3,289 results match your criteria: "Harvard Pilgrim Health Care Institute & Harvard Medical School[Affiliation]"

Article Synopsis
  • The study explores the relationship between green space and childhood obesity by using advanced metrics like NDVI and street-view imagery, rather than solely relying on BMI.
  • Participants were assessed from mid-childhood through late adolescence to analyze how green space exposure relates to various measures of adiposity, including BMI and fat mass index.
  • The research aims to provide a more comprehensive understanding of how green environments may influence children's health outcomes over time, factoring in socio-economic and demographic variables.
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Importance: Cancer mortality has decreased over time, but the contributions of different interventions across the cancer control continuum to averting cancer deaths have not been systematically evaluated across major cancer sites.

Objective: To quantify the contributions of prevention, screening (to remove precursors [interception] or early detection), and treatment to cumulative number of cancer deaths averted from 1975 to 2020 for breast, cervical, colorectal, lung, and prostate cancers.

Design, Setting, And Participants: In this model-based study using population-level cancer mortality data, outputs from published models developed by the Cancer Intervention and Surveillance Modeling Network were extended to quantify cancer deaths averted through 2020.

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Asthma and sleep disordered breathing in the pediatric adenotonsillectomy trial for snoring study.

Sleep Breath

December 2024

Division of Pediatric Pulmonology and Sleep Medicine, UH Rainbow Babies and Children's Hospital, Case Western Reserve University, 11100 Euclid Ave, Pediatric Pulmonology, MS 6006, Cleveland, OH, 44106, USA.

Article Synopsis
  • The study investigates the link between asthma and sleep-disordered breathing (SDB) in children aged 3-12.9 years, focusing on identifying risk factors and assessing sleep-related outcomes.
  • Results show that 19.1% of the children had asthma, with moderate-to-severe asthma linked to worse SDB symptoms and lower quality of life.
  • Key risk factors for asthma included exposure to environmental tobacco smoke and signs of atopy, highlighting the complex relationship between asthma severity and sleep disturbances in children.
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Reply to A H Quirino et al.

Am J Clin Nutr

December 2024

Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, United States.

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Evaluating the Cost-Effectiveness of Etranacogene Dezaparvovec Gene Therapy for Hemophilia B Treatment in the USA.

Appl Health Econ Health Policy

December 2024

Department of Pharmacy Systems, Outcomes, and Policy, Retzky College of Pharmacy, University of Illinois Chicago, Chicago, IL, USA.

Article Synopsis
  • - The study evaluates the cost-effectiveness of a new gene therapy, Etranacogene dezaparvovec (EDZ), for severe hemophilia B, comparing it to the traditional treatment, factor IX (FIX) prophylaxis over a lifetime perspective in the U.S.
  • - Results show that despite EDZ costing $3.5 million, it offers lifetime savings of $11 million and slightly improves quality of life by 0.64 QALYs compared to FIX, which has very high annual costs.
  • - The cost-effectiveness of EDZ is influenced significantly by capping annual cost offsets, emphasizing how these limits can help balance price and value for healthcare systems.
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Assessing greenspace and cardiovascular health through deep-learning analysis of street-view imagery in a cohort of US children.

Environ Res

January 2025

Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA; Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Public Health Sciences, University of California, Davis School of Medicine, Sacramento, CA, USA.

Background: Accurately capturing individuals' experiences with greenspace at ground-level can provide valuable insights into their impact on children's health. However, most previous research has relied on coarse satellite-based measurements.

Methods: We utilized CVH and residential address data from Project Viva, a US-based pre-birth cohort, tracking participants from mid-childhood to late adolescence (2007-21).

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Cesarean delivery and blood DNA methylation at birth and childhood: Meta-analysis in the Pregnancy and Childhood Epigenetics Consortium.

Sci Adv

November 2024

Division of Chronic Disease Research Across the Lifecourse (CoRAL), Department of Population Medicine, Harvard Medical School, Harvard Pilgrim Health Care Institute, Boston, MA 02215, USA.

Article Synopsis
  • - Children born via cesarean delivery have a greater risk of various health issues compared to those born vaginally, but the exact reasons are still not fully understood.
  • - A meta-analysis involving over 12,000 participants found six specific DNA methylation markers in newborns linked to cesarean delivery, but these markers did not persist into childhood.
  • - The study indicates that cesarean delivery affects certain blood cell proportions at birth, but further research is necessary to understand its long-term impacts on child health.
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Immediate Postoperative Changes After Expansion Pharyngoplasty and Hypoglossal Nerve Stimulation.

Laryngoscope

November 2024

Department of Otolaryngology, Massachusetts Eye and Ear, Boston, Massachusetts, U.S.A.

Article Synopsis
  • The study aimed to evaluate the effects of hypoglossal nerve stimulation (HGNS) and expansion pharyngoplasty (EP) on patients with obstructive sleep apnea (OSA) to understand potential respiratory complications post-surgery.
  • Thirty patients (19 received HGNS and 11 received EP) were monitored using the NightOwl Mini device for changes in the apnea-hypopnea index (AHI) and oxygen levels after surgery.
  • Results showed no significant changes in AHI after HGNS, indicating no need for extended overnight observation, whereas EP led to increased AHI and hypoxemia, suggesting tailored postoperative care is necessary for those patients.
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Article Synopsis
  • A study investigated how prenatal dietary patterns affect child outcomes related to autism, analyzing data from up to 6084 participants across 14 cohorts.
  • Results showed that higher scores on healthy eating indices were linked to lower scores on the Social Responsiveness Scale (SRS), indicating a potential connection between better prenatal diets and social behaviors in children.
  • However, there were no significant links found between prenatal diets and official autism diagnoses, suggesting that while diet may influence some traits, more research is needed to clarify its effects on autism-related conditions.
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Modern Sources of Controls in Case-Control Studies.

Am J Epidemiol

November 2024

Center for Opioid Epidemiology and Policy, Division of Epidemiology, Department of Population Health, New York University Grossman School of Medicine.

In 1992, Wacholder and colleagues developed a theoretical framework for case-control studies to minimize bias in control selection. They described three comparability principles (study base, deconfounding, and comparable accuracy) to reduce the potential for selection bias, confounding, and information bias in case-control studies. Wacholder et al.

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Automated Electronic Health Record Data Extraction and Curation Using ExtractEHR.

JCO Clin Cancer Inform

November 2024

Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, University of Pennsylvania School of Medicine, Philadelphia, PA.

Article Synopsis
  • - The study highlights the limited impact of electronic health record (EHR) data on pediatric oncology research due to fewer pediatric cancer cases and challenges in identifying phenotypic cases within EHR data.
  • - ExtractEHR, a software package originally designed for reporting clinical trial adverse events, has been expanded to create comprehensive multisite EHR data sets for pediatric cancer research, enabling automated data extraction across hospitals.
  • - Installations of ExtractEHR have occurred at four major pediatric institutions, and it has been used for various research activities, including clinical epidemiology studies and multicenter trials, with ongoing efforts to enhance its capabilities for sustainability and interoperability.
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The Philadelphia Beverage Tax and Pediatric Weight Outcomes.

JAMA Pediatr

January 2025

Department of Medical Ethics and Health Policy, Perelman School of Medicine, University of Pennsylvania, Philadelphia.

Importance: Taxation of sweetened beverages is a proposed strategy to reduce excess sugar consumption. The association of such taxes with health outcomes is not well studied. Philadelphia, Pennsylvania, is the largest US city with a beverage tax.

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Background: Inequities in genetic testing have been documented in a range of diseases, and no-charge genetic testing programs have been proposed as a means to enhance access. However, no studies have examined disparities in genetic testing for inborn errors of immunity (IEI) and the impact of no-charge programs on testing equity.

Objective: To examine socioeconomic, geographic, and racial disparities in the uptake of genetic testing for IEI in the United States and the impact of a no-charge sponsored program on testing equity.

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Objective: This study aimed to examine sexual orientation differences in natural menopause timing and symptoms between lesbian and bisexual women compared with heterosexual women.

Methods: We used longitudinal questionnaire data (1989-2015) from 92,314 women (858 lesbian, 375 bisexual) in the Nurses' Health Study II cohort. Women were 24-44 yr old at baseline and biennially reported their menopause status, including reasons for cessation of menstrual periods.

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Article Synopsis
  • This study investigates how historical redlining and current racial and economic segregation affect healthcare access for people with rheumatic conditions in Massachusetts and nearby areas.
  • The research involved a cohort of 5597 patients who received care from rheumatology practices affiliated with Mass General Brigham, using data dating back to 2000 and geocoding their addresses with 1930s redlining maps.
  • Findings revealed that a significant portion of the patients lived in heavily redlined neighborhoods, highlighting the ongoing impact of structural racism on healthcare utilization and access for marginalized communities.
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Article Synopsis
  • The study investigates how prenatal dietary quality, assessed through the Healthy Eating Index (HEI) and Empirical Dietary Inflammatory Pattern (EDIP), impacts infant sizes at birth and growth patterns up to age 24 months.
  • Researchers analyzed data from 2854 parent-child pairs participating in a long-term health program, highlighting the diverse racial and ethnic backgrounds of the participants.
  • Results revealed that a healthier diet during pregnancy (high HEI score) is linked to lower likelihoods of having large infants at birth and experiencing rapid growth, suggesting that dietary choices may play a vital role in combating obesity later in life.
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Background: Sweetened beverage taxes are associated with large decreases in sugar-sweetened beverage sales, but their effects on weight outcomes are unclear. We examined associations of the 2017 Philadelphia beverage tax with changes in adult weight outcomes.

Methods: We obtained electronic health record data on adults 18-65 years old in Philadelphia (intervention) and other areas of Pennsylvania and New Jersey (control) from 2014 to 2019.

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Background: The JYNNEOS vaccine (two doses given 28 days apart) was recommended in the United States for people at high risk of exposure to monkeypox virus during the 2022 mpox outbreak. Our objective was to assess the safety of JYNNEOS using two complementary epidemiologic methods.

Methods: This observational cohort included patients of eight large integrated healthcare organizations who received JYNNEOS.

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Article Synopsis
  • Large vessel vasculitides (LVV) are inflammatory disorders that primarily affect large arteries like the aorta, often linked to conditions such as giant cell arteritis and Takayasu arteritis, with age and gender influencing prevalence.
  • Giant cell arteritis commonly occurs in individuals over 50, especially women, while Takayasu arteritis typically affects younger women; both require urgent diagnosis to prevent serious complications like blindness or artery damage.
  • Noninvasive imaging techniques, such as ultrasound and MRI, have revolutionized the diagnosis and management of LVV, reducing the need for invasive procedures and aiding in monitoring treatment response and disease progression.
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Mucopolysaccharidosis type I (MPS I), a lysosomal disorder caused by variants in IDUA, was added to the Recommended Uniform Screening Panel for newborn screening in 2016. Positive screening results for MPS I are commonly due to variants known as "pseudodeficiency alleles," which decrease in vitro alpha-L-iduronidase enzyme activity but are thought to provide sufficient in vivo activity. Despite the historic assumption that these variants are biologically benign, the possibility that they could give rise to complex, multigenic, or attenuated phenotypes has not been systemically evaluated in adults.

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Purpose: Health care stakeholders' perspectives on the value of genomic testing vary widely and directly affect the access and practice of genomic medicine. To our knowledge, a review of US health care payers' perspectives on genomic testing has not been performed.

Methods: We conducted a systematic literature review of US payers' perspectives on genomic testing in the MEDLINE, PubMed, and Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases.

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Stopping the intergenerational risk of diabetes - from mechanisms to interventions.

Diabetes

November 2024

1- Division of Chronic Disease Research Across the Lifecourse (CoRAL), Department of Population Medicine, Harvard Pilgrim Health Care Institute, Harvard Medical School, Boston, MA.

Embedded in the Developmental Origins of Health and Disease hypothesis, maternal hyperglycemia in utero, from pre-existing diabetes or gestational diabetes mellitus, predisposes the offspring to excess adiposity and heightened risk of prediabetes and type 2 diabetes development. This transmission creates a vicious cycle increasing the presence of diabetes from one generation to another, leading to the question: how can we interrupt this vicious cycle? In this Perspective article, we presented the current state of knowledge on the intergenerational transmission of diabetes from epidemiological life course studies. Then, we discussed the potential mechanisms implicated in the intergenerational transmission of diabetes with a focus on epigenetics.

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