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Browsing by Author "Owora, Arthur H."
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Item Body mass index trajectories and mortality risk in Japan using a population-based prospective cohort study: the Japan Public Health Center-based Prospective Study(Oxford University Press, 2024) Yamamoto, Nao; Ejima, Keisuke; Mestre, Luis M.; Owora, Arthur H.; Inoue, Manami; Tsugane, Shoichiro; Sawada, Norie; Epidemiology, School of Public HealthBackground: Recent studies have found that long-term changes in weight during adulthood are associated with a high risk of mortality. The objective of this study was to characterize body mass index (BMI) trajectories during adulthood and to examine the association between BMI trajectories and risk of death in the Japanese population. Methods: The data were extracted from Japan Public Health Center-based Prospective Study-a population-based prospective cohort study in Japan with participants aged 40-69 years followed over 20 years. The participants were categorized into multiple BMI trajectory groups using the latent class growth model. The Cox proportional-hazards model was conducted using all-cause mortality and cause-specific mortality as outcomes and the identified BMI trajectory groups as a predictor. In total, 65 520 participants were included in the analysis. Results: Six BMI trajectory groups were identified: underweight stable (Group 1), low-to-high normal (Group 2), high-to-low normal (Group 3), normal to overweight (Group 4), overweight to normal (Group 5) and normal to obese (Group 6). Our Cox models showed a higher hazard (risk) of all-cause mortality among participants in the BMI-declining groups [Group 3, adjusted hazard ratio (aHR): 1.10, 95% CI: 1.05-1.16; Group 5, aHR: 1.16, 95% CI: 1.08-1.26], underweight stable group (Group 1, aHR: 1.27, 95% CI: 1.21-1.33) and normal to obese group (Group 6, aHR: 1.22, 95% CI: 1.13-1.33) than Group 2 (low-to-high normal BMI trajectory). Conclusions: Stable underweight and weight loss were associated with a high risk of mortality, both of which were uniquely observed in a Japanese population.Item Frequency and Correlates of Pediatric High-Flow Nasal Cannula Use for Bronchiolitis, Asthma, and Pneumonia(Daedalus Enterprises, 2022) Rogerson, Colin M.; Carroll, Aaron E.; Tu, Wanzhu; He, Tian; Schleyer, Titus K.; Rowan, Courtney M.; Owora, Arthur H.; Mendonca, Eneida A.; Pediatrics, School of MedicineBackground: Heated humidified high-flow nasal cannula (HFNC) is a respiratory support device historically used in pediatrics for infants with bronchiolitis. No large-scale analysis has determined the current frequency or demographic distribution of HFNC use in children. The objective of this study was to determine the frequency and correlates of HFNC use in children presenting to the hospital for asthma, bronchiolitis, or pneumonia. Methods: This longitudinal observational study was based on electronic health record data from a large regional health information exchange, the Indiana Network for Patient Care (INPC). Subjects were age 0-18 y with recorded hospital encounters at an INPC hospital between 2010-2019 with International Classification of Diseases codes for bronchiolitis, asthma, or pneumonia. Annual proportions of HFNC use among all hospital encounters were assessed using generalized additive models. Log-binomial regression models were used to identify correlates of incident HFNC use and determine risk ratios of specific subjects receiving HFNC. Results: The study sample included 242,381 unique subjects with 412,712 hospital encounters between 2010-2019. The 10-y period prevalence of HFNC use was 2.54% (6,155/242,381) involving 7,974 encounters. Hospital encounters utilizing HFNC increased by 400%, from 326 in 2010 to 1,310 in 2019. This increase was evenly distributed across all 3 diagnostic categories (bronchiolitis, asthma, and pneumonia). Sex, race, age, and ethnicity all significantly influenced the risk of HFNC use. Over the 10-y period, the percentage of all hospital encounters using HFNC increased from 1.11% in 2010 to 3.15% in 2018. Subjects with multiple diagnoses had significantly higher risk of receiving HFNC. Conclusions: The use of HFNC in children presenting to the hospital with common respiratory diseases has increased substantially over the past decade and is no longer confined to treating infants with bronchiolitis. Demographic and diagnostic factors significantly influenced the frequency of HFNC use.Item Impact of time-varying confounders on the association between early-life allergy sensitization and the risk of current asthma: A post hoc analysis of a birth cohort(Wiley, 2022) Owora, Arthur H.; Li, Rui; Tepper, Robert S.; Ramsey, Clare D.; Chan-Yeung, Moira; Watson, Wade T. A.; Becker, Allan B.; Epidemiology, School of Public HealthItem Transitions between alternating childhood allergy sensitization and current asthma states: A retrospective cohort analysis(Wiley, 2022) Owora, Arthur H.; Tepper, Robert S.; Ramsey, Clare D.; Chan-Yeung, Moira; Watson, Wade T.A.; Becker, Allan B.; Pediatrics, School of Medicine