Epidemiology Commons^™

The Utility Of Bayesian Predictive Models To Forecast Arboviruses In The United States Of America And Territories, Maggie Suzanne Jennave Mccarter

Theses and Dissertations

Statistical models have been utilized to understand and forecast infectious diseases across the globe. However, these models have historically been difficult to access and interpret for non-specialist audiences. This dissertation focuses on one computationally efficient model fitting method, the integrated nested LaPlace approximation approach, to forecast three arboviruses in hopes of encouraging accessibility to statistical modelling. Such accessibility could provide areas who simultaneously are most susceptible to infection, and have the least resources, an invaluable tool for informing policy and prevention decisions. The resulting models included biological, land cover, and environmental factors and produced accurate forecasts of neuroinvasive West Nile …

Universal Health Coverage: A Basis For Pandemic Preparedness?, Merline Feero

Independent Study Project (ISP) Collection

Amid extensive research and reporting on the effects of COVID-19 on Universal Health Coverage (UHC) progress, this study explores an often neglected topic: the potential of UHC to contribute to the foundations of pandemic preparedness. Herein, quantitative analysis reveals that countries with higher UHC coverage tend to exhibit greater pandemic preparedness (as determined by the UHC Service Coverage Index and the Global Health Security Index). Complementary qualitative analysis is used to further illustrate and explain the correlation between UHC and pandemic preparedness using four case study countries, integrating literature reviews and relevant expert interviews. Through these methods, a clear tie …

Epidemiological Algorithm And Early Molecular Testing To Prevent Covid-19 Outbreaks In A Mexican Oncologic Center, Moises González-Escamilla, Diana C. Peréz-Ibave, Carlos H. Burciaga-Flores, Vanessa N. Ortiz-Murillo, Genaro A. Ramírez-Correa, Patricia Rodríguez-Niño, Rafael Piñeiro-Retif, Hazyadee F. Rodríguez-Gutiérrez, Orlando D. Solis-Coronado, Juan F. González-Guerrero, Oscar Vidal-Gutiérrez, María Lourdes Garza-Rodríguez

Research Symposium

Introduction: Prevention strategies and detection of latent COVID-19 infections in oncology staff and oncologic patients are essential to prevent outbreaks in a cancer center. In this study, we used two statistical predictive models in oncology staff and patients from the radiotherapy area to prevent outbreaks and detect COVID-19 cases.

Methods: Staff and patients answered a questionnaire (electronic and paper surveys, respectively) with clinical and epidemiological information. The data was collected through two online survey tools: Real-Time Tracking (R-Track) and Summary of Factors (S-Facts). According to the algorithm's models, cut-off values were established. SARS-CoV-2 qRT-PCR tests confirmed the algorithm's positive individuals. …

Childhood Cancer Survival In The Highly Vulnerable Population Of South Texas: Persistent Challenges For Adolescents And Hispanic Ethnicity, Shenghui Wu, Y. N. Liu, M. Williams, C. Aguilar, A. G. Ramirez, R. Mesa, G. E. Tomlinson

Research Symposium

Background: This study examines childhood cancer survival rates and prognostic factors related to survival in the majority Hispanic population of South Texas (STX), whereas most other population studies in childhood cancer survival focus on populations with relatively few Hispanics.

Methods: The population-based cohort study used Texas Cancer Registry data (1995-2017) to examine survival and prognostic factors.

Results: The 5-year relative survival rate for STX cancer patients diagnosed at 0–19 years was 80.3% for all races/ethnicity. Hispanics had statistically significant lower 5-year relative survival rates than non-Hispanic Whites (NHW) for male and female together diagnosed at age ≥ 5 years. When …

Characterization Of Oral Cavity And Oropharyngeal Cancer In The Texas Rio Grande Valley, Jared A. Sperling, Rachel Giese

Research Symposium

Background: Cancers of the oral cavity (OC) and oropharynx (OP) account for 3% of cancers diagnosed in the United States each year. A primary cause of death among the Hispanic population in the United States is cancer, accounting for 20% of annual mortality. The Rio Grande Valley (RGV) is a medically-underserved area of South Texas with a large Hispanic population facing health disparities. In this study, we examine the incidence and mortality of OC and OP cancer in the RGV.

Methods: CDC population-level incidence and mortality rate per 100,000 of OC/OP cancer among patients in the RGV counties of Hidalgo …

Awareness Of Genetic Testing For High-Risk Cancer Among Different Racial Groups In The United States, Okechukwu C. Erinne, Modupe O. Onigbogi

Research Symposium

Background: Genetic testing for high-risk cancer can provide information on personal risk of developing cancer, as well as diagnosis, prognosis and treatment once cancer has been detected.

Methods: Data for this study were obtained from the Health Information National Trends (HINTS 5, Cycle 4), conducted among U.S. adults (age ≥ 18 years) from February 24 to June 20, 2020. An equal probability sample of addresses were stratified, and an adult was selected from each household. Data analysis was conducted 3,865 respondents who completed the survey. The primary outcome was awareness of genetic testing for high-risk cancer (GTHC). We …

Clinical Characteristics And Risk Factors For Mortality During The 'First Wave' Of Covid-19 In Reynosa, Tamaulipas, Luis G. Vargas Garcia, Francisco E. Díaz Cisneros, Antonio Gutiérrez Sierra, Juan Rosales Martínez, Manlio F. Lara Duck, Netzahualcoyotl Mayek Pérez

Research Symposium

Background: The COVID-19 pandemic has impacted public health in Mexico. As of February 2020, there have been at least four "waves" of contagion that resulted in 5.82 million positive cases and more than 325 thousand deaths. At the beginning of the COVID-19 pandemic, hospital and population-based information was available, frequently with non-specific symptoms. Little was known about the risk factors for mortality in specific conditions. We described the clinical characteristics of patients with COVID-19 in Reynosa, Tamaulipas during 2020 and identified the risk factors for mortality.

Methods: The COVID-19 cases registered from March to November 2020 in Reynosa were divided …

Quality Of Nutritional Care During Pregnancy: Folic Acid And Vitamin D Supplementation, Isabel Omaña-Guzmán, Monica Ancira-Moreno, Cecilia Pérez-Navarro, Sonia Hernández-Cordero, Soraya Burrola Méndez, Eric Monterrubio-Flores, Arturo Bautista Morales, Omar Acosta Ruiz, Constanza Bernat, Belén Sánchez,, Ariana Cajero

Research Symposium

Backgrounds: Folic acid (FA) and vitamin D supplementation is recommended during pregnancy. Quality nutritional care during pregnancy should include the supplementation of these vitamins. Therefore, the aim of this study was to assess the quality of nutritional care regarding supplementation during pregnancy in primary health care units in six states of Mexico (Estado de México, Oaxaca, Yucatán, Chihuahua, Veracruz and Chiapas).

Methods: A mixed study was conducted. An indicator (formed by two sub-indicators) to assess the quality of nutritional care focused on FA and vitamin D supplementation in pregnancy was developed and validated. To assess the quality of care, a …

Exploring Conformational Landscapes And Cryptic Binding Pockets In Distinct Functional States Of The Sars-Cov-2 Omicron Ba.1 And Ba.2 Trimers: Mutation-Induced Modulation Of Protein Dynamics And Network-Guided Prediction Of Variant-Specific Allosteric Binding Sites, Gennady M. Verkhivker, Mohammed Alshahrani, Grace Gupta

Mathematics, Physics, and Computer Science Faculty Articles and Research

A significant body of experimental structures of SARS-CoV-2 spike trimers for the BA.1 and BA.2 variants revealed a considerable plasticity of the spike protein and the emergence of druggable binding pockets. Understanding the interplay of conformational dynamics changes induced by the Omicron variants and the identification of cryptic dynamic binding pockets in the S protein is of paramount importance as exploring broad-spectrum antiviral agents to combat the emerging variants is imperative. In the current study, we explore conformational landscapes and characterize the universe of binding pockets in multiple open and closed functional spike states of the BA.1 and BA.2 Omicron …

Sugar-Sweetened Beverages And Artificially Sweetened Beverages Consumption And The Risk Of Nonalcoholic Fatty Liver (Nafld) And Nonalcoholic Steatohepatitis (Nash), Tung Sung Tseng, Wei Ting Lin, Peng Sheng Ting, Chiung Kuei Huang, Po Hung Chen, Gabrielle V. Gonzalez, Hui Yi Lin

School of Public Health Faculty Publications

Nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH) are fast becoming the most common chronic liver disease and are often preventable with healthy dietary habits and weight management. Sugar-sweetened beverage (SSB) consumption is associated with obesity and NAFLD. However, the impact of different types of SSBs, including artificially sweetened beverages (ASBs), is not clear after controlling for total sugar intake and total caloric intake. The aim of this study was to examine the association between the consumption of different SSBs and the risk of NAFLD and NASH in US adults. The representativeness of 3739 US adults aged ≥20 years …

Tobacco, Alcohol And Diet As Mortality Risk Factors: The Secondary Analysis Of The 25-Year Cohort Study, Alina Egorova, Bulat Idrisov, Romany Redman, Stanislav Otstavnov, Sergey Soshnikov

Journal of Health Research

Background: Individual lifestyle risk factors have been linked to increased mortality globally; however, there is limited data on these associations in Russia. A secondary analysis of the Russia Longitudinal Monitoring Survey (RLMS) data was conducted to close this gap.

Methods: The secondary data have been obtained from a nationally-representative annual cohort survey conducted by the Higher School of Economics (HSE). In this original study, for the first time in Russia, we extracted RRs for researched risk factors. Of additional original value, we made a prospective-retrospective cohort based on a representative longitudinal survey and provided the deaths as outcomes for survival …

History And Current Status Of Mediterranean Spotted Fever (Msf) In The Crimean Peninsula And Neighboring Regions Along The Black Sea Coast, Muniver T. Gafarova, Marina E. Eremeeva

Biostatistics, Epidemiology & Environmental Health Sciences: Faculty Publications

Mediterranean spotted fever (MSF) is a tick-borne rickettsiosis caused by Rickettsia conorii subspecies conorii and transmitted to humans by Rhipicephalus sanguineus ticks. The disease was first discovered in Tunisia in 1910 and was subsequently reported from other Mediterranean countries. The first cases of MSF in the former Soviet Union were detected in 1936 on the Crimean Peninsula. This review summarizes the historic information and main features of MSF in that region and contemporary surveillance and control efforts for this rickettsiosis. Current data pertinent to the epidemiology of the disease, circulation of the ticks and distribution of animal hosts are discussed …

The Public Health Impact Of Paxlovid Covid-19 Treatment In The United States, Yuan Bai, Zhanwei Du, Lin Wang, Eric H. Y. Lau, Isaac Fung, Petter Holme, Ben Cowling, Alison Galvani, Robert Krug, Lauren Ancel Meyers

Biostatistics, Epidemiology & Environmental Health Sciences: Faculty Publications

The antiviral drug Paxlovid has been shown to rapidly reduce viral load. Coupled with vaccination, timely administration of safe and effective antivirals could provide a path towards managing COVID-19 without restrictive non-pharmaceutical measures. Here, we estimate the population-level impacts of expanding treatment with Paxlovid in the US using a multi-scale mathematical model of SARS-CoV-2 transmission that incorporates the within-host viral load dynamics of the Omicron variant. We find that, under a low transmission scenario (Re∼1.2) treating 20% of symptomatic cases would be life and cost saving, leading to an estimated 0.26 (95% CrI: 0.03, 0.59) million hospitalizations averted, 30.61 (95% …

Integrating Participant Feedback And Concerns To Improve Community And Individual Level Chemical Exposure Assessment Reports, Samantha M Samon, Michael Barton, Kim Anderson, Abiodun Oluyomi, Melissa Bondy, Georgina Armstrong, Diana Rohlman

Faculty, Staff and Students Publications

BACKGROUND: As exposure assessment has shifted towards community-engaged research there has been an increasing trend towards reporting results to participants. Reports aim to increase environmental health literacy, but this can be challenging due to the many unknowns regarding chemical exposure and human health effects. This includes when reports encompass a wide-range of chemicals, limited reference or health standards exist for those chemicals, and/or incompatibility of data generated from exposure assessment tools with published reference values (e.g., comparing a wristband concentration to an oral reference dose).

METHODS: Houston Hurricane Harvey Health (Houston-3H) participants wore silicone wristbands that were analyzed for 1,530 …

Differences In Clinical Presentation At First Hospitalization And The Impact On Involuntary Admissions Among First-Generation Migrant Groups With Non-Affective Psychotic Disorders., Kelly K Anderson, Rebecca Rodrigues

Epidemiology and Biostatistics Publications

BACKGROUND: Some migrant and ethnic minority groups have a higher risk of coercive pathways to care; however, it is unclear whether differences in clinical presentation contribute to this risk. We sought to assess: (i) whether there were differences in clinician-rated symptoms and behaviours across first-generation immigrant and refugee groups at the first psychiatric hospitalization after psychosis diagnosis, and (ii) whether these differences accounted for disparities in involuntary admission.

METHODS: Using population-based health administrative data from Ontario, Canada, we constructed a sample (2009-2013) of incident cases of non-affective psychotic disorder followed for two years to identify first psychiatric hospitalization. We compared …

Adolescent Hope And Optimism: A Scoping Review Of Measures And Their Psychometric Properties, Esther Chongwo, Ezra Too, Adam Mabrouk, Amina Abubakar

Institute for Human Development, East Africa

There is much research examining adolescent hope and optimism, but there is limited information on the available measures, particularly the most frequently used measures and their psychometric properties. We conducted a scoping review to: (1) identify measures of hope and optimism for use among adolescents; (2) determine the most frequently used measures of adolescent hope and optimism; (3) document the psychometric properties of the identified measures. We searched five bibliographic databases and Open Grey for relevant articles published from database inception to 03 May 2023. The search included the key terms ‘adolescents’, ‘optimism’, ‘hope’ and ‘measures’. We targeted adolescents aged …

Comparison Of Bivalent And Monovalent Sars-Cov-2 Variant Vaccines: The Phase 2 Randomized Open-Label Covail Trial, Angela R Branche, Nadine G Rouphael, David J Diemert, Ann R Falsey, Cecilia Losada, Lindsey R Baden, Sharon E Frey, Jennifer A Whitaker, Susan J Little, Evan J Anderson, Emmanuel B Walter, Richard M Novak, Richard Rupp, Lisa A Jackson, Tara M Babu, Angelica C Kottkamp, Anne F Luetkemeyer, Lilly C Immergluck, Rachel M Presti, Martín Bäcker, Patricia L Winokur, Siham M Mahgoub, Paul A Goepfert, Dahlene N Fusco, Elissa Malkin, Jeffrey M Bethony, Edward E Walsh, Daniel S Graciaa, Hady Samaha, Amy C Sherman, Stephen R Walsh, Getahun Abate, Zacharoula Oikonomopoulou, Hana M El Sahly, Thomas C S Martin, Satoshi Kamidani, Michael J Smith, Benjamin G Ladner, Laura Porterfield, Maya Dunstan, Anna Wald, Tamia Davis, Robert L Atmar, Mark J Mulligan, Kirsten E Lyke, Christine M Posavad, Megan A Meagher, David S Stephens, Kathleen M Neuzil, Kuleni Abebe, Heather Hill, Jim Albert, Kalyani Telu, Jinjian Mu, Teri C Lewis, Lisa A Giebeig, Amanda Eaton, Antonia Netzl, Samuel H Wilks, Sina Türeli, Mamodikoe Makhene, Sonja Crandon, David C Montefiori, Mat Makowski, Derek J Smith, Seema U Nayak, Paul C Roberts, John H Beigel, Covail Study Group

Faculty, Staff and Students Publications

Vaccine protection against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection wanes over time, requiring updated boosters. In a phase 2, open-label, randomized clinical trial with sequentially enrolled stages at 22 US sites, we assessed safety and immunogenicity of a second boost with monovalent or bivalent variant vaccines from mRNA and protein-based platforms targeting wild-type, Beta, Delta and Omicron BA.1 spike antigens. The primary outcome was pseudovirus neutralization titers at 50% inhibitory dilution (ID50 titers) with 95% confidence intervals against different SARS-CoV-2 strains. The secondary outcome assessed safety by solicited local and systemic adverse events (AEs), unsolicited AEs, serious AEs …

Transfusion Reactions Associated With Covid-19 Convalescent Plasma In Outpatient Clinical Trials, Moises A Huaman, Jay S Raval, James H Paxton, Giselle S Mosnaim, Bela Patel, Shweta Anjan, Barry R Meisenberg, Adam C Levine, Christi E Marshall, Anusha Yarava, Aarthi G Shenoy, Sonya L Heath, Judith S Currier, Yuriko Fukuta, Janis E Blair, Emily S Spivak, Joann R Petrini, Patrick B Broderick, William Rausch, Marieelena Cordisco, Jean Hammel, Benjamin Greenblatt, Valerie C Cluzet, Daniel Cruser, Kevin Oei, Matthew Abinante, Laura L Hammitt, Catherine G Sutcliffe, Donald N Forthal, Martin S Zand, Edward R Cachay, Seble G Kassaye, Malathi Ram, Ying Wang, Piyali Das, Karen Lane, Nichol A Mcbee, Amy L Gawad, Nicky Karlen, Daniel E Ford, Oliver Laeyendecker, Andrew Pekosz, Sabra L Klein, Stephan Ehrhardt, Bryan Lau, Sheriza N Baksh, David M Shade, Arturo Casadevall, Daniel F Hanley, Jiangda Ou, Thomas J Gniadek, Alyssa Ziman, Shmuel Shoham, Kelly A Gebo, Evan M Bloch, Aaron A R Tobian, David J Sullivan, Jonathan M Gerber

Faculty, Staff and Students Publications

BACKGROUND: COVID-19 convalescent plasma (CCP) is an important therapeutic option for outpatients at high risk of hospitalization from SARS-CoV-2 infection. We assessed the safety of outpatient CCP transfusions administered during clinical trials.

STUDY DESIGN AND METHODS: We analyzed data pertaining to transfusion-related reactions from two randomized controlled trials in the U.S. that evaluated the efficacy of CCP versus control plasma in various ambulatory settings. Multivariable logistic regression was used to assess whether CCP was associated with transfusion reactions, after adjusting for potential confounders.

RESULTS: The combined study reported 79/1351 (5.9%) adverse events during the transfusion visit, with the majority 62/1351 …

Immune Infiltration In Tumor And Adjacent Non-Neoplastic Regions Codetermines Patient Clinical Outcomes In Early-Stage Lung Cancer, Chao Cheng, Thinh T Nguyen, Mabel Tang, Xinan Wang, Chongming Jiang, Yanhong Liu, Ivan Gorlov, Olga Gorlova, John Iafrate, Michael Lanuti, David C Christiani, Christopher I Amos

Faculty, Staff and Students Publications

INTRODUCTION: In recent years, the proportion of patients with NSCLC diagnosed at an early stage has increased continuously.

METHODS: In this study, we analyzed samples and data collected from 119 samples from 67 early stage patients with NSCLC, including 52 pairs of tumor and adjacent non-neoplastic samples, and performed RNA-sequencing analysis with high sequencing depth.

RESULTS: We found that immune-related genes were highly enriched among the differentially expressed genes and observed significantly higher inferred immune infiltration levels in adjacent non-neoplastic samples than in tumor samples. In survival analysis, the infiltration of certain immune cell types in tumor, but not adjacent …

Cancer Patients' Preferences And Perceptions Of Advantages And Disadvantages Of Telehealth Visits During The Covid-19 Pandemic, Deepika Kumar, Nancy Gordon, Constanza Zamani, Tammy Sheehan, Ernesto Martin, Olga Egorova, Jessica Payne, Tatjana Kolevska, Elad Neeman, Raymond Liu

Faculty, Staff and Student Publications

PURPOSE: We aimed to ascertain oncology patients' perceptions of telehealth versus in-person (IP) visits for different types of clinical encounters.

METHODS: We surveyed adults undergoing cancer treatment at Kaiser Permanente Northern California infusion centers between November 2021 and May 2022 using a self-administered questionnaire. Patients were asked about visit modality preferences (video, phone, and IP) for six types of clinical discussions, overall advantages and disadvantages of telehealth (video or phone) versus IP modalities, and barriers to video visit use.

RESULTS: The 839 patients who completed surveys in English were 63% female; median age 63 years; 64% White; and 73% college-educated …