Rural-Urban Differences in Diagnosed Cervical Artery Dissection in New York State

2022 ◽  
pp. 1-5
Author(s):  
Madeleine Dulany Hunter ◽  
Erin R. Kulick ◽  
Eliza Miller ◽  
Joshua Willey ◽  
Amelia K. Boehme ◽  
...  
Keyword(s):  
New York ◽  
Rural Areas ◽  
Small Town ◽  
Negative Binomial ◽  
New York State ◽  
Artery Dissection ◽  
Cervical Artery Dissection ◽  
York State ◽  
The Us ◽  
Cervical Artery

<b><i>Background:</i></b> Cervical artery dissection (CeAD) is a leading cause of stroke in young adults. Incidence estimates may be limited by under- or overdiagnosis. <b><i>Objective:</i></b> We aimed to investigate if CeAD diagnosis would be higher in urban centers compared to rural regions of New York State (NYS). <b><i>Methods:</i></b> For this ecological study, administrative codes were used to identify CeAD discharges in the NYS Statewide Planning and Research Cooperative System (SPARCS) from 2009 to 2014. Rural Urban Commuting Area (RUCA) codes were taken from the US Department of Agriculture and included the classifications metropolitan, micropolitan, small town, and rural. Negative binomial models were used to calculate effect estimates and 95% confidence limits (e<sup>β</sup>; 95% CL) for the association between RUCA classification and the number of dissections per ZIP code. Models were further adjusted by population. <b><i>Results:</i></b> Population information was obtained from the US Census Bureau on 1,797 NYS ZIP codes (70.7% of NYS ZIP codes), 826 of which had at least 1 CeAD-related discharge from 2009 to 2014. Nonrural ZIP codes were more likely to report more CeAD cases relative to rural areas even after adjusting for population (metropolitan effect = e<sup>β</sup> 5.00; 95% CI: 3.75–6.66; micropolitan effect 3.02; 95% CI: 2.16–4.23; small town effect 2.34; 95% CI: 1.58–3.47). <b><i>Conclusions:</i></b> CeAD diagnosis correlates with population density as defined by rural-urban status. Our results could be due to underdiagnosis in rural areas or overdiagnosis with increasing urbanicity.

Abstract 49: Male Sex is Associated With Cervical Artery Dissection in Patients With Fibromuscular Dysplasia

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Charlotte Arnaud ◽  
Marion Boulanger ◽  
Aurélien Lorthioir ◽  
Laurence Amar ◽  
Arshid Azarine ◽  
...  
Keyword(s):  
Risk Factors ◽  
Fibromuscular Dysplasia ◽  
Pooled Analysis ◽  
Artery Dissection ◽  
Cervical Artery Dissection ◽  
University Hospitals ◽  
The Us ◽  
Cervical Artery ◽  
History Of ◽  
Male Sex

Background: Cervical artery dissection (CeAD) is one of the most frequent manifestations of fibromuscular dysplasia (FMD). However, the risk factors for CeAD are unknown. We investigated factors associated with CeAD in the ARCADIA (Assessment of Renal and Cervical Artery Dysplasia) registry and performed a pooled analysis of published and unpublished data. Methods: Patients included were women and men ≥18 years, diagnosed with renal, cervical, or intracranial artery FMD, prospectively recruited at 16 university hospitals in France and Belgium. Diagnosis of CeAD was established by stroke specialists in each participating center, according to standard diagnostic criteria. Associations between CeAD and potential determinants were assessed by calculations of crude and adjusted odds ratios. Results: Among 469 patients (415 women) with FMD, 68 (14.5%) had CeAD. CeAD patients were younger, more likely to be men and to have a history of migraine, and less likely to have a history of hypertension, than non-CeAD patients. In the multivariate analysis, male sex (OR=2.75 ; CI95% 1.39-5.46), history of migraine (OR=1.93 ; 1.08-3.44), age >50 years (OR=0.41 ; 0.23-0.74), history of hypertension (OR=0.35 ; 0.19-0.63), and the number of vascular beds involved by FMD >=3 (OR=2.46 ; 1.13-5.35) remained significantly associated with CeAD. We collected data from 2 published studies and unpublished data from the US and the European Registries. There was no overlap between studies. In a pooled analysis (289 CeAD in 1933 patients), male sex was significantly associated with CeAD (pooled OR=2.04 ; 1.41-2.95, I2=0%, Figure). Conclusion: In patients with FMD, male sex and multisite involvement are associated with of CeAD, in addition to other previous known risk factors.

scholarly journals Using Rural–Urban Continuum Codes (RUCCS) to Examine Alcohol-Related Motor Vehicle Crash Injury and Enforcement in New York State

2019 ◽  
Vol 16 (8) ◽  
pp. 1346 ◽  
Author(s):  
Joyce C. Pressley ◽  
Leah M. Hines ◽  
Michael J. Bauer ◽  
Shin Ah Oh ◽  
Joshua R. Kuhl ◽  
...  
Keyword(s):  
New York ◽  
Rural Areas ◽  
Evaluation System ◽  
Motor Vehicle ◽  
Metropolitan Areas ◽  
New York State ◽  
Emergency Department Visits ◽  
Higher Alcohol ◽  
York State ◽  
Metropolitan Counties

Rural areas of New York State (NYS) have higher rates of alcohol-related motor vehicle (MV) crash injury than metropolitan areas. While alcohol-related injury has declined across the three geographic regions of NYS, disparities persist with rural areas having smaller declines. Our study aim was to examine factors associated with alcohol-related MV crashes in Upstate and Long Island using multi-sourced county-level data that included the Crash Outcome Data Evaluation System (CODES) with emergency department visits and hospitalizations, traffic citations, demographic, economic, transportation, alcohol outlets, and Rural–Urban Continuum Codes (RUCCS). A cross-sectional study design employed zero-truncated negative binominal regression models to assess relative risks (RR) with 95% confidence interval (CI). Counties (n = 57, 56,000 alcohol-related crashes over the 3 year study timeframe) were categorized by mean annual alcohol-related MV injuries per 100,000 population: low (24.7 ± 3.9), medium (33.9 ± 1.7) and high (46.1 ± 8.0) (p < 0.0001). In multivariable analyses, alcohol-related MV injury was elevated for non-adjacent, non-metropolitan counties (RR 2.5, 95% CI: 1.6–3.9) with higher citations for impaired driving showing a small, but significant protective effect. Less metropolitan areas had higher alcohol-related MV injury with inconsistent alcohol-related enforcement measures. In summary, higher alcohol-related MV injury rates in non-metropolitan counties demonstrated a dose–response relationship with proximity to a metropolitan area. These findings suggest areas where intervention efforts might be targeted to lower alcohol-related MV injury.

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 Urban/rural disparities in cancer incidence in New York State, 2008-2012

2015 ◽  
Author(s):  
Timothy Conwell ◽  
Francis P Boscoe
Keyword(s):  
New York ◽  
New York City ◽  
Cancer Incidence ◽  
York City ◽  
Rural Areas ◽  
New York State ◽  
Data Set ◽  
York State ◽  
Relative Risks ◽  
Urban Rural

We measured urban/rural disparities in cancer incidence in New York State using a data set with more than 500,000 tumors diagnosed among New York State residents between 2008-2012 geocoded to the census tract level. Using poisson regression, we computed the site and stage-specific relative risks of cancer by level of urbanicity after adjustment for age, sex, socioeconomic status and race/ethnicity. 18 of the 23 cancer sites analyzed showed some form of significant association between cancer incidence and urbanicity, although the risk differences were generally small. Differences in risk of 50% or more were seen for stomach, liver, distant-stage uterine, and thyroid cancers (each higher in New York City than in rural areas); esophagus, distant-stage kidney, and distant-stage lung (each lower in New York City than in rural areas); and distant-stage prostate cancer (higher in rural areas).

Strategic technology adoption and entry deterrence in broadband

2019 ◽  
Vol 29 (3) ◽  
pp. 713-729
Author(s):  
Tedi Skiti
Keyword(s):  
New York ◽  
Technology Adoption ◽  
Local Level ◽  
New York State ◽  
Investment Strategy ◽  
Entry Deterrence ◽  
Strategic Investment ◽  
York State ◽  
The Us

Abstract In this article, we examine the role of strategic investment in the US broadband industry. In particular, we provide evidence that cable incumbents adjust their investment strategy in response to fiber entry threat and that these deterrence strategies have been successful particularly in intermediate sized markets. We compile data on broadband deployment and exogenous franchise agreements for potential fiber entrants at the most local level in New York State. The results indicate that strategic cable investment may negatively affect optical fiber diffusion.

scholarly journals The Effect of Snow on Traffic Counts in Western New York State

2011 ◽  
Vol 3 (2) ◽  
pp. 71-75 ◽  
Author(s):  
David A. Call
Keyword(s):  
New York ◽  
Rural Areas ◽  
New York State ◽  
Passenger Cars ◽  
Traffic Counts ◽  
York State ◽  
The Road ◽  
Traffic Volumes ◽  
Moderate Negative Correlation ◽  
On The Road

Abstract While most people know anecdotally that weather affects traffic, relatively little research has examined the correlation between snow and traffic in great detail. Most studies have also been difficult to generalize for other areas and regions where drivers may be accustomed to more (or less) snow. This study examines the relationship between snow and traffic volumes in western New York State, an area that is regularly inundated by snow (more than 225 cm most seasons). Total daily traffic counts for the New York State Thruway (Interstate 90) showed a moderate negative correlation to snow for the period of study (2003–10). However, this correlation is caused by the large number of passenger cars and other similar vehicles on the road. Most other vehicle types, such as tractor trailers, had no correlation whatsoever. Additionally, the results for all vehicle classes were similar for both suburban and rural areas. Finally, it was observed that the ratio of large to small vehicles increases during snow events.

scholarly journals Analysis of SARS-CoV-2 Genomes from Southern California Reveals Community Transmission Pathways in the Early Stage of the US COVID-19 Pandemic

2020 ◽  
Author(s):  
Wenjuan Zhang ◽  
John Paul Govindavari ◽  
Brian Davis ◽  
Stephanie Chen ◽  
Jong Taek Kim ◽  
...  
Keyword(s):  
New York ◽  
Los Angeles ◽  
Local Community ◽  
Early Stage ◽  
Medical Center ◽  
New York State ◽  
The United States ◽  
Genomic Diversity ◽  
York State ◽  
The Us

AbstractGiven the higher mortality rate and widespread phenomenon of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS CoV-2) within the United States (US) population, understanding the mutational pattern of SARS CoV-2 has global implications for detection and therapy to prevent further escalation. Los Angeles has become an epicenter of the SARS-CoV-2 pandemic in the US. Efforts to contain the spread of SARS-CoV-2 require identifying its genetic and geographic variation and understanding the drivers of these differences. For the first time, we report genetic characterization of SARS-CoV-2 genome isolates in the Los Angeles population using targeted next generation sequencing (NGS). Samples collected at Cedars Sinai Medical Center were collected from patients with confirmed SARS-CoV-2 infection. We identified and diagnosed 192 patients by our in-house qPCR assay. In this population, the highest frequency variants were in known mutations in the 5’UTR, AA193 protein, RdRp and the spike glycoprotein. SARS-CoV-2 transmission within the local community was tracked by integrating mutation data with patient postal codes with two predominant community spread clusters being identified. Notably, significant viral genomic diversity was identified. Less than 10% of the Los Angeles community samples resembled published mutational profiles of SARS-CoV-2 genomes from China, while >50% of the isolates shared closely similarities to those from New York State. Based on these findings we conclude SARS-CoV-2 was likely introduced into the Los Angeles community predominantly from New York State but also via multiple other independent transmission routes including but not limited to Washington State and China.

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