Digital Commons Network^™

Large-Bore Mechanical Thrombectomy Versus Catheter-Directed Thrombolysis In The Management Of Intermediate-Risk Pulmonary Embolism: Primary Results Of The Peerless Randomized Controlled Trial, Wissam Jaber, Carin Gonsalves, Stefan Stortecky, Samuel Horr, Orestis Pappas, Ripal Gandhi, Keith Pereira, Jay Giri, Sameer Khandhar, Khawaja Afzal Ammar, David Lasorda, Brian Stegman, Lucas Busch, David Dexter, Ezana Azene, Nikhil Daga, Fakhir Elmasri, Chandra Kunavarapu, Mark Rea, Joseph Rossi, Joseph Campbell, Jonathan Lindquist, Adam Raskin, Jason Smith, Thomas Tamlyn, Gabriel Hernandez, Parth Rali, Torrey Schmidt, Jeffrey Bruckel, Juan Camacho, Jun Li, Samy Selim, Catalin Toma, Sukhdeep Singh Basra, Brian Bergmark, Bhavraj Khalsa, David Zlotnick, Jordan Castle, David O'Connor, C. Michael Gibson

Department of Radiology Faculty Papers

BACKGROUND: There are a lack of randomized controlled trial data comparing outcomes of different catheter-based interventions for intermediate-risk pulmonary embolism.

METHODS: PEERLESS is a prospective, multicenter, randomized controlled trial that enrolled 550 patients with intermediate-risk pulmonary embolism with right ventricular dilatation and additional clinical risk factors randomized 1:1 to treatment with large-bore mechanical thrombectomy (LBMT) or catheter-directed thrombolysis (CDT). The primary end point was a hierarchal win ratio composite of the following (assessed at the sooner of hospital discharge or 7 days after the procedure): (1) all-cause mortality, (2) intracranial hemorrhage, (3) major bleeding, (4) clinical deterioration and/or escalation to …

Infection-Related Hospitalization And Incident Heart Failure: The Atherosclerosis Risk In Communities Study, Rebecca L Molinsky, Amil Shah, Melana Yuzefpolskaya, Bing Yu, Jeffrey R Misialek, Bruno Bohn, David Vock, Richard Maclehose, Barry A Borlaug, Paolo C Colombo, Chiadi E Ndumele, Junichi Ishigami, Kunihiro Matsushita, Pamela L Lutsey, Ryan T Demmer

Faculty, Staff and Student Publications

Background: The immune response to infections may become dysregulated and promote myocardial damage contributing to heart failure (HF). We examined the relationship between infection-related hospitalization (IRH) and HF, HF with preserved ejection fraction, and HF with reduced ejection fraction.

Methods and results: We studied 14 468 adults aged 45 to 64 years in the ARIC (Atherosclerosis Risk in Communities) Study who were HF free at visit 1 (1987-1989). IRH was identified using select International Classification of Diseases (ICD) codes in hospital discharge records and was treated as a time-varying exposure. HF incidence was defined as the first occurrence …

A Randomized, Double-Blind, Placebo-Controlled Trial Of Il-7 In Critically Ill Patients With Covid-19, Manu Shankar-Hari, Bruno Francois, Kenneth E Remy, Cristina Gutierrez, Stephen Pastores, Thomas Daix, Robin Jeannet, Jane Blood, Andrew H Walton, Reinaldo Salomao, Georg Auzinger, David Striker, Robert S Martin, Nitin J Anand, James Bosanquet, Teresa Blood, Scott Brakenridge, Lyle L Moldawer, Vidula Vachharajani, Cassian Yee, Felipe Dal-Pizzol, Michel Morre, Frederique Berbille, Marcel Van Den Brink, Richard Hotchkiss

Faculty, Staff and Student Publications

Background: Lymphopenia and failure of lymphocytes to mount an early IFN-γ response correlate with increased mortality in COVID-19. Given the essential role of CD4 helper and CD8 cytotoxic cells in eliminating viral pathogens, this profound loss in lymphocytes may impair patients' ability to eliminate the virus. IL-7 is a pleiotropic cytokine that is obligatory for lymphocyte survival and optimal function.

Methods: We conducted a prospective, double-blind, randomized, placebo-controlled trial of CYT107, recombinant human IL-7, in 109 critically ill, patients with lymphopenia who have COVID-19. The primary endpoint was to assess CYT107's effect on lymphocyte recovery with secondary clinical endpoints including …

Multimorbidity And Peak Oxygen Uptake In Patients Undergoing Cardiac Rehabilitation, Pauline F. Gomes, Audry Chacin-Suarez, Sophie A. Miller, Karen M. Fischer, Thomas P. Olson

Einstein Health Papers

No abstract provided.

Spending Changes After Moving To Areas With Greater Aco Participation Among Nonattributed Medicare Beneficiaries, Yucheng Hou, Marisa Elena Domino, Valerie A Lewis, Qing Gong, Kevin Callison, Justin G Trogdon

Faculty, Staff and Student Publications

IMPORTANCE: Accountable care organizations (ACOs) under the Medicare Shared Savings Program have long been envisioned as a pathway to improved care efficiency and quality of care for all Medicare beneficiaries. However, little is known about whether the changes in health care spending associated with ACOs have extended beyond ACO-attributed Medicare beneficiaries to all Medicare beneficiaries.

OBJECTIVE: To estimate spending changes by non-ACO-attributed Medicare beneficiaries after moving to geographic areas with greater ACO participation.

DESIGN, SETTING, AND PARTICIPANTS: This repeated cross-sectional study analyzed claims from a 20% representative sample of all Medicare beneficiaries, aged 65 to 99 years, from 2009 to …

Sleep Trajectories And All-Cause Mortality Among Low-Income Adults, Kelsie M Full, Hui Shi, Loren Lipworth, Lawrence T Dauer, Michael T Mumma, Qian Xiao

Faculty, Staff and Student Publications

IMPORTANCE: Short and long sleep durations are adversely associated with cardiovascular disease (CVD), type 2 diabetes, and mortality. It remains unclear how sleep duration trajectories over time are associated with mortality and whether these associations vary by well-documented sex, race, and socioeconomic sleep disparities.

OBJECTIVE: To investigate the association of 5-year sleep duration trajectories with all-cause and cause-specific mortality among US adults, predominantly those in low-income groups.

DESIGN, SETTING, AND PARTICIPANTS: The Southern Community Cohort Study included participants aged 40 to 79 years recruited and enrolled (from March 2002 to September 2009) from community health centers by using random sampling …

Validation Of A Novel Landmark-Guided Intra-Articular Postero-Medial Surgeon-Administered Injection Technique, Nicolas Piuzzi, Andrew Spitzer, Jason Mussell, Ignacio Pasqualini, Stan Dysart, Jeffrey Gonzales, Michael Mont, Jess H. Lonner, Md, William Mihalko

Rothman Institute Papers

BACKGROUND: This study aimed to define an intra-articular surgeon-administered technique that may be comparable to ultrasound (US)-guided adductor canal block (ACB).

METHODS: Five cadaver lower limbs were examined. An anesthesiologist administered a US-guided ACB using 20 mL of dilute indocyanine dye. An orthopedic surgeon performed a medial parapatellar arthrotomy and introduced an 18-gauge needle 1-2 cm proximal to the palpated adductor tubercle angled posteromedially. Needle position and dye spread were fluoroscopically documented.

RESULTS: This technique consistently reached the infrapatellar branch of the saphenous nerve, nerve to the vastus medialis muscle, and posterior capsule, with minimal proximal dye spread.

CONCLUSIONS: This …

Unveiling The Pathophysiology Of Hpv And Cervical Cancer, Yazeth Gonzalez, Maria F. Lozano Bonilla, Maria Camila Gonzalez Tovar, Bria Okere

MEDI 9331 Scholarly Activities Clinical Years

Background: Human papillomavirus (HPV) is a sexually transmitted infection that causes HPV-associated diseases such as vaginal, penile, cervical, and oropharyngeal cancer. Each year in the United States, about 13,000 cases of cervical cancer develop, and an estimated 4,000 deaths are attributed to it. Approximately 35,000 of U.S. citizens develop an HPV-related cancer every year. There are disparities in the incidence and mortality of cervical cancer across ethnicities, socioeconomic statuses, and regions. In the United States, Hispanic individuals comprise only 18% of the population, yet Hispanic women have the highest incidence of cervical cancer. The Rio Grande Valley’s (RGV) cervical cancer …

The Global Epidemiology And Health Burden Of The Autism Spectrum: Findings From The Global Burden Of Disease Study 2021, Global Burden Of Disease Study 2021 Autism Spectrum Collaborators, Lourdes Bernadette Tanchanco, Angel Belle Dy

Ateneo School of Medicine and Public Health Publications

Background

High-quality estimates of the epidemiology of the autism spectrum and the health needs of autistic people are necessary for service planners and resource allocators. Here we present the global prevalence and health burden of autism spectrum disorder from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 following improvements to the epidemiological data and burden estimation methods.

Methods

For GBD 2021, a systematic literature review involving searches in PubMed, Embase, PsycINFO, the Global Health Data Exchange, and consultation with experts identified data on the epidemiology of autism spectrum disorder. Eligible data were used to estimate prevalence …

Prevalence And Correlates Of Depressive And Anxiety Symptoms Among Pregnant Women From An Urban Informal Settlement In Nairobi, Kenya: A Community-Based Cross-Sectional Study, Stephen Mulupi, Amina Abubakar, Moses Nyongesa, Vibian Angweny, Margaret Kabue, Paul Mwangi, Rachel Odhiambo, Joyce Marangu, Eunice Njoroge, Mercy Mokaya, Emmanuel Obulemire, Eunice Ombech, Kofi Marfo

Institute for Human Development, East Africa

Purpose: Previous research, largely from the Global North, reports high rates of common mental health disorders among women in the antenatal period, but there is paucity of such data in contexts like Kenya. This study investigated the prevalence and correlates of depressive and anxiety symptoms among pregnant women in an urban informal settlement in Kenya’s capital – Nairobi.

Method: An analysis of baseline cross-sectional data from a pilot cluster randomized trial of an integrated early childhood development programme. Participants were pregnant women in their third pregnancy trimester (N = 249), residing in an urban informal settlement in Nairobi County. Mental …

Air Pollution Exposures In Early Life And Brain Development In Children (Abc): Protocol For A Pregnancy Cohort Study, Sarah Benki-Nugent, Faridah H. Were, Anne M Riederer, Michael Gatari, Cj Karr, Edmund Yw Seto, Beatrice C. Mutai, Susan Wamithi, Brent R. Collett, John Kinuthia

Paediatrics and Child Health, East Africa

Introduction Air pollution is linked with poor neurodevelopment in high-income countries. Comparable data are scant for low-income countries, where exposures are higher. Longitudinal pregnancy cohort studies are optimal for individual exposure assessment during critical windows of brain development and examination of neurodevelopment. This study aims to determine the association between prenatal ambient air pollutant exposure and neurodevelopment in children aged 12, 24 and 36 months through a collaborative, capacity-enriching research partnership.

Methods and analysis This observational cohort study is based in Nairobi, Kenya. Eligibility criteria are singleton pregnancy, no severe pregnancy complications and maternal age 18 to 40 years. At …

Post-Term Births As A Risk Factor For Small For Gestational Age Births And Infant Mortality In Brazil, Mexico, And Palestinian Refugees: An Analysis Of Electronic Birth Records, Zeina Jamaluddine, Lorena Suarez Idueta, Enny S. Paixao, Julia M. Pescarini, Hala Ghattas Ph.D., Miho Sato, Akihiro Seita, Luis A. Martinez-Juarez, Mauricio L. Barreto, Eric O. Ohuma, Louise T. Day, Oona M.R. Campbell, Hannah Blencowe

Faculty Publications

Background:

Post-term pregnancy, defined as reaching or exceeding 42 + 0 weeks of gestation, is known to be associated with unfavourable birth outcomes. High-income countries have responded to this risk by widely adopting labour induction protocols in late-term, but many low- and middle-income countries have not. However, understanding underlying mechanisms linking post-term births to adverse newborn and infant outcomes remains limited.

Objective:

To investigate the (a) prevalence of post-term, (b) the risk factors associated with post-term (c) the association between post-term births and the risk of small-for-gestational-age (SGA) neonates and of infant mortality in middle-income settings.

Methods:

We used existing …

Evaluating Donor-Recipient Sex Mismatch In Anterior Cruciate Ligament Reconstruction With Allograft: Outcomes At 2 Years Postoperatively, Connor Crutchfield, Natalie Lowenstein, Chilan Leite, Christian Lattermann, Elizabeth Matzkin

SKMC Student Presentations and Publications

BACKGROUND: Female patients tend to suffer a greater risk of reinjury and worse patient-reported outcome measures (PROMs) after anterior cruciate ligament reconstruction (ACLR) than male patients, regardless of the graft type used.

PURPOSE/HYPOTHESIS: This study explored the role of donor-recipient sex mismatching to help explain these sex-based dispar- ities in outcomes after ACLR with an allograft. The hypothesis was that allograft donor-recipient sex mismatch would adversely affect surgical outcomes at a 2-year follow-up, with male-to-female graft donations yielding the lowest rates of success.

STUDY DESIGN: Cohort study; Level of evidence, 3.

METHODS: Patients who underwent primary ACLR with an allograft …

Exploring Access To Care In Zimbabwe Using The 3-Delay Model, Katerina Green, Naboth Matinhira, Amiti Jain, Tissiana Vallecillo, Priya Arya, Estephania Candelo, Munyaradzi Katiro, Tafadzwa Nyamurowa, Dontre' Douse, Joshua Wiedermann

SKMC Student Presentations and Publications

OBJECTIVES: We aim to identify the diversity of barriers to care for otolaryngology-head and neck surgery patients in Harare, Zimbabwe.

METHODS: Interviews were conducted at four general otolaryngology clinics in Harare in October 2022.The patient population included children and adults presenting to either government or private clinics. Via interpreter, six standardized questions were discussed with each patient. Survey responses were used to categorize patients into one or more of three types of delays: (1) deciding to seek care, (2) reaching the appropriate healthcare facility, and (3) receiving adequate care after reaching that facility.

RESULTS: Forty-six patients participated in this survey. …

Hypoalbuminemia And Postoperative Outcomes Following Major Salivary Gland Resection, Praneet C. Kaki, Aman M. Patel, Jason A. Brant, Steven B. Cannady, Karthik Rajasekaran, Robert M. Brody, Ryan M. Carey

SKMC Student Presentations and Publications

OBJECTIVE: Hypoalbuminemia (HA) is a proxy for malnutrition that has been associated with postoperative complications in several surgical subspecialties. This study investigates the association between pre-operative HA and complications following major salivary gland (MSG) resection.

METHODS: Patients undergoing outpatient, elective MSG resection were extracted from the 2005 to 2020 National Surgical Quality Improvement Program database. Demographics and comorbidities were compared between HA (preoperative serum albumin < 3.5 g/dL) and non-HA cohorts. To determine associations between albumin status and postoperative complications, univariate and multivariable binary logistic regression analyses were performed.

RESULTS: A total of 5774 patients undergoing MSG resection were included, of which 321 (5.6%) had preoperative HA. HA was associated with older age on univariate analysis (65.2 vs. 60.2 years,

CONCLUSION: Preoperative HA may …

Gestational Weight Gain And Increased Risk Of Cesarean Delivery Across Body Mass Index Categories., Pearl A Mcelfish, Britni L Ayers, Nicola L Hawley, Aaron Caldwell, Austin Porter, Michael D Macechko, Donya Watson, Jennifer A Callaghan-Koru, James P Selig, Jennifer A Andersen, Nirvana Manning, Lanita White, Enrique Gomez-Pomar, Clare C Brown

Pediatrics Faculty Publications

BACKGROUND: Unnecessary cesarean delivery can have negative implications for both mothers and infants. In the United States, the proportion of women undergoing cesarean delivery exceeds the acceptable World Health Organization proportion. Reducing cesarean deliveries is a national goal of Centers for Disease Control and Prevention Healthy People 2030, the American College of Obstetricians and Gynecologists, and the Alliance for Innovation on Maternal Health.

OBJECTIVE: This study aimed to examine if excessive gestational weight gain is associated with increased risk of cesarean delivery across multiple body mass index categories.

STUDY DESIGN: Analysis was conducted using vital records data from the National …

Outcomes Of Pregnant Icu Patients With Severe Covid-19 Pneumonia In Qatar During The Three Waves Of The Covid-19 Pandemic: A Retrospective Cohort Study, Layla J.M Kily, Sohel M.G Ahmed, Tamam A.K.M Alhusban, Mohammed J. Orompurath, Marcus Lance, Mogahed I.H Hussein, Salwa M. Abuyaqoub, Huda A. Saleh, Eynas Abdalla, Santhosh Gopalakrishnan

Anaesthesiology, East Africa

Introduction: Pregnant women are considered a high-risk group for COVID-19 infection/pneumonia as they are known to be more vulnerable to viral infections. They require close monitoring and appropriate timely intervention to minimize the impact on both the mother and the fetus. Although the more prevalent Omicron variant led to fewer severe infections and fewer intensive care unit (ICU) admissions globally during the third wave, the effect on pregnant women and pregnancy outcomes was unknown. The vaccination campaign was thoroughly established by the third wave of the pandemic in Qatar. This retrospective descriptive cohort study investigates the characteristics, hospital stay, interventions, …

Consolidating The Evidence On The Effectiveness Of Strategies To Promote Vegetable Intake In Priority Settings: An Overview Of Systematic Reviews, Paige G. Brooker, Astrid A.M. Poelman, Katherine M. Livingstone, Clare E. Collins, Seema Mihrshahi, Ros Sambell, Jason H.Y. Wu, Gilly A. Hendrie

Research outputs 2022 to 2026

Background: Effective interventions to increase vegetable intake are urgently needed. This systematic rapid review aimed to summarise the effectiveness of interventions targeting increased vegetable intakes across diverse settings. Methodology: The review was guided by the conduct of rapid reviews from the Cochrane Handbook. The literature was searched in February 2024 across PubMed, Web of Science and Cochrane Central for systematic review articles published since 2014. The Risk of Bias In Systematic Reviews tool was used and characteristics of reviews synthesised narratively with intervention effectiveness results were summarised. Results: A total of 20 systematic reviews met the eligibility criteria. Most targeted …

A Child-Centred Research Checklist To Improve The Design And Reporting Of Paediatric Research Studies: A Descriptive Mixed Methods Study, Mandie Foster, Lisa Whitehead, Therese A. O'Sullivan, Julie Hill, Evalotte Mörelius

Research outputs 2022 to 2026

Background: No internationally developed child-centred research checklist is currently available to enhance the quality and transparency of the development, reporting and evaluation of research undertaken with children. Objective: To develop an internationally relevant, expert informed child-centred research checklist. Design: A descriptive mixed methods study was undertaken in five sequential phases, including a Delphi component. Setting(s): Academic/international context. Methods: This study involved five sequential stages: 1. Literature review using four databases (CINAHL, MEDLINE, Scopus, PsycINFO) and analysis to identify key themes in child-centred research (January 2020). 2. Generate a questionnaire based on the key themes for international experts in child research …

Ethical Issues In Conducting Health Research With People In Prison: Results Of A Deliberative Research Project Conducted With People In Australian Prisons, Paul Leslie Simpson, Jill Guthrie, Jocelyn Jones, Bridget Haire, Tony Butler

Research outputs 2022 to 2026

Planning research involving people in prison raises concerns based on past abuses of incarcerated people amongst other factors. Despite the development of guidelines for the ethical conduct of research in prisons, researchers and advocates have questioned whether current approaches aimed at protecting incarcerated persons from unethical research unfairly exclude this group from participating in and benefitting from research. Discussion of these issues comes mostly from expert opinion. An absent voice is that of people in prison. This study identifies the key ethical issues according to people in prison for health research involving people in prison. Using a deliberative approach, citizens' …

Protocol For A Field Trial Of A Hearing And Vision Support Intervention For People Living In Long-Term Care In Australia, Carly Meyer, Najwan El-Saifi, Naomi Rose, Kasia Bail, Colette Browning, Dayna Cenin, Antonio Ahumada-Canale, Megan Campbell, Tim England, Melanie Ferguson, Yuanyuan Gu, Reema Harrison, Chyrisse Heine, Lisa Keay, Sheela Kumaran, Iracema Leroi, Gerald Liew, Angelita Martini, Ralph Martins, John Newall, Smriti Raichand, Emma Scanlan, Hamid R. Sohrabi, Melinda Toomey, Johanna Westbrook, Piers Dawes

Research outputs 2022 to 2026

Introduction: Hearing and vision impairments are prevalent among residents in long-term care settings. Hearing and vision impairments frequently go unsupported, affecting residents' quality of life and healthcare costs. This paper describes the protocol for a pre−post evaluation and process evaluation of a pragmatic sensory support intervention (SSI) that was developed with residents, informal caregivers and long-term care workers. Methods and Analysis: A prospective pre−post-intervention trial within long-term care will be conducted, including three groups: residents (n = 87), informal caregivers (n = 87) and long-term care workers (n = 40). Outcome measures include health-related quality of life and well-being measures …

Cardiac Surgical Bleeding, Transfusion, And Quality Metrics: Joint Consensus Statement By The Enhanced Recovery After Surgery Cardiac Society And Society For The Advancement Of Patient Blood Management, Rawn Salenger, Rakesh C Arora, Arthur Bracey, Mario D'Oria, Daniel T Engelman, Caroline Evans, Michael C Grant, Serdar Gunaydin, Vicki Morton, Sherri Ozawa, Prakash A Patel, Jacob Raphael, Todd K Rosengart, Linda Shore-Lesserson, Pierre Tibi, Aryeh Shander

Faculty, Staff and Students Publications

Background: Excessive perioperative bleeding is associated with major complications in cardiac surgery, resulting in increased morbidity, mortality, and cost.

Methods: An international expert panel was convened to develop consensus statements on the control of bleeding and management of transfusion and to suggest key quality metrics for cardiac surgical bleeding. The panel reviewed relevant literature from the previous 10 years and used a modified RAND Delphi methodology to achieve consensus.

Results: The panel developed 30 consensus statements in 8 categories, including prioritizing control of bleeding, prechest closure checklists, and the need for additional quality indicators beyond reexploration rate, such as time …

The Built Environment And Place Attachment: Insights From Japanese Cities, Juiling Li, Mohammed Javad Koohsari, Andrew T. Kaczynski, Ryo Tanimoto, Reo Watanabe, Tomoki Nakaya, Yufeng Luo, Jing Zhao, Akitomo Yasunaga, Koichiro Oka, Tomoya Hanibuchi

Faculty Publications

Objective

Methods

Results

Tracking Community Outreach And Engagement Activities Among National Cancer Institute-Designated Cancer Centers, Todd Burus, Caree Mcafee, Pamela Hull, Amy Leader, Christopher Mcnair

Kimmel Cancer Center Faculty Papers

The National Cancer Institute's (NCI) Cancer Center Support Grant mandates that NCI-designated cancer centers establish a Community Outreach and Engagement (COE) component to help direct efforts at reducing cancer burden within their catchment areas. Despite the critical role of COE offices, little is known about how they track and evaluate outreach activities and outcomes. We gathered information on current practices from representatives of 40 out of 65 COE offices using an online survey. Although nearly all responding centers (97.5%) tracked COE activities, no consensus existed on resources used, and satisfaction with current solutions was mixed (51.0% not satisfied). Respondents expressed …

The Case For An International Severity Of Illness Scoring System, Alexander Tracy, Jorge Ibrain Figueira Salluh, Eirik Alnes Buanes, Dave A. Dongelmans, Stefano Finazz, Bharath Kumar Tirupakuzhi Vijayaraghavan, Nazir Lone, David Pilcher, Matti Reinikainen, Wangari Siika

Anaesthesiology, East Africa

Severity of illness scores in the critical care context have evolved to serve multiple functions. These scores enable risk-adjusted outcomes to be benchmarked for the assessment of intensive care unit (ICU) performance, inform resource allocation, and enable the characterization of disease severity. Numerous illness severity scores have been developed to optimize calibration at the national level, but few studies have examined the international application of such scores.()

The COVID-19 pandemic demonstrated the value of benchmarking outcomes across heterogeneous populations and across various health care systems. Severity of illness scores were widely used to describe trial populations, assess treatment effects and …

Association Of Racial Residential Segregation And Other Social Determinants Of Health With Hiv Late Presentation, Fanghui Shi, Jiajia Zhang Ph.D., Shujie Chen, Xueying Yang Ph.D., Zhenlong Li, Sharon Weissman, Bankole Olatosi Ph.D., Xiaoming Li Ph.D.

Faculty Publications

Understanding social determinants of HIV late presentation with advanced disease (LPWA) beyond individual-level factors could help decrease LPWA and improve population-level HIV outcomes. This study aimed to examine county-level social determinants of health (SDOH) with HIV late presentation. We aggregated datasets for analysis by linking statewide HIV diagnosis data from the South Carolina (SC) Enhanced HIV/AIDS Reporting System and multiple social contextual datasets (e.g., the American Community Survey). All adult (18 years and older) people with HIV diagnosed from 2014 to 2019 in SC were included. Linear mixed models with forward selection were employed to explore the association of county-level …

Childhood Sexual Trauma, Substance Use, And Antiretroviral Therapy Adherence Among Older Adults Living With Hiv: A Mediational Analysis, Monique J. Brown, Josie Zhang, Prince Nii Ossah Addo, Amandeep Kaur, Daniel Amoatika, Elizabeth L. Crouch Ph.D., Steven A. Cohen

Faculty Publications

Childhood sexual abuse (CSA) is linked to substance use and lower antiretroviral therapy (ART) adherence. However, studies examining the mediational role of substance use between CSA and ART adherence are lacking. Therefore, the aim of this study was to determine the potential mediational role of substance use between CSA and ART adherence among older adults living with HIV (OALH) (n = 91). Mediation analyses assessed the direct and indirect relationships between CSA, substance use, and ART adherence. Statistically significant differences existed in substance use by gender (male vs. female: 12.3 vs. 9.97) and ART adherence by race (Black vs. …

Seroprevalence And Associated Factors For Hepatitis B And Hepatitis C Viral Infection Among Patients With Diabetes Mellitus In Northern Tanzania, Doreen T. Eliah, Nyasatu G. Chamba, Abid M. Sadiq, Amos Mwasamwaja, Faustini C. Kimondo, Cuthbert D. Matay, Eliada B. Nziku, Tumaini E. Mirai, Ibrahim Ali Ibrahim Muhina, Fuad H. Said

Internal Medicine, East Africa

Background: The coexistence of viral hepatitis with diabetes mellitus (DM) significantly escalates the risk of severe outcomes. This study aimed to determine the seroprevalence and associated factors of hepatitis B (HBV) and hepatitis C (HCV) viral infections among DM patients in northern Tanzania.

Materials and methods: Conducted between February 2023 and May 2023, this hospital-based cross-sectional study enrolled 189 patients with DM from the Diabetic Clinic of Kilimanjaro Christian Medical Centre. A structured questionnaire captured relevant clinical information, and plasma blood sample was assessed for hepatitis B surface antigen and anti-hepatitis C antibody seropositivity. Data analysis employed SPSS v26, and …

Identifying Mechanisms Of Action For Implementation Strategies Using A Retrospective Implementation Mapping Logic Model Approach, Timothy J Walker, Funlola Are, Natalia I Heredia, Kempson Onadeko, Emma E Saving, Eunyoung Kang, Maria E Fernandez

Faculty, Staff and Student Publications

Understanding causal mechanisms for implementation strategies is a priority for implementation and health promotion research. Logic models are helpful for understanding and illustrating mechanisms through which implementation strategies operate. Little guidance exists for developing logic models for existing implementation strategies. We demonstrate how to use Implementation Mapping (IM) in a retrospective manner to develop an IMap Logic Model for a social-emotional learning program implemented at Boys & Girls Clubs of Greater Houston (BGCGH). To inform logic model development, we used qualitative interview data (from implementers) and conversations with program organizers. To develop the logic model, we specified the most accessible …

A Qualitative Assessment Of Changes In Occupational Exposures Among Healthcare Facility Workers, David Gimeno Ruiz De Porras, Jenil Patel, Sadie Conway, Lisa Pompeii, Laura E Mitchell, Arch Carson, Lawrence W Whitehead, Inkyu Han, Jan-Paul Zock, Paul K Henneberger, Riddhi Patel, Joy De Los Reyes, George L Delclos

Faculty, Staff and Student Publications

Adult-onset asthma, notably prevalent among healthcare professionals, especially nurses, is often attributed to occupational factors such as exposure to cleaning agents. Studies consistently underscore the substantial role of such exposure in work-related asthma among hospital staff. We aimed to (a) identify and characterize current practices in cleaning and aerosolized medication administration; (b) assess changes in practices since a similar 2003 study of Texas healthcare workers; and (c) identify factors contributing to diverse exposures within healthcare job categories. We conducted focus groups with 38 participants in 6 healthcare settings, analyzing current practices, changes since 2003, and factors contributing to exposure diversity. …