scholarly journals Clinical and Pregnancy Outcomes of COVID-19 Among Hospitalized Pregnant Women in the United States

2021 ◽  
Author(s):  
Christina M Ackerman ◽  
Jennifer L Nguyen ◽  
Swapna Ambati ◽  
Maya Reimbaeva ◽  
Birol Emir ◽  
...  
Keyword(s):  
United States ◽  
Pregnant Women ◽  
Pregnancy Outcomes ◽  
Negative Impact ◽  
Invasive Mechanical Ventilation ◽  
Age Groups ◽  
The United States ◽  
Supplemental Oxygen ◽  
Healthcare Database ◽  
The Impact

Abstract Background Pregnant women with coronavirus disease 19 (COVID-19) may be at greater risk of poor maternal and pregnancy outcomes. This retrospective analysis reports clinical and pregnancy outcomes among hospitalized pregnant women with COVID-19 in the United States. Methods The Premier Healthcare Database – Special Release was used to examine the impact of COVID-19 among pregnant women aged 15–44 years who were hospitalized and who delivered compared with pregnant women without COVID-19. Outcomes evaluated were COVID-19 clinical progression, including the use of supplemental oxygen therapy, intensive care unit admission, critical illness, receipt of invasive mechanical ventilation/extracorporeal membrane oxygenation, and maternal death, and pregnancy outcomes, including preterm delivery and stillbirth. Results Overall, 473,902 hospitalized pregnant women were included, of whom 8584 (1.8%) had a COVID-19 diagnosis (mean [SD] age 28.4 [6.1] years; 40% Hispanic). The risk of poor clinical and pregnancy outcomes was greater among pregnant women with COVID-19 compared with pregnant women without a COVID-19 diagnosis in 2020; the risk of poor clinical and pregnancy outcomes increased with increasing age. Hispanic and Black non-Hispanic women were consistently observed to have the highest relative risk of experiencing poor clinical or pregnancy outcomes across all age groups. Conclusions Overall, COVID-19 had a significant negative impact on maternal health and pregnancy outcomes. These data help inform clinical practice and counselling to pregnant women regarding the risks of COVID-19. Clinical studies evaluating the safety and efficacy of vaccines against severe acute respiratory syndrome coronavirus 2 in pregnant women are urgently needed.

The Impact of the Nicaragua Case on the Court and Its Role: Harmful, Helpful, or In Between?

2012 ◽  
Vol 25 (1) ◽  
pp. 135-147 ◽  
Author(s):  
LORI FISLER DAMROSCH
Keyword(s):  
United States ◽  
Dispute Settlement ◽  
Negative Impact ◽  
The United States ◽  
Negative Effects ◽  
International Court Of Justice ◽  
International Court ◽  
International Dispute ◽  
Us Government ◽  
The Impact

AbstractAt the time the United States withdrew from participation in the Nicaragua case at the International Court of Justice, the US government expressed concern that ‘the course on which the Court may now be embarked could do enormous harm to it as an institution and to the cause of international law’. This essay examines whether or to what extent the anticipated negative effects came to pass. It concludes that dire predictions of harm to the Court were overstated. Twenty-five years later, the rate at which states accept the Court's jurisdiction has held steady. Only a few states have added jurisdictional reservations concerning military activities. The mix of cases being brought to the Court has shifted towards a more representative distribution. States are generally complying with the Court's decisions, though some compliance problems remain. The most serious negative impact has been on the willingness of the United States (still the Court's most active litigant) to participate fully in international dispute settlement.

scholarly journals Contact surveys reveal heterogeneities in age-group contributions to SARS-CoV-2 dynamics in the United States

2021 ◽  
Author(s):  
Taylor Chin ◽  
Dennis M. Feehan ◽  
Caroline O. Buckee ◽  
Ayesha S. Mahmud
Keyword(s):  
United States ◽  
Age Groups ◽  
The United States ◽  
Contact Rate ◽  
Age Group ◽  
Contact Rates ◽  
Contact Patterns ◽  
Age Structured ◽  
The Impact ◽  
Over Time

SARS-CoV-2 is spread primarily through person-to-person contacts. Quantifying population contact rates is important for understanding the impact of physical distancing policies and for modeling COVID-19, but contact patterns have changed substantially over time due to shifting policies and behaviors. There are surprisingly few empirical estimates of age-structured contact rates in the United States both before and throughout the COVID-19 pandemic that capture these changes. Here, we use data from six waves of the Berkeley Interpersonal Contact Survey (BICS), which collected detailed contact data between March 22, 2020 and February 15, 2021 across six metropolitan designated market areas (DMA) in the United States. Contact rates were low across all six DMAs at the start of the pandemic. We find steady increases in the mean and median number of contacts across these localities over time, as well as a greater proportion of respondents reporting a high number of contacts. We also find that young adults between ages 18 and 34 reported more contacts on average compared to other age groups. The 65 and older age group consistently reported low levels of contact throughout the study period. To understand the impact of these changing contact patterns, we simulate COVID-19 dynamics in each DMA using an age-structured mechanistic model. We compare results from models that use BICS contact rate estimates versus commonly used alternative contact rate sources. We find that simulations parameterized with BICS estimates give insight into time-varying changes in relative incidence by age group that are not captured in the absence of these frequently updated estimates. We also find that simulation results based on BICS estimates closely match observed data on the age distribution of cases, and changes in these distributions over time. Together these findings highlight the role of different age groups in driving and sustaining SARS-CoV-2 transmission in the U.S. We also show the utility of repeated contact surveys in revealing heterogeneities in the epidemiology of COVID-19 across localities in the United States.

scholarly journals Statistical Analysis of the Performance of a Big and Open Economy: The Case of the U.S.

2018 ◽  
pp. 10-17
Author(s):  
O. V. Zhuravliov ◽  
О. М. Simachova
Keyword(s):  
United States ◽  
Open Economy ◽  
Developing Economies ◽  
Negative Impact ◽  
The United States ◽  
Us Economy ◽  
The Us ◽  
The World ◽  
Macroeconomic Indicators ◽  
The Impact

The US economy is one of the richest and most diversified economies in the world and keeps its leadership in the global economy for the past 100 years. The United States is a global leader in computer technology, pharmaceuticals and the manufacture of medical, aerospace and military equipment. And although services make up about 80% of GDP, the US remains the second largest producer of industrial goods in the world and is a leader in research and development. President Donald Trump was elected in November 2016, promising a big gap with his predecessor’s regulatory, tax and trade policies. Therefore, the current socio-economic status of the USA and the possible ways of its development in the future are interesting for studying the impact on other economies, in particular, on the Ukrainian economy and the search for new and optimal ways of developing relations between the United States and Ukraine. Key macroeconomic indicators of the US economy in 2011–2018 are analyzed, demonstrating the influence of Donald Tramp’s new policy on changes in the indicators of the economy, the labor market, trade, etc., as well as possible ways of development in the coming years. The review of key macroeconomic indicators gives grounds for classifying the American economy as healthy one. Rates of GDP growth will remain in the range of 2 to 3%. These rates of growth in the world’s largest economy are callable to ensure a substantial increase in the global activity. But uncertainties in the politics may hinder global growth and have clearly negative impact on the investment growth in developed and developing economies.

scholarly journals 1386. Current Estimates of the Impact of Routine Childhood Immunizations in Reducing Vaccine-Preventable Diseases in the United States

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S703-S703
Author(s):  
Elizabeth M La ◽  
Justin Carrico ◽  
Sandra E Talbird ◽  
Ya-Ting Chen ◽  
Mawuli K Nyaku ◽  
...  
Keyword(s):  
United States ◽  
Research Study ◽  
Disease Incidence ◽  
Age Groups ◽  
Scientific Research ◽  
The United States ◽  
Annual Number ◽  
Study Investigator ◽  
Routine Childhood ◽  
The Impact

Abstract Background Routine immunizations for children aged 10 years and younger in the United States (US) currently cover 14 diseases. Updated estimates of public health impact are needed, given changes in disease epidemiology, evolving recommendations, and the dynamic nature of compliance with the immunization schedule. Methods Pre-vaccine disease incidence was estimated before each routine vaccine was recommended, with average values across multiple years obtained directly from published literature or calculated based on disease surveillance data or annual case estimates from the published literature. Pre-vaccine incidence then was compared to current, post-vaccine incidence, which was generally calculated as average values over the most recent 5 years of available incidence data. Overall incidence estimates and estimates by age group were calculated. Differences in pre- and post-vaccine disease incidence rates were used to calculate the annual number of cases averted, based on 2019 US population estimates. This analysis did not separately estimate the proportion of disease incidence reduction that may be attributed to adult vaccines or booster doses. Results Post-vaccine disease incidence decreased overall and for all age groups across all diseases evaluated (Table 1). Decreases ranged from 17.4% for influenza to 100.0% for polio (Figure 1). Over 90% reduction in incidence was achieved for 10 of the 14 diseases evaluated (including reduction in incidence of rotavirus hospitalizations). Overall post-vaccine disease incidence estimates were highest for influenza, rotavirus, and varicella. Estimated annual cases averted by vaccination in 2019 ranged from 1,269 for tetanus to more than 4.2 million for varicella. Table 1. Pre- and Post-Vaccine Disease Incidence Estimates, Annual Cases, and 2019 Cases Averted, by Disease Figure 1. Percentage Reduction in Disease Incidence Post-Vaccine, by Disease Conclusion Routine childhood immunization in the US continues to result in high, sustained reduction in disease across all vaccines and for all age groups evaluated. Disclosures Elizabeth M. La, PhD, RTI Health Solutions (Employee) Justin Carrico, BS, GlaxoSmithKline (Consultant) Sandra E. Talbird, MSPH, RTI Health Solutions (Employee) Ya-Ting Chen, PhD, Merck & Co., Inc. (Employee, Shareholder) Mawuli K. Nyaku, DrPh, Merck & Co. Inc. (Employee, Shareholder) Cristina Carias, PhD, Merck (Employee, Shareholder) Gary S. Marshall, MD, GlaxoSmithKline (Consultant, Scientific Research Study Investigator)Merck (Consultant, Scientific Research Study Investigator)Pfizer (Consultant, Scientific Research Study Investigator)Sanofi Pasteur (Consultant, Grant/Research Support, Scientific Research Study Investigator, Honorarium for conference lecture)Seqirus (Consultant, Scientific Research Study Investigator) Craig S. Roberts, PharmD, MPA, MBA, Merck & Co., Inc (Employee, Shareholder)

scholarly journals THE INFLUENCE OF CHINESE-AMERICAN TRADE RELATIONS ON CHINA's FOREIGN POLICY RELATING TO THE USA

2021 ◽  
Vol 5 (1) ◽  
pp. 65-73
Author(s):  
Jiang Junjing
Keyword(s):  
United States ◽  
Foreign Policy ◽  
World Economy ◽  
Negative Impact ◽  
The United States ◽  
Economic Benefits ◽  
Wide Range ◽  
The World ◽  
China’S Foreign Policy ◽  
The Impact

Based on a wide range of sources, the article analyzes the impact of China's trade and economic relations with the United States. Several periods of interaction between countries after the end of World War II are considered. Special attention is paid to the period of restoration of diplomatic relations since 1979. Based on various sources and historiography, the author analyzes the researchers' points of view on the impact of economic issues on the relations between the two countries. In the course of the research, the author came to the conclusion that an important aspect in the direction of the foreign economic policy of the People’s Republic of China in the first post-war years was the ideological factor. The article presents an analysis of changes in the vector of China's foreign policy in different periods. The main ways of interaction between the United States and China are described, depending on changing foreign policy doctrines. The reforms launched in 1978 provided China with economic growth and a growing prestige on the world stage, which is still present today. The rapprochement between the United States and China after the collapse of the Soviet Union in 1991 brought certain economic benefits for the two countries. However, the aggravation of relations between the countries in the new Millennium provides an opportunity for new assessments of the PRC's position on the world stage. Trump’s coming to power in the United States is regarded as an economic war between the two countries. China's increased investment capacity and technological independence make it an attractive partner for other countries, which in turn has a negative impact on trade with America. The most important thing in this situation is the fact that the globalization of the world economy caused by scientific and technological progress, including the rather close interweaving of the US and Chinese economies, contradicts the national interests of both countries, which are trying to strengthen their positions and role in the world economy. Based on the analyzed material, the author comes to the conclusion that recently the foreign policy relations between China and the United States directly depend on the economic interests of the parties.

Associations of Antimicrobial-Resistant Gram-Negative Bloodstream Infections with Outcomes among Hospitalized Pediatric Patients in the United States

2021 ◽  
Author(s):  
Alicen Burns Spaulding ◽  
David Watson ◽  
Jill Dreyfus ◽  
Phillip Heaton ◽  
Christina Koutsari ◽  
...  
Keyword(s):  
United States ◽  
Retrospective Cohort ◽  
Pediatric Patients ◽  
Bloodstream Infections ◽  
The United States ◽  
Healthcare Database ◽  
Gram Negative ◽  
Drug Classes ◽  
Antibiotic Drug ◽  
The Impact

Abstract Objective The aim of this study was to assess the impact of pediatric antimicrobial-resistant gram-negative bloodstream infections (GNBSIs). Methods A retrospective cohort study (2009–2016) was conducted using the Premier Healthcare Database among pediatric admissions with GNBSIs at hospitals reporting microbiology data. Infections for neonates and nonneonates were classified as multidrug resistance (MDR), resistant to one or two antibiotic drug classes (1–2DR), or susceptible. Results Among 1,276 GNBSIs, 266 (20.8%) infections were 1–2DR and 23 (1.8%) MDR. Compared with susceptible GNBSIs, MDR nonneonates had higher mortality and higher costs, whereas 1–2DR neonates had longer stays and higher costs. Conclusions Antimicrobial-resistant GNBSIs were associated with worse outcomes among pediatric hospitalized patients.

The impact of social stress and strain on cognitive function in older people

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
J Lindert ◽  
K C Paul ◽  
M Lachman ◽  
B Ritz ◽  
T Seeman
Keyword(s):  
United States ◽  
Cognitive Function ◽  
Executive Functioning ◽  
Episodic Memory ◽  
Social Stress ◽  
Age Groups ◽  
The United States ◽  
Stress And Strain ◽  
Men And Women ◽  
The Impact

Abstract Background Social stress and strain, especially discrimination and inequality might have an impact on memory and cognitive function. This is a major concern for older individuals, their families, communities and societies. We sought to assess changes in episodic memory (EM) and executive functioning (EF) among men and women in the 'Midlife in the United States' (MIDUS) cohort study, to delineate variations in EM and EF by gender, and to determine the impact of social stress/strain at three levels (family, work, society) on longitudinal changes in EM and EF in men and women. Methods We used data from the MIDUS study - a national probability sample of non-institutionalized, English speaking respondents aged 25-74 living in the 48 contiguous states of the United States. The initial wave in our study (1995) included 4963 non-institutionalized adults aged 32 to 84 (M = 55, SD = 12.4). The dependent variables are EM and EF, which were assessed with the Brief Test for Cognition. The independent variables were social stress and discrimination variables at the family/partner level, the work level and the society level, assessed with validated discrimination measures. To assess cognition changes we estimated adjusted linear regression models. Results Women report more perceived inequality for their family and more family strain than men across all age groups. After controlling for other explanatory variables, the main effect on cognition for all age groups was found for perceived inequality of one's family opportunities. Conclusions Reducing social stress and providing opportunities might be an important measure to support episodic memory and executive functioning in aging populations.

scholarly journals 2851. Impact of Antimicrobial-Resistant Gram-Negative Bloodstream Infections on Outcomes Among Pediatric Hospitalizations in the United States, 2009–2016

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S73-S73
Author(s):  
Alicen B Spaulding ◽  
David Watson ◽  
Jill Dreyfus ◽  
Phillip Heaton ◽  
Anupam Kharbanda
Keyword(s):  
United States ◽  
Susceptibility Testing ◽  
Hospital Admissions ◽  
Bloodstream Infections ◽  
Healthcare Facility ◽  
The United States ◽  
Healthcare Database ◽  
Gram Negative ◽  
Patients Âgés ◽  
The Impact

Abstract Background Antimicrobial-resistant (AMR) Gram-negative bloodstream infections (GNBSIs) are more challenging to treat and may be associated with higher rates of morbidity and mortality. However, no recent studies have assessed the impact of pediatric AMR GNBSIs on outcomes. This study’s objective was to analyze the impact of AMR GNBSIs on mortality, length of stay (LOS), and costs among pediatric hospital admissions in the United States. Methods We conducted a retrospective cohort study of patients ages < 19 from the Premier Healthcare Database (2009–2016) limited to hospitals reporting ≥4 years of blood culture data and to encounters with susceptibility testing among the five most common laboratory-confirmed GNBSIs. AMR was defined per pathogen according to Centers for Disease Control and Prevention criteria. Outcomes mortality, LOS, and total patient encounter costs were compared between AMR and susceptible GNBSIs using Bayesian hierarchical regression modeling, which allowed us to analyze outcomes at the pathogen-level and to incorporate adjustment for confounding factors in order to produce risk-adjusted average differences or risk ratios (RR), and corresponding 95% credible intervals (CrI). Results Among 1,279 GNBSI encounters with susceptibility testing from 104 hospitals, 153 (12%) were AMR, but varied by pathogen. AMR GNBSI occurred more often among non-neonates (62% vs. 51%); non-neonates more often had hospital-acquired infections (27% vs. 13%) or were transferred from a healthcare facility (16% vs. 10%) vs. susceptible GNBSIs. The adjusted RR for mortality was 1.31 (95% CrI 0.62, 3.07) and adjusted average differences for LOS were 6.8 days (95% CrI: −0.3, 16.3) and for cost $23800 (95% CrI $400, $53900) comparing AMR to susceptible GNBSIs. Conclusion This study analyzed the impact of AMR GNBSIs, which were rare, on pediatric patient outcomes using laboratory-confirmed GNBSIs with susceptibility results and advanced statistical methods, finding the greatest impact of pediatric AMR on costs. Knowing the impact of AMR GNBSIs can help improve management of these serious infections, increase clinician and patient awareness of the issue, and further strengthen evidence for justifying pediatric antimicrobial stewardship. Disclosures All Authors: No reported Disclosures.

Intervention analysis of the antidumping investigation on wooden bedroom furniture imports from China

2010 ◽  
Vol 40 (7) ◽  
pp. 1434-1447 ◽  
Author(s):  
Yang Wan ◽  
Changyou Sun ◽  
Donald L. Grebner
Keyword(s):  
United States ◽  
Negative Impact ◽  
Positive Impact ◽  
Trade Diversion ◽  
Fair Value ◽  
The United States ◽  
Intervention Analysis ◽  
Depression Effect ◽  
Antidumping Duties ◽  
The Impact

In recent years, the annual imports of wooden bedroom furniture by the United States have been over five billion dollars, with more than two billion dollars of that coming from China. This trend led to an antidumping action against China in October 2003. Since January 2005, antidumping duties of 0.83% to 198.08% have been imposed on individual Chinese firms. To assess the impact of this antidumping action, intervention analysis was employed to examine the import values of four furniture commodities and the prices of two of them over 1997–2008. China and six other major competing countries were included in the analysis. With regard to import values from China, significant trade investigation effects were identified: the petition announcement generated a positive impact in March 2004; the preliminary less-than-fair-value (LTFV) determination had a negative impact from July to December 2004. However, the final implementation did not show any expected trade duty effect. The aggregate impact of the antidumping action on import values from China over 2003–2008 was approximately equivalent to a 1-month import reduction. The impact on the unit prices for China was insignificant. For the six competing countries, intervention analyses revealed that the antidumping action generated a positive trade diversion effect, with the magnitude smaller than the trade depression effect on China.

scholarly journals A National Survey Evaluating the Impact of the COVID-19 Pandemic on Students Pursuing Careers in Neurosurgery

NeuroSci ◽  
2021 ◽  
Vol 2 (4) ◽  
pp. 320-333
Author(s):  
Roxanna M. Garcia ◽  
Rebecca A. Reynolds ◽  
Hannah K. Weiss ◽  
Nathan A. Shlobin ◽  
Lola B. Chambless ◽  
...  
Keyword(s):  
United States ◽  
Medical Students ◽  
Negative Impact ◽  
Academic Career ◽  
The United States ◽  
Professional Organizations ◽  
Application Process ◽  
First Year Students ◽  
Residency Application ◽  
The Impact

Background: The COVID-19 pandemic has profoundly disrupted medical education and the residency application process. Methods: We conducted a descriptive observational study in April 2020 of medical students and foreign medical graduates considering or pursuing careers in neurosurgery in the United States to examine the impact of the pandemic. Results: A total of 379 respondents from 67 medical schools completed the survey. Across all participants, 92% (n = 347) stopped in-person didactic education, and 43% (n = 161) experienced basic science and 44% (n = 167) clinical research delays. Sixty percent (n = 227) cited a negative impact on academic productivity. Among first year students, 18% (n = 17) were less likely to pursue a career in neurosurgery. Over half of second year and third year students were likely to delay taking the United States Medical Licensing Examination Steps I and II. Among third year students, 77% (n = 91) reported indefinite postponement of sub-internships, and 43% (n = 53) were unsatisfied with communication from external programs. Many fourth-year students (50%, n = 17) were graduating early to participate in COVID-19-related patient care. Top student-requested support activities included access to student-focused educational webinars and sessions at upcoming conferences. Conclusions: Medical students pursuing careers in neurosurgery faced unique academic, career, and personal challenges secondary to the pandemic. These challenges may become opportunities for new initiatives guided by professional organizations and residency programs.

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