Medicine and Health Sciences Commons^™

Brief Report: The Impact Of Disease Stage On Early Gaps In Art In The "Treatment For All" Era - A Multisite Cohort Study., Ingrid T. Katz, Nicholas Musinguzi, Kathleen Bell, Anna Cross, Mwebesa Bosco Bwana, Gideon Amanyire, Stephen Asiimwe, Catherine Orrell, David R. Bangsberg, Jessica E. Haberer

OHSU-PSU School of Public Health Faculty Publications and Presentations

Adoption of "Treat All" policies has increased ART initiation in sub-Saharan Africa; however, unexplained early losses continue to occur. More information is needed to understand why treatment discontinuation continues at this vulnerable stage in care.

Provider Perspectives On Persistent Urinary Incontinence Following Obstetric Fistula Repair In Ethiopia, Laura E. Jacobson, Melaku Abriha Marye, Elena Phoutrides, Rahel Nardos

OHSU-PSU School of Public Health Faculty Publications and Presentations

Each year an estimated 50,000 to 100,000 women worldwide are affected by obstetric fistula. This devastating but preventable maternal morbidity leaves women incontinent, stigmatized, isolated, and often with a still birth. While fistula rates in Ethiopia have declined in recent years, estimates range from 7 to 40 percent of women suffer from persistent urinary incontinence after successful closure of their fistula. Few studies have focused on the unique experiences and challenges that providers face treating fistula patients, particularly those who experience persistent urinary incontinence. The goal of this research is to characterize the fistula provider's accounts of how to manage, …

What You Should Know About Racism-20: A Fact Sheet In The Time Of Covid-19, Ryan J. Petteway

OHSU-PSU School of Public Health Faculty Publications and Presentations

Satire has a history within public health and medical scholarship. However, research and academic works related to COVID-19, health inequities, and structural racism to date have not engaged/explored satire as a critical mode of reflection, analysis, and commentary. Drawing from social epidemiology literature related to structural racism, and rooted in critical race theory and critical theory related to narrative power, this paper—in the form of a "RACISM-20" fact sheet/health promotion flyer—uses satire and humor as critical commentary on mainstream public health discourse of/responses to COVID-19, transposing structural racism and COVID-19 to accentuate how individualist, apolitical, and “colorblind” downstream frames of …

Predicting Vaginal Birth After Previous Cesareavn: Using Machine-Learning Models And A Population-Based Cohort In Sweden, Charlotte Wollmann, Kyle D. Hart, Can Liu, Aaron B. Caughey, Olof Stephansson, Jonathan M. Snowden

OHSU-PSU School of Public Health Faculty Publications and Presentations

Introduction: Predicting a woman’s probability of vaginal birth after cesarean could facilitate the antenatal decision-making process. Having a previous vaginal birth strongly predicts vaginal birth after cesarean. Delivery outcome in women with only a cesarean delivery is more unpredictable. Therefore, to better predict vaginal birth in women with only one prior cesarean delivery and no vaginal deliveries would greatly benefit clinical practice and fill a key evidence gap in research. Our aim was to predict vaginal birth in women with one prior cesarean and no vaginal deliveries using machine-learning methods, and compare with a US prediction model and its further …

Health Impact Assessment And City Council Policy: Identifying Opportunities To Address Local Social Determinants Of Health & Place-Health Relationships, 10 Years Later, Ryan J. Petteway, Shannon Cosgrove

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background: Health Impact Assessment (HIA) can be used to assess any type of policy/program related to social determinants (SDH). However, local public health departments (LHDs) have been slow to adopt formal use of HIA in efforts to address local SDH, even with growing evidence linking SDH and place-health relationships. Ten years ago we completed a review of Baltimore City Council policies to advance this conversation within the LHD. Our goal here is to revisit this review and, again, outline a process by which LHDs can: a) monitor local policies in regard to SDH and b) identify opportunities for potential HIA …

Community-Derived Recommendations For Healthcare Systems And Medical Students To Support People Who Are Houseless In Portland, Oregon: A Mixed-Methods Study, Caroline King, Cameron Fisher, Jacob Johnson, Arum Chun, David Bangsberg, Paula C. Carder

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background: People who are houseless (also referred to as homeless) perceive high stigma in healthcare settings, and face disproportionate disparities in morbidity and mortality versus people who are housed. Medical students and the training institutions they are a part of play important roles in advocating for the needs of this community. The objective of this study was to understand perceptions of how medical students and institutions can meet needs of the self-identified needs of the houseless community.

Methods: Between February and May 2018, medical students conducted mixed-methods surveys with semi-structured qualitative interview guides at two community-based organizations that …

Variation In Hiv-1 Nef Function Within And Among Viral Subtypes Reveals Genetically Separable Antagonism Of Serinc3 And Serinc5, Steven W. Jin, Francis M. Mwimanzi, Jaclyn K. Mann, Mwebesa Bosco Bwana, Guinevere Q. Lee, Chanson Brumme, Peter W. Hunt, Jeff N. Martin, David R. Bangsberg, Thumbi Ndung'u, Zabrina L. Brumme, Mark A. Brockman

OHSU-PSU School of Public Health Faculty Publications and Presentations

HIV Nef counteracts cellular host restriction factors SERINC3 and SERINC5, but our understanding of how naturally occurring global Nef sequence diversity impacts these activities is limited. Here, we quantify SERINC3 and SERINC5 internalization function for 339 Nef clones, representing the major pandemic HIV-1 group M subtypes A, B, C and D. We describe distinct subtype-associated hierarchies for Nef-mediated internalization of SERINC5, for which subtype B clones display the highest activities on average, and of SERINC3, for which subtype B clones display the lowest activities on average. We further identify Nef polymorphisms that modulate its ability to counteract SERINC proteins, including …

An Intersectional Mixed Methods Approach To Understand American Indian Men’S Health, Ka‘Imi Sinclair, Kelly L. Gonzales, Claire Woosley, Tish Rivera Cree, Celina M. Garza, Dedra Buchwald

OHSU-PSU School of Public Health Faculty Publications and Presentations

This study used a parallel, convergent, mixed-methods design with TribalCrit theory and intersectionality as analytical frameworks to identify how the identities of American Indian men intersect with broader structures and systems in shaping their eating and physical activity choices and behaviors, and in eliciting recommendations for a men’s lifestyle intervention. American Indian men were recruited in Minneapolis, Minnesota, and Portland, Oregon, between March and December 2017, and in Phoenix, Arizona, in December 2019 to participate in a survey and focus groups. The survey included questions on demographics and physical and cultural activities men engage in, perceived social support for lifestyle …

Adherence To Hiv Antiretroviral Therapy Among Pregnant And Postpartum Women During The Option B+ Era: 12-Month Cohort Study In Urban South Africa And Rural Uganda, Lynn T. Matthews, Catherine Orrell, Mwebesa B. Bwana, Alexander C. Tsai, Christina A. Psaros, Stephen Asiimwe, Gideon Amanyire, Nicholas Musinguzi, Kathleen Bell, David Bangsberg, Jessica E. Haberer

OHSU-PSU School of Public Health Faculty Publications and Presentations

Introduction: We conducted a cohort study to understand patterns of anti-retroviral therapy (ART) adherence during pregnancy, postpartum and non-pregnancy follow-up among women initiating ART in public clinics offering Option B+ in rural Uganda and urban South Africa. Methods: We collected survey data, continuously monitored ART adherence (Wisepill), HIV-RNA and pregnancy tests at zero, six and twelve months from women initiating ART in Uganda and South Africa, 2015 to 2017. The primary predictor of interest was follow-up time categorized as pregnant (pregnancy diagnosis to pregnancy end), postpartum (pregnancy end to study exit) or non-pregnancy-related (neither pregnant nor postpartum). Fractional regression …

Sexually Transmitted Infection Prevalence Among Women At Risk For Hiv Exposure Initiating Safer Conception Care In Rural, Southwestern Uganda, Pooja Chitneni, Mwebesa Bosco Bwana, Moran Owembabazi, Kasey O'Neil, Paul Kato Kalyebara, Winnie Muyindike, Nicholas Musinguzi, David R. Bangsberg, Jeanne M. Marrazzo, Jessica E. Haberer, Angela Kaida, Lynn T. Matthews

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background Knowledge of sexually transmitted infection (STI) prevalence and risk factors is important to the development of tenofovir-based preexposure prophylaxis (PrEP) and safer conception programming. We introduced STI screening among women at risk for HIV exposure who were participating in a safer conception study in southwestern Uganda. Methods We enrolled 131 HIV-uninfected women, planning for pregnancy with a partner living with HIV or of unknown HIV serostatus (2018-2019). Women were offered comprehensive safer conception counseling, including PrEP. Participants completed interviewer-administered questionnaires detailing sociodemographics and sexual history. We integrated laboratory screening for chlamydia, gonorrhea, trichomoniasis, and syphilis as a substudy to …

Trajectories Of Initiation For The Heroin-Based Drug Whoonga – Qualitative Evidence From South Africa, Griffin A. Tyree, Nzwakie Mosery, Elizabeth F. Closson, Zonke Mabude, Carol Du Toit, David Bangsberg, Steven A. Safren, Kenneth H. Mayer, Jennifer A. Smit, Matthew J. Mimiaga, David J. Grelotti

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background: Whoonga is a smoked heroin-based street drug that first emerged in South Africa a decade ago. While previous scientific reports suggest that use is growing and youth are particularly vulnerable, trajectories of initiation are not well characterized. Methods: In 2015, 30 men undergoing residential addiction treatment for this smoked heroin drug in KwaZulu-Natal, South Africa participated in semi-structured interviews about their experiences using the drug. Interview data were coded using qualitative content analysis. Results: Participant trajectories to initiating smoked heroin were “vertical” in the context of marijuana use or “horizontal” in the context of other hard drug use. Participants …

The Data Are Inadequate To Assess Safety And Efficacy Of Mass Chemotherapy For Taenia Solium Taeniasis, A. Clinton White Jr., Seth E. O'Neal, Andrea Winkler, Annette Abraham, Hélène Carabin

OHSU-PSU School of Public Health Faculty Publications and Presentations

As members of the Pan American Health Organization (PAHO) and World Health Organization (WHO) guidelines development group on chemotherapy strategies for the control of Taenia solium taeniasis, we are very disappointed at the systematic review by Haby and colleagues. With respect to the analysis of efficacy, the authors did not account for differences in the methods used to ascertain the outcome in the studies analyzed. There are also major concerns regarding the safety analyses. Few of the included studies used carefully designed active surveillance protocols to detect epileptic seizures and/or chronic progressive headaches. These neurologic side effects, due the inadvertent …

Differential Vpu-Mediated Cd4 And Tetherin Downregulation Functions Among Major Hiv-1 Group M Subtypes, Gisele Umviligihozo, Kyle D. Cobarrubias, Sandali Chandrarathna, Steven W. Jin, Nicole Reddy, Helen Byakwaga, Conrad Muzoora, Mwebesa B. Bwana, Guinevere Q. Lee, Peter W. Hunt, David Bangsberg, Multiple Additional Authors

OHSU-PSU School of Public Health Faculty Publications and Presentations

Downregulation of BST-2/tetherin and CD4 by HIV-1 viral protein U (Vpu) promotes viral egress and allows infected cells to evade host immunity. Little is known however about the natural variability in these Vpu functions among the genetically diverse viral subtypes that contribute to the HIV-1 pandemic. We collected Vpu isolates from 332 treatment-naive individuals living with chronic HIV-1 infection in Uganda, Rwanda, South Africa, and Canada. Together, these Vpu isolates represent four major HIV-1 group M subtypes (A [n = 63], B [n = 84], C [n = 94], and D [n = 59]) plus intersubtype …

Practice Gap In Atrial Fibrillation Oral Anticoagulation Prescribing At Emergency Department Home Discharge, Bory Kea, Bethany T. Waites, Amber Lynn, Merritt H. Raitt, David R. Vinson, Niroj Ari, Luke Welle, Andrew Sill, Dana Button, Benjamin C. Sun

OHSU-PSU School of Public Health Faculty Publications and Presentations

Introduction: Current U.S. cardiology guidelines recommend oral anticoagulation (OAC) to reduce stroke risk in selected patients with atrial fibrillation (AF), but no formal AF OAC recommendations exist to guide emergency medicine clinicians in the acute care setting. We sought to characterize emergency department (ED) OAC prescribing practices after an ED AF diagnosis.

Methods: This retrospective study included index visits for OAC-naive patients ≥18 years old who were discharged home from the ED at an urban, academic, tertiary hospital with a primary diagnosis of AF from 2012-2014. Five hypothesis-blinded, chart reviewers abstracted data from patient problem lists and medical history in …

Do Household Asset Wealth Measurements Depend On Who Is Surveyed? Asset Reporting Concordance Within Multi-Adult Households In Rural Uganda., Meghan L. Smith, Bernard Kakuhikire, Charles Baguma, Justin D. Rasmussen, David Bangsberg, Alexander C. Tsai

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background: In resource-limited settings, the Filmer & Pritchett asset index is frequently used to measure household economic status. Little is known about how its validity is affected by differential reporting or recall within households.

Methods: As part of a whole-population survey in a rural region of southwestern Uganda, we elicited household asset information from married dyads (404 men and 404 matched women) residing within the same households. We assessed the extent to which the asset index yielded differing measures of relative household wealth, depending on whether the husband’s or wife’s survey data were used in its calculation. To …

Health And Dental Care Expenditures In The United States From 1996 To 2016, Man Hung, Martin S. Lipsky, Ryan Moffat, Evelyn Lauren, Eric S. Hon, Jungweon Park, Gagandeep Gill, Julie Xu, Lourdes Peralta, Multiple Additional Authors

OHSU-PSU School of Public Health Faculty Publications and Presentations

Introduction: As total health and dental care expenditures in the United States continue to rise, healthcare disparities for low to middle-income Americans creates an imperative to analyze existing expenditures. This study examined health and dental care expenditures in the United States from 1996 to 2016 and explored trends in spending across various population subgroups.

Methods: Using data collected by the Medical Expenditure Panel Survey, this study examined health and dental care expenditures in the United States from 1996 to 2016. Trends in spending were displayed graphically and spending across subgroups examined. All expenditures were adjusted for inflation or …

Variability In State Regulations Pertaining To Infection Control And Pandemic Response In Us Assisted Living Communities, Taylor Bucy, Lindsey Smith, Paula C. Carder, Jaclyn Winfree, Kali Thomas

OHSU-PSU School of Public Health Faculty Publications and Presentations

At the end of 2019, international attention was drawn to an outbreak of zoonotic coronavirus SARS-CoV-2, formally named COVID-19, in Wuhan, China. The World Health Organization officially declared the outbreak a global pandemic on March 11, 2020, with the United States recording >1600 confirmed and presumptive travel-related and community-acquired cases at that time. As of April 10, 2020, all 50 US states and the District of Columbia, have reported cases, with the total number of US cases now totaling >400,000.2 Seattle, WA, is the US epicenter, with nursing facilities experiencing the greatest number of fatalities. Because of the communal living …

Pregnancy Outcomes And Documentation Status Among Latina Women: A Systematic Review, Dawn M. Richardson, Sarah B. Andrea, Amber Ziring, Cassandra Robinson, Lynne Messer

OHSU-PSU School of Public Health Faculty Publications and Presentations

Purpose: The impression that Latinas experience paradoxically good pregnancy outcomes in the United States persists, despite evidence showing that these outcomes are not enjoyed by all Latina subgroups. We conducted this systematic literature review to examine the relationship between documentation status and pregnancy outcomes among Latinas.

Methods: This review synthesizes empirical evidence on this relationship; examines how these studies define and operationalize documentation status; and makes recommendations of how a more comprehensive methodological approach can guide public health research on the impact of documentation status on Latina immigrants to the United States. We searched the literature within PubMed, …

Opioid Agonist Therapy During Hospitalization Within The Veterans Health Administration: A Pragmatic Retrospective Cohort Analysis, Kelsey C. Priest, Travis I. Lovejoy, Honora Englander, Sarah Shull, Dennis Mccarty

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background

Hospitalization of patients with opioid use disorder (OUD) is increasing, yet little is known about opioid agonist therapy (OAT: methadone and buprenorphine) administration during admission.

Objective

Describe and examine patient- and hospital-level characteristics associated with OAT receipt during hospitalization in the Veterans Health Administration (VHA).

Participants

A total of 12,407 unique patients, ≥ 18 years old, with an OUD-related ICD-10 diagnosis within 12 months prior to or during index hospitalization in fiscal year 2017 from 109 VHA hospitals in the continental U.S.

Main Measure

OAT received during hospitalization.

Key Results

Few admissions received OAT (n = 1914; 15%) …

Potency And Breadth Of Human Primary Zikv Immune Sera Shows That Zika Viruses Cluster Antigenically As A Single Serotype, Chad M. Nix, Jonathan Salberg, Felicity J. Coulter, Bettie W. Kareko, Zoe L. Lyski, Brian L. Booty, William B. Messer

OHSU-PSU School of Public Health Faculty Publications and Presentations

The recent emergence of Zika virus as an important human pathogen has raised questions about the durability and breadth of Zika virus immunity following natural infection in humans. While global epidemic patterns suggest that Zika infection elicits a protective immune response that is likely to offer long-term protection against repeat infection by other Zika viruses, only one study to date has formally examined the ability of human Zika immune sera to neutralize different Zika viruses. That study was limited because it evaluated human immune sera no more than 13 weeks after Zika virus infection and tested a relatively small number …

Ethnic Enclaves And Pregnancy And Behavior Outcomes Among Asian/Pacific Islanders In The Usa, Andrew D. Williams, Lynne C. Messer, Jenna Kanner, Sandie Ha, Katherine L. Grantz, Pauline Mendola

OHSU-PSU School of Public Health Faculty Publications and Presentations

Objectives—Ethnic enclaves are ethnically, spatially, and socially distinct communities that may promote health through access to culturally appropriate resources and reduced exposure to discrimination. This study examined ethnic enclave residence and pregnancy outcomes among Asian/Pacific Islander (API) women in the USA.

Design—We examined 9206 API births in the Consortium on Safe Labor (2002–2008). Ethnic enclaves were defined as hospital regions with high percentage of API residents (> 4%), high dissimilarity index (> 0.41; distribution of API and white residents within a geographic area), and high isolation index (> 0.03; interaction between API and white residents in an area). …

Screening For Hepatitis C Virus Infection In Adolescents And Adults: Updated Evidence Report And Systematic Review For The Us Preventive Services Task Force, Roger Chou, Tracy Dana, Rongwei Fu, Bernadette Zahker, Jesse Wagner, Shaun Ramirez, Sara Grusing, Janice H. Jou

OHSU-PSU School of Public Health Faculty Publications and Presentations

IMPORTANCE: A 2013 review for the US Preventive Services Task Force (USPSTF) of hepatitis C virus (HCV) screening found interferon-based antiviral therapy associated with increased likelihood of sustained virologic response (SVR) and an association between achieving an SVR and improved clinical outcomes. New direct-acting antiviral (DAA) regimens are available.

OBJECTIVE: To update the 2013 review on HCV screening to inform the USPSTF.

DATA SOURCES: Ovid MEDLINE, the Cochrane Central Register of Controlled Trials, and the Cochrane Database of Systematic Reviews through February 2019, with surveillance through September 2019.

STUDY SELECTION: Randomized clinical trials (RCTs) and nonrandomized treatment studies of HCV …

Analysis Of Covid-19 Transmission: Low Risk Of Presymptomatic Spread?, Mark K. Slifka, William B. Messer, Ian J. Amanna

OHSU-PSU School of Public Health Faculty Publications and Presentations

More than 6 million confirmed cases of COVID-19 (coronavirus disease 2019) have been identified worldwide and a number of case reports1-5 have indicated that COVID-19 has the potential to be transmitted prior to disease onset. Studies have also shown that infectious virus can be isolated from presymptomatic COVID-19 cases6 and although it is unknown what level of infectious virus is needed to confer efficient transmission potential, detection of infectious virus in the upper respiratory tract indicates that presymptomatic transmission of COVID-19 is plausible. Fear of asymptomatic and presymptomatic transmission of COVID-19 has led to considerable concern among public health policy …

Gut Carriage Of Antimicrobial Resistance Genes In Women Exposed To Small-Scale Poultry Farms In Rural Uganda: A Feasibility Study, Ana A. Weil, Meti D. Debela, Daniel M. Muyanja, Bernard Kakuhikire, Charles Baguma, David Bangsberg, Alexander C. Tsai, Peggy S. Lai

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background: Antibiotic use for livestock is presumed to be a contributor to the acquisition of antimicrobial resistance (AMR) genes in humans, yet studies do not capture AMR data before and after livestock introduction.

Methods: We performed a feasibility study by recruiting a subset of women in a delayed-start randomized controlled trial of small-scale chicken farming to examine the prevalence of clinically-relevant AMR genes. Stool samples were obtained at baseline and one year post-randomization from five intervention women who received chickens at the start of the study, six control women who did not receive chickens until the end of the study, …

Association Of A Multisite Interprofessional Education Initiative With Quality Of Primary Care, Samuel T. Edwards, Elizabeth Hooker, Rebecca Brienza, Bridget O’Brien, Hyunjee Kim, Stuart Gilman, Nancy Harada, Lillian Gelberg, Sarah Shull, Meike Niederhausen, Multiple Additional Authors

OHSU-PSU School of Public Health Faculty Publications and Presentations

Importance Studies have shown that interprofessional education (IPE) improves learner proficiencies, but few have measured the association of IPE with patient outcomes, such as clinical quality.

Objective To estimate the association of a multisite IPE initiative with quality of care.

Design, Setting, and Participants This study used difference-in-differences analysis of US Department of Veterans Affairs (VA) electronic health record data from July 1, 2008, to June 30, 2015. Patients cared for by resident clinicians in 5 VA academic primary care clinics that participated in the Centers of Excellence in Primary Care Education (CoEPCE), an initiative designed to promote IPE among …

Hiv Care Continuum Characteristics Among People With Opioid Use Disorder And Hiv In Vietnam: Baseline Results From The Bravo Study, Caroline King, Le Minh Giang, Gavin Bart, Lynn Elizabeth Kunkel, P. Todd Korthuis

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background

Little is known about patient characteristics that contribute to initiating antiretroviral therapy (ART) and achieving viral suppression among HIV people with opioid use disorder in Vietnam. The primary objective of this analysis was to evaluate associations between participant characteristics and the critical steps in the HIV care continuum of ART initiation and HIV viral suppression among people with opioid use disorder and HIV in Vietnam.

Methods

We assessed baseline participant characteristics, ART status, and HIV viral suppression (HIV RNA PCR < 200 copies/mL) enrolled in a clinical trial of HIV clinic-based buprenorphine versus referral for methadone among people with opioid use disorder in Vietnam. We developed logistic regression models to identify characteristics associated with ART status and HIV viral suppression.

Results

Among 283 study participants, 191 (67.5%) were prescribed ART at baseline, and 168 of those on ART (90%) …

Rapid Deployment Of A Statewide Covid-19 Echo Program For Frontline Clinicians: Early Results And Lessons Learned, Anna Louise Steeves-Reece, Nancy Elder, Tuesday A. Graham, Miriam L. Wolf, Isabel Stock, Melinda M. Davis, Robert D. Stock

OHSU-PSU School of Public Health Faculty Publications and Presentations

In a pattern repeated around the country, Oregon reported its first coronavirus patient on February 28, 2020.1 A week later, the governor declared a state of emergency.2 While the media initially focused on efforts to address COVID-19 in large cities, many rural communities were working in parallel to prepare. In these rural areas, there was an increasing concern that the burden of COVID-19 may be particularly dire due to factors such as older populations, higher prevalence of chronic diseases and poverty, and less health care access.3-6 Rural clinicians, especially those working in outpatient settings, are caring for patients during the …

Super Learner Analysis Of Real-Time Electronically Monitored Adherence To Antiretroviral Therapy Under Constrained Optimization And Comparison To Non-Differentiated Care Approaches For Persons Living With Hiv In Rural Uganda, Alejandra E. Benitez, Nicholas Musinguzi, David Bangsberg, Mwebesa B. Bwana, Conrad Muzoora, Peter Hunt, Jeffrey N. Martin, Jessica E. Haberer, Maya L. Petersen

OHSU-PSU School of Public Health Faculty Publications and Presentations

Introduction

Real‐time electronic adherence monitoring (EAM) systems could inform on‐going risk assessment for HIV viraemia and be used to personalize viral load testing schedules. We evaluated the potential of real‐time EAM (transferred via cellular signal) and standard EAM (downloaded via USB cable) in rural Uganda to inform individually differentiated viral load testing strategies by applying machine learning approaches.

Methods

We evaluated an observational cohort of persons living with HIV and treated with antiretroviral therapy (ART) who were monitored longitudinally with standard EAM from 2005 to 2011 and real‐time EAM from 2011 to 2015. Super learner, an ensemble machine learning method, …

Sildenafil For The Treatment Of Alzheimer’S Disease: A Systematic Review, Owen Sanders

OHSU-PSU School of Public Health Faculty Publications and Presentations

Nitric oxide/cyclic guanosine monophosphate (cGMP) signaling is compromised in Alzheimer’s disease (AD), and phosphodiesterase 5 (PDE5), which degrades cGMP, is upregulated. Sildenafil inhibits PDE5 and increases cGMP levels. Integrating previous findings, we determine that most doses of sildenafil (especially low doses) likely activate peroxisome proliferator-activated receptor-γ coactivator 1α (PGC1α) via protein kinase G-mediated cyclic adenosine monophosphate (cAMP) response element binding protein (CREB) phosphorylation and/or Sirtuin-1 activation and PGC1α deacetylation. Via PGC1α signaling, low-dose sildenafil likely suppresses β-secretase 1 expression and amyloid-β (Aβ) generation, upregulates antioxidant enzymes, and induces mitochondrial biogenesis. Plus, sildenafil should increase brain perfusion, insulin sensitivity, long-term potentiation, …

Molecular Analysis Of Lymphoid Tissue From Rhesus Macaque Rhadinovirus-Infected Monkeys Identifies Alterations In Host Genes Associated With Oncogenesis, Ryan D. Estep, Aparna N. Govindan, Minsha Manoharan, He Li, Suzanne S. Fei, Byung S. Park, Michael K. Axthelm, Scott Wong

OHSU-PSU School of Public Health Faculty Publications and Presentations

Rhesus macaque (RM) rhadinovirus (RRV) is a simian gamma-2 herpesvirus closely related to human Kaposi’s sarcoma-associated herpesvirus (KSHV). RRV is associated with the development of diseases in simian immunodeficiency virus (SIV) co-infected RM that resemble KSHV-associated pathologies observed in HIV-infected humans, including B cell lymphoproliferative disorders (LPD) and lymphoma. Importantly, how de novo KSHV infection affects the expression of host genes in humans, and how these alterations in gene expression affect viral replication, latency, and disease is unknown. The utility of the RRV/RM infection model provides a novel approach to address these questions in vivo, and utilizing the RRV …