Last data update: Nov 04, 2024. (Total: 48056 publications since 2009)
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Query Trace: Zhang J[original query] |
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National health and economic impact of a lifestyle program to prevent type 2 diabetes mellitus in Germany: a simulation study
Ogurtsova K , Laxy M , Emmert-Fees K , Dintsios CM , Zhang P , Icks A . BMJ Open Diabetes Res Care 2024 12 (5) INTRODUCTION: To examine the long-term health and economic impact of a lifestyle diabetes prevention program in people with high risk of developing type 2 diabetes in Germany. RESEARCH DESIGN AND METHODS: We assessed the lifetime cost-effectiveness of a 2-year pragmatic lifestyle program for preventing type 2 diabetes targeting German adults aged 35-54 and 55-74 years old with hemoglobin A1c (HbA1c) from 6.0% to 6.4%. We used the Centers for Disease Control and Prevention RTI Diabetes Cost-Effectiveness Model to run a simulation on the program effectiveness. We estimated incremental health benefits in quality-adjusted life years (QALYs) and costs using an established simulation model adapted to the German context, from a healthcare system and societal perspective. The cost-effectiveness of the program was measured by incremental cost-effectiveness ratios (ICERs) in cost per QALY. We projected the number of type 2 diabetes cases prevented by participation rate if the program was implemented nationwide. RESULTS: The lifestyle program would result to more QALYs and higher costs. The lifetime ICERs were 14 690€ (35-54 years old) and 14 372€ (55-74 years old) from a healthcare system perspective and cost saving (ICER=-3805€) and cost-effective (ICER=4579€), respectively, from a societal perspective. A total of 10 527 diabetes cases would be prevented over lifetime if the program was offered to all eligible people nationwide and 25% of those would participate in the program. CONCLUSIONS: Implementing the lifestyle intervention for people with HbA1c from 6.0% to 6.4% could be a cost-effective at standard willingness to pay level strategy for type 2 diabetes prevention. The intervention in the younger cohort could be cost saving from a societal perspective. The successful implementation of a lifestyle-based diabetes prevention program could be an important component of a successful National Diabetes Strategy in Germany. |
Randomized immunogenicity trial comparing 2019-2020 recombinant and egg-based influenza vaccines among frequently vaccinated healthcare personnel in Israel
Fowlkes AL , Peretz A , Greenberg D , Hirsch A , Martin ET , Levine MZ , Edwards L , Radke S , Lauring AS , Ferdinands JM , Zhang C , Yoo YM , Dryer J , Newes-Adeyi G , Azziz-Baumgartner E , Fry AM , Monto AS , Balicer R , Thompson MG , Katz MA . Int J Infect Dis 2024 107260 BACKGROUND: Trivalent inactivated influenza vaccine effectiveness was low in a prospective cohort of healthcare personnel (HCP) in Israel from 2016-2019. We conducted a randomized immunogenicity trial of quadrivalent recombinant influenza vaccine (RIV4) and standard-dose inactivated influenza vaccine (IIV4) among frequently and infrequently vaccinated previous cohort participants. METHODS: From October 2019 to January 2020, we enrolled and randomly allocated HCP from two Israeli hospitals to receive IIV4 or RIV4. Hemagglutination inhibition (HAI) antibody titers against 2019-2020 vaccine reference influenza viruses were compared between vaccine groups using geometric mean titer (GMT) ratios from sera collected one-month post-vaccination and by frequency of vaccination in the past 5 years (>2 versus ≤2). RESULTS: Among 415 HCP, the GMT ratio comparing RIV4 to IIV4 was 2.0 (95% confidence interval [CI] 1.7-2.7) for A(H1N1)pdm09, 1.6 (95% CI: 1.3-1.9) for A(H3N2), 1.8 (95% CI: 1.4-2.2) for B(Yamagata), and 1.1 (95% CI: 0.9-1.4) for B(Victoria). Similarly, RIV4 elicited higher HAI titers than IIV4 against all 2019-2020 vaccine reference viruses except B(Victoria) among infrequently and frequently vaccinated HCP (lower bound of GMT ratio 95% CIs ≥1.0). CONCLUSIONS: RIV4 had improved immunogenicity for influenza vaccine strains among both infrequent and frequent vaccinees compared to standard-dose IIV4. |
The role of multiple birth and birth complications in the association between assisted reproductive technology conception and autism diagnosis
Winter AS , Yartel AK , Fountain C , Cheslack-Postava K , Zhang Y , Schieve LA , Kissin DM , Bearman P . Am J Epidemiol 2024 193 (10) 1426-1432 In recent decades, the use of assisted reproductive technology (ART) has increased rapidly. To assess the relationship between ART and autism diagnosis, we linked California birth records from 2000 through 2016 with contemporaneous records from the National ART Surveillance System (NASS) and autism caseload records from California's Department of Developmental Services from 2000 through November 2019. All 95 149 birth records that were successfully linked to a NASS record, indicating an ART birth, were matched 1:1 using propensity scores to non-ART births. We calculated the hazard risk ratio for autism diagnosis and the proportions of the relationship between ART conception and autism diagnosis mediated by multiple birth pregnancy and related birth complications. The hazard risk ratio for autism diagnosis following ART compared with non-ART conception is 1.26 (95% CI, 1.17-1.35). Multiple birth, preterm birth, and cesarean delivery jointly mediate 77.9% of the relationship between ART conception and autism diagnosis. Thus, increased use of single embryo transfer in the United States to reduce multiple births and related birth complications may be a strategy to address the risk of autism diagnosis among ART-conceived children. |
Factors influencing vaccine receipt during a 2018 pediatric typhoid conjugate vaccine campaign in Navi Mumbai, India
Borhade P , LeBoa C , Jayaprasad N , Date K , Haldar P , Harvey P , Shimpi R , An Q , Zhang C , Horng L , Fagerli K , Yewale VN , Daruwalla S , Dharmapalan D , Gavhane J , Joshi S , Rai R , Rathod V , Shetty K , Warrier DS , Yadav S , Chakraborty D , Bahl S , Katkar A , Kunwar A , Andrews JR , Bhatnagar P , Dutta S , Luby SP , Hoffman SA . Am J Trop Med Hyg 2024 In 2018, the Navi Mumbai Municipal Corporation implemented phase 1 of a public sector typhoid conjugate vaccine campaign in Navi Mumbai, India, targeting all children aged 9 months to 14 years within its administrative boundaries. To assess associations with receipt of vaccine in phase 1, we used generalized estimating equations to calculate estimates of vaccination by child-, household-, and community-level demographics (child education and age; household head education, income, and occupation; community informal settlement percent). Campaign vaccine receipt was most associated with children enrolled in school (odds ratio [OR] = 3.84, 95% CI: 2.18-6.77), the lowest household income tertile when divided into three equal parts (OR = 1.64, 95% CI: 1.43-1.84), and lower community-level socioeconomic status (OR = 1.06, 95% CI: 1.04-1.08 per 10% informal settlement proportion). The campaign was successful in reaching the most underserved populations of its target communities. |
Promotion of order Bunyavirales to class Bunyaviricetes to accommodate a rapidly increasing number of related polyploviricotine viruses
Kuhn JH , Brown K , Adkins S , de la Torre JC , Digiaro M , Ergünay K , Firth AE , Hughes HR , Junglen S , Lambert AJ , Maes P , Marklewitz M , Palacios G , Sasaya T , Shi M , Zhang YZ , Wolf YI , Turina M . J Virol 2024 e0106924 Prior to 2017, the family Bunyaviridae included five genera of arthropod and rodent viruses with tri-segmented negative-sense RNA genomes related to the Bunyamwera virus. In 2017, the International Committee on Taxonomy of Viruses (ICTV) promoted the family to order Bunyavirales and subsequently greatly expanded its composition by adding multiple families for non-segmented to polysegmented viruses of animals, fungi, plants, and protists. The continued and accelerated discovery of bunyavirals highlighted that an order would not suffice to depict the evolutionary relationships of these viruses. Thus, in April 2024, the order was promoted to class Bunyaviricetes. This class currently includes two major orders, Elliovirales (Cruliviridae, Fimoviridae, Hantaviridae, Peribunyaviridae, Phasmaviridae, Tospoviridae, and Tulasviridae) and Hareavirales (Arenaviridae, Discoviridae, Konkoviridae, Leishbuviridae, Mypoviridae, Nairoviridae, Phenuiviridae, and Wupedeviridae), for hundreds of viruses, many of which are pathogenic for humans and other animals, plants, and fungi. |
Feasibility of metrological traceability implementation using the Joint Committee on Traceability in Laboratory Medicine Database Entries including the fulfillment of "fit-for-purpose" maximum allowable measurement uncertainty
Panteghini M , Camara JE , Delatour V , Van Uytfanghe K , Vesper HW , Zhang T . Clin Chem 2024 BACKGROUND: In previous publications, the Task Force on Reference Measurement System Implementation proposed a procedural approach combining a critical review of entries available in the Joint Committee on Traceability in Laboratory Medicine (JCTLM) database with a comparison of this information against analytical performance specifications for measurement uncertainty (MU) and applied it to a group of 13 measurands. CONTENT: Here we applied this approach to 17 additional measurands, of which measurements are frequently requested. The aims of the study were (a) to describe the main characteristics for implementing traceability and the potential to fulfill the maximum allowable MU (MAU) at the clinical sample level of certified reference materials and reference measurement procedures listed in the JCTLM database; (b) to discuss limitations and obstacles, if any, to the achievement of the required quality of laboratory measurements; and (c) to provide a gap analysis by highlighting what is still missing in the database. Results were integrated with those obtained in the previous study, therefore offering an overview of where we are and what is still missing in the practical application of the metrological traceability concept to 30 common biochemical tests employed in laboratory medicine. SUMMARY: Our analysis shows that for 28 out of 30 measurands, conditions exist to correctly implement metrological traceability to the International System of units and fulfill at least the MAU of the minimum quality level derived according to internationally recommended models. For 2 measurands (serum albumin and chloride), further improvements in MU of higher-order references would be necessary. |
Early, robust mucosal secretory IgA but not IgG response to SARS-CoV-2 spike in oral fluid is associated with faster viral clearance and COVID-19 symptom resolution
Pisanic N , Antar AAR , Hetrich MK , Demko ZO , Zhang X , Spicer K , Kruczynski KL , Detrick B , Clarke W , Knoll MD , Thomas DL , Dawood FS , Veguilla V , Karron RA , Manabe YC , Heaney CD . J Infect Dis 2024 BACKGROUND: High priority efforts are underway to support the development of novel mucosal COVID-19 vaccines, such as the US Government's Project NextGen and the Center for Epidemic Preparedness Innovations' goal to respond to the next pandemic with a new vaccine in 100 days. However, there is limited consensus about the complementary role of mucosal immunity in disease progression and how to evaluate immunogenicity of mucosal vaccines. This study investigated the role of oral mucosal antibody responses in viral clearance and COVID-19 symptom duration. METHODS: Participants with PCR-confirmed SARS-CoV-2 infection provided oral fluid for testing with SARS-CoV-2 antibody multiplex assays, nasal swabs for RT-PCR and symptom information at up to eight follow-ups from April 2020 to February 2022. RESULTS: High and moderate oral fluid anti-spike (S) secretory IgA (SIgA) post infection was associated with significantly faster viral clearance and symptom resolution across age groups with effect sizes equivalent to having COVID-19 vaccine immunity at the time of infection. Those with high and moderate anti-S SIgA cleared the virus 14 days (95% CI: 10-18) and recovered 9-10 days (95% CI: 6-14) earlier. Delayed and higher anti-S IgG was associated with significantly longer time to clearance and recovery. Experiencing symptoms longer than four weeks was associated with lower anti-RBD SIgA 15-30 days after infection onset (p<0.001). CONCLUSION: Robust mucosal SIgA early post infection appears to support faster clearance of SARS-CoV-2 and recovery from COVID-19 symptoms. This research underscores the importance of harmonizing mucosal immune response assays to evaluate new mucosal vaccines. |
Predicted heart age and life's essential 8 among U.S. Adults: Nhanes 2015-March 2020: Running title: Life's essential 8 and heart age
Yang Q , Zhou W , Tong X , Zhang Z , Merritt R . Am J Prev Med 2024 INTRODUCTION: This study examined the association between American Heart Association's (AHA) cardiovascular health (CVH) metrics -Life's Essential 8 (LE8)- and predicted heart age among U.S. adults. METHODS: The sample comprised 7,075 participants aged 30-74 years without CVD and/or stroke from the National Health and Nutrition Examination Survey (NHANES) 2015-March 2020. LE8 was measured according to AHA's metrics (overall score ranging from 0 to 100 points), and nonlaboratory-based Framingham Risk Score was used to estimate predicted heart age. Analyses were completed in June 2024. RESULTS: Median LE8 scores were 62.8 for men and 66.0 for women. Over 80% of participants had less than optimal CVH scores, affecting 141.5 million people and 1-in-6 participants had a low CVH score, impacting 30.0 million people. Mean predicted heart age and excess heart age (EHA, difference between actual and predicted heart age) were 56.6 (95% CI 56.1-57.1) and 8.6 (8.1-9.1) years for men and 54.0 (53.4-54.7) and 5.9 (5.2-6.5) years for women. Participants in the low CVH group (scores<50), had an EHA that was 20.7 years higher than those in the high CVH group (score 80-100). Compared to the high CVH group, participants in low CVH group had 15 times (for men) and 44 times (for women) higher risk of having EHA ≥10 years. The pattern of differences in predicted heart age, EHA, and prevalence of EHA ≥10 years by LE8 groups remained largely consistent across subpopulations. CONCLUSIONS: These findings highlight the importance of maintaining a healthy lifestyle to improve cardiovascular health and reduce excess heart age. |
Early biological markers of post-acute sequelae of SARS-CoV-2 infection
Lu S , Peluso MJ , Glidden DV , Davidson MC , Lugtu K , Pineda-Ramirez J , Tassetto M , Garcia-Knight M , Zhang A , Goldberg SA , Chen JY , Fortes-Cobby M , Park S , Martinez A , So M , Donovan A , Viswanathan B , Hoh R , Donohue K , McIlwain DR , Gaudiliere B , Anglin K , Yee BC , Chenna A , Winslow JW , Petropoulos CJ , Deeks SG , Briggs-Hagen M , Andino R , Midgley CM , Martin JN , Saydah S , Kelly JD . Nat Commun 2024 15 (1) 7466 To understand the roles of acute-phase viral dynamics and host immune responses in post-acute sequelae of SARS-CoV-2 infection (PASC), we enrolled 136 participants within 5 days of their first positive SARS-CoV-2 real-time PCR test. Participants self-collected up to 21 nasal specimens within the first 28 days post-symptom onset; interviewer-administered questionnaires and blood samples were collected at enrollment, days 9, 14, 21, 28, and month 4 and 8 post-symptom onset. Defining PASC as the presence of any COVID-associated symptom at their 4-month visit, we compared viral markers (quantity and duration of nasal viral RNA load, infectious viral load, and plasma N-antigen level) and host immune markers (IL-6, IL-10, TNF-α, IFN-α, IFN-γ, MCP, IP-10, and Spike IgG) over the acute period. Compared to those who fully recovered, those reporting PASC demonstrated significantly higher maximum levels of SARS-CoV-2 RNA and N-antigen, burden of RNA and infectious viral shedding, and lower Spike-specific IgG levels within 9 days post-illness onset. No significant differences were identified among a panel of host immune markers. Our results suggest early viral dynamics and the associated host immune responses play a role in the pathogenesis of PASC, highlighting the importance of understanding early biological markers in the natural history of PASC. |
JYNNEOS vaccine safety surveillance during the 2022 mpox outbreak using the Vaccine Adverse Event Reporting System (VAERS) and v-safe, United States, 2022-2023
Duffy J , Myers TR , Marquez P , Rouse D , Brown H , Zhang B , Shay DK , Moro PL . Sex Transm Dis 2024 51 (8) 509-515 BACKGROUND: In response to the 2022 mpox outbreak in the United States, people with higher potential for exposure to mpox were recommended to receive 2 doses of the JYNNEOS vaccine. Vaccine safety was monitored using 2 complementary systems. METHODS: The Vaccine Adverse Event Reporting System (VAERS) is a passive surveillance system that accepts reports of adverse events after vaccination. VAERS is capable of rapidly identifying rare adverse events and unusual reporting patterns. Medical records were requested and reviewed for adverse events of special interest, including myocarditis. Adverse event reporting rates were calculated as the number of verified adverse event cases divided by the number of JYNNEOS doses administered. V-safe for mpox was a voluntary smartphone-based vaccine safety surveillance system that sent enrolled persons text messages linked to health surveys asking about reactions and health impact events occurring after vaccination. RESULTS: There were 1,207,056 JYNNEOS doses administered in the United States. VAERS received 1927 reports for JYNNEOS. The myocarditis reporting rate per million doses was 2.69 after dose 1 and 8.64 after dose 2. V-safe had 213 participants complete at least one health survey. Rates of injection site and systemic reactions were similar in the first week after dose 1 and dose 2. CONCLUSIONS: JYNNEOS vaccine safety surveillance findings from VAERS and v-safe did not identify any unexpected safety concerns. The VAERS reporting rate for myocarditis was similar to previously published population background rates. |
Mixtures of urinary phenol and phthalate metabolite concentrations in relation to serum lipid levels among pregnant women: Results from the EARTH Study
Shen X , Génard-Walton M , Williams PL , James-Todd T , Ford JB , Rexrode KM , Calafat AM , Zhang D , Chavarro JE , Hauser R , Mínguez-Alarcón L , The Earth Study Team . Toxics 2024 12 (8) We examined whether mixtures of urinary concentrations of bisphenol A (BPA), parabens and phthalate metabolites were associated with serum lipid levels among 175 pregnant women who enrolled in the Environment and Reproductive Health (EARTH) Study (2005-2017), including triglycerides, total cholesterol, high-density lipoprotein (HDL), non-HDL, and low-density lipoprotein (LDL). We applied Bayesian Kernel Machine Regression (BKMR) and quantile g-computation while adjusting for confounders. In the BKMR models, we found no associations between chemical mixture and lipid levels, e.g., total cholesterol [mean difference (95% CRI, credible interval) = 0.02 (-0.31, 0.34)] and LDL [mean difference (95% CRI) = 0.10 (-0.22, 0.43)], when comparing concentrations at the 75th to the 25th percentile. When stratified by BMI, we found suggestive positive relationships between urinary propylparaben and total cholesterol and LDL among women with high BMI [mean difference (95% CRI) = 0.25 (-0.26, 0.75) and 0.35 (-0.25, 0.95)], but not with low BMI [mean difference (95% CRI) = 0.00 (-0.06, 0.07) and 0.00 (-0.07, 0.07)]. No association was found by quantile g-computation. This exploratory study suggests mixtures of phenol and phthalate metabolites were not associated with serum lipid levels during pregnancy, while there were some suggestive associations for certain BMI subgroups. Larger longitudinal studies with multiple assessments of both exposure and outcome are needed to corroborate these novel findings. |
Economic costs attributed to diagnosed diabetes in each U.S. State and the District of Columbia: 2021
Khavjou OA , Sun M , D'Angelo SR , Neuwahl SJ , Hoerger TJ , Cho P , Myers K , Zhang P . Diabetes Care 2024 OBJECTIVE: To update state-specific estimates of diabetes-attributable costs in the U.S. and assess changes in spending from 2013 to 2021. RESEARCH DESIGN AND METHODS: We used an attributable fraction approach to estimate direct medical costs of diagnosed diabetes using the 2021 State Health Expenditure Accounts, the 2021 Behavioral Risk Factor Surveillance System, and the Centers for Medicare and Medicaid Services 2018-2019 Minimum Data Set. We estimated diabetes-attributable productivity losses from morbidity and mortality using the 2016-2021 National Health Interview Survey and the 2021 mortality data from the Centers for Disease Control and Prevention. Costs were adjusted to 2021 U.S. dollars. RESULTS: Total diabetes-attributable cost in 2021 was $640 billion ($335 billion in direct medical costs and $305 billion in indirect costs). The median state-level total diabetes-attributable cost was $8.2 billion (range $842 million to $81 billion). The median state-level per-person cost was $21,082, ranging from $17,452 to $37,090. Total diabetes-attributable cost increased by a median of 33% between 2013 and 2021, ranging from 16 to 68% across states. Medical costs increased by 50% overall (range 33-79%) and by 27% (range 15-41%) for per person with diabetes. Costs paid by Medicaid experienced the highest increase between 2013 and 2021 (median 153%; range 41-483%). CONCLUSIONS: State economic costs of diagnosed diabetes are substantial and increased over the last decade. These costs and their growth vary considerably across states. These findings may help state policy makers in developing evidenced-based public health interventions in their respective states to prevent and control the prevalence of diabetes. |
Field effectiveness of a typhoid conjugate vaccine: The 2018 Navi Mumbai Pediatric TCV Campaign
Date K , LeBoa C , Hoffman SA , Haldar P , Harvey P , An Q , Zhang C , Yewale VN , Daruwalla S , Dharmapalan D , Gavhane J , Joshi S , Rai R , Rathod V , Shetty K , Warrier DS , Yadav S , Shimpi R , Jayaprasad N , Horng L , Fagerli K , Borhade P , Chakraborty D , Katkar A , Kunwar A , Andrews JR , Bahl S , Bhatnagar P , Dutta S , Luby SP . Am J Trop Med Hyg 2024 Typbar-TCV®, a typhoid conjugate vaccine (TCV), was prequalified by the World Health Organization in 2017. We evaluated its effectiveness in a mass vaccination program targeting children 9 months to 14 years in Navi Mumbai, India, from September 2018 to July 2020. We compared laboratory-confirmed typhoid cases from six clinical sites with age-matched community controls. Of 38 cases, three (8.6%) received TCV through the campaign, compared with 53 (37%) of 140 controls. The adjusted odds ratio of typhoid fever among vaccinated children was 0.16 (95% CI: 0.05-0.55), equivalent to a vaccine effectiveness of 83.7% (95% CI: 45.0-95.3). Vaccine effectiveness of Typbar-TCV in this large public sector vaccine introduction was similar to prior randomized controlled trials, providing reassurance to policymakers that TCV effectiveness is robust in a large-scale implementation. |
Per- and polyfluoroalkyl substances exposure is associated with polycystic ovary syndrome risk among women attending a fertility clinic
Zhang Y , Martin L , Mustieles V , Ghaly M , Archer M , Sun Y , Torres N , Coburn-Sanderson A , Souter I , Petrozza JC , Botelho JC , Calafat AM , Wang YX , Messerlian C . Sci Total Environ 2024 950 175313 Previous studies reported that exposures to per- and polyfluoroalkyl substances (PFAS), largely in higher exposed populations, were associated with elevated risk of polycystic ovary syndrome (PCOS). However, studies evaluating PCOS risk in populations with lower background exposures to PFAS are limited. This study aimed to examine the associations between serum PFAS concentrations and PCOS risk among women attending a U.S. academic fertility clinic during 2005-2019. A total of 502 females who sought fertility evaluation and assisted reproduction treatments were included. Nine PFAS were quantified in non-fasting serum samples collected at study entry. Diagnosis of PCOS was based on the Rotterdam criteria. We used logistic regression to examine the odds ratio (OR) of PCOS in relation to individual PFAS concentrations (continuous and by tertiles) and quantile g-computation (QGC) and Bayesian Kernel Machine Regression (BKMR) to examine the joint associations of PFAS mixture with PCOS. Most participants were White and had a graduate degree or higher. Per doubling of serum perfluorooctane sulfonate (PFOS) and perfluorohexane sulfonate (PFHxS) concentrations were associated with higher odds of PCOS [OR (95%CI): 1.70 (1.06, 2.81) and 1.45 (1.02, 2.08) for PFOS and PFHxS respectively]. There was a dose-response relationship of PFOS with PCOS risk (p of trend by PFOS tertiles = 0.07). Both QGC and BKMR identified PFOS as the most important contributor among the mixture to PCOS risk. No clear joint effects were found for other PFAS or PFAS mixtures on PCOS risk. Our findings are consistent with existing evidence in populations with higher background PFAS concentrations and highlight the adverse effects of PFAS exposure on reproductive health. Findings can inform public health measures and clinical care to protect populations vulnerable to PCOS, in part, due to environmental exposures. |
A general procedure for evaluating models and ensemble Support Vector Regression
Zhang G , He Y . Commun Stat Simul Comput 2024 In practice, we may want to discover if there is a relationship between a response variable as a function of the predictor variables. Multiple linear regression (MLR) is a popular tool for such purpose. When the relationship is nonlinear, nonparametric regression methods such as local linear regression, smoothing splines, and support vector regression (SVR) provide flexible alternatives to MLR. How do we compare the performance of these methods and choose an appropriate one for use? In this research, we propose a general procedure to evaluate the performance of different regression methods for use in large data. We also propose an ensemble SVR for regression analysis. The proposed methods are applied to address research questions using the Research and Development Survey, conducted by the National Center for Health Statistics. © 2024 Taylor & Francis Group, LLC. |
A case study of shale gas well casing deformation in longwall chain pillars under deep cover
Zhang P , Su D , Van Dyke M , Kim BH . Rock Mech Rock Eng 2024 Shale gas wells located in longwall chain pillars are subject to longwall-induced subsurface ground movements. Longwall mining on either side of the chain pillars can induce deformations in gas well casings. Excessive casing deformations could diminish casing integrity so that intrusive shale gas might leak into the longwall mine jeopardizing mine safety. This study investigated longwall-induced casing deformations of eight shale gas wells in the chain pillars between two adjacent longwall panels in the Pittsburgh coal seam under a cover depth of 314 m. The casing deformations were measured with a 56-arm caliper after each longwall face passed the gas well pad. Casing deformations were detected at ten locations below the surface after first panel mining, and the maximum casing deformation of 1.27 cm occurred at a 184-m depth. After second panel mining, the caliper survey showed that casing deformation locations remained the same, but generally the deformations increased slightly. The maximum deformation at the 184-m depth increased from 1.27 to 1.5 cm. The eight shale gas wells were also modeled by the FLAC3D modeling technique. The casing deformations predicted by the FLAC3D model were compared with the caliper survey results. The modeling predictions were in a good agreement with the caliper measurements in terms of deformation level and locations. The modeling results suggested that the gas well setback distance to the longwall gob would affect casing deformations, and that casing deformations can be minimized if gas wells are located around the center of the abutment pillar. The study showed that longwall-induced casing deformations occur at the same weak/strong rock interfaces after both first and second panel mining. The study also showed that, under deep cover, casing deformations above the coal seam horizon are smaller than those under shallow cover. Under deep cover, the production casing deformations evaluated in this study were demonstrated to be minimized by locating gas wells at the center of the chain pillars and by leaving the production casing uncemented from the surface to below the coal seam. © This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply 2024. |
Global update on measles molecular epidemiology
Bankamp B , Kim G , Hart D , Beck A , Ben Mamou M , Penedos A , Zhang Y , Evans R , Rota PA . Vaccines (Basel) 2024 12 (7) Molecular surveillance of circulating measles variants serves as a line of evidence for the absence of endemic circulation and provides a means to track chains of transmission. Molecular surveillance for measles (genotyping) is based on the sequence of 450 nucleotides at the end of the nucleoprotein coding region (N450) of the measles genome. Genotyping was established in 1998 and, with over 50,000 sequence submissions to the Measles Nucleotide Surveillance database, has proven to be an effective resource for countries attempting to trace pathways of transmission. This review summarizes the tools used for the molecular surveillance of measles and describes the challenge posed by the decreased number of circulating measles genotypes. The Global Measles and Rubella Laboratory Network addressed this challenge through the development of new tools such as named strains and distinct sequence identifiers that analyze the diversity within the currently circulating genotypes. The advantages and limitations of these approaches are discussed, together with the need to generate additional sequence data including whole genome sequences to ensure the continued utility of strain surveillance for measles. |
Impact of state telehealth parity laws for private payers on hypertension medication adherence before and during the COVID-19 pandemic
Zhang D , Lee JS , Popoola A , Lee S , Jackson SL , Pollack LM , Dong X , Therrien NL , Luo F . Circ Cardiovasc Qual Outcomes 2024 e010739 BACKGROUND: Telehealth has emerged as an effective tool for managing common chronic conditions such as hypertension, especially during the COVID-19 pandemic. However, the impact of state telehealth payment and coverage parity laws on hypertension medication adherence remains uncertain. METHODS: Data from the 2016 to 2021 Merative MarketScan Commercial Claims and Encounters Database were used to construct the study cohort, which included nonpregnant individuals aged 25 to 64 years with hypertension. We coded telehealth parity laws related to hypertension management in all 50 US states and the District of Columbia, distinguishing between payment and coverage parity laws. The primary outcomes were measures of antihypertension medication adherence: the average medication possession ratio; medication adherence (medication possession ratio ≥80%); and average number of days of drug supply. We used a generalized difference-in-differences design to examine the impact of these laws. RESULTS: Among 353 220 individuals (mean [SD] age, 49.5 (7.1) years; female, 45.55%), states with payment parity laws were significantly linked to increased average medication possession ratio by 0.43 percentage point (95% CI, 0.07-0.79), and an increase of 0.46 percentage point (95% CI, 0.06-0.92) in the probability of medication adherence. Payment parity laws also led to an average increase of 2.14 days (95% CI, 0.11-4.17) in prescription supply, after controlling for state-fixed effects, year-fixed effects, individual sociodemographic characteristics and state time-varying covariates including unemployment rates, gross domestic product per capita, and poverty rates. In contrast, coverage parity laws were associated with a 2.13-day increase (95% CI, 0.19-4.07) in days of prescription supply but did not significantly increase the average medication possession ratio or probability of medication adherence. CONCLUSIONS: State telehealth payment parity laws were significantly associated with greater medication adherence, whereas coverage parity laws were not. With the increasing adoption of telehealth parity laws across states, these findings may support policymakers in understanding potential implications on management of hypertension. |
Modelling the potential impact of global hepatitis B vaccination on the burden of chronic hepatitis B in the United States
Hutton DW , Toy M , Yang D , Zhang H , Handanagic S , Armstrong PA , Wasley A , Menzies NA , Pham H , Salomon JA , So SK . J Viral Hepat 2024 About 80% of persons with chronic hepatitis B virus (HBV) infection in the United States are non-US-born. Despite improvements in infant hepatitis B vaccination globally since 2000, work remains to attain the World Health Organization's (WHO) global 2030 goal of 90% vaccination. We explore the impacts on the United States of global progress in hepatitis B vaccination since 2000 and of achieving WHO hepatitis B vaccination goals. We simulated immigrants with HBV infection arriving to the United States from 2000 to 2070 using models of the 10 countries from which the largest numbers of individuals with HBV infection were born. We estimated costs in the United States among these cohorts using a disease simulation model. We simulated three scenarios: a scenario with no progress in infant vaccination for hepatitis B since 2000 (baseline), current (2020) progress and achieving WHO 2030 goals for hepatitis B vaccination. We estimate current hepatitis B vaccination progress since the 2000 baseline in these 10 countries will lead to 468,686 fewer HBV infections, avoid 35,582 hepatitis B-related deaths and save $4.2 billion in the United States through 2070. Achieving the WHO 2030 90% hepatitis B infant vaccination targets could lead to an additional 16,762 fewer HBV infections, 989 fewer hepatitis B-related deaths and save $143 million through 2070. Global hepatitis B vaccination since 2000 reduced prevalence of HBV infection in the United States. Achieving the WHO 2030 infant vaccination goals globally could lead to over one hundred million dollars in additional savings. |
Pyrazinamide safety, efficacy, and dosing for treating drug-susceptible pulmonary tuberculosis: A phase 3, randomized, controlled clinical trial
Xu AY , Velásquez GE , Zhang N , Chang VK , Phillips PP , Nahid P , Dorman SE , Kurbatova EV , Whitworth WC , Sizemore E , Bryant K , Carr W , Brown NE , Engle ML , Nhung NV , Nsubuga P , Diacon A , Dooley KE , Chaisson RE , Swindells S , Savic RM . Am J Respir Crit Care Med 2024 RATIONALE: Optimizing pyrazinamide dosing is critical to improve treatment efficacy while minimizing toxicity during tuberculosis treatment. Study 31/ACTG A5349 represents the largest Phase 3 randomized controlled therapeutic trial to date for such investigation. OBJECTIVES: We sought to report pyrazinamide pharmacokinetic parameters, risk factors for lower pyrazinamide exposure, and relationships between pyrazinamide exposure with efficacy and safety outcomes. We aimed to determine pyrazinamide dosing strategies that optimize risks and benefits. METHODS: We analyzed pyrazinamide steady-state pharmacokinetic data using population nonlinear mixed-effects models. We evaluated the contribution of pyrazinamide exposure to long-term efficacy using parametric time-to-event models and safety outcomes using logistic regression. We evaluated optimal dosing with therapeutic windows targeting ≥95% durable cure and safety within the observed proportion of the primary safety outcome. MEASUREMENTS AND MAIN RESULTS: Among 2255 participants with 6978 plasma samples, pyrazinamide displayed 7-fold exposure variability (151-1053 mg·h/L). Body weight was not a clinically relevant predictor of drug clearance and thus did not justify the need for weight-banded dosing. Both clinical and safety outcomes were associated with pyrazinamide exposure, resulting in a therapeutic window of 231-355 mg·h/L for the control and 226-349 mg·h/L for the rifapentine-moxifloxacin regimen. Flat dosing of pyrazinamide at 1000 mg would have permitted an additional 13.1% (n=96) participants allocated to the control and 9.2% (n=70) to the rifapentine-moxifloxacin regimen dosed within the therapeutic window, compared to the current weight-banded dosing. CONCLUSIONS: Flat dosing of pyrazinamide at 1000 mg daily would be readily implementable and could optimize treatment outcomes in drug-susceptible tuberculosis. Clinical trial registration available at www. CLINICALTRIALS: gov, ID: NCT02410772. |
The health status of women with children living in public and assisted housing: Linkage of the National Health Interview Survey to U.S. Department of Housing and Urban Development Administrative Data
Helms Garrison V , Bachand JV , Zhang C , Cox C , Golden C , Lochner KA . Cityscape 2024 26 (1) 49-64 For more than a decade, the U.S. Department of Housing and Urban Development (HUD) and the National Center for Health Statistics (NCHS) have partnered to link NCHS national health survey data with HUD administrative records on persons participating in federal public and assisted housing programs. This study used 2015-18 National Health Interview Survey (NHIS)-HUD linked data to examine women 18-44 years old with children and renting their home who were receiving HUD assistance (n=852) and a comparison population of women of the same age with children, who were low-income renters but did not link to HUD records at the time of their NHIS interview (n=894). The population of HUD-assisted women differed from the comparison group on key sociodemographic characteristics and health indicators. HUD-assisted women were more likely to report their health as fair or poor and to being a current smoker. HUD-assisted women also were less likely to be uninsured and more likely to have a regular source of care. The findings in this article are exploratory but demonstrate how the NCHS-HUD-linked data can be a resource for researchers and policymakers in further examining housing status as an important social determinant of health. |
Gestational exposure to environmental chemicals and epigenetic alterations in the placenta and cord blood mononuclear cells
Puvvula J , Braun JM , DeFranco EA , Ho SM , Leung YK , Huang S , Zhang X , Vuong AM , Kim SS , Percy Z , Calafat AM , Botelho JC , Chen A . Epigenetics Commun 2024 4 (1) 4 BACKGROUND: Exposure to environmental chemicals such as phthalates, phenols, and polycyclic aromatic hydrocarbons (PAHs) during pregnancy can increase the risk of adverse newborn outcomes. We explored the associations between maternal exposure to select environmental chemicals and DNA methylation in cord blood mononuclear cells (CBMC) and placental tissue (maternal and fetal sides) to identify potential mechanisms underlying these associations. METHOD: This study included 75 pregnant individuals who planned to give birth at the University of Cincinnati Hospital between 2014 and 2017. Maternal urine samples during the delivery visit were collected and analyzed for 37 biomarkers of phenols (12), phthalates (13), phthalate replacements (4), and PAHs (8). Cord blood and placenta tissue (maternal and fetal sides) were also collected to measure the DNA methylation intensities using the Infinium HumanMethylation450K BeadChip. We used linear regression, adjusting for potential confounders, to assess CpG-specific methylation changes in CBMC (n = 54) and placenta [fetal (n = 67) and maternal (n = 68) sides] associated with gestational chemical exposures (29 of 37 biomarkers measured in this study). To account for multiple testing, we used a false discovery rate q-values < 0.05 and presented results by limiting results with a genomic inflation factor of 1±0.5. Additionally, gene set enrichment analysis was conducted using the Kyoto Encyclopedia of Genes and Genomics pathways. RESULTS: Among the 29 chemical biomarkers assessed for differential methylation, maternal concentrations of PAH metabolites (1-hydroxynaphthalene, 2-hydroxyfluorene, 4-hydroxyphenanthrene, 1-hydroxypyrene), monocarboxyisononyl phthalate, mono-3-carboxypropyl phthalate, and bisphenol A were associated with altered methylation in placenta (maternal or fetal side). Among exposure biomarkers associated with epigenetic changes, 1-hydroxynaphthalene, and mono-3-carboxypropyl phthalate were consistently associated with differential CpG methylation in the placenta. Gene enrichment analysis indicated that maternal 1-hydroxynaphthalene was associated with lipid metabolism and cellular processes of the placenta. Additionally, mono-3-carboxypropyl phthalate was associated with organismal systems and genetic information processing of the placenta. CONCLUSION: Among the 29 chemical biomarkers assessed during delivery, 1-hydroxynaphthalene and mono-3-carboxypropyl phthalate were associated with DNA methylation in the placenta. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s43682-024-00027-7. |
Lifetime medical spending attributed to incident type 2 diabetes in Medicare beneficiaries: A longitudinal study using 1999-2019 national Medicare claims
Shao Y , Wang Y , Bigman E , Imperatore G , Holliday C , Zhang P . Diabetes Care 2024 OBJECTIVE: To estimate lifetime incremental medical spending attributed to incident type 2 diabetes (T2D) among Medicare beneficiaries by age at diagnosis, sex, and race/ethnicity. RESEARCH DESIGN AND METHODS: We used the 1999-2019 100% Medicare fee-for-service claims database to identify a cohort of beneficiaries with newly diagnosed T2D in 2001-2003 using ICD codes. We matched this cohort with a nondiabetes cohort using a propensity score method and then followed the two cohorts until death, disenrollment, or the end of 2019. Lifetime medical spending for each cohort was the sum of expected annual spending, a product of actual annual spending multiplied by the annual survival rate, from the age at T2D diagnosis to death. Lifetime incremental medical spending was calculated as the difference in lifetime medical spending between the two cohorts. All spending was standardized to 2019 U.S. dollars. RESULTS: Medicare beneficiaries with newly diagnosed T2D, despite having a shorter life expectancy, had 36-40% higher lifetime medical spending compared with a comparable group without diabetes. Lifetime incremental medical spending ranged from $16,115 to $122,146, depending on age at diagnosis, sex, and race/ethnicity, declining with age at diagnosis, and being highest for Asian/Pacific Islander and non-Hispanic Black beneficiaries. CONCLUSIONS: The large lifetime incremental medical spending associated with incident T2D underscores the need for preventing T2D among Medicare beneficiaries. Our results could be used to estimate the potential financial benefit of T2D prevention programs both overall and among subgroups of beneficiaries. |
Malpresentation and autism spectrum disorder in the study to explore early development
Zhang Y , Delahanty MT , Engel SM , Marshall S , O'Shea TM , Garcia T , Schieve LA , Bradley C , Daniels JL . Paediatr Perinat Epidemiol 2024 Background: An infant's presentation at delivery may be an early indicator of developmental differences. Non-vertex presentation (malpresentation) complicates delivery and often leads to caesarean section, which has been associated with neurodevelopmental delays, including autism spectrum disorder (ASD). However, malpresentation could be an early sign of an existing developmental problem that is also an upstream factor from caesarean delivery. Little research has been done to investigate the association between malpresentation and ASD. Objectives: We examine the association between malpresentation at delivery and ASD and whether this association differs by gestational age. Methods: We used data from the Study to Explore Early Development (SEED), a multi-site, case–control study of children with ASD compared to population controls. The foetal presentation was determined using medical records, birth records and maternal interviews. We defined malpresentation as a non-vertex presentation at delivery, then further categorised into breech and other malpresentation. We used multivariable logistic regression to estimate the adjusted odds ratio (aOR) for the association between malpresentation and ASD. Results: We included 4047 SEED participants, 1873 children with ASD and 2174 controls. At delivery, most infants presented vertex (n = 3760, 92.9%). Malpresentation was associated with higher odds of ASD (aOR 1.31, 95% confidence interval [CI] 1.02, 1.68) after adjustment for maternal age, poverty level, hypertensive disorder and smoking. The association was similar for breech and other types of malpresentation (aOR 1.28, 95% CI 0.97, 1.70 and aOR 1.40, 95% CI 0.87, 2.26, respectively) and did not differ markedly by gestational age. Conclusions: Malpresentation at delivery was modestly associated with ASD. Early monitoring of the neurodevelopment of children born with malpresentation could identify children with ASD sooner and enhance opportunities to provide support to optimise developmental outcomes. © 2024 John Wiley & Sons Ltd. |
Dolutegravir- versus efavirenz-based treatment in pregnancy: Impact on red blood cell folate concentrations in pregnant women and their infants
Jacobson DL , Crider KS , DeMarrais P , Brummel S , Zhang M , Pfeiffer CM , Moore CA , McCarthy K , Johnston B , Mohammed T , Vhembo T , Kabugho E , Muzorah GA , Cassim H , Fairlie L , Machado ES , Ngocho JS , Shapiro RL , Serghides L , Chakhtoura N , Chinula L , Lockman S . J Infect Dis 2024 In IMPAACT 2010/VESTED, pregnant women were randomized to initiate dolutegravir (DTG)+emtricitabine (FTC)/tenofovir alafenamide (TAF), DTG+FTC/tenofovir disoproxil fumarate (TDF), or efavirenz (EFV)/FTC/TDF. We assessed red blood cell folate concentrations (RBC-folate) at maternal study entry and delivery, and infant birth. RBC-folate outcomes were: 1) maternal change entry to delivery (trajectory), 2) infant, 3) ratio of infant-to-maternal delivery. Generalized estimating equation models for each log(folate) outcome were fit to estimate adjusted geometric mean ratio (Adj-GMR)/GMR trajectories (Adj-GMRT) of each arm comparison in 340 mothers and 310 infants. Overall, 90% of mothers received folic acid supplements and 78% lived in Africa. At entry, median maternal age was 25 years, gestational age was 22 weeks, CD4 count was 482 cells/mm3 and log10HIV RNA was 3 copies/mL. Entry RBC-folate was similar across arms. Adj-GMRT of maternal folate was 3% higher in the DTG+FTC/TAF versus EFV/FTC/TDF arm (1.03, 95%CI 1.00, 1.06). The DTG+FTC/TAF arm had an 8% lower infant-maternal folate ratio (0.92, 95%CI 0.78, 1.09) versus EFV/FTC/TDF. Results are consistent with no clinically meaningful differences between arms for all RBC-folate outcomes and they suggest that cellular uptake of folate and folate transport to the infant do not differ in pregnant women starting DTG- vs. EFV-based ART. |
Tobacco use among adults with disabilities in nine countries-Demographic and Health Survey, 2016-2021
Kress AC , Vashist A , Zhang QC , Dragicevic A , Njie GJ . PLOS Glob Public Health 2024 4 (6) e0003232 Few studies have investigated tobacco use among people with disabilities living in low- and middle-income countries (LMICs). We aimed to examine current tobacco use among men and women with disabilities using Demographic and Health Survey (DHS) data from 9 LMICs. We considered a respondent currently use tobacco products if they reported current use of any combustible/smoked tobacco products or smokeless tobacco products. We performed secondary analyses of DHS data from 2016-2021 collected in Haiti, Mali, Mauritania, Nigeria, Pakistan, Rwanda, South Africa, Timor-Leste, and Uganda. We examined marginal effects in logistic regression to calculate the adjusted prevalence and adjusted prevalence differences of tobacco use by disability status, controlling for selected sociodemographic characteristics. The adjusted prevalence of current use of tobacco products among women with a moderate/severe disability, mild disability, and no disability varied across countries, with medians of 1.9% (range = 0.1% [Mali] to 11.3% [Pakistan]), 3.2% (range = 0.9% [Nigeria] to 13.3% [South Africa]), and 2.3% (range = 0.5% [Nigeria] to 8.9% [South Africa]), respectively. For men with moderate/severe disability, the median adjusted prevalence for current use of tobacco products was 18.8% (range = 8.9% [Rwanda] to 55.0% [Timor-Leste]). The median prevalences of current use of tobacco products for men with mild disability and no disability were similar to those with moderate/severe disability, at 16.5% and 15.9%, respectively. Current tobacco product use among people with disabilities varied for countries included in our study; however, with few exceptions, current tobacco product use was similar across disability status groups. Additional research is warranted to determine whether our findings extend beyond the nine countries assessed here. It is important to consider the needs of people with disabilities in tobacco prevention, control, and cessation efforts so that this substantial population can benefit equitably from such programs, interventions, or policies. |
Trends in the administration of COVID-19 vaccines with other vaccines in the United States reported to V-safe during December 14, 2020-May 19, 2023
Parker CE , Hause AM , Marquez P , Zhang B , Myers TR , Shay DK . Hum Vaccin Immunother 2024 20 (1) 2361946 Introduction COVID-19 vaccines may be administered with other vaccines during the same healthcare visit. COVID-19 monovalent (Fall 2021) and bivalent (Fall 2022) vaccine recommendations coincided with annual seasonal influenza vaccination. Data describing the frequency of the co-administration of COVID-19 vaccines with other vaccines are limited. Methods We used V-safe, a voluntary smartphone-based U.S. safety surveillance system established by the CDC, to describe trends in the administration of COVID-19 vaccines with other vaccines reported to V-safe during December 14, 2020 - May 19, 2023. Results Of the 21 million COVID-19 vaccinations reported to V-safe, 2.2% (459,817) were administered with at least 1 other vaccine. Co-administration most frequently occurred during the first week of October 2023 (27,092; 44.1%). Most reports of co-administration included influenza vaccine (393,003; 85.5%). Co-administration was most frequently reported for registrants aged 6 months-6 years (4,872; 4.4%). Conclusion Reports of co-administration to V-safe peaked during October 2023, when influenza vaccination most often occurs, possibly reflecting increased opportunities for multiple vaccinations and greater acceptability of the co-administration of COVID-19 vaccine with other vaccines, especially influenza vaccine. |
Early safety findings among persons aged ≥60 years who received a respiratory syncytial virus vaccine - United States, May 3, 2023-April 14, 2024
Hause AM , Moro PL , Baggs J , Zhang B , Marquez P , Melgar M , Britton A , Stroud E , Myers TR , Rakickas J , Blanc PG , Welsh K , Broder KR , Su JR , Shay DK . MMWR Morb Mortal Wkly Rep 2024 73 (21) 489-494 |
Sociodemographic trends and correlation between parental hesitancy towards pediatric COVID-19 vaccines and routine childhood immunizations in the United States: 2021-2022 National Immunization Survey-Child COVID Module
Olusanya OA , Masters NB , Zhang F , Sugerman DE , Carter RJ , Weiss D , Singleton JA . Vaccines (Basel) 2024 12 (5) Multiple factors may influence parental vaccine hesitancy towards pediatric COVID-19 vaccines and routine childhood immunizations (RCIs). Using the United States National Immunization Survey-Child COVID Module data collected from parents/guardians of children aged 5-11 years, this cross-sectional study (1) identified the trends and prevalence estimates of parental hesitancy towards pediatric COVID-19 vaccines and RCIs, (2) examined the relationship between hesitancy towards pediatric COVID-19 vaccines and RCIs, and (3) assessed trends in parental hesitancy towards RCIs by sociodemographic characteristics and behavioral and social drivers of COVID-19 vaccination. From November 2021 to July 2022, 54,329 parents or guardians were interviewed. During this 9-month period, the proportion of parents hesitant about pediatric COVID-19 vaccines increased by 15.8 percentage points (24.8% to 40.6%). Additionally, the proportion of parents who reported RCIs hesitancy increased by 4.7 percentage points from November 2021 to May 2022 but returned to baseline by July 2022. Over nine months, parents' concerns about pediatric COVID-19 infections declined; however, parents were increasingly worried about pediatric COVID-19 vaccine safety and overall importance. Furthermore, pediatric COVID-19 vaccine hesitancy was more prevalent among parents of children who were White (43.2%) versus Black (29.3%) or Hispanic (26.9%) and those residing in rural (51.3%) compared to urban (28.9%) areas. In contrast, RCIs hesitancy was higher among parents of children who were Black (32.0%) versus Hispanic (24.5%) or White (23.6%). Pediatric COVID-19 vaccine hesitancy was 2-6 times as prevalent among parents who were RCIs hesitant compared to those who were RCIs non-hesitant. This positive correlation between parental hesitancy towards pediatric COVID-19 vaccines and RCIs was observed for all demographic and psychosocial factors for unadjusted and adjusted prevalence ratios. Parent-provider interactions should increase vaccine confidence, shape social norms, and facilitate behavior change to promote pediatric vaccination rates. |
Gestational diabetes prevalence estimates from three data sources, 2018
Bolduc MLF , Mercado CI , Zhang Y , Lundeen EA , Ford ND , Bullard KM , Carty DC . Matern Child Health J 2024 INTRODUCTION: We investigated 2018 gestational diabetes mellitus (GDM) prevalence estimates in three surveillance systems (National Vital Statistics System, State Inpatient Database, and Pregnancy Risk Assessment Monitoring Survey). METHODS: We calculated GDM prevalence for jurisdictions represented in each system; a subset of data was analyzed for people 18-39 years old in 22 jurisdictions present in all three systems to observe dataset-specific demographics and GDM prevalence using comparable categories. RESULTS: GDM prevalence estimates varied widely by data system and within the data subset despite comparable demographics. DISCUSSION: Understanding the differences between GDM surveillance data systems can help researchers better identify people and places at higher risk of GDM. |
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