scholarly journals Waning COVID-19 Vaccine Effectiveness for BNT162b2 and CoronaVac in Malaysia: An Observational Study

2022 ◽  
Author(s):  
Jing Lian Suah ◽  
Masliyana Husin ◽  
Peter Seah Keng Tok ◽  
Boon Hwa Tng ◽  
Thevesh Thevananthan ◽  
...  
Keyword(s):  
Observational Study ◽  
Negative Binomial ◽  
Negative Binomial Regression ◽  
Vaccine Effectiveness ◽  
Negative Binomial Regression Model ◽  
Early Group ◽  
Icu Admission ◽  
Nationally Representative ◽  
Late Group ◽  
Over Time

Evaluation of vaccine effectiveness over time against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection or coronavirus disease 2019 (COVID-19) is important. Evidence on effectiveness over time for the CoronaVac vaccine is lacking despite its widespread use globally. In Malaysia, a diverse set-up of COVID-19 vaccines was rolled out nationwide, and the waning of vaccine protection is a concern. We aimed to investigate and compare waning vaccine effectiveness against COVID-19 infections, COVID-19 related ICU admission and COVID-19 related deaths for BNT162b2 and CoronaVac vaccines. In this observational study, we consolidated nationally representative data on COVID-19 vaccination and patients′ outcomes. Data on all confirmed COVID-19 cases from 1 to 30 September 2021 were used to compare vaccine effectiveness between the ′early′ group (fully vaccinated in April to June 2021) and the ′late′ group (fully vaccinated in Jul to Aug 2021). We used a negative binomial regression model to estimate vaccine effectiveness against COVID-19 infections for both ′early′ and ′late′ groups, by comparing the rates of infection for individuals vaccinated in the two different periods relative to the unvaccinated. Among confirmed COVID-19 cases, we used logistic regression to estimate and compare vaccine effectiveness against ICU admission and deaths between the two different periods. For BNT162b2, vaccine effectiveness against COVID-19 infections declined from 90.8% (95% CI 89.4, 92.0) in the late group to 79.1% (95% CI 75.8, 81.9) in the late group. Vaccine effectiveness for BNT162b2 against ICU admission and deaths were comparable between the two different periods. For CoronaVac, vaccine effectiveness waned against COVID-19 infections from 74.4% in the late group (95% CI 209 70.4, 77.8) to 30.0% (95% CI 18.4, 39.9) in the early group. It also declined significantly against ICU admission, dropping from 56.1% (95% CI 51.4, 60.2) to 29.9% (95% CI 13.9, 43.0). For deaths, however, CoronaVac′s effectiveness did not wane after three to five months of full vaccination. Vaccine effectiveness against COVID-19 infections waned after three to five months of full vaccination for both BNT162b2 and CoronaVac in Malaysia. Additionally, for CoronaVac, protection against ICU admission declined as well. Evidence on vaccine effectiveness over time informs evolving policy decisions on vaccination.

scholarly journals COVID-19 vaccine effectiveness against hospitalizations and ICU admissions in the Netherlands, April- August 2021

2021 ◽  
Author(s):  
Brechje de Gier ◽  
Marjolein Kooijman ◽  
Jeanet Kemmeren ◽  
Nicolette de Keizer ◽  
Dave Dongelmans ◽  
...  
Keyword(s):  
Negative Binomial ◽  
Incidence Rate Ratio ◽  
Age Groups ◽  
Negative Binomial Regression ◽  
Incidence Rates ◽  
Vaccine Effectiveness ◽  
Negative Binomial Regression Model ◽  
Age Group ◽  
Icu Admission ◽  
Binomial Regression

The objective of this study was to estimate vaccine effectiveness (VE) against COVID-19 hospitalization and ICU admission, per period according to dominating SARS-CoV-2 variant (Alpha and Delta), per vaccine, and per time since vaccination. To this end, data from the national COVID-19 vaccination register was added to the national register of COVID-19 hospitalizations. For the study period 4 April- 29 August 2021, 15,571 hospitalized people with COVID-19 were included in the analysis, of whom 887 (5.7%) were fully vaccinated. Incidence rates of hospitalizations and ICU admissions per age group and vaccination status were calculated, and VE was estimated as 1-incidence rate ratio, adjusted for calendar date and age group in a negative binomial regression model. VE against hospitalization for full vaccination was 94% (95%CI 93-95%) in the Alpha period and 95% (95%CI 94-95%) in the Delta period. The VE for full vaccination against ICU admission was 93% (95%CI 87-96%) in the Alpha period and 97% (95%CI 97-98%) in the Delta period. VE was high in all age groups and did not show waning with time since vaccination up to 20 weeks after full vaccination.

Compliance to the Surgical Safety Checklist over time in late and early adopters

2019 ◽  
Vol 30 (3) ◽  
pp. 57-62
Author(s):  
Romain Seppey ◽  
Antoine Oesch ◽  
Carsten T Viehl
Keyword(s):  
Observational Study ◽  
Statistical Difference ◽  
Early Group ◽  
Early Adopters ◽  
Surgical Safety Checklist ◽  
Surgical Safety ◽  
Group A ◽  
Group B ◽  
Late Group ◽  
Over Time

Aims To compare the compliance of the Surgical Safety Checklist in two groups of users: early (Group A) and late (Group B) adopters, and to detect change over time. Method Observational study. We collected all Surgical Safety Checklist protocols in one calendar month period and, eight months later, we repeated collection for another month. Analysis was then performed to compare the compliance in different groups and over time. Results There was no statistical difference in the overall compliance between the two groups or between elective and emergency cases. Equally, there was no significant change in compliance over time in Group A. In Group B, however, there was a trend to an improved compliance over time. Compliance to the Surgical Safety Checklist was significantly lower during operations performed by consulting surgeons in comparison to internally employed surgeons.

Oral contraceptives and MS disease activity in a contemporary real-world cohort

2017 ◽  
Vol 24 (2) ◽  
pp. 227-230 ◽  
Author(s):  
Riley Bove ◽  
Kelsey Rankin ◽  
Alicia S Chua ◽  
Taylor Saraceno ◽  
Neda Sattarnezhad ◽  
...  
Keyword(s):  
Observational Study ◽  
Relapse Rate ◽  
Negative Binomial ◽  
Negative Binomial Regression ◽  
Hormonal Contraceptives ◽  
Negative Binomial Regression Model ◽  
Childbearing Age ◽  
Primary Analysis ◽  
Disease Modifying Therapy ◽  
Annualized Relapse Rate

Background: There is uncertainty regarding the effect of oral hormonal contraceptives (OC) on multiple sclerosis (MS) course. Objective: To evaluate the hypothesis that OC use is associated with decreased risk of relapses in an observational study of women of childbearing age with new-onset MS starting a first-line injectable disease-modifying therapy (DMT). Methods: From our CLIMB longitudinal observational study, we identified 162 women with MS or CIS with known OC use who initiated injectable DMT within two years of symptom onset, and categorized OC use at DMT onset as past, ever or never. Our primary analysis was comparison of annualized relapse rate from baseline DMT start across the three OC use categories using a negative binomial regression model. Results: In this cohort of 162 women, 81 were treated with interferon therapy and 81 with glatiramer acetate. Mean ages for current-, past-, and never-OC users were 31.4 ( n = 46), 40.3 ( n = 66), and 37.9 ( n = 50) years, respectively ( p < 0.05); mean disease duration (1.0 years) and median baseline EDSS (1.0) did not differ between groups. Prior OC users had significantly lower relapse rates than never-users ( p = 0.031); the lower annualized relapse rate in current-users relative to never-users was not significant ( p = 0.91). Annualized relapse rate was not significantly different across the OC groups ( p = 0.057, three-group comparison). Results: These observations provide reassurance for women newly diagnosed that OC use, past or current, does not appear to be associated with greater risk of relapses.

scholarly journals Polytobacco use among young adult smokers: prospective association with cigarette consumption

2018 ◽  
Vol 29 (1) ◽  
pp. 43-48 ◽  
Author(s):  
Angela Petersen ◽  
Mark G Myers ◽  
Lyric Tully ◽  
Kristin Brikmanis ◽  
Neal Doran
Keyword(s):  
Cigarette Smoking ◽  
Negative Binomial ◽  
Negative Binomial Regression ◽  
Tobacco Product ◽  
Negative Binomial Regression Model ◽  
Use Patterns ◽  
Product Use ◽  
Smoking Quantity ◽  
Prospective Association ◽  
Over Time

Background. The risks of polytobacco use among young adults are unclear because we know relatively little about the consistency of multiproduct patterns over time and how these patterns impact cigarette smoking. The purpose of this study was to examine changes in multiple tobacco product use over time and associations with cigarette smoking quantity.Methods. Participants (n=335; 55% male) were 18–24 years old non-daily cigarette smokers living in California. Polytobacco use patterns were assessed quarterly for 2 years.Results. Transition analyses showed that while the number of products that had been used recently was volatile, the most common pattern was stability between timepoints. A longitudinal negative binomial regression model indicated that those who used more non-cigarette products also reported greater cigarette quantity. The strength of this relationship increased over time.Conclusions. Findings suggest that individuals who use more tobacco products are at greater risk for increased cigarette smoking and maintaining a multiple product use pattern.

scholarly journals Surgery as a Teachable Moment for Smoking Cessation

2010 ◽  
Vol 112 (1) ◽  
pp. 102-107 ◽  
Author(s):  
Yu Shi ◽  
David O. Warner
Keyword(s):  
Smoking Cessation ◽  
Surgical Procedures ◽  
Negative Binomial ◽  
Outpatient Surgery ◽  
Negative Binomial Regression ◽  
The United States ◽  
Major Surgery ◽  
Negative Binomial Regression Model ◽  
Teachable Moment ◽  
Nationally Representative

Background A "teachable moment" is an event that motivates spontaneous behavior change. Some evidence suggests that major surgery for a smoking-related illness can serve as a teachable moment for smoking cessation. This study tested the hypotheses that surgery increases the likelihood of smoking cessation and that cessation is more likely after major surgical procedures compared with outpatient surgery. Methods Secondary analyses were performed of longitudinal biennial survey data (1992-2004) from the nationally representative Health and Retirement Study of U.S. adults older than 50 yr, determining the relationship between the incidence of smoking cessation and the occurrence of surgery. Results Five thousand four hundred ninety-eight individuals reported current smoking at enrollment, and 2,444 of them (44.5%) quit smoking during the period of examination. The incidence of quitting in smokers undergoing major surgery was 20.6/100 person-years of follow-up and 10.2/100 person-years in those undergoing outpatient surgery. In a multivariate negative binomial regression model, the incidence rate ratio of quitting associated with major surgery was 2.02 (95% CI: 1.67-2.44) and that of those associated with outpatient surgery was 1.28 (95% CI: 1.09-1.50). Estimates derived from national surgical utilization data show that approximately 8% of all quit events in the United States annually can be attributed to the surgical procedures analyzed. Conclusions Undergoing surgery is associated with an increased likelihood of smoking cessation in the older U.S. population. Cessation is more likely in association with major procedures compared with outpatient surgery. These data support the concept that surgery is a teachable moment for smoking cessation.

scholarly journals Association between fatality rate of COVID-19 and selenium deficiency in China

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hai-Yang Zhang ◽  
An-Ran Zhang ◽  
Qing-Bin Lu ◽  
Xiao-Ai Zhang ◽  
Zhi-Jie Zhang ◽  
...  
Keyword(s):  
Negative Binomial ◽  
Viral Infections ◽  
Case Fatality ◽  
Selenium Deficiency ◽  
Negative Binomial Regression ◽  
Negative Binomial Regression Model ◽  
Fatality Rate ◽  
Selenium Content ◽  
Individual Level ◽  
Binomial Regression

Abstract Background COVID-19 has impacted populations around the world, with the fatality rate varying dramatically across countries. Selenium, as one of the important micronutrients implicated in viral infections, was suggested to play roles. Methods An ecological study was performed to assess the association between the COVID-19 related fatality and the selenium content both from crops and topsoil, in China. Results Totally, 14,045 COVID-19 cases were reported from 147 cities during 8 December 2019–13 December 2020 were included. Based on selenium content in crops, the case fatality rates (CFRs) gradually increased from 1.17% in non-selenium-deficient areas, to 1.28% in moderate-selenium-deficient areas, and further to 3.16% in severe-selenium-deficient areas (P = 0.002). Based on selenium content in topsoil, the CFRs gradually increased from 0.76% in non-selenium-deficient areas, to 1.70% in moderate-selenium-deficient areas, and further to 1.85% in severe-selenium-deficient areas (P < 0.001). The zero-inflated negative binomial regression model showed a significantly higher fatality risk in cities with severe-selenium-deficient selenium content in crops than non-selenium-deficient cities, with incidence rate ratio (IRR) of 3.88 (95% CIs: 1.21–12.52), which was further confirmed by regression fitting the association between CFR of COVID-19 and selenium content in topsoil, with the IRR of 2.38 (95% CIs: 1.14–4.98) for moderate-selenium-deficient cities and 3.06 (1.49–6.27) for severe-selenium-deficient cities. Conclusions Regional selenium deficiency might be related to an increased CFR of COVID-19. Future studies are needed to explore the associations between selenium status and disease outcome at individual-level.

scholarly journals Statistical models for analyzing count data: predictors of length of stay among HIV patients in Portugal using a multilevel model

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ahmed Nabil Shaaban ◽  
Bárbara Peleteiro ◽  
Maria Rosario O. Martins
Keyword(s):  
Length Of Stay ◽  
Regression Model ◽  
Random Effects ◽  
Count Data ◽  
Negative Binomial ◽  
Negative Binomial Regression ◽  
Comprehensive Approach ◽  
Negative Binomial Regression Model ◽  
Hiv Patients ◽  
Binomial Regression

Abstract Background This study offers a comprehensive approach to precisely analyze the complexly distributed length of stay among HIV admissions in Portugal. Objective To provide an illustration of statistical techniques for analysing count data using longitudinal predictors of length of stay among HIV hospitalizations in Portugal. Method Registered discharges in the Portuguese National Health Service (NHS) facilities Between January 2009 and December 2017, a total of 26,505 classified under Major Diagnostic Category (MDC) created for patients with HIV infection, with HIV/AIDS as a main or secondary cause of admission, were used to predict length of stay among HIV hospitalizations in Portugal. Several strategies were applied to select the best count fit model that includes the Poisson regression model, zero-inflated Poisson, the negative binomial regression model, and zero-inflated negative binomial regression model. A random hospital effects term has been incorporated into the negative binomial model to examine the dependence between observations within the same hospital. A multivariable analysis has been performed to assess the effect of covariates on length of stay. Results The median length of stay in our study was 11 days (interquartile range: 6–22). Statistical comparisons among the count models revealed that the random-effects negative binomial models provided the best fit with observed data. Admissions among males or admissions associated with TB infection, pneumocystis, cytomegalovirus, candidiasis, toxoplasmosis, or mycobacterium disease exhibit a highly significant increase in length of stay. Perfect trends were observed in which a higher number of diagnoses or procedures lead to significantly higher length of stay. The random-effects term included in our model and refers to unexplained factors specific to each hospital revealed obvious differences in quality among the hospitals included in our study. Conclusions This study provides a comprehensive approach to address unique problems associated with the prediction of length of stay among HIV patients in Portugal.

Evaluation of Strategies to Mitigate Culvert-Involved Crashes

2021 ◽  
pp. 036119812199207
Author(s):  
Hitesh Chawla ◽  
Megat-Usamah Megat-Johari ◽  
Peter T. Savolainen ◽  
Christopher M. Day
Keyword(s):  
Negative Binomial ◽  
Negative Binomial Regression ◽  
Cost Effective ◽  
Negative Binomial Regression Model ◽  
Promising Alternative ◽  
Roadside Safety ◽  
Adverse Conditions ◽  
Traffic Characteristics ◽  
Annual Average Daily Traffic ◽  
Binomial Regression

The objectives of this study were to assess the in-service safety performance of roadside culverts and evaluate the potential impacts of installing various safety treatments to mitigate the severity of culvert-involved crashes. Such crashes were identified using standard fields on police crash report forms, as well as through a review of pertinent keywords from the narrative section of these forms. These crashes were then linked to the nearest cross-drainage culvert, which was associated with the nearest road segment. A negative binomial regression model was then estimated to discern how the risk of culvert-involved crashes varied as a function of annual average daily traffic, speed limit, number of travel lanes, and culvert size and offset. The second stage of the analysis involved the use of the Roadside Safety Analysis Program to estimate the expected crash costs associated with various design contexts. A series of scenarios were evaluated, culminating in guidance as to the most cost-effective treatments for different combinations of roadway geometric and traffic characteristics. The results of this study provide an empirical model that can be used to predict the risk of culvert-involved crashes under various scenarios. The findings also suggest that the installation of safety grates on culvert openings provides a promising alternative for most of the cases where the culvert is located within the clear zone. In general, a guardrail is recommended when adverse conditions are present or when other treatments are not feasible at a specific location.

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