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2.
Environ Sci Pollut Res Int ; 30(51): 110119-110132, 2023 Nov.
Article in English | MEDLINE | ID: mdl-37783988

ABSTRACT

To address the adjustment of the Chinese agricultural industry and to better promote the development of Chinese household biogas, this article summarizes and analyzes the spatial distribution characteristics and influencing factors of the type and number of biogas digesters, biogas production, biogas fermentation materials, and methods of fermentation residue utilization and ecological agriculture with household biogas by compiling a dataset covering 31 provincial administrative regions in China. The results show that hydraulic biogas digesters are distributed mainly in northwestern and northeastern China; in addition, continuously stirred biogas digesters and bottom-discharging biogas digesters are distributed mainly in southern and northern China, respectively. Because of temperature and population, the Sichuan and Henan Provinces have the highest number of biogas digesters and biogas production. The type of biogas fermentation materials depends on the local raw materials. Biogas slurry and residue are widely used as fertilizers; furthermore, biogas slurry is used for seed soaking in northeastern and southern China, and biogas residue is used as feed in central southern and northern China. The "Three-in-one" and "Four-in-one" biogas ecological models are used mostly in southern and northern China, respectively, and both are mainly affected by temperature. Finally, we propose various problems and countermeasures to enhance the development of the household biogas industry in China. Our findings are critical for China's policymakers to adopt effective measures for promoting the development of cleaner energy and the layout of the agricultural industry.


Subject(s)
Biofuels , Family Characteristics , Biofuels/analysis , China , Fermentation , Agriculture/methods
3.
Zhong Nan Da Xue Xue Bao Yi Xue Ban ; 48(3): 323-329, 2023 Mar 28.
Article in English, Chinese | MEDLINE | ID: mdl-37164915

ABSTRACT

OBJECTIVES: Chronic obstructive pulmonary disease (COPD) is a disease characterized by persistent airflow restriction. This study aims to explore whether there is endothelial-to-mesenchymal transition (EndMT) in COPD mice and to explore the relationship between microRNA-21 (miR-21) and EndMT. METHODS: We established the COPD and the miR-21 gene knockout COPD animal model (both cigarette smoke-induced). Mice were divided into 3 groups (n=4): a control group, a COPD group, and a miR-21 knockout COPD (miR-21-/--COPD) group. Masson trichrome staining was used to observe the deposition of collagen around the perivascular. The relative protein levels and positions of endothelial cell markers including vascular endothelial-cadherin (VE-cadherin), endothelial nitric oxide synthase (eNOS), and platelet endothelial cell adhesion molecule-1 (CD31) as well as mesenchymal cell markers including α-smooth muscle actin (α-SMA) and neural cadherin (N-cadherin) in lung tissues were observed by immunohistochemical staining. RESULTS: Compared with the control group, the area of collagen fibril deposition was increased in the COPD group (P<0.05), the expression levels of VE-cadherin, eNOS, and CD31 were all decreased (all P<0.05), and the expression levels of α-SMA and N-cadherin were increased (both P<0.05). Compared with the COPD group, the miR-21-/--COPD group had a reduced area of collagen fiber deposition (P<0.05), the expression levels of VE-cadherin, eNOS, and CD31 were all increased (all P<0.05), and the expression levels of α-SMA and N-cadherin were decreased (both P<0.05). CONCLUSIONS: There is a EndMT process in cigarette smoke-induced COPD animal models.MiR-21 gene knockdown could reduce collagen deposition area and inhibit the EndMT process in COPD mice.


Subject(s)
MicroRNAs , Pulmonary Disease, Chronic Obstructive , Mice , Animals , Epithelial-Mesenchymal Transition , Collagen , MicroRNAs/metabolism , Pulmonary Disease, Chronic Obstructive/genetics , Cadherins/genetics , Cadherins/metabolism
4.
Immun Inflamm Dis ; 11(4): e820, 2023 04.
Article in English | MEDLINE | ID: mdl-37102667

ABSTRACT

INTRODUCTION: Chronic obstructive pulmonary disease (COPD) is associated with chronic inflammation that predominantly affects the lung and peripheral airways. Previous investigation has underlined the efficacy of luteolin in the treatment of inflammation-related symptoms. Accordingly, our study concentrates on unveiling the effect of luteolin on COPD. METHODS: Mice or A549 cells were treated with cigarette smoke (CS) to establish COPD models in vivo and in vitro. Then, the serum and bronchoalveolar lavage fluid of mice were harvested. The lung tissues of mice were subjected to hematoxylin-eosin staining to observe the degree of damage. The inflammation and oxidative stress factors level were calculated via enzyme-linked immunosorbent assay and quantitative real-time polymerase chain reaction. The expressions of nuclear factor-kappa B (NF-κB) pathway-related factors were detected by Western blot. RESULTS: In in vivo experiments, CS treatment reduced the weight of mice and promoted lung tissue damage, while luteolin attenuated the effect of CS on the mice. Moreover, luteolin inhibited the inflammation factors level, oxidative stress, and NADPH oxidase 4 (NOX4)-mediated NF-κB signaling pathway in CS-induced COPD mice. Similar results were obtained in in vitro experiments that luteolin alleviated CS-induced inflammation, oxidative stress, and NOX4-mediated NF-κB signaling pathway activation in CS-treated A549 cells. Besides, NOX4 overexpression offset the impacts of luteolin on the CS-induced A549 cells. CONCLUSION: Luteolin alleviates inflammation and oxidative stress in COPD via NOX4-mediated NF-κB signaling pathway, which provides a theoretical basis for the treatment of COPD with luteolin.


Subject(s)
NF-kappa B , Pulmonary Disease, Chronic Obstructive , Humans , NF-kappa B/metabolism , Luteolin/pharmacology , NADPH Oxidase 4/genetics , NADPH Oxidase 4/metabolism , Pulmonary Disease, Chronic Obstructive/drug therapy , Pulmonary Disease, Chronic Obstructive/metabolism , Signal Transduction , Inflammation/drug therapy , Inflammation/metabolism , Oxidative Stress
5.
Sci Rep ; 12(1): 21450, 2022 12 12.
Article in English | MEDLINE | ID: mdl-36509888

ABSTRACT

A simple prognostic model is needed for ICU patients. This study aimed to construct a modified prognostic model using easy-to-use indexes for prediction of the 28-day mortality of critically ill patients. Clinical information of ICU patients included in the Medical Information Mart for Intensive Care III (MIMIC-III) database were collected. After identifying independent risk factors for 28-day mortality, an improved mortality prediction model (mionl-MEWS) was constructed with multivariate logistic regression. We evaluated the predictive performance of mionl-MEWS using area under the receiver operating characteristic curve (AUROC), internal validation and fivefold cross validation. A nomogram was used for rapid calculation of predicted risks. A total of 51,121 patients were included with 34,081 patients in the development cohort and 17,040 patients in the validation cohort (17,040 patients). Six predictors, including Modified Early Warning Score, neutrophil-to-lymphocyte ratio, lactate, international normalized ratio, osmolarity level and metastatic cancer were integrated to construct the mionl-MEWS model with AUROC of 0.717 and 0.908 for the development and validation cohorts respectively. The mionl-MEWS model showed good validation capacities with clinical utility. The developed mionl-MEWS model yielded good predictive value for prediction of 28-day mortality in critically ill patients for assisting decision-making in ICU patients.


Subject(s)
Critical Illness , Intensive Care Units , Humans , Prognosis , Retrospective Studies , ROC Curve , Area Under Curve
6.
Zhong Nan Da Xue Xue Bao Yi Xue Ban ; 47(7): 936-941, 2022 Jul 28.
Article in English, Chinese | MEDLINE | ID: mdl-36039591

ABSTRACT

Autophagy is a regulatory mechanism that packages damaged organelles, proteins, and pathogens to form vesicles and transports to lysosomes for degradation, enabling the recycle of useful components. Therefore, autophagy plays an important role in biological growth regulation and homeostasis. In the past two decades, growing evidence has shown that microRNA (miRNA) is closely related to autophagy. MiRNA-21 promotes or inhibits autophagy via regulating relevant pathways for different downstream target genes, and plays a role in tumors, ischemia-reperfusion injury, and other diseases.


Subject(s)
MicroRNAs , Neoplasms , Reperfusion Injury , Autophagy/genetics , Humans , Lysosomes/metabolism , Lysosomes/pathology , MicroRNAs/metabolism , Neoplasms/pathology , Reperfusion Injury/metabolism
7.
Carbohydr Polym ; 125: 35-44, 2015 Jul 10.
Article in English | MEDLINE | ID: mdl-25857957

ABSTRACT

The structures (morphology, molecule, and crystallinity) and functional properties (gelatinization, hydrolysis, and in vitro digestion) of normal rice starches with different amylose contents were investigated and their relationships were analyzed. The results showed that the morphology, granule size, and crystalline type did not significantly change among rice starches. The molecular structure (amylose content, amylopectin branch-chain content, and amylopectin branching degree) and crystalline structure (relative crystallinity, IR ratio of 1045/1022 cm(-1), lamellar peak intensity, and lamellar distance) significantly varied among rice starches, which resulted in different functional properties. The gelatinization temperature and water solubility were significantly positively correlated with amylose content but significantly negatively correlated with amylopectin short branch-chain. The swelling power, hydrolysis and in vitro digestion were significantly positively correlated with amylopectin short branch-chain, relative crystallinity, IR ratio of 1045/1022 cm(-1), and lamellar peak intensity but significantly negatively correlated with amylose content and lamellar distance.


Subject(s)
Amylose/chemistry , Oryza/chemistry , Amylopectin/analysis , Amylopectin/chemistry , Amylose/analysis , Hydrolysis , Phase Transition , Transition Temperature
8.
South Med J ; 107(8): 513-7, 2014 Aug.
Article in English | MEDLINE | ID: mdl-25084190

ABSTRACT

OBJECTIVES: Community violence is associated with health-compromising behaviors (HCBs) and adverse general health and pregnancy outcomes. It is unknown whether these effects persist after adjusting for health behaviors. METHODS: Retrospective cohort study of 36,637 pregnancies, 2005-2009, using birth certificate/hospital discharge databases. Community violence rate = (nonaccidental injuries/total injuries) × 100%. ZIP codes were categorized into levels (CVL) by quartiles (lowest, 1, to highest, 4). Outcomes included HCBs (tobacco, alcohol, or drugs), fetal death, preterm birth, and infant small-for-gestational-age (SGA). Covariates included HCBs and maternal characteristics. RESULTS: The CVL median (interquartile range) was 5.5% (3.8%-8.8%). As CVL increased, rates of HCBs (8% vs 13% vs 14% vs 16%), fetal death (4 vs 5 vs 6 vs 8/1000 pregnancies), preterm birth (8% vs 9% vs 11% vs 13%), and infant SGA (8% vs 10% vs 13% vs 16%) increased. The odds of preterm birth (CVL1 = 1.00 [reference] vs CVL2 = 1.00 [0.88-1.14] vs CVL3 = 1.10 [0.96-1.26] vs CVL4 = 1.25 [1.09-1.42]) and infant SGA (CVL2 = 1.03 [0.93-1.17] vs CVL3 = 1.15 [1.01-1.30] vs CVL4 = 1.21 [1.07-1.38]) increased, after controlling for HCB. CONCLUSIONS: CVL is associated with fetal death, preterm birth, and infant SGA, independent of HCB. These findings may support the role of violence-reduction programs in improving pregnancy health behaviors and outcomes.


Subject(s)
Health Behavior , Pregnancy Outcome , Violence , Adult , Cohort Studies , Female , Fetal Death/etiology , Humans , Infant, Newborn , Infant, Small for Gestational Age , Obstetric Labor, Premature/epidemiology , Pregnancy , Retrospective Studies
9.
Am J Health Behav ; 38(2): 316-20, 2014 Mar.
Article in English | MEDLINE | ID: mdl-24629560

ABSTRACT

OBJECTIVE: To examine the impact of repeat, G2, and outcomes of first, G1, (previous livebirth, PLB, or stillbirth, PSB) pregnancies on health-compromising behaviors (HCB). METHODS: Retrospective cohort study of 137,374 pregnancies in Kansas City, MO, 1990 through 2009, using birth certificate database. RESULTS: Overall HCB rate was 17% and increased with G2 and PSB (G1=12% v G2-PLB=21% v G2-PSB=29%, p < .001). Compared to G2-PLB, the odds of HCB increased for G2-PSB (OR=1.42; 95%CI 1.10, 1.82) and decreased for G1 (0.54; 0.52, 0.56). CONCLUSION: Women are more likely to engage in HCB during their second pregnancy, especially those who lose their first pregnancy. This finding is evidence for promoting effective inter-conception health care at post-partum and primary care visits.


Subject(s)
Gravidity , Health Behavior , Pregnancy Outcome , Pregnant Women/psychology , Adult , Birth Certificates , Cohort Studies , Female , Gestational Age , Health Behavior/ethnology , Humans , Live Birth/epidemiology , Logistic Models , Marital Status , Missouri/epidemiology , Pregnancy , Prenatal Care/statistics & numerical data , Retrospective Studies , Risk-Taking , Stillbirth/epidemiology , Young Adult
10.
Carbohydr Polym ; 102: 799-807, 2014 Feb 15.
Article in English | MEDLINE | ID: mdl-24507349

ABSTRACT

The crystalline and structural properties of acid-modified C-type starch from lotus rhizomes were investigated using a combination of techniques. The degradation of granule during hydrolysis began from the end distant from the hilum and then propagated into the center of granule, accompanied by loss of birefringence. The crystallinity changed from C-type to A-type via CA-type during hydrolysis. At the early stage of hydrolysis, the amylose content substantially reduced, the peak and conclusion gelatinization temperatures increased, and the enthalpy decreased. During hydrolysis, the double helix content gradually increased and the amorphous component decreased, the lamellar peak intensity firstly increased and then decreased accompanied by hydrolysis of amorphous and crystalline regions. This study elucidated that B-type allomorph was mainly arranged in the distal region of eccentric hilum, A-type allomorph was mainly located in the periphery of hilum end, and the center of granule was a mixed distribution of A- and B-type allomorphs.


Subject(s)
Acids/chemistry , Lotus/chemistry , Rhizome/chemistry , Starch/chemistry , Crystallization , Crystallography, X-Ray , Hydrolysis , Magnetic Resonance Spectroscopy , Microscopy, Electron, Scanning , Molecular Structure , Scattering, Small Angle
11.
Food Chem ; 142: 408-15, 2014 Jan 01.
Article in English | MEDLINE | ID: mdl-24001859

ABSTRACT

The allomorph distribution and granule structure of C-type starch from lotus rhizomes were investigated using a combination of techniques during gelatinization. The disruption of crystallinity during gelatinization began from the end distant from the eccentric hilum and then propagated into the center of granule. The periphery of hilum end was finally gelatinized, accompanied by high swelling. The crystallinity changed from C-type to A-type via CA-type during gelatinization, and finally became amorphous structure. The amylose content, crystal degree, helix content, ratio of 1045/1022cm(-1), and peak intensity of crystalline lamellae of gelatinizing starch significantly decreased after 70°C. The amorphous content and ratio of 1022/995cm(-1) increased after 70°C. This study elucidated that B-type allomorph was mainly arranged in the distal region of eccentric hilum, A-type allomorph was mainly located in the periphery of hilum end, and the center of granule was a mixed distribution of A- and B-type allomorphs.


Subject(s)
Lotus/chemistry , Rhizome/chemistry , Starch/chemistry , Carbohydrate Conformation , Crystallization , Gelatin/chemistry
12.
Food Chem ; 145: 245-53, 2014 Feb 15.
Article in English | MEDLINE | ID: mdl-24128474

ABSTRACT

Native starches were isolated from mature grains of high-amylose transgenic rice TRS and its wild-type rice TQ and treated with 0.1% and 0.4% NaOH for 7 and 14 days at 35 °C. Alkali-treated starches were characterised for structural and functional properties using various physical methods. The 0.1% NaOH treatment had no significant effect on structural and functional properties of starches except that it markedly increased the hydrolysis of starch by amylolytic enzymes. The 0.4% NaOH treatment resulted in some changes in structural and functional properties of starches. The alkali treatment affected granule morphology and decreased the electron density between crystalline and amorphous lamellae of starch. The effect of alkali on the crystalline structure including long- and short-range ordered structure was not pronounced. Compared with control starch, alkali-treated TRS starches had lower amylose content, higher onset and peak gelatinisation temperatures, and faster hydrolysis of starch by HCl and amylolytic enzymes.


Subject(s)
Alkalies/chemistry , Amylose/analysis , Oryza/chemistry , Starch/chemistry , Edible Grain/chemistry , Hydrolysis , Magnetic Resonance Spectroscopy , Spectroscopy, Fourier Transform Infrared , Structure-Activity Relationship , Temperature
13.
Carbohydr Polym ; 101: 289-300, 2014 Jan 30.
Article in English | MEDLINE | ID: mdl-24299776

ABSTRACT

This study investigated the structural and functional properties of C-type starches from pea seeds, faba bean seeds, yam rhizomes and water chestnut corms. These starches were mostly oval in shape with significantly different sizes and contents of amylose, damaged starch and phosphorus. Pea, faba bean and water chestnut starches had central hila, and yam starch had eccentric hilum. Water chestnut and yam starches had higher amylopectin short and long chain, respectively. Water chestnut and faba bean starches showed CA-type crystallinities, and pea and yam starches had C-type crystallinities. Water chestnut starch had the highest swelling power, granule swelling and pasting viscosity, lowest gelatinization temperatures and enthalpy. Faba bean starch had the lowest pasting viscosity, whereas yam starch had the highest gelatinization temperatures. Water chestnut and yam starches possessed significantly higher and lower susceptibility to acid and enzyme hydrolysis, the highest and lowest RDS contents, and the lowest and highest RS contents, respectively.


Subject(s)
Starch/chemistry , Starch/metabolism , Amylose/analysis , Digestion , Food Industry , Hydrolysis , Molecular Weight , Phosphorus/analysis , Temperature
14.
South Med J ; 105(12): 636-44, 2012 Dec.
Article in English | MEDLINE | ID: mdl-23211497

ABSTRACT

OBJECTIVE: To assess the trends for smoking during pregnancy for whites and blacks in Missouri, a state with a high prevalence of smoking, for the period 1990-2009. METHODS: Retrospective cohort study of annual pregnancy smoking rates recorded on birth certificates. Trends were assessed by regression analyses for all births, births to whites and blacks, births to whites and blacks in aggregate, and by zip codes within the combined jurisdictions of Kansas City, St Louis City, and St Louis County. Zip code smoking during pregnancy rates matched with the respective zip code race-specific population compositions were analyzed by chi-square tests. RESULTS: Smoking during pregnancy rates trends for whites and blacks differed significantly during the 2 decades. Although rates for whites declined over time, they were relatively stable from 1999 through 2007. Rates for blacks exhibited a steep decline in the early 1990s, remaining stable after 1995. Within the combined jurisdictions, rates for blacks who smoked during pregnancy surpassed those of whites beginning in 2001. The lack of prenatal care for either race was the only maternal characteristic consistently associated with lack of reduction in smoking during pregnancy. There also were no declines among young birth mothers of either race who had 12 or fewer years of education. Rates of smoking during pregnancy for blacks and whites were highest in zip codes with a ≥50% black population. CONCLUSIONS: Rates for smoking during pregnancy for whites and blacks in Missouri overall have not changed appreciably from 2000 to 2009. Beneficial antismoking during pregnancy effects that could reverse this trend may be achievable via improved access to prenatal care, especially for young, uneducated women.


Subject(s)
Smoking/epidemiology , Adolescent , Adult , Black or African American/statistics & numerical data , Chi-Square Distribution , Educational Status , Female , Humans , Missouri/epidemiology , Pregnancy , Prevalence , Regression Analysis , Retrospective Studies , White People/statistics & numerical data
15.
Carbohydr Polym ; 89(2): 571-7, 2012 Jun 20.
Article in English | MEDLINE | ID: mdl-24750760

ABSTRACT

This study investigated the physicochemical properties of rhizome starch of A. altaica for the first time. The results were compared to those obtained from two common starches (potato and rice). The rhizome had a starch content of 49.8%. Isolated starch granules were mostly oval in shape with a central Maltese cross and an average long axis of 6.25 µm. The starch contained 35.5% amylose and had lower gelatinization and pasting temperatures than rice and potato starches and a swelling power comparable to potato. Altaica starch had high breakdown and setback viscosities. X-ray diffraction revealed B-type starch with relative degree of crystallinity of 17.5%. Starch possessed a high susceptibility to hydrolysis by acid, porcine pancreatic α-amylase and Aspergillus niger amyloglucosidase when compared with potato and rice starches.


Subject(s)
Anemone , Rhizome , Starch/chemistry , Amylose/analysis , Glucan 1,4-alpha-Glucosidase , Hydrochloric Acid/chemistry , Hydrolysis , Medicine, Chinese Traditional , Particle Size , Plants, Medicinal , alpha-Amylases
16.
Int J Pharm Pract ; 19(3): 166-70, 2011 Jun.
Article in English | MEDLINE | ID: mdl-21554441

ABSTRACT

OBJECTIVE: The study objective was to identify demographic risk factors associated with emergency room visits caused by benzodiazepine poisoning. METHODS: A retrospective study was conducted utilizing Missouri Hospital Discharge Data for Kansas City, Missouri, USA, for 2001-2007. The data included patients' demographics such as racial group, age, sex, health insurance status and annual income. Emergency room visits due to benzodiazepine poisoning were identified by ICD-9 code 969.4. The frequencies of patient visits were calculated according to categories of each demographic variable. Chi-square tests were used to assess the difference of emergency room visits among categories of each demographic variable. A multiple logistic regression analysis was performed, where the outcome variable was emergency room visits due to benzodiazepine poisoning (yes/no), and the independent variables were the demographic variables. KEY FINDINGS: Of 1317566 emergency room visits over the 7-year period, 562 were due to benzodiazepine poisoning. Seventy-seven per cent of these visits were made by patients who were white, of whom 53% were 30-49years old, 56% were female, 74% had health insurance and 44% lived in zip codes with median family incomes of $40000-59999. Chi-square tests were significant for racial group, age and annual income (P<0.01). In the logistic regression white patients were 73% more likely than black patients to have emergency room visits caused by benzodiazepine poisoning (P<0.01), with an odds ratio (95% confidence interval) of 5.63 (4.33-7.30). Compared with those aged 0-19 years, the odds ratio for patients aged 30-39 to have such visits was 2.73 (2.09-3.57), and the odds ratio for patients aged 40-49 was 2.84 (2.17-3.71). CONCLUSIONS: White patients and patients aged 30-49years were at higher risk for emergency room visits due to benzodiazepine poisoning. Health interventions such as medication review by pharmacists may reduce the risk of benzodiazepine poisoning for these patients.


Subject(s)
Benzodiazepines/poisoning , Emergency Service, Hospital , Adolescent , Adult , Aged , Child , Emergency Service, Hospital/statistics & numerical data , Female , Humans , Infant , Infant, Newborn , Male , Middle Aged , Missouri , Retrospective Studies , Risk Factors , Time Factors
17.
Public Health Rep ; 126(2): 210-9, 2011.
Article in English | MEDLINE | ID: mdl-21387951

ABSTRACT

OBJECTIVES: We determined the trends, risk factors, and costs of emergency department (ED) visits for dental complaints during a six-year period in Kansas City, Missouri (KCMO). METHODS: We used de-identified hospital discharge data from all facilities serving KCMO during 2001-2006. Using the International Classification of Diseases, Ninth Revision codes, we determined both counts and rates of ED visits related to toothache or tooth injury and analyzed the discharge diagnosis and costs of these visits. We used multivariable regression analysis to assess risk factors for the ED visits for dental complaints. RESULTS: We found a significant increasing trend in dental complaint visits during the six-year period (from 13.1% to 19.0%, p < 0.01). Dental caries accounted for 20.4%, pulpitis or periapical abscess accounted for 14.8%, dental injury accounted for 8.7%, temporomandibular joint (TMJ) disorders accounted for 1.5%, and all other unspecified dental diseases accounted for 54.6% of the ED visits for dental complaints. The mean charge was approximately $360 per visit and was highest for TMJ disorders ($747) and lowest for unspecified other dental diseases ($277). Self-pay (38.3%) and Medicaid (32.3%) constituted the majority of the payment sources. Multivariable regression analysis indicated that self-payers, nonwhite people, adults, people with lower family income, and weekends were associated with increased use of ED visits for dental complaints. CONCLUSIONS: There was a significant increasing trend in dental complaint-related ED visits. EDs have become an important site for people with dental problems to seek urgent care, particularly for individuals who self-pay or are on Medicaid.


Subject(s)
Emergency Service, Hospital/statistics & numerical data , Stomatognathic Diseases/diagnosis , Stomatognathic Diseases/epidemiology , Adolescent , Adult , Age Distribution , Child , Child, Preschool , Emergency Service, Hospital/trends , Female , Health Care Surveys , Hospital Charges/statistics & numerical data , Humans , Infant , Insurance Coverage/statistics & numerical data , Insurance, Health/statistics & numerical data , Male , Middle Aged , Missouri/epidemiology , Retrospective Studies , Risk Factors , Sex Distribution , Small-Area Analysis , Socioeconomic Factors , Tooth Diseases/diagnosis , Tooth Diseases/epidemiology , Young Adult
18.
Am J Perinatol ; 27(1): 1-7, 2010 Jan.
Article in English | MEDLINE | ID: mdl-19670131

ABSTRACT

The factors associated with recurrent small-for-gestational-age birth (R-SGA) have not been previously studied in a multiracial population. This is a retrospective cohort study of 5932 black and white women who had consecutive singleton first and second births in a Midwestern metropolis, from 1995 through 2004, to measure the risk and determine the factors associated with R-SGA. The rates for second-born small-for-gestational-age birth and R-SGA were 10.3% and 4.0%, respectively. Compared with mothers of firstborns who were appropriate for gestational age, mothers of firstborns who were small for gestation age had a higher risk of second-born small-for-gestational-age infants (relative risk [RR] = 3.93; 95% confidence interval [95% CI] = 3.36 to 4.59). Among those with firstborns who were small for gestational age, the odds ratio (OR) and 95% CI of R-SGA were higher for lean body mass index + poor gain (2.83; 1.20 to 6.69), blacks (1.58; 1.09 to 2.29), and smokers (1.61; 1.05 to 2.47). R-SGA occurs in 4% of second births and is responsible for 40% of second-born small-for-gestational-age infants. R-SGA is potentially preventable because of its association with potentially modifiable factors such as smoking and weight gain in pregnancy.


Subject(s)
Infant, Small for Gestational Age , Adult , Body Mass Index , Cohort Studies , Female , Gestational Age , Humans , Infant, Newborn , Male , Pregnancy , Recurrence , Retrospective Studies , Risk Assessment , Risk Factors , Smoking , Weight Gain
19.
Am J Perinatol ; 27(5): 353-60, 2010 May.
Article in English | MEDLINE | ID: mdl-20013634

ABSTRACT

The ponderal index (PI) is evaluated in the context of its distribution within a given population. Low PI (<10th percentile for gestational age) has been extensively studied but not much is known about the distribution and factors associated with a high (>90th percentile) PI among small-for-gestational-age (SGA) infants. This retrospective study of singleton live first births from 1990 to 2007 in a Midwestern city explores factors associated with a high PI, particularly among SGA infants. Independent variables included exposures (none, smoke, hypertension) and maternal and infant demographic characteristics. There were 45,453 births, 28 to 42 weeks' gestational age, 55% Whites and 51% male. Mean PI increased with gestational age and was highest among Hispanics and lower among SGA infants. High PI was present in 11% of appropriate-for-gestational-age and 4% of SGA infants. Among SGA infants, odds ratios (ORs) of high PI were higher for smoke exposure (1.21; 95% confidence interval 0.97, 1.87) and lower for males (0.66; 0.47, 0.93). In conclusion, the distribution of PI varies by exposures and of high PI by race/ethnicity/gender. SGA infants with high PI have relative surplus of mass, and ostensibly, adiposity, for their frame. There is a need to use PI in exploring and defining previously observed associations between SGA and adult-onset obesity/metabolic syndrome.


Subject(s)
Infant, Small for Gestational Age , Pregnancy Complications, Cardiovascular , Smoking/adverse effects , Body Mass Index , Female , Gestational Age , Humans , Hypertension/complications , Infant, Newborn , Male , Pregnancy , Pregnancy Outcome , Retrospective Studies , Risk Factors
20.
Public Health Rep ; 124(5): 711-7, 2009.
Article in English | MEDLINE | ID: mdl-19753949

ABSTRACT

OBJECTIVE: We assessed excess fetal-infant mortality for Hispanic, non-Hispanic white, and non-Hispanic black populations in five contiguous counties of Missouri and Kansas. METHODS: We conducted a perinatal periods of risk (PPOR) assessment of fetal-infant mortality using electronic linked birth-death record files from 2001 through 2005. We generated an internal reference group in accordance with established PPOR protocol. We used Kitagawa analysis to determine whether excess deaths were due to birthweight distribution (a higher frequency of prematurity or growth retardation) or to higher mortality rates once born at that birthweight (birthweight-specific mortality). RESULTS: We found the excess fetal-infant death rates for Hispanic and non-Hispanic white populations to be similar and considerably lower than that for non-Hispanic black populations. Among Hispanic children, we judged 21.6% of fetal-infant mortality to be excess in relation to the reference population. Within the PPOR matrix, Hispanic excess mortality rates were distributed differently from those of non-Hispanic white and non-Hispanic black populations. Among Hispanic children, 93.6% of the excess mortality could be explained by low birthweight and birthweight-specific mortality, with the greatest contribution attributable to low birthweight. CONCLUSION: The excess fetal-infant mortality experience of Hispanic people in the five-county region was similar to that of the non-Hispanic white population, but was distributed differently in the PPOR model, which has significance regarding interventions targeting reductions in fetal-infant mortality.


Subject(s)
Fetal Mortality/ethnology , Hispanic or Latino/statistics & numerical data , Infant Mortality/ethnology , Black or African American/statistics & numerical data , Female , Humans , Infant , Infant, Low Birth Weight , Infant, Newborn , Infant, Premature , Kansas/epidemiology , Maternal Welfare/statistics & numerical data , Medical Record Linkage , Missouri/epidemiology , Perinatal Care , Pregnancy , White People/statistics & numerical data
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