Digital Commons Network^™

State And Regional Variation In Access To Pediatric Extracorporeal Membrane Oxygenation., Allan M. Joseph, Andrew J. Lautz, Carlie N. Myers, Ranjit S. Chima, Juan P. Gurria, Shafee Salloum, Wendy Hasson, Matthew P. Malone, Jenna Miller, Reanna Smith, Maya L. Dewan

Manuscripts, Articles, Book Chapters and Other Papers

Extracorporeal membrane oxygenation (ECMO) is only available in specialized medical centers. We conducted a geospatial analysis and found state- and region-level variation in the supply of ECMO centers, and the number of children who had access to ECMO. These findings may help target areas for the development of new ECMO programs.

Heat And Socioeconomic Deprivation Compound To Drive Coronary Heart Disease In Los Angeles, Shutong Huo, Tessa R. Pulido, Reginald S. Archer, Joshua B. Fisher, Jason A. Douglas

Biology, Chemistry, and Environmental Sciences Faculty Articles and Research

Background:

Socioeconomic deprivation and environmental heat exposure each increase cardiovascular risk, yet evidence is limited on how these stressors co-occur and jointly shape disease burden within cities. Mapping their overlap can inform equity-oriented planning and needs-based allocation of health and social protection resources.

Methods:

We conducted an ecological geospatial analysis of 2,513 census tracts in Los Angeles County. Adult coronary heart disease (CHD) prevalence was obtained from CDC Population Level Analysis and Community Estimates (2021). Socioeconomic deprivation was measured using the Social Deprivation Index (SDI), and heatwave surface heat hazard was measured using land surface temperature (LST) retrieved from the …

Geographic Access To Pediatric Ecmo And Ecpr: A Geospatial Study Of Transport Networks And Disparities., Allan M. Joseph, Andrew J. Lautz, Carlie N. Myers, Ranjit S. Chima, Juan P. Gurria, Shafee Salloum, Wendy Hasson, Matthew P. Malone, Jenna Miller, Maya L. Dewan

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND AND AIM: Extracorporeal membrane oxygenation (ECMO) can help children survive severe cardiac and/or respiratory failure, but it is only provided in specialized centers. There are disparities in access by ground transport to ECMO services, but it is unknown to what extent interfacility transfer systems can expand access. Additionally, the number of children who live in proximity to centers that perform extracorporeal cardiopulmonary resuscitation (ECPR) to be potential candidates in case of out-of-hospital cardiac arrest (OHCA) is unknown. We conducted a geospatial analysis to answer these questions.

METHODS: We conducted a geospatial analysis of the Extracorporeal Life Support Organization (ELSO) …

Preferences Of Health Professions Learners: A Scoping Review Of The Use And Role Of Dces In Health Professions Education, Sarah O'Neal, Natalie Smith, Jan Ostermann Ph.D., Binbin Zheng, Laiton Steele, Chris Gillette

Faculty Publications

While discrete choice experiments (DCE), have increasingly been used in the medical literature, little is known about the use of these methods for eliciting preferences from and about students and trainees in health professions. The objectives of this scoping review are to (1) describe the extent to which DCEs have been used in health professions’ education, (2) identify which health professionals have been studied, and (3) identify thematic areas of research in which these methods have been used thematic areas. Between June and September 2024, we conducted a scoping review of the PubMed/Medline, EconLit, Web of Science, and Global Index …

Sociodemographic Differences In Sepsis-Related Medicare Hospitalizations: A State-Level Analysis Of Diagnosis-Related Groups For Severe Sepsis In 2019 And 2022, Alba Kuqi

College of Graduate Studies: Theses & Dissertations

Introduction: This state-level ecological repeated cross-sectional study examined sociodemographic differences in sepsis-related Medicare hospitalizations assigned to Medicare Severity Diagnosis-Related Groups (MS-DRGs) 871 and 872 in 2019 and 2022.

Objective: The study focused on three outcomes: changes in sepsis-related Medicare discharge volume, changes in average Medicare payment per sepsis discharge, and changes in the proportion of MS-DRG 871 discharges relative to MS-DRG 872 discharges.

Methods: Publicly available Medicare inpatient hospital data and state-level demographic data were used to evaluate whether age, race, gender composition, and median household income were associated with these changes across the 50 U.S. states and …

Environmental Health Risks To Children In Sub-Saharan Africa: A Scoping Review Of Evidence And Gaps In Global Interventions, Tadius C. Chitambwe, Dewi Susanna

Jurnal Epidemiologi Kesehatan Indonesia

Sub-Saharan Africa’s (SSA) children experience a disproportionate burden of environmental health risks, contributing to over half of global under-five deaths despite representing only 27% of live births ¹. This scoping review synthesised evidence from sixty-seven (67) eligible studies (2010–2025) to map out environmental exposures affecting children (0–18 years) in Sub-Saharan Africa, and to identify gaps in global interventions. Included studies focused on children (0-18 years) in SSA, addressed one or more of the four predefined environmental exposure domains (air pollution, WASH, toxic chemicals, climate-related risks), and reported on child health outcomes or interventions. Guided by the PRISMA and Arksey …

Mapping Climatic And Environmental Determinants Of Parasitic Helminth Prevalence In Southeast Asia, Angelica Avisado

UNLV Theses, Dissertations, Professional Papers, and Capstones

Climate change is reshaping environmental conditions across Southeast Asia (SEA) through rising temperatures, altered precipitation patterns, and increased droughts. These changes alter transmission dynamics of neglected tropical diseases (NTDs) by shifting spatial distribution, increasing larval development rates, faster pathogen growth development, and increasing transmission rates. NTDs are a group of preventable and treatable infections that disproportionately affect more than 1 billion people globally, specifically in tropical and subtropical regions. A subgroup of NTDs, parasitic helminth infections (PHIs) - particularly schistosomiasis, soil-transmitted helminths, and lymphatic filariasis remains a public health concern in the Southeast Asian region. PHIs and their ecological responses …

Beyond Smoking: A Geospatial Investigation Of Factors Associated With Lung And Bronchus Cancer Risk In Pennsylvania, Tesla D. Dubois, Daniel Wiese, Kevin A. Henry, Shannon M. Lynch

Kimmel Cancer Center Faculty Papers

INTRODUCTION: While smoking is the leading cause of lung and bronchus cancer (LBC), additional exposures have been implicated and may explain the rise in LBC among never-smokers. To better understand the spatial distribution of LBC incidence and associated risk factors, this study aims to identify geographic areas with significantly elevated incidence rates in Pennsylvania and investigate the potential underlying risk factors.

METHODS: Using cancer registry data aggregated to the census tract level, spatial scan statistics were applied to detect areas of higher-than-expected LBC incidence across the state. Associations were then tested between census tract inclusion in a high-incidence area and …

Temporal Disparities In Diagnosis: The Critical Impact Of Laboratory Workflow Inefficiencies On Outcomes In Metabolic And Cardiovascular Disorders, Evans Dzreke, Celene Dzreke, Ramseyer Adekorang Asamoah, David Kanze

Health & Biomedical Sciences Faculty Publications

Diagnostic delays and laboratory process inefficiencies constitute a common but unaddressed dilemma in contemporary healthcare, quietly undermining patient outcomes in metabolic and cardiovascular illnesses where immediate intervention is critical. This seminal work goes beyond traditional operational viewpoints to demonstrate diagnostic inefficiency as an independent, adjustable risk factor with far-reaching implications. We rigorously quantified the impact of delayed test processing and reporting on clinical outcomes using a comprehensive mixed-methods approach that included multi-center retrospective cohort analysis (N=128,743 patients), real-time workflow mapping across 37 laboratories, in-depth case reviews, and economic modeling. Our findings challenged conventional wisdom by indicating that each 24-hour increase …

Addressing Socioeconomic Disparities In The Treatment Of Antimicrobial-Resistant Infections: The Role Of Pharmacists In Mitigating Barriers, Arin Wade, Danielle Egbujor, Anna Spalvieri, Owen Fox, Marisa Petrunich, Joshua Honaker, Samantha Mccord, Kasie Landin

Pharmacy and Wellness Review

Antimicrobial resistance is an escalating global threat driven by inappropriate antibiotic use and shaped by socioeconomic disparities. Social determinants of health, including limited healthcare access, poverty, low health literacy, and environmental conditions, contribute to higher rates of resistant infections and poorer treatment outcomes in underserved populations. Barriers such as pharmacy deserts, self-medication, and inadequate stewardship infrastructure amplify these risks. Pharmacists, as accessible and highly trained healthcare professionals, play a critical role in combating antimicrobial resistance by optimizing antibiotic use, delivering culturally competent education, and leading antimicrobial stewardship programs across settings. Community and clinical pharmacists are especially well positioned to bridge …

Urban School Neighbourhoods Dominated By Unhealthy Food Retailers And Advertisements In Greater Tunis: A Geospatial Study In The Midst Of The Nutrition Transition, Christelle Akl, Nehmat El-Helou, Gloria Safadi, Aline Semaan, Aya El Sammak, Tarek Trabelsi, Sonia Sassi, Chaza Akik, Jalila El Ati, Pierre Traissac, Hala Ghattas Ph.D.

Faculty Publications

Objective:

Food environments are a major determinant of children’s nutritional status. Scarce evidence on food environments exists in low- and middle-income countries (LMIC). This study aims to fill this gap by documenting the obesogenicity of food environments around schools in Greater Tunis, Tunisia – an LMIC of the Middle East and North Africa region with an ongoing nutrition transition and increasing rates of childhood obesity.

Design:

In this cross-sectional study, we assessed built food environments around fifty primary schools. Ground-truthing was performed to collect geographic coordinates and pictures of food retailers and food advertisement sets within an 800-m road network …

Investigating Interpersonal And Community Drivers Of Taenia Solium Prevention To Reduce Acquired Seizure Disorders In Northern Peru: An Analysis Of Social Networks, Social Capital, And Community-Identified Barriers And Facilitators, Angela Gayle Spencer

Dissertations and Theses

Background: In Northern Peru and other low- and middle-income countries (LMICs) worldwide, the Taenia solium parasite causes an estimated 30% of acquired epilepsy -- an entirely preventable disease burden. Sanitation development and pork production regulation would reduce infection risk in endemic communities, but large-scale systemic improvements are not likely to occur in the near future. In the meantime, communities can reduce infection risk by adopting protective behaviors. Social networks can provide role modeling and support for health-promoting behaviors, and deliver social capital in the form of trusting relationships, norms of reciprocity, and information exchange in support of T. solium control. …

A Geospatial Approach To Identify Patterns Of Antibiotic Susceptibility At A Neighborhood Level In Wisconsin, United States, Laurel Legenza, Kyle Mcnair, Song Gao, James P Lacy, Brooke J Olson, Thomas R Fritsche, Lucas T Schulz, Samantha Lamuro, Frances Spray-Larson, Tahmeena Siddiqui, Warren E Rose

Faculty, Staff and Student Publications

The global threat of antimicrobial resistance (AMR) varies regionally. This study explores whether geospatial analysis and data visualization methods detect both clinically and statistically significant variations in antibiotic susceptibility rates at a neighborhood level. This observational multicenter geospatial study collected 10 years of patient-level antibiotic susceptibility data and patient addresses from three regionally distinct Wisconsin health systems (UW Health, Fort HealthCare, Marshfield Clinic Health System [MCHS]). We included the initial Escherichia coli isolate per patient per year per sample source with a patient address in Wisconsin (N = 100,176). Isolates from U.S. Census Block Groups with less than 30 isolates …

Regional Variations In The Incidence Of Brain Glioma In Adults In Alabama, Mina Lobbous

All ETDs from UAB

Purpose: Gliomas are the most common primary brain tumor in adults in the US with an annual age-adjusted incidence rate of 4.67 to 5.73 per 100,000 persons. Exposure to ioniz-ing radiation is the only established risk factor for non-hereditary glioma risk. There are several sources of carcinogenic contaminants in northeast Alabama and western Georgia with the Coosa River serving as the region’s primary water source. In this study, we aimed to examine the incidence rate of glioma in northeast Alabama compared to the rest of the state as well as the association of possible environmental exposure on disease risk and …

Temporal Geospatial Analysis Of Covid-19 Pre-Infection Determinants Of Risk In South Carolina, Tianchu Lyu, Nicole Hair, Nicholas Yell, Zhenlong Li, Shan Qiao Ph.D., Xiaoming Li Ph.D.

Faculty Publications

Disparities and their geospatial patterns exist in morbidity and mortality of COVID-19 patients. When it comes to the infection rate, there is a dearth of research with respect to the disparity structure, its geospatial characteristics, and the pre-infection determinants of risk (PIDRs). This work aimed to assess the temporal-geospatial associations between PIDRs and COVID-19 infection at the county level in South Carolina. We used the spatial error model (SEM), spatial lag model (SLM), and conditional autoregressive model (CAR) as global models and the geographically weighted regression model (GWR) as a local model. The data were retrieved from multiple sources including …

Temporal Geospatial Analysis Of Covid-19 Pre-Infection Determinants Of Risk In South Carolina, Tianchu Lyu, Nicole L. Hair, Nicholas Yell, Zhenlong Li, Shan Qiao, Chen Liang, Xiaoming Li

Faculty Publications

Disparities and their geospatial patterns exist in morbidity and mortality of COVID-19 patients. When it comes to the infection rate, there is a dearth of research with respect to the disparity structure, its geospatial characteristics, and the pre-infection determinants of risk (PIDRs). This work aimed to assess the temporal–geospatial associations between PIDRs and COVID-19 infection at the county level in South Carolina. We used the spatial error model (SEM), spatial lag model (SLM), and conditional autoregressive model (CAR) as global models and the geographically weighted regression model (GWR) as a local model. The data were retrieved from multiple sources including …

Trends And Opportunities In Tick-Borne Disease Geography, Catherine A. Lippi, Sadie J. Ryan, Alexis L. White, Holly D. Gaff, Colin J. Carlson

Biological Sciences Faculty Publications

Tick-borne diseases are a growing problem in many parts of the world, and their surveillance and control touch on challenging issues in medical entomology, agricultural health, veterinary medicine, and biosecurity. Spatial approaches can be used to synthesize the data generated by integrative One Health surveillance systems, and help stakeholders, managers, and medical geographers understand the current and future distribution of risk. Here, we performed a systematic review of over 8,000 studies and identified a total of 303 scientific publications that map tick-borne diseases using data on vectors, pathogens, and hosts (including wildlife, livestock, and human cases). We find that the …

Geocoding Cryptosporidiosis Cases In Ireland (2008–2017)—Development Of A Reliable, Reproducible, Multiphase Geocoding Methodology, Lisa Domegan, Patricia Garvey, Paul Mckeown, Howard Johnson, Paul Hynds, Jean O'Dwyer, Coilín Óhaiseadha

Articles

Background: Geocoding (the process of converting a text address into spatial data) quality may affect geospatial epidemiological study findings. No national standards for best geocoding practice exist in Ireland. Irish postcodes (Eircodes) are not routinely recorded for infectious disease notifications and > 35% of dwellings have non-unique addresses. This may result in incomplete geocoding and introduce systematic errors into studies.

Aims: This study aimed to develop a reliable and reproducible methodology to geocode cryptosporidiosis notifications to fine-resolution spatial units (Census 2016 Small Areas), to enhance data validity and completeness, thus improving geospatial epidemiological studies.

Methods: A protocol was devised to utilise …

The Dynamics Of Real-Time Online Information And Disease Progression: Understanding Spatial Heterogeneity In The Relationship, Blake Tindol, Utkarsh Shrivastava, Kuanchin Chen

Transactions of the International Conference on Health Information Technology Advancement

The re-emergence of infectious diseases such as measles and polio is creating logistics challenges for the state authorities to curb their spread and contain them. (CL, 2015) Real-time surveillance of infectious diseases is important to detect possible epidemics in advance to prevent shortages of medications (FDA, 2018). The outbreak of an infectious disease creates panic in the community and is accompanied by a sudden increase in the online interest in knowing more about the disease and its symptoms. Prior studies have found a strong relationship between web-based information and disease outbreak but the influence of dynamics of web-based information in …

A Geographic Study Of Lung And Bronchus Cancer Rates In Kentucky, Gabriel Njoh Dikong

Walden Dissertations and Doctoral Studies

The average age-adjusted incidence and mortality rates of lung and bronchus cancer is 55% and 56% higher in Kentucky than the national averages in the United States, respectively. Populations with low income and educational attainment, and those who live close to the mining regions across Kentucky are more affected by the high prevalence and resulting mortality rates of lung and bronchus cancer. This study was conducted because of the high incidence of lung and bronchus cancer and resulting mortality rates in the state of Kentucky that may not be caused solely by social and demographic factors. The theoretical foundation for …

A Geographic Study Of Lung And Bronchus Cancer Rates In Kentucky, Gabriel Njoh Dikong

Walden Dissertations and Doctoral Studies

The average age-adjusted incidence and mortality rates of lung and bronchus cancer is 55% and 56% higher in Kentucky than the national averages in the United States, respectively. Populations with low income and educational attainment, and those who live close to the mining regions across Kentucky are more affected by the high prevalence and resulting mortality rates of lung and bronchus cancer. This study was conducted because of the high incidence of lung and bronchus cancer and resulting mortality rates in the state of Kentucky that may not be caused solely by social and demographic factors. The theoretical foundation for …

Geospatial Analysis Of Spatial Patterns Of U.S. Hospital Readmission Rates, Yamei Wang

Walden Dissertations and Doctoral Studies

Unplanned hospital readmission after a recent hospitalization is an indication of poor healthcare quality and a waste of healthcare resources. The Centers for Medicare and Medicaid Services (CMS) initiated the Hospital Readmission Reduction Program (HRRP) to improve healthcare quality and reduce costs; however, studies found the risk adjustment method used in calculating the standardized readmission rate was less accurate without hospital region or community factors. Accordingly, this cross-sectional quantitative study was designed to examine spatial patterns in hospital readmission rates following Andersen's behavioral model of health service utilization. This study was the first geospatial analysis on risk standardized hospital readmissions …

Utilizing Landsat Tm And Oli In Predicting Oncomelania Hupensis Habitats Around Poyang Lake Before And After Three Gorges Dam Completion, Stephanie L. Mccracken

Honors Theses

Schistosomiasis is a parasitic disease caused by the Schistomsoma japonicum flatworm that utilizes the Oncomelania hupensis snail as an intermediate agent. In the People’s Republic of China, these amphibious snails contaminate freshwater systems infecting humans, bovines, and other mammals and have caused significant morbidity for over two thousand years (Wertheim, et al. 2012; Zhang, et al. 2012.) The gravity of this disease prompted the national government to initiate sizable public health programs, such as the World Bank Loan Project (WBLP.) In spite of WBLP's achievements, in 2004, after this program ended, a national survey acknowledged a resurgence of schistosomiasis in …

Hepatitis B, C Virus And Hiv Co-Infection Among Reported Female Cases In South Carolina, 2004 - 2011: An Epidemiological Analysis Of Pregnancy Outcomes, Afiba Manza-Azele Agovi

Theses and Dissertations

HIV, hepatitis B and C virus (HBV, HCV) are three of the most common blood-borne infections and they continue to be a major public health problem in the United States (US) and globally. It is not well understood if maternal infection with either HBV or HCV has an adverse impact on pregnancy outcomes as findings from previous studies have provided some mixed results. The overall goal of this study was to assess the risk of preterm birth, low birth weight (LBW), small for gestational age (SGA) and admission into neonatal intensive care unit (NICU) for babies born to HBV- and …

Landscape Epidemiology And Machine Learning: A Geospatial Approach To Modeling West Nile Virus Risk In The United States, Sean Gregory Young

Graduate Theses and Dissertations

The complex interactions between human health and the physical landscape and environment have been recognized, if not fully understood, since the ancient Greeks. Landscape epidemiology, sometimes called spatial epidemiology, is a sub-discipline of medical geography that uses environmental conditions as explanatory variables in the study of disease or other health phenomena. This theory suggests that pathogenic organisms (whether germs or larger vector and host species) are subject to environmental conditions that can be observed on the landscape, and by identifying where such organisms are likely to exist, areas at greatest risk of the disease can be derived. Machine learning is …

Developing Risk Assessment Maps For Schistosoma Haematobium In Kenya Based On Climate Grids And Remotely Sensed Data, Kelsey Lee Mcnally

LSU Master's Theses

It is important to be able to predict the potential spread of water borne diseases when building dams or redirecting rivers. This study was designed to test whether the use of a growing degree day (GDD) climate model and remotely sensed data (RS) within a geographic information system (GIS), could be used to predict both the distribution and severity of Schistosoma haematobium. Growing degree days are defined as the number of degrees centigrade over the minimum temperature required for development. The base temperature and the number of GDD required to complete one generation varies for each species. A monthly climate …