Public Health Commons^™

The Perpetual Evidence-Practice Gap: Addressing Ongoing Barriers To Chronic Pain Management In Primary Care In Three Steps, Laura Ellen Ashcraft, Megan E Hamm, Serwaa S Omowale, Valerie Hruschak, Elizabeth Miller, Shaun M Eack, Jessica S Merlin

Faculty, Staff and Student Publications

Background: Most management of chronic pain, a serious illness affecting the physical and psychological wellbeing of millions, occurs in primary care settings. Primary care practitioners (PCPs) attempt to provide evidence-based practices to treat chronic pain. However, there continues to be a gap between the care people receive and the evidence. The objectives for this study were to (1) explore determinants of evidence-based chronic pain management and (2) develop a novel approach to using implementation science to address the evidence-practice gap.

Method: A convenience sample of twenty-one Pennsylvania PCPs participated in one-time semi-structured telephone interviews. Interviews were transcribed verbatim and both …

Self-Perception Of Mental Health, Covid-19 And Associated Sociodemographic-Contextual Factors In Latin America, Pablo Roa, Guillermo Rosas, Gloria Isabel Niño-Cruz, Sergio Mauricio Moreno-López, Juliana Mejía-Grueso, Haney Aguirre-Loaiza, Javiera Alarcón-Aguilar, Rodrigo Reis, Adriano Akira Ferreira Hino, Fernando López, Deborah Salvo, Andrea Ramírez-Varela

Faculty, Staff and Student Publications

This study aimed to estimate the prevalence of alterations in self-perceived mental health during the COVID-19 pandemic and their associated factors in four Latin American countries. This is a cross-sectional study based on data collected from adults in 2021 through the Collaborative Response COVID-19 Survey by the MacDonnell Academy at Washington University in St. Louis (United States). The sample was composed of 8,125 individuals from Brazil, Colombia, Mexico, and Chile. A generalized linear model for a binary outcome variable with a logistic link and fixed country effects was used. There were 2,336 (28.75%) individuals who considered having suffered alterations in …

Prozone Masks Elevated Sars-Cov-2 Antibody Level Measurements, Micaela N Sandoval, Samuel P Mcclellan, Stephen J Pont, Jessica A Ross, Michael D Swartz, Mark A Silberman, Eric Boerwinkle

Faculty, Staff and Student Publications

We report a prozone effect in measurement of SARS-CoV-2 spike protein antibody levels from an antibody surveillance program. Briefly, the prozone effect occurs in immunoassays when excessively high antibody concentration disrupts the immune complex formation, resulting in a spuriously low reported result. Following participant inquiries, we observed anomalously low measurement of SARS-CoV-2 spike protein antibody levels using the Roche Elecsys® Anti-SARS-CoV-2 S immunoassay from participants in the Texas Coronavirus Antibody Research survey (Texas CARES), an ongoing prospective, longitudinal antibody surveillance program. In July, 2022, samples were collected from ten participants with anomalously low results for serial dilution studies, and a …

Colonial Drivers And Cultural Protectors Of Brain Health Among Indigenous Peoples Internationally, Rita Henderson, Joyla A Furlano, Shayla Scott Claringbold, Ashley Cornect-Benoit, Anh Ly, Jennifer Walker, Lisa Zaretsky, Pamela Roach

Faculty, Staff and Student Publications

Despite relatively higher rates of dementia among Indigenous populations internationally, research into drivers of disparities in brain health and cognitive function has tended to focus on modifiable risk factors over cultural understandings and contextual determinants. By seeking to characterize social and cultural factors that shape brain health and cognition in Indigenous populations, this mini scoping review expands prevailing schools of thought to include Indigenous knowledge systems. This reveals important gaps in culturally aligned care. It also reclaims horizons for research important to Indigenous Peoples that have garnered diminished attention in biomedical approaches. Twenty-three sources were included for data extraction. This …

Higher Baseline Serum Bilirubin Levels Are Associated With Increased Risk Of Early Neurological Deterioration In Women With Acute Ischemic Stroke, Meng Sun, Yingfeng Weng, Jiwei Cheng, Guoyi Li, Qian Xiao

Faculty, Staff and Student Publications

BACKGROUND AND OBJECTIVES: Early neurological deterioration (END) occurs in up to one-third of patients with acute ischemic stroke (AIS) and associated with poor outcome. The role of serum bilirubin in END remains controversial. This study aims to investigate the association of total bilirubin (TBIL), direct bilirubin (DBIL) and indirect bilirubin (IBIL) with END.

METHODS: This study was a cross-sectional retrospective study with 344 AIS patients enrolled. We retrospectively reviewed consecutive AIS patients with END through a medical record retrieval system and enrolled patients as control randomly from the AIS patients without END at the same period. The bilirubin levels were …

State Of The Science Of Scale-Up Of Cancer Prevention And Early Detection Interventions In Low- And Middle-Income Countries: A Scoping Review, Tara M Friebel-Klingner, Gloria Guevara Alvarez, Hope Lappen, Lydia E Pace, Keng-Yen Huang, Maria E Fernández, Donna Shelley, Anne F Rositch

Faculty, Staff and Student Publications

Purpose: Cancer deaths in low- and middle-income countries (LMICs) will nearly double by 2040. Available evidence-based interventions (EBIs) for cancer prevention and early detection can reduce cancer-related mortality, yet there is a lack of evidence on effectively scaling these EBIs in LMIC settings.

Methods: We conducted a scoping review to identify published literature from six databases between 2012 and 2022 that described efforts for scaling cancer prevention and early detection EBIs in LMICs. Included studies met one of two definitions of scale-up: (1) deliberate efforts to increase the impact of effective intervention to benefit more people or (2) an intervention …

Using Focus Groups To Explore Older Black Men's Perception Of Dietary Interventions., Ashley R Shaw, Eric D Vidoni, Mickeal N Key, Brandon A Yates, Roland Thorpe

Faculty, Staff and Student Publications

Older Black men are underrepresented in research despite being disproportionately affected by Alzheimer’s disease (AD) and cardiovascular (CV) risk factors related to AD compared with non-Hispanic Whites. Although dietary interventions have shown promise to reduce modifiable CV risk factors related to AD, Black Americans have lower adherence likely due to lack of cultural considerations. Using a noninterventional convergent parallel mixed-methods approach, this study examined the cultural contexts that inform perceptions of dietary interventions among older Midwestern Black men. All participants completed an online demographic and dietary habit survey prior to focus group discussions. Two focus group discussion sessions were conducted …

An Exploration Of Anxiety And Depressive Symptoms Among Sexual And Gender Minority Young Adults Visiting A Drop-In Center For Youth Experiencing Homelessness, Lourence Misedah-Robinson, Laura Witte, Elizabeth Henneke, Madonna Land, Vanessa Schick

Faculty, Staff and Student Publications

Background: Research suggests that marginalized young adults, particularly sexual and gender minorities (SGM), face distinctive healthcare transition challenges. SGM often navigate a complex intersection of identities, experiences, and stressors that can contribute to mental health disparities. However, they often lack access to appropriate support and resources tailored to their needs, which can result in increased psychological distress. Drop-in centers are effective mental health interventions for marginalized communities. Therefore, we conducted a study to explore the healthcare access experiences and mental health outcomes of young adult SGM compared to their non-SGM counterparts.

Methods: We surveyed 151 young adults aged 18-25 who …

Association Of Cancer Diagnosis With Disability Status Among Older Survivors Of Colorectal Cancer: A Population-Based Retrospective Cohort Study, Shiming Zhang, Lin-Na Chou, Michael D Swartz, Hemalkumar B Mehta, James S Goodwin, Yong-Fang Kuo, Sharon Hermes Giordano, Carole A Tucker, Karen M Basen-Engquist, Elizabeth J Lyons, Brian Downer, Susan K Peterson, Tru Cao, Maria C Swartz

Faculty, Staff and Student Publications

BACKGROUND: Older cancer survivors likely experience physical function limitations due to cancer and its treatments, leading to disability and early mortality. Existing studies have focused on factors associated with surgical complications and mortality risk rather than factors associated with the development of poor disability status (DS), a proxy measure of poor performance status, in cancer survivors. We aimed to identify factors associated with the development of poor DS among older survivors of colorectal cancer (CRC) and compare poor DS rates to an age-sex-matched, non-cancer cohort.

METHODS: This retrospective cohort study utilized administrative data from the Texas Cancer Registry Medicare-linked database. …

Racial And Ethnic Differences In Infant Survival For Hydrocephaly-Texas, 1999–2017, Munir Ahmed, Charles Shumate, Heidi Bojes, Ketki Patel, A J Agopian, Mark Canfield

Faculty, Staff and Student Publications

Background: Congenital hydrocephaly, an abnormal accumulation of fluid within the ventricular spaces at birth, can cause disability or death if untreated. Limited information is available about survival of infants born with hydrocephaly in Texas. Therefore, the purpose of the study was to calculate survival estimates among infants born with hydrocephaly without spina bifida in Texas.

Methods: A cohort of live-born infants delivered during 1999-2017 with congenital hydrocephaly without spina bifida was identified from the Texas Birth Defects Registry. Deaths within 1 year of delivery were identified using vital and medical records. One-year infant survival estimates were generated for multiple descriptive …

Factors Associated With Infant Sex And Preterm Birth Status For Selected Birth Defects From The National Birth Defects Prevention Study, 1997–2011, Eva M Williford, Wei Yang, Meredith M Howley, Chen Ma, Ronnie T Collins, Kari A Weber, Dominique Heinke, Julie M Petersen, A J Agopian, Natalie P Archer, Andrew F Olshan, Lindsay A Williams, Marilyn L Browne, Gary M Shaw

Faculty, Staff and Student Publications

Background: Birth defects and preterm birth co-occur, with some overlapping risk factors. Many birth defects and preterm births tend to have a male preponderance. We explored potential risk factors impacting sex and preterm (< 37 weeks of gestation) birth differences among infants with selected birth defects delivered from 1997 to 2011 using data from the National Birth Defects Prevention Study (NBDPS).

Methods: The NBDPS was a large multisite, population-based case-control study. Using random forests, we identified important predictors of male preterm, female preterm, and male term, each compared with female term births for each birth defect. Using logistic regression, we estimated odds ratios for associations between important predictors and sex-preterm birth status by birth defect.

Results: We examined 11,379 infants with nine specific birth defects. The top …

Developing A National Implementation Strategy To Accelerate Uptake Of Evidence-Based Family Caregiver Support In Us Cancer Centers, J Nicholas Odom, Heather M Young, Katherine Sterba, Timothy S Sannes, Susan Reinhard, Chandylen L Nightingale, Diane Meier, Tamryn F Gray, Betty Ferrell, Maria E Fernandez, Heidi Donovan, Kayleigh Curry, Erin R Currie, Tara Bryant, Marie A Bakitas, Allison J Applebaum

Faculty, Staff and Student Publications

OBJECTIVE: Characterize key factors and training needs of U.S. cancer centers in implementing family caregiver support services.

METHODS: Sequential explanatory mixed methods design consisting of: (1) a national survey of clinicians and administrators from Commission-on-Cancer-accredited cancer centers (N = 238) on factors and training needed for establishing new caregiver programs and (2) qualitative interviews with a subsample of survey respondents (N = 30) to elicit feedback on survey findings and the outline of an implementation strategy to facilitate implementation of evidence-based family caregiver support (the Caregiver Support Accelerator). Survey data was tabulated using descriptive statistics and transcribed interviews were analyzed …

Risk Of Depression In Persons With Alzheimer's Disease: A National Cohort Study, Casey Crump, Weiva Sieh, Barbara G Vickrey, Alexis C Edwards, Jan Sundquist, Kristina Sundquist

Faculty, Staff and Student Publications

INTRODUCTION: Depression is a risk factor and possible prodromal symptom of Alzheimer's disease (AD), but little is known about subsequent risk of developing depression in persons with AD.

METHODS: National matched cohort study was conducted of all 129,410 persons diagnosed with AD and 390,088 with all-cause dementia during 1998-2017 in Sweden, and 3,900,880 age- and sex-matched controls without dementia, who had no prior depression. Cox regression was used to compute hazard ratios (HRs) for major depression through 2018.

RESULTS: Cumulative incidence of major depression was 13% in persons with AD and 3% in controls. Adjusting for sociodemographic factors and comorbidities, …

Feri: A Multitask-Based Fairness Achieving Algorithm With Applications To Fair Organ Transplantation, Can Li, Dejian Lai, Xiaoqian Jiang, Kai Zhang

Faculty, Staff and Student Publications

Liver transplantation often faces fairness challenges across subgroups defined by sensitive attributes such as age group, gender, and race/ethnicity. Machine learning models for outcome prediction can introduce additional biases. Therefore, we introduce Fairness through the Equitable Rate of Improvement in Multitask Learning (FERI) algorithm for fair predictions of graft failure risk in liver transplant patients. FERI constrains subgroup loss by balancing learning rates and preventing subgroup dominance in the training process. Our results show that FERI maintained high predictive accuracy with AUROC and AUPRC comparable to baseline models. More importantly, FERI demonstrated an ability to improve fairness without sacrificing accuracy. …

Acceptability Of Anal Human Papillomavirus Home Self-Sampling And Clinician Sampling Among Sexual And Gender Minority Individuals In Milwaukee, Wisconsin: The Prevent Anal Cancer Self-Swab Study, Jenna Nitkowski, Anna R Giuliano, Tim Ridolfi, Elizabeth Chiao, Maria E Fernandez, Vanessa Schick, Michael D Swartz, Jennifer S Smith, Alan G Nyitray

Faculty, Staff and Student Publications

Purpose: Anal cancer has disproportionately high incidence among sexual minority men. We compared acceptability of home versus clinic human papillomavirus (HPV) anal swabbing.

Methods: The Prevent Anal Cancer Self-Swab Study recruited sexual and gender minority individuals in Milwaukee, Wisconsin. Eligible participants were randomized to a home or clinic arm. Home participants received a mailed anal HPV self-sampling kit. Clinic participants attended a clinic appointment where a clinician collected an anal HPV swab. We examined acceptability (overall thoughts, comfort with method, pain, and future willingness to swab) of home versus clinic swabbing using postswab survey responses.

Results: A total of 191 …

Characteristics And Quality Of Life Of People Living With Comorbid Disorders In Substance Use Recovery Residences, Elizabeth O Obekpa, Sheryl A Mccurdy, Kathryn R Gallardo, Serena A Rodriguez, Cecilia Ganduglia Cazaban, H Shelton Brown, James J Yang, J Michael Wilkerson

Faculty, Staff and Student Publications

BACKGROUND: Opioid use disorder (OUD) is associated with significant morbidity and mortality; however, research on physical and mental health comorbidities and health-related quality of life (HRQoL) among people taking medication for OUD (MOUD) and living in recovery residences is sparse. We investigated the prevalence of comorbidities and examined which EQ-5D-5L HRQoL dimensions are most affected by these comorbidities.

METHODS: Data were collected from 358 residents living in 14 Texas-based recovery residences from April 2021 to June 2023. The EQ-5D-5L descriptive system comprises five dimensions (mobility, self-care, usual activities, pain/discomfort, anxiety/depression). Each dimension has five levels of perceived problems, dichotomized into …

Human Papillomavirus (Hpv) Vaccination In Males: Associations Of Hpv-Related Knowledge And Perceptions With Hpv Vaccination Intention Among Korean Mothers Of Boys, Jihye Choi, Paula Cuccaro, Christine Markham, Sooyoun Kim, Irene Tamí-Maury

Faculty, Staff and Student Publications

OBJECTIVES: Human papillomavirus (HPV) vaccination rates among males are suboptimal worldwide. In South Korea, little is known about parents' intention to vaccinate boys against HPV. Therefore, we examined the associations of HPV-related knowledge and perceptions with vaccination intention among Korean mothers of boys.

METHODS: From August to December 2021, eligible mothers were surveyed about HPV-related knowledge, perceptions, and intention to vaccinate their sons against HPV. Mothers were categorized into no intention, contemplating, and intention to vaccinate groups. Using analysis of variance, we compared the groups' scores on the scales measuring HPV-related knowledge, attitudes, and beliefs. We conducted a multinomial logistic …

A Randomized Controlled Study Of Auricular Point Acupressure To Manage Chemotherapy-Induced Neuropathy: Study Protocol, Nada Lukkahatai, Michael V Nguyen, Jingyu Zhang, Yu-Min Cho, Chitchanok Benjasirisan, Heijingzi Monica Jia, Claudia M Campbell, Jennifer Kawi, Hulin Wu, Hongyu Wang, Rupsikha Bora, Johannes Thrul, Constance M Johnson, Thomas J Smith

Faculty, Staff and Student Publications

Objective: Chemotherapy-induced neuropathy (CIN) significantly impacts cancer patients, leading to functional disability, diminished quality of life, and increased healthcare costs amid the ongoing opioid crisis. Auricular point acupressure (APA), a non-invasive and non-pharmacological alternative, has shown potential for alleviating the pain, numbness, and tingling associated with CIN. This study aims to assess the efficacy of APA for CIN symptoms and physical function and to examine the mechanisms underlying APA's effects on CIN.

Methods: This is a three-arm randomized controlled clinical trial protocol. Patients aged 18 and older who are experiencing CIN are randomly assigned to one of the three groups: …

A Comparative Study Of Venezuelan Immigrants’ Pre- And Post-Migration Concerns For Their Children In The United States And Colombia, Aigerim Alpysbekova, Pablo Montero-Zamora, Mary H Soares, Carolina Scaramutti, Sumeyra Sahbaz, Maria Duque, Tara Bautista, Maria Fernanda Garcia, Christopher P Salas-Wright, Mildred M Maldonado-Molina, Melissa M Bates, Augusto Pérez-Gómez, Juliana Mejía Trujillo, Eric C Brown, Seth J Schwartz

Faculty, Staff and Student Publications

Research suggests that forced migration may lead to cultural stress and psychological distress. However, little is known about immigrant parents' pre- and post-migration concerns for their children's welfare. The present study examined the concerns of Venezuelan parents who migrated to the United States versus those who migrated to Colombia, and whether post-migration concerns were related to cultural stressors, mental health, and cultural identity. A sample of 609 Venezuelan immigrants completed surveys and responded to an open-ended prompt asking about pre- and post-migration concerns for children's welfare. Lack of safety was the most common pre-migration concern for Venezuelans in the U.S., …

Joint Problem-Solving Orientation, Mutual Value Recognition, And Performance In Fluid Teamwork Environments, Michaela Kerrissey, Zhanna Novikov

Faculty, Staff and Student Publications

INTRODUCTION: Joint problem-solving orientation (JPS) has been identified as a factor that promotes performance in fluid teamwork, but research on this factor remains nascent. This study pushes the frontier of understanding about JPS in fluid teamwork environments by applying the concept to within-organization work and exploring its relationships with performance, mutual value recognition (MVR), and expertise variety (EV).

METHODS: This is a longitudinal, survey-based field study within a large United States healthcare organization

RESULTS: Our results affirm a moderated mediation model wherein JPS enhances performance, both directly and through MVR; EV serves as a moderator in the JPS-MVR relationship. JPS …

Rural Racial Disparities And Barriers In Mammography Utilization Among Medicare Beneficiaries In Texas: A Longitudinal Study, Zhaoli Liu, Yong Shan, Yong-Fang Kuo, Sharon H Giordano

Faculty, Staff and Student Publications

This study examined rural racial/ethnic disparities in long-term mammography screening practices among Medicare beneficiaries. A retrospective longitudinal study was conducted using 100% Texas Medicare data for women aged 65-74 who enrolled in Medicare between 2010-2013. Of the 114,939 eligible women, 21.2% of Hispanics, 33.3% of non-Hispanic Blacks (NHB), and 38.4% non-Hispanic Whites (NHW) in rural areas were regular users of mammography, compared to 33.5%, 44.9%, and 45.3% of their counterparts in urban areas, respectively. Stratification analyses showed rural Hispanics and NHB were 33% (95% CI, 25% - 40%) and 22% (95% CI, 6% - 36%) less likely to be regular …

Mesenchymal Stem Cells Suppress Inflammatory Cytokines In Lipopolysaccharide Exposed Preterm And Term Human Pregnant Myometrial Cells, Arunmani Mani, John Hotra, Sean C Blackwell, Laura Goetzl, Jerrie S Refuerzo

Faculty, Staff and Student Publications

Objective  The objective of this study was to determine the cytokine response in human pregnant preterm and term myometrial cells exposed to lipopolysaccharide (LPS) and cocultured with mesenchymal stem cells (MSCs).

Study Design  Myometrium was obtained at cesarean delivery in term and preterm patients. Human myometrial cells were exposed to 5 μg/mL LPS for 4 hours followed by 1 μg/mL LPS for 24 hours and were cocultured with MSCs for 24 hours. Culture supernatants were collected at 24 hours and expression of cytokines, including interleukin-1β (IL-1β), IL-6, IL-8, tumor necrosis factor-α (TNF-α), transforming growth factor-β (TGF-β), and IL-10, was quantified …

Mesenchymal Stem Cells Suppress Inflammatory Cytokines In Lipopolysaccharide Exposed Preterm And Term Human Pregnant Myometrial Cells, Arunmani Mani, John Hotra, Sean C Blackwell, Laura Goetzl, Jerrie S Refuerzo

Faculty, Staff and Student Publications

Objective  The objective of this study was to determine the cytokine response in human pregnant preterm and term myometrial cells exposed to lipopolysaccharide (LPS) and cocultured with mesenchymal stem cells (MSCs).

Study Design  Myometrium was obtained at cesarean delivery in term and preterm patients. Human myometrial cells were exposed to 5 μg/mL LPS for 4 hours followed by 1 μg/mL LPS for 24 hours and were cocultured with MSCs for 24 hours. Culture supernatants were collected at 24 hours and expression of cytokines, including interleukin-1β (IL-1β), IL-6, IL-8, tumor necrosis factor-α (TNF-α), transforming growth factor-β (TGF-β), and IL-10, was quantified …

Rising Prevalence Of Mild Chronic Gastritis In Children: A Single Center Experience, Rohit Josyabhatla, Mary Lauren Wood, Amber Gafur, Nina Tatevian, Amanda S Tchakarov, Syed Shahrukh Hashmi, Jon Marc Rhoads, Melissa Renee Van Arsdall

Faculty, Staff and Student Publications

OBJECTIVES AND METHODS: We analyzed upper endoscopic and histological findings in 3 cohorts of children undergoing upper gastrointestinal endoscopy over a 10-year period. Five hundred seventy-nine patients were identified, with 244 (42%), 199 (35%), and 136 (23%) in the 2011, 2015, and 2019 cohorts, respectively. The most common symptoms and signs were abdominal pain, vomiting, failure to thrive, and diarrhea.

RESULTS: The number of patients who had histological evidence of chronic gastritis increased from 2011 (n = 70, 29%) to 2015 (n = 106, 53%) and 2019 (n = 92, 68%;

CONCLUSIONS: There has been a significant rise in the …

Impact Of Covid Status And Blood Group On Complications In Patients In Hemorrhagic Shock, Jason Bradley Brill, Krislynn M Mueck, Madeline E Cotton, Brian Tang, Mariela Sandoval, Lillian S Kao, Bryan A Cotton

Faculty, Staff and Student Publications

OBJECTIVE: Among critically injured patients of various blood groups, we sought to compare survival and complication rates between COVID-19-positive and COVID-19-negative cohorts.

BACKGROUND: SARS-CoV-2 infections have been shown to cause endothelial injury and dysfunctional coagulation. We hypothesized that, among patients with trauma in hemorrhagic shock, COVID-19-positive status would be associated with increased mortality and inpatient complications. As a secondary hypothesis, we suspected group O patients with COVID-19 would experience fewer complications than non-group O patients with COVID-19.

METHODS: We evaluated all trauma patients admitted 4/2020-7/2020. Patients 16 years or older were included if they presented in hemorrhagic shock and received …

Association Between Serum Vitamin D Status And Uterine Leiomyomas: A Case-Control Study, Chukwuemeka Chukwubuikem Okoro, Okechukwu Christian Ikpeze, George Uchenna Eleje, Gerald Okanandu Udigwe, Chukwuemeka Okwudili Ezeama, Joseph Odirichukwu Ugboaja, Chukwunonso Isaiah Enechukwu, Osita Samuel Umeononihu, Chukwudi Anthony Ogabido, Charlotte Blanche Oguejiofor, Tobechi Kingsley Njoku, Richard Obinwanne Egeonu, Chigozie Geoffrey Okafor, Hillary Ikechukwu Obiagwu, Chukwudubem Chinagorom Onyejiaka, Afam Ben Obidike, Christian Ejike Onah, Ifeanyi Uzukwu, Amarachukwu Doris Okoro, Evaristus Chino Ezema, Adaobi Maryann Ibekwe, Joseph Ifeanyichukwu Ikechebelu

Faculty, Staff and Student Publications

OBJECTIVE: Uterine leiomyoma is a common gynecological condition that negatively affects women's quality of life. Vitamin D plays an important role in tumor development and progression. However, clinical studies comparing serum vitamin D levels between women with and without uterine leiomyomas are limited and inconclusive. This study aimed to compare serum vitamin D levels in women with and without uterine leiomyomas.

METHODS: This hospital-based case-control study included 150 women who visited a gynecological clinic. The cases included 75 women with uterine leiomyoma, whereas the controls included 75 age-and parity-matched participants without uterine leiomyoma. Serum vitamin D levels were measured in …

Assessing Laryngectomy Patient Education On Youtube: Investigating Quality And Reliability, Matthew E Lin, Oluwatobiloba Ayo-Ajibola, Carlos X Castellanos, Jonathan West, Neil Luu, Ian Kim, Niels C Kokot

Faculty, Staff and Student Publications

OBJECTIVE: This study aimed to characterize the quality of laryngectomy-related patient education on YouTube and understand factors impacting video content quality.

STUDY DESIGN: Cross-sectional cohort analysis.

SETTING: Laryngectomy-related videos on YouTube.

METHODS: YouTube was anonymously queried for various laryngectomy procedure search terms. Video quality was evaluated using the validated DISCERN instrument which assesses treatment-related information quality. Descriptive statistics were used to characterize our cohort. Univariate and multivariable linear regression were used to assess factors associated with increased DISCERN score. Significance was set at

RESULTS: Our 78-video cohort exhibited moderate levels of engagement, averaging 13,028.40 views (SD = 24,246.93), 69.79 likes …

Association Of Risk Factors And Comorbidities With Chronic Pain In The Elderly Population, Neil Mookerjee, Nicole Schmalbach, Gianna Antinori, Subhadra Thampi, Dylan Windle-Puente, Amy Gilligan, Ha Huy, Megha Andrews, Angela Sun, Roshni Gandhi, William Benedict, Austin Chang, Ben Sanders, Justin Nguyen, Maanika Reddy Keesara, Janet Aliev, Aneri Patel, Isaiah Hughes, Ian Millstein, Krystal Hunter, Satyajeet Roy

Faculty, Staff and Student Publications

INTRODUCTION/OBJECTIVE: Chronic pain disorders affect about 20% of adults in the United States, and it disproportionately affects individuals living in the neighborhoods of extreme socioeconomic disadvantage. In many instances, chronic pain has been noted to arise from an aggregation of multiple risk factors and events. Therefore, it is of importance to recognize the modifiable risk factors. The aim of this study was to investigate the comorbid medical conditions and risk factors associated with chronic pain disorders in patients aged 65 years and older.

METHODS: Our team retrospectively reviewed medical records of elderly patients (65 years and older) who were evaluated …

Applying Market Basket Analysis To Determine Complex Coassociations Among Food Allergens In Children With Food Protein-Induced Enterocolitis Syndrome (Fpies), Ankona Banerjee, Kenneth Nobleza, Cynthia Haddad, Joshua Eubanks, Ruchit Rana, Nicholas L Rider, Lisa Pompeii, Duc Nguyen, Sara Anvari

Faculty, Staff and Students Publications

BACKGROUND: Food protein-induced enterocolitis syndrome (FPIES) is a non-IgE-mediated food allergy, characterized by delayed onset of repetitive vomiting occurring 1 to 4 h following ingestion of a food allergen. Managing FPIES requires strict avoidance of the food trigger. The concern with FPIES is determining the risk of another FPIES food trigger reaction due to potential coassociations with other foods or food groups. An effective statistical approach for analyzing FPIES-related data is essential to identify common coallergens and their associations.

METHODS: This study employed Market Basket Analysis, a data-mining technique, to examine correlations and patterns among allergens in FPIES patients at …

Practical Quality Improvement Changes For A Low-Resourced Pediatric Unit, Phoebe H Yager, Kevin Mary Callans, Aubrey Samost-Williams, Jose A Bonilla, Luis J G Flores, Susana C A Hasbun, Angel E A Rodríguez, Alejandra B A Cárdenas, Alexia M L Núñez, Asitha D L Jayawardena, Evelyn J Zablah, Christopher J Hartnick

Faculty, Staff and Student Publications

Background: This work describes a sustainable and replicable initiative to optimize multi-disciplinary care and uptake of clinical best practices for patients in a pediatric intensive care unit in Low/Middle Income Countries and to understand the various factors that may play a role in the reduction in child mortality seen after implementation of the Quality Improvement Initiative.

Methods: This was a longitudinal assessment of a quality improvement program with the primary outcome of intubated pediatric patient mortality. The program was assessed 36 months following implementation of the quality improvement intervention using a t-test with linear regression to control for co-variates. …