Publications by authors named "McClure D"
Objective: Chronic opioid use can lead to detrimental effects on the immune and various organ systems that put individuals prescribed chronic opioid therapy (COT) for pain and those with an opioid use disorder (OUD) at risk for severe COVID-19 disease. We assessed the association of COT and OUD with COVID-19-related hospitalization and death to inform targeted interventions to improve clinical outcomes in COVID-19 patients who use opioids.
Methods: We conducted a retrospective cohort study of adults ages ≥ 18 with laboratory-confirmed SARS-CoV-2 infection in 2020 and 2021 from three US health systems.
Purpose: Vaccine-associated enhanced disease (VAED) is a theoretical concern with new vaccines, although trials of authorized vaccines against SARS-CoV-2 have not identified markers for VAED. The purpose of this study was to detect any signals for VAED among adults vaccinated against coronavirus disease 2019 (COVID-19).
Methods: In this cross-sectional study, we assessed COVID-19 severity as a proxy for VAED among 400 adults hospitalized for COVID-19 from March through October 2021 at eight US healthcare systems.
The immune response to inactivated influenza vaccines (IIV) is influenced by multiple factors, including hemagglutinin content and egg-based manufacturing. Only two US-licensed vaccines are manufactured without egg passage: cell culture-based inactivated vaccine (ccIIV) and recombinant vaccine (RIV). We conducted a randomized open-label trial in central Wisconsin during the 2018-19 and 2019-20 seasons to compare immunogenicity of sequential vaccination.
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- COVID-19 vaccinations are effective in preventing severe illness and death but their impact on post-COVID conditions (PCC) is less understood, prompting a study to evaluate this association.
- The study analyzed electronic health records from over 161,000 vaccinated and unvaccinated COVID-19 patients from multiple healthcare systems, focusing on new diagnoses of PCC within six months after infection.
- Results showed that vaccinated individuals had a lower risk of several PCC categories, especially sensory and circulatory issues, while mental health disorders had a slightly higher risk in vaccinated individuals, indicating that vaccination may help reduce long-term COVID-19 consequences.
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- The study assesses outcomes in trauma patients with blunt abdominal injuries and liver cirrhosis, comparing emergency laparotomy to nonoperative management.
- It analyzed data from 929 patients, finding that those who underwent laparotomy had significantly higher mortality, required more blood, and spent longer in the ICU.
- The conclusion suggests that nonoperative management might be a safer and more effective strategy for these patients.
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- A study re-evaluated mortality risks associated with COVID-19 vaccinations using a modified self-controlled case series design to minimize confounding biases.
- Researchers analyzed death data from vaccinated and unvaccinated individuals, focusing on non-COVID-19 mortality and specific cardiac-related deaths within set observation periods.
- Results for Pfizer-BioNTech showed reduced mortality risks for all outcomes, while Moderna and Janssen also indicated low risks, although some results for Moderna had confidence intervals that included 1, suggesting uncertainty in the estimates.
Background: A third dose of measles-mumps-rubella vaccine (MMR) may be administered for various reasons, but data on long-term immunity are limited. We assessed neutralizing antibody levels against measles and rubella among adults up to 11 years after receipt of a third MMR dose.
Methods: In this longitudinal study, healthy adults who received a third MMR dose as young adults (ages 18-28 years) were recalled around 5 years and 9-11 years after the third dose.
Purpose: The aim of this study is to use electronic opioid dispensing data to develop an individual segmented trajectory approach for identifying opioid use patterns. The resulting opioid use patterns can be used for examining the association between opioid use and drug overdose.
Methods: We retrospectively assembled a cohort of members on long-term opioid therapy (LTOT) between January 1, 2006 and June 30, 2019 who were 18 years and older and enrolled in one of three health care systems in the US.
Background: Tapering long-term opioid therapy is an increasingly common practice, yet rapid opioid dose reductions may increase the risk of overdose. The objective of this study was to compare overdose risk following opioid dose reduction rates of ≤10%, 11% to 20%, 21% to 30%, and >30% per month to stable dosing.
Methods: We conducted a retrospective cohort study in three health systems in Colorado and Wisconsin.
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- Traditional vaccine safety monitoring usually checks specific health outcomes within set timeframes, but this study used more comprehensive methods to examine over 60,000 potential adverse events following bivalent COVID-19 vaccination.* -
- The analysis involved 352,509 doses of the Moderna vaccine and 979,189 doses of the Pfizer-BioNTech vaccine, with significant clusters of adverse events detected only after the Pfizer-BioNTech vaccine, including unspecified adverse effects and respiratory illnesses.* -
- The observed respiratory issues were likely influenced by the concurrent spread of seasonal viruses, highlighting the method's capability to detect clusters while accounting for various diagnoses and temporal factors.*
Background: US recommendations for COVID-19 vaccine boosters have expanded in terms of age groups covered and numbers of doses recommended, whereas evolution of Omicron sublineages raises questions about ongoing vaccine effectiveness.
Methods: We estimated effectiveness of monovalent COVID-19 mRNA booster vaccination versus two-dose primary series during a period of Omicron variant virus circulation in a community cohort with active illness surveillance. Hazard ratios comparing SARS-CoV-2 infection between booster versus primary series vaccinated individuals were estimated using Cox proportional hazards models with time-varying booster status.
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- A large cohort study was conducted to assess the risk of non-COVID-19 mortality after vaccination, which is crucial to combat vaccine hesitancy, taking into account various demographic, clinical, and socioeconomic factors.
- The study analyzed data from seven Vaccine Safety Datalink sites, comparing non-COVID-19 mortality rates among vaccinated individuals with those who were not, across different age, sex, and racial/ethnic groups.
- The findings revealed lower non-COVID-19 mortality rates for vaccinated individuals, with adjusted hazard ratios indicating a significantly reduced risk after receiving COVID-19 vaccines, despite some remaining confounding bias.
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- A study utilized tree-based data mining to identify potential adverse events following COVID-19 vaccinations from Pfizer-BioNTech, Moderna, and Janssen, focusing on a broad range of health outcomes rather than pre-specified conditions.
- The analysis involved monitoring patients for up to 70 days after vaccination, using a specific statistical method to determine clusters of incidents in emergency or inpatient settings, with a significance threshold set at p = 0.01.
- Notable findings included clusters of various common vaccine reactions and myocarditis/pericarditis post-Pfizer-BioNTech vaccination, while Moderna showed similar reactions without myocarditis clustering; Janssen vaccinees primarily reported unspecified reactions and some mobility issues likely influenced by site-specific practices.
Background: The Centers for Disease Control and Prevention's Vaccine Safety Datalink (VSD) has been performing safety surveillance for COVID-19 vaccines since their earliest authorization in the United States. Complementing its real-time surveillance for pre-specified health outcomes using pre-specified risk intervals, the VSD conducts tree-based data-mining to look for clustering of a broad range of health outcomes after COVID-19 vaccination. This study's objective was to use this untargeted, hypothesis-generating approach to assess the safety of first booster doses of Pfizer-BioNTech (BNT162b2), Moderna (mRNA-1273), and Janssen (Ad26.
View Article and Find Full Text PDFLarge-scale photoautotrophic production of microalgae has the potential to provide a sustainable supply of omega-3 fatty acids (eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA)) for human and animal nutrition. This study presents a kinetic model for the EPA-producing microalga in photoautotrophic conditions, with light and nitrogen being the growth limiting factors. The model was developed using a dataset obtained from bench-scale (5 L) cultures and was successfully validated against pilot-scale (50 L) cultures.
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- The study examines the long-term outcomes of different opioid management strategies, particularly focusing on group-based trajectory modeling of opioid doses and their impact on patient health and behavior.
- Conducted in three health systems, the retrospective cohort study analyzed data from 3,913 patients on long-term opioid therapy, looking at outcomes such as opioid use disorder, continued therapy, mortality, and health plan disenrollment.
- Results showed that patients on a decreasing dose trajectory had lower rates of opioid use disorder and continued therapy but were more likely to disenroll from their health plans, with no significant impact on mortality.
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- A study aimed to investigate the link between aluminum exposure from vaccines in children under 24 months and the development of persistent asthma between 24 and 59 months of age.
- The research was based on the Vaccine Safety Datalink and analyzed data from 326,991 children, finding that higher aluminum exposure was associated with higher rates of persistent asthma, especially in those with eczema.
- The conclusion suggests a possible connection but calls for further research due to the small effect sizes and potential confounding factors.
Human gut microbiome structure and emergent metabolic outputs impact health outcomes. However, what drives such community characteristics remains underexplored. Here, we rely on high throughput genomic reconstruction modeling, to infer the metabolic attributes and nutritional requirements of 816 gut strains, via a framework termed GEMNAST.
View Article and Find Full Text PDFImportance: After SARS-CoV-2 infection, many patients present with persistent symptoms for at least 6 months, collectively termed post-COVID conditions (PCC). However, the impact of PCC on health care utilization has not been well described.
Objectives: To estimate COVID-19-associated excess health care utilization following acute SARS-CoV-2 infection and describe utilization for select PCCs among patients who had positive SARS-CoV-2 test results (including reverse transcription-polymerase chain reaction and antigen tests) compared with control patients whose results were negative.
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- Frailty is a significant predictor of poor outcomes and higher mortality rates in patients undergoing vascular surgery, particularly during the resource-limited COVID-19 pandemic.
- In a study involving 917 patients, 22.1% were identified as frail, with no significant difference in mortality rates between frail and non-frail patients over 30 days and 6 months; however, frail patients experienced longer hospital stays and more complications.
- The study emphasizes the need for targeted care interventions for frail individuals to prevent adverse outcomes, particularly during healthcare challenges like pandemics.
Scaling the number of qubits while maintaining high-fidelity quantum gates remains a key challenge for quantum computing. Presently, superconducting quantum processors with >50 qubits are actively available. For these systems, fixed-frequency transmons are attractive because of their long coherence and noise immunity.
View Article and Find Full Text PDFReduced COVID-19 vaccine effectiveness (VE) has been observed with increasing predominance of SARS-CoV-2 Delta (B.1.617.
View Article and Find Full Text PDFObjectives: Safety studies assessing the association between the entire recommended childhood immunization schedule and autoimmune diseases, such as type 1 diabetes mellitus (T1DM), are lacking. To examine the association between the recommended immunization schedule and T1DM, we conducted a retrospective cohort study of children born between 2004 and 2014 in 8 US health care organizations that participate in the Vaccine Safety Datalink.
Methods: Three measures of the immunization schedule were assessed: average days undervaccinated (ADU), cumulative antigen exposure, and cumulative aluminum exposure.
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- The study focuses on analyzing traumatic injuries and mortality trends in a rural Wisconsin trauma center from 2000 to 2018, contrasting it with data from urban centers.
- Results showed an increase in injuries from falls (from 35.6% to 51.5%) and a decrease from motor vehicle events (from 37.0% to 22.5%) over three time periods, mirroring national trends.
- The overall fatality ratios decreased significantly, with findings indicating that the median age of patients increased from 42 to 55 years during the study period.