschinski U, Riessen R, Bercker S, Spies C, Ragaller M, Weiss M, Dey K, Michalsen A, Briegel J, Pohrt A, Sprung CL, Avidan A, Hartog CS. End-of-life practices in 11 German intensive care units : Results from the ETHICUS-2 study. Med Klin Intensivmed Notfmed 2023; 118:663-673. [PMID: 36169693 PMCID: PMC10624715 DOI: 10.1007/s00063-022-00961-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 08/09/2022] [Accepted: 08/30/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND End-of-life care is common in German intensive care units (ICUs) but little is known about daily practice. OBJECTIVES To study the practice of end-of-life care. METHODS Prospectively planned, secondary analysis comprising the German subset of the worldwide Ethicus‑2 Study (2015-2016) including consecutive ICU patients with limitation of life-sustaining therapy or who died. RESULTS Among 1092 (13.7%) of 7966 patients from 11 multidisciplinary ICUs, 967 (88.6%) had treatment limitations, 92 (8.4%) died with failed CPR, and 33 (3%) with brain death. Among patients with treatment limitations, 22.3% (216/967) patients were discharged alive from the ICU. More patients had treatments withdrawn than withheld (556 [57.5%] vs. 411 [42.5%], p < 0.001). Patients with treatment limitations were older (median 73 years [interquartile range (IQR) 61-80] vs. 68 years [IQR 54-77]) and more had mental decision-making capacity (12.9 vs. 0.8%), advance directives (28.6 vs. 11.2%), and information about treatment wishes (82.7 vs 33.3%, all p < 0.001). Physicians reported discussing treatment limitations with patients with mental decision-making capacity and families (91.3 and 82.6%, respectively). Patient wishes were unknown in 41.3% of patients. The major reason for decision-making was unresponsiveness to maximal therapy (34.6%). CONCLUSIONS Treatment limitations are common, based on information about patients' wishes and discussion between stakeholders, patients and families. However, our findings suggest that treatment preferences of nearly half the patients remain unknown which affects guidance for treatment decisions.
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Affiliation(s)
- C Denke
- Department of Anaesthesiology and Operative Intensive Care Medicine, Charité Universitätsmedizin Berlin, Campus Virchow, Berlin, Germany
| | - U Jaschinski
- Department of Anesthesiology and Critical Care, Medicine, University Hospital Augsburg, Augsburg, Germany
| | - R Riessen
- Department of Internal Medicine, Medical Intensive Care Unit, Universitätsklinikum Tübingen, Tübingen, Germany
| | - S Bercker
- Department of Anaesthesiology and Intensive, Care, University of Leipzig Medical Centre, Leipzig, Germany
| | - C Spies
- Department of Anaesthesiology and Operative Intensive Care Medicine, Charité Universitätsmedizin Berlin, Campus Virchow, Berlin, Germany
| | - M Ragaller
- Technical University Dresden, Department, of Anesthesiology and Intensive Care Medicine, Universitätsklinikum Carl Gustav Carus, Dresden, Germany
| | - M Weiss
- Klinik für Anästhesiologie und Intensivmedizin, Universitätsklinikum Ulm, Ulm, Germany
| | - K Dey
- Department of Anesthesiology and Intensive Care Medicine, Hospital of the Bundeswehr Berlin, Berlin, Germany
| | - A Michalsen
- Department of Anesthesiology, Critical Care, Emergency, Medicine, and Pain Therapy, Konstanz Hospital, Konstanz, Germany
| | - J Briegel
- Klinik für Anästhesiologie, LMU Klinikum München, Munich, Germany
| | - A Pohrt
- Institute of Biometry and Clinical Epidemiology, Charité Universitätsmedizin Berlin, Campus Charité Mitte, Berlin, Germany
| | - C L Sprung
- Department of Anesthesiology, Critical Care and Pain Medicine, Hadassah Medical Organization and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - A Avidan
- Department of Anesthesiology, Critical Care and Pain Medicine, Hadassah Medical Organization and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - C S Hartog
- Klinik Bavaria Kreischa, Kreischa, Germany.
- Department of Anesthesiology and Operative Intensive Care Medicine, Charité Universitätsmedizin Berlin; Campus Charité, Berlin, Germany.
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Monteith LL, Kittel J, Miller C, Schneider AL, Holliday R, Gaeddert LA, Spark T, Brenner LA, Hoffmire CA. Identifying U.S. regions with the highest suicide rates and examining differences in suicide methods among Asian American, Native Hawaiian, and Pacific Islander Veterans. Asian J Psychiatr 2023; 89:103797. [PMID: 37847965 DOI: 10.1016/j.ajp.2023.103797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 09/26/2023] [Accepted: 10/05/2023] [Indexed: 10/19/2023]
Abstract
The suicide rate among Asian American, Native Hawaiian, and Pacific Islander (AANHPI) Veterans increased from 2001 to 2020. Identifying regions where suicide rates are elevated and increasing among AANHPI Veterans would inform targeted prevention efforts for members of this cohort. We conducted a population-based retrospective cohort study of 377,833 AANHPI Veterans to examine suicide rates and methods (2005-2019) by United States (US) region and over time (2005-2009, 2010-2014, 2015-2019), using US Veteran Eligibility Trends and Statistics and Joint DoD/VA Mortality Data Repository data. AANHPI Veterans across most regions experienced increases in suicide rates from the earliest to latest period; however, patterns differed by region. Age-adjusted suicide rates increased across all three periods among those in the Northeast and West, but increased, then declined in the Midwest and South. In 2015-2019, the age-adjusted suicide rate among AANHPI Veterans was highest in the Northeast (42.0 per 100,000) and lowest in the West (27.5). However, the highest percentages of AANHPI Veteran suicide deaths in 2005-2019 occurred in the West (39.5%) and South (34.7%), with lower percentages in the Midwest (15.0%) and Northeast (10.8%). Across regions, those ages 18-34 had the highest suicide rates. Firearms were the most frequently used suicide method across regions (44.4%-60.2%), except the Northeast (35.2%), where suffocation was more common (38.3%). Results suggest particular needs for suicide prevention efforts among AANHPI Veterans in the Northeast and to ensure that lethal means safety initiatives for AANHPI Veterans encompass both firearms and suffocation, with some variations in emphasis across regions.
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Affiliation(s)
- Lindsey L Monteith
- VA Rocky Mountain Mental Illness Research, Education and Clinical Center for Suicide Prevention, 1700 North Wheeling St., Aurora, CO 80045, USA; Department of Physical Medicine and Rehabilitation, University of Colorado Anschutz Medical Campus, 12631 E 17th Ave, Aurora, CO 80045, USA; Department of Psychiatry, University of Colorado Anschutz Medical Campus, 1890 N Revere Ct, Suite 4003, Mail Stop F546, Aurora, CO 80045, USA; Firearm Injury Prevention Initiative, 12401 East 17th Avenue, 7th Floor, Aurora, CO 80045, USA.
| | - Julie Kittel
- VA Rocky Mountain Mental Illness Research, Education and Clinical Center for Suicide Prevention, 1700 North Wheeling St., Aurora, CO 80045, USA; Department of Physical Medicine and Rehabilitation, University of Colorado Anschutz Medical Campus, 12631 E 17th Ave, Aurora, CO 80045, USA
| | - Christin Miller
- VA Rocky Mountain Mental Illness Research, Education and Clinical Center for Suicide Prevention, 1700 North Wheeling St., Aurora, CO 80045, USA
| | - Alexandra L Schneider
- VA Rocky Mountain Mental Illness Research, Education and Clinical Center for Suicide Prevention, 1700 North Wheeling St., Aurora, CO 80045, USA
| | - Ryan Holliday
- VA Rocky Mountain Mental Illness Research, Education and Clinical Center for Suicide Prevention, 1700 North Wheeling St., Aurora, CO 80045, USA; Department of Psychiatry, University of Colorado Anschutz Medical Campus, 1890 N Revere Ct, Suite 4003, Mail Stop F546, Aurora, CO 80045, USA
| | - Laurel A Gaeddert
- VA Rocky Mountain Mental Illness Research, Education and Clinical Center for Suicide Prevention, 1700 North Wheeling St., Aurora, CO 80045, USA
| | - Talia Spark
- VA Rocky Mountain Mental Illness Research, Education and Clinical Center for Suicide Prevention, 1700 North Wheeling St., Aurora, CO 80045, USA
| | - Lisa A Brenner
- VA Rocky Mountain Mental Illness Research, Education and Clinical Center for Suicide Prevention, 1700 North Wheeling St., Aurora, CO 80045, USA; Department of Physical Medicine and Rehabilitation, University of Colorado Anschutz Medical Campus, 12631 E 17th Ave, Aurora, CO 80045, USA; Department of Psychiatry, University of Colorado Anschutz Medical Campus, 1890 N Revere Ct, Suite 4003, Mail Stop F546, Aurora, CO 80045, USA
| | - Claire A Hoffmire
- VA Rocky Mountain Mental Illness Research, Education and Clinical Center for Suicide Prevention, 1700 North Wheeling St., Aurora, CO 80045, USA; Department of Physical Medicine and Rehabilitation, University of Colorado Anschutz Medical Campus, 12631 E 17th Ave, Aurora, CO 80045, USA
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Yeboah I, Agyekum MW, Okyere J, Mensah RO, Essiaw MN, Appiah H, Conduah AK, Koduah SNK, Christian AK. Use of any contraceptive method among women in rural communities in the eastern region of Ghana: a cross-sectional study. BMC Public Health 2023; 23:1925. [PMID: 37798705 PMCID: PMC10552324 DOI: 10.1186/s12889-023-16795-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 09/19/2023] [Indexed: 10/07/2023] Open
Abstract
BACKGROUND In Ghana, there is an increase in contraceptive use for traditional and modern methods in rural areas. This study seeks to examine the prevalence and determinants of current use of any contraceptive method among women of reproductive age in the rural Eastern Region of Ghana. METHODS A community-based cross-sectional study was conducted among women of reproductive age in the rural Eastern region of Ghana. A structured questionnaire was used to interview women in rural Lower Manya and Upper Manya Krobo districts of Eastern region who were selected using a simple random sampling technique. The data were analysed using Stata version 16. A Binary logistic regression was used to examine the determinants of current use of any contraceptive use (traditional and modern methods). RESULTS The prevalence of contraceptive use was 27.8%. In the adjusted analysis of binary logistic regression, contraceptive use was significantly lower (aOR = 0.24; 95%CI = 0.10-0.56; p = 0.001) among respondents aged 41-49 years compared to those aged 18-35 years. Contraceptive use was significantly lower among migrants (aOR:0.53; 95%CI:0.28-0.99; p = 0.048) compared with non-migrant. CONCLUSION The prevalence of any contraceptive use among rural women was low. Government and other stakeholders need to create awareness about contraception in the rural areas of Eastern region of Ghana and that would help increase contraceptive methods utilization. In addition, family planning programs should target migrants to design an intervention to increase contraceptive use in rural areas.
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Affiliation(s)
- Isaac Yeboah
- Institute of Work, Employment and Society, University of Professional Studies, Accra, Ghana
| | - Martin Wiredu Agyekum
- Institute for Educational Research and Innovation Studies (IERIS), University of Education, Winneba, Ghana.
| | - Joshua Okyere
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana
| | - Ronald Osei Mensah
- Centre for Languages and Liberal Studies, Takoradi Technical University, Takoradi, Ghana
| | - Mary Naana Essiaw
- Institute of Work, Employment and Society, University of Professional Studies, Accra, Ghana
| | - Hilda Appiah
- Institute of Work, Employment and Society, University of Professional Studies, Accra, Ghana
| | - Andrew Kweku Conduah
- Institute of Work, Employment and Society, University of Professional Studies, Accra, Ghana
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15
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Scheipner L, Cano Garcia C, Barletta F, Incesu RB, Morra S, Baudo A, Assad A, Tian Z, Saad F, Shariat SF, Chun FKH, Briganti A, Tilki D, Longo N, Carmignani L, Leitsmann M, Ahyai S, Karakiewicz PI. Regional differences in penile cancer patient characteristics and treatment rates across the United States. Cancer Epidemiol 2023; 86:102424. [PMID: 37506474 DOI: 10.1016/j.canep.2023.102424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 06/30/2023] [Accepted: 07/09/2023] [Indexed: 07/30/2023]
Abstract
INTRODUCTION We tested for regional-specific differences in patient, tumor and treatment characteristics as well as cancer-specific mortality (CSM) of squamous cell carcinoma of the penis (SCCP) patients, across the Surveillance, Epidemiology, and End Results (SEER) registries. METHODS The SEER database (2000-2018) was used to tabulate patient (age at diagnosis, race/ethnicity), tumor (stage, grade, N-stage) and treatment characteristics (proportions of primary tumor surgery, local lymph node surgery, systemic therapy), according to 12 SEER registries. Multinomial regression models, as well as multivariable Cox regression models tested for CSM differences, adjusting for patient, tumor and treatment characteristics. RESULTS In 5395 SCCP patients, registry-specific patient counts ranged from 2060 (38 %) to 64 (1 %). Differences across registries existed for race/ethnicity, stage, grade and N-stage. Additionally, in stage I-II SCCP patients, proportions of local tumor destruction (LTD) ranged from 19 % to 39 % and from 33 % to 61 % for partial penectomy. In stage III-IV SCCP patients, proportions of partial penectomy ranged from 40 % to 59 % and from 17 % to 50 % for radical penectomy. Local lymph node surgery ranged from 8 % to 24 % and proportions of systemic therapy ranged from 3 % to 14 %. Significant inter-registry differences remained, after adjustment for treatment proportions. Unadjusted five-year CSM ranged from 19 % to 32 %. In multivariable analyses, one registry exhibited significantly higher CSM (SEER registry 10, Hazard Ratio [HR] 1.48), relative to the largest reference registry (SEER registry 1, n = 2060). CONCLUSION Important regional differences including patient, tumor and treatment characteristics exist for SCCP patients across SEER registries. After multivariable adjustment, no differences in CSM were recorded, with the exception of one registry.
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Affiliation(s)
- Lukas Scheipner
- Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada; Department of Urology, Medical University of Graz, Graz, Austria.
| | - Cristina Cano Garcia
- Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada; Department of Urology, University Hospital Frankfurt, Goethe University Frankfurt am Main, Frankfurt am Main, Germany
| | - Francesco Barletta
- Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada; Unit of Urology/Division of Oncology, Gianfranco Soldera Prostate Cancer Lab, IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
| | - Reha-Baris Incesu
- Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada; Martini-Klinik Prostate Cancer Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany
| | - Simone Morra
- Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada; Department of Neurosciences, Science of Reproduction and Odontostomatology, University of Naples Federico II, 80131 Naples, Italy
| | - Andrea Baudo
- Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada; Department of Urology, IRCCS Policlinico San Donato, Milan, Italy
| | - Anis Assad
- Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada
| | - Zhe Tian
- Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada
| | - Fred Saad
- Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada
| | - Shahrokh F Shariat
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; Department of Urology, Weill Cornell Medical College, New York, NY, USA; Department of Urology, University of Texas Southwestern, Dallas, TX, USA; Hourani Center for Applied Scientific Research, Al-Ahliyya Amman University, Amman, Jordan
| | - Felix K H Chun
- Department of Urology, University Hospital Frankfurt, Goethe University Frankfurt am Main, Frankfurt am Main, Germany
| | - Alberto Briganti
- Unit of Urology/Division of Oncology, Gianfranco Soldera Prostate Cancer Lab, IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
| | - Derya Tilki
- Martini-Klinik Prostate Cancer Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany; Department of Urology, University Hospital Hamburg-Eppendorf, Hamburg, Germany; Department of Urology, Koc University Hospital, Istanbul, Turkey
| | - Nicola Longo
- Department of Neurosciences, Science of Reproduction and Odontostomatology, University of Naples Federico II, 80131 Naples, Italy
| | - Luca Carmignani
- Department of Urology, IRCCS Policlinico San Donato, Milan, Italy; Department of Urology, IRCCS Ospedale Galeazzi - Sant'Ambrogio, Milan, Italy
| | | | - Sascha Ahyai
- Department of Urology, Medical University of Graz, Graz, Austria
| | - Pierre I Karakiewicz
- Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada
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Li L, Ren S, Gao Z. Green through finance: The impact of monetary policy uncertainty on inclusive green growth. Environ Sci Pollut Res Int 2023; 30:99913-99929. [PMID: 37615920 DOI: 10.1007/s11356-023-29076-6] [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] [Received: 06/08/2023] [Accepted: 07/27/2023] [Indexed: 08/25/2023]
Abstract
For high-quality development, inclusive green growth (IGG) is a crucial strategic option. Given the deceleration in economic growth, monetary policy has several obligations, including stabilizing growth, changing structure, and mitigating risks. However, frequent revisions of monetary policy may diminish its regulatory efficacy due to resulting uncertainty. Accordingly, this study reveals the mechanism of the impact of monetary policy uncertainty (MPU) on IGG. Research suggests that MPU significantly inhibits IGG in the region, as demonstrated by robustness tests. Mechanism test reveal that MPU inhibits IGG by reducing green finance, ecological innovation, media attention, and employment levels. These four transmission mechanisms all show a masking effect. Additionally, further tests show that under different levels of green finance, ecological innovation, media attention, and employment, the impact of MPU on IGG is nonlinear. Heterogeneity analyses also indicate that the inhibition of MPU is weaker in cities with high scientific and technological progress and local fiscal expenditure. Finally, quantile regression demonstrates that the restraining effect of MPU diminishes before rising. This study contributes to the advancement of MPU research, provides a solid foundation for formulating, modifying, and executing monetary policy, and serves as a valuable resource for promoting IGG.
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Affiliation(s)
- Lianqing Li
- School of Economics and Management, Dalian University of Technology, Dalian, 116024, China
| | - Shuming Ren
- School of Economics and Management, Dalian University of Technology, Dalian, 116024, China.
| | - Zhiyuan Gao
- School of Economics and Management, Beijing Institute of Petrochemical Technology, Beijing, 102617, China
- Development Research Centre of Beijing New Modern Industrial Area, Beijing, 102617, China
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López-López S, Del Pozo-Rubio R, Ortega-Ortega M, Escribano-Sotos F. Catastrophic out-of-pocket payments for dental treatment: regional evidence from Spain. BMC Health Serv Res 2023; 23:784. [PMID: 37480038 PMCID: PMC10362549 DOI: 10.1186/s12913-023-09761-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 06/28/2023] [Indexed: 07/23/2023] Open
Abstract
BACKGROUND To estimate the incidence and concentration of catastrophic out-of-pocket payments for healthcare and dental treatment, by region in Spain (calculated as the proportion of households needing to exceed a given threshold of their income to make these payments) in 2008, 2011 and 2015. METHODS The data analysed were obtained from the Spanish Family Budget Survey reports for the years in question. The study method was that proposed by Wagstaff and van Doorslaer (2003), contrasting payments for dental treatment versus household income and considering thresholds of 10%, 20%, 30% and 40%, thus obtaining incidence rates. In addition, relevant sociodemographic variables were obtained for each household included in the study. RESULTS With some regional heterogeneity, on average 4.75% of Spanish households spend more than 10% of their income on dental treatment, and 1.23% spend more than 40%. Thus, 38.67% of catastrophic out-of-pocket payments for dental services in Spain corresponds to payments at the 10% threshold. This value rises to 55.98% for a threshold of 40%. CONCLUSIONS An important proportion of catastrophic out-of-pocket payments for health care in Spain corresponds to dental treatment, a service that has very limited availability under the Spanish NHS. This finding highlights the need to formulate policies aimed at enhancing dental cover, in order to reduce inequalities in health care and, consequently, enhance the population's quality of life and health status.
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Affiliation(s)
- Samuel López-López
- Castilla-La Mancha Health Services, SESCAM, Cuenca Hospital. C/ Hermandad de Donantes de Sangre, 1. 16.002, Cuenca, Spain.
| | - Raúl Del Pozo-Rubio
- Department of Economic Analysis and Finance, University of Castilla-La Mancha, Avda, Los Alfares, 44, 16.071, Cuenca, Spain
- Research Group On Food, Economy and Society, University of Castilla-La Mancha, Cuenca, Spain
| | - Marta Ortega-Ortega
- Department of Applied and Public Economics and Political Economy, Complutense University of Madrid, Campus de Somosaguas S/N. 28.223, Pozuelo de Alarcón, Madrid, Spain
| | - Francisco Escribano-Sotos
- Research Group On Food, Economy and Society, University of Castilla-La Mancha, Cuenca, Spain
- Department of Economic Analysis and Finance, University of Castilla-La Mancha, Plaza de La Universidad S/N. 02.001, Albacete, Spain
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18
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Fennell G, Jacobson M, Grol-Prokopczyk H. Predictors of Multiwave Opioid Use Among Older American Adults. Innov Aging 2023; 7:igad068. [PMID: 38094934 PMCID: PMC10714904 DOI: 10.1093/geroni/igad068] [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: 02/24/2023] [Indexed: 02/01/2024] Open
Abstract
Background and Objectives Despite limited analgesic benefits, long-term opioid therapy (L-TOT) is common among older adults with chronic pain. Extended opioid use poses a threat to older adults as aging metabolisms retain opioids for longer, increasing the risk of injury, overdose, and other negative health outcomes. In contrast to predictors of general opioid use, predictors of L-TOT in older adults are not well documented. We aimed to identify such predictors using all available data on self-reported opioid use in the Health and Retirement Study. Research Design and Methods Using 5 waves of data, respondents (N = 10,713) aged 51 and older were identified as reporting no opioid use (n = 8,621), a single wave of use (n = 1,410), or multiple waves of use (n = 682). We conducted a multinomial logistic regression to predict both single- and multiwave opioid use relative to no use. Demographic, socioeconomic, geographic, health, and health care-related factors were included in our model. Results Multivariable findings show that, relative to nonusers, both single- and multiwave users were significantly more likely to be younger (relative risk ratio [RRR] = 1.33; RRR = 2.88); report lower household wealth (RRR = 1.47; RRR = 2.88); live in the U.S. Midwest (RRR = 1.29; RRR = 1.56), South (RRR = 1.34; RRR = 1.58), or West (RRR = 1.46; RRR = 2.34); experience interfering pain (RRR = 1.59; RRR = 3.39), back pain (RRR = 1.35; RRR = 1.53), or arthritic pain (RRR = 1.46; RRR = 2.32); and see the doctor frequently (RRR = 1.50; RRR = 2.02). Multiwave users were less likely to be Black (RRR = 0.69) or Hispanic (RRR = 0.45), and less likely to be never married (RRR = 0.52). Discussion and Implications We identified demographic, socioeconomic, geographic, and health care-related predictors of chronic multiyear opioid use. Our focus on individuals taking opioids for this extended duration is novel. Differences in opioid use by geographic region and frequency of doctor visits particularly warrant attention from policy-makers and researchers. We make additional recommendations based on a sensitivity analysis limited to 2016-2020 data.
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Affiliation(s)
- Gillian Fennell
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, California, USA
| | - Mireille Jacobson
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, California, USA
- Schaeffer Center for Health Policy & Economics, University of Southern California, Los Angeles, California, USA
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Merz AA, Kerns JL, Logan R, Gutierrez S, Marshall C, Diamond-Smith N. Contraceptive care in the United States during the COVID-19 pandemic: a social media survey study of contraceptive access, telehealth use and telehealth quality. Contraception 2023:110000. [PMID: 36871620 PMCID: PMC9985539 DOI: 10.1016/j.contraception.2023.110000] [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: 10/09/2022] [Revised: 02/21/2023] [Accepted: 02/27/2023] [Indexed: 03/07/2023]
Abstract
OBJECTIVES To examine demographic, socioeconomic, and regional differences in contraceptive access, differences between telehealth and in-person contraception visits, and telehealth quality in the United States during the COVID-19 pandemic. STUDY DESIGN We surveyed reproductive-age women about contraception visits during the COVID-19 pandemic via social media in July 2020 and January 2021. We used multivariable regression to examine relationships between age, racial/ethnic identity, educational attainment, income, insurance type, region, and COVID-19 related hardship, and ability to obtain a contraceptive appointment, telehealth vs in-person visits, and telehealth quality scores. RESULTS Among 2,031 respondents who answered questions about contraception visits, 1,490 (73.4%) reported any visit, of which 530 (35.6%) were telehealth. In adjusted analyses, lower odds of any visit was associated with Hispanic/Latinx and Mixed race/Other identity (aOR 0.59 [0.37-0.94], aOR 0.36 [0.22-0.59], respectively), the South, Midwest, Northeast (aOR 0.63 [0.47-0.85], aOR 0.64 [0.46-0.90], aOR 0.52 [CI 0.36-0.75], respectively), no insurance (aOR 0.63 [0.43-0.91]), greater COVID-19 hardship (aOR 0.52 [0.31-0.87]), and earlier pandemic timing (January 2021 vs July 2020 aOR 2.14 [1.69-2.70]). Respondents from the Midwest and South had lower odds of telehealth vs in-person care (aOR 0.63 [0.44-0.88], aOR 0.54 [0.40-0.72], respectively). Hispanic/Latinx respondents and those in the Midwest had lower odds of high telehealth quality (aOR 0.37 [0.17-0.80], aOR 0.58 [0.35-0.95], respectively). CONCLUSIONS We found inequities in contraceptive care access, less telehealth use for contraception visits in the South and Midwest, and lower telehealth quality among Hispanic/Latinx people during the COVID-19 pandemic. Future research should focus on telehealth access, quality, and patients' preferences.
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Affiliation(s)
- Allison A Merz
- University of California, San Francisco, Department of Obstetrics, Gynecology and Reproductive Sciences, San Francisco, CA, United States.
| | - Jennifer L Kerns
- University of California, San Francisco, Department of Obstetrics, Gynecology and Reproductive Sciences, San Francisco, CA, United States
| | - Rachel Logan
- University of California, San Francisco, Department of Family and Community Medicine, San Francisco, CA, United States
| | - Sirena Gutierrez
- University of California, San Francisco, Department of Epidemiology and Biostatistics, San Francisco, CA, United States
| | - Cassondra Marshall
- School of Public Health, University of California, Berkeley, Berkeley, CA, United States
| | - Nadia Diamond-Smith
- University of California, San Francisco, Department of Epidemiology and Biostatistics, San Francisco, CA, United States
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20
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Kuo YF, Kwo P, Wong RJ, Singal AK. Impact of COVID-19 on Liver Transplant Activity in the USA: Variation by Etiology and Cirrhosis Complications. J Clin Transl Hepatol 2023; 11:130-135. [PMID: 36406316 PMCID: PMC9647098 DOI: 10.14218/jcth.2022.00129] [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: 03/16/2022] [Revised: 05/17/2022] [Accepted: 07/04/2022] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND AND AIMS The COVID-19 pandemic has impacted the care of patients with liver disease. We examined impact of COVID-19 on liver transplant (LT) activity in the USA. METHODS LT listings in the United Network for Organ Sharing (UNOS) database (April 2018-May 2021) were analyzed to examine the impact of COVID-19 pandemic on the LT activity based on etiology: hepatitis C virus (HCV), alcohol-associated liver disease (ALD), alcoholic hepatitis (AH), and nonalcoholic steatohepatitis (NASH) complications: hepatocellular carcinoma (HCC) and acute-on-chronic liver failure (ACLF) grade 2 or 3) and Model for End-Stage Liver Disease (MELD) score. Joinpoint regression models assessed time trend changes on a log scale. RESULTS Of 23,871 recipients (8,995 in the COVID era, April 2018-February 2020), mean age 52 years, 62% men, 61% Caucasian, 32% ALD, 15% HCC, 30% ACLF grades 2-3, and mean MELD score 20.5), monthly LT changes were a decrease of 3.4% for overall LTs and 22% for HCC after September 2020, and increase of 4.5% for ALD since 11/2020 and 17% since 03/2021 for ACLF grade 2-3. Monthly MELD scores increased by 0.7 and 0.36 after June 2020 for HCV and HCC respectively. CONCLUSIONS The COVID-19 pandemic has impacted LT activity, with a decrease of LTs especially for HCC, and an increase of LTs for ALD and severe ACLF. Strategies are needed to reorganize cirrhosis patients to overcome the aftereffects of COVID-19 pandemic.
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Affiliation(s)
- Yong-Fang Kuo
- Department of Biostatistics, University of Texas Medical Branch, Galveston, TX, USA
- Correspondence to: Ashwani K. Singal, University of South Dakota Sanford, School of Medicine, Avera McKennan University Hospital and Avera Transplant Institute, Sioux Falls, SD 57105, USA. ORCID: https://orcid.org/0000-0003-1207-3998. Tel: +1-605-322-8535 (office) and +1-605-322-5989 (research), Fax: +1-605-322-8536, E-mail: ; Yong-Fang Kuo, University of Texas Medical Branch, Galveston, TX 77755, USA. ORCID: https://orcid.org/0000-0003-1927-0927. Tel: +1-409-772-5276, Fax: +1-409-772-9127, E-mail:
| | - Paul Kwo
- Division of Gastroenterology and Hepatology, Veterans Affairs Palo Alto Healthcare System, Stanford University School of Medicine, Palo Alto, CA, USA
| | - Robert J Wong
- Division of Gastroenterology and Hepatology, Veterans Affairs Palo Alto Healthcare System, Stanford University School of Medicine, Palo Alto, CA, USA
| | - Ashwani K. Singal
- University of South Dakota Sanford, School of Medicine, Vermillion, SD, USA
- Avera Transplant Institute, Sioux Falls, SD, USA
- Correspondence to: Ashwani K. Singal, University of South Dakota Sanford, School of Medicine, Avera McKennan University Hospital and Avera Transplant Institute, Sioux Falls, SD 57105, USA. ORCID: https://orcid.org/0000-0003-1207-3998. Tel: +1-605-322-8535 (office) and +1-605-322-5989 (research), Fax: +1-605-322-8536, E-mail: ; Yong-Fang Kuo, University of Texas Medical Branch, Galveston, TX 77755, USA. ORCID: https://orcid.org/0000-0003-1927-0927. Tel: +1-409-772-5276, Fax: +1-409-772-9127, E-mail:
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21
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Lantos T, Nyári TA. The impact of the COVID-19 pandemic on suicide rates in Hungary: an interrupted time-series analysis. BMC Psychiatry 2022; 22:775. [PMID: 36494787 PMCID: PMC9733003 DOI: 10.1186/s12888-022-04322-2] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 10/18/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND From 2010 to 2019, suicide mortality fell steadily and substantially in Hungary: the declining trend remained stable, and the suicide rate decreased by more than one-third which was remarkable even from an international perspective. However, despite the declining trend, regional inequalities have always characterised the distribution of suicide mortality in Hungary. Following these favourable trends, COVID-19 appeared in Hungary on the 4th of March 2020 which might lead to an increase in suicides. We aimed to investigate this hypothesis in Hungary by gender, age, educational attainment, and region, as well. METHODS To test whether the pandemic changed the declining trend of Hungarian suicide rates, the observed number of suicides during March-December 2020 (pre-vaccination period) was compared with the expected numbers (without the appearance of COVID-19). An interrupted time-series analysis was conducted by negative binomial regression using monthly data from January 2010 to February 2020 (pre-pandemic period). RESULTS Suicide mortality increased significantly compared to the trend during the pre-pandemic period: overall (by 16.7%), among males (18.5%), in the age group 35-49 years (32.8%), and among vocational school graduates (26.1%). Additionally, significant growths in suicide rates were detected in the two regions (Central Hungary and Central Transdanubia) with the lowest COVID mortality rates (by 27.3% and 22.2%, respectively). CONCLUSIONS Our study revealed reversed trend in suicide mortality during the pre-vaccination period compared to the pre-pandemic period in Hungary. There were significant differences in the pattern of suicide rates by gender, age group, educational attainment, and region during the pre-vaccination period in Hungary, which might be attributed to the socio-economic effects of the COVID-19 pandemic. These findings could prove useful in preventive strategies as the identification of groups at higher risk may be important for suicide prevention; however, further investigations are needed to explore the reasons.
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Affiliation(s)
- Tamás Lantos
- Department of Medical Physics and Informatics, Faculty of Medicine, University of Szeged, 9 Korányi alley, 6720, Szeged, Hungary.
| | - Tibor András Nyári
- grid.9008.10000 0001 1016 9625Department of Medical Physics and Informatics, Faculty of Medicine, University of Szeged, 9 Korányi alley, 6720 Szeged, Hungary
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22
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Güttler N. [Counter-Experts: Environment, Activism and the Regional Epistemologies of Social Movements]. NTM 2022; 30:541-567. [PMID: 36251039 PMCID: PMC9700601 DOI: 10.1007/s00048-022-00350-x] [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] [Accepted: 09/20/2022] [Indexed: 06/16/2023]
Abstract
With the demand for "counter-knowledge" in the social movements of the 1970s and 1980s, "counter-experts" became an integral part of politics. In the field of environmental activism, counter-experts were particularly well represented in regions and agglomerations with high levels of industrial pollution. This essay argues that awareness correlated with a mode of knowledge production that was typical for the environmental sciences in the twentieth century. The history of the environmental sciences throughout that period was shaped by regional epistemologies, often emerging in the context of large-scale infrastructural projects. Many counter-experts therefore had strong ties with the field of the environmental sciences. The article traces three influential counter-experts in the Frankfurt Main region by 1980: the pastor Kurt Oeser; scientific green activist Jutta Ditfurth; and the project of a "social natural science" related to the Darmstadt philosopher Gernot Böhme.
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Affiliation(s)
- Nils Güttler
- Institut für Geschichte, Universität Wien, Wien, Österreich.
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23
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Dada OE, Haizel-Cobbina J, Ohonba E, Bukenya GW, Kitonga LM, Sebopelo LA, Nteranya DS, Annor E, Nkansah-Poku KAB, Umutoni A, Akilimali A, Chellunga ES, Awad AK, Djoutsop OM, Kanmounye US, Abu-Bonsrah N. Barriers Encountered Toward Pursuing a Neurosurgical Career: A Cross-Sectional Study Among Medical Students, Interns, and Junior Doctors in Africa. World Neurosurg 2022; 166:e388-e403. [PMID: 35840089 DOI: 10.1016/j.wneu.2022.07.021] [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: 06/08/2022] [Revised: 07/04/2022] [Accepted: 07/05/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND Africa has an increased burden of neurosurgical diseases with an estimate of 1,986,392 neurosurgical cases, 108,824 neurosurgical case capacity, and 1,877,568 case deficits yearly. Literature suggests that about 8420 neurosurgeons are needed to fill this vast gap. The main objective of this study is to elucidate barriers encountered in pursuing neurosurgery training in the African context. METHODS A cross-sectional electronic survey, developed in English and subsequently translated into French, was utilized. This was disseminated among medical students, medical interns, and junior doctors in all 5 African regions. RESULTS A total of 491 responses were received from the following 5 African regions: West Africa (30.5%), East Africa (30.3%), Central Africa (18.1%), North Africa (11.8%), and Southern Africa (9.2%). Of the participants, 55.2% were men and 44.8% were women. Seventy-six percent of respondents were aware of the neurosurgery deficit in Africa. Barriers to pursuing neurosurgery included discouragement from others over lack of an "ideal personality" trait, culture/cultural beliefs as related to gender roles, lack of mentorship, inadequate neurosurgical training opportunities, poor health infrastructure for neurosurgical practice in Africa, poor patient outcomes, and challenges with work/life balance were some of the barriers highlighted to pursuing neurosurgical career on the continent. CONCLUSION Even with its robust population growth, Africa is not producing enough neurosurgeons to meet the demands of the population due to several barriers. Delineating these challenges and barriers represents an important step in developing sustainable mechanisms for recruitment, training, mentorship, and support of burgeoning African neurosurgeons.
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Affiliation(s)
- Olaoluwa Ezekiel Dada
- College of Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria; Research Department, Association of Future African Neurosurgeons, Yaounde, Cameroon.
| | - Joseline Haizel-Cobbina
- Vanderbilt Institute for Global Health, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Efosa Ohonba
- Research Department, Association of Future African Neurosurgeons, Yaounde, Cameroon; Division of Neurosurgery, Groote Schuur Hospital, Cape Town, South Africa
| | - George William Bukenya
- Research Department, Association of Future African Neurosurgeons, Yaounde, Cameroon; Case Western Reserve University, Cleveland, Ohio, USA
| | - Lilian Mwende Kitonga
- Faculty of Health Sciences, School of Medicine, University of Nairobi, Nairobi, Kenya
| | - Lorraine Arabang Sebopelo
- Research Department, Association of Future African Neurosurgeons, Yaounde, Cameroon; Faculty of Medicine, University of Botswana, Gaborone, Botswana
| | - Daniel Safari Nteranya
- Research Department, Association of Future African Neurosurgeons, Yaounde, Cameroon; Faculty of Medicine, Official University of Bukavu, Bukavu, Democratic Republic of the Congo
| | - Eugene Annor
- College of Public Health, East Tennessee State University, Johnson City, Tennessee, USA
| | | | - Alice Umutoni
- Research Department, Association of Future African Neurosurgeons, Yaounde, Cameroon; College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | - Aymar Akilimali
- Faculty of Medicine, Official University of Bukavu, Bukavu, Democratic Republic of the Congo
| | - Edwin Samwel Chellunga
- Research Department, Association of Future African Neurosurgeons, Yaounde, Cameroon; The Benjamin Mkapa Hospital, Dodoma, Tanzania
| | - Ahmed K Awad
- Research Department, Association of Future African Neurosurgeons, Yaounde, Cameroon; Faculty of Medicine, Ain-Shams University, Cairo, Egypt
| | - Olga Mbougo Djoutsop
- Research Department, Association of Future African Neurosurgeons, Yaounde, Cameroon; Faculty of Medicine, Universite Technologique Bel Campus, Kinshasa, DR Congo
| | | | - Nancy Abu-Bonsrah
- Research Department, Association of Future African Neurosurgeons, Yaounde, Cameroon; Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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24
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Nayak A, Matta G, Uniyal DP. Hydrochemical characterization of groundwater quality using chemometric analysis and water quality indices in the foothills of Himalayas. Environ Dev Sustain 2022; 25:1-32. [PMID: 36118735 PMCID: PMC9468253 DOI: 10.1007/s10668-022-02661-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 08/30/2022] [Indexed: 05/28/2023]
Abstract
Groundwater pollution of the watershed is mainly influenced by the multifaceted interactions of natural and anthropogenic process. To analyse the spatial-temporal variation and pollution source identification and apportionment, the dataset was subjected to a globally acknowledged coherent technique using water quality indices and chemometric techniques (principal component analysis (PCA) and cluster analysis. The bulk of the samples tested were below the BIS's permissible levels. Groundwater samples from the pre- and post-monsoon seasons mostly contained the anions HCO- 3 > Cl- > SO2- 4 > NO- 3, while the primary cations were Ca2+ > Mg2+ > Na+ > K+. Groundwater was alkaline and hard at most of the sites. According to hydro-geochemical facies and relationships, Piper diagrams, and principal component analysis, weathering, dissolution, leaching, ion exchange, and evaporation were the key mechanisms influencing groundwater quality. The hydrochemical facies classified the groundwater samples into the Ca-Mg-HCO3 type. For all the sampling locations, PIG was determined to be 0.43, 0.52, 0.47, 0.48, 1.00, and 0.70; respectively. The majority of the test locations fell into the low to medium contamination zone, as determined by the groundwater pollution index (PIG) and contamination index. Three principal components, which together account for 93.8% of the total variance, were identified via PCA. The study's findings confirm the value of these statistical techniques in interpreting and understanding large datasets and offering reliable information to reduce the time and expense of programmes for monitoring and evaluating water quality.
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Affiliation(s)
- Anjali Nayak
- Hydrological Research Lab., Department of Zoology and Environmental Science, Gurukul Kangri (Deemed to Be University), Haridwar, India
| | - Gagan Matta
- Hydrological Research Lab., Department of Zoology and Environmental Science, Gurukul Kangri (Deemed to Be University), Haridwar, India
| | - D. P. Uniyal
- Uttarakhand State Council for Science and Technology, Dehradun, India
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25
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Uddin J, Zhu S, Malla G, Levitan EB, Rolka DB, Long DL, Carson AP. Trends in diagnosed hypertension prevalence by geographic region for older adults with and without diagnosed diabetes, 2005-2017. J Diabetes Complications 2022; 36:108208. [PMID: 35597703 PMCID: PMC10142383 DOI: 10.1016/j.jdiacomp.2022.108208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Revised: 05/02/2022] [Accepted: 05/03/2022] [Indexed: 11/16/2022]
Abstract
Given that the prevalence of hypertension increases with age and is more common among adults with diabetes than those without diabetes, the objective of this study was to examine trends in hypertension prevalence by geographic region among older adults with and without diabetes. Among older adults with diabetes, hypertension prevalence generally increased from 2005 to 2017 across all regions, although the annual percent change was lower from 2011 to 2017 than 2005-2011 for all regions.
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Affiliation(s)
- Jalal Uddin
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, USA.
| | - Sha Zhu
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, USA.
| | - Gargya Malla
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, USA.
| | - Emily B Levitan
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, USA.
| | - Deborah B Rolka
- Division of Diabetes Translation, Centers for Disease Control and Prevention, USA.
| | - D Leann Long
- Department of Biostatistics, University of Alabama at Birmingham, Birmingham, USA.
| | - April P Carson
- Department of Medicine, University of Mississippi Medical Center, Jackson, MS, USA.
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Yun J, Lee Y, Lee HJ. A comparison of health-related quality of life and personal, social, and environmental factors of older adults according to a residential area: a propensity score matching analysis. Qual Life Res 2022; 31:2631-2643. [PMID: 35366760 DOI: 10.1007/s11136-022-03131-0] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/20/2022] [Indexed: 11/26/2022]
Abstract
PURPOSE This study identified individual, social, and environmental factors affecting the health-related quality of life (HRQoL) of older individuals living in urban and non-urban areas of the Republic of Korea and investigated their effects on HRQoL. METHODS A secondary data analysis study was conducted using raw data from Korea's 2017 Community Health Survey. Propensity score matching (PSM) was performed to compare the individual, social, and environmental characteristics of older individuals living in urban and non-urban areas (16,695 and 29,106 individuals, respectively). Statistical analyses were performed using R program 4.0.5. The differences between variables were analyzed using chi-squared and t-tests, whereas factors influencing HRQoL were analyzed using multiple regression analysis. RESULTS Among the individual factors, the living arrangement (p = 0.001, confidence interval [CI] = 0.00-0.02) was an influencing factor in urban areas, whereas it showed no statistical significance in non-urban areas. Moreover, Helping their neighbors (p = 0.001, CI = 0.00-0.01) among the social factors and satisfaction with the living environment (p = 0.011, CI = 0.00-0.02) and with healthcare services (p = 0.047, CI = 0.00-0.01) among the environmental factors were influencing factors in urban areas, whereas they showed no statistical significance in non-urban areas. CONCLUSION Satisfaction with the living environment and with healthcare services was positively associated with HRQoL among older individuals living in urban areas. Therefore, factors associated with regional health inequality should be identified, and health equality sought through the development of local government policies that consider diversity in population composition and health indicators by region.
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Affiliation(s)
- Jungmi Yun
- College of Nursing, Research Institute of Nursing Science, Pusan National University, Yangsan, Republic of Korea
| | - Yeongsuk Lee
- College of Nursing, Catholic University of Pusan, Busan, Republic of Korea
| | - Hyun-Ju Lee
- College of Nursing, Catholic University of Pusan, Busan, Republic of Korea.
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27
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Schielein L, Tizek L, Biedermann T, Zink A. Tick bites in different professions and regions: pooled cross-sectional study in the focus area Bavaria, Germany. BMC Public Health 2022; 22:234. [PMID: 35120477 PMCID: PMC8817479 DOI: 10.1186/s12889-021-12456-3] [Citation(s) in RCA: 1] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 12/21/2021] [Indexed: 12/25/2022] Open
Abstract
Background As the vector-borne diseases tick-borne encephalitis (TBE) and Lyme borreliosis (LB) are common in Germany and transmitted by tick bites, the aim of this study was to assess differences in the number of tick bites in various professions and regions across southern Germany to evaluate the differences in tick-associated risk. Materials and methods The analysis is based on three cross-sectional studies that were conducted in 2016 and 2017 in two real-life settings and in one medical setting in Bavaria. All participants filled in a paper-based questionnaire about their history with tick bites. Only adult participants (≥ 18 years) were included in this study. Results Overall, 3503 individuals (mean age 50.8 ± 15.2 years, median age 53.0 ± 12.2 years, 54.0% female) were included. Of these, 50% worked in an outdoor profession and 56% lived in environs. Around 70% of participants reported at least one previous tick bite. In comparison to indoor workers, forestry workers (OR = 2.50; 95% CI: 1.10–5.68) had the highest risk for a tick bite followed by farmers (OR = 1.22; 95% CI: 1.01–1.47). Furthermore, people living in rural areas (OR = 1.97, 95% CI:1.49–2.59) and environs (OR = 1.98, 95% CI: 1.54–2.55) were twice as likely to have a previous tick bite than people living in urban areas. In general, slightly more tick bites were reported by people living in eastern Bavaria. Conclusion Rising numbers of TBE and LB indicate the need for further prevention strategies, which should focus on outdoor professions with a higher risk and people living in environs and rural areas.
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Affiliation(s)
- Louisa Schielein
- Department of Dermatology and Allergy, Technical University of Munich, School of Medicine, Biedersteiner Strasse 29, 80802, Munich, Germany
| | - Linda Tizek
- Department of Dermatology and Allergy, Technical University of Munich, School of Medicine, Biedersteiner Strasse 29, 80802, Munich, Germany
| | - Tilo Biedermann
- Department of Dermatology and Allergy, Technical University of Munich, School of Medicine, Biedersteiner Strasse 29, 80802, Munich, Germany
| | - Alexander Zink
- Department of Dermatology and Allergy, Technical University of Munich, School of Medicine, Biedersteiner Strasse 29, 80802, Munich, Germany. .,Division of Dermatology and Venereology, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden.
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Zhou S, Jiang Y, Pei W, Liang J, Zhou Z. Prognostic significance of lateral pelvic lymph node dissection for middle-low rectal cancer patients with lateral pelvic lymph node metastasis: a propensity score matching study. BMC Cancer 2022; 22:136. [PMID: 35109810 PMCID: PMC8812196 DOI: 10.1186/s12885-022-09254-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Accepted: 01/28/2022] [Indexed: 11/25/2022] Open
Abstract
Background There is still controversy regarding the clinical value and significance of lateral pelvic lymph node (LPN) dissection (LPND). The present study aimed to investigate whether the addition of LPND to total mesorectal excision (TME) confers survival benefits in rectal cancer patients with clinical lateral pelvic node metastasis (LPNM). Methods From January 2015 to January 2021, a total of 141 rectal cancer patients with clinical evidence of LPNM who underwent TME + LPND were retrospectively analysed and divided into the LPNM group (n = 29) and the non-LPNM group (n = 112). The LPNM group was further subdivided into a high-risk LPNM group (n = 14) and a low-risk LPNM group (n = 15). Propensity score matching (PSM) was performed to minimize selection bias. The primary outcomes of this study were 3-year overall survival (OS) and disease-free survival (DFS). Results Of the 141 patients undergoing LPND, the local recurrence rate of patients with LPNM was significantly higher than that of patients without LPNM both before (27.6% vs. 4.5%, P = 0.001) and after (27.6% vs. 3.4%, P = 0.025) PSM. Multivariate analysis revealed that LPNM was an independent risk factor for not only OS (HR: 3.06; 95% CI, 1.15–8.17; P = 0.025) but also DFS (HR: 2.39; 95% CI, 1.18–4.87; P = 0.016) in patients with LPNM after TME + LPND. When the LPNM group was further subdivided, multivariate logistic regression analysis showed that OS and DFS were significantly better in the low-risk group (obturator/internal iliac artery region and < 2 positive LPNs). Conclusion Even after LPND, LPNM patients have a poor prognosis. Moreover, LPNM is an independent poor prognostic factor affecting OS and DFS after TME + LPND. However, LPND appears to confer survival benefits to specific patients with single LPN involvement in the obturator region or internal iliac vessel region. Furthermore, LPND may have no indication in stage IV patients and should be selected carefully.
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Affiliation(s)
- Sicheng Zhou
- Department of Colorectal Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 17 Panjiayuan South Lane, Chaoyang District, Beijing, 100021, China
| | - Yujuan Jiang
- Department of Colorectal Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 17 Panjiayuan South Lane, Chaoyang District, Beijing, 100021, China
| | - Wei Pei
- Department of Colorectal Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 17 Panjiayuan South Lane, Chaoyang District, Beijing, 100021, China
| | - Jianwei Liang
- Department of Colorectal Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 17 Panjiayuan South Lane, Chaoyang District, Beijing, 100021, China.
| | - Zhixiang Zhou
- Department of Colorectal Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 17 Panjiayuan South Lane, Chaoyang District, Beijing, 100021, China.
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29
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Schofield BJ, Andreani NA, Günther CS, Law GR, McMahon G, Swainson M, Goddard MR. Livestock microbial landscape patterns: Retail poultry microbiomes significantly vary by region and season. Food Microbiol 2022; 101:103878. [PMID: 34579846 PMCID: PMC8494115 DOI: 10.1016/j.fm.2021.103878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 12/18/2020] [Accepted: 08/02/2021] [Indexed: 11/21/2022]
Abstract
Microbes play key roles in animal welfare and food safety but there is little understanding of whether microbiomes associated with livestock vary in space and time. Here we analysed the bacteria associated with the carcasses of the same breed of 28 poultry broiler flocks at different stages of processing across two climatically similar UK regions over two seasons with 16S metabarcode DNA sequencing. Numbers of taxa types did not differ by region, but did by season (P = 1.2 × 10-19), and numbers increased with factory processing, especially in summer. There was also a significant (P < 1 × 10-4) difference in the presences and abundances of taxa types by season, region and factory processing stage, and the signal for seasonal and regional differences remained highly significant on final retail products. This study therefore revealed that both season and region influence the types and abundances of taxa on retail poultry products. That poultry microbiomes differ in space and time should be considered when testing the efficacy of microbial management interventions designed to increase animal welfare and food safety: these may have differential effects on livestock depending on location and timing.
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Affiliation(s)
- B J Schofield
- School of Life Sciences, University of Lincoln, Lincolnshire, United Kingdom
| | - N A Andreani
- School of Life Sciences, University of Lincoln, Lincolnshire, United Kingdom
| | - C S Günther
- School of Life Sciences, University of Lincoln, Lincolnshire, United Kingdom
| | - G R Law
- School of Health and Social Care, University of Lincoln, Lincolnshire, United Kingdom
| | - G McMahon
- Moy Park Ltd., Craigavon, Co. Armagh, United Kingdom
| | - M Swainson
- National Centre for Food Manufacturing, University of Lincoln, Lincolnshire, United Kingdom
| | - M R Goddard
- School of Life Sciences, University of Lincoln, Lincolnshire, United Kingdom.
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Ueno S, Hayano D, Noguchi E, Aruga T. Investigating age and regional effects on the relation between the incidence of heat-related ambulance transport and daily maximum temperature or WBGT. Environ Health Prev Med 2021; 26:116. [PMID: 34893022 PMCID: PMC8903699 DOI: 10.1186/s12199-021-01034-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 11/10/2021] [Indexed: 11/16/2022] Open
Abstract
Background Although age and regional climate are considered to have effects on the incidence ratio of heat-related illness, quantitative estimation of age or region on the effect of occurring temperature for heat stroke is limited. Methods By utilizing data on the number of daily heat-related ambulance transport (HAT) in each of three age groups (7–17, 18–64, 65 years old, or older) and 47 prefectures in Japan, and daily maximum temperature (DMT) or Wet Bulb Globe Temperature (DMW) of each prefecture for the summer season, the effects of age and region on heat-related illness were studied. Two-way ANOVA was used to analyze the significance of the effect of age and 10 regions in Japan on HAT. The population-weighted average of DMT or DMW measured at weather stations in each prefecture was used as DMT or DMW for each prefecture. DMT or DMW when HAT is one in 100,000 people (T1 and W1, respectively) was calculated for each age category and prefecture as an indicator of heat acclimatization. The relation between T1 or W1 and average DMT or DMW of each age category and prefecture were also analyzed. Results HAT of each age category and prefecture was plotted nearly on the exponential function of corresponding DMT or DMW. Average R2 of the regression function in 47 prefectures in terms of DMW was 0.86, 0.93, and 0.94 for juveniles, adults, and elderly, respectively. The largest regional difference of W1 in 47 prefectures was 4.5 and 4.8 °C for juveniles and adults, respectively between Hokkaido and Tokyo, 3.9 °C for elderly between Hokkaido and Okinawa. Estimated W1 and average DMT or DMW during the summer season for 47 prefectures was linearly related. Regarding age difference, the regression line showed that W1 of the prefecture for DMW at 30 °C of WBGT was 31.1 °C, 32.4 °C, and 29.8 °C for juveniles, adults, and elderly, respectively. Conclusions Age and regional differences affected the incidence of HAT. Thus, it is recommended that public prevention measures for heat-related disorders take into consideration age and regional variability.
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Affiliation(s)
- Satoru Ueno
- Work Environment Research Group, National Institute of Occupational Safety and Health, Japan Organization of Occupational Health and Safety, Kawasaki, Japan.
| | - Daisuke Hayano
- Department of Emergency and Critical Care Medicine, Kanto Rosai Hospital, Japan Organization of Occupational Health and Safety, Kawasaki, Japan
| | - Eiichi Noguchi
- Yokohama Branch, General Incorporated Association Toda Medical Group Headquarters, Yokohama, Japan
| | - Tohru Aruga
- Japan Organization of Occuational Health and Safety, Kawasaki, Japan
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Li R, Lin M, Guo S, Yang S, Han X, Ren M, Song Y, Du L, You Y, Zhan J, Huang W. A fundamental landscape of fungal biogeographical patterns across the main Chinese wine-producing regions and the dominating shaping factors. Food Res Int 2021; 150:110736. [PMID: 34865755 DOI: 10.1016/j.foodres.2021.110736] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 09/02/2021] [Accepted: 09/30/2021] [Indexed: 01/20/2023]
Abstract
The microbial terroir plays an indispensable role in the formation of regional wine characteristics. A fundamental landscape of the fungal biogeographical patterns across Chinese wine-producing regions was obtained by characterizing the fungal communities in spontaneous fermentation. After confirming the established national microbial terroir, the fungal heterogeneity was evaluated at different geographical levels. The result showed that the variation between the wineries was more evident than at a regional level. Moreover, the microbial comparability from various regions with similar climates or wineries within the same regions was revealed. Further discriminant analysis determined the specific fungal biomarkers in different regions, while the associated reverse identification model displayed reliable accuracy (>70%). Correlation analysis illustrated the primary role of the geoclimatic factors (>41%) in shaping the fungal geographical patterns, and the relationship between the microbiome and spontaneous fermentation performance. In addition to expanding the knowledge regarding wine microbes, these findings provided a new benchmark for harnessing the microbial terroir to enhance regional wine expression.
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Affiliation(s)
- Ruilong Li
- Beijing Key Laboratory of Viticulture and Enology, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing 100083, China
| | - Mengyuan Lin
- Beijing Key Laboratory of Viticulture and Enology, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing 100083, China
| | - Sijiang Guo
- Beijing Key Laboratory of Viticulture and Enology, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing 100083, China
| | - Siyu Yang
- Beijing Key Laboratory of Viticulture and Enology, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing 100083, China
| | - Xiaoyu Han
- Beijing Key Laboratory of Viticulture and Enology, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing 100083, China
| | - Mengmeng Ren
- Beijing Key Laboratory of Viticulture and Enology, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing 100083, China
| | - Yinghui Song
- Penglai Grape and Wine Industry Development Service Center, Yantai 265600, China
| | - Le Du
- Wuhan Donghu Big Data Trading Center Co. Ltd., Wuhan 430200, China
| | - Yilin You
- Beijing Key Laboratory of Viticulture and Enology, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing 100083, China
| | - Jicheng Zhan
- Beijing Key Laboratory of Viticulture and Enology, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing 100083, China.
| | - Weidong Huang
- Beijing Key Laboratory of Viticulture and Enology, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing 100083, China.
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Hsu AL, Konner M, Muttreja A, Lee CH, Chien JL, Irish RD. A comprehensive analysis of authorship trends in Skeletal Radiology since inception from 1976 to 2020. Skeletal Radiol 2021; 50:2519-2523. [PMID: 34076724 DOI: 10.1007/s00256-021-03810-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 04/26/2021] [Accepted: 05/02/2021] [Indexed: 02/02/2023]
Abstract
OBJECTIVE The purpose of this study is to explore authorship trends within the musculoskeletal radiology subspecialty-focused journal, Skeletal Radiology, from inception to 2020. MATERIALS AND METHODS Skeletal Radiology articles published in 1976, 1986, 1996, 2006, 2016, and 2020 were reviewed. For each article, the number of authors, the number of distinct institutions, the names of first and last authors, the country of the first author, the article length, and the number of article references were recorded. RESULTS A total of 885 articles passed the exclusion criteria to be included in the study. Since inception, there has been a significant increase in the number of SR articles published (P = 0.02), the mean number of authors per article (P < 0.01), the mean number of references per article (P < 0.01), the mean number of distinct institutions per article (P = 0.02), and the mean number of pages per article (P < 0.01). The proportion of female first and last authors significantly increased (P = 0.02, P = 0.02). There was a significant increase in the proportion of articles published from Asia (P = 0.04). However, no significant changes in the proportion of articles published from other regions were observed. CONCLUSION Similar to authorship trends in other medical journals, Skeletal Radiology demonstrated upward trends in authorship count, distinct institutional count, and article length. A rise in first and last female authorship was observed. Finally, an increase in the proportion of authors from Asia was observed while no significant changes in the proportion of authors from other regions were demonstrated.
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Affiliation(s)
- Alexander L Hsu
- Department of Radiology, Icahn School of Medicine At Mount Sinai (West), New York, NY, USA.
| | - Marcus Konner
- Department of Radiology, Icahn School of Medicine At Mount Sinai (West), New York, NY, USA
| | - Ashima Muttreja
- Department of Radiology, Icahn School of Medicine At Mount Sinai (West), New York, NY, USA
| | - Cheng-Han Lee
- Department of Radiology, Icahn School of Medicine At Mount Sinai (West), New York, NY, USA
| | - Jason L Chien
- Department of Ophthalmology, Weill Cornell Medical College, New York, NY, USA
| | - Robert D Irish
- Department of Radiology, Icahn School of Medicine At Mount Sinai (West), New York, NY, USA
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Yang X, Zhang D, Liu L, Niu J, Zhang X, Wang X. Development trajectory for the temporal and spatial evolution of the resilience of regional tourism environmental systems in 14 cities of Gansu Province, China. Environ Sci Pollut Res Int 2021; 28:65094-65115. [PMID: 34231155 PMCID: PMC8260156 DOI: 10.1007/s11356-021-14932-0] [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] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Accepted: 06/11/2021] [Indexed: 06/13/2023]
Abstract
The rapid development of the urban economy in China and the accompanying income growth experienced by urban residents have increased demand for tourism and leisure, which has brought pressure on the urban tourism environment system (UTES), making the contradiction between tourism economic development and the ecological environment increasingly acute. While seeking to rationalize the economic, social, and ecological benefits of tourism, reducing the fragility of the UTES and improving its anti-interference and recovery capabilities have become attracted significant attention from scholars in China and elsewhere. This paper establishes a definition of resilience for an UTES and constructs an evaluation index system for it in terms of the social, economic, and ecological environments. It also establishes an entropy weight-TOPSIS resilience evaluation model to measure resilience in regional systems, using ArcGIS to analyze the standard deviation ellipse and center of the gravity track of the resilience. System dynamics was used to construct diagrams of causal relationships and stock flow for the constituent elements of UTES to show the mechanisms that promote its resilience. This paper investigates 14 cities of Gansu Province in particular to simulate the resilience model of a regional system.
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Affiliation(s)
- Xiuping Yang
- Department of Economy and Management, Lanzhou University of Technology, Lanzhou, 730050, China.
| | - Dacheng Zhang
- School of Business Administration, Xuzhou College of Industrial Technology, Xuzhou, 221140, China
| | - Lili Liu
- Department of Economy and Management, Lanzhou University of Technology, Lanzhou, 730050, China
| | - Jing Niu
- Department of Economy and Management, Lanzhou University of Technology, Lanzhou, 730050, China
| | - Xiaobo Zhang
- Department of Economy and Management, Lanzhou University of Technology, Lanzhou, 730050, China
| | - Xiaoyun Wang
- Department of Economy and Management, Lanzhou University of Technology, Lanzhou, 730050, China
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Stefaniuk CM, Schlegelmilch J, Meyerson HJ, Harding CV, Maitta RW. Initial assessment of α-synuclein structure in platelets. J Thromb Thrombolysis 2021; 53:950-953. [PMID: 34797472 PMCID: PMC9117560 DOI: 10.1007/s11239-021-02607-z] [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] [Accepted: 11/07/2021] [Indexed: 11/24/2022]
Abstract
Over the last few years data from our group have indicated that α-synuclein is important in development of immune cells as well as potentially erythrocytes and platelets. The latter is important since this protein may work as negative regulator of granule release. Thus, we sought to begin to understand the structure of this protein in platelets. Flow cytometric analysis of this protein using region-specific (N-terminus, central region and C-terminus) monoclonal antibodies was performed. Antibody to the central region gave the strongest shift among all three antibodies, with the C-terminus having intermediate shift and N-terminus minimal shift. Western blotting using the same antibodies showed similar binding of all antibodies to α-synuclein. These results suggest a similar arrangement of this protein in platelets as seen in neurons. Future studies ought to look at the role that each protein region plays in platelets.
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Affiliation(s)
- Catherine M Stefaniuk
- Department of Pathology, University Hospitals Cleveland Medical Center, Cleveland, OH, USA.,Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - June Schlegelmilch
- Department of Pathology, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | - Howard J Meyerson
- Department of Pathology, University Hospitals Cleveland Medical Center, Cleveland, OH, USA.,Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Clifford V Harding
- Department of Pathology, University Hospitals Cleveland Medical Center, Cleveland, OH, USA.,Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Robert W Maitta
- Department of Pathology, University Hospitals Cleveland Medical Center, Cleveland, OH, USA. .,Case Western Reserve University School of Medicine, Cleveland, OH, USA.
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Salvia M, Olazabal M, Fokaides PA, Tardieu L, Simoes SG, Geneletti D, De Gregorio Hurtado S, Viguié V, Spyridaki NA, Pietrapertosa F, Ioannou BI, Matosović M, Flamos A, Balzan MV, Feliu E, Rižnar K, Šel NB, Heidrich O, Reckien D. Climate mitigation in the Mediterranean Europe: An assessment of regional and city-level plans. J Environ Manage 2021; 295:113146. [PMID: 34186317 DOI: 10.1016/j.jenvman.2021.113146] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 05/14/2021] [Accepted: 06/21/2021] [Indexed: 06/13/2023]
Abstract
In Europe, regions in the Mediterranean area share common characteristics in terms of high sensitivity to climate change impacts. Does this translate into specificities regarding climate action that could arise from these Mediterranean characteristics? This paper sheds light on regional and local climate mitigation actions of the Mediterranean Europe, focusing on the plans to reduce greenhouse gases emissions in a representative sample of 51 regions and 73 cities across 9 Mediterranean countries (Croatia, Cyprus, France, Greece, Italy, Malta, Portugal, Slovenia, Spain). The study investigates: (i) the availability of local and regional mitigation plans, (ii) their goals in term of greenhouse gas emissions reduction targets on the short and medium-long term, and (iii) the impact of transnational climate networks on such local and regional climate mitigation planning. Results of this study indicate an uneven and fragmented planning, that shows a Mediterranean West-East divide, and a link with population size. However, overall, both regional and city action seem insufficiently ambitious with regards to meeting the Paris Agreement, at least at city level. While national frameworks are currently weak in influencing regional and local actions, transnational networks seem to be engaging factors for commitment (at city level) and ambitiousness (at regional level). The uneven and fragmented progress revealed by this study, does not align with the characteristics shared by investigated regions and cities in terms of environmental, socio-political, climatic and economic conditions. The results support the call of a common green deal at the Mediterranean level to further address specific Mediterranean challenges and related needs. This will allow to capitalise on available resources, generate local-specific knowledge, build capacities, and support Mediterranean regions and cities in preparing the next generation of more ambitious mitigation plans.
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Affiliation(s)
- Monica Salvia
- Institute of Methodologies for Environmental Analysis, National Research Council of Italy, C.da S. Loja, 85050, Tito Scalo, PZ, Italy.
| | - Marta Olazabal
- Basque Centre for Climate Change (BC3), Parque Científico UPV/EHU, Barrio Sarriena, s/n, 48940, Leioa, Spain.
| | - Paris A Fokaides
- School of Engineering, Frederick University, 7, Frederickou Str., 1036, Nicosia, Cyprus.
| | - Léa Tardieu
- TETIS, INRAE, AgroParisTech, Cirad, CNRS, Univ Montpellier, F-34093, Montpellier, France.
| | - Sofia G Simoes
- The National Energy Laboratory of Portugal (LNEG), Unit on Resource Economics, Estrada da Portela, Bairro do Zambujal Ap 7586, 2720-999, Amadora, Portugal.
| | - Davide Geneletti
- Department of Civil, Environmental and Mechanical Engineering, University of Trento, Via Mesiano 77, 38123, Trento, Italy.
| | - Sonia De Gregorio Hurtado
- School of Architecture, Department of Urban and Spatial Planning, Universidad Politécnica de Madrid, Avenida de Juan de Herrera, 4, 28040, Madrid, Spain.
| | - Vincent Viguié
- Centre International de Recherche sur l'Environnement et le Développement (CIRED), 45bis, Av de la Belle Gabrielle, F-94736, Nogent-sur-Marne, France.
| | - Niki-Artemis Spyridaki
- Department of Industrial Management & Technology, University of Piraeus (UNIPI), 80, Karaoli & Dimitriou street, 18534, Piraeus, Greece.
| | - Filomena Pietrapertosa
- Institute of Methodologies for Environmental Analysis, National Research Council of Italy, C.da S. Loja, 85050, Tito Scalo, PZ, Italy.
| | - Byron I Ioannou
- School of Engineering, Frederick University, 7, Frederickou Str., 1036, Nicosia, Cyprus.
| | | | - Alexandros Flamos
- Department of Industrial Management & Technology, University of Piraeus (UNIPI), 80, Karaoli & Dimitriou street, 18534, Piraeus, Greece.
| | - Mario V Balzan
- Institute of Applied Sciences, Malta College of Arts, Science and Technology, Paola, PLA9032, Malta.
| | - Efren Feliu
- TECNALIA, Basque Research and Technology Alliance (BRTA), Parque Tecnológico de Bizkaia, Astondo Bidea, edificio 700c/ Geldo, 48160, Derio, Spain.
| | - Klavdija Rižnar
- Scientific Research Centre Bistra Ptuj, Slovenski trg 6, 2250, Ptuj, Slovenia.
| | - Nataša Belšak Šel
- Scientific Research Centre Bistra Ptuj, Slovenski trg 6, 2250, Ptuj, Slovenia.
| | - Oliver Heidrich
- School of Engineering, Tyndall Centre for Climate Change Research, Newcastle University, Newcastle upon Tyne, NE1 7RU, United Kingdom.
| | - Diana Reckien
- Faculty of Geo-Information Science and Earth Observation, University of Twente, PO Box 217, 7500 AE, Enschede, Netherlands.
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Fang K, Qi J, Zhou M, Zhang Z, Han Y. Clinical Characteristics, Prognosis, and Treatment Strategies of TP53 Mutations in Myelodysplastic Syndromes. Clin Lymphoma Myeloma Leuk 2021; 22:224-235. [PMID: 34690091 DOI: 10.1016/j.clml.2021.09.013] [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] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 09/17/2021] [Accepted: 09/20/2021] [Indexed: 11/28/2022]
Abstract
TP53 gene mutations are common in myelodysplastic syndromes (MDS). Previous studies have reported their detrimental effects on patient survival. However, current treatment strategies mainly based on hypomethylating agent therapy (HMA) and hematopoietic stem cell transplantation (HSCT) still leave a lot to be desired. And there is also a lack of studies on large sample with a view to the refinement of specific characteristics and disease progression. So we performed a meta-analysis including 20 studies compromising 5067 patients to assess the prognostic impact and clinical characteristics of TP53 mutations in MDS patients. The overall hazard ratio for overall survival (OS) was 2.14 (95% confidence interval 1.94-2.37, P < .00001) compared with patients with MDS without TP53 mutations. Lower progression-free survival and leukemia-free survival were associated with TP53 mutations. Subgroup analysis revealed that TP53 mutations were significantly associated with high levels of blast cells and karyotypic aberrations. And among Asian population, the adverse impact on OS of TP53 mutations seemed worse than those in Western countries. (HR 2.87 vs. 2.02, P = .01). In addition, TP53 mutations had no effect on response to HMA therapy, and HSCT improved OS in patients carrying TP53 mutations.
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Affiliation(s)
- Kun Fang
- National clinical research center for hematologic diseases, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Suzhou, China; Institute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology, Soochow University, Suzhou, China
| | - Jiaqian Qi
- National clinical research center for hematologic diseases, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Suzhou, China; Institute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology, Soochow University, Suzhou, China; Key Laboratory of Thrombosis and Hemostasis of Ministry of Health, Suzhou, China
| | - Meng Zhou
- National clinical research center for hematologic diseases, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Suzhou, China; Institute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology, Soochow University, Suzhou, China; Key Laboratory of Thrombosis and Hemostasis of Ministry of Health, Suzhou, China
| | - Ziyan Zhang
- National clinical research center for hematologic diseases, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Suzhou, China; Institute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology, Soochow University, Suzhou, China
| | - Yue Han
- National clinical research center for hematologic diseases, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Suzhou, China; Institute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology, Soochow University, Suzhou, China; Key Laboratory of Thrombosis and Hemostasis of Ministry of Health, Suzhou, China; State Key Laboratory of Radiation Medicine and Protection, Soochow University, Suzhou, China.
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AlMukdad S, Harfouche M, Wettstein A, Abu-Raddad LJ. Epidemiology of herpes simplex virus type 2 in Asia: A systematic review, meta-analysis, and meta-regression. Lancet Reg Health West Pac 2021; 12:100176. [PMID: 34527970 PMCID: PMC8356094 DOI: 10.1016/j.lanwpc.2021.100176] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 05/04/2021] [Accepted: 05/13/2021] [Indexed: 10/25/2022]
Abstract
Background Herpes simplex virus type 2 (HSV-2) infection is a prevalent sexually transmitted infection worldwide. This systematic review was conducted to characterize HSV-2 epidemiology in Asia, including the World Health Organization regions of Southeast Asia and the Western Pacific. Methods Cochrane and PRISMA guidelines were followed to systematically review and report findings. Pooled mean seroprevalence and proportions of HSV-2 isolated in genital ulcer disease (GUD) and in genital herpes were calculated using random-effects meta-analyses. Meta-regressions were also conducted. Quality assessment was performed. Findings HSV-2 measures extracted from 173 publications included 15 seroconversion rates, 11 seroincidence rates, 272 overall seroprevalence measures (678 stratified), 14 proportions of HSV-2 isolation in GUD (15 stratified), and 27 proportions of HSV-2 isolation in genital herpes (36 stratified). Pooled mean seroprevalence was 12.1% (95% confidence interval (CI): 11.0-13.2%) among general populations, 23.6% (95% CI: 20.9-26.3%) among men who have sex with men and transgender people, 46.0% (95% CI: 39.2-52.9%) among HIV-positive individuals and individuals in HIV-discordant couples, and 62.2% (95% CI: 58.9-65.6%) among female sex workers. Among general populations, pooled mean seroprevalence increased gradually from 4.7% (95% CI: 3.3-6.3%) in <20-year-old individuals to 26.6% (95% CI: 19.2-34.7%) in >60-year-old individuals. Compared to women and across all populations, men had 0.60-fold (95% CI: 54.0-67.0) lower seroprevalence, that is women had 70% higher seroprevalence. Seroprevalence declined by 0.98-fold (95% CI: 0.97-0.99) per year, that is a 2% decline per year in the last three decades. Pooled mean proportions of HSV-2 isolation in GUD and in genital herpes were 48.2% (95% CI: 34.9-61.6%) and 75.9% (95% CI: 68.3-82.8%), respectively. Interpretation Over 1 in 10 individuals is infected with HSV-2, but seroprevalence is declining. HSV-2 accounts for half of GUD cases and three-quarters of genital herpes cases. These findings support the need for an HSV-2 vaccine and universal access to sexual and reproductive health services. Funding This work was supported by the Qatar National Research Fund [NPRP 9-040-3-008] and by pilot funding from the Biomedical Research Program at Weill Cornell Medicine in Qatar.
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Affiliation(s)
- Sawsan AlMukdad
- Infectious Disease Epidemiology Group, Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation - Education City, Doha, Qatar.,World Health Organization Collaborating Centre for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis, Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation - Education City, Doha, Qatar
| | - Manale Harfouche
- Infectious Disease Epidemiology Group, Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation - Education City, Doha, Qatar.,World Health Organization Collaborating Centre for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis, Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation - Education City, Doha, Qatar
| | - Anja Wettstein
- Infectious Disease Epidemiology Group, Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation - Education City, Doha, Qatar
| | - Laith J Abu-Raddad
- Infectious Disease Epidemiology Group, Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation - Education City, Doha, Qatar.,World Health Organization Collaborating Centre for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis, Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation - Education City, Doha, Qatar.,Department of Population Health Sciences, Weill Cornell Medicine, Cornell University, New York, New York, USA
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Choi HM, Chen C, Son JY, Bell ML. Temperature-mortality relationship in North Carolina, USA: Regional and urban-rural differences. Sci Total Environ 2021; 787:147672. [PMID: 34000533 PMCID: PMC8214419 DOI: 10.1016/j.scitotenv.2021.147672] [Citation(s) in RCA: 9] [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] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 05/06/2021] [Accepted: 05/06/2021] [Indexed: 05/30/2023]
Abstract
BACKGROUND Health disparities exist between urban and rural populations, yet research on rural-urban disparities in temperature-mortality relationships is limited. As inequality in the United States increases, understanding urban-rural and regional differences in the temperature-mortality association is crucial. OBJECTIVE We examined regional and urban-rural differences of the temperature-mortality association in North Carolina (NC), USA, and investigated potential effect modifiers. METHODS We applied time-series models allowing nonlinear temperature-mortality associations for 17 years (2000-2016) to generate heat and cold county-specific estimates. We used second-stage analysis to quantify the overall effects. We also explored potential effect modifiers (e.g. social associations, greenness) using stratified analysis. The analysis considered relative effects (comparing risks at 99th to 90th temperature percentiles based on county-specific temperature distributions for heat, and 1st to 10th percentiles for cold) and absolute effects (comparing risks at specific temperatures). RESULTS We found null effects for heat-related mortality (relative effect: 1.001 (95% CI: 0.995-1.007)). Overall cold-mortality risk for relative effects was 1.019 (1.015-1.023). All three regions had statistically significant cold-related mortality risks for relative and absolute effects (relative effect: 1.019 (1.010-1.027) for Coastal Plains, 1.021 (1.015-1.027) for Piedmont, 1.014 (1.006-1.023) for Mountains). The heat mortality risk was not statistically significant, whereas the cold mortality risk was statistically significant, showing higher cold-mortality risks in urban areas than rural areas (relative effect for heat: 1.006 (0.997-1.016) for urban, 1.002 (0.988-1.017) for rural areas; relative effect for cold: 1.023 (1.017-1.030) for urban, 1.012 (1.001-1.023) for rural areas). Findings are suggestive of higher relative cold risks in counties with the less social association, higher population density, less green-space, higher PM2.5, lower education level, higher residential segregation, higher income inequality, and higher income (e.g., Ratio of Relative Risks 1.72 (0.68, 4.35) comparing low to high education). CONCLUSION Results indicate cold-mortality risks in NC, with potential differences by regional, urban-rural areas, and community characteristics.
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Affiliation(s)
| | - Chen Chen
- School of the Environment, Yale University, New Haven, CT, USA
| | - Ji-Young Son
- School of the Environment, Yale University, New Haven, CT, USA
| | - Michelle L Bell
- School of the Environment, Yale University, New Haven, CT, USA.
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Abstract
Purpose The purpose of this paper is to explore the formation and composition of “regions” as places of care, both empirically and conceptually. Design/methodology/approach This paper draws on action-oriented research involving experiments aimed at designing, implementing and evaluating promising solutions to the entwined problems of a burgeoning elderly population and an increasing shortage of medical staff. It draws on ethnographic research conducted in 14 administrative areas in the Netherlands, a total of 273 in-depth interviews and over 1,000 h of observations. Findings This research challenges the understanding of a healthcare region as a clearly bounded topological area. It shows that organizations and professionals collaborate in a variety of different networks, some conterminous with the administrative region established by policymakers and others not. These networks are by nature unstable and dynamic. Attempts to form new regional collaborations with neighbouring organizations are complicated by existing healthcare governance and accountability structures that position organizations as competitors. Practical implications Policymakers should take the pre-established partnerships of healthcare organizations into account before delineating the area in which regionalization is meant to take place. A better alignment of governance and accountability structures is also needed for regionalization to occur in healthcare. Originality/value This paper combines insights from valuation studies with sociogeographical literature and provides a framework for understanding the assembling and disassembling of “regions”.
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Affiliation(s)
- Jitse Jonne Schuurmans
- Erasmus School of Health Policy and Management, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Nienke van Pijkeren
- Erasmus School of Health Policy and Management, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Roland Bal
- Erasmus School of Health Policy and Management, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Iris Wallenburg
- Erasmus School of Health Policy and Management, Erasmus University Rotterdam, Rotterdam, The Netherlands
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Burjonrappa S, Snyder AN. Regional variation in gastroschisis: a nationwide database review of demographics and outcomes. Pediatr Surg Int 2021; 37:911-7. [PMID: 33787981 DOI: 10.1007/s00383-021-04894-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/23/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Gastroschisis is an index neonatal malformation with an increasing incidence from earlier decades. The aim of this study was to investigate regional variations in patient demographics, outcomes, and costs in gastroschisis. MATERIALS AND METHODS The 2016 kid's inpatient database (KID) obtained from the Healthcare Cost and Utilization Project (HCUP) was used to obtain gastroschisis birth, demographic, and outcome data across four U.S. geographical regions: Northeast, Midwest, South, and West. Categorical variables were analyzed with Pearson's Chi-squared test. Odds ratios (OR) with 95% confidence intervals (CI) were reported for variables with significance (p < 0.05). Appropriate logistic regressions were used for comparing categorical, cardinal, and continuous data. RESULTS 2043 gastroschisis cases were obtained from the 2016 KID database with a weighted incidence of 5.1 per 10,000 live births. Incidence of gastroschisis across regions was similar when controlling for a number of hospitals reporting to KID. Prematurity was common, with 59% (1204) of neonates with gastroschisis born at less than 37 weeks. 52% (N = 1067) of gastroschisis infants were male. 46% (955) were White, 9% (178) African American, 22% (450) Hispanic, and 8% (155) other. The overall mortality of gastroschisis in this database was 3.6% (75). The average length of stay was 39 days and average cost of treatment was $357,436. Though without significant differences in mortality, there were significant differences in demographics, costs, and lengths of stay between regions. CONCLUSIONS There has been a significant increase in gastroschisis incidence over the last three decades. This significant increase appears to be related to an increase in socioeconomic inequality and an alteration in the population demographics in the United States. Further study of regional variations will facilitate the development of best practice guidelines that benefit all.
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Harfouche M, Abu-Hijleh FM, James C, Looker KJ, Abu-Raddad LJ. Epidemiology of herpes simplex virus type 2 in sub-Saharan Africa: Systematic review, meta-analyses, and meta-regressions. EClinicalMedicine 2021; 35:100876. [PMID: 34027335 DOI: 10.1016/j.eclinm.2021.100876] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Herpes simplex virus type 2 (HSV-2) infection is a prevalent, sexually transmitted infection with a sizable disease burden that is highest in sub-Saharan Africa. This study aimed to characterize HSV-2 epidemiology in this region. METHODS Cochrane and PRISMA guidelines were followed to systematically review, synthesize, and report HSV-2 related findings up to August 23, 2020. Meta-analyses and meta-regressions were conducted. FINDINGS From 218 relevant publications, 451 overall outcome measures and 869 stratified measures were extracted. Pooled incidence rates ranged between 2.4-19.4 per 100 person-years across populations. Pooled seroprevalence was lowest at 37.3% (95% confidence interval (CI): 34.9-39.7%) in general populations and high in female sex workers and HIV-positive individuals at 62.5% (95% CI: 54.8-70.0%) and 71.3% (95% CI: 66.5-75.9%), respectively. In general populations, pooled seroprevalence increased steadily with age. Compared to women, men had a lower seroprevalence with an adjusted risk ratio (ARR) of 0.61 (95% CI: 0.56-0.67). Seroprevalence has decreased in recent decades with an ARR of 0.98 (95% CI: 0.97-0.99) per year. Seroprevalence was highest in Eastern and Southern Africa. Pooled HSV-2 proportion in genital ulcer disease was 50.7% (95% CI: 44.7-56.8%) and in genital herpes it was 97.3% (95% CI: 84.4-100%). INTERPRETATION Seroprevalence is declining by 2% per year, but a third of the population is infected. Age and geography play profound roles in HSV-2 epidemiology. Temporal declines and geographic distribution of HSV-2 seroprevalence mirror that of HIV prevalence, suggesting sexual risk behavior has been declining for three decades. HSV-2 is the etiological cause of half of genital ulcer disease and nearly all genital herpes cases with limited role for HSV-1. FUNDING This work was supported by pilot funding from the Biomedical Research Program at Weill Cornell Medicine in Qatar and by the Qatar National Research Fund [NPRP 9-040-3-008].
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Harfouche M, Abu-Hijleh FM, James C, Looker KJ, Abu-Raddad LJ. Epidemiology of herpes simplex virus type 2 in sub-Saharan Africa: Systematic review, meta-analyses, and meta-regressions. EClinicalMedicine 2021; 35:100876. [PMID: 34027335 PMCID: PMC8129943 DOI: 10.1016/j.eclinm.2021.100876] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 04/13/2021] [Accepted: 04/14/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Herpes simplex virus type 2 (HSV-2) infection is a prevalent, sexually transmitted infection with a sizable disease burden that is highest in sub-Saharan Africa. This study aimed to characterize HSV-2 epidemiology in this region. METHODS Cochrane and PRISMA guidelines were followed to systematically review, synthesize, and report HSV-2 related findings up to August 23, 2020. Meta-analyses and meta-regressions were conducted. FINDINGS From 218 relevant publications, 451 overall outcome measures and 869 stratified measures were extracted. Pooled incidence rates ranged between 2.4-19.4 per 100 person-years across populations. Pooled seroprevalence was lowest at 37.3% (95% confidence interval (CI): 34.9-39.7%) in general populations and high in female sex workers and HIV-positive individuals at 62.5% (95% CI: 54.8-70.0%) and 71.3% (95% CI: 66.5-75.9%), respectively. In general populations, pooled seroprevalence increased steadily with age. Compared to women, men had a lower seroprevalence with an adjusted risk ratio (ARR) of 0.61 (95% CI: 0.56-0.67). Seroprevalence has decreased in recent decades with an ARR of 0.98 (95% CI: 0.97-0.99) per year. Seroprevalence was highest in Eastern and Southern Africa. Pooled HSV-2 proportion in genital ulcer disease was 50.7% (95% CI: 44.7-56.8%) and in genital herpes it was 97.3% (95% CI: 84.4-100%). INTERPRETATION Seroprevalence is declining by 2% per year, but a third of the population is infected. Age and geography play profound roles in HSV-2 epidemiology. Temporal declines and geographic distribution of HSV-2 seroprevalence mirror that of HIV prevalence, suggesting sexual risk behavior has been declining for three decades. HSV-2 is the etiological cause of half of genital ulcer disease and nearly all genital herpes cases with limited role for HSV-1. FUNDING This work was supported by pilot funding from the Biomedical Research Program at Weill Cornell Medicine in Qatar and by the Qatar National Research Fund [NPRP 9-040-3-008].
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Affiliation(s)
- Manale Harfouche
- Infectious Disease Epidemiology Group, Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation - Education City, Doha, Qatar
- World Health Organization Collaborating Centre for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis, Weill Cornell Medicine–Qatar, Cornell University, Qatar Foundation – Education City, Doha, Qatar
| | - Farah M. Abu-Hijleh
- Department of Public Health, College of Health Sciences, Academic Quality Affairs Office, QU Health, Qatar University, Doha, Qatar
| | - Charlotte James
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Katharine J. Looker
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Laith J. Abu-Raddad
- Infectious Disease Epidemiology Group, Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation - Education City, Doha, Qatar
- World Health Organization Collaborating Centre for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis, Weill Cornell Medicine–Qatar, Cornell University, Qatar Foundation – Education City, Doha, Qatar
- Department of Population Health Sciences, Weill Cornell Medicine, Cornell University, New York, NY, United States
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Ren F, Misselbrook TH, Sun N, Zhang X, Zhang S, Jiao J, Xu M, Wu L. Spatial changes and driving variables of topsoil organic carbon stocks in Chinese croplands under different fertilization strategies. Sci Total Environ 2021; 767:144350. [PMID: 33434843 DOI: 10.1016/j.scitotenv.2020.144350] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Revised: 11/02/2020] [Accepted: 12/05/2020] [Indexed: 06/12/2023]
Abstract
The effect of different fertilization strategies on changes in soil organic carbon (SOC) largely depends on the current status of a given agricultural region. We analysed the results of 90 long-term field trials (20-37 years) in Chinese croplands to determine the effects of fertilization strategies [i.e., no fertilizer (CK), chemical fertilizer (NPK), manure only (M) and manure plus chemical fertilizers (NPKM)] on soil organic carbon stock (SOCs) at 0-20 cm depth in the North (NC), Northeast (NEC), Northwest (NWC) and South (SC) China. Compared with initial values, SOCs increased by 24-68% and 24-74% under NPKM and M applications, respectively, over the experimental periods. Furthermore, final SOCs under NPKM in NEC and NWC were significantly higher than those under other treatments, but there was no significant difference between NPKM and M in SC and no significant differences among fertilizer treatments in NC. Average SOC stock change rates (SOCr) were positive under all treatments for all regions except for CK and NPK in NEC, which were negative. There were regional differences in treatment effects: all treatments showed significantly different rates in NC and NWC, whereas there were no significant differences between the M and NPKM in NEC and SC. Random forest (RF) modeling showed that among the selected variables initial SOCs was the most important in accounting for differences in SOCr, followed by soil bulk density, mean annual temperature and precipitation for all treatments. Soil total nitrogen content was also an important explanatory variable for SOCr for CK and NPK, and soil pH for M. This study has highlighted the main driving variables of SOC change which can be of use in optimizing fertilization strategies, by taking account of the baseline SOCs status and environmental factors for different regions, to minimize soil carbon emissions while maximizing carbon sequestration in soils.
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Affiliation(s)
- Fengling Ren
- National Engineering Laboratory for Improving Quality of Arable Land, Institute of Agricultural Resources and Regional Planning, Chinese Academy of Agricultural Sciences, Beijing 100081, China; Sustainable Agriculture Systems, Rothamsted Research, North Wyke, Okehampton, Devon EX20 2SB, UK
| | - T H Misselbrook
- Sustainable Agriculture Systems, Rothamsted Research, North Wyke, Okehampton, Devon EX20 2SB, UK
| | - Nan Sun
- National Engineering Laboratory for Improving Quality of Arable Land, Institute of Agricultural Resources and Regional Planning, Chinese Academy of Agricultural Sciences, Beijing 100081, China.
| | - Xubo Zhang
- Key Laboratory of Ecosystem Network Observation and Modeling, Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing 100101, China
| | - Shuxiang Zhang
- National Engineering Laboratory for Improving Quality of Arable Land, Institute of Agricultural Resources and Regional Planning, Chinese Academy of Agricultural Sciences, Beijing 100081, China
| | - Jianghua Jiao
- National Engineering Laboratory for Improving Quality of Arable Land, Institute of Agricultural Resources and Regional Planning, Chinese Academy of Agricultural Sciences, Beijing 100081, China
| | - Minggang Xu
- National Engineering Laboratory for Improving Quality of Arable Land, Institute of Agricultural Resources and Regional Planning, Chinese Academy of Agricultural Sciences, Beijing 100081, China.
| | - L Wu
- Sustainable Agriculture Systems, Rothamsted Research, North Wyke, Okehampton, Devon EX20 2SB, UK
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Abdelfattah EM, Ekong PS, Okello E, Chamchoy T, Karle BM, Black RA, Sheedy D, ElAshmawy WR, Williams DR, Califano D, Tovar LFD, Ongom J, Lehenbauer TW, Byrne BA, Aly SS. Epidemiology of antimicrobial resistance (AMR) on California dairies: descriptive and cluster analyses of AMR phenotype of fecal commensal bacteria isolated from adult cows. PeerJ 2021; 9:e11108. [PMID: 33976962 PMCID: PMC8063881 DOI: 10.7717/peerj.11108] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Accepted: 02/23/2021] [Indexed: 12/17/2022] Open
Abstract
Background This study describes the occurrence of antimicrobial resistance (AMR) in commensal Escherichia coli and Enterococcus/Streptococcus spp. (ES) isolated from fecal samples of dairy cows and assesses the variation of AMR profiles across regions and seasons following the implementation of the Food and Agricultural Code (FAC) Sections 14400–14408 (formerly known as Senate Bill, SB 27) in California (CA). Methods The study was conducted on ten dairies distributed across CA’s three milk sheds: Northern California (NCA), Northern San Joaquin Valley (NSJV), and the Greater Southern California (GSCA). On each study dairy, individual fecal samples were collected from two cohorts of lactating dairy cows during the fall/winter 2018 and spring/summer 2019 seasons. Each cohort comprised of 12 cows per dairy. The fecal samples were collected at enrollment before calving (close-up stage) and then monthly thereafter for four consecutive time points up to 120 days in milk. A total of 2,171 E. coli and 2,158 ES isolates were tested for antimicrobial susceptibility using the broth microdilution method against a select panel of antimicrobials. Results The E. coli isolates showed high resistance to florfenicol (83.31% ± 0.80) and sulphadimethoxine (32.45%), while resistance to ampicillin (1.10% ± 0.21), ceftiofur (1.93% ± 0.29), danofloxacin (4.01% ± 0.42), enrofloxacin (3.31% ± 0.38), gentamicin (0.32% ± 0.12) and neomycin (1.61% ± 0.27) had low resistance proportions. The ES isolates were highly resistant to tildipirosin (50.18% ± 1.10), tilmicosin (48% ± 1.10), tiamulin (42%) and florfenicol (46% ± 1.10), but were minimally resistant to ampicillin (0.23%) and penicillin (0.20%). Multidrug resistance (MDR) (resistance to at least 1 drug in ≥3 antimicrobial classes) was observed in 14.14% of E. coli isolates and 39% of ES isolates. Escherichia coli isolates recovered during winter showed higher MDR prevalence compared to summer isolates (20.33% vs. 8.04%). A higher prevalence of MDR was observed in NSJV (17.29%) and GSCA (15.34%) compared with NCA (10.10%). Conclusions Our findings showed high rates of AMR to several drugs that are not labeled for use in lactating dairy cattle 20 months of age or older. Conversely, very low resistance was observed for drugs labeled for use in adult dairy cows, such as cephalosporins and penicillin. Overall, our findings identified important differences in AMR by antimicrobial class, region and season.
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Affiliation(s)
- Essam M Abdelfattah
- Veterinary Medicine Teaching and Research Center, School of Veterinary Medicine, University of California, Davis, Tulare, CA, USA.,Department of Animal Hygiene, and Veterinary Management, Faculty of Veterinary Medicine, Benha University, Moshtohor, Qalyubia, Egypt
| | - Pius S Ekong
- Veterinary Medicine Teaching and Research Center, School of Veterinary Medicine, University of California, Davis, Tulare, CA, USA.,Department of Epidemiology, National Veterinary Research Institute, Vom, Plateau State, Nigeria
| | - Emmanuel Okello
- Veterinary Medicine Teaching and Research Center, School of Veterinary Medicine, University of California, Davis, Tulare, CA, USA.,Department of Population Health & Reproduction, School of Veterinary Medicine, University of California, Davis, Davis, CA, USA
| | - Tapakorn Chamchoy
- Veterinary Medicine Teaching and Research Center, School of Veterinary Medicine, University of California, Davis, Tulare, CA, USA
| | - Betsy M Karle
- Cooperative Extension, Division of Agriculture and Natural Resources, University of California, Davis, Orland, CA, USA
| | - Randi A Black
- Cooperative Extension, Division of Agriculture and Natural Resources, University of California, Davis, Santa Rosa, CA, USA
| | - David Sheedy
- Veterinary Medicine Teaching and Research Center, School of Veterinary Medicine, University of California, Davis, Tulare, CA, USA
| | - Wagdy R ElAshmawy
- Veterinary Medicine Teaching and Research Center, School of Veterinary Medicine, University of California, Davis, Tulare, CA, USA.,Department of Internal Medicine and Infectious Diseases, Cairo University, Giza, Giza, Egypt
| | - Deniece R Williams
- Veterinary Medicine Teaching and Research Center, School of Veterinary Medicine, University of California, Davis, Tulare, CA, USA
| | - Daniela Califano
- Veterinary Medicine Teaching and Research Center, School of Veterinary Medicine, University of California, Davis, Tulare, CA, USA
| | - Luis Fernando Durán Tovar
- Veterinary Medicine Teaching and Research Center, School of Veterinary Medicine, University of California, Davis, Tulare, CA, USA
| | - Jonathan Ongom
- Veterinary Medicine Teaching and Research Center, School of Veterinary Medicine, University of California, Davis, Tulare, CA, USA
| | - Terry W Lehenbauer
- Veterinary Medicine Teaching and Research Center, School of Veterinary Medicine, University of California, Davis, Tulare, CA, USA.,Department of Population Health & Reproduction, School of Veterinary Medicine, University of California, Davis, Davis, CA, USA
| | - Barbara A Byrne
- Department of Pathology, Microbiology, and Immunology, School of Veterinary Medicine, University of California, Davis, Davis, CA, USA
| | - Sharif S Aly
- Veterinary Medicine Teaching and Research Center, School of Veterinary Medicine, University of California, Davis, Tulare, CA, USA.,Department of Population Health & Reproduction, School of Veterinary Medicine, University of California, Davis, Davis, CA, USA
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Lowrey K, Van Hook J. Standing on Their Own Two Feet: How the New Public Charge Rules Could Impact Non-European LPR Applicants. Popul Res Policy Rev 2021; 41:559-582. [PMID: 33814656 PMCID: PMC8010279 DOI: 10.1007/s11113-021-09648-5] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 03/17/2021] [Indexed: 12/01/2022]
Abstract
In February 2020, the U.S. government began to implement a new Public Charge rule that greatly expands the definition of “public charge” when determining admissibility for legal permanent residency (LPR). The rule seeks to determine not only whether applicants used public benefits in the past, but also whether they are likely to use them in the future. However, predicting future use based on characteristics measured at the time of application, such as English language proficiency and income, is difficult. We evaluate the risk of being deemed inadmissible as well as the likelihood of using public assistance by regional group. Using a sample of recently arrived LPRs in the 2013–2017 American Community Survey, we find that Mexicans/Central Americans face disproportionate risk of being deemed a public charge despite their relatively low public assistance use. This increased risk would likely alter the composition of newly admitted LPRs with relatively fewer Mexican/Central American LPRs.
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Affiliation(s)
- Kendal Lowrey
- The Pennsylvania State University, University Park, PA 16802 USA
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Wenzel M, Nocera L, Collà Ruvolo C, Würnschimmel C, Tian Z, Shariat SF, Saad F, Briganti A, Tilki D, Mandel P, Becker A, Kluth LA, Chun FKH, Karakiewicz PI. Incidence rates and contemporary trends in primary urethral cancer. Cancer Causes Control 2021; 32:627-634. [PMID: 33751293 PMCID: PMC8089076 DOI: 10.1007/s10552-021-01416-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Accepted: 03/09/2021] [Indexed: 12/15/2022]
Abstract
PURPOSE We assessed contemporary incidence rates and trends of primary urethral cancer. METHODS We identified urethral cancer patients within Surveillance, Epidemiology and End Results registry (SEER, 2004-2016). Age-standardized incidence rates per 1,000,000 (ASR) were calculated. Log linear regression analyses were used to compute average annual percent change (AAPC). RESULTS From 2004 to 2016, 1907 patients with urethral cancer were diagnosed (ASR 1.69; AAPC: -0.98%, p = 0.3). ASR rates were higher in males than in females (2.70 vs. 0.55), respectively and did not change over the time (both p = 0.3). Highest incidence rates were recorded in respectively ≥75 (0.77), 55-74 (0.71) and ≤54 (0.19) years of age categories, in that order. African Americans exhibited highest incidence rate (3.33) followed by Caucasians (1.72), other race groups (1.57) and Hispanics (1.57), in that order. A significant decrease occurred over time in Hispanics, but not in other race groups. In African Americans, male and female sex-stratified incidence rates were higher than in any other race group. Urothelial histological subtype exhibited highest incidence rate (0.92), followed by squamous cell carcinoma (0.41), adenocarcinoma (0.29) and other histologies (0.20). In stage stratified analyses, T1N0M0 stage exhibited highest incidence rate. However, it decreased over time (-3.00%, p = 0.02) in favor of T1-4N1-2M0 stage (+ 2.11%, p = 0.02). CONCLUSION Urethral cancer is rare. Its incidence rates are highest in males, elderly patients, African Americans and in urothelial histological subtype. Most urethral cancer cases are T1N0M0, but over time, the incidence of T1N0M0 decreased in favor of T1-4N1-2M0.
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Affiliation(s)
- Mike Wenzel
- Department of Urology, University Hospital Frankfurt, Theodor- Stern Kai 7, 60590, Frankfurt am Main, Germany.
- Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada.
| | - Luigi Nocera
- Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada
- Department of Urology and Division of Experimental Oncology, URI, Urological Research Institute, IBCAS San Raffaele Scientific Institute, Milan, Italy
| | - Claudia Collà Ruvolo
- Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, Naples, Italy
| | - Christoph Würnschimmel
- Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada
- Martini-Klinik Prostate Cancer Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany
| | - Zhe Tian
- Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada
| | - Shahrokh F Shariat
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
- Departments of Urology, Weill Cornell Medical College, New York, NY, USA
- Department of Urology, University of Texas Southwestern, Dallas, TX, USA
- Department of Urology, Second Faculty of Medicine, Charles University, Prag, Czech Republic
- Institute for Urology and Reproductive Health, I.M. Sechenov First Moscow State Medical University, Moscow, Russia
- Division of Urology, Department of Special Surgery, Jordan University Hospital, The University of Jordan, Amman, Jordan
| | - Fred Saad
- Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada
| | - Alberto Briganti
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, Naples, Italy
| | - Derya Tilki
- Martini-Klinik Prostate Cancer Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany
| | - Philipp Mandel
- Department of Urology, University Hospital Frankfurt, Theodor- Stern Kai 7, 60590, Frankfurt am Main, Germany
| | - Andreas Becker
- Department of Urology, University Hospital Frankfurt, Theodor- Stern Kai 7, 60590, Frankfurt am Main, Germany
| | - Luis A Kluth
- Department of Urology, University Hospital Frankfurt, Theodor- Stern Kai 7, 60590, Frankfurt am Main, Germany
| | - Felix K H Chun
- Department of Urology, University Hospital Frankfurt, Theodor- Stern Kai 7, 60590, Frankfurt am Main, Germany
| | - Pierre I Karakiewicz
- Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada
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Ni M, Wang Y, Wu R, Zhang L, Xu X, Yang Y, Chen J. Total and Sn-2 Fatty Acid Profile in Human Colostrum and Mature Breast Milk of Women Living in Inland and Coastal Areas of China. Ann Nutr Metab 2021; 77:29-37. [PMID: 33730729 DOI: 10.1159/000510379] [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] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Accepted: 07/11/2020] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Although lipid is the major energy source and exerts beneficial effects on infant growth, research on the composition of fatty acid (FA) at the sn-2 position of human milk (HM) in China and abroad is limited. OBJECTIVES This study aimed to investigate the FA positional distribution in colostrum and mature HM of women living in the inland and coastal areas of China and explore the potential influences of geographical region and lactation stage on the FA profile of Chinese women. METHODS Colostrum milk (n = 61) and mature milk (n = 56) samples were obtained longitudinally from healthy lactating women in Guangzhou and Chengdu, China. Gas chromatography was used to determine the total and sn-2 FA composition. RESULTS Significant differences were observed in the FA profile of HM between different regions and lactation stages, with differences in polyunsaturated FA levels being the most pronounced. Nearly 70% of sn-2 FAs were saturated FAs, of which C16:0 accounted for approximately 75%. C8:0, C10:0, C18:0, C20:0, C22:0, and all of the unsaturated FAs were mainly located at the sn-1 and sn-3 positions, while C14:0, C15:0, and C16:0 were mainly at the sn-2 position. The proportion of C12:0 and C17:0 at sn-2 was approximately equivalent to that at the sn-1, 3 positions. CONCLUSIONS The results indicate the variability in the FA profile of HM between regions and lactation stages. The contents of polyunsaturated FAs and sn-2 FAs, especially palmitic acid, should be paid more attention when optimizing infant formula.
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Affiliation(s)
- Mengmei Ni
- Department of Nutrition, Food Safety and Toxicology, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | | | - Rui Wu
- Department of Nutrition, Food Safety and Toxicology, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Lishi Zhang
- Department of Nutrition, Food Safety and Toxicology, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Xuebing Xu
- Wilmar (Shanghai) Biotechnology Research & Development Center Co., Ltd., Shanghai, China
| | | | - Jinyao Chen
- Department of Nutrition, Food Safety and Toxicology, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
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Tamimy Z, Kevenaar ST, Hottenga JJ, Hunter MD, de Zeeuw EL, Neale MC, van Beijsterveldt CEM, Dolan CV, van Bergen E, Boomsma DI. Multilevel Twin Models: Geographical Region as a Third Level Variable. Behav Genet 2021; 51:319-30. [PMID: 33638732 DOI: 10.1007/s10519-021-10047-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Accepted: 01/21/2021] [Indexed: 12/24/2022]
Abstract
The classical twin model can be reparametrized as an equivalent multilevel model. The multilevel parameterization has underexplored advantages, such as the possibility to include higher-level clustering variables in which lower levels are nested. When this higher-level clustering is not modeled, its variance is captured by the common environmental variance component. In this paper we illustrate the application of a 3-level multilevel model to twin data by analyzing the regional clustering of 7-year-old children’s height in the Netherlands. Our findings show that 1.8%, of the phenotypic variance in children’s height is attributable to regional clustering, which is 7% of the variance explained by between-family or common environmental components. Since regional clustering may represent ancestry, we also investigate the effect of region after correcting for genetic principal components, in a subsample of participants with genome-wide SNP data. After correction, region no longer explained variation in height. Our results suggest that the phenotypic variance explained by region might represent ancestry effects on height.
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Borsekova K, Koróny S, Nijkamp P. In Search of Concerted Strategies for Competitive and Resilient Regions. Netw Spat Econ 2021; 22:607-634. [PMID: 33584156 PMCID: PMC7865117 DOI: 10.1007/s11067-021-09522-z] [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] [Figures] [Subscribe] [Scholar Register] [Accepted: 01/13/2021] [Indexed: 06/12/2023]
Abstract
The European space-economy represents a complex system with a great internal heterogeneity, intensive socioeconomic interactions and differential growth trajectories among countries and regions. The present study aims to investigate the connectivity between spatial competitiveness and resilience in Europe and seeks to design an operational framework for concerted strategies of competitive and resilient regions. To assess the linkage between resilience and competitiveness, we have developed a new measure, viz. the Resilience and Competitiveness Index (RACI) as a function of two constituent sub-indices: Resilience and Competitiveness. This approach is tested on the basis of detailed data on European regions. The empirical results from 268 EU NUTS2 regions offer a solid anchor point for the proposed operational framework for concerted development strategies of competitive and resilient regions. Our research distinguishes and proposes several systematic types of concerted regional strategies according to the performance of a region measured by Resilience and Competiveness sub-indices. A key result of the study is the design of an operational constellation for strategic regional policy evaluation, with a major added value for policy- and decision-making purposes. The use of official data from Eurostat and of standard indicators in our research assures continuity and consistency with the official Regional Competitiveness Index (RCI) classification and measurement, so that policy makers are able to compare the performance of their regions over time and to develop proper concerted strategies accordingly. The clear evidence of a connectivity between regional competitiveness and resilience may help to develop a governance approach that balances competitiveness (mainly represented by productive assets) with resilience (mainly represented by sustainability and ecological awareness) and thus to deal with the complexity in socioeconomic systems.
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Affiliation(s)
| | | | - Peter Nijkamp
- Adam Mickiewicz University, Poznan, Poland
- Open University, Heerlen, Netherlands
- Alexandru Ioan Cuza University of Iasi, Iasi, Romania
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Sangineto M, Arena F, De Nittis R, Villani R, Gallo C, Serviddio G. Temporal profile of SARS-CoV-2 viral load in posterior nasopharyngeal samples: Analysis of 944 patients in Apulia, Italy. Int J Infect Dis 2021; 104:696-700. [PMID: 33545362 PMCID: PMC7989060 DOI: 10.1016/j.ijid.2021.01.068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 01/25/2021] [Accepted: 01/26/2021] [Indexed: 02/05/2023] Open
Abstract
Objectives The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has heavily impacted Italy. The government's restriction measures have attenuated the burden on hospitals. The association of high viral replication with disease severity suggests the potential for lower viral load in milder clinical presentations. Methods The reverse-transcription-polymerase-chain-reaction (RT-PCR) profile of 944 consecutive, non-replicate, positive retropharyngeal swabs was collected from 3 March to 8 June 2020 to investigate the temporal profile of SARS-CoV-2 viral load in the region of Capitanata, Apulia. Cycle threshold (Ct) values of 3 targets (N [nucleocapsid protein], E [envelope protein] and RdRP [RNA-dependent RNA-polymerase]) were analysed. Results The median Ct values of the 3 targets increased considerably over the study period, showing a progressive and constant weekly change. The negative detection rate of E and RdRP increased over time. These data suggest that SARS-CoV-2 viral load progressively decreased along the outbreak course. During the first epidemic peak (March and April) the viral load among patients >80-years was significantly higher than for younger subjects. However, in May this age-dependent difference disappeared, underlying viral load reduction in the elderly. Conclusions An attenuation of viral transmission or pathogenicity during the epidemic course is suggested, likely due to restriction measures, although viral factors might also be considered.
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Affiliation(s)
- Moris Sangineto
- C.U.R.E. (University Center for Liver Disease Research and Treatment), Liver Unit, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Fabio Arena
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy; IRCCS Don Carlo Gnocchi Foundation, Florence, Italy
| | - Rosella De Nittis
- Microbiology Unit, Ospedali Riuniti University Hospital, Foggia, Italy
| | - Rosanna Villani
- C.U.R.E. (University Center for Liver Disease Research and Treatment), Liver Unit, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Crescenzio Gallo
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Gaetano Serviddio
- C.U.R.E. (University Center for Liver Disease Research and Treatment), Liver Unit, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy.
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