scholarly journals Age of first infection across a range of parasite taxa in a wild mammalian population

2020 ◽  
Vol 16 (2) ◽  
pp. 20190811 ◽  
Author(s):  
Leigh Combrink ◽  
Caroline K. Glidden ◽  
Bree R. Beechler ◽  
Bryan Charleston ◽  
Anson V. Koehler ◽  
...  
Keyword(s):  
Temporal Trends ◽  
Infection Risk ◽  
Host Population ◽  
African Buffalo ◽  
Intestinal Worms ◽  
The Relationship ◽  
Parasite Exposure ◽  
Immature Immune System ◽  
Longitudinal Dataset ◽  
Parasite Dynamics

Newborn mammals have an immature immune system that cannot sufficiently protect them against infectious diseases. However, variation in the effectiveness of maternal immunity against different parasites may couple with temporal trends in parasite exposure to influence disparities in the timing of infection risk. Determining the relationship between age and infection risk is critical in identifying the portion of a host population that contributes to parasite dynamics, as well as the parasites that regulate host recruitment. However, there are no data directly identifying timing of first infection among parasites in wildlife. Here, we took advantage of a longitudinal dataset, tracking infection status by viruses, bacteria, protists and gastro-intestinal worms in a herd of African buffalo ( Syncerus caffer ) to ask: how does age of first infection differ among parasite taxa? We found distinct differences in the age of first infection among parasites that aligned with the mode of transmission and parasite taxonomy. Specifically, we found that tick-borne and environmentally transmitted protists were acquired earlier than directly transmitted bacteria and viruses. These results emphasize the importance of understanding infection risk in juveniles, especially in host species where juveniles are purported to sustain parasite persistence and/or where mortality rates of juveniles influence population dynamics.

scholarly journals Effects of heterogeneity in infection-exposure history and immunity on the dynamics of a protozoan parasite

2007 ◽  
Vol 4 (16) ◽  
pp. 841-849 ◽  
Author(s):  
Maite Severins ◽  
Don Klinkenberg ◽  
Hans Heesterbeek
Keyword(s):  
Dynamic Behaviour ◽  
Protozoan Parasite ◽  
Host Population ◽  
Infection Process ◽  
Control Measures ◽  
Complex Dynamic ◽  
Systems Models ◽  
Exposure History ◽  
The Relationship ◽  
Initial Contamination

Infection systems where traits of the host, such as acquired immunity, interact with the infection process can show complex dynamic behaviour with counter-intuitive results. In this study, we consider the traits ‘immune status’ and ‘exposure history’, and our aim is to assess the influence of acquired individual heterogeneity in these traits. We have built an individual-based model of Eimeria acervulina infections, a protozoan parasite with an environmental stage that causes coccidiosis in chickens. With the model, we simulate outbreaks of the disease under varying initial contaminations. Heterogeneity in the traits arises stochastically through differences in the dose and frequency of parasites that individuals pick up from the environment. We find that the relationship between the initial contamination and the severity of an outbreak has a non-monotonous ‘wave-like’ pattern. This pattern can be explained by an increased heterogeneity in the host population caused by the infection process at the most severe outbreaks. We conclude that when dealing with these types of infection systems, models that are used to develop or evaluate control measures cannot neglect acquired heterogeneity in the host population traits that interact with the infection process.

scholarly journals Temporal trends and variation in out-of-pocket expenditures and patient cost sharing: evidence from a Chinese national survey 2011–2015

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Vicky Mengqi Qin ◽  
Yuting Zhang ◽  
Kee Seng Chia ◽  
Barbara McPake ◽  
Yang Zhao ◽  
...  
Keyword(s):  
Prescription Drugs ◽  
Cost Sharing ◽  
Temporal Trends ◽  
Absolute Amount ◽  
Financial Protection ◽  
Patient Cost ◽  
Older Chinese ◽  
Using Data ◽  
Reported Data ◽  
The Relationship

Abstract Objectives This study aims to examine: (1) temporal trends in the percentage of cost-sharing and amount of out-of-pocket expenditure (OOPE) from 2011 to 2015; (2) factors associated with cost-sharing and OOPE; and (3) the relationships between province-level economic development and cost-sharing and OOPE in China. Setting A total of 10,316 adults aged ≥45 years from China followed-up from 2011 to 2015 were included in the analysis. We measured two main outcome variables: (1) patient cost sharing, measured by the percentage of OOPE as total healthcare expenditure, and (2) absolute amount of OOPE. Results Based on self-reported data, we did not find substantial differences in the percentage of cost sharing, but a significant increase in the absolute amount of OOPE among the middle-aged and older Chinese between 2011 and 2015. The percentage of cost-sharing was considerably higher for outpatient than inpatient care, and the majority paid more than 80% of the total cost for prescription drugs. Provinces with higher GDP per capita tend to have lower cost-sharing and a higher OOPE than their counterparts, but the relationship for OOPE became insignificant after adjusting for individual factors. Conclusion Reducing out-of-pocket expenditure and patient cost sharing is required to improve financial protection from illness, especially for those with those with chronic conditions and reside in less developed regions in China. Ongoing monitoring of financial protection using data from various sources is warranted.

scholarly journals Anticholinergics for overactive bladder: Temporal trends in prescription and treatment persistence

2016 ◽  
Vol 10 (7-8) ◽  
pp. 277 ◽  
Author(s):  
Christopher J.D. Wallis ◽  
Colin Lundeen ◽  
Nicole Golda ◽  
Hilary Brotherhood ◽  
Peter Pommerville ◽  
...  
Keyword(s):  
Overactive Bladder ◽  
Temporal Trends ◽  
Population Based ◽  
Current Therapy ◽  
Anticholinergic Medication ◽  
Treatment Persistence ◽  
Anticholinergic Medications ◽  
Single Payer ◽  
Pharmacologic Management ◽  
The Relationship

<p><strong>Introduction:</strong> We sought to understand the contemporary pharmacologic management of overactive bladder (OAB) in a single-payer system. We examined temporal trends in the use of anticholinergic<br />medications and assessed whether the likelihood of patients changing their anticholinergic therapy was predicted by their current therapy.</p><p><strong>Methods:</strong> We conducted a retrospective, population-based analysis of prescription records from the PharmaNet database in BC, Canada. We identified patients treated with one or more anticholinergic<br />prescriptions between 2001 and 2009. We characterized temporal trends in the use of anticholinergic medications. We used generalized estimating equations with a logit wing to assess the relationship between the type of anticholinergic medication and the change in prescription.</p><p><strong>Results:</strong> The 114 325 included patients filled 1 140 296 anticholinergic prescriptions. The number of prescriptions each year increased over the study, both in aggregate and for each individual medication. While oxybutynin was the most commonly prescribed medication (68% of all prescriptions), the proportion of newer anticholinergics (solifenacin, darifenacin, and trospium) prescribed increased over time (p&lt;0.0001). Patients taking tolterodine (odds ratio [OR] 1.03; p=0.01) and darifenacin (OR 1.12; p=0.0006) were significantly more likely to change their prescription than those taking oxybutynin. There was no association seen for patients taking solifenacin (p=0.6) and trospium (p=0.9).</p><p><strong>Conclusions:</strong> There are an increasing number of anticholinergic prescriptions being filled annually. Patients taking newer anticholinergics are at least as likely to change therapy as those taking<br />oxybutynin. The reimbursement environment in BC likely affects these results. Restrictions in the available data limit assessment of other relevant predictors.</p>

scholarly journals Intergenerational Income Elasticity in Turkey

2016 ◽  
Vol 5 (3) ◽  
pp. 30-37
Author(s):  
Murat Anıl Mercan ◽  
Hande Barlin
Keyword(s):  
Instrumental Variable ◽  
Income Elasticity ◽  
Developed Countries ◽  
Social Scientists ◽  
Income Status ◽  
Nationally Representative ◽  
Different Characteristics ◽  
Relationship Of ◽  
The Relationship ◽  
Longitudinal Dataset

Social scientists have been intrigued by the relationship between generations based on different characteristics. Economists, has been especially interested in measuring intergenerational income elasticity, which looks at the relationship of parents and that of their children when they become adults and gives clue on trends of income inequality. Most of the literature concentrates on the experiences of developed countries and measurement issues. Nevertheless, new studies concerning intergenerational income elasticity is being undertaken in developing countries as the data become increasingly available for these countries. In this vein, there is only one previous study that investigates intergenerational income elasticity for Turkey. Mercan (2012) finds that intergenerational income elasticity is around 0.1 in Turkey, which depicts Turkey as a highly mobile country meaning that children of poor parents have a higher likelihood to have a better income status. However, his study does not depend on a longitudinal dataset, which might make Mercan’s (2012) estimate biased. Following Solon (1992) in using OLS for lower bound and instrumental variable (IV) for upper bound, this study puts forth a new estimate, which relies on a nationally representative and longitudinal dataset for Turkey. The study's estimate for intergenerational income elasticity varies between 0.3 and 0.6, which is much higher than the result of Mercan (2012), indicating that Turkey is a less mobile country than previously foreseen.

Absence of Association Between Abatacept Exposure and Initial Infection in Patients With Juvenile Idiopathic Arthritis

2021 ◽  
pp. jrheum.200154
Author(s):  
Nicolino Ruperto ◽  
Hermine I. Brunner ◽  
Nikolay Tzaribachev ◽  
Gabriel Vega-Cornejo ◽  
Ingrid Louw ◽  
...  
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Pediatric Patients ◽  
Opportunistic Infections ◽  
Infection Risk ◽  
Rank Tests ◽  
Link Type ◽  
Kaplan Meier ◽  
Significant Difference ◽  
Exposure Levels ◽  
The Relationship

Objective To assess the relationship between infection risk and abatacept exposure levels in patients with polyarticular-course juvenile idiopathic arthritis (pJIA) following treatment with subcutaneous and intravenous abatacept. Methods Data from two published studies (NCT01844518, NCT00095173) of abatacept treatment in pediatric patients were analyzed. One study treated patients aged 2–17 years with subcutaneous abatacept and the other treated patients aged 6–17 years with intravenous abatacept. Association between serum abatacept exposure measures and infection was evaluated using Kaplan–Meier plots of probability of first infection versus time on treatment by abatacept exposure quartiles and log-rank tests. Number of infections by abatacept exposure quartiles was investigated. Results Overall, 343 patients were included in this analysis: 219 patients received subcutaneous abatacept and 124 patients received intravenous abatacept. Overall, 237/343 (69.1%) patients had ≥1 infection over 24 months. No significant difference in time to first infection across four quartiles of abatacept exposure levels was observed in the pooled (p = 0.4458), subcutaneous (2–5 years p = 0.9305; 6–17 years p = 0.4787), or intravenous (p = 0.4999) analyses. Concomitant use of methotrexate and glucocorticoids (at baseline and throughout) with abatacept did not increase infection risk across the abatacept exposure quartiles. There was no evidence of association between number of infections and abatacept exposure quartiles. No opportunistic infections related to abatacept were reported. Conclusion In patients aged 2–17 years with pJIA, no evidence of association between higher levels of exposure to intravenous or subcutaneous abatacept and incidence of infection was observed.

Abstract TMP65: Depth of Hospital Participation in Telestroke is Associated with Faster Door-to-Needle Time for Stroke Patients

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Arianna Moreno ◽  
Khawja A Saddiqui ◽  
Anand Viswanathan ◽  
Cynthia Whitney ◽  
Natalia Rost ◽  
...  
Keyword(s):  
Temporal Trends ◽  
Predictor Variable ◽  
Median Number ◽  
Hospital Level ◽  
Time Data ◽  
Frequent Contact ◽  
Frequent Use ◽  
The Relationship ◽  
Median Hospital ◽  
Primary Predictor

Background: Telestroke increases tPA use at spoke hospitals, yet its effect on door-to-needle (DTN) times is unknown. More frequent use of telestroke may introduce delays in DTN time or may improve it as practice leads to streamlined processes. Hypothesis: We hypothesize that spoke hospitals with more frequent contact to a hub hospital will have shorter DTN times than those with less frequent contact. Methods: We identified 367 patients treated with tPA by conventional or telestroke methods in the MGH Telestroke network for whom date and time data were available. Strength of the spoke-MGH connection was the primary predictor variable, defined as the number of all telestroke consults (tPA and non-tPA) done at each spoke hospital during the year of the patient’s presentation. Patient-level regression analyses examined the relationship between DTN time and spoke-MGH connection. We controlled for hospitals’ tPA volume, temporal trends, and clustering within hospitals. Results: Sixteen spoke hospitals contributed data on 367 tPA-treated patients from 2006-2016. Hospitals treated a median of 12.5 patients with tPA (IQR 7-33.5). Median hospital-level DTN was 78.8 minutes (IQR 71.3-85). Median number of telestroke consults per year was 37 (IQR 15-60). Among all 367 patients, median DTN was 76 minutes (IQR 61-98), and 24.8% of patients were treated within 60 minutes (n=91). Strength of connection between the spoke and hub hospital was significantly associated with faster DTN time for patients (1.8 minute gain per 10 additional consults, p<0.001) and increased likelihood of tPA delivery within 60 minutes (OR 1.01, p<0.001). Conclusion: More frequent contact between a telestroke spoke and its hub was associated with faster tPA delivery for patients, even after accounting for hospitals’ tPA volume and secular trends in DTN improvements. This highlights added benefits of increased utilization of telestroke.

scholarly journals Housing Stability and Hepatitis C Infection for Young Adults Who Inject Drugs: Examining the Relationship of Consistent and Intermittent Housing Status on HCV Infection Risk

2020 ◽  
Vol 97 (6) ◽  
pp. 831-844
Author(s):  
Meghan D. Morris ◽  
Irene H. Yen ◽  
Steve Shiboski ◽  
Jennifer L. Evans ◽  
Kimberly Page
Keyword(s):  
Hepatitis C ◽  
Cox Regression ◽  
Infection Risk ◽  
Hcv Infection ◽  
Hepatitis C Infection ◽  
Housing Status ◽  
Housing Stability ◽  
Stable Housing ◽  
Independent Association ◽  
The Relationship

AbstractHousing status affects drug using behaviors, but less is known about the relationship between housing patterns and hepatitis C virus (HCV) infection. HCV-negative young people who inject drugs (PWID) were enrolled into a prospective cohort (2003–2019) with quarterly study visits. We used Cox regression to estimate the independent association of recent housing status (housed vs. unhoused, housing stability, and housing trajectory) on HCV incidence. Among 712 participants, 245 incident HCV infections occurred over 963.8 person-years (py) (cumulative incidence 24.4/100 py). An inverse relationship between time housed and HCV incidence was observed (always unhoused 45.0/100 py, 95% confidence interval (CI) 37.1, 54.5; variably housed 18.0/100 py, 95% CI 15.0, 21.3; and always housed 7.0/100 py, 95% CI 3.0, 17.3). In Cox regression models controlling for confounders, those unhoused versus housed at baseline had a 1.9-fold increased infection risk (95% CI 1.4, 2.6). Those always unhoused versus always housed had a 1.5 times greater risk of HCV (95% CI 1.0, 2.3), and those spending a portion of time in stable housing a lower risk (adjusted relative hazard 0.05, 95% CI 0.3, 0.9) with a similar trend for those being housed for less time. Young adult PWID experiencing both recent and chronic states of being unhoused are at elevated risk for HCV infection. Importantly for this group of PWID, our findings indicate that some frequency of residential housing significantly reduces HCV infection risk.

scholarly journals Risk of Subsequent HIV Infection Following Sexually Transmissible Infections Among Men Who Have Sex With Men

2019 ◽  
Vol 6 (10) ◽  
Author(s):  
Brendan L Harney ◽  
Paul A Agius ◽  
Carol El-Hayek ◽  
Christopher K Fairley ◽  
Eric P F Chow ◽  
...  
Keyword(s):  
Hiv Infection ◽  
Sexual Behaviors ◽  
Infection Risk ◽  
Linear Modeling ◽  
Sexually Transmissible Infections ◽  
History Of ◽  
Test Event ◽  
Sex With Men ◽  
The Relationship ◽  
Hiv Infection Risk

Abstract Background HIV and bacterial sexually transmissible infection (STI) notifications among men who have sex with men (MSM) have increased in Australia and many other countries. The relationship between HIV infection and other STIs has been demonstrated previously. However, the relationship between the cumulative history of STIs and subsequent HIV infection remains largely unexplored and limits our understanding of the mechanisms underpinning the elevated HIV risk. Methods Data from HIV-negative MSM who attended high–HIV caseload primary care clinics in Melbourne, Australia, from 2007 to 2014 with 2 or more HIV and STI tests were included. Controlling for sexual behaviors self-reported at clinic visits, discrete time survival analyses using generalized linear modeling estimated the effect of an STI at the prior test event and the cumulative history of STIs (none, 1, 2, or more [repeated]) on risk of HIV infection. Results A total of 8941 MSM met the study criteria; 227 (2.5%) were diagnosed with HIV over the follow-up period. Adjusting for sexual behaviors, a cumulative history of repeated rectal gonorrhea infections (adjusted hazard ratio [aHR], 6.27; 95% confidence interval [CI], 2.68–14.50) and a single rectal gonorrhea infection (aHR, 2.09; 95% CI, 1.15–3.79) were associated with increased HIV infection risk. Conclusions Repeated and single rectal gonorrhea infections were independently associated with increased HIV infection risk. These findings suggest that MSM with any history of rectal gonorrhea, particularly repeat rectal gonorrhea, represent a group for whom preventive interventions for HIV should be emphasized.

scholarly journals Relationship between Spatiotemporal Variations of Climate, Snow Cover and Plant Phenology over the Alps—An Earth Observation-Based Analysis

2018 ◽  
Vol 10 (11) ◽  
pp. 1757 ◽  
Author(s):  
Sarah Asam ◽  
Mattia Callegari ◽  
Michael Matiu ◽  
Giuseppe Fiore ◽  
Ludovica De Gregorio ◽  
...  
Keyword(s):  
Snow Cover ◽  
Regional Scale ◽  
Temporal Trends ◽  
Earth Observation ◽  
European Alps ◽  
Climate Variables ◽  
South Tyrol ◽  
Mean Temperature ◽  
The Alps ◽  
The Relationship

Alpine ecosystems are particularly sensitive to climate change, and therefore it is of significant interest to understand the relationships between phenology and its seasonal drivers in mountain areas. However, no alpine-wide assessment on the relationship between land surface phenology (LSP) patterns and its climatic drivers including snow exists. Here, an assessment of the influence of snow cover variations on vegetation phenology is presented, which is based on a 17-year time-series of MODIS data. From this data snow cover duration (SCD) and phenology metrics based on the Normalized Difference Vegetation Index (NDVI) have been extracted at 250 m resolution for the entire European Alps. The combined influence of additional climate drivers on phenology are shown on a regional scale for the Italian province of South Tyrol using reanalyzed climate data. The relationship between vegetation and snow metrics strongly depended on altitude. Temporal trends towards an earlier onset of vegetation growth, increasing monthly mean NDVI in spring and late summer, as well as shorter SCD were observed, but they were mostly non-significant and the magnitude of these tendencies differed by altitude. Significant negative correlations between monthly mean NDVI and SCD were observed for 15–55% of all vegetated pixels, especially from December to April and in altitudes from 1000–2000 m. On the regional scale of South Tyrol, the seasonality of NDVI and SCD achieved the highest share of correlating pixels above 1500 m, while at lower elevations mean temperature correlated best. Examining the combined effect of climate variables, for average altitude and exposition, SCD had the highest effect on NDVI, followed by mean temperature and radiation. The presented analysis allows to assess the spatiotemporal patterns of earth-observation based snow and vegetation metrics over the Alps, as well as to understand the relative importance of snow as phenological driver with respect to other climate variables.

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