Empiristat Inc.

Mount Airy, MD, United States

Empiristat Inc.

Mount Airy, MD, United States

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Jain R.,EmpiriStat Inc.
Journal of Telemedicine and Telecare | Year: 2015

A retrospective study of a telemedicine clinic for active duty US Army soldiers with type 1 diabetes was conducted. Fifty-one consecutive patients (mean age 33.9 years) were enrolled into the clinic. All soldiers with known or newly diagnosed type 1 diabetes received three weekly office visits for intensive diabetes education. After this, all communication occurred via a messaging system consisting of texting, web-based download, and/or email to a diabetes management team. For urgent matters, 24/7 direct paging or telephone access was provided. Routine adjustments in insulin dosing were accomplished via email. Soldiers were followed for a mean of 17.1 months. Baseline, three-month, and end of study glycated hemoglobin (A1C) values were 9.8, 7.3, and 6.9, respectively. There were no significant differences in end of study A1C levels between patients with known vs. newly diagnosed type 1 diabetes, nor were there any differences between those patients who received insulin via pump therapy vs. multiple daily injections. Telemedicine was safe and effective in lowering A1C levels in US Army soldiers with type 1 diabetes. © 2015, © The Author(s) 2015.


Todd C.S.,Columbia University | Nasir A.,International Rescue Committee | Stanekzai M.R.,International Rescue Committee | Scott P.T.,U.S. Army | And 4 more authors.
AIDS Care - Psychological and Socio-Medical Aspects of AIDS/HIV | Year: 2011

There is little information about HIV awareness or condom use among female sex workers (FSWs) in Afghanistan. The purpose of this cross-sectional study was to assess HIV awareness, knowledge, and condom use among FSWs in three Afghan cities. FSWs residing in Jalalabad, Kabul, and Mazar-i-Sharif were recruited through outreach programs and completed an interviewer-administered questionnaire and rapid tests for hepatitis B surface antigen, HIV, syphilis, and hepatitis C virus. Logistic regression identified factors associated with HIV awareness, comprehensive HIV knowledge (knowledge that HIV cannot be detected by sight, that condoms prevent HIV, and rejection of local misconceptions about HIV transmission), and consistent condom use (use with every sex act) with clients in the last six months. Of 520 participants, 76.9% had no formal education and 37.7% lived outside Afghanistan in the last five years. Nearly half (44.2%) were aware of HIV but, of these, only 17.4% (N=40) had comprehensive HIV knowledge. There were significant differences by site; FSWs in Jalalabad were more likely to be aware of HIV but FSWs in Kabul were more likely to have correct HIV knowledge and use condoms consistently with clients. Consistent client condom use was reported by 11.5% (N=60) and was independently associated with having more clients per month (AOR=1.99, 95% CI: 1.04-3.81). In conclusion, comprehensive HIV knowledge and consistent condom use with clients are low among Afghan FSWs in these cities. Efforts to reach this population should focus on relaying accurate information and expanding condom use with clients. © 2011 Taylor & Francis.


PubMed | U.S. Army, Naval Hospital Camp Lejeune, EmpiriStat Inc, University of Colorado at Denver and 7 more.
Type: Clinical Trial, Phase II | Journal: JAMA internal medicine | Year: 2015

Improvement has been anecdotally observed in patients with persistent postconcussion symptoms (PCS) after mild traumatic brain injury following treatment with hyperbaric oxygen (HBO). The effectiveness of HBO as an adjunctive treatment for PCS is unknown to date.To compare the safety of and to estimate the efficacy for symptomatic outcomes from standard PCS care alone, care supplemented with HBO, or a sham procedure.Multicenter, double-blind, sham-controlled clinical trial of 72 military service members with ongoing symptoms at least 4 months after mild traumatic brain injury enrolled at military hospitals in Colorado, North Carolina, California, and Georgia between April 26, 2011, and August 24, 2012. Assessments occurred before randomization, at the midpoint, and within 1 month after completing the interventions.Routine PCS care was provided in specialized clinics. In addition, participants were randomized 1:1:1 to 40 HBO sessions administered at 1.5 atmospheres absolute (ATA), 40 sham sessions consisting of room air at 1.2 ATA, or no supplemental chamber procedures.The Rivermead Post-Concussion Symptoms Questionnaire (RPQ) served as the primary outcome measure. A change score of at least 2 points on the RPQ-3 subscale (range, 0-12) was defined as clinically significant. Change scores from baseline were calculated for the RPQ-3 and for the total RPQ. Secondary measures included additional patient-reported outcomes and automated neuropsychometric testing.On average, participants had sustained 3 lifetime mild traumatic brain injuries; the most recent occurred 23 months before enrollment. No differences were observed between groups for improvement of at least 2 points on the RPQ-3 subscale (25% in the no intervention group, 52% in the HBO group, and 33% in the sham group; P = .24). Compared with the no intervention group (mean change score, 0.5; 95% CI, -4.8 to 5.8; P = .91), both groups undergoing supplemental chamber procedures showed improvement in symptoms on the RPQ (mean change score, 5.4; 95% CI, -0.5 to 11.3; P = .008 in the HBO group and 7.0; 95% CI, 1.0-12.9; P = .02 in the sham group). No difference between the HBO group and the sham group was observed (P = .70). Chamber sessions were well tolerated.Among service members with persistent PCS, HBO showed no benefits over sham compressions. Both intervention groups demonstrated improved outcomes compared with PCS care alone. This finding suggests that the observed improvements were not oxygen mediated but may reflect nonspecific improvements related to placebo effects.clinicaltrials.gov Identifier: NCT01306968.


Jain R.B.,U.S. Army | Jain R.B.,Empiristat Inc.
Toxicological and Environmental Chemistry | Year: 2014

Developing fetus can be exposed to toxicants during pregnancy. Impact of human pregnancy on the concentrations of phthalate metabolites mono(carboxynonyl) (MCNP), mono(carboxyoctyl) (MCOP), mono-2-ethyl-5-carboxypentyl, mono-n-butyl, mono-(3-carboxy propyl), monoethyl, mono-2-ethyl-5-hydroxyhexyl, mono-2-ethylhexyl, monoisobutyl, mono-2-ethyl-5-oxohexyl phthalate, mono-benzyl, sum of low molecular weight phthalates (∑LMW), sum of high molecular weight phthalates (∑HMW), and sum of diethylhexyl phthalates was assessed. Data from the National Health and Nutrition Examination Survey for the years 2005–2010 were used for this purpose. Regression models with logs of these metabolites as dependent variables and age, race/ethnicity, education, pregnancy, smoking and iron storage status, study year, family poverty income ratio (PIR), body mass index, urine albumin, and urine creatinine as independent variables were fitted. Pregnant females were found to have significantly lower concentrations of ∑HMW and MCNP than non-pregnant females. Concentrations of ∑LMW during the third trimester of pregnancy were significantly lower than during the second trimester of pregnancy. © 2014, © 2014 Taylor & Francis.


Jain R.B.,U.S. Army | Jain R.B.,Empiristat Inc. | Choi Y.S.,U.S. Army
Journal of Trace Elements in Medicine and Biology | Year: 2015

Data from National Health and Nutrition Examination Survey for the period 2011-2012 were used to determine normal reference ranges and percentile distributions for manganese (Mn) and selenium (Se) in blood by gender, age, race/ethnicity, socioeconomic status as determined by annual family income, and smoking status. The effect of gender, age, race/ethnicity, family income, and smoking status on the levels of Mn and Se was also determined by fitting regression models. Males had lower adjusted levels of Mn and higher adjusted levels of Se than females. Adjusted levels of Mn decreased with increase in age but adjusted levels of Se were lower in adolescents aged 12-19 years than adults aged 20-64 years. Non-Hispanic black (NHB) had the lowest levels of both Mn and Se and non-Hispanic Asians (NHAS) had the highest levels of both Mn and Se. Non-Hispanic white (NHW) and NHB had lower levels of Mn than Hispanics (HISP) and NHAS. NHB and HISP had lower levels of Se than NHW and NHAS. Low annual income (<$20,000) was associated with lower levels of Se than high annual income (≥$55,000). Smoking negatively affected the adjusted levels of Se among seniors aged ≥65 years but this was not observed in other age groups. Mn levels were not affected by smoking. © 2014.


McLinden R.J.,University of Hawaii at Manoa | McLinden R.J.,U.S. Army | Paris R.M.,U.S. Army | Polonis V.R.,U.S. Army | And 5 more authors.
AIDS | Year: 2012

Objective: We investigated the impact of neutralizing antibodies (NAbs) on CD4 T-cell count and viral load in a cohort of HAART recipients who underwent extended structured treatment interruption. Design: Substudy of NAb in the AIDS Clinical Trials Group 5170 trial. Methods: Early plasma samples from 50 volunteers who discontinued HAART were evaluated in a peripheral blood mononuclear cell-based neutralization assay against a panel of four subtype B primary isolates. Results: We found that high-titer (90% inhibitory dose> 500) NAb against two or more isolates was associated with reduced viral load (P=0.003 at 12-week posttreatment interruption). This effect faded with time, losing significance (P=0.161) by study conclusion. Participants possessing the highest NAb levels against individual isolates appeared more likely to have lower viral loads with the association gaining significance against the R5-tropic primary isolate US1 (P=0.005). There was no association between broader neutralization and CD4 T-cell slope over time. Conclusion: The data suggest that high-titer NAb responses at the time of treatment interruption are associated with reduced viral load over time, but not CD4 + T-cell decline. © 2011 Wolters Kluwer Health.


Jain R.B.,U.S. Army | Jain R.B.,Empiristat Inc. | Choi Y.S.,U.S. Army
International Journal of Environmental Health Research | Year: 2016

Interacting effects of blood levels of manganese (Mn), selenium, cadmium (Cd), lead (Pb), and mercury, and serum levels of iron (Fe), zinc (Zn), and copper (Cu) on thyroid function in general US population were evaluated. Data from the National Health and Nutrition Examination Survey for 2011-2012 were used for this evaluation. The variables used to evaluate thyroid function were as follows: thyroid-stimulating hormone, free and total triiodothyronine (FT3, TT3), free and total thyroxine (FT4, TT4), and thyroglobulin (Tg). Levels of FT4 were positively associated with the levels of copper and negatively associated with the levels of Fe for males only. Elevated levels of Mn and Fe were associated with increased levels of FT3 for both males and females. TT4 had a positive association with the levels of Cu and a negative association with the levels of Fe for both males and females. © 2015, Taylor & Francis. All rights reserved.


Jain R.B.,U.S. Army | Jain R.B.,Empiristat Inc.
Environmental Toxicology and Pharmacology | Year: 2015

Association of arsenic exposure with smoking, alcohol, and caffeine consumption was investigated. Data from National Health and Nutrition Examination Survey for the years 2005-2010 were used for this investigation. Urinary levels of total arsenic (UAS) and dimethylarsonic acid (UDMA) were evaluated for children aged 6-12 years and adolescents and adults aged ≥12 years. Urinary levels of arsenobetaine (UAB) were evaluated for adolescents and adults only. Regression models were fitted for log transformed values of UAB, UAS, and UDMA. For the models for children, however, gender, race/ethnicity, SES, and fish/shell fish consumption during the last 30 days were the only independent variables that were included in the models. Nonsmokers were found to have higher levels of UAS and UDMA than smokers. Elevated levels of UAB, UAS, and UDMA were associated with higher amounts of daily alcohol consumption. The associations were in the opposite direction for daily caffeine consumption. Females were found to have statistically significantly lower adjusted levels of UDMA than males for those aged ≥12 years. Irrespective of age, those with unclassified race/ethnicity had the highest levels of UAB, UAS, and UDMA and non-Hispanic whites had the lowest levels. Adolescents had the higher levels of UAB, UAS, and UDMA than adults. Higher SES was associated with higher levels of UAB, UAS, and UDMA among adolescents and adults. Irrespective of age, fish consumption was associated with higher levels of UAB, UAS, and UDMA. © 2015.


Jain R.B.,U.S. Army | Jain R.B.,Empiristat Inc.
Environmental Toxicology and Pharmacology | Year: 2015

Data from National Health and Nutrition Examination Survey for the years 2009-2010 were used to estimate the levels of caffeine and 14 of its metabolite among U.S. smokers and nonsmokers after adjustments were made for other factors that affect observed caffeine levels. In this study, when adjusted for daily caffeine intake, adjusted levels (AGM) of caffeine and its metabolites were not found to be statistically significantly different between smokers and nonsmokers. AGMs for caffeine and all of its metabolites were found to be statistically significantly higher (p<. 0.01) among females aged ≥12 years than males. For caffeine, 1,3-dimethylxanthine, and 1,7-dimethylxanthine, those aged ≥20 years had statistically significantly higher (p<. 0.01) AGM than those aged 12-19 years but the reverse was true for 7-methylxanthine and 3,7-dimethylxanthine (p≤. 0.02). The order of the AGMs by race/ethnicity was non-Hispanic whites. >. Hispanics. >. non-Hispanic blacks and most of the differences were statistically significant, at least between non-Hispanic whites and non-Hispanic blacks (p<. 0.01). In general, there was a statistically significant positive association between the levels of caffeine and its metabolites and body mass index as well as daily caffeine intake. However, the levels of 7-methylxanthine were negatively associated with body mass index. © 2015 Elsevier B.V.


The objective of this study was to evaluate serum cotinine and total urinary 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanonol (NNAL) levels from a nationally representative sample of non-Hispanic Asian Americans as compared with other racial/ethnic groups. Data from the latest National Health and Nutrition Examination Survey for the years 2011-2012 were used for this purpose. The total sample size used was 4580. Regression models were fitted to estimate serum cotinine and urinary NNAL levels for smokers and nonsmokers aged 20years and older adjusted for other factors that affect these levels. For nonsmokers, exposure to second hand smoke at home was associated with about 30 times higher serum cotinine levels when compared to those without such exposure (0.717ngmL-1 vs. 0.024ngmL-1, p<0.01). NNAL levels among nonsmokers with second hand smoke exposure at home were about twenty times what they were in those without such exposure (9pgmL-1 vs. 109pgmL-1, p<0.01). As compared to other racial/ethnic groups, the lowest adjusted serum cotinine levels occurred in non-Hispanic Asian smokers (92.6ngmL-1) and Hispanics (84.5ngmL-1) as compared to non-Hispanic whites (143.8ngmL-1) and non-Hispanic blacks (158.4ngmL-1). Urinary NNAL levels for smokers were in the order: non-Hispanic Asian (0.121ngmL-1)

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