Proceedings of the 2018 Childhood Arthritis and Rheumatology Research Alliance (CARRA) Scientific Meeting
Notice bibliographique
Résumé
BackgroundAdverse Childhood Experiences (ACEs) such as witnessing violence in the home or neighborhood, parental incarceration, and racial or ethnic discrimination are associated with increased risk of chronic disease and poorer health in children and adults.Emerging data suggest an association between exposure to ACEs and autoimmune diseases in adults, but the relationship between ACEs and childhood-onset rheumatologic diseases has not been examined.Our objective was to investigate the relationship between ACEs and arthritis, the most common manifestation of childhood-onset rheumatologic disease. MethodsWe used data from the 2016 National Survey of Children's Health (NSCH) to describe the distribution of ACEs among children with current arthritis compared to 1) children with other chronic acquired physical conditions (CAPC)* and 2) all other children.The NSCH is a survey of sampled households with children <18 years conducted by the National Center for Health Statistics at the Centers for Disease Control.Children were determined to have current conditions, including arthritis, if their guardian indicated yes to both "has a doctor or other health care provider ever told you that this child has…" and "does this child currently have the condition?"We performed bivariate and multivariable logistic regression to determine associations between arthritis and cumulative ACE scores, measured as a categorical variable (0 ACEs, 1 ACE, 2-3 ACEs, >=4 ACEs).Logistic regression was also utilized to determine the relationship between cumulative ACE exposure and comorbid depression/ anxiety.Results Among 50,212 children included in the survey, 16,892 had CAPC and 138 had current arthritis.More children with arthritis had any ACE exposure compared to both children with other CAPC (63.4% vs 46.9%, p<0.001) and all other children (40.1%, p<0.001).The prevalence of all individual ACE categories except racial/ethnic discrimination was significantly higher among children with arthritis compared to other CAPC and all other children.A graded relationship was observed between ACE scores and arthritis in logistic regression models for 1) children with CAPC and 2) all children.An overall significant association between ACE score and arthritis persisted after adjusting for confounders in both models (Table 1).No significant interaction was found between ACE and minority status or between ACE and poverty.Among youth with current arthritis, a graded relationship was observed between ACE scores and odds of comorbid depression/anxiety (Table 2).Conclusions A markedly high prevalence of ACEs is reported among youth with arthritis from a large national survey.Higher ACE scores were associated with increased odds of arthritis.Future investigations should examine how adversity may play a role in arthritis development, disease severity, and physical and mental health outcomes.Protective psychosocial factors, such as resilience, may mitigate the impact of ACEs and should be studied further to inform development of effective interventions.*Allergies, asthma, diabetes, and epilepsy.Ethics Approval Approval for exemption was obtained from the Einstein-Montefiore Institutional Review Board.* CAPC = Chronic acquired physical conditions: allergies, asthma, arthritis, diabetes, and epilepsy.** Children with a history of arthritis, but no current arthritis, were censored from this analysis.^Adjusted for age, sex, minority race
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,002 | 0,002 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,000 | 0,001 |
| Études des sciences et des technologies | 0,001 | 0,003 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,001 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».