American journal of preventive medicine
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Including race as a biological construct in risk prediction models may guide clinical decisions in ways that cause harm and widen racial disparities. This study reports on using race versus social determinants of health (SDoH) in predicting the associations between cardiometabolic disease severity (assessed using cardiometabolic disease staging) and COVID-19 hospitalization. ⋯ Cardiometabolic disease staging was predictive of hospitalization after a positive COVID-19 test. Adding race did not markedly increase the predictive ability; however, adding SDoH to the model improved the area under the curve to ≥0.80. Future research should include SDoH with biological variables in prediction modeling to capture social experience of race.
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This study compares rural and urban differences in the rates of nonfatal self-harm in the U.S. in 2018. ⋯ Comprehensive suicide prevention strategies tailored to rural communities may mitigate the rural-urban disparity in morbidity from suicidal behavior.
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The impact of COVID-19 infection on surgical patients is largely described by small-cohort studies. This study characterized the risk factors for postoperative mortality among patients with preoperative COVID-19 infection. ⋯ Although data abstraction was limited by the electronic medical record, postoperative mortality is nearly 6 times higher for patients infected with COVID-19 within 2 weeks before surgery when adjusting for patient- and procedure-level factors. Among those with previous COVID-19 infection, postoperative mortality is associated with male sex, American Society of Anesthesiologists Physical Status Classification Score, and smoking history.
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Black participants often lose less weight than White participants in response to behavioral weight-loss interventions. Many participants experience significant pretreatment weight fluctuations (between baseline measurement and treatment initiation), which have been associated with treatment outcomes. Pretreatment weight gain has been shown to be more prevalent among Black participants and may contribute to racial differences in treatment responses. The purpose of this study was to (1) examine the associations between pretreatment weight change and treatment outcomes and (2) examine racial differences in pretreatment weight change and weight loss among Black and White participants. ⋯ Pretreatment weight changes can impact weight outcomes after initial treatment, although no differences between Black and White participants were observed. Future studies should consider the influence of pretreatment weight change on long-term outcomes (e.g., weight loss maintenance) along with potential racial differences in these associations. This study is registered (retrospectively registered) at ClinicalTrials.gov (NCT02487121) on June 26, 2015.
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Obesity is associated with kidney stone disease, but it is unknown whether this association differs by SES. This study assessed the extent to which obesity and neighborhood characteristics jointly contribute to urinary risk factors for kidney stone disease. ⋯ Obesity was associated with the presence of multiple stone risk factors and multiple dietary factors; however, the strength and magnitude of these associations did not vary significantly by neighborhood SES, family structure, and housing characteristics.