Medicine and Health Sciences Commons^™

Public Health Impacts Of Climate Change: U.S. Fifth National Climate Assessment, Adrienne Katner

Journal of the Louisiana Public Health Association

The United States’ Fifth National Climate Assessment was released by the U.S. Global Climate Change Research Program on November, 14, 2023.1 The National Climate Assessment is a peer-reviewed report resulting from the collaboration of nearly 500 authors and scientists from 14 federal agencies, universities and research institutions. The authors of this report are tasked with evaluating and predicting the effects of climate change on the nation’s environment, natural resources, infrastructure, and human health every five years; and providing a report summarizing their findings to Congress. Some of the findings of this report are summarized here, with emphasis on public health …

Advocating For Inclusion Of Recreational Athletics In State-Level Youth Concussion Policy, Joseph T. Vaughn

Journal of the Louisiana Public Health Association

Introduction: Interest in pediatric sports concussions has received increased interest in the last decade, with all fifty states and the District of Columbia passing laws based on Washington State’s Lystedt Law. Although these policies have made strides in addressing pediatric concussions, they lack provisions for recreational sports. Methods: A literature review of relevant statutes for all 50 states and the District of Columbia was performed. States with existing protections and evidence-based guidelines were also examined to provide recommendations. Results: States with the policy gap either had no statutes that applied to recreational sports or statutes that lacked at least the …

Policies Surround Comprehensive Sexual Education For 8th - 12th Grade Public School Students: Literature Review & Policy Recommendations In Louisiana, Alexis Hernandez, Leat Halpert, Lea Mascarenas

Journal of the Louisiana Public Health Association

No abstract provided.

Factors Impacting Adoption Of And Experience With Point-Of-Use Activated Carbon Faucet Mount Water Filters, Aubrey Gilliland, Victoria Peluso, Corisandra Leyton-High, Susanne Straif-Bourgeois, Kari Brisolara, Greg Pierce, Kelsey Pieper, Adrienne Katner

Journal of the Louisiana Public Health Association

Introduction: Public health officials increasingly rely on point-of-use drinking water filters (POUs) to reduce waterborne lead exposures, and upcoming regulatory changes will soon require utilities to distribute POUs under certain conditions. While POUs are generally a costeffective measure for reducing lead exposure, they may not be adoptable by all households. To promote sustained adoption of POUs, we need to understand the situational and technical factors which may facilitate or impede adoption. Methods: Study participants were interviewed before and after field-testing of activated carbon faucet mount POU filters to identify factors impacting adoption in New Orleans and Enterprise, Louisiana, both sites …

Characterizing How Food Advertising And Genetic Obesity Risk Factors Affect Neural Reward Reactivity And Eating In The Absence Of Hunger In Children, Dabin Yeum

Dartmouth College Ph.D Dissertations

The complex and multifactorial etiology of obesity involves the interaction of numerous risk factors. Assessing the gene-environment interaction of pediatric obesity can provide valuable insights for the characterization of key factors contributing to obesity and identification of potential points of intervention. The data used in this thesis comes from a single sample of young children recruited from the communities surrounding Dartmouth College. The primary objective of this thesis is to assess the impacts of complicated gene-environment interaction on pediatric obesity. First, we assessed the dynamic and static advertising of food cues to examine they lead to differential neural reward responsivity. …

Public Health Fight Against Heat, Fires, And Drinking Water Contamination, Sundée Winder

Journal of the Louisiana Public Health Association

No abstract provided.

Vol 3 November '23 Full Issue, Donna L. Williams

Journal of the Louisiana Public Health Association

No abstract provided.

Perinatal Sars-Cov-2 Infection: A Review Of Infant And Maternal Data And Outcomes In Southeast Louisiana, Christy Mumphrey, Peter Joslyn, Judston Robinson, Hannah Doran, Jessica Patrick-Esteve

Journal of the Louisiana Public Health Association

Background: Throughout the COVID-19 pandemic, Louisiana healthcare providers sought guidance for the care of infected pregnant persons and their infants. Prior to the pandemic, pregnant persons and infants in Louisiana experienced increased risk for poor perinatal outcomes. Methods: This secondary data research study was conducted using prospective study data collected from March 2020 through March 2022 at 4 southeast Louisiana hospitals. Pregnant persons who tested positive for COVID-19 from 14 days before to 10 days after delivery, and their infants were eligible for inclusion. Demographic, clinical, and hospital course data were collected. Results: We identified 247 eligible pregnant persons. Of …

Impact On The Volume Of Pathology Reports Before And During The Covid-19 Pandemic In Seer Cancer Registries, Amina Chtourou, Pamela V. Sanchez, Todd Golden, Huann Sheng Chen, Stephen M. Schwartz, Xiao Cheng Wu, Brenda Y. Hernandez, Jovanka N. Harrison, Lynne Penberthy, Serban Negoita

School of Public Health Faculty Publications

Introduction: Health care procedures including cancer screening and diagnosis were interrupted due to the COVID-19 pandemic. The extent of this impact on cancer care in the United States is not fully understood. We investigated pathology report volume as a reflection of trends in oncology services pre-pandemic and during the pandemic. Methods: Electronic pathology reports were obtained from 11 U.S. central cancer registries from NCI’s SEER Program. The reports were sorted by cancer site and document type using a validated algorithm. Joinpoint regression was used to model temporal trends from January 2018 to February 2020, project expected counts from March 2020 …

An Educational Program To Improve African American Women’S Knowledge And Self Efficiency In Seeking Treatment For Endometrial Cancer, Lauren Elise Rosenthall

Electronic Theses and Dissertations

In the United States, there is a significant difference in the survival rate for endometrial cancer for African American women when compared to women of other ethnic groups, specifically White women. There is supporting evidence that supports that morbidity and mortality rates for endometrial cancer increase if diagnosed in later stages. There are many contributing factors to a patient receiving an early diagnosis of a disease. One of the key determinants to early diagnosis of endometrial cancer is understanding risk factors, and what symptoms require further evaluation. An educational program was developed to identify knowledge deficits in the African American …

J Mich Dent Assoc November 2023

The Journal of the Michigan Dental Association

Every month, The Journal of the Michigan Dental Association brings news, information, and features about Michigan dentistry to our state's oral health community and the MDA's 6,200+ members. No publication reaches more Michigan dentists!

In this issue, the reader will find the following original content:

• A cover story on The University of Michigan's Gordon H. Sindecuse Museum of Dentistry.
• News you need, Editorial and regular department articles on MDA Foundation activities, Dentistry and the Law, Staff Matters, and component news.

This issue also includes two articles reprinted with permission.

• A feature from Ontario Dentist on The Challenge of False Belief: …

Transposable Elements Are Co-Opted As Oncogenic Regulatory Elements By Lineage-Specific Transcription Factors In Prostate Cancer, Giacomo Grillo, Tina Keshavarzian, Simon Linder, Christopher Arlidge, Lisanne Mout, Ankita Nand, Mona Teng, Aditi Qamra, Stanley Zhou, Ken J Kron, Alex Murison, James R Hawley, Michael Fraser, Theodorus H Van Der Kwast, Ganesh V Raj, Housheng Hansen He, Wilbert Zwart, Mathieu Lupien

Faculty, Staff and Student Publications

Transposable elements hold regulatory functions that impact cell fate determination by controlling gene expression. However, little is known about the transcriptional machinery engaged at transposable elements in pluripotent and mature versus oncogenic cell states. Through positional analysis over repetitive DNA sequences of H3K27ac chromatin immunoprecipitation sequencing data from 32 normal cell states, we report pluripotent/stem and mature cell state–specific “regulatory transposable elements.” Pluripotent/stem elements are binding sites for pluripotency factors (e.g., NANOG, SOX2, OCT4). Mature cell elements are docking sites for lineage-specific transcription factors, including AR and FOXA1 in prostate epithelium. Expanding the analysis to prostate tumors, we identify a …

Environmental Contamination Contributing To The Spread Of Vancomycin-Resistant Enterococci In Nursing Homes, Catherine Vaziri, Charles Darkoh

Faculty, Staff and Student Publications

No abstract provided.

Differences In The Circulating Proteome In Individuals With Versus Without Sickle Cell Trait, Yanwei Cai, Nora Franceschini, Aditya Surapaneni, Melanie E Garrett, Usman A Tahir, Li Hsu, Marilyn J Telen, Bing Yu, Hua Tang, Yun Li, Simin Liu, Robert E Gerszten, Josef Coresh, Joann E Manson, Genevieve L Wojcik, Charles Kooperberg, Paul L Auer, Matthew W Foster, Morgan E Grams, Allison E Ashley-Koch, Laura M Raffield, Alex P Reiner

Faculty, Staff and Student Publications

BACKGROUND: Sickle cell trait affects approximately 8% of Black individuals in the United States, along with many other individuals with ancestry from malaria-endemic regions worldwide. While traditionally considered a benign condition, recent evidence suggests that sickle cell trait is associated with lower eGFR and higher risk of kidney diseases, including kidney failure. The mechanisms underlying these associations remain poorly understood. We used proteomic profiling to gain insight into the pathobiology of sickle cell trait.

METHODS: We measured proteomics ( N =1285 proteins assayed by Olink Explore) using baseline plasma samples from 592 Black participants with sickle cell trait and 1:1 …

Acc: An R Package To Process, Visualize, And Analyze Accelerometer Data, Jaejoon Song, Michael D Swartz, Karen Basen-Engquist

Faculty, Staff and Student Publications

Wearable activity monitors are now widely used in behavioral and epidemiological studies to measure physical activity in free-living conditions. Despite the widespread use in research, the development of software to explore the data collected from these devices has been limited. We present acc, a comprehensive, free, and open-source R package to provide a seamless environment for exploring accelerometer data (https://cran.r-project.org/web/packages/acc). In this article, we demonstrate the software for processing, visualizing, and analyzing accelerometer data using real and simulated datasets.

Survival Of Neonates, Infants, And Children With Birth Defects: A Population-Based Study In Texas, 1999–2018, Renata H Benjamin, Joanne M Nguyen, Mark A Canfield, Charles J Shumate, A J Agopian

Faculty, Staff and Student Publications

Background: Birth defects are a leading cause of neonatal, infant, and childhood mortality, but recent population-based survival estimates for a spectrum in the U.S. are lacking.

Methods: Using the statewide Texas Birth Defects Registry (1999-2017 births) and vital records linkage to ascertain deaths, we conducted Kaplan-Meier analyses to estimate survival probabilities at 1, 7, and 28 days, and 1, 5, and 10 years. We evaluated survival in the full cohort of infants with any major defect and for 30 specific conditions. One-year survival analyses were stratified by gestational age, birth year, and case classification.

Findings: Among 246,394 live-born infants with …

Feasibility And Implementation Determinants Of A Structured Goal Setting And Goal Management System, Eunyoung Kang, Julie Chen, Erin R Foster

Faculty, Staff and Student Publications

Importance: There is no evidence-based system to guide occupational therapists in implementing theory-based, client-engaged goal setting and goal management. A new system is needed to support high-quality goal setting and goal management.

Objective: To determine the acceptability, appropriateness, feasibility, credibility, and expectancy of a new structured theory-based, client-engaged goal setting and goal management system, called MyGoals, for occupational therapists. We explored MyGoals' implementation determinants, potential positive outcomes, and comparative advantages.

Design: This was a mixed-methods feasibility study.

Setting: Community.

Participants: Occupational therapists (N = 7).

Outcomes and measures: Acceptability, appropriateness, and feasibility were assessed using the Acceptability of Intervention Measure …

Burden Of Respiratory Failure In Pediatric Patients: Analysis Of A Prospective Multicenter Cohort In Bogotá, Colombia, Laura Hernández-Corredor, Rocio Plazas-Pachón, Fernanda Argote-Bolaños, Pedro Barrera-Lopez, Melisa Naranjo Vanegas, Sergio Moreno-Lopez, Paola Rueda-Guevara, Juan G Piñeros, Olga Lucía Baquero Castañeda, Carolina Bonilla, Luz M Mejía, María L Mesa, Sonia Restrepo-Gualteros, Andrea Ramírez Varela

Faculty, Staff and Student Publications

BACKGROUND AND AIMS: The approach to the burden of disease is a demographic, economic, and a health problem, which requires the design and application of specific measures of cost of the disease, such as disability-adjusted life years (DALYs), to establish better public health policies in the pediatric population. The aim of this study is to approach the burden of disease in children with acute respiratory failure (ARF) through the calculation of DALYs.

METHODS: This study was conducted in the framework of a prospective, multicenter cohort in Bogotá, Colombia. Inclusion criteria were all pediatric patients admitted to the emergency department, hospitalization, …

Mosaic Chromosomal Alterations In Blood Across Ancestries Using Whole-Genome Sequencing, Yasminka A Jakubek, Ying Zhou, Adrienne Stilp, Jason Bacon, Justin W Wong, Zuhal Ozcan, Donna Arnett, Kathleen Barnes, Joshua C Bis, Eric Boerwinkle, Jennifer A Brody, April P Carson, Daniel I Chasman, Jiawen Chen, Michael Cho, Matthew P Conomos, Nancy Cox, Margaret F Doyle, Myriam Fornage, Xiuqing Guo, Sharon L R Kardia, Joshua P Lewis, Ruth J F Loos, Xiaolong Ma, Mitchell J Machiela, Taralynn M Mack, Rasika A Mathias, Braxton D Mitchell, Josyf C Mychaleckyj, Kari North, Nathan Pankratz, Patricia A Peyser, Michael H Preuss, Bruce Psaty, Laura M Raffield, Ramachandran S Vasan, Susan Redline, Stephen S Rich, Jerome I Rotter, Edwin K Silverman, Jennifer A Smith, Aaron P Smith, Margaret Taub, Kent D Taylor, Jeong Yun, Yun Li, Pinkal Desai, Alexander G Bick, Alexander P Reiner, Paul Scheet, Paul L Auer

Faculty, Staff and Student Publications

Megabase-scale mosaic chromosomal alterations (mCAs) in blood are prognostic markers for a host of human diseases. Here, to gain a better understanding of mCA rates in genetically diverse populations, we analyzed whole-genome sequencing data from 67,390 individuals from the National Heart, Lung, and Blood Institute Trans-Omics for Precision Medicine program. We observed higher sensitivity with whole-genome sequencing data, compared with array-based data, in uncovering mCAs at low mutant cell fractions and found that individuals of European ancestry have the highest rates of autosomal mCAs and the lowest rates of chromosome X mCAs, compared with individuals of African or Hispanic ancestry. …

A Small Molecule Exerts Selective Antiviral Activity By Targeting The Human Cytomegalovirus Nuclear Egress Complex, Han Chen, Ming F Lye, Christoph Gorgulla, Scott B Ficarro, Gregory D Cuny, David A Scott, Fan Wu, Paul W Rothlauf, Xiaoou Wang, Rosio Fernandez, Jean M Pesola, Sorin Draga, Jarrod A Marto, James M Hogle, Haribabu Arthanari, Donald M Coen

Faculty, Staff and Student Publications

Human cytomegalovirus (HCMV) is an important pathogen for which new antiviral drugs are needed. HCMV, like other herpesviruses, encodes a nuclear egress complex (NEC) composed of two subunits, UL50 and UL53, whose interaction is crucial for viral replication. To explore whether small molecules can exert selective antiviral activity by inhibiting NEC subunit interactions, we established a homogeneous time-resolved fluorescence (HTRF) assay of these interactions and used it to screen >200,000 compound-containing wells. Two compounds, designated GK1 and GK2, which selectively inhibited this interaction in the HTRF assay with GK1 also active in a co-immunoprecipitation assay, exhibited more potent anti-HCMV activity …

Clonal Hematopoiesis Of Indeterminate Potential (Chip) And Incident Type 2 Diabetes Risk, Deirdre K Tobias, Alisa K Manning, Jennifer Wessel, Sridharan Raghavan, Kenneth E Westerman, Alexander G Bick, Daniel Dicorpo, Eric A Whitsel, Jason Collins, Adolfo Correa, L Adrienne Cupples, Josée Dupuis, Mark O Goodarzi, Xiuqing Guo, Barbara Howard, Leslie A Lange, Simin Liu, Laura M Raffield, Alex P Reiner, Stephen S Rich, Kent D Taylor, Lesley Tinker, James G Wilson, Peitao Wu, April P Carson, Ramachandran S Vasan, Myriam Fornage, Bruce M Psaty, Charles Kooperberg, Jerome I Rotter, James Meigs, Joann E Manson

Faculty, Staff and Student Publications

OBJECTIVE: Clonal hematopoiesis of indeterminate potential (CHIP) is an aging-related accumulation of somatic mutations in hematopoietic stem cells, leading to clonal expansion. CHIP presence has been implicated in atherosclerotic coronary heart disease (CHD) and all-cause mortality, but its association with incident type 2 diabetes (T2D) is unknown. We hypothesized that CHIP is associated with elevated risk of T2D.

RESEARCH DESIGN AND METHODS: CHIP was derived from whole-genome sequencing of blood DNA in the National Heart, Lung, and Blood Institute Trans-Omics for Precision Medicine (TOPMed) prospective cohorts. We performed analysis for 17,637 participants from six cohorts, without prior T2D, cardiovascular disease, …

Time To Endoscopy Or Colonoscopy Among Adults Younger Than 50 Years With Iron-Deficiency Anemia And/Or Hematochezia In The Vha, Joshua Demb, Lin Liu, Caitlin C Murphy, Chyke A Doubeni, Maria Elena Martinez, Samir Gupta

Faculty, Staff and Student Publications

IMPORTANCE: to date, the diagnostic test completion rate and the time to diagnostic endoscopy or colonoscopy among adults with iron-deficiency anemia (IDA) and/or hematochezia have not been well characterized.

OBJECTIVE: to evaluate the diagnostic test completion rate and the time to diagnostic testing among veterans younger than 50 years with IDA and/or hematochezia.

DESIGN, SETTING, AND PARTICIPANTS: This cohort study was conducted within the Veterans Health Administration between October 1, 1999, and December 31, 2019, among US veterans aged 18 to 49 years from 2 separate cohorts: those with a diagnosis of IDA (n = 59 169) and those with …

Screening For Lung Cancer: 2023 Guideline Update From The American Cancer Society, Andrew M. D. Wolf, Kevin C. Oeffinger, Tina Ya-Chen Shih, Louise C. Walter, Timothy R. Church, Elizabeth T. H. Fontham, Elena B. Elkin, Ruth D. Etzioni, Carmen E. Guerra, Rebecca B. Perkins, Karli K. Kondo, Tyler B. Kratzer, Deanna Manassaram-Baptiste, William L. Dahut, Robert A. Smith

School of Public Health Faculty Publications

Lung cancer is the leading cause of mortality and person-years of life lost from cancer among US men and women. Early detection has been shown to be associated with reduced lung cancer mortality. Our objective was to update the American Cancer Society (ACS) 2013 lung cancer screening (LCS) guideline for adults at high risk for lung cancer. The guideline is intended to provide guidance for screening to health care providers and their patients who are at high risk for lung cancer due to a history of smoking. The ACS Guideline Development Group (GDG) utilized a systematic review of the LCS …

Mda Foundation: Mda Foundation Teams Up With Victors For Veterans Program, Anne Berquist

The Journal of the Michigan Dental Association

The MDA Foundation partners with the Victors for Veterans (V4V) program to provide dental care to impoverished veterans in Michigan, especially those with disabilities, homelessness, or limited income. The program, established in 2012, currently operates in the VINA Community Dental Center in Brighton, Michigan, providing free dental services to veterans in the region. The MDA Foundation supports this initiative with grants to secure clinic space, enabling 30 to 60 veterans to receive comprehensive dental care annually. Dental students at the University of Michigan School of Dentistry volunteer their time and skills and precept dentists oversee patient care.

Improved Humoral Immunity And Protection Against Influenza Virus Infection With A 3d Porous Biomaterial Vaccine, Hiromi Miwa, Olivia Q Antao, Kindra M Kelly-Scumpia, Sevana Baghdasarian, Daniel P Mayer, Lily Shang, Gina M Sanchez, Maani M Archang, Philip O Scumpia, Jason S Weinstein, Dino Di Carlo

Faculty, Staff and Student Publications

New vaccine platforms that activate humoral immunity and generate neutralizing antibodies are required to combat emerging pathogens, including influenza virus. A slurry of antigen-loaded hydrogel microparticles that anneal to form a porous scaffold with high surface area for antigen uptake by infiltrating immune cells as the biomaterial degrades is demonstrated to enhance humoral immunity. Antigen-loaded-microgels elicited a robust cellular humoral immune response, with increased CD4

Comparison Between Viral Vector And Mrna Based Covid-19 Vaccination In Prevalence And Severity Of Regional Immune Reactions, And 18f-Fdg Pet/Ct Features, Narjess Ayati, Scott Evans, S Rasoul Zakavi, Simon M Gruenewald

Faculty, Staff and Student Publications

Objective(s):

The coronavirus pandemic caused by SARS-CoV-2 commenced in late 2019, and global wide vaccination appears to be the only reasonable solution to fight this dreadful virus. There are two main types of COVID-19 immunization using viral vector and mRNA-based vaccines. However, the impact of each of type on 18F-FDG PET/CT needs to be accurately assessed. This study aimed to compare the 18F-FDG PET/CT features of these two types of COVID-19 vaccines.

Methods:

A total of 188 patients referred for 18F-FDG PET/CT with a recent history of either BioNTech/Pfizer or AstraZeneca COVID-19 vaccination, and a control group of 40 patients …

Deep Learning-Based Dose Prediction To Improve The Plan Quality Of Volumetric Modulated Arc Therapy For Gynecologic Cancers, Mary P Gronberg, Anuja Jhingran, Tucker J Netherton, Skylar S Gay, Carlos E Cardenas, Christine Chung, David Fuentes, Clifton D Fuller, Rebecca M Howell, Meena Khan, Tze Yee Lim, Barbara Marquez, Adenike M Olanrewaju, Christine B Peterson, Ivan Vazquez, Thomas J Whitaker, Zachary Wooten, Ming Yang, Laurence E Court

Faculty, Staff and Student Publications

Background: In recent years, deep‐learning models have been used to predict entire three‐dimensional dose distributions. However, the usability of dose predictions to improve plan quality should be further investigated.

Purpose: To develop a deep‐learning model to predict high‐quality dose distributions for volumetric modulated arc therapy (VMAT) plans for patients with gynecologic cancer and to evaluate their usability in driving plan quality improvements.

Methods: A total of 79 VMAT plans for the female pelvis were used to train (47 plans), validate (16 plans), and test (16 plans) 3D dense dilated U‐Net models to predict 3D dose distributions. The models received the …

Use Of Term Reference Infants In Assessing The Developmental Outcome Of Extremely Preterm Infants: Lessons Learned In A Multicenter Study, Charles E Green, Jon E Tyson, Roy J Heyne, Susan R Hintz, Betty R Vohr, Carla M Bann, Abhik Das, Edward F Bell, Sana Boral Debsareea, Emily Stephens, Marie G Gantz, Carolyn M Petrie Huitema, Karen J Johnson, Kristi L Watterberg, Ricardo Mosquera, Myriam Peralta-Carcelen, Deanne E Wilson-Costello, Tarah T Colaizy, Nathalie L Maitre, Stephanie L Merhar, Ira Adams-Chapman, Janell Fuller, Michelle E Hartley-Mcandrew, William F Malcolm, Sarah Winter, Andrea F Duncan, Gary J Myer, Stephen D Kicklighter, Myra H Wyckoff, Sara B Demauro, Anna Maria Hibbs, Barbara J Stoll, Waldemar A Carlo, Krisa P Van Meurs, Matthew A Rysavy, Ravi M Patel, Pablo J Sánchez, Abbot R Laptook, C Michael Cotten, Carl T D'Angio, Michele C Walsh, Human Development Neonatal Research Network

Faculty, Staff and Student Publications

OBJECTIVE: Extremely preterm (EP) impairment rates are likely underestimated using the Bayley III norm-based thresholds scores and may be better assessed relative to concurrent healthy term reference (TR) infants born in the same hospital.

STUDY DESIGN: Blinded, certified examiners in the Neonatal Research Network (NRN) evaluated EP survivors and a sample of healthy TR infants recruited near the 2-year assessment age.

RESULTS: We assessed 1452 EP infants and 183 TR infants. TR-based thresholds showed higher overall EP impairment than Bayley norm-based thresholds (O.R. = 1.86; [95% CI 1.56-2.23], especially for severe impairment (36% vs. 24%; p ≤ 0.001). Difficulty recruiting …

Review Of Generic Scenario Environmental Release And Occupational Exposure Models Used In Chemical Risk Assessment, William M Barrett, David E Meyer, Raymond L Smith, Sudhakar Takkellapati, Michael A Gonzalez

Faculty, Staff and Student Publications

Under the Toxic Substances Control Act (TSCA), the United States Environmental Protection Agency (USEPA) is required to determine whether a new chemical substance poses an unreasonable risk to human health or the environment before the chemical is manufactured in or imported into the United States. This manuscript provides a review of the process used to evaluate the risk associated with a chemical based on the scenarios and models used in the evaluation. Specifically, the Generic Scenarios and Emission Scenario Documents developed by the USEPA were reviewed, along with background documentation prepared by USEPA to identify the core elements of the …

Ramipril For The Treatment Of Covid-19: Ramic, A Randomized, Double-Blind, Placebo-Controlled Clinical Trial, Daniel Q Huang, Veeral Ajmera, Christian Tomaszewski, Andrew Lafree, Ricki Bettencourt, Wesley K Thompson, Davey M Smith, Atul Malhotra, Ravindra L Mehta, Vaishal Tolia, Jeffrey Yin, Paul A Insel, Stone Leachman, Jinho Jung, Summer Collier, Lisa Richards, Kristin Woods, Maral Amangurbanova, Archana Bhatt, Xinlian Zhang, Oana M Penciu, Stuart Zarich, Tamrat Retta, Michelle S Harkins, J Pedro Teixeira, Brian Chinnock, Netanya S Utay, Jordan E Lake, Rohit Loomba

Faculty, Staff and Student Publications

Introduction: Retrospective studies report that angiotensin-converting enzyme inhibitors (ACEIs) may reduce the severity of COVID-19, but prospective data on de novo treatment with ACEIs are limited. The RAMIC trial was a randomized, multicenter, placebo-controlled, double-blind, allocation-concealed clinical trial to examine the efficacy of de novo ramipril versus placebo for the treatment of COVID-19.

Methods: Eligible participants were aged 18 years and older with a confirmed diagnosis of SARS-CoV-2 infection, recruited from urgent care clinics, emergency departments, and hospital inpatient wards at eight sites in the USA. Participants were randomly assigned to daily ramipril 2.5 mg or placebo orally in a …