ABSTRACT A strategy for stopping long-term randomized clinical trials with time-to-event as a pri... more ABSTRACT A strategy for stopping long-term randomized clinical trials with time-to-event as a primary outcome measure has been considered using the criteria requiring multiple consecutive (or non consecutive) rejections at a specified α-level that controls against elevation of type I error. The procedure using two consecutive rejections is presented in this work along with the corresponding α-levels for the interim tests. The boundary cutoff values for these interim levels were determined based on an overall prespecified test size and were calculated using multidimensional integration and/or simulations. The reduction in the interim α-level values that is required to maintain the experiment-wise error rate is found to be modest. The power of the test is evaluated under various alternative accrual and hazard patterns. This procedure provides a more realistic stopping rule in large multi-center trials where it may be undesirable to terminate a trial unless a sustained effect has been demonstrated.
ABSTRACT Study Objectives: To evaluate the effects of 1 or 2 capsule(s) of BIO-K+CL-1285®(50x109 ... more ABSTRACT Study Objectives: To evaluate the effects of 1 or 2 capsule(s) of BIO-K+CL-1285®(50x109 Lactobacilli acidophyli and Caseivs) vs. placebo, on a) incidence of AAD, b) severity of AAD and c) incidence of C. diff. Design/Methods: This was a 3-arm randomized, double blind study, conducted at Xinhua/Yuyao Hosp., Shanghai Jiao Tong University, China between Oct 2008-Mar 2009. Data was analyzed according to ITT principles. 250 eligible men and women (1:1); 50-70 yrs, initially hospitalized, were recruited and randomized to three study arms; group A: 2 capsules of placebo (n=84); group B: one capsule of placebo and one capsule of BIO-K+CL-1285® (n=85) or group C: 2 capsules of BIO-K+CL-1285® (n=86). Participants were administered study products while on antibiotics (3-14 days) and for 5 more days thereafter. Subjects were then followed up for 21 days. Incidence and severity of AAD data were collected via in-hospital questionnaires and diaries given to participants upon discharge. Stool samples were collected by study nurses. Endpoints included: 1) incidence of AAD, 2) severity of AAD (total days of diarrhea (> 3 episodes of liquid to soft stool/day)) and 3) incidence of C. diff. Results: Prognostic baseline subjects’ characteristics were balanced among study groups. Incidence of AAD: Overall: 74 cases (29.6%); group A: 37 (48.7%); group B: 24 (30.8%) and group C: 13 (15.9%). Severity of AAD (µ ± σ of days with AAD): group A: 6.4 ± 1.75 ; Group B: 4.1 ± 1.48 and group C: 2.8 ± 0.83. Incidence of C. diff : group A: (23.4%); group B: (10.3%) and group C: (1.2%). Controlled group comparisons for incidence and severity of AAD as well Incidence of C. diff were all stat. sig. and indicative of a dose response effect. Conclusions: One or two capsules of BIO-K+CL-1285® significantly reduced the incidence and severity of AAD. Effects indicated a stat. sig. dose response effect.
Compare children/adolescents with and without at least one parent with type 1 diabetes (T1D). 12,... more Compare children/adolescents with and without at least one parent with type 1 diabetes (T1D). 12,980 participants <18 years old at enrollment in the T1D Exchange Registry were included. Statistical comparisons between those with and without parental T1D were conducted using univariate generalized linear mixed model. 1056 (8.2%) registrants had ≥1 parent with T1D. Those with parental T1D were slightly younger (6.3 vs. 6.9 yr, p < 0.001) and less likely to have diabetic ketoacidosis at diagnosis (24% vs. 41%, p < 0.001). There were no differences between groups in HbA1c, use of continuous glucose monitoring or insulin pump therapy, or development of severe hypoglycemia or DKA. There were no differences comparing those with a mother versus those with a father with T1D. Children and adolescents with parental T1D tend to be diagnosed earlier. Diabetes management, glycemic control, and acute complications are similar in those with vs. without parental T1D.
BackgroundSickle cell anemia (SCA) is a severe monogenic disorder, caused by single nucleotide mu... more BackgroundSickle cell anemia (SCA) is a severe monogenic disorder, caused by single nucleotide mutations in the hemoglobin (Hb) gene, that is prevalent in malaria endemic regions of the world. Sickle cell trait (SCT) individuals carry only one of the mutated alleles and were shown to be protected against malaria. However, defining the relative contribution of hematological, clinical, and environmental factors to the overall burden of malaria in individuals with hemoglobinopathies such as SCA has been challenging.MethodsWe hypothesized that hematological differences, clinical presentations, and self-reported bed net usage among Plasmodium-infected and uninfected individuals may govern overall malaria burden in individuals with sickle cell disease (SCD). We conducted a cross-sectional study in Ghana from 2014 to 2019 and described clinical presentations, hematological characteristics, and bed net use based on a comprehensive questionnaire. Hematological characteristics were compared using a parametric or nonparametric ANOVA, pending if data passed D'Agostino & Pearson normality test. When comparing only two Hb genotypes hematological characteristics a Mann–Whitney U-test were used. Logistic regressions and Chi-squared tests were used to compare questionnaire responses between Hb genotypes. All statistical significance was set at p < 0.05.FindingsMultiple hematological parameters were significantly (p < 0.05) altered depending on sickle cell genotype and/or malaria status. When compared to other Hb genotypes, SCA individuals with or without malaria had significantly (p < 0.05) higher WBC and platelets counts and lower Hb levels. While the sickle cell genotype may affect malaria severity, SCT and SCA participants were found to significantly (p < 0.007) use bet nets more than HbAA participants.InterpretationsOur findings can be utilized to enhance national guidelines for reducing the incidence of malaria especially among individuals with SCD, SCT protection and health disparities among hemoglobinopathies.FundingThis study was supported by the National Institute for Health.
Introduction: Sleep is hypothesized to be a contributing factor towards disparities in cardiovasc... more Introduction: Sleep is hypothesized to be a contributing factor towards disparities in cardiovascular disease (CVD). It has been demonstrated that Black Americans have worse sleep quality compared to other ethnic groups, but within group differences have not been studied. Whether overall sleep quality and patterns affect cardiovascular health (CVH) among Blacks has yet to be elucidated. Hypothesis: Black individuals reporting worse sleep quality and patterns will have poor CVH as measured by the American Heart Association’s Life’s Simple 7 (LS7) scores. Methods: We recruited 499 Black adults (age 53 ± 10, 38% male) without known CVD from the Atlanta, GA metropolitan area. Sleep quality and patterns were assessed by the Pittsburgh Sleep Quality Index (PSQI) which includes sleep quality, nighttime disturbance, efficiency (amount of time slept while in bed), daytime dysfunction, duration, need of medications and latency (time required to fall asleep). CVH was determined by LS7 scores calculated from measured blood pressure, glucose, cholesterol, body mass index (BMI), and self-reported exercise, diet, and smoking, and categorized into poor (0-8), intermediate (9-10), and ideal (11-14). Multinomial logistic regression was used to examine the relationship between sleep and the odds of intermediate (vs. poor) and ideal (vs. poor) CVH categories after adjusting for age, gender, household income, education, marital status, and employment status. Results: A total of 55 (11%), 107 (21%), and 337 (67%) participants had ideal, intermediate, and poor LS7 scores, respectively. Those reporting PSQI-assessed poor sleep quality (OR 0.50, 95% CI [0.33 - 0.78]), longer latency (OR 0.50, 95% CI [0.36 - 0.70]), disturbance (OR 0.45, 95% CI [0.26 - 0.77]) and daytime dysfunction (OR 0.52, 95% CI [0.31 - 0.89]) had significantly lower adjusted odds of having ideal CVH. Daytime dysfunction was significantly associated with lower adjusted odds of having ideal blood pressure (OR 0.57, 95% CI [0.38 - 0.87]), glucose (OR 0.71, 95% CI [0.51 - 0.98]), and physical activity (OR 0.58, 95% CI [0.36 - 0.93]). Similarly, longer latency was significantly associated with lower adjusted odds of having ideal BMI (OR 0.72, 95% CI [0.54 - 0.95]), blood pressure (OR 0.71, 95% CI [0.55 - 0.92]), and cholesterol (OR 0.73, 95% CI [0.55 - 0.98]). PSQI-assessed shorter sleep duration was not associated with poor overall CVH, but was associated with significantly lower adjusted odds of having ideal blood pressure (OR 0.77, 95% CI [0.61 - 0.99]). Conclusion: Among Black Americans, poor sleep in terms of quality, nighttime disturbance, daytime dysfunction and longer latency, was associated with worse overall CVH or its components. Whether addressing sleep quality in Blacks will improve CVH and outcomes needs to be studied.
International Journal of Environmental Research and Public Health
Background: Enhancement of diversity within the U.S. research workforce is a recognized need and ... more Background: Enhancement of diversity within the U.S. research workforce is a recognized need and priority at a national level. Existing comprehensive programs, such as the National Research Mentoring Network (NRMN) and Research Centers in Minority Institutions (RCMI), have the dual focus of building institutional research capacity and promoting investigator self-efficacy through mentoring and training. Methods: A qualitative comparative analysis was used to identify the combination of factors that explain the success and failure to submit a grant proposal by investigators underrepresented in biomedical research from the RCMI and non-RCMI institutions. The records of 211 participants enrolled in the NRMN Strategic Empowerment Tailored for Health Equity Investigators (NRMN-SETH) program were reviewed, and data for 79 early-stage, underrepresented faculty investigators from RCMI (n = 23) and non-RCMI (n = 56) institutions were included. Results: Institutional membership (RCMI vs. non-R...
International Journal of Environmental Research and Public Health
The COVID-19 pandemic has significantly taxed scientific research and seems to have exacerbated e... more The COVID-19 pandemic has significantly taxed scientific research and seems to have exacerbated existing inequities within the research field, particularly for early-stage investigators (ESIs). This study examines the effects of the COVID-19 pandemic on traditionally underrepresented ESIs enrolled in an NIH-supported study evaluating the effectiveness of developmental networks, grant writing coaching, and mentoring on research career advancement. The survey consisted of 24 closed-ended (quantitative) and 4 open-ended questions (qualitative) linked to a participant’s ability to meet grant submission deadlines, research and professional development disruptions, stress level, career transition level, self-efficacy and management of scholarly tasks, and familial responsibilities. Results from 32 respondents (53%) suggest that COVID-19 adversely impacted the continuity of research (81%) and grant submissions (63%). On average, grant submissions were delayed by 6.69 months (i.e., greater ...
Digital health innovations, such as telehealth and remote monitoring, have shown promise in addre... more Digital health innovations, such as telehealth and remote monitoring, have shown promise in addressing patient barriers to accessing evidence-based programs and providing a scalable path for tailored behavioral interventions that support self-management skills, knowledge acquisition and promotion of relevant behavioral change. However, significant attrition continues to plague internet-based studies, a result we believe can be attributed to characteristics of the intervention, or individual user characteristics. In this paper, we provide the first analysis of determinants of non usage attrition in a randomized control trial of a technology-based intervention for improving self-management behaviors among Black adults who face increased cardiovascular risk factors. We introduce a different way to measure nonusage attrition that considers usage over a specific period of time and estimate a cox proportional hazards model of the impact of intervention factors and participant demographics...
Circulation: Cardiovascular Quality and Outcomes, 2021
Background:Early trauma (general, emotional, physical, and sexual abuse before age 18 years) has ... more Background:Early trauma (general, emotional, physical, and sexual abuse before age 18 years) has been associated with both cardiovascular disease risk and lifestyle-related risk factors for cardiovascular disease, including smoking, obesity, and physical inactivity. Despite higher prevalence, the association between early trauma and cardiovascular health (CVH) has been understudied in Black Americans, especially those from low-income backgrounds, who may be doubly vulnerable. Therefore, we investigated the association between early trauma and CVH, particularly among low-income Black Americans.Methods:We recruited 457 Black adults (age 53±10, 38% male) without known cardiovascular disease from the Atlanta, GA, metropolitan area using personalized, community-based recruitment methods. The Early Trauma Inventory was administered to assess overall early traumatic life experiences which include physical, sexual, emotional abuse, and general trauma. Our primary outcome was the American He...
Genetics and molecular research : GMR, Jan 23, 2016
Hematogenous osteomyelitis (HO) is a bone infection wherein bacteria penetrate to the bone throug... more Hematogenous osteomyelitis (HO) is a bone infection wherein bacteria penetrate to the bone through the blood stream. Several single nucleotide polymorphisms (SNPs) have been associated with susceptibility to infectious diseases. In this study, we investigated the contribution of SNPs in interleukin (IL)-1B1 (rs16944), IL1A (rs1800587), IL1B (rs1143634), toll-like receptor (TLR)-2 (rs3804099), TLR4 (rs4986790), TLR4 (rs4986791), IL1R (rs2234650), tumor necrosis factor (TNF)-α (rs1800629), TNF (rs361525), and IL1RN (rs315952) towards the development of HO in Saudi patients and compared to healthy controls. Fifty-two patients diagnosed with HO and 103 healthy individuals were genotyped. The frequencies of genotypes GG (rs16944) and AA (rs16944) were lower and higher in patients [odds ratio (OR) = 0.34, Pc = 0.05] and controls (OR = 1.33, Pc = 0.05), respectively, suggesting that SNPs at this locus could alter HO susceptibility. In addition, the patients and controls exhibited lower and...
ABSTRACT A strategy for stopping long-term randomized clinical trials with time-to-event as a pri... more ABSTRACT A strategy for stopping long-term randomized clinical trials with time-to-event as a primary outcome measure has been considered using the criteria requiring multiple consecutive (or non consecutive) rejections at a specified α-level that controls against elevation of type I error. The procedure using two consecutive rejections is presented in this work along with the corresponding α-levels for the interim tests. The boundary cutoff values for these interim levels were determined based on an overall prespecified test size and were calculated using multidimensional integration and/or simulations. The reduction in the interim α-level values that is required to maintain the experiment-wise error rate is found to be modest. The power of the test is evaluated under various alternative accrual and hazard patterns. This procedure provides a more realistic stopping rule in large multi-center trials where it may be undesirable to terminate a trial unless a sustained effect has been demonstrated.
ABSTRACT Study Objectives: To evaluate the effects of 1 or 2 capsule(s) of BIO-K+CL-1285®(50x109 ... more ABSTRACT Study Objectives: To evaluate the effects of 1 or 2 capsule(s) of BIO-K+CL-1285®(50x109 Lactobacilli acidophyli and Caseivs) vs. placebo, on a) incidence of AAD, b) severity of AAD and c) incidence of C. diff. Design/Methods: This was a 3-arm randomized, double blind study, conducted at Xinhua/Yuyao Hosp., Shanghai Jiao Tong University, China between Oct 2008-Mar 2009. Data was analyzed according to ITT principles. 250 eligible men and women (1:1); 50-70 yrs, initially hospitalized, were recruited and randomized to three study arms; group A: 2 capsules of placebo (n=84); group B: one capsule of placebo and one capsule of BIO-K+CL-1285® (n=85) or group C: 2 capsules of BIO-K+CL-1285® (n=86). Participants were administered study products while on antibiotics (3-14 days) and for 5 more days thereafter. Subjects were then followed up for 21 days. Incidence and severity of AAD data were collected via in-hospital questionnaires and diaries given to participants upon discharge. Stool samples were collected by study nurses. Endpoints included: 1) incidence of AAD, 2) severity of AAD (total days of diarrhea (&gt; 3 episodes of liquid to soft stool/day)) and 3) incidence of C. diff. Results: Prognostic baseline subjects’ characteristics were balanced among study groups. Incidence of AAD: Overall: 74 cases (29.6%); group A: 37 (48.7%); group B: 24 (30.8%) and group C: 13 (15.9%). Severity of AAD (µ ± σ of days with AAD): group A: 6.4 ± 1.75 ; Group B: 4.1 ± 1.48 and group C: 2.8 ± 0.83. Incidence of C. diff : group A: (23.4%); group B: (10.3%) and group C: (1.2%). Controlled group comparisons for incidence and severity of AAD as well Incidence of C. diff were all stat. sig. and indicative of a dose response effect. Conclusions: One or two capsules of BIO-K+CL-1285® significantly reduced the incidence and severity of AAD. Effects indicated a stat. sig. dose response effect.
Compare children/adolescents with and without at least one parent with type 1 diabetes (T1D). 12,... more Compare children/adolescents with and without at least one parent with type 1 diabetes (T1D). 12,980 participants &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;18 years old at enrollment in the T1D Exchange Registry were included. Statistical comparisons between those with and without parental T1D were conducted using univariate generalized linear mixed model. 1056 (8.2%) registrants had ≥1 parent with T1D. Those with parental T1D were slightly younger (6.3 vs. 6.9 yr, p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001) and less likely to have diabetic ketoacidosis at diagnosis (24% vs. 41%, p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001). There were no differences between groups in HbA1c, use of continuous glucose monitoring or insulin pump therapy, or development of severe hypoglycemia or DKA. There were no differences comparing those with a mother versus those with a father with T1D. Children and adolescents with parental T1D tend to be diagnosed earlier. Diabetes management, glycemic control, and acute complications are similar in those with vs. without parental T1D.
BackgroundSickle cell anemia (SCA) is a severe monogenic disorder, caused by single nucleotide mu... more BackgroundSickle cell anemia (SCA) is a severe monogenic disorder, caused by single nucleotide mutations in the hemoglobin (Hb) gene, that is prevalent in malaria endemic regions of the world. Sickle cell trait (SCT) individuals carry only one of the mutated alleles and were shown to be protected against malaria. However, defining the relative contribution of hematological, clinical, and environmental factors to the overall burden of malaria in individuals with hemoglobinopathies such as SCA has been challenging.MethodsWe hypothesized that hematological differences, clinical presentations, and self-reported bed net usage among Plasmodium-infected and uninfected individuals may govern overall malaria burden in individuals with sickle cell disease (SCD). We conducted a cross-sectional study in Ghana from 2014 to 2019 and described clinical presentations, hematological characteristics, and bed net use based on a comprehensive questionnaire. Hematological characteristics were compared using a parametric or nonparametric ANOVA, pending if data passed D'Agostino & Pearson normality test. When comparing only two Hb genotypes hematological characteristics a Mann–Whitney U-test were used. Logistic regressions and Chi-squared tests were used to compare questionnaire responses between Hb genotypes. All statistical significance was set at p < 0.05.FindingsMultiple hematological parameters were significantly (p < 0.05) altered depending on sickle cell genotype and/or malaria status. When compared to other Hb genotypes, SCA individuals with or without malaria had significantly (p < 0.05) higher WBC and platelets counts and lower Hb levels. While the sickle cell genotype may affect malaria severity, SCT and SCA participants were found to significantly (p < 0.007) use bet nets more than HbAA participants.InterpretationsOur findings can be utilized to enhance national guidelines for reducing the incidence of malaria especially among individuals with SCD, SCT protection and health disparities among hemoglobinopathies.FundingThis study was supported by the National Institute for Health.
Introduction: Sleep is hypothesized to be a contributing factor towards disparities in cardiovasc... more Introduction: Sleep is hypothesized to be a contributing factor towards disparities in cardiovascular disease (CVD). It has been demonstrated that Black Americans have worse sleep quality compared to other ethnic groups, but within group differences have not been studied. Whether overall sleep quality and patterns affect cardiovascular health (CVH) among Blacks has yet to be elucidated. Hypothesis: Black individuals reporting worse sleep quality and patterns will have poor CVH as measured by the American Heart Association’s Life’s Simple 7 (LS7) scores. Methods: We recruited 499 Black adults (age 53 ± 10, 38% male) without known CVD from the Atlanta, GA metropolitan area. Sleep quality and patterns were assessed by the Pittsburgh Sleep Quality Index (PSQI) which includes sleep quality, nighttime disturbance, efficiency (amount of time slept while in bed), daytime dysfunction, duration, need of medications and latency (time required to fall asleep). CVH was determined by LS7 scores calculated from measured blood pressure, glucose, cholesterol, body mass index (BMI), and self-reported exercise, diet, and smoking, and categorized into poor (0-8), intermediate (9-10), and ideal (11-14). Multinomial logistic regression was used to examine the relationship between sleep and the odds of intermediate (vs. poor) and ideal (vs. poor) CVH categories after adjusting for age, gender, household income, education, marital status, and employment status. Results: A total of 55 (11%), 107 (21%), and 337 (67%) participants had ideal, intermediate, and poor LS7 scores, respectively. Those reporting PSQI-assessed poor sleep quality (OR 0.50, 95% CI [0.33 - 0.78]), longer latency (OR 0.50, 95% CI [0.36 - 0.70]), disturbance (OR 0.45, 95% CI [0.26 - 0.77]) and daytime dysfunction (OR 0.52, 95% CI [0.31 - 0.89]) had significantly lower adjusted odds of having ideal CVH. Daytime dysfunction was significantly associated with lower adjusted odds of having ideal blood pressure (OR 0.57, 95% CI [0.38 - 0.87]), glucose (OR 0.71, 95% CI [0.51 - 0.98]), and physical activity (OR 0.58, 95% CI [0.36 - 0.93]). Similarly, longer latency was significantly associated with lower adjusted odds of having ideal BMI (OR 0.72, 95% CI [0.54 - 0.95]), blood pressure (OR 0.71, 95% CI [0.55 - 0.92]), and cholesterol (OR 0.73, 95% CI [0.55 - 0.98]). PSQI-assessed shorter sleep duration was not associated with poor overall CVH, but was associated with significantly lower adjusted odds of having ideal blood pressure (OR 0.77, 95% CI [0.61 - 0.99]). Conclusion: Among Black Americans, poor sleep in terms of quality, nighttime disturbance, daytime dysfunction and longer latency, was associated with worse overall CVH or its components. Whether addressing sleep quality in Blacks will improve CVH and outcomes needs to be studied.
International Journal of Environmental Research and Public Health
Background: Enhancement of diversity within the U.S. research workforce is a recognized need and ... more Background: Enhancement of diversity within the U.S. research workforce is a recognized need and priority at a national level. Existing comprehensive programs, such as the National Research Mentoring Network (NRMN) and Research Centers in Minority Institutions (RCMI), have the dual focus of building institutional research capacity and promoting investigator self-efficacy through mentoring and training. Methods: A qualitative comparative analysis was used to identify the combination of factors that explain the success and failure to submit a grant proposal by investigators underrepresented in biomedical research from the RCMI and non-RCMI institutions. The records of 211 participants enrolled in the NRMN Strategic Empowerment Tailored for Health Equity Investigators (NRMN-SETH) program were reviewed, and data for 79 early-stage, underrepresented faculty investigators from RCMI (n = 23) and non-RCMI (n = 56) institutions were included. Results: Institutional membership (RCMI vs. non-R...
International Journal of Environmental Research and Public Health
The COVID-19 pandemic has significantly taxed scientific research and seems to have exacerbated e... more The COVID-19 pandemic has significantly taxed scientific research and seems to have exacerbated existing inequities within the research field, particularly for early-stage investigators (ESIs). This study examines the effects of the COVID-19 pandemic on traditionally underrepresented ESIs enrolled in an NIH-supported study evaluating the effectiveness of developmental networks, grant writing coaching, and mentoring on research career advancement. The survey consisted of 24 closed-ended (quantitative) and 4 open-ended questions (qualitative) linked to a participant’s ability to meet grant submission deadlines, research and professional development disruptions, stress level, career transition level, self-efficacy and management of scholarly tasks, and familial responsibilities. Results from 32 respondents (53%) suggest that COVID-19 adversely impacted the continuity of research (81%) and grant submissions (63%). On average, grant submissions were delayed by 6.69 months (i.e., greater ...
Digital health innovations, such as telehealth and remote monitoring, have shown promise in addre... more Digital health innovations, such as telehealth and remote monitoring, have shown promise in addressing patient barriers to accessing evidence-based programs and providing a scalable path for tailored behavioral interventions that support self-management skills, knowledge acquisition and promotion of relevant behavioral change. However, significant attrition continues to plague internet-based studies, a result we believe can be attributed to characteristics of the intervention, or individual user characteristics. In this paper, we provide the first analysis of determinants of non usage attrition in a randomized control trial of a technology-based intervention for improving self-management behaviors among Black adults who face increased cardiovascular risk factors. We introduce a different way to measure nonusage attrition that considers usage over a specific period of time and estimate a cox proportional hazards model of the impact of intervention factors and participant demographics...
Circulation: Cardiovascular Quality and Outcomes, 2021
Background:Early trauma (general, emotional, physical, and sexual abuse before age 18 years) has ... more Background:Early trauma (general, emotional, physical, and sexual abuse before age 18 years) has been associated with both cardiovascular disease risk and lifestyle-related risk factors for cardiovascular disease, including smoking, obesity, and physical inactivity. Despite higher prevalence, the association between early trauma and cardiovascular health (CVH) has been understudied in Black Americans, especially those from low-income backgrounds, who may be doubly vulnerable. Therefore, we investigated the association between early trauma and CVH, particularly among low-income Black Americans.Methods:We recruited 457 Black adults (age 53±10, 38% male) without known cardiovascular disease from the Atlanta, GA, metropolitan area using personalized, community-based recruitment methods. The Early Trauma Inventory was administered to assess overall early traumatic life experiences which include physical, sexual, emotional abuse, and general trauma. Our primary outcome was the American He...
Genetics and molecular research : GMR, Jan 23, 2016
Hematogenous osteomyelitis (HO) is a bone infection wherein bacteria penetrate to the bone throug... more Hematogenous osteomyelitis (HO) is a bone infection wherein bacteria penetrate to the bone through the blood stream. Several single nucleotide polymorphisms (SNPs) have been associated with susceptibility to infectious diseases. In this study, we investigated the contribution of SNPs in interleukin (IL)-1B1 (rs16944), IL1A (rs1800587), IL1B (rs1143634), toll-like receptor (TLR)-2 (rs3804099), TLR4 (rs4986790), TLR4 (rs4986791), IL1R (rs2234650), tumor necrosis factor (TNF)-α (rs1800629), TNF (rs361525), and IL1RN (rs315952) towards the development of HO in Saudi patients and compared to healthy controls. Fifty-two patients diagnosed with HO and 103 healthy individuals were genotyped. The frequencies of genotypes GG (rs16944) and AA (rs16944) were lower and higher in patients [odds ratio (OR) = 0.34, Pc = 0.05] and controls (OR = 1.33, Pc = 0.05), respectively, suggesting that SNPs at this locus could alter HO susceptibility. In addition, the patients and controls exhibited lower and...
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Papers by Mohamed Mubasher