Clinical and Inflammatory Features of Exacerbation-Prone Asthma: A Cross-Sectional Study Using Multidimensional Assessment

Background: Reducing asthma exacerbations is a major target of current clinical guidelines, but identifying features of exacerbation-prone asthma (EPA) using multidimensional assessment (MDA) is lacking. Objective: To systemically explore the clinical and inflammatory features of adults with EPA in a Chinese population. Methods: We designed a cross-sectional study using the Severe Asthma Web-based Database from the Australasian Severe Asthma Network (ASAN). Eligible Chinese adults with asthma (n = 546) were assessed using MDA. We stratified patients based on exacerbation frequency: none, few (1 or 2), and exacerbation prone (≥3). Univariate and multivariable negative binomial regression analyses were performed to investigate features associated with the frequency of exacerbations. Results: Of 546 participants, 61.9% had no exacerbations (n = 338), 29.6% had few exacerbations (n = 162), and 8.4% were exacerbation prone (n = 46) within the preceding year. EPA patients were characterized by elevated blood and sputum eosinophils but less atopy, with more controller therapies but worse asthma control and quality of life (all p < 0.05). In multivariable models, blood and sputum eosinophils (adjusted rate ratio = 2.23, 95% confidence interval = [1.26, 3.84] and 1.67 [1.27, 2.21], respectively), FEV1 (0.90 [0.84, 0.96]), bronchodilator responsiveness (1.16 [1.05, 1.27]), COPD (2.22 [1.41, 3.51]), bronchiectasis (2.87 [1.69, 4.89]), anxiety (2.56 [1.10, 5.95]), and depression (1.94 [1.20, 3.13]) were found. Further, upper respiratory tract infection (1.83 [1.32, 2.54]) and food allergy (1.67 [1.23, 2.25]) were at high risk of asthma symptom triggers. Conclusion: EPA is a clinically recognizable phenotype associated with several recognizable traits that could be addressed by targeted treatment.

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Factors associated with COVID-19 infections and mortality in Africa: a cross-sectional study using publicly available data

BMJ Open ◽

10.1136/bmjopen-2020-042750 ◽

2020 ◽

Vol 10 (11) ◽

pp. e042750

Author(s):

Charles Okeahalam ◽

Victor Williams ◽

Kennedy Otwombe

Keyword(s):

Risk Factors ◽

Negative Binomial ◽

Negative Binomial Regression ◽

Cross Sectional Study ◽

Sub Saharan Africa ◽

Sectional Study ◽

African Countries ◽

Cross Sectional ◽

Life Expectancy At Birth ◽

Services Delivery

IntroductionThe current COVID-19 pandemic is a global threat. This elicits questions on the level of preparedness and capacity of health systems to respond to emergencies relative to other parts of the world.MethodsThis cross-sectional study uses publicly available core health data for 53 African countries to determine risk factors for cumulative COVID-19 deaths and cases per million in all countries in the continent. Descriptive statistics were determined for the indicators, and a negative binomial regression was used for modelling the risk factors.ResultsIn sub-Saharan Africa, an increase in the number of nursing and midwifery personnel decreased the risk of COVID-19 deaths (p=0.0178), while a unit increase in universal healthcare (UHC) index of service coverage and prevalence of insufficient physical activity among adults increased the risk of COVID-19 deaths (p=0.0432 and p=0.0127). An increase in the proportion of infants initiating breast feeding reduced the number of cases per million (p<0.0001), while an increase in higher healthy life expectancy at birth increased the number of cases per million (p=0.0340).ConclusionDespite its limited resources, Africa’s preparedness and response to the COVID-19 pandemic can be improved by identifying and addressing specific gaps in the funding of health services delivery. These gaps impact negatively on service delivery in Africa, which requires more nursing personnel and increased UHC coverage to mitigate the effects of COVID-19.

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Psychological distress among Ethiopian migrant returnees who were in quarantine in the context of COVID-19: institution-based cross-sectional study

BMC Psychiatry ◽

10.1186/s12888-021-03429-2 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Kassahun Habtamu ◽

Yekoyealem Desie ◽

Mulat Asnake ◽

Endirias Gina Lera ◽

Temesgen Mequanint

Keyword(s):

Psychological Distress ◽

Depressive Symptoms ◽

Negative Binomial ◽

Addis Ababa ◽

Negative Binomial Regression ◽

Cross Sectional Study ◽

Anxiety Symptoms ◽

Sectional Study ◽

Cross Sectional ◽

Stress Symptoms

Abstract Background In association with the novel coronavirus (SARS-CoV-2) disease 2019 (COVID-19) pandemic, many numbers of Ethiopian migrants are returning to their home country, and they are required to stay in mandatory quarantine centers. This results in severe disruptions of life routines, social isolation, and loss of freedom. Studies on psychological distress among Ethiopian migrant returnees in the context of COVID-19 are scarce. This study aimed to investigate the prevalence of psychological distress and associated factors among migrant returnees who were in quarantine during the time of COVID-19. Methods A cross-sectional study was conducted with 405 migrant returnees recruited from quarantine centers in Addis Ababa. We developed a structured questionnaire to collect data on sociodemographic, migration related, quarantine related and COVID-19 related characteristics of participants. We used the 21 item Depression, Anxiety and Stress Scale to assess psychological distress. Univariate and multivariable negative binomial regression models were fitted to assess the association between exposure variables with depression, anxiety and stress separately. Results A little more than half of the participants (55%) had depressive symptoms; around half had anxiety symptoms (48.9%) and more than a third (35.6%) experienced symptoms of stress. We found significantly higher prevalence of anxiety (ARR = 0.59; 95% CI = 0.39, 0.91) and depressive symptoms (ARR = 0.56; 95% CI = 0.39, 0.81) among women than men. Fear of discrimination after the quarantine was significantly associated with depressive (ARR = 0.76; 95% CI = 0.63, 0.92) and anxiety symptoms (ARR = 0.77; 95% CI = 0.62, 0.97). Experiencing COVID-19 like symptoms is associated with depressive (ARR = 0.40; 95% CI = 0.25, 0.65), anxiety (ARR = 0.35; 95% CI = 0.20, 0.62) and stress symptoms (ARR = 0.43; 95% CI = 0.28, 0.66). Have no a plan of what to do after the quarantine (ARR = 1.30; 95% CI = 1.09, 1.54) was significantly associated with increasing stress scores. Conclusions We found a very high prevalence of depressive, anxiety and stress symptoms among Ethiopian migrant returnees who were in quarantine due to the COVID-19 pandemic. Screening, integration of mental health services with other socioeconomic and psychosocial services, and effective and efficient referral may be useful to address the burden of psychological distress in this group.

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Effect of weather on GP home visits: a cross-sectional study

British Journal of General Practice ◽

10.3399/bjgp19x702257 ◽

2019 ◽

Vol 69 (683) ◽

pp. e430-e436 ◽

Cited By ~ 2

Author(s):

Olaoluwa Oyawoye ◽

Louise Marston ◽

Melvyn Jones

Keyword(s):

Negative Binomial ◽

Home Visits ◽

Negative Binomial Regression ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Temporal Variables ◽

Binomial Regression ◽

Day Of The Week ◽

The Uk

BackgroundGPs in the UK conduct >13 million home visits each year. The visits, which are resource intensive, are usually to the frailest patients who are least resilient to adverse weather.AimTo explore the relationship between meteorological variables (temperature, rainfall, sunshine) and temporal variables (day of the week, season) with GP home visits (HVs).Design and settingA cross-sectional study using data provided by Herts Urgent Care for its GP acute in-hours visiting service and UK Meteorological (Met) Office weather data for the Herts & South East region of the UK.MethodThe association between the number of GP HVs and weather and temporal variables was explored using univariable and multivariable negative binomial regression.ResultsThere was a significant 0.4% decrease in HVs per degrees Celsius increase in minimum temperature (incidence rate ratio [IRR] 0.996, 95% confidence interval [CI] = 0.993 to 0.999), and a 0.4% decrease per hour increase in sunshine (IRR 0.996, 95% CI = 0.992 to 1.000), as well as significant decreases in weekday HVs compared with Mondays (Thursday IRR 0.824, 95% CI = 0.790 to 0.859). There were 6.2% fewer HVs in summer compared with winter (IRR 0.938, 95% CI = 0.902 to 0.975). Multivariable negative binomial regression showed non-significant relationships between meteorological variables and HVs, but a significant day-of-the-week relationship.ConclusionGP HVs increased on cold days and fell on sunnier days. The effect sizes were small so it is unlikely that there is any clinically significant effect of weather on HVs in this acute GP visit setting. A tentative conclusion might also be that GPs in this system can deliver care to frail housebound patients in most weather conditions.

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Overuse of Antibiotics in Children Under Four Years Presenting to Al Jalila Children's Hospital with Viral Upper Respiratory Tract Infection: A Cross-Sectional Study

SSRN Electronic Journal ◽

10.2139/ssrn.3475582 ◽

2019 ◽

Author(s):

Eman Almerashi ◽

Lemis Yavuz

Keyword(s):

Tract Infection ◽

Respiratory Tract ◽

Respiratory Tract Infection ◽

Cross Sectional Study ◽

Upper Respiratory Tract Infection ◽

Upper Respiratory Tract ◽

Sectional Study ◽

Cross Sectional ◽

Children's Hospital ◽

Upper Respiratory

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Consumption of Sugar-Sweetened or Artificially Sweetened Beverages and Semen Quality in Young Men: A Cross-Sectional Study

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph19020682 ◽

2022 ◽

Vol 19 (2) ◽

pp. 682

Author(s):

Maiken Meldgaard ◽

Nis Brix ◽

Anne Gaml-Sørensen ◽

Andreas Ernst ◽

Cecilia Høst Ramlau-Hansen ◽

...

Keyword(s):

Negative Binomial ◽

Semen Quality ◽

Young Men ◽

Cross Sectional Study ◽

Male Participant ◽

Negative Binomial Regression Model ◽

Sectional Study ◽

Cross Sectional ◽

Sweetened Beverages ◽

Artificially Sweetened Beverages

Background: Existing literature suggests that frequent consumption of sugar-sweetened drinks may be associated with lower semen quality. Studies performed in mice suggest a dose-response relationship between intake of saccharin or aspartame, two artificial sweeteners, and sperm and testis function. Methods: A cross-sectional study based on data from The Fetal Programming of Semen Quality (FEPOS) Cohort, including 1047 young men (mean age = 19 years) was performed. Each male participant completed an online questionnaire on health, health behavior and diet, and provided a semen sample. The associations between consumption of sugar-sweetened or artificially sweetened beverages (moderate ≥ 3 days/week; infrequent < 3 days/week) and semen quality were analyzed using a multivariable, negative, binomial regression model. Results: Sugar-sweetened or artificially sweetened beverage consumption was not strongly associated with either semen volume, sperm concentration, total sperm count or total motility in young men. The proportion of morphologically normal sperm was 11% lower (0.89 (95% CI 0.76, 1.04)) for moderate (≥3 days/week) consumption of artificially sweetened beverages relative to infrequent (<3 days/week). Conclusion: Consumption of sugar-sweetened or artificially sweetened beverages, at the levels present in this study had limited effect on the measured markers of semen quality in young men.

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The needs and well‐being of severe asthma and COPD carers: A cross‐sectional study

Respirology ◽

10.1111/resp.14167 ◽

2021 ◽

Author(s):

Eleanor C. Majellano ◽

Vanessa L. Clark ◽

Peter G. Gibson ◽

Juliet M. Foster ◽

Vanessa M. McDonald

Keyword(s):

Severe Asthma ◽

Well Being ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional

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Characteristics of prescriptions and costs for acute upper respiratory tract infections in Chinese outpatient pediatric patients: a nationwide cross-sectional study

BMC Complementary Medicine and Therapies ◽

10.1186/s12906-020-03141-w ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Shan Wang ◽

Lihua Liu ◽

Jianchao Liu ◽

Likun Miao ◽

Qian Zhuang ◽

...

Keyword(s):

Outpatient Care ◽

Pediatric Patients ◽

Cross Sectional Study ◽

Upper Respiratory Tract ◽

Sectional Study ◽

Cross Sectional ◽

Short Supply ◽

Upper Respiratory ◽

Tract Infections ◽

Clinical Records

Abstract Background To understand the characteristics of prescriptions and costs in pediatric patients with acute upper respiratory infections (AURI) is important for the regulation of outpatient care and reimbursement policy. This study aims to provide evidence on these issues that was in short supply. Methods We conducted a retrospective cross-sectional study based on data from National Engineering Laboratory of Application Technology in Medical Big Data. All outpatient pediatric patients aged 0–14 years with an uncomplicated AURI from 1 January 2015 to 31 December 2017 in 138 hospitals across the country were included. We reported characteristics of patients, the average number of medications prescribed per encounter, the categories of medication used and their percentages, the cost per visit and prescription costs of drugs. For these measurements, discrepancies among diverse groups of age, regions, insurance types, and AURI categories were compared. Kruskal-Wallis nonparametric test and Student-Newman-Keuls test were performed to identify differences among subgroups. A multinomial logistic regression was conducted to examine the independent effects of those factors on the prescribing behavior. Results A total of 1,002,687 clinical records with 2,682,118 prescriptions were collected and analyzed. The average number of drugs prescribed per encounter was 2.8. The most frequently prescribed medication was Chinese traditional patent medicines (CTPM) (36.5% of overall prescriptions) followed by antibiotics (18.1%). It showed a preference of CPTM over conventional medicines. The median cost per visit was 17.91 USD. The median drug cost per visit was 13.84 USD. The expenditures of antibiotics and CTPM per visit (6.05 USD and 5.87 USD) were among the three highest categories of drugs. The percentage of out-of-pocket patients reached 65.9%. Disparities were showed among subgroups of different ages, regions, and insurance types. Conclusions The high volume of CPTM usage is the typical feature in outpatient care of AURI pediatric patients in China. The rational and cost-effective use of CPTM and antibiotics still faces challenges. The reimbursement for child AURI cases needs to be enhanced.

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Concordances and differences between a unidimensional and multidimensional assessment of frailty: a cross-sectional study

BMC Geriatrics ◽

10.1186/s12877-019-1369-7 ◽

2019 ◽

Vol 19 (1) ◽

Author(s):

Michael C. J. Van der Elst ◽

◽

Birgitte Schoenmakers ◽

Linda P. M. Op het Veld ◽

Ellen E. De Roeck ◽

...

Keyword(s):

Life Satisfaction ◽

Cross Sectional Study ◽

Community Dwelling ◽

Assessment Instrument ◽

Net Income ◽

Sectional Study ◽

Cross Sectional ◽

Multidimensional Assessment ◽

Many Instruments ◽

Kappa Value

Abstract Background Many instruments to identify frail older people have been developed. One of the consequences is that the prevalence rates of frailty vary widely dependent on the instrument selected. The aims of this study were 1) to examine the concordances and differences between a unidimensional and multidimensional assessment of frailty, 2) to assess to what extent the characteristics of a ‘frail sample’ differ depending on the selected frailty measurement because ‘being frail’ is used in many studies as an inclusion criterion. Method A cross-sectional study was conducted among 196 community-dwelling older adults (≥60 years), which were selected from the census records. Unidimensional frailty was operationalized according to the Fried Phenotype (FP) and multidimensional frailty was measured with the Comprehensive Frailty Assessment Instrument (CFAI). The concordances and differences were examined by prevalence, correlations, observed agreement and Kappa values. Differences between sample characteristics (e.g., age, physical activity, life satisfaction) were investigated with ANOVA and Kruskall-Wallis test. Results The mean age was 72.74 (SD 8.04) and 48.98% was male. According to the FP 23.59% was not-frail, 56.92% pre-frail and 19.49% frail. According to the CFAI, 44.33% was no-to-low frail, 37.63% was mild frail and 18.04% was high frail. The correlation between FP and the CFAI was r = 0.46 and the observed agreement was 52.85%. The Kappa value was κ = 0.35 (quadratic κ = 0.45). In total, 11.92% of the participants were frail according to both measurements, 7.77% was solely frail according to the FP and 6.21% was solely frail according to the CFAI. The ‘frail sample respondents’ according to the FP had higher levels of life satisfaction and net income, but performed less physical activities in comparison to high frail people according to the CFAI. Conclusion The present study shows that the FP and CFAI partly measure the same ‘frailty-construct’, although differences were found for instance in the prevalence of frailty and the composition of the ‘frail participants’. Since ‘being frail’ is an inclusion criterion in many studies, researchers must be aware that the choice of the frailty measurement has an impact on both the estimates of frailty prevalence and the characteristics of the selected sample.

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