Epidemiology Commons^™

Cancer Survivorship And Subjective Cognitive Decline In The Us: Results From A Nationally Representative Sample, Monique J. Brown, Ally Hucek, Jingkai Wei, Loretta Anderson, Muzi Na

Faculty Publications

Cancer may be associated with objective cognitive decline. However, studies examining the link between cancer and subjective cognitive decline (SCD), which occurs earlier during cognitive trajectories, are lacking. In addition, research assessing risk factors for SCD among cancer survivors is scant. Therefore, this study aimed to examine the association between cancer and SCD in the past year, and assess the association between age of diagnosis, cancer treatment, and SCD among cancer survivors. Data were obtained from the 2021 Behavioral Risk Factor Surveillance System (N=15,447). Crude and adjusted logistic regression models, controlling for sociodemographic characteristics, were used to determine the association …

Lifestyle Behaviors Before And After Diagnosis Of Type 2 Diabetes: Findings From The Nurses’ Health Studies, Amelia E. Roebuck

Dissertations and Theses (Open Access)

Short- and long-term changes in diet or physical activity in relation to type 2 diabetes mellitus (T2DM) and factors associated with behavior change with adequate inclusion of relevant confounding and effect-modifying variables have been minimally explored. The objective of this research was to examine changes in diet and physical activity following a diagnosis of T2DM and identify sociodemographic, medical, psychosocial, and lifestyle factors associated with changes in dietary or physical activity behaviors. This dissertation utilized two prospective cohorts of U.S. female nurses participating in the Nurses’ Health Study (1976-2016) and Nurses’ Health Study II (1989-2017). Linear mixed effects modeling was …

Association Of Covid-19 Coinfection With Increased Mortality Among Patients With Pseudomonas Aeruginosa Bloodstream Infection In The Veterans Health Administration System, Leila S. Hojat, Brigid M. Wilson, Federico Perez, Maria F. Mojica, Mendel E. Singer, Robert A. Bonomo

Faculty Scholarship

Objective: Pseudomonas aeruginosa bloodstream infection (PA-BSI) and COVID-19 are independently associated with high mortality. We sought to demonstrate the impact of COVID-19 coinfection on patients with PA-BSI. Design: Retrospective cohort study. Setting: Veterans Health Administration. Patients: Hospitalized patients with PA-BSI in pre-COVID-19 (January 2009 to December 2019) and COVID-19 (January 2020 to June 2022) periods. Patients in the COVID-19 period were further stratified by the presence or absence of concomitant COVID-19 infection. Methods: We characterized trends in resistance, treatment, and mortality over the study period. Multivariable logistic regression and modified Poisson analyses were used to determine the association between COVID-19 …

Dna Methylation-Based Epigenetic Biomarkers In Cell-Type Deconvolution And Tumor Tissue Of Origin Identification, Ze Zhang

Dartmouth College Ph.D Dissertations

DNA methylation is an epigenetic modification that regulates gene expression and is essential to establishing and preserving cellular identity. Genome-wide DNA methylation arrays provide a standardized and cost-effective approach to measuring DNA methylation. When combined with a cell-type reference library, DNA methylation measures allow the assessment of underlying cell-type proportions in heterogeneous mixtures. This approach, known as DNA methylation deconvolution or methylation cytometry, offers a standardized and cost-effective method for evaluating cell-type proportions. While this approach has succeeded in discerning cell types in various human tissues like blood, brain, tumors, skin, breast, and buccal swabs, the existing methods have major …

Timigp: An R Package To Depict The Tumor Microenvironment From Bulk Transcriptomics, Chenyang Li, Jianjun Zhang, Chao Cheng

Faculty, Staff and Students Publications

Exploring the clinical relevance of diverse immune cell types within the tumor microenvironment is pivotal for unraveling cancer intricacies and developing treatments. Here, we present a protocol for using tumor immune microenvironment illustration based on gene pairs, an R package to deduce cell-cell interactions, unveiling the association between immune cell relative abundance and patient prognoses from bulk gene expression and survival data. We describe steps for harnessing cell-type markers derived from single-cell RNA sequencing data to map the tumor immune microenvironment across a spectrum of cancer types. For complete details on the use and execution of this protocol, please refer …

Where Did All The Bed Bugs Go?, Lauren Friedman

Capstones

In the early 2000s in New York City, everyone was talking about bed bugs. The disc-shaped, bloodsucking pests had been a common domestic nuisance up to the World War II era, but in the decades since, they’d mostly faded into obscurity. That was until bed bug infestations, which are often psychologically distressing and sometimes impossible to overcome, suddenly became routine across the five boroughs, driving people from their apartments and stoking fear about everything from upholstered theater seats to thrift stores.

But then, just as quickly as bed bugs had invaded, they seemed to fade away. In a 2022 study …

Opportunities For Mental Health Interventions In Rural Mississippi Communities During The Covid-19 Pandemic: A Quantitative Analysis, Brice Fortinberry

Theses and Dissertations

COVID-19 presented unique challenges for rural Mississippi communities including impacts on the mental health of rural individuals. This research study aimed to identify opportunities for mental health interventions to provide health promotion professionals with quantitative data on the accessibility and the likelihood of engagement with mental health-fostering behaviors. A secondary objective of this research was to categorize these behaviors within the constructs of the Social Ecological Model. Demographics for rural Mississippi communities were collected and displayed, and using multivariate analyses including Spearman’s correlation and a Mann-Whitney U test the correlation between mental health fostering behaviors and demographic factors was obtained. …

Predictors Of Lung Cancer Screening Recommendation In Virginia Using The Community Health Assessment Survey, Aashish Batheja, Carrie Miller, Sunny Jung Kim, Bernard Fuemmeler F., Rajsh Balkrishnan

Virginia Journal of Public Health

Purpose: The purpose of this analysis was to determine the factors that may influence the probability of being recommended a lung cancer screening by a health professional in Virginia.

Methods: Data were obtained from the Community Health Assessment Survey conducted by the University of Virginia (UVA) Health System and Cancer System in collaboration with Virginia Commonwealth University (VCU) Cancer Center. SAS software was used to conduct a logistic regression with the following variables: age, sex, race, current smoking status, cancer history, education level, income level, insurance, and rurality.

Results: Statistically significant positive predictors included being a current smoker (OR: 3.504, …

Detection Of Suicide Clusters Using Small-Area Geographic Data From The Virginia Violent Death Reporting System, 2010 – 2015, Kurtis M. Anthony, Allison Ertl, Rachel A. Leavitt, Alexander E. Crosby, Ryan M. Diduk-Smith, Kevin A. Matthews

Virginia Journal of Public Health

Introduction: From 1999 to 2020, the suicide rate in Virginia increased from 13.1 to 15.9 per 100,000 persons aged 10 years and older. Few studies have examined spatial patterns of suicide geographies smaller than the county level.

Methods: We analyzed data from suicide decedents aged ≥10 years from 2010 through 2015 in the Virginia Violent Death Reporting System. We identified spatial clusters of high suicide rates using spatially adaptive filtering with standardized mortality ratio (SMR) significantly higher than the state SMR (p < 0.001). We compared demographic characteristics, method of injury, and suicide circumstances of decedents within each cluster to decedents outside any cluster.

Results: We identified 13 high-risk suicide clusters (SMR between 1.7 and 2.0). Suicide decedents in the clusters were …

Duchenne Muscular Dystrophy: Age, Disease Stage, And Patient-Reported Quality Of Life, Sheila Jagers

Walden Dissertations and Doctoral Studies

No abstract provided.

Models Of Shared Care For The Management Of Psychotic Disorder After First Diagnosis In Ontario., Joshua C. Wiener, Rebecca Rodrigues, Jennifer N S Reid, Kelly K. Anderson

Epidemiology and Biostatistics Publications

OBJECTIVE: To describe the provision of care for young people following first diagnosis of psychotic disorder.

DESIGN: Retrospective cohort study using health administrative data.

SETTING: Ontario.

PARTICIPANTS: People aged 14 to 35 years with a first diagnosis of nonaffective psychotic disorder in Ontario between 2005 and 2015 (N=39,449).

MAIN OUTCOME MEASURES: Models of care, defined by psychosis-related service contacts with primary care physicians and psychiatrists during the 2 years after first diagnosis of psychotic disorder.

RESULTS: During the 2-year follow-up period, 29% of the cohort received only primary care, 30% received only psychiatric care, and 32% received both primary and …

Epidemiology Of Musculoskeletal Injury In Military Recruits: A Systematic Review And Meta-Analysis, Myles C. Murphy, Joanne Stannard, Vanessa R. Sutton, Patrick J. Owen, Brendon Park, Paola T. Chivers, Nicolas H. Hart

Research outputs 2022 to 2026

Background: Injuries are a common occurrence in military recruit training, however due to differences in the capture of training exposure, injury incidence rates are rarely reported. Our aim was to determine the musculoskeletal injury epidemiology of military recruits, including a standardised injury incidence rate. Methods: Epidemiological systematic review following the PRISMA 2020 guidelines. Five online databases were searched from database inception to 5th May 2021. Prospective and retrospective studies that reported data on musculoskeletal injuries sustained by military recruits after the year 2000 were included. We reported on the frequency, prevalence and injury incidence rate. Incidence rate per 1000 training …

Associations Between Maternal Alcohol Consumption During Pregnancy And Selected Musculoskeletal Birth Defects Among Offspring In The National Birth Defects Prevention Study, Sarah Fisher

Legacy Theses & Dissertations (2009 - 2024)

Maternal alcohol consumption during pregnancy is known to be associated with poor pregnancy outcomes, including fetal alcohol spectrum disorders. However, evidence for associations between alcohol consumption during pregnancy and some major structural birth defects among offspring is conflicting or inconclusive. This dissertation used data from the National Birth Defects Prevention Study (NBDPS), a multi-site, population-based case-control study, to examine associations between maternal alcohol consumption and risk of three major musculoskeletal birth defects: gastroschisis, omphalocele, and craniosynostosis. Our analyses built upon previous analyses of these associations using NBDPS data, including larger sample sizes and more robust analytic methods to explore issues …

Prescription Opioid Misuse Among High School Students In The United States, By Sex And Race/Ethnicity, In 2019 And 2021, Deepika Reddy Kandhi

Legacy Theses & Dissertations (2009 - 2024)

Background: Drug overdose deaths in the U.S. have been increasing and are primarily related to opioid use. In 2019, an estimated 7.2% of US high school students reported misusing prescription opioids in the past 30 days. Prescription opioid misuse in adolescents may lead to development of a substance use disorder, overdose, or other serious harms. Some researchers have observed sex and race differences in prescription opioid use. This study aimed to identify patterns of prescription opioid misuse among adolescent subgroups categorized by both sex and race/ethnicity, to provide insight into intervention development and targeting.Methods: We analyzed data from the Youth …

Feasibility Of Pevonedistat Combined With Azacitidine, Fludarabine, Cytarabine In Pediatric Relapsed/Refractory Aml: Results From Cog Advl1712, Katherine Tarlock, Xiaowei Liu, Charles G Minard, Emasenyie A Isikwei, Joel M Reid, Terzah M Horton, Elizabeth Fox, Brenda J Weigel, Todd Cooper

Faculty, Staff and Students Publications

Background:

Outcomes for children with relapsed/refractory (R/R) acute myeloid leukemia (AML) and myelodysplastic syndrome (MDS) are poor and new therapies are needed. Pevonedistat is an inhibitor of the NEDD-8 activating enzyme, a key regulator of the ubiquitin proteasome system that is responsible for protein turnover, with protein degradation regulating cell growth and survival.

Procedure:

We evaluated the feasibility, toxicity, and pharmacokinetics (PK) of pevonedistat (20 mg/m² days 1, 3, 5) in combination with azacitidine, fludarabine, cytarabine (aza-FLA) in children with R/R AML and MDS (NCT03813147). Twelve patients were enrolled, median age was 13 years (range 1-21). Median …

Association Of The Covid-19 Pandemic With Women, Infants, And Children (Wic) Receipt Among Pregnant Individuals: United States, 2016-2022, Savannah Busch, Jennifer A Andersen, Don E Willis, Pearl Anna Mcelfish, Sharon Reece, Dominique Dubois, Clare C Brown

Faculty, Staff and Students Publications

Objectives. To evaluate the effect of COVID-19 on Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) receipt among pregnant individuals overall and by race/ethnicity.

Methods. We measured changes in WIC receipt among Medicaid-covered births (n = 10 484 697) from the US National Center for Health Statistics Natality Files (2016–2022). Our interrupted time series logistic model included a continuous monthly variable, a binary post-COVID variable, and a continuous slope shift variable. We additionally fit separate models for each race/ethnicity relative to White individuals, using interaction terms between the time series variables and race/ethnicity.

Results. We found decreases in …

Dual Barriers: Examining Digital Access And Travel Burdens To Hospital Maternity Care Access In The United States, 2020, Peiyin Hung Ph.D., Marion Granger, Nansi Boghossian, Jiani Yu, Sayward Harrison, Jihong Liu Sc.D., Berry A. Campbell, Bo Cai Ph.D., Chen Liang, Xiaoming Li Ph.D.

Faculty Publications

Policy Points The White House Blueprint for Addressing the Maternal Health Crisis report released in June 2022 highlighted the need to enhance equitable access to maternity care. Nationwide hospital maternity unit closures have worsened the maternal health crisis in underserved communities, leaving many birthing people with few options and with long travel times to reach essential care. Ensuring equitable access to maternity care requires addressing travel burdens to care and inadequate digital access. Our findings reveal socioeconomically disadvantaged communities in the United States face dual barriers to maternity care access, as communities located farthest away from care facilities had the …

Environmental Exposures And Aging., Daniel Chris Gomes

Electronic Theses and Dissertations

In recent years, research into air pollution has shown that exposure to certain components in air pollution, primarily PM2.5 can accelerate biological aging and thereby lead to increased susceptibility to multiple diseases. We hypothesize that prolonged exposure to air pollutants can result in premature aging leading to extensive tissue dysfunction and susceptibility to diseases. To examine this, we exposed mice to PM2.5 for 9, 15, and 21 days, then measured the telomere lengths, cellular senescence, and histone methylation patterns of multiple cell types. We found consistently increased telomere attrition, cellular senescence and advanced age-consistent histone methylation patterns in groups exposed …

Genetic Risk Scores For Hypertension And Chronic Kidney Disease In African Americans., Aastha Kakar

Electronic Theses and Dissertations

Hypertension (HT) and chronic kidney diseases (CKD) are complex conditions, disproportionally prevalent among African Americans (AA) and are influenced by multiple genetic as well as environmental factors. Genetic risk scores (GRS) enable the analysis of the combined effects of multiple single nucleotide polymorphisms (SNPs). This study investigates the association of blood pressure (BP) and CKD GRS with BP, hypertension (HT) and CKD; early-onset HT and CKD; and investigates interactions of the GRSs with environmental measures in AA. We observed a significant association between the BP-GRS with HT, SBP and DBP. The odds of HT for one standard deviation (s.d.) increase …

The Association Between Inflammatory Bowel Disease And All-Cause And Cause-Specific Mortality In The Uk Biobank, Fangyu Li, Yesenia Ramirez, Yukiko Yano, Carrie R Daniel, Shreela V Sharma, Eric L Brown, Ruosha Li, Baharak Moshiree, Erikka Loftfield, Qing Lan, Rashmi Sinha, Maki Inoue-Choi, Emily Vogtmann

Faculty, Staff and Student Publications

PURPOSE: Inflammatory bowel disease (IBD) has a rising global prevalence. However, the understanding of its impact on mortality remains inconsistent so we explored the association between IBD and all-cause and cause-specific mortality.

METHODS: This study included 502,369 participants from the UK Biobank, a large, population-based, prospective cohort study with mortality data through 2022. IBD was defined by baseline self-report or from primary care or hospital admission data. We estimated hazard ratios (HRs) and 95% confidence intervals (CIs) for all-cause and cause-specific mortality in multivariable Cox proportional hazards regression models.

RESULTS: A total of 5799 (1.2%) participants had a history of …