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1.
Am Soc Clin Oncol Educ Book ; 42: 1-16, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-35522914

RESUMO

By 2030, early-onset colorectal cancer (EOCRC) is expected to become the leading cancer-related cause of death for people age 20 to 49. To improve understanding of this phenomenon, we analyzed the geographic determinants of EOCRC in Utah by examining county-level incidence and mortality. We linked data from the Utah Population Database to the Utah Cancer Registry to identify residents (age 18-49) diagnosed with EOCRC between 2000 and 2020, and we used spatial empirical Bayes smoothing to determine county-level hotspots. We identified 1,867 EOCRC diagnoses (52.7% in male patients, 69.2% in non-Hispanic White patients). Ten counties (34%) were classified as hotspots, with high EOCRC incidence or mortality. Hotspot status was unrelated to incidence rates, but non-Hispanic ethnic-minority men (incidence rate ratio, 1.49; 95% CI, 1.15-1.91), Hispanic White men and women (incidence rate ratio, 2.24; 95% CI, 2.00-2.51), and Hispanic ethnic-minority men and women (incidence rate ratio, 4.59; 95% CI, 3.50-5.91) were more likely to be diagnosed with EOCRC. After adjustment for income and obesity, adults living in hotspots had a 31% higher hazard for death (HR, 1.31; 95% CI, 1.02-1.69). Survival was poorest for adults with a late-stage diagnosis living in hotspots (chi square (1) = 4.0; p = .045). Adults who were married or who had a life partner had a lower hazard for death than single adults (HR, 0.73; 95% CI, 0.58-0.92). The risk for EOCRC is elevated in 34% of Utah counties, warranting future research and interventions aimed at increasing screening and survival in the population age 18 to 49.


Assuntos
Neoplasias Colorretais , Adolescente , Adulto , Teorema de Bayes , Neoplasias Colorretais/diagnóstico , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Utah/epidemiologia , Adulto Jovem
2.
J Sex Med ; 19(5): 823-833, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-35341725

RESUMO

BACKGROUND: Pornography has become mainstream in society, including in the state of Utah, which is a highly religious, conservative state. AIM: The purpose of this study is to gather basic descriptive norms for pornography use in the state of Utah (given its unique religious profile), establish clinical cutoffs based on frequency and duration of pornography consumption, and begin to establish a clinical picture of problematic pornography use in a regionally representative sample. METHODS: We recruited a representative sample of 892 Utahns via CloudResearch.com. Participants completed the following measures: Consumption of Pornography - General (COPS); Problematic Pornography Use Scale; Clear Lake Addiction to Pornography Scale; The Inventory of Depression and Anxiety Symptoms (Second Version). OUTCOME: Documentation of pornography use norms among Utahns. RESULTS: In our sample, 79% reported viewing pornography in their lifetime (85% of men, 75% of women). The most common frequency of pornography viewing was weekly or monthly among men, and monthly or every 6 months among women, which is comparable to national averages. Men and women showed significantly different pornography use frequencies. We demonstrate a relationship between higher levels of pornography use and higher perceived levels of pornography use as a problem or "addiction" and depression scores and explore the typical demographics of our highest pornography users. CLINICAL TRANSLATION: This study will aid clinicians in using the COPS to derive normal pornography use compared to above average pornography use among pornography users from a religious background, especially for clinicians who seek to provide normative data to clients presenting with problematic pornography use like in motivational interviewing interventions. STRENGTHS AND LIMITATIONS: Strengths include our measures generally demonstrated strong validity, we provide the beginnings of sound clinical implementation of the COPS for benchmarking pornography use in a clinical setting in Utah, and that our sample was representative of the state of Utah according to current census data. Limitations include those commonly seen in survey-based data collection methods, and that findings from our unique Utah sample may not be as relevant among other religious or cultural samples. CONCLUSION: Our findings provide an updated picture of pornography use in the state of Utah and suggest that even those high in religiosity continue to use pornography. Our results can provide a spectrum of pornography use, aiding a pornography user in treatment to be able to compare his or her use to this norm. Esplin CR, Hatch SG, Ogles BM, et al. What is Normal Pornography Use in a Highly Religious Area? Exploring Patterns of Pornography Use in Utah. J Sex Med 2022;19:823-833.


Assuntos
Comportamento Aditivo , Literatura Erótica , Feminino , Humanos , Masculino , Religião , Comportamento Sexual , Inquéritos e Questionários , Utah
3.
JAMA Netw Open ; 5(2): e2147882, 2022 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-35142831

RESUMO

Importance: Sepsis guidelines and research have focused on patients with sepsis who are admitted to the hospital, but the scope and implications of sepsis that is managed in an outpatient setting are largely unknown. Objective: To identify the prevalence, risk factors, practice variation, and outcomes for discharge to outpatient management of sepsis among patients presenting to the emergency department (ED). Design, Setting, and Participants: This cohort study was conducted at the EDs of 4 Utah hospitals, and data extraction and analysis were performed from 2017 to 2021. Participants were adult ED patients who presented to a participating ED from July 1, 2013, to December 31, 2016, and met sepsis criteria before departing the ED alive and not receiving hospice care. Exposures: Patient demographic and clinical characteristics, health system parameters, and ED attending physician. Main Outcomes and Measures: Information on ED disposition was obtained from electronic medical records, and 30-day mortality data were acquired from Utah state death records and the US Social Security Death Index. Factors associated with ED discharge rather than hospital admission were identified using penalized logistic regression. Variation in ED discharge rates between physicians was estimated after adjustment for potential confounders using generalized linear mixed models. Inverse probability of treatment weighting was used in the primary analysis to assess the noninferiority of outpatient management for 30-day mortality (noninferiority margin of 1.5%) while adjusting for multiple potential confounders. Results: Among 12 333 ED patients with sepsis (median [IQR] age, 62 [47-76] years; 7017 women [56.9%]) who were analyzed in the study, 1985 (16.1%) were discharged from the ED. After penalized regression, factors associated with ED discharge included age (adjusted odds ratio [aOR], 0.90 per 10-y increase; 95% CI, 0.87-0.93), arrival to ED by ambulance (aOR, 0.61; 95% CI, 0.52-0.71), organ failure severity (aOR, 0.58 per 1-point increase in the Sequential Organ Failure Assessment score; 95% CI, 0.54-0.60), and urinary tract (aOR, 4.56 [95% CI, 3.91-5.31] vs pneumonia), intra-abdominal (aOR, 0.51 [95% CI, 0.39-0.65] vs pneumonia), skin (aOR, 1.40 [95% CI, 1.14-1.72] vs pneumonia) or other source of infection (aOR, 1.67 [95% CI, 1.40-1.97] vs pneumonia). Among 89 ED attending physicians, adjusted ED discharge probability varied significantly (likelihood ratio test, P < .001), ranging from 8% to 40% for an average patient. The unadjusted 30-day mortality was lower in discharged patients than admitted patients (0.9% vs 8.3%; P < .001), and their adjusted 30-day mortality was noninferior (propensity-adjusted odds ratio, 0.21 [95% CI, 0.09-0.48]; adjusted risk difference, 5.8% [95% CI, 5.1%-6.5%]; P < .001). Alternative confounder adjustment strategies yielded odds ratios that ranged from 0.21 to 0.42. Conclusions and Relevance: In this cohort study, discharge to outpatient treatment of patients who met sepsis criteria in the ED was more common than previously recognized and varied substantially between ED physicians, but it was not associated with higher mortality compared with hospital admission. Systematic, evidence-based strategies to optimize the triage of ED patients with sepsis are needed.


Assuntos
Assistência Ambulatorial/normas , Serviço Hospitalar de Emergência/normas , Alta do Paciente/normas , Guias de Prática Clínica como Assunto , Sepse/terapia , Idoso , Assistência Ambulatorial/estatística & dados numéricos , Estudos de Coortes , Serviço Hospitalar de Emergência/estatística & dados numéricos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Razão de Chances , Alta do Paciente/estatística & dados numéricos , Prevalência , Estudos Retrospectivos , Fatores de Risco , Resultado do Tratamento , Utah
4.
Hum Nat ; 33(1): 1-21, 2022 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-35175544

RESUMO

Social network analysis has become an increasingly important tool among political scientists for understanding legislative cooperation in modern, democratic nation-states. Recent research has demonstrated the influence that group affinity (homophily) and mutual exchanges (reciprocity) have in structuring political relationships. However, this literature has typically focused on political cooperation where costs are low, relationships are not exclusive, and/or partisan competition is high. Patterns of legislative behavior in alternative contexts are less clear and remain largely unexamined. Here, we compare theoretical expectations of cooperation in these contexts from the political and biosocial sciences and implement the first assessment of political alliance formation in a novel legislative environment where costs to cooperation are high and party salience low. We implement a stochastic actor-oriented model (SAOM) to examine bill floor sponsorship, a process in which a "floor sponsor" becomes the exclusive advocate for a colleague's piece of legislation, in the Utah state legislature from 2005 to 2008-a context in which gender (male) and political party (Republican) supermajorities exist. We find that (1) party and gender homophily predict who legislators recruit as floor sponsors, whereas seniority does not, and (2) legislators frequently engage in reciprocal exchanges of floor sponsorship. In addition, whereas gender homophily increases the likelihood of reciprocity, party homophily decreases it. Our findings suggest that when the cost of cooperation is high, political actors use in-group characteristics for initiating alliances, but once a cooperative relationship is established with an out-group political member, it is reinforced through repeated exchanges. These findings may be useful for understanding the rise of political polarization and gridlock in democracies internationally.


Assuntos
Política , Humanos , Masculino , Utah
5.
PLoS One ; 17(1): e0263025, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35077511

RESUMO

The highly contagious nature of SARS-CoV-2 has led to several studies on the transmission of the virus. A little studied potential fomite of great concern in the community is currency, which has been shown to harbor microbial pathogens in several studies. Since the onset of the COVID-19 pandemic, many businesses in the United States have limited the use of banknotes in favor of credit cards. However, SARS-CoV-2 has shown greater stability on plastic in several studies. Herein, the stability of SARS-CoV-2 at room temperature on banknotes, money cards and coins was investigated. In vitro studies with live virus suggested SARS-CoV-2 was highly unstable on banknotes, showing an initial rapid reduction in viable virus and no viral detection by 24 hours. In contrast, SARS-CoV-2 displayed increased stability on money cards with live virus detected after 48 hours. Environmental swabbing of currency and money cards on and near the campus of Brigham Young University supported these results, with no detection of SARS-CoV-2 RNA on banknotes, and a low level on money cards. However, no viable virus was detected on either. These preliminary results suggest that the use of money cards over banknotes in order to slow the spread of this virus may be ill-advised. These findings should be investigated further through larger environmental studies involving more locations.


Assuntos
COVID-19/transmissão , Fômites/virologia , SARS-CoV-2/isolamento & purificação , Animais , Chlorocebus aethiops , Papel , Plásticos , SARS-CoV-2/patogenicidade , Utah , Células Vero
6.
Obstet Gynecol ; 139(2): 211-222, 2022 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-34991148

RESUMO

OBJECTIVE: To compare risks of adverse birth outcomes among pregnancies conceived with and without medically assisted reproduction treatments. METHODS: Birth certificates were used to study birth outcomes of all neonates born in Utah from 2009 through 2017. Of the 469,919 deliveries, 52.8% (N=248,013) were included in the sample, with 5.2% of the neonates conceived through medically assisted reproduction. The outcome measures included birth weight, gestational age, low birth weight (LBW, less than 2,500 g), preterm birth (less than 37 weeks of gestation), and small for gestational age (SGA, birth weight less than the 10th percentile). Linear models were estimated for the continuous outcomes (birth weight, gestational age), and linear probability models were used for the binary outcomes (LBW, preterm birth, SGA). First, we compared the birth outcomes of neonates born after medically assisted reproduction and natural conception in the overall sample (between-family analyses), before and after adjustment for parental background and neonatal characteristics. Second, we employed family fixed effect models to investigate whether the birth outcomes of neonates conceived through medically assisted reproduction differed from those of their naturally conceived siblings (within-family comparisons). RESULTS: Neonates conceived through medically assisted reproduction weighed less, were born earlier, and were more likely to be LBW, preterm, and SGA than neonates conceived naturally. More invasive treatments (assisted reproductive technology [ART] and artificial insemination [AI] or intrauterine insemination) were associated with worse birth outcomes; for example, the proportion of LBW and preterm birth was 6.1% and 7.9% among neonates conceived naturally and 25.5% and 29.8% among neonates conceived through ART, respectively. After adjustments for various neonatal and parental characteristics, the differences in birth outcomes between neonates conceived through medically assisted reproduction and naturally were attenuated yet remained statistically significant; for example, neonates conceived through ART were at 3.2 percentage points higher risk for LBW (95% CI 2.4-4.1) and 4.8 percentage points higher risk for preterm birth (95% CI 3.9-5.7). Among siblings, the differences in the frequency of adverse outcomes between neonates conceived through medically assisted reproduction and neonates conceived naturally were small and statistically insignificant for all types of treatments. CONCLUSION: Medically assisted reproduction treatments are associated with adverse birth outcomes; however, those risks are unlikely to be associated with the infertility treatments itself.


Assuntos
Complicações na Gravidez/epidemiologia , Técnicas de Reprodução Assistida/estatística & dados numéricos , Adulto , Estudos Transversais , Feminino , Humanos , Recém-Nascido , Recém-Nascido Prematuro , Recém-Nascido Pequeno para a Idade Gestacional , Masculino , Gravidez , Complicações na Gravidez/etiologia , Técnicas de Reprodução Assistida/efeitos adversos , Utah/epidemiologia , Adulto Jovem
7.
Environ Sci Technol ; 56(3): 1885-1893, 2022 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-35044770

RESUMO

There have only been a few wintertime studies of heavy-duty vehicle (HDV) NOx emissions in the United States, and while they have observed increased emissions, fleet characterization to identify the cause has been lacking. We have collected wintertime measurements of NOx emission factors from 1591 HDVs at a Utah Port of Entry in December 2020 that includes individual vehicle identification. In general, NOx emission factors for 2011 and newer chassis model year HDV are significantly higher than those for 2017 spring measurements from California. The newest chassis model year HDV (2017-2021) NOx emission factors are similar, indicating no significant emission deterioration over the 5 year period, though they are still approximately a factor of 3 higher than the portable emission measurement on-road enforcement standard. We estimate that ambient temperature increases NOx emissions no more than 25% in the newer HDV, likely through reductions in catalyst efficiencies. NOx emissions increase to a significantly higher level for the 2011-2013 chassis model year vehicles, where within the uncertainties, they have emissions similar to older precontrol vehicles, indicating that they have lost their NOx control capabilities within 8 years. MOVES3 modeling of the Utah fleet underpredicted mean NOx emissions by a factor of 1.8 but the MOVES3 estimate is helped by including a larger fraction of high-emitting glider kit trucks (new chassis with pre-emission control engines) than found in the observations.


Assuntos
Poluentes Atmosféricos , Emissões de Veículos , Poluentes Atmosféricos/análise , Monitoramento Ambiental , Veículos Automotores , Óxido Nítrico , Óxidos de Nitrogênio/análise , Utah , Emissões de Veículos/análise
8.
J Vet Diagn Invest ; 34(1): 82-85, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34697977

RESUMO

Mink are susceptible to infection with influenza A virus (IAV) of swine and human origin. In 2019, a Utah mink farm had an outbreak of respiratory disease in kits caused by infection with the pandemic influenza A(H1N1)2009 virus [A(H1N1)pdm09]. In 3 wk, ~325, 1-2-wk-old kits died (10% mortality in kits). All deaths occurred in a single barn that housed 640 breeding females. No clinical signs or deaths occurred among adult mink. Five dead kits and 3 euthanized female mink were autopsied. All kits had moderate-to-severe neutrophilic and lymphohistiocytic interstitial pneumonia; adult mink had minimal-to-moderate lymphohistiocytic bronchointerstitial pneumonia. Immunohistochemistry and real-time PCR targeting the matrix gene detected IAV in lung of kits and adults. Virus isolation and genetic analysis identified the A(H1N1)pdm09 virus. The source of the virus was not determined but is thought to be the result of reverse zoonosis. Our case emphasizes the need for close monitoring on mink farms for interspecies transmission of IAV and for safe work practices on farms and in diagnostic laboratories. Additionally, a pandemic virus may continue to circulate at low levels long after the global event is declared over.


Assuntos
Vírus da Influenza A Subtipo H1N1 , Vison , Infecções por Orthomyxoviridae/veterinária , Animais , Fazendas , Feminino , Vírus da Influenza A Subtipo H1N1/genética , Masculino , Vison/virologia , Infecções por Orthomyxoviridae/epidemiologia , Utah/epidemiologia
9.
Am J Clin Pathol ; 157(4): 498-501, 2022 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-34664618

RESUMO

OBJECTIVES: Hantavirus is endemic in the Four Corners region of Arizona, Colorado, New Mexico, and Utah, and hantavirus cardiopulmonary syndrome (HCPS) disproportionately affects the Navajo Nation. We describe the application of a rapid screening tool for identification of HCPS. METHODS: A rapid screening tool for HCPS was implemented at Tséhootsooí Medical Center (TMC) in collaboration with academic partners. RESULTS: Since its implementation in 2016, 20 TMC staff members have been trained to perform this test, and 189 screens for HCPS have been reported. Although hantavirus infection is rare even in high-risk areas, use of this tool resulted in the identification of 4 acute cases of hantavirus infection. CONCLUSIONS: The results demonstrate the successful implementation of a 5-point screening tool for hantavirus infection in an endemic setting by a laboratory in a small community hospital.


Assuntos
Infecções por Hantavirus , Hantavirus , Infecções por Hantavirus/epidemiologia , Hospitais Comunitários , Humanos , Síndrome , Utah/epidemiologia
10.
Matern Child Health J ; 26(2): 397-406, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-34633615

RESUMO

OBJECTIVES: Despite known health benefits of breastfeeding, the Navajo have low reported frequency of breastfeeding initiation and support. We evaluated breastfeeding frequencies and practices in the predominately Navajo community of rural San Juan County, Utah, to identify factors that affect breastfeeding decisions and duration. METHODS: We performed retrospective chart review for 135 infants aged 0 to 12 months, and surveys of 85 mothers of infants aged 0 to 2 years, and eight primary care providers. We characterized demographic factors using counts/percentages and medians/inter-quartile ranges, and compared mothers who breastfed for 6 months or less versus greater than 6 months. RESULTS: In 96 infants with complete feeding documentation, 86 infants (90%) received some breast milk and 36 infants (38%) were exclusively breastfed at age 2 months. In 67 infants with complete feeding documentation at ≥ 6 months, 22 infants (33%) were exclusively breastfed 6 months. Most mothers knew about breastfeeding benefits. In 56 mothers whose infants were aged ≥ 6 months at the time of the survey, breastfeeding for more than 6 months had been planned by 44 mothers (79%) but performed by only 29 mothers (52%). Mothers who breastfed for > 6 months were more likely to have been influenced by WIC and less likely to have introduced formula at an early age. Barriers to breastfeeding included maternal pain, latch difficulties, and concerns about inadequate milk supply. Primary care providers reported limited confidence in providing breastfeeding support but would support telehealth-driven interventions. CONCLUSIONS FOR PRACTICE: Practical, culturally sensitive interventions, including telehealth and improved provider education, may improve breastfeeding outcomes and community health in this underserved population.


Assuntos
Aleitamento Materno , Leite Humano , Atitude , Feminino , Humanos , Lactente , Mães , Estudos Retrospectivos , Utah
11.
Int J Obes (Lond) ; 46(1): 107-112, 2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-34508153

RESUMO

BACKGROUND/OBJECTIVES: While an increased risk for substance use disorders (SUD) and also for several adverse pregnancy and birth outcomes in patients who have undergone bariatric surgery have been well documented when considered separately, an association between these important risk factors has not been investigated. This study explored the potential dependence of these two bariatric surgery-related risks. SUBJECTS/METHODS: This study was a retrospective cohort study with adult women (18-45) who underwent bariatric surgery between 1996 and 2016 and who gave birth after surgery between 1996 and 2018. The study population consisted of 1849 post-bariatric surgery women with 3010 reported post-surgical births. Subjects with post-surgical, prenatal SUD were identified based on diagnosis codes extracted within the 10 months prior to delivery. Using random-effects logistic regression with retrospective cohort data, preterm birth, low birth weight, macrosomia, Caesarian delivery, congenital anomalies, and neonatal intensive care unit admission were considered as outcomes. RESULTS: About 10% (n = 289) of women had an SUD diagnosis within 10 months prior to child delivery. Women with SUD during pregnancy had significantly more pregnancy and birth complications compared to women without SUD: preterm birth (OR = 2.08, p = 0.03, 95% CI: 1.07-4.03), low birth weight (OR = 3.41, p < 0.01, 95% CI: 1.99-5.84), Caesarian delivery (OR = 9.71, p < 0.01, 95% CI: 2.69-35.05), and neonatal intensive care unit admission (OR = 3.87, p < 0.01, 95% CI: 2.04-7.34). Women with SUD had lower risk for macrosomia than women without SUD (OR = 0.07, p = 0.02, 95% CI: 0.01-0.70). CONCLUSION: Results from this study demonstrated that post-bariatric surgery women who had SUD during pregnancy had significantly more pregnancy- and birth-related complications than post-surgery pregnant women without SUD, despite the reduction in macrosomia. Where possible, greater prenatal surveillance of post-surgery women with SUD should be considered.


Assuntos
Cuidado Pré-Natal/estatística & dados numéricos , Transtornos Relacionados ao Uso de Substâncias/complicações , Adulto , Cirurgia Bariátrica/métodos , Cirurgia Bariátrica/estatística & dados numéricos , Estudos de Coortes , Feminino , Humanos , Recém-Nascido , Gravidez , Complicações na Gravidez/epidemiologia , Resultado da Gravidez/epidemiologia , Cuidado Pré-Natal/métodos , Estudos Retrospectivos , Transtornos Relacionados ao Uso de Substâncias/fisiopatologia , Utah/epidemiologia
12.
Sex Reprod Healthc ; 31: 100688, 2022 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-34864316

RESUMO

OBJECTIVE: Research has called for more exploration into how reproductive autonomy (which includes agency over pregnancy decisions) is related to structural, relational, and individual elements. Thus, we use surveys to investigate how one potential indicator of reproductive autonomy-feelings of control over pregnancy-may relate to structural, relational, and individual factors in emerging adults' (age 18-24) lives. METHODS: Using survey data from 2594 emerging adult women participating in a contraceptive initiative in Utah (USA), we analyzed level of agreement with the statement: "I feel that I have control over whether or not I get pregnant," exploring relationships between sociodemographic characteristics and agreement with the statement. We used chi-square tests and multinomial logistic regression to investigate relationships between individual, relational, and structural factors and feelings of control. RESULTS: Most participants (86%) agreed with the statement (n = 2231), while the remainder were neutral or disagreed. Participants reporting poverty-level incomes (RRR: 1.80; 95 %CI 1.25-2.59) and previous unwanted pregnancies (RRR: 2.74; 95 %CI: 1.56-4.81) were more likely to describe "neutral" feelings of control. CONCLUSION: Findings indicate a relationship between feelings of control over pregnancy and several factors, and these results may help identify reproductive autonomy access gaps among emerging adults. More work should investigate these relationships as well as the meaning of "neutral" responses when it comes to assessments of control over pregnancy. TRIAL REGISTRATION: Clinicaltrials.gov identifier NCT02734199, Registered 12 April 2016.


Assuntos
Anticoncepção , Anticoncepcionais , Adolescente , Anticoncepção/métodos , Comportamento Contraceptivo , Emoções , Feminino , Humanos , Gravidez , Reprodução , Utah , Adulto Jovem
13.
J Wildl Dis ; 58(1): 222-227, 2022 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-34780603

RESUMO

We investigated causes of antler deformities in mule deer (Odocoileus hemionus) bucks from the Paunsaugunt Plateau in southern Utah, US. A total of 10 hunter-harvested and nine live-captured bucks with antler deformities and six hunter-harvested and 43 live-captured bucks with normal antlers were included in the study. All were screened by serology for exposure to epizootic hemorrhagic disease virus (EHDV) types 1, 2, and 6, bluetongue virus, Brucella abortus, Brucella ovis, caprine arthritis, encephalitis virus, and bovine viral diarrhea virus (BVDV) types 1 and 2. Serum testosterone and trace minerals concentrations were measured, and whole-blood counts evaluated. Testicular tissue from the hunter-harvested bucks was tested by quantitative PCR for EHDV-1, -2, and -6. All bucks with antler deformities had low to non-detectable serum testosterone concentrations from end-stage fibrosing orchitis, and EHDV-2 was detected by quantitative PCR in one of the testicular tissues tested. All bucks with antler deformities were seropositive for EHDV-2. In comparison, only 53% of bucks with normal antlers were EHDV-2 seropositive. More than 67% of hunter-harvested and live-captured bucks had antibodies to BVDV-1 and BVDV-2, probably because of high cattle exposure in the area. Our results support previous research linking infection with EHDV-2 to development of antler deformities; however, it remains unclear why some infected bucks develop testicular fibrosis, and others recover from the infection.


Assuntos
Chifres de Veado , Cervos , Vírus da Doença Hemorrágica Epizoótica , Animais , Bovinos , Equidae , Cabras , Masculino , Utah/epidemiologia
14.
J Rheumatol ; 49(3): 307-311, 2022 03.
Artigo em Inglês | MEDLINE | ID: mdl-34725179

RESUMO

OBJECTIVE: Rates of total knee arthroplasty (TKA) among Medicare beneficiaries (adults aged ≥ 65 yrs) vary across the United States, with higher rates in the Midwest and West than in the South. It is not known if a similar variation is present among younger patients, or if findings in Medicare reflect selective postponement of TKA in some regions. METHODS: Data on all primary TKA performed in adults aged ≥ 20 years in 3 states (Iowa, Utah, and Florida) in 2016 were obtained from state inpatient databases. Rates of TKA were computed based on population census data. Age-, sex-, and race-standardized rates were compared between Iowa and Florida, and between Utah and Florida, among adults aged 20-64 years and adults aged ≥ 65 years. RESULTS: There were 10,074, 8954, and 43,908 primary TKAs in Iowa, Utah, and Florida, respectively. Standardized rates were higher in Iowa and Utah than in Florida among both adults aged 20-64 years (Iowa:Florida rate ratio [RR] 1.89, 95% CI 1.79-1.99; Utah:Florida RR 2.31, 95% CI 2.18-2.45) and those aged ≥ 65 years (Iowa:Florida RR 1.41, 95% CI 1.35-1.47; Utah:Florida RR 1.77, 95% CI 1.70-1.85). Results were similar in sensitivity analyses limited to White patients, urban residents, and those with a diagnosis of knee osteoarthritis. CONCLUSION: TKA rates were higher in Iowa and Utah than in Florida among both younger adults and those aged ≥ 65 years, indicating that geographic differences are not specific to elderly patients.


Assuntos
Artroplastia do Joelho , Osteoartrite do Joelho , Idoso , Artroplastia do Joelho/métodos , Bases de Dados Factuais , Humanos , Medicare , Osteoartrite do Joelho/epidemiologia , Osteoartrite do Joelho/cirurgia , Estados Unidos/epidemiologia , Utah/epidemiologia
15.
Schizophr Bull ; 48(2): 457-462, 2022 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-34559220

RESUMO

Approximately 5% of individuals with schizophrenia die from suicide. However, suicide in psychosis is still poorly characterized, partly due to a lack of adequate population-based clinical or genetic data on suicide death. The Utah Suicide Genetics Research Study (USGRS) provides a large population-based cohort of suicide deaths with medical record and genome-wide data (N = 4380). Examination of this cohort identified medical and genetic risks associated with type of suicide death and investigated the relative contributions of psychotic and affective symptoms to method of suicide. Key differences in method of suicide (common vs. atypical methods) were tested in relation to lifetime psychosis and genome-wide genetic risk for schizophrenia, major depressive disorder, and neuroticism. Consistent with previous studies, psychosis-spectrum disorders were observed to be common in suicide (15% of the cohort). Individuals with psychosis more frequently died from atypical methods, with rates of atypical suicide increasing across the schizophrenia spectrum. Genetic risk for schizophrenia was also associated with atypical suicide, regardless of clinical diagnosis, though this association weakened when filtering individuals with schizophrenia from the analysis. Follow-up examination indicated that high rates of atypical suicide observed in schizophrenia are not likely accounted for by restricted access to firearms. Overall, better accounting for the increased risk of atypical suicide methods in psychosis could lead to improved prevention strategies in a large portion of the suicide risk population.


Assuntos
Transtornos Psicóticos/psicologia , Suicídio/psicologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Estudos de Coortes , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Transtornos Psicóticos/epidemiologia , Fatores de Risco , Suicídio/estatística & dados numéricos , Utah/epidemiologia
16.
JAMA Pediatr ; 176(1): 59-67, 2022 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-34623377

RESUMO

Importance: Data about the risk of SARS-CoV-2 infection among children compared with adults are needed to inform COVID-19 risk communication and prevention strategies, including COVID-19 vaccination policies for children. Objective: To compare incidence rates and clinical characteristics of SARS-CoV-2 infection among adults and children and estimated household infection risks within a prospective household cohort. Design, Setting, and Participants: Households with at least 1 child aged 0 to 17 years in selected counties in Utah and New York City, New York, were eligible for enrollment. From September 2020 through April 2021, participants self-collected midturbinate nasal swabs for reverse transcription-polymerase chain reaction testing for SARS-CoV-2 and responded to symptom questionnaires each week. Participants also self-collected additional respiratory specimens with onset of COVID-19-like illness. For children unable to self-collect respiratory specimens, an adult caregiver collected the specimens. Main Outcomes and Measures: The primary outcome was incident cases of any SARS-CoV-2 infection, including asymptomatic and symptomatic infections. Additional measures were the asymptomatic fraction of infection calculated by dividing incidence rates of asymptomatic infection by rates of any infection, clinical characteristics of infection, and household infection risks. Primary outcomes were compared by participant age group. Results: A total of 1236 participants in 310 households participated in surveillance, including 176 participants (14%) who were aged 0 to 4 years, 313 (25%) aged 5 to 11 years, 163 (13%) aged 12 to 17 years, and 584 (47%) 18 years or older. Overall incidence rates of SARS-CoV-2 infection were 3.8 (95% CI, 2.4-5.9) and 7.7 (95% CI, 4.1-14.5) per 1000 person-weeks among the Utah and New York City cohorts, respectively. Site-adjusted incidence rates per 1000 person-weeks were similar by age group: 6.3 (95% CI, 3.6-11.0) for children 0 to 4 years, 4.4 (95% CI, 2.5-7.5) for children 5 to 11 years, 6.0 (95% CI, 3.0-11.7) for children 12 to 17 years, and 5.1 (95% CI, 3.3-7.8) for adults (≥18 years). The asymptomatic fractions of infection by age group were 52%, 50%, 45%, and 12% among individuals aged 0 to 4 years, 5 to 11 years, 12 to 17 years, and 18 years or older, respectively. Among 40 households with 1 or more SARS-CoV-2 infections, the mean risk of SARS-CoV-2 infection among all enrolled household members was 52% (range, 11%-100%), with higher risks in New York City compared with Utah (80% [95% CI, 64%-91%] vs 44% [95% CI, 36%-53%]; P < .001). Conclusions and Relevance: In this study, children had similar incidence rates of SARS-CoV-2 infection compared with adults, but a larger proportion of infections among children were asymptomatic.


Assuntos
Infecções Assintomáticas/epidemiologia , Teste para COVID-19/estatística & dados numéricos , COVID-19/transmissão , Adolescente , Adulto , COVID-19/epidemiologia , Criança , Pré-Escolar , Busca de Comunicante/estatística & dados numéricos , Suscetibilidade a Doenças , Características da Família , Humanos , Incidência , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Cidade de Nova Iorque/epidemiologia , Estudos Prospectivos , Utah/epidemiologia , Adulto Jovem
17.
Andrologia ; 54(1): e14293, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-34734429

RESUMO

We determine the time to first live birth for female partners of males after a cancer diagnosis. Our group performed a retrospective, population-based, age-matched cohort study of Utah male residents diagnosed with cancer at age 18 years or later between 1956 and 2013 (exposed) matched to male Utah residents without cancer diagnosis (unexposed). Using stratified Cox proportional hazard models, we adjusted for race, ethnicity and number of live births prior to cancer diagnosis, to estimate the effect of time to a partner live birth following cancer diagnosis. Our study cohort included 19,303 men diagnosed with cancer (exposed) and 93,608 age-matched men without cancer diagnoses (unexposed). Exposed men were less likely to have a live birth prior to first cancer diagnosis (60.7% vs. 65.4%, p < 0.001) and after first cancer diagnosis (10.9% vs. 12.2%, p < 0.001) compared to unexposed men. Exposed men had a fertility hazard rate that was 31% lower after cancer diagnosis date than unexposed men (HR: 0.69; 95% CI: 0.65-0.72). This was most profound for men aged 18-30 years (HR: 0.59, 95% CI: 0.55-0.63). Male cancer survivors have a 31% lower female partner live birth rate after cancer diagnosis. These findings are important for patient counselling regarding fertility preservation at the time of cancer diagnosis.


Assuntos
Sobreviventes de Câncer , Neoplasias , Adolescente , Coeficiente de Natalidade , Estudos de Coortes , Feminino , Humanos , Nascido Vivo/epidemiologia , Masculino , Neoplasias/epidemiologia , Gravidez , Estudos Retrospectivos , Utah/epidemiologia
18.
Am J Gastroenterol ; 117(2): 336-342, 2022 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-34889311

RESUMO

INTRODUCTION: Patients with serrated polyposis syndrome (SPS) and their first-degree relatives (FDRs) have increased colorectal cancer (CRC) risk. Patients with sporadic sessile serrated lesion (SSL) have risk for progression to CRC. Yet familial risks of common extracolonic cancers and even CRC in these cohorts are poorly understood. Our aim was to examine cancer risk for patients with SPS and sporadic SSL and their close and more distant relatives using a large population database. METHODS: Patients with SPS (n = 59) from hereditary patient registries were eligible for study. Sporadic SSL (n = 754) and sex- and age-matched normal colonoscopy controls (n = 1,624) were selected from clinical data linked to the Utah Population Database. Cox models adjusting for the number of relatives, degree of relatedness, and person-years at risk were used to estimate CRC, extracolonic, and any-site adenocarcinoma/carcinoma cancer risk in patients and their relatives. RESULTS: Compared with controls, CRC risk was elevated 10-fold in patients with SPS (P = 0.04) and 5-fold in their FDRs (P = 0.001). Any-site adenoma/carcinoma risk was increased 2.6-fold in FDRs of patients with SPS. No elevated risks of other common extracolonic cancers were observed in SPS and family members. The FDRs, second-degree relatives, and third-degree relatives of patients with both SSL and adenomatous polyps exhibited a 50% increased CRC risk. DISCUSSION: Patients with SPS and their FDRs have an increased CRC risk, confirming other reports. Interestingly, patients with SSL were noted to have an increased risk of prostate cancer. Relatives of individuals with both sporadic SSL and adenomas, irrespective of size or dysplasia on examination, may have an elevated CRC risk, suggesting closer colonoscopy surveillance in this population.


Assuntos
Adenocarcinoma/diagnóstico , Polipose Adenomatosa do Colo/diagnóstico , Neoplasias Colorretais/diagnóstico , Detecção Precoce de Câncer/métodos , Predisposição Genética para Doença , Sistema de Registros , Medição de Risco/métodos , Adenocarcinoma/epidemiologia , Polipose Adenomatosa do Colo/etiologia , Polipose Adenomatosa do Colo/genética , Idoso , Colonoscopia/métodos , Neoplasias Colorretais/epidemiologia , Diagnóstico Diferencial , Feminino , Seguimentos , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Linhagem , Estudos Retrospectivos , Fatores de Risco , Síndrome , Utah/epidemiologia
19.
Ir J Med Sci ; 191(1): 327-335, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33665779

RESUMO

BACKGROUND: The Wender Utah Rating Scale (WURS) is a widely used retrospective scale in adults presenting for ADHD evaluations which features items relating to childhood symptoms. AIMS: The aim of this study is to establish if certain childhood symptoms (including ADHD) as identified by the WURS-61 are associated with specific mental health disorders in adulthood. METHODS: Case-control study of N=630 attending Adult Mental Health Services (AMHS) and a control group without mental disorders (N=96). RESULTS: The mean age of the participants was 39.81 (SD 12.94) of which 387 (53.3%) were females. There were no significant differences between cases and controls in terms of age (t= 1.829, df 724, p=.068) and gender (x2=1.123, df 1, p=.289). Exploratory factor analysis of WURS-61 reveals 5 factors. Using factor scores and after cross-tabulation, we found that: The presence of childhood impulsivity, emotional lability and distress in addition to inattention/disorganisation were significantly associated with adult ADHD diagnosis (F90). WURS items which suggests childhood conduct problems were associated with a number of adult diagnoses, when present either on its own (psychoactive substance use, or when present in combination with childhood impulsivity, emotional lability and distress (personality disorders). CONCLUSION: There is an association between certain childhood behaviours and risk for later development of personality disorders, and psychoactive substance use. There is overlap of childhood symptoms to those who later diagnosed in adulthood with ADHD, personality disorders, and substance abuse.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade , Adulto , Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico , Transtorno do Deficit de Atenção com Hiperatividade/epidemiologia , Estudos de Casos e Controles , Feminino , Humanos , Escalas de Graduação Psiquiátrica , Estudos Retrospectivos , Utah/epidemiologia
20.
Public Health Rep ; 137(1): 87-93, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-33673777

RESUMO

OBJECTIVES: The Utah Study of Associated Risks of Stillbirth (SOARS) collects data about stillbirths that are not included in medical records or on fetal death certificates. We describe the design, methods, and survey response rate from the first year of SOARS. METHODS: The Utah Department of Health identified all Utah women who experienced a stillbirth from June 1, 2018, through May 31, 2019, via fetal death certificates and invited them to participate in SOARS. The research team based the study protocol on the Pregnancy Risk Assessment Monitoring System surveillance of women with live births and modified it to be sensitive to women's recent experience of a stillbirth. We used fetal death certificates to examine survey response rates overall and by maternal characteristics, gestational age of the fetus, and month in which the loss occurred. RESULTS: Of 288 women invited to participate in the study, 167 (58.0%) completed the survey; 149 (89.2%) responded by mail and 18 (10.8%) by telephone. A higher proportion of women who were non-Hispanic White (vs other races/ethnicities), were married (vs unmarried), and had ≥high school education (vs

Assuntos
Natimorto/epidemiologia , Inquéritos e Questionários/estatística & dados numéricos , Adulto , Feminino , Idade Gestacional , Humanos , Serviços Postais , Fatores de Risco , Telefone , Utah/epidemiologia , Adulto Jovem
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