scholarly journals Proposed virulence-associated genes of Streptococcus suis isolates from the United States serve as predictors of pathogenicity

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
April A. Estrada ◽  
Marcelo Gottschalk ◽  
Aaron Rendahl ◽  
Stephanie Rossow ◽  
Lacey Marshall-Lund ◽  
...  
Keyword(s):  
United States ◽  
Streptococcus Suis ◽  
The United States ◽  
Limited Information ◽  
Lasso Regression ◽  
Chi Square ◽  
Pathogenic Potential ◽  
Multiple Production ◽  
Pan Genome ◽  
Protein Factor

Abstract Background There is limited information on the distribution of virulence-associated genes (VAGs) in U.S. Streptococcus suis isolates, resulting in little understanding of the pathogenic potential of these isolates. This lack also reduces our understanding of the epidemiology associated with S. suis in the United States and thus affects the efficiency of control and prevention strategies. In this study we applied whole genome sequencing (WGS)-based approaches for the characterization of S. suis and identification of VAGs. Results Of 208 S. suis isolates classified as pathogenic, possibly opportunistic, and commensal pathotypes, the genotype based on the classical VAGs (epf, mrp, and sly encoding the extracellular protein factor, muramidase-release protein, and suilysin, respectively) was identified in 9% (epf+/mrp+/sly+) of the pathogenic pathotype. Using the chi-square test and LASSO regression model, the VAGs ofs (encoding the serum opacity factor) and srtF (encoding sortase F) were selected out of 71 published VAGs as having a significant association with pathotype, and both genes were found in 95% of the pathogenic pathotype. The ofs+/srtF+ genotype was also present in 74% of ‘pathogenic’ isolates from a separate validation set of isolates. Pan-genome clustering resulted in the differentiation of a group of isolates from five swine production companies into clusters corresponding to clonal complex (CC) and virulence-associated (VA) genotypes. The same CC-VA genotype patterns were identified in multiple production companies, suggesting a lack of association between production company, CC, or VA genotype. Conclusions The proposed ofs and srtF genes were stronger predictors for differentiating pathogenic and commensal S. suis isolates compared to the classical VAGs in two sets of U.S. isolates. Pan-genome analysis in combination with metadata (serotype, ST/CC, VA genotype) was illustrated to be a valuable subtyping tool to describe the genetic diversity of S. suis.

The economic burden of vertigo and dizziness in the United States

2020 ◽  
pp. 1-10
Author(s):  
Jeremy S. Ruthberg ◽  
Chandruganesh Rasendran ◽  
Armine Kocharyan ◽  
Sarah E. Mowry ◽  
Todd D. Otteson
Keyword(s):  
United States ◽  
Health Care ◽  
Economic Burden ◽  
Clinical Characteristics ◽  
Care Service ◽  
Adult Population ◽  
Health Care Service ◽  
The United States ◽  
Medical Expenditures ◽  
Limited Information

BACKGROUND: Vertigo and dizziness are extremely common conditions in the adult population and therefore place a significant social and economic burden on both patients and the healthcare system. However, limited information is available for the economic burden of vertigo and dizziness across various health care settings. OBJECTIVE: Estimate the economic burden of vertigo and dizziness, controlling for demographic, socioeconomic, and clinical comorbidities. METHODS: A retrospective analysis of data from the Medical Expenditures Panel Survey (2007–2015) was performed to analyze individuals with vertigo or dizziness from a nationally representative sample of the United States. Participants were included via self-reported data and International Classification of Diseases, 9th Revision Clinical Modification codes. A cross-validated 2-component generalized linear model was utilized to assess vertigo and dizziness expenditures across demographic, socioeconomic and clinical characteristics while controlling for covariates. Costs and utilization across various health care service sectors, including inpatient, outpatient, emergency department, home health, and prescription medications were evaluated. RESULTS: Of 221,273 patients over 18 years, 5,275 (66% female, 34% male) reported either vertigo or dizziness during 2007–2015. More patients with vertigo or dizziness were female, older, non-Hispanic Caucasian, publicly insured, and had significant clinical comorbidities compared to patients without either condition. Furthermore, each of these demographic, socioeconomic, and clinical characteristics lead to significantly elevated costs due to having these conditions for patients. Significantly higher medical expenditures and utilization across various healthcare sectors were associated with vertigo or dizziness (p <  0.001). The mean incremental annual healthcare expenditure directly associated with vertigo or dizziness was $2,658.73 (95% CI: 1868.79, 3385.66) after controlling for socioeconomic and demographic characteristics. Total annual medical expenditures for patients with dizziness or vertigo was $48.1 billion. CONCLUSION: Vertigo and dizziness lead to substantial expenses for patients across various healthcare settings. Determining how to limit costs and improve the delivery of care for these patients is of the utmost importance given the severe morbidity, disruption to daily living, and major socioeconomic burden associated with these conditions.

Feel the Burn! Fireworks-related Otolaryngologic Trauma

2021 ◽  
pp. 000348942110081
Author(s):  
Alexander J. Straughan ◽  
Luke J. Pasick ◽  
Vrinda Gupta ◽  
Daniel A. Benito ◽  
Joseph F. Goodman ◽  
...  
Keyword(s):  
United States ◽  
Head And Neck ◽  
Emergency Departments ◽  
Closed Head Injury ◽  
Penetrating Trauma ◽  
The United States ◽  
Neck Injuries ◽  
Chi Square ◽  
Injury Surveillance System ◽  
Cross Sectional

Objectives: Fireworks are used commonly for celebrations in the United States, but can lead to severe injury to the head and neck. We aim to assess the incidence, types, and mechanisms of head and neck injuries associated with fireworks use from 2010 to 2019. Methods: A retrospective cross-sectional study, using data from the National Electronic Injury Surveillance System, of individuals presenting to United States Emergency Departments with head and neck injuries caused by fireworks and flares from 2010 to 2019. Incidence, types, and mechanisms of injury related to fireworks use in the US population were assessed. Results: A total of 541 patients (349 [64.5%] male, and 294 [54%] under 18 years of age) presented to emergency departments with fireworks-related head and neck injuries; the estimated national total was 20 584 patients (13 279 male, 9170 white, and 11 186 under 18 years of age). The most common injury diagnoses were burns (44.7% of injuries), laceration/avulsion/penetrating trauma (21.1%), and otologic injury (15.2%), which included hearing loss, otalgia, tinnitus, unspecified acoustic trauma, and tympanic membrane perforation. The remaining 19% of injuries were a mix, including contusion, abrasion, hematoma, fracture, and closed head injury. Associations between fireworks type and injury diagnosis (chi-square P < .001), as well as fireworks type by age group (chi-square P < .001) were found. Similarly, associations were found between age groups and injury diagnoses (chi-square P < .001); these included children 5 years and younger and adults older than 30 years. Conclusions: Fireworks-related head and neck injuries are more likely to occur in young, white, and male individuals. Burns are the most common injury, while otologic injury is a significant contributor. Annual rates of fireworks-related head and neck injuries have not changed or improved significantly in the United States in the past decade, suggesting efforts to identify and prevent these injuries are insufficient.

Abstract 177: Credentials of Staff Performing Echocardiography in the United States: Insights from the Intersocietal Accreditation Commission

2014 ◽  
Vol 7 (suppl_1) ◽  
Author(s):  
Matthew W Parker ◽  
Diana Sobieraj ◽  
Mary Beth Farrell ◽  
Craig I Coleman
Keyword(s):  
United States ◽  
Cardiovascular Diseases ◽  
The United States ◽  
Chi Square ◽  
Volume Number ◽  
National Board ◽  
Formal Level ◽  
Chi Square Test ◽  
Level 3 ◽  
Medical Directors

Background: Little has been published on the practice of echocardiography (echo) in the United States. We used the Intersocietal Accreditation Commission-Echocardiography (IAC-Echo) applications database to describe the personnel in echo laboratories seeking accreditation. Methods: We used de-identified data provided on IAC-Echo applications to characterize facilities by hospital association, census region, annual volume, number of sites, previous accreditation, and numbers of physicians and sonographers as well as National Board of Echocardiography (NBE) testamur status of physicians and registered credential status of sonographers. We categorized Medical Directors by board certification in cardiovascular diseases, internal medicine, other specialty, or none. Medical Director echo training could be formal Level 2 or 3 or experiential by ≥3 years of practice. Frequencies, means, and medians were compared between groups using the chi-square test, t-test, or Mann Whitney test, respectively. Results: From 2011 to 2013, 1926 echo labs representing 10618 physicians and 6870 sonographers applied for IAC-Echo accreditation or re-accreditation. The majority of medical directors were board certified in cardiovascular diseases and 34.1% of medical directors and 27.2% of staff physicians held NBE testamur status; 79.5% of sonographers held registered credentials. Most echo labs were in the Northeast or South census regions, have an average of 1.75 sites, and are based outside of hospitals (Table). Compared to nonhospital echo labs, medical directors of hospital-based echo labs were more likely to be Level 3 trained (19.8% versus 30.8%, p<0.01) and be NBE testamurs (28.9% versus 45.6%, p<0.01). Markers of echo lab size, region, previous accreditation, and credentialed sonographers were associated with accreditation versus delay decisions; there was a trend toward accreditation among facilities with NBE medical directors. Conclusion: Among facilities seeking IAC-Echo accreditation, the minority of echo physicians hold NBE testamur status. Hospital and nonhospital facilities are different in the credentials of their personnel.

scholarly journals A Balanced Literacy Initiative for One Suburban School District in the United States

2012 ◽  
Vol 2012 ◽  
pp. 1-9 ◽  
Author(s):  
Donita Shaw ◽  
Karen Hurst
Keyword(s):  
United States ◽  
School District ◽  
Quantitative Data ◽  
Balanced Literacy ◽  
The United States ◽  
Descriptive Statistics ◽  
Chi Square ◽  
Survey Question ◽  
Suburban School District ◽  
Pearson Correlations

The purpose of this study was to investigate how the teachers employed by this suburban USA school district implemented balanced literacy instruction. The 111 teachers who taught grades K-6 completed surveys and were observed. Quantitative data from the surveys and observations were analyzed through descriptive statistics, nonparametric chi-square tests, and Pearson correlations. One open-ended survey question was analyzed qualitatively. Findings show that the majority of teachers had an acceptable understanding of balanced literacy. There were differences among teachers’ instruction on literacy components and structures across grades. Weak correlations among self-reported and observed practices were found. Implications are discussed as the data are being used for research-informed improvements in the district.

An Analysis of Unmanned Aircraft Registration Effectiveness

2017 ◽  
Vol 4 (1) ◽  
pp. 54-66
Author(s):  
Ronald Pentz ◽  
He (Herman) Tang
Keyword(s):  
United States ◽  
Statistical Analysis ◽  
The United States ◽  
Unmanned Aircraft ◽  
Unmanned Aircraft Systems ◽  
Courts Of Appeals ◽  
Chi Square ◽  
Difficult Time ◽  
Significant Difference ◽  
Rapid Pace

This article describes how small unmanned aircraft systems (sUAS) are growing at a rapid pace. They are inexpensive and widely available for both hobbyist and commercial use. However, with this rapid growth, regulations are having a difficult time keeping pace to safely incorporate them into the United States National Airspace. Recent regulations requiring the registration of all sUAS have been overturned by the United States Courts of Appeals. This research provides a statistical analysis of the effectiveness of the registration regulation in the reduction of unauthorized and careless sUAS operation prior to being overturned by the courts. Statistical analysis including descriptive statistics and chi square hypothesis tests were used to analyze more than 3,000 reported unauthorized and careless events. The findings show a significant difference in events pre-registration and post registration.

Emergency Department Visits due to Scabies in the United States: A Retrospective Analysis of a Nationally Representative Emergency Department Sample

2019 ◽  
Author(s):  
Raghav Tripathi ◽  
Konrad D Knusel ◽  
Harib H Ezaldein ◽  
Jeremy S Bordeaux ◽  
Jeffrey F Scott
Keyword(s):  
United States ◽  
Emergency Department ◽  
Retrospective Analysis ◽  
The United States ◽  
Cost Of Care ◽  
Emergency Department Visits ◽  
Limited Information ◽  
Targeted Interventions ◽  
Ed Visits ◽  
Nationally Representative

Abstract Background Limited information exists regarding the burden of emergency department (ED) visits due to scabies in the United States. The goal of this study was to provide population-level estimates regarding scabies visits to American EDs. Methods This study was a retrospective analysis of the nationally representative National Emergency Department Sample from 2013 to 2015. Outcomes included adjusted odds for scabies ED visits, adjusted odds for inpatient admission due to scabies in the ED scabies population, predictors for cost of care, and seasonal/regional variation in cost and prevalence of scabies ED visits. Results Our patient population included 416 017 218 ED visits from 2013 to 2015, of which 356 267 were due to scabies (prevalence = 85.7 per 100 000 ED visits). The average annual expenditure for scabies ED visits was $67 125 780.36. The average cost of care for a scabies ED visit was $750.91 (±17.41). Patients visiting the ED for scabies were most likely to be male children from lower income quartiles and were most likely to present to the ED on weekdays in the fall, controlling for all other factors. Scabies ED patients that were male, older, insured by Medicare, from the highest income quartile, and from the Midwest/West were most likely to be admitted as inpatients. Older, higher income, Medicare patients in large Northeastern metropolitan cities had the greatest cost of care. Conclusion This study provides comprehensive nationally representative estimates of the burden of scabies ED visits on the American healthcare system. These findings are important for developing targeted interventions to decrease the incidence and burden of scabies in American EDs.

Sport Management Scholarship: A Professoriate in Transition?

1996 ◽  
Vol 10 (2) ◽  
pp. 119-130 ◽  
Author(s):  
Janet B. Parks ◽  
Michael E. Bartley
Keyword(s):  
United States ◽  
Sport Management ◽  
The United States ◽  
Legal Aspects ◽  
Management Program ◽  
Chi Square ◽  
Sociology Of Sport ◽  
Gender Parity ◽  
Tests Of Independence ◽  
Management Scholarship

Scholarship expectations of many universities in the United States are becoming more stringent. The purpose of this study was to examine variables associated with the scholarship of the sport management professoriate. The participants were 266 of the 422 academics in the NASPE-NASSM Sport Management Program List (1991). Chi-square tests of independence (alpha < .004) revealed slight tendencies for (a) younger faculty to have doctorates in areas such as sport management, psychology/sociology of sport, and legal aspects of sport rather than in physical education; (b) younger faculty to have more publications than older faculty; (c) women to be concentrated in the lower ranks and salary ranges; and (d) movement toward gender parity in rank and salary. This study should be replicated in 5 years to discover if these tendencies were precursors of trends.

scholarly journals PSI-7 Prevalence and distribution of Senecavirus A in United States swine feed mills

2019 ◽  
Vol 97 (Supplement_2) ◽  
pp. 243-244
Author(s):  
Shannon P Ney ◽  
Vlad Petrovan ◽  
Savannah C Stewart ◽  
Shania Davis ◽  
Megan C Niederwerder ◽  
...  
Keyword(s):  
United States ◽  
Environmental Samples ◽  
Limited Information ◽  
Rt Pcr ◽  
Chi Square ◽  
Late Fall ◽  
Chi Square Test ◽  
Swine Feed ◽  
Ct Data ◽  
Feed Mill

Abstract There is limited information about Senecavirus A (SVA) transmission in the feed supply chain. The objective of this experiment was to determine the prevalence and distribution of SVA in U.S. swine feed mills. A total of 375 samples were collected from 11 surfaces + one feed sample collected from 11 different feed mills in 8 different states. Due to the seasonality associated with pathogenic hazards, the same locations in feed mills were swabbed in Late Fall 2016, Winter 2016/17, and Summer 2017. Surfaces were swabbed according to the Centers for Disease Control protocols for collecting environmental samples using pre-moistened environmental swabs in 5 mL of neutralizing broth. Detection of SVA was performed via RT-PCR and reported in Cycle threshold (Ct). Data were analyzed using the freq procedure of SAS, with chi-square test to determine the prevalence of SVA within season or distribution among feed mill locations. Notably, no mills were manufacturing feed for SVA-positive herds at the time of analysis. Five of 375 samples analyzed positive for SVA, with Ct ranging from 37.4 to 39.9. There was a tendency (P = 0.069) for SVA prevalence to be greater in winter than late fall or summer. There was no detected impact (P = 0.409) of SVA distribution varying across location within feed mill. A sow farm being fed by the mill with SVA on worker shoes was subsequently diagnosed with SVA after the sample as collected. These results indicate that SVA was not widespread throughout the swine feed mills analyzed in this experiment. However, we are unaware of any other studies evaluating presence in feed mills. Little is known about SVV transmission, but the clinically affected farm fed out of the mill with SVV presence suggest further investigation, as feed or feed delivery may be a route of entry into farms.

scholarly journals Statistical Analysis of Natural Events in the United States

1991 ◽  
Vol 21 (2) ◽  
pp. 253-276 ◽  
Author(s):  
Charles Levi ◽  
Christian Partrat
Keyword(s):  
United States ◽  
Statistical Analysis ◽  
Negative Binomial ◽  
The United States ◽  
Normal Model ◽  
Chi Square ◽  
Expected Frequency ◽  
Kolmogorov Smirnov ◽  
Anderson Darling ◽  
Log Normal

AbstractA statistical analysis is performed on natural events which can produce important damages to insurers. The analysis is based on hurricanes which have been observed in the United States between 1954 et 1986.At first, independence between the number and the amount of the losses is examined. Different distributions (Poisson and negative binomial for frequency and exponential, Pareto and lognormal for severity) are tested. Along classical tests as chi-square, Kolmogorov-Smirnov and non parametric tests, a test with weights on the upper tail of the distribution is used: the Anderson – Darling test.Confidence intervals for the probability of occurrence of a claim and expected frequency for different potential levels of claims are derived. The Poisson Log-normal model gives a very good fit to the data.

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