Spatial variation of pneumonia hospitalization risk in Twin Cities metro area, Minnesota

SUMMARYFine resolution spatial variability in pneumonia hospitalization may identify correlates with socioeconomic, demographic and environmental factors. We performed a retrospective study within the Fairview Health System network of Minnesota. Patients 2 months of age and older hospitalized with pneumonia between 2011 and 2015 were geocoded to their census block group, and pneumonia hospitalization risk was analyzed in relation to socioeconomic, demographic and environmental factors. Spatial analyses were performed using Esri's ArcGIS software, and multivariate Poisson regression was used. Hospital encounters of 17 840 patients were included in the analysis. Multivariate Poisson regression identified several significant associations, including a 40% increased risk of pneumonia hospitalization among census block groups with large, compared with small, populations of ⩾65 years, a 56% increased risk among census block groups in the bottom (first) quartile of median household income compared to the top (fourth) quartile, a 44% higher risk in the fourth quartile of average nitrogen dioxide emissions compared with the first quartile, and a 47% higher risk in the fourth quartile of average annual solar insolation compared to the first quartile. After adjusting for income, moving from the first to the second quartile of the race/ethnic diversity index resulted in a 21% significantly increased risk of pneumonia hospitalization. In conclusion, the risk of pneumonia hospitalization at the census-block level is associated with age, income, race/ethnic diversity index, air quality, and solar insolation, and varies by region-specific factors. Identifying correlates using fine spatial analysis provides opportunities for targeted prevention and control.

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Lower perception of pharmacological treatment increases risk of non-adherence to medication

European Journal of Preventive Cardiology ◽

10.1093/eurjpc/zwab061.258 ◽

2021 ◽

Vol 28 (Supplement_1) ◽

Author(s):

CB Graversen ◽

JB Valentin ◽

ML Larsen ◽

S Riahi ◽

T Holmberg ◽

...

Keyword(s):

Pharmacological Treatment ◽

Poisson Regression ◽

Drug Class ◽

Angiotensin Receptor Blockers ◽

Adverse Outcomes ◽

Adherence To Medication ◽

Increased Risk ◽

Patient Reported ◽

High Level

Abstract Funding Acknowledgements Type of funding sources: Foundation. Main funding source(s): The Danish Heart Foundation Background A large proportion of patients fail to reach optimal adherence to medication following incident ischemic heart disease (IHD) despite amble evidence of the beneficial effect of medication. Non-adherence to medication increases risk of disease-related adverse outcomes but none has explored how perception about pharmacological treatment detail on non-adherence using register-based follow-up data. Purpose To investigate the association between patients’ perception of pharmacological treatment and risk of non-initiation and non-adherence to medication in a population with incident IHD. Methods This cohort study followed 871 patients until 365 days after incident IHD. The study combined patient-reported survey data on perception about pharmacological treatment (categorised by ‘To a high level’, ‘To some level’, and ‘To a lesser level’) with register-based data on reimbursed prescription of cardiovascular medication (antithrombotics, statins, ACE-inhibitors/angiotensin receptor blockers, and β-blockers). Non-initiation was defined as no pick-up of medication in the first 180 days following incident IHD and analysed by Poisson regression. Two different measures evaluated non-adherence in patients initiating treatment: 1) proportion of days covered (PDC) analysed by Poisson regression, and 2) risk of discontinuation analysed by Cox proportional hazard regression. All analyses were adjusted for confounding variables (age, sex, ethnicity, income, educational level, civil status, occupation, charlson comorbidity index, supportive relatives, and individual consultation in medication) identified by directed acyclic graph and obtained from national registers and the survey. Item non-response was handled by multiple imputation and item consistency was evaluated by McDonalds omega. Results Lower perceptions about pharmacological treatment was associated with increased risk of non-initiation and non-adherence to medication irrespectively of drug class and adherence measure in the multiple adjusted analyses (please see figure illustrating results on antithrombotics). A dose-response relationship was observed both at 180- and 365-days of follow-up, but the steepest decline in adherence differed when comparing the two adherence measures (results not shown). Moderate internal consistency was found for the summed measure of perception (McDonalds omega = 0.67). Conclusion Lower perception of pharmacological treatment was associated with subsequent non-initiation and non-adherence to medication, irrespectively of measurement method and drug class. Abstract Figure. Figre: Multiple adjusted analyses

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Cost-Effectiveness of Colorectal Cancer Genetic Testing

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18168330 ◽

2021 ◽

Vol 18 (16) ◽

pp. 8330

Author(s):

Abdul Rahman Ramdzan ◽

Mohd Rizal Abdul Manaf ◽

Azimatun Noor Aizuddin ◽

Zarina A. Latiff ◽

Keng Wee Teik ◽

...

Keyword(s):

Colorectal Cancer ◽

Genetic Testing ◽

Cost Effectiveness ◽

Cancer Survival ◽

Screening Method ◽

Targeted Prevention ◽

Activity Based Costing ◽

Cross Sectional ◽

Increased Risk ◽

The Cost

Colorectal cancer (CRC) remains the second leading cause of cancer-related deaths worldwide. Approximately 3–5% of CRCs are associated with hereditary cancer syndromes. Individuals who harbor germline mutations are at an increased risk of developing early onset CRC, as well as extracolonic tumors. Genetic testing can identify genes that cause these syndromes. Early detection could facilitate the initiation of targeted prevention strategies and surveillance for CRC patients and their families. The aim of this study was to determine the cost-effectiveness of CRC genetic testing. We utilized a cross-sectional design to determine the cost-effectiveness of CRC genetic testing as compared to the usual screening method (iFOBT) from the provider’s perspective. Data on costs and health-related quality of life (HRQoL) of 200 CRC patients from three specialist general hospitals were collected. A mixed-methods approach of activity-based costing, top-down costing, and extracted information from a clinical pathway was used to estimate provider costs. Patients and family members’ HRQoL were measured using the EQ-5D-5L questionnaire. Data from the Malaysian Study on Cancer Survival (MySCan) were used to calculate patient survival. Cost-effectiveness was measured as cost per life-year (LY) and cost per quality-adjusted life-year (QALY). The provider cost for CRC genetic testing was high as compared to that for the current screening method. The current practice for screening is cost-saving as compared to genetic testing. Using a 10-year survival analysis, the estimated number of LYs gained for CRC patients through genetic testing was 0.92 years, and the number of QALYs gained was 1.53 years. The cost per LY gained and cost per QALY gained were calculated. The incremental cost-effectiveness ratio (ICER) showed that genetic testing dominates iFOBT testing. CRC genetic testing is cost-effective and could be considered as routine CRC screening for clinical practice.

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Increase in the Risk of Respiratory Disorders in Adults and Children Related to Crop-Growing in Niger

Journal of Environmental and Public Health ◽

10.1155/2016/9848520 ◽

2016 ◽

Vol 2016 ◽

pp. 1-8 ◽

Cited By ~ 4

Author(s):

Ali Mamane ◽

Jean-François Tessier ◽

Ghislaine Bouvier ◽

Roger Salamon ◽

Pierre Lebailly ◽

...

Keyword(s):

Multivariate Analysis ◽

Environmental Factors ◽

Respiratory Symptoms ◽

Respiratory Health ◽

Cross Sectional Study ◽

Cross Sectional ◽

Face To Face ◽

Increased Risk ◽

Adults And Children ◽

Agricultural Areas

Background and Objective. Environmental factors are an increasing concern for respiratory health in developing countries. The objective of this study was to investigate whether Nigerien people living in cultivated areas have more respiratory symptoms than those living in pastoral areas. Method. A cross-sectional study was conducted in 2013 in two populations during the rainy season when land is cultivated. Environmental factors including pesticide use and respiratory symptoms were collected in adults and children during face-to-face interviews. Multivariate analysis between exposures and symptoms was performed in children and in adults separately. Results. The study included 471 adults and 229 children. Overall, none of the households reported the use of pesticides for agricultural purposes. However, 87.2% reported the use of insecticides at home. Multivariate analysis showed that people living in agricultural areas compared to those in pastoral areas had an increased risk of respiratory symptoms in adults (wheezing, dyspnea, sudden shortness of breath, and cough without fever) and in children (cough without fever). The use of insecticides showed no effect on respiratory symptoms after adjustment. Conclusion. This first epidemiological study on the environment and respiratory health conducted in Niger demonstrates a significant relationship between respiratory manifestations and the agricultural characteristics of the living area. However only the effect of insecticides in the home on respiratory health was observed.

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The Relationship Between P16INK4A and TP53 Promoter Methylation and The Risk and Prognosis in Patients With Oesophageal Cancer in Thailand

10.21203/rs.3.rs-1014952/v1 ◽

2021 ◽

Author(s):

Arisara Poosari ◽

Thitima Nutravong ◽

Wises Namwat ◽

Wiphawan Wasenang ◽

Prakasit Sa-ngiamwibool ◽

...

Keyword(s):

Environmental Factors ◽

Oesophageal Cancer ◽

Promoter Methylation ◽

Cox Regression ◽

Methylation Status ◽

Predictive Biomarker ◽

Study Data ◽

Tumour Suppressor Genes ◽

Promoter Methylation Status ◽

Increased Risk

Abstract DNA methylation can regulate the expression of tumour suppressor genes P16 and TP53, environmental factors, which are both important factors related to an increased risk and prognosis of oesophageal cancer (EC). However, the association between these two genes methylation status, as well as the effects of gene-environment interactions, EC risk remains unclear. A Hospital-based case-control study data were collected from 105 new EC cases and 108 controls. Promoter methylation status was investigated for P16 and TP53 genes using methylation-specific polymerase (MSP) chain reaction methods with SYBR green. Logistic and Cox regression models were used to analyse the association of P16 and TP53 promotor methylation status with EC risk and prognosis, respectively. Our results suggest P16, TP53 methylation significantly increased the risk of EC (OR = 5.24, 95 % CI: 2.57–10.66, P < 0.001; OR = 3.38, 95% CI: 1.17–6.67, P < 0.001, respectively). In addition, P16 and TP53 promoter methylation status and the combined effects between environmental factors and its methylations in tissue were correlated with the EC risk and prognosis of EC patients. As a new biomarker, the methylation of P16 and TP53 can serve as a potential predictive biomarker of EC.

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Combined Effects of Lung Disease History, Environmental Exposures, and Family History of Lung Cancer to Susceptibility of Lung Cancer in Chinese Non-smokers

10.21203/rs.3.rs-389632/v1 ◽

2021 ◽

Author(s):

Fanglin Yu ◽

Rendong Xiao ◽

Xu Li ◽

Zhijian Hu ◽

Lin Cai ◽

...

Keyword(s):

Lung Cancer ◽

Family History ◽

Environmental Factors ◽

Lung Disease ◽

Environmental Exposures ◽

Collective Effects ◽

Combined Effects ◽

Cancer History ◽

Increased Risk ◽

History Of

Abstract Background: Although cigarette smoking is a major risk factor for lung cancer, the incidence rate of lung cancer among non-smokers is notable. The etiology and potential mechanism of non-smoker lung cancer are worthy of further research. This study was designed to explore the collective effects of environmental factors and the relationship between environmental exposure index (EEI) and lung cancer among non-smokers by evaluating the joint effects among lung disease history, environmental factors, and family history of lung cancer without smoking confounders.Methods: A total of 767 never-smoked lung cancer cases and 767 sex- and age-matched controls were selected from the department of Thoracic Surgery and Respiratory Medicine of three hospitals in Fujian, China. We used two methods to develop the EEI according to 12 statistically significant environmental risk factors. Restricted cubic spline (RCS) was applied to analyze the non-linear relationship between EEI and lung cancer in non-smokers. Combined effects, additive interaction, and multiplicative interaction were assessed among lung disease history, EEI, and family history of lung cancer to estimate susceptibility to develop lung cancer.Results: Lung disease history, especially asthma, was significantly associated with an increased risk of lung cancer with an odds ratio (OR) for asthma history of 14.720 (95% CI: 1.877–115.449). Family history of lung cancer was related to susceptibility of lung cancer (OR = 3.347, 95% CI: 1.930–5.806). According to type of relatives and cancer, a parental or children’s history and a sibling’s history of lung cancer were significantly associated with an increased risk of lung cancer. The positive association between EEI and lung cancer was apparently stronger in those with lung disease history or family lung cancer history. Furthermore, there was a addictive interaction between EEI and lung disease history, and a possibly addictive interaction between EEI and family lung cancer history on development of lung cancer.Conclusions: There were combined effects among lung disease history, environmental exposures, and family history of lung cancer toward susceptibility to lung cancer in Chinese non-smokers. Non-smokers who had a family history of lung cancer were at higher risk of lung cancer than non-smokers who had lung disease history. Non-smokers with family cancer history may obtain benefits from removal of environmental exposures and active treatment of lung disease.

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Environmental factors linked with identifying as a sexual minority may increase suicidality risk

10.13056/acamh.15070 ◽

2021 ◽

Keyword(s):

Environmental Factors ◽

Study Design ◽

Sexual Minority ◽

Increased Risk

Adolescents who identify as a sexual minority (e.g., gay/lesbian, bisexual) are at an increased risk for suicidality compared to their heterosexual counterparts.1 Until now, inherent limitations in study design has meant that the extent of this association has been unclear.

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KEANEKARAGAMAN JENIS ANGGREK ALAM (Orchidaceae) BERDASARKAN KETINGGIAN TEMPAT DI GUNUNG POTENG CAGAR ALAM RAYA PASI KOTA SINGKAWANG PROVINSI KALIMANTAN BARAT

JURNAL HUTAN LESTARI ◽

10.26418/jhl.v8i3.43429 ◽

2020 ◽

Vol 8 (3) ◽

Author(s):

Novita Putri Sesar ◽

Iskandar A M ◽

Togar Fernando Manurung

Keyword(s):

Species Diversity ◽

Environmental Factors ◽

Nature Reserve ◽

Diversity Index ◽

Economic Value ◽

Survey Method ◽

Species Diversity Index ◽

Orchid Species ◽

West Kalimantan ◽

Medium Range

Natural orchids are one of the flora in Mount Poteng which is included of Raya Pasi Nature Reserve located at Singkawang City, West Kalimantan Province. Orchids have economic value for source of income and be beneficial to ecology that needs to be protected. The altitudes and environmental factors strongly affected the presence of orchid species.The research aims to record the diversity of natural orchids species based on the altitudes place in Mount Poteng. The research was conducted on February 28 until March 28, 2020. This research uses survey method. The research sample was taken using double plots method and to determine sample plots locations is conducted by purposive. The total number of the sample plots is 16 plots and each plot measure 20 by 50 meters. Based on the result of research found 19 species of natural orchids that consist of 348 individuals. The results analysis of the diversity index of orchid species in whole of altitudes at Mount Poteng is 1,338 that is included medium range. The highest species diversity index of 1,300 occurred at altitude of 400-500 m asl and the lowest species diversity index at altitude of 700-725 m asl that is 0,594. Orchid species which found in whole of altitudes is Dendrobium crumenatum. Furthermor, there were found the orchid species on certain heights are Cleisostoma scortechinii, Cordiglottis filiformis, Ludisia discolor, and Phalaenopsis pantherina at altitude of 400-500 m asl and species of Bromheadia finlaysoniana and Pomatocalpa latifolia found at altitude of 700-725 m asl.Keywords: altitudes, mount poteng, orchids, species diversity

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Longitudinal and seasonal succession of algal periphyton colonization in lowland river (Tundzha River Part of Turkey)

10.7287/peerj.preprints.1953v1 ◽

2016 ◽

Author(s):

Burak Öterler

Keyword(s):

Environmental Factors ◽

Dissolved Oxygen ◽

Green Algae ◽

Environmental Variables ◽

Diversity Index ◽

Seasonal Succession ◽

Lowland River ◽

Blue Green Algae ◽

Periphytic Algae ◽

Wiener Diversity Index

The aim of this paper is to determine and compare the environmental factors controlling longitudinal colonisation of periphytic algae in agricultural and urbanization effects of a lowland river, the Tundzha River, located in Turkish Tunca. To investigate the effect of the environmental factors on periphyton colonization at the river, 6 stations were selected and samples were collected between April 2012 and March 2013. Canonical correspondence analyses have been applied to clarify relationships between environmental variables and periphytic algae. During the study, the Shannon-Wiener diversity index (H′) varied from 1.62 to 3.91. The phytoplankton biovolume was positively related to pH, temperature, salinity, chlorophyll- a and nutrients, and was negatively correlated with dissolved oxygen, turbidity, and silicate. Out of the 5 divisions and of 73 identified species of phytoplankton, the diatoms, namely Fragilaria ulna, Cymbella tumida, Cocconeis placentula, Gomphonema acuminatum and Cymbella cystula were found to be dominant. In addition to these species, the biovolumes of filamentous diatom Melosira varians, filamentous blue-green algae Oscillatoria limosa, and placcoderm desmids Cosmarium botrytis were determined to be at high levels during the year. The euglenoid blooms in St.5 showed many times during the study period.

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Longitudinal and seasonal succession of algal periphyton colonization in lowland river (Tundzha River Part of Turkey)

10.7287/peerj.preprints.1953 ◽

2016 ◽

Author(s):

Burak Öterler

Keyword(s):

Environmental Factors ◽

Dissolved Oxygen ◽

Green Algae ◽

Environmental Variables ◽

Diversity Index ◽

Seasonal Succession ◽

Lowland River ◽

Blue Green Algae ◽

Periphytic Algae ◽

Wiener Diversity Index

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Serum ferritin levels are associated with carotid atherosclerosis in Chinese postmenopausal women: the Shanghai Changfeng Study

British Journal Of Nutrition ◽

10.1017/s0007114515001944 ◽

2015 ◽

Vol 114 (7) ◽

pp. 1064-1071 ◽

Cited By ~ 6

Author(s):

Hui Ma ◽

Huandong Lin ◽

Yu Hu ◽

Xiaoming Li ◽

Wanyuan He ◽

...

Keyword(s):

Postmenopausal Women ◽

Serum Ferritin ◽

Carotid Atherosclerosis ◽

Ferritin Level ◽

Oral Glucose ◽

Model Assessment ◽

Cvd Risk ◽

Carotid Plaques ◽

Increased Risk ◽

Fourth Quartile

Postmenopausal women are at increased risk of CVD: the increased serum ferritin level may be involved in the pathogenesis. The aim of the present study is to investigate the relationship of ferritin and carotid atherosclerosis in postmenopausal women. A total of 1178 postmenopausal women (mean age, 60·8 years) were enrolled from the Changfeng Study. A standard interview, anthropometric measurements and laboratory analyses were performed for each participant. Bilateral CIMT (carotid intima–media thickness) were measured using ultrasonography, and the presence of carotid plaques was assessed. Serum ferritin was measured using electrochemiluminescence immunoassay. The results showed that serum ferritin was 181·9 (sd 65·8) ng/ml in the postmenopausal women. Multivariate, linear, stepwise regression analysis demonstrated that age (standardised β = 0·233, P< 0·001), alanine transaminase (standardised β = 0·194, P< 0·001), log homeostasis model assessment index for insulin resistance (standardised β = 0·181, P< 0·001), TAG (standardised β = 0·083, P= 0·003), Hb (standardised β = 0·080, P= 0·004) and PPG (2-h glucose levels following a 75-g oral glucose challenge) (standardised β = 0·079, P= 0·004) were independently associated with serum ferritin. Compared with the ferritin level of subjects in the first quartile, that in the fourth quartile had greater CIMT, and higher prevalence of carotid plaque. After adjusting for conventional CVD risk factors, Hb, leucocytes, log urine albumin:creatinine ratio and liver function, the ferritin level of postmenopausal women in the fourth quartile had a 1·587-fold increased risk of carotid plaques relative to those in the lowest quartile. In conclusion, these results suggest that serum ferritin is independently and positively associated with carotid atherosclerosis in postmenopausal women and that ferritin may be implicated in atherosclerosis.

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