Epidemiology Commons^™

Disparities In Cancer Mortality Patterns: A Comprehensive Examination Of Us Rural And Urban Adults, 1999–2020, Itunu O Sokale, Syed Ahsan Raza, Aaron P Thrift

Faculty, Staff and Students Publications

BACKGROUND: Cancer mortality rates overall in the U.S. have decreased significantly; however, the rate of decline has not been uniform across sociodemographic groups. We aimed to compare trends in cancer mortality rates from 1999 to 2020 between rural and urban individuals and to examine whether any rural-urban differences are uniform across racial and ethnic groups.

METHODS: We used U.S.-wide data from the National Center for Health Statistics, for all cancer deaths among individuals aged 25 years or older. We estimated average annual percentage change (AAPC) in age-standardized cancer mortality rates in the U.S. by cancer type, rural-urban status, sex, and …

Retrospective Evaluation Of The Covid-19 Contact Tracing Program At The Maine Center For Disease Control And Prevention, Elisabeth Brewington Mha, Mph, Ben K. Greenfield Phd, Jessica Purser Phd

Journal of Maine Medical Center

Introduction: Despite the widespread use of contact tracing efforts throughout the COVID-19 pandemic, there are limited findings available about best practices and recommendations. The Maine Center for Disease Control and Prevention contracted staff to conduct COVID-19 contact tracing from August 2020 through February 2022. A retrospective evaluation of this program was conducted to share lessons learned with public health and health care leaders for future use.

Methods: Contracted contact tracing staff participated in facilitated discussions structured by the Strengths, Weaknesses, Opportunities, and Threats analysis framework. Three sessions were recorded and transcribed, and qualitative analysis through thematic review and evaluation coding …

Development Of A Medication Compliance Determinant Instrument For Low-Middle Literate Patients With Type 2 Diabetes Mellitus, Ivans Panduwiguna, Rani Sauriasari, Ratu Ayu Dewi Sartika, Woro Riyadina, Fransiskus Samuel Renaldi

Kesmas

Diabetes, a leading cause of 6.7 million deaths in 2021, poses a significant challenge despite existing interventions. Non-adherence to treatment remains a barrier to diabetes management. However, a comprehensive instrument to assess medication adherence determinants in diabetes patients’ population in Indonesia with low-medium literacy levels and following the sociocultural characteristics of Indonesian society has been lacking. This study aimed to develop and evaluate a valid and reliable instrument for measuring medication adherence in type 2 diabetes mellitus patients based on the Borg and Gall model. Through the input of an expert panel, a valid and reliable instrument was developed, which …

Effects Of Early Hospital-Based Palliative Care Consultation On Length Of Stay And Costs Of Care At Indonesian Tertiary Hospital, Rudi Putranto, Hamzah Shatri, Wulyo Rajabto, Sumariyono Sumariyono, Edward Faisal, Sihwastuti Sihwastuti

Kesmas

Despite the numerous benefits of palliative care for cancer patients, there have been few studies on palliative care services for terminal cancer patients, particularly near the end of life. This study aimed to evaluate whether there were differences in length of stay and cost of care associated with how early or late a patient received palliative care intervention. Another objective was to compare the length of stay and cost of care of those who received palliative care intervention and those who did not. This study used a cohort retrospective design at Hospital A, Jakarta, Indonesia, from January to December 2019. …

Risk Factors Of Worsening Of Systemic Lupus Erythematosus In Patients At Two Tertiary Hospitals In Jakarta, Giri Aji, Mondastri Korib Sudaryo, Ratna Djuwita, Sukamto Sukamto

Kesmas

Systemic Lupus Erythematosus (SLE) is a prototypical multiorgan autoimmune disease with a fluctuating and chronic disease course. As an emerging disease in this century, SLE will burden stakeholders and the country. This study was conducted to determine the prognostic factors for SLE worsening, especially in ambulatory patients. This ambispective study used logistic regression to view the risk factors for worsening SLE in patients. Anemia, age, body mass index, education level, employment status, marital status, hydroxychloroquine, and immunosuppressants were the independent variables in this study. This study concludes that anemia is statistically significant and, therefore, a risk factor for worsening SLE …

Self-Reported Consumption Of Bottled Water V. Tap Water In Appalachian And Non-Appalachian Kentucky, Jason W. Marion

Journal of Appalachian Health

Introduction: Quantitative studies on drinking water perceptions in Appalachia are limited. High-profile water infrastructure failures in the U.S. and Eastern Kentucky, coupled with human-made and natural disasters in the Appalachian Region, have likely impacted opinions regarding tap water.

Purpose: To use existing unexplored data to describe baseline tap water v. bottled water consumption in Kentucky.

Methods: Telephone-based cross-sectional data were obtained from the 2013 Kentucky Health Issues Poll (KHIP) directed by the Foundation for a Healthy Kentucky. Among many items in KHIP, self-reported consumption of bottled water over tap water, reasons for bottled water use, and demographic data were obtained. …

Car-T Cells Targeting Cd38 And Lmp1 Exhibit Robust Antitumour Activity Against Nk/T Cell Lymphoma, Hongwen Li, Wenting Song, Jiazhuo Wu, Zhuangzhuang Shi, Yuyang Gao, Jiwei Li, Lijuan Han, Jianxiang Zhang, Zhaoming Li, Yong Li, Mingzhi Zhang

Faculty, Staff and Students Publications

BACKGROUND: Natural killer/T cell lymphoma (NKTCL) is an aggressive lymphoma with a poor prognosis. Chimeric antigen receptor-transduced T (CAR-T) cell therapy has become a promising immunotherapeutic strategy against haematologic malignancies.

METHODS: In this study, four CAR-T cell lines (CD38-CAR, LMP1-CAR, CD38-LMP1 tandem CAR 1 and CD38-LMP1 tandem CAR 2) were generated. The effect of CAR-T cells against NKTCL cells was evaluated both in vitro and in vivo. Expression of T cell activation markers and cytokines produced by CAR-T cells were detected by flow cytometry.

RESULTS: The four CAR-T cell lines could effectively eliminate malignant NKTCL cells. They could be activated …

The Impact Of Vaccinations And Chronic Disease On Covid Death Rates, James L. Doti

Economics Faculty Articles and Research

This study presents a theoretical and empirical regression model to measure the efficacy of vaccinations in reducing COVID death rates across states over the 3/10/21 to 12/28/22 period. During that period, it was estimated that the availability of vaccinations resulted in a reduction of 427,000 COVID deaths in the nation. To arrive at that estimate, other covariants were held constant. In particular, it was found that chronic disease should be included as an explanatory variable to arrive at unbiased measures of the efficacy of vaccinations in reducing deaths. In addition, the percentage of people over the age of 65 was …

Characteristics And Source-Specific Health Risks Of Ambient Pm2.5-Bound Pahs In An Urban City Of Northern Taiwan, Yu-Chieh Ting, Chun-Hung Ku, Yu-Xuan Zou, Kai-Hsien Chi, Jhy-Charm Soo, Chin-Yu Hsu, Yu-Cheng Chen

Biostatistics, Epidemiology & Environmental Health Sciences: Faculty Publications

Polycyclic aromatic hydrocarbons (PAHs) with highly toxic compounds mainly exist in small-sized particles and can induce considerable human health risks. Studies on PM2.5-bound PAHs and their source-specific human health risks still remain scarce. Daily PM2.5 samples (n = 119) were collected every three days from 2016 to 2017 in Taipei city, Taiwan. Fifteen PAHs in PM2.5 were analyzed via gas chromatography tandem mass spectrometry (GC/MS-MS). We utilized a positive matrix factorization (PMF) model, diagnostic ratios, and potential source contribution function (PSCF) to identify the origins of PM2.5-bound PAHs. The annual concentration of total PAHs (TPAH) was 0.79 ± 0.67 ng …

Metapopulation Dynamics Of Sars-Cov-2 Transmission In A Small-Scale Amazonian Society, Thomas Kraft, Edmond Seabright, Sarah Alami, Samuel M. Jenness, Paul L. Hooper, Bret Beheim, Helen Davis, Daniel K. Cummings, Daniel Eid Rodriguez, Maguin Gutierrez Cayuba, Emily J. Miner, Xavier De Lamballerie, Lucia Inchauste, Stéphane Priet, Benjamin Trumble, Jonathan Stieglitz, Hillard Kaplan, Michael Gurven

ESI Publications

The severity of infectious disease outbreaks is governed by patterns of human contact, which vary by geography, social organization, mobility, access to technology and healthcare, economic development, and culture. Whereas globalized societies and urban centers exhibit characteristics that can heighten vulnerability to pandemics, small-scale subsistence societies occupying remote, rural areas may be buffered. Accordingly, voluntary collective isolation has been proposed as one strategy to mitigate the impacts of COVID-19 and other pandemics on small-scale Indigenous populations with minimal access to healthcare infrastructure. To assess the vulnerability of such populations and the viability of interventions such as voluntary collective isolation, we …

Stratification Of Pediatric Covid-19 Cases Using Inflammatory Biomarker Profiling And Machine Learning., Devika Subramanian, Aadith Vittala, Xinpu Chen, Christopher Julien, Sebastian Acosta, Craig Rusin, Carl Allen, Nicholas Rider, Zbigniew Starosolski, Ananth Annapragada, Sridevi Devaraj

Faculty, Staff and Students Publications

While pediatric COVID-19 is rarely severe, a small fraction of children infected with SARS-CoV-2 go on to develop multisystem inflammatory syndrome (MIS-C), with substantial morbidity. An objective method with high specificity and high sensitivity to identify current or imminent MIS-C in children infected with SARS-CoV-2 is highly desirable. The aim was to learn about an interpretable novel cytokine/chemokine assay panel providing such an objective classification. This retrospective study was conducted on four groups of pediatric patients seen at multiple sites of Texas Children's Hospital, Houston, TX who consented to provide blood samples to our COVID-19 Biorepository. Standard laboratory markers of …

A Mixed Methods Approach To Understanding The Links Between Mining, Climate Change And Selected Health Outcomes In India, Mary J. Cheruvillil

Dissertations and Theses

Despite ample evidence of the significant role that mining activities play in determining health outcomes, in India there is a dearth of comprehensive health studies that draw linkages between mining and health. The purpose of the following study is to investigate the impact of mining activities on population health in India using three different methods: ecological multivariable regression, exploratory spatial data analysis (ESDA) and content analysis of government documents using a phenomenological approach. The first aim uses the ecological multivariable regression to examine associations between mining activities and children’s malnutrition outcomes at the district level. Census data, the Demographic Health …

Genome-Scale Methylation Analysis In Blood And Tumor Identifies Immune Profile, Age Acceleration, And Dna Methylation Alterations Associated With Bladder Cancer Outcomes, Ji-Qing Chen

Dartmouth College Ph.D Dissertations

Bladder cancer patients receive frequent screening due to the high tumor recurrence rate (more than 60%). Nowadays, the conventional monitoring method relies on cystoscopy which is highly invasive and increases patient morbidity and burden to the health care system with frequent follow-up. As a result, it is urgent to explore novel markers related to the outcomes of bladder cancer. Immune profiles have been associated with cancer outcomes and may have the potential to be biomarkers for outcomes management. However, little work has been conducted to investigate the associations of immune cell profiles with bladder cancer outcomes. Here, I utilized the …

Improving Minors' Access To Treatment For Opioid Use Disorder: A Policy Analysis, Sara Jane Hamilton

Master's Projects and Capstones

As the opioid epidemic continues to have devastating effects on our communities, medications to treat opioid use disorder (MOUDs) are severely underutilized especially for adolescents. Unlike adults, minors need parental approval before obtaining MOUDs presenting a key barrier to timely treatment. Being able to treat adolescents as soon as they are ready is critically important for people with OUD, and while cost and other barriers have been addressed in the literature, there is a paucity on how parental consent affects the accessibility of treatment. This paper aims to explore a potential policy in California that addresses the lack of access …

Pediatric Firearm Injury Epidemiology At A Level 1 Trauma Center From 2019 To 2021: Including Time Of The Covid-19 Pandemic, Cynthia Orantes, Hei Kit Chan, Daniel Walter, Summer Chavez, Irma T Ugalde

Faculty, Staff and Student Publications

BACKGROUND: Firearms are a leading cause of death in children. The demand for firearms increased following COVID-19 "stay-at home orders" in March 2020, resulting in record-breaking firearm sales and background checks. We aim to describe the changes in pediatric firearm-related injuries, demographics, and associated risk factors at a Level 1 trauma center in Houston before and during the COVID 19 pandemic.

RESULTS: The total number of pediatric firearm-related injury cases increased during March 15th to December 31st, 2020 and 2021 compared to the same time period in 2019 (104 verses 89 verses 78). The demographic group most affected across years …

Reduced Racial Disparity As A Result Of Survival Improvement In Prostate Cancer, Baoyi Zhang, Jianrong Li, Mabel Tang, Chao Cheng

Faculty, Staff and Students Publications

Prostate cancer is a cancer type associated with a high level of racial and socioeconomic disparities as reported by many previous studies. However, the changes in these disparities in the past two decades have not been systematically studied. In this study, we investigated the Surveillance Epidemiology End Results (SEER) data for prostate cancer patients diagnosed during 2004-2018. African Americans and Asians showed significantly better and worse cancer-specific survival (CSS), respectively, compared to non-Hispanic white individuals after adjusting for confounding factors such as age and cancer stage. Importantly, the data indicated that racial disparities fluctuated and reached the highest level during …

The Co-Delivery Of Adenovirus-Based Immune Checkpoint Vaccine Elicits A Potent Anti-Tumor Effect In Renal Carcinoma, Nan Jiang, Yanyan Zheng, Jiage Ding, Jiawei Wang, Fei Zhu, Meng Wang, Navid Sobhani, Praveen Neeli, Gang Wang, Hailong Li, Junnian Zheng, Dafei Chai

Faculty, Staff and Students Publications

Immune-based checkpoint therapy has made significant progress in cancer treatment, but its therapeutic effect is limited. A replication-defective adenovirus (Ad) vaccine encoding tumor antigen carbonic anhydrase IX (CAIX) combined with Ad-encoding immune checkpoint PD-L1 was developed to treat renal carcinoma. Three tumor models, subcutaneous, lung metastasis and orthotopic tumor were established, and Ad vaccines were used to immunize them and evaluate the vaccine's therapeutic effect. Compared to the single Ad vaccine group, the subcutaneous tumor growth was significantly reduced in Ad-CAIX/Ad-PD-L1 combination group. Co-immunization of Ad-CAIX/Ad-PD-L1 enhanced the induction and maturation of CD11c

Skp2-Mediated Mlkl Degradation Confers Cisplatin-Resistant In Non-Small Cell Lung Cancer Cells, Huiling Zhou, Li Zhou, Qing Guan, Xuyang Hou, Cong Wang, Lijun Liu, Jian Wang, Xinfang Yu, Wei Li, Haidan Liu

Faculty, Staff and Students Publications

Non-small cell lung cancer (NSCLC) is the most prevalent type of cancer and the leading cause of cancer-related death. Chemotherapeutic resistance is a major obstacle in treating NSCLC patients. Here, we discovered that the E3 ligase Skp2 is overexpressed, accompanied by the downregulation of necroptosis-related regulator MLKL in human NSCLC tissues and cell lines. Knockdown of Skp2 inhibited viability, anchorage-independent growth, and in vivo tumor development of NSCLC cells. We also found that the Skp2 protein is negatively correlated with MLKL in NSCLC tissues. Moreover, Skp2 is increased and accompanied by an upregulation of MLKL ubiquitination and degradation in cisplatin-resistant …

Investigation Of Orthohantavirus Genetics In Rodent Reservoirs And Clinical Samples, Samuel Melvin Goodfellow

Biomedical Sciences ETDs

Orthohantaviruses are negative-sense, single stranded RNA viruses with trisegmented genomes that can cause severe disease in humans and are carried by several host reservoirs throughout the world. In the United States, Sin Nombre orthohantavirus (SNV) is the primary cause of hantavirus cardiopulmonary syndrome (HCPS) with a fatality rate of ~36% and the highest cases occuring in the southwest region. The primary SNV host reservoir is thought to be the western deer mouse, Peromyscus maniculatus, however it has been shown that other rodents can carry different orthohantaviruses. We designed a pan-orthohantavirus detection tool to survey several small mammal populations throughout New …

Weighted Mean Difference Statistics For Paired Data In The Presence Of Missing Values, Yuntong Li, Brent J. Shelton, William St Clair, Heidi L. Weiss, John L. Villano, Arnold Stromberg, Chi Wang, Li Chen

Markey Cancer Center Faculty Publications

Missing data is a common issue in many biomedical studies. Under a paired design, some subjects may have missing values in either one or both of the conditions due to loss of follow-up, insufficient biological samples, etc. Such partially paired data complicate statistical comparison of the distribution of the variable of interest between the two conditions. In this article, we propose a general class of test statistics based on the difference in weighted sample means without imposing any distributional or model assumption. An optimal weight is derived from this class of tests. Simulation studies show that our proposed test with …