Public Health Commons^™

Charting A Path To The Quintuple Aim: Harnessing Ai To Address Social Determinants Of Health, Yash Shah, Zachary Goldberg, Erika Harness, David Nash

College of Population Health Faculty Papers

The Quintuple Aim seeks to improve healthcare by addressing social determinants of health (SDOHs), which are responsible for 70-80% of medical outcomes. SDOH-related concerns have traditionally been addressed through referrals to social workers and community-based organizations (CBOs), but these pathways have had limited success in connecting patients with resources. Given that health inequity is expected to cost the United States nearly USD 300 billion by 2050, new artificial intelligence (AI) technology may aid providers in addressing SDOH. In this commentary, we present our experience with using ChatGPT to obtain SDOH management recommendations for archetypal patients in Philadelphia, PA. ChatGPT identified …

Advancing Objective Mobile Device Use Measurement Inchildren Ages 6–11 Through Built-In Device Sensors: A Proof-Of-Concept Study, Olivia L. Finnegan, Robert Glenn Weaver Med, Phd, Hongpeng Yang, James W. White, Srihari Nelakuditi, Zifei Zhong, Rahul Ghosal Ph.D., Yan Tong, Aliye B. Cepni, Elizabeth L. Adams, Sarah Burkart Mph, Ph.D., Michael W. Beets Med, Mph, Phd, Bridget Armstrong Ph.D.

Faculty Publications

Mobile devices (e.g., tablets and smartphones) have been rapidly integrated into the lives of children and have impacted howchildren engage with digital media. The portability of these devices allows for sporadic, on-demand interaction, reducing theaccuracy of self-report estimates of mobile device use. Passive sensing applications objectively monitor time spent on a givendevice but are unable to identify who is using the device, a significant limitation in child screen time research. Behavioralbiometric authentication, using embedded mobile device sensors to continuously authenticate users, could be applied toaddress this limitation. This study examined the preliminary accuracy of machine learning models trained on iPad …

Entertainment-Education And Climate Change: Program Examples, Evidence, And Best Practices From Around The World, Suruchi Sood, Amy Henderson Riley, Lyena Birkenstock

College of Population Health Faculty Papers

Entertainment-education is a global theory-driven and evidence-based storytelling strategy that promotes social and behavioral change. A formal review of the peer-reviewed and grey literature, alongside consultations with program and industry experts, revealed several contemporary examples of entertainment-education and climate change. Late-night comedy, with the inclusion of climate change storylines within popular entertainment, is common in the Global North. In the Global South, climate adaptation and mitigation narratives are situated in formats portraying audiences’ lived experiences. Crosscutting trends relate to documentary storytelling, children’s programming, and future efforts. Recommendations include re-examining theories across the social-ecological model; placing entertainment front and center; including …

Employing Digital Pcr For Enhanced Detection Of Perinatal Toxoplasma Gondii Infection: A Cross-Sectional Surveillance And Maternal-Infant Outcomes Study In El Salvador, Mary K. Lynn, Marvin Stanley Rodriguez Aquino, Pamela Michelle Cornejo Rivas, Xiomara Miranda, David F. Torres-Romero, Hanson Cowan, Madeleine M. Meyer, Willber D. Castro-Godoy, Mufaro Kanyangarara Ph.D., Stella Coker Watson Self Ph.D., Ms, Berry A. Campbell, Melissa Nolan Ph.D., Mph

Faculty Publications

Toxoplasma gondii is a parasitic infection that can be transmitted in utero, resulting in fetal chorioretinitis and other long-term neurological outcomes. If diagnosed early, pregnancy-safe chemotherapeutics can prevent vertical transmission. Unfortunately, diagnosis of acute, primary infection among pregnant women remains neglected, particularly in low-and-middle-income countries. Clinically actionable diagnosis is complex due to the commonality of infection during childhood and early adulthood which spawn long-last antibody titers and historically unreliable direct molecular diagnostics. The current study employed a cross-sectional T. gondii perinatal surveillance study using digital PCR, a next generation molecular diagnostic platform, and a maternal-fetal outcomes survey to ascertain …

Supporting South Korea’S Aging Population: How Ai And Iot Acceptance Connects The Young And Old, Bobby Im

Master's Projects and Capstones

In 2024, South Korea surpassed every other nation by becoming the country with the lowest fertility rate (below 0.7%). Population decline will hinder future ability to care for their aging population and although the government and private corporations are investing millions of dollars on developing Artificial Intelligence-Internet of Things (AI-IoT) devices to support the aging, the acceptance levels and the amount of family support required is undervalued. By examining AI-IoT’s current use and role in South Korea’s public health system this paper shows how intergenerational support helps optimize existing procedures and equipment, increases the level of acceptance and use, and …

Information Feedback Delays Within Epidemic Models And Their Effect On Model Dynamics., Maria K. Bouka, Christopher Strickland Dr

Biology and Medicine Through Mathematics Conference

No abstract provided.

Youth Interest In Reusable Menstrual Hygiene Products: An Opportunity For Improving Menstruation Management, Makenna R. Eccles

College Honors Program

Adolescents experience inconsistent menstrual hygiene material access that is exacerbated by poverty and results in menstruation management difficulty, health risks, and interruptions to school attendance. The study centered the adolescent menstruation management experience through qualitative interviews to identify management difficulties and to assess knowledge, interest, and perceived feasibility of implementing reusable menstrual hygiene materials such as reusable sanitary pads, period underwear, menstrual cups, and menstrual disks to improve both menstrual hygiene access and menstrual management experiences. Inductive and deductive coding was used to analyze interview data and identify key themes. Adolescents expressed interest in reusable menstrual hygiene materials due to …

How Financial Beliefs And Behaviors Influence The Financial Health Of Individuals Struggling With Opioid Use Disorder, James R Langabeer, Francine R Vega, Marylou Cardenas-Turanzas, A Sarah Cohen, Karima Lalani, Tiffany Champagne-Langabeer

Faculty, Staff and Student Publications

The surge in opioid use disorder (OUD) over the past decade escalated opioid overdoses to a leading cause of death in the United States. With adverse effects on cognition, risk-taking, and decision-making, OUD may negatively influence financial well-being. This study examined the financial health of individuals diagnosed with OUD by reviewing financial beliefs and financial behaviors. We evaluated quality of life, perceptions of financial condition during active use and recovery, and total debt. We distributed a 20-item survey to 150 individuals in an outpatient treatment program for OUD in a large metropolitan area, yielding a 56% response rate. The results …

Heavy Metals In Afforested Mangrove Sediment From The World's Largest Delta: Distributional Mapping, Contamination Status, Risk Assessment And Source Tracing, Md Saifur Rahman, Moshiur Rahman, Yeasmin N Jolly, Md Kamal Hossain, Sanjida Afrin Semme, Bilal Ahamad Paray, Takaomi Arai, Jimmy Yu, M Belal Hossain

Faculty, Staff and Student Publications

This study aims to assess seasonal and spatial variations, contamination status, ecological risks, and metal sources (Ni, Pb, Cr, Cu, Mn, and Zn) in human-afforested mangrove sediments in a deltaic region. Five sampling locations were sampled during dry and wet seasons. Heavy metal concentrations followed the order: Mn > Zn > Ni > Cr > Cu > Pb. Metal loads, except Cu and Pb, were higher during the dry season, aligning with national and international recommendations. Sediment quality guidelines, contamination factor, geoaccumulation index, enrichment factors, and pollution load index indicated uncontaminated sediment in both seasons. Potential ecological risk assessment showed low risk conditions in all …

Identifying Phytoremediation Performing Plant Species That Can Be Utilized In The Improvement Of Heavy Metal Contaminated Soils, Ashley Clark*, Samuel Mutiti

Graduate Research Showcase

Heavy metal pollution is a problem associated with industrialization and development. Two major metals that are commonly mined and can enter the environment, which can jeopardize communities’ health, are copper (Cu) and lead (Pb). There are different options for reducing heavy metal pollution in the environment via remediation efforts, including physical, chemical, and biological methods. However, physical and chemical remediation can be costly and labor-intensive, making them unsuitable for regions that do not have the funds to utilize these practices. Biological remediation is a more cost-conservative practice that has been shown in many studies to be effective in the gradual …

Evaluating The Epidemiological, Hormonal, And Psychosocial Sex-Based Differences In Sports-Related Concussion Outcomes, Samantha Kanny

All Dissertations

Sports-related concussions (SRCs) affect approximately 3.8 million athletes in the United States per year. A multitude of risk factors including age, sex, concussion history and prior medical conditions have been observed to significantly increase sports-related concussion symptom burden. Researchers have posited many reasons to explain sex-based differences in SRC outcomes, often categorized by biological characteristics or sociocultural factors, however, females are vastly underrepresented in sports-related concussion research, making it difficult to understand the true mechanisms underlying SRC sex-based differences. The goal of this dissertation is to help fill the current gap in knowledge on sex-based differences in sports-related concussion outcomes. …

Seasonal Comparison Of Air Quality Variables And Evaluation Of Carbon Dioxide And Particulate Measurement Period In Classrooms, Daud Nosham

Durham School of Architectural Engineering and Construction: Dissertations, Theses, and Student Research

Indoor air quality and thermal environmental variables were measured in 55 classrooms in the mid-western United States spanning a full academic year. The studied air quality and environmental factors included carbon dioxide, temperature, relative humidity, particle counts, air velocity, formaldehyde, total volatile organic compounds, carbon monoxide, nitrogen dioxide, and ozone.

Carbon dioxide and Particulate matter concentrations were measured for a four-day measurement period. Then one-day, two-day, and four-day occupied time average concentrations were calculated which were then compared statistically to figure out an appropriate measurement period for these air quality variables. Kruskal Wallis test and Wilcoxon test were used to …

Bayesian Estimation Of Reproduction Numbers From Distributions Of Outbreaks Sizes: Branching Process Approach, Alberta Araba Johnson

Theses and Dissertations

The Generalized Poisson distribution is useful in modeling epidemiological processes as a branching stochastic processes problem. Our goal is to construct accurate and reliable estimators for the reproduction number (R0) (i.e., the number of secondary infections), particularly in the context of disease outbreaks modeled by a Galton-Watson process. Towards this goal, we construct the classical Bayes estimator, the Maximum Likelihood estimator, and the Empirical Bayes (EB) estimator under the Square Error Loss function in Chapter II. We prove that the Empirical Bayes estimator is asymptotically optimal and estimate the rate of convergence. We then proceed to monotonize the Empirical Bayes …

Employing Digital Pcr For Enhanced Detection Of Perinatal Toxoplasma Gondii Infection: A Cross-Sectional Surveillance And Maternalinfant Outcomes Study In El Salvador, Mary K. Lynn, Marvin Stanley Rodriguez Aquino, Pamela Michelle Cornejo Rivas, Xiomara Miranda, David F. Torres-Romero, Hanson Cowan, Madeleine M. Meyer, Willber D. Castro-Godoy, Mufaro Kanyangarara Ph.D., Stella C.W. Self Ph.D., Ms, Berry A. Campbell, Melissa S. Nolan Ph.D., Mph

Faculty Publications

Toxoplasma gondii is a parasitic infection that can be transmitted in utero, resulting in fetal chorioretinitis and other long-term neurological outcomes. If diagnosed early, pregnancysafe chemotherapeutics can prevent vertical transmission. Unfortunately, diagnosis of acute, primary infection among pregnant women remains neglected, particularly in low-andmiddle-income countries. Clinically actionable diagnosis is complex due to the commonality of infection during childhood and early adulthood which spawn long-last antibody titers and historically unreliable direct molecular diagnostics. The current study employed a cross-sectional T. gondii perinatal surveillance study using digital PCR, a next generation molecular diagnostic platform, and a maternal-fetal outcomes survey to ascertain the …

Factors Predictive Of The Development Of Surgical Site Infection In Thyroidectomy, A Replication Study Of Myssiorek (2018), Kaitlyn M. Kenig

Capstone Experience: Master of Public Health

The original study aimed to show that thyroidectomy does not result in surgical site infection (SSI) in most cases, and thus routine prescription of antibiotics is not necessary. The study looked to see what risk factors could predict the incidence of SSI. This would highlight those individuals who were at most risk of developing SSI, and then antibiotics would only be prescribed to these individuals instead of all or most individuals who undergo thyroidectomy.

This study used NSQIP data to look at incidence of SSI and look for risk factors that may be predictive of SSI. Only surgeries that were …

Exploring Binding Pockets In The Conformational States Of The Sars-Cov-2 Spike Trimers For The Screening Of Allosteric Inhibitors Using Molecular Simulations And Ensemble-Based Ligand Docking, Grace Gupta, Gennady M. Verkhivker

Mathematics, Physics, and Computer Science Faculty Articles and Research

Understanding mechanisms of allosteric regulation remains elusive for the SARS-CoV-2 spike protein, despite the increasing interest and effort in discovering allosteric inhibitors of the viral activity and interactions with the host receptor ACE2. The challenges of discovering allosteric modulators of the SARS-CoV-2 spike proteins are associated with the diversity of cryptic allosteric sites and complex molecular mechanisms that can be employed by allosteric ligands, including the alteration of the conformational equilibrium of spike protein and preferential stabilization of specific functional states. In the current study, we combine conformational dynamics analysis of distinct forms of the full-length spike protein trimers and …

Effect Of Asynchronous Virtual Interviews On Ethnic Minority Matriculation Into A Doctor Of Physical Therapy Program, Conner Clark, Nanea Lagasca, Gladys Miller, Jasmine Puspos

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose/Methods: This study examines the impact of the use of asynchronous virtual interviews (AVIs) in the admissions process of the Doctor of Physical Therapy (DPT) program at the University of Nevada, Las Vegas (UNLV). This research aims to examine racial and ethnic subgroup differences in AVI scores, evaluate the influence of AVIs on applicant scores in the admissions process, and assess the AVI inter-rater reliability among faculty evaluators using data from the 2019-2022 admissions cycles.

Results: Significant differences were found in AVI scores among racial and ethnic groups, with Black applicants scoring highest and Asian applicants scoring lowest. Additionally, inclusion …

Maternal Care Utilization And Provision During The Covid-19 Pandemic: Voices From Minoritized Pregnant And Postpartum Women And Maternal Care Providers In Deep South, Ran Zhang, Tiffany Byrd, Shan Qiao Ph.D., Myriam E. Torres Phd, Msph, Xiaoming Li Ph.D., Jihong Liu Sc.D.

Faculty Publications

Background

The COVID-19 pandemic has significantly affected maternal care services especially for minoritized individuals, creating challenges for both service users (i.e., African American and Hispanic pregnant/postpartum women) and maternal care providers (MCPs). Guided by a socioecological framework, this study aims to investigate the experiences of African American and Hispanic pregnant and postpartum women, as well as MCPs, in accessing and providing maternal care services during the COVID-19 pandemic in the Deep South.

Methods

We conducted semi-structured interviews with 19 African American women, 20 Hispanic women, and 9 MCPs between January and August 2022. Participants were recruited from Obstetrics and Gynecology …

Identifying Multilevel Predictors Of Behavioral Outcomes Like Park Use: A Comparison Of Conditional And Marginal Modeling Approaches, Marilyn E. Wende, S. Morgan Hughey, Alexander C. Mclain, Shirelle Hallum, J. Aaron Hipp, Jasper Schipperijn, Ellen W. Stowe, Andrew T. Kaczynski Ph.D.

Faculty Publications

This study compared marginal and conditional modeling approaches for identifying individual, park and neighborhood park use predictors. Data were derived from the ParkIndex study, which occurred in 128 block groups in Brooklyn (New York), Seattle (Washington), Raleigh (North Carolina), and Greenville (South Carolina). Survey respondents (n = 320) indicated parks within one half-mile of their block group used within the past month. Parks (n = 263) were audited using the Community Park Audit Tool. Measures were collected at the individual (park visitation, physical activity, sociodemographic characteristics), park (distance, quality, size), and block group (park count, population density, age structure, racial …

Latent Classification Of Multi-Model Non-Homogeneous Continuous-Time Markov Chains, Joonha Chang

Dissertations and Theses (Open Access)

The continuous-time Markov chain (CTMC) model and latent clustering models are commonly used to study longitudinal measures of categorical outcomes. Because of its simple but powerful Markovian property, CTMC models have been widely used in medical and public health researches. Due to limitations in the standard CTMC model, there have been some studies on non-homogeneous continuous-time Markov chain (NH-CTMC) that utilized time-dependent rates, but the progresses have been limited. NH-CTMC can be more powerful than CTMC by its default nature of time-dependent rate that can be fitted to a wider range of applications in medical studies. In this study, we …

Identifying A Group Of Factors Predicting Cognitive Impairment Among Older Adults, Longgang Zhao, Yuan Wang, Eric Mishio Bawa, Zichun Meng, Jingkai Wei, Sarah Newman-Norlund, Tushar Trivedi, Hatice Hasturk, Roger Newman-Norlund, Julius Fridriksson Ph.D., Anwar T. Nerchant

Faculty Publications

Background

Cognitive impairment has multiple risk factors spanning several domains, but few studies have evaluated risk factor clusters. We aimed to identify naturally occurring clusters of risk factors of poor cognition among middle-aged and older adults and evaluate associations between measures of cognition and these risk factor clusters.

Methods

We used data from the National Health and Nutrition Examination Survey (NHANES) III (training dataset, n = 4074) and the NHANES 2011–2014 (validation dataset, n = 2510). Risk factors were selected based on the literature. We used both traditional logistic models and support vector machine methods to construct a composite score …

Post-Modeling Adjustments And Delivered Dose Verification Of The 6fff Beam Model Commissioned For The Monaco Treatment Planning System, Grant C. Debevec

LSU Master's Theses

External beam radiation therapy has been shown to be an effective treatment method for tumors and abnormalities of the spine and vertebral region. Treating the spine using a stereotactic body radiation therapy (SBRT) technique can reduce toxicity to the spinal cord. The 6 MV flattening filter free (6FFF) beam model is currently used to plan and calculate dose for SBRT treatment plans, and the treatment plans are delivered using a linear accelerator (LINAC).

The commissioned beam model represents an invariant component of a LINAC. For volumetric modulated arc therapy (VMAT) treatment plans, the multileaf collimator (MLC) positions are changing throughout …

Modeling An Infection Outbreak With Quarantine: The Sibkr Model, Mikenna Dew, Amanda Langosch, Theadora Baker-Wallerstein

Rose-Hulman Undergraduate Mathematics Journal

Influenza is a respiratory infection that places a substantial burden in the world population each year. In this project, we study and interpret a data set from a flu outbreak in a British boarding school in 1978 with mathematical modeling. First, we propose a generalization of the SIR model based on the quarantine measure in place and establish the long-time behavior of the model. By analyzing the model mathematically, we determine the analytic formulas of the basic reproduction number, the long-time limit of solutions, and the maximum number of infection population. Moreover, we estimate the parameters of the model based …

Effects Of Sars-Cov-2 Variants On Cd8+ T Cell Epitope Diversity: Estimating Clinical Severity In The United States, Grace Kim, Jacob Elnaggar, Maya Sevalia, Najah Nicholas, Mallory Varnado, Judy Crabtree, Lucio Miele

School of Medicine Faculty Publications

Association for Clinical and Translational Science 2024; April 3 - April 5, 2024; Las Vegas, NV

Associations Between Sleep Duration, Sleep Disturbance And Cardiovascular Disease Biomarkers Among Adults In The United States, Prince Nii Ossah Addo, Paddington T. Mundagowa, Longgang Zhao, Mufaro Kanyangarara, Monique J. Brown Ph.D., Mph, Jihong Liu Sc.D.

Faculty Publications

Background

Sleep problems are associated with abnormal cardiovascular biomarkers and an increased risk of cardiovascular diseases (CVDs). However, studies investigating associations between sleep problems and CVD biomarkers have reported conflicting findings. This study examined the associations between sleep problems and CVD biomarkers in the United States.

Methods

Data were from the National Health and Nutrition Examination Survey (NHANES) (2007–2018) and analyses were restricted to adults ≥ 20 years (n = 23,749). CVD biomarkers [C-reactive Protein (CRP), low-density lipoproteins, high-density lipoproteins (HDL), triglycerides, insulin, glycosylated hemoglobin (HbA1c), and fasting blood glucose] were categorized as abnormal or normal using standardized cut-off …

A Systematic Review: Mirror Neurons & Schizophrenia, Yashesvi Sharma, Surajit Dey

Annual Research Symposium

This research project establishes a link between Mirror Neuron System (MNS) activity and this information's implications in treating and understanding schizophrenia, specifically, schizophrenic patients with negative symptoms.

Health And Healthcare: Designing For The Social Determinants Of Health And Blue Zones In North Nashville, Rebecca Tonguis, Honor Thomas, Olivia Hobbs

[Archive] Belmont University Research Symposium (BURS)

Owned by North Nashville’s First Community Church, a now empty site in the Osage-North Fisk neighborhood of North Nashville has been identified as a potential site for a new location of The Store, in addition to a community-centric architectural development based on the social determinants of health and informed by the principles behind Blue Zones, the locations with the highest lifespans in the world. Opened by Brad Paisley and Kimberly Williams-Paisley, The Store is a free grocery store that “allow[s] people to shop for their basic needs in a way that protects dignity and fosters hope”, for which North Nashville …

Short-Term Larval Surveys Reveal Rainy Season Breeding Site Preferences Of Malaria Vector Anopheles Spp. In Zanzibar City, Kaeden K. Hill

Independent Study Project (ISP) Collection

Malaria is a serious illness that causes over 500,000 deaths annually worldwide, with Tanzania alone contributing to approximately 4% of those deaths. Malaria is caused by Plasmodium spp. parasites, and it is vectored by mosquitoes in the Anopheles genus. In Zanzibar City, the incidence of malaria has decreased over the past few decades due to standardized treatment protocols and public health interventions targeting adult mosquitoes. However, the incidence remains between 1-2%, with an increasing trend observed over the past few years likely stemming from continued exchange of Plasmodium spp. from other malaria-endemic areas. Because larvicidal strategies can be useful in …

Transcriptional Signature Of Durable Effector T Cells Elicited By A Replication Defective Hcmv Vaccine, Xiaohua Ye, David J H Shih, Zhiqiang Ku, Junping Hong, Diane F Barrett, Richard E Rupp, Ningyan Zhang, Tong-Ming Fu, W Jim Zheng, Zhiqiang An

Faculty, Staff and Student Publications

Human cytomegalovirus (HCMV) is a leading infectious cause of birth defects and the most common opportunistic infection that causes life-threatening diseases post-transplantation; however, an effective vaccine remains elusive. V160 is a live-attenuated replication defective HCMV vaccine that showed a 42.4% efficacy against primary HCMV infection among seronegative women in a phase 2b clinical trial. Here, we integrated the multicolor flow cytometry, longitudinal T cell receptor (TCR) sequencing, and single-cell RNA/TCR sequencing approaches to characterize the magnitude, phenotype, and functional quality of human T cell responses to V160. We demonstrated that V160 de novo induces IE-1 and pp65 specific durable polyfunctional …

Digital Health Technologies For High-Risk Pregnancy Management: Three Case Studies Using Digilego Framework, Sahiti Myneni, Alexandra Zingg, Tavleen Singh, Angela Ross, Amy Franklin, Deevakar Rogith, Jerrie Refuerzo

Faculty, Staff and Student Publications

OBJECTIVE: High-risk pregnancy (HRP) conditions such as gestational diabetes mellitus (GDM), hypertension (HTN), and peripartum depression (PPD) affect maternal and neonatal health. Patient engagement is critical for effective HRP management (HRPM). While digital technologies and analytics hold promise, emerging research indicates limited and suboptimal support offered by the highly prevalent pregnancy digital solutions within the commercial marketplace. In this article, we describe our efforts to develop a portfolio of digital products leveraging advances in social computing, data science, and digital health.

METHODS: We describe three studies that leverage core methods from

RESULTS: Scalable social computing models using deep learning classifiers …