scholarly journals Estimating the cumulative incidence of SARS-CoV-2 infection and the infection fatality ratio in light of waning antibodies

2020 ◽  
Author(s):  
Kayoko Shioda ◽  
Max SY Lau ◽  
Alicia NM Kraay ◽  
Kristin N Nelson ◽  
Aaron J Siegler ◽  
...  
Keyword(s):  
New York ◽  
Cumulative Incidence ◽  
National Science Foundation ◽  
Population Level ◽  
Credible Interval ◽  
Mortality Data ◽  
Cross Sectional ◽  
Seroprevalence Data ◽  
The Us ◽  
Using Data

AbstractBackgroundSerology tests can identify previous infections and facilitate estimation of the number of total infections. However, immunoglobulins targeting severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have been reported to wane below the detectable level of serological assays. We estimate the cumulative incidence of SARS-CoV-2 infection from serology studies, accounting for expected levels of antibody acquisition (seroconversion) and waning (seroreversion), and apply this framework using data from New York City (NYC) and Connecticut.MethodsWe estimated time from seroconversion to seroreversion and infection fatality ratio (IFR) using mortality data from March-October 2020 and population-level cross-sectional seroprevalence data from April-August 2020 in NYC and Connecticut. We then estimated the daily seroprevalence and cumulative incidence of SARS-CoV-2 infection.FindingsThe estimated average time from seroconversion to seroreversion was 3-4 months. The estimated IFR was 1.1% (95% credible interval: 1.0-1.2%) in NYC and 1.4% (1.1-1.7%) in Connecticut. The estimated daily seroprevalence declined after a peak in the spring. The estimated cumulative incidence reached 26.8% (24.2-29.7%) and 8.8% (7.1-11.3%) at the end of September in NYC and Connecticut, higher than maximum seroprevalence measures (22.1% and 6.1%), respectively.InterpretationThe cumulative incidence of SARS-CoV-2 infection is underestimated using cross-sectional serology data without adjustment for waning antibodies. Our approach can help quantify the magnitude of underestimation and adjust estimates for waning antibodies.FundingThis study was supported by the US National Science Foundation and the National Institute of Allergy and Infectious Diseases.

scholarly journals A risk index for COVID-19 severity is associated with COVID-19 mortality in New York City

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Wil Lieberman-Cribbin ◽  
Naomi Alpert ◽  
Raja Flores ◽  
Emanuela Taioli
Keyword(s):  
Risk Factors ◽  
New York ◽  
New York City ◽  
York City ◽  
Underserved Populations ◽  
Risk Index ◽  
Data Repository ◽  
Severe Illness ◽  
Mortality Data ◽  
Cross Sectional

Abstract Background New York City (NYC) was the epicenter of the COVID-19 pandemic, and is home to underserved populations with higher prevalence of chronic conditions that put them in danger of more serious infection. Little is known about how the presence of chronic risk factors correlates with mortality at the population level. Here we determine the relationship between these factors and COVD-19 mortality in NYC. Methods A cross-sectional study of mortality data obtained from the NYC Coronavirus data repository (03/02/2020–07/06/2020) and the prevalence of neighborhood-level risk factors for COVID-19 severity was performed. A risk index was created based on the CDC criteria for risk of severe illness and complications from COVID-19, and stepwise linear regression was implemented to predict the COVID-19 mortality rate across NYC zip code tabulation areas (ZCTAs) utilizing the risk index, median age, socioeconomic status index, and the racial and Hispanic composition at the ZCTA-level as predictors. Results The COVID-19 death rate per 100,000 persons significantly decreased with the increasing proportion of white residents (βadj = − 0.91, SE = 0.31, p = 0.0037), while the increasing proportion of Hispanic residents (βadj = 0.90, SE = 0.38, p = 0.0200), median age (βadj = 3.45, SE = 1.74, p = 0.0489), and COVID-19 severity risk index (βadj = 5.84, SE = 0.82, p <  0.001) were statistically significantly positively associated with death rates. Conclusions Disparities in COVID-19 mortality exist across NYC and these vulnerable areas require increased attention, including repeated and widespread testing, to minimize the threat of serious illness and mortality.

scholarly journals Measuring Historical Urban Neighborhood Sustainability: America’s Grand Avenues

2021 ◽  
Vol 13 (3) ◽  
pp. 1358
Author(s):  
Michael R. Greenberg
Keyword(s):  
New York ◽  
New York City ◽  
Kansas City ◽  
White Supremacy ◽  
Urban Neighborhood ◽  
Industrial Cities ◽  
The Us ◽  
Education Medical ◽  
Using Data ◽  
Us Cities

From 1850 through approximately 1920, wealthy entrepreneurs and elected officials created “grand avenues” lined by mansions in New York City, Chicago, Detroit, and other developing US cities. This paper examines the birthplaces of grand avenues to determine whether they have remained sustainable as magnets for healthy and wealthy people. Using data from the US EPA’s EJSCREEN system and the CDC’s 500 cities study across 11 cities, the research finds that almost every place where a grand avenue began has healthier and wealthier people than their host cities. Ward Parkway in Kansas City and New York’s Fifth Avenue have continued to be grand. Massachusetts Avenue in Washington, D.C., Richmond’s Monument Avenue, St. Charles Avenue in New Orleans, and Los Angeles’s Wilshire Boulevard are national and regional symbols of political power, culture and entertainment, leading to sustainable urban grand avenues, albeit several are challenged by their identification with white supremacy. Among Midwest industrial cities, Chicago’s Prairie Avenue birthplace has been the most successful, whereas the grand avenues of St. Louis, Cleveland, Detroit, and Buffalo have struggled, trying to use higher education, medical care, and entertainment to try to rebirth their once pre-eminent roles in their cities.

Absence of the weekend effect and industry-style portfolios

2019 ◽  
Vol 12 (4) ◽  
pp. 463-475
Author(s):  
Selma Izadi ◽  
Abdullah Noman
Keyword(s):  
New York ◽  
Stock Market ◽  
Structural Breaks ◽  
Stock Exchange ◽  
Structural Break ◽  
Weekend Effect ◽  
Content Type ◽  
Market Portfolio ◽  
The Us ◽  
Using Data

Purpose The existence of the weekend effect has been reported from the 1950s to 1970s in the US stock markets. Recently, Robins and Smith (2016, Critical Finance Review, 5: 417-424) have argued that the weekend effect has disappeared after 1975. Using data on the market portfolio, they document existence of structural break before 1975 and absence of any weekend effects after that date. The purpose of this study is to contribute some new empirical evidences on the weekend effect for the industry-style portfolios in the US stock market using data over 90 years. Design/methodology/approach The authors re-examine persistence or reversal of the weekend effect in the industry portfolios consisting of The New York Stock Exchange (NYSE), The American Stock Exchange (AMEX) and The National Association of Securities Dealers Automated Quotations exchange (NASDAQ) stocks using daily returns from 1926 to 2017. Our results confirm varying dates for structural breaks across industrial portfolios. Findings As for the existence of weekend effects, the authors get mixed results for different portfolios. However, the overall findings provide broad support for the absence of weekend effects in most of the industrial portfolios as reported in Robins and Smith (2016). In addition, structural breaks for other weekdays and days of the week effects for other days have also been documented in the paper. Originality/value As far as the authors are aware, this paper is the first research that analyzes weekend effect for the industry-style portfolios in the US stock market using data over 90 years.

Relationship of Area-Level Socioeconomic Status Indicators and Nutritional Anemias: Analysis of Folate, Vitamin B12, and Iron Deficiencies

Blood ◽  
2020 ◽  
Vol 136 (Supplement 1) ◽  
pp. 16-17
Author(s):  
Miguel Gonzalez Velez ◽  
Carolyn Mead-Harvey ◽  
Heidi E. Kosiorek ◽  
Yael Kusne ◽  
Leyla Bojanini ◽  
...  
Keyword(s):  
Socioeconomic Status ◽  
Vitamin B12 ◽  
Conflicts Of Interest ◽  
Population Level ◽  
Serum Folate ◽  
Continuous Variables ◽  
Cross Sectional ◽  
The Us ◽  
Relationship Of ◽  
The Relationship

Introduction: Serum folate (SF), vitamin B12 (B12), and iron deficiency (def) are common causes of nutritional anemias (NA). These deficiencies are usually multifactorial, with nutritional and non-nutritional causes playing a role. SF, B12, and iron levels are usually ordered in the setting of anemia, and malnutrition with or without neurologic symptoms. Clinical evidence suggests that these def have a strong dietary component and socioeconomic status (SES). The relationship of NA and area-based SES in the US has not been studied. We aimed to determine the relationship of SES with the prevalence of NA. Methods: We performed a cross-sectional analysis of adult patients with SF, B12 and iron levels at Mayo Clinic Arizona and Florida between 2010 and 2018. Race was classified using the NIH criteria. Normal laboratory values were determined according to our lab reference and the US NHANES III. SF levels (mcg/Lt) were defined as deficient &lt;4, normal ≥4.0, and excess ≥20. B12 levels (ng/L) as deficient &lt;150, borderline 150-400, normal &gt;400-900, and excess ≥900. Iron def was determined by ferritin levels (mcg/L) as low &lt;24, normal 24-336, elevated &gt;336 for men, low &lt;11, normal 11-307, elevated &gt;307 for women. Area-Level SES indicators: Median Household income (MHI), unemployment rate (UR), median gross rent month (MGRM), % uninsured, median house value (MHV), % high school; were geocoded by zip code using the 2014 American Community Survey. Demographics and clinical variables were compared between groups by chi-square test for frequency data or Kruskal Wallis rank-sum test for continuous variables. Results: 202,046 samples from 128,084 patients were analyzed. In the sample-level analysis, there were statistically significant associations between SES and SF def; all SES indicators except UR for B12 def; and no differences for iron def, except % uninsured (Table 1). There was no statistically significant interaction between race and SES for SF def and iron def. Race was a statistically significant modifier between B12 def and MHI (p&lt;0.001), % uninsured (p=0.002), and MHV (p=0.007). Asian and Other race had an increase in odds of B12 def with increasing MHI (Asian OR=1.11 , Other OR=1.18); white race had a decrease in odds of B12 def with increasing MHI (OR=0.95 for a $10,000 increase in MHI). Conclusions: We show significant relationships between SES and NA in the US. Differences were observed between SF def and all the SES indicators without race interactions. There were significant interactions between B12 def, race and SES for pts of White, Asian and Other race. There were no differences between SES and race for iron def. These relationships confirm that NA are related to area-level SES and other social determinants of health. Research regarding the causes of these disparities on a population level are needed. Disclosures No relevant conflicts of interest to declare.

scholarly journals Impact of Powered Toothbrush Use and Interdental Cleaning on Oral Health

2020 ◽  
pp. 002203452097395
Author(s):  
V. Pitchika ◽  
R. Jordan ◽  
W. Micheelis ◽  
A. Welk ◽  
T. Kocher ◽  
...  
Keyword(s):  
Oral Health ◽  
Population Level ◽  
Cross Sectional ◽  
Free Surfaces ◽  
Number Of Teeth ◽  
Long Run ◽  
Probing Depth ◽  
Health Studies ◽  
Using Data ◽  
Lower Magnitude

The long-term effectiveness of powered toothbrushes (PTBs) and interdental cleaning aids (IDAs) on a population level is unproven. We evaluated to what extent changes in PTB and IDA use may explain changes in periodontitis, caries, and tooth loss over the course of 17 y using data for adults (35 to 44 y) and seniors (65 to 74 y) from 3 independent cross-sectional surveys of the German Oral Health Studies (DMS). Oaxaca decomposition analyses assessed to what extent changes in mean probing depth (PD), number of caries-free surfaces, and number of teeth between 1) DMS III and DMS V and 2) DMS IV and DMS V could be explained by changes in PTB and IDA use. Between DMS III and V, PTB (adults: 33.5%; seniors: 28.5%) and IDA use (adults: 32.5%; seniors: 41.4%) increased along with an increase in mean PD, number of caries-free surfaces, and number of teeth. Among adults, IDA use contributed toward increased number of teeth between DMS III and V as well as DMS IV and V. In general, the estimates for adults were of lower magnitude. Among seniors between DMS III and V, PTB and IDA use explained a significant amount of explained change in the number of caries-free surfaces (1.72 and 5.80 out of 8.44, respectively) and the number of teeth (0.49 and 1.25 out of 2.19, respectively). Between DMS IV and V, PTB and IDA use contributed most of the explained change in caries-free surfaces (0.85 and 1.61 out of 2.72, respectively) and the number of teeth (0.25 and 0.46 out of 0.94, respectively) among seniors. In contrast to reported results from short-term clinical studies, in the long run, both PTB and IDA use contributed to increased number of caries-free healthy surfaces and teeth in both adults and seniors.

scholarly journals Assessment of the use of Unna boot in the treatment of chronic venous leg ulcers in adults: systematic review protocol

BMJ Open ◽  
2019 ◽  
Vol 9 (12) ◽  
pp. e032091
Author(s):  
Thalita Paranhos ◽  
Caroline S B Paiva ◽  
Fernanda C I Cardoso ◽  
Priscila P Apolinário ◽  
Flavia Figueiredo Azevedo ◽  
...  
Keyword(s):  
Systematic Review ◽  
New York ◽  
Cochrane Library ◽  
Leg Ulcers ◽  
Venous Flow ◽  
Cross Sectional ◽  
Venous Leg Ulcers ◽  
The Us ◽  
Registration Number ◽  
Review Protocol

IntroductionChronic venous insufficiency (CVI) is an anomaly of the normal functioning of the venous system caused by valvular incompetence with or without the obstruction of venous flow. This condition can affect either or both of the superficial and the deep venous systems. Venous dysfunction can even result in congenital or acquired disorders, and its complications include venous leg ulcers (VLUs). The objective of this systematic review is to determine the effectiveness of Unna boot in the treatment of wound healing of VLU by assessing the quality of the available evidence.Methods and analysisA literature search in PubMed, CINAHL, Scopus, Web of Science, Cochrane Library, BVS/BIREME, Embase, ProQuest, BDTD, Thesis and Dissertation Catalog, Sao Paulo Research Foundation/Thesis and dissertation, OPEN THESIS, A service of the US National Institute of Health, Center for Reviews and Dissemination-University of New York and SciElo published in the last 10 years, the period from January 1999 to March 2019. The review will include primary studies (original), and Controlled Trials or Observational studies (cross-sectional, case–control or longitudinal studies) with VLU. The exclusion will include leg ulceration due to different causes, such as pressure, arterial, diabetic or mixed-aetiology leg ulcers. Data synthesis will be performed using a narrative summary and quantitative analysis.Ethics and disseminationThis systematic review does not require approval by the ethics committee, as individual patient data will not be collected. Dissemination of findings will be through publications in peer-reviewed journals and/or via conference presentations.PROSPERO registration numberCRD42019127947

scholarly journals Different outcomes for different interventions with different focus!— A cross-country comparison of community interventions in rural Swedish and US populations

2001 ◽  
Vol 29 (56_suppl) ◽  
pp. 46-58 ◽  
Author(s):  
L. Weinehall ◽  
C. Lewis ◽  
A.N. Nafziger ◽  
P.L. Jenkins ◽  
T.A. Erb ◽  
...  
Keyword(s):  
Risk Factors ◽  
New York ◽  
Risk Reduction ◽  
New York State ◽  
Reference Population ◽  
Cvd Risk ◽  
Cross Sectional ◽  
York State ◽  
The Us ◽  
Cross Sectional Studies

Objectives: There is a need among healthcare providers to acquire more knowledge about small-scale and low budget community intervention programmes. This paper compares risk factor outcomes in Swedish and US intervention programmes for the prevention of cardiovascular disease (CVD). The aim was to explore how different intervention programme profiles affect outcome. Methods: Using a quasi-experimental design, trends in risk factors and estimated CVD risk in two intervention areas (Norsjö, Sweden and Otsego- Schoharie County, New York state) are compared with those in reference areas (Northern Sweden region and Herkimer County, New York state) using serial cross-sectional studies and panel studies. Results: The programmes were able to achieve significant changes in CVD risk factors that the local communities recognized as major concerns: changing eating habits in the Swedish population and reducing smoking in the US population. For the Swedish cross-sectional follow-up study cholesterol reduction was 12%, compared to 5% in the reference population ( p for trend differences < 0.000) . The significantly higher estimated CVD risk (as assessed by risk scores) at baseline in the intervention population was below that of the Swedish reference population after 5 years of intervention. The Swedish panel study provided the same results. In the US, both the serial cross-sectional and panel studies showed a >10% decline in smoking prevalence in the intervention population, while it increased slightly in the reference population. When pooling the serial cross-sectional studies the estimated risk reduction (using the Framingham risk equation) was significantly greater in the intervention populations compared to the reference populations. Conclusions: The overall pattern of risk reduction is consistent and suggests that the two different models of rural county intervention can contribute to significant risk reduction. The Swedish programme had its greatest effect on reduction of serum cholesterol levels whereas the US programme had its greatest effect on smoking prevention and cessation. These outcomes are consistent with programmatic emphases. Socially less privileged groups in these rural areas benefited as much or more from the interventions as those with greater social resources.

scholarly journals Impact of pneumococcal conjugate vaccine uptake on childhood pneumonia mortality across income levels in Brazil, Colombia, and Peru

2020 ◽  
Vol 4 ◽  
pp. 136
Author(s):  
Kayoko Shioda ◽  
Cristiana M. Toscano ◽  
Maria Tereza Valenzuela ◽  
William Valdez Huarcaya ◽  
Joshua L. Warren ◽  
...  
Keyword(s):  
Low Income ◽  
Healthcare Access ◽  
Population Level ◽  
Income Level ◽  
High Income ◽  
Vaccine Uptake ◽  
Mortality Data ◽  
Income Levels ◽  
The Difference ◽  
Using Data

Background: Pneumococcal conjugate vaccines (PCVs) have prevented deaths due to pneumonia among children. The effect may differ between higher- and lower-income populations due to various factors, such as differences in the distribution of pneumococcal serotypes, healthcare access, and PCV uptake. This study aims to evaluate an association between increasing PCV coverage and population-level declines in death due to pneumonia and its variation by socioeconomic status of subnational regions. Methods: We analyzed municipality-level mortality data from 2005 and 2015 for children aged 2-23 months in Brazil, Colombia, and Peru. We fit Poisson regression models to estimate the relationship between changes in PCV uptake and deaths due to all-cause pneumonia among subnational regions with different income levels. We controlled for changes unrelated to PCV by using data on non-respiratory deaths over time. Results: Uptake of the third dose of PCV varied across subnational regions and was higher in high-income regions. Higher uptake of PCV was associated with larger declines in pneumonia mortality. This association did not differ by income level of the region in Brazil and Colombia. In Peru, low-income regions observed larger declines in pneumonia deaths, but there was large uncertainty in the difference between the low- and high-income regions. We estimated that, with 90% coverage, there would be 4-38% declines in all-cause pneumonia mortality across income levels and countries. Conclusions: Regions with higher PCV coverage experienced larger declines in pneumonia deaths, regardless of the income level. Having more reliable data on mortality records and vaccine uptake would improve the reliability of vaccine impact estimates.

scholarly journals Evaluation of the US governors decision when to issue stay-at-home orders [Running title: When to shut down: the Weber-Fechner law describes the timing of U. S. governors decisions to issue stay-at-home orders]

2020 ◽  
Author(s):  
Benjamin Djulbegovic ◽  
David J Weiss ◽  
Iztok Hozo
Keyword(s):  
New York ◽  
Cox Model ◽  
New York Times ◽  
Just Noticeable Difference ◽  
Infected People ◽  
The Us ◽  
Clear Dose Response ◽  
Using Data ◽  
Stimulus Design ◽  
At Home

Objectives To evaluate if the US governors decision to issue the stay-at-home orders reflects the classic Weber-Fechner law of psychophysics, the amount by which a stimulus (such as number of cases or deaths) must increase in order to be noticed-the just noticeable difference- as a fraction of the intensity of that stimulus. Design A prospective observational study using data on the daily number of infected patients and deaths from the New York Times daily database. Setting 50 States and the District of Columbia Participants All individuals judged to be positive for the coronavirus or to have died from COVID19. Main outcome measures Number of people diagnosed with or died from COVID19. Results We found that the decision to issue the state-at-home order reflects the Weber-Fechner law of psychophysics. Both the number of infections (p=<0.0001; R2=0.79) and deaths (p<0.0001; R2=0.63) were highly statistically significantly associated with the decision to issue the stay-at-home orders. The results indicate that for each doubling of infections or deaths within their state, an additional four to six governors will issue the stay-at-home order. We also observed a clear dose-response relationship in the Cox model: the larger the number of cases, or deaths, the higher the probability that the stay-at-home order will be made. When the number of deaths reached 256 or the number of infected people was greater than 16,384, the probability of issuing a stay-at-home order was close to 100%. Conclusions When there are not clearly articulated rules to follow, decision-makers in times of crisis such as COVID19 resort to use of simple heuristics consistent with the Weber-Fechner law of psychophysics. The findings are important for the public to understand how their elected officials make important public health decisions.

scholarly journals Improving SARS-CoV-2 cumulative incidence estimation through mixture modelling of antibody levels

2021 ◽  
Author(s):  
C. Bottomley ◽  
M. Otiende ◽  
S. Uyoga ◽  
K. Gallagher ◽  
E.W. Kagucia ◽  
...  
Keyword(s):  
Sensitivity And Specificity ◽  
Antibody Level ◽  
Cumulative Incidence ◽  
Model Estimate ◽  
Mixture Modelling ◽  
Seroprevalence Data ◽  
Incidence Estimation ◽  
Using Data ◽  
Serological Data ◽  
Antibody Levels

AbstractAs countries decide on vaccination strategies and how to ease movement restrictions, estimates of cumulative incidence of SARS-CoV-2 infection are essential in quantifying the extent to which populations remain susceptible to COVID-19. Cumulative incidence is usually estimated from seroprevalence data, where seropositives are defined by an arbitrary threshold antibody level, and adjusted for sensitivity and specificity at that threshold. This does not account for antibody waning nor for lower antibody levels in asymptomatic or mildly symptomatic cases. Mixture modelling can estimate cumulative incidence from antibody-level distributions without requiring adjustment for sensitivity and specificity. To illustrate the bias in standard threshold-based seroprevalence estimates, we compared both approaches using data from several Kenyan serosurveys. Compared to the mixture model estimate, threshold analysis underestimated cumulative incidence by 31% (IQR: 11 to 41) on average. Until more discriminating assays are available, mixture modelling offers an approach to reduce bias in estimates of cumulative incidence.One-Sentence SummaryMixture models reduce biases inherent in the standard threshold-based analysis of SARS-CoV-2 serological data.

Sign in / Sign up

Export Citation Format

Share Document