Medicine and Health Sciences Commons^™

Challenges And Best Practices In Real-Time Prediction Of Infectious Disease: A Case Study Of Dengue In Thailand, Nicholas Reich, Stephen Lauer, Krzysztof Sakrejda, Sopon Iamsirithaworn, Soawapak Hinjoy, Paphanij Suangtho, Suthanun Suthachana, Hannah Clapham, Henrik Salje, Derek Cummings, Justin Lessler

Nicholas G Reich

Epidemics of communicable diseases place a huge burden on public health infrastructures across the world. Producing accurate and actionable forecasts of infectious disease incidence at short and long time scales will improve public health response to outbreaks. However, scientists and public health officials face many obstacles in trying to create accurate and actionable real-time forecasts of infectious disease incidence. Dengue is a mosquito-borne virus that annually infects over 400 million people worldwide. We developed a real-time forecasting model for dengue hemorrhagic fever in the 77 provinces of Thailand. We created an operational and computational infrastructure that generated multi-step predictions of …

Acceptance Of Wife Beating And Its Association With Physical Violence Towards Women In Nepal: A Cross-Sectional Study Using Couple's Data, Kayoko Yoshikawa, Tara M. Shakya, Krishna C. Poudel, Masamine Jimba

Krishna C. Poudel

Background: Intimate partner violence (IPV) is a serious global public health issue. Acceptance of wife beating is known to be associated with IPV, but few studies have analysed the acceptance of wife beating from both women and men’s points of view. The objective of this study was to examine whether acceptance of wife beating among couples is associated with lifetime and past one-year physical IPV perpetration towards wives in Nepal. Methods: A cross-sectional study was conducted from August to September 2011, with 717 randomly selected couples with wives aged 18 to 49 years old from the Kirtipur municipality and Bhaktapur …

Perceived Family Support, Depression, And Suicidal Ideation Among People Living With Hiv/Aids: A Cross- Sectional Study In The Kathmandu Valley, Nepal, Rachel M. Amiya, Krishna C. Poudel, Kalpana Poude-Tandukar, Basu D. Pandey, Masamine Jimba

Krishna C. Poudel

Background: Depression and suicidal thinking occur frequently alongside HIV/AIDS, triggering profound detrimental impacts on quality of life, treatment adherence, disease progression, and mortality. Yet the psychosocial factors contributing to these psychiatric comorbidities remain underexplored, particularly in the developing country context. This study thus examined different dimensions of perceived family support in relation to depression and suicidal ideation among people living with HIV/AIDS (PLWHA) in Nepal. Methods: A cross-sectional survey of 322 adult PLWHA residing in the Kathmandu Valley, Nepal was conducted. Data were analyzed using multiple logistic regressions for correlates of Beck Depression Inventory (BDI)-Ia-defined depressive symptoms and suicidal ideation …

Preventing Hiv Among Black Men In College Using A Cbpr Approach, Louis Graham, Robert Aronson, Regina Pulliam, L Mann, Scott Rhodes

Louis Graham

No abstract provided.

Malaria-Related Knowledge And Prevention Practices In Four Neighbourhoods In And Around Mumbai, India: A Cross-Sectional Study, Gaurav Dhawan, Nidhin Joseph, Penelope S. Pekow, Christine A. Rogers, Krishna C. Poudel, Maria T. Bulzacchelli

Krishna C. Poudel

Background: India accounts for the highest number of malaria cases outside of Africa. Eighty per cent of India’s population lives in malaria-risk areas, with cases increasing in urban areas. Mumbai, India, one of the most populous cities in the world, has experienced such an increase. To be successful, many malaria control efforts require community participation, which in turn depends on individuals’ knowledge and awareness of the disease. This study assessed the knowledge and prevention practices regarding malaria in residents of four different areas of Mumbai, India, around the time of a malaria outbreak and the start of a widespread awareness …

Risk Factors For Persistent Mrsa Colonization In Children With Multiple Intensive Care Unit Admissions, Victor Popoola, Pranita Tamma, Nicholas Reich, Trish Perl, Aaron Milstone

Nicholas G Reich

We studied methicillin-resistant Staphylococcus aureus (MRSA)-colonized children with multiple intensive care unit (ICU) admissions to assess the persistence of MRSA colonization. Our data found that children with more than 1 year between ICU admissions had a higher prevalence of MRSA colonization than the overall ICU population, which supports empirical contact precautions for children with previous MRSA colonization.

Addressing Economic Devastation And Built Environment Degradation To Prevent Violence: A Photovoice Project Of Detroit Youth Passages, Louis Graham, Armando Reyes, William Lopez, Alana Gracey, Rachel Snow, Mark Padilla

Louis Graham

This project increased awareness about issues of violence to youth, their communities, and policy makers through the technique of photovoice and its translation into photo exhibitions and other community events. Youth participants learned photography skills, engaged in critical communal discussions about important issues affecting their health, wrote reflective stories about their photos, and engaged in policy change efforts. Their photos depict the need to address economic devastation and built environment degradation to prevent violence in their communities. Youth presented policy makers and community leaders with an “insider’s perspective” of the issues facing their communities, with the hope of promoting policy …

Better Learning In Schools To Improve Attitudes Toward Abstinence And Intentions For Safer Sex Among Adolescents In Urban Nepal, Rachana Manandhar Shrestha, Keiko Otsuka, Krishna C. Poudel, Junko Yasuoka, Medin Lamichhane, Masamine Jimba

Krishna C. Poudel

Background: School-based sex education is an effective medium to convey health information and skills about preventing sexually transmitted infections (STIs) and unwanted pregnancies among adolescents. However, research on school-based sex education is limited in many developing countries, including Nepal. This study thus had two main objectives: (1) to assess students’ evaluation of school-based sex education, and (2) to examine the associations between students’ evaluations of school-based sex education and their (a) attitudes toward abstinence and (b) intentions for safer sex. Methods: This cross-sectional study was conducted among 634 students from six schools in the Kathmandu Valley during May–June 2010. We …

Interactions Between Serotypes Of Dengue Highlight Epidemiological Impact Of Cross-Immunity, Nicholas Reich, Sourya Shrestha, Aaron King, Pejman Rohani, Justin Lessler, Siripen Kalayanarooj, In-Kyu Yoon, Robert Gibbons, Donald Burke, Derek Cummings

Nicholas G Reich

Dengue, a mosquito-borne virus of humans, infects over 50 million people annually. Infection with any of the four dengue serotypes induces protective immunity to that serotype, but does not confer long-term protection against infection by other serotypes. The immunological interactions between sero- types are of central importance in understanding epidemiological dynamics and anticipating the impact of dengue vaccines. We analysed a 38-year time series with 12 197 serotyped dengue infections from a hospital in Bangkok, Thailand. Using novel mechanistic models to represent different hypothesized immune interactions between serotypes, we found strong evidence that infec- tion with dengue provides substantial short-term …

Improved Quality Of Life After Surgery For Pelvic Organ Prolapse In Nepalese Women, Rolina Dhital, Keiko Otsuka, Krishna C. Poudel, Junko Yasuoka, Ganesh Dangal, Masamine Jimba

Krishna C. Poudel

Background: Pelvic organ prolapse (POP) is a common gynecological condition that can affect quality of life (QOL) in women. In Nepal, the prevalence of POP is high, but many affected women are still deprived of treatment. Vaginal hysterectomy with pelvic floor repair is one of the common treatment options for advanced POP. However, QOL outcomes after surgery have not been reported in low-income countries. Thus, we aimed to examine changes in QOL among Nepalese women with POP after such surgery. Methods: This longitudinal study was conducted in the selected central and peripheral hospitals in Nepal where vaginal hysterectomy was being …

Serum 25-Hydroxyvitamin D Levels And C-Reactive Protein In Persons With Human Immunodeficiency Virus Infection, Kalpana Poudel-Tandukar, Krishna C. Poudel, Masamine Jimba, Jun Kobayashi, C. Anderson Johnson, Paula H. Palmer

Krishna C. Poudel

Human immunodeficiency virus (HIV) infection has frequently been associated with vitamin D deficiency as well as chronic inflammatory response. We tested the hypothesis of an independent relationship between serum concentrations of 25-hydroxyvitamin D [25(OH)D] and high-sensitivity C-reactive protein (CRP) in a cohort of HIV-positive people. A cross-sectional survey was conducted among 316 HIV-positive people (181 men and 135 women) aged 16 to 60 years residing in the Kathmandu Valley, Nepal. Serum high-sensitivity CRP concentrations and serum 25(OH)D levels were measured by the latex agglutination nephelometry method and the competitive protein-binding assay, respectively. The relationship between serum CRP concentrations and 25(OH)D …

Dried Whole Plant Artemisia Annua As An Antimalarial Therapy, Mostafa Elfawal, Melissa Towler, Nicholas Reich, Douglas Golenbock, Pamela Weathers, Stephen Rich

Nicholas G Reich

Drugs are primary weapons for reducing malaria in human populations. However emergence of resistant parasites has repeatedly curtailed the lifespan of each drug that is developed and deployed. Currently the most effective anti-malarial is artemisinin, which is extracted from the leaves of Artemisia annua. Due to poor pharmacokinetic properties and prudent efforts to curtail resistance to monotherapies, artemisinin is prescribed only in combination with other anti-malarials composing an Artemisinin Combination Therapy (ACT). Low yield in the plant, and the added cost of secondary anti-malarials in the ACT, make artemisinin costly for the developing world. As an alternative, we compared the …

Ready To Use Therapeutic Foods (Rutf) Improves Undernutrition Among Art-Treated, Hiv-Positive Children In Dar Es Salaam, Tanzania, Bruno Sunguya, Krishna C. Poudel, Linda B. Mlunde, Keiko Otsuka, Junko Yasuoka, David P. Urassa, Namala P. Mkopi

Krishna C. Poudel

Background: HIV/AIDS is associated with an increased burden of undernutrition among children even under antiretroviral therapy (ART). To treat undernutrition, WHO endorsed the use of Ready to Use Therapeutic Foods (RUTF) that can reduce case fatality and undernutrition among ART-naïve HIV-positive children. However, its effects are not studied among ART-treated, HIV-positive children. Therefore, we examined the association between RUTF use with underweight, wasting, and stunting statuses among ART-treated HIV-positive children in Dar es Salaam, Tanzania. Methods: This cross-sectional study was conducted from September-October 2010. The target population was 219 ART-treated, HIV-positive children and the same number of their caregivers. We …

Caregiving Associated With Selected Cancer Risk Behaviors And Screening Utilization Among Women: Cross-Sectional Results Of The 2009 Brfss, Katherine Reeves, Kathryn Bacon, Lisa Fredman

Katherine Reeves

Background Informal caregiving is increasingly common as the U.S. population ages, and there is concern that caregivers are less likely than non-caregivers to practice health-promoting behaviors, including cancer screening. We examined caregiving effects on cancer risk behaviors and breast and cervical cancer screening in the 2009 Behavioral Risk Factor Surveillance System. Methods Women age ≥41 with data on breast and cervical cancer screening were included (weighted frequency 3,478,000 women). Cancer screening was classified according to American Cancer Society guidelines. We evaluated the association of caregiving with cancer risk behaviors (obesity, physical activity, alcohol intake, smoking status, and fruit/vegetable consumption) and …

Genetic Variability In Igf-1 And Igfbp-3 And Body Size In Early Life, Elizabeth Poole, Shelley Tworoger, Susan Hankinson, Heather Baer

Susan E. Hankinson

Background Early life body size and circulating levels of IGF-1 and IGFBP-3 have been linked to increased risks of breast and other cancers, but it is unclear whether these exposures act through a common mechanism. Previous studies have examined the role of IGF-1 and IGFBP-3 genetic variation in relation to adult height and body size, but few studies have examined associations with birthweight and childhood size. Methods We examined whether htSNPs in IGF-1 and the IGFBP-1/IGFBP-3 gene region are associated with the self-reported outcomes of birthweight, body fatness at ages 5 and 10, and body mass index (BMI) at age …

Uptake Of Interventions For Preventing Mother-To-Child Hiv Transmission In 11 Operational Districts In Cambodia, Krishna C. Poudel

Krishna C. Poudel

INTRODUCTION: To achieve the global goal of eliminating mother-to-child transmission of HIV, retention of HIV-positive women and their babies throughout the cascade of prevention of mother-to-child transmission of HIV (PMTCT) services is necessary. Little evidence has been published on coverage of the cascade in resource-limited settings. Along with PMTCT service expansion in Cambodia, a national routine reporting system was developed. This study examines coverage of six PMTCT interventions to improve our understanding of retention throughout the cascade. METHOD: WE DEVELOPED INDICATORS TO MONITOR COVERAGE OF THE SIX KEY INTERVENTIONS: (1) maternal antiretroviral treatment or prophylaxis; (2) delivery in a health …

Influence Of Prenatal Arsenic Exposure And Newborn Sex On Global Methylation Of Cord Blood Dna, Richard Pilsner, Megan Hall, Xinhua Liu, Vesna Ilievski, Vesna Slavkovich, Diane Levy, Pam Factor-Litvak, Mahammad Yunus, Mahfuzar Rahman, Joseph Graziano, Mary Gamble

J. Richard Pilsner

Background

An emerging body of evidence indicates that early-life arsenic (As) exposure may influence the trajectory of health outcomes later in life. However, the mechanisms underlying these observations are unknown.

Objective

The objective of this study was to investigate the influence of prenatal As exposure on global methylation of cord blood DNA in a study of mother/newborn pairs in Matlab, Bangladesh.

Design

Maternal and cord blood DNA were available from a convenience sample of 101 mother/newborn pairs. Measures of As exposure included maternal urinary As (uAs), maternal blood As (mbAs) and cord blood As (cbAs). Several measures of global DNA …

Empirical Power And Sample Size Calculations For Cluster-Randomized And Cluster-Randomized Crossover Studies, Nicholas Reich, Jessica Myers, Daniel Obeng, Aaron Milstone, Trish Perl

Nicholas G Reich

In recent years, the number of studies using a cluster-randomized design has grown dramatically. In addition, the cluster-randomized crossover design has been touted as a methodological advance that can increase efficiency of cluster-randomized studies in certain situations. While the cluster-randomized crossover trial has become a popular tool, standards of design, analysis, reporting and implementation have not been established for this emergent design. We address one particular aspect of cluster-randomized and cluster-randomized crossover trial design: estimating statistical power. We present a general framework for estimating power via simulation in cluster-randomized studies with or without one or more crossover periods. We have …

Hormones And Endocrine-Disrupting Chemicals: Low-Dose Effects And Nonmonotonic Dose Responses, Laura Vandenberg, Theo Colborn, Tyrone Hayes, Jerrold Heindel, David Jacobs Jr., Duk-Hee Lee, Toshi Shioda, Ana Soto, Frederick Vom Saal, Wade Welshons, R. Zoeller, John Myers

Laura Vandenberg

For decades, studies of endocrine-disrupting chemicals (EDCs) have challenged traditional concepts in toxicology, in particular the dogma of “the dose makes the poison,” because EDCs can have effects at low doses that are not predicted by effects at higher doses. Here, we review two major concepts in EDC studies: low dose and nonmonotonicity. Low-dose effects were defined by the National Toxicology Program as those that occur in the range of human exposures or effects observed at doses below those used for traditional toxicological studies. We review the mechanistic data for low-dose effects and use a weight-of-evidence approach to analyze five …

A Call For Parental Monitoring To Improve Condom Use Among Secondary School Students In Dar Es Salaam, Tanzania, Linda B. Mlunde, Krishna C. Poudel, Bruno F. Sunguya, Jessie K. K. Mbwambo, Junko Yasuoka, Keiko Otsuka, Omary Ubuguyu, Masamine Jimba

Krishna C. Poudel

Background: The number of people newly infected with human immunodeficiency virus (HIV) has been decreasing in sub-Saharan Africa, but prevalence of the infection remains unacceptably high among young people. Despite the alarming pervasiveness of the virus, young people in this region continue to engage in risky sexual behaviors including unprotected sexual intercourse. In developed countries, parents can play important roles in protecting young people from such behaviors, but evidence regarding the impact of parental involvement is still limited in sub-Saharan Africa. Therefore, we conducted this study to examine the magnitude of risky sexual behaviors and the association of parental monitoring …

Hormesis And The Salk Polio Vaccine, Edward Calabrese

Edward Calabrese

The production of the Salk vaccine polio virus by monkey kidney cells was generated using the synthetic tissue culture medium, Mixture 199. In this paper’s retrospective assessment of this process, it was discovered that Mixture 199 was modified by the addition of ethanol to optimize animal cell survival based on experimentation that revealed a hormetic-like biphasic response relationship. This hormesis-based optimization procedure was then applied to all uses of Mixture 199 and modifications of it, including its application to the Salk polio vaccine during preliminary testing and in its subsequent major societal treatment programs.

Weight Gain Prevention Among Black Women In The Rural Community Health Center Setting: The Shape Program, Perry Foley, Erica Levine, Sandy Askew, Elaine Puleo, Jessica Whiteley, Bryan Batch, Daniel Heil, Daniel Dix, Veronica Lett, Michele Lanpher, Jade Miller, Karen Emmons, Gary Bennett

Elaine M. Puleo

Background: Nearly 60% of black women are obese. Despite their increased risk of obesity and associated chronic diseases, black women have been underrepresented in clinical trials of weight loss interventions, particularly those conducted in the primary care setting. Further, existing obesity treatments are less effective for this population. The promotion of weight maintenance can be achieved at lower treatment intensity than can weight loss and holds promise in reducing obesity-associated chronic disease risk. Weight gain prevention may also be more consistent with the obesity-related sociocultural perspectives of black women than are traditional weight loss approaches.

Methods/Design: We conducted an 18-month …

The Combined Influence Of Multiple Sex And Growth Hormones On Risk Of Postmenopausal Breast Cancer: A Nested Case-Control Study, Shelley Tworoger, Bernard Rosner, Walter Willett, Susan Hankinson

Susan E. Hankinson

Introduction Sex and growth hormones are positively associated with postmenopausal breast cancer risk. However, few studies have evaluated the influence of multiple hormones simultaneously. Methods We considered the roles of estrone, estradiol, estrone sulfate, testosterone, androstenedione, dehydroepiandrosterone (DHEA), DHEA sulfate and prolactin and, secondarily, insulin-like growth factor 1 (IGF-1) and c-peptide in postmenopausal breast cancer risk among 265 cases and 541 controls in the prospective Nurses' Health Study. We created several hormone scores, including ranking women by the number of hormones above the age- and batch-adjusted geometric mean and weighting hormone values by their individual associations with breast cancer risk. …

Low Frequency Vibrations Disrupt Left-Right Patterning In The Xenopus Embryo, Laura Vandenberg, Brian Pennarola, Michael Levin

Laura Vandenberg

The development of consistent left-right (LR) asymmetry across phyla is a fascinating question in biology. While many pharmacological and molecular approaches have been used to explore molecular mechanisms, it has proven difficult to exert precise temporal control over functional perturbations. Here, we took advantage of acoustical vibration to disrupt LR patterning in Xenopus embryos during tightly-circumscribed periods of development. Exposure to several low frequencies induced specific randomization of three internal organs (heterotaxia). Investigating one frequency (7 Hz), we found two discrete periods of sensitivity to vibration; during the first period, vibration affected the same LR pathway as nocodazole, while during …

Exposure To Bisphenol A In Canada: Invoking The Precautionary Principle, Laura Vandenberg

Laura Vandenberg

No abstract provided.

A Stochastic Simulator Of A Blood Product Donation Environment With Demand Spikes And Supply Shocks, Ming-Wen An, Nicholas Reich, Stephen Crawford, Ron Brookmeyer, Thomas Louis, Kenrad Nelson

Nicholas G Reich

The availability of an adequate blood supply is a critical public health need. An influenza epidemic or another crisis affecting population mobility could create a critical donor shortage, which could profoundly impact blood availability. We developed a simulation model for the blood supply environment in the United States to assess the likely impact on blood availability of factors such as an epidemic. We developed a simulator of a multi-state model with transitions among states. Weekly numbers of blood units donated and needed were generated by negative binomial stochastic processes. The simulator allows exploration of the blood system under certain conditions …

Intergenerational Dialogue Exchange And Action: Introducing A Community-Based Participatory Approach To Connect Youth, Adults And Elders In An Alaskan Native Community, Lisa Wexler

Lisa Wexler

The broad goals of the community-based participatory research (CBPR) include community engagement, capacity building, developing practical solutions for community concerns and knowledge building. This article describes the data generation and sharing process as it relates to the goals of CBPR and health promotion in an American Indian/Alaska Native communities. The project described herein, “Investigating Inupiaq Cultural Resilience: A Pilot Study,” achieved these goals in a tribal context by fostering intergenerational dialogue through data collection. The intergenerational exchange served to collect data for a community-based participatory study and provide an opportunity for communication between Elders, adults and youth. By providing an …

Risk Factors For Ductal And Lobular Breast Cancer: Results From The Nurses' Health Study, Joanne Kotsopoulos, Wendy Chen, Margaret Gates, Shelley Tworoger, Susan Hankinson, Bernard Rosner

Susan E. Hankinson

Introduction Ductal and lobular carcinomas are the two most common types of invasive breast cancer. Whether well-established risk factors are differentially associated with risk on the basis of histologic subtype is not clear. We prospectively investigated the association between a number of hormonal and nonhormonal exposures and risk defined by histologic subtype among 4,655 ductal and 659 lobular cases of postmenopausal breast cancer from the Nurses' Health Study. Methods Multivariate Cox proportional hazards regression stratified by histologic subtype and time period was used to examine the association between risk factors and the incidence of ductal and lobular subtypes. For each …

Adiposity And The Development Of Premenstrual Syndrome, Elizabeth Bertone-Johnson, Susan Hankinson, Walter Willett, Susan Johnson, Joann Manson

Elizabeth R. Bertone-Johnson

Background Moderate to severe premenstrual syndrome (PMS) affects 8%–20% of premenopausal women and causes substantial levels of impairment, but few modifiable risk factors for PMS have been identified. Adiposity may impact risk through the complex interaction of hormonal and neurochemical factors, but it is not known if adiposity increases a woman's risk of developing PMS. We have addressed these issues in a prospective study nested within the Nurses' Health Study 2. Methods Participants were a subset of women aged 27–44 and free from PMS at baseline, including 1057 women who developed PMS over 10 years of follow-up and 1968 controls. …

Biomonitoring Studies Should Be Used By Regulatory Agencies To Assess Human Exposure Levels And Safety Of Bisphenol A, Laura Vandenberg, Ibrahim Chahoud, Vasantha Padmanabhan, Francisco Paumgartten, Gilbert Schoenfelder

Laura Vandenberg

BACKGROUND: Within the past 3 years, four major evaluations of bisphenol A (BPA) safety have been undertaken. However, these assessments have arrived at quite different conclusions regarding the safety of BPA at current human exposure levels. OBJECTIVES: We compared the reasons provided by the European Food Safety Authority (EFSA) BPA risk assessment panel for their conclusion that human exposures are negligible with the conclusions reached by the other panels, with all panels having the same body of literature at their disposal. DISCUSSION: The EFSA panel dismissed > or = 80 biomonitoring studies that documented significant levels of BPA exposure in humans, …