Epidemiology Commons^™

Healthcare Providers’ Perspective On Hiv Testing And Hypothetical Mhealth-Connected Linkage To Care Among Men Who Have Sex With Men (Msm) In South Carolina, Tony Brown, Prince Nii Ossah Addo, Monique J. Brown Ph.D., Mph, Xiaoming Li, Oluwafemi Adeagbo

Faculty Publications

Background: HIV continues to be an important public health concern in South Carolina (SC). However, an examination of providers’ willingness to use mHealth technologies to address ongoing barriers to HIV care and prevention strategies, particularly among men who have sex with men (MSM) is currently lacking in SC. We therefore explored HIV care providers’ perceptions of HIV testing and treatment uptake among MSM, and providers’ willingness to use mHealth technology to address barriers to HIV testing and treatment in SC. Methods: Between August and December 2021, we conducted semistructured virtual interviews with 10 HIV care providers recruited purposively based on …

Sars-Cov-2 Detection And Persistence In A Remote Amazonian Settlement, Glauco M. Silva, Roberto C. Ilacqua, Franciely G. Gonçalves, Carla M. Santana, Felipe T. Jordão, Paula R. Prist, Melissa S. Nolan Ph.D., Mph, Andreia F. Brilhante, Marcia A. Sperança, Gabriel Z. Laporta

Faculty Publications

Background: COVID-19 continues to pose a major global health challenge. Despite its geographic distance from Brazil’s major urban centers, Acre state has experienced notable outbreaks. This study assessed the detection and persistence of SARS-CoV-2 in the rural settlement of Santa Luzia, located in the remote municipality of Cruzeiro do Sul, Acre state, Brazil. Methods: In July 2022, a cross-sectional survey was conducted at 40 sites from an ongoing environmental study, selected by deforestation patterns and proximity to health posts. Saliva samples were collected from residents aged 5–90 years, followed by nucleic acid extraction and multiplex RT-qPCR for SARS-CoV-2 detection. Results: …

Risk Of Post-Acute Symptoms Among Adults: A Comparison Study Of Severe Covid-19, Pneumonia, And Influenza, Caroline M Schaefer, Trudy Millard Krause, George L Delclos, Raymond S Greenberg

Faculty, Staff and Student Publications

Background: A retrospective cohort study was undertaken to assess the relationship between initial disease severity of COVID-19 and the risk of post-acute symptoms. The COVID-19 cohort was compared against influenza and pneumonia cohorts to assess whether risk of post-acute symptoms differed.

Methods: Administrative health claims data were obtained for commercially insured and Medicare Advantage covered adults (≥ 18 years) with symptomatic laboratory-confirmed COVID-19 diagnosed in 2020 (n=121,205), and similar cohorts of influenza (n=20,844) and pneumonia (n=29,052) patients diagnosed prior to the pandemic. Post-acute symptoms were assessed at four weeks, three and six months following initial diagnosis.

Results: Among the patients …

Understanding Women's Access To And Utilization Of Syringe Service Programs, Annelisa E. Swiersz

Honors Undergraduate Theses

As of 2020, 138 million Americans ages 12 and over reported illicit drug use in their lifetime, with over 3 million of those people injecting drugs. There are risks for all people who use drugs, but people who inject drugs (PWID) pose specific risks such as hepatitis B, hepatitis C, and human immunodeficiency virus (HIV), with women who inject drugs (WWID) facing even more risks. WWID involved in sex work have a higher risk of HIV transmission and lack access to sterile injection devices and sexual and reproductive health services. To address these risks, syringe service programs (SSPs) were developed …

Modeling Vaccination Strategies And Intervention Impacts On Infectious Disease Dynamics, Elizabeth B. Amona

Theses and Dissertations

This dissertation explores how mathematical and statistical modeling can inform vaccination strategies and evaluate the impact of interventions during infectious disease outbreaks. Motivated by the challenges observed during the COVID-19 pandemic, the research integrates compartmental modeling, Bayesian inference, and agent-based simulation to assess policy effectiveness and disease control across varying contexts. The first study develops a SEIRDV model that incorporates government interventions and vaccination rollout to examine COVID-19 dynamics in Qatar. A Bayesian approach is used to estimate parameters and compute time-varying transmission rates. The model captures shifts in transmission following policy changes and quantifies the reduction in deaths attributable …

Place, Culture, And Care: A Socioecological Examination Of Type 2 Diabetes Among Hispanics In The U.S., Danielle Montoya

Theses and Dissertations

Introduction: Type 2 diabetes (T2D) disproportionately affects U.S. Hispanic populations. This dissertation examined whether structural determinants fundamentally drive T2D disparities among Hispanics, with attention to within-group racial heterogeneity.

Methods: Three studies utilized nationally representative data. Study 1 examined neighborhood segregation and ethnic enclave residence associations with T2D using restricted NHANES data (2011-2018, n=5,056). Study 2 investigated acculturation and T2D associations using restricted NHANES data (2011-2018, n=4,540). Study 3 analyzed patient-provider racial/ethnic concordance and adequate diabetes care using MEPS data (2008-2021, n=17,138).

Results: Structural factors demonstrated primacy across all studies. Neighborhood segregation (aOR=1.17, p>0.05) and ethnic enclave residence showed no …

Effect Of Pre-Treatment Lab-Based Comorbidities On Treatment Related Outcomes Among Patients With Cancer, Jeffrey Alan Franks

All ETDs from UAB

Cancer is one of the leading causes of mortality and morbidity in the United States. In addition to their cancer, nearly 50% of individuals have a comorbid condition. This adds complexity to the treatment of these patients as it may delay cancer diagnosis or treatment or prevent treatment all together. Lab-values are an important tool to measure comorbidities and end-organ damage as they are routinely captured as part of standard of care and the basis of clinician decision making. However, despite the widespread multimorbidity and how crucial they are to decision making, few studies assess the association of lab abnormalities …

The Impact Of Transportation Insecurity On No-Show Appointments And Acute Care Utilization In Pediatric Sickle Cell Patients, Seabrook Hannah Jeffcoat

All ETDs from UAB

Sickle cell disease (SCD) patients experience high levels of transportation insecurity. Missed or delayed medical care due to transportation barriers can result in worsened clinical outcomes and increased hospital admissions and emergency department (ED) visits. We hypothesized that the relationship between transportation insecurity and acute care utilization is partially mediated by no-show appointments. This retrospective cohort study included 101 SCD patients aged ≤ 21 treated through the Pediatric Sickle Cell Clinic at Children’s of Alabama (COA) hospital from 2023 to 2024 and completed a social determinants of health (SDoH) questionnaire. Negative binomial or Poisson regression was used to model ED …

"The Association Between Serious Psychological Distress And Life Satisfaction Among U.S Adults With Hypertension", Kellen Michael Lenz

All ETDs from UAB

Purpose: Given the observed link between psychosocial and physical health outcomes, this study investigates the association between serious psychological distress and life satisfaction among U.S adults with hypertension. Methods: A cross-sectional study using 2021 National Health Interview Survey data among U.S adults was conducted to investigate the association between serious psychological distress and hypertension and assess the role of life satisfaction in modifying this relationship. Hypertension (diagnosed, undiagnosed), serious psychological distress (≥ 13 on the Kessler 6 nonspecific distress scale), and life satisfaction (Very satisfied, Satisfied, Dissatisfied, Very dissatisfied) were self-reported by participants. Ordinal logistic regression was used to investigate …

Exploring The Impact Of Returning To Office Work Post-Pandemic On The Mental Health Of Workers: A Cross-Sectional Analysis, Jasmine M. Nelson

All ETDs from UAB

This study examines the association between work settings and mental health outcomes among Black working-aged women, with a focus on racial disparities and the role of self-care. Using data from the U.S. Census Bureau's 2024 Household Pulse Survey, this cross-sectional analysis includes responses from 196,293 employed women aged 18–65. Mental health outcomes, including anxiety, worry, lack of interest, and depressive symptoms—were assessed through self-reported measures. Work settings were categorized as telework (hybrid/remote) or in-office, and logistic regression models were used to assess associations between work setting and mental health outcomes, adjusting for demographic and socioeconomic factors. Findings indicate that Black …

Psychometric Evaluation Of A Novel Measure Of Trauma-Related Cannabis Use To Cope, Sage E. Hawn, Terrell A. Hicks, Christopher Latourrette, Anita Thomas, Daniela Chaname, Sarah Ehlke, Abigail Powers Lott

Psychology Faculty Publications

Background: Posttraumatic stress disorder (PTSD) and cannabis use disorder (CUD) are commonly comorbid and are associated with many negative public health outcomes. One plausible explanation for this comorbidity comes from a self-medication framework, which suggests people use cannabis to cope with PTSD symptoms. Despite theoretical and empirical evidence for PTSD-related cannabis use to cope, no measure of this construct exists.

Objective: We sought to address this gap by developing and validating a novel measure of PTSD-specific cannabis self-medication, which we have termed the Trauma-Related Cannabis Use to Cope (TRCU) questionnaire.

Method: The psychometric properties of the TRCU and how it …

Generation Z’S Perception Of Skin Cancer And How It Relates To Climate Change, Piercen Bogolea

Honors Undergraduate Theses

Skin cancer is the most common cancer worldwide, and climate change has been identified as a significant contributor. Preventative action early on can help reduce occurrence, but it is unknown if Generation Z is aware of this and is taking the necessary action now to protect themselves. This research aims to gauge the perception of Generation Z on the severity of skin cancer, the relationship between climate change and skin cancer, and the prevalence of preventative measures being taken. A survey was distributed to students aged 18 to 27 enrolled at the University of Central Florida through mixed sampling. The …

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 …

Micro/Nanoplastics And Cancer: Focus On Gastrointestinal Malignancies - A Narrative Review, Sana Rabeeah, Priyata Dutta, Ahmad Mahdi, Alejandra Vargas, Edward C. Oldfield, David A. Johnson

Department of Medicine Faculty Publications

Micro- and nanoplastics (MNPs) are plastic particles smaller than 5 mm and 1 μm, respectively, and are emerging environmental pollutants with growing implications for human health. These particles stem from either 'primary sources', such as intentionally manufactured microbeads and industrial abrasives, or 'secondary sources', where larger plastic items break down into smaller fragments over time. Human exposure primarily occurs through ingestion and inhalation, with contaminated seafood and plastic-laden food packaging representing key routes of entry. Once ingested, MNPs can cross the intestinal barrier, accumulate in gastrointestinal (GI) tissues, and trigger biological responses. Mechanistic studies reveal that MNPs induce oxidative stress, …

Multisociety Guidance For Infection Prevention And Control In Nursing Homes, Lona Mody, Sonali D. Advani, Muhammad Salman Ashraf, Allison H. Bartlett, Suzanne F. Bradley, Deborah P. Burdsall, Jennifer A. Hanrahan, Susan S. Huang, Robert L.P. Jump, Lindsay Nicolle, Mary-Claire Roghmann, Patricia Stone, Rekha K. Murthy

Department of Medicine Faculty Publications

This multisociety guidance was endorsed by SHEA, APIC, IDSA, PALTmed, and AGS. It provides recommendations for infection prevention and control (IPC) in the context of the complexity of nursing home care in the United States: increased medical acuity of residents, the spread of multidrug-resistant organisms, and the threat of emerging pathogens. Recommendations and implementation suggestions address IPC leadership, staffing, and resources, healthcare personnel and residents‘ adherence to precautions and effective hand hygiene, outbreak preparedness, training, occupational health, cleaning and disinfection in the care environment, and the involvement of IPC in the facility. The guidance also addresses the challenges of maintaining …

Faktor Risiko Kejadian Hipertensi Dalam Kehamilan Pada Ibu Hamil Di Provinsi Jawa Timur (Analisis Data Riset Kesehatan Dasar Tahun 2018), Putri Amalia Firjatillah, Sudarto Ronoatmodjo

Jurnal Epidemiologi Kesehatan Indonesia

Hypertension during pregnancy is one of the most common pregnancy complications and the leading cause of maternal mortality in Indonesia. One of the regions in Indonesia with a high number of hypertension-related pregnancy complications is East-Java Province with a prevalence rate of 17,8%. This study aims to analyze the risk factors associated with hypertension during pregnancy among pregnant women in East Java. The study adopts a cross-sectional design using secondary data from 758 pregnant women aged 15-54 years in East Java Province who participated in 2018 Riskesdas Survey during which blood pressure measurements were taken. The dependent variable analyzed in …

Determinan Faktor Dengan Ketidakpatuhan Dalam Mengonsumsi Obat Antiretroviral Pada Orang Dengan Hiv(Odhiv) Di Rumah Sakit Umum Daerah Kabupaten Tangerang Tahun 2023, Dessi Marantika Nilam Sari, Mondastri Korib Sudaryo, Syahrizal Syarif, Helwiah Umniyati, Suyono .

Jurnal Epidemiologi Kesehatan Indonesia

Ketidakpatuhan alasan utama Pasien HIV tidak menerima pengobatan ARV sehingga harus selalu dipantau dan dinilai secara teratur serta didorong pada setiap kunjungan. Penelitian ini bertujuan untuk mengamati determinan faktor terjadinya ketidakpatuhan dalam mengonsumsi obat ARV pada ODHIV yang mendapatkan terapi ARV di Rumah Sakit Umum Daerah Kabupaten Tangerang. Jenis penelitian ini menggunakan penelitian observasional dengan rancangan cross sectional. Penelitian dilakukan di poli HIV RSUD Kabupaten pada bulan November 2023 menggunakan data laporan HIV pada SIHA. Populasi penelitian berjumlah 1.337 ODHIV aktif menjalani pengobatan antiretroviral di RSUD Kabupaten Tangerang dengan menggunakan total sampling sesuai dengan kriteria inklusi dan ekslusi sehingga sampel …

Evaluation Of A 20-Item Version Of The Trauma-Related Drinking To Cope Questionnaire, Sage E. Hawn, Lauren Smith, Kaytlin Armitage, Selah Ball, Cathy Lau-Barraco, Abigail Powers, Ananda B. Amstadter

Psychology Faculty Publications

Objectives: This study sought to develop and psychometrically evaluate an expanded version of the Trauma-Related Drinking to Cope (TRD) scale, a four-item self-report tool, which was developed to address a crucial gap in self-medication research. Before the development of the TRD, no measures existed which assessed alcohol use for coping with symptoms of posttraumatic stress disorder (PTSD) specifically. Previous work showed that the TRD has strong psychometric properties and clinical utility in its ability to identify individuals with PTSD who may be at risk for developing comorbid alcohol use disorder (AUD). The aim of the present study was to develop …

In Danger: Hiv Vaccine Research And Development In Europe, Roger Tatoud, Yves Lévy, Roger Le Grand, Jose Alcami, Giorgio Barbareschi, Christian Brander, Andrea Cara, Behazine Combadière, François Dabis, Sarah Fidler, Tomáš Hanke, Carolina Herrera, Gunilla B. Karlsson Hedestam, Hester Kuipers, Sheena Mccormack, Christiane Moog, Giuseppe Pantaleo, Laura Richert, Rogier W. Sanders, Robin Shattock, Hendrik Streeck, Rodolphe Thiebaut, Alexandra Trkola, Klaus Üeberla, Marit J. Van Gills, Ralf Wagner, Winfried Weissenhorn, Yazdan Yazdanpanah, Gabriella Scarlatti, Jean Daniel Lelièvre

Department of Obstetrics & Gynecology Faculty Publications

Highly effective antiretroviral-based HIV prevention plays an important role in ending the global HIV/AIDS epidemic. However, the sustainable control of the epidemic is hampered by unequal access to prevention options, including HIV testing, alongside with drug resistance and ongoing barriers to accessing sustainable HIV treatment. Therefore, an HIV vaccine, combined with effective prevention and treatment, remains an absolute necessity to control the epidemic. Yet, the recent discontinuation of four major vaccine efficacy studies is raising concerns about the future of HIV vaccine research and development globally, and particularly in the European region where funding for vaccine research and development has …

Predicting Mental Health Disparities Using Machine Learning For African Americans In Southeastern Virginia, Ismail El Moudden, Michael C. Bittner, Matvey V. Karpov, Isaac O. Osunmakinde, Akosua Acheamponmaa, Breshell J. Nevels, Mamadou T. Mbaye, Tonya L. Fields, Karthiga Jordan, Messaoud Bahoura

Department of Obstetrics & Gynecology Faculty Publications

This study examined mental health disparities among African Americans using AI and machine learning for outcome prediction. Analyzing data from African American adults (18–85) in Southeastern Virginia (2016–2020), we found Mood Affective Disorders were most prevalent (41.66%), followed by Schizophrenia Spectrum and Other Psychotic Disorders. Females predominantly experienced mood disorders, with patient ages typically ranging from late thirties to mid-forties. Medicare coverage was notably high among schizophrenia patients, while emergency admissions and comorbidities significantly impacted total healthcare charges. Machine learning models, including gradient boosting, random forest, neural networks, logistic regression, and Naive Bayes, were validated through 100 repeated 5-fold cross-validations. …

Dance-Related Fractures Occur In The Upper And Lower Extremities At Similar Rates: An Analysis Of The 2004-2023 National Electronic Injury Surveillance System Database, Senah E. Stephens, Joshua F. Edwards, Lisa K. Cannada

Department of Medicine Faculty Publications

Introduction

In the United States, 21% of adolescents participate in dance. Dancers are susceptible to injuries, particularly of the lower extremity, due to extreme positioning, dynamic overload, and repetitive movements.

Objectives

(1) to report the prevalence and describe demographic characteristics of dance-related fractures and (2) to analyze variables associated with disposition status.

Methods

The National Electronic Injury Surveillance System (NEISS) database, published by the US Consumer Product Safety Commission, was used to investigate dance-related fractures diagnosed in a sample of 100 emergency departments over 20 years. Descriptive statistics and demographic variables were analyzed using chi square tests. Age was analyzed …

Delayed Hypertension Diagnosis And Its Association With Cardiovascular Treatment And Outcomes, Yuan Lu, John E. Brush Jr, Chungsoo Kim, Yuntian Liu, Xin Xin, Chenxi Huang, Mitsuaki Sawano, Patrick Young, Jacob Mcpadden, Mark Anderson, John S. Burrows, Jordan R. Asher, Harlan M. Krumholz

Department of Medicine Faculty Publications

Importance Hypertension is a major risk factor for cardiovascular disease, yet delays in diagnosis may limit timely treatment initiation and increase cardiovascular risk.

Objectives To examine the timing of clinical hypertension diagnosis, its association with antihypertensive medication prescribing, and its association with long-term cardiovascular outcomes.

Design, Setting, and Participants This retrospective cohort study analyzed electronic health record (EHR) data from an integrated health care system. Adults aged 18 to 85 years with at least 2 outpatient blood pressure (BP) readings of 140/90 mm Hg or more recorded at least 30 days apart from January 1, 2010, to December 31, 2021, …

Frailty And Sleep In Adult Survivors Of Childhood Cancer: A Childhood Cancer Survivor Study Report, Lauren C. Daniel, Margaret M. Lubas, Huiqi Wang, Mariana Szklo-Coxe, Kirsten K. Ness, Annalynn M. Williams, Daniel A. Mulrooney, Rebecca Howell, Wendy Leisenring, Yutaka Yasui, Leslie L. Robinson, Gregory T. Armstrong, Eric J. Chow, Kevin R. Krull, Tara M. Brinkman

Epidemiology, Biostatistics, & Environmental Health Faculty Publications

Background

Young adult survivors of childhood cancer exhibit rates of frailty similar to adults several decades older without a cancer history. Frailty has been associated with sleep disturbances in non-cancer populations, but the relationship has not been examined in childhood cancer survivors who are known to exhibit elevated rates of sleep problems.

Aims

Examine associations between frailty and poor sleep quality in long-term survivors of childhood cancer.

Methods

This study utilized data from 9044 participants (> 5 years from diagnosis, M(age) = 40.8 years [SD = 9.5]) in the Childhood Cancer Survivor Study. Survivors' frailty status, chronic health conditions (CHC), …

Pediatric Cancer Incidence, Temporal Trends, And Mortality In The United States By Health Disparities Indicators, Seer (1973-2014), Prachi P. Chavan, Laurens Holmes Jr.

Epidemiology, Biostatistics, & Environmental Health Faculty Publications

Background: Pediatric cancer incidence has been increasing in the United States, despite improvement in pediatric cancer survival. This steady increase in incidence trends is not completely understood but maybe associated with social and environmental factors. In this study we aimed to assess the cumulative incidence, temporal trends, and mortality rates in pediatric cancer. Additionally, we examined sub-group variability in both incidence and mortality rates. Methods: Data from Surveillance, Epidemiology, and End Results (SEER) −18 from 1973–2014 were used for the purpose of analysis in this study. Age-adjusted incidence rates were used to assess temporal trends in cancer among children aged < 1–19 years. Univariable and multivariable binomial regression models were used to examine the association between race and cancer mortality while adjusting for potential confounders. Results: There were 92,594 cancer diagnoses during this period. White children comprised 74,758, (80.7%), black children 10,030, (10.8%), and other races 6648, (7.2%). Overall the age-adjusted cumulative incidence was slightly higher among white children (16.4%) than black children (12.4%) and other (13.0%). Children aged 15–19 years and those in metropolitan regions were more likely to be diagnosed with pediatric cancer. Relative to females, males were 16% more likely to die from the disease [adjusted Risk Ratio (aRR): 1.16, 95% Confidence Interval (CI): 1.09–1.22]. Additionally, compared to white children, black children had higher mortality rates [(aRR): 1.37, 99% CI: 1.23–1.52]. Conclusions: There is an increasing trend in pediatric cancer incidence; while white children have the highest incidence, black children and males indicated a survival disadvantage, indicative of racial and sex variability in overall pediatric cancer in the United States.

Analyzing The Centers For Disease Control And Prevention Mortality Data Using Weekly Exceedance In Mortality Count And Weekly Change In Mortality Indicator: A Time Series Study, Aditya Chakraborty, Mohan D. Pant

Epidemiology, Biostatistics, & Environmental Health Faculty Publications

Background and Aims

Cause-specific mortality (CSM) count prediction plays a vital role in the context of public health policy. In this study, we introduce a new analytical approach, which is divided into three phases to answer specific questions regarding CSM due to 14 specific causes by computing different simple, compound, and conditional probabilities.

Methods

A multivariate time series forecasting model was developed using the CDC weekly mortality count data. A binary data matrix was constructed for 14 causes of death (COD) as a function of weeks by combining the observed and forecasted mortalities. We introduced two new concepts: Weekly Exceedance …

Epidemiological Principles In Claims Of Causality: An Enquiry Into Repetitive Head Impacts (Rhi) And Chronic Traumatic Encephalopathy (Cte), Lauren V. Fortington, J. David Cassidy, Rudolph J. Castellani, Andrew J. Gardner, Andrew S. Mcintosh, Michael Austen, Zachary Yukio Kerr, Kenneth L. Quarrie

Research outputs 2022 to 2026

Determining whether repetitive head impacts (RHI) cause the development of chronic traumatic encephalopathy (CTE)-neuropathological change (NC) and whether pathological changes cause clinical syndromes are topics of considerable interest to the global sports medicine community. In 2022, an article was published that used the Bradford Hill criteria to evaluate the claim that RHI cause CTE. The publication garnered international media attention and has since been promoted as definitive proof that causality has been established. Our counterpoint presents an appraisal of the published article in terms of the claims made and the scientific literature used in developing those claims. We conclude that …

Association Between Hypertension And Dementia Risk In Low- And Middle-Income Countries: A Systematic Review, Josephine E. Lindhout, Marieke P. Hoevenaar-Blom, Jan Willem Van Dalen, Manshu Song, Dong Lin, Wei Wang, Edo Richard, Eric P. Moll Van Charante, Tessa Van Middelaar

Research outputs 2022 to 2026

Background: Dementia prevalence is rising most rapidly in low- and middle-income countries (LMICs), yet most evidence on risk factors such as hypertension stems from high-income settings. In LMICs, hypertension may have a greater impact due to its high prevalence and poor control. We systematically reviewed evidence on the association between blood pressure and dementia and cognition in LMICs, and compared findings across regions. Methods: We searched PubMed, Embase, PsycINFO, and Global Index Medicus and reviewed reference lists for relevant studies. We included longitudinal studies (follow-up ≥6 months) from LMICs on the association between systolic blood pressure or hypertension and incident …

Impact Of Volume-Based Procurement Policy On Coronary Stent Use In Tianjin: Interrupted Time Series Analysis, Zhao Yang, Liangyu Ni, Wei Zhao, Yuxi Li, Yongyi Wu, Qiyun Zhu, Linlin Da, Weijia Liu, Qi Zhang, Jianping Li, Bin Jiang

Health Behavior, Policy & Management Faculty Publications

Objectives

This study aimed to analyze the impact of China’s centralized volume-based procurement policy on the procurement and utilization of coronary stents in Tianjin from 2019 to 2021.

Methods

An interrupted time-series design was used to assess monthly procurement data of coronary stents and balloons in Tianjin from January 2019 to December 2021.

Results

The volume-based procurement policy significantly reduced coronary stents prices, with an average price reduction of 92.67% for ten selected stents, and the lowest price dropped to 469 CNY. Following policy implementation, annual procurement in Tianjin increased by 59.55%, and tertiary hospitals demonstrated a significant monthly level …

Forecasting Covid-19 Cases, Hospital Admissions, And Deaths Based On Wastewater Sars-Cov-2 Surveillance Using Gaussian Copula Time Series Marginal Regression Model, Hueiwang Anna Jeng, Norou Diawara, Cynthia Jackson, Rekha Singh, Kyle Curtis, Raul Gonzalez, David Jurgens, Sasanka Adikari

Epidemiology, Biostatistics, & Environmental Health Faculty Publications

Modeling efforts are needed to predict trends in COVID-19 cases and related health outcomes, aiding in the development of management strategies and adaptation measures. This study was conducted to assess whether the SARS-CoV-2 viral load in wastewater could serve as a predictor for forecasting COVID-19 cases, hospitalizations, and deaths using copula-based time series modeling. SARS-CoV-2 RNA load in wastewater in Chesapeake, VA, was measured using the RT-qPCR method. A Gaussian copula time series (CTS) marginal regression model, incorporating an autoregressive moving average model and Gaussian copula function, was used as a forecasting model. Wastewater SARS-CoV-2 viral loads were correlated with …

Machine Learning Models For Pancreatic Cancer Survival Prediction: A Multi-Model Analysis Across Stages And Treatments Using The Surveillance, Epidemiology, And End Results (Seer) Database, Aditya Chakraborty, Mohan D. Pant

Epidemiology, Biostatistics, & Environmental Health Faculty Publications

Background: Pancreatic cancer is among the most lethal malignancies, with poor prognosis and limited survival despite treatment advances. Accurate survival modeling is critical for prognostication and clinical decision-making. This study had three primary aims: (1) to determine the best-fitting survival distribution among patients diagnosed and deceased from pancreatic cancer across stages and treatment types; (2) to construct and compare predictive risk classification models; and (3) to evaluate survival probabilities using parametric, semi-parametric, non-parametric, machine learning, and deep learning methods for Stage IV patients receiving both chemotherapy and radiation. Methods: Using data from the SEER database, parametric models (Generalized Extreme Value, …