scholarly journals COVID-19 Spreading Dynamics with Vaccination – Allocation Strategy, Return to Normalcy and Vaccine Hesitancy

2020 ◽  
Author(s):  
B Shayak ◽  
Mohit M Sharma
Keyword(s):  
Significant Risk ◽  
High Rate ◽  
Vaccine Hesitancy ◽  
Allocation Strategy ◽  
Spreading Dynamics ◽  
Majority Population ◽  
High Interaction ◽  
Group Basis ◽  
Delay Differential ◽  
Cutoff Rate

ABSTRACTIn this work we use mathematical modeling to analyse the dynamics of COVID-19 spread after a vaccination program is initiated. The model used is a delay differential equation developed earlier by our group. Basis of currently available data, our principal findings are as follows. (a) For fastest deceleration of the pandemic, people with high interaction rate such as grocers and airline cabin crew should be given priority in vaccine access. (b) Individuals who have been vaccinated may be selectively cleared to return to normal activities without significant risk of a resurgence in cases. (c) If an infection as well as a vaccine confers immunity for a duration τ0, then the pandemic can be eliminated by vaccinating people at a sufficiently high rate. Unless τ0 is very small, the cutoff rate required appears feasible to achieve in practice. (d) The presence of a substantial minority of vaccine-hesitant population might not amount to a significant threat or even an inconvenience to a vaccine-compliant majority population.

scholarly journals Mortality and Conversion Rate to Below Knee or Above Knee Amputation Following Transmetatarsal Amputation

2020 ◽  
Vol 5 (4) ◽  
pp. 2473011420S0011
Author(s):  
D. Anthony Barcel ◽  
Susan M. Odum ◽  
Taylor Rowe ◽  
Jefferson B. Sabatini ◽  
Samuel E. Ford ◽  
...  
Keyword(s):  
Risk Factors ◽  
Conversion Rate ◽  
Significant Risk ◽  
High Rate ◽  
Administrative Database ◽  
Categorical Variables ◽  
Diabetic Patients ◽  
Knee Amputation ◽  
History Of ◽  
Transmetatarsal Amputation

Category: Midfoot/Forefoot; Diabetes; Other Introduction/Purpose: Non-traumatic lower extremity amputations (LEA), especially those performed in dysvascular and diabetic patients, are known to have poor long-term prognosis. Perioperative mortality has been reported at between 4 and 10%, and the 1 and 5 year mortality rates range between 22-33% and 39-69%, respectively. While poor outcomes in these patients have been described, there is no consensus as to the predictors of mortality. The purpose of the study is to determine the percentage of patients who had a complication following transmetatarsal amputation (TMA) and identify associated risk factors for complications and mortality. Methods: We queried our institution’s administrative database to identify 247 TMA procedures performed in 229 patients between January, 2002 and December, 2016. Electronic health records were reviewed to document complications defined as reoperation, amputation and mortality. Mortality was also verified using the National Death Index. Additionally, we recorded risk factors including diabetes, A1c level, end stage renal disease (ESRD), cardiovascular disease (CVD), peripheral vascular disease (PVD), history of revascularization, contralateral amputation, and neuropathy. The majority of the study patients were males (157, 69%) and the average age was 57 years (range 24-91). The median BMI was 28 (range 16-58) and 29% of the study patients were obese with a BMI ≥ 30. Fishers Exact tests were used to compare categorical variables. Kruskal-Wallis and Independent T-tests were used to compare numeric data. All data were analyzed using SAS/STAT software version 9.4 (Carey, NC) and a 0.05 level of significance was defined apriori. Results: The conversion rate to below (BKA) or above knee amputation (AKA) was 26% (64 of 247). Males (p=.0274), diabetics (p=.0139), patients in ESRD (p=.019), and patients with a history of CVD (p=.0247) or perioperative revascularization (p=.022) were more likely to undergo further amputation following an index TMA. BMI was significantly higher in patients requiring BKA/AKA (p=.0305). There were no significant differences in age (p=.2723) or A1c levels (p=.4219). The overall mortality rate was 35% (84 of 229). Diabetes (p=.0272), ESRD (p=.0031), history of CVD (p<.0001) or PVD (p=.0179) were all significantly associated with mortality. Patients who died were significantly older (p=.0006) and had significantly higher A1c levels (p=.0373). BMI was not significantly associated with mortality. Twenty-two patients who had 23 further amputations subsequently died. Conclusion: In our series of patients undergoing TMA, 26% underwent further amputation and 35% of patients died. Conversion rate to BKA or AKA occurred at a high rate regardless of preoperative revascularization or the use of tendo-achilles or gastrocnemius lengthening procedures. Male sex, diabetes, ESRD, history of CVD or revascularization are significant risk factors for further amputation. ESRD, diabetes, history of CVD or PVD, older age and higher A1c levels are significant risk factors for mortality. These data provide useful insight into risk factors to be emphasized when counseling patients and their families to establish realistic postoperative expectations.

scholarly journals Assessing longitudinal and cross-sectional effects of age on adult obesity in an Iranian population: results from a large population-based cohort study

2021 ◽  
Author(s):  
Mahsa Rafiee Alhossaini ◽  
Anoshirvan Kazemnejad ◽  
Farid Zayeri ◽  
Masoumeh Sadeghi
Keyword(s):  
Odds Ratio ◽  
Large Population ◽  
Significant Risk ◽  
High Rate ◽  
Noncommunicable Diseases ◽  
Public Health Issue ◽  
Related Factors ◽  
Cross Sectional ◽  
Longitudinal Effects ◽  
Prevalence Of Obesity

Abstract Background Obesity is a significant risk factor for Noncommunicable diseases, and it is related to many adverse health consequences. The risk of obesity commonly changes with age, which is called a longitudinal or aging effect. Also, individuals born or enter to the study of the same age have similar living conditions that may influence their obesity risk in a particular way; this is a cross-sectional effect. In the current study, an advanced statistical model is used to distinguish between longitudinal and cross-sectional effects of age on the risk of obesity for men and women. Methods Participants are a group of 6504 Iranian adults over 35 years of age in 2001, who live in the central region of Iran. They were followed up for 12 years in a large community-based study. Various medical indexes, including Body Mass Index, were collected in 2001, 2007, and 2013. The Marginal Logistic Regression model, which includes linear and quadratic effects of the Baseline Age and its difference with current age, is used. Results Between 2001 and 2013, the prevalence of obesity raised from 13% to 18% in men and from 31% to 44% in women. The odds of obesity for women was approximately three times the odds of obesity for men on average adjusting for the age effects. Both cross-sectional and longitudinal effects of age were significantly associated with the odds ratio of obesity. There was a rise in the prevalence of obesity for individuals with Baseline Age 35 to 55 and a decline thereafter. Also, the odds ratio of obesity across one’s life course, had about 3% increase, on average, by each year aging, regardless of the age at baseline. Conclusions The high rate of obesity and its fast growth is a serious public health issue among Iranians, especially in adults age 35-55, and women. In the present study, Baseline Age was more strongly associated with the risk of obesity than aging. Considering both cross-sectional and longitudinal effects of age, helps us to understand the effect of age on obesity better and to identify the related factors.

Hepatitis B Reactivation in Patients With Previous Hepatitis B Virus Exposure Undergoing Rituximab-Containing Chemotherapy for Lymphoma: A Prospective Study

2014 ◽  
Vol 32 (33) ◽  
pp. 3736-3743 ◽  
Author(s):  
Wai-Kay Seto ◽  
Thomas S.Y. Chan ◽  
Yu-Yan Hwang ◽  
Danny Ka-Ho Wong ◽  
James Fung ◽  
...  
Keyword(s):  
Hepatitis B Virus ◽  
Hepatitis B ◽  
Significant Risk ◽  
Hbv Dna ◽  
High Rate ◽  
Chinese Patients ◽  
Core Antigen ◽  
Hbv Reactivation ◽  
B Virus ◽  
Cumulative Rate

PurposePatterns of hepatitis B virus (HBV) reactivation in hepatitis B surface antigen (HBsAg) –negative, antihepatitis B core antigen antibody (anti-HBc) –positive patients with lymphoma receiving rituximab-containing chemotherapy have not been well described.Patients and MethodsHBsAg-negative, anti-HBc–positive Chinese patients with undetectable serum HBV DNA (< 10 IU/mL), diagnosed with hematologic malignancies and receiving rituximab-containing chemotherapy, were prospectively monitored every 4 weeks for up to 2 years. Entecavir was started when HBV reactivation (defined as detectable HBV DNA) was encountered.ResultsAmong 260 patients receiving rituximab-containing chemotherapy, 63 patients (24.2%) who were HBsAg negative and anti-HBc positive underwent follow-up for a median of 70 weeks (range, 6 to 104 weeks). The 2-year cumulative rate of HBV reactivation was 41.5%, occurring at a median of 23 weeks (range, 4 to 100 weeks) after rituximab treatment. The median HBV DNA level at reactivation was 43 IU/mL (range, 14 to 920 IU/mL). A baseline undetectable antibody to HBsAg (anti-HBs; < 10 mIU/mL) was the only significant risk factor that was positively associated with HBV reactivation (hazard ratio, 3.51; 95% CI, 1.37 to 8.98; P = .009). Patients with negative baseline anti-HBs, compared with those with positive anti-HBs, had a significantly higher 2-year cumulative rate of HBV reactivation (68.3% v 34.4%; P = .012). At HBV reactivation, all patients had normal ALT, and all patients but one were HBsAg negative. Entecavir successfully controlled HBV reactivation in all patients.ConclusionA high rate of HBV reactivation was observed in HBsAg-negative, anti-HBc–positive patients undergoing rituximab-containing chemotherapy, with the risk of reactivation significantly higher in anti-HBs–negative patients. Periodic HBV DNA monitoring was an effective strategy in preventing HBV-related complications.

scholarly journals Disparities in Smoking Cessation Outcomes among Multi-ethnic Pregnant Smokers in San Bernardino County, CA: Findings from the Loma Linda University Health Comprehensive Tobacco Treatment Program

2020 ◽  
Author(s):  
Anne Berit Petersen ◽  
Temidayo Ogunrinu ◽  
Shane Wallace ◽  
Jane Yun ◽  
Juan Carlos Belliard ◽  
...  
Keyword(s):  
Treatment Program ◽  
Tobacco Cessation ◽  
Significant Risk ◽  
High Rate ◽  
San Bernardino County ◽  
Tobacco Treatment ◽  
Pregnant Smokers ◽  
San Bernardino ◽  
Loma Linda University

Smoking during pregnancy remains one of the most significant risk factors for poor birth outcomes. The Loma Linda University Health Comprehensive Tobacco Treatment Program (CTTP) is the largest maternal tobacco cessation program in San Bernardino County &ndash; the largest county in the contiguous US. CTTP is an eight week, incentivized, behavioral intervention for tobacco cessation for pregnant smokers. As part of program evaluation, we used a retrospective cohort design to assess smoking abstinence and to identify predictors of relapse/smoking after enrollment. Among CTTP cohort enrollees (n=233) from 2012-2013 we found: 1) a 28.4% 8 week point prevalence abstinence (PPA), and at a median of 9 months of follow-up after the PPA, 81.6% continued to indicate tobacco cessation, and 2) a high rate of relapse or loss to follow-up (56%). Our modeling of relapse/smoking after enrollment indicated that this was higher in young mothers, non-Hispanic mothers (White, Black), first/third trimester mothers, and rural mothers. The evaluation identified efficacy of the behavioral model at 8 weeks, but that relapse/smoking was occurring in disparity populations. Formative research is needed to expand the programmatic outreach and enrollment of mothers wanting to quit smoking.

scholarly journals Episode of Hepatitis C viral infection in the people of Swat, Pakistan

2022 ◽  
Vol 82 ◽  
Author(s):  
M. A. Rahat ◽  
M. Israr ◽  
I. Hassan ◽  
M. Islam ◽  
A. -ud-Din ◽  
...  
Keyword(s):  
Risk Factors ◽  
Family History ◽  
Dental Treatment ◽  
Significant Risk ◽  
High Rate ◽  
Blood Collection ◽  
Inform Consent ◽  
The People ◽  
Precautionary Measures ◽  
Associated Risk Factors

ABSTRACT Infectious agents cause serious diseases in humans worldwide and are responsible for the high rate of morbidity and mortality. The prevalence and epidemiology of infectious disease (HCV) in the hospital visited patients referred by the physicians through the initial findings and their associated risk factors were studied in Swat. The data of 174 infected patients were collected during the period of 2015 to 2017 from two clinical laboratories of Tehsil Matta Swat. Inform consent form was taken before blood collection. After taking informed consent blood samples were collected and ICT test was performed and then ICT positive cases were conform through PCR. A total of 174 ICT positive samples [106 male and 68 females] were included in this study. Age was considered from 10 to 72 years. Of the 174 ICT strip positive, 99 [63 males, 36 females] were confirmed through PCR. The prevalence rate was recorded 56.89%. I.V/I.M injection was recorded in 100% of the individuals. Visits to the barber shop was reported in (58%) of the individuals, married individuals were (81.0), surgical operation was reported in (44.8%), sharing toothbrush was observed in (29.9%), piercing was reported in (39.7%), family history was reported in (26.4%), dental treatment was observed in (21.8%), jaundice were (13.2%) and tattooing was (1.7%). Blood transfusion, surgical operations, Jaundice, family history and dental treatment were found significant risk factors for acquiring HCV infection. It was concluded that proper implementation of precautionary measures should be needed to control the spread of HCV in far near future.

scholarly journals A high rate of COVID-19 vaccine hesitancy in a large-scale survey on Arabs

eLife ◽  
2021 ◽  
Vol 10 ◽  
Author(s):  
Eyad A Qunaibi ◽  
Mohamed Helmy ◽  
Iman Basheti ◽  
Iyad Sultan
Keyword(s):  
Side Effects ◽  
Large Scale ◽  
Online Survey ◽  
Demographic Data ◽  
Arab Countries ◽  
High Rate ◽  
Vaccine Hesitancy ◽  
Academic Education ◽  
Health Authorities ◽  
Care Workers

Background: Vaccine hesitancy can limit the benefits of available vaccines in halting the spread of COVID-19 pandemic. Previously published studies paid little attention to Arab countries, which has a population of over 440 million. In this study, we present the results of the first large-scale multinational study that measures vaccine hesitancy among Arab-speaking subjects.Methods: An online survey in Arabic was conducted from 14-Jan-2021 to 29-Jan-2021. It consisted of 17 questions capturing demographic data, acceptance of COVID-19 vaccine, attitudes towards the need for COVID-19 vaccination and associated health policies, and reasons for vaccination hesitancy. R software- v.4.0.2 was used for data analysis and visualization.Results: The survey recruited 36,220 eligible participants (61.1% males, 38.9% females, mean age 32.6±10.8 years) from all the 23 Arab countries and territories (83.4%) and 122 other countries (16.6%). Our analysis shows a significant rate of vaccine hesitancy among Arabs in and outside the Arab region (83% and 81%, respectively). The most cited reasons for hesitancy are concerns about side effects and distrust in healthcare policies, vaccine expedited production, published studies and vaccine producing companies. We also found that female participants, participants 30-59 year-old, those with no chronic diseases, those with lower-level of academic education, and those who do not know the type of vaccine authorized in their countries are more hesitant to receive COVID-19 vaccination. On the other hand, participants who regularly receive the influenza vaccine, health care workers, and those from countries with higher rates of COVID-19 infections showed more vaccination willingness. Interactive representation of our results is posted on our project website at https://mainapp.shinyapps.io/CVHAA.Conclusion: Our results show higher vaccine hesitancy and refusal among Arab subjects, related mainly to distrust and concerns about side effects. Health authorities and Arab scientific community have to transparently address these concerns to improve vaccine acceptance.Funding: This study received no funding.

scholarly journals The social specificities of hostility toward vaccination against Covid-19 in France

PLoS ONE ◽  
2022 ◽  
Vol 17 (1) ◽  
pp. e0262192
Author(s):  
Nathalie Bajos ◽  
Alexis Spire ◽  
Léna Silberzan ◽  
Keyword(s):  
First Generation ◽  
Social Inequalities ◽  
Population Based ◽  
Social Hierarchy ◽  
Vaccine Hesitancy ◽  
Public Health Issue ◽  
The Social ◽  
Majority Population ◽  
The Government ◽  
To Receive

Equal Access to the COVID-19 vaccine for all remains a major public health issue. The current study compared the prevalence of vaccination reluctance in general and COVID-19 vaccine hesitancy and social and health factors associated with intentions to receive the vaccine. A random socio-epidemiological population-based survey was conducted in France in November 2020, in which 85,855 adults participants were included in this study. We used logistic regressions to study being "not at all in favor" to vaccination in general, and being "certainly not" willing to get vaccinated against Covid-19. Our analysis highlighted a gendered reluctance toward vaccination in general but even more so regarding vaccination against COVID-19 (OR = 1.88 (95% CI: 1.79–1.97)). We also found that people at the bottom of the social hierarchy, in terms of level of education, financial resources, were more likely to refuse the COVID-19 vaccine (from OR = 1.22 (95% CI:1.10–1.35) for respondents without diploma to OR = 0.52 (95% CI:0.47–0.57) for High school +5 or more years level). People from the French overseas departments, immigrants and descendants of immigrants, were all more reluctant to the Covid-19 vaccine (first-generation Africa/Asia immigrants OR = 1.16 (95% CI:1.04–1.30)) versus OR = 2.19 (95% CI:1.96–2.43) for the majority population). Finally, our analysis showed that those who reported not trusting the government were more likely to be Covid-19 vaccine-reluctant (OR = 3.29 (95% CI: 3.13–3.45)). Specific campaigns should be thought beforehand to reach women and people at the bottom of the social hierarchy to avoid furthering social inequalities in terms of morbidity and mortality.

scholarly journals Determinants and aetiologies of postpartum pyrexia; a retrospective analysis in a tertiary health facility in the Littoral Region of Cameroon.

2020 ◽  
Author(s):  
Yannick Lechedem Ngunyi ◽  
Gregory Halle-Ekane ◽  
Nicholas Tendongfor ◽  
Etheldreda Leinyuy Mbivnjo ◽  
Armel Evouna Mbarga ◽  
...  
Keyword(s):  
Risk Factors ◽  
Significant Risk ◽  
Tertiary Hospital ◽  
High Rate ◽  
E Coli ◽  
Factors Associated ◽  
Littoral Region ◽  
Perineal Tears ◽  
Chi Squared ◽  
Tract Infections

Abstract Background Postpartum febrile morbidity is relatively common, occurring in approximately 5–7% of births. Differentiating between potentially serious and benign causes of postpartum pyrexia (PP) is fundamental in curbing the mortality rate from sinister causes such as sepsis. The paucity of data on PP in Cameroon makes it difficult to access its actual burden. This study was aimed at determining the prevalence, risk factors and aetiologies of PP at a tertiary hospital in Douala, Cameroon. Methods This was a 2 – year hospital – based retrospective cohort study carried out at the Douala General Hospital (DGH), during which medical records of all postpartum admissions between January 1 st 2017 and December 31st 2018 were reviewed. The review consisted of collecting data on socio-demographic characteristics, clinical profile, investigations and final diagnoses. The collected data was analysed in SPSS 23.0. Chi-squared test was used to test the association between variables and a logistic regression analysis was fitted to identify risk factors associated to PP. Results A total of 1520 postpartum files were reviewed. The prevalence of PP was 8.82%. The most frequent causes of PP were: malaria (46.7%), urinary tract infections (18.7%), puerperal sepsis (17.9%) and pneumonia (8.7%). E. coli was the most (49.3%) cultured germ isolated in positive cultures. Onset of PP was more common (85%) within the first 3 days postpartum and malaria (60%) was the leading aetiology within this period. Five or more vaginal examinations prior to delivery (OR 59.151, 95% CI: 21.463-163.019; p<0.001), perineal tears (OR 45.157, 95% CI: 2.266-899.722; p<0.001), and duration of labour >18hours (OR 26.760, 95% CI: 7.100-100.862; p<0.001) were the most significant risk factors associated with PP. Conclusion Approximately 1 in every 12 postpartum cases in the DGH presents with PP . Malaria was the leading cause of PP at DGH especially for cases registered within 3 days postpartum. The risk factors identified were mostly associated to perinatal events, such as frequent vaginal examinations, perineal tears and prolonged labour. Efforts towards preventing identified risk factors thus becomes paramount in order to curb this high rate of PP in the DGH.

Vaccine-hesitant parents' reasons for choosing alternative protection methods in Turkey

2020 ◽  
pp. 174498712097063
Author(s):  
Aylin Akca Sumengen ◽  
Damla Ozcevik ◽  
Hulya Yaren Kursun ◽  
Ayse Ferda Ocakci
Keyword(s):  
Immune System ◽  
Healthcare Workers ◽  
Qualitative Interviews ◽  
Immigrant Children ◽  
High Rate ◽  
Alternative Methods ◽  
Vaccine Hesitancy ◽  
False Information ◽  
Protective Methods

Background Parents use alternative protective methods instead of having their children vaccinated because of their various concerns. Aims The aim of this study is to examine the processes by which the parents preferred alternative methods rather than the vaccines to strengthen their child's immune system. Methods Semi-structured, qualitative interviews were conducted with 22 parents who had vaccine hesitancy. The study sample consisted of parents whose children were between the ages of 0 and 18 years and who experienced vaccine hesitancy and lived in Turkey. The interviews with individuals were conducted online and aimed to be representative of the population of Turkey. Results The factors that caused parental vaccine hesitancy were various, such as vaccine contents, distrust of healthcare workers and false information about vaccines. Because of these factors, parents resorted to natural nutrition, vitamin support and some other precautions, such as avoiding takeaway food or preparing homemade food, rather than having their children vaccinated. Conclusions In recent years, it is thought that parents need education about vaccination; outbreaks may be caused by immigrant children who cannot be registered, and therefore cannot be vaccinated, in Turkey, which has received immigration at a high rate.

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