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Full-Text Articles in Biostatistics

Handling Missing Data In Copd Research, Chia-Ying Chiu Jan 2026

Handling Missing Data In Copd Research, Chia-Ying Chiu

ETDs from 2020-2029

Chronic Obstructive Pulmonary Disease (COPD) remains a major global health concern and one of the leading causes of death in the United States, affecting approximately 4.6% of adults and reaching a prevalence of 9.4% in Alabama according to 2024 National Health Interview Survey. The disease imposes a substantial burden on quality of life and healthcare costs and contributes to increased disability-adjusted life years and years of life lost, as highlighted by the 2022 Lancet Commission report. Despite its im-pact, COPD is frequently diagnosed only after irreversible lung damage has occurred, largely due to under-recognized symptoms and limited diagnostic tools. Early …


Dietary Inflammatory Index And Risk Of Colorectal Cancer In Japanese Men, Ayaka Kotemori, Kumiko Kito, Motoki Iwasaki, Taiki Yamaji, James Hébert Scd, Junko Ishihara, Manami Inoue, Shoichiro Tsugane, Norie Sawada On The Behalf Of Jphc Study Group Jan 2026

Dietary Inflammatory Index And Risk Of Colorectal Cancer In Japanese Men, Ayaka Kotemori, Kumiko Kito, Motoki Iwasaki, Taiki Yamaji, James Hébert Scd, Junko Ishihara, Manami Inoue, Shoichiro Tsugane, Norie Sawada On The Behalf Of Jphc Study Group

Faculty Publications

Background/Objectives: Unhealthy lifestyles lead to chronic low-grade inflammation, increasing the risk of colorectal cancer. Few studies in East Asia have examined the association between the dietary inflammation potential and colorectal cancer incidence. Therefore, we aimed to investigate this association further in the Japanese population. Methods: This study included 38,807 men aged 45–74 years who participated in the Japan Public Health Center-based prospective study (JPHC Study). The energy-adjusted dietary inflammatory index (E-DII) was derived from a food frequency questionnaire. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox proportional hazards regression models. Differences in risk due to a …


Protocol For The Development Of The Who Gestational Weight Gain Charts, Thais Rangel Bousquet Carrilho, Olufemi Taiwo Oladapo, Jennifer A. Hutcheon, Giovanna Gatica-Domínquez, Kathleen M. Rasmussen, Monica C. Flores-Urrutia, Richard Kumapley, Ӧzge Tunçalp, Dang Bahya-Batinda, Amel A. Fayed, Annick Bogaerts, Aris T. Papageorghiou, Cinthya Muñoz-Manrique, Dayana Rodrigues Farias, Eric Ohuma, Harshpal Sachdev, Hayfaa A. Wahabi, Helena J. Teede, Molin Wang, Nandita Perumal Phd Jan 2026

Protocol For The Development Of The Who Gestational Weight Gain Charts, Thais Rangel Bousquet Carrilho, Olufemi Taiwo Oladapo, Jennifer A. Hutcheon, Giovanna Gatica-Domínquez, Kathleen M. Rasmussen, Monica C. Flores-Urrutia, Richard Kumapley, Ӧzge Tunçalp, Dang Bahya-Batinda, Amel A. Fayed, Annick Bogaerts, Aris T. Papageorghiou, Cinthya Muñoz-Manrique, Dayana Rodrigues Farias, Eric Ohuma, Harshpal Sachdev, Hayfaa A. Wahabi, Helena J. Teede, Molin Wang, Nandita Perumal Phd

Faculty Publications

Introduction Gestational weight gain (GWG) is an important indicator of maternal nutrition to be monitored during pregnancy. However, there is no evidence-based tool that can be used to monitor it across all geographic locations and pre-pregnancy body mass index (BMI) categories. The WHO is undertaking a project to develop GWG charts by pre-pregnancy BMI category, and to identify GWG ranges associated with the lowest risks of adverse maternal and infant outcomes. This protocol describes all the steps that will be used to accomplish the development of these GWG charts.

Methods and analysis This project will involve the analysis of individual …


Sociodemographic And Hiv-Related Characteristics Associated With Mental Health Diagnoses Among People Living With Hiv, Monique J. Brown Ph.D., Mph, Jiayang Xiao, Xueying Yang Ph.D., Bankole Olatosi Ph.D., Sharon Weissman, Xiaoming Li Ph.D., Jiajia Zhang Ph.D. Jan 2026

Sociodemographic And Hiv-Related Characteristics Associated With Mental Health Diagnoses Among People Living With Hiv, Monique J. Brown Ph.D., Mph, Jiayang Xiao, Xueying Yang Ph.D., Bankole Olatosi Ph.D., Sharon Weissman, Xiaoming Li Ph.D., Jiajia Zhang Ph.D.

Faculty Publications

Mental health diagnoses have been linked to poor HIV treatment outcomes and poorer quality of life among people living with HIV (PLWH). Therefore, this study aimed to investigate the association between sociodemographic and HIV-related characteristics, and common and serious mental health disorders among PLWH in South Carolina (SC). Data were obtained from the integrated system of statewide electronic health record (EHR) data in SC (2006–2019; N = 8,124). Multivariable logistic regression models were used to determine the associations between sociodemographic and HIV-related characteristics, and common mental health disorders and serious mental health disorders. Among the study population, 4% were 60 …


Multiple Myeloma Risk Linked To Dna Damage Response Genes, Michael Conry, Irina Ostrovnaya, Yelena Kemel, Saloni Sinha, Linda B. Baughn, Brian Avery, Kylee Maclachlan, Victoria Groner, Lauren Banaszak, Aaron Norman, Nicholas J. Boddicker, Alyssa I. Clay-Gilmour Ph.D., Shaji Kumar, Ellen Kim, Sita Dandiker, Mitul Waghmare, Susan Slager, Douglas Sborov, Judy Garber, Elizabeth E. Brown, Michelle Hildebrandt, Et. Al. Jan 2026

Multiple Myeloma Risk Linked To Dna Damage Response Genes, Michael Conry, Irina Ostrovnaya, Yelena Kemel, Saloni Sinha, Linda B. Baughn, Brian Avery, Kylee Maclachlan, Victoria Groner, Lauren Banaszak, Aaron Norman, Nicholas J. Boddicker, Alyssa I. Clay-Gilmour Ph.D., Shaji Kumar, Ellen Kim, Sita Dandiker, Mitul Waghmare, Susan Slager, Douglas Sborov, Judy Garber, Elizabeth E. Brown, Michelle Hildebrandt, Et. Al.

Faculty Publications

Background DNA damage response genes (DDRG), implicated in several cancers as both predisposing risk factors as well as biomarkers for aggressiveness, have not been fully explored in multiple myeloma (MM).

Methods Herein, we analyzed disease associations of pathogenic variations in nine putative candidate genes using 3 446 MM cases and 323 233 cancer-free controls.

Results Increased MM risk was found to be associated with inherited rare pathogenic mutations in TP53, ATM, CHEK2, KDM1A, and ARID1A, with an enrichment of these variants among individuals with early onset or family history of MM. Individuals with TP53 or ATM germline mutations are also …


Improving Glycemic Control Among Indonesian Urban Adults: A Digital And Behavioral Extension Of The Information–Motivation–Behavioral Skills Model, Imelda Appulembang Nov 2025

Improving Glycemic Control Among Indonesian Urban Adults: A Digital And Behavioral Extension Of The Information–Motivation–Behavioral Skills Model, Imelda Appulembang

Kesmas

Management of type 2 diabetes mellitus (T2DM) in Indonesia continues to face challenges due to behavioral, informational, and technological gaps among patients. This study analyzed the influence of self-regulatory competence and information, motivation, family support, and digital health literacy on glycemic control behavior. A cross-sectional survey was conducted from February to April 2025 among 587 adults aged >30 years with T2DM enrolled in the Chronic Disease Management Program at primary health care in six major cities: Jakarta, Surabaya, Yogyakarta, Medan, Makassar, and Banjarmasin. Data were collected through structured questionnaires and analyzed using partial least squares structural equation modeling. The findings …


Field Validation Of Multiple Species Distribution Models Shows Variation In Performance For Predicting Aedes Albopictus Distributions At The Invasion Edge, Anna V. Shattuck, Brandon D. Hollingsworth Ph.D., Jared Skrotzki, Scott R. Campbell, Christopher L. Romano, Courtney C. Murdock Nov 2025

Field Validation Of Multiple Species Distribution Models Shows Variation In Performance For Predicting Aedes Albopictus Distributions At The Invasion Edge, Anna V. Shattuck, Brandon D. Hollingsworth Ph.D., Jared Skrotzki, Scott R. Campbell, Christopher L. Romano, Courtney C. Murdock

Faculty Publications

Background

Climate and land use changes have resulted in range expansion of many species. In this shifting disease landscape, it is important to leverage tools that can predict the distributions of invading vectors to target surveillance and control efforts and identify at-risk populations. Species distribution models (SDMs) are used to predict ranges of invasive species; however, invasive species often violate assumptions of equilibrium and niche conservatism. Moreover, these studies are rarely validated using independent data.

Methods 

We use long-term surveillance data for Aedes albopictus, a highly invasive mosquito capable of transmitting several arboviruses, at its range edge to evaluate a …


Circulating Levels Of Insulin-Like Growth Factor I (Igf-I) And Risk Ofmultiple Myeloma: An Observational And Mendelian Randomisation Study, Yolanda Benavente, Sara Hermosa, Nikos Papadimitriou, Alyssa I. Clay-Gilmour Ph.D., Elizabeth E. Brown, Jonathan N. Hofmann, Nathaniel Rothman, Qing Lan, Sonja I. Berndt, Demetrius Albanes, Mark Purdue, Mitchell J. Machiela, Stephen J. Chanock, Parveen Bhatti, Wendy Cozen, Aaron Norman, Susan L. Slager, James R. Cerhan, Vincent Rajkumar, Shaji J. Kumar, Et. Al. Nov 2025

Circulating Levels Of Insulin-Like Growth Factor I (Igf-I) And Risk Ofmultiple Myeloma: An Observational And Mendelian Randomisation Study, Yolanda Benavente, Sara Hermosa, Nikos Papadimitriou, Alyssa I. Clay-Gilmour Ph.D., Elizabeth E. Brown, Jonathan N. Hofmann, Nathaniel Rothman, Qing Lan, Sonja I. Berndt, Demetrius Albanes, Mark Purdue, Mitchell J. Machiela, Stephen J. Chanock, Parveen Bhatti, Wendy Cozen, Aaron Norman, Susan L. Slager, James R. Cerhan, Vincent Rajkumar, Shaji J. Kumar, Et. Al.

Faculty Publications

Evidence for an association between insulin-like growth factors (IGF) and multiple myeloma (MM) is inconsistent. We examined total IGF-I concentrations and risk of MM by combining baseline serological data among UK Biobank participants (n = 444 187; 732 incident MM) with a two-sample Mendelian randomisation (MR) analysis using identified genetic variants associated with circulating total IGF-I and IGF-binding protein 3 (IGFBP-3) in the InterLymph consortium (2434 MM and their 2567 controls). Finally, additional lymphoid neoplasm (LN) subtypes were included for comparison with the main hypothesis. Circulating IGF-I level was positively associated with MM risk Hazard ratio-HR-per one standard deviation-SD-increase …


Adverse Childhood Experiences, Positive Childhood Experiences, And Digital Media Use Among Children And Adolescents In The United States, Elizabeth L. Crouch, Emma Boswell, Monique J. Brown Ph.D., Kevin J. Bennett Oct 2025

Adverse Childhood Experiences, Positive Childhood Experiences, And Digital Media Use Among Children And Adolescents In The United States, Elizabeth L. Crouch, Emma Boswell, Monique J. Brown Ph.D., Kevin J. Bennett

Publications

No abstract provided.


Smarter Disease Detection From Electronic Health Record Data: An End-To-End Ai-Augmented Pipeline For Computable Phenotyping, Dylan Owens Oct 2025

Smarter Disease Detection From Electronic Health Record Data: An End-To-End Ai-Augmented Pipeline For Computable Phenotyping, Dylan Owens

Statistical Science Theses and Dissertations

Electronic Health Records (EHR) contain a wealth of structured and unstructured patient data that can be leveraged for computable phenotyping, the process of algorithmically identifying patient cohorts with specific diseases or conditions. Traditional rule-based phenotyping approaches, while interpretable, often struggle with scalability, portability across institutions, and effective use of unstructured clinical narratives. Recent advances in large language models (LLMs) present new opportunities for synthesizing complex free-text information into concise, clinically meaningful representations. However, integrating LLMs into phenotyping workflows requires careful design to maintain transparency, interpretability, and measurable uncertainty—features essential for clinical adoption and downstream applications such as decision support.

We …


Spatiotemporal Modeling Of Maternal Mortality In South Carolina 2018-2023, Leah Wood, Ray Bai, Emily Mann Oct 2025

Spatiotemporal Modeling Of Maternal Mortality In South Carolina 2018-2023, Leah Wood, Ray Bai, Emily Mann

Senior Theses

Maternal death serves as a public health indicator due to fact that it is considered preventable with the availability of modern biomedicine, however, it persists broadly throughout the United States. Current literature outlines national trends in maternal mortality with complicating, preexisting conditions, and structural upstream factors often cited as being the largest contributors to increased risk. This study utilizes publicly available, county-level data for maternal death in addition to demographic and descriptive data in order to estimate maternal mortality rates in each of South Carolina’s 46 counties from 2018 to 2023. In order to address sparsity in the outcome variable …


Glucodensity Functional Profiles Outperform Traditional Continuous Glucose Monitoring Metrics, Marcos Matabuena, Rahul Ghosal Ph.D., Javier Enrique Aguilar, Ayya Keshet, Robert Wagner, Carmen Fernández Merino, Juan Sánchez Castro, Vadim Zipunnikov, Jukka-Pekka Onnela, Francisco Gude Sep 2025

Glucodensity Functional Profiles Outperform Traditional Continuous Glucose Monitoring Metrics, Marcos Matabuena, Rahul Ghosal Ph.D., Javier Enrique Aguilar, Ayya Keshet, Robert Wagner, Carmen Fernández Merino, Juan Sánchez Castro, Vadim Zipunnikov, Jukka-Pekka Onnela, Francisco Gude

Faculty Publications

Continuous glucose monitoring (CGM) data have revolutionized the management of type 1 diabetes, particularly when integrated with insulin pumps to mitigate clinical events such as hypoglycemia. Recently, there has been growing interest in utilizing CGM devices in clinical studies involving healthy and diabetic populations. However, efficiently exploiting the high temporal resolution of CGM profiles remains a significant challenge. Numerous indices—such as time–in–range metrics and glucose variability measures–have been proposed, but evidence suggests these metrics overlook critical aspects of dynamic glucose homeostasis. As an alternative method, this paper explores the clinical value of glucodensity metrics in capturing glucose dynamics—specifically the speed …


Effect Of Vitamin D Supplementation During Pregnancy And Lactation On The Development Of Infants Born To Tanzanian Women Living With Hiv: A Secondary Analysis Of A Randomised Controlled Trial, Temiwunmi Shobanke, Alfa Muhihi, Nandita Perumal Phd, Nzovu Ulenga, Fadhlun M. Alwy Al-Beity, Christopher P. Duggan, Wafaie W. Fawzi, Karim P. Manji, Christopher R. Sudfeld Sep 2025

Effect Of Vitamin D Supplementation During Pregnancy And Lactation On The Development Of Infants Born To Tanzanian Women Living With Hiv: A Secondary Analysis Of A Randomised Controlled Trial, Temiwunmi Shobanke, Alfa Muhihi, Nandita Perumal Phd, Nzovu Ulenga, Fadhlun M. Alwy Al-Beity, Christopher P. Duggan, Wafaie W. Fawzi, Karim P. Manji, Christopher R. Sudfeld

Faculty Publications

Background Infants born to pregnant women living with HIV (WLHIV) are at greater risk for morbidity and mortality and may also have poorer developmental outcomes as compared with infants who are not exposed to HIV. Nutrition interventions in pregnancy may affect developmental outcomes.

Objectives This study evaluated the effect of maternal vitamin D supplementation on infant development outcomes.

Design We conducted a secondary analysis of a randomised, triple-blind, placebo-controlled trial of maternal vitamin D supplementation from June 2015 to October 2019.

Setting Antenatal care clinics in Dar es Salaam, Tanzania.

Participants Pregnant WLHIV and their offspring.

Interventions Daily 3000 IU …


Access To Information On Toddler Family Development Program And Family Participation In Child Growth And Development, Dita Dhammayanti, Demsa Simbolon, Lissa Ervina, Yusran Fauzi Aug 2025

Access To Information On Toddler Family Development Program And Family Participation In Child Growth And Development, Dita Dhammayanti, Demsa Simbolon, Lissa Ervina, Yusran Fauzi

Kesmas

The comprehension of the Toddler Family Development (TFD) Program among families in Indonesia remains limited, likely due to insufficient access to information and low participation rates. Limited participation can negatively affect a family’s ability to support optimal child growth and development. This study examined the relationship between access to information on the TFD Program and family participation in child growth and development. Using secondary data from the 2019 Program Performance and Accountability Survey in Indonesia, the cross-sectional analysis included 21,497 respondents. The results revealed an association between access to information on the TFD Program and family participation in child growth …


Exploring Stunting In South Kalimantan Province Using R Programming-Based Data Visualization, Muhammad Hudaya, Wahyudin Nor, Mellani Yuliastina, Muhammad Nordiansyah Aug 2025

Exploring Stunting In South Kalimantan Province Using R Programming-Based Data Visualization, Muhammad Hudaya, Wahyudin Nor, Mellani Yuliastina, Muhammad Nordiansyah

Kesmas

South Kalimantan Province continues to face the challenge of relatively high stunting prevalence despite being endowed with abundant coal resources that could serve as a source of funding for public health. Therefore, this study aimed to examine differences in stunting prevalence among cities, mining districts, and non-mining districts in South Kalimantan to raise stakeholder awareness of disparities across these regional types. This study was conducted between April and December 2024, using secondary data obtained from the Indonesian Ministry of Health and the South Kalimantan Provincial Government. R programming was used to process the data, generate visualizations, and perform analysis of …


Understanding User Needs In Health Crisis Risk Monitoring Information System Development: A Lesson From Tasikmalaya District, Indonesia, Arief Tarmansyah Iman, Hari Kusnanto, Ariani Arista Putri Pertiwi Aug 2025

Understanding User Needs In Health Crisis Risk Monitoring Information System Development: A Lesson From Tasikmalaya District, Indonesia, Arief Tarmansyah Iman, Hari Kusnanto, Ariani Arista Putri Pertiwi

Kesmas

A health crisis risk monitoring information system needs to be developed, especially during the pre-disaster phase; therefore, understanding the needs of prospective users is crucial. This study aimed to investigate the needs of potential users regarding the development of this system. This study employed a qualitative, exploratory approach to gather user needs from stakeholders through interviews (n = 7) and one focus group discussion (n = 12). The data were audio-recorded, transcribed verbatim, and then thematically analyzed using qualitative content analysis. The need for information was related to disaster preparedness and its preferred format. The system should be targeted, multiplatform, …


Low Economic Level And The Risk Of Overweight Among Indonesian Junior And Senior High School Students, Ariyanto Nugroho, Purwo Setiyo Nugroho, Amarin Yudhana, Sri Sunarti Aug 2025

Low Economic Level And The Risk Of Overweight Among Indonesian Junior And Senior High School Students, Ariyanto Nugroho, Purwo Setiyo Nugroho, Amarin Yudhana, Sri Sunarti

Kesmas

Overweight and obesity among Indonesian adolescents have emerged as a pressing public health issue, reflecting global trends. This study examines the relationship between economic status and overweight prevalence among junior and senior high school students in Indonesia, using secondary data from the Global School-based Health Survey (GSHS). This study analyzed data from 9,977 students aged 11–18 years through a cross-sectional design and binary logistic regression, adjusting for dietary habits, physical activity, and sedentary behavior. Overall, 14.7% of students were overweight; the prevalence was notably higher among low-income students (27.4%) compared to high-income groups (14.2%). Students from lower economic backgrounds were …


An Evidence-Based Intervention To Increase Trypanosoma Cruzi, A Neglected Parasitic Infection, Diagnosis In Rural And Moderate-Size-City Us Clinics, M K. Lynn, Hunter M. Boehme, Jeffrey Hall, Patrick Kent, Alain H. Litwin, Quang H. Pham, Melissa Nolan Ph.D., Mph, Prisma Chagas Team Aug 2025

An Evidence-Based Intervention To Increase Trypanosoma Cruzi, A Neglected Parasitic Infection, Diagnosis In Rural And Moderate-Size-City Us Clinics, M K. Lynn, Hunter M. Boehme, Jeffrey Hall, Patrick Kent, Alain H. Litwin, Quang H. Pham, Melissa Nolan Ph.D., Mph, Prisma Chagas Team

Faculty Publications

Background

Chagas disease is a chronic, insidious parasitic infection (Trypanosoma cruzi) that slowly develops to irreversible organomegaly over several decades. The disease is traditionally acquired in endemic Latin American countries during childhood; < 1% of foreign-born adult residents in the United States have been diagnosed or treated with this potentially fatal disease. Low physician knowledge is a primary factor leading to misdiagnosis.

Methods

Starting in April 2022, a 4-part T cruzi clinical education intervention began, which included (i) 2 grand rounds presentations to >100 internal medicine providers; (ii) implementation of a “clinical Chagas champions program” incorporating 14 key clinical staff at varying departments and administrative levels educated on their specific role related to T cruzi screening, diagnosis confirmation, clinical management, and medical billing; ( …


Changes In Mental Health Care Utilisation Before And During The Covid-19 Pandemic Among People Living With Hiv In The Usa: A Retrospective Cohort Study Using The All Of Us Dataset, Atena Pasha, Shan Qiao, Jiajia Zhang Ph.D., Ruilie Cai, Buwei He, Xueying Yang, Chen Liang Ph.D., Sharon Weissman, Xiaoming Li Ph.D. Aug 2025

Changes In Mental Health Care Utilisation Before And During The Covid-19 Pandemic Among People Living With Hiv In The Usa: A Retrospective Cohort Study Using The All Of Us Dataset, Atena Pasha, Shan Qiao, Jiajia Zhang Ph.D., Ruilie Cai, Buwei He, Xueying Yang, Chen Liang Ph.D., Sharon Weissman, Xiaoming Li Ph.D.

Faculty Publications

Introduction Despite the profound impact of the COVID-19 pandemic on people living with HIV (PLWH) mental health, large-scale, real-world data on mental healthcare utilisation and associated factors among PLWH remain limited. This study explores mental healthcare utilisation and associated factors among PLWH during the COVID-19 pandemic.

Methods Using a retrospective cohort design, we identified and included 4575 PLWH through computational phenotyping based on relevant Observational Medical Outcomes Partnership Common Data Model concept sets from the All of Us programme between March 2018 and March 2022. Mental healthcare utilisation was measured using the yearly count of mental healthcare visits and compared …


Neighborhood Socioeconomic Status And Overall Survival Among Children With Acute Lymphoblastic Leukemia, Anna Hoppmann, Debroah M. Hurley, Stuart Cramer, Monique J. Brown Ph.D., Mph Aug 2025

Neighborhood Socioeconomic Status And Overall Survival Among Children With Acute Lymphoblastic Leukemia, Anna Hoppmann, Debroah M. Hurley, Stuart Cramer, Monique J. Brown Ph.D., Mph

Faculty Publications

A disadvantaged neighborhood, as represented by area-level socioeconomic status (SES) has been associated with adverse outcomes among children with acute lymphoblastic leukemia (ALL) in the US, but the duration of impact after ALL diagnosis is not well understood. This retrospective cohort study utilized the National Cancer Database (NCDB) to examine the impact of area-level SES on overall survival among children with ALL. Median income and education quartiles based on residential zip code were used to create a composite area-level SES variable. Individual-level variables included age, sex, race, year of diagnosis, primary payer, distance to care, rurality, time to treatment, and …


The Effectiveness Of Remote Patient Monitoring In Reducing The Risk Of Rehospitalizations In Covid-19 Patients: A Meta-Analysis, Dela Riadi, Indang Trihandini, Dewi Nirmala Sari, Fikri Wijaya Jul 2025

The Effectiveness Of Remote Patient Monitoring In Reducing The Risk Of Rehospitalizations In Covid-19 Patients: A Meta-Analysis, Dela Riadi, Indang Trihandini, Dewi Nirmala Sari, Fikri Wijaya

Kesmas

An integrated analysis of various Remote Patient Monitoring (RPM) studies is needed to evaluate the reduction rate of the risk of rehospitalization in COVID-19 patients. This meta-analysis aimed to provide an overview of the effectiveness of RPM. A literature search through online databases (PubMed, Science Direct, Scopus, ProQuest, and Embase) was conducted from 2019 to 2022. After using the Cochrane Collaboration's risk of bias tool, five studies on COVID-19 were selected. Based on the data collected from 2,685 participants (intervention = 1,060, control = 1,625), the use of RPM was found to reduce rehospitalization by 0.56 times compared to not …


Cross-Cultural Adaptation And Validation Of Ranas-Based Instrument For Measuring Latrine Use Behavior In Indonesia, Vera Yulyani, Fatwa Sari Tetra Dewi, Iswanto Iswanto Jul 2025

Cross-Cultural Adaptation And Validation Of Ranas-Based Instrument For Measuring Latrine Use Behavior In Indonesia, Vera Yulyani, Fatwa Sari Tetra Dewi, Iswanto Iswanto

Kesmas

Using toilets is a simple way to prevent diarrhea, yet no validated tool exists to measure this habit. This study aimed to develop and validate instruments for measuring latrine use consistency. This questionnaire was adapted from the risk, attitude, norm, ability, and self-regulation (RANAS) framework developed in India and modified for Indonesia. It was evaluated by three experts using the content validity index (CVI). The face validity index (FVI) was pilot-tested on 40 community respondents. Variables measured included behavior, habits, intentions to use toilets, knowledge, attitudes, norms, abilities, and self-regulation. Question items with relevance and clarity scores of item CVI …


Analyzing High-Risk Fertility Behavior For Sustainable Maternal-Child Health: A 2017 Sociodemographic Study In Urban And Rural Indonesia, Asti Annisa Utami, Fadhaa Aditya Kautsar Murti, Popy Yuniar, Milla Herdayati Jul 2025

Analyzing High-Risk Fertility Behavior For Sustainable Maternal-Child Health: A 2017 Sociodemographic Study In Urban And Rural Indonesia, Asti Annisa Utami, Fadhaa Aditya Kautsar Murti, Popy Yuniar, Milla Herdayati

Kesmas

Indonesia's goal of achieving Indonesia Emas 2045 hinges on improving Maternal-Child Health (MCH), essential for building a healthy and competitive population. Despite some advancements, the Maternal Mortality Rate (MMR) and Under-five Mortality Rate (U5MR) remain high, particularly because of High-Risk Fertility Behavior (HRFB). The HRFB poses significant risks to MCH, affecting both urban and rural women. This study aimed to identify the factors associated with HRFB in these areas to enhance MCH outcomes and support Indonesia's sustainable health goals. This cross-sectional study used a secondary dataset from the 2017 Indonesian Demographic Health Survey. A total of 20,530 women of reproductive …


An Experimental Investigation Of Federal Messaging On Public Support For Enforcement- And Treatment-Based Approaches For Opioid Overdose Prevention In South Carolina, Lídia Gual-Gonzalez, Hunter M. Boehme, Peter Baker, Melissa Nolan Ph.D., Mph Jul 2025

An Experimental Investigation Of Federal Messaging On Public Support For Enforcement- And Treatment-Based Approaches For Opioid Overdose Prevention In South Carolina, Lídia Gual-Gonzalez, Hunter M. Boehme, Peter Baker, Melissa Nolan Ph.D., Mph

Faculty Publications

Background

As the opioid overdose crisis continues to produce excessive morbidity and mortality in the United States, government agencies have applied various approaches to prevent overdoses, including law-enforcement efforts (e.g., arresting people who use drugs, interrupting drug traffickers, etc.) and treatment-based approaches (e.g., naloxone, medications for opioid use disorder, etc.). Public perception and support of these approaches are relevant for informing policy, allocating resources, and effectively implementing community interventions to prevent drug-related harms.

Methods

Using an embedded informational survey design, we experimentally assessed whether public support for strategies to prevent overdose in South Carolina is influenced by language from federal …


Predicting Sleep And Sleep Stage In Children Using Actigraphy And Heartrate Via A Long Short-Term Memory Deep Learning Algorithm: A Performance Evaluation, Robert Weaver Med, Phd, James White, Olivia Finnegan, Hongpeng Yang, Zifei Zhong, Keagan Kiely, Catherine Jones, Yan Tong, Srihari Nelakuditi, Rahul Ghosal, David E. Brown, Russell R. Pate Ph.D., Gregory J. Welk, Massimiliano De Zambotti, Yuan Wang, Sarah Burkart, Elizabeth L. Adams Phd, Bridget Armstrong, Michael Beets Med, Mph, Phd Jul 2025

Predicting Sleep And Sleep Stage In Children Using Actigraphy And Heartrate Via A Long Short-Term Memory Deep Learning Algorithm: A Performance Evaluation, Robert Weaver Med, Phd, James White, Olivia Finnegan, Hongpeng Yang, Zifei Zhong, Keagan Kiely, Catherine Jones, Yan Tong, Srihari Nelakuditi, Rahul Ghosal, David E. Brown, Russell R. Pate Ph.D., Gregory J. Welk, Massimiliano De Zambotti, Yuan Wang, Sarah Burkart, Elizabeth L. Adams Phd, Bridget Armstrong, Michael Beets Med, Mph, Phd

Faculty Publications

Children's ambulatory sleep is commonly measured via actigraphy. However, traditional actigraphy measured sleep (e.g., Sadeh algorithm) struggles to predict wake (i.e., specificity, values typically < 70) and cannot predict sleep stages. Long short-term memory (LSTM) is a machine learning algorithm that may address these deficiencies. This study evaluated the agreement of LSTM sleep estimates from actigraphy and heartrate (HR) data with polysomnography (PSG). Children (N = 238, 5–12 years,52.8% male, 50% Black 31.9% White) participated in an overnight laboratory polysomnography. Participants were referred be-cause of suspected sleep disruptions. Children wore an ActiGraph GT9X accelerometer and two of three consumer wearables(i.e., Apple Watch Series 7, Fitbit Sense, Garmin Vivoactive 4) on their non-dominant wrist during the polysomnogram. LSTM estimated sleep versus wake and sleep stage (wake, not-REM, REM) using raw actigraphy and HR data for each 30-s epoch. Logistic regression and random forest were also estimated as a benchmark for performance with which to compare the LSTM results. A 10-fold cross-validation technique was employed, and confusion matrices were constructed. Sensitivity and specificity were calculated to assess the agreement between research-grade and consumer wearables with the criterion polysomnography. For sleep versus wake classification, LSTM outperformed logistic regression and random forest with accuracy ranging from 94.1to 95.1, sensitivity ranging from 94.9 to 95.9 across different devices, and specificity ranging from 84.5 to 89.6. The addition of HR improved the prediction of sleep stages but not binary sleep versus wake. LSTM is promising for predicting sleep and sleep staging from actigraphy data, and HR may improve sleep stage prediction.


Functional Time Transformation Model With Applications To Digital Health, Rahul Ghosal Ph.D., Marcos Matabuena, Sujit K. Ghosh Jul 2025

Functional Time Transformation Model With Applications To Digital Health, Rahul Ghosal Ph.D., Marcos Matabuena, Sujit K. Ghosh

Faculty Publications

The advent of wearable and sensor technologies now leads to functional predictors which are intrinsically infinite dimensional. While the existing approaches for functional data and survival outcomes lean on the well-established Cox model, the proportional hazard (PH) assumption might not always be suitable in real-world applications. Motivated by physiological signals encountered in digital medicine, we develop a more general and flexible functional time-transformation model for estimating the conditional survival function with both functional and scalar covariates. A partially functional regression model is used to directly model the survival time on the covariates through an unknown monotone transformation and …


Hypertensive Disorders Of Pregnancy And Perinatal Outcomes: Two Prospective Cohort Studies Of Nulliparous Women In India And Tanzania, Andrea B. Pembe, Pratibha Dwarkanath, Amani Kikula, John Michael Raj, Nandita Perumal Phd, Heavenlight A. Paulo, Rajalakshmi M, Christopher P. Duggan, Honorati M. Masanja, Nandini Chopra, Mary M. Sando, Tinku Thomas, Cara A. Yelverton, Alfa Muhihi, Anura V. Kurpad, Wafaie E. Fawzi, Blair J. Wylie, Christopher R. Sudfeld Jun 2025

Hypertensive Disorders Of Pregnancy And Perinatal Outcomes: Two Prospective Cohort Studies Of Nulliparous Women In India And Tanzania, Andrea B. Pembe, Pratibha Dwarkanath, Amani Kikula, John Michael Raj, Nandita Perumal Phd, Heavenlight A. Paulo, Rajalakshmi M, Christopher P. Duggan, Honorati M. Masanja, Nandini Chopra, Mary M. Sando, Tinku Thomas, Cara A. Yelverton, Alfa Muhihi, Anura V. Kurpad, Wafaie E. Fawzi, Blair J. Wylie, Christopher R. Sudfeld

Faculty Publications

Introduction Hypertensive disorders of pregnancy (HDP) have been linked with increased risk for maternal and offspring complications in high-income settings. However, in resource-limited settings, studies with robust measurement of HDP, including severity and timing, and perinatal outcomes are limited.

Methods We analysed data from two prospective cohorts of nulliparous women in India (n=10 570 pregnancies) and Tanzania (n=10 299 pregnancies) who were enrolled in calcium supplementation trials and had blood pressure and proteinuria assessments throughout pregnancy and at the time of labour and delivery. Generalised estimating equations were used to assess the relationship between HDP severity categories (gestational hypertension, preeclampsia …


Association Between Dietary Inflammatory And Antioxidant Potential And Systemic Inflammatory And Oxidative Status With The Risk And Severity Of Coronary Artery Disease, Zahara Namkhah, Elham Alipoor, Manhnaz Salmani, Negar Ebrahimi, Monireh Ahmadpanahi, Ali Vasheghani-Farahani, Mehdi Yaseri, Michael David Wirth, Longgang Zhao, James Hébert Scd, Javad Hosseinzadeh-Attar Jun 2025

Association Between Dietary Inflammatory And Antioxidant Potential And Systemic Inflammatory And Oxidative Status With The Risk And Severity Of Coronary Artery Disease, Zahara Namkhah, Elham Alipoor, Manhnaz Salmani, Negar Ebrahimi, Monireh Ahmadpanahi, Ali Vasheghani-Farahani, Mehdi Yaseri, Michael David Wirth, Longgang Zhao, James Hébert Scd, Javad Hosseinzadeh-Attar

Faculty Publications

Background and aims

Unhealthy diets have pro-inflammatory properties that have been shown to contribute to coronary artery disease (CAD). The dietary inflammatory index (DII®) and the dietary antioxidant quality score (DAQS) quantify the anti-/pro-inflammatory and antioxidant potential of a diet. This study aims to investigate the association between the energy-adjusted DII (E-DIITM), DAQS, oxidant/anti-oxidant biomarkers, and CAD risk and severity.

Methods and results

This cross-sectional study investigated 158 participants for the presence and severity of CAD based on coronary angiography. E-DII and DAQS scores, malondialdehyde (MDA), total oxidant status (TOS), glutathione peroxidase (GPX) activity, total antioxidant capacity (TAC) and conventional …


Socioeconomic Disparities In Breast Cancer Survival: Examining Potential Mediator Role Of Oncotype Dx(Odx) Test And Stage At Diagnosis Among Hr+/Her2- Breast Cancer Women, Pratibha Shrestha, Qingzhao Yu, Edward S. Peters, Edward Trapido, Mei Chin Hsieh, Tekeda Ferguson, Quyen D. Chu, Xiao Cheng Wu May 2025

Socioeconomic Disparities In Breast Cancer Survival: Examining Potential Mediator Role Of Oncotype Dx(Odx) Test And Stage At Diagnosis Among Hr+/Her2- Breast Cancer Women, Pratibha Shrestha, Qingzhao Yu, Edward S. Peters, Edward Trapido, Mei Chin Hsieh, Tekeda Ferguson, Quyen D. Chu, Xiao Cheng Wu

School of Public Health Faculty Publications

Background: Women with a lower socioeconomic status (SES) have an increased risk of dying from breast cancer (BC) than those with a higher SES. The association of SES with BC survival may be partially mediated by factors such as Oncotype DX (ODX) testing and stage at diagnosis. This study aims to examine SES disparities in survival among HR+/HER2- BC women and to quantify the mediating effects of the ODX test and stage. Methods: We used data from the Louisiana Tumor Registry to identify women aged 20–90 years diagnosed with stage I–II in 2011–2014 and stage I–III in 2015–2017 HR+/HER2- BC …


“Do You Even Lift, Bro?”: Correlates Of Muscle Dysmorphia Symptomatology In Filipino Male University Students, Pamela Paula C. Pioquinto May 2025

“Do You Even Lift, Bro?”: Correlates Of Muscle Dysmorphia Symptomatology In Filipino Male University Students, Pamela Paula C. Pioquinto

UNLV Theses, Dissertations, Professional Papers, and Capstones

Muscle Dysmorphia (MD) is a subtype of Body Dysmorphic Disorder (BDD) and is marked by the desire to increase muscularity and reduce body fat. MD is typically more prevalent among younger male populations, and it often drives comorbid disorders, including substance abuse, eating disorders, and social anxiety. Despite the growing literature on MD, it remains understudied in certain racial/ethnic populations, such as Filipinos. Acculturation, defined as the process in which an individual adopts, acquires, and adapts to a new cultural environment as a result of immigration, influences body image by reshaping an individual’s perceptions of beauty and muscularity standards. Guided …