Clinical Epidemiology Commons^™

Identifying Micrornas Panel Associated With Hepatocellular Carcinoma In Serum Of Chronic Hepatitis C Patients, Areeg Dabbish

Theses and Dissertations

Introduction: early detection of hepatocellular carcinoma (HCC) will reduce morbidity and mortality rates of this poorly diagnosed widely-spread disease. Dysregulation in microRNA (miRNAs) expression is associated with HCC progression. Objective: Is to identify a panel of differentially expressed miRNAs (DE-miRNAs) to enhance HCC early prediction in hepatitis C virus (HCV) infected patients. Methodology: Candidate miRNAs were selected using bioinformatic analysis of microarray and RNA-sequencing datasets, resulting in nine DE- miRNAs (miR-142, miR-150, miR-183, miR-199a, miR-215, miR-217, miR-224, miR-424 and miR-3607). Their expressions were validated in the serum of 44 healthy individuals, 62 non-cirrhotic HCV patients, 67 cirrhotic-HCV and 72 HCV-associated …

Genomic Epidemiology Of Clostridium Difficile Colonization And Transmission In An Intensive Care Unit Cohort, Brianne Ciferri

Dissertations and Theses

Abstract

Genomic epidemiology of Clostridium difficile colonization and transmission in an intensive care unit cohort

by Brianne Ciferri, MPH

Advisor: C. Mary Schooling, PhD

Introduction: Clostridiodes difficile (C. difficile) is a leading cause of healthcare associated infections (HAI) in the United States and responsible for an estimated incidence of 223,900 cases and 12,800 deaths per year^1,2. C. difficile can cause gastrointestinal illness with symptoms ranging from mild diarrheal illness to a life-threatening condition. C. difficile is an opportunistic pathogen in which spores can live in an undisturbed dormant state within the intestinal tract and become …

The Yearly Financing Need Of Providing Paid Maternity Leave In The Informal Sector In Indonesia, Adiatma Y. M. Siregar, Pipit Pitriyan, Donny Hardiawan, Paul Zambrano, Mireya Vilar-Compte, Graciela Ma Teruel Belismelis, Meztli Moncada, David Tamayo, Grace Carroll, Rafael Perez-Escamilla, Roger Mathisen

Department of Public Health Scholarship and Creative Works

Background: The economic cost of not breastfeeding in Indonesia is estimated at US$1.5–9.4 billion annually, the highest in South East Asia. Half of the 33.6 million working women of reproductive age (WRA) in Indonesia (15–49 years) are informal employees, meaning they are working as casual workers or they are self-employed (small scale business) and assisted by unpaid/family worker(s). No specific maternity protection entitlements are currently available for WRA working informally in Indonesia. This study aims to estimate the financing need of providing maternity leave cash transfer (MCT) for WRA working in the informal sector in Indonesia. Method: The costing methodology …

Breastfeeding Media Coverage And Beliefs During The Covid-19 Pandemic In Mexico: Implications For Breastfeeding Equity, Mireya Vilar-Compte, P. Gaitán‐Rossi, E. C. Rhodes, V. Cruz‐Villalba, R. Pérez‐Escamilla

Department of Public Health Scholarship and Creative Works

Background: Because breastfeeding offers short- and long- term health benefits to mothers and children, breastfeeding promotion and support is a public health priority. Evidence shows that SARS-CoV-2 is not likely to be transmitted via breastmilk. Moreover, antibodies against SARS-CoV-2 are thought to be contained in breastmilk of mothers with history of COVID-19 infection or vaccination. WHO recommends direct breastfeeding as the preferred infant feeding option during the COVID-19 pandemic, even among women with COVID-19; but conflicting practices have been adopted, which could widen existing inequities in breastfeeding. This study aims to describe how information about breastfeeding was communicated in Mexican …

Community And Provider Acceptability Of The Covid-19 Vaccine: A Systematic Review And Meta-Analysis, Christian Akem Dimala, Benjamin Momo Kadia, Hai Nguyen, Anthony Donato

Advances in Clinical Medical Research and Healthcare Delivery

Background:

The novel coronavirus disease (COVID-19) vaccines may help control the current pandemic but would require immunization levels that would achieve herd immunity. This study aimed to quantify current COVID-19 vaccine acceptance rates, as well as characterize the determinants, enablers and barriers to vaccine acceptability across the globe by synthesizing published evidence.

Methods:

A systematic review and meta-analysis of studies was performed on studies assessing the acceptability of a COVID-19 vaccine published between November 1^st, 2019, and November 30^th, 2020. PubMed, Embase and Cochrane central were searched for eligible studies. Data extracted from retained studies was …

Racial And Ethnic Data Reported For Peanut Allergy Epidemiology Do Little To Advance Its Cause, Treatment, Or Prevention, Nigel Mark Thomas

Publications and Research

No abstract provided.

The Compounding Effect Of Rurality On Health Disparities Among Black Patients With Covid-19, Jessica E. Johnson, Ruchi Bhandari, Allison Lastinger, Rebecca Reece

Journal of Appalachian Health

Background: West Virginia had garnered national attention for its vaccination rollout against coronavirus 2019 (COVID-19). Outcomes of this mostly rural population, however, have been underreported. As the pandemic continues, identifying high risk populations remains important to further epidemiologic information and target vaccines.

Purpose: The objective of this study is to examine the effects of COVID-19 and the influence of race and rurality on hospitalization and outcomes in Appalachians.

Methods: In this retrospective study, data from patients who tested positive and were admitted for COVID-19 and seen within the state’s largest health system (West Virginia University Health System) between March …

Lessons Learned From The Hiv/Aids Pandemic And Access To Medicines For Covid-19 Treatment, Thalia Le

Independent Study Project (ISP) Collection

There is an imminent need to address the healthcare disparities in accessing all COVID-19 medicinal products in developing countries. While logistical issues like inadequate production facilities such as the lack of vaccines administration capacity, storage issues, gap between supply and demand as well as vaccine hesitancy can certainly play a part in impeding COVID19 medicines distribution, patent monopolies and intellectual property protection laws further exacerbated the problem, especially when vaccines were at its early stages of authorization. Historical and contemporary case studies of efforts to challenge patents on HIV AVRs treatment provide a useful lens through which we may glean …

Impact Of The Covid-19 Pandemic On Loneliness And Social Isolation: A Multi-Country Study, Roger O’Sullivan, Annette Burns, Gerard Leavey, Iracema Leroi, Vanessa Burholt, James Lubben, Julianne Holt-Lunstad, Christina Victor, Brian Lawlor, Mireya Vilar-Compte, Carla M. Perissinotto, Mark A. Tully, Mary Pat Sullivan, Michael Rosato, Joanna Mchugh Power, Elisa Tiilikainen, Thomas R. Prohaska

Department of Public Health Scholarship and Creative Works

The COVID-19 global pandemic and subsequent public health social measures have challenged our social and economic life, with increasing concerns around potentially rising levels of social isolation and loneliness. This paper is based on cross-sectional online survey data (available in 10 languages, from 2 June to 16 November 2020) with 20,398 respondents from 101 different countries. It aims to help increase our understanding of the global risk factors that are associated with social isolation and loneliness, irrespective of culture or country, to support evidence-based policy, services and public health interventions. We found the prevalence of severe loneliness was 21% during …

La Migración Como Determinante De La Obesidad Infantil En Estados Unidos Y Latinoamérica, Mireya Vilar-Compte, Arturo V. Bustamante, Nancy López-Olmedo, Pablo Gaitán-Ross, Jaqueline Torres, Karen E. Peterson, Graciela Teruel, Rafael Pérez-Escamilla

Department of Public Health Scholarship and Creative Works

La migración internacional tiene consecuencias económicas y en la salud. El proceso de aculturación en el país de acogida puede estar relacionado con la obesidad infan-til. Utilizamos el marco conceptual del balance energético comunitario (CEB, por sus siglas en inglés) para analizar la relación entre migración y obesidad infantil en los hogares mexicanos con migrantes internacionales. Utilizando datos longitudinales de la Encuesta Nacional de Niveles de Vida de los Hogares de México (ENNViH), exami-namos cómo influyen las redes de migrantes sobre la obesidad infantil en las comuni-dades de origen. También revisamos programas de salud binacionales que podrían ser eficaces para …

Living Environment Considerations On Obesity Prevention Behaviors And Self-Efficacy Among Chinese Americans, Doreen Liou, Jessica A. Karasik

Department of Nutrition and Food Studies Scholarship and Creative Works

The aim of this study is to ascertain if the living environment (type of residential neighborhood and number of household members) will elucidate differences in obesity risk reduction behaviors and self-efficacy in Chinese Americans. A cross-sectional survey design was used to recruit participants from Los Angeles County and New York City metropolitan areas. A total of 650 adults were recruited from diverse socioeconomic backgrounds. Descriptive statistics were measured for 19 behaviors reflecting food intake and portion size control and items measuring self-efficacy and attitudes. T-tests were applied for the two categories of living environment. The mean age of the sample …

Interpreting Covid-19 Deaths Among Nursing Home Residents In The Us: The Changing Role Of Facility Quality Over Time, Debasree Das Gupta, Uma Kelekar, Sidney C. Turner, Anupam A. Sule, Taya G. Jerman

Kinesiology and Health Science Faculty Publications

A report published last year by the Centers for Medicare & Medicaid Services (CMS) highlighted that COVID-19 case counts are more likely to be high in lower quality nursing homes than in higher quality ones. Since then, multiple studies have examined this association with a handful also exploring the role of facility quality in explaining resident deaths from the virus. Despite this wide interest, no previous study has investigated how the relation between quality and COVID-19 mortality among nursing home residents may have changed, if at all, over the progression of the pandemic. This understanding is indeed lacking given that …

Car Ratings Take A Back Seat To Vehicle Type: Outcomes Of Suv Versus Passenger Car Crashes, Dietrich Jehle, Albert Arslan, Chirag Doshi, Clay O'Brien

HCA Healthcare Journal of Medicine

Background

Car safety ratings are routinely utilized in making automobile purchase decisions. These 1- to 5-star ratings are based on crash test data comparing vehicles of similar type, size and weight.

Objectives

We hypothesized that car safety ratings are less important than vehicle factors such as vehicle type and weight in predicting outcomes of head-on crashes.

Methods

A retrospective study was conducted on severe head-on motor vehicle crashes entered into the FARS (Fatality Analysis Reporting System) database between 1995 and 2010. This database includes all US motor vehicle crashes that resulted in a death within 30 days of the accident. …

Resilience And Its Associated Factors In Head And Neck Cancer Patients In Pakistan: An Analytical Cross-Sectional Study, Nida Zahid, Wajeeha Zahid, Wardah Khalid, Syed Iqbal Azam, Mubasher Ikram, Aneesa Hassan, Haissan Iftikhar, Shireen Shehzad Bhamani, Adnan Jabbar, Shabbir Akhtar, Moghira Siddiqui, Mohammad Sohail Awan, Nargis Asad, Khabir Ahmad

Department of Surgery Docs

Introduction: The study aimed to assess resilience and its associated factors in head and neck cancer patients, post-treatment in a low middle income country (LMIC) such as Pakistan.
Methods: An analytical cross-sectional study was conducted from November 2019 to May 2020 among head and neck cancer patients aged at least 18 years at the largest private tertiary care hospital, in Karachi, Pakistan. Information regarding their resilience scores was collected through Wagnild and Young's Resilience scale that comprises of 14 items (RS-14). Moreover, depression and anxiety were also assessed via Hospital Anxiety and Depression Scale (HADS) and social support was assessed …

Economic Insecurity, Poverty, And Parental Alcohol Misuse, Joey Tucciarone

Electronic Theses and Dissertations

Because parental alcohol misuse is associated with numerous negative outcomes for drinkers and other family members, it is important to examine factors predictive of alcohol misuse patterns among parents living with at least one child under the age of 18. Two possible factors include economic insecurity and poverty. This study sought to address whether measures of economic insecurity (i.e., housing and/or food insecurity in the past 12 months) and a dichotomous measure of poverty predict parental binge drinking and parental heavy alcohol consumption in a large population-based sample. It was hypothesized that economic insecurity and poverty, analyzed separately, would predict …

Surveillance Of The Incidence And Mortality Of Oral And Pharyngeal, Esophageal, And Lung Cancer In Nevada: Potential Implications Of The Nevada Indoor Clean Air Act, Kevin Foote, David Foote, Karl Kingsley

Dental Medicine Faculty Research

Reviews of national and state-specific cancer registries have revealed differences in rates of oral, esophageal, and lung cancer incidence and mortality that have implications for public health research and policy. Many significant associations between these types of cancers and major risk factors, such as cigarette usage, may be influenced by public health policy such as smoking restrictions and bans—including the Nevada Clean Indoor Air Act (NCIAA) of 2006 (and subsequent modification in 2011). Although evaluation of general and regional advances in public policy have been previously evaluated, no recent studies have focused specifically on the changes to the epidemiology of …

Prevalence Trend And Disparities In Rheumatoid Arthritis Among Us Adults, 2005–2018, Yingke Xu, Qing Wu

School of Public Health Faculty Research

Rheumatoid arthritis (RA) trends among US adults and disparities in RA patients in recent years have not been well described. We aimed to examine the trend of RA prevalence and disparities among US adults. Data from the National Health and Nutrition Examination Survey (NHANES) of the years 2005–2018 were analyzed to examine the self-reported RA prevalence trend. Age-adjusted RA prevalence stratified by race/ethnicity and socioeconomic status (SES), as well as associated linear trends, were calculated for both genders. The multivariable adjustment was used to evaluate the association between race, SES, and RA. During 2005–2018, there was no significant linear trend …

Triple Negative Breast Cancer In An Appalachian Region: Exponential Tumor Grade Increase With Age Of Diagnosis, Gina Sizemore, Toni Marie Rudisill

Journal of Appalachian Health

Introduction: Triple negative breast cancer is an aggressive breast cancer with decreased five-year survival, increased risk for recurrence, and higher risk for metastases. Unlike other breast cancers, it has no targeted treatment and has heterogeneous genetics which make classification and treatment difficult.

Purpose: The purpose of our research was to compare triple negative breast cancer to non-triple negative breast cancer to identify key epidemiologic factors that might lead to improved basic science directives for biomarkers, treatments, and classification.

Methods: The state cancer registry was used to provide the first West Virginia state-wide population evaluation of triple negative breast cancer.

Results: …

Prevalencia Mensual De Trastorno De Ansiedad Generalizada Durante La Pandemia Por Covid-19 En México, Pablo Gaitán-Rossi, Víctor Pérez-Hernández, Mireya Vilar-Compte, Graciela Teruel-Belismelis

Department of Public Health Scholarship and Creative Works

Objective. Estimate the prevalence of generalized anxiety disorder (GAD) from April to June 2020. Materials and methods. Repeated cross-sections design based in the Encovid-19, a series of monthly mobile surveys with represen- tative samples of Mexico (N= 833-1 674).The questionnaire includes the GAD-2 scale, and, in July, the GAD-7 scale was added; we examined its internal validity with confirmatory factor analysis and its concurrent validity with sociodemo- graphic variables. Using GAD-7 as criterion, we analyzed the predictive validity of the GAD-2.We estimated the monthly prevalence with the GAD-2. Results. The GAD-7 and the GAD-2 are reliable and valid.The GAD-2 has …

Lagged Meteorological Impacts On Covid-19 Incidence Among High-Risk Counties In The United States—A Spatiotemporal Analysis, Lung-Chang Chien, Lung-Wen Antony Chen, Ro-Ting Lin

School of Public Health Faculty Research

Background: The associations between meteorological factors and coronavirus disease 2019 (COVID-19) have been discussed globally; however, because of short study periods, the lack of considering lagged effects, and different study areas, results from the literature were diverse and even contradictory. Objective: The primary purpose of this study is to conduct more reliable research to evaluate the lagged meteorological impacts on COVID-19 incidence by considering a relatively long study period and diversified high-risk areas in the United States. Methods: This study adopted the distributed lagged nonlinear model with a spatial function to analyze COVID-19 incidence predicted by multiple meteorological measures from …

Characterization Of Oral Cavity And Oropharyngeal Cancer In The Texas Rio Grande Valley, Jared A. Sperling, Rachel Giese

MEDI 9331 Scholarly Activities Clinical Years

Cancers of the oral cavity (OC) and oropharynx (OP) account for 3% of cancers diagnosed in the United States each year. A primary cause of death among the Hispanic population in the United States is cancer, accounting for 20% of annual mortality. The Rio Grande Valley (RGV) is a medically-underserved area of South Texas with a large Hispanic population facing health disparities. In this study, we examine the incidence and mortality of OC and OP cancer in the RGV. CDC population-level incidence and mortality rate per 100,000 of OC/OP cancer among patients in the RGV counties of Hidalgo and Cameron …

Migration As A Determinant Of Childhood Obesity In The United States And Latin America, Mireya Vilar-Compte, Arturo V. Bustamante, Nancy López-Olmedo, Pablo Gaitán-Rossi, Jaqueline Torres, Karen E. Peterson, Graciela Teruel, Rafael Pérez-Escamilla

Department of Public Health Scholarship and Creative Works

International migration has economic and health implications. The acculturation process to the host country may be linked to childhood obesity. We use the Community Energy Balance (CEB) framework to analyze the relationship between migration and childhood obesity in Mexican households with international migrants. Using longitudinal data from the Mexican Family Life Survey (MxFLS), we examine how migrant networks affect childhood obesity in origin communities. We also review binational health programs that could be effective at tackling childhood obesity in migrant households from Mexico. Children embedded in migrant networks are at greater risk of developing overweight or obesity, suggesting a significant …

Implementation Of Childhood Obesity Prevention And Control Policies In The United States And Latin America: Lessons For Cross-Border Research And Practice, Rafael Perez-Escamilla, Mireya Vilar-Compte, Elizabeth Rhodes, Olga L. Sarmiento, Camila Corvalan, Rachel Sturke, Susan Vorkoper

Department of Public Health Scholarship and Creative Works

Progress has been made in the development and widespread implementation of effective interventions to address childhood obesity, yet important challenges remain. To understand how the United States and Latin American countries achieved success in implementing obesity policies and programs (PAPs) and identify improvement opportunities using implementation science principles. We identified three comparative case studies: (1) front-of-food package labeling (Mexico and Chile); (2) Open Streets/play streets (Colombia and the United States); and (3) the Baby-Friendly Hospital Initiative (Brazil and the United States). Information from multiple sources (e.g., scientific and gray literature and key informant interviews) was synthesized to describe barriers, facilitators, …

Complexity Of Malaria Transmission Dynamics In The Brazilian Atlantic Forest, Ana Maria Ribeiro De Castro Duarte, Licia Natal Fernandes, Fabiana Santos Silva, Igor Lucoves Sicchi, Luis Filipe Mucci, Izilda Curado, Aristides Ferrnandes, Antônio Ralph Medeiros-Sousa, Walter Ceretti-Junior, Mauro Toledo Marrelli, Eduardo Evangelista, Renildo Teixeira, Juliana Laurito Summa, Marcello Schiavo Nardi, Margoth Ramos Garnica, Ana Carolina Loss, Julyana Cerqueira Buery, Crispim Cerutti Jr., M. Andreína Pacheco, Ananias A. Escalante, Maria Anice Mureb Sallum, Gabriel Zorello Laporta

Harold W. Manter Laboratory of Parasitology: Library Materials

Plasmodium malariae and Plasmodium vivax are protozoan parasites that can cause malaria in humans. They are genetically indistinguishable from, respectively, Plasmodium brasilianum and Plasmodium simium, that is, parasites infecting New World non-human primates in South America. In the tropical rainforests of the Brazilian Atlantic coast, it has long been hypothesized that P. brasilianum and P. simium in platyrrhine primates originated from P. malariae and P. vivax in humans. A recent hypothesis proposed the inclusion of Plasmodium falciparum into the transmission dynamics between humans and non-human primates in the Brazilian Atlantic tropical rainforest. Herein, we assess the occurrence of human …

Use Of Artificial Intelligence To Identify Predictors Of Functional Outcomes In Patients With Facioscapulohumeral Muscular Dystrophy, Natalie K. Katz

Research Days

Background: Facioscapulohumeral muscular dystrophy (FSHD) is one of the most common forms of muscular dystrophy characterized by slowly progressive muscle weakness. Symptoms initially involve the facial and shoulder girdle muscles, with later involvement of the distal lower extremities, pelvic girdle and proximal lower extremities. FSHD type 1 (FHSD1) is the most common form (~95% of individuals) and is caused by deletion of microsatellite repeats in the D4Z4 region on chromosome 4 (4q35). Normal individuals have >10 repeats whereas individuals with FSHD1 have 1-10 repeats. There is significant variability in regards to disease severity, rates of progression and functional outcomes, but …

Clinical Consequences And Determinants Of False Positive Blood Cultures In Adult Hospitalized Patients, Sidra Liaquat

Theses & Dissertations

Blood cultures are the gold standard for detecting blood stream infections. However, in the US, 0.6-6% of all blood cultures get contaminated leading to adverse clinical outcomes such as unnecessarily prolonged hospital stay and antibiotic therapy. Using electronic medical records, we explored the clinical outcomes and patient-specific risk factors of contaminated blood cultures in an era where rapid blood culture testing was being utilized to provide blood culture results within hours. Rapid blood culture test results can help clinicians in early and more effective management of patients with contaminated blood cultures, thus improving clinical outcomes. We also studied the impact …

Evaluating The Caprini Risk Assessment In An Inpatient Rehabilitation Facility, Alissa Payne, Kelsey Boersma, Sarah Nechuta

Masters Projects

Deep vein thrombosis (DVT) is an often underdiagnosed disease that can be life threatening for individuals. Currently, the best practice approach to assess the risk of venous thromboembolism (VTE) in patients within a rehabilitation hospital is unknown. We examined how well the Caprini risk assessment (CRA) score predicts VTE events (deep vein thrombosis (DVT), pulmonary embolism (PE)) within an inpatient rehabilitation hospital. Between January 2015 and October 2020, VTE events, the CRA Score, and risk factors were collected from a chart review conducted at Mary Free Bed Rehabilitation Hospital (MFB) among 3,091 patients. Results from the unadjusted logistic regression model …

The Migration Of Carbapenem-Resistant Acinetobacter Baumannii From The Battlefields Of Iraq And Afghanistan To The Healthcare Facilities Of The Veterans Health Administration, Jeffery Rogers

Capstone Experience: Master of Public Health

Multidrug-resistant organisms (MDRO) pose a great threat to health across the globe. That threat is also felt in the Veterans Health Administration (VHA). Wounded warriors returning home from the battlefields of Iraq and Afghanistan may have brought with them MDROs, such as the bacterium Acinetobacter baumannii, as they have transitioned from military service into the VHA facilities. This study investigates the interconnectedness of military service in the Department of Defense (DoD) and a lifetime of care at VHA through a longitudinal tracking of a linked cohort of combat veterans with battlefield injuries and subsequent MDR infections of A. baumannii. …

Treatment Access For Dual Diagnosis Substance Use And Mental Health Disorders, Pedro Banuelos

Electronic Theses, Projects, and Dissertations

In 2018, of 1.3 million Latinx adults in the United States facing concurrent issues with substance use disorders (SUD) and mental health disorders (MHD) 93% remained untreated for either diagnosis. This is concerning since Substance Abuse and Mental Health Services Administration (SAMHSA) data reveals that this population is at greater risk for suicidal thoughts, plans, and attempts. They also face structural barriers such as employment, housing, legal involvement, and insurability that further impede access to treatment.

This study’s purpose was to examine barriers to accessing treatment for Latinx populations confronting co-occurring SUDs and MHDs. This study used a qualitative design …

Prevalence Of Common Disease Conditions In A Large Cohort Of Individuals With Down Syndrome In The United States, Brian Chicoine, Anne Rivelli, Veronica Fitzpatrick, Laura Chicoine, Gengjie Jia, Andrey Rzhetsky

Journal of Patient-Centered Research and Reviews

Purpose: Given the current life expectancy and number of individuals living with Down syndrome (DS), it is important to learn common occurrences of disease conditions across the developmental lifespan. This study analyzed data from a large cohort of individuals with DS in an effort to better understand these disease conditions, inform future screening practices, tailor medical care guidelines, and improve utilization of health care resources.

Methods: This retrospective, descriptive study incorporated up to 28 years of data, compiled from 6078 individuals with DS and 30,326 controls matched on age and sex. Data were abstracted from electronic medical records within a …