Trends in outpatient and inpatient visits for separate ambulatory-care-sensitive conditions during the first year of the COVID-19 pandemic: a province-based study

BackgroundThe COVID-19 pandemic led to global disruptions in non-urgent health services, affecting health outcomes of individuals with ambulatory-care-sensitive conditions (ACSCs).MethodsWe conducted a province-based study using Ontario health administrative data (Canada) to determine trends in outpatient visits and hospitalization rates (per 100,000 people) in the general adult population for seven ACSCs during the first pandemic year (March 2020–March 2021) compared to previous years (2016–2019), and how disruption in outpatient visits related to acute care use. ACSCs considered were chronic obstructive pulmonary disease (COPD), asthma, angina, congestive heart failure (CHF), hypertension, diabetes, and epilepsy. We used time series auto-regressive integrated moving-average models to compare observed versus projected rates.ResultsFollowing an initial reduction (March–May 2020) in all types of visits, primary care outpatient visits (combined in-person and virtual) returned to pre-pandemic levels for asthma, angina, hypertension, and diabetes, remained below pre-pandemic levels for COPD, and rose above pre-pandemic levels for CHF (104.8 vs. 96.4, 95% CI: 89.4–104.0) and epilepsy (29.6 vs. 24.7, 95% CI: 22.1–27.5) by the end of the first pandemic year. Specialty visits returned to pre-pandemic levels for COPD, angina, CHF, hypertension, and diabetes, but remained above pre-pandemic levels for asthma (95.4 vs. 79.5, 95% CI: 70.7–89.5) and epilepsy (53.3 vs. 45.6, 95% CI: 41.2–50.5), by the end of the year. Virtual visit rates increased for all ACSCs. Among ACSCs, reductions in hospitalizations were most pronounced for COPD and asthma. CHF-related hospitalizations also decreased, albeit to a lesser extent. For angina, hypertension, diabetes, and epilepsy, hospitalization rates reduced initially, but returned to pre-pandemic levels by the end of the year.ConclusionThis study demonstrated variation in outpatient visit trends for different ACSCs in the first pandemic year. No outpatient visit trends resulted in increased hospitalizations for any ACSC; however, reductions in rates of asthma, COPD, and CHF hospitalizations persisted

Hubungan Status Gizi Dengan Usia Menarche Pada Remaja Putri Di SMP Negeri 6 Tidore Kepulauan

. Background : Adolescence isatransition periodbetweenchildhoodandadulthood,is a time ofphysical maturity, cognitive, social andemotional. In young women, pubertyis oftenmarked bymenarche.Menarcheisthefirstmenstruationoccurs, whichis the hallmark ofmaturity ofa woman who ishealthyandnot pregnant. Menarcheusuallyoccurs at age11-13years. There are manyfactors that affectthe age ofmenarche,one of them isnutritionalstatus. This research was aimed to know the relationship nutritional status with age of menarche in young women at 6 Junior High School of Tidore Islands. The research methodsanalytical survey usingcross sectionaldesign. This research was conducted in 6 Junior High School of Tidore Islands on November 30 - December 8, 2015. Population is 97 students.Sampling technique is the total sampling with a sample size of 97 students. The instrument of this research used questionnaire, scales and height measuring devices.The data analysis is done with using the chi-square test, at the 95% significance level (á 0.05) showed the value of ñ=0.000, this value is smaller than á = 0.05. Conclusion : there is a relationship of nutritional status with age of menarche in young women at 6 Junior High School of Tidore Islands.Advice for young women to maintain normal nutritional status to achieve the normal age of menarche

Correction to: Global asthma prevalence in adults: findings from the cross-sectional world health survey

Correction to: BMC Public Health 12, 204 (2012) https://doi.org/10.1186/1471-2458-12-20

Global asthma prevalence in adults: findings from the cross-sectional world health survey

<p>Abstract</p> <p>Background</p> <p>Asthma is a major cause of disability, health resource utilization and poor quality of life world-wide. We set out to generate estimates of the global burden of asthma in adults, which may inform the development of strategies to address this common disease.</p> <p>Methods</p> <p>The World Health Survey (WHS) was developed and implemented by the World Health Organization in 2002-2003. A total of 178,215 individuals from 70 countries aged 18 to 45 years responded to questions related to asthma and related symptoms. The prevalence of asthma was based on responses to questions relating to self-reported doctor diagnosed asthma, clinical/treated asthma, and wheezing in the last 12 months.</p> <p>Results</p> <p>The global prevalence rates of doctor diagnosed asthma, clinical/treated asthma and wheezing in adults were 4.3%, 4.5%, and 8.6% respectively, and varied by as much as 21-fold amongst the 70 countries. Australia reported the highest rate of doctor diagnosed, clinical/treated asthma, and wheezing (21.0%, 21.5%, and 27.4%). Amongst those with clinical/treated asthma, almost 24% were current smokers, half reported wheezing, and 20% had never been treated for asthma.</p> <p>Conclusions</p> <p>This study provides a global estimate of the burden of asthma in adults, and suggests that asthma continues to be a major public health concern worldwide. The high prevalence of smoking remains a major barrier to combating the global burden of asthma. While the highest prevalence rates were observed in resource-rich countries, resource-poor nations were also significantly affected, posing a barrier to development as it stretches further the demands of non-communicable diseases.</p

Prevalence and characteristics of progressive fibrosing interstitial lung disease in a prospective registry

Rationale Progressive fibrosing interstitial lung disease (PF-ILD) is characterized by progressive physiologic, symptomatic, and/or radiographic worsening. The real-world prevalence and characteristics of PF-ILD remain uncertain. Methods Patients were enrolled from the Canadian Registry for Pulmonary Fibrosis between 2015-2020. PF-ILD was defined as a relative forced vital capacity (FVC) decline ≥10%, death, lung transplantation, or any 2 of: relative FVC decline ≥5 and &lt;10%, worsening respiratory symptoms, or worsening fibrosis on computed tomography of the chest, all within 24 months of diagnosis. Time-to-event analysis compared progression between key diagnostic subgroups. Characteristics associated with progression were determined by multivariable regression. Results Of 2,746 patients with fibrotic ILD (mean age 65±12 years, 51% female), 1,376 (50%) met PFILD criteria in the first 24 months of follow-up. PF-ILD occurred in 427 (59%) patients with idiopathic pulmonary fibrosis (IPF), 125 (58%) with fibrotic hypersensitivity pneumonitis (HP), 281 (51%) with unclassifiable ILD (U-ILD), and 402 (45%) with connective tissue diseaseassociated ILD (CTD-ILD). Compared to IPF, time to progression was similar in patients with HP (hazard ratio [HR] 0.96, 95% confidence interval, CI 0.79-1.17), but was delayed in patients with U-ILD (HR 0.82, 95% CI 0.71-0.96) and CTD-ILD (HR 0.65, 95% CI 0.56-0.74). Background treatment varied across diagnostic subtypes with 66% of IPF patients receiving antifibrotic therapy, while immunomodulatory therapy was utilized in 49%, 61%, and 37% of patients with CHP, CTD-ILD, and U-ILD respectively. Increasing age, male sex, gastroesophageal reflux disease, and lower baseline pulmonary function were independently associated with progression. Interpretation Progression is common in patients with fibrotic ILD, and is similarly prevalent in HP and IPF. Routinely collected variables help identify patients at risk for progression and may guide therapeutic strategie

Focal adhesion is associated with lithium response in bipolar disorder: evidence from a network-based multi-omics analysis

Lithium (Li) is one of the most effective drugs for treating bipolar disorder (BD), however, there is presently no way to predict response to guide treatment. The aim of this study is to identify functional genes and pathways that distinguish BD Li responders (LR) from BD Li non-responders (NR). An initial Pharmacogenomics of Bipolar Disorder study (PGBD) GWAS of lithium response did not provide any significant results. As a result, we then employed network-based integrative analysis of transcriptomic and genomic data. In transcriptomic study of iPSC-derived neurons, 41 significantly differentially expressed (DE) genes were identified in LR vs NR regardless of lithium exposure. In the PGBD, post-GWAS gene prioritization using the GWA-boosting (GWAB) approach identified 1119 candidate genes. Following DE-derived network propagation, there was a highly significant overlap of genes between the top 500- and top 2000-proximal gene networks and the GWAB gene list (Phypergeometric = 1.28E–09 and 4.10E–18, respectively). Functional enrichment analyses of the top 500 proximal network genes identified focal adhesion and the extracellular matrix (ECM) as the most significant functions. Our findings suggest that the difference between LR and NR was a much greater effect than that of lithium. The direct impact of dysregulation of focal adhesion on axon guidance and neuronal circuits could underpin mechanisms of response to lithium, as well as underlying BD. It also highlights the power of integrative multi-omics analysis of transcriptomic and genomic profiling to gain molecular insights into lithium response in BD.publishedVersio

Measurement of the radiative Ke3 branching ratio

We present a measurement of the relative branching ratio of the decay K0 → π± e± νγ (Ke3γ) with respect to K0 → π± e± ν (Ke3 + Ke3γ ) decay. The result is based on observation of 19 000 Ke3γ and 5.6 × 10^6 Ke3 decays. The value of the branching ratio is BR(K0e3γ , E∗γ &gt; 30 MeV, θ∗eγ &gt; 20◦)/ Br(K0e3 ) = (0.964 ± 0.008+0.011-0.009)%. This result agrees with theoretical predictions but is at variance with a recently published result

Measurement of K0e3 form factors

The semileptonic decay of the neutral K meson, K0L → π± e∓ ν (Ke3 ), was used to study the strangeness-changing weak interaction of hadrons. A sample of 5.6 million reconstructed events recorded by the NA48 experiment was used to measure the Dalitz plot density. Admitting all possible Lorentz-covariant couplings, the form factors for vector (f+(q2)), scalar (fS) and tensor (fT) interactions were measured. The linear slope of the vector form factor λ+ = 0.0284 ± 0.0007 ± 0.0013 and values for the ratios |fS/f+(0)| = 0.015 +0.007-0.010 ± 0.012 and |fT/f+(0)| = 0.05 +0.03-0.04 ± 0.03 were obtained. The values for fS and fT are consistent with zero. Assuming only vector–axial-vector couplings, λ+ = 0.0288 ± 0.0004 ± 0.0011 and a good fit consistent with pure V–A couplings were obtained. Alternatively, a fit to a dipole form factor yields a pole mass of M = 859 ± 18 MeV, consistent with the K∗(892) mass