Statistics and Probability Commons^™

Use Of Healthcare Utilization Records For Analyzing Trends In Clinical Toxoplasmosis: A Comparison Of Nevada And The United States, Elijah Kreutzer

UNLV Theses, Dissertations, Professional Papers, and Capstones

Toxoplasmosis, a zoonotic disease caused by the parasitic protist Toxoplasma gondii, is a ubiquitous, global public health concern with a wide variety of clinical manifestations. Surveillance for the disease is lacking even in developed countries, and what surveillance is present most often focuses on pregnant women. This research investigated trends in clinical toxoplasmosis in Nevada and nationally to address the lack of knowledge concerning how Nevada discharges compare to national discharges in cases of toxoplasmosis. Specifically, this research sought to determine what characterizes toxoplasmosis in Nevada across inpatient, outpatient, and emergency department settings, as well as how these cases differ …

Impact Of Neoantigen Expression And T-Cell Activation On Breast Cancer Survival, Wenjing Li, Amei Amei, Francis Bui, Saba Norouzifar, Lingeng Lu, Zuoheng Wang

Mathematical Sciences Faculty Research

Neoantigens are derived from tumor-specific somatic mutations. Neoantigen-based syn-thesized peptides have been under clinical investigation to boost cancer immunotherapy efficacy. The promising results prompt us to further elucidate the effect of neoantigen expression on patient survival in breast cancer. We applied Kaplan–Meier survival and multivariable Cox regression models to evaluate the effect of neoantigen expression and its interaction with T-cell activation on overall survival in a cohort of 729 breast cancer patients. Pearson’s chi-squared tests were used to assess the relationships between neoantigen expression and clinical pathological variables. Spearman correlation analysis was conducted to identify correlations between neoantigen expression, mutation …

Does Social Support Moderate The Association Between Income And Food Security Status Among Seniors Living In Southern Nevada?, Adugna Teka Siweya

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Income is the strongest predictor of food insecurity among seniors, and social support also an essential factor to help mitigate the effects of food insecurity. However, little is known about the potential role that social support may play as a moderator of the association between income and food insecurity. Thus, we aim to examine social support as a moderator for the relationship between income and food insecurity among seniors. Methods: Logistic regression models were used to analyze data collected in 2019 from seniors residing in Southern Nevada. Predictors of food insecurity, sociodemographic factors, social support variables, and income and …

Food Insecurity And Adiposity Among Children And Adults Nhanes 2015-2016, Denise Vidal

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Obesity is a preventable disease that has been associated with many adverse health outcomes. A possible factor that may influence adiposity development is food insecurity. Although several epidemiological studies have been conducted examining the association between food insecurity and adiposity among children and adults, results have been inconsistent. Objective: This cross-sectional study investigates the relationship between food insecurity and adiposity among children and adults using recent data from a representative sample of the US population. Methods: We examined 3,391 adults and 2,837 children from the National Health and Nutrition Examination Survey (NHANES) 2015-2016. Household food insecurity was assessed using …

Addressing The Ecological Fallacy With Lagrangian Inference, Michael Schwob

Calvert Undergraduate Research Awards

Most epidemiologists elect to use statistical models that use population-level data to make inference on the spread of some virus or disease. This has become commonplace in the fields of epidemiology and biostatistics since most data used to construct and verify epidemic models are recorded at the population-level. Obtaining inference from a population-level model may be beneficial in studying the spread of disease in a homogeneous population, but the use of such models to describe a heterogeneous population results in inadequate inference. The inaccuracy of these models is further amplified when one tries to make individual-level inference from these population-level …

Gardasil Vaccine Trends Within Nevada, California, And The U.S.: A Comparative Study, Karen S. Gutierrez

UNLV Theses, Dissertations, Professional Papers, and Capstones

Despite decreasing incidence in cervical cancer in the U.S., there continues to be an increase in public health concern for cervical cancer worldwide. Recent studies report that individuals are disproportionately affected based on region, sex, and race. Additionally, the human papillomavirus (HPV) attributable cancers may be reduced between 70% and 90% through the universal use of HPV-vaccines. In order to expand current knowledge and implement intervention programs in Nevada, it is critical to examine the associations among the Gardasil vaccine, cervical cancer screening, and adverse events following immunization as well as to understand the different socio-demographic subgroups affected. To our …

Tricyclic Antidepressant Use And Risk Of Fractures: A Meta-Analysis Of Cohort Studies Through The Use Of Both Frequentist And Bayesian Approaches, Qing Wu, Yingke Xu, Yueyang Bao, Jovan Alvarez, Mikee Lianne Gonzales

School of Medicine Faculty Publications

Background: Research findings regarding the association between tricyclic antidepressant (TCA) treatment and the risk of fracture are not consistent; we aimed to assess whether people who take TCAs are at an increased fracture risk. Methods: Relevant studies published through June 2020 were identified through database searches of MEDLINE, EMBASE, Scopus, PsycINFO, ISI Web of Science, WorldCat Dissertations and Theses from each database’s inception, as well as through manual searches of relevant reference lists. Two researchers independently performed literature searches, study selection, data abstraction and study appraisal by using a standardized protocol. Frequentist and Bayesian hierarchical random-effects models were used for …

Interplay Of Trna-Derived Fragments And T Cell Activation In Breast Cancer Patient Survival, Nayang Shan, Ningshan Li, Qile Dai, Lin Hou, Xiting Yan, Amei Amei, Lingeng Lu, Zuoheng Wang

Mathematical Sciences Faculty Research

Effector CD8+ T cell activation and its cytotoxic function are positively correlated with improved survival in breast cancer. tRNA-derived fragments (tRFs) have recently been found to be involved in gene regulation in cancer progression. However, it is unclear how interactions between expression of tRFs and T cell activation affect breast cancer patient survival. We used Kaplan–Meier survival and multivariate Cox regression models to evaluate the effect of interactions between expression of tRFs and T cell activation on survival in 1081 breast cancer patients. Spearman correlation analysis and weighted gene co-expression network analysis were conducted to identify genes and pathways that …

Utility Of Inflammatory Markers To Predict Adverse Outcome In Acute Pancreatitis: A Retrospective Study In A Single Academic Center, Mohamad Mubder, Banreet Dhindsa, Danny Nguyen, Syed Saghir, Chad Cross, Ranjit Makar, Gordon Ohning

School of Medicine Faculty Publications

Background/Aim: Acute pancreatitis (AP) is a commonly encountered emergency where early identification of complicated cases is important. Inflammatory markers like lymphocyte to monocyte ratio (LMR) and neutrophil to lymphocyte ratio (NLR) are simple and readily available markers. In this study, we evaluated the utility of these markers in the early identification of patients with complicated AP. Patients and Methods: All patients with a diagnosis of AP admitted to the University Medical Center in Las Vegas/Nevada between August 2015 and September 2018 were identified using ICD-10 codes. Medical records were reviewed retrospectively. Epidemiological measures and their associated confidence intervals were calculated …

Physical Therapy Nontreatment Events With Primary Physical Therapist, Stephen Johnson

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Physical therapy improves prognosis reduces stay and is generally helpful in aiding recovery from a wide range of ailments. Nontreatment rates occur for multiple reasons and are also related to the personalities of physical therapists.

Methods: We used data from a research project involving physical therapy at an acute care facility in our community. Our study focused on the retrospectively determined primary physical therapist for each patient. We used the chi-squared tests to compare nontreatment rates between days of the week and disease type and the reasons for nontreatment events. Repeated-measure models were used to evaluate the effect of …

Evaluating Parents Sociodemographic Factors And Childhood Vaccine Decisions, Mehret Girmay

UNLV Theses, Dissertations, Professional Papers, and Capstones

Vaccination is considered one of the most successful public health achievements of the 20th century. However, with increasing vaccine skepticism emerging over the past decades, there is a threat to the ongoing sustainment of vaccine coverage within all US communities. This study evaluated and compared parents’ sociodemographic factors associated with childhood vaccine decisions. This study is a secondary analysis of 893 parents/guardians, age 18-55 years with child(ren) < 7 years living in the U.S.

Predictive analysis was conducted using multinomial logistic regression modeling was used to examine vaccine decisions (accept, hesitant, and refuse) in relation to parents’ sociodemographic factors. Overall, (66.6%) of parents accepted recommended vaccines, while …

Trends And Disparities In Self-Reported And Measured Osteoporosis Among Us Adults, 2007-2014., Qing Wu, Yingke Xu, Ge Lin

Environmental & Occupational Health Faculty Publications

(1) Background: Studies examining osteoporosis trends among US adults by different socioeconomic status (SES) are limited. The prevalence of self-reported osteoporosis in the US is rarely reported. (2) Methods: Data from the National Health and Nutritional Examination Survey (NHANES) between 2007–2008 and 2013–2014 cycles were analyzed. Age-adjusted prevalence of self-reported and that of measured osteoporosis were calculated overall and by sex, race/ethnicity, education attainment, and SES. (3) Results: The prevalence of self-reported osteoporosis was higher than that of measured osteoporosis in all three survey cycles for women, and in 2007–2008 and 2009–2010 for men. Participants with high school/GED or higher …

Factors Associated With Eosinophilic Esophagitis In Nevada, Julia Lorraine Anderson

UNLV Theses, Dissertations, Professional Papers, and Capstones

Eosinophilic esophagitis (EoE) is a rare immune-mediated illness with symptoms that range from difficulty swallowing to food impaction of the esophagus. Most published studies have been documented among patients residing in cool regions with significant annual rainfall. No published studies to our knowledge have been performed examining the healthcare utilization trends of EoE in Nevada. Utilizing two unique databases, the factors associated with EoE healthcare utilization patterns in Nevada were examined. All analyses were performed in R version 3.5.1. This study included a demographic and regional analysis identifying risk factors associated with having an EoE healthcare visit in Nevada. Several …

Health Disparities Among Sexual And Gender Minorities, Jennifer Keeley

UNLV Theses, Dissertations, Professional Papers, and Capstones

Decades of research has shown that sexual and gender minorities (SGMs) experience adverse health and mental health outcomes to a greater extent than their heterosexual peers. The need to better understand and eliminate health disparities in the SGM population was recognized by the National Institute on Minority Health and Health Disparities (NIMHD) at NIH. The Secretary of Health at the Department of Health and Human Services approved the designation of the SGM population as a health disparities population in 2016 and called for SGM studies to examine the health needs of the SGM population across SGM subgroups via large representative …

Telomeres, Nutrition And Mortality: Risk Factors For The Rate Of Telomere Length Decline And The Associations Between Telomere Length, Nutrition And Mortality, Saruna Ghimire

UNLV Theses, Dissertations, Professional Papers, and Capstones

Introduction: Telomeres are nucleoprotein structures located at the ends of eukaryotic chromosomes, thought to protect the DNA from damage. As a person experiences stressors, harmful exposures, and other diseases throughout their life, telomeres are thought to become damaged and their length shortened, decreasing their ability to protect the DNA. Nutrition is an important aspect of healthy aging. Preservation of telomere length (TL) is thought to be one of the mechanisms by which good nutrition can delay or prevent the development of chronic disease and death. Recent evidence of preservation of TL with good nutrition is promising. Thus, the aim of …

An Analysis Of Postmastectomy Breast Reconstruction Due To Breast Cancer In Nevada And The United States From 2008-2013, Jenna Webb

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: In the United States, female breast cancer was the leading cause of new cancer cases from 2011-2015. Since the Women’s Health and Cancer Act of 1998 (WHCRA), the federal government mandates employee and private health insurance providers to cover breast reconstruction if they cover mastectomies. Postmastectomy breast reconstruction (PBR) rates increased after the WHCRA, but these rates have remained relatively low throughout recent years. Objective: The objective of this study was to determine factors associated with women having PBR due to breast cancer in Nevada and the United States from 2008 to 2013. Methods: Using two HCUP database, NIS …

Prostate Cancer Survival Among Hispanics: A Surveillance, Epidemiology, And End Results (Seer) Population-Based Cohort Study, David Rivas

UNLV Theses, Dissertations, Professional Papers, and Capstones

Hispanics are now the youngest, largest, and fastest growing minority group in the U.S. Prostate cancer (PC) is the most commonly diagnosed cancer in men and is the second-leading cause of cancer deaths among Hispanics. For the first time, we examined PC-specific survival among distinct Hispanic groups that include Mexicans, Cubans, Dominicans, Puerto Ricans, as well as Central and South Americans. We compared these groups to the main reference population in the U.S., non-Hispanic Whites (NHW), after adjustment for prognostic factor risk categories (prostate-specific antigen (PSA) level, Gleason score, and tumor stage), as well as sociodemographic covariates (e.g., health insurance, …

The Role Of Pre-Existing Type 2 Diabetes Mellitus In Colorectal Cancer Stage And Survival In Elderly Americans: A Seer-Medicare Population-Based Study 2002-~2011, Sanae El Ibrahimi

UNLV Theses, Dissertations, Professional Papers, and Capstones

Diabetes is a common comorbid condition among colorectal cancer (CRC) patients, yet its effects in CRC outcomes, particularly stage at diagnosis, risk of death and variations by diabetes severity (complications vs no complications) and Hispanic ethnicity have not been adequately studied. The purpose of this study was to investigate the association between pre-existing T2DM and advanced stage at diagnosis in elderly patients with CRC; to examine whether diabetes is an independent predictor of poor survival from all-cause and CRC-specific mortality; to assess whether variations exist by diabetes severity and to analyze the outcomes for the Hispanic group.

The Surveillance Epidemiology …

The Impact Of Economic Recession On The Health Of Adult Nevadans, Ariana Goertz

UNLV Theses, Dissertations, Professional Papers, and Capstones

Recessions are generally considered to cause negative consequences, but recent studies have provided evidence that some health outcomes improve as the economy deteriorates. The relationship between economic downfalls and health is not straightforward; it is important to look at how health has been impacted in one of the areas hit hardest by the recession. Las Vegas, Nevada was previously considered recession-proof, seemingly unaffected by previous economic downturns exhibited by the rest of the country. However, during the Great Recession of 2007-2009, Las Vegas led the country in highest rates of unemployment and foreclosures. This was quite a collapse for a …

Does Educational Level Influence Postmenopausal Breast Cancer Mortality Among Asians In U.S.?, Sfurti Maheshwari

UNLV Theses, Dissertations, Professional Papers, and Capstones

Studies on mortality from postmenopausal breast cancer (PMBC) by education level have not shown consistent results among US women. For US Asians, often seen as a “model” minority in terms of affluence and education this relationship has never been studied despite PMBC being the most common cancer in the country.

We analyzed 2008-2012 California Vital Statistics data and population data from the American Community Survey 2012 to compute age and education adjusted mortality ratios using negative binomial regression model for White (as a reference category) and Asian women. In total 3,277,106 (80%) White women and 852,376 (20%) Asian women died …

The Role Of Functional, Social, And Mobility Dynamics In Facilitating Older African Americans Participation In Clinical Research, Eve T. Shapiro, Jay T. Schamel, Kimberly A. Parker, Laura A. Randall, Paula M. Frew

Environmental & Occupational Health Faculty Publications

Purpose: Older African Americans experience disproportionately higher incidence of morbidity and mortality related to chronic and infectious diseases, yet are significantly underrepresented in clinical research compared to other racial and ethnic groups. This study aimed to understand the extent to which social support, transportation access, and physical impediments function as barriers or facilitators to clinical trial recruitment of older African Americans. Methods: Participants (N=221) were recruited from six African American churches in Atlanta and surveyed on various influences on clinical trial participation.

Phase I Dose-Escalation Trial Of Intravaginal Curcumin In Women For Cervical Dysplasia, Leda Gattoc, Paula M. Frew, Shontell N. Thomas, Kirk A. Easley, Laura Ward, H-H Sherry Chow, Chiemi A. Ura, Lisa Flowers

Environmental & Occupational Health Faculty Publications

Background: This is a Phase I trial demonstrating safety and tolerability of intravaginal curcumin for future use in women with cervical neoplasia. Objective: The objective of this study was to assess the safety, tolerability, and pharmacokinetics of intravaginal curcumin in healthy women. Study design: We conducted a 3+3 dose-escalation Phase I trial in a group of women aged 18–45 years. Thirteen subjects were given one of four doses of curcumin powder (500 mg, 1,000 mg, 1,500 mg, and 2,000 mg) packed in gelatin capsules, which was administered intravaginally daily for 14 days. The primary end point for this study was …

Research On Problem Gambling Websites, Chang Boon Patrick Lee

International Conference on Gambling & Risk Taking

This is a continuation of a series of studies on problem gambling websites. It has been noted in prior studies that one avenue problem gamblers might look for help was to go online to perform a web search. Online help is practical as help can be located immediately and this can help to ease the gamblers’ concerns that they are left alone to handle their own problems. While there are some anecdotal evidences regarding the success of problem gambling websites, there have been few empirical studies that relate directly to the perceptions and usefulness of the websites for the problem …

A Public Health-Based Approach To German Gaming Regulation, Knut Walter, Gerhard Buehringer

International Conference on Gambling & Risk Taking

The current situation of the German gambling market can be characterized by an unrelated framework of different legal systems, different regulatory authorities and different control principles, and has led to (1) an increasing number of court decisions and information requests by European Commission questioning parts of that regulatory system, (2) public tolerance of illicit gambling, and consequently (3) a lack of consumer protection.

Taking RENO Model 1.0 and 2.0 seriously, a new and comprehensive regulatory framework based on common consumer protection standards for all types of gambling – land-based and online, state-owned and private operated – has been developed and …

Mandatory Pre-Commitment Loss Limits: Six Years’ Experience Shows It Works, Bjorn H. Hoffmann

International Conference on Gambling & Risk Taking

The Norwegian state owned company Norsk Tipping is a pioneer in the gambling indusrty with its secure player identification and mandatory registered play across all channels. Knowing who your player is and having a strong link between the player and his consumption of games across all channels (land based, EGM, web and mobile) is an important premise for having a credible responsible gaming platform.

Norsk Tipping introduced in 2009 EGM’s with both pre commitment tools and maximum loss limits. In 2014 we introduced our Internet casino with probably the best responsible gambling platform in the world, including mandatory loss limits. …

An Empirical Evaluation Of The Clubsnsw (Australia) Multi-Venue Self-Exclusion Program, Dylan A. Pickering, Alexander Blaszczynski, Sally Gainsbury, Rowan Cameron

International Conference on Gambling & Risk Taking

Few empirical studies have evaluated the effectiveness of self-exclusion programs. Research is required to identify factors contributing to decisions to enter and/or breach self-exclusion orders, or to self-excluded gamblers to seek additional treatment. Clinical characteristics of self-excluders remain relatively unknown in addition to factors that differentiate gamblers who do or do not breach. Limitations of current programs are that gamblers can self-exclude from only one or a limited number of venues. The Multi-venue Self-exclusion program, developed and implemented by ClubsNSW (Australia), is a centralised web-based system designed to help problem gamblers self exclude from up to 35 venues at a …

Monitoring Gambling Impacts In Massachusetts: Honing Strategies And Preventing Harm, Rachel A. Volberg, Amanda Houpt

International Conference on Gambling & Risk Taking

In November 2011, an Act Establishing Expanded Gaming in the Commonwealth of Massachusetts was signed into law (Chapter 194 of the Acts of 2011). This legislation permits casinos and slot parlors in Massachusetts under the regulatory auspices of the Massachusetts Gaming Commission (MGC). Section 71 of the Expanded Gaming Act requires the MGC to establish an annual research agenda to assist in understanding the effects of casino gambling in Massachusetts and in minimizing the negative impacts. Research activities launched thus far include a comprehensive study of the social and economic impacts of casino gambling in Massachusetts (SEIGMA), a cohort study …

Best Practices For Self-Exclusion Reinstatement And Renewal, Alex Price

International Conference on Gambling & Risk Taking

While many studies have examined self-exclusion few have focused on the processes through which gamblers return at the end of their agreements. In 2014, the RGC Centre for the Advancement of Best Practices examined voluntary self-exclusion reinstatement and renewal in an effort to develop evidence-informed best-practices for both land-based and online gambling operations. The presentation outlines the findings of the study and the recommended best practices for reintegration and ban renewal.

The study examined a range of practices around the world. In the end the study recommended an active reinstatement process in which all participants are required to apply to …

A Behavioural Account Of Mobile Gambling, Richard James, Richard Tunney, Claire O'Malley

International Conference on Gambling & Risk Taking

Mobile gambling is an emerging market in which there is evidence that some gamblers are introduced to gambling through their mobile device, and that mobile gambling does not ‘cannibalise’ participation with other forms of gambling. There is a concern that mobile gamblers face distinct risks from other forms of gambling, particularly for harmful behaviours. This paper presentation outlines a behavioural account of mobile gambling that combines both the learned characteristics of problem gambling with how individuals interact with their mobile devices. This hypothesizes that the extended gaps between plays or sessions potentially attracts extended play, even in the face of …

Ready, Set, And Go Back: The Role Of The Judiciary In Brazil’S Bingo Ban, Luiza Jobim Llm, Toni Williams

International Conference on Gambling & Risk Taking

Brazil, the host of the 2014 World Cup and the 2016 Olympics, is known for strong competitive traditions in sports and games. It is also one of only three G-20 countries (together with Saudi Arabia and Indonesia) that currently bans non-state provision of gambling products. Bingo was a notable exception to this prohibition, after enabling legislation was enacted in 1993, with the intention that proceeds would help fund national sports development. The game quickly became very popular but there were persistent questions about, and contestations over, the capacity of the regulatory framework to control the dual risks of exploitation of …