Medicine and Health Sciences Commons^™

Decoding Implant-Related Sickness: Unraveling The Complexities Of Breast Implant Illness, Madison M. Stewart

Senior Theses

This thesis investigates the phenomenon of breast implant illness (BII), examining its potential correlation with individual factors such as obesity and poor lifestyle habits. BII, characterized by nonspecific symptoms, is often self-diagnosed by patients influenced by social media and internet sources, leading to requests for implant removal. Conducting a comprehensive meta-analysis, the study scrutinizes existing literature to evaluate the association between BII, obesity, and lifestyle choices. Employing inclusion criteria, peer-reviewed publications are analyzed through systematic review methodology to offer insights into the interplay between BII and adiposity, exploring inflammatory mechanisms and patient behaviors like exercise and smoking. The research aims …

The Genetic Associations Of Circadian Rhythm And Sleep Disorder Traits With Risk Of Monoclonal Gammopathy Of Undetermined Significance And Multiple Myeloma, Brittany Crawford

Theses and Dissertations

Background: Circadian rhythm disruption and sleep have been widely studied for their roles in immunity and cancer development. Evidence for an association of circadian rhythm and sleep traits with multiple myeloma (MM) risk is inconclusive. No studies have investigated these traits in relation to monoclonal gammopathy of undetermined significance (MGUS). Given that MGUS precedes almost all MM cases, investigating sleep and circadian rhythm in relation to both MM and MGUS is necessary. The purpose of this dissertation was to explore the genetic influences of circadian rhythm and sleep traits on the risk of MGUS and MM. Methods: Data were leveraged …

Dietary Inflammatory Index During Pregnancy And Changes Over Time: Associations With Post-Partum Sleep Duration And Quality And Depressive Symptoms., Nowrin Tamanna

Theses and Dissertations

STUDY OBJECTIVES: Sleep and mental health are two important factors for a new mother, as adequate sleep and a healthy mind help her prioritize self-care, seek support when needed, and create a nurturing environment for both her and her baby. Among various plausible theories exploring the etiology of sleep disturbances and depression, the concept of inflammation is gaining attention. This study examined the hypothesis that more pro-inflammatory diets during pregnancy are associated with a decrease in sleep quality and duration, abnormal sleep timing and higher Edinburg Postnatal depression score (EPDS) scores 6 months and 12 months post-partum.

METHODS: A secondary …

Covid-19 Vaccine Hesitancy And Vaccination Rate Among The Latino Population In South Carolina, Brynn E. Lynagh

Senior Theses

It is common knowledge that COVID-19 disproportionately impacts racial and ethnic minorities in the United States. Furthermore, these sects of the population exhibit increased vaccine hesitancy and lower vaccination rates as compared to the aggregated population of the United States, furthering the risk posed by COVID-19 to these communities. In particular, this study focuses on the Latino population in South Carolina, the vaccination rate among this community, and the perspectives which contributed to their vaccination decision. Two hundred Spanish and Portuguese speaking residents of South Carolina were interviewed using a paper survey conducted by pre-trained interviewers. The survey gathered data …

A Cross-Sectional Analysis Of Infectious Causes Of Congenital Morbidity And Mortality In Central America: Torch, El Salvador, Mary Katherine Lynn

Theses and Dissertations

The primary goal of this dissertation was to understand the prevalence of the most regionally salient TORCH pathogens among a group of perinatal women from a highly vulnerable region of El Salvador at the time of parturition. TORCH pathogens, that cause TORCH congenital syndromes, are classically defined as Toxoplasma gondii, other infectious causes of concern (Zika virus, malaria, human immunodeficiency virus, etc), Rubella virus, Cytomegalovirus(CMV), and Herpes Simplex Viruses. These infections can be passed from mother to fetus through the placenta or other perinatal routes and cause severe maternal and neonatal morbidity and mortality. This dissertation sought to understand perinatal …

Food Insecurity In Youth And Young Adults With Diabetes: Prevalence And Association With Health Behaviors, Lauren Helene Martini

Theses and Dissertations

Given the life-long impact of diabetes(1-5), it is important to engage in behaviors that promote health and wellness to delay or prevent negative health outcomes(3, 6-10). Despite this, youth and young adults with diabetes generally do not adhere to nutritional(11-17) or physical activity(18, 19) recommendations. In households experiencing financial difficulties, especially those who are having difficulty providing sufficient food to all of its members, adhering to recommendations may be even more difficult.

The purpose of this dissertation is to better understand and contextualize food insecurity among youth and young adults (YYA) with youth-onset T1DM and T2DM. The first aim addresses …

Quantile Differences In The Age-Related Decline In Cardiorespiratory Fitness Between Sexes In Adults Without Type 2 Diabetes Mellitus In The United States, Andrew Ortaglia, Melissa Stansbury, Michael David Wirth, Xuemei Sui, Matteo Bottai

Faculty Publications

Objective: To comprehensively assess the extent to which the decline in cardiorespiratory fitness (CRF) with age differs between sexes. Participants and Methods: This study used data from the Aerobics Center Longitudinal Study, conducted between September 1974 and August 2006, consisting primarily of White adults from middle-to-upper socioeconomic strata restricted to adults without type 2 diabetes mellitus (33,742 men and 9,415 women). Quantile regression models were used to estimate the differences in age-associated changes in CRF between the sexes, estimated using a maximal treadmill test. Results: For adults aged up to 45 years, significant differences in slopes relating to age and …

Association Between Postpartum Weight Retention And The Dietary Inflammatory Index, Nyrobi Tyson

Theses and Dissertations

Objective: The objective of this thesis is to examine the relationship between the Dietary Inflammatory Index (DII), measured during the postpartum period, and postpartum weight retention.

Setting and Participants: We used the Infant Feeding Practices Study (IFPS) II (n=5000), a longitudinal study of women from late pregnancy through their infant’s first year of life conducted between 2005 and 2007. Survey topics included feeding practices, infant health, food allergies, sleeping arrangements, mother’s employment, childcare, and mother’s dietary intake.

Main Outcomes: Postpartum weight retention (PPWR) was calculated in kilograms by subtracting self-reported body weight at 3, 6, 9, and 12 months postpartum …

Unearthing An Emerging Neglected Bacterial Disease: Evidence Of Spotted Fever Group Rickettsioses In El Salvador, Kyndall Christian Braumuller

Theses and Dissertations

The main objectives of this dissertation were to investigate the seroprevalence of Spotted Fever Group Rickettsioses (SFGR) antibodies in a specific vulnerable population at high risk for vector-borne disease in El Salvador, understand the relevant risk factors for SFGR past and acute infection in this same population through logistic regression modeling, and clarify the presence of SFGR bacteria in locally collected ticks.

SFGR are a group of bacterial diseases caused by species in the Rickettsia genus of the phylogenetic spotted fever group. These are tick-borne diseases (TBD) that have been described in almost every region of the world. SFGR are …

Rural-Urban Differences In Survival Among People With Early Onset Colorectal Cancer, Radhika Ranganathan

Theses and Dissertations

Colorectal cancer (CRC) is the third most common cancer and the second most among cancer deaths both in the US and globally. Early Onset Colorectal Cancer (EOCRC), occurring between the ages of 20 and 49, has continued to rise over the past decades. Several studies have reported a persistent increase in EOCRC incidence and mortality, especially in rural areas as compared to urban areas, despite decreases in rates for people over the age of 50 years. Increase in EOCRC may have played a role in lowering the age of screening recommendation to 45-49 age group. The objective of this study …

Food Insecurity And Suicidal Behaviors Among Us High School Students*, Andrea D. Brown, Hilary Seligman, Sarah Silwa, Ellen Barnidge, Kathryn L. Krupsky, Zewiditu Demissie, Angela D. Liese

Faculty Publications

BACKGROUND: Food insecurity (FI) rates in the United States are particularly high among households with children. This research set aims to analyze if high school students experiencing FI had higher risk for mental health and suicidal behaviors.

METHODS: Using combined data from 11 states that conducted the 2017 Youth Risk Behavior Survey, a total of 26,962 and24,051 high school students were used to estimate race/ethnicity and sex-stratified prevalence ratios (PRs) from Poissonregression models. A single-question was used to measure the exposure of FI and outcomes of mental health and suicidalbehaviors.

RESULTS: Overall, 10.8% of students reported FI. Students experiencing FI …

“Pandemias Políticas: The Effects Of Political And Social Instability On Infectious Disease Epidemiology In Latin America"”, Sarah H. Noonan

Senior Theses

This paper seeks to analyze the relationship between political and social unrest and conflict and infectious disease epidemiology in Latin America. An analysis of published literature regarding epidemiological, biomedical, political, and historical content was conducted to highlight potential connections between infectious disease epidemics and sociopolitical conflict in the region. Specific analyses of Smallpox, Venezuelan Equine Encephalitis, Chagas disease, Cholera, Dengue, and COVID-19 were conducted, in an effort to uncover potential causations and context of epidemics of these conditions. Results of this analysis depict a necessity for further research into public health and disease control mechanisms during times of conflict and …

The Age Of E-Cigarette Initiation And Association With Frequency Of Use And Risk Of Combustible Tobacco Cigarette Smoking Initiation, Andy Hu

Senior Theses

Background - Studies have shown that electronic nicotine delivery systems (ENDS) are unsafe for consumption. However, the prevalence of e-cigarette use among adolescents and young adults continues to increase, which is being addressed by research. Little attention has been paid to the effects of earlier age of ENDS initiation.

Purpose - This paper examined published research studies on the topic of the age of initiation of e-cigarette use in relation to 1) frequency of e-cigarette use and 2) risk of combustible tobacco cigarette smoking initiation. This research tested the hypothesis that an earlier age of e-cigarette initiation was associated with …

Association Between Diet Quality Indices And Incidence Of Type 2 Diabetes In The Melbourne Collaborative Cohort Study, Allison M. Hodge, Md Nazmul Karim, James Hébert Scd, Nitin Shivappa Mbbs, Mph, Ph.D., Barbora De Courten

Faculty Publications

Type 2 diabetes mellitus is a common condition whose incidence is increasing worldwide, and for which obesity and diet are important risk factors. The aim of this study was to assess the association of three diet quality scores with diabetes risk and how much of the association was mediated through body size. The Melbourne Collaborative Cohort Study recruited 41,513 men and women aged 40–69 years during 1990–1994. At baseline, data were collected on lifestyle and diet, anthropometric measures were performed. Incident diabetes was assessed by self-report at follow-up surveys in 1994–1998 and 2003–2007. The associations between the dietary inflammatory index …

Utilization Of Remote Sensing To Analyze Aedes Mosquito Egg Abundance With Combined Weather Variables In Two Southeastern Coastal Cities, Danielle M. Johnson

Theses and Dissertations

Several vector-borne diseases have recently resurfaced, and many have suddenly spread to new areas in the United States (U.S.) due to climate change and tropicalization. Two vectors of public health importance are Aedes aegyptiand Aedes albopictus. The Southeastern region of the U.S. appears to be a preferential ecological niche for both Aedes species. Aedes aegyptiand Aedes albopictus are highly susceptible to environmental conditions, such as humidity, precipitation, temperature. Remote sensing technology has proven to be useful for estimating vector populations. Miami-Dade County is an established hotspot for disease transmission. Charleston County is newly vulnerable due to similar …

Associations Between Fasting Duration, Timing Of First And Last Meal, And Cardiometabolic Endpoints In The National Health And Nutrition Examination Survey, Michael David Wirth, Longgang Zhao, Gabrielle Turner-Mcgrievy, Andrew Ortaglia

Faculty Publications

Background: Research indicates potential cardiometabolic benefits of energy consumption earlier in the day. This study examined the association between fasting duration, timing of first and last meals, and cardiometabolic endpoints using data from the National Health and Nutrition Examination Survey (NHANES). Methods: Cross-sectional data from NHANES (2005–2016) were utilized. Diet was obtained from one to two 24-h dietary recalls to characterize nighttime fasting duration and timing of first and last meal. Blood samples were obtained for characterization of C-reactive protein (CRP); glycosylated hemoglobin (HbA1c %); insulin; glucose; and high-density lipoprotein (HDL), low-density lipoprotein (LDL), and total cholesterol. Survey design procedures …

Household Food Security, Lifestyle Factors, And Glycemic Control Among Youth And Young Adults With Diabetes, Lauren A. Reid

Theses and Dissertations

The purpose of this study was to assess the associations between household food insecurity (HFI) and glycemic control, physical activity, and diet quality in youth and young adults (YYA) with type 1 diabetes (T1D) and type 2 diabetes (T2D). Among older adults, HFI has been shown to complicate diabetes management due to the essential role of diet in diabetes management and the financial stress associated with HFI. Although HFI is more prevalent among YYA with diabetes than the general population, there are only a handful of studies that have focused on this population and, studies that include YYA with T2D …

Intersection Of Maternal Disability Status, Prescription Opioid Use Before And During Pregnancy, And Adverse Birth Outcomes, Chelsea Lynes Richard

Theses and Dissertations

Nationally, individuals with disability, like those with chronic health conditions, have higher rates of opioid use and misuse and are prescribed higher dosages than those without disability. Because opioid agonists and antagonists can cross the placenta rapidly, there is biological plausibility that they may have an impact on birth outcomes. Therefore, monitoring prescription opioid use, particularly among pregnant women, is of great public health importance. While evidence for the impact of opioid use on preterm birth and low birthweight are conflicting; findings are consistent that opioid use during pregnancy is associated with a higher risk of small for gestational age, …

Dysbiosis-Related Medications And The Association With Cognitive Decline, Cognitive Impairment, And Dementia, Nicholas Victor Resciniti

Theses and Dissertations

The main objectives of this dissertation were to quantitatively assess whether there is an association between medications (e.g., antibiotics, PPIs, antipsychotics) and cognitive performance over time, conduct a causal mediation analysis to evaluate the role of inflammation (C-reactive protein) in the association between medications and subsequent cognitive decline, and examine if dysbiosis-related medications (DRM) are associated with a greater risk of dementia for participants that were cognitively normal and had MCI at baseline.

The Health and Retirement Study (HRS) was used to conduct a secondary data analysis that used longitudinal data from 2004 to 2016. The HRS is an ongoing, …

Comparing Dietary Score Associations With Lipoprotein Particle Subclass Profiles: A Cross-Sectional Analysis Of A Middle-To Older-Aged Population, Seán R. Millar, Pilar Navarro, Janas M. Harrington, Nitin Shivappa Mbbs, Mph, Ph.D., James Hébert Scd, Ivan J. Perry, Catherine M. Phillips

Faculty Publications

Background and objectives: Lipoprotein particle concentrations and size are associated with increased risk for atherosclerosis and premature cardiovascular disease. Studies also suggest that certain dietary behaviours may be cardioprotective. Limited comparative data regarding any dietary score/index-lipoprotein particle subclass associations exist. Thus, our objective was to assess relationships between the Dietary Approaches to Stop Hypertension (DASH), Health Eating Index-2015 (HEI-2015), Mediterranean Diet (MD) and Energy-adjusted Dietary Inflammatory Index (E-DII™) scores and plasma lipids and lipoprotein profiles to test the hypothesis that healthier diet (better quality and more anti-inflammatory) would be associated with a more favourable lipoprotein profile.

Materials and methods: This …

Diabetes, Anti-Diabetic Medication Use, And The Risk Of Ovarian Cancer, Chantaezia Joseph

Theses and Dissertations

Background- Although ovarian cancer is a rare disease, it is the 5th leading cause of cancer-related deaths among women in the United States. Diabetes is a serious chronic disease that plagues over 436 million adults worldwide and was ranked 7th in causes of death in the US in 2017. Epidemiologic evidence suggests that diabetes may lead to an increased risk of ovarian cancer due to shared risk factors such as sedentary behaviors, smoking and poor diet or through biological mechanisms related to hyperglycemia and obesity, but the epidemiologic evidence yields mixed results. Certain anti-diabetic medications may increase the risk …

Diet Quality And Risk Of Lung Cancer In The Multiethnic Cohort Study, Song-Yi Park, Carol J. Boushey, Yurii B. Shvetsov, Michael David Wirth Msph,Ph.D., Nitin Shivappa Ph.D., James R. Hébert Sc.D., Christopher A. Haiman, Lynee R. Wilkens, Loic Le Marchand

Faculty Publications

Diet quality, assessed by the Healthy Eating Index-2015 (HEI-2015), the Alternative Healthy Eating Index-2010 (AHEI-2010), the alternate Mediterranean Diet (aMED) score, the Dietary Approaches to Stop Hypertension (DASH) score, and the Dietary Inflammatory Index (DII®), was examined in relation to risk of lung cancer in the Multiethnic Cohort Study. The analysis included 179,318 African Americans, Native Hawaiians, Japanese Americans, Latinos, and Whites aged 45–75 years, with 5350 incident lung cancer cases during an average follow-up of 17.5 ± 5.4 years. In multivariable Cox models comprehensively adjusted for cigarette smoking, the hazard ratios (95% confidence intervals) for the highest vs. lowest …

Association Between Dietary Inflammatory Index, Dietary Patterns, Plant-Based Dietary Index And The Risk Of Obesity, Yoko B. Wang, Nitin Shivappa, James R. Hébert Scd, Amanda J. Page, Yohannes Adama Melaku

Faculty Publications

Evidence on the association between various dietary constructs and obesity risk is limited. This study aims to investigate the longitudinal relationship between different diet indices and dietary patterns with the risk of obesity. Non-obese participants (n = 787) in the North West Adelaide Health Study were followed from 2010 to 2015. The dietary inflammatory index (DII®), plant-based dietary index (PDI) and factor-derived dietary pattern scores were computed based on food frequency questionnaire data. We found the incidence of obesity was 7.62% at the 5-year follow up. In the adjusted model, results from multivariable log-binomial logistic regression showed that a prudent …

Disparities In Meeting Uspstf Breast, Cervical, And Colorectal Cancer Screening Guidelines Among Women In The United States, Gabriel A. Benavidez, Anja Zgodic, Whitney Zahnd, Jan Eberth

Faculty Publications

Introduction

Many sociodemographic factors affect women’s ability to meet cancer screening guidelines. Our objective was to examine which sociodemographic characteristics were associated with women meeting US Preventive Services Task Force (USPSTF) guidelines for breast, cervical, and colorectal cancer screening.

Methods

We used 2018 Behavioral Risk Factor Surveillance System data to examine the association between sociodemographic variables, such as race/ethnicity, rurality, education, and insurance status, and self-reported cancer screening for breast, cervical, and colorectal cancer. We used multivariable log-binomial regression models to estimate adjusted prevalence ratios and 95% CIs.

Results

Overall, the proportion of women meeting USPSTF guidelines for breast, cervical, …

Dietary Inflammatory Index Is Associated With Inflammation In Japanese Men, Ayaka Kotemori, Norie Sawada, Motoki Iwasaki, Taiki Yamaji, Nitin Shivappa Mbbs, Mph, Ph.D., James Hébert Scd, Junko Ishihara, Manami Inoue, Shoichiro Tsugane

Faculty Publications

Background: Dietary components are known to affect chronic low-grade inflammation status. The dietary inflammatory index (DII®) was developed to measure the potential impact of a diet on an individual's inflammatory status, and it has been validated mainly in Western countries.

Objective: This study aimed to examine the validity of the energy-adjusted DII (E-DIITM) using high-sensitivity C-reactive protein (hs-CRP) concentration in Japanese men and women.

Methods: In total, 6,474 volunteers from a cancer-screening program (3,825 men and 2,649 women) completed a food frequency questionnaire (FFQ) and their hs-CRP concentrations were evaluated. E-DII scores were calculated on the basis of 30 food …

Change In Dietary Inflammatory Index Score Is Associated With Control Of Long-Term Rheumatoid Arthritis Disease Activity In A Japanese Cohort: The Tomorrow Study, Yoshinari Matsumoto, Nitin Shivappa Mbbs, Mph, Ph.D., Yuko Sugioka, Masahiro Tada, Tadashi Okano, Kenji Mamoto, Kentaro Inui, Daiki Habu, James R. Hébert Scd, Tatsuya Koike

Faculty Publications

Background: The dietary inflammatory index (DII®), a quantitative measure of the inflammatory potential of daily food and nutrient intake, and associations between a variety of health outcomes have been reported. However, the association between DII score and disease activity of rheumatoid arthritis (RA) is unclear. Therefore, this study was designed to test whether higher DII score contributes to disease activity and as a corollary, y, whether reducing DII score helps to achieve or maintain low disease activity or remission in patients with RA.

Methods: We performed a cross-sectional and longitudinal analysis using 6 years of data (from 2011 to 2017) …

The Association Of Dietary Patterns With Dietary Inflammatory Index, Systemic Inflammation, And Insulin Resistance, In Apparently Healthy Individuals With Obesity, Maryam Saghafi-Asl, Susan Mirmajidi, Mohammad Asghari Jafarabadi, Farhad Vahid, Nitin Shivappa, James R. Hébert Scd, Vahideh Ebrahimzadeh Attari

Faculty Publications

Inflammation is considered a key mechanism leading to obesity. Dietary patterns and certain food items influence inflammation. Few studies have investigated the contribution of major dietary patterns to biological measures of inflammation. Therefore, the present study aimed to examine the associations of different dietary patterns with dietary inflammatory index (DII), systemic inflammation, and insulin resistance (IR) in the apparently healthy obese. In this cross-sectional study, 151 abdominally obese subjects were recruited from the Northwest of Iran. Dietary intake, demographic data, anthropometric indices, and physical activity (PA) was assessed. DII scores were calculated based on a validated 168-item food frequency questionnaire …

The Association Of Dietary Patterns With Dietary Inflammatory Index, Systemic Inflammation, And Insulin Resistance, In Apparently Healthy Individuals With Obesity, Maryam Saghafi-Asl, Susan Mirmajidi, Mohammad Asghari Jafarabadi, Farhad Vahid, Nitin Shivappa, James Hébert Scd, Vahideh Ebrahimzadeh Attari

Faculty Publications

Infammation is considered a key mechanism leading to obesity. Dietary patterns and certain food items infuence infammation. Few studies have investigated the contribution of major dietary patterns to biological measures of infammation. Therefore, the present study aimed to examine the associations of diferent dietary patterns with dietary infammatory index (DII), systemic infammation, and insulin resistance (IR) in the apparently healthy obese. In this cross-sectional study, 151 abdominally obese subjects were recruited from the Northwest of Iran. Dietary intake, demographic data, anthropometric indices, and physical activity (PA) was assessed. DII scores were calculated based on a validated 168-item food frequency questionnaire …

The Current State Of Health Care Facility Preparedness, Health Care Utilization, And Covid-19 Knowledge Amidst The Covid-19 Pandemic In The Malaria-Endemic Setting Of Manicaland Province, Zimbabwe, Julia Grace Scott

Theses and Dissertations

The impact of the coronavirus disease 2019 (COVID-19) pandemic has been felt worldwide, especially in Sub-Saharan Africa (SSA). With fractured health systems, disrupted supply chains, limited resources, and continued fighting of endemic diseases such as malaria, SSA is at risk for greater impact. Manicaland Province has the highest incidence rate of malaria in Zimbabwe, and a higher malaria mortality rate than the national average. Manicaland also has the third highest number of COVID-19 cases and deaths in Zimbabwe. In this study, health care facilities and households throughout Makoni, Mutare, and Buhera districts in Manicaland Province were administered cross-sectional surveys. We …

Neurodevelopment Correlates With Gut Microbiota In A Cross-Sectional Analysis Of Children At 3 Years Of Age In Rural China, Sarah E. Rothenberg, Qiurong Chen, Yanfen Nong, Hua Nong, Eva P. Trinh, Fred J. Biasini, Jihong Liu, Xiaoyun Zeng, Yunfeng Zou, Fengxiu Ouyang, Susan A. Korrick

Faculty Publications

We investigated cross-sectional associations between children’s neurodevelopment and their gut microbiota composition. Study children (36 months of age) lived in rural China (n = 46). Neurodevelopment was assessed using the Bayley Scales of Infant Development, 2nd Edition, yielding the Mental Developmental Index (MDI) and Psychomotor Developmental Index (PDI). Children's gut microbiota was assessed using 16S rRNA gene profiling. Microbial diversity was characterized using alpha diversity patterns. Additionally, 3 coabundance factors were determined for the 25 most abundant taxa. Multivariable linear regression models were constructed to examine the relationships between Bayley scores (MDI and PDI) and children's gut microbiota. In adjusted …