Epidemiology Commons^™

A Genome-Wide Association Study Identifies Genetic Determinants Of Hemoglobin Glycation Index With Implications Across Sex And Ethnicity, John S. House, Joseph H. Breeyear, Farida S. Akhtari, Violet Evans, John B. Buse, James Hempe, Alessandro Doria, Josyf C. Mychaleckyi, Vivian Fonseca, Mengyao Shi, Changwei Li, Shuqian Liu, Tanika N. Kelly, Daniel Rotroff, Alison A. Motsinger-Reif

School of Medicine Faculty Publications

Introduction: We investigated the genetic determinants of variation in the hemoglobin glycation index (HGI), an emerging biomarker for the risk of diabetes complications. Methods: We conducted a genome-wide association study (GWAS) for HGI in the Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial (N = 7,913) using linear regression and additive genotype encoding on variants with minor allele frequency greater than 3%. We conducted replication analyses of top findings in the Atherosclerosis Risk in Communities (ARIC) study with inverse variance-weighted meta-analysis. We followed up with stratified GWAS analyses by sex and self-reported race. Results: In ACCORD, we identified single …

Aromatase, Testosterone, Tmprss2: Determinants Of Covid-19 Severity, Eric C Mohan, Jude P J Savarraj, Gabriela D Colpo, Diego Morales, Carson E Finger, Alexis Mcalister, Hilda Ahnstedt, Huimahn Choi, Louise D Mccullough, Bharti Manwani

Faculty, Staff and Student Publications

Background: Male sex has been identified as a risk factor for worse COVID-19 outcomes. This sex difference has been mostly attributed to the complex role of sex hormones. Cell surface entry of SARS-CoV-2 is mediated by the transmembrane protease serine 2 (TMPRSS2) which is under transcriptional regulation by androgens. P450 aromatase enzyme converts androgens to estrogens. This study measured concentrations of aromatase enzyme, testosterone, estradiol, and TMPRSS-2 in plasma of hospitalized COVID-19 patients to elucidate the dynamics of sex-linked disparity in COVID-19 and correlate them with disease severity and mortality.

Methods: In this prospective cohort study, a total of 265 …

Micrornas Are Enriched At Covid-19 Genomic Risk Regions, And Their Blood Levels Correlate With The Covid-19 Prognosis Of Cancer Patients Infected By Sars-Cov-2, Simone Anfossi, Faezeh Darbaniyan, Joseph Quinlan, Steliana Calin, Masayoshi Shimizu, Meng Chen, Paola Rausseo, Michael Winters, Elena Bogatenkova, Kim-Anh Do, Ivan Martinez, Ziyi Li, Loredana Antal, Tudor Rares Olariu, Ignacio Wistuba, George A Calin

Faculty, Staff and Student Publications

Background: Cancer patients are more susceptible to an aggressive course of COVID-19. Developing biomarkers identifying cancer patients at high risk of COVID-19-related death could help determine who needs early clinical intervention. The miRNAs hosted in the genomic regions associated with the risk of aggressive COVID-19 could represent potential biomarkers for clinical outcomes.

Patients and methods: Plasma samples were collected at The University of Texas MD Anderson Cancer Center from cancer patients (N = 128) affected by COVID-19. Serum samples were collected from vaccinated healthy individuals (n = 23) at the Municipal Clinical Emergency Teaching Hospital in Timisoara, Romania. An in …

Marijuana Legalization And Opioid Use Disorder In Ontario, Canada, From 2015 To 2021, Luke Ome Agada

Walden Dissertations and Doctoral Studies

This study examined the trends in opioid-related hospitalizations and deaths in Ontario, Canada, from 2015, to 2021, with a particular focus on the periods before and after cannabis legalization. The social problem addressed was the ongoing opioid crisis, exacerbated by rising opioid-related health issues. Grounded in the harm reduction theory, this research explored whether cannabis legalization could serve as a substitute to mitigate opioid use disorder. Data were extracted from the Discharge Database, Emergency Department Database, National Ambulatory Care Reporting System, and Hospital Morbidity Database. Analysis using the generalized estimation equation (GEE) method revealed a significant increase in opioid-related hospitalizations, …

Examining The Relationship Between Employment And Health Status Among Adults With Autism Spectrum Disorder (Asd) In The United States, Winifred Beckles

Walden Dissertations and Doctoral Studies

Autism spectrum disorder (ASD), characterized by challenges in social communication and repetitive behaviors, is a developmental disability that impacts over five million adults in the United States. Despite the significant amount of research literature on the association between health and employment in the general population, there remains a gap in research on the relationship between health and employment in adults with autism. Utilizing the Social Ecological Model (SEM) framework, this study examined whether there is a relationship between employment, current living status, non-paid activities, United States Census regions, type of health insurance, and health status when controlling for age, race, …

Access To Waitlisting And Posttransplant Outcomes In Patients With Failed Kidney Allografts Secondary To Recurrent Glomerulonephritis, Ryan Gately, Germaine Wong, Armando Teixeira-Pinto, Helen Pilmore, Carmel Hawley, Scott Campbell, William Mulley, Wai H. Lim

Research outputs 2022 to 2026

Background. Recurrent glomerulonephritis (GN) is an important cause of allograft loss after transplantation when GN is the primary cause of kidney failure. Retransplantation after allograft loss from recurrent disease requires careful consideration. We aimed to determine the probability of relisting and the risk of allograft loss after retransplantation in recipients with prior allograft loss from recurrent GN. Methods. Using data from the Australia and New Zealand Dialysis and Transplant Registry and multivariable Cox modeling, we compared the probability of waitlisting and allograft loss after second transplantation between those with and without prior allograft loss from recurrent disease. Results. Of 3276 …

Exploring The Association Between Parenting Stress And A Child’S Exposure To Positive Childhood Experiences (Pces), Elizabeth Crouch Ph.D., Elizabeth Radcliff, Monique J. Brown Ph.D., Mph, Peiyin Hung Ph.D

Faculty Publications

High levels of parenting stress, defined as a caregiver or parent feeling stress or aggravation from parenting, has been previously shown to be associated with an increased likelihood of neglect, child maltreatment, and household dysfunction: adverse childhood experiences (ACEs). Despite the potential mitigation of positive childhood experiences (PCEs) on ACEs, prior studies on the increased likelihood of a child experiencing ACEs due to parenting stress have left a critical question unanswered: whether high parenting stress may decrease a child’s likelihood of experiencing PCEs. We analyzed the 2019–2020 National Survey of Children’s Health to examine whether higher levels of parenting stress …

Social Isolation And Loneliness Prevention Among Rural Older Adults Aging-In-Place: A Needs Assessment, Jodi L. Southerland, Shimin Zheng, Kayla Dodson, Erin Mauck, Juanita-Dawne R. Bacsu, Monique J. Brown Ph.D., Mph, Jeremy Holloway, Steffi M. Kim, Ayse Malatyali, Matthew Lee Smith

Faculty Publications

Introduction: The adverse effects of social isolation and loneliness (SI/L) have been documented among older adults in rural communities and contribute to poor health outcomes, premature disability and mortality, and increased burden on the healthcare system. The identification of factors contributing to SI/L among older adults can build the foundation for rural policymakers and leaders to allocate resources and develop tailored strategies more efficiently. The purpose of this article is to describe findings from a needs assessment designed to understand local factors that contribute to SI/L among rural older adults in a county in Northeast Tennessee. Findings from the needs …

Sex Hormones And Risk Of Lung And Colorectal Cancers In Women: A Mendelian Randomization Study, Marion Denos, Yi-Qian Sun, Ben Michael Brumpton, Yafang Li, Demetrius Albanes, Andrea Burnett-Hartman, Peter T Campbell, Sébastien Küry, Christopher I Li, Emily White, Jewel N Samadder, Mark A Jenkins, Xiao-Mei Mai

Faculty, Staff and Students Publications

The roles of sex hormones such as estradiol, testosterone, and sex hormone-binding globulin (SHBG) in the etiology of lung and colorectal cancers in women, among the most common cancers after breast cancer, are unclear. This Mendelian randomization (MR) study evaluated such potential causal associations in women of European ancestry. We used summary statistics data from genome-wide association studies on sex hormones and from the Trøndelag Health Study (HUNT) and large consortia on cancers. There was suggestive evidence of 1-standard deviation increase in total testosterone levels being associated with a lower risk of lung non-adenocarcinoma (hazard ratio 0.60, 95% confidence interval …

93rd Annual Georgia Public Health Association Meeting And Conference Report, Jimmie H. Smith Jr, Angela Peden, Patrina L. Bowles

Journal of the Georgia Public Health Association

The 93^rd Annual Meeting and Conference of the Georgia Public Health Association (GPHA) was held in Jekyll Island, Georgia, at the Jekyll Island Convention Center, on May 3-5, 2023. The goal of the 2023 Georgia Public Health Association Annual Meeting and Conference was to assemble emerging public health professionals, current practitioners, academicians, governing entities, and community stakeholders for educational opportunities and networking to support the vision and mission of GPHA.

The theme for the 2023 Georgia Public Health Association Annual Meeting and Conference theme was selected by the GPHA Executive Board during a meeting in the early fall of …

Association Between Particulate Matter And Copd Among Adults In Alaska, Adeyemi Samuel Alimi

Walden Dissertations and Doctoral Studies

Exposure to high levels of fine particulate matter (PM2.5) is emerging as a crucial risk factor for chronic obstructive pulmonary disease (COPD), a deadly lung disease with a significant public health burden. The Fairbanks North Star Borough (FNSB) in Alaska has one of the worst PM2.5 issues in the United States. The PM2.5 issues in the area are associated with increased wood-burning and temperature inversions in the winter and wildfires in the summer. Given these prevailing PM2.5 issues, this quantitative study was conducted using Alaska BRFSS datasets and a chi-square test to compare the COPD prevalence in the FNSB with …

Reactions To The Mpox Vaccine Regarding Absences And Disruption Of Daily Activities In The United States, Robert Rossi

Walden Dissertations and Doctoral Studies

Since its global outbreak in 2022, the monkeypox (Mpox) virus has infected over 32,000 individuals in the United States, resulting in approximately 58 deaths. Although the JYNNEOS vaccine is effective at disease prevention, it has also been found to cause side effects, such as a disruption in daily activities and/or attendance at work or school. This quantitative, cross-sectional study was conducted to investigate whether differences existed in reactions to the Mpox vaccine, using secondary data from the Centers for Disease Control and Prevention’s V-safe Mpox survey. The two dependent variables were work/school absenteeism and disruption of daily activities, and the …

Burden Of Disease Attributable To High Body Mass Index: An Analysis Of Data From The Global Burden Of Disease Study 2021, Xiao-Dong Zhou, Qin-Fen Chen, Wah Yang, Mauricio Zuluaga, Giovanni Targher, Christopher Byrne, Luca Valentu, Fei Luo, Christos Katsouras, Christopher Opio

Internal Medicine, East Africa

Background: Obesity represents a major global health challenge with important clinical implications. Despite its recognized importance, the global disease burden attributable to high body mass index (BMI) remains less well understood.

Methods: We systematically analyzed global deaths and disability-adjusted life years (DALYs) attributable to high BMI using the methodology and analytical approaches of the Global Burden of Disease Study (GBD) 2021. High BMI was defined as a BMI over 25 kg/m2 for individuals aged ≥20 years. The Socio-Demographic Index (SDI) was used as a composite measure to assess the level of socio-economic development across different regions. Subgroup analyses considered age, …

Parallel Electrophysiological Abnormalities Due To Covid-19 Infection And To Alzheimer’S Disease And Related Dementia, Yang Jiang, Jennifer Neal, Pradoldej Sompol, Görsev Yener, Xianghong Arakaki, Christopher M. Norris, Francesca R. Farina, Agustin Ibanez, Susanna Lopez, Abdulhakim Al-Ezzi, Voyko Kavcic, Bahar Güntekin, Claudio Babiloni, Mihály Hajós

Neurology Faculty Publications

Many coronavirus disease 2019 (COVID-19) positive individuals exhibit abnormal electroencephalographic (EEG) activity reflecting “brain fog” and mild cognitive impairments even months after the acute phase of infection. Resting-state EEG abnormalities include EEG slowing (reduced alpha rhythm; increased slow waves) and epileptiform activity. An expert panel conducted a systematic review to present compelling evidence that cognitive deficits due to COVID-19 and to Alzheimer’s disease and related dementia (ADRD) are driven by overlapping pathologies and neurophysiological abnormalities. EEG abnormalities seen in COVID-19 patients resemble those observed in early stages of neurodegenerative diseases, particularly ADRD. It is proposed that similar EEG abnormalities in …

Contemporary Epidemiology Of Hepatocellular Carcinoma: Understanding Risk Factors And Surveillance Strategies, Fouad Jaber, George Cholankeril, Hashem B El-Serag

Faculty, Staff and Students Publications

The contemporary epidemiology of hepatocellular carcinoma (HCC) shows a shift in the main etiological risk factors from less common but highly virulent (eg, hepatitis C and B) to more common but weak risk factors (eg, alcohol and metabolic syndrome). Therefore, we are in a seemingly paradoxical state of declining overall incidence rates of HCC-related to improved prevention and treatment of viral hepatitis but burgeoning number of people at an elevated risk of HCC. Several geographic regions have reported an increase in HCC attributable to alcoholic liver disease and metabolic dysfunction associated with steatotic liver disease (MASLD). The importance of risk …

Dna Vaccines Against Gprc5d Synergize With Pd-1 Blockade To Treat Multiple Myeloma, Praveen Neeli, Perry Ayn Mayson A Maza, Dafei Chai, Dan Zhao, Xen Ping Hoi, Keith Syson Chan, Ken H Young, Yong Li

Faculty, Staff and Students Publications

Multiple myeloma (MM), a hematological malignancy of the bone marrow, remains largely incurable. The orphan G protein-coupled receptor, GPRC5D, which is uniquely expressed in plasma cells and highly expressed in MM, is a compelling candidate for immunotherapy. In this study, we investigated the efficacy of a combination of DNA vaccine encoding mouse GPRC5D and PD-1 blockade in preventing and treating MM using the 5TGM1 murine model of MM. The mouse vaccine alone was effective in preventing myeloma growth but required PD-1 antibodies to inhibit established MM tumors. We next evaluated the prophylactic and therapeutic efficacy of a nanoplasmid vector encoding …

Reframing And Advancing Academic Mentorship To Support New And Early Career Faculty Members, Juanita-Dawne R. Bacsu, Patricia C. Heyn, Steffi Kim, Zahra Rahemi, Monique J. Brown, Darina V. Petrovsky, Justine S. Sefcik, Jodi L. Southerland, Jeremy Holloway, Elyse Couch, Ayse Malatyali, Matthew L. Smith

Faculty Publications

Mentorship is critical to fostering professional growth and career development in academia. However, academic mentorship is often an informal activity that is overlooked and under researched. There is much ambiguity and uncertainty surrounding mentorship roles and strategies in academia. This paper provides recommendations and strategies to reframe and advance academic mentorship to support new and early career faculty.

Allura Red Ac Is A Xenobiotic. Is It Also A Carcinogen?, Lorne J. Hofseth Ph.D., James Hébert Scd, Elizabeth Angela Murphy, Erica Trauner, Athul Vikas, Quinn Harris, Alexander A. Chumanevich

Faculty Publications

Merriam-Webster and Oxford define a xenobiotic as any substance foreign to living systems. Allura Red AC (a.k.a., E129; FD&C Red No. 40), a synthetic food dye extensively used in manufacturing ultra-processed foods and therefore highly prevalent in our food supply, falls under this category. The surge in synthetic food dye consumption during the 70s and 80s was followed by an epidemic of metabolic diseases and the emergence of early-onset colorectal cancer in the 1990s. This temporal association raises significant concerns, particularly given the widespread inclusion of synthetic food dyes in ultra-processed products, notably those marketed toward children. Given its interactions …

Allura Red Ac Is A Xenobiotic. Is It Also A Carcinogen?, Lorne J. Hofseth, James R. Hébert Scd, Elizabeth Angela Murphy, Erica Trauner, Athul Vikas, Quinn Harris, Alexander A. Chumanevich

Faculty Publications

Merriam-Webster and Oxford define a xenobiotic as any substance foreign to living systems. Allura Red AC (a.k.a., E129; FD&C Red No. 40), a synthetic food dye extensively used in manufacturing ultra-processed foods and therefore highly prevalent in our food supply, falls under this category. The surge in synthetic food dye consumption during the 70s and 80s was followed by an epidemic of metabolic diseases and the emergence of early-onset colorectal cancer in the 1990s. This temporal association raises significant concerns, particularly given the widespread inclusion of synthetic food dyes in ultra-processed products, notably those marketed toward children. Given its interactions …

Parental Knowledge And Perception Of Obesity And Effect On Feeding Behavior And Child's Weight Status, Fidelia Senayah

Walden Dissertations and Doctoral Studies

Childhood obesity is a significant public health problem that leads to poor health outcomes in affected children, including the potential for developing chronic diseases in adulthood if not addressed at an early stage. While there are several studies on childhood obesity, data on parental obesity knowledge and risk perception as it relates to feeding behavior and child weight outcome is inadequate. No data were found on the topic in Ohio, which has a high rate of childhood obesity and overweight. This study examined how parental obesity risk knowledge and risk perception influenced parental feeding behavior and children’s weight status in …