Public Health Commons^™

Ai-Drugnet: A Network-Based Deep Learning Model For Drug Repurposing And Combination Therapy In Neurological Disorders, Xingxin Pan, Jun Yun, Zeynep H Coban Akdemir, Xiaoqian Jiang, Erxi Wu, Jason H Huang, Nidhi Sahni, S Stephen Yi

Faculty, Staff and Student Publications

Discovering effective therapies is difficult for neurological and developmental disorders in that disease progression is often associated with a complex and interactive mechanism. Over the past few decades, few drugs have been identified for treating Alzheimer's disease (AD), especially for impacting the causes of cell death in AD. Although drug repurposing is gaining more success in developing therapeutic efficacy for complex diseases such as common cancer, the complications behind AD require further study. Here, we developed a novel prediction framework based on deep learning to identify potential repurposed drug therapies for AD, and more importantly, our framework is broadly applicable …

Gain-Of-Function Variomics And Multi-Omics Network Biology For Precision Medicine, Mark M Li, Sharad Awasthi, Sumanta Ghosh, Deepa Bisht, Zeynep H Coban Akdemir, Gloria M Sheynkman, Nidhi Sahni, S Stephen Yi

Faculty, Staff and Student Publications

Traditionally, disease causal mutations were thought to disrupt gene function. However, it becomes more clear that many deleterious mutations could exhibit a "gain-of-function" (GOF) behavior. Systematic investigation of such mutations has been lacking and largely overlooked. Advances in next-generation sequencing have identified thousands of genomic variants that perturb the normal functions of proteins, further contributing to diverse phenotypic consequences in disease. Elucidating the functional pathways rewired by GOF mutations will be crucial for prioritizing disease-causing variants and their resultant therapeutic liabilities. In distinct cell types (with varying genotypes), precise signal transduction controls cell decision, including gene regulation and phenotypic output. …

A Novel Bayesian Spatial-Temporal Approach To Quantify Sars-Cov-2 Testing Disparities For Small Area Estimation, Cici Bauer, Xiaona Li, Kehe Zhang, Miryoung Lee, Esmeralda Guajardo, Susan Fisher-Hoch, Joseph Mccormick, Maria E Fernandez, Belinda Reininger

Faculty, Staff and Student Publications

Objectives. To propose a novel Bayesian spatial–temporal approach to identify and quantify severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) testing disparities for small area estimation.

Methods. In step 1, we used a Bayesian inseparable space–time model framework to estimate the testing positivity rate (TPR) at geographically granular areas of the census block groups (CBGs). In step 2, we adopted a rank-based approach to compare the estimated TPR and the testing rate to identify areas with testing deficiency and quantify the number of needed tests. We used weekly SARS-CoV-2 infection and testing surveillance data from Cameron County, Texas, between March 2020 …

Genetic Associations Between Sleep Traits And Cognitive Ageing Outcomes In The Hispanic Community Health Study/Study Of Latinos, Yuan Zhang, Michael Elgart, Einat Granot-Hershkovitz, Heming Wang, Wassim Tarraf, Alberto R Ramos, Ariana M Stickel, Donglin Zeng, Tanya P Garcia, Fernando D Testai, Sylvia Wassertheil-Smoller, Carmen R Isasi, Martha L Daviglus, Robert Kaplan, Myriam Fornage, Charles Decarli, Susan Redline, Hector M González, Tamar Sofer

Faculty, Staff and Student Publications

BACKGROUND: Sleep phenotypes have been reported to be associated with cognitive ageing outcomes. However, there is limited research using genetic variants as proxies for sleep traits to study their associations. We estimated associations between Polygenic Risk Scores (PRSs) for sleep duration, insomnia, daytime sleepiness, and obstructive sleep apnoea (OSA) and measures of cogntive ageing in Hispanic/Latino adults.

METHODS: We used summary statistics from published genome-wide association studies to construct PRSs representing the genetic basis of each sleep trait, then we studied the association of the PRSs of the sleep phenotypes with cognitive outcomes in the Hispanic Community Healthy Study/Study of …

Enabling Structural Resilience Of Street-Involved Children And Youth In Kenya: Reintegration Outcomes And The Flourishing Community Model, Michael L Goodman, Sarah E Seidel, Andrew Springer, Aleisha Elliott, Christine Markham, Hani Serag, Philip Keiser, Ben Raimer, Lauren Raimer-Goodman, Christine Gatwiri, Kelvin Munene, Stanley Gitari

Faculty, Staff and Student Publications

Introduction: Millions of children and youth live on city streets across the globe, vulnerable to substance use, abuse, material and structural neglect. Structural resilience, the re-establishment of access to structural goods within a society such as housing, education, and healthcare following some interruption, provides an orientation for research and interventional efforts with street-involved children and youth (SICY). Further, a structural resilience framework supports organizing interactions between levels and sectors of a socio-ecology.

Methods: Following the expressed interests of Kenyan SICY, and consistent with emerging policy interests at national and global levels, we assess reintegration trajectories of Kenyan SICY (n …

Pregnancy-Related Covid Worry, Depressive Symptom Severity, And Mediation Through Sleep Disturbance In A Low-Income, Primarily Latinx Population In California’S Central Valley, Jennifer N Felder, Patience A Afulani, Kimberly Coleman-Phox, Serwaa S Omowale, Charles E Mcculloch, Lauren Lessard, Miriam Kuppermann

Faculty, Staff and Student Publications

Purpose: This study (1) assessed the psychometric properties of a pregnancy-related COVID worry scale, (2) explored variations in pregnancy-related COVID worry over the course of the pandemic, and (3) examined associations between pregnancy-related COVID worry and depressive symptom severity, and evaluated sleep disturbance as a mediator.

Methods: Data were drawn from an ongoing randomized trial comparing the effectiveness of two enhanced forms of prenatal care. The current analysis includes baseline pre-randomization data collected from participants who enrolled November 2020-November 2021 (n = 201). Participants were pregnant individuals with low income and primarily Latinx.

Results: Our 7-item scale was valid and …

Maternal Perceptions Of Vaccinating Boys Against Human Papillomavirus (Hpv) In Seoul, South Korea: A Descriptive Exploratory Qualitative Study, Jihye Choi, Christine Markham, Irene Tamí-Maury, Sooyoun Kim, Paula Cuccaro

Faculty, Staff and Student Publications

Human Papillomavirus (HPV) vaccination is of paramount importance to reduce HPV-associated cancers in both genders. In South Korea, the prophylactic vaccine is recognized as prevention of cervical cancer with little attention given to male HPV vaccination. The purpose of this study was to explore perceptions of male HPV vaccination and underlying factors for vaccine hesitancy among mothers of unvaccinated boys in Seoul, Korea using a qualitative method. We used a purposive sampling strategy to recruit mothers of unvaccinated middle school-aged boys living in one of the 25 districts in Seoul, supplemented by a snowball sampling approach. We conducted one-on-one telephone …

A Narrative Review Of The Lesser Known Medications For Treatment Of Restless Legs Syndrome And Pathogenetic Implications For Their Use, Paul G Yeh, Karen Spruyt, Lourdes M Delrosso, Arthur S Walters

Faculty, Staff and Student Publications

BACKGROUND: There are several well-known treatments for Restless Legs Syndrome (RLS), including dopamine agonists (pramipexole, ropinirole, rotigotine), anticonvulsants (gabapentin and its analogs, pregabalin), oral or intravenous iron, opioids and benzodiazepines. However, in clinical practice, treatment is sometimes limited due to incomplete response or side effects and it is necessary to be aware of other treatment options for RLS, which is the purpose of this review.

METHODS: We performed a narrative review detailing all of the lesser known pharmacological treatment literature on RLS. The review purposefully excludes well-established, well-known treatments for RLS which are widely accepted as treatments for RLS in …

From The National To The Local: Issues Of Trust And A Model For Community-Academic-Engagement, Olufunmilayo Chinekezi, Lauri Andress, Etsemaye P Agonafer, Susan Massick, Sarah Piepenbrink, Karey M Sutton, Philip M Alberti, Desiree De La Torre, Shannon Guillot-Wright, Marshala Lee

Faculty, Staff and Student Publications

Inequities in health and health care in the United States have persisted for decades, and the impacts on equity from the COVID-19 pandemic were no exception. In addition to the disproportionate burden of the disease across various populations, the pandemic posed several challenges, which exacerbated these existing inequities. This has undoubtedly contributed to deeply rooted public mistrust in medical research and healthcare delivery, particularly among historically and structurally oppressed populations. In the summer of 2020, given the series of social injustices posed by the pandemic and highly publicized incidents of police brutality, notably the murder of George Floyd, the Association …

The Predictive Value Of Coronary Microvascular Dysfunction For Left Ventricular Reverse Remodelling In Dilated Cardiomyopathy, Ao Kan, Yinping Leng, Shuhao Li, Fang Lin, Qimin Fang, Xinwei Tao, Mengyao Hu, Lianggeng Gong

Faculty, Staff and Student Publications

AIMS: to evaluate the degree of coronary microvascular dysfunction (CMD) in dilated cardiomyopathy (DCM) patients by cardiac magnetic resonance (CMR) first-pass perfusion parameters and to examine the correlation between myocardial perfusion and left ventricle reverse remodelling (LVRR).

METHODS: In this study, 94 DCM patients and 35 healthy controls matched for age and sex were included. Myocardial perfusion parameters, including upslope, time to maximum signal intensity (Time

RESULTS: With a median follow-up period of 12 months [interquartile range (IQR), 8-13], 41 DCM patients (44%) achieved LVRR. Compared with healthy controls, DCM patients presented CMD with reduced upslope, SI

CONCLUSIONS: CMD could …

A Case Of Successful Treatment Of Recurrent Urinary Tract Infection By Extended-Spectrum Β-Lactamase Producing, Naomi Bier, Blake Hanson, Zhi-Dong Jiang, Herbert L Dupont, Cesar A Arias, William R Miller

Faculty, Staff and Student Publications

Recurrent urinary tract infections (UTIs) are a challenging clinical entity that can be frustrating for patient and physician alike. Repeated rounds of antibiotics can select for multidrug-resistant organisms, further complicating care. We describe the successful use of fecal microbiota transplantation (FMT) for the treatment of recurrent extended-spectrum β-lactamase (ESBL)-producing

Subendocardial And Transmural Myocardial Ischemia: Clinical Characteristics, Prevalence, And Outcomes With And Without Revascularization, K Lance Gould, Tung Nguyen, Richard Kirkeeide, Amanda E Roby, Linh Bui, Danai Kitkungvan, Monica B Patel, Mohammad Madjid, Mary Haynie, Dejian Lai, Ruosha Li, Jagat Narula, Nils P Johnson

Faculty, Staff and Student Publications

BACKGROUND: Subendocardial ischemia is commonly diagnosed but not quantified by imaging.

OBJECTIVES: This study sought to define size and severity of subendocardial and transmural stress perfusion deficits, clinical associations, and outcomes.

METHODS: Regional rest-stress perfusion in mL/min/g, coronary flow reserve, coronary flow capacity (CFC), relative stress flow, subendocardial stress-to-rest ratio and stress subendocardial-to-subepicardial ratio as percentage of left ventricle were measured by positron emission tomography (PET) with rubidium Rb 82 and dipyridamole stress in serial 6,331 diagnostic PETs with prospective 10-year follow-up for major adverse cardiac events with and without revascularization.

RESULTS: Of 6,331 diagnostic PETs, 1,316 (20.7%) had severely …

Corrigendum: Editorial: Period Poverty, Lea Sacca, Christine Margaret Markham, Jhumka Gupta, Melissa Peskin

Faculty, Staff and Student Publications

This corrects the article "Editorial: Period poverty" in volume 5, 1140981.

Quantifying The Implementation And Cost Of A Multisite Antibiotic Stewardship Intervention For Asymptomatic Bacteriuria, Eva Amenta, Larissa Grigoryan, Suja S Rajan, David Ramsey, Jennifer R Kramer, Annette Walder, Andrew Chou, John N Van, Sarah L Krein, Sylvia Hysong, Aanand D Naik, Barbara W Trautner

Faculty, Staff and Student Publications

OBJECTIVE: The intensity of an antibiotic stewardship intervention to achieve clinical impact is not known. We conducted a multisite dissemination project of an intervention to reduce treatment of asymptomatic bacteriuria (ASB) and studied: (1) the association between implementation metrics and clinical outcomes and (2) the cost of implementation.

DESIGN/SETTING/PARTICIPANTS: A central site facilitated a multimodality intervention to decrease unnecessary urine cultures and antibiotic treatment in patients with ASB at 4 Veterans Affairs medical centers.

METHODS: The intervention consisted of a decision support aid algorithm and interactive teaching cases that provided in the moment audit and feedback on how to manage …

Risk Factors Associated With The Development Of Type Ii Diabetes-Related Complications, Jessica Danielle Lucas Williams

Walden Dissertations and Doctoral Studies

By 2040, it is estimated that 642 million people ages 20 to 79 will have Type II diabetes, thereby making it a heavily studied topic among scholars. As more people are diagnosed with Type II diabetes each year, the literature is slowly shifting to long-term complications. However, the many risk and protective factors that exist have created gaps in the literature. The purpose of this study was to determine the relationship between participation in diabetes self-management classes, mental health, physical health, BMI, smoking status, exercise, and possible diabetes complications (diabetes-related retinopathy and diabetes-related kidney disease). The gap in the literature …

Moderators Of Peripheral Neuropathy On Overall And Cardiovascular Mortality In People Without Diabetes, Adeoye Muideen Adenekan

Walden Dissertations and Doctoral Studies

Peripheral neuropathy (PN), a group of common heterogeneous disorders with varied etiologies, is associated with substantial morbidity and mortality. PN presents both as a diagnostic and therapeutic challenge to physicians and other healthcare providers. Socioeconomic moderators of PN in adults without diabetes in the United States have not been well studied. The consequences of PN can be devastating and include foot ulcers, amputations, a general decline in the quality of life, and death. The overall prevalence of PN in the United States is 13.5% in adults with diabetes and 11.6% in adults without diabetes. Clearly, these statistics indicate a public …

A Comparison By Ethnicity Of Usage Of Medication, Intubation Use, And Mortality Rates Of Covid-19 Patients In An Urban Hospital, Howard Rubin Baruch

Walden Dissertations and Doctoral Studies

Evidence from an urban hospital initially revealed that ethnicity had no bearing on treatment modalities or mortality among patients admitted and diagnosed with COVID-19 symptoms from January 1, 2020 to January 1, 2021. The purpose of this study was focused on answering three principal research questions concerning evidence at one hospital of differences in medication used, whether intubation was used, and mortality by ethnicity for those treated for COVID-19 while controlling for age, gender, and co-morbidities. The health belief model served as the theoretical framework. Data was collected from 1188 patient charts, and binary logistic regression was used to test …

Personal Hardiness As An Unexamined Component Of The Healthy Volunteer Effect, Angelique E. Blann

Walden Dissertations and Doctoral Studies

Clinical trials are the standard for approving medicines for public use. To conduct trials, researchers depend on a declining number of volunteers. The healthy volunteer effect, a phenomenon in which participants demonstrate better outcomes than their peers, limits the generalizability of trial outcomes. The healthy volunteer effect does not fully explain the outcome difference between volunteers and nonvolunteers. The purpose of this cross-sectional quantitative study was to examine personal hardiness as an unexplored component of the healthy volunteer effect and determine whether personal hardiness is associated with willingness to participate. Hardiness was a personality construct that represented resilience to stress. …

Neighborhood Factors, Cardiovascular Illness, Mental Health, And Aging In The United States, Brenda Billings

Walden Dissertations and Doctoral Studies

The inability to age in place among people 65 years old and older is a public health problem in the United States. However, it is unknown what neighborhood factors (i.e., trust, safety, shared values) impact the communities that are struggling to support individuals looking to stay in their homes as they age. The purpose of this quantitative correlational study was to examine the relationship between neighborhood factors (i.e., trust, safety, and shared values), cardiovascular illness (i.e., heart attack and stroke), mental health (i.e., depression), and aging in place, controlling for sex, age, marital status, educational level, employment status, and race. …

Association Between Covid-19 Health Knowledge, Self-Efficacy And Preventive Behaviors Among Nursing Students, Josephine Miane Britanico

Walden Dissertations and Doctoral Studies

Abstract Nursing students possess valuable public health knowledge to prevent the spread of COVID-19 infection. They can provide health education to the public with reliable information and adequate resources. To better understand the role nursing students can take in prevention efforts, the purpose of this quantitative correlational study was to examine the association between COVID-19 health knowledge, self-efficacy, and preventive behavior among undergraduate nursing students. The health belief model was the theoretical framework that guided this study. The primary research questions assessed (a) if there was a statistically significant association between COVID-19 health knowledge and preventive behavior among nursing students, …

Exploration Of Nurses' Knowledge About Healthcare For Transgender Patients, Elizabeth Kempt

Walden Dissertations and Doctoral Studies

AbstractThe transgender population is growing, and along with the population growth, the healthcare needs for gender transitioning of both medical and surgical procedures. Registered nurses (RNs) who care for hospitalized transgender patients are required to be knowledgeable about their care, yet little is known about what nurses know about the healthcare of the transgender patient. The purpose of this basic qualitative study, guided by Benner’s novice to expert theory, was to explore the knowledge and perceptions of RNs regarding healthcare of transgender persons undergoing transition to the opposite gender. Social media and snowball sampling were used to recruit 10 RNs …

Academic Performance And E-Cigarette Use Among Teenagers, Jeremy Tan Rondael

Walden Dissertations and Doctoral Studies

Early e-cigarette use by youth has the capacity to create an early addiction to nicotine, increasing the risk of life-long dependency and the possible development of multiple cardiovascular and pulmonary diseases. Reinforced by the socioecological model, the purpose of this study was to determine if academic performance is associated with e-cigarette use among teenagers and young people and if the presence of adverse childhood events (e.g., cyberbullying in school and/or the presence of homelessness) mediated this association. This study included all respondents (N = 1,401) from the state of Nevada who answered the 2019 National Youth Risk Behavior Survey. Binary …

Sexual Violence And University Campus Response To Sexual Violence, Jennifer Bivins

Walden Dissertations and Doctoral Studies

While anyone can be a victim of sexual violence, college-aged females between the ages of 18 and 21 are more likely to be victimized than any other group. Sexual violence continues to be a barrier to education, and colleges/universities make it challenging for students to report on campus. The purpose of this study is to explore the factors, intervention/prevention strategies, and policies/procedures used to address sexual violence on a university campus. The framework used was the ecological model, which focuses on factors and influences within the environment that affected individual behavior. The research questions focused on participants describing their experiences …

Personal Hardiness As An Unexamined Component Of The Healthy Volunteer Effect, Angelique E. Blann

Walden Dissertations and Doctoral Studies

Clinical trials are the standard for approving medicines for public use. To conduct trials, researchers depend on a declining number of volunteers. The healthy volunteer effect, a phenomenon in which participants demonstrate better outcomes than their peers, limits the generalizability of trial outcomes. The healthy volunteer effect does not fully explain the outcome difference between volunteers and nonvolunteers. The purpose of this cross-sectional quantitative study was to examine personal hardiness as an unexplored component of the healthy volunteer effect and determine whether personal hardiness is associated with willingness to participate. Hardiness was a personality construct that represented resilience to stress. …

Environmental Factors And Breast Cancer Mortality, Joel Collazo Rodriguez

Walden Dissertations and Doctoral Studies

Breast cancer is a public health problem in the United States that impacts diverse ethnic female groups in different ways regarding incidence and mortality. Much is known about the factors increasing the risk of developing breast cancer, but little is known about those that increase the chances of dying from it, other than access to health care, screening, and appropriate treatment. This study aimed to understand the association between exposure to Environmental Protection Agency-regulated air pollutants and breast cancer mortality, including how the interaction between these air contaminants impacts the outcome of interest, considering median income, education level, and percentage …

Health Education Practices For Middle Eastern Women With Polycystic Ovary Syndrome, Walaa Daffaalla

Walden Dissertations and Doctoral Studies

Polycystic ovarian syndrome (PCOS) is a complex women’s health condition that reduces women’s quality of life, leading to health complications, such as menstruation issues, infertility, insulin resistance, risk of type 2 diabetes, depression, anxiety, emotional stress, being overweight or obese, and more. Research on PCOS has focused on the etiology and complications in women from different ethnicities. But limited research has explored the experiences and perspectives of Middle Eastern (ME) women in the United States with PCOS related to PCOS health education. The purpose of this qualitative study was to explore the perspectives and experiences of ME women of reproductive …

The Effect Of Community Health Linkages On Suicide Rates In Veterans, Erica Anderson

Walden Dissertations and Doctoral Studies

Suicide risk is a public health issue. It is a complex and poorly understood mental health and societal threat. This study examined veteran suicide rates and their relationship to family and social support, as measured by the social association rate, mental health funding per capita, and the lethality of the method rate. The interpersonal-psychological theory of suicide and the social-ecological model are the theoretical frameworks that guided the study. Both theories emphasize the complexity surrounding suicide at the state level as it is related to the individual, social, environmental, and political landscape related to veteran suicide. The quantitative bivariate correlation …

Non-Alcoholic Fatty Liver Disease And Metabolic Syndrome: The Role Of Gender Differences And Menopausal Status Of Women, Kimberly Kushner

Walden Dissertations and Doctoral Studies

There are few studies that investigate the association between non-alcoholic fatty liver disease (NAFLD) and metabolic syndrome (MetS) predominantly in menopausal women. This quantitative study investigated the association between MetS and NAFLD while controlling for age, gender, ethnicity, and menopausal status of women. The theoretical framework that helps establish and guide the research was the diffusion of innovation (DOI). A multivariable logistic regression was conducted using secondary data from the National Health and Nutrition Examination Survey. There is a statistically significant association between MetS, and NAFLD after controlling for age (OR = 2.96, 95% CI = 2.319–3.778, p < 0.001). However, ethnicity was not statistically significant. After further controlling for gender, the relationship remained statistically significant and exhibited a decrease in risk for females compared to males (OR = -.734, 95%CI = .387–.596, p < 0.001). Lastly, focusing on women only, and further controlling for menopausal status, the association between MetS and NAFLD was still statistically significant (OR = 2.227, p < 0.001). Mexican Americans, other Hispanics, and Non-Hispanic Black women were at higher risk (95% CI 1.102–7.039, 1.321–5.351, and 1.255–3.013, respectively). Implications for positive social change include adopting proactive and preventative strategies that can improve the quality of life for vulnerable patients and reduce morbidity and mortality associated with MetS and NAFLD.

The Relationship Between Socioeconomic Factors And Obesity In Adults (25-54 Years) In Guam In 2020, Perinne O'Brien

Walden Dissertations and Doctoral Studies

In Guam, a United States Pacific Island territory, the rate of obesity in adults continues to rise. Relationships between obesity and six socioeconomic factors (health care coverage, education level, employment status, home ownership, household income, and marital status) in adults 25 to 54 years of age living in Guam in 2020 were explored. Because obesity may be affected at multiple levels of influence, the socioecological model grounded this research. Secondary data from the Centers for Disease Control and Prevention’s Behavioral Risk Factor Surveillance System was used to carry out a quantitative, cross-sectional study. Complex samples binary logistic regression analyses were …

Providing Health Care To Patients With Intellectual And Developmental Disability During Covid-19, Pauline Andrea Park-Maxwell

Walden Dissertations and Doctoral Studies

AbstractThis project sought to enhance the care offered in a local clinic to individuals with an intellectual and developmental disability (IDD) during the COVID-19 pandemic. Individuals with IDD are faced with the challenges of coping with some social conditions. Mainly waiting for extended periods in a doctor’s office can be challenging. To reduce this population’s waiting time, a staff education program was developed to address this concern. Currently, this local clinic did not have a prescreening exercise that would meet the needs of this population. This DNP project aimed to develop a staff education program for staff in a primary …