Changes In Rates Research Articles

Design, rationale, and characterization of the mobile health based occupational cardiovascular risk intervention study (mHealth-OPEN study).

Design, rationale, and characterization of the mobile health based occupational cardiovascular risk intervention study (mHealth-OPEN study).

Public health policy and cancer prevention: Impact of HPV vaccine laws on oropharyngeal cancer.

e23046 Background: Oropharyngeal cancer is a significant global health challenge and the sixth most common cancer worldwide. Human Papillomavirus (HPV) vaccination effectively prevents HPV infections, a leading cause of oropharyngeal cancer. To prevent HPV infection, five jurisdictions in the United States passed laws requiring HPV vaccination for school attendance: Virginia and Washington, D.C. in 2007, Rhode Island in 2015, Puerto Rico in 2017, and Hawaii in 2019. This study is the first to assess the association between laws requiring HPV vaccinations and changes in oropharyngeal cancer incidence rates in the United States. Methods: This study is a retrospective, observational study. State Cancer Profiles from the National Cancer Institute and Centers for Disease Control and Prevention were utilized to analyze oropharyngeal cancer incidence rates in Virginia, Washington, D.C., Rhode Island, Hawaii, and Puerto Rico from 2002 to 2021, compared to the rest of the United States. Linear regression models were developed for each jurisdiction using MATLAB to evaluate changes in incidence rates before and after implementing HPV vaccination laws. Statistical significance was defined as a p-value < 0.05. Results: Washington, D.C. demonstrated a significant decrease in oropharyngeal cancer incidence rates following the implementation of HPV vaccination laws (p = 0.02). However, no significant decreases were observed in the other four jurisdictions. In fact, during the same period, the nationwide incidence rate of oropharyngeal cancer increased. Conclusions: This study provides preliminary evidence suggesting that HPV vaccination laws may contribute to reduced oropharyngeal cancer incidence rates, as demonstrated in Washington, D.C. However, similar effects were not seen in other jurisdictions, likely due to the small number of jurisdictions with such laws, the short follow-up period after these laws were passed, and the long latency period of oropharyngeal cancer. These initial results underscore the potential impact of HPV vaccine mandates on cancer prevention and highlight the need for further longitudinal studies to evaluate their long-term effectiveness. Our findings provide insight into the role of policy-driven public health interventions in reducing cancer incidence and may guide future legislative or regulatory strategies aimed at combating HPV-related cancers.

A new factor of dynamic lighting schedule on dust production in commercial laying hen house.

A new factor of dynamic lighting schedule on dust production in commercial laying hen house.

Changes in primary care encounter rates during the veteran health administration’s electronic health record transition

Changes in primary care encounter rates during the veteran health administration’s electronic health record transition

Shifting trends and disparities in colorectal cancer and heart failure-related mortality in the United States: A two-decade retrospective analysis.

Shifting trends and disparities in colorectal cancer and heart failure-related mortality in the United States: A two-decade retrospective analysis.

Cardiovascular diseases mortality in Brazilian municipalities: estimates from the Global Burden of Disease study, 2000-2018.

Cardiovascular diseases mortality in Brazilian municipalities: estimates from the Global Burden of Disease study, 2000-2018.

Initiation of Dolutegravir Versus Efavirenz on Viral Suppression and Retention at 6 months: A Regression Discontinuity Design.

In 2019, South Africa's Antiretroviral Therapy (ART) Treatment Guidelines replaced efavirenz with dolutegravir in first-line ART. We assessed the impact of this national guideline change on retention and viral suppression in the Themba Lethu Clinical Cohort, Johannesburg, South Africa. We applied a regression discontinuity design in a prospective cohort study of 1654 adults living with HIV initiating first-line ART within 12 months (±12 months) of the guideline change. We compared outcomes in individuals presenting just before and after the guideline change and estimated intention-to-treat effects on initiating a dolutegravir- vs efavirenz-based regimen. Primary outcomes were retention and viral suppression. Participants were defined as retained in care if a visit took place within ±3 months of the 6-month end point. Viral suppression was defined as having a viral load ≤1000 copies/mL 3 months before and up to 6 months after the 6-month end point. The 2019 guideline change led to an increase in uptake of dolutegravir. We noted a 26.6 percentage point increase in the proportion initiating dolutegravir [95% Confidence Interval (CI): 14.1 to 38.6]. We saw a small increase in viral suppression [Risk Difference (RD): 7.4 percentage points; 95% CI: -1.6 to 16.5] and no change in retention (RD: -1.7 percentage points; 95% CI: -13.9 to 10.5) at 6 months, though our findings were imprecise. Our estimates suggest early uptake of the revised treatment guidelines after implementation. Despite this, there was no meaningful change in viral suppression and retention rates at 6 months.

Detection and prevalence of avian influenza epidemic in the southwest of Poyang Lake and analysis of the influence of meteorological factors.

Detection and prevalence of avian influenza epidemic in the southwest of Poyang Lake and analysis of the influence of meteorological factors.

Trends in Medicare reimbursement for urological cancer surgeries in male genitourinary malignancies: A 10-year analysis.

e23129 Background: Male genitourinary (GU) cancers, including testicular, penile, kidney, and prostate cancers, necessitate surgical interventions critical for disease management. Medicare reimbursement trends for these procedures have implications for healthcare access, provider sustainability, and policy planning. This study evaluates changes in reimbursement rates for urological surgeries over the past decade, focusing on trends from 2015 to projected 2025 rates. Methods: Medicare reimbursement rates for commonly performed surgical procedures in testicular, penile, kidney, and prostate cancers were extracted for 2015 (adjusted for inflation) and projected for 2025. Percent change (% change) and compound annual growth rate (CAGR) were calculated to evaluate trends. Procedures analyzed included orchiectomies, partial and radical penectomies, nephrectomies, ablative procedures for renal tumors, and various forms of prostatectomies. Results: Across all GU cancer types, significant reductions in adjusted Medicare reimbursement rates were observed between 2015 and 2025. Procedures for testicular cancer (e.g., extensive orchiectomy) saw a total % decrease of -27.19% to -27.35% (CAGR: -3.12% to -3.14%). Penile cancer procedures (e.g., partial and radical penectomies) exhibited a decline of -26.94% to -28.94% (CAGR: -3.09% to -3.36%). Reimbursements for kidney cancer surgeries, including open radical nephrectomies and percutaneous ablative procedures, decreased by -28.74% to -34.61% (CAGR: -3.33% to -4.16%). Prostate cancer procedures, particularly radical and extensive prostatectomies, demonstrated a reduction of -28.43% to -34.99% (CAGR: -3.29% to -4.21%). The greatest declines were observed in minimally invasive kidney cancer interventions (e.g., percutaneous cryoablation) and subtotal prostatectomies, reflecting a CAGR exceeding -4%. Conclusions: Medicare reimbursement rates for male GU cancer surgeries have declined significantly over the past decade, with reductions ranging from -26.94% to -34.99%. These trends may challenge provider participation and access to care, particularly for complex or minimally invasive procedures. Policymakers should consider the financial implications of declining reimbursement rates to ensure equitable care for patients with GU malignancies.

Global evaluation of the impact of food fortification with folic acid on rates of schizophrenia.

Global evaluation of the impact of food fortification with folic acid on rates of schizophrenia.

Long-term trends in gallbladder cancer incidence, mortality, and survival disparities: The impact of stage, age, ethnicity, and sex—Surveillance, Epidemiology, and End Results analysis.

e16182 Background: Gallbladder cancer (GBC) is a rare but aggressive malignancy, with survival outcomes influenced by disease stage, patient age, ethnicity, and sex. It is unknown how incidence and survival have evolved over the past decades. This study analyzes long-term trends in GBC incidence, mortality, and survival rates in the United States from 1975 to 2022, using SEER data, including disparities. To our knowledge, no such study has systematically evaluated these trends. Methods: This retrospective cohort study examined trends in GBC incidence and mortality between 1975 and 2022, and 5-year relative survival rates (RSR) for GBC patients diagnosed between 2014 and 2020. Data were stratified by stage (localized, regional, distant, unstaged), age group (< 50, 50-64, 65+ years), ethnicity (White, Black, Asian/Pacific Islander, Hispanic), and sex (female, male). Survival outcomes were reported as 5-year RSRs with standard error (SE), 95% confidence intervals (C.I.), and case counts. The annual percent change (APC) and average annual percent change (AAPC) in incidence and mortality rates were calculated. Statistical significance was determined at p < 0.01. Results: Between 1975 and 2021, GBC incidence rates declined significantly with an APC of -2.4% (95% CI: -2.9% to -2%, p < 0.01), and mortality rates showed a similar decrease of -2.7% (p < 0.01). Localized GBC had an overall 5-year relative survival rate (RSR) of 68%, with younger patients (< 50 years) showing higher survival (91.7%). Regional GBC had a survival rate of 28.2%, with younger patients (41.2%) faring better. Distant GBC had a very low survival rate (3.6%), though patients < 50 years showed slightly better survival (5.9%). Unstaged GBC had an overall survival rate of 17.3%, with patients aged 50-64 showing the highest survival (27%). Ethnic disparities were noted, with White patients showing better survival in localized and regional stages compared to Black and Hispanic/Asian/Pacific Islander patients. For distant GBC, White patients had a 4.2% survival rate, while Black patients had 3.7%. Survival was similar for both sexes in localized GBC (females: 67%, males: 69.5%) and regional GBC (females: 28.4%, males: 27.6%). Distant GBC had extremely low survival rates for both sexes (females: 3.4%, males: 4.2%). Conclusions: This study reveals a significant decline in gallbladder cancer incidence and mortality rates over time, with early-stage diagnosis and younger age associated with better survival. Ethnic and sex disparities highlight the need for tailored interventions to improve outcomes, particularly for high-risk populations. Further research into biological, socioeconomic, and healthcare access factors is essential to understand the factors driving these trends and disparities and improve the outcomes for high-risk populations.

Growing burden of cancer and high body mass index in the United States from 1990-2021: A benchmarking cross-state analysis.

10528 Background: Cancer (CA) remains a major public health challenge and is the second leading cause of death and disability in the United States. Among the various modifiable risk factors, a high body mass index (h-BMI) significantly contributes to the burden of non-communicable diseases, including CA. Methods: This study is the first to estimate deaths and disability attributable to h-BMI for 12 different CA types across the USA, disaggregated by age, sex, year, and location, using the standardized Global Burden of Disease Study 2021 methodology from 1990–2021. Results: From 1990-2021, the annual percentage change (APC) in age-standardized mortality rates (ASMR) due to CA attributable to h-BMI increased by 0.22%, disability-adjusted life years rates (ASDALR) by 0.19%, and years lived with disability rates (ASYLDR) by 0.78%. Among all CA, the highest increase in APC for ASMR was observed for liver CA at 3.81%, followed by pancreatic CA at 2.66%, uterine CA at 1.16%, thyroid CA at 0.84%, multiple myeloma at 0.50%, and kidney CA at 0.35%. Conversely, APC decreased for leukemia by 0.16%, ovarian CA by 0.37%, non-Hodgkin lymphoma by 0.44%, and gall bladder and biliary tract CA by 0.45%, as well as for colon and rectum CA by 0.49%, and breast CA by 0.85%. Among states, Mississippi observed the highest increase in APC for ASMR at 1.21%, followed by Oklahoma at 1.39%, West Virginia at 1.20%, and New Mexico at 1.19%. In terms of ASYLDR, the largest increases were seen in New Mexico at 1.83%, California at 1.77%, Mississippi at 1.74%, West Virginia at 1.60%, and Tennessee at 1.47%. Age-wise, individuals aged 20-54 recorded 3,833 deaths (95% uncertainty interval: 1,727-5,876), while those 55 and older recorded 43,371 deaths (16,854-71,488) in 2021. Similarly, DALYs for ages 20-54 were 173,448 (82,011-258,288), and for those 55 and older were 930,410 (366,885-1,528,824). In terms of gender, males observed higher increases in ASMR and ASDALR compared to females, with 0.58% vs 0.06% and 0.46% vs 0.05%, respectively, while females saw higher increases in ASYLDR at 1.02% compared to 0.86% from 1990-2021. Conclusions: Deaths due to CA attributable to h-BMI accounted for 14.95% of all CA attributable risk factors in 2021. Notably, liver, pancreatic, and uterine CA have shown the most significant rises in ASMR, highlighting an urgent need for targeted public health strategies and research to address these alarming trends. Conversely, decreases in APC for CA like leukemia, ovarian, and breast CA suggest that some progress is being made, possibly attributed to advancements in treatments and early detection programs. Age and gender analyses further illuminate the disproportionate burden of CA on older adults and males, though females exhibit a higher increase in YLDs.

The effect of COVID-19 vaccination on change in contact and implications for transmission.

The effect of COVID-19 vaccination on change in contact and implications for transmission.

Enhanced efficacy of inavolisib combined with anti-PD-1 or anti-HER2 antibody in treating brain metastases from breast cancer.

1108 Background: The PI3K/AKT/mTOR signaling pathway is a crucial regulatory pathway involved in cell proliferation, survival, migration, and metabolism. This dysregulation can occur through various mechanisms, such as PIK3CA gene mutations and PTEN gene loss. The research of PI3K inhibitors has made significant progress in the treatment of ER-positive and HER2-negative breast cancer. Alpelisib is the only approved PI3K inhibitor for treating PIK3CA mutation-positive breast cancer. The SOLAR-1 trial demonstrated that Alpelisib combined with endocrine therapy significantly prolongs progression-free survival in these patients. However, despite improving PFS, the side effects of PI3K inhibitors pose limitations on their widespread application. Consequently, researchers are exploring next-generation PI3K inhibitors with improved safety and efficacy. Inavolisib is a novel, highly selective PI3Kα inhibitor that shows better tolerability and safety compared to existing PI3K inhibitors and has demonstrated promising antitumor effects in clinical trials. Building on this, our study aims to identify the optimal treatment regimen combining Inavolisib with various breast cancer therapies to effectively target brain metastases. Methods: We established a brain metastasis model in C57BL/6 mice by intracardiac injection of control (triple-negative) and hHER2+ Py8119 breast cancer cells. In addition to the Inavolisib monotherapy and vehicle control groups, Inavolisib was combined with a PD-1 antibody or albumin-bound paclitaxel in the triple-negative model. In the HER2+ model, Inavolisib was combined with Tucatinib, trastuzumab, or SHR-A1811 (an ADC drug targeting HER2). We monitored changes in body weight and survival rates in each group and assessed brain metastasis using IVIS small animal in vivo imaging. Results: In the triple-negative model, Inavolisib monotherapy or its combination with albumin-bound paclitaxel reduced intracranial tumor size but did not significantly extend mouse survival. Conversely, the combination of Inavolisib and PD-1 antibody significantly prolonged overall survival in triple-negative breast cancer mice. In the HER2+ breast cancer model, all three combination therapies reduced tumor burden and extended survival compared to monotherapy. However, overall, the combination with trastuzumab achieved unexpectedly good results, which were comparable to SHR-A1811 and superior to Tucatinib. Conclusions: Our findings suggest that the combination of the PI3K inhibitor Inavolisib with anti-PD-1 or anti-HER2 antibody therapy may offer an effective strategy for treating brain metastases in breast cancer. This discovery provides new insights and possibilities for improving treatment options in breast cancer brain metastasis. Further research is needed to validate the efficacy and safety of this combination therapy.

Parasite prevalence in a social host has colony-wide impacts on transcriptional activity and survival

Abstract Parasites pose significant challenges not only to individual hosts but also to entire social groups. We investigated the effects of parasitism by the cestode Anomotaenia brevis on colonies of its intermediate host, the ant Temnothorax nylanderi. We evaluated changes in worker and queen survival rates and transcriptional activity in the fat body of infected and uninfected workers, as well as in the parasite itself, in relation to infected worker prevalence and colony size. Cestode-infected workers are known to exhibit a significantly extended lifespan compared to uninfected workers. Here, we demonstrate that the survival rates of infected workers, uninfected queens, and uninfected workers decrease with increasing infected worker prevalence and increase with colony size. Transcriptomic analysis revealed stress-related signatures in all workers, regardless of infection status, as infection prevalence increased. Moreover, gene expression patterns, particularly in uninfected workers, were strongly influenced by colony size. The transcriptional activity of the parasitic cestode also shifted with infected worker prevalence, highlighting the complex dynamics of host-parasite interactions. These results demonstrate that parasites in social species impose colony-wide impacts that extend beyond infected individuals, even in the absence of direct cross-nestmate infection risks. Moreover, the consequences of parasitism can be modulated by colony size.

Fed rates and movement of bank stocks in India

PurposeThe purpose of this paper is to identify the changes in the stock market prices of banks in India with changes in FED rates in long run.Design/methodology/approachUsing both bivariate granger causality and ANOVA along with binomial logistic regression the influence of changes in FED rates on stock market prices of both major public sector and private sector banks have been derived.FindingsPrivate banks with higher shareholding of Foreign Institutions investors are influenced significantly as compared to public sector banks.Research limitations/implicationsThe changes in FED rates and its influence over the stock prices are related directly to the shareholding pattern of Foreign Institutional Investors. The results suggest that changes in the FED rates have a direct impact on the financial sector stock prices, where a positive relationship is observed.Practical implicationsFor investors this provides a decisive signal for market-related investments in public sector vis-a- vis the private sector banks and for the policy makers this may open the door for policies related to foreign investments as well as policies related to managing liquidity positions.Originality/valueBy using real datasets and granger causality analysis this paper will help in understanding the relationship between the banking stocks in India and changes in FED rates.

Dose-dependent tolerability and safety of transcranial photobiomodulation: a randomized controlled trial.

Transcranial photobiomodulation (t-PBM) with near-infrared (NIR) light has emerged as a promising therapy for major depressive disorder (MDD). However, the dose-dependent tolerability of t-PBM has not been adequately explored. This secondary analysis of a sham-controlled clinical trial evaluated the safety and tolerability of t-PBM across varying doses in 31 subjects with MDD. Participants were randomly assigned to receive four sessions of NIR (808nm) t-PBM (sham, low, medium, and high doses) approximately one week apart. The outcome was the emergence of side effects, assessed by the Systematic Assessment for Treatment-Emergent Effects-Specific Inquiry (SAFTEE-SI) scale. The frequency of side effects, compared to baseline or the prior week, was analyzed using Cochran's Q test. Additionally, body weight and systolic and diastolic blood pressures (SBP and DBP, respectively) were recorded and assessed with repeated measures ANOVA. The results showed no statistically significant changes in rates of any adverse events compared to baseline or prior week. The most notable rate increases were in "delayed or absent orgasm" for the medium dose compared to baseline among 10% of participants (Cochran's Q = 6.231; p = 0.101), and in "ringing in ears or trouble hearing" for the high dose compared to the prior week among 13% of participants (Cochran's Q = 6.231; p = 0.101). There were no significant changes in weight or SBP and DBP (F(4, 85) = 0.277, p = 0.892; F(4, 87.45) = 1.722, p = 0.152; F(4, 87.10) = 1.672, p = 0.164, respectively). In conclusion, this study did not find a significant association between the dose of t-PBM sessions and rates of adverse events or changes in vital signs. The side-effect profile of t-PBM appears benign, regardless of dosimetry.

Pharmaceutical stimulant diversion, 2002–2022: data from a national sample of law enforcement and regulatory agencies in the US

Background Nonmedical use (NMU) and diversion of stimulant medications methylphenidate and amphetamines is ongoing. Yet, data describing national diversion rates are not apparent. Methods Data were drawn from a survey of pharmaceutical diversion completed by law enforcement. Quarterly rates of pharmaceutical stimulant diversion (per 100,000 population) were calculated for the period 2002-2022. Analyses examined changes in diversion rates following the COVID-19 pandemic. Results There were 3,324 methylphenidate cases and 12,875 amphetamine cases reported across all 50 states. Diversion rates were characterized by an increase over time, for methylphenidate (t = 5.91, p < .0001, R 2 = 0.299, β = .001) and amphetamines (t = 11.76, p < .0001, R 2 = 0.628, β = .011). Beginning in 1Q2020, amphetamine diversion rates decreased by half, coinciding with the COVID-19 pandemic. Trendlines prior to 1Q2020 indicate an increase in amphetamine diversion rates over time (t = 16.89, p < .0001, R 2 = 0.801, β = .015). Diversion rates post-1Q2020 similarly show an increase over time (t = 2.99, p = .0151, R 2 = 0.499, β = .026). Conclusions Findings show increases in diversion rates of pharmaceutical stimulants. Since 2020, diversion rates are on a trajectory to exceed pre-pandemic levels. Continued surveillance is warranted.

A Dual Stable Isotope Study of the Effect of Altitude and Simulated Flight on Glucose Metabolism in Type 1 Diabetes: A Randomized Crossover Study.

The effects of acute atmospheric pressure changes on glucose metabolism in type 1 diabetes remain controversial and may have safety implications for pilots and travelers alike. What are the differences in glucose kinetics and hormones between ground and simulated flight environments? Glucose disposal and insulin concentration are increased in response to a meal during flight, without associated changes in endogenous glucose production or meal glucose appearance rates. Pressure-related changes in insulin pump performance and hypoxia may explain these findings. Because glucose concentrations were unaffected, there is no evidence that insulin pump therapy is a risk factor in flight.

Proof of principle concept for the analysis and functional prediction of rare genetic variants in the CYP2C19 and CYP2D6 genes

BackgroundVariations in pharmacogenes that regulate drug absorption, distribution, metabolism, and excretion (ADME) contribute to approximately 20–30% of interindividual differences in drug response. While many common variants are successfully utilized in clinical settings to predict individual drug responses, a significant portion of the genetic basis underlying this variability remains unidentified. This includes rare variants, which are estimated to account for 4–6% of drug response variability.ResultsTo comprehensively elucidate the functional consequences and molecular mechanisms of rare variants, we conducted in vitro enzyme expression studies combined with in silico structure–function analyses. We selected 11 rare variants in the CYP2C19 and CYP2D6 genes identified among participants within the Estonian Biobank. Variant cDNAs were heterologously expressed in HEK-293 cells, and detailed enzyme activity analyses were performed. The experimental results were further validated against average scores from five optimized in silico prediction models: LRT, Mutation Assessor, PROVEAN, VEST3, and CADD. To explore structure–activity relationships, we performed in silico docking of substrates into available 3D enzyme structures. Our findings reveal that most of the rare genetic variants caused significant functional alterations, including: (i) Likely impairments in substrate transport to the active site due to narrowing of access channels; (ii) Changes in catalytic rates; and (iii) Potential effects on substrate extrusion rates from the active site. The in silico prediction tools accurately anticipated the functional impact of 6 out of the 11 variants (54%). ConclusionsEvaluating the functionality of rare variants will become increasingly essential as rapid and cost-effective whole-genome sequencing technologies continue to advance. Our results highlight the need for further refinement of in silico prediction models, particularly those leveraging 3D crystal enzyme structures, to enhance the accuracy of functional predictions for rare genetic variants.