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University of Alabama at Birmingham

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Master of Science (MS) School of Public Health

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Full-Text Articles in Medicine and Health Sciences

Temporal Trends In Tularemia Incidence In The United States From 2010 To 2020. Are Age And Sex Associated With These Changing Trends?, Carla V. Brooks Jan 2023

Temporal Trends In Tularemia Incidence In The United States From 2010 To 2020. Are Age And Sex Associated With These Changing Trends?, Carla V. Brooks

All ETDs from UAB

Background: Tularemia or Rabbit Fever was discovered in 1911 in a plague-like outbreak among rodents in Tulare County, California. Tularemia in the US has expanded from rural to more metropolitan areas, which may be potentially correlated with the escalating exposure of humans to animal vectors. There has not been a recent study evaluating trends in Tularemia, especially one that has evaluated if the trends in Tularemia over time differ by demographic characteristics. Methods: This is an ecological study to evaluate the temporal trends and if trends Tularemia incidence over time differs by age and sex in the United States from …


Impact Of Malaria Rapid Diagnostic Test On The Receipt Of Antimalarials Among Children Aged 6-59 Months In Nigeria From 2010 To 2021, Sandra Chibuzor Olisakwe Jan 2023

Impact Of Malaria Rapid Diagnostic Test On The Receipt Of Antimalarials Among Children Aged 6-59 Months In Nigeria From 2010 To 2021, Sandra Chibuzor Olisakwe

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Background: Nigeria has the highest malaria burden globally, and antimalarials have been commonly used to treat malaria without parasitological confirmation. In 2012, Nigeria implemented RDTs to reduce use of antimalarials for those without malaria and to increase the use of artemisinin-combination therapies (ACTs) for malaria treatment. In this study, we examined trends in antimalarial receipt among children aged 6-59 months during a 12-year period of increasing RDT availability. Methods: We conducted a cross-sectional analysis using nationally representative Nigeria Malaria Indicator Survey (NMIS) data from 2010 (before RDT implementation), 2015, and 2021. NMIS surveys used histidine-rich protein 2 (HRP2)- based RDTs …


Social Vulnerability And Racial Disparities In Overall Survival Among Endometrial Cancer Patients, Alfonsus Adrian Hadikusumo Harsono Jan 2023

Social Vulnerability And Racial Disparities In Overall Survival Among Endometrial Cancer Patients, Alfonsus Adrian Hadikusumo Harsono

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Introduction. Social vulnerability (SV) refers to potential negative effects on communities caused by external stresses on human health. The CDC/ATSDR Social Vulnerability Index (SVI) scores communities on 15 social indicators in 4 themes: (1) socioeconomic status (SES), (2) household composition and disability, (3) minority status and language, and (4) housing type and transportation. An overall score ranging from 0 (least vulnerable) to 1 (most vulnerable) is calculated to estimate vulnerability. We investigated whether SV as measured by the SVI can explain why black endometrial cancer (EC) patients survive less well than do white EC patients. Methods. We studied the survival …


Acute Placental Inflammation And Growth Outcomes In Preterm Infants, Emily Gunawan Jan 2023

Acute Placental Inflammation And Growth Outcomes In Preterm Infants, Emily Gunawan

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Background. Acute placental inflammation (API) has been associated with various adverse outcomes in preterm infants. However, little is known about how API affects their body composition and growth outcomes. This study aims to examine the association between API and growth outcomes in preterm infants. Methods. We conducted a retrospective cohort study of mother-infant dyads born < 326/7 weeks of gestation with fat mass (FM) accretion measured using air displacement plethysmography at term-equivalent age. API severity including maternal inflammatory response (MIR) and fetal inflammatory response (FIR) was staged according to criteria by Society for Pediatric Pathology based on placental pathology reports. We examined the differences in characteristics of mother-infant dyads by API severity using ANOVA or the Kruskall-Wallis test. The association between API severity and growth outcomes was analyzed using linear regression models and adjusted for statistically significant confounders. Mediation analyses were used to study the direct and indirect association of API and growth outcomes via gestational age. Results. Among 375 mother-infant dyads analyzed, 104 (28%) dyads had MIR. FIR was found in 82% of dyads with MIR. Adjusted models indicated that API severity progression was positively associated with FM accretion. Gestational age partially (49%) iv mediated the association between API severity and FM z score (indirect effect: b=0.12, 95% CI: 0.05-0.19; direct effect: b=0.12, 95% CI: 0.01-0.25). Conclusions. API severity is associated with growth outcomes and helps to accurately predict body composition in preterm infants.


The Effect Of Weather Events On Dengue Fever In Brazil 2014-2022, Maryclare Gabel Jan 2023

The Effect Of Weather Events On Dengue Fever In Brazil 2014-2022, Maryclare Gabel

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Dengue fever is a mosquito-borne infectious disease that is spread through the bite of an infected Aedes aegypti or Aedes albopictus mosquito. Half the world's population lives in a dengue fever risk zone. There are an estimated 100 million symptomatic dengue fever cases each year, with 40,000 deaths reported. Brazil reports the highest annual dengue fever cases in Latin America. In 2022, Brazil recorded 2.36 million dengue fever cases, the highest number of cases ever recorded in the country. We designed a retrospective ecological study to evaluate the temporal trends and the association between weather events and dengue fever incidence …


Association Between Regional Covid-19 Vaccine Hesitancy And Reported Positive Covid-19 Cases In The Southern United States, Orielle Caudle Jan 2022

Association Between Regional Covid-19 Vaccine Hesitancy And Reported Positive Covid-19 Cases In The Southern United States, Orielle Caudle

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The use of vaccinations has been shown to be beneficial in pandemics in the past, and in some cases, it has led to elimination of a particular disease (i.e. polio). The COVID-19 vaccination can also serve the same purpose, however, vaccine hesitancy within specific regions of the country may prevent and/or dilute the effectiveness of the vaccine. Vaccine hesitancy can be defined as a delay in acceptance, or refusal despite the availability of vaccine services. Southern regions have consistently had the lower vaccination rates compared to its other regional counterparts, even as the pandemic progressed and death rates increased over …


Racial Differences In The Association Of Insulin Resistance With Risk Of Incident Heart Failure In Participants Of Regards, Nirav Patel Jan 2022

Racial Differences In The Association Of Insulin Resistance With Risk Of Incident Heart Failure In Participants Of Regards, Nirav Patel

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Background: Insulin resistance is linked to the development of heart failure (HF). However, there is limited understanding of the racial differences in the association of insulin resistance with the risk of incident HF among individuals without diabetes. Objectives: In a US national cohort of Black and White participants, we sought to evaluate: 1) the relationship between insulin resistance with incident HF participants, and 2) whether there are racial differences in the association of insulin resistance with HF. Methods: We examined >16,000 participants without HF and diabetes at baseline from the REGARDS cohort. Cox regression modeling was used to assess the …


The Association Between Metabolically Healthy Obesity And Coronary Heart Disease Among Regards Study Participants, Kiara N. Aaron Jan 2022

The Association Between Metabolically Healthy Obesity And Coronary Heart Disease Among Regards Study Participants, Kiara N. Aaron

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A major obstacle to the advancement of our understanding of the metabolically healthy obesity (MHO) phenotype is the inconsistent definition of metabolic health and obesity among studies. A harmonized definition of MHO in adults has been proposed based on the diagnosis of obesity (BMI > 30 k/m2) and meeting the cardio-metabolic criteria for triglycerides, high-density lipoprotein (HDL) cholesterol, systolic blood pressure (SBP), diastolic blood pressure (DBP), no antihypertensive treatment, fasting blood glucose, and no drug treatment with glucose-lowering agents. In addition, waist circumference can be associated with increased disease risk when WC is >94 cm in men and >80 cm in …


Evaluation Of Ventilation Performance And Respirable Particles In Food Trucks, Dong Lee Yang Jan 2022

Evaluation Of Ventilation Performance And Respirable Particles In Food Trucks, Dong Lee Yang

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Background: The food truck industry in the U.S. has rapidly expanded, with an average growth of 7.9 % from 2017 to 2022. Food truck workers are potentially exposed to harmful airborne contaminants such as particulate matter (PM) and aldehydes produced during cooking process. Kitchen exhaust hoods are designed to capture the cooking emissions, but it is not well understood whether the commercial kitchen exhaust hoods in food trucks are properly, efficiently operated to reduce the workers' exposure to such harmful contaminants. The purpose of the study was to evaluate food truck workers' exposure to respirable particulates generated from cooking process …


Early Detection Of Acute Kidney Injury In Neonates After Cardiopulmonary Bypass, Tennille N. Webb Jan 2022

Early Detection Of Acute Kidney Injury In Neonates After Cardiopulmonary Bypass, Tennille N. Webb

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Prophylactic peritoneal dialysis (PD) in neonates undergoing cardiac surgery with cardiopulmonary bypass (CPB) has proven to be safe and improve outcomes. Understanding which neonates would most benefit from prophylactic PD is needed to optimize care. Objective: We sought to validate patient-specific characteristics associated with the need for PD in neonates requiring CPB. We hypothesized serum creatinine (SCr), pre-operative weight, or open chest post-operatively are associated with the need for PD. Methods: We evaluated neonates in the cardiac ICU requiring cardiac surgery with CPB from March 2019 through March 2021 with our new protocol for PD catheter placement. Neonates were classified …


History Of Allergy, Atopy, Infectious And Autoimmune Disease And Risk Of Multiple Myeloma, Tony B. Zbysinski Iii Jan 2022

History Of Allergy, Atopy, Infectious And Autoimmune Disease And Risk Of Multiple Myeloma, Tony B. Zbysinski Iii

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Multiple Myeloma (MM) is a plasma cell malignancy, which is defined in part by antibodies and complexes of immunoglobulin (Ig) heavy and light chains (IgH and IgL). Previous associations of immune-stimulating conditions such as allergic, autoimmune, and infectious conditions and the risk of multiple myeloma (MM) are inconsistent. However, these studies were conducted in populations of European ancestry, leaving the possibility that these conditions may contribute to the excess risk of plasma cell proliferative disorders observed among Black Americans. Therefore, we assessed MGUS, a precursor condition to myeloma, and MM risk related to a history of allergy, atopy, infections and …


Regional Variations In The Incidence Of Brain Glioma In Adults In Alabama, Mina Lobbous Jan 2022

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

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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 …


The Association Between Paraquat Exposure And Parkinson's Disease Mortality: A County-Level Ecological Study In The United States, Alexander Kozuch Jan 2022

The Association Between Paraquat Exposure And Parkinson's Disease Mortality: A County-Level Ecological Study In The United States, Alexander Kozuch

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Objectives: The current study reports the results of an ecological study regarding the association between PQ exposure and Parkinson’s disease mortality in the United States. Methods: The outcome of interest for this study was mortality due to Parkinson’s disease, obtained from CDC Wonder. The exposure of interest was PQ exposure at the county level which was obtained from the United States Geological Survey (USGS). Statistical analysis was done using the mortality data, grouped into ten-year age groups, and focused on data from 2015-2019 to account for the lag time between initial Paraquat exposure and Parkinson’s Disease mortality. A Negative Binomial …


Intracerebral Hemorrhage Hospitalizations And Outcomes: Comparisons Between Institutional And National Data, Zhuobin Huang Jan 2022

Intracerebral Hemorrhage Hospitalizations And Outcomes: Comparisons Between Institutional And National Data, Zhuobin Huang

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Intracerebral hemorrhage (ICH) is associated with a high risk of in-hospital mortality therefore we decided to define the effect of procedures and other risk factors on in-hospital mortality among different regions in the US. South and UAB Hospital. We used 2 datasets, the University of Alabama at Birmingham Hospital data and the National Inpatient Sample (NIS). We included 425 patients with a diagnosis of intracerebral hemorrhage over 18 years of age from the UAB Hospital stroke registry between 2016 to 2019; in NIS between 2016 to 2018, 68525 patients age 18 or above met inclusion criteria selected by International Classification …


Socioeconomic Status, Hbb, And Ttr Variants, And Cardiorenal Outcomes: The Regards Study, Onika E. Abrams Jan 2022

Socioeconomic Status, Hbb, And Ttr Variants, And Cardiorenal Outcomes: The Regards Study, Onika E. Abrams

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Blacks are disproportionately affected by heart failure (HF) and end-stage renal disease (ESRD). While poorer health outcomes in Blacks have been associated with social determinants of health, there are some biological differences worth noting, namely genetic risk variants for both TTR and HBB. These genetic risk variants are known to confer additional risk in the development of heart failure and end-stage renal disease, respectively. While we understand these genetic variants aren’t fully penetrant, and genetics and are not deterministic, we aimed to examine additional factors and mechanisms responsible for the increased risk in HF and ESRD in Blacks. Neighborhood socioeconomic …


Analysis Of Excess Mortality At The County Level In Alabama By Socioeconomic Factors, Abigail Jo Tucker Jan 2022

Analysis Of Excess Mortality At The County Level In Alabama By Socioeconomic Factors, Abigail Jo Tucker

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Objective: Analyze county level socioeconomic factors and their association with Covid-19 excess mortality in Alabama.Methods: Linear regression analyses were used to evaluate the association between potential risk factors assessed using the American Community survey (n = 40 counties and county clusters) and excess mortality in 2020 per 100,000 population. Excess mortality came from a previously published paper by Ackley et al. Results: Median household income (per 1,000 dollars); an average county median household income that 1,000 dollars higher was associated with 6 per 100,000 lower excess mortality (β= -5.953 p-value


An Analysis Of Preterm Birth Related To Sars-Cov-2 Infection By Race, Madeleine B. Mcgwin Jan 2021

An Analysis Of Preterm Birth Related To Sars-Cov-2 Infection By Race, Madeleine B. Mcgwin

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Research investigating the association between pregnant women with COVID-19 infection and adverse birth outcomes, including preterm birth, having been contradicting. Individual differences between study populations, e.g., racial composition, may explain some of these inconsistencies. The aim of the present study is to determine if the association between SARS-CoV-2 infection and pre-term birth varies according to race. A cross-sectional study was conducted using data from the Vizient Clinical Data Base/Research Manager (CDB/RM). The study participants were women who gave birth in one of the Vizient facilities between March 2020 and January 2021. A positive COVID-19 test status was the primary exposure …


Pain Among Older Adults With Cancer-Results From The Cancer And Aging Resilience Evaluation (Care) Registry, Mustafa Al Obaidi Jan 2021

Pain Among Older Adults With Cancer-Results From The Cancer And Aging Resilience Evaluation (Care) Registry, Mustafa Al Obaidi

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Purpose: The impact of pain on functional status and mental health among older adults with cancer is a relevant, yet understudied issue. Our aim of this study sought to identify prevalence of pain at diagnosis in older adults with cancer and evaluate the association with functional status limitations, cognition, and mental health issues. Methods: This study included patients diagnosed with cancer at age ≥60 enrolled in the CARE Registry at University of Alabama at Birmingham. Patients completed a patient-reported geriatric assessment at the time of their initial visit with a medical oncologist. Pain measured in numeric rating scale from 0-10. …


Risk Of Coronary Heart Disease In Blood Of Marrow Transplant Survivors, Radhika Gangaraju Jan 2021

Risk Of Coronary Heart Disease In Blood Of Marrow Transplant Survivors, Radhika Gangaraju

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Background: Blood or marrow transplant (BMT) recipients are vulnerable to accelerated atherosclerosis due to prior exposure to chemotherapy and radiation, and consequent long-term cardiovascular morbidity, such as coronary heart disease (CHD). A comprehensive evaluation of the risk of late-occurring CHD in adult BMT survivors and the associated risk factors has not been performed. Patients and Methods: Using the Blood or Marrow Transplant Survivor Study (BMTSS), we analyzed the incidence and risk factors for CHD in patients who underwent BMT between 1974 and 2014, and survived ≥2 years. The risk of CHD was examined in BMT survivors as compared to 1,131 …


Effect Of Patient-Level Characteristics On Fluoroquinolone Susceptibility, Jeffrey Alan Franks Jan 2020

Effect Of Patient-Level Characteristics On Fluoroquinolone Susceptibility, Jeffrey Alan Franks

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Antimicrobial stewardship programs are becoming more widespread to combat antibiotic resistance. This study aimed to evaluate the influence of patient-level characteristics on fluoroquinolone susceptibly among five gram-negative isolates to help better their implementation. We performed a retrospective analysis of patients over the age of 18 for five gram-negative isolates (Acinetobacter species, Enterobacter cloacae, Escherichia coli, Klebsiella pneumoniae, and Pseudomonas aeruginosa). We utilized Cox proportional hazards to determine the risk of patient-level characteristics, for both hospital and community-acquired infections, on fluoroquinolone resistance between 2016 and 2019. The population sample consisted of 8,285 patients receiving fluoroquinolones for at least one of the …


Race, Type Ii Diabetes Mellitus And Vertebral Fragility Fractures: A Cross-Sectional Analysis From Nhanes, Yuchen At Xiao Jan 2020

Race, Type Ii Diabetes Mellitus And Vertebral Fragility Fractures: A Cross-Sectional Analysis From Nhanes, Yuchen At Xiao

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IntroductionThis study examined the association between race and bone health, and if T2DM modifies this association in a diverse sample of adults. Methods We conducted a cross-sectional study using the 2013-2014 National Health and Nutrition Examine Survey (NHANES) data. Bone health outcomes included lumbar spine BMD (lowered BMD based on T-scores <-1), and vertebral deformities, assessed via vertebral fracture assessment (VFA), including presence, number of deformities, and severity ratio of deformities. T2DM status and other demographic, lifestyle, and health characteristics were self-reported via questionnaire data. To assess if T2DM modifies the association between race and bone health outcomes, we conducted stratified analyses using logistic regression for dichotomous outcomes, Poison regression for count outcomes, and linear regression for continuous outcomes. Results Non-Hispanic (NH) Blacks have significantly less odds of being lowered BMD and osteoporosis comparing to NH-Whites in the crude model and significantly less odds of having vertebral deformities comparing to NH-White in both crude and adjusted model for non-diabetic participants. Such differences are not observed in diabetic groups. Participants in Other race group have significantly more odds of being lowered BMD comparing to NH-Whites in the adjusted model for both diabetic and non-diabetic groups. And have significantly more odds of having vertebral deformities in the diabetic group, crude and adjusted, yet the differences are not significant in non-diabetic groups. Similar results were seen in the number of deformities and total bone loss ratio. The potential modification effect of T2DM was not significant in these models. Conclusions In our national evaluation, bone health differs not only by race and ethnic group but also by T2DM status. The protective vertebral fragility effects observed among NH-Blacks was no longer present among those with diabetes. Likewise, among participants in other racial and ethnic groups, T2DM seemed to magnify the association of worse vertebral fragility. Such trends indicate a potential modifying effect of participants’ T2DM status and should be noted clinically, yet more studies are required for more precise results.