Biostatistics Commons^™

Short-Term Preeclampsia Prediction: Cutoff Variations For Sflt-1/Plgf In U.S. Patients With Or Without Hypertensive Disorders, Yaxin Li, Kristen Cagino, Jim Yee, Caroline Andy, Dajana Borova, Ayush Shah, Isla Racine, Tracy Grossman, Zhen Zhao

Student Papers, Posters & Projects

BACKGROUND: Preeclampsia (PE) is a complex disorder with significant maternal and fetal risks. The soluble fms-like tyrosine kinase-1 (sFlt-1) and placental growth factor (PlGF) ratio shows promise as a diagnostic tool, but its adoption in the U.S. remains limited due to the lack of accessible testing platforms, U.S.-based studies, and evidence-based implementation guidelines.

PATIENTS/MATERIALS AND METHODS: We conducted a cohort study to evaluate the sFlt-1/PlGF ratio for predicting PE within two weeks among pregnant individuals ≥18 years, ≥20 weeks gestation. Serum samples were obtained from routine prenatal visits or triage evaluations. sFlt-1/PlGF ratios were measured using Roche Elecsys assays, and …

The Sodium-Glutamate Antagonist Riluzole Improves Outcome After Acute Spinal Cord Injury: Results From The Riscis Randomised Controlled Trial Analysed Using A Global Statistical Analytic Technique, Michael G. Fehlings, Karlo M. Pedro, Mohammed Ali Alvi, Ali Moghaddamjou, James S. Harrop, Ralph Stanford, Jonathon Ball, Bizhan Aarabi, Paul M. Arnold, James D. Guest, Shekar N. Kurpad, James M. Schuster, Ahmad N. Nassr, Karl M. Schmitt, Jefferson R. Wilson, Darrel S. Brodke, Faiz U. Ahmad, Albert Yee, Wilson Z. Ray, Nathaniel P. Brooks, Jason Wilson, Diana S.L. Chow, Elizabeth G. Toups, Kevin E. Thorpe, Jiaxin Huang, Peng Huang

School of Medicine Faculty Publications

Background: Spinal cord injury (SCI) clinical trials typically rely on a single primary endpoint to assess drug efficacy. This strategy fails to adequately capture the full impact of treatment in heterogenous neurological conditions like SCI. A more patient-centric analysis requires assessment of neurological function, functional capacity, and quality of life, incorporating meaningful patient-reported outcomes. The global statistical test (GST) addresses this challenge using a unified statistical conclusion regarding the superiority of a treatment strategy over another by evaluating multiple trial endpoints simultaneously. Methods: The RISCIS trial (Safety and Efficacy of Riluzole in Acute Spinal Cord Injury Study) data was analysed …

Ethnic Disparities In Hba1c And Hypoglycemia Among Youth With Type 1 Diabetes: Beyond Access To Technology, Social Deprivation And Mean Blood Glucose, J. Pemberton, Zhide Fang, Stuart Chalew, S. Uday

School of Public Health Faculty Publications

Introduction The UK national pediatric diabetes audit reports higher HbA1c for children and young people (CYP) with type 1 diabetes (T1D) of Black ethnicity compared with White counterparts. This is presumably related to higher mean blood glucose (MBG) due to lower socioeconomic status (SES) and less access to technology. We aimed to determine if HbA1c ethnic disparity persists after accounting for the above variables. Research design and methods A retrospective analysis of participants who received structured education in continuous glucose monitoring (CGM) use was conducted at a tertiary center. HbA1c was paired with glucose metrics from 90-day CGM data. The …

Surgical Delay-Associated Mortality Risk Varies By Subtype In Loco-Regional Breast Cancer Patients In Seer-Medicare, Macall Leslie Salewon, Rashmi Pathak, William Dooley, Ronald Squires, Hallgeir Rui, Inna Chervoneva, Takemi Tanaka

Department of Pharmacology, Physiology, and Cancer Biology Faculty Papers

Substantial evidence supports that delay of surgery after breast cancer diagnosis is associated with increased mortality risk, leading to the introduction of a new Commission on Cancer quality measure for receipt of surgery within 60 days of diagnosis for non-neoadjuvant patients. Breast cancer subtype is a critical prognostic factor and determines treatment options; however, it remains unknown whether surgical delay-associated breast cancer-specific mortality (BCSM) risk differs by subtype. This retrospective cohort study aimed to assess whether the impact of delayed surgery on survival varies by subtype (hormone [HR] + /HER2 -, HR -/HER2 -, and HER2 +) in patients with …

Measurement Of Breast Artery Calcification Using An Artificial Intelligence Detection Model And Its Association With Major Adverse Cardiovascular Events, Suzanne Rose, Josette Hartnett, Zachary Estep, Daniyal Ameen, Shweta Karki, Edward Schuster, Rebecca Newman, David Hsi

Department of Medicine Faculty Papers

Breast artery calcification (BAC) obtained from standard mammographic images is currently under evaluation to stratify risk of major adverse cardiovascular events in women. Measuring BAC using artificial intelligence (AI) technology, we aimed to determine the relationship between BAC and coronary artery calcification (CAC) severity with Major Adverse Cardiac Events (MACE). This retrospective study included women who underwent chest computed tomography (CT) within one year of mammography. T-test assessed the associations between MACE and variables of interest (BAC versus MACE, CAC versus MACE). Risk differences were calculated to capture the difference in observed risk and reference groups. Chi-square tests and/or Fisher's …

Access To Prostate-Specific Antigen Testing And Mortality Among Men With Prostate Cancer, Hari S. Iyer, Benjamin V. Stone, Charlotte Roscoe, Mei Chin Hsieh, Antoinette M. Stroup, Charles L. Wiggins, Fredrick R. Schumacher, Scarlett L. Gomez, Timothy R. Rebbeck, Quoc Dien Trinh

School of Public Health Faculty Publications

Importance: Prostate-specific antigen (PSA) screening for prostate cancer is controversial but may be associated with benefit for certain high-risk groups. Objectives: To evaluate associations of county-level PSA screening prevalence with prostate cancer outcomes, as well as variation by sociodemographic and clinical factors. Design, Setting, and Participants: This cohort study used data from cancer registries based in 8 US states on Hispanic, non-Hispanic Black, and non-Hispanic White men aged 40 to 99 years who received a diagnosis of prostate cancer between January 1, 2000, and December 31, 2015. Participants were followed up until death or censored after 10 years or December …

Statistical Approaches For The Early Detection Of Colorectal Cancer Using Longitudinal Biomarkers, Emily Berry

Statistical Science Theses and Dissertations

Colorectal cancer (CRC) is the third leading cause of cancer-related death in the United States [45]. CRC is believed to advance from adenomatous polyps creating a unique opportunity for both early detection and cancer prevention [4, 23]. Like other diseases, CRC screening reduces mortality by detecting cancer at earlier, more treatable stages; however, it can also reduce incidence through the removal of precancerous lesions [4]. As a result, screening is recommended for average-risk adults ≥ 45 years of age and includes a variety of tests [4, 12]. Despite alternate screening options, colonoscopy capacity is often cited as a barrier to …

Assessing Social Vulnerabilities Of Salivary Gland Cancer Care, Prognosis, And Treatment In The United States, Govind S. Bindra, David J. Fei-Zhang, Atharva Desai, John Maddalozzo, Stephanie S. Smith, Urjeet A. Patel, Daniel C. Chelius, Jill N. D'Souza, Jeffrey C. Rastatter, M. Boyd Gillespie, Anthony M. Sheyn

School of Medicine Faculty Publications

Background: Salivary gland cancers (SGC)-social determinants of health (SDoH) investigations are limited by narrow scopes of SGC-types and SDoH. This Social Vulnerability Index (SVI)-study hypothesized that socioeconomic status (SES) most contributed to SDoH-associated SGC-disparities. Methods: Retrospective cohort of 24 775 SGCs assessed SES, minority-language status (ML), household composition (HH), housing-transportation (HT), and composite-SDoH measured by the SVI via regressions with surveillance and survival length, late-staging presentation, and treatment (surgery, radio-, chemotherapy) receipt. Results: Increasing social vulnerability showed decreases in surveillance/survival; increased odds of advanced-presenting-stage (OR: 1.12, 95% CI: 1.07, 1.17), chemotherapy receipt (OR: 1.13, 95% CI: 1.03, 1.23); decreased odds …

Applications Of Causal Inference Methods For The Estimation Of Effects Of Bone Marrow Transplant And Prescription Drugs On Survival Of Aplastic Anemia Patients, Yesha M. Patel

Computational and Data Sciences (PhD) Dissertations

This dissertation provides an in-depth exploration into the treatment effectiveness for aplastic anemia using causal inference methods, structured around three pivotal research papers. Each paper contributes to a nuanced understanding of treatment impacts, specifically focusing on bone marrow transplantation (BMT) and prescription drugs, and the identification of optimal treatment strategies.

The first paper, "Causal Inference Analysis for Assessing the Effect of Bone Marrow Transplantation on the One-Year Survival of Adult and Pediatric Aplastic Anemia Patients," sets the foundation. It examines the short-term effectiveness of BMT in both adult and pediatric patients, providing crucial insights into how this treatment affects survival …

Assessment Of First-Phase Covid-19 Pandemic In Europe Using Hierarchical Clustering Based On Principal Components Analysis, Sanjay Kumar, Evrim Oral

School of Public Health Faculty Publications

It is of great interest for researchers to assess the COVID-19 pandemic in Europe. Grouping of COVID-19-affected regions is an effective way to monitor and optimize planning to combat the disease. This paper applied hierarchical clustering based on principal components analysis (HCPCA) to COVID-19 data from affected European countries. Considering several attribute indices, we obtained a new set of indicators using principal components analysis to aggregate and reduce the dimension of attribute indices of affected countries. Further, we obtained groups of affected countries subject to their similarity using hierarchical clustering to the reduced observations of new attributes indices of these …

Sugar-Sweetened Beverages And Artificially Sweetened Beverages Consumption And The Risk Of Nonalcoholic Fatty Liver (Nafld) And Nonalcoholic Steatohepatitis (Nash), Tung Sung Tseng, Wei Ting Lin, Peng Sheng Ting, Chiung Kuei Huang, Po Hung Chen, Gabrielle V. Gonzalez, Hui Yi Lin

School of Public Health Faculty Publications

Nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH) are fast becoming the most common chronic liver disease and are often preventable with healthy dietary habits and weight management. Sugar-sweetened beverage (SSB) consumption is associated with obesity and NAFLD. However, the impact of different types of SSBs, including artificially sweetened beverages (ASBs), is not clear after controlling for total sugar intake and total caloric intake. The aim of this study was to examine the association between the consumption of different SSBs and the risk of NAFLD and NASH in US adults. The representativeness of 3739 US adults aged ≥20 years …

Design, Analysis, And Interpretation Of Treatment Response Heterogeneity In Personalized Nutrition And Obesity Treatment Research, Roger S. Zoh, Bridget H. Esteves, Xiaoxin Yu, Amanda J. Fairchild, Ana I. Vazquez, Andrew G. Chapple, Andrew W. Brown, Brandon George, Derek Gordon, Douglas Landsittel, Gary L. Gadbury, Greg Pavela, Gustavo De Los Campos, Luis M. Mestre, David B. Allison

School of Public Health Faculty Publications

It is increasingly assumed that there is no one-size-fits-all approach to dietary recommendations for the management and treatment of chronic diseases such as obesity. This phenomenon that not all individuals respond uniformly to a given treatment has become an area of research interest given the rise of personalized and precision medicine. To conduct, interpret, and disseminate this research rigorously and with scientific accuracy, however, requires an understanding of treatment response heterogeneity. Here, we define treatment response heterogeneity as it relates to clinical trials, provide statistical guidance for measuring treatment response heterogeneity, and highlight study designs that can quantify treatment response …

The Effects Of Demographics And Risk Factors On The Morphological Characteristics Of Human Femoropopliteal Arteries, Sayed Ahmadreza Razian, Majid Jadidi, Alexey Kamenskiy

UNO Student Research and Creative Activity Fair

Background: Disease of the lower extremity arteries (Peripheral Arterial Disease, PAD) is associated with high morbidity and mortality. During disease development, the arteries adapt by changing their diameter, wall thickness, and residual deformations, but the effects of demographics and risk factors on this process are not clear.

Methods: Superficial femoral arteries from 736 subjects (505 male, 231 female, 12 to 99 years old, average age 51±17.8 years) and the associated demographic and risk factor variables were used to construct machine learning (ML) regression models that predicted morphological characteristics (diameter, wall thickness, and longitudinal opening angle resulting from the …

Potential Alzheimer's Disease Plasma Biomarkers, Taylor Estepp

Theses and Dissertations--Epidemiology and Biostatistics

In this series of studies, we examined the potential of a variety of blood-based plasma biomarkers for the identification of Alzheimer's disease (AD) progression and cognitive decline. With the end goal of studying these biomarkers via mixture modeling, we began with a literature review of the methodology. An examination of the biomarkers with demographics and other health factors found evidence of minimal risk of confounding along the causal pathway from biomarkers to cognitive performance. Further study examined the usefulness of linear combinations of biomarkers, achieved via partial least squares (PLS) analysis, as predictors of various cognitive assessment scores and clinical …

Infrastructure Development For Personalized Risk Prediction To Reduce Cardiovascular Disease In Childhood Cancer Survivors, Suman Shrestha

Dissertations and Theses (Open Access)

Although childhood cancer survivors have lengthy life expectancies, they run the risk of experiencing long-term health issues as a result of their treatment. The most frequent non-cancerous cause of morbidity and mortality for these survivors is cardiac disease. Radiation therapy (RT) has been linked in numerous cohort studies to a higher chance of developing a late cardiac disease in these survivors, and this risk rises with higher mean heart doses and increased RT exposure to larger cardiac volumes. Since, the heart is a heterogeneous organ made up of several distinct substructures, RT dose received by the entire heart does not …

Smoking, Alcohol Consumption, And Depression In Association With Incidence Of Type 2 Diabetes Among Mexican Americans In Starr County, Texas, Gabriela Rubannelsonkumar

Honors Program Theses and Research Projects

Previous studies on conditions like obesity, hypertension, and type 2 diabetes mellitus (T2DM) have explored the correlations between them and various other human conditions, including aortic stiffness, left ventricular hypertrophy and sleep apnea, as they predict possibilities of developing certain diseases in Mexican Americans. This study aims to observe the correlation between lifestyle decisions that could relate to the onset of the depression in normal, prediabetic, and diabetic individuals. These include smoking habits and alcohol consumption. Many papers have previously conducted research on these lifestyle habits as they relate to obesity, hypertension, diabetes, however, have done so in a singular …

Anti-Vaxxers: Parents Fighting Science, Katie West

Symposium of Student Scholars

Immunizing children helps protect the health of our community, especially those people who cannot be immunized. Yet, since 1996 after a study was released that linked autism to vaccinations, there has been a trend of parents refusing to vaccinate their children. What are the demographics of the parents who believe their children are better off without vaccines? By knowing where these parents live and what decisions they make for their children’s education, counties and medical professionals can provide education and address their concerns.

My research involves data on 116,141 kindergarten classes from 2000-2015 in California. The two vaccine exemption options …

Predictive Modeling And Estimation Of The Doubling Time Of Confirmed Cases Of Covid-19 In Niger, Ibrahim Sidi Zakari, Hadiza Galadima

Community & Environmental Health Faculty Publications

Modeling is increasingly used to assess scenarios and make projections on the future course of new coronavirus disease. This allows for better planning of care as well as a relaxation or tightening of the restrictive measures decreed by the government and the health authorities. The data analyzed in this study covers the period from March 19 to June 05, 2020 and allowed predictions of new cases of COVID-19 based on a growth model with a growth rate that changes linearly over time. In addition, we calculated and predicted the doubling time of the number of positive cases in each region …

Regression Analyses Assessing The Impact Of Environmental Factors On Covid-19 Transmission And Mortality, El Hussain Shamsa, Kezhong Zhang

Medical Student Research Symposium

No abstract provided.

Maternal Proximity To Mountaintop Removal Mining And Birth Defects In Appalachian Kentucky, 1997-2003, Daniel B. Cooper

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Background: Extraction of coal through mountaintop removal mining (MTR) alters many dimensions of the landscape, and explosive blasts, exposed rock, and coal washing have the potential to pollute air and water with substances known to increase risk of developmental and birth anomalies. Previous research suggests that infants born to mothers living in MTR coal mining counties have higher prevalence of most types of birth defects.

Objectives: This study seeks to examine further the relationship between MTR activity and birth defects by employing individual level exposure estimation through precise satellite data of MTR activity in the Appalachian region and maternal residence …

Addressing The Ecological Fallacy With Lagrangian Inference, Michael Schwob

Calvert Undergraduate Research Awards

Most epidemiologists elect to use statistical models that use population-level data to make inference on the spread of some virus or disease. This has become commonplace in the fields of epidemiology and biostatistics since most data used to construct and verify epidemic models are recorded at the population-level. Obtaining inference from a population-level model may be beneficial in studying the spread of disease in a homogeneous population, but the use of such models to describe a heterogeneous population results in inadequate inference. The inaccuracy of these models is further amplified when one tries to make individual-level inference from these population-level …

A Model For Inhalation Of Infectious Aerosol Contaminants In An Aircraft Passenger Cabin, Bert A. Silich

International Journal of Aviation, Aeronautics, and Aerospace

Aerosol contamination of an aircraft cabin by infectious passengers is a concern of passengers, aircrew and the aviation industry. This may be especially important during a pandemic, such as COVID-19, where the full extent of aerosol transmission is not well understood. A statistical method to determine the number of infectious passengers on board along with a mathematical model estimating the contaminant concentration of aerosols in the cabin and the number of inhaled infectious particles by passengers is presented. An example is used to demonstrated how the results can be estimated during normal operations and emergency conditions with malfunctions of the …

Novel Inference Methods For Generalized Linear Models Using Shrinkage Priors And Data Augmentation., Arinjita Bhattacharyya

Electronic Theses and Dissertations

Generalized linear models have broad applications in biostatistics and sociology. In a regression setup, the main target is to find a relevant set of predictors out of a large collection of covariates. Sparsity is the assumption that only a few of these covariates in a regression setup have a meaningful correlation with an outcome variate of interest. Sparsity is incorporated by regularizing the irrelevant slopes towards zero without changing the relevant predictors and keeping the resulting inferences intact. Frequentist variable selection and sparsity are addressed by popular techniques like Lasso, Elastic Net. Bayesian penalized regression can tackle the curse of …

Accounting For The Uncertainty Due To Chemicals Below The Detection Limit In Mixture Analysis, Paul M. Hargarten

Theses and Dissertations

Humans are exposed to multiple chemicals every day. Epidemiological studies have shown that chemical mixtures are associated with cancers, allergies, neurodevelopmental disorders, and other adverse health effects. To assess these associations, investigators are increasingly using chemical mixture approaches like weighted quantile sum (WQS) regression. In these studies, the research objectives are to determine whether a mixture of correlated chemicals is associated with an adverse health outcome and to identify the important chemicals. However, as experimental equipment measures each exposure to a chemical-specific detection limit, the exposures are unknown between zero and the detection limit. Indeed, the number of exposures below …

Classification Of Coronary Artery Disease In Non-Diabetic Patients Using Artificial Neural Networks, Demond Handley

Annual Symposium on Biomathematics and Ecology Education and Research

No abstract provided.

An Analysis Of The Rajasthan Public Health System’S Response To The 2019 Dengue Insurgence, Luke Bryan

Independent Study Project (ISP) Collection

Dengue virus is in a pandemic status and is a major public health issue in the modern world. The mosquito-borne disease is largely prevalent in Asia and specifically India, where more than half of the states are considered to have complete presence of the dengue virus. The intricate infrastructure of the Indian public health system looks for dengue cases at all levels and reports to the integrated disease surveillance programme (IDSP).

Analyses of the IDSP and trends of dengue cases was done in response to dengue outbreaks throughout the state. Geographic information system (GIS) maps were created to evaluate a …

Characterizing The Permanence And Stationary Distribution For A Family Of Malaria Stochastic Models, Divine Wanduku

Biology and Medicine Through Mathematics Conference

No abstract provided.

Gene Co-Expression Networks Analysis Reveal Novel Molecular Endotypes In Alpha-1 Antitrypsin Deficiency, Jen-Hwa Chu, Wenlan Zang

Yale Day of Data

Rationale:Alpha-1 antitrypsin deficiency (AATD) is a genetic condition that predisposes to early onset pulmonary emphysema and airways obstruction. The exact mechanism through which AATD leads to lung disease is incompletely understood.

Objectives: To investigate the effect of AAT genotype and augmentation therapy on bronchoalveolar lavage (BAL) and peripheral blood mononuclear cells (PBMC) transcriptome, while examining the link between gene expression profiles, and clinical features of AATD.

Methods: We performed RNA-Seq on RNA extracted from BAL and PBMC on samples obtained from 89 AATD patients enrolled in the Genomic Research in Alpha-1 Antitrypsin Deficiency and Sarcoidosis (GRADS) study. Differential …

Safety Constraint Optimization Of Combination Drug Therapy In Hypertension Clinical Trials, Victor Chukwu

College of Graduate Studies: Theses & Dissertations

In Clinical Practice, combination drug therapy has become common in treating many disease conditions. The purpose of these combinations is often to ensure optimal efficacy and to reduce adverse effects that may arise from monotherapy. Clinical trials have also been conducted to ensure efficacy and safety of these combinations before they are introduced into the market. However, adverse effects still occur with combination therapies. The objective of this study is to (1) To determine a region of optimum doses of Drug A and Drug B in combination while focusing on efficacy alone (2) To determine a region of optimum doses …

Statistical Methods For Joint Analysis Of Multiple Phenotypes And Their Applications For Phewas, Xueling Li

Dissertations, Master's Theses and Master's Reports

Genome-wide association studies (GWAS) have successfully detected tens of thousands of robust SNP-trait associations. Earlier researches have primarily focused on association studies of genetic variants and some well-defined functions or phenotypic traits. Emerging evidence suggests that pleiotropy, the phenomenon of one genetic variant affects multiple phenotypes, is widespread, especially in complex human diseases. Therefore, individual phenotype analyses may lose statistical power to identify the underlying genetic mechanism. Contrasting with single phenotype analyses, joint analysis of multiple phenotypes exploits the correlations between phenotypes and aggregates multiple weak marginal effects and is therefore likely to provide new insights into the functional consequences …