Polytomous Disease Mapping to Detect Uncommon Risk Factors for Related Diseases

Abstract Background Disease mapping aims at identifying geographic patterns in disease. This may provide a better understanding of disease aetiology and risk factors as well as enable targeted prevention and allocation of resources. Joint mapping of multiple diseases may lead to improved insights since e.g. similarities and differences between geographic patterns may reflect shared and disease-specific determinants of disease. The objective of this study was to compare the geographic patterns in incident acute myocardial infarction (AMI), stroke and atrial fibrillation (AF) using the unique, population-based Danish register data. Methods Incident AMI, stroke and AF was modelled by a multivariate Poisson model including a disease-specific random effect of municipality modelled by a multivariate conditionally autoregressive (MCAR) structure. Analyses were adjusted for age, sex and income. Results The study included 3.5 million adults contributing 6.8 million person-years. In total, 18,349 incident cases of AMI, 28,006 incident cases of stroke, and 39,040 incident cases of AF occurred. Estimated municipality-specific standardized incidence rates ranged from 0.76 to 1.35 for AMI, from 0.79 to 1.38 for stroke, and from 0.85 to 1.24 for AF. In all diseases, geographic variation with clusters of high or low risk of disease after adjustment was seen. The geographic patterns displayed overall similarities between the diseases, with stroke and AF having the strongest resemblances. The most notable difference was observed in Copenhagen (high risk of stroke and AF, low risk of AMI). AF showed the least geographic variation. Conclusion Using multiple-disease mapping, this study adds to the results of previous studies by enabling joint evaluation and comparison of the geographic patterns in AMI, stroke and AF. The simultaneous mapping of diseases displayed similarities and differences in occurrence that are non-assessable in traditional single-disease mapping studies. In addition to reflecting the fact that AF is a strong risk factor for stroke, the results suggested that AMI, stroke and AF share some, but not all environmental risk factors after accounting for age, sex and income (indicator of lifestyle and health behaviour).

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Disease Mapping and Spatial Landscape Characterization of Tuberculosis Ecology in Malaysia

Abstracts of the ICA ◽

10.5194/ica-abs-1-1-2019 ◽

2019 ◽

Vol 1 ◽

pp. 1-2 ◽

Cited By ~ 1

Author(s):

Abdul Rauf Abdul Rasam ◽

Noresah Mohd Shariff

Keyword(s):

Risk Factors ◽

Human Mobility ◽

Random Medium ◽

Disease Mapping ◽

Central Zone ◽

Epidemiological Data ◽

Geographical Information ◽

Disease Pattern ◽

Potential Risk Factors ◽

Northern Zone

Abstract. This paper analyses the pattern distribution and influential risk factors of tuberculosis (TB) at 47 Sections of Shah Alam, Malaysia using spatial epidemiological (SE) approach. Quantifying environmental risk factors of the disease pattern can be a challenging task due to spatial environmental and transmission process, whereby each area may have its own unique risk factors and dynamics. A conceptual framework of spatial epidemiological data analysis (Pfieffer et al. 2008), and geographical information system (GIS) method (Chang 2011) are mainly adapted in this research method. Disease mapping of the 3-year datasets (2013 to 2015) was created using GIS analysis and satellite remote sensed land used in identifying the clustering areas of TB pattern. Meanwhile, the potential risk factors of TB in the clustering areas were assessed using spatial landscape ecology through site observation.Figure 1 shows the spatial pattern of TB cases in the study area as a random medium, revealing that TB distribution is well distributed in the area. However, there is also some clustering concentration at the northern zone (Section U17 to Section U20) and some in U5 and U13, while in the central zone, the majority cases are concentrated at Section S7, S17, S18, S19 and S24. Section S27 and S28 are also indicated as high-case areas in the southern zone. It is interesting to note that in the recent years (2015), the disease was a little dispersed and scattered to the northern area especially in U13, U10, U15 and U17 due to the new township area, physical development and human mobility (Nava-Aguilera et al., 2011; Prussing et al., 2013). Furthermore, every zone or section may have its own risk factors; hence, there is a need for specific investigation to be conducted in a smaller area.

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Elevated level of circulatory sTLT1 induces inflammation through SYK/MEK/ERK signalling in coronary artery disease

Clinical Science ◽

10.1042/cs20190999 ◽

2019 ◽

Vol 133 (22) ◽

pp. 2283-2299

Author(s):

Apabrita Ayan Das ◽

Devasmita Chakravarty ◽

Debmalya Bhunia ◽

Surajit Ghosh ◽

Prakash C. Mandal ◽

...

Keyword(s):

Risk Factors ◽

Coronary Artery Disease ◽

Coronary Artery ◽

Chronic Inflammation ◽

Ex Vivo ◽

Human Subjects ◽

Critical Role ◽

Atherosclerotic Cardiovascular Disease ◽

Tnf Α ◽

Artery Disease

Abstract The role of inflammation in all phases of atherosclerotic process is well established and soluble TREM-like transcript 1 (sTLT1) is reported to be associated with chronic inflammation. Yet, no information is available about the involvement of sTLT1 in atherosclerotic cardiovascular disease. Present study was undertaken to determine the pathophysiological significance of sTLT1 in atherosclerosis by employing an observational study on human subjects (n=117) followed by experiments in human macrophages and atherosclerotic apolipoprotein E (apoE)−/− mice. Plasma level of sTLT1 was found to be significantly (P<0.05) higher in clinical (2342 ± 184 pg/ml) and subclinical cases (1773 ± 118 pg/ml) than healthy controls (461 ± 57 pg/ml). Moreover, statistical analyses further indicated that sTLT1 was not only associated with common risk factors for Coronary Artery Disease (CAD) in both clinical and subclinical groups but also strongly correlated with disease severity. Ex vivo studies on macrophages showed that sTLT1 interacts with Fcɣ receptor I (FcɣRI) to activate spleen tyrosine kinase (SYK)-mediated downstream MAP kinase signalling cascade to activate nuclear factor-κ B (NF-kB). Activation of NF-kB induces secretion of tumour necrosis factor-α (TNF-α) from macrophage cells that plays pivotal role in governing the persistence of chronic inflammation. Atherosclerotic apoE−/− mice also showed high levels of sTLT1 and TNF-α in nearly occluded aortic stage indicating the contribution of sTLT1 in inflammation. Our results clearly demonstrate that sTLT1 is clinically related to the risk factors of CAD. We also showed that binding of sTLT1 with macrophage membrane receptor, FcɣR1 initiates inflammatory signals in macrophages suggesting its critical role in thrombus development and atherosclerosis.

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Hearing Loss Risk Factors and Strategies in Rural Areas

Perspectives on Aural Rehabilitation and Its Instrumentation ◽

10.1044/arii12.1.17 ◽

2004 ◽

Vol 12 (1) ◽

pp. 17-20

Author(s):

Gregory A. Flamme

Keyword(s):

Risk Factors ◽

Hearing Loss ◽

Rural Areas

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The Preschool Stuttering Screen for Health Care Professionals

Perspectives on Fluency and Fluency Disorders ◽

10.1044/ffd21.2.59 ◽

2011 ◽

Vol 21 (2) ◽

pp. 59-62

Author(s):

Joseph Donaher ◽

Christina Deery ◽

Sarah Vogel

Keyword(s):

Risk Factors ◽

Health Care ◽

Differential Diagnosis ◽

Preschool Children ◽

Health Care Professionals ◽

Healthcare Professionals ◽

Evidence Based ◽

Developmental Profile

Healthcare professionals require a thorough understanding of stuttering since they frequently play an important role in the identification and differential diagnosis of stuttering for preschool children. This paper introduces The Preschool Stuttering Screen for Healthcare Professionals (PSSHP) which highlights risk factors identified in the literature as being associated with persistent stuttering. By integrating the results of the checklist with a child’s developmental profile, healthcare professionals can make better-informed, evidence-based decisions for their patients.

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Clinical Response to Questions Regarding Outcomes and Therapy Efficacy

Perspectives on Fluency and Fluency Disorders ◽

10.1044/ffd20.3.76 ◽

2010 ◽

Vol 20 (3) ◽

pp. 76-83 ◽

Cited By ~ 1

Author(s):

Joseph Donaher ◽

Tom Gurrister ◽

Irving Wollman ◽

Tim Mackesey ◽

Michelle L. Burnett

Keyword(s):

Risk Factors ◽

Clinical Response ◽

Speech Language Pathologists ◽

Specific Therapy ◽

Therapy Efficacy ◽

Therapy Program ◽

Adults Who Stutter ◽

Cure Rates

Parents of children who stutter and adults who stutter frequently ask speech-language pathologists to predict whether or not therapy will work. Even though research has explored risk-factors related to persistent stuttering, there remains no way to determine how an individual will react to a specific therapy program. This paper presents various clinicians’answers to the question, “What do you tell parents or adults who stutter when they ask about cure rates, outcomes, and therapy efficacy?”

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