scholarly journals SARS-CoV-2 Testing Disparities in Massachusetts

2020 ◽  
Author(s):  
Scott Dryden-Peterson ◽  
Gustavo E. Velásquez ◽  
Thomas J. Stopka ◽  
Sonya Davey ◽  
Shahin Lockman ◽  
...  
Keyword(s):  
Molecular Testing ◽  
Community Characteristics ◽  
Socioeconomic Vulnerability ◽  
Vulnerable Communities ◽  
Testing Data ◽  
Adjusted Rate ◽  
Structural Inequities ◽  
Adjusted Rate Ratio ◽  
Observation Period ◽  
Testing Gap

AbstractObjectiveEarly deficiencies in testing capacity contributed to poor control of transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). In the context of marked improvement in SARS-CoV-2 testing infrastructure, we sought to examine the alignment of testing with epidemic intensity to mitigate subsequent waves of COVID-19 in Massachusetts.MethodsWe compiled publicly available weekly SARS-CoV-2 molecular testing data for period (May 27 to October 14, 2020) following the initial COVID-19 wave. We defined testing intensity as weekly SARS-CoV-2 tests performed per 100,000 population and used weekly test positivity (percent of tests positive) as a measure of epidemic intensity. We considered optimal alignment of testing resources to be matching community ranks of testing and positivity. In communities with a lower rank of testing than positivity in a given week, the testing gap was calculated as the additional tests required to achieve matching ranks. Multivariable Poisson modeling was utilized to assess for trends and association with community characteristics.ResultsDuring the observation period, 4,262,000 tests were reported in Massachusetts and the misalignment of testing with epidemic intensity increased. The weekly testing gap increased 9.0% per week (adjusted rate ratio [aRR]: 1.090, 95% confidence interval [CI]: 1.08-1.10). Increasing levels of community socioeconomic vulnerability (aRR: 1.35 per quartile increase, 95% CI: 1.23-1.50) and the highest quartile of minority and language vulnerability (aRR: 1.46, 95% CI 0.96-1.49) were associated with increased testing gaps, but the latter association was not statistically significant. Presence of large university student population (>10% of population) was associated with a marked decrease in testing gap (aRR 0.21, 95% CI: 0.12-0.38).ConclusionThese analyses indicate that despite objectives to promote equity and enhance epidemic control in vulnerable communities, testing resources across Massachusetts have been disproportionally allocated to more affluent communities. Worsening structural inequities in access to SARS-CoV-2 testing increase the risk for another intense wave of COVID-19 in Massachusetts, particularly among vulnerable communities.

scholarly journals Clinical outcomes of surgical embolectomy versus catheter-directed thrombolysis for acute limb ischemia: a nationwide cohort study

2021 ◽  
Author(s):  
Po-Kai Yang ◽  
Chien-Chou Su ◽  
Chih-Hsin Hsu
Keyword(s):  
Rate Ratio ◽  
Surgical Intervention ◽  
Limb Ischemia ◽  
Acute Limb Ischemia ◽  
Antithrombotic Agent ◽  
Catheter Directed Thrombolysis ◽  
Significant Difference ◽  
Surgical Embolectomy ◽  
Adjusted Rate ◽  
Adjusted Rate Ratio

AbstractIn Taiwan, the outcomes of acute limb ischemia have yet to be investigated in a standardized manner. In this study, we compared the safety, feasibility and outcomes of acute limb ischemia after surgical embolectomy or catheter-directed therapy in Taiwan. This study used data collected from the Taiwan’s National Health Insurance Database (NHID) and Cause of Death Data between the years 2000 and 2015. The rate ratio of all-cause in-hospital mortality and risk of amputation during the same period of hospital stay were estimated using Generalized linear models (GLM). There was no significant difference in mortality risk between CDT and surgical intervention (9.5% vs. 10.68%, adjusted rate ratio (95% CI): regression 1.0 [0.79–1.27], PS matching 0.92 [0.69–1.23]). The risk of amputation was also comparable between the two groups. (13.59% vs. 14.81%, adjusted rate ratio (95% CI): regression 0.84 [0.68–1.02], PS matching 0.92 [0.72–1.17]). Age (p < 0.001) and liver disease (p = 0.01) were associated with higher mortality risks. Heart failure (p = 0.03) and chronic or end-stage renal disease (p = 0.03) were associated with higher amputation risks. Prior antithrombotic agent use (p = 0.03) was associated with a reduced risk of amputation. Both surgical intervention and CDT are effective and feasible procedures for patients with ALI in Taiwan.

scholarly journals Prevalence and Incidence of Statin Use and 3-Year Adherence and Discontinuation Rates Among Older Adults With Dementia

2018 ◽  
Vol 33 (8) ◽  
pp. 527-534 ◽  
Author(s):  
Richard Ofori-Asenso ◽  
Jenni Ilomaki ◽  
Mark Tacey ◽  
Andrea J. Curtis ◽  
Ella Zomer ◽  
...  
Keyword(s):  
Older Adults ◽  
Poisson Regression ◽  
Rate Ratio ◽  
Annual Prevalence ◽  
People With Dementia ◽  
Proportion Of Days Covered ◽  
Adjusted Rate ◽  
Adjusted Rate Ratio ◽  
Statin Use

Objective: To examine the patterns of statin use and determine the 3-year adherence and discontinuation rates among a cohort of Australians aged ≥65 years with dementia. Methods: The yearly prevalence and incidence of statin use were compared via Poisson regression modeling using 2007 as the reference year. People with dementia were identified according to dispensing of antidementia medications. A cohort of 589 new statin users was followed longitudinally. Adherence was estimated via the proportion of days covered (PDC). Discontinuation was defined as ≥90 days without statin coverage. Results: The annual prevalence of statin use among older Australians with dementia increased from 20.6% in 2007 to 31.7% in 2016 (aged-sex adjusted rate ratio: 1.51, 95% confidence interval: 1.35-1.69). Among the new users, the proportion adherent (PDC ≥ 0.80) decreased from 60.3% at 6 months to 31.0% at 3 years. During the 3-year follow-up, 58.7% discontinued their statin. Conclusions: Despite increased use of statins among older Australians with dementia, adherence is low and discontinuation is high, which may point to intentional cessation.

scholarly journals Association between maternal and paternal mental illness and risk of injuries in children and adolescents: nationwide register based cohort study in Sweden

BMJ ◽  
2020 ◽  
pp. m853 ◽  
Author(s):  
Alicia Nevriana ◽  
Matthias Pierce ◽  
Christina Dalman ◽  
Susanne Wicks ◽  
Marie Hasselberg ◽  
...  
Keyword(s):  
Mental Illness ◽  
Cohort Study ◽  
Rate Ratio ◽  
Parental Mental Illness ◽  
Affective Psychosis ◽  
Fall Injuries ◽  
Increased Risk ◽  
Adjusted Rate ◽  
Adjusted Rate Ratio ◽  
Parents With Mental Illness

Abstract Objective To determine the association between parental mental illness and the risk of injuries among offspring. Design Retrospective cohort study. Setting Swedish population based registers. Participants 1 542 000 children born in 1996-2011 linked to 893 334 mothers and 873 935 fathers. Exposures Maternal or paternal mental illness (non-affective psychosis, affective psychosis, alcohol or drug misuse, mood disorders, anxiety and stress related disorders, eating disorders, personality disorders) identified through linkage to inpatient or outpatient healthcare registers. Main outcome measures Risk of injuries (transport injury, fall, burn, drowning and suffocation, poisoning, violence) at ages 0-1, 2-5, 6-9, 10-12, and 13-17 years, comparing children of parents with mental illness and children of parents without mental illness, calculated as the rate difference and rate ratio adjusted for confounders. Results Children with parental mental illness contributed to 201 670.5 person years of follow-up, while children without parental mental illness contributed to 2 434 161.5 person years. Children of parents with mental illness had higher rates of injuries than children of parents without mental illness (for any injury at age 0-1, these children had an additional 2088 injuries per 100 000 person years; number of injuries for children with and without parental mental illness was 10 235 and 72 723, respectively). At age 0-1, the rate differences ranged from 18 additional transport injuries to 1716 additional fall injuries per 100 000 person years among children with parental mental illness compared with children without parental mental illness. A higher adjusted rate ratio for injuries was observed from birth through adolescence and the risk was highest during the first year of life (adjusted rate ratio at age 0-1 for the overall association between any parental mental illness that has been recorded in the registers and injuries 1.30, 95% confidence interval 1.26 to 1.33). Adjusted rate ratios at age 0-1 ranged from 1.28 (1.24 to 1.32) for fall injuries to 3.54 (2.28 to 5.48) for violence related injuries. Common and serious maternal and paternal mental illness was associated with increased risk of injuries in children, and estimates were slightly higher for common mental disorders. Conclusions Parental mental illness is associated with increased risk of injuries among offspring, particularly during the first years of the child’s life. Efforts to increase access to parental support for parents with mental illness, and to recognise and treat perinatal mental morbidity in parents in secondary care might prevent child injury.

Risk of Cataracts among Idiopathic Thrombocytopenic Purpura (ITP) Patients in the UK General Practice Research Database (GPRD).

Blood ◽  
2007 ◽  
Vol 110 (11) ◽  
pp. 3922-3922
Author(s):  
Maurille A. Feudjo-Tepie ◽  
Susan A. Hall ◽  
John W. Logie ◽  
Noah J. Robinson ◽  
Dimitri Bennett
Keyword(s):  
Rate Ratio ◽  
General Practice Research Database ◽  
Oral Steroid ◽  
Practice Research ◽  
Research Database ◽  
Steroid Use ◽  
Increased Risk ◽  
Oral Steroids ◽  
Adjusted Rate ◽  
Adjusted Rate Ratio

Abstract ITP is a disease caused by inadequate platelet production as well as increased platelet destruction. Oral systemic steroids are recommended as first-line treatment. Prolonged use of oral steroids in other disease populations has been associated with an approximately two-fold increase in the risk of developing a cataract. This study aimed to quantify the underlying risk of cataracts among ITP patients compared with non-ITP patients. Using the GPRD, a retrospective matched cohort study was conducted in which each ITP patient newly diagnosed between 1992 and 2005 and age 18 years or older was matched to 5 non-ITP patients on gender, age, practice and duration of follow-up. ITP patients and cataract events were identified using specific Read/Oxmis disease codes and validated by a clinical epidemiologist. The exposure of interest was oral steroid use and the primary outcome was cataracts (recorded as cataracts or cataract surgery). Patients with a history of cataracts were not excluded from the study. Potential covariates of interest were diabetes, schizophrenia, glaucoma, splenectomy and hypertension. The risk of cataracts was quantified using incidence rates and 95% confidence intervals (CI) and, the difference between groups was estimated using a rate ratio and 95% CI. All analyses were further stratified by age and gender. Adjusted rate ratios were estimated using the Cox proportional hazard model. Seven hundred sixty ITP patients were identified, 745 (98%) of whom had 5 matched controls. The entire sample had a mean age of 56.4 years and 60.1% were female. Among ITP patients, users of oral steroids had a cataract incidence rate of 14.0 per 1000 person-years (PY) (95% CI: 8.7 – 21.4) and non steroid users 6.1 per 1000 PY (95% CI: 2.7 – 11.4). In the non-ITP population, these figures were 16.9 per 1000 PY (95% CI: 11.9 – 23.3) and 9.2 per 1000 PY (95% CI: 7.6 – 11.0), respectively. The incidence of cataracts was observed to increase with age. Adjusting for steroid use and other factors, the risk of cataracts was similar in the ITP and non-ITP populations (adjusted rate ratio 0.8, 95% CI: 0.5 – 1.2) whereas, oral steroid use was associated with an increased risk of cataracts in both ITP and non ITP populations (adjusted rate ratio 1.6, 95% CI: 1.2 – 2.2). There was no evidence of increased risk with either inhaled steroids, or intranasal steroids. As expected, our study shows that the use of oral steroids is associated with an increased risk of cataracts in both ITP and non-ITP populations. However, we found no evidence of a difference in the risk of cataracts between an ITP and a matched non-ITP population.

scholarly journals Integrated use of the GeneXpert Platform for TB, HIV and EVD Testing in Liberia

2020 ◽  
pp. 19-30
Author(s):  
Kassaye Tekie Desta ◽  
John B. Dogba ◽  
Julia Toomey Garbo ◽  
Dedeh B. Kessely ◽  
Candace B. Eastman ◽  
...  
Keyword(s):  
Viral Load ◽  
Ebola Virus ◽  
Point Of Care ◽  
Secondary Data ◽  
Molecular Testing ◽  
Virus Diseases ◽  
Hiv Viral Load ◽  
Immunodeficiency Virus ◽  
Testing Data ◽  
Disease Testing

Background: The capacity for molecular testing of the Human Immunodeficiency Virus (HIV) Viral load, Tuberculosis (TB) and epidemic- prone disease was very limited in Liberia prior to the Ebola Virus Diseases (EVD) outbreak. The use of point of care and near point of care machines for multiple disease testing of HIV, TB and EVD was adopted as a solution to these challenges. The purpose of this study was to evaluate the integrated use of GeneXpert for the three disease testing. Methods: A previously collected and reported GeneXpert testing data was used to evaluate the integrated use of the GeneXpert platform for TB, HIV viral load and EVD testing. All the laboratory GeneXpert secondary data available since the machines were installed and started testing were analyzed.

scholarly journals Systemic Antibiotics and Tooth Loss in Periodontal Disease

2008 ◽  
Vol 87 (9) ◽  
pp. 871-876 ◽  
Author(s):  
J. Cunha-Cruz ◽  
P.P. Hujoel ◽  
G. Maupome ◽  
B. Saver
Keyword(s):  
Periodontal Disease ◽  
Tooth Loss ◽  
Randomized Trials ◽  
Severe Disease ◽  
Antibiotic Use ◽  
Subgroup Analyses ◽  
Adjusted Rate ◽  
Systemic Antibiotics ◽  
Adjusted Rate Ratio

Systemic antibiotics have been recommended for the treatment of destructive periodontal disease. Our goal was to relate antibiotic use for medical or dental reasons to subsequent tooth loss in a cohort of 12,631 persons with destructive periodontal disease. After adjustment for age, smoking, and other confounders, the dispensing of antibiotics for 1–13 days, 14–20 days, or 21 or more days was not associated with reduced tooth loss [Adjusted rate ratio (RR) = 1.0; 95% Confidence Interval (CI) = 0.8–1.1; RR = 1.2; 95% CI = 0.9–1.4, and RR =1.2, 95% CI =1.0–1.3, respectively]. Numerous subgroup analyses were consistent with these overall null findings, with two exceptions: Longer courses of tetracyclines were associated with reduced tooth loss among persons receiving periodontal care, and penicillin was associated with reduced tooth loss among persons with more severe disease. Long-term, larger randomized trials are needed to provide evidence that antibiotics reduce tooth loss when used in the management of destructive periodontal disease.

scholarly journals Approaches and Barriers to Addressing Equity in Transportation: Experiences of Transportation Practitioners

2021 ◽  
pp. 036119812110145
Author(s):  
Kaylla Cantilina ◽  
Shanna R. Daly ◽  
Matthew P. Reed ◽  
Robert C. Hampshire
Keyword(s):  
Professional Practice ◽  
Explicit Integration ◽  
Non Profit ◽  
The Public ◽  
Related Data ◽  
Vulnerable Communities ◽  
Transportation Equity ◽  
Structural Inequities

The importance of advancing transportation equity has become more visible as other structural inequities in our society have received increasing attention. Articulating approaches that practitioners use to address equity in their work, including experience-based strategies and research-developed equity metrics, contribute to supporting the achievement of transportation equity goals. However, a gap exists between knowing these approaches and integrating them into regular professional practice, in part because of barriers that span across different transportation-related contexts. To investigate practitioners’ approaches to transportation equity, as well as barriers they encounter in trying to achieve improved equity, interviews were conducted with 59 transportation practitioners from the public, private, non-profit, and academic sectors. Findings revealed that a majority of the transportation practitioners in the study engaged in addressing equity in their work, including through collaborating with other organizations and sectors, integrating non-transportation-related data, and considering the contextual needs of vulnerable communities. They identified key barriers to their implementation of transportation equity approaches, including the lack of sufficient and quality equity-related data, challenges with accessing and collecting data, and a lack of standards and metrics for measuring equity-related outcomes. These findings can guide work that supports the explicit integration of transportation equity approaches into practitioners’ practices.

scholarly journals Gestational age and hospital admissions during childhood: population based, record linkage study in England (TIGAR study)

BMJ ◽  
2020 ◽  
pp. m4075
Author(s):  
Victoria Coathup ◽  
Elaine Boyle ◽  
Claire Carson ◽  
Samantha Johnson ◽  
Jennifer J Kurinzcuk ◽  
...  
Keyword(s):  
Hospital Admission ◽  
Gestational Age ◽  
Record Linkage ◽  
Hospital Admissions ◽  
Population Based ◽  
Admission Rates ◽  
Adjusted Rate ◽  
Gestational Age At Birth ◽  
Adjusted Rate Ratio ◽  
Age At Birth

AbstractObjectiveTo examine the association between gestational age at birth and hospital admissions to age 10 years and how admission rates change throughout childhood.DesignPopulation based, record linkage, cohort study in England.SettingNHS hospitals in England, United Kingdom.Participants1 018 136 live, singleton births in NHS hospitals in England between January 2005 and December 2006.Main outcome measuresPrimary outcome was all inpatient hospital admissions from birth to age 10, death, or study end (March 2015); secondary outcome was the main cause of admission, which was defined as the World Health Organization’s first international classification of diseases, version 10 (ICD-10) code within each hospital admission record.Results1 315 338 admissions occurred between 1 January 2005 and 31 March 2015, and 831 729 (63%) were emergency admissions. 525 039 (52%) of 1 018 136 children were admitted to hospital at least once during the study period. Hospital admissions during childhood were strongly associated with gestational age at birth (<28, 28-29, 30-31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, and 42 weeks). In comparison with children born at full term (40 weeks’ gestation), those born extremely preterm (<28 weeks) had the highest rate of hospital admission throughout childhood (adjusted rate ratio 4.92, 95% confidence interval 4.58 to 5.30). Even children born at 38 weeks had a higher rate of hospital admission throughout childhood (1.19, 1.16 to 1.22). The association between gestational age and hospital admission decreased with increasing age (interaction P<0.001). Children born earlier than 28 weeks had an adjusted rate ratio of 6.34 (95% confidence interval 5.80 to 6.85) at age less than 1 year, declining to 3.28 (2.82 to 3.82) at ages 7-10, in comparison with those born full term; whereas in children born at 38 weeks, the adjusted rate ratios were 1.29 (1.27 to 1.31) and 1.16 (1.13 to 1.19), during infancy and ages 7-10, respectively. Infection was the main cause of excess hospital admissions at all ages, but particularly during infancy. Respiratory and gastrointestinal conditions also accounted for a large proportion of admissions during the first two years of life.ConclusionsThe association between gestational age and hospital admission rates decreased with age, but an excess risk remained throughout childhood, even among children born at 38 and 39 weeks of gestation. Strategies aimed at the prevention and management of childhood infections should target children born preterm and those born a few weeks early.

scholarly journals Association between palliative care and healthcare outcomes among adults with terminal non-cancer illness: population based matched cohort study

BMJ ◽  
2020 ◽  
pp. m2257 ◽  
Author(s):  
Kieran L Quinn ◽  
Therese Stukel ◽  
Nathan M Stall ◽  
Anjie Huang ◽  
Sarina Isenberg ◽  
...  
Keyword(s):  
Palliative Care ◽  
Standard Deviation ◽  
Confidence Interval ◽  
Rate Ratio ◽  
Emergency Department Visits ◽  
Crude Rate ◽  
Adjusted Rate ◽  
Dying At Home ◽  
Adjusted Rate Ratio ◽  
At Home

Abstract Objective To measure the associations between newly initiated palliative care in the last six months of life, healthcare use, and location of death in adults dying from non-cancer illness, and to compare these associations with those in adults who die from cancer at a population level. Design Population based matched cohort study. Setting Ontario, Canada between 2010 and 2015. Participants 113 540 adults dying from cancer and non-cancer illness who were given newly initiated physician delivered palliative care in the last six months of life administered across all healthcare settings. Linked health administrative data were used to directly match patients on cause of death, hospital frailty risk score, presence of metastatic cancer, residential location (according to 1 of 14 local health integration networks that organise all healthcare services in Ontario), and a propensity score to receive palliative care that was derived by using age and sex. Main outcome measures Rates of emergency department visits, admissions to hospital, and admissions to the intensive care unit, and odds of death at home versus in hospital after first palliative care visit, adjusted for patient characteristics (such as age, sex, and comorbidities). Results In patients dying from non-cancer illness related to chronic organ failure (such as heart failure, cirrhosis, and stroke), palliative care was associated with reduced rates of emergency department visits (crude rate 1.9 (standard deviation 6.2) v 2.9 (8.7) per person year; adjusted rate ratio 0.88, 95% confidence interval 0.85 to 0.91), admissions to hospital (crude rate 6.1 (standard deviation 10.2) v 8.7 (12.6) per person year; adjusted rate ratio 0.88, 95% confidence interval 0.86 to 0.91), and admissions to the intensive care unit (crude rate 1.4 (standard deviation 5.9) v 2.9 (8.7) per person year; adjusted rate ratio 0.59, 95% confidence interval 0.56 to 0.62) compared with those who did not receive palliative care. Additionally increased odds of dying at home or in a nursing home compared with dying in hospital were found in these patients (n=6936 (49.5%) v n=9526 (39.6%); adjusted odds ratio 1.67, 95% confidence interval 1.60 to 1.74). Overall, in patients dying from dementia, palliative care was associated with increased rates of emergency department visits (crude rate 1.2 (standard deviation 4.9) v 1.3 (5.5) per person year; adjusted rate ratio 1.06, 95% confidence interval 1.01 to 1.12) and admissions to hospital (crude rate 3.6 (standard deviation 8.2) v 2.8 (7.8) per person year; adjusted rate ratio 1.33, 95% confidence interval 1.27 to 1.39), and reduced odds of dying at home or in a nursing home (n=6667 (72.1%) v n=13 384 (83.5%); adjusted odds ratio 0.68, 95% confidence interval 0.64 to 0.73). However, these rates differed depending on whether patients dying with dementia lived in the community or in a nursing home. No association was found between healthcare use and palliative care for patients dying from dementia who lived in the community, and these patients had increased odds of dying at home. Conclusions These findings highlight the potential benefits of palliative care in some non-cancer illnesses. Increasing access to palliative care through sustained investment in physician training and current models of collaborative palliative care could improve end-of-life care, which might have important implications for health policy.

scholarly journals Antiphospholipid patterns predict risk of thrombosis in systemic lupus erythematosus

Rheumatology ◽  
2020 ◽  
Author(s):  
Selcan Demir ◽  
Jessica Li ◽  
Laurence S Magder ◽  
Michelle Petri
Keyword(s):  
Lupus Erythematosus ◽  
Significant Risk ◽  
Interaction Model ◽  
Significant Risk Factor ◽  
Glycoprotein I ◽  
Adjusted Rate ◽  
Incident Cases ◽  
The Relationship ◽  
Adjusted Rate Ratio

Abstract Objective We evaluated which aPL combinations increase the risk of future thrombosis in patients with SLE. Methods This prospective cohort study consisted of SLE patients who had been tested for all seven aPL (LA, aCL isotypes IgM, IgG and IgA, and anti-β2-glycoprotein I isotypes IgM, IgG and IgA). Pooled logistic regression was used to assess the relationship between aPL and thrombosis. Results There were 821 SLE patients with a total of 75 048 person-months of follow-up. During the follow-up we observed 88 incident cases of thrombosis: 48 patients with arterial, 37 with venous and 3 with both arterial and venous thrombosis. In individual models, LA was the most predictive of any [age-adjusted rate ratio 3.56 (95% CI 2.01, 6.30), P &lt; 0.0001], venous [4.89 (2.25, 10.64), P &lt; 0.0001] and arterial [3.14 (1.41, 6.97), P = 0.005] thrombosis. Anti-β2-glycoprotein I IgA positivity was a significant risk factor for any [2.00 (1.22, 3.3), P = 0.0065] and venous [2.8 (1.42, 5.51), P = 0.0029] thrombosis. Only anti-β2-glycoprotein I IgA appeared to add significant risk to any [1.73 (1.04, 2.88), P = 0.0362] and venous [2.27 (1.13, 4.59), P = 0.0218] thrombosis among those with LA. We created an interaction model with four categories based on combinations of LA and other aPL to look at the relationships between combinations and the risk of thrombosis. In this model LA remained the best predictor of thrombosis. Conclusion Our study demonstrated that in SLE, LA remained the best predictor of thrombosis and adding additional aPL did not add to the risk, with the exception of anti-β2-glycoprotein I IgA.

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