Category: Nevin Manimala

Scand J Work Environ Health. 2022 Oct 21:4064. doi: 10.5271/sjweh.4064. Online ahead of print.

ABSTRACT

OBJECTIVES: This study investigates the influence of onset of disease on exit from paid employment and whether this differs across diseases and sociodemographic groups.

METHODS: Register data from Statistics Netherlands on medication prescription was linked to information on employment status and demographics. Persons who were employed in 2009 and 2010 and who did not use medication for the selected disease in 2009 (N=5 889 036) were followed-up over nine years. Six diseases were identified based on medication prescription in 2010 and 2011: cardiovascular diseases, inflammatory diseases, diabetes mellitus, respiratory diseases, common mental disorders, and psychotic disorders. Four pathways out of paid employment were defined: disability benefits, unemployment, no income, and early retirement. Early exit from paid employment was defined as exiting paid employment before retirement age. Cause-specific Cox proportional hazards regression analyses were performed, with interaction terms for age, sex, and migration background.

RESULTS: Onset of disease increased the likelihood of exit from paid employment, with the strongest associations for psychotic disorders [hazard ratio (HR) 2.88, 95% confidence interval (CI) 2.78-2.98] and common mental disorders (HR 2.00, 95% CI 1.97-2.03). Onset of disease was most strongly associated with disability benefits, followed by unemployment. The influence of common mental and psychotic disorders on disability increased until around middle-age, after which it decreased. The influence of mental health problems on exit from paid employment was stronger for persons with a non-native Dutch background and males.

CONCLUSION: Onset of diseases, especially mental health disorders, is a risk for exiting paid employment before the retirement age. Effective interventions are needed to enhance an inclusive workforce and prevent involuntary loss of paid employment.

PMID:36265177 | DOI:10.5271/sjweh.4064

JMIR Public Health Surveill. 2022 Oct 18. doi: 10.2196/38898. Online ahead of print.

ABSTRACT

BACKGROUND: Several risk factors have been identified for severe COVID-19 disease by the scientific community. In this work we focus on understanding the risks for severe COVID-19 infections post-vaccination, i.e. in breakthrough SARS-CoV-2 infections. Studying these risks by vaccine type, age, sex, comorbidities, any prior SARS-CoV-2 infection is important for making policy decisions regarding booster vaccinations for each vaccine.

OBJECTIVE: We perform a comparative study of the risks of hospitalization (n=1140) and mortality (n=159) in a SARS-CoV-2 positive cohort of 19,815 patients who were all fully vaccinated with either the Pfizer, Moderna or Janssen vaccines.

METHODS: We perform Cox regression analysis to calculate the risk factors for developing a severe breakthrough SARS-CoV-2 infection in the study cohort, by controlling for vaccine-type, age, sex, comorbidities and a prior SARS-CoV-2 infection.

RESULTS: We find lower hazard ratios for those receiving the Moderna vaccine (P<.001) and Pfizer vaccine (P<.001) with the lowest hazard rates being for Moderna, as compared to those who received the Janssen vaccine independent of age, sex, comorbidities, vaccine type and prior SARS-CoV-2 infection. Further, individuals who had a SARS-CoV-2 infection prior to vaccination had some increased protection over and above the protection already provided by the vaccines, from the risk of hospitalization (P=.001) and mortality (P=.035), independent of age, sex, comorbidities, and vaccine type. We find that the top statistically significant risk factors for severe breakthrough SARS-CoV-2 infections were age>50, male gender, moderate and severe renal failure, severe liver disease, leukemia, chronic lung disease, coagulopathy and alcohol abuse.

CONCLUSIONS: We find that among individuals who were fully vaccinated, the risk of severe breakthrough SARS-CoV-2 infection was lower for those who had received the Moderna or Pfizer vaccines, and higher for those who received the Janssen vaccine. This result from our analysis at a population level, suggests that individuals who received the Janssen vaccine could benefit from a booster shot. Our result on the influence of a previous SARS-CoV-2 infection necessitates further research into the impact of multiple exposures on the risk of developing severe COVID-19.

PMID:36265135 | DOI:10.2196/38898

JMIR Public Health Surveill. 2022 Oct 13. doi: 10.2196/35025. Online ahead of print.

ABSTRACT

BACKGROUND: A vaccine against coronavirus disease 2019 (COVID-19) has been developed; however, COVID-19 transmission continues. Although there have been many studies of comorbidities that have important roles in COVID-19, some studies have reported contradictory results.

OBJECTIVE: This study was conducted using real-world data of COVID-19 patients in South Korea and aimed to investigate the impact of patient demographics and comorbidities on the infection rate and severity of COVID-19.

METHODS: Data were derived from a nationwide South Korean COVID-19 cohort study with propensity score (PS) matching. We included infected individuals who were COVID-19-positive between January 1, 2020 and May 30, 2020, and PS-matched uninfected controls. PS matching was performed to balance the baseline characteristics of each comorbidity and to adjust for potential confounders, such as age, sex, Charlson Comorbidity Index, medication, and other comorbidities, that were matched with binary variables. The outcomes were the confirmed comorbidities affecting the infection rate and severity of COVID-19. The endpoints were COVID-19 positivity and severe clinical outcomes of COVID-19 (such as tracheostomy, continuous renal replacement therapy, intensive care unit admission, ventilator use, cardiopulmonary resuscitation, and death).

RESULTS: The COVID-19 cohort w¬ith PS matching included 8070 individuals with positive COVID-19 test results and 8070 matched controls. The proportions of patients corresponding to the severe group tended to be increased for individuals 60 years or older (severe clinical outcomes for those 60 years or older, 16.52%; severe clinical outcomes for those of other ages, 2.12%), those insured with Medicaid (Medicaid, 10.81%; other insurance, 5.61%), and those with disabilities (with disabilities, 18.26%; without disabilities, 5.07%). The infection rate of COVID-19 was high for patients with pulmonary disease (odds ratio [OR], 1.88; 95% confidence interval [CI], 1.70-2.03), dementia (OR, 1.75; 95% CI, 1.40-2.20), gastrointestinal disease (OR, 1.74; 95% CI, 1.62-1.88), stroke (OR, 1.67; 95% CI, 1.23-2.27), hepatobiliary disease (OR, 1.31; 95% CI, 1.19-1.44), diabetes mellitus (OR, 1.28; 95% CI, 1.16-1.43), and cardiovascular disease (OR, 1.20; 95% CI, 1.07-1.35). In contrast, it was lower for individuals with hyperlipidemia (OR, 0.73; 95% CI, 0.67-0.80), autoimmune disease (OR, 0.73; 95% CI, 0.60-0.89), and cancer (OR, 0.73; 95% CI, 0.62-0.86). The severity of COVID-19 was high for individuals with kidney disease (OR, 5.59; 95% CI, 2.48-12.63), hypertension (OR, 2.92; 95% CI, 1.91-4.47), dementia (OR, 2.92; 95% CI, 1.91-4.47), cancer (OR, 1.84; (95% CI, 1.15-2.94), pulmonary disease (OR, 1.72; 95% CI, 1.35-2.19), cardiovascular disease (OR, 1.54; 95% CI, 1.17-2.04), diabetes mellitus (OR, 1.43; 95% CI, 1.09-1.87), and psychotic disorders (OR, 1.29; 95% CI, 1.01-6.52). However, it was low for those with hyperlipidemia (OR, 0.78; 95% CI, 0.60-1.00).

CONCLUSIONS: Upon PS matching considering the use of statins, it was concluded that subjects with hyperlipidemia could reduce the infection rate and disease severity of COVID-19.

INTERNATIONAL REGISTERED REPORT: RR2-https://doi.org/10.1101/2021.09.22.21263946.

PMID:36265125 | DOI:10.2196/35025

JCO Precis Oncol. 2022 Oct;6:e2200323. doi: 10.1200/PO.22.00323.

ABSTRACT

PURPOSE: Clinical genomic testing is increasingly being used to direct pediatric cancer care. Many centers are interested in offering testing of tumors and paired germline tissues at or near the time of cancer diagnosis. We conducted this study to better understand parent preferences surrounding timing and content of consent conversations for clinical germline genetic testing of their children with cancer as a part of real-time cancer care.

PATIENTS AND METHODS: A seven-question survey developed by the Division of Cancer Predisposition and collaborators at St Jude Children’s Research Hospital (St Jude) was distributed to members of the St Jude Patient Family Advisory Council, which included parents of childhood cancer survivors and bereaved parents whose children with cancer had died. Parents were asked to provide free text comments after each question. Qualitative methods were used to derive codes from parent comments, and survey results were depicted using descriptive statistics.

RESULTS: The survey was completed by 172 parents. Ninety-three (54%) endorsed an approach for consent conversations ≥ 1 month after cancer diagnosis, whereas 58 (34%) endorsed an approach at 1-2 weeks and 21 (12%) at 1-2 days. Needing time to adjust to a new or relapsed cancer diagnosis and feeling overwhelmed were frequent themes; however, parents acknowledged the urgency and importance of testing. Parents desired testing of as many cancer-related genes as possible, with clinical utility the most important factor for proceeding with testing. Most parents (75%) desired germline results to be disclosed in person, preferably by a genetic counselor.

CONCLUSION: Parents described urgency and benefits associated with germline testing, but desired flexibility in timing to allow for initial adjustment after their child’s cancer diagnosis.

PMID:36265116 | DOI:10.1200/PO.22.00323

Arch Prev Riesgos Labor. 2022 Jul 15;25(3):259-270. doi: 10.12961/aprl.2022.25.03.03.

ABSTRACT

INTRODUCTION: To design and validate a scale of perception of teleworking in Peruvian primary schoolteachers.

METHOD: This was a cross-sectional study of 400 primary schoolteachers (61.5% women) between 21 and 61 years of age, from six cities in Peru. Eight items were proposed, corresponding to indicators of training, safety, and flexibility of schedules, derived from the scientific literature. The scale was validated by seven experts who evaluated the relevance, representativeness and clarity of the items. Subsequently, we applied exploratory f (EFA) and confirmatory factor analysis (CFA), using the FACTOR Analysis program and SPSS AMOS version 21.

RESULTS: The Aiken V indicators were statistically significant for the eight items. Before running the AFE, we calculated the KMO coefficient (0.93) and Bartlett’s test (1832.9; gl = 28; p = 0.00). A single factor explained 62.27% of the total variance of the scale and its factor loadings ranged from 0.65 to 0.84. The CFA corroborated the internal structure of the scale (?2 = 58.24, df = 20, p < 0.01; RMR = 0.03; TLI = 0.97; CFI = 0.97; and RMSEA = 0.06) and the reliability was acceptable (? = 0.93; 95% CI = 0.89 – 0.92).

CONCLUSIONS: The scale demonstrates evidence of content-based validity, internal structure and reliability.

PMID:36265110 | DOI:10.12961/aprl.2022.25.03.03

Arch Prev Riesgos Labor. 2022 Jul 15;25(3):285-299. doi: 10.12961/aprl.2022.25.03.05.

ABSTRACT

AIM: To analyse the psychometric properties of the demand scales of the UNIPSICO questionnaire in in Valencian / Catalan language.

METHOD: The sample consisted of 2114 participants from public administration centres of Generalitat Valenciana in Valencia. Data were collected using the UNIPSICO questionnaire, which is grouped into six scales that measure psychosocial risk factors related to job demands (33 items): role conflict (5 items), role ambiguity (5 items), workload (6 items), interpersonal conflicts (6 items), inequity in social exchanges (5 items), and work-family and family-work conflict (6 items). We performed confirmatory factor analysis (CFA) and measured Cronbach alpha and McDonald omega coefficients for the scales.

RESULTS: All items had adequate statistical and psychometric values. The six-factor model that reproduces the original structure of the questionnaire presented an adequate fit to the data, and gender invariance. The Cronbach alpha and McDonald omega coefficients were acceptable for the six scales of the instrument.

CONCLUSIONS: These results contribute to the psychometric validation of the questionnaire and allow us to conclude that the demand scales of the UNIPSICO questionnaire translated to Valencian / Catalan language are reliable and possess construct validity for the assessment of psychosocial risk factors in government employees.

PMID:36265108 | DOI:10.12961/aprl.2022.25.03.05

Prev Chronic Dis. 2022 Oct 20;19:E65. doi: 10.5888/pcd19.220113.

ABSTRACT

INTRODUCTION: Breast cancer affects 1 in 8 women in the US and is the most frequently diagnosed cancer in women. In South Dakota, 102 women die from breast cancer each year. We assessed which sociodemographic factors contributed to mortality rates in South Dakota and used spatial analysis to investigate how counties’ observed age-adjusted mortality rates compared with expected rates.

METHODS: We computed standardized incidence ratios (SIRs) of all counties in South Dakota by using the age-adjusted mortality rates, the 2000 US standard population, and the South Dakota estimated population. We used a linear regression model to identify sociodemographic factors associated with breast cancer mortality rates and to compute a new SIR value, after controlling for relevant factors.

RESULTS: Educational level and breast cancer incidence rates were significantly associated with breast cancer mortality rates at the county level. The SIR values based on age-adjusted counts showed which counties had more deaths due to breast cancer than what might be expected using South Dakota as the reference population. After controlling for sociodemographic factors, the range of SIR values decreased and had lower variability.

CONCLUSION: The regression model helped identify factors associated with mortality and provided insights into which risk factors are at play in South Dakota. This information, in combination with the spatial distribution of mortality by county, can be used to help allocate resources to the counties in South Dakota that need them most.

PMID:36265079 | DOI:10.5888/pcd19.220113

J Am Chem Soc. 2022 Oct 20. doi: 10.1021/jacs.2c09120. Online ahead of print.

ABSTRACT

The catalysis by a π-allyl-Co/Ni complex has drawn significant attention recently due to its distinct reactivity in reductive Co/Ni-catalyzed allylation reactions. Despite significant success in reaction development, the critical oxidative addition mechanism to form the π-allyl-Co/Ni complex remains unclear. Herein, we present a study to investigate this process with four catalysis-relevant complexes: Co(^MeBPy)Br₂, Co(^MePhen)Br₂, Ni(^MeBPy)Br₂, and Ni(^MePhen)Br₂. Enabled by an electroanalytical platform, Co(I)/Ni(I) species were found responsible for the oxidative addition of allyl acetate. Kinetic features of different substrates were characterized through linear free-energy relationship (Hammett-type) studies, statistical modeling, and a DFT computational study. In this process, a coordination-ionization-type transition state was proposed, sharing a similar feature with Pd(0)-mediated oxidative addition in Tsuji-Trost reactions. Computational and ligand structural analysis studies support this mechanism, which should provide key information for next-generation catalyst development.

PMID:36265077 | DOI:10.1021/jacs.2c09120

J Appl Clin Med Phys. 2022 Oct 20:e13793. doi: 10.1002/acm2.13793. Online ahead of print.

ABSTRACT

BACKGROUND AND PURPOSE: For postoperative breast cancer patients, deformable image registration (DIR) is challenged due to the large deformations and non-correspondence caused by tumor resection and clip insertion. To deal with it, three metrics (fiducial-, region-, and intensity-based) were jointly used in DIR algorithm for improved accuracy.

MATERIALS AND METHODS: Three types of metrics were combined to form a single-objective function in DIR algorithm. Fiducial-based metric was used to minimize the distance between the corresponding point sets of two images. Region-based metric was used to improve the overlap between the corresponding areas of two images. Intensity-based metric was used to maximize the correlation between the corresponding voxel intensities of two images. The two CT images, one before surgery and the other after surgery, were acquired from the same patient in the same radiotherapy treatment position. Twenty patients who underwent breast-conserving surgery and postoperative radiotherapy were enrolled in this study.

RESULTS: For target registration error, the difference between the proposed and the conventional registration methods was statistically significant for soft tissue (2.06 vs. 7.82, p = 0.00024 < 0.05) and body boundary (3.70 vs. 6.93, p = 0.021 < 0.05). For visual assessment, the proposed method achieved better matching result for soft tissue and body boundary.

CONCLUSIONS: Comparing to the conventional method, the registration accuracy of the proposed method was significantly improved. This method provided a feasible way for target volume delineation of tumor bed in postoperative radiotherapy of breast cancer patients.

PMID:36265074 | DOI:10.1002/acm2.13793

JMIR Med Inform. 2022 Sep 7. doi: 10.2196/35622. Online ahead of print.

ABSTRACT

BACKGROUND: The Covid-19 disease has multiple symptoms, being anosmia, varying from 75-95%, and ageusia, varying from 50-80% of infected patients, the most prevalent ones. An automatic assessment tool for these symptoms will help monitor the disease in a fast and non-invasive manner.

OBJECTIVE: We hypothesized that people with Covid-19 experiencing anosmia and ageusia had different voice features than those without such symptoms. Our objective was to develop an artificial intelligence pipeline to identify and internally validate a vocal biomarker of these symptoms for remotely monitoring them.

METHODS: This study is made on population-based data. Participants were assessed daily through an online questionnaire and asked to register two different types of voice recordings, they were adults (older than 18 years old) that were confirmed by a PCR test to be positive for Covid-19 in Luxembourg and that passed through the exclusion criteria. Statistical methods like Recursive Feature Elimination (RFE) for dimensionality reduction, multiple statistical learning methods, and hypothesis tests were used throughout this study. The TRIPOD Prediction Model Development checklist was used to structure the research.

RESULTS: This study included 259 participants. Young (<35 years old) and females showed a higher rate of ageusia and anosmia. Participants were 41 (SD = 13) years old on average and the dataset was balanced for sex (134 females (52%) and 125 males (48%) out of 259). The analyzed symptom was present in 94 out of 259 (36%) participants of the population and in 450 out of 1636 (28%) audio recordings. Two machine learning models were built, one for Android and one for iOS devices and both had high accuracy, being 88% for Android and 85% for iOS. The final biomarker was then calculated using these models and internally validated.

CONCLUSIONS: This study demonstrates that people with Covid-19 who have anosmia and ageusia have different voice features from those without it. Upon further validation, these vocal biomarkers could be nested in digital devices to improve symptom assessment in clinical practice and enhance telemonitoring of Covid-19-related symptoms.

CLINICALTRIAL: Approved by the National Research Ethics Committee of Luxembourg (study number 202003/07) in April 2020 and is registered Clinicaltrials.gov NCT04380987, https://clinicaltrials.gov/ct2/show/NCT04380987.

PMID:36265042 | DOI:10.2196/35622