Characteristics of Cheyenne Little Filtered Cigar Instagram Ads, 2019-2020 (Preprint)

BACKGROUND Little filtered cigar (LFC) marketing has often blurred the line between cigar and cigarette, and little is known about LFC marketing on social media. OBJECTIVE This study examined the characteristics of Instagram posts by Cheyenne—a popular LFC brand—from 2019-2020. METHODS A content analysis of 323 images posted in 2019 and 2020 on Cheyenne’s official Instagram account was conducted. Descriptive statistics were examined, and Chi-square and Fisher’s exact tests were used to test differences by year. RESULTS Most posts (76.0%) showed 1 pack and/or LFC stick, which look highly similar to cigarette packs and sticks, and the pack was often flavored (62.2%). Images of lit LFC sticks increased from 2019 (12.2%) to 2020 (26.7%, P=.005). Warning labels were present on the ad in 79.9% of posts, but were always presented at the bottom, and used the same single warning statement that they are not a safe alternative to cigarettes. The depiction of people nearly doubled from 2019 (18.1%) to 2020 (34.8%, P=.001), and women (51%) were more commonly depicted than men (32%). Popular depictions and themes included the outdoors (57.6%) and seasonal imagery (36.2%) among others. CONCLUSIONS Cheyenne actively used Instagram to market its product and grow its brand. Posts seemed designed to promote the similarity of their LFC to cigarettes, through depictions of cig-a-like packs/sticks. Although warning labels were highly prevalent on Cheyenne Instagram posts, the warnings were not compliant with FDA warning guidelines and might have been counterproductive by emphasizing their viability as cigarette alternatives rather than their dangerous health effects. Future surveillance is needed, and regulation of LFC advertising on social media may be warranted.

Đánh giá biến chứng của phẫu thuật đặt lại xương sọ: Tỷ lệ và các yếu tố liên quan

Mục tiêu: Đánh giá các biến chứng của phẫu thuật đặt lại bản sọ sau các phẫu thuật mở sọ giải áp và xác định mối liên quan với một số yếu tố nguy cơ. Đối tượng và phương pháp: Hồi cứu 202 bệnh nhân được phẫu thuật đặt lại bản sọ sau phẫu thuật mở sọ giải áp do các nguyên nhân khác nhau tại Bệnh viện Trung ương Quân đội 108, từ tháng 8 năm 2018 đến tháng 1 năm 2021. Tất cả các bệnh nhân đều được theo dõi ít nhất 6 tháng sau phẫu thuật. Các biến chứng chính được thống kê và đánh giá trong mối liên quan với một số yếu tố nguy cơ: Nguyên nhân mở sọ giải áp, các bệnh kèm theo (tăng huyết áp, tiểu đường, dùng thuốc chống đông), vị trí khuyết xương, thời điểm tiến hành phẫu thuật đặt lại bản sọ… Các thuật toán được sử dụng để phân tích bao gồm Student’s t-test, Chi-square tests và Fisher’s exact tests. Khoảng tin cậy được tính là 95%. Kết quả: Tỷ lệ biến chứng chung sau phẫu thuật là 23,26%. Các biến chứng thường gặp: Nhiễm trùng (6,44%), tiêu sập mảnh ghép (6,44%), động kinh (6,44%), chảy máu (3,46%). Thời gian đặt lại bản sọ sớm (trong vòng 3 tháng sau phẫu thuật giải áp) và sự rối loạn lưu thông dịch tủy là những yếu tố nguy cơ làm tăng tỷ lệ biến chứng (p<0,05). Một số yếu tố liên quan: Thời điểm đặt lại bản sọ sớm (< 3 tháng) liên quan đến tình trạng nhiễm trùng và tiêu sập mảnh ghép với giá trị p<0,05, thời điểm đặt lại bản sọ muộn có mối liên quan đến tình trạng động kinh (p=0,007). Sự rối loạn lưu thông dịch tủy có liên quan đến tình trạng động kinh và tiêu sập mảnh ghép (p<0,05). Kết luận: Mặc dù phẫu thuật tạo hình hộp sọ là một phẫu thuật đơn giản, nhưng nó thường có tỷ lệ biến chứng tương đối cao. Kiểm soát các yếu tố nguy cơ của bệnh nhân và nhận biết sớm các biến chứng có thể giúp các bác sĩ tránh được các biến chứng.

Sample size determination and power analysis using the G*Power software

Appropriate sample size calculation and power analysis have become major issues in research and publication processes. However, the complexity and difficulty of calculating sample size and power require broad statistical knowledge, there is a shortage of personnel with programming skills, and commercial programs are often too expensive to use in practice. The review article aimed to explain the basic concepts of sample size calculation and power analysis; the process of sample estimation; and how to calculate sample size using G*Power software (latest ver. 3.1.9.7; Heinrich-Heine-Universität Düsseldorf, Düsseldorf, Germany) with 5 statistical examples. The null and alternative hypothesis, effect size, power, alpha, type I error, and type II error should be described when calculating the sample size or power. G*Power is recommended for sample size and power calculations for various statistical methods (F, t, χ2, Z, and exact tests), because it is easy to use and free. The process of sample estimation consists of establishing research goals and hypotheses, choosing appropriate statistical tests, choosing one of 5 possible power analysis methods, inputting the required variables for analysis, and selecting the “Calculate” button. The G*Power software supports sample size and power calculation for various statistical methods (F, t, χ2, z, and exact tests). This software is helpful for researchers to estimate the sample size and to conduct power analysis.

Sustained reductions in online search interest for communicable eye and other conditions during the COVID-19 Pandemic: An Infodemiology Study (Preprint)

BACKGROUND At the start of the COVID 19 pandemic, we found reduced numbers of google searches for the term conjunctivitis. We hypothesized that physical distancing during COVID-10 reduced the spread of contagious eye disease. Here we test this hypothesis a year later, expanding to include other communicable conditions. OBJECTIVE Determine if reduction in USA searches for terms related to conjunctivitis and other common communicable diseases occurred in spring-winter of the COVID-19 pandemic, and compare this outcome to terms representing non-communicable conditions, COVID-19, and to seasonality. METHODS Weekly relative search frequency volume data from Google trends for 68 search terms in English for the USA, were obtained for the weeks of March 2011 through February 2021. Terms were classified a priori as 16 terms related to COVID-19, 29 terms representing communicable conditions and 23 terms representing control non-communicable conditions. To reduce bias, all analyses were conducted while masked to term names, classifications and locations. To test for the significance of changes during the pandemic, we detrended and compared post-pandemic values to that expected based on pre-pandemic trends, per season, computing 1 and 2 sided P-values. We then compared these P-values between term groups using Wilcoxon rank-sum and Fisher exact tests to assess if non-COVID terms representing communicable disease were more likely to show significant reductions in search in 2020-21 than terms not representing such disease. We also assessed any relationship between a term’s seasonality and reduced search for it in 2020-21 seasons. P-values were subjected to FDR correction prior to reporting. Data were then unmasked. RESULTS Terms representing conjunctivitis and other communicable conditions had sustained reduced search in the first 4 seasons of the 2020-2021 COVID-19 pandemic, compared to prior years. In comparison, search for non-communicable condition terms was significantly less reduced (Wilcoxon and Fisher’s Exact Tests, P < 0.001; summer, autumn, winter). A significant correlation was also found between reduced search for a term in 2020-21 and seasonality of that term (Theil-Sen, P < 0.001; summer, autumn, winter). COVID-19 related conditions were significantly elevated compared to prior years, and influenza-related terms were significantly lower than prior years in winter 2020-21 (P < 0.0001). CONCLUSIONS We demonstrate the low-cost and unbiased use of online search data to study how a wide range of conditions may be affected by large-scale interventions or events such as social distancing during the COVID-19 pandemic. Our findings support emerging clinical evidence implicating social distancing and the COVID-19 pandemic in the reduction of communicable disease. They also agree with elevation of ocular conditions suggested to be linked to COVID-19 infection or behavioral changes such as mask-wearing. CLINICALTRIAL Not applicable

Oral Estrogen, Thromboembolic Events and Cardiometabolic Risk in Older vs. Younger Transgender Women Veterans

Data support increases in absolute thromboembolic event (TE) risk and worsening of cardiometabolic (CM) risk factors associated with estrogen (E)-based feminizing gender-affirming hormone therapy (GAHT). Few data exist comparing age, E type and CM risk in transgender women (TW) veterans. We conducted a retrospective analysis in TW prescribed E through our local Veterans Health Administration (VHA) between 2014-2019. Rates of TE (venous and arterial) and CM risk factors (hypertension [HTN], hyperlipidemia [HLD], type 2 diabetes mellitus [T2DM], obesity and smoking) were stratified by age (&lt;45 vs. ≥45 years) and oral vs. never-oral E therapy and compared using Fisher’s Exact Tests. We also compared TW rates with those of local men (N=77,514) and women (N=11,918) veterans using Chi-Square and Fisher’s Exact tests. Of 226 veterans with gender dysphoria, 130 identified as TW and 100 used VHA-prescribed E (&lt;45 years: N=54, ≥45 years: N=46). Only 9 TW (9%) had a history of TE (55.6% venous: 4 deep venous thrombosis +/- pulmonary embolism, 1 superficial thrombophlebitis; 44.4% arterial: 2 myocardial infarction, 2 ischemic stroke). Of the 7 TW with documented age at TE (median: 67 years, range: 33-80) and duration of E prior to TE (median: 5 years, range: 0-22), 4 were on E at the time of TE (2 oral estradiol, 1 conjugated Es, 1 injectable), 2 discontinued E 1-2 years prior to TE, and 1 unknown. Age and HTN were predictors of TE (P&lt;0.01) in univariate logistic regressions. Smoking history, body mass index (BMI) and oral E were not. Odds of TE were 10% higher (95% CI: 2-19%; P&lt;0.05) for every 1-year of any E therapy and 9% higher (95% CI: 3-16%; P&lt;0.01) for every 1-year increase in age at E initiation. TW ≥45 years had higher rates of CM risk including T2DM, 23.9%, HTN, 52.2%, and HLD, 54.3%, than TW &lt;45 years (5.6%, 16.7% and 20.4%, respectively). Obesity rates were similar between age groups (&lt;45 years: 53.7%; ≥45 years: 52.2%). Among TW with oral E, obesity rates were also similar between age groups (&lt;45 years: 54.5%; ≥45 years: 51.4%). Increased levels of LDL-cholesterol, triglycerides, systolic blood pressure (BP), diastolic BP and BMI were observed after any E initiation (P&lt;0.001). These increases remained significant after adjusting for time elapsed between pre-hormone and highest post-hormone values, age at initiation and oral E therapy. In addition, rates of HTN, HLD, obesity and smoking were significantly higher for TW compared to men and women in age-stratified analyses. TW &lt;45 years had a higher rate of T2DM than women (P=0.04) of the same age. TW ≥45 years had higher rates of arterial TE compared to men (p&lt;0.001) and women (P&lt;0.001), and higher rates of venous TE (P=0.02) and T2DM (P=0.01) compared women of the same age. In TW, absolute TE risk was low, but GAHT increased CM risk factors regardless of age and oral E use. Clinicians should consider these findings when discussing risks and benefits of E-based GAHT with TW veterans.

Anemia and Iron-Deficiency Anemia in Children Born to Mothers with HIV in Western Kenya

The objective of this study was to determine and compare anemia and iron-deficiency anemia (IDA) rates in young Kenyan children who are HIV infected (HI), HIV exposed, uninfected (HEU), and HIV unexposed (HU). Questionnaires, anthropometrics, and blood samples were collected from HI, HEU, and HU aged 18 to 36 months. Descriptive statistics, Fisher’s exact tests, and linear regression were used for analysis. Of 137 total participants, HI (n = 18), HEU (n = 70), and HU (n = 49), 61.1%, 53.6%, and 36.7%, respectively, were anemic, with mean hemoglobin levels highest in HU ( P = .006). After adjusting for covariates, HI (β = −9.6, 95% CI:−17.3 to −2.0) and HEU (β = −7.4, 95% CI: −12.9 to −1.9) had lower hemoglobin levels compared with HU. The proportion of children with IDA did not differ significantly across groups ( P = .08). HEU have rates of anemia and IDA similar to HI. Anemia risk is generally higher in HEU than HU, even after adjusting for covariates.

Role of accuracy and quantity of field tests in engineering-geotechnical researches for construction

The aim of this work is to summarize previously conducted studies on the optimization of the unequal geotechnical testing program and on the selection of the desired calculation indicator based on the results of such tests. The approximate, but quick and cheap tests (“express methods”) are recommended to be performed on a large scale and considered as a means of assessing the geotechnical structure of the site as a whole. It is proposed to carry out expensive “accurate” tests in a reduced volume and to use them as a means of correcting approximate tests. In the article, these issues are considered by the example of determining the bearing capacity of piles according to the data of static sounding (cone penetration testing – CPT), dynamic and static tests of full-scale piles. We propose the mathematical model for evaluating the informative content of the test complex, based on the concepts of information theory. The site is mentally divided into several sections, each of which is characterized by one of the possible values of the ultimate resistance of piles of a certain length. All variants of “placement in the plan” of possible values of pile resistances (“site images”) are considered. Initially, when nothing is known about the true value of the pile resistances in each section, all possible values of the pile resistances are assumed to be equally probable, i.e. the uncertainty of the situation is maximum. In the theory of information, such uncertainty is quantified by the value called entropy. When any test is performed at the site, the uncertainty decreases, and the more accurate the test the more significant is the decrease. The difference in entropy before and after the test represents the amount of information (in bits) that these tests carry. The calculations using this model showed that the information content of a large number of approximate tests can (due to heterogeneity of the soil) exceed the information content of small exact tests. Only one approximate test method can lead to the systematic error (overestimation or underestimation of the average value of the desired indicator). It is necessary to carry out control “exact” tests and approximate tests to eliminate such a danger. A technique is proposed for adjusting approximate estimates based on data from “accurate” tests, which ensures optimal “safety margins” in decisions being made.