Biostatistics Commons^™

Multivariate Joint Models And Dynamic Predictions, Md Akhtar Hossain

Theses and Dissertations

The joint modeling of longitudinal and time-to-event data is an active area of statistical research that has received a lot of attention. The standard joint models, referred to as univariate joint models, allow simultaneous modeling of a single longitudinal outcome and a single time-to-event under an assumption of independent censoring. The majority of the joint modeling research in the last two decades has focused on extending and improving the univariate joint models. While many of the practical applications involve data on multivariate longitudinal outcomes and multiple timeto- events possibly informatively censored by some other terminal time-to-event, the developments of joint …

Validity Study Of The R-Pla, A Resilience Scale For People Living With Hiv, Jinxiang Hu, Julianne M. Serovich, Monique J. Brown, Judy A. Kimberly, Yi-Hsin Chen

Faculty Publications

This study provides psychometric assessment of a resilience scale with a sample of women living with HIV. Baseline data were used from a longitudinal HIV disclosure study of 124 women aged between 18-63 collected between 2001 and 2004 in a large Midwestern city. The Rasch model was used to examine the psychometric properties of the resilience scale. Results indicated that the resilience instrument meets the Rasch model application assumptions. Evidence of validity suggested the resilience instrument demonstrated good item and person fit, as well as good item and person reliability. Most items showed measurement invariance across different age and racial …

Chorioamnionitis: Case Definition & Guidelines For Data Collection, Analysis, And Presentation Of Immunization Safety Data, Alisa Kachikis, Linda O. Eckert, Christie Walker, Azucena Bardají, Frederick Varricchio, Heather S. Lipkind, Khady Diouf, Wan Ting Huang, Ronald Mataya, Mustapha Bittaye, Clare Cutland, Nansi S. Boghossian, Tamala Mallett Moore, Rebecca Mccall, Jay King, Shuchita Mundle, Flor M. Munoz, Caroline Rouse, Michael Gravett, Lakshmi Katikaneni, Kevin Ault, Nicola P. Klein, Drucilla J. Roberts, Sonali Kochhar, Nancy Chescheir

Faculty Publications

No abstract provided.

Neurodevelopmental Delay: Case Definition & Guidelines For Data Collection, Analysis, And Presentation Of Immunization Safety Data, Adrienne N. Villagomez, Flor M. Muñoz, Robin L. Peterson, Alison M. Colbert, Melissa Gladstone, Beatriz Macdonald, Rebecca Wilson, Lee Fairlie, Gwendolyn J. Gerner, Jackie Patterson, Nansi S. Boghossian, Vera Joanna Burton, Margarita Cortés, Lakshmi D. Katikaneni, Jennifer C.G. Larson, Abigail S. Angulo, Jyoti Joshi, Mirjana Nesin, Michael A. Padula, Sonali Kochhar, Amy K. Connery

Faculty Publications

No abstract provided.

Dietary Inflammatory Index And Non-Communicable Disease Risk: A Narrative Review, Catherine M. Phillips, Ling-Wei Chen, Barbara Heude, Jonathan Y. Bernard, Nicholas C. Harvey, Liesbeth Duijts, Sara M. Mensink-Bout, Kinga Polanska, Giulia Mancano, Matthew Suderman, Nitin Shivappa, James R. Hébert

Faculty Publications

There are over 1,000,000 publications on diet and health and over 480,000 references on inflammation in the National Library of Medicine database. In addition, there have now been over 30,000 peer-reviewed articles published on the relationship between diet, inflammation, and health outcomes. Based on this voluminous literature, it is now recognized that low-grade, chronic systemic inflammation is associated with most non-communicable diseases (NCDs), including diabetes, obesity, cardiovascular disease, cancers, respiratory and musculoskeletal disorders, as well as impaired neurodevelopment and adverse mental health outcomes. Dietary components modulate inflammatory status. In recent years, the Dietary Inflammatory Index (DII^®), a literature-derived …

Increased Dietary Inflammatory Index Is Associated With Schizophrenia: Results Of A Case–Control Study From Bahrain, Haitham Jahrami, Moez Al-Islam Faris, Hadeel Ghazzawi, Zahra Saif, Layla Habib, Nitin Shivappa, James R. Hébert

Faculty Publications

Background: Several studies have indicated that chronic low-grade inflammation is associated with the development of schizophrenia. Given the role of diet in modulating inflammatory markers, excessive caloric intake and increased consumption of pro-inflammatory components such as calorie-dense, nutrient-sparse foods may contribute toward increased rates of schizophrenia. This study aimed to examine the association between dietary inflammation, as measured by the dietary inflammatory index (DII^®), and schizophrenia. Methods: A total of 120 cases attending the out-patient department in the Psychiatric Hospital/Bahrain were recruited, along with 120 healthy controls matched on age and sex. The energy-adjusted DII (E-DII) was computed …

Dietary Inflammatory Index And Its Relationship With Cervical Carcinogenesis Risk In Korean Women: A Case-Control Study, Sundara Raj Sreeja, Hyun Yi Lee, Minji Kwon, Nitin Shivappa, James R. Hébert, Mi Kyung Kim

Faculty Publications

Several studies have reported that diet’s inflammatory potential is related to chronic diseases such as cancer, but its relationship with cervical cancer risk has not been studied yet. The aim of this study was to investigate the association between Dietary Inflammatory Index (DII^®) and cervical cancer risk among Korean women. This study consisted of 764 cases with cervical intraepithelial neoplasia (CIN)1, 2, 3, or cervical cancer, and 729 controls from six gynecologic oncology clinics in South Korea. The DII was computed using a validated semiquantitative Food Frequency Questionnaire (FFQ). Odds ratios and 95% CI were calculated using multinomial …

Extension Of Risk-Based Measure Of Time-Varying Prognostic Discrimination For Survival Models, Shujie Chen

Theses and Dissertations

The Cox proportional hazards (PH) model and time dependent PH model are the most popular survival models in survival analysis. The hazard discrimination summary HDS(t) proposed by Liang and Heagerty [2017] is used to evaluate the mean hazard difference between cases and controls at time t. Liang and Heagerty [2017] evaluated the discrimination performance under the PH model and time dependent PH model with right censoring.

In this thesis, first, we further investigate their method via comprehensive simulations including 1) We extend the simulation in Liang and Heagerty [2017] under the PH model by adding more scenarios such as different …

Dietary Inflammatory Index, Dietary Non-Enzymatic Antioxidant Capacity, And Colorectal And Breast Cancer Risk(Mcc-Spain Study), Mireia Obón-Santacana, Dora Romaguera, Esther Gracia-Lavedan, Amaia Molinuevo, Esther Molina-Montes, Nitin Shivappa, James R. Hébert, Adonia Tardón, Gemma Castaño-Vinyals, Ferran Moratalla, Elisabet Guinó, Rafael Marcos-Gragera, Mikel Azpiri Leire Gil, Rocío Olmedo-Requena, Macarena Lozano-Lorca, Juan Alguacil, Tania Fernández-Villa, Vicente Martín, Antonio J. Molina, María Ederra, Beatriz Perez, Nuria Aragonés, Adela Castello, José Mª Huerta, Trinidad Dierssen-Sotos, Ana Molina-Barceló, Marina Pollán, Manolis Kogevinas, Victor Moreno, Pilar Amiano

Faculty Publications

Inflammation and antioxidant capacity have been associated with colorectal and breast cancer. We computed the dietary inflammatory index (DII®), and the total dietary non-enzymatic antioxidant capacity (NEAC) and associated them with colorectal and breast cancer risk in the population-based multi case-control study in Spain (MCC-Spain). We included 1852 colorectal cancer and 1567 breast cancer cases, and 3447 and 1486 population controls, respectively. DII score and NEAC were derived using data from a semi-quantitative validated food frequency questionnaire. Unconditional logistic regression models were used to estimate odds ratios (OR) and 95% confidence intervals (95%CI) for energy-adjusted DII (E-DII), and a score …

Dietary Inflammatory Index, Dietary Non-Enzymatic Antioxidant Capacity, And Colorectal And Breast Cancer Risk (Mcc-Spain Study), Mireia Obon-Santacana, Dora Romaguera, Esther Gracia-Lavedan, Amaia Molinuevo, Esther Molina-Montes, Nitin Shivappa, James R. Hébert, Adonina Tardon, Gemma Castano-Vinyals, Ferran Moratalla, Elisabet Guino, Rafael Marcos-Gragera, Mikel Azpiri, Leire Gil, Rocio Olmedo-Requena, Macarena Lozano-Lorca, Juan Alguacil, Tania Fernandez-Villa, Vicente Martin, Antonio J. Molina, Maria Ederra, Conchi Moreno-Iribas, Beatriz Perez, Nuria Aragones

Faculty Publications

Inflammation and antioxidant capacity have been associated with colorectal and breast cancer. We computed the dietary inflammatory index (DII^®), and the total dietary non-enzymatic antioxidant capacity (NEAC) and associated them with colorectal and breast cancer risk in the population-based multi case-control study in Spain (MCC-Spain). We included 1852 colorectal cancer and 1567 breast cancer cases, and 3447 and 1486 population controls, respectively. DII score and NEAC were derived using data from a semi-quantitative validated food frequency questionnaire. Unconditional logistic regression models were used to estimate odds ratios (OR) and 95% confidence intervals (95%CI) for energy-adjusted DII (E-DII), and …

Dietary Inflammatory Index And Sleep Quality In Southern Italian Adults, Justyna Godos, Raffaele Ferri, Filippo Caraci, Filomena I. I. Cosentino, Sabrina Castellano, Nitin Shivappa, James R. Hébert, Fabio Galvano, Giuseppe Grosso

Faculty Publications

Background: Current evidence supports the central role of a subclinical, low-grade inflammation in a number of chronic illnesses and mental disorders; however, studies on sleep quality are scarce. The aim of this study was to test the association between the inflammatory potential of the diet and sleep quality in a cohort of Italian adults. Methods: A cross-sectional analysis of baseline data of the Mediterranean healthy Eating, Aging, and Lifestyle (MEAL) study was conducted on 1936 individuals recruited in the urban area of Catania during 2014-2015 through random sampling. A food frequency questionnaire and other validated instruments were used to calculate …

An Interdisciplinary Weight Loss Program Improves Body Composition And Metabolic Profile In Adolescents With Obesity: Associations With The Dietary Inflammatory Index, Yasmin Alaby Martins Ferreira, Ana Claudia Pelissari Kravchychyn, Sofia De Castro Ferreira Vicente, Raquel Munhoz Da Silveira Campos, Lian Tock, Lila Missae Oyama, Valter Tadeu Boldarine, Deborah Cristina Landi Masquio, David Thivel, Nitin Shivappa, James R. Hébert, Ana R. Dâmaso

Faculty Publications

Background and Aims: The prevalence of overweight and obesity consitutes a global epidemic and it is growing around the world. Food and nutrition are essential requirements for promoting health and protecting against non-communicable chronic diseases, such as obesity and cardiovascular disease. Specific dietary components may modulate inflammation and oxidative stress in obese individuals. The Dietary Inflammatory Index (DII®) was developed to characterize the anti- and pro-inflammatory effects of individuals' diet. Few studies have investigated the role of diet-associated inflammation in adolescents with obesity. The present study aims to investigate the effects of an interdisciplinary weight loss therapy on DII scores …

Adiposity Mediates The Association Between The Dietary Inflammatory Index And Markers Of Type 2 Diabetes Risk In Middle-Aged Black South African Women, Asanda Mtintsilana, Lisa K. Micklesfield, Elin Chorell, Tommy Olsson, Nitin Shivappa, James R. Hebert, Andre P. Kengne, Julia H. Goedecke

Faculty Publications

The dietary inflammatory index (DII^®), a validated tool used to measure the inflammatory potential of the diet, has been associated with metabolic disorders in various settings, but not in African populations. The aim of this study was to investigate whether the DII is associated with markers of type 2 diabetes (T2D) risk, and if this association is mediated by adiposity and/or low-grade inflammation, in black South Africa women. Energy-adjusted-DII (E-DII) scores were calculated in 190 women (median age, 53 years) from the Birth-to-Twenty plus cohort using a validated food frequency questionnaire. Fasting glucose, insulin, HbA1c, and inflammatory cytokines …

Dietary Inflammatory Index And Odds Of Colorectal Cancer And Colorectal Adenomatous Polyps In A Case-Control Study From Iran, Pegah Rafiee, Nitin Shivappa, James R. Hébert, Saeede Jaafari Nasab, Alireza Bahrami, Azita Hekmatdoost, Bahram Rashidkhani, Amir Sadeghi, Mohammad Houshyari, Ehsan Hejazi

Faculty Publications

Background: Chronic inflammation is implicated in the development of colorectal cancer (CRC) and its precursor; colorectal adenomatous polyps (CAP). Some dietary factors are important triggers for systemic inflammation. Therefore, the present study aimed to investigate the association between the dietary inflammatory index (DII^®) and the risk of CRC and CAP in an Iranian case-control study. Methods: 134 newly diagnosed CRC patients, 130 newly diagnosed CAP patients, and 240 hospitalized controls were recruited using convenience sampling. Energy-adjusted DII (E-DII) scores were computed based on dietary intake assessed using a reproducible and valid 148-item food frequency questionnaire. Logistic regression models …

Randomization Analysis Driven Software, Steph-Yves Louis

Theses and Dissertations

The application of a method of randomization for a clinical trial frequently summarizes to using Simple Randomization. Even though the latter method provides favorable characteristics, if the collected sample is not large enough, it still presents the highest chance of imbalance both marginally in the treatment groups and locally in terms of the covariates. Methods of Permuted Block Randomization, Urn Randomization, Stratified Permuted Block Randomization, and Minimization represent popular alternative methods that one should consider depending on the goal of the study. A comparison of the previously mentioned methods is carried to evaluate their performance with samples that are not …

Positive Association Between Dietary Inflammatory Index And The Risk Of Osteoporosis: Results From The Koges_Health Examinee (Hexa) Cohort Study, Hye Sun Kim, Cheongmin Sohn, Minji Kwon, Woori Na, Nitin Shivappa, James R. Hébert, Mi Kyung Kim

Faculty Publications

Previous studies have found that diet’s inflammatory potential is related to various diseases. However, little is known about its relationship with osteoporosis. The aim of this study was to investigate the association between the dietary inflammatory index (DII®) and osteoporosis risk in a large-scale prospective cohort study in Korea. This prospective cohort study included 159,846 participants (men 57,740; women 102,106) from South Korea with a mean follow-up of 7.9 years. The DII was calculated through a validated semi-quantitative FFQ (SQFFQ), and information on osteoporosis was self-reported by the participants. Analyses were performed by using a multivariable Cox proportional hazard model. …

Modification Of Asphalt Rubber With Nanoclay Towards Enhanced Storage Stability, Song-Yi Park, Minji Kang, Lynne Wilkens, Yurii Shvetsov, Brook Harmon, Nitin Shivappa, Michael Wirth, James R. Hébert, Christopher Haiman, Loïc Le Marchand, Carol Boushey

Faculty Publications

Asphalt rubber (AR), which is prepared by blending crumb rubber and bitumen, provides various advantages, including superior rutting resistance, lower road-tire noise and longer service life. However, contractors have expressed concerns regarding its poor storage stability, which in turn limits its wider application. This study aims to address the storage stability concern by incorporating nano-montmorillonite (nanoclay). Three types of nanoclay were dispersed into hot AR binder by high shear blending. The rheological properties of nanoclay-crumb rubber modifier (CRM)-modified bitumen were evaluated through Superpave performance grade (PG) tests and the storage stability was characterized by measuring the difference in softening points …

The Impact Of Peer Support On The Risk Of Future Hospital Readmissions Among Older Adults With A Medical Illness And Co-Occurring Depression, Kyaien O. Conner, Tamara Cadet, Monique J. Brown, Joshua T. Barnett

Faculty Publications

Older adults account for 60% of all preventable hospital readmissions. Although not all readmissions are preventable, evidence indicates that up to 75% of hospital readmissions can be prevented with enhanced patient education, pre-discharge assessment, and effective care upon discharge. Social support, specifically peer support, after discharge from hospital may be a crucial factor in minimizing the risk of preventable hospital readmission. The pilot study reported here evaluated the relationship between peer support and hospital readmissions in a sample of depressed older adults (N = 41) who were recently discharged from hospital due to a medical condition and who simultaneously had …

Dietary Inflammatory Index And Biomarkers Of Lipoprotein Metabolism, Inflammation And Glucose Homeostasis In Adults, Catherine Phillips, Nitin Shivappa, James R. Hébert, Ivan Perry

Faculty Publications

Accumulating evidence identifies diet and inflammation as potential mechanisms contributing to cardiometabolic risk. However, inconsistent reports regarding dietary inflammatory potential, biomarkers of cardiometabolic health and metabolic syndrome (MetS) risk exist. Our objective was to examine the relationships between a food frequency questionnaire (FFQ)-derived dietary inflammatory index (DII®), biomarkers of lipoprotein metabolism, inflammation and glucose homeostasis and MetS risk in a cross-sectional sample of 1992 adults. Energy-adjusted DII (E-DII) scores derived from an FFQ were calculated. Lipoprotein particle size and subclass concentrations were measured using nuclear magnetic resonance (NMR) spectroscopy. Serum acute-phase reactants, adipocytokines, pro-inflammatory cytokines and white blood cell (WBC) …

Design, Development And Construct Validation Of The Children’S Dietary Inflammatory Index, Samira Khan, Micheal D. Wirth, Andrew Ortaglia, Christian R. Alvarado, Nitin Shivappa, Thomas Hurley, James R. Hébert

Faculty Publications

Objective: To design and validate a literature-derived, population-based Children’s Dietary Inflammatory Index (C-DII)TM. Design: The C-DII was developed based on a review of literature through 2010. Dietary data obtained from children in 16 different countries were used to create a reference database for computing C-DII scores based on consumption of macronutrients, vitamins, minerals, and whole foods. Construct validation was performed using quantile regression to assess the association between C-reactive protein (CRP) concentrations and C-DII scores. Data Sources: All data used for construct validation were obtained from children between six and 14 years of age (n = 3300) who participated in …

Dietary Inflammatory Index And Type 2 Diabetes Mellitus In Adults: The Diabetes Mellitus Survey Of Mexico City, Edgar Denova-Gutiérrez, Paloma Muñoz-Aguirre, Nitin Shivappa, James R. Hébert, Lizbeth Tolentino-Mayo, Carolina Batis, Simón Barquera

Faculty Publications

Diet and inflammation are both associated with type 2 diabetes mellitus (T2DM). In the present study, we aimed to assess the relation between the dietary inflammatory index (DII) and the presence of T2DM in Mexican adults participating in the Diabetes Mellitus Survey administered in Mexico City (DMS-MC). The study involved 1174 subjects (48.5% men) between 20–69 years of age. A validated semi-quantitative food frequency questionnaire was employed to evaluate dietary intake and to compute DII. The DII is based on scientific evidence about the association between dietary compounds and six established inflammatory biomarkers. Multivariate logistic regression models were used to …

Dietary Inflammatory Index And Cardiovascular Risk And Mortality—A Meta-Analysis, Nitin Shivappa, Justyna Godos, James R. Hébert, Michael Wirth, Gabriele Piuri, Attilio Speciani, Giuseppe Grosso

Faculty Publications

Diet and chronic inflammation have been suggested to be risk factors in the development of cardiovascular disease (CVD) and related mortality. The possible link between the inflammatory potential of diet measured through the Dietary Inflammatory Index (DII^®) and CVD has been investigated in several populations across the world. The aim of this study was to conduct a meta-analysis on studies exploring this association. Data from 14 studies were eligible, of which two were case-control, eleven were cohort, and one was cross-sectional. Results from the random-effects meta-analysis showed a positive association between increasing DII, indicating a pro-inflammatory diet, and …

Lower Dietary Inflammatory Index Scores Are Associated With Lower Glycemic Index Scores Among College Students, Yeonsoo Kim, Jie Chen, Michael Wirth, Nitin Shivappa, James R. Hébert

Faculty Publications

The association between the Dietary Inflammatory Index (DII^®), the glycemic index (GI), and the glycemic load (GL) is not known, although it is known that carbohydrates are pro-inflammatory. We aimed to measure the association between the DII and both GI and GL among college students. In this cross-sectional study, 110 college students completed a 3-day food diary, which was used to calculate the DII, the GI, the GL, and the healthy eating index (HEI)-2010. Least square means and 95% confidence intervals of the GI, the GL, and the HEI-2010 were presented per DII tertile using generalized linear mixed …

Adjusting For Mis-Reporting In Count Data, Gelareh Rahimighazikalayeh

Theses and Dissertations

Any counting system is prone to recording errors including underreporting and overreporting. Ignoring the misreporting pattern in count data can give rise to bias in the estimation of model parameters. Accordingly, Poisson, negative binomial and generalized Poisson regression have been expanded in some instances to capture reporting biases. However, to our knowledge, no program has been developed to allow users to apply all of these models when needed. In the first part of the dissertation, we review the available models for underreported counts and develop a Stata command to estimate Poisson, negative binomial and generalized Poisson regression models for underreported …

Comparison Of The Performance Of Simple Linear Regression And Quantile Regression With Non-Normal Data: A Simulation Study, Marjorie Howard

Theses and Dissertations

Linear regression is a widely used method for analysis that is well understood across a wide variety of disciplines. In order to use linear regression, a number of assumptions must be met. These assumptions, specifically normality and homoscedasticity of the error distribution can at best be met only approximately with real data. Quantile regression requires fewer assumptions, which offers a potential advantage over linear regression. In this simulation study, we compare the performance of linear (least squares) regression to quantile regression when these assumptions are violated, in order to investigate under what conditions quantile regression becomes the more advantageous method …

Estimation Procedures For Complex Survival Models And Their Applications In Epidemiology Studies, Jie Zhou

Theses and Dissertations

In this dissertation, we aim to address three important questions in practice, which can be solved through complex survival models. The first project focuses on studying the longitudinal fitness effect on cardiovascular disease (CVD) mortality. In the second project, we study the disease-death relation between CVD and all-cause mortality and evaluate important covariate effects on the disease or death transitions. In the third project, we compare antiretroviral treatment (ART) for HIV patients and consider both treatment effect and side effect of the drugs. The first two projects are motivated by the Aerobics Center Longitudinal Study (ACLS) datasets and the third …

Fetal Growth Restriction: Case Definition & Guidelines For Data Collection, Analysis, And Presentation Of Immunization Safety Data, Sarah Rae Easter, Linda O. Eckert, Nansi Boghossian, Rebecca Spencer, Eugene Oteng-Ntim, Christos Ioannou, Manasi Patwardhan, Margo S. Harrison, Asma Khalil, Michael Gravett, Robert Goldenberg, Alastair Mckelvey, Manish Gupta, Vitali Pool, Stephen C. Robson, Jyoti Joshi, Sonali Kochhar, Tom Mcelrath

Faculty Publications

No abstract provided.

Small For Gestational Age: Case Definition & Guidelines For Data Collection, Analysis, And Presentation Of Maternal Immunisation Safety Data, Elizabeth P. Schlaudecker, Flor M. Munoz, Azucena Bardají, Nansi S. Boghossian, Asma Khalil, Hatem Mousa, Mirjana Nesin, Muhammad Imran Nisar, Vitali Pool, Hans M.L. Spiegel, Milagritos D. Tapia, Sonali Kochhar, Steven Black

Faculty Publications

No abstract provided.

Dietary Inflammatory Index And Colorectal Cancer Risk – A Meta-Analysis, Nitin Shivappa, Justyna Godos, James R. Hébert, Michael David Wirth, Gabriele Piuri, Attilio Speciani, Giuseppe Grosso

Faculty Publications

Diet and chronic inflammation of the colon have been suggested to be risk factors in the development of colorectal cancer (CRC). The possible link between inflammatory potential of diet, measured through the Dietary Inflammatory Index (DII®), and CRC has been investigated in several populations across the world. The aim of this study was to conduct a meta-analysis on studies exploring this association. Data from nine studies were eligible, of which five were case-control and four were cohort studies. Results from meta-analysis showed a positive association between increasing DII scores, indicating a pro-inflammatory diet, and CRC. Individuals in the highest versus …

The Relationship Of Plasma Trans Fatty Acids With Dietary Inflammatory Index Among Us Adults, Mohsen Mazidi, Hong-Kai Gao, Nitin Shivappa, Michael David Wirth, James R. Hébert, Andre Pascal Kengne

Faculty Publications

Background: It has been suggested that trans fatty acids (TFAs) play an important role in cardiovascular diseases. We investigated the association between plasma TFAs and the dietary inflammatory index (DII) ™ in US adults.

Methods: National Health and Nutrition Examination Survey (NHANES) participants with data on plasma TFAs measured from 1999 to 2010 were included. Energy-adjusted-DII ™ (E-DII ™) expressed per 1000 kcal was calculated from 24-h dietary recalls. All statistical analyses accounted for the survey design and sample weights.

Results: Of the 5446 eligible participants, 46.8% (n = 2550) were men. The mean age of the population was 47.1 …