Dataset Information

Temporal Trends in Cervical Spine Curvature of South Korean Adults Assessed by Deep Learning System Segmentation, 2006-2018.

ABSTRACT: Importance:The loss of the physiologic cervical lordotic curve is a common degenerative disorder known to be associated with abnormal spinal alignment. However, the changing trends among sex and age groups has not yet been well established. Objective:To analyze the temporal trends in cervical curvature across sex and age groups using an automated deep learning system (DLS). Design, Setting, and Participants:A retrospective cross-sectional study was conducted using lateral cervical radiographs of 13?691 individuals from January 1, 2006, to December 31, 2018. The degree of anterior vertical curvature was approximated by a DLS approach and convexity measurement method. This population-based study used the Yonsei University College of Medicine Severance Hospital, Seoul, South Korea, cohort database to identify 13?691 consecutive adults (?18 years of age) who underwent standing lateral radiography in inpatient and outpatient settings. Main Outcomes and Measures:The prevalence of kyphotic and straight cervical curve as well as the trends of degree of cervical curvature in 2006 to 2018 among sex and age groups were determined. The DLS performance was validated with quantitative metrics and compared with interobserver and intraobserver variations. Results:Automatic cervical spine segmentation was identified from lateral radiographs of 13?691 individuals (mean [SD] age, 49.9 [15.3] years; 8051 women [58.8%]). From 2006 to 2018, the decrease in the lordotic curve was significant across both sexes and age groups younger than 70 years, with the decrease more pronounced in women and successively younger generations (female, -0.05; 95% CI, -0.06 to -0.04; 18-29 years of age, -0.06; 95% CI, -0.08 to -0.04; 30-39 years of age, -0.06; 95% CI, -0.08 to -0.04; and 40-49 years of age, -0.05; 95% CI, -0.06 to -0.03; all P?

SUBMITTER: Shin Y

PROVIDER: S-EPMC7563081 | biostudies-literature | 2020 Oct

REPOSITORIES: biostudies-literature

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Temporal Trends in Cervical Spine Curvature of South Korean Adults Assessed by Deep Learning System Segmentation, 2006-2018.

Shin YiRang Y Han Kyunghwa K Lee Young Han YH

JAMA network open 20201001 10

<h4>Importance</h4>The loss of the physiologic cervical lordotic curve is a common degenerative disorder known to be associated with abnormal spinal alignment. However, the changing trends among sex and age groups has not yet been well established.<h4>Objective</h4>To analyze the temporal trends in cervical curvature across sex and age groups using an automated deep learning system (DLS).<h4>Design, setting, and participants</h4>A retrospective cross-sectional study was conducted using lateral c ...[more]

PMID: 33057644

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Project description:IntroductionGiven that maternal mortality is a major global health concern, multiple measures including antenatal care visits have been promoted by the global community. However, most pregnant women in Ghana and other sub-Saharan African countries do not attain the recommended timelines, in addition to a slower progress towards meeting the required minimum of eight visits stipulated by the World Health Organization. Therefore, this study explored the trends in antenatal care visits and the associated factors in Ghana from 2006 to 2018 using the Multiple Indicator Cluster Surveys.MethodsThe study used women datasets (N = 7795) aged 15 to 49 years from three waves (2006, 2011, and 2017-2018) of the Ghana Multiple Indicator Cluster Surveys (GMICS). STATA version 14 was used for data analyses. Univariable analyses, bivariable analyses with chi-square test of independence, and multivariable analyses with robust multinomial logistic regression models were fitted.ResultsThe study found a consistent increase in the proportion of women having adequate and optimal antenatal attendance from 2006 to 2018 across the women's sociodemographic segments. For instance, the proportion of mothers achieving adequate antenatal care (4 to 7 antenatal care visits) increased from 49.3% in 2006 to 49.98% in 2011 to 58.61% in 2017-2018. In the multivariable model, women with upward attainment of formal education, health insurance coverage, increasing household wealth, and residing in the Upper East Region were consistently associated with a higher likelihood of adequate and/or optimal antenatal care attendance from 2006 to 2018.ConclusionWomen who are less likely to achieve optimal antenatal care visits should be targeted by policies towards reducing maternal mortalities and other birth complications. Poverty-reduction policies, promoting maternal and girl-child education, improving general livelihood in rural settings, expanding health insurance coverage and infrastructural access, harnessing community-level structures, and innovative measures such as telehealth and telemedicine are required to increase antenatal care utilization.

Project description:ImportanceFew studies have examined the dietary trends in Korea beyond evaluating selected food groups. To help prevent cardiometabolic disease burdens, a comprehensive investigation of the trends in overall diet quality and identification of possible contributing factors would be useful.ObjectiveTo investigate the trends and independent associations of age, period, and birth cohort with diet quality and cardiometabolic risk factors among Korean adults.Design, setting, and participantsSerial cross-sectional and age-period-cohort analyses were conducted of nationally representative 24-hour dietary recall data from the Korea National Health and Nutrition Examination Survey 2007-2018. The study population included 65 416 Korean adults aged 19 to 79 years. Data analyses were conducted from March 1, 2020, through April 30, 2021.ExposuresAge, calendar year, birth cohort, and population sociodemographic characteristics.Main outcomes and measuresKorean Healthy Eating Index (KHEI), a validated diet quality score (range, 0-90, with higher scores indicating greater diet quality), and 8 cardiometabolic risk factors (waist circumference and systolic blood pressure, diastolic blood pressure, serum total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, triglyceride, and fasting blood glucose levels).ResultsAmong 65 416 participants, mean age (SD) was 44.5 (0.1) years and 36 631 were women (55.8%). In 2007-2018, the age-standardized mean (SE) KHEI score increased from 51.0 (0.4) to 52.1 (0.5), which was associated with reduced sodium intake and increased whole grain, dairy, and protein-rich food intakes. The mean (SE) KHEI score was lowest at age 39 years (50.1 [0.3]) and increased at older ages (58.0 [0.3] at 79 years). Controlling for age and period effects, the highest KHEI score was observed among the birth cohorts of 1960-1964 (53.6 [0.9]) and decreased in subsequent cohorts (45.5 [1.2] in the 1990-1999 birth cohort). Similar cohort effects in cardiometabolic risk factors were observed, showing the lowest waist circumference, blood pressure, and total cholesterol levels among the birth cohorts of the 1960s and 1970s and higher levels among more recent birth cohorts (1990-1999 vs 1960-1964: waist circumference, 83.8 [0.5] vs 81.4 [0.4] cm; systolic blood pressure, 118.7 [0.7] vs 116.4 [0.4] mm Hg; total cholesterol, 200.2 [0.9] vs 198.9 [0.7] mg/dL). At most ages, periods, and birth cohorts, the mean KHEI score was consistently higher in adults living in urban areas (at age 45 years: 50.5 [1.0] vs 49.7 [0.9] rural) and among high-income (at age 45 years: 50.7 [1.1] vs 49.3 [0.9] low income) and educational levels (at age 45 years: 53.1 [0.9] vs 49.1 [1.0] low educational level).Conclusions and relevanceThe findings of this study suggest that, from 2007 to 2018, the diet quality of Korean adults modestly improved. Despite the improvement, inequalities in diet among age, birth cohort, and socioeconomic subgroups persisted, suggesting that more intense interventions may be needed to target the susceptible groups.

Project description:ImportanceAtrial fibrillation (AF) is the most common cardiac arrhythmia, and multiple studies have reported increasing AF incidence rates over time, although the underlying explanations remain unclear.ObjectivesTo estimate AF incidence rates from 2006 to 2018 in a community-based setting and to investigate possible explanations for increasing AF by evaluating the changing features of incident AF cases and the pool of patients at risk for AF over time.Design, setting, and participantsThis cohort study included 500 684 patients who received primary care and other health care services for more than 2 years through a single integrated health care delivery network in Pennsylvania. Data collection was conducted from January 2003 to December 2018. The base study population had no documentation of AF in the electronic medical record for at least 2 years prior to baseline. Data analysis was conducted from May to December 2019.Main outcomes and measuresIncident AF cases were identified through diagnostic codes recorded at inpatient or outpatient encounters. Age- and sex-adjusted AF incidence rates were estimated by calendar year from 2006 to 2018 both overall and across subgroups, including according to diagnostic setting (inpatient vs outpatient) and priority (primary vs secondary diagnosis).ResultsAmong 514 293 patients meeting criteria for the base study population, the mean (SD) age at baseline was 47 (18) years and 282 103 (54.9%) were women; 13 609 (2.6%) met AF diagnostic criteria on or prior to the baseline date and were excluded. Among 500 684 patients free of AF at baseline, standardized AF incidence rates from 2006 to 2018 increased from 4.74 (95% CI, 4.58-4.90) to 6.82 (95% CI, 6.65-7.00) cases per 1000 person-years, increasing significantly over time (P < .001). Incidence rates increased in all age and sex subgroups, although absolute rate increases were largest among those aged 85 years or older. The fraction of incident AF cases among individuals aged 85 years or older increased from 135 of 1075 (12.6%) in 2006 to 451 of 2427 (18.6%) in 2017. Patients with incident AF were more likely over time to have high body mass index (1351 of 3389 patients [39.9%] in 2006-2008 vs 4504 of 9214 [48.9%] in 2015-2018; P < .001), hypertension (2764 [81.6%] in 2006-2008 vs 7937 [86.1%] in 2015-2018; P < .001), and ischemic stroke (328 [9.7%] in 2006-2008 vs 1455 [15.8%] in 2015-2018; P < .001), but less likely to have coronary artery disease (1533 [45.2%] in 2006-2008 vs 3810 [41.4%] in 2015-2018; P < .001). Among 22 077 new cases of AF, 9146 (41.4%) were diagnosed as inpatients and 5731 (26.0%) as the primary diagnosis. Incidence rates of AF increased significantly in all diagnostic setting and priority pairings (eg, inpatient, primary: rate ratio, 1.07; 95% CI, 1.06-1.08; P < .001). Among patients at risk for AF, high BMI and hypertension increased over time (BMI: 71 433 of 198 245 [36.0%] in 2007 to 130 218 of 282 270 [46.1%] in 2017; hypertension: 79 977 [40.3%] in 2007 to 134 404 [47.6%] in 2017). Documentation of short-term ECG increased over time (23 297 of 207 349 [11.2%] in 2008 to 45 027 [16.0%] in 2017); however, long-term ECG monitoring showed no change (1871 [0.9%] in 2007 to 4036 [1.4%] in 2017).Conclusions and relevanceIn this community-based study, AF incidence rates increased significantly during the study period. Concurrent increases were observed in AF risk factors in the at-risk population and short-term ECG use.

Dataset Information

Temporal Trends in Cervical Spine Curvature of South Korean Adults Assessed by Deep Learning System Segmentation, 2006-2018.

Publications

Temporal Trends in Cervical Spine Curvature of South Korean Adults Assessed by Deep Learning System Segmentation, 2006-2018.

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