Browsing by Author "Wang, Y."
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Item Characterizing patients initiating abaloparatide, teriparatide, or denosumab in a real-world setting: a US linked claims and EMR database analysis(Springer, 2020-12) Imel, E.A.; Starzyk, K.; Gliklich, R.; Weiss, R.J.; Wang, Y.; Williams, S.A.; Medicine, School of MedicineSummary We characterized patients initiating abaloparatide (ABL), teriparatide (TPTD), or denosumab (DMAB) in a real-world clinical setting from a large medical and pharmacy claims database. Differences were noted in sex, age, pathologic fractures, comorbidity index, and prior bisphosphonate use for patients initiating ABL and TPTD compared with those receiving DMAB. Introduction To characterize patients initiating abaloparatide (ABL), teriparatide (TPTD), or denosumab (DMAB) treatment in a real-world clinical setting. Methods Patients aged ≥ 18 years initiating ABL, TPTD, or DMAB between May 1, 2017, and September 24, 2018 (without receiving the same drug in the previous 12 months), were identified using the OM1 Data Cloud, which contains medical and pharmacy claims from approximately 200 million US patients. The index date was the date of initial prescription or dispensing for ABL, TPTD, or DMAB during the study period. Results During the study period, 2666 patients initiated ABL, 9210 TPTD, and 116,718 DMAB. Mean age (standard deviation) was 69.2 (10.6) years for the ABL cohort, 68.6 (11.3) for TPTD, and 72.1 (10.2) for DMAB (P < 0.001; ABL vs DMAB). Proportionally more patients initiating ABL were female (95.2% ABL, 86.9% TPTD, and 91.3% DMAB, P < 0.001 ABL vs TPTD or DMAB). Nearly twice as many patients initiating ABL (19.1%) and TPTD (18.8%) had a previous pathologic/fragility fracture vs DMAB (9.6%; P < 0.001 ABL vs DMAB). Fewer patients initiating ABL (36.3%) or TPTD (39.7%) had Charlson comorbidity index of ≥ 2 vs DMAB (48.4%; P < 0.001 ABL vs DMAB). Before initiating ABL, TPTD, or DMAB, 44.3%, 33.8%, and 33.9% of patients had prior osteoporosis treatment, respectively. Bisphosphonate use was more common before initiating ABL (19.2%) or TPTD (19.6%), than before initiating DMAB (16.6%; P < 0.001 ABL vs DMAB). Conclusions Patients initiating ABL and TPTD differed in sex, age, pathologic fractures, comorbidity index, and prior bisphosphonate use compared with those initiating DMAB. Electronic supplementary material The online version of this article (10.1007/s00198-020-05388-y) contains supplementary material, which is available to authorized users.Item Climate change impacts on human health at an actionable scale: a state-level assessment of Indiana, USA(Springer, 2020-12) Filippelli, G. M.; Freeman, J. L.; Gibson, J.; Jay, S.; Moreno-Madriñán, M. J.; Ogashawara, I.; Rosenthal, F. S.; Wang, Y.; Wells, E.; Earth Sciences, School of ScienceClimate change is already being felt on local levels, with historical records from the State of Indiana (USA) revealing warmer winters and more extreme precipitation events. To refine our understanding of climate change impacts on human health, we conducted a state-level assessment of future climate change impacts on human health using outputs from advanced climate model projections for this century. Future projections show a steep increase in extreme heat events, leading to greater potential vulnerability to heat disasters for Indiana communities. Additionally, a 2- to 4-fold increase in days with “uncomfortable night” conditions by the end of the century will strongly impact the cardiopulmonary health of more vulnerable populations (i.e., elderly, those with pre-existing conditions, children, and those with inadequate access to cooling). Continued trends for warmer winters and more flooding suggest a much greater risk for the expansion and virulence of a number of vector-borne diseases, such as Lyme disease, West Nile Virus, and “tropical” diseases for which the mosquito vectors will thrive. Higher temperatures will also drive more frequent and severe harmful algal blooms in lakes and reservoirs, with implications for human and animal health. Food systems will also be impacted, particularly with increased risk of contamination by bacteria and mycotoxins due to elevated heat and humidity.Item Gendered exposures: exploring the role of paid and unpaid work throughout life in U.S. women’s cardiovascular health(Taylor & Francis, 2020) Ahonen, Emily Q.; Fujishiro, K.; Brown, S.; Wang, Y.; Palumbo, A. J.; Michael, Y. L.; Social and Behavioral Sciences, School of Public HealthThe paper explores how paid and unpaid labor history over the life course influence women’s cardiovascular disease. U.S. women comprise about 50% of the paid workforce and perform the majority of unpaid labor. However, the influence of women’s work on their health is under-researched. Our sample was drawn from the Women’s Health Initiative Observational Study, a cohort of post-menopausal women in the U.S. aged 50–79 at recruitment. Women were categorized into five groups according to paid labor history: worked in paid jobs consistently throughout adult life; left the workforce early; entered the workforce later; discontinuous work history; never worked outside the home. Live birth history (none, at least one, missing) served as a proxy for unpaid labor in prime age. Cox proportional hazard models were used to estimate the hazard ratio of CVD associated with different paid work histories. We then assessed the effect of unpaid labor on the relation between paid labor and CVD. Paid labor participation was not associated with CVD risk among women without unpaid labor after adjusting for age, education, and birth cohort. Among those with unpaid demands, leaving the workforce early or having discontinuous work history was protective. In this U.S. sample, the association between paid work participation history and CVD risk depends on the presence of unpaid labor. Our results demonstrate the necessity of including work – paid and unpaid – in consideration of women’s health.Item Prospective assessment of white matter integrity in adult stem cell transplant recipients(Springer, 2016-06) Correa, D. D.; Wang, Y.; West, J. D.; Peck, K. K.; Root, J. C.; Baser, R. E.; Thaler, H. T.; Shore, T. B.; Jakubowski, A.; Saykin, A. J.; Relkin, N.; Department of Radiology and Imaging Sciences, School of MedicineHematopoietic stem cell transplantation (HSCT) is often used in the treatment of hematologic disorders. Although it can be curative, the pre-transplant conditioning regimen can be associated with neurotoxicity. In this prospective study, we examined white matter (WM) integrity with diffusion tensor imaging (DTI) and neuropsychological functioning before and one year after HSCT in twenty-two patients with hematologic disorders and ten healthy controls evaluated at similar intervals. Eighteen patients received conditioning treatment with high-dose (HD) chemotherapy, and four had full dose total body irradiation (fTBI) and HD chemotherapy prior to undergoing an allogeneic or autologous HSCT. The results showed a significant decrease in mean diffusivity (MD) and axial diffusivity (AD) in diffuse WM regions one year after HSCT (p-corrected <0.05) in the patient group compared to healthy controls. At baseline, patients treated with allogeneic HSCT had higher MD and AD in the left hemisphere WM than autologous HSCT patients (p-corrected <0.05). One year post-transplant, patients treated with allogeneic HSCT had lower fractional anisotropy (FA) and higher radial diffusivity (RD) in the right hemisphere and left frontal WM compared to patients treated with autologous HSCT (p-corrected <0.05). There were modest but significant correlations between MD values and cognitive test scores, and these were greatest for timed tests and in projection tracts. Patients showed a trend toward a decline in working memory, and had lower cognitive test scores than healthy controls at the one-year assessment. The findings suggest a relatively diffuse pattern of alterations in WM integrity in adult survivors of HSCT.