Epidemiology Commons^™

The Sky’S The Limit: Improving Satellite Imagery Data Literacy To Address Noncommunicable Diseases, M. Courtney Hughes, Elizabeth J. Folkmann

Faculty Articles, Papers, and Other Scholarship

Low-and middle-income countries experience 77% of the world’s premature deaths caused by non- communicable diseases, and their underlying health determinant data are often scarce and inaccurate. Im- proving satellite imagery data literacy worldwide is an integral step toward using the vast amount of publicly available data collected via satellites, such as air pollution, green space and light at night—all determinants of non-communicable diseases. Existing machine learning–based algorithms enable automated analysis of satel- lite imagery data, but health officials and scientists must know where to find and how to apply these algorithms to measure risk and target interventions.

Academic Proficiency In Ugandan Children With Sickle Cell Anemia: A Cross-Sectional Study, Robert Opoka, Shubaya Kasule Naggayi, Paul Bangirana, Simple Ouma, Betty Nyangoma, Annet Birabwa, Grace Nambatya, Maxencia Kabatabaazi, Ann Jacqueline Nakitende, Dennis Kalibbala

Paediatrics and Child Health, East Africa

Introduction: Academic proficiency is crucial for advancing learning goals, school advancement, and future economic security. Children with sickle cell anemia (SCA) in sub-Saharan Africa (SSA) may be at risk of disease-associated learning difficulties. Limited data exist on this topic among school-age children in the region. We aimed to assess academic proficiency in a sample of children with SCA in Uganda compared with unaffected controls.

Methods: This cross-sectional study was conducted in Kampala, Uganda. Participants were school-going children with SCA, aged 6–12 years, attending Mulago Hospital SCA Clinic, and age-matched sibling controls without SCA. Academic proficiency was assessed by the Wide …

Temporal Network Analysis Of Comorbidities Among People With Hiv In South Carolina, Yunqing Ma, Matthew Lohman Ph.D., Monique J. Brown Ph.D., Mph, Yichen Li, Xiaoming Li Ph.D., Bankole Olatosi Ph.D., Jiajia Zhang Ph.D.

Faculty Publications

Introduction: People with HIV experience a high rate of comorbidities that can complicate their health outcomes. Understanding the prevalence, interrelationships and temporal development of these comorbidities is crucial for improving health management and quality of life for people with HIV. Methods: We used a population-based cohort extracted from statewide electronic health record (EHR) data in South Carolina (SC), including 18 649 people with HIV who survived at least 1 year after HIV diagnosis between January 1, 2005, and December 31, 2020. Comorbidities and organ systems were classified using ICD-10 codes. Network analysis was performed to assess the closeness centrality among …

High-Resolution Geospatial Database: National Criteria-Air-Pollutant Concentrations In The Contiguous U.S., 2016–2020, Tianjun Lu, Sun-Young Kim, Julian D. Marshall

Epidemiology and Environmental Health Faculty Publications

Concentration estimates for ambient air pollution are used widely in fields such as environmental epidemiology, health impact assessment, urban planning, environmental equity and sustainability. This study builds on previous efforts by developing an updated high-resolution geospatial database of population-weighted annual-average concentrations for six criteria air pollutants (PM_2.5, PM₁₀, CO, NO₂, SO₂, O₃) across the contiguous U.S. during a five-year period (2016–2020). We developed Land Use Regression (LUR) models within a partial-least-squares–universal kriging framework by incorporating several land use, geospatial and satellite–based predictor variables. The LUR models were validated using conventional …

Delayed And Misdiagnosed Endometriosis, Teresa Doyle

Nursing | Senior Theses

Aim: This research investigates whether targeted education can improve the early diagnosis of endometriosis, a chronic condition affecting around 10% of women of reproductive age. Unfortunately, endometriosis is often misdiagnosed, delaying treatment, prolonging discomfort, and lowering quality of life. Healthcare practitioners' knowledge gap is addressed by this study, which examines whether organized training promotes awareness and diagnostic accuracy. This research proposal evaluates an educational intervention developed to improve gynecological experts' knowledge and diagnostic skills. The main research issue is whether the intervention reduces misdiagnosis and improves patient outcomes. A quasi-experimental design will examine participants' knowledge and diagnosis accuracy before and …

Investigating The Impact Of Phthalate Exposures From Personal Care Products On Uterine Fibroid Incidence And Prevalence In Us-Born Black Women, Ella Brissett

CMC Senior Theses

Uterine fibroids are benign tumors composed of smooth muscle cells and connective tissue that develop within or on the walls of the uterus. Despite being non-cancerous, they can severely affect quality of life by causing heavy bleeding, chronic pain, and reproductive complications. Fibroids are typically found in women of reproductive age, but they disproportionately affect Black women, who experience higher incidence and severity. The underlying causes of this disparity is poorly understood; however, an emerging body of research is highlighting the role of phthalates, endocrine-disrupting chemicals found in many personal care products, in exacerbating fibroid development. Through a critical analysis …

Occupational Exposure To Combustion By-Products And Breast Cancer Risk In Postmenopausal Women, Kahlila Paul-Cole, France Labrèche, Mark S. Goldberg, Sydney Westra, Vikki Ho

Études primaires

Objective

To estimate the association between lifetime occupational exposure to select combustion by-products and postmenopausal breast cancer (BC) risk.

Materials and Methods

Data from a population-based case-control study among postmenopausal women residing in Montréal, Quebec were used. Cases included 661 women aged between 47 and 75 yr, diagnosed with incident malignant BC between 2008 and 2011. Controls comprised 587 women randomly selected from the Quebec Electoral List, frequency-matched to cases by 5-year age groups. Information on risk factors and lifetime occupational histories was collected by interview. Two industrial hygienists used job histories to assign exposure to 293 agents, including 6 …

Blood Biomarkers In Down Syndrome: Facilitating Alzheimer’S Disease Detection And Monitoring, Melissa E. Petersen, Lisi Flores-Aguilar, Elizabeth Head, Laia Montoliu-Gaya, Andre Strydom, Sarah E. Pape, Juan Fortea, Nicholas J. Ashton, Chinedu Udeh-Momoh, Sid E. O’Bryant, Dwight German, Florin Despa, Mark Mapstone, Henrik Zetterberg

Neurology Faculty Publications

Blood-based biomarkers continue to be explored for disease detection, monitoring of progression, and therapeutic outcomes as the diagnostic determination of Alzheimer’s Disease in Down Syndrome (DS-AD) remains challenging in clinical settings. This perspective highlights the current status of this effort. Overall, amyloid (A), tau (T), and neurodegeneration (AT[N]) blood-based biomarkers have been shown to increase with disease pathology for individuals with DS. Phosphorylated tau biomarkers (p-tau217, p-tau181) have been consistently shown to track disease progression for DS-AD and are likely good candidates for use in clinical settings. Biomarkers of inflammation (glial fibrillary acidic protein) also show promise; however, additional work …

Bones And Brains: The Association Between Osteoporosis And Depression, Mason Taylor

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

Introduction: Osteoporosis and depression are two public health problems that are increasing in prevalence. Previous studies have found a positive association between the two variables in women and men and women together, but there is a gap when looking at men. Therefore, it was important to investigate the odds of depression in men, women, and men and women together to make comparisons by sex.

Methods: 1,602 participants aged 65 and older were included in the study from the National Health and Nutrition Examination Survey (NHANES) 2017 – March 2020 Pre-Pandemic dataset. One unadjusted and seven adjusted models were created for …

How Sleep Disorders And Sleep Duration Impact Memory, Alexandria J. Sims

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

INTRODUCTION: Sleep duration and sleep disorders can cause changes in memory function as populations age. Previous studies have shown that disordered sleep is associated with increased risk of cognitive dysfunction and long and short sleep durations can cause memory impairment. This study studies aims to find if there is an association between sleep disorders and sleep duration and the impacts on memory.

METHODS: In this study, 3,478 participants aged 60 year and older from the National Health and Nutrition Examination Survey (NHANES) 2013-2014 dataset were included in adjusted and unadjusted models, comparing the sleep disorders and sleep duration exposures to …

Environmental And Behavioral Determinants Of Congenital Defects: An Ecologic Study In Kentucky, Amelia G. Floyd

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

Congenital defects are a significant contributor to infant morbidity and mortality. The multifactorial etiology of such defects presents complex challenges for public health. This ecologic study investigates the association between environmental and behavioral exposures and congenital defects rates at the county level in Kentucky from 2010 to 2019. The Kentucky Department for Public Health, Office of Vital Statistics, provided all relevant defect data. County-level exposure data was collected from multiple sources.

Descriptive and geospatial analyses revealed substantial geographic variability, with notable high defect rates in northeastern Kentucky. Negative binomial regression models identified behavioral and socioeconomic factors to be the strongest …

Epidemiology Of Recurrent Herpes Labialis Among Dentistry Students: A Cross-Sectional Survey In Egypt, Sara Abdelwahed, Dalia Ghalwash, Al Hassan Diab

Dentistry

Aim: Recurrent herpes labialis (RHL) is a common viral infection with significant psychosocial and clinical implications. Dental students are particularly vulnerable due to stress and frequent patient contact, yet data on their epidemiology in Egyptian cohorts are scarce. The study aimed to determine the prevalence, recurrence patterns, and associated risk factors of RHL among dentistry students in Egypt. Materials and Methods: A cross-sectional survey was conducted among 559 dentistry students at the British University in Egypt. A structured, self-administered questionnaire captured sociodemographic data, history of RHL episodes, frequency, severity, and triggering factors. Data were analyzed using descriptive statistics and Chi-square …

Clostridioides Difficile Infection Study Models And Prospectives For Probing The Microbe-Host Interface, Tatiana Zvonareva, David S. Courson, Erin B. Purcell

Chemistry & Biochemistry Faculty Publications

Clostridioides difficile infection (CDI) is an urgent public health threat with a high rate of recurrence and limited treatment options. In vivo models have been indispensable in understanding CDI pathophysiology and establishing treatment protocols and continue to be essential in pre-clinal testing. More importantly, in vivo models offer the opportunity to probe the complex systemic host response to the microbe, which is impossible to recapitulate in vitro. Nonetheless, constraints related to the availability of animal models, cost, ethical considerations, and regulatory control limit their accessibility for basic research. Furthermore, physiological and habitual divergences between animal models and humans often result …

Rwanda's Natural Remedies: A Fresh Look At The Fight Against Malaria, Leandre Nsabimana Ndisanze

Pomona Senior Theses

Malaria remains one of the most devastating parasitic diseases globally, disproportionately affecting sub-Saharan Africa, where Rwanda continues to face high transmission rates and rising resistance to conventional interventions. Despite decades of control efforts, the emergence of drug-resistant Plasmodium falciparum and insecticide-resistant Anopheles mosquitoes threatens to reverse recent gains. This research responds to the urgent need for sustainable and culturally relevant alternatives by exploring the therapeutic potential of Rwandan traditional medicinal plants. These indigenous remedies, long used by local healers, offer an underexplored reservoir of bioactive compounds that may provide the basis for novel antimalarial drugs.

The central hypothesis of this …

Patterns Of Exclusive, Dual And Poly Tobacco Products Use Among Cancer Survivors In The United States, Ateeqa Ijaz, Miranda E. Gehris, Paul T. Harrell, Aditya Chakraborty, Rime Jebai, Wei Li, Olatokunbo Osibogun, Seyedeh Yasaman Alemohammad, Ziyad Ben Taleb, Ebbie Kalan

Department of Pediatrics Faculty Publications

Purpose

Identifying tobacco products use (TPU) patterns among cancer survivors (CSs) is critical to optimize survivorship care. This study examines exclusive cigarette/e-cigarette, dual (two tobacco-products) and poly (≥ 3 tobacco-products) use among CSs (vs. no cancer history) and its sub-types: smoking-related-cancers (SRCs) vs. non-smoking-related cancers (NSRCs) while also exploring socio-demographic factors.

Methods

The study analyzed 86,551 adults from the 2021–2023 National Health Interview Survey, including 10,846 (9.7%) CSs. Participants were categorized and analyzed based on their CSs status and TPU patterns. Weighted logistic regression models assessed the relationship between TPU and CSs status while adjusting for socio-demographic characteristics.

Results

CSs …

Assessment Of Primary Malignancy Risk Following Initiation Of Biologic Therapy In Psoriasis Patients, Chunghwan Ro, Ana Ormaza Vera, Waleed Adawi, Alexander Yap, Clinton W. Enos

Department Dermatology Faculty Publications

Limited evidence exists regarding the long-term oncologic safety of biologic therapies, particularly interleukin (IL)-17 inhibitors (IL-17i) and IL-23i, in the management of psoriasis. This propensity-score-matched retrospective-cohort study assessed the risk of developing a primary malignancy within 10-years following exposure to an FDA-approved biologic among psoriasis patients compared to biologic-naïve controls. After propensity-score-matching, 32,230 biologic-exposed patients were further grouped into cohorts of tumor necrosis factor inhibitors (TNFi, n=16,011), IL-23i (n=5,604), IL-12/23i (n=3,856), and IL-17i (n=5,467). During a 10-year period, TNFi-treated patients had a reduced risk of developing any primary malignancy compared to biologic-naïve psoriasis patients [HR 0.80(0.73-0.87)]. Similarly, a lower incidence …

Changes In Cancer Diagnosis And Survival In The United States During The Covid-19 Pandemic, Justin T. Burus

Theses and Dissertations--Epidemiology and Biostatistics

The COVID-19 Pandemic led to global societal disruptions as political leaders and public health authorities attempted to control the spread of the newly discovered SARS- CoV-2 virus. While these measures were designed to lessen morbidity and mortality from a novel pathogen, their impact was also felt in many other, often unintended ways. The purpose of this dissertation is to use cancer surveillance research methods to examine the association between COVID-19 Pandemic-related disruptions and changes in the normal diagnosis and care of cancer in the United States.

The first two studies of this dissertation analyzed reductions in cancer diagnoses in the …

Enhancing Public Health Surveillance: Development And Validation Of Machine Learning Models For Suspected Opioid Overdose Detection In Emergency Medical Services Data, Peter J. Rock

Theses and Dissertations--Clinical and Translational Science

The ongoing opioid overdose crisis in the United States requires timely and accurate surveillance systems to inform public health responses. Traditional public health surveillance methods rely on hospital discharge data and death certificates, which suffer from significant reporting delays and miss cases where patients refuse hospital transportation. Emergency Medical Services (EMS) data presents a promising alternative with advantages in timeliness and case ascertainment but lacks validated definitions for suspected opioid overdose (SOO).

This dissertation addresses this critical gap through the development, validation, and fairness assessment of machine learning models with natural language processing (ML-NLP) for identifying SOOs in EMS data. …

Gambaran Putus Obat Berdasarkan Sosial-Demografi Pada Penderita Tuberkulosis Di Indonesia Tahun 2023: Cross-Sectional Study, Anindya Oktaria Yudhanti, Arina Syahida Hurva Radisan Saf, Benita Riska, Enita Fransiska Tamba

Jurnal Epidemiologi Kesehatan Indonesia

Introduction: Tuberculosis is an infectious disease that spreads through the air. Based on data at the international and national levels, there has been an increase. Most pulmonary TB patients are cured with consecutive antibiotic treatment for 6-9 months, but there are still patients who eventually drop out of treatment. This could be a challenge in achieving the international tuberculosis elimination target of 2035 and the national target of 2030. Methods: This study analyzed the socio-demographic distribution and dropout analysis of Tuberculosis patients in Indonesia in 2023 based on SKI data with a cross-sectional study type. Results: The incidence of drug …

Real-World Clinical And Cost Effectiveness Of Osteoporotic Treatments In Men, Yu Ren

Open Access Dissertations

Osteoporosis is a condition characterized by the loss of bone mass, which increases the risk of fractures. In 2017-2018, the age-adjusted prevalence of osteoporosis among adults aged 50 and over was 12.6%, with 19.6% in women and 4.4% in men. Untreated osteoporosis can lead to a cycle of recurrent fractures that severely impact quality of life and place significant emotional, physical, and financial strain on patients, families, and healthcare resources. Approximately 50% of women and 20% of men will experience at least one fracture in their lifetime. In the United States, an estimated 1.5 million osteoporotic fractures occur each year, …