Trends in the Cumulative Incidence of Vocational Rehabilitation Indicators in Brazil, 2007–2016

Vocational rehabilitation (VR) aims at improving work ability to facilitate workers’ return to work. VR is provided in Brazil by the public social security system. The aim of the present study was to analyze trends in VR indicators for Brazil from 2007 to 2016. Based on open-access, secondary aggregate data, we calculated the cumulative incidence of VR indicators. We fitted Prais-Winsten generalized linear regression models to estimate trends and calculated annual percent variation with the corresponding 95% confidence interval (95% CI). The mean cumulative incidence of referrals to VR services was 37.16/1000 temporary disability benefits granted and exhibited a decreasing trend of −6.92% (95% CI: −8.38; −5.43). The mean cumulative incidence of admissions to VR services was 57.34/100 referrals and exhibited an increasing trend of 3.31% (95% CI: 1.13; 5.53). The mean cumulative incidence of rehabilitation was 57.43/100 admissions and remained stable along the analyzed period, −2.84 (95% CI: −5.87; 0.29). Our findings evidence a reduction in the number of workers referred for VR, an increase of admissions, and stability in the cumulative incidence of rehabilitated workers.

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Assessing Early Heterogeneity in Doubling Times of the COVID-19 Epidemic across Prefectures in Mainland China, January–February, 2020

Epidemiologia ◽

10.3390/epidemiologia2010009 ◽

2021 ◽

Vol 2 (1) ◽

pp. 95-113 ◽

Cited By ~ 1

Author(s):

Isaac Chun-Hai Fung ◽

Xiaolu Zhou ◽

Chi-Ngai Cheung ◽

Sylvia K. Ofori ◽

Kamalich Muniz-Rodriguez ◽

...

Keyword(s):

Regression Models ◽

Doubling Time ◽

Metropolitan Areas ◽

Mainland China ◽

Linear Regression Models ◽

Case Count ◽

Daily Time Series ◽

The Mean ◽

Doubling Times ◽

Daily Time

To describe the geographical heterogeneity of COVID-19 across prefectures in mainland China, we estimated doubling times from daily time series of the cumulative case count between 24 January and 24 February 2020. We analyzed the prefecture-level COVID-19 case burden using linear regression models and used the local Moran’s I to test for spatial autocorrelation and clustering. Four hundred prefectures (~98% population) had at least one COVID-19 case and 39 prefectures had zero cases by 24 February 2020. Excluding Wuhan and those prefectures where there was only one case or none, 76 (17.3% of 439) prefectures had an arithmetic mean of the epidemic doubling time <2 d. Low-population prefectures had a higher per capita cumulative incidence than high-population prefectures during the study period. An increase in population size was associated with a very small reduction in the mean doubling time (−0.012, 95% CI, −0.017, −0.006) where the cumulative case count doubled ≥3 times. Spatial analysis revealed high case count clusters in Hubei and Heilongjiang and fast epidemic growth in several metropolitan areas by mid-February 2020. Prefectures in Hubei and neighboring provinces and several metropolitan areas in coastal and northeastern China experienced rapid growth with cumulative case count doubling multiple times with a small mean doubling time.

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Abstract WMP14: Association of Systolic Blood Pressure, LDL Cholesterol, and Hgb A1c With White Matter Hyperintensity on MRI in the ACCORDION MIND Study

Stroke ◽

10.1161/str.51.suppl_1.wmp14 ◽

2020 ◽

Vol 51 (Suppl_1) ◽

Author(s):

Adam H de Havenon ◽

Tanya Turan ◽

Rebecca Gottesman ◽

Sharon Yeatts ◽

Shyam Prabhakaran ◽

...

Keyword(s):

Blood Pressure ◽

Risk Factor ◽

Regression Models ◽

Ldl Cholesterol ◽

Vascular Risk Factor ◽

White Matter Hyperintensity ◽

Vascular Risk ◽

Linear Regression Models ◽

Risk Factor Profile ◽

The Mean

Introduction: While retrospective studies have shown that poor control of vascular risk factors is associated with progression of white matter hyperintensity (WMH), it has not been studied prospectively. Hypothesis: We hypothesize that higher systolic blood pressure (SBP) mean, LDL cholesterol, and Hgb A1c will be correlated with WMH progression in diabetics. Methods: This is a secondary analysis of the Memory in Diabetes (MIND) substudy of the Action to Control Cardiovascular Risk in Diabetes Follow-on Study (ACCORDION). The primary outcome was WMH progression, evaluated by fitting linear regression models to the WMH volume on the month 80 MRI and adjusting for the WMH volume on the baseline MRI. The primary predictors were the mean values of SBP, LDL, and A1c from baseline to month 80. We defined a good vascular risk factor profile as mean SBP <120 mm Hg and mean LDL <120 mg/dL. Results: We included 292 patients, with a mean (SD) age of 62.6 (5.3) years and 55.8% male. The mean number of SBP, LDL, and A1c measurements per patient was 17, 5, and 12. We identified 86 (29.4%) patients with good vascular risk factor profile. In the linear regression models, mean SBP and LDL were associated with WMH progression and in a second fully adjusted model they both remained associated with WMH progression (Table). Those with a good vascular risk factor profile had less WMH progression (β Coefficient -0.80, 95% CI -1.42, -0.18, p=0.012). Conclusions: Our data reinforce prior research showing that higher SBP and LDL is associated with progression of WMH in diabetics, likely secondary to chronic microvascular ischemia, and suggest that control of these factors may have protective effects. This study has unique strengths, including prospective serial measurement of the exposures, validated algorithmic measurement methodology for WMH, and rigorous adjudication of study data. Clinical trials are needed to investigate the effect of vascular risk factor reduction on WMH progression.

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Association Between Ov16 Seropositivity and Neurocognitive Performance Among Children in Rural Cameroon: a Pilot Study

Journal of Pediatric Neuropsychology ◽

10.1007/s40817-021-00111-z ◽

2021 ◽

Author(s):

Joseph Nelson Siewe Fodjo ◽

Wepnyu Y. Njamnshi ◽

Leonard Ngarka ◽

Leonard N. Nfor ◽

Constance Ayuk ◽

...

Keyword(s):

Confidence Interval ◽

Verbal Fluency ◽

Regression Models ◽

Linear Regression Models ◽

Neurocognitive Performance ◽

Anthropometric Parameters ◽

School Aged Children ◽

Gender Education ◽

Rural Cameroon ◽

Scale Estimate

AbstractInfection with Onchocerca volvulus was recently reported to increase the risk for epilepsy in Cameroonian children. We investigated whether infection with O. volvulus may alter the cognitive function of children who may or may not develop epilepsy later in their lifetime. Using rapid diagnostic tests, we determined the presence of Ov16 antibodies in 209 school-aged children without epilepsy recruited from three Cameroonian villages, as a proxy for onchocerciasis exposure. In addition, the neurocognitive performance of these children was assessed using a battery of validated tools. Participants were aged 6–16 years, and 46.4% were Ov16 seropositive. Upon standardizing age-specific neurocognitive scores and investigating predictors of neurocognitive performance using multiple linear regression models (adjusted for gender, education level, previous ivermectin use, and anthropometric parameters), we found that being Ov16-positive was significantly associated with reduced semantic verbal fluency (estimate –0.38; 95% confidence interval –0.65 to –0.11; p = 0.006) and lower scores on the International HIV Dementia Scale (estimate –0.31; confidence interval –0.56 to –0.04; p = 0.025). Furthermore, an increasing frequency of past ivermectin use was associated with increased neurocognitive scores. Our findings suggest that exposure to O. volvulus may affect neurocognitive performance of children.

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Physical activity accrued as part of public transport use in England

Journal of Public Health ◽

10.1093/pubmed/fdy099 ◽

2018 ◽

Vol 41 (2) ◽

pp. 222-230 ◽

Cited By ~ 10

Author(s):

R Patterson ◽

E Webb ◽

C Millett ◽

A A Laverty

Keyword(s):

Physical Activity ◽

Logistic Regression ◽

Confidence Interval ◽

Public Transport ◽

Regression Models ◽

Daily Life ◽

Active Travel ◽

Linear Regression Models ◽

Physical Activity Guidelines ◽

Logistic Regression Models

Abstract Background Walking and cycling for transport (active travel) is an important source of physical activity with established health benefits. However, levels of physical activity accrued during public transport journeys in England are unknown. Methods Using the English National Travel Survey 2010–14 we quantified active travel as part of public transport journeys. Linear regression models compared levels of physical activity across public transport modes, and logistic regression models compared the odds of undertaking 30 min a day of physical activity. Results Public transport users accumulated 20.5 min (95% confidence interval=19.8, 21.2) a day of physical activity as part of public transport journeys. Train users accumulated 28.1 min (26.3, 30.0) with bus users 16.0 min (15.3, 16.8). Overall, 34% (32%, 36%) of public transport users achieved 30 min a day of physical activity in the course of their journeys; 21% (19%, 24%) of bus users and 52% (47%, 56%) of train users. Conclusion Public transport use is an effective way to incorporate physical activity into daily life. One in three public transport users meet physical activity guidelines suggesting that shifts from sedentary travel modes to public transport could dramatically raise the proportion of populations achieving recommended levels of physical activity.

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Prenatal Exposure to Cigarette Smoke and Anogenital Distance at 4 Years in the INMA-Asturias Cohort

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18094774 ◽

2021 ◽

Vol 18 (9) ◽

pp. 4774

Author(s):

Miguel García-Villarino ◽

Rocío Fernández-Iglesias ◽

Isolina Riaño-Galán ◽

Cristina Rodríguez-Dehli ◽

Izaro Babarro ◽

...

Keyword(s):

Confidence Interval ◽

Regression Models ◽

Tobacco Consumption ◽

Smoke Exposure ◽

Linear Regression Models ◽

Anogenital Distance ◽

Exposure During Pregnancy ◽

Adverse Pregnancy ◽

Prenatal Androgen ◽

Relevant Covariates

Smoking by women is associated with adverse pregnancy outcomes such as spontaneous abortion, preterm delivery, low birth weight, infertility, and prolonged time to pregnancy. Anogenital distance (AGD) is a sensitive biomarker of prenatal androgen and antiandrogen exposure. We investigated the effect of smoking and passive smoke exposure during pregnancy on anogenital distance in offspring at 4 years in the INMA-Asturias cohort (Spain). Women were interviewed during pregnancy to collect information on tobacco consumption, and anogenital distance was measured in 381 children: Anoscrotal distance in boys and anofourchetal distance in girls. We also measured maternal urinary cotinine levels at 32 weeks of pregnancy. We constructed linear regression models to analyze the association between prenatal smoke exposure and anogenital distance and adjusted the models by relevant covariates. Reported prenatal smoke exposure was associated with statistically significant increased anogenital index (AGI), both at week 12 of pregnancy (β = 0.31, 95% confidence interval: 0.00, 0.63) and at week 32 of pregnancy (β = 0.31, 95% confidence interval: 0.00, 0.63) in male children, suggesting altered androgenic signaling.

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Exposure to Organophosphate Pesticides and Menstrual Cycle Characteristics in Chinese Preconceptional Women

American Journal of Epidemiology ◽

10.1093/aje/kwz242 ◽

2019 ◽

Vol 189 (5) ◽

pp. 375-383 ◽

Cited By ~ 2

Author(s):

Yan Zhang ◽

Lin Ji ◽

Yi Hu ◽

Lap Ah Tse ◽

Yiwen Wang ◽

...

Keyword(s):

Menstrual Cycle ◽

Confidence Interval ◽

Regression Models ◽

Linear Regression Models ◽

Cross Sectional ◽

Logistic Regression Models ◽

Maternity Hospitals ◽

Diethyl Phosphate ◽

Sectional Analysis ◽

The Relationship

Abstract Organophosphates (OPs) are the most heavily used pesticides in China. The Chinese population, including preconceptional women, is highly exposed, yet little is known regarding the associations between OP exposure and menstruation in humans. We conducted a cross-sectional analysis in women preparing for pregnancy to investigate the relationship between biomarkers of OP exposure and menstrual cycle characteristics. From 2013 to 2015, 627 women visiting free preconception-care clinics at 2 maternity hospitals in Shanghai, China, were included. Information on menstrual cycle characteristics was obtained through questionnaires. OP exposure was assessed by measuring urine concentrations of 6 dialkylphosphate metabolites (dimethylphosphate, dimethylthiophosphate, dimethyldithiophosphate, diethylphosphate, diethylthiophosphate, and diethyldithiophosphate). The relationship between concentrations of dialkylphosphate metabolites and menstrual cycle characteristics was analyzed using multiple linear regression models and logistic regression models. Log-transformed levels of diethyl phosphate metabolites (the sum of diethylphosphate and diethylthiophosphate levels) were related to a higher risk of irregularity of menstrual cycles (adjusted odds ratio = 2.36, 95% confidence interval: 1.28, 4.34). Subjects with a higher concentration of diethyl phosphate metabolites (log-transformed) had a shorter duration of menstrual bleeding (adjusted β = −0.33, 95% confidence interval: −0.64, −0.02). The findings suggest that OP exposure may be associated with alterations in menstrual function in preconceptional women.

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Sun exposure and intima-media thickness in the Mexican Teachers' Cohort

10.21203/rs.3.rs-33495/v1 ◽

2020 ◽

Author(s):

Mercedes Aguilar ◽

Paloma Muñoz-Aguirre ◽

Adrian Cortés-Valencia ◽

Mario H. Flores-Torres ◽

Andrés Catzin-Kuhlmann ◽

...

Keyword(s):

Regression Models ◽

Carotid Atherosclerosis ◽

Sun Exposure ◽

Intima Media Thickness ◽

Linear Regression Models ◽

Positive Role ◽

Cross Sectional ◽

Media Thickness ◽

Percentage Difference ◽

The Mean

Abstract Background Previous studies have evaluated how sun exposure affects cardiovascular health. In this sense, some evidence from ecological studies have found an inverse relationship between sun exposure and blood pressure or CVD. The aim of this study is to determine whether long-term sun exposure has a protective role in subclinical cardiovascular disease in adult Mexican women. Methods We conducted a cross-sectional analysis of a sample of women from the Mexican Teachers’ Cohort (MTC) study. Sun exposure was assessed in the MTC 2008 baseline questionnaire, in which women were asked about their sun-related behavior. Vascular neurologists measured carotid intima-media thickness (IMT) using standard techniques. Multivariate linear regression models were used to estimate the percentage difference in mean IMT and 95% confidence intervals (95% CIs), according to categories of sun exposure and multivariate logistic regression models were used to estimate the odds ratio (OR) and 95% CIs for carotid atherosclerosis. Results The mean age of participants was 49.6 ± 5.5 years, the mean IMT was 0.678 ± 0.097 mm, and the mean accumulated hours of weekly sun exposure were 2.9 ± 1.9. Prevalence of carotid atherosclerosis was 20.9%. Compared to women in the lowest category of sun exposure, the multivariate adjusted ORs of carotid atherosclerosis were 0.54 (95%CI: 0.24, 1.18) for women who were exposed 9 hours. For women who denied regular sun screen use, those in the higher exposure category (9 hours) had lower mean IMT compared to those in the lower category (multivariable-adjusted mean % difference = -2.67; 95%CI: -6.9, -1.5). Conclusion In general, we observed that cumulative sun exposure was inversely associated with IMT and subclinical carotid atherosclerosis. Our findings suggest that public health messages should also consider the sun’s positive role for health, while still emphasizing the negative impacts of excessive exposure.

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CHA2DS2-VASc score and risk of thromboembolism and bleeding in patients with atrial fibrillation and recent cancer

European Journal of Preventive Cardiology ◽

10.1177/2047487318759858 ◽

2018 ◽

Vol 25 (6) ◽

pp. 651-658 ◽

Cited By ~ 25

Author(s):

Maria D’Souza ◽

Nicholas Carlson ◽

Emil Fosbøl ◽

Morten Lamberts ◽

Lærke Smedegaard ◽

...

Keyword(s):

Atrial Fibrillation ◽

Confidence Interval ◽

Cancer Diagnosis ◽

Oral Anticoagulation ◽

Cumulative Incidence ◽

Regression Models ◽

Cox Regression ◽

Heparin Therapy

Background Cancer may influence the risk of thromboembolism and bleeding associated with the CHA2DS2-VASc score. We examined the risk of thromboembolism and bleeding associated with the CHA2DS2-VASc score in atrial fibrillation patients with and without recent cancer. Methods and results Using nationwide registers all patients diagnosed with atrial fibrillation from 2000 to 2015 and not on oral anticoagulation or heparin therapy were included and followed for 2 years. Recent cancer was defined by a cancer diagnosis 5 years or fewer earlier. Risks of thromboembolism and bleeding were estimated in cumulative incidence curves and Cox regression models. We included 122,053 patients with incident atrial fibrillation, 12,014 (10%) had recent cancer. The 2-year cumulative incidence of thromboembolism and bleeding in patients with versus without recent cancer was 1.7% (95% confidence interval (CI) 0.5–2.8) and 4.3% (95% CI 2.4–6.2) versus 1.2% (95% CI 0.9–1.5) and 1.7% (95% CI 1.4–2.0) for CHA2DS2-VASc score 0; 3.2% (95%CI 2.2-4.3) and 4.4% (95%CI 3.2-5.6) versus 1.8% (95%CI 1.6-2.1) and 3.0% (95% CI 2.7–3.3) for CHA2DS2-VASc score 1; and 7.1% (95% CI 6.6–7.7) and 6.8% (95% CI 6.3–7.2) versus 10.9% (95% CI 10.7–11.1) and 6.2% (95% CI 6.1–6.4) for CHA2DS2-VASc score 2 or greater. Although the CHA2DS2-VASc score was associated with thromboembolism and bleeding in both patients with and without cancer, the association differed between the groups for thromboembolism (test for interaction, p < 0.001) and bleeding (test for interaction, p < 0.001). Conclusion The association of the CHA2DS2-VASc score and risk of thromboembolism and bleeding differed between atrial fibrillation patients with and without recent cancer. Therefore, the CHA2DS2-VASc score should be used with caution in patients with recent cancer.

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Association between Urine Ammonium and Urine TGF-β1 in CKD

Clinical Journal of the American Society of Nephrology ◽

10.2215/cjn.07510717 ◽

2017 ◽

Vol 13 (2) ◽

pp. 223-230 ◽

Cited By ~ 5

Author(s):

Kalani L. Raphael ◽

Sarah Gilligan ◽

Thomas H. Hostetter ◽

Tom Greene ◽

Srinivasan Beddhu

Keyword(s):

Confidence Interval ◽

Regression Models ◽

Geometric Mean ◽

Ammonium Excretion ◽

Serum Bicarbonate ◽

Linear Regression Models ◽

Urine Ph ◽

Cross Sectional ◽

Kidney Fibrosis ◽

Tgf Β1

Background and objectivesUrinary ammonium excretion increases in response to nonvolatile acids to maintain normal systemic bicarbonate and pH. However, enhanced ammonia production promotes tubulointerstitial fibrosis in animal models. Therefore, a subset of individuals with CKD and normal bicarbonate may have acid-mediated kidney fibrosis that might be better linked with ammonium excretion than bicarbonate. We hypothesized that urine TGF-β1, as an indicator of kidney fibrosis, would be more tightly linked with urine ammonium excretion than serum bicarbonate and other acid-base indicators.Design, setting, participants, & measurementsWe measured serum bicarbonate and urinary ammonium, titratable acids, pH, and TGF-β1/creatinine in 144 persons with CKD. Multivariable-adjusted linear regression models determined the cross-sectional association between TGF-β1/creatinine and serum bicarbonate, urine ammonium excretion, urine titratable acids excretion, and urine pH.ResultsMean eGFR was 42 ml/min per 1.73 m2, mean age was 65 years old, 78% were men, and 62% had diabetes. Mean urinary TGF-β1/creatinine was 102 (49) ng/g, mean ammonium excretion was 1.27 (0.72) mEq/h, mean titratable acids excretion was 1.14 (0.65) mEq/h, mean urine pH was 5.6 (0.5), and mean serum bicarbonate was 23 (3) mEq/L. After adjusting for eGFR, proteinuria, and other potential confounders, each SD increase of urine ammonium and urine pH was associated with a statistically significant 1.22-fold (95% confidence interval, 1.11 to 1.35) or 1.11-fold (95% confidence interval, 1.02 to 1.21) higher geometric mean urine TGF-β1/creatinine, respectively. Each SD increase of serum bicarbonate and urine titratable acids was associated with a nonsignificant 1.06-fold (95% confidence interval, 0.97 to 1.16) or 1.03-fold (95% confidence interval, 0.92 to 1.14) higher geometric mean urine TGF-β1/creatinine, respectively.ConclusionsUrinary ammonium excretion but not serum bicarbonate is associated with higher urine TGF-β1/creatinine.

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Previous COVID-19 infection and antibody levels after vaccination

10.1101/2021.09.04.21263121 ◽

2021 ◽

Author(s):

Hamad Ali ◽

Barrak Alahmad ◽

Abdullah A. Al-Shammari ◽

Abdelmohsen Al-Terki ◽

Maha Hammad ◽

...

Keyword(s):

Neutralizing Antibodies ◽

Regression Models ◽

Individual Characteristics ◽

Linear Regression Models ◽

Serological Analysis ◽

Health Authorities ◽

Public Health Authorities ◽

The Mean ◽

Vaccine Shortages ◽

Antibody Levels

AbstractBackgroundThe emergence of new COVID-19 variants of concern coupled with a global inequity in vaccine access and distribution, prompted many public health authorities to circumvent the vaccine shortages by altering vaccination protocols and prioritizing high-risk individuals. Those with previous COVID-19 infection may have not been prioritized due to existing humoral immunity.ObjectiveWe aim to study the association between previous COVID-19 infection and antibody levels after COVID-19 vaccination.MethodsA serological analysis to measure SARS-CoV-2 IgG, IgA and neutralizing antibodies was performed on individuals who received one or two doses of either BNT162b2 or ChAdOx1 vaccines in Kuwait. Generalized linear regression models adjusted for individual characteristics and comorbidities were fitted to study the average levels of IgG and neutralizing antibodies in vaccinated individuals based who had previous COVID-19 infection compared to those who had not.ResultsA total of 1025 individuals were recruited. The mean levels of IgG, IgA and neutralizing antibodies were higher in vaccinated subjects with previous COVID-19 infection when compared with those vaccinated without previous COVID-19 infection. Regression analysis showed a steeper slope of decline for IgG in vaccinated individuals without previous COVID-19 infection in comparison with vaccinated individuals with previous COVID-19 infection.ConclusionPrevious COVID-19 infection appears to elicit robust and sustained levels of SARS-CoV-2 antibodies in vaccinated individuals. Given the inconsistent supply of COVID-19 vaccines in many countries due to the global inequity, our results point towards wider vaccination plans to especially cover individuals without previous COVID-19 infection.

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