Racial, Ethnic, and Socioeconomic Disparities in Glaucoma Onset and Severity in a Diverse Nationwide Cohort in the United States

PrcisRacial/ethnic minorities are diagnosed with glaucoma at younger ages, and Blacks are more likely to be diagnosed with moderate-to-severe glaucoma. In addition, we highlight a gap in the use of diagnosis codes.PurposeThe purpose of this study was to analyze patterns of diagnosis coding usage and validate epidemiologic patterns of glaucoma onset and severity among primary glaucoma patients within the National Institutes of Health All of Us database.Patients and methodsWe used International Classification of Disease diagnosis codes to build 4 cohorts of patients with mild, moderate, severe, and unspecified stage glaucoma (N=2982). Descriptive analyses were stratified by disease stage, and mean age at diagnosis was compared across racial and ethnic groups. Multivariable ordinal regression was used to examine risk factors for increasing glaucoma severity.ResultsOf 2982 participants, 1714 (57%) had unspecified severity staging. Black/African Americans and other races were diagnosed with glaucoma at significantly younger ages compared with Whites (means 60 and 60 vs. 66 y; P <0.001). Hispanic/Latino participants also had an earlier mean age of diagnosis (61 vs. 65 y; P =0.001). Black/African Americans had higher odds of more severe glaucoma (odds ratio: 2.20, 95% CI, 1.62-3.30; P <0.001) than Whites when adjusting for socioeconomic characteristics.ConclusionsBlack, Hispanic/Latino, and other minority participants are diagnosed with glaucoma at younger ages, and Blacks are more likely to be diagnosed with moderate-to-severe glaucoma. These findings validate prior population-based studies. Furthermore, we observed a gap in the use of diagnosis codes, as only 43% of participants had a specified severity stage in this national cohort. This may have implications for large-scale observational research concerning glaucoma severity, as electronic health records and claims databases typically lack other measures of disease progression, such as imaging and visual field data

The Mystery of Two Straight Lines in Bacterial Genome Statistics. Release 2007

In special coordinates (codon position--specific nucleotide frequencies) bacterial genomes form two straight lines in 9-dimensional space: one line for eubacterial genomes, another for archaeal genomes. All the 348 distinct bacterial genomes available in Genbank in April 2007, belong to these lines with high accuracy. The main challenge now is to explain the observed high accuracy. The new phenomenon of complementary symmetry for codon position--specific nucleotide frequencies is observed. The results of analysis of several codon usage models are presented. We demonstrate that the mean--field approximation, which is also known as context--free, or complete independence model, or Segre variety, can serve as a reasonable approximation to the real codon usage. The first two principal components of codon usage correlate strongly with genomic G+C content and the optimal growth temperature respectively. The variation of codon usage along the third component is related to the curvature of the mean-field approximation. First three eigenvalues in codon usage PCA explain 59.1%, 7.8% and 4.7% of variation. The eubacterial and archaeal genomes codon usage is clearly distributed along two third order curves with genomic G+C content as a parameter.Comment: Significantly extended version with new data for all the 348 distinct bacterial genomes available in Genbank in April 200

Multi-class Breast Cancer Classification Using CNN Features Hybridization

Breast cancer has become the leading cause of cancer mortality among women worldwide. The timely diagnosis of such cancer is always in demand among researchers. This research pours light on improving the design of computer-aided detection (CAD) for earlier breast cancer classification. Meanwhile, the design of CAD tools using deep learning is becoming popular and robust in biomedical classification systems. However, deep learning gives inadequate performance when used for multilabel classification problems, especially if the dataset has an uneven distribution of output targets. And this problem is prevalent in publicly available breast cancer datasets. To overcome this, the paper integrates the learning and discrimination ability of multiple convolution neural networks such as VGG16, VGG19, ResNet50, and DenseNet121 architectures for breast cancer classification. Accordingly, the approach of fusion of hybrid deep features (FHDF) is proposed to capture more potential information and attain improved classification performance. This way, the research utilizes digital mammogram images for earlier breast tumor detection. The proposed approach is evaluated on three public breast cancer datasets: mammographic image analysis society (MIAS), curated breast imaging subset of digital database for screening mammography (CBIS-DDSM), and INbreast databases. The attained results are then compared with base convolutional neural networks (CNN) architectures and the late fusion approach. For MIAS, CBIS-DDSM, and INbreast datasets, the proposed FHDF approach provides maximum performance of 98.706%, 97.734%, and 98.834% of accuracy in classifying three classes of breast cancer severities

Amino Acid Usage Is Asymmetrically Biased in AT- and GC-Rich Microbial Genomes.

INTRODUCTION: Genomic base composition ranges from less than 25% AT to more than 85% AT in prokaryotes. Since only a small fraction of prokaryotic genomes is not protein coding even a minor change in genomic base composition will induce profound protein changes. We examined how amino acid and codon frequencies were distributed in over 2000 microbial genomes and how these distributions were affected by base compositional changes. In addition, we wanted to know how genome-wide amino acid usage was biased in the different genomes and how changes to base composition and mutations affected this bias. To carry this out, we used a Generalized Additive Mixed-effects Model (GAMM) to explore non-linear associations and strong data dependences in closely related microbes; principal component analysis (PCA) was used to examine genomic amino acid- and codon frequencies, while the concept of relative entropy was used to analyze genomic mutation rates. RESULTS: We found that genomic amino acid frequencies carried a stronger phylogenetic signal than codon frequencies, but that this signal was weak compared to that of genomic %AT. Further, in contrast to codon usage bias (CUB), amino acid usage bias (AAUB) was differently distributed in AT- and GC-rich genomes in the sense that AT-rich genomes did not prefer specific amino acids over others to the same extent as GC-rich genomes. AAUB was also associated with relative entropy; genomes with low AAUB contained more random mutations as a consequence of relaxed purifying selection than genomes with higher AAUB. CONCLUSION: Genomic base composition has a substantial effect on both amino acid- and codon frequencies in bacterial genomes. While phylogeny influenced amino acid usage more in GC-rich genomes, AT-content was driving amino acid usage in AT-rich genomes. We found the GAMM model to be an excellent tool to analyze the genomic data used in this study

Hexammineruthenium(III) ion interactions with Z-­DNA

The structure of the complex of the hexanucleotide duplex d(CGCGCA)·d(TGCGCG) with hexammineruthenium(III) ion shows a tautomeric shift in the adenine base and a consequent disruption of the A·T base pair

Healthcare Access and Utilization Among Glaucoma Patients in a Nationwide Cohort

PrcisDespite having lower socioeconomic status on several measures, glaucoma patients do not report more barriers to healthcare access and utilization than non-glaucoma patients.PurposeTo characterize measures of socioeconomic status and barriers to healthcare access and utilization between patients with and without a diagnosis of glaucoma.MethodsPatients aged 65 years and over who enrolled in the NIH All of Us Research Program, a nationwide longitudinal cohort, were extracted. We analyzed demographic information and several measures of socioeconomic status and healthcare access and utilization. Survey responses were compared by glaucoma status (any type) with Pearson χ 2 tests, univariable logistic regression, and multivariable logistic regression adjusting for age, gender, race/ethnicity, and insurance status.ResultsOf the 49,487 patients who answered at least 1 question on the All of Us Healthcare Access and Utilization Survey, 4441 (9.0%) had a diagnosis of glaucoma. Majority of the cohort was female (28,162, 56.9%) and nonHispanic White (42,008, 84.9%). Glaucoma patients were observed to have lower rates of education ( P =0.004), employment ( P <0.001), and home ownership ( P <0.001) on χ 2 tests. On multivariable logistic regression models, those with glaucoma were significantly more likely to speak to an eye doctor (Odds ratio: 2.46; 95% confidence interval: 2.16 to 2.81) and significantly less likely to have trouble affording eyeglasses (OR: 0.85 95% CI: 0.72 to 0.99) in the prior year than those without a diagnosis of glaucoma. No significant association was found for other measures of healthcare access and utilization by glaucoma status.ConclusionAlthough glaucoma patients aged 65 years and over fared worse on several measures of socioeconomic status, no significant difference was found in measures of healthcare access and utilization

Influence of Sacrificial Cathodic Protection on the Chloride Profile in Concrete

The durability of reinforced concrete structures significantly depends on the condition of the steel embedded in them. Structures exposed to chloride containing environment have reduced durability due to corrosion of the reinforcement steel. Several diffusion models have been proposed for chloride penetration. They mainly aim at predicting the initiation of corrosion of the reinforcement. They are based on diffusion conditions influenced by parameters such as relative humidity, temperature, rains etc. This work presents the influence of sacrificial cathodic protection on the chloride profile in concrete. Cathodic protection to the embedded steel in concrete was established by plugging-in a sacrificial magnesium alloy anode at the center of the slab and providing an electrical link between them. The current flowing between the magnesium anode and the embedded steel was regularly measured. The water soluble chloride content at different distances from the anode and at different times was determined after implementation of cathodic protection. The chloride content decreased at different distances from the anode, with increase in time. The diffusion of chloride occurred at a more accelerated rate due to the flow of cathodic protection current

Gender Disparities in Depression, Stress, and Social Support Among Glaucoma Patients

PurposeTo understand differences in measures of depression, stress, and social support by gender among those diagnosed with glaucoma.MethodsWe obtained a cohort of glaucoma patients (any type) ages 18 years and over who answered the COVID-19 Participant Experience (COPE) survey of the NIH All of Us Research Program. We analyzed several measures of depression, stress, and social support by gender. Logistic regression was used to evaluate the association among reported stress associated with social distancing, depression (using Patient Health Questionnaire-9 [PHQ-9] scores), and measures of social support by self-reported gender, with men as the reference group. Multivariable models were adjusted for age, race and ethnicity, health insurance status, education, and income.ResultsOf 3633 glaucoma patients, 56.8% were women. Many patients had a PHQ-9 score > 4 (33.3%), indicating mild, moderate, or severe depression. In multivariable models, women were significantly more likely to report a PHQ-9 score > 4 (odds ratio [OR] = 1.40; 95% confidence interval [CI], 1.20-1.62; P < 0.001) and some or a lot of stress (OR = 1.34; 95% CI, 1.14-1.57; P < 0.001) compared with men. Further, women were significantly less likely to report having help all or most of the time if they needed someone to prepare meals (OR = 0.78; 95% CI, 0.67-0.92; P = 0.002) or perform daily chores (OR = 0.79; 95% CI, 0.67-0.91; P = 0.003) than men.ConclusionsWomen with glaucoma were more likely to experience depression and stress and were less likely to have social support on some measures than men.Translational relevanceThe disproportionate burden of psychosocial factors among women may complicate glaucoma management

Mental health and social support among glaucoma patients enrolled in the NIH All of Us COVID-19 Participant Experience (COPE) survey

BackgroundThe COVID-19 pandemic created many challenges for our society. In this study, we explore how measures of mental health, coping strategies, and social support during the pandemic varied by glaucoma status.MethodsA cohort of patients aged 40 and over enrolled in the NIH All of Us Research Program, a nationwide longitudinal cohort, who answered the COVID-19 Participant Experience (COPE) survey was obtained. We analyzed several measures of mental health, coping strategies, and social support used during the early stages of the COVID-19 pandemic. Surveys were recurring and answered from May 2020 to February 2021. Demographics and the most recently answered survey responses were obtained and stratified by glaucoma status. Pearson's Chi-squared tests and multivariable logistic regressions adjusting for age, gender, race, ethnicity, and income were used to generate p-values, odds ratios (ORs) and 95% confidence intervals (CIs) between outcome measures and glaucoma status.ResultsOf 42,484 patients who responded to All of Us COPE survey items, 2912 (6.9%) had a diagnosis of glaucoma. On Pearson's Chi-squared tests glaucoma patients were less likely to report drinking alcohol (P = 0.003), eating more food than usual (P = 0.004), and using marijuana (P = 0.006) to cope with social distancing than those without a diagnosis of glaucoma. Further, glaucoma patients had lower rates of probable mild, moderate, or severe depression as calculated by Patient Health Questionnaire-9 (PHQ-9) scores (P < 0.001) and had lower rates of reporting some or a lot of stress from social distancing (P < 0.001). However, glaucoma patients were less likely to report having someone to help prepare meals (P = 0.005) or help with daily chores (P = 0.003) if they became sick with COVID-19. In multivariable logistic regression analyses adjusting for confounding factors, no differences were found for measures of mental health or social support.ConclusionsGlaucoma patients did not fare worse on many measures of mental health and coping strategies during the early stages of the COVID-19 pandemic compared those without glaucoma. However, a substantial proportion of glaucoma patients still endorsed stress, social isolation, and probable depression, representing challenges for disease management

Epidemiology and factors associated with cannabis use among patients with glaucoma in the All of Us Research Program

Purpose: To examine the epidemiology and factors of cannabis use among open-angle glaucoma (OAG) patients. Methods: In this cross-sectional study, OAG participants in the All of Us database were included. Cannabis ever-users were defined based on record of cannabis use. Demographic and socioeconomic data were collected and compared between cannabis ever-users and never-users using Chi-Square tests and logistic regression. Odds ratios (OR) of potential factors associated with cannabis use were examined in univariable and multivariable models. Results: Among 3723 OAG participants, 1436 (39%) were cannabis ever-users. The mean (SD) age of never-users and ever-users was 72.9 (10.4) and 69.2 (9.6) years, respectively (P < 0.001). Compared to never-users, Black (34%) and male (55%) participants were better represented in ever-users, while Hispanic or Latino participants (6%) were less represented (P < 0.001). Diversity was also observed in socioeconomic characteristics including marital status, housing security, and income/education levels. A higher percentage of ever-users had a degree ≥12 grades (91%), salaried employment (26%), housing insecurity (12%), and history of cigar smoking (48%), alcohol consumption (96%), and other substance use (47%) (P < 0.001). In the multivariable analysis, Black race (OR [95% CI] = 1.33 [1.06, 1.68]), higher education (OR = 1.19 [1.07, 1.32]), and history of nicotine product smoking (OR: 2.04–2.83), other substance use (OR = 8.14 [6.63, 10.04]), and alcohol consumption (OR = 6.80 [4.45, 10.79]) were significant factors associated with cannabis use. Increased age (OR = 0.96 [0.95, 0.97]), Asian race (OR = 0.18 [0.09, 0.33]), and Hispanic/Latino ethnicity (OR = 0.43 [0.27, 0.68]) were associated with decreased odds of use (P < 0.02). Conclusions: This study elucidated the previously uncharacterized epidemiology and factors associated with cannabis use among OAG patients, which may help to identify patients requiring additional outreach on unsupervised marijuana use