Poisson Distribution Function Research Articles

Risk factors associated with neonatal mortality among neonates admitted to neonatal intensive care unit of the University Teaching Hospital in Lusaka

Globally, several children die shortly after birth and many more of them within the first 28 days of life. Sub-Sharan Africa accounts for almost half (43%) of the global neonatal death with slow progress in reduction. These neonatal deaths are associated with lack of quality care at or immediately after birth and in the first 28 days of life. This study aimed to determine the trends and risk factors of facility-based neonatal mortality in a major referral hospital in Lusaka, Zambia. We conducted retrospective analysis involving all neonates admitted in the University Teaching Hospital Neonatal Intensive Care Unit (UTH-NICU) in Lusaka from January 2018 to December 2019 (N = 2340). We determined the trends and assessed the factors associated with facility-based neonatal mortality using Generalized Linear Models (GLM) with a Poisson distribution and log link function. Overall, the facility-based neonatal mortality was 40.2% (95% CI 38.0–42.0) per 1000 live births for the 2-year period with a slight decline in mortality rate from 42.9% (95% CI 40.0–46.0) in 2018 to 37.3% (95% CI 35.0–40.0) in 2019. In a final multivariable model, home delivery (ARR: 1.70, 95% CI 1.46–1.96), preterm birth (ARR: 1.59, 95% CI 1.36–1.85), congenital anomalies (ARR: 1.59, 95% CI 1.34–1.88), low birthweight (ARR: 1.57, 95% CI 1.37–1.79), and health centre delivery (ARR: 1.48, 95% CI 1.25–1.75) were independently associated with increase in facility-based neonatal mortality. Conversely, hypothermia (ARR: 0.36, 95% CI 0.22–0.60), antenatal attendance (ARR: 0.76, 95% CI 0.68–0.85), and 1-day increase in neonatal age (ARR: 0.96, 95% CI 0.95–0.97) were independently associated with reduction in facility-based neonatal mortality. In this hospital-based study, neonatal mortality was high compared to the national and global targets. The improvement in neonatal survival observed in this study may be due to interventions including Kangaroo mother care already being implemented. Early identification and interventions to reduce the impact of risks factors of neonatal mortality in Zambia are important.

3D Reconstruction with Spherical Cameras

The goal of image-based 3D reconstruction is to establish a high-quality 3D expression from images. In order to achieve a high-resolution and real-time 3D model, inspired by the open source COLMAP, we propose a novel framework (3DMAP) to reconstruct 3D scenes based on spherical cameras. Unlike traditional methods which focus on building a 3D plane by Poisson distribution function, our method illustrates the key processes of 3D reconstruction: locating the camera based on global feature, estimating the scene’s relative depth from monocular panoramic images, and obtaining a high-quality 3D surface reconstruction. In the camera locating part, we use a global descriptor augmentation model to build a labeled panorama dataset GDAP, in which the images are captured by our designed spherical cameras; In the depth estimation part, we propose a new network UMDE that can estimate the depth of both indoor and outdoor scenes; Finally, in the 3D surface reconstruction section, we turn the reconstruction problem to a graph optimization problem, called GraphFit, in which, we optimize the point clouds with s-t graph and smoothing method successively. We conduct experiments on our own dataset to demonstrate the effectiveness of our proposed 3DMAP framework. Experimental results show that our 3DMAP has achieved good evaluation scores and visual effects.

Women's Autonomy and Anemia in Children under Five Years of Age: A Peruvian Population-Based Survey.

To determine the association between women's autonomy and the presence of childhood anemia in children under five years of age in Peru, a cross-sectional study utilizing data from the 2019 Demographic and Family Health Survey was carried out. The study employed generalized linear models with a Poisson distribution and log link function. Crude and adjusted prevalence ratios (aPR) were calculated, along with their corresponding 95% confidence intervals (CI), to assess the association of interest. A total of 15,815 women and their children under five years of age were analyzed. The prevalence of childhood anemia was 30.4% (95%CI: 29.5-31.3%), while the proportions of low, moderate and high autonomy of the mothers were 44.5%, 38.4% and 17.1%, respectively. Children under five years of age of women with a low level of autonomy were more likely to have anemia (aPR: 1.10; 95%CI: 1.00-1.21). Three out of ten children under five years of age suffer from anemia, and four out of ten mothers have a low level of autonomy. A low level of women's autonomy was associated with a higher probability of anemia in children under 5 years of age.

Effects of pathogen-specific clinical mastitis occurrence in the first 100 days of lactation 1 on future mastitis occurrence in Holstein dairy cows: An observational study

The objective of this observational study was to estimate effects of clinical mastitis (CM) cases caused by different pathogens (Streptococcus spp., Staphylococcus aureus, Staphylococcus spp., Escherichia coli, Klebsiella spp., and CM cases with no growth) occurring in the first 100 d in lactation 1, of a dairy cow on the future rate of occurrence of different types of CM during a cow's full lifetime. The outcomes were occurrence of Streptococcus spp., Staphylococcus aureus, Staphylococcus spp., Escherichia coli, Klebsiella spp., and CM cases with no growth, after the first 100 d of lactation 1, until a cow's removal through death or sale in that or a subsequent lactation. Data, including information on CM cases, milk production, and event dates (including death or sale dates), were collected from 14,440 cows in 5 New York State Holstein herds from January 2004 until February 2014. Generalized linear mixed models with a Poisson distribution and log link function were fit for each pathogen. The individual cow was the unit of analysis. Escherichia coli was a predictor of future occurrence of E. coli, Klebsiella spp., and CM cases with no growth. Early-occurring Klebsiella spp. was a predictor of future cases of Klebsiella spp. Cases with no growth were predictors of future occurrence of Staphylococcus spp., E. coli, Klebsiella spp., and cases with no growth. Thus, E. coli and cases with no growth occurring early in lactation 1 appear to be consistent risk factors for future cases of CM, whether cases with the same pathogen or a different pathogen. In this study, farm effects on later pathogen occurrence differed somewhat, so treatment protocol and culling strategy may play a role in the findings. Nevertheless, the findings may help farmers in managing young cows with CM in early productive life, especially those with E. coli or cases with no growth, in that they may be more susceptible to future CM cases in their later productive life, thus meriting closer attention.

A Clinical Measure of Trunk Neuromuscular Function Predicts Falling in Older Adults With Chronic Low Back Pain.

Older adults with low back pain (LBP) are at risk for falling, but condition-specific mechanisms are unknown. Trunk neuromuscular function is critical for maintaining balance during mobility tasks and is often impaired in older adults with LBP. The purpose of this study was to assess whether aberrant lumbopelvic movements (or aberrant movements), a clinical index of trunk neuromuscular function, were associated with increased fall risk among older adults with chronic LBP over a 12-month follow-up period. This study analyzed data from a prospective cohort study of 250 community-dwelling older adults with chronic LBP. Participants were screened for 4 aberrant movements during 3 trials of forward flexion from a standing position: instability catch, painful arc, altered lumbopelvic rhythm, and Gower's sign. Aberrant movements were totaled to yield a summary score (ie, 0-4). Prospective falls were monitored via monthly fall calendars for 12 months. A generalized linear model with Poisson distribution and log link function was used to evaluate the association between aberrant movements and prospective fall risk. Age, sex, body mass index, LBP intensity, dynamic balance performance, prior falls, anxiolytic medication usage, and hip osteoarthritis characteristics were included as covariates in the model. Baseline aberrant movements were independently associated with greater fall risk (risk ratio = 1.249, 95% CI = 1.047-1.491, P = .014); each 1-unit increase in aberrant movement score imparted a 24.9% increase in the risk of falling. Aberrant movements increased the risk of falling among older adults with chronic LBP over a 1-year span.

Analysis of the Effects of COVID-19 on Hip Fractures in Korea Without Lockdown: Interrupted Time Series Analysis Using a Nationwide Cohort.

The purpose of this study was to investigate the change in the incidence rate, length of hospital stay (LOS), in-hospital mortality rate, and surgical method of hip fractures during the coronavirus disease 2019 (COVID-19) pandemic in South Korea where lockdown restrictions were not implemented. We calculated the expected values of the incidence of hip fractures, in-hospital mortality and LOS of hip fracture patients in 2020 (COVID period) based hip fracture database of the Korean National Health Insurance Review and Assessment (HIRA) during a 9-year period from 2011 to 2019 (pre-COVID period). A generalized estimating equation model with Poisson distribution and logarithmic link function was used to estimate adjusted annual percent change (PC) of incidence rate and 95% confidence intervals (CIs). Then, we compared the annual incidence, in-hospital mortality rate and LOS in 2020 with the expected values. The overall incidence rate of hip fracture in 2020 was not significantly different from the expected value (PC, -5%; 95% CI, -13 to 4; P = 0.280). In women, the incidence rate of hip fracture in age groups over 70 years was smaller than the predicted value (P < 0.001). The in-hospital mortality rate was not significantly different from the expected value (PC, 5%; 95% CI, -8 to 19; P = 0.461). The mean LOS was larger than the expected value by 2% (PC, 2%; 95% CI, 1 to 3; P < 0.001). In intertrochanteric fracture, the proportion of internal fixation was smaller than the predicted value by 2% (PC, -2%; 95% CI, -3 to -1; P < 0.001), and that of hemiarthroplasty was larger than the predicted value by 8% (PC, 8%; 95% CI, 4 to 14; P < 0.001). In 2020, the incidence rate of hip fracture did not significantly decrease, and in-hospital mortality rate did not significantly increase compared to the expected rates, which were projected based on the HIRA hip fracture data from 2011 to 2019. Only LOS increased slightly.

Impact of cardiovascular events on primary and hospital care costs: findings from UK Biobank study

Abstract Background Need for primary and secondary healthcare increases following cardiovascular disease (CVD) events but there is no data on comparative increases in costs. Purpose To estimate annual primary care and hospital inpatient costs associated with key CVD and other adverse events using the UK Biobank (UKB) individual participant data. Methods UKB participants with linked primary care data (192,983 participants) or hospital inpatient episodes data (all 501,807 participants) contributed data to this study. The three categories of primary care services (patient consultations, diagnostic and monitoring tests, prescription medications), and hospital episodes were costed (2020 UK£) using the NHS England reference costs. Annual primary care costs and, separately, annual hospital inpatient costs were modelled as functions of participant characteristics at entry (socio-demographic, clinical, prior diseases) and time-updated first occurrences of myocardial infarction, stroke, coronary revascularization, incident cancer, incident diabetes, vascular death and non-vascular death during follow-up (p-value &amp;lt;0.01 in stepwise covariate selection). One-part generalized linear regression model (GLM) with Poisson distribution and identity link function was used for primary care costs, and two-part model was used for inpatient costs (part 1: logistic regression models probability of incurring costs; part 2: GLM with Poisson distribution and identity link function models costs conditional on incurring any). Separate models were fitted among participants with and without previous CVD at entry into UKB. Results Most adverse events were associated with excess primary care and hospital inpatient costs. Compared to people without previous CVD, people with previous CVD had on average larger excess primary care and hospital inpatient costs in years with myocardial infarction, stroke and vascular death; but similar excess costs in years with other events. Among both people without and with previous CVD, the excess annual primary care costs were less than 7% of the excess annual hospital inpatient costs for vascular events (Table). However, following diabetes diagnosis the excess annual primary care costs were higher than the excess annual hospital inpatient costs (Table). Conclusions These excess primary and hospital care costs associated with CVD events could inform assessments of interventions and policies to reduce CVD risks in UK. Funding Acknowledgement Type of funding sources: Public grant(s) – National budget only. Main funding source(s): UK National Institute for Health Research (NIHR) Health Technology Assessment (HTA) Programme, UK Medical Research Council (MRC), British Heart Foundation

Association between air pollutants and neural tube defects during pregnancy in Lanzhou, China: a time series analysis.

Few studies have evaluated the association between air pollutants and neural tube defects (NTDs). Moreover, the existing research ignores the lag effect of air pollution on health and provides inconsistent epidemiological evidence. We aim to estimate the association between air pollution and NTDs during the first trimester of pregnancy and identify specific susceptible windows. Birth data was collected from the Birth Defects Surveillance Network in Lanzhou from September 1, 2014, to December 31, 2019. Air quality and meteorological data were collected from ambient air monitoring stations and China Meteorological Data Network. The log connection function of the Poisson distribution function is used to establish a DLNM model to estimate the exposure-effect relationship and exposure-lag relationship association between air pollutants levels and NTDs. There were 320,787 perinatal infants in Lanzhou from September 1, 2014, to December 31, 2019, and 486 cases of NTDs (1.5‰). The result indicates that exposure to inhalable particles (PM10) at lag 2-4 weeks was significantly associated with the risk of NTDs, with the most significant impact at the lag 2 week (RR=1.048, 95%CI, 1.015-1.084). Exposure to fine particulate matter (PM2.5)at the lag 2 weekwas significantly associated with the risk of NTDs, with the most significant impact at the lag 2 week (RR=1.077, 95%CI, 1.004-1.155). Exposure to sulfur dioxide (SO2) andnitrogen dioxide (NO2)at lag 3-6weeks was significantly associated with the risk of NTDs, with the most significant impact at the lag 4 week (RR=1.220, 95%CI, 1.105-1.348; RR=1.143, 95%CI, 1.048-1.245). This study provides further evidence that exposure to air pollutants in the first trimester of pregnancy significantly increases the risk of neural tube defects.

Gender, race/skin colour and incidence of hypertension in ELSA-Brasil: an intersectional approach

ABSTRACT Objective Race and gender inequities in the incidence of hypertension (HTN) are well documented; however, few empirical investigations looked into these associations, considering the synergies and heterogeneous experiences of intersectional gender and race/skin colour groups. This study investigated the association of intersectional identities defined by gender and race/skin colour with HTN incidence, and verified whether they are affected by educational level in adulthood. Design We used the Longitudinal Study of Adult Health (ELSA-Brasil) data to estimate the incidence of HTN between visits 1 (2008–2010) and 2 (2012–2014), in 8528 participants without hypertension at visit 1. HTN was defined as systolic blood pressure ≥140 mmHg, or diastolic blood pressure ≥90 mmHg, or use of antihypertensive drugs. Generalized linear models with Poisson distribution and log link function were used to assess the associations. Results The incidence of HTN was 43.4/1000 person-years, ranging from 30.5/1000 in White women to 59.4/1000 in Black men. After adjusting by age and family history of HTN, the incidence rate ratio (IRR) was higher in Black men (2.25; 95%CI: 1.65–3.08), Brown (Pardo) men (1.89; 95%CI: 1.59–2.25), Black women (1.85; 95%CI: 1.50–2.30), Brown (Parda) women (1.47; 95%CI: 1.31–1.67) and White men (1.76; 95%CI: 1.49–2.08), compared to White women. These associations were maintained even after considering socioeconomic, behavioural and health mediators in the model. No interaction was found between education level and intersectional identities in the IRRs observed. Conclusion By using an intersectional approach, we showed the complex relations between race/skin colour and gender inequities in the incidence of HTN, pointing not only that Black men have the highest risk of developing HTN, but also that the risk of HTN is greater in Black women than in White men, when compared to White women.

Anatomical Substract of the Temporal Muscle Myofascial Trigger Points in Fresh Cadavers

BackgroundMyofascial syndrome is a common cause of chronic musculoskeletal pain and is characterized by myofascial trigger points (MTPs). MTPs are clinically identified by palpation of a muscle or fascial taut band. Although pathophysiology of MTPs remains unclear, coincidence between them and muscle motor plate at the innervation zone (IZ) have been reported. The temporal muscle is related to headache and temporomandibular disorders and pain radiates from hyperalgesic points to distant areas symptomatic patients. Clinical reports usually describe four trigger points located in the temporal muscle and we aimed to identify anatomical correlation with muscle innervation.MethodsWe dissected the temporal muscles from five fresh cadavers to observe the exact point where nerve fibers penetrated the muscle belly. As muscle size varies among individuals, we calculated the relative entry point of the nerve into the muscle by defining six different areas in the muscle belly: three superior (I, II and III) and three inferior (IV, V and VI), beginning at the posterior margin of the muscle. Statistical analysis of anatomical data was obtained by Poisson distribution and logarithm link function followed by Bonferroni multiple comparisons. The comparison of points between the sides was made by Student’s t‐test. IBM‐SPSS for Windows version 20.0 software was used to perform the analysis, and Microsoft Excel 2003 software was used to tabulate the data. Data are presented as the mean ± standard deviation, and the level of significance was adjusted to 5% (p &lt;0.05) for all tests.ResultsThe number of temporal nerve branches did not differ between sides. Areas II and V had the largest number of temporal nerve entry sites, with a mean of 3 (22%) and 5 (36%) points, respectively. Areas III and VI had a mean of 2 sites both (14%) and areas I and IV, one (7%).ConclusionIn accordance with the clinical literature, the branches of the temporal nerve in the temporal muscle corresponded to the described areas of the myofascial trigger points (MTPs). Anatomical correlations between MTPs may be a useful tool for a better understanding of the physiopathology of these disorders and may provide a rational basis for their treatment.

Innervation of Gluteus Medius Muscle and its Relationship with Myofascial Pain

Myofascial pain syndrome (MPS) is the most frequent cause of chronic musculoskeletal pain. According to the International Association for the Study of Pain, diagnosis of chronic pain due to MPS is based mostly on demonstration of trigger points and reproduction of pain by maneuvers which place stress upon proximal structures or nerve roots. The lack of a formal, widely accepted, criterion‐based diagnostic guideline hampers adequate management of this disorder. The gluteus medius muscle is a primary stabilizer of the pelvis during gait and myofascial disorders result in increased sensitivity, spontaneous pain, and weakness in the leg abduction. Also, MTPs of the gluteus medius muscle are common features of patellofemoral and low back pain. Three trigger points are described for the gluteus medius muscle: anterior, middle and posterior, but anatomical correlation is still lacking.MethodsGluteus medius muscles from ten adult cadavers were dissected to determine the point where the superior gluteal nerve branches enter the muscle belly. We divided the muscle in four areas (I to IV) obtained by two perpendicular lines; a longitudinal line was determined by the highest muscle attachment in the iliac crest and the great trochanter of the femur, and the transversal line was traced at the midpoint of the longitudinal line. To compare the number of points among quadrants, we employed generalized estimation equations with correlation matrix exchangeable between pairs of quadrants, with marginal Poisson distribution and identity link function. To compare quadrants, we used 2 to 2 multiple Bonferroni comparisons. Clinically, we examined 24 patients presenting with and without pain at the gluteal region and obtained the level of painful sensitivity with the digital pressure pain meter (Force Ten FDX Digital Force Cage‐Wagner Instruments, Greenwich‐ EUA). Twenty measurements were obtained for each muscle totaling 960 measurements in the patients group. Measurements were taken in five distinct points in all areas corresponding to the estimated quadrants defined by the same landmarks used during anatomical dissections. The algometer measures the lowest pressure to produce pain, thus the lowest numbers represent the highest pain sensitivity.Results. The total number of superior gluteal nerve entry points was 3±2; 2±2; 1±2 and 3±2 for quadrants I, II, III, and IV respectively. Algometer values were 5.10±2.7; 5.14±2.56; 5.29±2.8 and 5.50±2.79 for quadrants I, II, III and IV respectively. In quadrant I the patients showed greater sensitivity with the algometer and it is a quadrant that presented the largest number of nerves penetrating the muscle, the same occurring for quadrant 2. Quadrant 3 that presented the smallest number of nerves penetrating the muscle obtained a higher value for the algometer.ConclusionAnatomical correlation of the MTP may be useful for a better understanding of the physiopathology of these disorders and provide basis for their treatment.

Anatomical Study of the Innervation of the Fibularis Longus (FL) Muscle and its Correlation with Miofascial Trigger Points: Preliminary Results

BackgroundMyofascial syndrome is a common cause of chronic musculoskeletal pain and results in dysfunction of the affected muscles. It is characterized by myofascial trigger points (MTPs) which are clinically identified by palpation of a muscle or fascial taut band. Previous publications have found MTPs to coincide with neuromuscular junctions at the innervation zone (IZ). The fibularis longus syndrome is one of the most frequent myofascial syndrome of the lower limbs and occurs due to a wide variety of etiologies, most commonly, overuse and ankle sprain. Referred pain and tenderness caused by the trigger points of the FL muscle are located above, behind and below the lateral malleolus and may extend along the lateral aspect of the foot and leg.ObjectiveOur study aimed to correlate the innervation of the FL muscle to clinically described MTPs.MethodsFL muscles from five cadavers were dissected to observe the exact point where nerve fibers penetrated the muscle belly. As muscle size varies among individuals, we describe the relative entry point of the nerve into the muscle by defining four different areas in the muscle belly: two superior (I, II) and two inferior (III and IV). Statistical analysis of anatomical data was obtained by Poisson distribution and logarithm link function followed by Bonferroni multiple comparisons.ResultsWe found a mean of 12 branches of the superficial fibular nerve to the FL muscle. All of them were located into the areas I (67%) and II (33%). No branches were observed in areas III and IV. Our findings corresponded to previously described MTPs.ConclusionAnatomical correlation between MTPs may be a useful tool for a better understanding of the physiopathology of these disorders and may provide a rational basis for their treatment.

The Prevalence of Clostridium difficile Colitis and Effect on All-Cause Mortality in Elderly Patients after Hip Fracture Surgery: A Korean Nationwide Cohort Study.

This study aimed to investigate the prevalence of Clostridium difficile colitis (CDC) in elderly patients with hip fractures using a nationwide cohort database and to analyze the effect of CDC on the all-cause mortality rate after hip fracture. This retrospective nationwide study identified subjects from the Korean National Health Insurance Service-Senior cohort. The subjects of this study were patients who were over 65 years old and underwent surgical treatment for hip fractures from January 1, 2002, to December 31, 2015. The total number of patients included in this study was 10,158. The diagnostic code used in this study was A047 of the International Classification of Diseases, 10th revision for identifying CDC. Procedure codes for C. difficile culture or toxin assay were BY021 and BY022. CDC patients were defined as follows: patients treated with oral vancomycin or metronidazole over 10 days and patients with procedure codes BY021 and BY022 or diagnostic code A047 after hip fracture. Incidence date (index date, time zero) of hip fracture for analyzing risk of all-cause mortality was defined as the date of discharge. A generalized estimating equation model with Poisson distribution and logarithmic link function was used for estimating adjusted risk ratios and 95% confidence intervals to assess the association between CDC and cumulative mortality risk. The prevalence of CDC during the hospitalization period in the elderly patients with hip fractures was 1.43%. Compared to the non-CDC group, the CDC group had a 2.57-fold risk of 30-day mortality after discharge, and a 1.50-fold risk of 1-year mortality after discharge (p < 0.05). The prevalence of CDC after hip fracture surgery in elderly patients was 1.43%. CDC after hip fracture in the elderly patients significantly increased the all-cause mortality rate after discharge.

Landscape alteration affects the demography of an endangered avian predator by reducing the habitat quality

Habitat transformation is identified as major threat to biodiversity loss globally, affecting threatened raptors. Changes in land use can alter the abundance and distribution of birds of prey by affecting habitat availability and quality. In this study, we used multivariate analyses to investigate the effect of habitat alteration on the demography of a declining Eastern Imperial Eagle (Aquila heliaca), making assumptions for future population trajectories. We used the Generalized Linear Mixed Models with Poisson distribution and Log link function, searching a relationship between the demographic parameters and the landscape structure and possible effects of fragmentation. In our study area, habitat change affected dramatically permanent grasslands, shrinking their availability. As we expected, the share of grasslands in eagles’ territories significantly affected occupancy rate, but not productivity and breeding frequency. We found that occupancy rate decreased significantly, while productivity and breeding frequency showed no trend. Modeling the effect of habitat alteration on Eastern Imperial Eagle demography, we found out that territory quality was a more powerful factor driving the response of a top predator to the alteration of favorite foraging habitats. Only the habitat quality in source territories had a significant positive effect on eagle productivity. We found that simple rules to predict adverse agricultural impact on territory abandonment or breeding productivity of a top predator were not reliable. Our results could be used for planning conservation of other large territorial raptors, facing the same type of threat.

Diabetes mellitus, maternal adiposity, and insulin-dependent gestational diabetes are associated with COVID-19 in pregnancy: the INTERCOVID study

BackgroundAmong nonpregnant individuals, diabetes mellitus and high body mass index increase the risk of COVID-19 and its severity.ObjectiveThis study aimed to determine whether diabetes mellitus and high body mass index are risk factors for COVID-19 in pregnancy and whether gestational diabetes mellitus is associated with COVID-19 diagnosis.Study DesignINTERCOVID was a multinational study conducted between March 2020 and February 2021 in 43 institutions from 18 countries, enrolling 2184 pregnant women aged ≥18 years; a total of 2071 women were included in the analyses. For each woman diagnosed with COVID-19, 2 nondiagnosed women delivering or initiating antenatal care at the same institution were also enrolled. The main exposures were preexisting diabetes mellitus, high body mass index (overweight or obesity was defined as a body mass index ≥25 kg/m2), and gestational diabetes mellitus in pregnancy. The main outcome was a confirmed diagnosis of COVID-19 based on a real-time polymerase chain reaction test, antigen test, antibody test, radiological pulmonary findings, or ≥2 predefined COVID-19 symptoms at any time during pregnancy or delivery. Relationships of exposures and COVID-19 diagnosis were assessed using generalized linear models with a Poisson distribution and log link function, with robust standard errors to account for model misspecification. Furthermore, we conducted sensitivity analyses: (1) restricted to those with a real-time polymerase chain reaction test or an antigen test in the last week of pregnancy, (2) restricted to those with a real-time polymerase chain reaction test or an antigen test during the entire pregnancy, (3) generating values for missing data using multiple imputation, and (4) analyses controlling for month of enrollment. In addition, among women who were diagnosed with COVID-19, we examined whether having gestational diabetes mellitus, diabetes mellitus, or high body mass index increased the risk of having symptomatic vs asymptomatic COVID-19.ResultsCOVID-19 was associated with preexisting diabetes mellitus (risk ratio, 1.94; 95% confidence interval, 1.55–2.42), overweight or obesity (risk ratio, 1.20; 95% confidence interval, 1.06–1.37), and gestational diabetes mellitus (risk ratio, 1.21; 95% confidence interval, 0.99–1.46). The gestational diabetes mellitus association was specifically among women requiring insulin, whether they were of normal weight (risk ratio, 1.79; 95% confidence interval, 1.06–3.01) or overweight or obese (risk ratio, 1.77; 95% confidence interval, 1.28–2.45). A somewhat stronger association with COVID-19 diagnosis was observed among women with preexisting diabetes mellitus, whether they were of normal weight (risk ratio, 1.93; 95% confidence interval, 1.18–3.17) or overweight or obese (risk ratio, 2.32; 95% confidence interval, 1.82–2.97). When the sample was restricted to those with a real-time polymerase chain reaction test or an antigen test in the week before delivery or during the entire pregnancy, including missing variables using imputation or controlling for month of enrollment, the observed associations were comparable.ConclusionDiabetes mellitus and overweight or obesity were risk factors for COVID-19 diagnosis in pregnancy, and insulin-dependent gestational diabetes mellitus was associated with the disease. Therefore, it is essential that women with these comorbidities are vaccinated.

Abstract 11257: Intersection Between Race and Gender in the Incidence and Control of Hypertension in ELSA Brasil

Background: Few investigations examined the associations of race and gender with the incidence and control of hypertension (HTN) considering the synergies and heterogeneous experiences of intersectional groups. Hypothesis: HTN incidence and inadequate blood pressure (BP) control is higher in black men and women, brown men, and women, compared to their white counterparts. Inequalities are more pronounced in higher education vis-a-vis lower education group. Methods: Using data from the ELSA-Brasil, 6 intersectional groups of race/gender were identified: white, brown, and black men and women. We calculated by intersectional category: the HTN incidence between baseline (2008-2010) and visit 2 (2012-2014) in 8,528 individuals free of HTN or cardiovascular disease at baseline; and inadequate BP control prevalence in 4,571 individuals with drug treated HTN at visit 2. Generalized linear models with Poisson distribution and logarithmic link function were used. Results: After age and HTN family history adjustment, the HTN risk was higher in black men (IDR:2.25; 95%CI:1.65-3.08), brown men (IDR:1.89; 95%CI:1.59-2.25), black women (IDR:1.85; 95%CI:1.50-2.30), brown women (IDR:1.47; 95%CI:1.31-1.67), and white men (IDR:1.76; 95%CI:1.49-2.08) compared to white women. All associations remained significant in fully-adjusted models for sociodemographic, behavioral and health conditions The association between intersectional categories and inadequate BP control varied according to education level in fully-adjusted models: 1) in lower education participants, white men (PR:1.70; 95%CI:1.42-2.04), brown men (PR:1.67; 95%CI:1.43-1.94), black men (PR:1.60; 95%CI:1.37-1.87), and black women (PR:1.28; 95%CI:1.00-1.64) had worse BP control than white women; 2) in higher education participants, only black men (PR:1.55; 95%CI:1.08-2.22) and women (PR:1.49; 95%CI:1.05-2.13) showed worse control than white women. Conclusion: Our findings reinforce previous studies regarding the higher risk of HTN and worse BP control in black men, but also reveal that the intersectional approach accentuates the heterogeneity in the incidence and control of HTN, evidencing specific experiences of socially marginalized groups, especially that of black women.

Simulation of Two-Dimensional Images for Ion-Irradiation Induced Change in Lattice Structures and Magnetic States in Oxides by Using Monte Carlo Method

A Monte Carlo method was used to simulate the two-dimensional images of ion-irradiation-induced change in lattice structures and magnetic states in oxides. Under the assumption that the lattice structures and the magnetic states are modified only inside the narrow one-dimensional region along the ion beam path (the ion track), and that such modifications are affected by ion track overlapping, the exposure of oxide targets to spatially random ion impacts was simulated by the Monte Carlo method. Through the Monte Carlo method, the evolutions of the two-dimensional images for the amorphization of TiO2, the lattice structure transformation of ZrO2, and the transition of magnetic states of CeO2 were simulated as a function of ion fluence. The total fractions of the modified areas were calculated from the two-dimensional images. They agree well with the experimental results and those estimated by using the Poisson distribution functions.

Assessing glass‐ceramic homogeneity and nucleation self‐correlation by crystallization statistics

AbstractIn this work, we implemented and tested a statistical method to evaluate the microstructural uniformity of partially crystallized glasses employing the aggregation index (R‐index), a parameter derived from the Poisson distribution function, which has mainly been used in Ecology studies. Since the crystal nucleation rate strongly depends on the chemical composition, the spatial crystal distribution in glass‐ceramics can be used to infer their chemical homogeneity. We also tested the hypothesis, advanced by some authors, of preferential secondary nucleation close to preexisting crystals (even in chemically homogeneous samples). To this end, we conducted a nearest‐neighbor statistical analysis of the spatial crystal distribution in partially crystallized Li2Si2O5 and Ba5Si8O21 glasses, used as model materials, by inspecting optical micrographs obtained at different magnifications. The resultant R‐indexes indicate a very high degree of homogeneity of the crystal number distribution, reflecting the uniform distribution of the chemical elements in the parent glasses. Moreover, the results for both glasses refute the suggestion that crystal nucleation is self‐correlated. These outcomes allow us to suggest the R‐index as a valuable and easily implemented tool to evaluate the chemical homogeneity of glasses that undergo internal nucleation, such as those used for glass‐ceramics.

Hip osteoarthritis signs and symptoms are associated with increased fall risk among community-dwelling older adults with chronic low back pain: a prospective study

BackgroundOlder adults with concurrent low back and hip pain are predisposed to reductions in physical performance and health-related quality of life. Yet no study to date has assessed whether or not coexisting hip impairments increase fall risk in older adults with chronic low back pain (CLBP). The objective of this study was to determine if hip osteoarthritis (OA) signs and symptoms per American College of Rheumatology (ACR) criteria are associated with fall risk over a 1-year span.MethodsFalls were prospectively monitored for 1 year via fall calendars. Age, sex, body mass index (BMI), anxiolytic use, balance confidence, LBP-related disability, and prior fall history were identified as covariates. Hip pain, pain with hip internal rotation (IR), hip IR range of motion (ROM) ≥ 15°, and morning stiffness lasting ≤ 60 min were evaluated at baseline and summed to represent hip OA impairment burden. A generalized linear model with a Poisson distribution and log link function assessed the association between ACR criteria and fall risk beyond established covariates. As a secondary analysis, binary logistic regression assessed ACR criteria and the odds of falling two or more times within a year.ResultsData from two-hundred and ten participants were analyzed. Hip OA signs and symptoms were present in 97.1% of the participants, and hip OA impairment burden was significantly greater (p < 0.050) in participants who fell ≥ 2 times compared to single and non-fallers. Higher hip OA impairment burden was associated with significantly increased fall risk (p = 0.001, risk ratio = 1.23, 95% CI 1.09–1.38) and odds of falling multiple times (p < 0.05, odds ratio = 1.41, 95% CI 1.01–1.95) after adjustment for covariates.ConclusionsOlder adults with CLBP and concomitant hip impairments are an at-risk group for falling. Healthcare professionals should employ falls screening and preventive measures to avoid negative sequelae in this vulnerable population.

Correlates of HPV Vaccination Intentions Among Adults Ages 27-45 Years Old in the U.S.

HPV vaccine is recommended for 27-45year olds in the U.S. based on a shared clinical decision. This study examined knowledge, attitudes, and beliefs of adults 27-45years old and the association with the likelihood of asking a healthcare provider about the HPV vaccine and the likelihood of getting the HPV vaccine. We conducted a cross-sectional survey of U.S. adults aged 27-45years between April-May 2020 (n = 691). Primary outcomes were likelihood of asking their provider about the HPV vaccine and likelihood of getting the HPV vaccine. Demographic variables, knowledge, attitudes, and beliefs were covariates. Adjusted models were estimated for each outcome variable with a Poisson distribution and log function. More than half (55.7%) were likely to ask their provider about the HPV vaccine, but less than half (42.9%) were likely to get the HPV vaccine. Likelihood of asking their provider about the HPV vaccine was significantly associated with perceived likelihood of benefitting from the vaccine (aOR = 2.45; 95%CI = 1.69-3.57). Likelihood of receiving the vaccine was associated with attitudes (aOR = 1.04; 95%CI = 1.01-1.07), perceived effectiveness against HPV infection (aOR = 4.03; 95%CI = 1.20-13.53), and perceived likelihood of benefitting from the vaccine (aOR = 4.31; 95%CI = 2.64-7.03). Our findings suggest increasing positive attitudes, perceived effectiveness against infection, and perceived likelihood of benefitting from the vaccination are important factors to address when facilitating a shared clinical decision for HPV vaccination. Understanding factors associated with likelihood of discussing and receiving the HPV vaccine among people aged 27-45years is important to successfully implement the guidelines for shared clinical decision-making.