Public Health Commons^™

Case Growth Analysis To Inform Local Response To Covid-19 Epidemic In A Diverse Us Community, Marcia C De Oliveira Otto, Frances A Brito, Ji Yun Tark, Eric Bakota, Jose-Miguel Yamal, Dritana Marko, Shreela V Sharma, Michael R Brown, Savitri N Appana, Alison M Rector, Stephen H Linder, Jennifer Kiger, Karen C Tseng, Alanna C Morrison, Eric Boerwinkle

Faculty, Staff and Student Publications

Early detection of new outbreak waves is critical for effective and sustained response to the COVID-19 pandemic. We conducted a growth rate analysis using local community and inpatient records from seven hospital systems to characterize distinct phases in SARS-CoV-2 outbreak waves in the Greater Houston area. We determined the transition times from rapid spread of infection in the community to surge in the number of inpatients in local hospitals. We identified 193,237 residents who tested positive for SARS-CoV-2 via molecular testing from April 8, 2020 to June 30, 2021, and 30,031 residents admitted within local healthcare institutions with a positive …

Covid-19 Pandemic And Infant Neurodevelopmental Impairment: A Systematic Review And Meta-Analysis, Kamran Hessami, Amir Hossein Norooznezhad, Sonia Monteiro, Enrico R Barrozo, Abolfazl Shirdel Abdolmaleki, Sara E Arian, Nikan Zargarzadeh, Lara S Shekerdemian, Kjersti M Aagaard, Alireza A Shamshirsaz

Faculty, Staff and Students Publications

IMPORTANCE: Primary studies proposed that aberrant maternal antiviral immunity and/or giving birth in quarantine, such as during the ongoing COVID-19 pandemic, may be associated with the risk of neurodevelopmental impairment (NDI) in offspring.

OBJECTIVES: To evaluate the associations of birth and being raised during the COVID-19 pandemic with risk of NDI among infants and to assess the association of gestational exposure to SARS-CoV-2 with risk of NDI.

DATA SOURCES: PubMed, Web of Science, Scopus, Embase, and preprint servers were systematically searched from inception to March 25, 2022.

STUDY SELECTION: Studies evaluating the neurodevelopment of infants born during the SARS-CoV-2 pandemic …

Examining The Association Between A Modified Quan Charlson Comorbidity Index (Qcci) And Viral Suppression: A Cross Sectional Analysis Of Dc Cohort Participants, Hasmin C. Ramirez, Lauren O’Connor, Morgan Byrne, Anne Monroe

Epidemiology Faculty Posters and Presentations

No abstract provided.

Quality Of Life In Older And Younger People With Hiv And Diabetes, Lauren F. O’Connor, La’Marcus Wingate, Sam Simmens, Amanda D. Castel, Anne K. Monroe

Epidemiology Faculty Posters and Presentations

No abstract provided.

Cancer Incidence And Stage At Diagnosis Among People With Psychotic Disorders: Systematic Review And Meta-Analysis., Jared C Wootten, Joshua C Wiener, Phillip S Blanchette, Kelly K. Anderson

Epidemiology and Biostatistics Publications

Research regarding the incidence of cancer among people with psychotic disorders relative to the general population is equivocal, although the evidence suggests that they have more advanced stage cancer at diagnosis. We conducted a systematic review and meta-analysis to examine the incidence and stage at diagnosis of cancer among people with, relative to those without, psychotic disorders. We searched the MEDLINE, EMBASE, PsycINFO, and CINAHL databases. Articles were included if they reported the incidence and/or stage at diagnosis of cancer in people with psychotic disorders. Random effects meta-analyses were used to determine risk of cancer and odds of advanced stage …

A Case Study Investigating Perceptions Of The Covid-19 Vaccine In Cato Manor And Chesterville, Caitlin Chan

Independent Study Project (ISP) Collection

Despite countries all over the world transitioning to life post COVID-19, there are still many aspects of the pandemic that remain controversial and hot topics of debate. Perhaps among one of the most debated subjects is the question of whether vaccinations are necessary and if they truly had an impact on eliminating the virus. The concept of vaccine hesitancy has become a growing concern and threatens the health of communities around the world.

This project employed a mixed-methodology research design to investigate attitudes towards the COVID-19 vaccine constructed by community members living in the townships of Cato Manor and Chesterville. …

Novel Dietary Index For Gut Microbiota And Associations With Colorectal Cancer And Breast Cancer Risk, Bezawit Eyob Kase

Theses and Dissertations

Introduction: Diet serves as a driving force for shaping the gut microbiome. Understanding how diet may modify gut microbiota and subsequently may be associated with chronic disease is critical to public health prevention efforts. Aims: We aimed to develop a novel dietary index that captures the quality of diet with respect to attaining beneficial composition and function of gut microbiota. We then examined the relationship between the dietary index and two gut microbiota-related cancers, i.e., colorectal and breast cancers.

Methods: We conducted a systematic review of studies that examined the effect of foods on gut microbiota in adult populations. Dietary …

The Ubiquitin-Proteasome System Is Necessary For Long-Term Synaptic Depression In Aplysia, Jennifer S Love, Dana L Karshenas, Meghan B Spyres, Lynn A Farrugia, A Min Kang, Hoanvu Nguyen, Sharan L Campleman, Shao Li, Paul M Wax, Jeffery Brent, Kim Aldy, Toxicology Investigators Consortium Study Group

Faculty, Staff and Student Publications

The Toxicology Investigators Consortium (ToxIC) Core Registry was established by the American College of Medical Toxicology in 2010. The Core Registry collects data from participating sites with the agreement that all bedside and telehealth medical toxicology consultations will be entered. This twelfth annual report summarizes the registry's 2021 data and activity with its additional 8552 cases. Cases were identified for inclusion in this report by a query of the ToxIC database for any case entered from January 1 to December 31, 2021. Detailed data was collected from these cases and aggregated to provide information, which included demographics, reason for medical …

Monkeypox: What Do Dental Professionals Need To Know?, Charifa Zemouri, Edgar O Beltrán, Richard Holliday, Nicholas S Jakubovics, James R Allison

Faculty, Staff and Student Publications

Infection control is critical for the safe delivery of dental care. Infection control practices must be responsive to emerging and re-emerging infectious diseases and outbreaks, as was clearly seen during the peak of the COVID-19 pandemic. An emerging global outbreak of the monkeypox virus has again raised potential challenges for infection control in dentistry. Monkeypox is an infectious disease, characterised by a rash affecting the skin and soft tissues, including the oral cavity. Previously, cases were mostly seen following contact with infected animals in Central and West Africa, with limited human-to-human transmission within and outside of these areas. However, since …

The Impact Of Intraoperative Glucagon On The Diagnostic Accuracy Of Intraoperative Cholangiogram For The Diagnosis Of Choledocholithiasis: Experience From A Large Tertiary Care Center, Artem Boyev, Srinivas Sanjeevi, Martha M Estrada, Tien C Ko, Curtis J Wray

Faculty, Staff and Student Publications

INTRODUCTION: In response to the COVID-19 pandemic, hospitals reported decreased admissions for acute surgical diagnoses, but scant data was available to quantify the decrease and its consequences. The objective of this study was to examine the incidence of acute care surgery encounters before and during the COVID-19 pandemic.

MATERIALS AND METHODS: A retrospective cohort study was performed at a single, urban, United States safety-net hospital. Emergency room encounters, admissions, non-elective surgical procedures, patient acuity, and surgical complications were compared before and after the start of the COVID-19 pandemic. The primary outcome of the study was the incidence rate (IR) and …

Socioeconomic And Comorbid Factors Affecting Mortality And Length Of Stay In Covid-19 Patients, Adam Delora, Ashlynn Mills, David Jacobson, Brendon Cornett, William F Peacock, Anita Datta, Shane P Jenks

Faculty, Staff and Students Publications

Background The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic exposed and exacerbated health disparities between socioeconomic groups. Our purpose was to determine if age, sex, race, insurance, and comorbidities predicted patients' length of stay (LOS) in the hospital and in-hospital mortality in patients diagnosed with coronavirus disease 2019 (COVID-19) during the early pandemic. Methods Utilizing retrospective, secondarily sourced electronic health record (EHR) data for patients who tested positive for COVID-19 from HCA Healthcare facilities, predictors of LOS and in-hospital mortality were assessed using regression. LOS and in-hospital mortality were assessed using logistic regression and negative binomial regression, respectively. All …

From World War Ii To Covid-19: A Historical Perspective On The American Medical Supply Chain, Hunter D Bechtold, Andrea T Cruz, Brent D Kaziny

Faculty, Staff and Students Publications

COVID-19 is the latest episode of shortages of critical medical supplies. Historically and to the present day, medical supplies have been sourced from single regions in the world, thus rendering the supply chain vulnerable to a myriad of harmful circumstances. We argue that shortages in medications related and unrelated to COVID have illustrated the need for the United States to diversify its medical supply sources before future pandemics, political crises, or natural disasters occur.

Covid Community-Engaged Testing In Alabama: Reaching Underserved Rural Populations Through Collaboration, Christopher Greer Mccollum, Thomas N Creger, Aadia I Rana, Lynn T Matthews, Stefan D Baral, Greer A Burkholder, William A Curry, Latesha Elopre, Faith E Fletcher, Sydney Grooms, Emily B Levitan, Max Michael, Barbara Van Der Pol, Michael J Mugavero

Faculty, Staff and Students Publications

Rural communities are often underserved by public health testing initiatives in Alabama. As part of the National Institutes of Health's Rapid Acceleration of Diagnostics‒Underserved Populations initiative, the University of Alabama at Birmingham, along with community partners, sought to address this inequity in COVID-19 testing. We describe the participatory assessment, selection, and implementation phases of this project, which administered more than 23 000 COVID-19 tests throughout the state, including nearly 4000 tests among incarcerated populations. (

Characterization And Determinant Factors Of Critical Illness And In-Hospital Mortality Of Covid-19 Patients: A Retrospective Cohort Of 1,792 Patients In Kenya, Isinta M. Elijah, Endawoke Amsalu, Xuening Jian, Mingyang Cao, Eric K. Mibei, Danvas O. Kerosi, Francis G. Mwatsahu, Wei Wang, Faith Onyangore, Youxin Wang

Research outputs 2022 to 2026

Limited data is available on the coronavirus disease 2019 (COVID-19), critical illness rate, and in-hospital mortality in the African setting. This study investigates determinants of critical illness and in-hospital mortality among COVID-19 patients in Kenya. We conducted a retrospective cohort study at Kenyatta National Hospital (KNH) in Kenya. Multivariate logistic regression and Cox proportional hazard regression were employed to determine predictor factors for intensive care unit (ICU) admission and in-hospital mortality, respectively. In addition, the Kaplan-Meier model was used to compare the survival times using log-rank tests. As a result, 346 (19.3 %) COVID-19 patients were admitted to ICU, and …

Socioeconomic, Ethnocultural, Substance- And Cannabinoid-Related Epidemiology Of Down Syndrome Usa 1986–2016: Combined Geotemporospatial And Causal Inference Investigation, Albert Stuart Reece, Gary Kenneth Hulse

Research outputs 2022 to 2026

Background: Down syndrome (DS) is the commonest of the congenital genetic defects whose incidence has been rising in recent years for unknown reasons. This study aims to assess the impact of substance and cannabinoid use on the DS Rate (DSR) and assess their possible causal involvement. Methods: An observational population-based epidemiological study 1986–2016 was performed utilizing geotemporospatial and causal inferential analysis. Participants included all patients diagnosed with DS and reported to state based registries with data obtained from National Birth Defects Prevention Network of Centers for Disease Control. Drug exposure data was from the National Survey of Drug Use and …

Probing Mechanisms Of Binding And Allostery In The Sars-Cov-2 Spike Omicron Variant Complexes With The Host Receptor: Revealing Functional Roles Of The Binding Hotspots In Mediating Epistatic Effects And Communication With Allosteric Pockets, Gennady M. Verkhivker, Steve Agajanian, Ryan Kassab, Keerthi Krishnan

Mathematics, Physics, and Computer Science Faculty Articles and Research

In this study, we performed all-atom MD simulations of RBD–ACE2 complexes for BA.1, BA.1.1, BA.2, and BA.3 Omicron subvariants, conducted a systematic mutational scanning of the RBD–ACE2 binding interfaces and analysis of electrostatic effects. The binding free energy computations of the Omicron RBD–ACE2 complexes and comprehensive examination of the electrostatic interactions quantify the driving forces of binding and provide new insights into energetic mechanisms underlying evolutionary differences between Omicron variants. A systematic mutational scanning of the RBD residues determines the protein stability centers and binding energy hotpots in the Omicron RBD–ACE2 complexes. By employing the ensemble-based global network analysis, we …

Transmission Roles Of Symptomatic And Asymptomatic Covid-19 Cases: A Modelling Study, Jianbin Tan, Yang Ge, Leonardo Martinez, Jimin Sun, Changwei Li, Adrianna Westbrook, Enfu Chen, Jinren Pan, Yang Li, Wei Cheng, Feng Ling, Zhinping Chen, Ye Shen, Hui Huang

Faculty Publications

Coronavirus disease 2019 (COVID-19) asymptomatic cases are hard to identify, impeding transmissibility estimation. The value of COVID-19 transmissibility is worth further elucidation for key assumptions in further modelling studies. Through a population-based surveillance network, we collected data on 1342 confirmed cases with a 90-days follow-up for all asymptomatic cases. An age-stratified compartmental model containing contact information was built to estimate the transmissibility of symptomatic and asymptomatic COVID-19 cases. The difference in transmissibility of a symptomatic and asymptomatic case depended on age and was most distinct for the middle-age groups. The asymptomatic cases had a 66.7% lower transmissibility rate than symptomatic …

Do You Know The Pathophysiology Of Cytokine Storm During Covid-19?, Shameera Shaik Masthan, Deekshitha Turaka, Ahmed Abdelhaleem, Mounica Vorla, Steven B. Lippmann

The University of Louisville Journal of Respiratory Infections

No abstract provided.

Dietary Inflammatory Index And Mortality From All Causes, Cardiovascular Disease, And Cancer: A Prospective Study, Zhen Lin, Yanfei Feng, Nitin Shivappa Mbbs, Mph, Ph.D., James R. Hébert Scd, Xin Xu

Faculty Publications

The Energy-adjusted Dietary Inflammatory Index (E-DIITM) is a comprehensive, literature-derived index for assessing the effect of dietary constituents on inflammatory biomarkers and inflammation-related chronic diseases. Several studies have examined the association between E-DII scores and mortality, with results that vary across populations. Therefore, in the present study, we aimed to investigate the potential association between E-DII scores and all-cause, cardiovascular disease (CVD), and cancer mortality using data from the Prostate, Lung, Colorectal and Ovarian (PLCO) Screening Trial. E-DII scores, calculated based on a food-frequency questionnaire, were analyzed both as a continuous variable and after categorization into quintiles. A multivariate Cox …

Availability Of Hospital-Based Cancer Services Before And After Rural Hospital Closure, 2008-2017, Whitney Zahnd Ph.D., Peiyin Hung Ph.D., Sylvia Kewei Shi, Anja Zgodic, Melinda A. Merrell Ph.D., Elizabeth L. Crouch, Janice C. Probst, Jan Eberth Ph.D.

Faculty Publications

Introduction

Rural populations have less access to cancer care services and experience higher cancer mortality rates than their urban counterparts, which may be exacerbated by hospital closures. Our objective was to examine the impact of hospital closures on access to cancer-relevant hospital services across hospital service areas (HSAs).

Methods

We used American Hospital Association survey data from 2008 to 2017 to examine the change in access to cancer-related screening and treatment services across rural HSAs that sustained hospitals over time, experienced any closures, or had all hospitals close. We performed a longitudinal analysis to assess the association between hospital closure …

A Novel Approach To Assessment Of Us Pediatric Trauma System Development., Mary E. Fallat, Colin Traeger, Sophie Humphrey, Lindsey Gumer, Kahir Jawad, Elissa Butler, Frederick B. Rogers, Frederick P. Rivara, Amelia T. Collings

Faculty and Staff Scholarship

Importance Mature trauma systems are critical in building and maintaining national, state, and local resilience against all-hazard disasters. Currently, pediatric state trauma system plans are not standardized and thus are without concrete measures of potential effectiveness.

Objective To develop objective measures of pediatric trauma system capability at the state level, hypothesizing significant variation in capabilities between states, and to provide a contemporary report on the status of national pediatric trauma system planning and development.

Design, Setting, and Participants A national survey was deployed in 2018 to perform a gap analysis of state pediatric trauma system capabilities. Four officials from each …

Omicron Variants Of The Sars-Cov-2: A Potentially Significant Threat In A New Wave Of Infections, Lukasz Szarpak, Michal Pruc, Alla Navolokina, Kavita Batra, Francesco Chirico, Charles De Roquetaillade

School of Medicine Faculty Research

From the beginning, the COVID-19 pandemic turned out to be a huge challenge and burden for medical services [1]. Currently, humanity is dealing with a new wave of the virus that has evolved and presents a new challenge, mainly due to its ability to avoid immune surveillance. Indeed, our main line of defense — vaccines — may be compromised. Omicron variants are characterized by an evolutionary force unprecedented so far. Among the several sublines that have already emerged, the BA.5 strain exhibit higher transmissibility and demonstrates a worrisome immune evasion. According to several laboratory investigations, vaccination-induced antibodies are less successful …

Veterans’ Ambulatory Care Experience During Covid-19: Veterans’ Access To And Satisfaction With Primary Care Early In The Pandemic, Brice Thomas, Aanchal Thadani, Patricia V Chen, Israel C Christie, Lisa M Kern, Mangala Rajan, Himabindu Kadiyala, Drew A Helmer

Faculty, Staff and Students Publications

BACKGROUND: The COVID-19 pandemic caused widespread changes to healthcare, but few studies focus on ambulatory care during the early phase of the pandemic. We characterize veterans' ambulatory care experience, specifically access and satisfaction, early in the pandemic.

METHODS: We employed a semi-structured telephone interview to capture quantitative and qualitative data from patients scheduled with a primary care provider between March 1 - June 30, 2020. Forty veterans were randomly identified at a single large urban Veterans Health Administration (VHA) medical center. The interview guide utilized 56 closed and open-ended questions to characterize veterans' perceptions of access to and satisfaction with …

A Cross-Sectional Examination Of The Early-Onset Hypertensive Disorders Of Pregnancy And Industrial Emissions Of Toxic Metals Using Kentucky Birth Records, 2008–2017, Courtney J. Walker, W. Jay Christian, Anna M. Kucharska-Newton, Steven R. Browning

Epidemiology and Environmental Health Faculty Publications

This cross-sectional study assessed geospatial patterns of early-onset hypertensive disorders of pregnancy (eHDP) in primiparous mothers and exposure to industrial emissions using geocoded residential information from Kentucky live (N = 210,804) and still (N = 1,247) birth records (2008–2017) and census block group estimates of aerosol concentrations of arsenic (As), cadmium (Cd), chromium (Cr), lead (Pb), mercury (Hg), selenium (Se), and zinc (Zi) from the Risk Screening Environmental Indicators (RSEI) model. A latent class analysis allowed for the identification of four district exposure classes—As, Cd, and Pb (12.6%); Se and Zi (21.4%); Pb and Cr (8%); and low or no …

Neighborhood Characteristics And Dementia Symptomology Among Community-Dwelling Older Adults With Alzheimer’S Disease, Dana M. Alhasan, Matthew C. Lohman Ph.D., Jana A. Hirsch, Margaret Chandlee Miller Ms, Ph.D., Bo Cai Ph.D., Chandra L. Jackson

Faculty Publications

Background: Neuropsychiatric symptoms (NPSs) lead to myriad poor health outcomes among individuals with Alzheimer’s disease (AD). Prior studies have observed associations between the various aspects of the home environment and NPSs, but macro-level environmental stressors (e.g., neighborhood income) may also disrupt the neuronal microenvironment and exacerbate NPSs. Yet, to our knowledge, no studies have investigated the relationship between the neighborhood environment and NPSs.

Methods: Using 2010 data among older adults with AD collected from a sample of the South Carolina Alzheimer’s Disease Registry, we estimated cross-sectional associations between neighborhood characteristics and NPSs in the overall population and by race/ethnicity. Neighborhood …

Yin And Yang Of Cannabinoid Cb1 Receptor: Cb1 Deletion In Immune Cells Causes Exacerbation While Deletion In Non-Immune Cells Attenuates Obesity, Kathryn Miranda, William Becker, Philip B. Busbee, Nicholas Dopkins, Osama A. Abdulla, Yin Zhong, Jiajia Zhang Ph.D., Mitzi Nagarkatti, Prakash S. Nagarkatti

Faculty Publications

While blockade of cannabinoid receptor 1 (CB1) has been shown to attenuate diet-induced obesity (DIO), its relative role in different cell types has not been tested. The current study investigated the role of CB1 in immune vs non-immune cells during DIO by generating radiation-induced bone marrow chimeric mice that expressed functional CB1 in all cells except the immune cells or expressed CB1 only in immune cells. CB1^-/- recipient hosts were resistant to DIO, indicating that CB1 in non-immune cells is necessary for induction of DIO. Interestingly, chimeras with CB1^-/- in immune cells showed exacerbation in DIO combined with …

Analysis Of An Seir Model With The Vertical Transmission On Transmission And Spread Of Hepatitis B In Ghana, Kwaafo Akoto Awuah-Mensah, Ute Mueller, Steven Richardson

Research outputs 2022 to 2026

Lack of good quality information about hepatitis B (HB) is a major hindrance to policy direction and comprehensive implementation of interventions to prevent and control the disease in the endemic region of Sub- Saharan Africa (SSA), particularly Ghana. A SEIR deterministic compartmental model which incorporates latent period and vertical transmission, and applied to HB incidence data was used to examine the transmission and spread of HB in order to inform policy decision on prevention and control of the disease in a population. The model parameters were estimated by a unique hybrid optimisation method involving Genetic Algorithm and Levenberg Marquardt Algorithm …

Patterns And Determinants Of Hiv Postexposure Prophylaxis In A Tertiary Health Facility In Nigeria, Onyinye H. Chime, Edmund O Ndibuagu, Wilfred O. Okenwa

International Journal of Health and Allied Sciences

Background: One of the targets of HIV prevention strategy is to ensure that 95% of the population access prevention services by 2030 with the aspiration of ending the AIDS epidemic by 2030. Methods: This is a record-based cross-sectional review. Data was extracted from the PEP registers and treatment folders from January 2017 to December 2021. Results: Non-occupational exposure (82.5%) was reported more than occupational (17.5%). Majority of cases (442) resulted from rape. Only 9.1% of the clients returned for follow-up and all were negative. Conclusion: Behavioral interventions designed to promote HIV risk reduction and protective behaviors should be promoted.

Delineating Covid-19 Immunological Features Using Single-Cell Rna Sequencing, Wendao Liu, Johnathan Jia, Yulin Dai, Wenhao Chen, Guangsheng Pei, Qiheng Yan, Zhongming Zhao

Faculty, Staff and Student Publications

Understanding the molecular mechanisms of coronavirus disease 2019 (COVID-19) pathogenesis and immune response is vital for developing therapies. Single-cell RNA sequencing has been applied to delineate the cellular heterogeneity of the host response toward COVID-19 in multiple tissues and organs. Here, we review the applications and findings from over 80 original COVID-19 single-cell RNA sequencing studies as well as many secondary analysis studies. We describe that single-cell RNA sequencing reveals multiple features of COVID-19 patients with different severity, including cell populations with proportional alteration, COVID-19-induced genes and pathways, severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection in single cells, and adaptation …

Phylogenetic Diversity Of Animal Oral And Gastrointestinal Viromes Useful In Surveillance Of Zoonoses, Anthony Michael Esposito, Michelle Marie Esposito, Albert Ptashnik

Publications and Research

Great emphasis has been placed on bacterial microbiomes in human and animal systems. In recent years, advances in metagenomics have allowed for the detection and characterization of more and more native viral particles also residing in these organisms. The digestive tracts of animals and humans—from the oral cavity, to the gut, to fecal excretions—have become one such area of interest. Next-generation sequencing and bioinformatic analyses have uncovered vast phylogenetic virome diversity in companion animals, such as dogs and cats, as well as farm animals and wildlife such as bats. Zoonotic and arthropod-borne illnesses remain major causes of worldwide outbreaks, as …