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5. Vital Signs: Update on Zika Virus–Associated Birth Defects and Evaluation of All U.S. Infants with Congenital Zika Virus Exposure — U.S. Zika Pregnancy Registry, 2016

Author

Reynolds, M. R., Jones, A. M., Petersen, E. E., Lee, E. H., Rice, M. E., Bingham, A., Ellington, S. R., Evert, N., Reagan-Steiner, S., Oduyebo, T., Brown, C. M., Martin, S., Ahmad, N., Bhatnagar, J., Macdonald, J., Gould, C., Fine, A. D., Polen, K. D., Lake-Burger, H., Hillard, C. L., Hall, N., Mahsa Yazdy, Slaughter, K., Sommer, J. N., Adamski, A., Raycraft, M., Fleck-Derderian, S., Gupta, J., Newsome, K., Baez-Santiago, M., Slavinski, S., White, J. L., Moore, C. A., Shapiro-Mendoza, C. K., Petersen, L., Boyle, C., Jamieson, D. J., Meaney-Delman, D., Honein, M. A., Adair, J., Ruberto, I., Haselow, D. T., Im, L., Jilek, W., Lehmann, M. S., Olney, R., Porse, C. C., Ramstrom, K. C., Sowunmi, S., Marzec, N. S., Davis, K., Esponda-Morrison, B., Zachariah Fraser, M., O’connor, C. A., Chung, W., Richardson, F., Sexton, T., Stocks, M. E., Woldai, S., Bundek, A. M., Zambri, J., Goldberg, C., Eisenstein, L., Jackson, J., Kopit, R., Logue, T., Mendoza, R., Feldpausch, A., Graham, T., Mann, S., Park, S. Y., Carter, K. K., Potts, E. J., Stevens, T., Simonson, S., Tonzel, J. L., Davis, S., Robinson, S., Hyun, J. K., Jenkins, E. M., Piccardi, M., Reid, L. D., Dunn, J. E., Higgins, C. A., Lin, A. E., Munshi, G. S., Sandhu, K., Scotland, S. J., Soliva, S., Copeland, G., Signs, K. A., Schiffman, E., Byers, P., Hand, S., Mulgrew, C. L., Hamik, J., Koirala, S., Ludwig, L. A., Fredette, C. R., Garafalo, K., Worthington, K., Ropri, A., Ade, J. N., Alaali, Z. S., Blog, D., Brunt, S. J., Bryant, P., Burns, A. E., Carson, K., Dupuis, A. P., Sullivan-Frohm, A., Griffin, J., Hidalgo, C., Lance, L. A., Many, P. S., Naizby, B. E., Polfleit, M. J., Rahman, T., Rem, T., Robbins, A. E., Rowlands, J. V., Seaver, C., Seward, K. A., Smith, L., Sohi, I., Wester, R. E., Bush, S., Dean, A. B., Demarest, V., Dufort, E. M., Furuya, A. M., Fuschino, M., Kulas, K. E., Lamson, D. M., Lee, W. T., Limberger, R., Marchewka, M. J., Popowich, M., St George, K., Wong, S. J., Zeng, L., Glaze, V. H., Souto, M. I., Ackelsberg, J., Alex, B., Ballen, V., Baumgartner, J., Bloch, D., Clark, S., Conners, E., Cooper, H., Davidson, A., Dentinger, C., Deocharan, B., Vito, A., Fu, J., Hrusa, G., Iqbal, M., Iwamoto, M., Jones, L., Kubinson, H., Lash, M., Layton, M., Lee, C. T., Liu, D., Mcgibbon, E., Moy, M., Ngai, S., Parton, H. B., Peterson, E., Poy, J., Rakeman, J., Stoute, A., Thompson, C., Weiss, D., Westheimer, E., Winters, A., Younis, M., Chan, R. L., Cronquist, L. J., Caton, L., Lind, L., Nalluswami, K., Perella, D., Brady, D. S., Gosciminski, M., Mcauley, P., Drociuk, D., Leedom, V., Witrick, B., Bollock, J., Hartel, M. B., Lucinski, L. S., Mcdonald, M., Miller, A. M., Ponson, T. A., Price, L., Nance, A. E., Peterson, D., Cook, S., Martin, B., Oltean, H., Neary, J., Baker, M. A., Cummons, K., Bryan, K., Arnold, K. E., Arth, A. C., Bollweg, B. C., Cragan, J. D., Dawson, A. L., Denison, A. M., Dziuban, E. J., Estetter, L., Silva-Flannery, L., Free, R. J., Galang, R. R., Gary, J., Goldsmith, C. S., Green, C., Hale, G. L., Hayes, H. M., Igbinosa, I., Kelly Keating, M., Khan, S., Kim, S. Y., Lampe, M., Lewis, A., Mai, C., Martines, R. B., Miers, B., Moore, J., Muehlenbachs, A., Nahabedian, J., Panella, A., Parihar, V., Patel, M. M., Brett Rabeneck, D., Rasmussen, S. A., Ritter, J. M., Rollin, D. C., Sanders, J. H., Shieh, W. -J, Simeone, R. M., Simon, E. L., Sims, J. R., Spivey, P. J., Talley-Mcrae, H., Tshiwala, A. K., Maldeghem, K., Viens, L., Wainscott-Sargent, A., Williams, T., and Zaki, S.

Subjects
0301 basic medicine, Gerontology, medicine.medical_specialty, Microcephaly, Health (social science), Epidemiology, Health, Toxicology and Mutagenesis, Vital signs, Congenital Abnormalities, Zika virus, 03 medical and health sciences, Fetus, 0302 clinical medicine, Health Information Management, Central Nervous System Diseases, Pregnancy, Humans, Medicine, Eye Abnormalities, Neural Tube Defects, Registries, 030212 general & internal medicine, Pregnancy Complications, Infectious, Pregnancy registry, biology, Vital Signs, Zika Virus Infection, business.industry, Obstetrics, Public health, Infant, Newborn, Brain, Infant, Gestational age, Zika Virus, General Medicine, biology.organism_classification, medicine.disease, United States, 030104 developmental biology, Female, business
Abstract

Background In collaboration with state, tribal, local, and territorial health departments, CDC established the U.S. Zika Pregnancy Registry (USZPR) in early 2016 to monitor pregnant women with laboratory evidence of possible recent Zika virus infection and their infants. Methods This report includes an analysis of completed pregnancies (which include live births and pregnancy losses, regardless of gestational age) in the 50 U.S. states and the District of Columbia (DC) with laboratory evidence of possible recent Zika virus infection reported to the USZPR from January 15 to December 27, 2016. Birth defects potentially associated with Zika virus infection during pregnancy include brain abnormalities and/or microcephaly, eye abnormalities, other consequences of central nervous system dysfunction, and neural tube defects and other early brain malformations. Results During the analysis period, 1,297 pregnant women in 44 states were reported to the USZPR. Zika virus-associated birth defects were reported for 51 (5%) of the 972 fetuses/infants from completed pregnancies with laboratory evidence of possible recent Zika virus infection (95% confidence interval [CI] = 4%-7%); the proportion was higher when restricted to pregnancies with laboratory-confirmed Zika virus infection (24/250 completed pregnancies [10%, 95% CI = 7%-14%]). Birth defects were reported in 15% (95% CI = 8%-26%) of fetuses/infants of completed pregnancies with confirmed Zika virus infection in the first trimester. Among 895 liveborn infants from pregnancies with possible recent Zika virus infection, postnatal neuroimaging was reported for 221 (25%), and Zika virus testing of at least one infant specimen was reported for 585 (65%). Conclusions and implications for public health practice These findings highlight why pregnant women should avoid Zika virus exposure. Because the full clinical spectrum of congenital Zika virus infection is not yet known, all infants born to women with laboratory evidence of possible recent Zika virus infection during pregnancy should receive postnatal neuroimaging and Zika virus testing in addition to a comprehensive newborn physical exam and hearing screen. Identification and follow-up care of infants born to women with laboratory evidence of possible recent Zika virus infection during pregnancy and infants with possible congenital Zika virus infection can ensure that appropriate clinical services are available.

Published
2017
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6. The severity of pandemic H1N1 influenza in the United States, from April to July 2009: a Bayesian analysis

Author

Medina, W, Michelangelo, D, Milhofer, J, Milyavskaya, I, Misener, M, Mizrahi, J, Moskin, L, Motherwell, M, Myers, C, Nair, HP, Nguyen, T, Nilsen, D, Nival, J, Norton, J, Oleszko, W, Olson, C, Paladini, M, Palumbo, L, Papadopoulos, P, Parton, H, Paternostro, J, Paynter, L, Perkins, K, Perlman, S, Persaud, H, Peters, C, Pfeiffer, M, Platt, R, Pool, L, Punsalang, A, Rasul, Z, Rawlins, V, Reddy, V, Rinchiuso, A, Rodriguez, T, Rosal, R, Ryan, M, Sanderson, M, Scaccia, A, Seligson, AL, Seupersad, J, SevereDildy, J, Siddiqi, A, Siemetzki, U, Glaser, M, Girdharrie, L, Singh, T, Slavinski, S, Slopen, M, Snuggs, T, Starr, D, Stayton, C, Fung, L, Fu, J, Friedman, S, Frieden, T, France, AM, Stoute, A, Terlonge, J, Ternier, A, Thorpe, L, Travers, C, Tsoi, B, Turner, K, Tzou, J, Vines, S, Waddell, EN, Walker, D, Warner, C, Weisfuse, I, Weiss, D, WilliamsAkita, A, Wilson, E, Fitzgerald, K, Harper, S, Hasnain, Q, Hedge, S, Heller, M, Hendrickson, D, Herskovitz, A, Hinterland, K, Holmes, R, Hom, J, Hon, J, Hopke, T, Hsieh, J, Hughes, S, Immerwahr, S, Incalicchio, AM, Jasek, J, Jimenez, J, Johns, M, Jones, L, Jordan, H, Kambili, C, Kang, J, Kapell, D, Karpati, A, Kerker, B, Konty, K, Kornblum, J, Krigsman, G, Laraque, F, Layton, M, Lee, E, Lee, L, Lee, S, Lim, S, Marx, M, McGibbon, E, Mahoney, K, Marin, G, Matte, T, McAnanama, R, McKay, R, McKay, C, McVeigh, K, Medina, E, Fireteanu, AM, Fine, A, FilsAime, C, Fernandez, M, Feliciano, R, Farley, S, Evans, M, Eisenhower, D, Egger, J, Edwin, B, Edghill, Z, Wong, M, Wu, C, Yang, D, Younis, M, Yusuff, S, Zimmerman, C, Zucker, J, Eavey, J, Durrah, J, Duquaine, D, DiGrande, L, DiCaprio, K, Diaz, L, Deocharan, B, Del Cid, O, DeGrechie, S, DeGrasse, A, Darkins, B, Daniels, A, Da Costa, CA, Crouch, B, Coyle, C, Costarella, R, Corey, C, Cook, D, Cook, H, Cone, J, Cimini, D, Chamany, S, Camurati, L, Campbell, M, Cajigal, A, Cai, L, Butts, B, Burke, M, Bregman, B, Bornschlegel, K, Blank, S, Betz, J, Berger, M, Berg, D, Bell, G, Begier, E, Beaudry, G, Beatrice, ST, Barbot, O, Balter, S, Backman, P, Atamian, J, Aston, C, AgborTabi, E, Adman, G, Adamski, A, Ackelsberg, J, Lipsitch, M, Biedrzycki, P, Finelli, L, Cooper, BS, Riley, S, Reed, C, Hagy, A, De Angelis, D, Presanis, AM, Goranson, C, Griffing, F, Gupta, L, Hamilton, C, Hanson, H, HartmanO'Connell, I, and Team, The New York City Swine Flu Investigation

Subjects
medicine.medical_specialty, Pediatrics, Hospitalization - statistics and numerical data, medicine.medical_treatment, Population, Public Health and Epidemiology/Infectious Diseases, Influenza, Human - classification - epidemiology, Disease Outbreaks, 03 medical and health sciences, 0302 clinical medicine, Influenza A Virus, H1N1 Subtype, Epidemiology, Pandemic, Severity of illness, Infectious Diseases/Viral Infections, medicine, Credible interval, 030212 general & internal medicine, Young adult, education, Mechanical ventilation, 0303 health sciences, education.field_of_study, 030306 microbiology, business.industry, Incidence (epidemiology), virus diseases, Bayes Theorem, General Medicine, 3. Good health, Medicine, business, Research Article
Abstract

Marc Lipsitch and colleagues use complementary data from two US cities, Milwaukee and New York City, to assess the severity of pandemic (H1N1) 2009 influenza in the United States., Background Accurate measures of the severity of pandemic (H1N1) 2009 influenza (pH1N1) are needed to assess the likely impact of an anticipated resurgence in the autumn in the Northern Hemisphere. Severity has been difficult to measure because jurisdictions with large numbers of deaths and other severe outcomes have had too many cases to assess the total number with confidence. Also, detection of severe cases may be more likely, resulting in overestimation of the severity of an average case. We sought to estimate the probabilities that symptomatic infection would lead to hospitalization, ICU admission, and death by combining data from multiple sources. Methods and Findings We used complementary data from two US cities: Milwaukee attempted to identify cases of medically attended infection whether or not they required hospitalization, while New York City focused on the identification of hospitalizations, intensive care admission or mechanical ventilation (hereafter, ICU), and deaths. New York data were used to estimate numerators for ICU and death, and two sources of data—medically attended cases in Milwaukee or self-reported influenza-like illness (ILI) in New York—were used to estimate ratios of symptomatic cases to hospitalizations. Combining these data with estimates of the fraction detected for each level of severity, we estimated the proportion of symptomatic patients who died (symptomatic case-fatality ratio, sCFR), required ICU (sCIR), and required hospitalization (sCHR), overall and by age category. Evidence, prior information, and associated uncertainty were analyzed in a Bayesian evidence synthesis framework. Using medically attended cases and estimates of the proportion of symptomatic cases medically attended, we estimated an sCFR of 0.048% (95% credible interval [CI] 0.026%–0.096%), sCIR of 0.239% (0.134%–0.458%), and sCHR of 1.44% (0.83%–2.64%). Using self-reported ILI, we obtained estimates approximately 7–9× lower. sCFR and sCIR appear to be highest in persons aged 18 y and older, and lowest in children aged 5–17 y. sCHR appears to be lowest in persons aged 5–17; our data were too sparse to allow us to determine the group in which it was the highest. Conclusions These estimates suggest that an autumn–winter pandemic wave of pH1N1 with comparable severity per case could lead to a number of deaths in the range from considerably below that associated with seasonal influenza to slightly higher, but with the greatest impact in children aged 0–4 and adults 18–64. These estimates of impact depend on assumptions about total incidence of infection and would be larger if incidence of symptomatic infection were higher or shifted toward adults, if viral virulence increased, or if suboptimal treatment resulted from stress on the health care system; numbers would decrease if the total proportion of the population symptomatically infected were lower than assumed. Please see later in the article for the Editors' Summary, Editors' Summary Background Every winter, millions of people catch influenza—a viral infection of the airways—and about half a million people die as a result. In the US alone, an average of 36,000 people are thought to die from influenza-related causes every year. These seasonal epidemics occur because small but frequent changes in the virus mean that an immune response produced one year provides only partial protection against influenza the next year. Occasionally, influenza viruses emerge that are very different and to which human populations have virtually no immunity. These viruses can start global epidemics (pandemics) that kill millions of people. Experts have been warning for some time that an influenza pandemic is long overdue and in, March 2009, the first cases of influenza caused by a new virus called pandemic (H1N1) 2009 (pH1N1; swine flu) occurred in Mexico. The virus spread rapidly and on 11 June 2009, the World Health Organization declared that a global pandemic of pH1N1 influenza was underway. By the beginning of November 2009, more than 6,000 people had died from pH1N1 influenza. Why Was This Study Done? With the onset of autumn—drier weather and the return of children to school help the influenza virus to spread—pH1N1 cases, hospitalizations, and deaths in the Northern Hemisphere have greatly increased. Although public-health officials have been preparing for this resurgence of infection, they cannot be sure of its impact on human health without knowing more about the severity of pH1N1 infections. The severity of an infection can be expressed as a case-fatality ratio (CFR; the proportion of cases that result in death), as a case-hospitalization ratio (CHR; the proportion of cases that result in hospitalization), and as a case-intensive care ratio (CIR; the proportion of cases that require treatment in an intensive care unit). Because so many people have been infected with pH1N1 since it emerged, the numbers of cases and deaths caused by pH1N1 infection are not known accurately so these ratios cannot be easily calculated. In this study, the researchers estimate the severity of pH1N1 influenza in the US between April and July 2009 by combining data on pH1N1 infections from several sources using a statistical approach known as Bayesian evidence synthesis. What Did the Researchers Do and Find? By using data on medically attended and hospitalized cases of pH1N1 infection in Milwaukee and information from New York City on hospitalizations, intensive care use, and deaths, the researchers estimate that the proportion of US cases with symptoms that died (the sCFR) during summer 2009 was 0.048%. That is, about 1 in 2,000 people who had symptoms of pH1N1 infection died. The “credible interval” for this sCFR, the range of values between which the “true” sCFR is likely to lie, they report, is 0.026%–0.096% (between 1 in 4,000 and 1 in 1,000 deaths for every symptomatic case). About 1 in 400 symptomatic cases required treatment in intensive care, they estimate, and about 1 in 70 symptomatic cases required hospital admission. When the researchers used a different approach to estimate the total number of symptomatic cases—based on New Yorkers' self-reported incidence of influenza-like-illness from a telephone survey—their estimates of pH1N1 infection severity were 7- to 9-fold lower. Finally, they report that the sCFR and the sCIR were highest in people aged 18 or older and lowest in children aged 5–17 years. What Do These Findings Mean? Many uncertainties (for example, imperfect detection and reporting) can affect estimates of influenza severity. Even so, the findings of this study suggest that an autumn–winter pandemic wave of pH1N1 will have a death toll only slightly higher than or considerably lower than that caused by seasonal influenza in an average year, provided pH1N1 continues to behave as it did during the summer. Similarly, the estimated burden on hospitals and intensive care facilities ranges from somewhat higher than in a normal influenza season to considerably lower. The findings of this study also suggest that, unlike seasonal influenza, which kills mainly elderly adults, a high proportion of deaths from pH1N1infection will occur in nonelderly adults, a shift in age distribution that has been seen in previous pandemics. With these estimates in hand and with continued close monitoring of the pandemic, public-health officials should now be in a better position to plan effective strategies to deal with the pH1N1 pandemic. Additional Information Please access these Web sites via the online version of this summary at http://dx.doi.org/10.1371/journal.pmed.1000207. The US Centers for Disease Control and Prevention provides information about influenza for patients and professionals, including specific information on pandemic H1N1 (2009) influenza Flu.gov, a US government Web site, provides access to information on H1N1, avian and pandemic influenza The World Health Organization provides information on seasonal influenza and has detailed information on pandemic H1N1 (2009) influenza (in several languages) The UK Health Protection Agency provides information on pandemic influenza and on pandemic H1N1 (2009) influenza More information for patients about H1N1 influenza is available through Choices, an information resource provided by the UK National Health Service

Published
2016

8. Properties of poly(butylene terephthatlate) polymerized from cyclic oligomers and its composites

Author

UCL - FSA/MAPR - Département des sciences des matériaux et des procédés, Parton, H, Baets, J., Lipnik, Pascale, Goderis, Bart, Devaux, Jacques, Verpoest, Ignace, UCL - FSA/MAPR - Département des sciences des matériaux et des procédés, Parton, H, Baets, J., Lipnik, Pascale, Goderis, Bart, Devaux, Jacques, and Verpoest, Ignace

Abstract

The high viscosity of thermoplastic matrices hampers fiber impregnation. This problem can be overcome by using low viscous polymeric precursors such as cyclic butylene terephthalate (CBT (R) resins), which polymerize to form a thermoplastic matrix. This allows thermoset production techniques, like resin transfer molding (RTM), to be used for the production of textile reinforced thermoplastics. Due to the processing route and more specifically the time-temperature profile, inherent to the RTM process, the crystallites of the matrix consist out of well-defined, thick and well-oriented crystal lamellae. Together with a high overall degree of crystallinity and a low density of tie molecules, these large and perfect crystals cause polymer brittleness. Matrix brittleness lowers the transverse strength of unidirectional composites to below the matrix strength, but leaves the mechanical properties in the fiber direction unaffected. Although not a valid option for the RTM production route, crystallization from a truly random melt and at a sufficiently high cooling rate would substantially improve the ductility. (c) 2005 Elsevier Ltd. All rights reserved.

Published
2005

11. Reviews

Author

Parton, H N

Published
1957

12. The Fezzan Project 2001: Preliminary report on the fifth season of work

Author

Mattingly, D.J., primary, Brooks, N., additional, Cole, F., additional, Dore, J., additional, Drake, N., additional, Leone, A., additional, Hay, S., additional, McLaren, S., additional, Newson, P., additional, Parton, H., additional, Pelling, R., additional, Preston, J., additional, Reynolds, T., additional, Schrüfer-Kolb, I., additional, Thomas, D., additional, Tindall, A., additional, Townsend, A., additional, and White, K., additional

Published
2001
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13. Health of Older Adults in New York City Public Housing: Part 1, Findings From the New York City Housing Authority Senior Survey.

Author

Parton, H. B., Greene, R., Flatley, A. M., Viswanathan, N., Wilensky, L., Berman, J., Schneider, A. E., Uribe, A., Olson, E. C., Waddell, E. N., and Thorpe, L. E.

Subjects
MEDICAL care for older people, CARDIOVASCULAR diseases, HEALTH status indicators, HOUSING, MENTAL health, OBESITY, QUALITY of life, ACTIVITIES of daily living, SOCIAL support, INDEPENDENT living, PHYSICAL activity
Abstract

The article reports on the senior survey in New York City which found that over 60% of older Americans have multiple chronic conditions and 20% have a physical disability. It found that the risk for depression was higher among older New York City Housing Authority (NYCHA) residents with multiple chronic conditions than those with one or no chronic conditions. It states that low-income adults have higher rates of chronic illness and worse access to medical services.

Published
2012
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14. Guanylate Cyclase: Assay and Properties of the Particulate and Supernatant Enzymes in Mouse Parotid.

Author

Durham, John P. and Parton, H.

Subjects
*GUANYLATE cyclase, *LYASES, *ENZYMES, *CELL membranes, *CYCLIC guanylic acid, *BIOCHEMISTRY
Abstract

A new, very sensitive, rapid and reliable assay for guanylate cyclase has been established based on conversion of [32P]GTP to [32p]guanosine 3′: 5′-monophosphate and its separation on Dowex 50 and aluminium oxide columns. The optimum conditions for the assay of mouse parotid guanylate cyclase have been established and using this procedure the properties of the enzyme have been investigated. The enzyme was found in both the particulate and supernatant fractions. The particulate enzyme was activated 12-fold by Triton χ-100 and the supernatant enzyme activity increased 2-fold. In the presence of detergent guanylate cyclase activity was distributed 85% in the particulate and 15% in the supernatant fractions, respectively. The particulate activity was localised in a plasma membrane fraction. Guanylate cyclase activity was also assayed in a wide variety of other tissues. In all cases enzymatic activity was found in both the particulate and supernatant fractions. The distribution varied with the tissue but only the intestinal mucosa had a greater proportion of total guanylate cyclase activity in the particulate fraction than the parotid. The two enzymes showed some similar properties. Their pH optima were pH 7.4, both enzymes were inhibited by ATP, dATP, dGTP and ITP, required Mn2+ for activity and plots of activity versus Mn2+ concentration were sigmoidal. However, in many properties the enzymes were dissimilar. The ratios of Mn2+ to GTP for optimum activity were 4 and 1.5 for the supernatant and plasma-bound enzymes, respectively. The slope of Hill plots for the supernatant enzyme with varying Mn2+ was 2. The particulate enzyme plots also had a slope of 2 at low M2+ concentration but at higher concentrations (above 0.7 mM) the Hill coefficient shifted abruptly to 4. Calcium ions reduced sigmoidicity of the kinetics lowering the Hill coefficient, activated the enzyme at all Mn2+ concentrations but had no effect on the Mn2+: GTP ratio with the supernatant enzyme while with the plasma membrane enzyme Ca2+ had no effect on the sigmoid form of the kinetics at low Mn2+ but prevented the shift to a greater Hill coefficient at higher Mn2+, inhibited the activity at low Mn2+ and shifted the Mn2+ : GTP optimum ratio to 4. For the particulate enzyme plots of activity versus GTP concentration were sigmoid (n=1.3), while the supernatant enzyme exhibited hyperbolic kinetics. [ABSTRACT FROM AUTHOR]

Published
1976
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41. Prevalence of cardiovascular events in a population-based registry of patients with systemic lupus erythematosus.

Author

Joyce DP, Berger JS, Guttmann A, Hasan G, Buyon JP, Belmont HM, Salmon J, Askanase A, Bathon J, Geraldino-Pardilla L, Ali Y, Ginzler EM, Putterman C, Gordon C, Helmick CG, Barbour KE, Gold HT, Parton H, and Izmirly PM

Subjects
Humans, Male, Female, Adult, Middle Aged, Prevalence, Retrospective Studies, Young Adult, Aged, Risk Factors, New York City epidemiology, Lupus Erythematosus, Systemic epidemiology, Lupus Erythematosus, Systemic ethnology, Registries, Cardiovascular Diseases epidemiology, Cardiovascular Diseases ethnology
Abstract

Background: The Manhattan Lupus Surveillance Program (MLSP), a population-based retrospective registry of patients with systemic lupus erythematosus (SLE), was used to investigate the prevalence of cardiovascular disease events (CVE) and compare rates among sex, age and race/ethnicity to population-based controls., Methods: Patients with prevalent SLE in 2007 aged ≥ 20 years in the MLSP were included. CVE required documentation of a myocardial infarction or cerebrovascular accident. We calculated crude risk ratios and adjusted risk ratios (ARR) controlling for sex, age group, race and ethnicity, and years since diagnosis. Data from the 2009-2010 National Health and Nutrition Examination Survey (NHANES) and the 2013-2014 NYC Health and Nutrition Examination Survey (NYC HANES) were used to calculate expected CVE prevalence by multiplying NHANES and NYC HANES estimates by strata-specific counts of patients with SLE. Crude prevalence ratios (PRs) using national and NYC estimates and age standardized prevalence ratios (ASPRs) using national estimates were calculated., Results: CVE occurred in 13.9% of 1,285 MLSP patients with SLE, and risk was increased among men (ARR:1.7, 95%CI:1.2-2.5) and older adults (age > 60 ARR:2.5, 95%CI:1.7-3.8). Compared with non-Hispanic Asian patients, CVE risk was elevated among Hispanic/Latino (ARR:3.1, 95%CI:1.4-7.0) and non-Hispanic Black (ARR:3.5, 95%CI1.6-7.9) patients as well as those identified as non-Hispanic and in another or multiple racial groups (ARR:4.2, 95%CI:1.1-15.8). Overall, CVE prevalence was higher among patients with SLE than nationally (ASPR:3.1, 95%CI:3.0-3.1) but did not differ by sex. Compared with national race and ethnicity-stratified estimates, CVE among patients with SLE was highest among Hispanics/Latinos (ASPR:4.3, 95%CI:4.2-4.4). CVE was also elevated among SLE registry patients compared with all NYC residents. Comparisons with age-stratified national estimates revealed PRs of 6.4 (95%CI:6.2-6.5) among patients aged 20-49 years and 2.2 (95%CI:2.1-2.2) among those ≥ 50 years. Male (11.3, 95%CI:10.5-12.1), Hispanic/Latino (10.9, 95%CI:10.5-11.4) and non-Hispanic Black (6.2, 95%CI:6.0-6.4) SLE patients aged 20-49 had the highest CVE prevalence ratios., Conclusions: These population-based estimates of CVE in a diverse registry of patients with SLE revealed increased rates among younger male, Hispanic/Latino and non-Hispanic Black patients. These findings reinforce the need to appropriately screen for CVD among all SLE patients but particularly among these high-risk patients., (© 2024. The Author(s).)

Published
2024
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42. The Use of Wastewater Surveillance to Estimate SARS-CoV-2 Fecal Viral Shedding Pattern and Identify Time Periods with Intensified Transmission.

Author

Yang W, Omoregie E, Olsen A, Watts EA, Parton H, and Lee E

Abstract

Background: Wastewater-based surveillance is an important tool for monitoring the COVID-19 pandemic. However, it remains challenging to translate wastewater SARS-CoV-2 viral load to infection number, due to unclear shedding patterns in wastewater and potential differences between variants., Objectives: We utilized comprehensive wastewater surveillance data and estimates of infection prevalence (i.e., the source of the viral shedding) available for New York City (NYC) to characterize SARS-CoV-2 fecal shedding pattern over multiple COVID-19 waves., Methods: We collected SARS-CoV-2 viral wastewater measurements in NYC during August 31, 2020 - August 29, 2023 ( N = 3794 samples). Combining with estimates of infection prevalence (number of infectious individuals including those not detected as cases), we estimated the time-lag, duration, and per-infection fecal shedding rate for the ancestral/Iota, Delta, and Omicron variants, separately. We also developed a procedure to identify occasions with intensified transmission., Results: Models suggested fecal viral shedding likely starts around the same time as and lasts slightly longer than respiratory tract shedding. Estimated fecal viral shedding rate was highest during the ancestral/Iota variant wave, at 1.44 (95% CI: 1.35 - 1.53) billion RNA copies in wastewater per day per infection (measured by RT-qPCR), and decreased by ∼20% and 50-60% during the Delta wave and Omicron period, respectively. We identified around 200 occasions during which the wastewater SARS-CoV-2 viral load exceeded the expected level in any of 14 sewersheds. These anomalies disproportionally occurred during late January, late April - early May, early August, and from late-November to late-December, with frequencies exceeding the expectation assuming random occurrence ( P < 0.05; bootstrapping test)., Discussion: These estimates may be useful in understanding changes in underlying infection rate and help quantify changes in COVID-19 transmission and severity over time. We have also demonstrated that wastewater surveillance data can support the identification of time periods with potentially intensified transmission.

Published
2024
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43. SARS-CoV-2 dynamics in New York City during March 2020-August 2023.

Author

Yang W, Parton H, Li W, Watts EA, Lee E, and Yuan H

Abstract

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been widespread since 2020 and will likely continue to cause substantial recurring epidemics. However, understanding the underlying infection burden (i.e., including undetected asymptomatic/mild infections) and dynamics, particularly since late 2021 when the Omicron variant emerged, is challenging due to the potential for asymptomatic and repeat SARS-CoV-2 infection, changes in testing practices, and changes in disease reporting. Here, we leverage extensive surveillance data available in New York City (NYC) and a comprehensive model-inference system to reconstruct SARS-CoV-2 dynamics therein from the pandemic onset in March 2020 to August 2023, and further validate the estimates using independent wastewater surveillance data. The validated model-inference estimates indicate a very high infection burden totaling twice the population size (>5 times documented case count) but decreasing infection-fatality risk (a >10-fold reduction) during the first 3.5 years. The detailed estimates also reveal highly complex variant dynamics and immune landscape, changing virus transmissibility, and higher infection risk during winter in NYC over this time period. These transmission dynamics and drivers, albeit based on data in NYC, may be relevant to other populations and inform future planning to help mitigate the public health burden of SARS-CoV-2.

Published
2024
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44. Prevalence of concomitant rheumatologic diseases and autoantibody specificities among racial and ethnic groups in SLE patients.

Author

Denvir B, Carlucci PM, Corbitt K, Buyon JP, Belmont HM, Gold HT, Salmon JE, Askanase A, Bathon JM, Geraldino-Pardilla L, Ali Y, Ginzler EM, Putterman C, Gordon C, Barbour KE, Helmick CG, Parton H, and Izmirly PM

Abstract

Objective: Leveraging the Manhattan Lupus Surveillance Program (MLSP), a population-based registry of cases of systemic lupus erythematosus (SLE) and related diseases, we investigated the proportion of SLE with concomitant rheumatic diseases, including Sjögren's disease (SjD), antiphospholipid syndrome (APLS), and fibromyalgia (FM), as well as the prevalence of autoantibodies in SLE by sex and race/ethnicity., Methods: Prevalent SLE cases fulfilled one of three sets of classification criteria. Additional rheumatic diseases were defined using modified criteria based on data available in the MLSP: SjD (anti-SSA/Ro positive and evidence of keratoconjunctivitis sicca and/or xerostomia), APLS (antiphospholipid antibody positive and evidence of a blood clot), and FM (diagnosis in the chart)., Results: 1,342 patients fulfilled SLE classification criteria. Of these, SjD was identified in 147 (11.0%, 95% CI 9.2-12.7%) patients with women and non-Latino Asian patients being the most highly represented. APLS was diagnosed in 119 (8.9%, 95% CI 7.3-10.5%) patients with the highest frequency in Latino patients. FM was present in 120 (8.9%, 95% CI 7.3-10.5) patients with non-Latino White and Latino patients having the highest frequency. Anti-dsDNA antibodies were most prevalent in non-Latino Asian, Black, and Latino patients while anti-Sm antibodies showed the highest proportion in non-Latino Black and Asian patients. Anti-SSA/Ro and anti-SSB/La antibodies were most prevalent in non-Latino Asian patients and least prevalent in non-Latino White patients. Men were more likely to be anti-Sm positive., Conclusion: Data from the MLSP revealed differences among patients classified as SLE in the prevalence of concomitant rheumatic diseases and autoantibody profiles by sex and race/ethnicity underscoring comorbidities associated with SLE., Competing Interests: PI- consulting fees from Momenta/Janssen; JB- consulting fees from Bristol-Myers Squibb, GlaxoSmithKline, Related Sciences LLC, Ventus Therapeutics; and CG-consulting fees from Alumis, Amgen, Astra-Zeneca, Sanofi, and UCB. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. AA and CP declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision., (© 2024 Denvir, Carlucci, Corbitt, Buyon, Belmont, Gold, Salmon, Askanase, Bathon, Geraldino-Pardilla, Ali, Ginzler, Putterman, Gordon, Barbour, Helmick, Parton and Izmirly.)

Published
2024
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45. Population-based prevalence and incidence estimates of mixed connective tissue disease from the Manhattan Lupus Surveillance Program.

Author

Hasan G, Ferucci ED, Buyon JP, Belmont HM, Salmon JE, Askanase A, Bathon JM, Geraldino-Pardilla L, Ali Y, Ginzler EM, Putterman C, Gordon C, Helmick CG, Parton H, and Izmirly PM

Subjects
Humans, Prevalence, Incidence, Antibodies, Antinuclear, Mixed Connective Tissue Disease diagnosis, Mixed Connective Tissue Disease epidemiology, Myositis, Lupus Erythematosus, Systemic
Abstract

Objective: Epidemiological data for MCTD are limited. Leveraging data from the Manhattan Lupus Surveillance Program (MLSP), a racially/ethnically diverse population-based registry of cases with SLE and related diseases including MCTD, we provide estimates of the prevalence and incidence of MCTD., Methods: MLSP cases were identified from rheumatologists, hospitals and population databases using a variety of International Classification of Diseases, Ninth Revision codes. MCTD was defined as one of the following: fulfilment of our modified Alarcon-Segovia and Kahn criteria, which required a positive RNP antibody and the presence of synovitis, myositis and RP; a diagnosis of MCTD and no other diagnosis of another CTD; and a diagnosis of MCTD regardless of another CTD diagnosis., Results: Overall, 258 (7.7%) cases met a definition of MCTD. Using our modified Alarcon-Segovia and Kahn criteria for MCTD, the age-adjusted prevalence was 1.28 (95% CI 0.72, 2.09) per 100 000. Using our definition of a diagnosis of MCTD and no other diagnosis of another CTD yielded an age-adjusted prevalence and incidence of MCTD of 2.98 (95% CI 2.10, 4.11) per 100 000 and 0.39 (95% CI 0.22, 0.64) per 100 000, respectively. The age-adjusted prevalence and incidence were highest using a diagnosis of MCTD regardless of other CTD diagnoses and were 16.22 (95% CI 14.00, 18.43) per 100 000 and 1.90 (95% CI 1.49, 2.39) per 100 000, respectively., Conclusions: The MLSP provided estimates for the prevalence and incidence of MCTD in a diverse population. The variation in estimates using different case definitions is reflective of the challenge of defining MCTD in epidemiologic studies., (© The Author(s) 2022. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For permissions, please email: journals.permissions@oup.com.)

Published
2023
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46. Evaluation of the EULAR/American College of Rheumatology Classification Criteria for Systemic Lupus Erythematosus in a Population-Based Registry.

Author

Guttmann A, Denvir B, Aringer M, Buyon JP, Belmont HM, Sahl S, Salmon JE, Askanase A, Bathon JM, Geraldino-Pardilla L, Ali Y, Ginzler EM, Putterman C, Gordon C, Helmick CG, Parton H, and Izmirly PM

Subjects
Humans, Female, United States, Incidence, Prevalence, Registries, Rheumatology, Lupus Erythematosus, Systemic epidemiology
Abstract

Objective: Using the Manhattan Lupus Surveillance Program, a multiracial/ethnic population-based registry, we aimed to compare 3 commonly used classification criteria for systemic lupus erythematosus (SLE) to identify unique cases and determine the incidence and prevalence of SLE using the EULAR/American College of Rheumatology (ACR) criteria., Methods: SLE cases were defined as fulfilling the 1997 ACR, the Systemic Lupus International Collaborating Clinics (SLICC), or the EULAR/ACR classification criteria. We quantified the number of cases uniquely associated with each and the number fulfilling all 3 criteria. Prevalence and incidence using the EULAR/ACR classification criteria and associated 95% confidence intervals (95% CIs) were calculated., Results: A total of 1,497 cases fulfilled at least 1 of the 3 classification criteria, with 1,008 (67.3%) meeting all 3 classifications, 138 (9.2%) fulfilling only the SLICC criteria, 35 (2.3%) fulfilling only the 1997 ACR criteria, and 34 (2.3%) uniquely fulfilling the EULAR/ACR criteria. Patients solely satisfying the EULAR/ACR criteria had <4 manifestations. The majority classified only by the 1997 ACR criteria did not meet any of the defined immunologic criteria. Patients fulfilling only the SLICC criteria did so based on the presence of features unique to this system. Using the EULAR/ACR classification criteria, age-adjusted overall prevalence and incidence rates of SLE in Manhattan were 59.6 (95% CI 55.9-63.4) and 4.9 (95% CI 4.3-5.5) per 100,000 population, with age-adjusted prevalence and incidence rates highest among non-Hispanic Black female patients., Conclusion: Applying the 3 commonly used classification criteria to a population-based registry identified patients with SLE fulfilling only 1 validated definition. The most recently developed EULAR/ACR classification criteria revealed prevalence and incidence estimates similar to those previously established for the ACR and SLICC classification schemes., (© 2022 American College of Rheumatology.)

Published
2023
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47. Notes from the Field: Epidemiologic Characteristics of SARS-CoV-2 Recombinant Variant XBB.1.5 - New York City, November 1, 2022-January 4, 2023.

Author

Luoma E, Rohrer R, Parton H, Hughes S, Omoregie E, Taki F, Wang JC, Akther S, Amin H, Chang C, Cheng I, Di Lonardo S, Eddy M, Firestein L, Li W, Su M, and Lee EH

Subjects
Humans, New York City epidemiology, SARS-CoV-2 genetics, COVID-19 epidemiology
Abstract

Competing Interests: All authors have completed and submitted the International Committee of Medical Journal Editors form for disclosure of potential conflicts of interest. No potential conflicts of interest were disclosed.

Published
2023
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48. COVID-19-Specific Mortality among World Trade Center Health Registry Enrollees Who Resided in New York City.

Author

Yung J, Li J, Kehm RD, Cone JE, Parton H, Huynh M, and Farfel MR

Subjects
Humans, New York City epidemiology, Registries, Pandemics, COVID-19, September 11 Terrorist Attacks
Abstract

We examined the all-cause and COVID-19-specific mortality among World Trade Center Health Registry (WTCHR) enrollees. We also examined the socioeconomic factors associated with COVID-19-specific death. Mortality data from the NYC Bureau of Vital Statistics between 2015-2020 were linked to the WTCHR. COVID-19-specific death was defined as having positive COVID-19 tests that match to a death certificate or COVID-19 mentioned on the death certificate via text searching. We conducted step change and pulse regression to assess excess deaths. Limiting to those who died in 2019 ( n = 210) and 2020 ( n = 286), we examined factors associated with COVID-19-specific deaths using multinomial logistic regression. Death rate among WTCHR enrollees increased during the pandemic (RR: 1.70, 95% CL: 1.25-2.32), driven by the pulse in March-April 2020 (RR: 3.38, 95% CL: 2.62-4.30). No significantly increased death rate was observed during May-December 2020. Being non-Hispanic Black and having at least one co-morbidity had a higher likelihood of COVID-19-associated mortality than being non-Hispanic White and not having any co-morbidity (AOR: 2.43, 95% CL: 1.23-4.77; AOR: 2.86, 95% CL: 1.19-6.88, respectively). The racial disparity in COVID-19-specific deaths attenuated after including neighborhood proportion of essential workers in the model (AOR:1.98, 95% CL: 0.98-4.01). Racial disparities continue to impact mortality by differential occupational exposure and structural inequality in neighborhood representation. The WTC-exposed population are no exception. Continued efforts to reduce transmission risk in communities of color is crucial for addressing health inequities.

Published
2022
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49. Evaluation of Data Sources for Carbon Monoxide Poisoning Surveillance in New York City.

Author

Goldberg R, McKelvey W, Lane K, Parton H, and Su MK

Subjects
Emergency Service, Hospital, Humans, Information Storage and Retrieval, International Classification of Diseases, Male, New York City epidemiology, Carbon Monoxide Poisoning diagnosis, Carbon Monoxide Poisoning epidemiology
Abstract

Context: Carbon monoxide (CO) exposure can be life-threatening. Suspected and confirmed cases of CO poisoning warranting health care in New York City (NYC) are reportable to the NYC Poison Control Center (PCC)., Objectives: We evaluated 4 hospital-based sources of CO surveillance data to identify ways to improve data capture and reporting., Design: Suspected and confirmed CO poisoning records from October 2015 through December 2016 were collected from the NYC emergency department (ED) syndromic surveillance system, New York State Statewide Planning and Research Cooperative System (SPARCS) ED billing data, NYC PCC calls made from hospitals, and the Electronic Clinical Laboratory Reporting System (ECLRS). Syndromic and SPARCS records were person- and visit-matched. SPARCS and ECLRS records were also matched to PCC records on combinations of name, demographic characteristics, and visit information., Setting: Hospitals in NYC., Participants: Individuals who visited NYC hospitals for CO-related health effects., Main Outcome Measures: We assessed the validity of syndromic data, with SPARCS records as the gold standard. We matched SPARCS and ECLRS records to PCC records to analyze reporting rates by case characteristics., Results: The sensitivity of syndromic surveillance was 60% (225 true-positives detected among 372 visit-matched SPARCS cases), and positive predictive value was 46%. Syndromic records often missed CO flags because of a nonspecific or absent International Classification of Diseases code in the diagnosis field. Only 15% of 428 SPARCS records (total includes 56 records not visit-matched to syndromic) and 16% of 199 ECLRS records were reported to PCC, with male sex and younger age associated with higher reporting., Conclusions: Mandatory reporting makes PCC useful for tracking CO poisoning in NYC, but incomplete reporting and challenges in distinguishing between confirmed and suspected cases limit its utility. Simultaneous tracking of the systems we evaluated can best reveal surveillance patterns., Competing Interests: The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (Copyright © 2021 The Authors. Published by Wolters Kluwer Health, Inc.)

Published
2022
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50. Incidence rates of systemic lupus erythematosus in the USA: estimates from a meta-analysis of the Centers for Disease Control and Prevention national lupus registries.

Author

Izmirly PM, Ferucci ED, Somers EC, Wang L, Lim SS, Drenkard C, Dall'Era M, McCune WJ, Gordon C, Helmick C, and Parton H

Subjects
Centers for Disease Control and Prevention, U.S., Ethnicity, Female, Humans, Incidence, Male, Registries, United States epidemiology, Lupus Erythematosus, Systemic epidemiology
Abstract

Objective: To estimate the annual incidence rate of SLE in the USA., Methods: A meta-analysis used sex/race/ethnicity-specific data spanning 2002-2009 from the Centers for Disease Control and Prevention network of four population-based state registries to estimate the incidence rates. SLE was defined as fulfilling the 1997 revised American College of Rheumatology classification criteria. Given heterogeneity across sites, a random effects model was employed. Applying sex/race/ethnicity-stratified rates, including data from the Indian Health Service registry, to the 2018 US Census population generated estimates of newly diagnosed SLE cases., Results: The pooled incidence rate per 100 000 person-years was 5.1 (95% CI 4.6 to 5.6), higher in females than in males (8.7 vs 1.2), and highest among black females (15.9), followed by Asian/Pacific Islander (7.6), Hispanic (6.8) and white (5.7) females. Male incidence was highest in black males (2.4), followed by Hispanic (0.9), white (0.8) and Asian/Pacific Islander (0.4) males. The American Indian/Alaska Native population had the second highest race-specific SLE estimates for females (10.4 per 100 000) and highest for males (3.8 per 100 000). In 2018, an estimated 14 263 persons (95% CI 11 563 to 17 735) were newly diagnosed with SLE in the USA., Conclusions: A network of population-based SLE registries provided estimates of SLE incidence rates and numbers diagnosed in the USA., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Published
2021
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