Clinical Epidemiology Commons^™

Exploring The Impact Of Adverse Childhood Experiences On Preventive Healthcare Utilization In Rural Georgia, Ryan R. Traylor

College of Graduate Studies: Theses & Dissertations

This study examines the relationship between Adverse Childhood Experiences (ACEs) and preventive healthcare use among adults in Georgia, specifically within rural populations facing structural barriers. Using 2023 Georgia Behavioral Risk Factor Surveillance System (BRFSS) data, the research analyzes associations between ACE exposure, rural residence, and preventive care outcomes, including physical exams and flu vaccinations. Guided by an intersectionally adapted version of Andersen’s Behavioral Model of Health Services Use, the study evaluates how predisposing factors, enabling resources, and perceived barriers relate to healthcare engagement. Logistic regression analyses assess the correlation of ACE exposure, cost barriers, provider access, and sociodemographics with preventive …

Geospatial Analysis Of Breast Cancer Incidence, Mortality, And Access To Screening In Rural And Appalachian Virginia, Jennifer Osher, Caleb Brown, Phillip Nichols, Tariq Ayubi, Jeremy Powers

Journal of Appalachian Health

Introduction: Breast cancer is the most common malignancy among women in the United States (U.S.), despite recent survival rates improving nationally. However, rural and Appalachian regions have experienced slower mortality declines. These communities face unique health care-related challenges that may contribute to observed disparities.

Purpose: The purpose of this study is to assess differences in breast cancer incidence, mortality, and mortality-to-incidence ratio (MIR) between Appalachian and non-Appalachian counties, as well as rural and non-rural counties in Virginia (VA). Furthermore, we aim to evaluate whether availability of mammography is associated with these differences.

Methods: County-level breast cancer incidence and mortality data …

Enhancing Public Health Strategies: Addressing The Rsv Burden In Alabama Through Clinical Treatment, Community Prevention, And Surveillance Approaches, Martha K. Findley Roper, Jennifer S. Dawson

Journal of Public Health in the Deep South

Introduction: Respiratory Syncytial Virus (RSV) is a highly contagious pathogen driving morbidity, hospitalizations, and economic burden. This review uses the epidemiological triad and National Wastewater Surveillance System data to assess transmission, viral load spikes in Alabama, and strategies for treatment and prevention.

Methods: A review of literature on supportive care, vaccination, monoclonal antibodies, and emerging nanomedicine was reviewed to evaluate strategies for reducing viral burden and complications.

Results: Trends from December 2024–January 2025 were assessed with National Wastewater Surveillance System data. Primary prevention includes immunization, hygiene, air quality maintenance, and early diagnostics. Tertiary care addresses complications such as secondary …

Epidemiology, Presentation, And Diagnosis Of Type 2 Diabetes Mellitus In Children And Adolescents, Bisher Alsabbagh, Whard Alsabbagh

School of Integrative Biological & Chemical Sciences (Formerly Dept. of Biology)

The prevalence of type 2 diabetes mellitus (T2DM) in children and adolescents has increased substantially over recent decades, paralleling rising rates of pediatric obesity and metabolic risk. Youth-onset T2DM is characterized by significant insulin resistance accompanied by an inadequate compensatory insulin response, resulting in progressive hyperglycemia and early beta-cell dysfunction. Incidence varies widely among racial and ethnic groups, with the highest rates observed in non-Hispanic Black, Hispanic, Native American, Asian American, and Pacific Islander youth. Risk factors include obesity, family history, high-risk ethnicity, pubertal insulin resistance, prenatal metabolic exposures, and comorbid conditions such as polycystic ovary syndrome. Clinical presentation ranges …

Increasing Pediatric Hpv Vaccination Rates, Brooke A. Nicholas

Dissertations

Increasing Pediatric HPV Vaccination Rates

Abstract

Problem: The human papillomavirus (HPV) is a sexually transmitted infection that affects more than 80% of the population within the United States (Eisenhauer et al., 2020). HPV can develop into cervical, anogenital, and oropharyngeal cancers (Eisenhauer et al., 2020). About 4,000 individuals die from cervical cancer alone each year (O’Leary, 2022). The HPV vaccine, though recommended by the ACIP and AAP, is below national vaccination rates in comparison to other vaccines (O’Leary, 2022).

Methods: This quality improvement project is a non-randomized controlled trial that observed HPV vaccine dose completion rates for patients aged 9-14 …

A Comprehensive Evidence-Based Educational Initiative For Improving Hand Hygiene, Lyanna L. Chan

Master's Projects and Capstones

Abstract

Problem: Healthcare-associated infections (HAIs) are a persistent concern in assisted living facilities, often resulting from inconsistent hand hygiene practices. Although national guidelines exist, adherence remains suboptimal, especially where staff training and compliance monitoring are limited.

Context: This project took place in a 53-bed assisted living facility without a formal system to track or reinforce hand hygiene. The aim was to improve staff knowledge and promote infection prevention through education.

Interventions: A Clinical Nurse Leader (CNL) led an evidence-based hand hygiene education program. The intervention included interactive training, visual reminders, personal sanitizers, and leadership support during clinical huddles.

Measures: Pre- …

Transforming Primary Care: Innovative Post Graduate Pa Training For Real-World Solutions, Kenneth Botelho, James Ali

Lynchburg Journal of Medical Science

The ongoing crisis in primary care demands innovative and scalable strategies to prepare and retain advanced practice providers. This article introduces the Primary Care Practitioner (PCP) Program, a conceptual postgraduate training model designed for certified physician associates/assistants (PAs) who aim to serve in underserved and rural communities. The program integrates advanced clinical training, leadership development, telehealth competencies, VR-enhanced simulation, and evidence-based strategies to promote provider resilience. Rooted in systems-based thinking and real-world applicability, the PCP Program culminates in capstone projects that encourage innovation in care delivery and population health.

Aligned with national frameworks such as the HRSA Primary Care Training …

Childhood Myopia Part Ii: Treatment Mechanisms, Emerging Options, And Considerations, Safal Khanal Dr, Erin S. Tomiyama Dr, Síofra Harrington Dr

Articles

Abstract

The rapidly increasing prevalence of myopia and its association with vision-threatening complications in later life has intensified efforts to identify treatments that can prevent the onset and slow the progression of myopia in children. These efforts have led to the development of several optical, environmental, and pharmacological myopia control treatments. Investigations of additional treatment options are ongoing and have shown great promise for clinical translation. Although significant progress has been made in identifying potential pathways and modes of action of these treatments, a complete mechanistic understanding is still lacking. This critical review article explores the potential mechanisms underlying the …

Enhancing Healthcare-Associated Infection Prevention: The Role Of Hand Hygiene, Ppe, Isolation, And Vaccination Education, Kaitlyn N. Rollo

Aurora

Healthcare-associated infections (HAIs) represent a significant threat to patient safety in hospital environments. These infections are often linked to lapses in infection prevention protocols, including inadequate hand hygiene, improper use of personal protective equipment (PPE), and insufficient isolation procedures. This project aimed to evaluate compliance with infection control policies and identify areas for improvement at Lima Memorial Hospital. By focusing on auditing, education, and data analysis, the goal was to reduce HAI rates and strengthen overall infection prevention practices.

Methods included a comprehensive review of existing hospital infection prevention policies, followed by hand hygiene and PPE audits across the hospital’s …

Optimising Non-Cycloplegic Screening Strategies For Early Detection Of Pre-Myopia And Myopia In Young Children, Síofra Harrington, Michael Moore, James Loughman, Ian Flitcroft, Veronica O'Dwyer

Articles

Purpose: Early detection of myopia is essential to delay its onset and progression. Pre-myopia, defined by an inadequate hyperopic reserve, increases myopia risk in childhood. However, effective screening methods remain limited. This study aimed to develop practical non-cycloplegic screening methods for pre-myopia and myopia in 6- to 7-year-olds to support earlier interventions.

Methods: This cross-sectional study of 621 Irish schoolchildren (mean age: 7.12 ± 0.45 years; 51.8% boys) assessed uncorrected distance visual acuity (UDVA). Cycloplegic spherical equivalent refraction (SER) classified refractive status (myopia: SER ≤ −0.50D; pre-myopia: SER > −0.50 ≤ 0.75D). Pre- and post-cycloplegic SER were measured using the Welch …

Refractive Error And Axial Length (Real) Study: Feasibility Of A Population Study In The United States, Sarah E. Singh Dr, Lisa A. Ostrin, Kristen Kerber Dr, Concepcion Cayle, Celia Gong Dr, Lal Barsha Dr, Ian Flitcroft, Síofra Harrington, James Loughman, Kathryn Saunders Prof, Fuensanta Vera-Diaz Dr

Articles

Myopia is the most common eye disease and a leading cause of blindness. A contemporary, large, and ethnically and geographically diverse study of ocular biometry and refractive error in children in the United States is needed to help better describe differences between myopic and nonmyopic eyes.

This is an initial cross-sectional report from the Refractive Error and Axial Length Growth Curve Study that includes ocular component data as a function of age, gender, and geographic location. This feasibility report will inform a planned larger longitudinal ocular growth study in children in the United States.

Cross-sectional data on children, ages 3 …

An Application Of Minimization For Ensuring Balanced Study Arms In A Group-Randomized Covid-19 Educational Intervention Trial, Xu Zhang, Mohammad H Rahbar, Amirali Tahanan, Cici Bauer, Marcia C De Oliveira Otto, Alanna C Morrison, Belinda Reininger, Maria E Fernandez

Faculty, Staff and Student Publications

BACKGROUND: Our institution carried out a multi-center, group-randomized controlled trial to evaluate the effectiveness of two community-based interventions on promoting the uptake of COVID-19 testing and vaccination in three regions with high levels of health disparities in Texas. We selected Census Block Groups (CBGs) with high disparity for randomization. In each study region, selected CBGs were randomized into two intervention groups and one control group. An important goal was to ensure balanced distributions of two continuous covariates, the disparity index and population size, across study arms. In this paper, we describe a novel minimization method used to ensure balanced study …

A Qualitative Approach To Identifying Obstacles To Mental Healthcare In The Rio Grande Valley From The Perspective Of Mental Healthcare Professionals., Shania M. Linder, Cristian Botello, Raquel Villarreal, Nelda Rodriguez, Mario Gil, Dayana Zamora

Research Symposium

Background: There are many factors that prevent members of the Hispanic/Latino community from accessing mental health resources. This is important to investigate because there is a lack of knowledge on why residents of the Rio Grande Valley, an underserved region of South Texas, are unable to access and/or utilize mental health resources.

Methods: A focus group session was held at a mental health counseling clinic in Cameron County, Texas on February 1, 2024. The participants consisted of mental health professionals, such as two mental health clinicians, a clinical counselor, two school counselors, a licensed professional counselor supervisor, and a …

Patterns And Outcomes In Urotrauma: An Analysis Of Fatality Trends And Contributing Factors, Neharika Penmetcha, Aun Bangash, Kelsey Baker

Research Symposium

Background: Urotrauma, involving injuries to the kidneys, ureters, and bladder, represents a critical subset of trauma cases, significantly impacting patient morbidity and mortality. Renal and urogenital injuries account for 10–20% of abdominal trauma in adults and children. Understanding urotrauma's epidemiology is vital for improving care protocols and resource allocation. Despite its impact, data on injury mechanisms, intent, and care modalities specific to urotrauma remain limited. This study investigates patterns in injury mechanisms, intent, transport modalities, and facility transfer status to identify factors influencing patient outcomes and inform trauma care improvements.

Methods: A retrospective review analyzed 3,492 trauma cases, filtered for …

Perspectives Of African American And Hispanic/Latino Individuals On Hiv Molecular Cluster Detection, Maxwell Richardson, Brendan H. Pulsifer, Jane Yoon Scott, David Holland, Eleanor W. Garlow, Pascale Wortley, Daniel Mauck, Jenna Gettings, Valeria Cantos, Masonia Traylor, Eric Rangel, David Folkes, Carlos Saldana

Journal of the Georgia Public Health Association

Background: Responding to HIV clusters detected using molecular data has been shown to reduce transmission and improve testing, treatment, and prevention. However, there are varied opinions about the use of cluster detection activities, and some advocates have raised concerns about patient consent, data security, and the potential for HIV criminalization. Incorporating the perspectives of marginalized populations that are disproportionately affected by HIV is essential to understanding the diversity of those perspectives, yet it is often overlooked in the literature. Thus, our study seeks to highlight the perspectives of Black/African American and Hispanic/Latino individuals in the Southern United States on HIV …

Characteristics And Outcomes Of Adults Hospitalized With Respiratory Syncytial Virus, Brian S. Shaw, Cara Slaton, Ian P. Murphy, Michael Mcalister, Daniel Egan, Kwabena Ayesu

The University of Louisville Journal of Respiratory Infections

Background: Respiratory syncytial virus (RSV) is a negative sense single-stranded RNA virus (ssRNA) that primarily causes respiratory infections in both children and older adults. We examined clinical characteristics and outcomes of hospitalized adult patients who tested positive for RSV.

Methods: This was a multicenter, retrospective, descriptive study that examined adult patients admitted with a positive RSV test over two years across eight hospitals in Orlando, Florida.

Results: A total of 120 patients were included, of which 88 (73%) were 60 years old and older. Overall, patients with RSV infection were caucasian (62%) with a median age of 70 years and …

Hybrid Versus Vaccine Immunity Of Mrna-1273 Among People Living With Hiv In East And Southern Africa: A Prospective Cohort Analysis From The Multicentre Covpn 3008 (Ubuntu) Study, Nigel Garrett, Asa Tapley, Aaron Hudson, Sufia Dadabhai, Bo Zhang, Nyaradzo M Mgodi, Jessica Andriesen, Azwidihwi Takalani, Leigh H Fisher, Jia Jin Kee, Craig A Magaret, Manuel Villaran, John Hural, Erica Andersen-Nissen, Guido Ferarri, Maurine D Miner, Bert Le Roux, Eduan Wilkinson, Richard Lessells, Tulio De Oliveira, Jackline Odhiambo, Parth Shah, Laura Polakowski, Margaret Yacovone, Taraz Samandari, Zvavahera Chirenje, Peter James Elyanu, Joseph Makhema, Ethel Kamuti, Harriet Nuwagaba-Biribonwoha, Sharlaa Badal-Faesen, William Brumskine, Soritha Coetzer, Rodney Dawson, Sinead Delany-Moretlwe, Andreas Henri Diacon, Samantha Fry, Katherine Margaret Gill, Zaheer Ahmed Ebrahim Hoosain, Mina C Hosseinipour, Mubiana Inambao, Craig Innes, Steve Innes, Dishiki Kalonji, Margaret Kasaro, Priya Kassim, Noel Kayange, William Kilembe, Fatima Laher, Moelo Malahleha, Vongane Louisa Maluleke, Grace Mboya, Kirsten Mcharry, Essack Mitha, Kathryn Mngadi, Pamela Mda, Tumelo Moloantoa, Cissy Kityo Mutuluuza, Nivashnee Naicker, Vimla Naicker, Anusha Nana, Annet Nanvubya, Maphoshane Nchabeleng, Walter Otieno, Elsje Louise Potgieter, Disebo Potloane, Zelda Punt, Jamil Said, Yashna Singh, Mohammed Siddique Tayob, Yacoob Vahed, Deo Ogema Wabwire, M Juliana Mcelrath, James G Kublin, Linda-Gail Bekker, Peter B Gilbert, Lawrence Corey, Glenda E Gray, Yunda Huang, Philip Kotze, Covpn 3008 Ubuntu Study Team

Faculty, Staff and Students Publications

BACKGROUND: With limited access to mRNA COVID-19 vaccines in lower income countries, and people living with HIV (PLWH) largely excluded from clinical trials, Part A of the multicentre CoVPN 3008 (Ubuntu) study aimed to assess the safety of mRNA-1273, the relative effectiveness of hybrid versus vaccine immunity, and SARS-CoV-2 viral persistence among PLWH in East and Southern Africa during the omicron outbreak.

METHODS: Previously unvaccinated adults with HIV and/or other comorbidities associated with severe COVID-19 received either one (hybrid immunity) or two (vaccine immunity) 100-mcg doses of ancestral strain mRNA-1273 in the first month, depending on baseline evidence of prior …

Establishing A Student-Run Mobile Clinic In Appalachian Kentucky: A Community-Based Pilot Program To Address Health Inequities, Bradley A. Firchow, John C. Cornelius

Journal of Appalachian Health

The establishment of a student-run mobile clinic in Morehead, Kentucky, led by students from the University of Kentucky College of Medicine’s (UKCOM) Rural Physician Leadership Program (RPLP), aims to address health inequities in rural Appalachian communities. This pilot program is designed to serve vulnerable populations, including the unhoused, by delivering free, accessible healthcare services directly to underserved populations. This program serves as a model for expanding access to healthcare in rural regions while promoting a collaborative, community-based approach to addressing social determinants of health.

Resilience And Reality: Exploring The Lived Experiences Of People Living With Hiv In Texas During The Covid-19 Pandemic – A Qualitative Study., Ahmed F. Alanazi

Social Work Dissertations - Archive

This study investigated the lived experiences of individuals living with HIV (PLWH) in the Dallas-Fort Worth (DFW) area of Texas during the COVID-19 pandemic, using an Interpretative Phenomenological Analysis (IPA) framework. The research examined the intersection of health, social dynamics, and psychological resilience among PLWH, who faced compounded vulnerabilities due to systemic inequities and the dual public health crises of HIV and COVID-19. Through semi-structured interviews with ten participants from diverse backgrounds, the study captured the profound impacts of disrupted healthcare systems, heightened stigma, and social isolation on this marginalized population. The findings reveal that the pandemic exacerbated existing inequities …

Weighted Family History Density Of Substance Use: Influence On Participant Substance Use Onset, Escalation, And Duration, Carleigh A. Litteral

Theses and Dissertations--Psychology

Substance use disorders impose a staggering toll on the United States (U.S.), straining healthcare systems, destabilizing communities, and profoundly impacting both individuals and families. Approximately one in six Americans aged 12 and older had a past-year substance use disorder in 2022 (Key Substance Use, 2022), and nearly one-third of adults experience a substance use disorder in their lifetime (Wu, 2010), contributing to an economic burden exceeding $400 billion annually (National Drug Threat Assessment, 2011). Family history of substance use disorders is a key predictor of vulnerability, with individuals who have affected relatives being 2–8 times more …

Molecular Epidemiologic Studies Of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (Me/Cfs), Anil Kumar

Electronic Theses & Dissertations (2024 - present)

Background: Myalgic encephalomyelitis (ME)/chronic fatigue syndrome (CFS) is a disabling multisystem complex disorder with no known etiology or approved treatment. Our studies aimed to assess the link between ME/CFS and autoimmune disease (AID) and cancer, and to identify potential biomarkers and biological mechanisms to further explore pathophysiology of this diseases.

Methods: All analyses were done using data from a case-control study of ME/CFS conducted by Dr. Roxana Moslehi and her collaborators. In our first study we estimated the cumulative incidences of AID and cancer among first degree relatives of 60 cases and 61 controls and compared cumulative …

Effectiveness Of Original Monovalent And Bivalent Covid-19 Vaccines Against Covid-19-Associated Hospitalization And Severe In-Hospital Outcomes Among Adults In The United States, September 2022-August 2023, Jennifer Decuir, Diya Surie, Yuwei Zhu, Adam S Lauring, Manjusha Gaglani, Tresa Mcneal, Shekhar Ghamande, Ithan D Peltan, Samuel M Brown, Adit A Ginde, Aimee Steinwand, Nicholas M Mohr, Kevin W Gibbs, David N Hager, Harith Ali, Anne Frosch, Michelle N Gong, Amira Mohamed, Nicholas J Johnson, Vasisht Srinivasan, Jay S Steingrub, Akram Khan, Laurence W Busse, Abhijit Duggal, Jennifer G Wilson, Nida Qadir, Steven Y Chang, Christopher Mallow, Jennie H Kwon, Matthew C Exline, Nathan I Shapiro, Cristie Columbus, Ivana A Vaughn, Mayur Ramesh, Basmah Safdar, Jarrod M Mosier, Jonathan D Casey, H Keipp Talbot, Todd W Rice, Natasha Halasa, James D Chappell, Carlos G Grijalva, Adrienne Baughman, Kelsey N Womack, Jillian P Rhoads, Sydney A Swan, Cassandra Johnson, Nathaniel Lewis, Sascha Ellington, Fatimah S Dawood, Meredith Mcmorrow, Wesley H Self, Investigating Respiratory Viruses In The Acutely Ill (Ivy) Network

Faculty, Staff and Students Publications

BACKGROUND: Assessments of COVID-19 vaccine effectiveness are needed to monitor the protection provided by updated vaccines against severe COVID-19. We evaluated the effectiveness of original monovalent and bivalent (ancestral strain and Omicron BA.4/5) COVID-19 vaccination against COVID-19-associated hospitalization and severe in-hospital outcomes.

METHODS: During September 8, 2022 to August 31, 2023, adults aged ≥ 18 years hospitalized with COVID-19-like illness were enrolled at 26 hospitals in 20 US states. Using a test-negative case-control design, we estimated vaccine effectiveness (VE) with multivariable logistic regression adjusted for age, sex, race/ethnicity, admission date, and geographic region.

RESULTS: Among 7028 patients, 2924 (41.6%) were …

The Challenges Of Down Syndrome Screening In Primary Healthcare For Pregnant Women In Iran In 2018, Mona Zeinaloo, Mohammad Shariati, Masoud Younesian, Azita Kheiltash

Makara Journal of Health Research

Background: This study aimed to evaluate the various aspects of the implementation phase, including an economic evaluation, of Iran’s Down syndrome (DS) screening program.

Methods: Data were collected via phone interviews involving three random sample groups, with each group consisting of 1000 mothers who completed their pregnancies in 2018. To analyze the DS screening program from an economic aspect, we compared the costs related to the care of a DS individual in the country with that of finding and aborting a DS fetus based on the current screening program. In addition, to examine the financial expenses, we assessed …

Factors Associated With Elevated Sars-Cov-2 Immune Response In Children And Adolescents, Sarah E Messiah, Rhiana Abbas, Emma Bergqvist, Harold W Kohl, Michael D Swartz, Yashar Talebi, Rachit Sabharwal, Haoting Han, Melissa A Valerio-Shewmaker, Stacia M Desantis, Ashraf Yaseen, Henal A Gandhi, Ximena Flandes Amavisca, Jessica A Ross, Lindsay N Padilla, Michael O Gonzalez, Leqing Wu, Mark A Silberman, David Lakey, Jennifer A Shuford, Stephen J Pont, Eric Boerwinkle

Faculty, Staff and Student Publications

BACKGROUND: Understanding the distinct immunologic responses to SARS-CoV-2 infection among pediatric populations is pivotal in navigating the COVID-19 pandemic and informing future public health strategies. This study aimed to identify factors associated with heightened antibody responses in children and adolescents to identify potential unique immune dynamics in this population.

METHODS: Data collected between July and December 2023 from the Texas Coronavirus Antibody REsponse Survey (Texas CARES), a statewide prospective population-based antibody survey among 1-to-19-year-old participants, were analyzed. Each participant had the following data available for analysis: (1) Roche Elecsys® Anti-SARS-CoV-2 Immunoassay for Nucleocapsid protein antibodies (Roche N-test), (2) qualitative and …

Bayesian Beta-Binomial Mixed Models For Longitudinal, Clustered, And Spatiotemporal Data, Chun-Che Wen

MUSC Theses and Dissertations

Overdispersed binomial data arise in many clinical and public health research studies. Examples include timeline followback data (TLFB), which are used in addiction research to monitor recent substance use. This dissertation proposes novel beta-binomial (BB) mixed models to address the challenges associated with overdispersed binomial data, including zero-inflation, heterogenous effects, and spatiotemporal correlation. Motivated by a 12-week randomized controlled trial evaluating the efficacy of varenicline tartrate for smoking cessation among adolescents, Aim 1 develops a Bayesian zero-inflated beta-binomial (ZIBB) model to analyze longitudinal and bounded TLFB data — namely, the number of abstinent days in the past week. Because treatment …

Seroprevalence Of Anti-Sars-Cov-2 Igg Antibodies In Healthcare Personnel In El Salvador Prior To Vaccination Campaigns, José Elías Aguilar Ramírez, Adrianna Maliga, Allison Stewart, Allison Lino, José Eduardo Oliva, Xochitl Sandoval, Emily Zielinski-Gutierrez, Rafael Chacon-Fuentes, Parminder S Suchdev, Susana Zelaya, Mario Sánchez, Delmy Lisseth Recinos, Beatriz López, Ella Hawes, Julie Liu, Shannon E Ronca, Sarah M Gunter, Kristy O Murray, Rhina Domínguez

Faculty, Staff and Students Publications

COVID-19, caused by the SARS-CoV-2 virus, is a highly pathogenic emerging infectious disease. Healthcare personnel (HCP) are presumably at higher risk of acquiring emerging infections because of occupational exposure. The prevalence of COVID-19 in HCP is unknown, particularly in low- to middle-income countries like El Salvador. The goal of this study was to determine the seroprevalence of anti-SARS-CoV-2 antibodies among HCP in El Salvador just prior to vaccine rollout in March 2021. We evaluated 2176 participants from a nationally representative sample of national healthcare institutions. We found 40.4% (n = 880) of the study participants were seropositive for anti-spike …

Associations Between Longer Leukocyte Telomere Length And Increased Lung Cancer Risk Among Never Smokers In Urban China, Jason Y Y Wong, Xiao-Ou Shu, Wei Hu, Batel Blechter, Jianxin Shi, Kevin Wang, Richard Cawthon, Qiuyin Cai, Gong Yang, Mohammad L Rahman, Bu-Tian Ji, Yutang Gao, Wei Zheng, Nathaniel Rothman, Qing Lan

Faculty, Staff and Student Publications

BACKGROUND: The complex relationship between measured leukocyte telomere length (LTL), genetically predicted LTL (gTL), and carcinogenesis is exemplified by lung cancer. We previously reported associations between longer pre-diagnostic LTL, gTL, and increased lung cancer risk among European and East Asian populations. However, we had limited statistical power to examine the associations among never smokers by gender and histology.

METHODS: To investigate further, we conducted nested case-control analyses on an expanded sample of never smokers from the prospective Shanghai Women's Health Studies (798 cases and 792 controls) and Shanghai Men's Health Studies (161 cases and 162 controls). We broke the case-control …

Spatial Associations Of Lung Cancer Rates And Socioeconomic, Health, And Environmental Factors In Georgia, Nguyet Le, Jun Tu

Symposium of Student Scholars

According to CDC, Lung and Bronchus Cancer ranks the highest by the rate of cancer deaths among different types of cancers in the United States with the rate of 31.8 per 100 thousand people, and also for Georgia with the rate of 33.4 per 100 thousand people. Thus, to reduce the death rate of lung cancer, it is quite important and urgent to understand its risk factors. Smoking and inhaling radon are among the top risk factors of lung cancer for individuals. The socioeconomic, health, and environmental characteristics of communities might be also related to the likelihood of getting …

Cardiovascular Disease Risk Reduction Program For Hispanics In The Us Midwest: A Culturally Adapted Intervention, Armando De Alba

Theses & Dissertations

Cardiovascular disease (CVD) represents the second leading cause of death in Nebraska (NE), accounting for approximately one in every five deaths. In the state, there are marked ethnic and rural-urban disparities in the prevalence of chronic diseases and resultant deaths. For instance, while the rates in NE of coronary heart disease and myocardial infarction between 2001 and 2010 decreased among non-Hispanic Whites, the rates for Hispanics almost tripled. There is little evidence of CVD risk factor reduction strategies being implemented in Midwestern areas and Hispanic populations.

One promising approach for reducing CVD risk involves health education and lifestyle modification programs …

Targeted Accurate Rna Consensus Sequencing (Tarc-Seq) Reveals Mechanisms Of Replication Error Affecting Sars-Cov-2 Divergence, Catherine C Bradley, Chen Wang, Alasdair J E Gordon, Alice X Wen, Pamela N Luna, Matthew B Cooke, Brendan F Kohrn, Scott R Kennedy, Vasanthi Avadhanula, Pedro A Piedra, Olivier Lichtarge, Chad A Shaw, Shannon E Ronca, Christophe Herman

Duncan NRI Faculty and Staff Publications

RNA viruses, like SARS-CoV-2, depend on their RNA-dependent RNA polymerases (RdRp) for replication, which is error-prone. Monitoring replication errors is crucial for understanding the virus’s evolution. Current methods lack the precision to detect rare de novo RNA mutations, particularly in low-input samples such as those from patients. Here, we introduce a new targeted Accurate RNA Consensus sequencing method (tARC-seq) to accurately determine the mutation frequency and types in SARS-CoV-2, both in cell culture and clinical samples. Our findings show an average of 2.68×10−5 new errors per cycle with a C>T bias that cannot be solely attributed to APOBEC …