PhD
November 25, 2020
Incidence, Longitudinal Trajectory, and Hemodynamic Implications of Cardiac Dysfunction Following Traumatic Brain Injury
Traumatic brain injury (TBI) is a major public heath problem and leading cause of death and disability worldwide. While hemodynamic instability is common following TBI and associated with increased mortality, few studies have evaluated the function of the heart following TBI. Understanding the role of cardiac dysfunction following TBI represents a major gap in the…
Maternal periconceptional physical activity, sedentary behavior, and offspring growth
BACKGROUND Current guidelines recommend regular moderate/vigorous physical activity before and during pregnancy to reduce pregnancy complications. However, the recommendations do not include light physical activity or address fetal and postnatal growth. While reductions in sedentary behavior, in addition to regular moderate/vigorous physical activity, have been recommended for the general population, little is known about the…
Substance Use, Sexual Networks, and HIV risk among men who have sex with men and transgender women in Peru
BACKGROUND In Peru, the HIV epidemic is concentrated among men who have sex with men (MSM) and transgender women (TGW) in whom HIV incidence rates are as high as 4.2 per 100 person-years with HIV prevalence reported to be as high as 22% in MSM and up to 30% in TGW. This dissertation seeks to…
Public Park System Characteristics Associated with Physical Activity
Physical activity (PA) is protective of many chronic diseases, but most Americans are not sufficiently active. Public parks are places where PA occurs, and thus expanding park land or the facilities in parks could result in greater population levels of PA. There is a lack of robust evidence, however, linking greater park proximity or more…
HIV-1 Risk and Prevention Strategies for Women during Pregnancy and Postpartum
HIV-1 is the leading cause of death worldwide among women of reproductive age, and this group is a priority to reach with effective HIV-1 prevention. There is great potential to provide HIV-1 interventions to women during the periconception, pregnancy, and postpartum periods by leveraging existing healthcare settings that serve women and couples at high risk…
November 24, 2020
The 2014 chikungunya virus outbreak in the U.S. Virgin Islands: epidemiology, long-term health outcomes, and economic burden
Background: Chikungunya virus (CHIKV), an emerging and acutely debilitating alphavirus transmitted by the Aedes aegypti and Aedes albopictus mosquito, was introduced into the Americas in December of 2013. As of April 2016, almost 2 million suspected or confirmed cases have been reported in 45 different countries in the Americas. Acute symptoms of the virus include…
Safety of oral tenofovir disoproxil fumarate-based pre-exposure prophylaxis for HIV prevention: prospective studies in HIV-uninfected men and women
Antiretroviral pre-exposure prophylaxis (PrEP) with tenofovir disoproxil fumarate (TDF) alone or when co-formulated with emtricitabine (FTC), the same medication used for treatment of HIV infection, is a recommended and highly effective strategy to reduce the risk of sexual acquisition of HIV. The central objective of the studies described in this dissertation was to quantify the…
Hypertension and diabetes treatment and risk of adverse outcomes among breast cancer patients
Background: Management of comorbidities is a critical issue among 2.9 million breast cancer survivors in the U.S. Hypertension and diabetes are two common chronic conditions affecting this patient population. Despite the generally good safety profile of widely used antihypertensive medications and diabetes treatments, few studies have examined their relationships with adverse breast cancer outcomes. In…
Methylomic and Transcriptomic Insights Linking Air Pollution and Atherosclerosis
Background: Current literature demonstrates a compelling relationship between long-term air pollution exposure and cardiovascular diseases such as atherosclerosis. DNA methylation is a potential mediator of the air pollution-atherosclerosis association because 1) exposure to particulate matter is associated with alterations in DNA methylation, and 2) alterations in DNA methylation are found in atherosclerotic lesions and are…
Prevalence of mixed neuropathologies in autopsied older adults and associations with clinical disease progression
Introduction: Many older adults have multiple brain pathologies (aka mixed neuropathologies) at autopsy; however, the clinical importance of mixed neuropathologies is not well established. The objectives of this dissertation were 1.) to examine the prevalence of Alzheimer’s disease neuropathologic change (ADNC), Lewy body disease (LBD), vascular brain injury (VBI), and their co-occurrence and 2.) to…
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