Congenital anomalies in Santa Catarina: case distribution and trends in 2010–2018

Objective: To evaluate the distribution of cases of congenital anomalies in the state of Santa Catarina by health macro-region, to determine the frequency according to maternal and neonatal variables, to estimate the related mortality, and the trends in the period 2010–2018. Methods: An ecological time-series study with secondary data on congenital anomalies and the sociodemographic and health variables of mothers and newborns living in Santa Catarina, from 2010 to 2018. For temporal trend analysis, generalized linear regression was performed using the Prais-Winsten method with robust variance. Results: The average prevalence of congenital anomalies in the period was 8.9 cases per 1,000 live births, being 9.4 cases by 1,000 live births in 2010 and, in 2018, 8.2/1,000. The trend remained stable in the analyzed period. The major malformations were musculoskeletal, hip, and foot malformations, with a proportion ≥30%. There was a higher prevalence of congenital anomalies in low birthweight, preterm, male livebirths with Apgar≤7, born by cesarean section, mothers of older age (≥40 years), and less educated (less than eight years of study). Infant mortality due to congenital malformations was 2.6 deaths/1,000 live births, representing about 25.8% of the total infant deaths in the period. Conclusions: The frequency of congenital anomalies and the mortality with anomalies was stable in the studied period in Santa Catarina. The presence of anomalies was associated with low birth weight, prematurity, and low Apgar score. The highest proportion of congenital anomalies was in the musculoskeletal system.

Deviations in Predicted COVID-19 cases in the US during early months of 2021 relate to rise in B.1.526 and its family of variants

ObjectiveTo investigate the abrogation of COVID-19 case declines from predicted rates in the US in relationship to viral variants and mutations.DesignEpidemiological prediction and time series study of COVID-19 in the US by State.SettingCommunity testing and sequencing of COVID-19 in the US.ParticipantsTime series US COVID-19 case data from the Johns Hopkins University CSSE database. Time series US Variant and Mutation data from the GISAID database.Main outcome measuresPrimary outcomes were statistical modeling of US state deviations from epidemiological predictions, percentage of COVID-19 variants, percentage of COVID-19 mutations, and reported SARS-CoV-2 infections.ResultsDeviations in epidemiological predictions of COVID-19 case declines in the North Eastern US in March 2021 were highly positively related to percentage of B.1.526 (Iota) lineage (p < 10e − 7) and B.1.526.2 (p < 10 − 8) and the T95I mutation (p < 10e − 9). They were related inversely to B.1.427 and B.1.429 (Epsilon) and there was a trend for association with B.1.1.7 (Alpha) lineage.ConclusionDeviations from accurate predictive models are useful for investigating potential immune escape of COVID-19 variants at the population level. The B.1.526 and B.1.526.2 lineages likely have a high potential for immune escape and should be designated as variants of concern. The T95I mutation which is present in the B.1.526, B.1.526.2, and B.1.617.2 (Delta) lineages in the US warrants further investigation as a mutation of concern.

Increasing Prevalence of Pediatric Metabolic Syndrome and Its Components among Arab Youth: A Time-Series Study from 2010–2019

Background: Metabolic syndrome (MetS) is a cluster of cardiometabolic disorders, mostly studied in adults with certain ethnic groups, such as Arabs with higher predisposition and heritability. In this time-series study, we tried to determine the prevalence of MetS in the Arabic pediatric population from 2010–2019 to gauge the need to intervene in the younger population. Methods: A total of 7985 Saudi school children aged 12–18 coming from different sets of cohorts in different timepoints were included in this time-series studies (Year 2010, n = 2081, 877 boys and 1204 girls; Year 2015, n = 3360, 1625 boys and 1735 girls, Year 2019, n = 2544, 956 boys and 1588 girls). Anthropometrics were measured as well as fasting blood samples for the assessment of lipids and glucose. Screening for MetS was conducted using the pediatric definition obtained from the 2004 definition of de Ferranti et al. Results: In 2010, the prevalence of MetS was 11.8%, which increased sharply to 20.1% in 2015 and again in 2019 to 20.6%. Stratified according to sex, the increased prevalence of MetS was more evident in boys with only 7.8% in 2010 jumping to 25.3% in 2019. In girls, the increase in prevalence was modest with 14.8% in 2010 to 17.7% in 2019. In both boys and girls, the highest increase in prevalence among MetS components was observed to be low HDL-cholesterol, elevated triglycerides, and central obesity, respectively. Conclusions: The alarming increase in pediatric MetS among Arab children and adolescents over a short timespan have significant clinical and economic implications if not addressed immediately. Health policy makers should implement lifestyle interventions aimed at high-risk children or overweight youths.

Did States’ Adoption of More Rigorous Standards Lead to Improved Student Achievement? Evidence From a Comparative Interrupted Time Series Study of Standards-Based Reform

This study was designed to assess the effects of states’ adoption of more rigorous standards as part of the current wave of standards-based reform on student achievement using comparative interrupted time series analyses based on state-level NAEP data from 1990 to 2017. Results show that the effects of adopting more rigorous standards on students’ mathematics achievement were generally small and not significant. The effects on students’ reading achievement were also generally small, but negative and statistically significant for Grade 4. The study also revealed that the effects of states’ adoption of more rigorous standards varied across NAEP subscales and student subgroups.