Physical Sciences and Mathematics Commons^™

Genetic Contributors Of Incident Stroke In 10,700 African Americans With Hypertension: A Meta-Analysis From The Genetics Of Hypertension Associated Treatments And Reasons For Geographic And Racial Differences In Stroke Studies, Nicole D. Armstrong, Vinodh Srinivasasainagendra, Amit Patki, Rikki M. Tanner, Bertha A. Hidalgo, Hemant K. Tiwari, Nita A. Limdi, Ethan M. Lange, Leslie A. Lange, Donna K. Arnett, Marguerite R. Irvin

Epidemiology and Environmental Health Faculty Publications

Background: African Americans (AAs) suffer a higher stroke burden due to hypertension. Identifying genetic contributors to stroke among AAs with hypertension is critical to understanding the genetic basis of the disease, as well as detecting at-risk individuals.

Methods: In a population comprising over 10,700 AAs treated for hypertension from the Genetics of Hypertension Associated Treatments (GenHAT) and Reasons for Geographic and Racial Differences in Stroke (REGARDS) studies, we performed an inverse variance-weighted meta-analysis of incident stroke. Additionally, we tested the predictive accuracy of a polygenic risk score (PRS) derived from a European ancestral population in both GenHAT and REGARDS AAs …

Dysregulation Of Dna Methylation And Epigenetic Clocks In Prostate Cancer Among Puerto Rican Men, Anders Berglund, Jaime Matta, Jarline Encarnación-Medina, Carmen Ortiz-Sanchéz, Julie Dutil, Raymond Linares, Joshua Marcial, Caren Abreu-Takemura, Natasha Moreno, Ryan Putney, Ratna Chakrabarti, Hui Yi Lin, Kosj Yamoah, Carlos Diaz Osterman, Liang Wang, Jasreman Dhillon, Youngchul Kim, Seung Joon Kim, Gilberto Ruiz-Deya, Jong Y. Park

School of Public Health Faculty Publications

In 2021, approximately 248,530 new prostate cancer (PCa) cases are estimated in the United States. Hispanic/Latinos (H/L) are the second largest racial/ethnic group in the US. The objective of this study was to assess DNA methylation patterns between aggressive and indolent PCa along with ancestry proportions in 49 H/L men from Puerto Rico (PR). Prostate tumors were classified as aggressive (n = 17) and indolent (n = 32) based on the Gleason score. Genomic DNA samples were extracted by macro-dissection. DNA methylation patterns were assessed using the Illumina EPIC DNA methylation platform. We used ADMIXTURE to estimate global ancestry proportions. …

Deep Convolutional Neural Networks For Accurate Diagnosis Of Covid-19 Patients Using Chest X-Ray Image Databases From Italy, Canada, And The Usa, Amgad A. Salama, Samy H. Darwish, Samir M. Abdel-Mageed, Radwa A. Meshref, Ehab I. Mohamed

The University of Louisville Journal of Respiratory Infections

Introduction: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), famously known as COVID-19, has quickly become a global pandemic. Chest X-ray (CXR) imaging has proven reliable, fast, and cost-effective for identifying COVID-19 infections, which proceeds to display atypical unilateral patchy infiltration in the lungs like typical pneumonia. We employed the deep convolutional neural network (DCNN) ResNet-34 to detect and classify CXR images from patients with COVID-19 and Viral Pneumonia and Normal Controls.

Methods: We created a single database containing 781 source CXR images from four different international sub-databases: the Società Italiana di Radiologia Medica e Interventistica (SIRM), the GitHub Database, the …

A Multilayer Network Model Of The Coevolution Of The Spread Of A Disease And Competing Opinions, Kaiyan Peng, Zheng Lu, Vanessa Lin, Michael R. Lindstrom, Christian Parkinson, Chuntian Wang, Andrea L. Bertozzi, Mason A. Porter

School of Mathematical and Statistical Sciences Faculty Publications and Presentations

During the COVID-19 pandemic, conflicting opinions on physical distancing swept across social media, affecting both human behavior and the spread of COVID-19. Inspired by such phenomena, we construct a two-layer multiplex network for the coupled spread of a disease and conflicting opinions. We model each process as a contagion. On one layer, we consider the concurrent evolution of two opinions — pro-physical-distancing and anti-physical-distancing — that compete with each other and have mutual immunity to each other. The disease evolves on the other layer, and individuals are less likely (respectively, more likely) to become infected when they adopt the pro-physical-distancing …

Basis For Changes In The Disease Burden Estimates Related To Vitamin A And Zinc Deficiencies In The 2017 And 2019 Global Burden Of Disease Studies, Sonja Y. Hess, Alexander C. Mclain Ph.D., Haley Lescinsky, Kenneth H. Brown, Ashkan Afshin

Faculty Publications

Background:

The Global Burden of Disease (GBD) Study provides estimates of death and disability from eighty-seven risk factors, including some micronutrient deficiencies.

Objectives:

To review methodological changes that led to large differences in the disease burden estimates for vitamin A and Zn deficiencies between the GBD 2017 and 2019 Studies.

Methods:

GBD publications were reviewed; additional information was provided by GBD researchers.

Results:

Vitamin A deficiency prevalence is based on plasma retinol concentration, whereas the estimate for Zn deficiency prevalence uses dietary adequacy as a proxy. The estimated global prevalence of vitamin A deficiency for children aged 1–4 years in …

Nutrient Intake And Dietary Inflammatory Potential In Current And Recovered Anorexia Nervosa, Olivia Patsalos, Bethan Dalton, Christia Kyprianou, Joseph Firth, Nitin Shivappa Mbbs, Mph, Ph.D., James Hébert Scd, Ulrike Schmidt, Hubertus Himmerich

Faculty Publications

Anorexia nervosa (AN) is characterised by disrupted and restrictive eating patterns. Recent investigations and meta-analyses have found altered concentrations of inflammatory markers in people with current AN. We aimed to assess nutrient intake in participants with current or recovered AN, as compared to healthy individuals, and explore group differences in dietary inflammatory potential as a possible explanation for the observed alterations in inflammatory markers. We recruited participants with current AN (n = 51), those recovered from AN (n = 23), and healthy controls (n = 49). We used the Food Frequency Questionnaire (FFQ), to calculate a Dietary …

How Community Participation In Water And Sanitation Interventions Impacts Human Health, Wash Infrastructure And Service Longevity In Low-Income And Middle-Income Countries: A Realist Review, Sarah Nelson, Dorothy Drabarek, Aaron Jenkins, Joel Negin, Seye Abimbola

Research outputs 2014 to 2021

Objective:

To understand how, and under what circumstances community participation in water and sanitation interventions impacts the availability of safe water and sanitation, a change in health status or behaviour and the longevity of water, sanitation and hygiene (WASH) resources and services.

Design:

Realist review.

Data sources:

PubMed, Web of Science and Scopus databases were used to identify papers from low-income and middle-income countries from 2010 to 2020.

Eligibility criteria for selecting studies:

Criteria were developed for papers to be included. The contribution of each paper was assessed based on its relevance and rigour (eg, can it contribute to context, …

(R1468) Global Analysis Of An Seirs Model For Covid-19 Capturing Saturated Incidence With Treatment Response, David A. Oluyori, Helen O. Adebayo, Ángel G.C. Pérez

Applications and Applied Mathematics: An International Journal (AAM)

In this work, a new SEIRS model with saturated incidence rate and piecewise linear treatment response is proposed to describe the dynamics of COVID-19. It is assumed that the treatment response is proportional to the number of infected people as long as the incidence cases are within the capacity of the healthcare system, after which the value becomes constant, when the number of confirmed cases exceeds the carrying capacity of the available medical facilities. Thus, the basic reproduction number of the model is obtained. It is proved that the disease-free equilibrium is globally asymptotically stable when the basic reproduction number …

(R1412) Stability And Bifurcation Of A Cholera Epidemic Model With Saturated Recovery Rate, Huda Abdul-Satar, Raid K. Naji

Applications and Applied Mathematics: An International Journal (AAM)

In this paper, a Cholera epidemic model is proposed and studied analytically as well as numerically. It is assumed that the disease is transmitted by contact with Vibrio cholerae and infected person according to dose-response function. However, the saturated treatment function is used to describe the recovery process. Moreover, the vaccine against the disease is assumed to be utterly ineffective. The existence, uniqueness and boundedness of the solution of the proposed model are discussed. All possible equilibrium points and the basic reproduction number are determined. The local stability and persistence conditions are established. Lyapunov method and the second additive compound …

Institute For Global Health And Development : Issue 1 - December 2021, Institute For Global Health And Development

IGHD Newsletter

• Climate Change and Environment Sustainability
• Agriculture, Food Security, and Nutrition
• Gender Equality and Women Empowerment
• Sustainable Development Goals

Challenges For Estimating The Global Prevalence Of Micronutrient Deficiencies And Related Disease Burden: A Case Study Of The Global Burden Of Disease Study, Sonja Y. Hess, Alexander C. Mclain Ph.D., Edward A. Frongillo Jr. Ph.D., Ashkan Afshin, Nicholas J. Kassebaum, Saskia Jm Osendarp, Reed Atkin, Rahul Rawat, Kenneth H. Brown

Faculty Publications

Information on the prevalence of micronutrient deficiencies is needed to determine related disease burden; underpin evidence-based advocacy; and design, deliver, and monitor safe, effective interventions. Assessing the global prevalence of deficiency requires a valid micronutrient status biomarker with an appropriate cutoff to define deficiency and relevant data from representative surveys across multiple locations and years. The Global Burden of Disease Study includes prevalence estimates for iodine, iron, zinc, and vitamin A deficiencies, for which recommended biomarkers and appropriate deficiency cutoffs exist. Because representative survey data are lacking, only retinol concentration is used to model vitamin A deficiency, and proxy indicators …

A Statistical Comparison Of Covid-19 In The United States Across Political Affiliations And Census Regions, Margarito Torres

Theses and Dissertations

In mid-January 2020, the United States reported their first cases of the coronavirus disease (COVID-19) from a passenger returning from Wuhan, China. Initially, the situation wasn’t very alarming as in China and European countries, but the situation began to worsen in March 2020 when the number of cases began to multiply. Then, in a matter of a few months, the United States became the number one country in terms of total cases and total deaths from COVID-19. We have been closely observing the United States and the world since July 2020. Our study aims to compare the political affiliations and …

Predictors Of Poor Glycemic Control In Diabetic Clients With Mental Health Illness, Community Alliance, Omaha, Nebraska, Rachelle Flick

Capstone Experience

People with severe mental illness tend to die 10-25 years earlier than the general population (WHO). Main contributors to these premature deaths include comorbidities such as hypertension, cardiovascular disease, and diabetes. Diabetes prevalence in mentally ill people is 2 times higher than the general population (WHO). The World Health Organization is taking action to improve the health of people with severe mental illness. These efforts include creating protocols of prevention, identification, assessment, and treatment for mentally ill people, as well as improving access to general health services through the integration of physical and mental health services. Community Alliance, located in …

Factors Influencing Intent To Take A Covid-19 Test In The United States, Sheila Rutto

Theses and Dissertations

In 2020, COVID-19 became the first pandemic in the world’s history that brought the entire world to an abrupt and unexpected halt. Since the first reported case of the disease to date, the novel coronavirus has been able to wreak havoc in literary every corner of the globe and left an ever-growing number of unprecedented fatalities. The normal way of life has been disrupted, and the level of uncertainty about the end of this pandemic continues to manifest to many. Due to the urgency to bring this pandemic under control, medical officers have been able to recommend actions that people …

Statistical Analysis Based On Adaptive Progressive Hybrid Censored Data From Lomax Distribution, Amal Helu, Hani Samawi

Department of Biostatistics, Epidemiology, and Environmental Health Sciences Faculty Publications

In this article, we consider statistical inferences about the unknown parameters of the Lomax distribution basedon the Adaptive Type-II Progressive Hybrid censoring scheme, this scheme can save both the total test time and the cost induced by the failure of the units and increases the efficiency of statistical analysis. The estimation of the parameters is derived using the maximum likelihood (MLE) and the Bayesian procedures. The Bayesian estimators are obtained based on the symmetric and asymmetric loss functions. There are no explicit forms for the Bayesian estimators, therefore, we propose Lindley’s approximation method to compute the Bayesian estimators. A comparison …

A Healthy Dietary Pattern With A Low Inflammatory Potential Reduces The Risk Of Gestational Diabetes Mellitus, Lotta Pajunen, Liisa Korkalo, Noora Houttu, Outi Pellonperä, Kati Mokkala, Nitin Shivappa Mbbs, Mph, Ph.D., James Hébert Scd, Tero Vahlberg, Kristina Tertti, Kirsi Laitinen

Faculty Publications

Purpose An optimal diet for lowering the risk of gestational diabetes mellitus (GDM) is still to be defined, but may comprise of nutrient intakes, dietary patterns, diet quality, and eating frequency. This study was designed to investigate the contribution of diet in developing GDM in a comprehensive way. Methods The dietary intake of overweight or obese women, a risk group for GDM (n = 351), was assessed using 3-day food diaries and diet quality questionnaires in early pregnancy. Eating frequency and nutrient intakes were calculated, and dietary patterns identified using principal component analysis. The inflammatory potential of the diet was …

The Indonesian Strategy To Achieve Universal Health Coverage Through National Health Insurance System: Challenges In Human Resources, Atikah Adyas

Kesmas

Many countries are currently trying to achieve universal health insurance coverage in order to provide health protection for their population. Indonesia has received a strong political commitment to implement national health insurance including government support to finance the poor. The implementation of comprehensive national health insurance requires human resources, each of which has a role in fighting for noble goals for the welfare of all people. This paper is taken from the experience of Indonesia and several other countries as well as guidelines that can be used in exploring the role of human resources for the success of the implementation …

Mental Fatigue And Its Associated Factors Among Coal Mining Workers After One Year Of The Covid-19 Pandemic In Indonesia, Hendra Djamalus, Budi Utomo, I Made Djaja, Sjahrul M. Nasri

Kesmas

Mental fatigue among coal mining operators was related to driving activities that require high concentration. This study aimed to determine factors that contributed to mental fatigue among coal mine operators in Indonesia, specifically in Kalimantan and Sumatra, after a one-year COVID-19 pandemic. This cross-sectional study was conducted among 480 operators from two companies and seven sites. A self-administrated questionnaire in the Google Form was used to measure mental fatigue, the non-work-related factors (age, education, marital status, residence, and stress level), and work-related factors (working periods, shift pattern, type of shift, and work area in mining). The data analyzed using Chi-square …

Integrated Model Of A Family Approach And Local Support In Tuberculosis Case Finding Efforts In People With Hiv/Aids, Erni Astutik, Chatarina Umbul Wahyuni, Imelda F E Manurung, Geofrey Ssekalembe

Kesmas

The human immunodeficiency virus (HIV) remains a major global public health problem. People with HIV/acquired immune deficiency syndrome (AIDS) are more susceptible to opportunistic infections such as tuberculosis (TB). Therefore, families and community leaders need to help monitor people living with HIV/AIDS (PLWHA). This study aimed to analyze an integrated family approach and local support model to detect TB cases in PLWHA. This study used a case-control study in Kupang City, East Nusa Tenggara Province, in July 2020. The sample comprised 100 people (50 PLWHA with TB case and 50 controls) using total sampling and random sampling, respectively. The variables …

Predictors Of The Covid-19 Social Distancing Practice Among Undergraduate Health Students In Samarinda City, Indonesia: A Cross-Sectional Study, Siti Hadijah Aspan, Pramon Viwattanakulvanid

Kesmas

Social distancing is a health protocol recommended by the World Health Organization (WHO) for reducing the spread of COVID-19. Undergraduate health students play an important role in the dissemination of accurate information. This study identified predictors that influenced the COVID-19 social distancing practice and examined the sources of social distancing information among undergraduate health students in Samarinda City, Indonesia. This cross-sectionalonline survey study (March-April 2021) involved 422 undergraduate students from medicine, public health, and pharmacy faculties at Mulawarman University. Binary logistic regression was conducted to identify factors associated with the COVID-19 social distancing practice. The results showed that age (AOR …

Knowledge, Attitudes, And Practices Of Health Personnel In Responding To The Covid-19 Pandemic In Indonesia, Dyah Suryani, Suyitno Suyitno, Maretalinia Maretalinia, Elvi Juliansyah, Vernonia Yora Saki, Kraichat Tantrakarnapa

Kesmas

The COVID-19 pandemic, originated in China, has spread to worldwide, including Indonesia. Until July 2021, the growth rate has been gradually increasing, and cases have been found in all 34 provinces of Indonesia. This cross-sectional study aimed to investigate the knowledge, attitude, and practices (KAP) of health personnel in the primary health care towards the COVID-19 pandemic in Indonesia using online self-report questionnaire. A total of 440 respondents contributed to this online survey. The average level of KAP were 7.7 out of 10.0, 14.3 out of 15.0, and 31.9 out of 36.0, respectively. There was no significant association between respondents’ …

Are We Passing On Violence To The Next Generation?: Gender Norms And Gender-Based Violence Attitudes Among Early Adolescents In Indonesia, I Gusti A A. Mahendra, Anggriyani Wahyu Pinandari, Ifta Choiriyah, Siswanto Agus Wilopo

Kesmas

Intensification of gender norms during puberty affects adolescents’ perceptions and behavior related to violence. This study examined the association between gender norms and gender-based violence (GBV) among early adolescents considering socio-ecological variables using cross-sectional data from 3,618 Indonesian Global Early Adolescent Study pupils. Chi square tests with simple and multiple logistic regression analyses examined how different factors' levels predict GBV. Among boys, GBV attitudes were found high (53%). Furthermore, they also had high heteronormative expectations, threatened feelings, experiences of violence, porn access, and 5+ adverse childhood experiences (ACEs). Logistic regression results revealed that adolescent boys having one or two scores …

The Effectiveness And Safety Of Favipiravir In Covid-19 Hospitalized Patients At Tertiary Referral Hospital, Bali, Indonesia, Herni Damayanti, I Gede K Sajinadiyasa, Hindun Wilda Risni, Rani Sauriasari

Kesmas

COVID-19 is a major public health problem, with still questionable specific cure. Favipiravir is a COVID-19 antiviral that is potentially a therapy for COVID-19. This study aimed to analyze its effectivity and safety in moderate to critical hospitalized patients. This study was a retrospective cohort in a tertiary referral hospital in Denpasar City, Bali Province, Indonesia, from August 2020 to January 2021. There was a total of 192 patients; 96 in the favipiravir group and 96in the non-favipiravir group (remdesivir/oseltamivir). Effectivity was measured by assessing the clinical condition at the end of the isolation period of 14 days. The favipiravir …

Breastfeeding Knowledge And Behavior In Lactational Amenorrhea Method (Lam) As A Natural Contraceptive, Mufdlilah Mufdlilah, Reza Bintangdari Johan, Sri Ratna Ningsih

Kesmas

The lactational amenorrhea method (LAM) is a natural contraceptive that is highly effective after the three essential criteria are fulfilled. However, there is a significantly low adoption resulting from poor knowledge and correct practices. This study aimed to determine the correlation between knowledge and behavior of breastfeeding mothers on breastfeeding as a natural contraceptive. This was an analytic observational study with a cross-sectional design involving 89 breastfeeding mothers and was performed from January to March 2018. Furthermore, data were collected using a questionnaire, and the results showed knowledge of breastfeeding mothers to be good (59.6%) and not good (51.7%). However, …

The Seroprevalence Of Toxoplasma Gondii In Cats At The House Of Maternal Women With Toxoplasmosis In Badung, Indonesia, Made Subrata, Nyoman Mantik Astawa, Nyoman Tigeh Suryadi, Sang Gede Purnama, Kadek Karang Agustina, Ngakan Putu Anom Harjana, Made Damriyasa

Kesmas

Toxoplasmosis is a zoonotic disease caused by infection with the parasite called Toxoplasma gondii (T. gondii). The health and social impacts of the infectionare enormous, including miscarriage, hydrocephalus, blindness, and mental retardation. The occurrence of toxoplasmosis in maternal women cannot be se parated from cats around their houses. This study aimed to determine the seroprevalence of the parasite in cats found in the human carriers residences and identify the risk factors of toxoplasmosis in maternal women in Badung District, Bali Province, Indonesia. A total of 80 cat serum samples were obtained from two residential groups, 40 from the housing where …

The Covid-19 Pandemic: Role Of Coping Humor And Internal Health Locus Of Control On Social Dysfunction And Anxiety & Depression, Muhammad Arief Sumantri, Zahrani Zahrani, Hilda Rosa Ainiyah, Azmul Fuady Idham

Kesmas

The concerns about the impact of social distancing on mental health have been widely discussed. This study aimed to know the predictive effect of coping humor and Internal Health Locus of Control (Internal HLoC) on social dysfunction and anxiety & depression during the implementation of the COVID-19 social distancing agenda. This study was also intended to assess the effect of humor content on coping humor. A quantitative approach was used as the method ofthe study with 243 online-recruited participants, and a PLS-SEM analysis was applied to find out the predictive effect in this study. The results and conclusions showed that …

How Risky People Of Getting Covid-19 Based On Their Daily Activities?, Fajar Ariyanti, Mustakim Mustakim, Moch T A Al Ayubi, Desty Pratiwi Marlisman

Kesmas

In Indonesia at the end of 2020, COVID-19 cases were increasing and predicted to continue, as it had not yet passed the peak of the pandemic curve. The government had implemented mobility restrictions to reduce exposure to COVID-19. This study aimed to identify the risk of people getting COVID-19 based on their daily activities. Using a cross-sectional design, this study took 315 respondents under non-probability sampling from September to October 2020. Thedata were analyzed using the Chi-square test with α 0.05. This study showed that the risk percentage of people infected with COVID-19 based on their daily activities was 15.56% …

Aggregating Twitter Text Through Generalized Linear Regression Models For Tweet Popularity Prediction And Automatic Topic Classification, Chen Mo, Jingjing Yin, Isaac Chun-Hai Fung, Zion Tse

Department of Biostatistics, Epidemiology, and Environmental Health Sciences Faculty Publications

Social media platforms have become accessible resources for health data analysis. However, the advanced computational techniques involved in big data text mining and analysis are challenging for public health data analysts to apply. This study proposes and explores the feasibility of a novel yet straightforward method by regressing the outcome of interest on the aggregated influence scores for association and/or classification analyses based on generalized linear models. The method reduces the document term matrix by transforming text data into a continuous summary score, thereby reducing the data dimension substantially and easing the data sparsity issue of the term matrix. To …

The Dietary Inflammatory Index Is Not Associated With Gut Permeability Or Biomarkers Of Systemic Inflammation In Hiv Immunologic Non-Responders, Fat Malazogu, Rodney K. Rousseau, Nitin Shivappa Mbbs, Mph, Ph.D., Sanja Huibner, Sharon L. Walmsley, Colin M. Kovacs, Erika Benko, Robert J. Reinhard, Ron Rosenes, James R. Hébert, Rupert Kaul

Faculty Publications

Immunologic non-responders (INRs) are a subset of individuals living with HIV who have suboptimal blood CD4+ T cell recovery despite effective antiretroviral therapy (ART). They are at an increased risk of serious non-AIDS co-morbidities and death, and demonstrate enhanced systemic immune activation. In other populations diet has been correlated with markers of systemic inflammation through the Diet Inflammatory Index (DII), but this association has not been studied in persons living with HIV (PLWH). Blood was collected from 28 INR PLWH with a blood CD4+ T cell count <350/μL despite ≥2 years of effective ART. Participants completed a Canadian Diet History Questionnaire, and their responses were used to calculate the DII. Plasma inflammatory markers (IFNγ, TNF, IL-6, sVCAM, D-dimer, sCD14 and CRP) were assayed by ELISA, cellular immune activation (HLA-DR and CD38 on CD4+ and CD8+ T cells) was quantified using flow cytometry, and small bowel permeability assessed by calculation of the urine LacMan ratio after drinking a mix of lactulose and mannitol. Participants were a median age of 57 years, had been on effective ART for 15 years, and the median DII was −1.91 (range of −3.78 to +2.23). No correlation was observed between DII and plasma markers of inflammation, levels of T cell activation, gut permeability, or the biomarker of bacterial translocation sCD14. Self-reported alcohol intake, a potential confounder of the relationship between diet and inflammatory biomarkers, was also not associated with systemic inflammation or gut permeability. Our findings suggest that other mechanisms, rather than diet, are likely to be the major driver of systemic inflammation in INR individuals.

Association Between Diet Quality Indices And Incidence Of Type 2 Diabetes In The Melbourne Collaborative Cohort Study, Allison M. Hodge, Md Nazmul Karim, James Hébert Scd, Nitin Shivappa Mbbs, Mph, Ph.D., Barbora De Courten

Faculty Publications

Type 2 diabetes mellitus is a common condition whose incidence is increasing worldwide, and for which obesity and diet are important risk factors. The aim of this study was to assess the association of three diet quality scores with diabetes risk and how much of the association was mediated through body size. The Melbourne Collaborative Cohort Study recruited 41,513 men and women aged 40–69 years during 1990–1994. At baseline, data were collected on lifestyle and diet, anthropometric measures were performed. Incident diabetes was assessed by self-report at follow-up surveys in 1994–1998 and 2003–2007. The associations between the dietary inflammatory index …