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Full-Text Articles in Medicine and Health Sciences

Predicting Sleep And Sleep Stage In Children Using Actigraphy And Heartrate Via A Long Short-Term Memory Deep Learning Algorithm: A Performance Evaluation, Robert Weaver Med, Phd, James White, Olivia Finnegan, Hongpeng Yang, Zifei Zhong, Keagan Kiely, Catherine Jones, Yan Tong, Srihari Nelakuditi, Rahul Ghosal, David E. Brown, Russell R. Pate Ph.D., Gregory J. Welk, Massimiliano De Zambotti, Yuan Wang, Sarah Burkart, Elizabeth L. Adams Phd, Bridget Armstrong, Michael Beets Med, Mph, Phd Jul 2025

Predicting Sleep And Sleep Stage In Children Using Actigraphy And Heartrate Via A Long Short-Term Memory Deep Learning Algorithm: A Performance Evaluation, Robert Weaver Med, Phd, James White, Olivia Finnegan, Hongpeng Yang, Zifei Zhong, Keagan Kiely, Catherine Jones, Yan Tong, Srihari Nelakuditi, Rahul Ghosal, David E. Brown, Russell R. Pate Ph.D., Gregory J. Welk, Massimiliano De Zambotti, Yuan Wang, Sarah Burkart, Elizabeth L. Adams Phd, Bridget Armstrong, Michael Beets Med, Mph, Phd

Faculty Publications

Children's ambulatory sleep is commonly measured via actigraphy. However, traditional actigraphy measured sleep (e.g., Sadeh algorithm) struggles to predict wake (i.e., specificity, values typically < 70) and cannot predict sleep stages. Long short-term memory (LSTM) is a machine learning algorithm that may address these deficiencies. This study evaluated the agreement of LSTM sleep estimates from actigraphy and heartrate (HR) data with polysomnography (PSG). Children (N = 238, 5–12 years,52.8% male, 50% Black 31.9% White) participated in an overnight laboratory polysomnography. Participants were referred be-cause of suspected sleep disruptions. Children wore an ActiGraph GT9X accelerometer and two of three consumer wearables(i.e., Apple Watch Series 7, Fitbit Sense, Garmin Vivoactive 4) on their non-dominant wrist during the polysomnogram. LSTM estimated sleep versus wake and sleep stage (wake, not-REM, REM) using raw actigraphy and HR data for each 30-s epoch. Logistic regression and random forest were also estimated as a benchmark for performance with which to compare the LSTM results. A 10-fold cross-validation technique was employed, and confusion matrices were constructed. Sensitivity and specificity were calculated to assess the agreement between research-grade and consumer wearables with the criterion polysomnography. For sleep versus wake classification, LSTM outperformed logistic regression and random forest with accuracy ranging from 94.1to 95.1, sensitivity ranging from 94.9 to 95.9 across different devices, and specificity ranging from 84.5 to 89.6. The addition of HR improved the prediction of sleep stages but not binary sleep versus wake. LSTM is promising for predicting sleep and sleep staging from actigraphy data, and HR may improve sleep stage prediction.


Diversity And Equity In Medical Education Over The Past Decade: Applications, Matriculations, And The Growing Gaps, Gang Lv, Xiangxiang Jiang, Jordan Franklin, Minghui Li, Jing Yuan, Z Kevin Lu Ph.D. Jul 2025

Diversity And Equity In Medical Education Over The Past Decade: Applications, Matriculations, And The Growing Gaps, Gang Lv, Xiangxiang Jiang, Jordan Franklin, Minghui Li, Jing Yuan, Z Kevin Lu Ph.D.

Faculty Publications

Background

Diversity and race-concordant relationships contribute to improved patient experiences and outcomes. In contrast, the representation of underrepresented in medicine (URiM) individuals in different medical specialties is declining. The essential pathway to improving diversity within the future workforce centers around the inclusion of a diverse cohort of medical students. We aimed to examine the diversity of medical school applications and admissions across sex, race and ethnicity over the past decade.

Methods

This study used data from the Association of American Medical Colleges from 2015 to 2024. URiM individuals refer to minority populations that are underrepresented in the medical profession, including …


Characterizing The Influence Of Racism-Related Stress And Pandemic-Related Changes In Social Connections On Cardiovascular Health: Study Protocol And Theoretical Framework, Jewel Scott Phd, Rn, Fnp-C, Victoria Money, Charles Ellis, Chanita Hughes-Halbert, Michelle A. Birkett, Gayenell Magwood Jul 2025

Characterizing The Influence Of Racism-Related Stress And Pandemic-Related Changes In Social Connections On Cardiovascular Health: Study Protocol And Theoretical Framework, Jewel Scott Phd, Rn, Fnp-C, Victoria Money, Charles Ellis, Chanita Hughes-Halbert, Michelle A. Birkett, Gayenell Magwood

Faculty Publications

Background Cardiovascular-related morbidity and mortality among young adults are rising, and disparities between young Black and White women are immense. Health behaviors including physical activity and diet are essential for optimal cardiovascular health. Psychosocial factors, such as racism, perceived stress, and lack of social support, contribute to racial inequities in cardiovascular disease, which were further exacerbated by the COVID-19 pandemic. The proposed study aims to assess the influence of racism-related stress and other social determinants of health, including social connectedness, on quality of life and cardiovascular-related health behaviors. Methods This is a concurrent, triangulation, mixed-methods study combining survey data on …


Medicaid Managed Care Organization Service Coverage And Diagnosis And Treatment Of Opioid Use Disorder: Evidence From Quasi-Random Auto-Assignment In Kentucky, Shelby R. Steuart, Miguel Antonio G Estrada, Christina Andrews Ph.D., Colleen M. Grogan, Olivia M. Hinds, Emily C. Lawler, Lauren A. Peterson, Felipe Lozano-Rojas, Emily C. Lawler, Lauren A. Peterson, Felipe Lozano-Rojas, Melissa A. Westlake, Coady Wing, Amanda J. Abraham Jul 2025

Medicaid Managed Care Organization Service Coverage And Diagnosis And Treatment Of Opioid Use Disorder: Evidence From Quasi-Random Auto-Assignment In Kentucky, Shelby R. Steuart, Miguel Antonio G Estrada, Christina Andrews Ph.D., Colleen M. Grogan, Olivia M. Hinds, Emily C. Lawler, Lauren A. Peterson, Felipe Lozano-Rojas, Emily C. Lawler, Lauren A. Peterson, Felipe Lozano-Rojas, Melissa A. Westlake, Coady Wing, Amanda J. Abraham

Faculty Publications

Introduction

Opioid-related mortality continues to claim tens of thousands of American lives annually. Medicaid plays an outsized role in financing opioid use disorder (OUD) treatment, paying for almost 40% of all Americans who received OUD treatment in 2017. Methods

Using Medicaid T-MSIS Analytic Files data and a novel data set of Medicaid managed care organization (MCO) plan coverage, we examined the relationship between comprehensiveness of benefits for OUD treatment provided by Medicaid MCO plans and the likelihood of OUD diagnosis and medications for OUD (MOUD) receipt among newly enrolled Medicaid beneficiaries in Kentucky. We use two stage least squares to …


Functional Time Transformation Model With Applications To Digital Health, Rahul Ghosal Ph.D., Marcos Matabuena, Sujit K. Ghosh Jul 2025

Functional Time Transformation Model With Applications To Digital Health, Rahul Ghosal Ph.D., Marcos Matabuena, Sujit K. Ghosh

Faculty Publications

The advent of wearable and sensor technologies now leads to functional predictors which are intrinsically infinite dimensional. While the existing approaches for functional data and survival outcomes lean on the well-established Cox model, the proportional hazard (PH) assumption might not always be suitable in real-world applications. Motivated by physiological signals encountered in digital medicine, we develop a more general and flexible functional time-transformation model for estimating the conditional survival function with both functional and scalar covariates. A partially functional regression model is used to directly model the survival time on the covariates through an unknown monotone transformation and …


Supplemental Data: Analyzing Point Of Care Tools Through Faculty, Resident, And Stakeholder Buy-In: Promises And Pitfalls, J. Michael Lindsay Jun 2025

Supplemental Data: Analyzing Point Of Care Tools Through Faculty, Resident, And Stakeholder Buy-In: Promises And Pitfalls, J. Michael Lindsay

Faculty Publications

Costs for UpToDate, the library’s primary point of care clinical tool, had increased to half of the acquisitions budget but without user affiliation data to facilitate cost sharing. A working group led by librarians was formed to review alternatives. Surveys indicated users preferred UpToDate and renewal was recommended by the working group, with costs being shared between the academic unit and the hospital. These results showed that the library can effectively lead analysis projects with this level of visibility, but persuading users to consider alternatives to a trusted tool can be challenging.

Appendix 1 is a general survey meant to …


Hypertensive Disorders Of Pregnancy And Perinatal Outcomes: Two Prospective Cohort Studies Of Nulliparous Women In India And Tanzania, Andrea B. Pembe, Pratibha Dwarkanath, Amani Kikula, John Michael Raj, Nandita Perumal Phd, Heavenlight A. Paulo, Rajalakshmi M, Christopher P. Duggan, Honorati M. Masanja, Nandini Chopra, Mary M. Sando, Tinku Thomas, Cara A. Yelverton, Alfa Muhihi, Anura V. Kurpad, Wafaie E. Fawzi, Blair J. Wylie, Christopher R. Sudfeld Jun 2025

Hypertensive Disorders Of Pregnancy And Perinatal Outcomes: Two Prospective Cohort Studies Of Nulliparous Women In India And Tanzania, Andrea B. Pembe, Pratibha Dwarkanath, Amani Kikula, John Michael Raj, Nandita Perumal Phd, Heavenlight A. Paulo, Rajalakshmi M, Christopher P. Duggan, Honorati M. Masanja, Nandini Chopra, Mary M. Sando, Tinku Thomas, Cara A. Yelverton, Alfa Muhihi, Anura V. Kurpad, Wafaie E. Fawzi, Blair J. Wylie, Christopher R. Sudfeld

Faculty Publications

Introduction Hypertensive disorders of pregnancy (HDP) have been linked with increased risk for maternal and offspring complications in high-income settings. However, in resource-limited settings, studies with robust measurement of HDP, including severity and timing, and perinatal outcomes are limited.

Methods We analysed data from two prospective cohorts of nulliparous women in India (n=10 570 pregnancies) and Tanzania (n=10 299 pregnancies) who were enrolled in calcium supplementation trials and had blood pressure and proteinuria assessments throughout pregnancy and at the time of labour and delivery. Generalised estimating equations were used to assess the relationship between HDP severity categories (gestational hypertension, preeclampsia …


Partial Least Squares Multimodal Analysis Of Brain Network Correlates Of Language Deficits In Aphasia, Sigfus Kristinsson Ph.D., Dirk B. Den Ouden, Chris Rorden, Roger Newman-Norlund, Lisa Johnson, Janina Wilmskoetter, Ezequiel Gleichgerrcht, Argye E. Hillis, Gregory Hickok, Julius Fridriksson Ph.D., Leonardo Bonilha Jun 2025

Partial Least Squares Multimodal Analysis Of Brain Network Correlates Of Language Deficits In Aphasia, Sigfus Kristinsson Ph.D., Dirk B. Den Ouden, Chris Rorden, Roger Newman-Norlund, Lisa Johnson, Janina Wilmskoetter, Ezequiel Gleichgerrcht, Argye E. Hillis, Gregory Hickok, Julius Fridriksson Ph.D., Leonardo Bonilha

Faculty Publications

Lesion-symptom mapping techniques are essential to determine brain regions critical for language functions. However, high collinearity in neuroimaging and behavioural data remains a challenge for distinguishing neural substrates supporting multiple language domains (shared variance) and those subserving specific language functions (unique variance). Here, we employed a novel approach to multimodal lesion-symptom mapping using multivariate partial least squares regression to delineate the latent structure of lesion-behavioural mapping in aphasia and decompose the shared and unique neural determinants of language impairments. A total of 86 participants with chronic (>12-month post-stroke) aphasia after left hemisphere strokes were examined. Language impairment was assessed …


Association Between Dietary Inflammatory And Antioxidant Potential And Systemic Inflammatory And Oxidative Status With The Risk And Severity Of Coronary Artery Disease, Zahara Namkhah, Elham Alipoor, Manhnaz Salmani, Negar Ebrahimi, Monireh Ahmadpanahi, Ali Vasheghani-Farahani, Mehdi Yaseri, Michael David Wirth, Longgang Zhao, James Hébert Scd, Javad Hosseinzadeh-Attar Jun 2025

Association Between Dietary Inflammatory And Antioxidant Potential And Systemic Inflammatory And Oxidative Status With The Risk And Severity Of Coronary Artery Disease, Zahara Namkhah, Elham Alipoor, Manhnaz Salmani, Negar Ebrahimi, Monireh Ahmadpanahi, Ali Vasheghani-Farahani, Mehdi Yaseri, Michael David Wirth, Longgang Zhao, James Hébert Scd, Javad Hosseinzadeh-Attar

Faculty Publications

Background and aims

Unhealthy diets have pro-inflammatory properties that have been shown to contribute to coronary artery disease (CAD). The dietary inflammatory index (DII®) and the dietary antioxidant quality score (DAQS) quantify the anti-/pro-inflammatory and antioxidant potential of a diet. This study aims to investigate the association between the energy-adjusted DII (E-DIITM), DAQS, oxidant/anti-oxidant biomarkers, and CAD risk and severity.

Methods and results

This cross-sectional study investigated 158 participants for the presence and severity of CAD based on coronary angiography. E-DII and DAQS scores, malondialdehyde (MDA), total oxidant status (TOS), glutathione peroxidase (GPX) activity, total antioxidant capacity (TAC) and conventional …


Relocation Post-Dobbs Among Clinicians Providing Abortions, Dana Howard, Marta Bornstein Phd, Mph, Jocelyn Wascher, Alison H. Norris, Katherine Rivlin Jun 2025

Relocation Post-Dobbs Among Clinicians Providing Abortions, Dana Howard, Marta Bornstein Phd, Mph, Jocelyn Wascher, Alison H. Norris, Katherine Rivlin

Faculty Publications

Introduction

Intensifying state-level abortion restrictions following the Dobbs v Jackson Women’s Health Organization (2022) decision could lead clinicians to leave states that ban abortion.1 While large-scale changes are not yet apparent among obstetrician-gynecologists, the abortion care workforce may be uniquely at risk.2 We examined the proportion of abortion-providing clinicians who changed primary state of practice, comparing those who left states that banned abortion with those who left states that did not ban abortion after Dobbs, and the ban status of the states to which they relocated.

Methods

This survey study was approved by The Ohio State University …


Prevalence And Predictors Of Intimate Partner Violence Against Men In Kisumu Slums, Kenya, Elizabeth Akello Odemba, Edward A. Frongillo Jr. Ph.D., Sheri D. Weiser Jun 2025

Prevalence And Predictors Of Intimate Partner Violence Against Men In Kisumu Slums, Kenya, Elizabeth Akello Odemba, Edward A. Frongillo Jr. Ph.D., Sheri D. Weiser

Faculty Publications

Background

Men in sub-Saharan Africa experience intimate partner violence, with few reporting their cases to the legal authorities or coming out for assistance. Consequently, data on the prevalence and drivers of intimate partner violence in different parts of sub-Saharan Africa are inadequate. Therefore, this study was designed to investigate the prevalence and predictors of intimate partner violence against men in Kisumu slums, Kenya.

Methods

This retrospective cross-sectional study included 398 randomly selected men in intimate relationships aged 18–54 years and residing in Kisumu slums. The sampling frame used was from Community Health Volunteers covering the area of study. Data collection …


Telehealth And In-Person Hiv Care During The Covid-19 Pandemic At A Large Academic Medical Center In North Carolina, Valerie Yelverton, Jan Ostermann Ph.D., Michael E. Yarrington, Andrew K. Weinhold, Nabil Natafgi, Bankole Olatosi, Sharon Weissman, Nathan M. Thielman Jun 2025

Telehealth And In-Person Hiv Care During The Covid-19 Pandemic At A Large Academic Medical Center In North Carolina, Valerie Yelverton, Jan Ostermann Ph.D., Michael E. Yarrington, Andrew K. Weinhold, Nabil Natafgi, Bankole Olatosi, Sharon Weissman, Nathan M. Thielman

Faculty Publications

Background

To maintain HIV care during the COVID-19 pandemic, many HIV clinics across the United States adopted telehealth. However, not everyone participated in telehealth equally. This study assessed the use and disparities in telehealth and in-person HIV care at a large academic medical center in North Carolina (NC) relative to the COVID-19 pandemic.

Methods

Data from the Duke University Infectious Disease clinic in NC were extracted from electronic health records (EHR), aggregated across persons with HIV (PWH) by calendar month, visit type (in-person vs. telehealth HIV care), and by key sociodemographic and clinical characteristics. Variation in HIV care over time …


Social Exclusion And Mental Health Of Youths Affected By Parental Hiv/Aids In China: Based On A Serial Mediating Model, Jiaojiao Wan, Lili Ji, Zheqian Wang, Junfeng Zhao, Xiaoming Li Jun 2025

Social Exclusion And Mental Health Of Youths Affected By Parental Hiv/Aids In China: Based On A Serial Mediating Model, Jiaojiao Wan, Lili Ji, Zheqian Wang, Junfeng Zhao, Xiaoming Li

Faculty Publications

The mental health of youth living with patients with HIV needs focused attention. The primary source of psychological distress they experience may stem from social exclusion. Therefore, the current study was designed to explore the relationship between social exclusion and mental health among youths affected by parental HIV/AIDS in rural China.

Methods

297 youths affected by parental HIV/AIDS were recruited to completed questionnaires of social exclusion, perceived stress, future orientation and mental health. The bootstrap method was used to examine the mediation effects.

Results

It showed that: (1) the social exclusion (M = 32.48, SD = 15.25) significantly and …


What, When, And How Food And Beverage Are Advertised On Ghanian Television, Morgan Boncyk, Krystal K. Rampalli, Marian N. Winters, Muskaan K. Makkar, Silver Nanema, Gideon S. Amevinya, Amos Laar, Edward A. Frongillo Ph.D., Christine E. Blake Jun 2025

What, When, And How Food And Beverage Are Advertised On Ghanian Television, Morgan Boncyk, Krystal K. Rampalli, Marian N. Winters, Muskaan K. Makkar, Silver Nanema, Gideon S. Amevinya, Amos Laar, Edward A. Frongillo Ph.D., Christine E. Blake

Faculty Publications

Food marketing has increased volume, precision, and reach to influence viewers’ food attitudes, beliefs, and eating behaviors. What and how much people eat has implications for health. While many countries regulate food advertising to protect consumers and encourage healthy eating, Ghana has none. Understanding the content and framing of food and beverage advertisements can inform the development of effective policies and practices that encourage healthier diets. This content analysis examines the foods and beverages advertised, their timing, and marketing techniques on Ghanaian television. From February to May 2020, 486 hours of advertisements were recorded. Advertisements with ≥1 actors were coded …


Residential Factors Associated With Mental Health In United States Veterans, Air Force Military, And Air Force Employees, Andrew J. Hoisington, Christopher A. Stamper, Molly Penzenik, Meredith Reitter, Elizabeth J. Kovacs, Nazanin H. Bahraini, Lisa A. Brenner Jun 2025

Residential Factors Associated With Mental Health In United States Veterans, Air Force Military, And Air Force Employees, Andrew J. Hoisington, Christopher A. Stamper, Molly Penzenik, Meredith Reitter, Elizabeth J. Kovacs, Nazanin H. Bahraini, Lisa A. Brenner

Faculty Publications

Individuals in Westernized countries spend most of their time indoors. However, exploration of residential building factors that may influence occupants’ mental health is limited in scientific literature. The purpose of this study was to explore investigator's perceived areas of importance in residences to mental health via survey methods. To that end, we administered the Housing, Occupancy, Materials, and Environment (HOME) survey to assess factors that may influence mental health to those working in the United States (US) Air Force (n = 230) or past military members, US Veterans (n = 180). Self-reported mental health surveys were also administered to the …


Implementation Outcomes And Associated Constructs From The Consolidated Framework For Implementation Research Among Churches Trained Online To Implement Faith, Activity, And Nutrition In A National Implementation Study, Sara Wilcox Phd, Ruth P. Saunders Phd, Andrew T. Kaczynski Ph.D., Caroline Rudisill Ph.D., Msc, Ye Sil Kim Phd, Jasmin Parker-Brown, Kelsey R. Day May 2025

Implementation Outcomes And Associated Constructs From The Consolidated Framework For Implementation Research Among Churches Trained Online To Implement Faith, Activity, And Nutrition In A National Implementation Study, Sara Wilcox Phd, Ruth P. Saunders Phd, Andrew T. Kaczynski Ph.D., Caroline Rudisill Ph.D., Msc, Ye Sil Kim Phd, Jasmin Parker-Brown, Kelsey R. Day

Faculty Publications

Churches hold promise for reaching populations with high rates of chronic disease, yet few faith-based large-scale implementation studies exist. The study purpose was to examine 12-month implementation outcomes and associated Consolidated Framework for Implementation Research (CFIR) constructs after converting in-person training to online for an evidence-based intervention designed to improve church organizational practices related to physical activity (PA) and healthy eating (HE). US churches recruited from 2020 to 2022 participated in eight online lessons prior to implementation. Each church’s coordinator completed an online baseline and 12-month survey assessing church practices for PA/HE components targeted in the Faith, Activity, and Nutrition …


Association Between ‘Emergency Obstetric & Newborn Care Readiness’ And Delivery Service Utilization In Bangladesh: Evidence From National Health Facility Assessment Surveys, Kaji Keya-Korotki, Nabil Natafgi Ph.D., Mph, Cph, Mark Macauda, Syed Abdul Hamid, M. Mahmud Khan May 2025

Association Between ‘Emergency Obstetric & Newborn Care Readiness’ And Delivery Service Utilization In Bangladesh: Evidence From National Health Facility Assessment Surveys, Kaji Keya-Korotki, Nabil Natafgi Ph.D., Mph, Cph, Mark Macauda, Syed Abdul Hamid, M. Mahmud Khan

Faculty Publications

Background

Bangladesh faces one of the highest global burdens of maternal and newborn deaths, primarily caused by hemorrhage and eclampsia/preeclampsia. Despite reducing maternal mortality by 40%, comprehensive medical interventions remain insufficient in health facilities.

Objectives

This study assessed the readiness of sub-district hospitals in Bangladesh to provide Emergency Obstetric and Newborn Care (EmONC) and analyzed the association between facility readiness and delivery rates.

Methods

Using Health Facility Assessment Survey data from 140 hospitals in 2014 and 141 in 2017, facility readiness was measured based on nine signal functions: administering antibiotics, oxytocin, and anticonvulsants; providing blood transfusions; performing cesarean and assisted …


Association Between ‘Emergency Obstetric & Newborn Care Readiness’ And Delivery Service Utilization In Bangladesh: Evidence From National Health Facility Assessment Surveys, Kaji Keya-Korotki, Nabil Natafgi Ph.D., Mph, Cph, Mark Macauda, Syed Abdul Hamid, M. Mahmud Khan May 2025

Association Between ‘Emergency Obstetric & Newborn Care Readiness’ And Delivery Service Utilization In Bangladesh: Evidence From National Health Facility Assessment Surveys, Kaji Keya-Korotki, Nabil Natafgi Ph.D., Mph, Cph, Mark Macauda, Syed Abdul Hamid, M. Mahmud Khan

Faculty Publications

Background

Bangladesh faces one of the highest global burdens of maternal and newborn deaths, primarily caused by hemorrhage and eclampsia/preeclampsia. Despite reducing maternal mortality by 40%, comprehensive medical interventions remain insufficient in health facilities.

Objectives

This study assessed the readiness of sub-district hospitals in Bangladesh to provide Emergency Obstetric and Newborn Care (EmONC) and analyzed the association between facility readiness and delivery rates.

Methods

Using Health Facility Assessment Survey data from 140 hospitals in 2014 and 141 in 2017, facility readiness was measured based on nine signal functions: administering antibiotics, oxytocin, and anticonvulsants; providing blood transfusions; performing cesarean and assisted …


Distinct Brain Age Gradients Across The Adult Lifespan Reflect Diverse Neurobiological Hierarchies, Nicholas Riccardi, Alex Teghipco, Sarah Newman-Norlund B.S., M.A., Roger Newman-Norlund Ph.D., Ida Rangus, Chris Rorden, Julius Fridriksson Ph.D., Leonardo Bonilha May 2025

Distinct Brain Age Gradients Across The Adult Lifespan Reflect Diverse Neurobiological Hierarchies, Nicholas Riccardi, Alex Teghipco, Sarah Newman-Norlund B.S., M.A., Roger Newman-Norlund Ph.D., Ida Rangus, Chris Rorden, Julius Fridriksson Ph.D., Leonardo Bonilha

Faculty Publications

‘Brain age’ is a biological clock typically used to describe brain health with one number, but its relationship with established gradients of cortical organization remains unclear. We address this gap by leveraging a data-driven, region-specific brain age approach in 335 neurologically intact adults, using a convolutional neural network (volBrain) to estimate regional brain ages directly from structural MRI without a predefined set of morphometric properties. Six distinct gradients of brain aging are replicated in two independent cohorts. Spatial patterns of accelerated brain aging in older adults quantitatively align with the archetypal sensorimotor-to-association axis of cortical organization. Other brain aging gradients …


Generative Ai For Thematic Analysis In A Maternal Health Study: Coding Semistructured Interviews Using Large Language Models, Shan Qiao, Xingyu Fang, Junbo Wang, Ran Zhang, Xiaoming Li, Yuhao Kang May 2025

Generative Ai For Thematic Analysis In A Maternal Health Study: Coding Semistructured Interviews Using Large Language Models, Shan Qiao, Xingyu Fang, Junbo Wang, Ran Zhang, Xiaoming Li, Yuhao Kang

Faculty Publications

Study Objectives: The coding of semistructured interview transcripts is a critical step for thematic analysis of qualitative data. However, the coding process is often labor-intensive and time-consuming. The emergence of generative artificial intelligence (GenAI) presents new opportunities to enhance the efficiency of qualitative coding. This study proposed a computational pipeline using GenAI to automatically extract themes from interview transcripts. Methods: Using transcripts from interviews conducted with maternity care providers in South Carolina, we leveraged ChatGPT for inductive coding to generate codes from interview transcripts without a predetermined coding scheme. Structured prompts were designed to instruct ChatGPT to generate and summarize …


Impact Of Prior Exposures On Biomarkers Of Blast During Military Tactical Training, Zhaoyu Wang, Shengnan Sun, Alis Aksar Kranfli, Jeffrey Nemes, Molly J. Sullan, Andrew J. Hoisington, Lisa A. Brenner, Miciej Skotak, Christina R. Lavalle, Yongchao Ge, Walter Carr, Fatemah Haghighi May 2025

Impact Of Prior Exposures On Biomarkers Of Blast During Military Tactical Training, Zhaoyu Wang, Shengnan Sun, Alis Aksar Kranfli, Jeffrey Nemes, Molly J. Sullan, Andrew J. Hoisington, Lisa A. Brenner, Miciej Skotak, Christina R. Lavalle, Yongchao Ge, Walter Carr, Fatemah Haghighi

Faculty Publications

Blast injuries and subclinical effects are of significant concern among those Service Members (SMs) participating in military operations and tactical trainings. Studies of SMs repeatedly exposed during training find concussion-like symptomology with transient decrements in neurocognitive performance, and alterations in blood biomarkers. How prior mild TBI (mTBI) history interacts with low-level blast (LLB) exposure, however, remains unexplored, which we investigate in the present study, to identify interindividual biomarker changes from LLB exposures influenced by prior history of mTBI.


Pulse Pressure, White Matter Hyperintensities, And Cognition: Mediating Effects Across The Adult Lifespan, Jade Hannan, Sarah Newman-Norlund, Natalie Busby, Sarah C. Wilson, Roger Newman-Norlund, Chris Rorden, Julius Fridriksson Ph.D., Leonardo Bonilha May 2025

Pulse Pressure, White Matter Hyperintensities, And Cognition: Mediating Effects Across The Adult Lifespan, Jade Hannan, Sarah Newman-Norlund, Natalie Busby, Sarah C. Wilson, Roger Newman-Norlund, Chris Rorden, Julius Fridriksson Ph.D., Leonardo Bonilha

Faculty Publications

Objectives: To investigate whether pulse pressure or mean arterial pressure mediates the relationship between age and white matter hyperintensity load and to examine the mediating effect of white matter hyperintensities on cognition.

Methods: Demographic information, blood pressure, current medication lists, and Montreal Cognitive Assessment scores for231 stroke- and dementia-free adults were retrospectively obtained from the Aging Brain Cohort study. Total WMH load was determined from T2-FLAIR magnetic resonance scans using the TrUE-Net deep learning tool for white matter segmentation. In separate models, we used mediation analysis to assess whether pulse pressure or MAP mediates the relationship between age and total …


Pulse Pressure, White Matter Hyperintensities, Andcognition: Mediating Effects Across The Adult Lifespan, Jade Hannan, Sarah Newman-Norlund, Natalie Busby, Sarah C. Wilson, Roger Newman-Norlund, Chris Rorden, Julius Fridriksson, Leonardo Bon, Nicholas Riccardi May 2025

Pulse Pressure, White Matter Hyperintensities, Andcognition: Mediating Effects Across The Adult Lifespan, Jade Hannan, Sarah Newman-Norlund, Natalie Busby, Sarah C. Wilson, Roger Newman-Norlund, Chris Rorden, Julius Fridriksson, Leonardo Bon, Nicholas Riccardi

Faculty Publications

Objectives: To investigate whether pulse pressure or mean arterial pressure mediates the relationship between age and white matter hyperintensity load and to examine the mediating effect of white matter hyperintensities on cognition.

Methods: Demographic information, blood pressure, current medication lists, and Montreal Cognitive Assessment scores for231 stroke- and dementia-free adults were retrospectively obtained from the Aging Brain Cohort study. Total WMH load was determined from T2-FLAIR magnetic resonance scans using the TrUE-Net deep learning tool for white matter segmentation. In separate models, we used mediation analysis to assess whether pulse pressure or MAP mediates the relationship between age and total …


Podcasts In Mental, Physical, Or Combined Health Interventions For Adults: Scoping Review, Elizabeth M. Dascombe, Philip J. Morgan, Ryan J. Drew, Casey P. Regan, Gabrielle Turner-Mcgrievy, Myles D. Young May 2025

Podcasts In Mental, Physical, Or Combined Health Interventions For Adults: Scoping Review, Elizabeth M. Dascombe, Philip J. Morgan, Ryan J. Drew, Casey P. Regan, Gabrielle Turner-Mcgrievy, Myles D. Young

Faculty Publications

Background:

The increasing prevalence of poor mental and physical health in adults is a global health concern. Given the scope of this problem, scalable and effective treatment interventions are needed. While podcasts (online digital audio files) are becoming more popular, the extent of podcast use in mental, physical, or combined health interventions has not been reviewed.

Objective:

This scoping review primarily aims to summarize the available evidence regarding the use of podcasts in health promotion interventions. A series of 5 research questions was designed to systematically review and accurately represent podcast use in current research interventions.

Methods:

We conducted a …


Cardiovascular Health In The Transition From Adolescence To Emerging Adulthood: A Scientific Statement From The American Heart Association, Jewel Scott Phd, Rn, Fnp-C, Anandita Agarwala, Carissa M. Baker-Smith, Matthew J. Feinstein, Karen Jakubowski, Jill Kaar, Niyati Parekh, Kershaw V. Patel, Janna Stephens May 2025

Cardiovascular Health In The Transition From Adolescence To Emerging Adulthood: A Scientific Statement From The American Heart Association, Jewel Scott Phd, Rn, Fnp-C, Anandita Agarwala, Carissa M. Baker-Smith, Matthew J. Feinstein, Karen Jakubowski, Jill Kaar, Niyati Parekh, Kershaw V. Patel, Janna Stephens

Faculty Publications

Cardiovascular disease remains a leading cause of death in the United States, with an alarming rise in the proportion of young adults experiencing cardiovascular events. Many adolescents enter adulthood with significant cardiovascular disease risk factors. This scientific statement addresses the critical need for cardiovascular health promotion during emerging adulthood, a transitional stage between the ages of 18 and 25 or 29 years of age. We discuss the significance of social determinants of health and the interplay between individual-level risk factors and developmental changes, including shifts in substance use, social connections, and emotional well-being. We conclude by outlining strategies for optimizing …


Association Of Nucleoside Reverse Transcriptase Inhibitor Use With Reduced Risk Of Alzheimer's Disease Risk, Joseph Magagnoli Ph.D., Ms, Meenakshi Ambati, Tammy H. Cummings, Joseph Nguyen, Claire C. Thomas, Vidya L. Ambati, S. Scott Sutton, Bradley D. Gelfand, Jayakrishna Ambati May 2025

Association Of Nucleoside Reverse Transcriptase Inhibitor Use With Reduced Risk Of Alzheimer's Disease Risk, Joseph Magagnoli Ph.D., Ms, Meenakshi Ambati, Tammy H. Cummings, Joseph Nguyen, Claire C. Thomas, Vidya L. Ambati, S. Scott Sutton, Bradley D. Gelfand, Jayakrishna Ambati

Faculty Publications

INTRODUCTION

Inflammasome activation is implicated in Alzheimer's disease (AD). We previously demonstrated that nucleoside reverse transcriptase inhibitors (NRTIs), drugs approved to treat human immunodeficiency virus (HIV) and hepatitis B, also inhibit inflammasome activation.

METHODS

We evaluated the association between NRTI exposure and subsequent development of AD in the United States Veterans Health Administration over a 24-year period and in the MarketScan database over a 14-year period using propensity score-matched multivariate Cox hazards regression and Kaplan–Meier analyses.

RESULTS

We report that in humans, NRTI exposure was associated with a significantly lower incidence of AD in two of the largest health insurance …


Investigating The Suitability Of Dichotomous Responses For The Water Insecurity Experiences (Wise) Scales Using Nationally Representative Data From 39 Countries, Indira Bose, Joshua D. Miller, Hilary J. Bethancourt, Olga P. García, Hugo R. Melgar-Quiñonez, Rosana Salles-Costa, Mauro E. Delgrossi, Scott M. Miller, Tessa L. Durham, Teresa Shamah-Levy, Pablo Gaitán-Rossi, Sera L. Young, Edward A. Frongillo Jr. Ph.D. May 2025

Investigating The Suitability Of Dichotomous Responses For The Water Insecurity Experiences (Wise) Scales Using Nationally Representative Data From 39 Countries, Indira Bose, Joshua D. Miller, Hilary J. Bethancourt, Olga P. García, Hugo R. Melgar-Quiñonez, Rosana Salles-Costa, Mauro E. Delgrossi, Scott M. Miller, Tessa L. Durham, Teresa Shamah-Levy, Pablo Gaitán-Rossi, Sera L. Young, Edward A. Frongillo Jr. Ph.D.

Faculty Publications

The Water Insecurity Experiences (WISE) Scales have been validated to comparably measure water insecurity globally. The scales consist of 12 items that can be administered in approximately 3 minutes. There is interest in developing more rapid versions of the tools for when time is limited. One alternative is to use a subset of 4 items, which has been validated, but has some drawbacks. Here we investigate another alternative: dichotomous (yes/no) response options instead of the original four levels of frequency-based (polytomous) responses. We used nationally representative data from 39 countries to simulate dichotomized responses by collapsing the four levels of …


Sexually Transmitted Infection (Sti) Incidence And Risk Factors Among People With Hiv (Pwh): Insights From A 13-Year Cohort Study In South Carolina, Salome-Joelle Gass, Shujie Chen, Jiajia Zhang Ph.D., Bankole Olatosi Apr 2025

Sexually Transmitted Infection (Sti) Incidence And Risk Factors Among People With Hiv (Pwh): Insights From A 13-Year Cohort Study In South Carolina, Salome-Joelle Gass, Shujie Chen, Jiajia Zhang Ph.D., Bankole Olatosi

Faculty Publications

The Ending the HIV Epidemic (EHE) initiative aims to reduce new HIV infections by 90% by 2030 in the United States (US). However, rising sexually transmitted infection (STI) rates exacerbate the bidirectional infection risk between HIV and STIs. Most research on STIs among people with HIV (PWH) has focused on high-risk groups, resulting in limited data on broader populations. This study addresses that gap by examining the incidence and risk factors for gonorrhea, chlamydia, and syphilis in a statewide cohort of PWH in South Carolina. Data from South Carolina’s HIV and STI surveillance systems were linked, and all PWH aged …


Environmental Risk And Alpha-Gal Syndrome (Ags) In The Mid-Atlantic United States, Brandon D. Hollingsworth Ph.D., Margaret Wiener, Dana A. Giandimenico, Scott P. Commins, Ross M. Boyce Apr 2025

Environmental Risk And Alpha-Gal Syndrome (Ags) In The Mid-Atlantic United States, Brandon D. Hollingsworth Ph.D., Margaret Wiener, Dana A. Giandimenico, Scott P. Commins, Ross M. Boyce

Faculty Publications

Alpha-gal syndrome (AGS), commonly referred to as the tick bite red meat allergy, has been reported worldwide with the number of suspected cases in the United States increasing from 24 in 2009 to over 34,000 in 2019. Within the US, AGS is associated with the bite of two tick species, Amblyomma americanum and Ixodes scapularis, and has particularly high incidence rates in the mid-Atlantic region. Because AGS is associated with tick bites, the risk of developing AGS is affected by the environment individuals visit. Despite this, as well as the numerous studies associating the environment with Am. americanum, …


Vocal And Articulatory Speech Control Deficits In Individuals With Post-Stroke Aphasia, Roozbeh Behroozmand, Zeinab Khoshhal Mollasaraei, Vahid Nejati, Ayoub Daliri, Julius Fridriksson Ph.D. Apr 2025

Vocal And Articulatory Speech Control Deficits In Individuals With Post-Stroke Aphasia, Roozbeh Behroozmand, Zeinab Khoshhal Mollasaraei, Vahid Nejati, Ayoub Daliri, Julius Fridriksson Ph.D.

Faculty Publications

Individuals with post-stroke aphasia exhibit deficits in regulating vocal (i.e., laryngeal) pitch control during speech vowel production; however, it is not determined whether such deficits also exist when they control their supra-laryngeal speech articulators during word production. To address this question, 19 subjects with post-stroke aphasia and 20 controls were tested under an altered auditory feedback paradigm in which they received + 30% shifts in their vowel first-formant frequency during word production. In addition, 17 aphasia subjects and 19 controls from the same groups also completed steady vowel vocalizations while receiving randomized pitch shifts at ± 100 cents. Consistent with …