Biostatistics Commons^™

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

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 …

The Inflammatory Potential Of Diet In Adults With Knee Osteoarthritis: Sex-Specific Associations With Quality Of Life, Sleep, Fatigue And Mental Health, Lynette Law, Joshua J. Heerey, Brooke L. Devlin, Peter Brukner, Alysha M. De Livera, James Hébert Scd, Sherry Price, Nathan P. White, Adam G. Culvenor

Faculty Publications

Background:

Knee osteoarthritis (OA) is a disabling condition—characterized by pain, stiffness, and impaired quality of life—that affects more females than males. Chronic systemic inflammation is a key feature of knee OA and can be modulated by diet. We evaluated the sex-specific relationship between the inflammatory potential of diet and health-related quality of life (HRQOL), sleep quality, energy and fatigue levels, and psychological distress in individuals with knee OA.

Methods:

This cross-sectional study analyzed baseline data from 144 participants (64% female) aged 45–85 years with symptomatic knee OA enrolled in the FEAST (eFEct of an Anti-inflammatory diet for knee oSTeoarthritis) randomized …

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 Ph.D., Jiajia Zhang Ph.D., Ruilie Cai, Buwei He, Xueying Yang, Chen Liang, Sharon Weissman, Xiaoming Li

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 …

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; ( …

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 …

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 …

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

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.

Approaches To Enhancing Multiple Hypothesis Testing Methods With Side-Information, Siyu Zheng

Theses and Dissertations

Lesion-symptom mapping (LSM) studies offer insight into the brain areas involved in various aspects of cognition. This is commonly done via behavioral testing in patients with a naturally occurring brain injury or lesions (e.g., strokes or brain tumors). This results in high-dimensional observational data where lesion status (present/absent) is non-uniformly distributed, with some voxels having lesions in very few (or no) subjects. In this situation, mass univariate hypothesis tests have severe power heterogeneity where many tests are known a priori to have little to no power. Additionally, high-dimensional observational data can be grouped according to brain anatomical structure.

In this …

A Spatial Scan Statistic For Group Testing Data, Vincent Onyame

Theses and Dissertations

Group testing involves pooling specimens from multiple individuals and offers an efficient means to surveil low-prevalence pathogens, but poses challenges for spatial cluster detection when only pooled results are observed. In this thesis, we develop a spatial scan statistic tailored to group-testing data with variable pool sizes. The statistic compares a null hypothesis of a homogeneous infection rate across all clusters to an alternative hypothesis that infection probabilities differ inside and outside a candidate cluster, with both models fitted by maximum likelihood estimation. We approximate the null distribution of the maximum likelihood ratio test via Monte Carlo simulation.

Through a …

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

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

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 …

Sexually Transmitted Infection (Sti) Incidence And Risk Factors Among People With Hiv (Pwh): Insights From A 13-Year Cohort Study In South Carolina, Salome-Joelle Gass, Shujie Chen, Jiajia Zhang Ph.D., Bankole Olatosi

Faculty Publications

The Ending the HIV Epidemic (EHE) initiative aims to reduce new HIV infections by 90% by 2030 in the United States (US). However, rising sexually transmitted infection (STI) rates exacerbate the bidirectional infection risk between HIV and STIs. Most research on STIs among people with HIV (PWH) has focused on high-risk groups, resulting in limited data on broader populations. This study addresses that gap by examining the incidence and risk factors for gonorrhea, chlamydia, and syphilis in a statewide cohort of PWH in South Carolina. Data from South Carolina’s HIV and STI surveillance systems were linked, and all PWH aged …

Environmental Risk And Alpha-Gal Syndrome (Ags) In The Mid-Atlantic United States, Brandon D. Hollingsworth Ph.D., Margaret Wiener, Dana A. Giandimenico, Scott P. Commins, Ross M. Boyce

Faculty Publications

Alpha-gal syndrome (AGS), commonly referred to as the tick bite red meat allergy, has been reported worldwide with the number of suspected cases in the United States increasing from 24 in 2009 to over 34,000 in 2019. Within the US, AGS is associated with the bite of two tick species, Amblyomma americanum and Ixodes scapularis, and has particularly high incidence rates in the mid-Atlantic region. Because AGS is associated with tick bites, the risk of developing AGS is affected by the environment individuals visit. Despite this, as well as the numerous studies associating the environment with Am. americanum, …

Human Capital And Lifetime Income Gains Of Scaling-Up Small-Quantity Lipid Nutrient Supplements Among Children Under 2 Years: A Modelling Analysis, Nandita Perumal Phd, Goodrarz Danaei, Günther Fink, Mark Lambiris, Christopher R. Sudfeld

Faculty Publications

Undernutrition in early childhood is associated with adverse health and developmental outcomes later in life and remains a persistent global public health problem. Providing small-quantity lipid nutrient supplements (SQ-LNS) to children aged 6-24 months improves child growth and neurodevelopmental outcomes, but the potential long-term benefits to human capital have not been previously estimated. We estimated the potential returns to schooling and lifetime income attributable to increasing coverage of SQ-LNS for children < 2 years of age from 0% to 50% or 90% per five-year birth cohort in five countries (Bangladesh, Burkina Faso, Ethiopia, Pakistan, and Uganda) with a high burden of undernutrition. Random-effects meta-analyses were used to estimate the effect of SQ-LNS on child development using evidence from randomized controlled trials, and to estimate the returns to lifetime income as a function of change in development based on a de novo meta-analysis of observational economic studies. Gains in school years attributable to scaling-up SQ-LNS to 90% coverage ranged from 0.14 million school years (95% uncertainty interval [UI]: 0.064, …

Validating A Bayesian Spatio-Temporal Model To Predict La Crosse Virus Human Incidence In The Appalachian Mountain Region, Usa, Maggie Mccarter, Stella Coker Watson Self Ph.D., Ms, Huixuan Li, Joseph A. Ewing, Lídia Gual-Gonzalez, Mufaro Kanyangarara, Melissa Nolan Ph.D., Mph

Faculty Publications

La Crosse virus (LACV) is a rare cause of pediatric encephalitis, yet identifying and mitigating transmission foci is critical to detecting additional cases. Neurologic disease disproportionately occurs among children, and survivors often experience substantial, life-altering chronic disability. Despite its severe clinical impact, public health resources to detect and mitigate transmission are lacking. This study aimed to design a Bayesian modelling approach to effectively identify and predict LACV incidence for geospatially informed public health interventions. A Bayesian negative binomial spatio-temporal regression model best fit the data and demonstrated high accuracy. Nine variables were statistically significant in predicting LACV incidence for the …

Racial And Ethnic Inequalities In Actual Vs Nearest Delivery Hospitals, Nansi S. Boghossian, Lucy T. Greenberg, Jeffrey S. Buzas, Joshua Radack, Molly Passarella, Jeannette Rogowski, George R. Saade, Ciaran S. Phibbs, Scott A. Lorch

Faculty Publications

IMPORTANCE Minoritized racial and ethnic groups, such as American Indian and Black individuals, often receive lower quality health care compared with White individuals. There is limited understanding of how these disparities extend to obstetric care, particularly when comparing the quality of care at the actual delivery hospital vs the nearest obstetric hospital based on the birthing individual’s residence. OBJECTIVE To examine inequality in care based on the actual delivery hospital and the closest delivery hospital to the birthing individual’s residential zip code centroid. DESIGN, SETTING, AND PARTICIPANTS This population-based retrospective cohort study used data from 5 states (2008 to 2020 …

Comparative Assessment Of The Impacts Of Wildland–Urban Interface Fire Ash On Growth Of The Diatom Thalassiosira Weissflogii, Talal Alshehri, Amar Yasser Jassim, Bo Cai Ph.D., Tammi L. Richardson, Mohammed Baalousha M.Sc, Ph.D.

Faculty Publications

Fires at the wildland–urban interface (WUI) result in the release of ash into the atmosphere that can be transported for long distances and deposited on land and in oceans. Wildfire ash has the potential to increase phytoplankton biomass in the open ocean by providing both major nutrients and trace metals. However, fires that originate at the WUI contain potentially toxic concentrations of metals such as Ti, Cr, Cu, Pb, and Zn, especially in coastal oceans close to WUI fires, where ash deposition rates are high. Here, we investigated the impact of fire ash from different sources originating from vegetation, structures, …

Pre-Exposure Prophylaxis Uptake Among Black/African American Men Who Have Sex With Other Men In Midwestern, United States: A Systematic Review, Oluwafemi Adeagbo, Oluwaseun Abdulganiyu Badru, Prince Addo, Amber Hawkins, Monique J. Brown Ph.D., Mph, Xiaoming Li, Rima Afifi

Faculty Publications

Introduction: Black/African American men who have sex with other men (BMSM) are disproportionately affected by HIV, experience significant disparities in HIV incidence, and face significant barriers to accessing HIV treatment and care services, including pre-exposure prophylaxis (PrEP). Despite evidence of individual and structural barriers to PrEP use in the Midwest, no review has synthesized this finding to have a holistic view of PrEP uptake and barriers. This review examines patterns of, barriers to, and facilitators of PrEP uptake among BMSM in the Midwest, United States (US).

Methods: Five databases (CINAHL Plus, PUBMED, PsycINFO, SCOPUS, and Web of Science) were searched …

Geographic Disparities In Unpaid Caregiving, Emma Kathryn Boswell, Monique J. Brown Ph.D., Mph, Lorie Donelle Phd, Rn, Fcan, Nicholas Yell, Taryn Farrell, Peiyin Hung Ph.D., Elizabeth Crouch Ph.D.

Faculty Publications

Purpose: An updated, nationally representative examination of rural–urban differences in the experiences, health, and well-being of caregivers is needed; previous research on this topic uses older data or has limited generalizability. This study examines rural–urban differences in the characteristics, experiences, and health of caregivers. Methods: The 2021–2022 Behavioral Risk Factor Surveillance System (n = 44,274 unpaid caregivers) was used, with rurality defined according to the 2013 National Center for Health Statistics (NCHS) Urban-Rural Classification Scheme. Chi-square tests compared rural–urban differences in these caregivers’ characteristics, including demographic factors, caregiving intensity (e.g., weekly hours spent caregiving, reason for caregiving, past-month ADL/IADL assistance), …

Modifiable And Non-Modifiable Risk Factors For Dementia Among Non-Hispanic White And Black Populations Aged 50-64 In The United States, 2006-2016, Jingkai Wei, Matthew C. Lohman Ph.D., Monique J. Brown, James W. Hardin, Chih-Hsiang Yang, Anwar T. Nerchant, Daniela B. Friedman

Faculty Publications

Background and Objectives

Research Design and Methods

Adverse Childhood Experiences, Resilience, And Syringe Services Program Attendance Among Persons Who Inject Drugs In Northeast Georgia, Usa: A Mediation Analysis, Mohammad Rifat Haider, Samantha Clinton, Monique J. Brown, Nathan B. Hansen

Faculty Publications

Background: Syringe services programs (SSP) are evidence-based venues offering harm reduction services to persons who inject drugs (PWID), such as sterile syringes, STI/HIV testing, and linkage to care to decrease drug use-related morbidities and mortalities. Adverse childhood experiences (ACEs) have been linked with reduced resilience, while increased resilience can help PWID attend SSPs. This study examined the potential mediating role of resilience between ACEs and SSP attendance among PWID.

Methods: Data were collected from adult HIV-negative PWID in northeast Georgia, between February-December 2023 (N = 173). Data were collected on SSP attendance (Yes vs. No), resilience, and ACEs. Covariates included …

Burden Of Cardiometabolic Diseases And Depression In A Low-Income, Urban Community In Pakistan: A Cross-Sectional Survey, Unab I. Khan, Sabeen Shah, Asra Qureshi, Shankar Viswanathan, Anwar T. Nerchant, Salim S. Virani, Judith Wylie-Rosett, Yasmeen Noornabi

Faculty Publications

Background

With the rising epidemic of cardiometabolic diseases (CMDs) in low- and middle-income countries, urban populations face unique challenges such as poor sanitation, environmental pollution, and limited access to healthcare. This study estimates the point prevalence of CMDs and associated risk factors in adults in Karachi, analyses CMD prevalence by sex, and explores the relationship between CMDs and depression.

Methods

A door-to-door survey was conducted in a densely populated urban community within a 0.5 km radius of a primary health centre. A minimum of 1,480 families were required to estimate the prevalence of CMDs. Depression was screened using PHQ-2 and …

Childhood Sexual Trauma, Substance Use, And Antiretroviral Therapy Adherence Among Older Adults Living With Hiv: A Mediational Analysis, Monique J. Brown, Josie Zhang, Prince Nii Ossah Addo, Amandeep Kaur, Daniel Amoatika, Elizabeth L. Crouch Ph.D., Steven A. Cohen

Faculty Publications

Childhood sexual abuse (CSA) is linked to substance use and lower antiretroviral therapy (ART) adherence. However, studies examining the mediational role of substance use between CSA and ART adherence are lacking. Therefore, the aim of this study was to determine the potential mediational role of substance use between CSA and ART adherence among older adults living with HIV (OALH) (n = 91). Mediation analyses assessed the direct and indirect relationships between CSA, substance use, and ART adherence. Statistically significant differences existed in substance use by gender (male vs. female: 12.3 vs. 9.97) and ART adherence by race (Black vs. …

Distribution And Correlates Of Long-Acting Injectable Antipsychotic Use Among Community Mental Health Center Patients, Matthew C. Lohman Ph.D., Victoria Scott, Mansi Verma, Paige Jones, Eve Fields

Faculty Publications

Although long-acting injectable antipsychotics (LAIs) are an important pharmaceutical option in the management of schizophrenia and related disorders, little is known about patient characteristics related to LAI use in real-world outpatient settings. We analyzed electronic medical records from 41,401 patients who received psychiatric services from one of 16 regional mental health centers operated by the South Carolina Department of Mental Health in 2022. We compared the use of first- and second-generation LAIs and oral antipsychotics by sociodemographic (age, gender, race/ethnicity, zip code, payment source) and clinical characteristics (psychiatric diagnoses, service use). We used logistic regression models to estimate associations between …

An Investigation Of Travel Distance And Timeliness Of Breast Cancer Treatment Among A Diverse Cohort In The United States, Swann Arp Adams, Oluwole Adeyemi Babatunde, Whitney Zahnd, Peiyin Hung, Karen E. Wickersham, Nathaniel Bell Ph.D., Jan M. Eberth Ph.D.

Publications

Travel to and from distant cancer treatment facilities can place a significant burden on cancer patients, particularly rural and minority survivors. Thus, the purpose of our investigation was to examine the association between patient travel distance and delays in types of treatment for breast cancer (surgery, radiation, chemotherapy, and hormonal therapy) and treatment delays. Using a novel linkage between the state cancer registry and administrative data from Medicaid and a private insurance plan, 2155 BC patients were successfully linked to create the cohort. ArcGIS was used to geocode all case residences and treatment facility addresses and calculate network distance between …

Sleep Duration, Dietary Inflammatory Potential, And Obesity In Relation To Colorectal Cancer Incidence In The Multiethnic Cohort, Penias Tembo, Longgang Zhao, Loïc Le Marchan, Lynne R. Wilkens, Song-Yi Park, Christopher A. Haiman, Michael David Wirth Msph, Phd, Face, James R. Hébert Scd

Faculty Publications

Background/Objectives: Colorectal cancer (CRC) is a leading cause of cancer-related morbidity and mortality worldwide. Sleep duration, diet, and obesity have each been identified as modifiable risk factors linked to CRC. However, their joint effect on CRC incidence is underexplored. This study investigated the association between sleep duration and CRC incidence and explored the joint effects of sleep duration, a pro-inflammatory diet, and obesity on CRC incidence in the Multiethnic Cohort (MEC). Methods: This prospective cohort study analyzed 193,027 participants from Hawaii and California enrolled in the MEC between 1993 and 1996. Sleep duration was self-reported and categorized as short (≤6 …

Associations Between Social Determinants Of Health And Mental Health Disorders Among U.S. Population: A Cross-Sectional Study, S. Tanarsuwongkul

Faculty Publications

Aims

The impact of social determinants of health (SDOH) on mental health is increasingly realized. A comprehensive study examining the associations of SDOH with mental health disorders has yet to be accomplished. This study evaluated the associations between five domains of SDOH and the SDOH summary score and mental health disorders in the United States.

Methods

We analyzed data from a diverse group of participants enrolled in the All of Us research programme, a research programme to gather data from one million people living in the United States, in a cross-sectional design. The primary exposure was SDOH based on Healthy …