scholarly journals Screening for consistency and contamination within and between bottles of 29 herbal supplements

PLoS ONE ◽  
2021 ◽  
Vol 16 (11) ◽  
pp. e0260463
Author(s):  
Maren E. Veatch-Blohm ◽  
Iris Chicas ◽  
Kathryn Margolis ◽  
Rachael Vanderminden ◽  
Marisa Gochie ◽  
...  
Keyword(s):  
Antioxidant Activity ◽  
Adult Population ◽  
Health And Safety ◽  
The United States ◽  
Herbal Supplements ◽  
Over The Counter ◽  
Frequency Of Use ◽  
Coefficients Of Variation ◽  
The Mean ◽  
Fungal Contaminants

In the United States the marketing of dietary supplements, of which the majority are herbal supplements, is currently a multibillion-dollar industry involving use from over half of the adult population. Due to their frequency of use and the lack of regulation of herbal supplements by the Food and Drug Administration (FDA) it is important for the health and safety of consumers to know about consistency of supplements and any possible contamination by harmful products, such as heavy metals or microorganisms. The purpose of the study was to determine consistency and contamination within and between bottles of common herbal supplements. Duplicate bottles of 29 herbal supplements were tested for consistency for antioxidant activity, phenolic concentration and flavonoid concentration under methanolic and water extraction. The supplements were also analyzed for the presence of metals and fungal contaminants. For all of the supplements tested there was high variability around the mean in antioxidant activity, phenolic concentrations and flavonoid concentrations, with coefficients of variation (CV) ranging from 0–120. Zinc was found in almost 90% of the supplements, nickel in about half of the supplements and lead in none of the supplements. Approximately 60% of the supplements contained fungal isolates. Although the majority of the fungi that were found in the supplements are generally not hazardous to human health, many of them could be problematic to sensitive groups, such as immunocompromised individuals. The data, which demonstrates contamination and a lack of consistency, in conjunction with previous studies on supplement contamination, strengthen the case that the FDA should regulate over-the-counter herbal supplements the same way that they regulate food and drugs. Until such time it is crucial that consumers are informed that many of the supplements that they take may lack the standardization that would reduce the chance of contamination and lead to consistency from one pill to the next.

scholarly journals OR30-01 Real-World Minimed™ 670G System Use and Glycemic Outcomes of Pediatric and Adult Individuals Living with Type 1 Diabetes (T1D) in the United States

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Robert Alan Vigersky ◽  
Michael Stone ◽  
Pratik Agrawal ◽  
Alex Zhong ◽  
Kevin Velado ◽  
...  
Keyword(s):  
Glycemic Control ◽  
Real World ◽  
Adult Population ◽  
Age Groups ◽  
The United States ◽  
System Use ◽  
System Data ◽  
The Mean ◽  
The Impact ◽  
The U.S

Abstract Introduction: The MiniMed™ 670G system was FDA-approved in 2016 for adults and adolescents ≥14yrs, and in 2018 for children ages 7-13yrs with T1D. Since then, use of the system has grown to over 180,000 people in the U.S. The glycemic control benefits of real-world MiniMed™ 670G system Auto Mode use in the U.S. were assessed. Methods: System data (aggregated five-minute instances of sensor glucose [SG]) uploaded from March 2017 to July 2019 by individuals (N=118,737) with T1D and ≥7yrs of age who enabled Auto Mode were analyzed to determine the mean % of overall time spent <54mg/dL/<70mg/dL (TBR); between 70-180mg/dL (TIR); and >180mg/dL/>250mg/dL (TAR). The impact of Auto Mode was further assessed in a sub-group of individuals (N=51,254) with, at least, 7 days of SG data for both Auto Mode turned ON and turned OFF. The % of TIR, TBR and TAR, and the associated glucose management indicator (GMI) were evaluated for the overall OFF (2,524,570 days) and ON (6,308,806 days) periods, and across different age groups. Results: System data TIR was 71.3%; TBR was 0.4% and 1.9%, respectively; and TAR was 26.8% and 6.2%, respectively. User-wise data of Auto Mode OFF versus ON showed a mean of 70.3% of the time spent in Auto Mode, that TIR increased from 60.9% to 69.9%; and that both TBR and TAR decreased. For those 7-13yrs (N=1,417), TIR increased from 48.7% to 61.5%; TBR increased from 0.5% to 0.6% and from 2.0% to 2.2%, respectively; and TAR decreased from 49.3% to 36.3% and from 20.5% to 13.0%, respectively. For those 14-21yrs (N=4,194), TIR increased from 51.0% to 61.5%; TBR decreased from 0.7% to 0.6% and from 2.3% to 2.0%, respectively; and TAR decreased from 46.7% to 36.5% and from 18.5% to 12.5%, respectively. For those ≥22yrs (N=45,643), TIR increased from 62.2% to 70.9%; TBR decreased from 0.7% to 0.5% and from 2.6% to 1.9%, respectively; and TAR decreased from 35.2% to 27.3% and from 9.9% to 6.3%, respectively. The mean GMI decreased by 0.23% (overall), 0.48% (7-13yrs), 0.35% (14-21yrs), and 0.22% (≥22yrs), respectively, with Auto Mode ON versus OFF. Discussion: In over 6 million days of real-world MiniMed™ 670G system Auto Mode use in the U.S., TIR of a large pediatric and adult population with T1D improved by 9% compared to when Auto Mode was OFF, which was comparable to or exceeded the TIR observed in the smaller pivotal trials. These results further support outcomes of the pivotal trials and increased glycemic control with system use.

scholarly journals Effects of the COVID-19 pandemic on mental health (anxiety and depression symptoms) in the United States of America

2021 ◽  
Vol 69 (4) ◽  
pp. e95387
Author(s):  
Caner Baysan ◽  
Seher Palanbek-Yavaş ◽  
Ayşe Emel-Önal
Keyword(s):  
Mental Health ◽  
United States ◽  
United States Of America ◽  
Demographic Data ◽  
Adult Population ◽  
Average Frequency ◽  
The United States ◽  
Depression Symptoms ◽  
Mean Frequency ◽  
The Mean

Introduction: The COVID-19 pandemic has had a serious mental health impact in the United States of America, as well as all over the world. Objective: To assess some of the effects of the COVID-19 pandemic on the mental health of US adult population, as well as the relationship between the average number of new COVID-19 cases and the average frequency of symptoms of anxiety, of depression, and of anxiety or depression between April 23 and October 26 2020. Materials and methods: Retrospective study. Psychosocial and demographic data were obtained from the online community-based Household Pulse Survey website. Data about the number of new COVID-19 cases detected in USA during the study period were taken from the Our World in Data website. The Spearman’s rank correlation coefficient was used to evaluate the strength of the relationships between the average new cases of COVID-19 during the study period and the average frequency of symptoms of anxiety, of depression, and of anxiety or depression. These correlations were also assessed in a subgroup analysis (gender, age group, education level, and ethnicity). Results: A total of 1,351,911 US adults completed the survey. The average rates of symptoms of depression, of anxiety, and of anxiety or depression were 25.7±1.6%, 31.9±2.0%, and 36.8±2.0%, respectively. The average number of new COVID-19 cases was positively correlated with the mean frequency of symptoms of anxiety, of depression, and of anxiety or depression (r=0.858, r=0.710, and r=0.887; p<0.001). Likewise, positive correlations between the average number of new cases and the mean frequency of anxiety or depressive symptoms were found in the subgroups (r=0.484-0.917). Conclusions: According to our results, the number of new COVID-19 cases detected during the study period in USA was positively correlated with the frequency of anxiety or depression symptoms in the participants, that is, as the number of new cases increased, so did the frequency of the symptoms of these mental disorders.

scholarly journals Effect Of Gender And Lifestyle Behaviors On BMI Trends In A Sample Of The First State’s Undergraduate Population

2015 ◽  
Vol 6 (1) ◽  
pp. 59-74 ◽  
Author(s):  
Malcolm J. D’Souza ◽  
Karri-Jo E. Walls ◽  
Christine Rojas ◽  
Lynn M. Everett ◽  
Derald E. Wentzien
Keyword(s):  
Adult Population ◽  
The United States ◽  
The Body ◽  
United States Department ◽  
Lifestyle Behaviors ◽  
Dietary Recommendations ◽  
Chi Square ◽  
Frequency Distributions ◽  
Chi Square Test ◽  
The Mean

The 2010 Centers for Disease Control and Prevention (CDC) report indicates that 63.4% of Delaware’s adult population is overweight and 28% is obese. Here, the authors reveal analyses acquired from detailed investigations about the importance of gender, and other lifestyle factors and behaviors on the Body Mass Index (BMI) trends amongst an indiscriminate sample of the Wesley College (Wesley) undergraduate population. A 25-question paper-format survey was distributed to 307 randomly chosen Wesley undergraduates. The accrued qualitative (or categorical) data were transferred to an Excel spreadsheet to construct and observe frequency distributions. A Chi-square test of independence (χ2) was performed between BMI status (normal, overweight, obese) and the following factors: gender, diet plan, adherence to the United States Department of Agriculture (USDA) MyPlate nutrition guide, use of the seasonal flu shot, weekly workout schedule, supplement usage, participation on athletic teams, questioning of label nutritional facts, and the use of added salt in food. A 2-sample proportion test was performed between students who were overweight or obese for the same factors. Also performed were t-tests for mean BMI for those who followed USDA MyPlate guidelines and for those who did not. An analysis of 278 completed surveys show that 29.5% of the Wesley respondents are overweight and 19.8% are obese. The mean BMI for males was statistically higher than the mean BMI for females. The mean BMI for students living on-campus was statistically higher than the mean BMI for students living off-campus. The results also demonstrate that adhering to the USDA dietary recommendations for fruit and dairy can be important factors in reducing the risk of obesity. 

Variability in Medicaid Reimbursement in Hand Surgery May Lead to Inequality in Access to Patient Care

Hand ◽  
2020 ◽  
pp. 155894472096496
Author(s):  
William Baker ◽  
Michael Rivlin ◽  
Samir Sodha ◽  
Michael Nakashian ◽  
Brian Katt ◽  
...  
Keyword(s):  
Carpal Tunnel Release ◽  
Hand Surgery ◽  
The United States ◽  
Current Procedural Terminology ◽  
Substantial Variation ◽  
Medicaid Reimbursement ◽  
Coefficients Of Variation ◽  
The Mean ◽  
Fee Schedule ◽  
Average State

Background: Medicare (MCR) and Medicaid (MCD) remain the dominant providers of government-funded health insurance in the United States. The purpose of this study was to evaluate the variability between MCR and MCD reimbursements for common hand and wrist surgical procedures. We hypothesized that MCD reimbursement rates would have substantial variation between states, whereas MCR rates would remain relatively constant. Methods: Using the Medicare Physician Fee Schedule Database, the 2019 reimbursements for 7 common hand and wrist procedures were recorded via the respective Current Procedural Terminology codes. The MCD reimbursement rates were then obtained from each state’s physician fee schedule database. Comparisons of reimbursement for these procedures were then calculated between states and between MCD and MCR while adjusting for cost of living using the Medicare Wage Index. Finally, the coefficients of variation were computed to compare the extent of variability between the insurance types. Results: Across all procedures, reimbursement rates for MCD ranged from 30.6% to 240% of the average MCR reimbursement, with the mean reimbursement for MCD valued at 78.3% of MCR. Endoscopic carpal tunnel release (CTR) is valued similarly by MCD compared with open CTR with an average of 77.7% and 78.2% reimbursement of MCR, respectively. The coefficients of variation for MCD reimbursements ranged from 0.25 to 0.45, whereas the value was 0.06 for all MCR procedures. Conclusions: These findings demonstrate a wide variation in MCD payments between states. When compared with MCR, the lower average state MCD reimbursement questions the sustainability for hand surgeons to accept these patients in practice.

Relation of Statistically Significant, Abnormal, and Typical WAIS-R VIQ-PIQ Discrepancies to Full Scale IQs

2000 ◽  
Vol 16 (2) ◽  
pp. 107-114 ◽  
Author(s):  
Louis M. Hsu ◽  
Judy Hayman ◽  
Judith Koch ◽  
Debbie Mandell
Keyword(s):  
Graphical Method ◽  
The United States ◽  
Full Scale ◽  
True Score ◽  
Absolute Value ◽  
Normative Population ◽  
The Us ◽  
The Mean ◽  
And Performance ◽  
Quadratic Models

Summary: In the United States' normative population for the WAIS-R, differences (Ds) between persons' verbal and performance IQs (VIQs and PIQs) tend to increase with an increase in full scale IQs (FSIQs). This suggests that norm-referenced interpretations of Ds should take FSIQs into account. Two new graphs are presented to facilitate this type of interpretation. One of these graphs estimates the mean of absolute values of D (called typical D) at each FSIQ level of the US normative population. The other graph estimates the absolute value of D that is exceeded only 5% of the time (called abnormal D) at each FSIQ level of this population. A graph for the identification of conventional “statistically significant Ds” (also called “reliable Ds”) is also presented. A reliable D is defined in the context of classical true score theory as an absolute D that is unlikely (p < .05) to be exceeded by a person whose true VIQ and PIQ are equal. As conventionally defined reliable Ds do not depend on the FSIQ. The graphs of typical and abnormal Ds are based on quadratic models of the relation of sizes of Ds to FSIQs. These models are generalizations of models described in Hsu (1996) . The new graphical method of identifying Abnormal Ds is compared to the conventional Payne-Jones method of identifying these Ds. Implications of the three juxtaposed graphs for the interpretation of VIQ-PIQ differences are discussed.

Can increases in Twitter posts predict increases in cumulative incidence of COVID-19 in the United States? Evidence that social media can inform epidemic surveillance. (Preprint)

2020 ◽  
Author(s):  
Ruoyan Sun ◽  
Henna Budhwani
Keyword(s):  
Public Health ◽  
United States ◽  
Cumulative Incidence ◽  
Hot Spots ◽  
Adult Population ◽  
State Level ◽  
The United States ◽  
Education Attainment ◽  
Public Health Systems ◽  
Per Capita

BACKGROUND Though public health systems are responding rapidly to the COVID-19 pandemic, outcomes from publicly available, crowd-sourced big data may assist in helping to identify hot spots, prioritize equipment allocation and staffing, while also informing health policy related to “shelter in place” and social distancing recommendations. OBJECTIVE To assess if the rising state-level prevalence of COVID-19 related posts on Twitter (tweets) is predictive of state-level cumulative COVID-19 incidence after controlling for socio-economic characteristics. METHODS We identified extracted COVID-19 related tweets from January 21st to March 7th (2020) across all 50 states (N = 7,427,057). Tweets were combined with state-level characteristics and confirmed COVID-19 cases to determine the association between public commentary and cumulative incidence. RESULTS The cumulative incidence of COVID-19 cases varied significantly across states. Ratio of tweet increase (p=0.03), number of physicians per 1,000 population (p=0.01), education attainment (p=0.006), income per capita (p = 0.002), and percentage of adult population (p=0.003) were positively associated with cumulative incidence. Ratio of tweet increase was significantly associated with the logarithmic of cumulative incidence (p=0.06) with a coefficient of 0.26. CONCLUSIONS An increase in the prevalence of state-level tweets was predictive of an increase in COVID-19 diagnoses, providing evidence that Twitter can be a valuable surveillance tool for public health.

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.

An Assessment of Sampling Methods and Microbiological Hygiene Indicators for Process Verification in Poultry Slaughterhouses

2006 ◽  
Vol 69 (1) ◽  
pp. 145-153 ◽  
Author(s):  
M. L. HUTCHISON ◽  
L. D. WALTERS ◽  
G. C. MEAD ◽  
M. HOWELL ◽  
V. M. ALLEN
Keyword(s):  
Storage Time ◽  
Sampling Method ◽  
Indicator Bacteria ◽  
Aerobic Bacteria ◽  
Process Verification ◽  
Bacterial Indicator ◽  
Coefficients Of Variation ◽  
Microbiological Testing ◽  
The Mean ◽  
Poor Relationship

Studies to determine the appropriateness of the use of populations of indicator bacteria on poultry carcasses for process verification were undertaken in commercial slaughterhouses. Samples were collected from neck skin by excision or from whole carcass rinses and were examined for a range of presumptive process hygiene indicator bacteria. Coefficients of variation were calculated for each bacterial indicator and were significantly lower in excised samples, indicating more reproducible bacterial recovery by this sampling method. Total viable counts of aerobic bacteria, Enterobacteriaceae, and Pseudomonas in samples collected by excision had the lowest coefficients of variation when compared with other indicators and were therefore used for further study. The uncertainties associated with the quantification of each bacterial indicator were calculated and were lowest overall for total viable counts of aerobic bacteria. In general, uncertainty was higher for lower bacterial numbers. Results of microbiological testing on pooled excised neck skin samples were not significantly different from the mean of individually analyzed samples. Bacterial numbers increased by 1 log unit when cultures were stored under chilled conditions typical of those used for transporting samples to external laboratories, but the increases were not significant for Pseudomonas and aerobic bacteria when storage time was less than 17 h. Weak relationships were identified between bacterial indicator numbers and duration of processing, although cleanliness of the processing environment diminished visibly during this time. In the plants visited for this study, there was a poor relationship between presumptive bacterial indicator numbers and process hygiene. Consequently, bacterial analyses for process verification purposes may be of limited value.

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