Assessment of Metal Concentrations and Associations with Pulmonary Function among Children with Asthma in Chicago, Illinois.
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ABSTRACT:
SUBMITTER: Madrigal JM
PROVIDER: S-EPMC8307469 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:Background: Under-perception of pulmonary dysfunction may delay appropriate treatment, while over-perception may result in unnecessary treatments. Objectives: To evaluate the ability of patients with asthma or cystic fibrosis and their subspecialty caregivers to assess changes in lung function based on their subjective clinical impressions. Methods: Patients were asked to qualitatively describe how they felt compared to their prior visit (same/better/worse) and to quantitatively estimate their forced expiratory volume in 1 s (FEV1) after being reminded of their FEV1 at the prior visit. Providers made similar estimates based on history and physical examination and knowledge of prior FEV1. After adjusting for relevant clinical covariates, lung function estimates were categorized as accurate (±5% of measured FEV1), overestimated (>5% above measured), and underestimated (>5% below measured). Results: One hundred nine patients estimated FEV1 on 179 occasions. Concordance between patient qualitative assessment and FEV1-based categories was low (κ = 0.08); 44% of patients reported feeling better than the FEV1-based category showed. Quantitatively, 56% of patient estimates were accurate, 18% were underestimated, and 26% overestimated; accuracy improved with age (odds ratio = 1.16, P = 0.01). Concordance between provider qualitative assessments and FEV1-based category was moderate (κ = 0.35); about 19% said their patient looked better than the FEV1-based category showed. Quantitatively, 65% of provider estimates were accurate, 16% were underestimated, and 19% were overestimated; accuracy improved with years of experience. Conclusions: Patients' and providers' perceptions of lung function were low to moderately accurate. Relying on subjective impression may place patients at risk for unnecessary treatments or increased morbidity. These findings highlight the importance of objective lung function assessment.
| S-EPMC6154438 | biostudies-literature
Project description:Passive samplers were deployed across Cleveland, OH and Chicago, IL to evaluate the spatial variability of airborne PCBs in urban areas. We measured SigmaPCB concentrations, the sum of 151 congeners or congener groups quantified using tandem mass spectrometry, spatial distributions, and congener profiles in two urban areas in the Great Lakes region. Mean SigmaPCB concentrations were significantly different between Cleveland (1.73 +/- 1.16 ng m(-3)) and Chicago (1.13 +/- 0.58 ng m(-3)) during the August 2008 sampling period. Mean congener profiles were compared with commercial Aroclor mixtures and found to be similar to Aroclor 1242 in Cleveland and similar to a mixture of 1242 and 1254 in Chicago. We observed large spatial variation in concentrations and weak or no significant autocorrelation between sites in both cities. "Hot spots" of high SigmaPCB concentrations were identified in both urban areas and the congener profiles at these locations were most strongly correlated to that of PCB Aroclor mixtures. Congener profiles showed important differences including the enrichment of dioxin-like congeners in Chicago.
| S-EPMC2855146 | biostudies-literature
Project description:RationaleThe impact of asthma on chronic lung function deficits is well known. However, there has been little study of ethnic differences in these asthma-associated deficits.ObjectivesTo examine whether there are ethnic differences in the effects of asthma on children's lung function.MethodsWe evaluated the impact of asthma on lung function in 3,245 Hispanic and non-Hispanic white school children (age 10-18 yr) in a longitudinal analysis of the Southern California Children's Health Study. Sex-specific mixed-effects regression spline models were fitted separately for each ethnic group.Measurements and main resultsLarge deficits in flows were observed among children with asthma diagnosed before age 4 years regardless of ethnicity. Hispanic girls with asthma had greater deficits in flows than non-Hispanic girls and were largest for maximal midexpiratory flow (-5.13% compared with -0.58%, respectively). A bigger impact of asthma in Hispanic girls was also found for FEV(1), FEF(75), and PEF (P value 0.04, 0.07, and 0.005, respectively). These ethnic differences were limited to girls diagnosed after age 4 years. In boys, asthma was also associated with greater deficits in flows among Hispanic than in non-Hispanic white children (differences that were not statistically significant). Ethnic differences in prevalence of pets and pests in the home, health insurance coverage, parental education, and smoking did not explain the pattern of lung function differences.ConclusionsLarger asthma-associated lung function deficits in Hispanics, especially among girls, merit further investigation to determine public health implications and to identify causes amenable to intervention.
| S-EPMC3081280 | biostudies-literature
Project description:ImportanceThere has been large geographic inequity in vaccination coverage across Chicago, Illinois, with higher vaccination rates in zip codes with residents who predominantly have high incomes and are White.ObjectiveTo determine the association between inequitable zip code-level vaccination coverage and COVID-19 mortality in Chicago.Design, setting, and participantsThis retrospective cohort study used Chicago Department of Public Health vaccination and mortality data and Cook County Medical Examiner mortality data from March 1, 2020, through November 6, 2021, to assess the association of COVID-19 mortality with zip code-level vaccination rates. Data were analyzed from June 1, 2021, to April 13, 2022.ExposuresZip code-level first-dose vaccination rates before the Alpha and Delta waves of COVID-19.Main outcomes and measuresThe primary outcome was deaths from COVID-19 during the Alpha and Delta waves. The association of a marginal increase in zip code-level vaccination rate with weekly mortality rates was estimated with a mixed-effects Poisson regression model, and the total number of preventable deaths in the least vaccinated quartile of zip codes was estimated with a linear difference-in-difference design.ResultsThe study population was 2 686 355 Chicago residents in 52 zip codes (median [IQR] age 34 [32-38] years; 1 378 658 [51%] women; 773 938 Hispanic residents [29%]; 783 916 non-Hispanic Black residents [29%]; 894 555 non-Hispanic White residents [33%]). Among residents in the least vaccinated quartile, 80% were non-Hispanic Black, compared with 8% of residents identifying as non-Hispanic Black in the most vaccinated quartile (P < .001). After controlling for age distribution and recovery from COVID-19, a 10-percentage point increase in zip code-level vaccination 6 weeks before the peak of the Alpha wave was associated with a 39% lower relative risk of death from COVID-19 (incidence rate ratio [IRR], 0.61 [95% CI, 0.52-0.72]). A 10-percentage point increase in zip code vaccination rate 6 weeks before the peak of the Delta wave was associated with a 24% lower relative risk of death (IRR, 0.76 [95% CI, 0.66-0.87]). The difference-in-difference estimate was that 119 Alpha wave deaths (72% [95% CI, 63%-81%]) and 108 Delta wave deaths (75% [95% CI, 66%-84%]) might have been prevented in the least vaccinated quartile of zip codes if it had had the vaccination coverage of the most vaccinated quartile.Conclusions and relevanceThese findings suggest that low zip code-level vaccination rates in Chicago were associated with more deaths during the Alpha and Delta waves of COVID-19 and that inequitable vaccination coverage exacerbated existing racial and ethnic disparities in COVID-19 deaths.
| S-EPMC9142872 | biostudies-literature
Project description:IntroductionEpidemiologic studies have found low/absence of atopy in obese asthmatic children, but the association or lack thereof of atopy with disease morbidity, including pulmonary function, in obese asthma is not well understood. We sought to define the association of atopy with pulmonary function in overweight/obese minority children with asthma.MethodsIn a retrospective chart review of 200 predominantly minority children evaluated at an academic Pediatric Asthma Center over 5 years, we compared the prevalence of atopy, defined as ≥ 1 positive skin prick test or serum-specific immunoglobulin E quantification to environmental allergens, and its association with pulmonary function in overweight/obese (body mass index [BMI] > 85th percentile) (n = 99) to healthy-weight children (BMI, 5th-85th percentile for age) (n = 101).ResultsIn a cohort comprised of 47.5% Hispanics and 39.5% African Americans, 81% of overweight/obese and 74% of healthy-weight children were atopic. While atopic healthy-weight children had lower percent-predicted forced expiratory volume in the first second (FEV1 ) (93 ± 13.6 vs 107% ± 33.2%, P = .03) and lower percent-predicted forced vital capacity (FVC) (93% ± 12.2% vs 104% ± 16.1%, P = .01) as compared to nonatopic children, atopy was not associated with FEV1 (P = .7) or FVC (P = .17) in overweight/obese children. Adjusting for demographic and clinical variables, atopy was found to be an independent predictor of FEV1 and FVC in healthy-weight (β = -2.4, P = .07 and β = -1.7, P = .04, respectively) but not in overweight/obese children (β = .6, P = .5 and β = .8, P = .3).ConclusionsAtopy is associated with lower lung function in healthy-weight asthmatics but not in overweight/obese asthmatics, supporting the role of nonallergic mechanisms in disease burden in pediatric obesity-related asthma.
| S-EPMC7790165 | biostudies-literature
Project description:Current evidence suggests that in children there is a significant, albeit weak, association between asthma and obesity. Studies generally use body mass index (BMI) in evaluating body adiposity, but there are limitations to its use.Children from a population-based study attending follow-up (age 11 years) were weighed, measured and had percent body (PBF) and truncal (PTF) fat assessed using bioelectrical impedance. They were skin prick tested and completed spirometry. Parents completed a validated respiratory questionnaire. Children were defined as normal or overweight according to BMI and PBF cut-offs. We tested the association between these adiposity markers with wheeze, asthma, atopy, and lung-function.Six hundred forty-six children (339 male) completed follow-up. BMI z-score, PBF, and PTF were all positively associated with current wheeze (odds ratio [95% CI]: 1.27 [1.03, 1.57], P?=?0.03; 1.05 [1.00, 1.09], P?=?0.03; 1.04 [1.00, 1.08], P?=?0.04, respectively). Similar trends were seen with asthma. However, when examining girls and boys separately, significant positive associations were found with PBF and PTF and asthma but only in girls (gender interaction P?=?0.06 and 0.04, respectively). Associations between being overweight and wheezing and asthma were stronger when overweight was defined by PBF (P?=?0.007, 0.03) than BMI (P?>?0.05). Higher BMI was significantly associated with an increase in FEV(1) and FVC, but only in girls. Conversely, increasing body fat (PBF and PTF) was associated with reduced FEV(1) and FVC, but only in boys. No associations between adiposity and atopy were found.All adiposity measures were associated with wheeze, asthma, and lung function. However, BMI and PBF did not have the same effects and girls and boys appear to be affected differently.
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Project description:Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has the potential for rapid transmission in congregate settings. We describe the multidisciplinary response to an outbreak of coronavirus disease (COVID-19) in a large homeless shelter in Chicago, Illinois, USA. The response to the outbreak included 4 rounds of mass PCR testing of all staff and residents and subsequent isolation of persons who tested positive for SARS-CoV-2. We further describe the dynamics of the shelter outbreak by fitting a modified susceptible-exposed-infectious-recovered compartmental model incorporating the widespread SARS-CoV-2 testing and isolation measures implemented in this shelter. Our model demonstrates that rapid transmission of COVID-19 in the shelter occurred before the outbreak was detected; rates of transmission declined after widespread testing and isolation measures were put in place. Overall, we demonstrate the feasibility of mass PCR testing and isolation in congregate settings and suggest the necessity of prompt response to suspected COVID-19 outbreaks in homeless shelters.
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Project description:Accomplishing the goals outlined in "Ending the HIV (Human Immunodeficiency Virus) Epidemic: A Plan for America Initiative" will require properly estimating and increasing access to HIV testing, treatment, and prevention services. In this research, a computational spatial method for estimating access was applied to measure distance to services from all points of a city or state while considering the size of the population in need for services as well as both driving and public transportation. Specifically, this study employed the enhanced two-step floating catchment area (E2SFCA) method to measure spatial accessibility to HIV testing, treatment (i.e., Ryan White HIV/AIDS program), and prevention (i.e., Pre-Exposure Prophylaxis [PrEP]) services. The method considered the spatial location of MSM (Men Who have Sex with Men), PLWH (People Living with HIV), and the general adult population 15-64 depending on what HIV services the U.S. Centers for Disease Control (CDC) recommends for each group. The study delineated service- and population-specific accessibility maps, demonstrating the method's utility by analyzing data corresponding to the city of Chicago and the state of Illinois. Findings indicated health disparities in the south and the northwest of Chicago and particular areas in Illinois, as well as unique health disparities for public transportation compared to driving. The methodology details and computer code are shared for use in research and public policy.
| S-EPMC9328561 | biostudies-literature
Project description:Syrphid flies (Diptera: Syrphidae) are a cosmopolitan group of flower-visiting insects, though their diversity and importance as pollinators is understudied and often unappreciated. Data on 1,477 Syrphid occurrences and floral associations from three years of pollinator collection (2017-2019) in the Southern Illinois region of Illinois, United States, are here compiled and analyzed. We collected 69 species in 36 genera off of the flowers of 157 plant species. While a richness of 69 species is greater than most other families of flower-visiting insects in our region, a species accumulation curve and regional species pool estimators suggest that at least 33 species are yet uncollected. In order to further the understanding of Syrphidae as pollinators in the Southern Illinois region, we produced a NMDS ordination of floral associations for the most common syrphid species. The NMDS did not sort syrphid species into discrete ecological guilds, and syrphid floral associations generally fit those predicted by traditional pollination syndromes. We also conducted a preliminary analysis of the pollen-carrying capacity of different syrphid taxa, which found several Eristalis species to carry pollen loads comparable to the European Honey Bee, Apis mellifera, and showed significant differences in the pollen-carrying capacity of various syrphid species. Notably, the extremely common genus Toxomerus and other small Syrphinae species carried very little pollen, while large and pilose Eristalinae species carried large pollen loads.
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Project description:The increase in physical inactivity prevalence in the USA has been associated with neighborhood characteristics. While several studies have found an association between neighborhood and health, the relative importance of each component related to physical inactivity or how this value varies geographically (i.e., across different neighborhoods) remains unexplored. This study ranks the contribution of seven socioecological neighborhood factors to physical inactivity prevalence in Chicago, Illinois, using machine learning models at the census tract level, and evaluates their predictive capabilities. First, we use geographical random forest (GRF), a recently proposed nonlinear machine learning regression method that assesses each predictive factor’s spatial variation and contribution to physical inactivity prevalence. Then, we compare the predictive performance of GRF to geographically weighted artificial neural networks, another recently proposed spatial machine learning algorithm. Our results suggest that poverty is the most important determinant in the Chicago tracts, while on the other hand, green space is the least important determinant in the rise of physical inactivity prevalence. As a result, interventions can be designed and implemented based on specific local circumstances rather than broad concepts that apply to Chicago and other large cities. Supplementary Information The online version contains supplementary material available at 10.1007/s10109-023-00415-y.
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