Graduate
November 18, 2020
Longitudinal Association between Greenspace and Type 2 Diabetes: Evidence from MESA
This study aimed to evaluate the longitudinal association between the abundance of nearby greenspace in urban and suburban environments and incident type 2 diabetes mellitus (T2DM). Data was used from the Multi-Ethnic Study of Atherosclerosis (MESA). Normal Difference Vegetation Index (NDVI) was used as a proxy for greenspace. Exposure categories used NDVI median values from…
A Retrospective Cohort Study of Race and Ethnicity, Pre-pregnancy Weight, and Pregnancy Complications
Objective: To examine relationships between race/ethnicity, pre-pregnancy overweight/obesity status, and pregnancy complications: gestational diabetes (GDM), preeclampsia, and cesarean-delivery. Methods: We conducted a large retrospective population-based cohort study among mothers who delivered a singleton live birth in hospitals that participated in the Obstetrics Clinical Outcomes Assessment Program database (N=57,144). Race/ethnicity was categorized into mutually exclusive groups…
Assessing Optimal Intervention Targets for Respiratory Infections in Structured Populations
Background: Respiratory Viral Infections (RVI) are one of the most common health conditions globally, and are an enormous burden to health systems and society in terms of direct medical expenses and indirect productivity losses. Despite progress made in the 20th century with the introduction of antibiotics, vaccines, and antivirals there are no specific interventions for…
Assessing the Individual and Interactive Associations of Pre- and Postnatal Air Pollution Exposures and Maternal Nutrition During Pregnancy with Child Blood Pressure: A Prospective Study in a Community-based Birth Cohort
Background: Limited data suggest that the intrauterine environment and early life experience may contribute to increased child blood pressure, with effects possibly extending into adulthood. The individual and interactive effects of air pollution exposures and maternal nutrition during pregnancy upon child blood pressure are unclear. Methods: In this dissertation, we conducted two separate prospective studies…
Hepatocellular carcinoma screening reduces cancer-related mortality in patients with chronic hepatitis B infection: a case-control study
Background: Patients with chronic hepatitis B (CHB) infection often undergo screening for hepatocellular carcinoma (HCC), but the efficacy of such screening remains unclear. We aimed to evaluate the impact of screening with ultrasound (USS) and/or serum alpha-fetoprotein (AFP) on HCC-related mortality in Veterans Affairs (VA) patients with CHB. Methods: We performed a matched case-control study….
Proximal tubular secretion, cardiovascular events, and kidney clearance of medications
Background: Current detection and monitoring of chronic kidney disease (CKD) rely primarily on glomerular filtration rate (GFR) and albuminuria. However, the kidneys perform many important functions outside of the glomerulus. Among them, the secretion of organic anions and cations by kidney proximal tubules is a vital non-glomerular function for removing retained metabolic wastes, toxins, and…
The Epidemiology, Outcomes, and Prevention of HIV-associated Meningitis in Southern Africa
Central nervous system infection are a primary cause of HIV-associated morbidity and mortality worldwide. In this dissertation, I discuss results from research conducted in Botswana, a country in southern Africa with an HIV prevalence that is among the highest in the world, including the first comprehensive meningitis national incidence estimates in a high HIV prevalence…
November 17, 2020
Risk factors for health-related quality of life deterioration following pediatric critical illness
Background: Many children experience declines in health-related quality of life (HRQL) after critical illness, but it is unknown what components of HRQL are most affected. We aimed to evaluate risk factors for deterioration between baseline and post-discharge HRQL status in the individual components of common HRQL measures among pediatric survivors of critical illness. Methods: We…
Depression and HIV pre-exposure prophylaxis use among sub-Saharan African Women
Daily, oral pre-exposure prophylaxis (PrEP) with emtricitabine/tenofovir disoproxil fumarate (FTC/TDF) is a highly efficacious HIV prevention strategy for key populations at high risk of HIV, including women, in sub-Saharan Africa. However, open-label studies and demonstration projects have reported that young women have difficulty adhering to PrEP over time, which limits its effectiveness as a prevention…
Early diagnosis in infants born to HIV-positive adolescent compared to adult mothers in Kisumu, Kenya
Although many countries have made great efforts to establish prevention of mother to child HIV transmission (PMTCT) services, globally 160,000 children are newly infected with HIV each year. Early infant diagnosis (EID) of HIV is critical to the survival of HIV-positive infants. While adolescent girls, defined by WHO as 10-19 years olds, represent a growing…
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