Epidemiology Commons^™

Identifying Multilevel Predictors Of Behavioral Outcomes Like Park Use: A Comparison Of Conditional And Marginal Modeling Approaches, Marilyn E. Wende, S. Morgan Hughey, Alexander C. Mclain, Shirelle Hallum, J. Aaron Hipp, Jasper Schipperijn, Ellen W. Stowe, Andrew T. Kaczynski Ph.D.

Faculty Publications

This study compared marginal and conditional modeling approaches for identifying individual, park and neighborhood park use predictors. Data were derived from the ParkIndex study, which occurred in 128 block groups in Brooklyn (New York), Seattle (Washington), Raleigh (North Carolina), and Greenville (South Carolina). Survey respondents (n = 320) indicated parks within one half-mile of their block group used within the past month. Parks (n = 263) were audited using the Community Park Audit Tool. Measures were collected at the individual (park visitation, physical activity, sociodemographic characteristics), park (distance, quality, size), and block group (park count, population density, age structure, racial …

Ensemble-Based Mutational Profiling And Network Analysis Of The Sars-Cov-2 Spike Omicron Xbb Lineages For Interactions With The Ace2 Receptor And Antibodies: Cooperation Of Binding Hotspots In Mediating Epistatic Couplings Underlies Binding Mechanism And Immune Escape, Nishank Raisinghani, Mohammed Alshahrani, Grace Gupta, Gennady M. Verkhivker

Mathematics, Physics, and Computer Science Faculty Articles and Research

In this study, we performed a computational study of binding mechanisms for the SARS-CoV-2 spike Omicron XBB lineages with the host cell receptor ACE2 and a panel of diverse class one antibodies. The central objective of this investigation was to examine the molecular factors underlying epistatic couplings among convergent evolution hotspots that enable optimal balancing of ACE2 binding and antibody evasion for Omicron variants BA.1, BA2, BA.3, BA.4/BA.5, BQ.1.1, XBB.1, XBB.1.5, and XBB.1.5 + L455F/F456L. By combining evolutionary analysis, molecular dynamics simulations, and ensemble-based mutational scanning of spike protein residues in complexes with ACE2, we identified structural stability and binding …

‘Joining The Dots: Linking Prenatal Drug Exposure To Childhood And Adolescence’ – Research Protocol Of A Population Cohort Study, Kate Lawler, Mithilesh Dronavalli, Andrew Page, Evelyn Lee, Hannah Uebel, Barbara Bajuk, Lucinda Burns, Michelle Dickson, Charles Green, Lauren Dicair, John Eastwood, Ju Lee Oei

Faculty, Staff and Student Publications

INTRODUCTION: Prenatal drug exposure (PDE) is one of the most important causes of child harm, but comprehensive information about the long-term outcomes of the families is difficult to ascertain. The

METHODS AND ANALYSIS: Information from routinely collected administrative databases was linked for all births registered in New South Wales (NSW), Australia between 1 July 2001 and 31 December 2020 (n=1 834 550). Outcomes for seven mutually exclusive groups of children with varying prenatal exposure to maternal substances of addiction, including smoking, alcohol, prescription/illicit drugs and neonatal abstinence syndrome will be assessed. Key exposure measures include maternal drug use type, maternal …

Identifying A Group Of Factors Predicting Cognitive Impairment Among Older Adults, Longgang Zhao, Yuan Wang, Eric Mishio Bawa, Zichun Meng, Jingkai Wei, Sarah Newman-Norlund, Tushar Trivedi, Hatice Hasturk, Roger Newman-Norlund, Julius Fridriksson Ph.D., Anwar T. Nerchant

Faculty Publications

Background

Cognitive impairment has multiple risk factors spanning several domains, but few studies have evaluated risk factor clusters. We aimed to identify naturally occurring clusters of risk factors of poor cognition among middle-aged and older adults and evaluate associations between measures of cognition and these risk factor clusters.

Methods

We used data from the National Health and Nutrition Examination Survey (NHANES) III (training dataset, n = 4074) and the NHANES 2011–2014 (validation dataset, n = 2510). Risk factors were selected based on the literature. We used both traditional logistic models and support vector machine methods to construct a composite score …

Leveraging 4-H To Address Emergent Health Needs During The Covid-19 Pandemic: Epidemiology Pilot Project, Anne Marie Iaccopucci, Marcel Horowitz, Dorina Espinoza, Roshan Nayak

Journal of Extension

4-H academics responded to the Covid pandemic by rapidly adapting CDC and other resources for virtual delivery. A statewide epidemiology project was taught to 48 youth with the goal of minimizing fears and confusion, increasing prevention measures, leveraging current topics for education, and bolstering the social-emotional health of youth participants. Results indicated that youth enjoyed the project and adopted behaviors to reduce the spread of infectious diseases, such as increased mask-wearing.

Modeling An Infection Outbreak With Quarantine: The Sibkr Model, Mikenna Dew, Amanda Langosch, Theadora Baker-Wallerstein

Rose-Hulman Undergraduate Mathematics Journal

Influenza is a respiratory infection that places a substantial burden in the world population each year. In this project, we study and interpret a data set from a flu outbreak in a British boarding school in 1978 with mathematical modeling. First, we propose a generalization of the SIR model based on the quarantine measure in place and establish the long-time behavior of the model. By analyzing the model mathematically, we determine the analytic formulas of the basic reproduction number, the long-time limit of solutions, and the maximum number of infection population. Moreover, we estimate the parameters of the model based …

Cannabis Use Associated With Lower Mortality Among Hospitalized Covid-19 Patients Using The National Inpatient Sample: An Epidemiological Study, Joseph-Kevin Igwe, Ugo Alaribe

Faculty, Staff and Students Publications

BACKGROUND: Prior reports indicate that modulation of the endocannabinoid system (ECS) may have a protective benefit for Covid-19 patients. However, associations between cannabis use (CU) or CU not in remission (active cannabis use (ACU)), and Covid-19-related outcomes among hospitalized patients is unknown.

METHODS: In this multicenter retrospective observational cohort analysis of adults (≥ 18 years-old) identified from 2020 National Inpatient Sample database, we utilize multivariable regression analyses and propensity score matching analysis (PSM) to analyze trends and outcomes among Covid-19-related hospitalizations with CU and without CU (N-CU) for primary outcome of interest: Covid-19-related mortality; and secondary outcomes: Covid-19-related hospitalization, mechanical …

Predictors Of Prep Uptake By Black Gay And Bisexual Men In Ohio, Ade Elisha

Walden Dissertations and Doctoral Studies

No abstract provided.

The Association Between Acculturation & C-Reactive Protein In U.S. Immigrants: A Cross-Sectional Study, Jessica Kilinski Bs, Rosol Mikail Bs, Kelly M. Reavis Phd, Mph, Deborah Karasek Phd, Mph

OHSU-PSU School of Public Health Annual Conference

Purpose: Immigrants undergo acculturation as they assimilate to a different culture, potentially leading to immense stress. Our objective was to examine the association between acculturation and C-reactive protein (CRP), a marker of stress-induced inflammation. We hypothesized that U.S. foreign-born adults 20 years and older with higher degrees of acculturation would have higher CRP levels compared to those with lower acculturation.

Method: We used 2017-2018 National Health and Nutrition Examination Survey (NHANES) data from 1526 participants to conduct a cross-sectional analysis. We measured acculturation as language spoken at home (categorized as low, moderate, and high) and examined its association with CRP …

Impact Of Preexisting Hypertension And Demographic Factors On Pandemic-Era Anxiety Using The Coronavirus Anxiety Scale, Chukwuemeka Ogbonnaya Okpom

Walden Dissertations and Doctoral Studies

No abstract provided.

Broken Promises: Prolonged Diminished Quality-Of-Life Among Liberian Ebola Survivors Half A Decade After The 2014-16 West African Outbreak, Jessi Hanson-Defusco, Decontee Davis, Meghana Bommareddy, Zainab Olaniyan

Journal of Social, Behavioral, and Health Sciences

The 2014–2016 Ebola outbreak left thousands of Liberian survivors with severely diminished quality of life. Applying a social determinants framework, this mixed method study investigates to what extent Ebola virus disease (EVD) survivors suffer long-haul psychosocial stress, diminished quality-of-life factors, and the impact of EVD-related service provisions on their ongoing healing. We present the results of a quantitative analysis survey of data collected from 19 Liberian EVD survivors in 2022 using snowball sampling. Additionally, a qualitative analysis of survivor statements helps triangulate key statistical findings and inform causal mechanisms. Survivors report experiencing 5.25 of a total of 7 ongoing stressors …

Associations Between Sleep Duration, Sleep Disturbance And Cardiovascular Disease Biomarkers Among Adults In The United States, Prince Nii Ossah Addo, Paddington T. Mundagowa, Longgang Zhao, Mufaro Kanyangarara, Monique J. Brown Ph.D., Mph, Jihong Liu Sc.D.

Faculty Publications

Background

Sleep problems are associated with abnormal cardiovascular biomarkers and an increased risk of cardiovascular diseases (CVDs). However, studies investigating associations between sleep problems and CVD biomarkers have reported conflicting findings. This study examined the associations between sleep problems and CVD biomarkers in the United States.

Methods

Data were from the National Health and Nutrition Examination Survey (NHANES) (2007–2018) and analyses were restricted to adults ≥ 20 years (n = 23,749). CVD biomarkers [C-reactive Protein (CRP), low-density lipoproteins, high-density lipoproteins (HDL), triglycerides, insulin, glycosylated hemoglobin (HbA1c), and fasting blood glucose] were categorized as abnormal or normal using standardized cut-off …

Willingness To Utilize A Mobile Treatment Unit In Five Counties At The Epicenter Of The Us Rural Opioid Epidemic., Snigdha R. Peddireddy, Melvin D. Livingston Iii, April M. Young, Patricia R. Freeman, Umedjon Ibragimov, Kelli A. Komro, Michelle R. Lofwall, Carrie B. Oser, Michele Staton, Hannah L. F. Cooper

Epidemiology and Environmental Health Faculty Publications

INTRODUCTION: US federal policies are evolving to expand the provision of mobile treatment units (MTUs) offering medications for opioid use disorder (MOUD). Mobile MOUD services are critical for rural areas with poor geographic access to fixed-site treatment providers. This study explored willingness to utilize an MTU among a sample of people who use opioids in rural Eastern Kentucky counties at the epicenter of the US opioid epidemic.

METHODS: The study analyzed Cross-sectional survey data from the Kentucky Communities and Researchers Engaging to Halt the Opioid Epidemic (CARE2HOPE) study covering five rural counties in the state. Logistic regression models investigated the …

A Multi-Ancestry Genetic Study Of Pain Intensity In 598,339 Veterans., Sylvanus Toikumo, Rachel Vickers-Smith, Zeal Jinwala, Heng Xu, Divya Saini, Emily E Hartwell, Mirko Pavicic, Kyle A Sullivan, Ke Xu, Daniel A Jacobson, Joel Gelernter, Christopher T Rentsch, Million Veteran Program, Eli Stahl, Martin Cheatle, Hang Zhou, Stephen G Waxman, Amy C Justice, Rachel L Kember, Henry R Kranzler

Epidemiology and Environmental Health Faculty Publications

Chronic pain is a common problem, with more than one-fifth of adult Americans reporting pain daily or on most days. It adversely affects the quality of life and imposes substantial personal and economic costs. Efforts to treat chronic pain using opioids had a central role in precipitating the opioid crisis. Despite an estimated heritability of 25-50%, the genetic architecture of chronic pain is not well-characterized, in part because studies have largely been limited to samples of European ancestry. To help address this knowledge gap, we conducted a cross-ancestry meta-analysis of pain intensity in 598,339 participants in the Million Veteran Program, …

A Latter-Day Disease: Mormons And Cholera In The Nineteenth Century, Alexandra L. Wein

Student Publications

Nineteenth-century America saw the emergence of two seemingly parallel entities - the epidemic disease of cholera and the Church of Jesus Christ of Latter-day Saints, better known as the Mormon faith. To understand the intersection of Mormons and cholera, one must look within the interdisciplinary framework of Civil War-era history, religion, and epidemiology. Cholera epidemics in 1832 and 1849 coincided with the mass Mormon migration west, causing great suffering and death for Mormons traveling by land and sea. While their westward exodus exposed them to cholera, their religious teachings also contributed to why they contracted the disease. The Word of …

Barriers To Opioid Use Disorder Treatment Among People Who Use Drugs In The Rural United States: A Qualitative, Multi-Site Study., T. J. Stopka, A. T. Estadt, G. Leichtling, J. C. Schleicher, L. S. Mixson, J. Bresett, E. Romo, P. Dowd, S. M. Walters, A. M. Young, W. Zule, P. D. Friedmann, V. F. Go, R. Baker, R. J. Fredericksen

Epidemiology and Environmental Health Faculty Publications

BACKGROUND: In 2020, 2.8 million people required substance use disorder (SUD) treatment in nonmetropolitan or 'rural' areas in the U.S. Among this population, only 10% received SUD treatment from a specialty facility, and 1 in 500 received medication for opioid use disorder (MOUD). We explored the context surrounding barriers to SUD treatment in the rural United States.

METHODS: We conducted semi-structured, in-depth interviews from 2018 to 2019 to assess barriers to SUD treatment among people who use drugs (PWUD) across seven rural U.S. study sites. Using the social-ecological model (SEM), we examined individual, interpersonal, organizational, community, and policy factors contributing …

Decoding Implant-Related Sickness: Unraveling The Complexities Of Breast Implant Illness, Madison M. Stewart

Senior Theses

This thesis investigates the phenomenon of breast implant illness (BII), examining its potential correlation with individual factors such as obesity and poor lifestyle habits. BII, characterized by nonspecific symptoms, is often self-diagnosed by patients influenced by social media and internet sources, leading to requests for implant removal. Conducting a comprehensive meta-analysis, the study scrutinizes existing literature to evaluate the association between BII, obesity, and lifestyle choices. Employing inclusion criteria, peer-reviewed publications are analyzed through systematic review methodology to offer insights into the interplay between BII and adiposity, exploring inflammatory mechanisms and patient behaviors like exercise and smoking. The research aims …

The Use Of Telemedicine By Us Nephrologists For In-Center Hemodialysis Care During The Pandemic: An Analysis Of National Medicare Claims, Jingbo Niu, Omar Rosales, Abiodun Oluyomi, Susie Q Lew, Wolfgang C Winkelmayer, Glenn M Chertow, Kevin F Erickson

Faculty, Staff and Students Publications

RATIONALE & OBJECTIVE: Because of coronavirus disease 2019 (COVID-19), the US government issued emergency waivers in March 2020 that removed regulatory barriers around the use of telemedicine. For the first time, nephrologists were reimbursed for telemedicine care delivered during in-center hemodialysis. We examined the use of telemedicine for in-center hemodialysis during the first 16 months of the pandemic.

STUDY DESIGN: We ascertained telemedicine modifiers on nephrologist claims. We used multivariable regression to examine time trends and patient, dialysis facility, and geographic correlates of telemedicine use. We also examined whether the estimated effects of predictors of telemedicine use changed over time. …

Maintaining Program Fidelity In A Changing World: National Implementation Of A School-Based Hiv Prevention Program, Elizabeth Schieber, Lynette Deveaux, Lesley Cotrell, Xiaoming Li, Stephenie C Lemon, Arlene S Ash, Karen Macdonell, Samiran Ghosh, Maxwell Poitier, Glenda Rolle, Sylvie Naar, Bo Wang

Faculty, Staff and Student Publications

Large-scale, evidence-based interventions face challenges to program fidelity of implementation. We developed implementation strategies to support teachers implementing an evidence-based HIV prevention program in schools, Focus on Youth in The Caribbean (FOYC) and Caribbean Informed Parents and Children Together (CImPACT) in The Bahamas. We examined the effects of these implementation strategies on teachers' implementation in the subsequent year after the initial implementation during the COVID-19 pandemic. Data were collected from 79 Grade 6 teachers in 24 government elementary schools. Teachers completed training workshops and a pre-implementation questionnaire to record their characteristics and perceptions that might affect their program fidelity. School …

Comparison Of Raw Accelerometry Data From Actigraph, Apple Watch, Garmin, And Fitbit Using A Mechanical Shaker Table, James W. White Iii, Olivia L. Finnegan, Nick Tindall, Srihari Nelakuditi, David E. Brown Iii, Russell R. Pate Ph.D., Gregory J. Welk, Massimiliano De Zambotti, Rahul Ghosal, Yuan Wang, Sarah Burkart, Elizabeth L. Adams, Mvs Chandrashekhar, Bridget Armstrong, Michael W. Beets, Robert Weaver Med, Phd

Faculty Publications

The purpose of this study was to evaluate the reliability and validity of the raw accelerometry output from research-grade and consumer wearable devices compared to accelerations produced by a mechanical shaker table. Raw accelerometry data from a total of 40 devices (i.e., n = 10 ActiGraph wGT3X-BT, n = 10 Apple Watch Series 7, n = 10 Garmin Vivoactive 4S, and n = 10 Fitbit Sense) were compared to reference accelerations produced by an orbital shaker table at speeds ranging from 0.6 Hz (4.4 milligravity-mg) to 3.2 Hz (124.7mg). Two-way random effects absolute intraclass correlation coefficients (ICC) tested inter-device reliability. …

Pre-Covid-19 Hospital Quality And Hospital Response To Covid-19: Examining Associations Between Risk-Adjusted Mortality For Patients Hospitalised With Covid-19 And Pre-Covid-19 Hospital Quality, Doris Peter, Shu-Xia Li, Yongfei Wang, Jing Zhang, Jacqueline Grady, Kerry Mcdowell, Erica Norton, Zhenqiu Lin, Susannah Bernheim, Arjun K Venkatesh, Lee A Fleisher, Michelle Schreiber, Lisa G Suter, Elizabeth W Triche

Faculty, Staff and Student Publications

OBJECTIVES: The extent to which care quality influenced outcomes for patients hospitalised with COVID-19 is unknown. Our objective was to determine if prepandemic hospital quality is associated with mortality among Medicare patients hospitalised with COVID-19.

DESIGN: This is a retrospective observational study. We calculated hospital-level risk-standardised in-hospital and 30-day mortality rates (risk-standardised mortality rates, RSMRs) for patients hospitalised with COVID-19, and correlation coefficients between RSMRs and pre-COVID-19 hospital quality, overall and stratified by hospital characteristics.

SETTING: Short-term acute care hospitals and critical access hospitals in the USA.

PARTICIPANTS: Hospitalised Medicare beneficiaries (Fee-For-Service and Medicare Advantage) age 65 and older hospitalised …

Sex-Based Differences In Melanoma Survival Improvement From 2004 To 2018, Vikram R Shaw, Angela Hudock, Baoyi Zhang, Christopher Amos, Chao Cheng

Faculty, Staff and Students Publications

Simple Summary

Melanoma is the deadliest form of skin cancer and its incidence and mortality may vary by demographic factors, such as sex, age, race, and socioeconomic status. Few studies, however, have characterized disparities in survival improvement across these demographic groups in melanoma. In the present study, the authors highlight disparities in melanoma survival improvement, both in diagnosed melanoma and carcinoma in situ. While melanoma survival has improved overall, some patient subgroups have experienced a lower improvement in survival from 2004 to 2018.

Abstract

Background: Melanoma is the deadliest form of skin cancer and its incidence and mortality vary by …

Exploring The Associations Between Drug Resistant Mutations, Low-Level Viremia, And Virological Failure In Persons With Hiv In Florida, Adriana Campos

USF Tampa Graduate Theses and Dissertations

Virologic suppression is an essential part to a successful regimen for Persons with HIV (PWH) and the 95-95-95 initiative. Yet, PWH experiencing episodes of low-level viremia (LLV) may be more prone to experience virological failure (VF). Currently, studies debate the clinical relevance of LLV and its effect on virological outcomes, but none have explored its interconnectedness with drug resistant mutations (DRM) and antiretroviral treatment (ART) adherence – all integral elements in predicting virological outcomes.

The goal of the proposed study was to contribute to the knowledge gap regarding the interconnectivity of drug resistant mutations, low-level viremia, adherence, and virological failure …

Community-Centered Early Warning For Outbreaks In Humanitarian Emergencies: Evaluating Community-Based Surveillance For Priority Communicable Diseases Among Internally Displaced Populations In Iraq, Caitlin M. Wolfe

USF Tampa Graduate Theses and Dissertations

Background: Community based surveillance (CBS) is the organized and rapid collection of information from health events identified in the community and includes the systematic detection and reporting of events of public health significance. While used globally to enhance the detection of priority diseases, CBS has not been routinely deployed in Iraq, where a once-robust health system has been devastated by decades of war, international sanctions, and large-scale population displacement. During infectious disease outbreaks, it is imperative to quickly detect and isolate suspect cases, investigate confirmed cases, and trace and monitor the contacts of confirmed cases. The COVID-19 pandemic underscored the …

Examining Childhood Trauma And Substance Use Problems Among Justice-Involved Adolescents In Florida, Skye C. Bristol

USF Tampa Graduate Theses and Dissertations

The purpose of this dissertation was to assess the relationship between childhood trauma and substance use problems as latent constructs among justice-involved adolescents (JIA). Additionally, racial differences and spatial analyses were examined. Previous research underscores the limitations of conceptualizing childhood trauma solely through Adverse Childhood Experiences (ACEs). This justified integrating child welfare involvement, or out-of-home placement, as an additional indicator to develop a comprehensive scope of childhood trauma among JIA. Furthermore, current literature established that childhood trauma is a key predictor of substance misuse among JIA. However, the lack of a standardized measure of substance misuse across juvenile justice systems …

Lstm-Based Recurrent Neural Network Predicts Influenza-Like-Illness In Variable Climate Zones, Alfred Amendolara, Christopher Gowans, Joshua Barton, David Sant, Andrew Payne

Annual Research Symposium

Purpose: Influenza virus is responsible for a recurrent, yearly epidemic in most temperate regions of the world. For the 2021-2022 season the CDC reports 5000 deaths and 100,000 hospitalizations, a significant number despite the confounding presence of SARS-CoV-2. The mechanisms behind seasonal variance in flu burden are not well understood. Based on a previously validated model, this study seeks to expand understanding of the impact of variable climate regions on seasonal flu trends. To that end, three climate regions have been selected. Each region represents a different ecological region and provides different weather patterns showing how the climate variables impact …

Posteriormedial Ankle Impingement In A Male Division I Ice Hockey Player: A Case Report, Bethany Thompson

UNO Student Research and Creative Activity Fair

The purpose of this case report is to present the case of a 21 year old male Division I collegiate hockey player’s injury during their season, resulting in posteriormedial ankle impingement of the deep posterior tibiotalar ligament, osteochondral lesion of the talus, and tenosynovitis of the tibialis posterior. The patient’s injury did not require surgery; however, they did complete a rehabilitation plan with a physical therapist and receive a cortisone injection. The patient had a positive outcome due to the athletic trainer sending the patient for immediate diagnostic imaging after initial consultation. The patient was able to continue participation in …

Use Of A Primary Care Dataset To Describe ‘The Real Picture’ Of Diabetes In Kimberley Aboriginal Communities, Caitlyn S. White, Kimberley Seear, Lorraine Anderson, Emma Griffiths

Journal of the Australian Indigenous HealthInfoNet

Objective
Aboriginal communities are impacted by high rates of diabetes, however these are currently underestimated by national data sources used by policy and decision makers to inform allocation of health resources. We aimed to estimate diabetes prevalence and screening coverage using primary care electronic medical record data.

Methods
A cross-sectional audit was conducted using primary care data from Aboriginal regular Aboriginal Community Controlled Health Service (ACCHS) clinic attendees aged 15 years and over (n=1763) in five remote communities in the Kimberley region. Main outcome measures were overall diabetes prevalence; age-specific diabetes prevalence; prevalence of pre-diabetes; and screening rates among patients …

Effect Of Alcohol Consumption On Cognitive Decline Among Mexican Adults, Silvia Mejia-Arango, Ihsan Salloum, Gladys E. Maestre

Research Symposium

Background: Studies on the association between alcohol use and cognitive impairment have yielded controversial results suggesting a reduced risk of dementia in drinkers vs. nondrinkers. We aimed to examine the effect of alcohol use on cognitive trajectories among Mexican adults aged 50 and over.

Methods: Data are from 5,898 cognitively normal individuals (2,512 men and 3,386 women) from the Mexican Health and Aging Study (MHAS) with a mean age of 59 years (50-90 years) at baseline (2001) and followed-up after 11 years (2012). The Cross-Cultural Cognitive Examination was the cognitive battery measuring verbal memory, visual memory, attention, and …

Individual Risk Factors Associated With Cesarean Section Surgical Site Infections Among African American Women In California, Paula St Hill

Walden Dissertations and Doctoral Studies

No abstract provided.