Sri Ram Pentakota

What Pertussis Mortality Rates Make Maternal Acellular Pertussis Immunization Cost-Effective in Low- and Middle-Income Countries? A Decision Analysis

Background. Despite longstanding infant vaccination programs in low- and middle-income countries (LMICs), pertussis continues to cause deaths in the youngest infants. A maternal monovalent acellular pertussis (aP) vaccine, in development, could prevent many of these deaths. We estimated infant pertussis mortality rates at which maternal vaccination would be a cost-effective use of public health resources in LMICs. Methods. We developed a decision model to evaluate the cost-effectiveness of maternal aP immunization plus routine infant vaccination vs routine infant vaccination alone in Bangladesh, Nigeria, and Brazil. For a range of maternal aP vaccine prices, one-way sensitivity analyses identified the infant pertussis mortality rates required to make maternal immunization cost-effective by alternative benchmarks (

Cost-effectiveness of maternal GBS immunization in low-income sub-Saharan Africa

100, 0.5 gross domestic product [GDP] per capita, and GDP per capita per disability-adjusted life-year [DALY]). Probabilistic sensitivity analysis provided uncertainty intervals for these mortality rates. Results. Infant pertussis mortality rates necessary to make maternal aP immunization cost-effective exceed the rates suggested by current evidence except at low vaccine prices and/or cost-effectiveness benchmarks at the high end of those considered in this report. For example, at a vaccine price of

Social and clinically-relevant cardiovascular risk factors in Asian Americans adults: NHANES 2011-2014.

0.50/dose, pertussis mortality would need to be 0.051 per 1000 infants in Bangladesh, and 0.018 per 1000 in Nigeria, to cost 0.5 per capita GDP per DALY. In Brazil, a middle-income country, at a vaccine price of

Gastrostomy tube placement: An opportunity for establishing patient-centered goals of care

4/dose, infant pertussis mortality would need to be 0.043 per 1000 to cost 0.5 per capita GDP per DALY. Conclusions. For commonly used cost-effectiveness benchmarks, maternal aP immunization would be cost-effective in many LMICs only if the vaccine were offered at less than

Breast radiology malpractice suits: Characteristics of frequency and outcomes- national and statewide distinctions

1–

Outcomes and palliative care utilization in patients with dementia and acute abdominal emergency: opportunities for surgical quality improvement

2/dose.

Clashing paradigms: an empirical examination of cultural proxies and socioeconomic condition shaping Latino health

Highlights • Maternal GBS vaccination could prevent many neonatal deaths in low-income sub-Saharan Africa.• Immunization during pregnancy could cut GBS deaths by 30%-55% in typical sub-Saharan settings.• To show the full cost of vaccination, cost/dose includes vaccine price and delivery cost.• Maternal GBS vaccine is cost-effective at

Socioeconomic factors and mortality in emergency general surgery: trends over a 20-year period

2 to more than

Remote Ischemic Preconditioning in Neurological Death Organ Donors: The RIPNOD Prospective Randomized Clinical Trial

20/dose, depending on efficacy and disease incidence.• A maternal GBS vaccine would be cost-effective in low-income sub-Saharan Africa.

Unmet palliative care needs in elderly trauma patients: can the Palliative Performance Scale help close the gap?

Little evidence exists examining cardiovascular risk factors among Asian Americans and how social determinants such as nativity status and education pattern risk in the United States (U.S.) context. We used the National Health and Nutrition Examination Survey, which purposely oversampled Asian Americans from 2011 to 2014, and examined prevalence of Type II diabetes, smoking and obesity for Asian Americans (n=1363) and non-Latino Whites (n=4121). We classified Asian Americans as U.S. or foreign-born and by years in the U.S. Obesity status was based on standard body mass index (BMI) cut points of ≥30kg/m2 and Asian-specific cut points (BMI≥25kg/m2) that may be more clinically relevant for this population. We fit separate logistic regression models for each outcome using complex survey design methods and tested for the joint effect of race, nativity and education on each outcome. Diabetes and obesity prevalence (applying Asian-specific BMI cut points) were higher among Asian Americans when compared to non-Latino Whites but smoking prevalence was lower. These patterns remained in fully adjusted models and showed small increases with longer duration in the U.S. Joint effects models showed higher odds of prevalent Type II diabetes and obesity (Asian-specific) for foreign-born Asians, regardless of years in the U.S. and slightly higher risk for low education, when compared to non-Latino Whites with high education. Smoking models showed significant interaction effects between race and education for non-Latino Whites only. Our study supports the premise that social as well as clinical factors should be considered when developing health initiatives for Asian Americans.