Browse
Recent Submissions
Item Weight Trends Among Children and Adolescents within Centeral Indiana 2024 Data Addendum(2025-07-01) Duszynski, Tom; Carr, Zach; Crago, Jennifer; Hancock, Amy; Valvi, Nimish; Wandai, MuchiriThe 2024 data addendum report on childhood obesity trends in central Indiana from 2014 to 2024 reveals significant insights into the prevalence and changes in obesity rates among children and adolescents. Among the 602,209 unique individuals, the updated data include an additional 377.204 patient encounters in 2024, extending the longitudinal nature of this report and its findings. This analysis encompasses data from 1,615,866 encounters, stratified by county, age group, sex, and race/ethnicity.Item Weight Trends Among Children and Adolescents within Central Indiana 2023 data addendum(2025-03-04) Duszynski, Tom; Carr, Zach; Crago, Jennifer; Hancock, Amy; Valvi, Nimish; Wandai, MuchiriThe 2024 addendum to the full report on obesity trends among children and adolescents in central Indiana presents updated data and insights, reflecting changes observed over the past year. This addendum incorporates an additional 389,000 patient encounters, enhancing the robustness of the longitudinal analysis. The updated findings reveal a continued increase in obesity prevalence, with notable demographic variations and significant impacts from the COVID-19 pandemic. This report aims to provide a deeper understanding of the evolving obesity trends and inform targeted public health strategies to mitigate this growing concern.Item Weight Trends Among Children and Adolescents within Central Indiana(2023-07) Duszynski, Tom; Crago, Jennifer; Hancock, Amy; Valvi, Nimish; Luo, AvaChildhood and adolescent obesity represents a serious health problem in the U.S. and globally and is the biggest risk factor for adult obesity. Sequalae from childhood and adolescent obesity has been emerging earlier in life, resulting in long-term complications and lower quality of life and life expectancy. Focusing on primordial, primary, and secondary prevention among younger population translates into primary prevention in the adult populations as prevention is less expensive than treatment.Item Dietary Magnesium and Genetic Interactions in Diabetes and Related Risk Factors: A Brief Overview of Current Knowledge(MDPI, 2013-12-06) Hruby, Adela; McKeown, Nicola M.; Song, Yiqing; Djoussé, Luc; Epidemiology, Richard M. Fairbanks School of Public HealthNutritional genomics has exploded in the last decade, yielding insights-both nutrigenomic and nutrigenetic-into the physiology of dietary interactions and our genes. Among these are insights into the regulation of magnesium transport and homeostasis and mechanisms underlying magnesium's role in insulin and glucose handling. Recent observational evidence has attempted to examine some promising research avenues on interaction between genetics and dietary magnesium in relation to diabetes and diabetes risk factors. This brief review summarizes the recent evidence on dietary magnesium's role in diabetes and related traits in the presence of underlying genetic risk, and discusses future potential research directions.Item Associations between serum micronutrients and all-cause, cancer, and cardiovascular mortality in a national representative population: Mediated by inflammatory biomarkers(Elsevier, 2025) Liu, Chunliang; Wongsonegoro, Harrison; Sheng, Tianchen; Fan, Hao; Zhang, Jianjun; Epidemiology, Richard M. Fairbanks School of Public HealthBackground: Micronutrient intake was inversely associated with cancer and cardiovascular risk in previous studies, but obtained results were inconsistent and the biological mechanisms for this potential protective effect remain elusive. Therefore, we investigated the associations of serum vitamin C, 25(OH)D, α-tocopherol, β-carotene, lycopene, folate, and iron with all-cause, cancer, and cardiovascular mortality. We further evaluated whether these associations were mediated through altered inflammatory responses. Methods: Data were obtained from 11,539 participants aged ≥40 years in the National Health and Nutrition Examination Survey (NHANES) in 2001-2006 and 2017-2018. Mortality status of the participants with an average follow-up of 10.5 years was ascertained from the linked mortality files of the National Death Index. Cox proportional hazards regression was performed to evaluate mortality risk in relation to serum micronutrients, while mediation analysis was used to assess the mediating effects of serum C-reactive protein and white blood cell count on the associations of interest. Results: After adjustment for confounders, serum levels of vitamin C, 25(OH)D, β-carotene, and lycopene were associated with a reduced risk of death from all causes, cancer, and cardiovascular disease. For example, HRs (95 % CIs) for quartiles 2, 3, and 4 vs. quartile 1 of 25(OH)D were, respectively, 0.72 (0.62, 0.83), 0.70 (0.62, 0.79), and 0.66 (0.56, 0.78) (p-trend: <0.0001) for all-cause mortality, 0.68 (0.52, 0.91), 0.54 (0.39, 0.73), and 0.48 (0.32, 0.71) (p-trend: 0.0001) for cancer mortality, and 0.64 (0.50, 0.83), 0.66 (0.53, 0.83), and 0.59 (0.42, 0.82) (p-trend: 0.0012) for cardiovascular mortality. Additionally, serum C-reactive protein significantly mediated 5.3%-20.4 %, 4.5%-18.1 %, and 3.3%-15.7 % of the associations of vitamin C, 25(OH)D, β-carotene, and lycopene with all-cause, cancer, and cardiovascular mortality, respectively. Conclusion: This study suggested that serum levels of several antioxidants and vitamin D were inversely associated with all-cause, cancer, and cardiovascular mortality, mediated in part by mitigated inflammatory responses.Item Informatics Interventions for Maternal Morbidity: Scoping Review(JMIR Publications, 2025-03-25) Inderstrodt, Jill; Stumpff, Julia C.; Smollen, Rebecca; Sridhar, Shreya; El-Azab, Sarah; Ojo, Opeyemi; Bowns, Brendan; Haggstrom, David A.Background: Women have been entering pregnancy less healthy than previous generations, placing them at increased risk for pregnancy complications. One approach to ensuring effective monitoring and treatment of at-risk women is designing technology-based interventions that prevent maternal morbidities and treat perinatal conditions. Objective: This scoping review evaluates what informatics interventions have been designed and tested to prevent and treat maternal morbidity. Methods: MEDLINE, Embase, and Cochrane Library were searched to identify relevant studies. The inclusion criteria were studies that tested a medical or clinical informatics intervention; enrolled adult women; and addressed preeclampsia, gestational diabetes mellitus (GDM), preterm birth, Centers for Disease Control and Prevention-defined severe maternal morbidity, or perinatal mental health conditions. Demographic, population, and intervention data were extracted to characterize the technologies, conditions, and populations addressed. Results: A total of 80 studies were identified that met the inclusion criteria. Many of the studies tested for multiple conditions. Of these, 73% (60/82) of the technologies were tested for either GDM or perinatal mental health conditions, and 15% (12/82) were tested for preeclampsia. For technologies, 32% (28/87) of the technologies tested were smartphone or tablet applications, 26% (23/87) were telehealth interventions, and 14% (12/87) were remote monitoring technologies. Of the many outcomes measured by the studies, almost half (69/140, 49%) were patient physical or mental health outcomes. Conclusions: Per this scoping review, most informatics interventions address three conditions: GDM, preeclampsia, and mental health. There may be opportunities to treat other potentially lethal conditions like postpartum hemorrhage using proven technologies such as mobile apps. Ample gaps in the literature exist concerning the use of informatics technologies aimed at maternal morbidity. There may be opportunities to use informatics for lesser-targeted conditions and populations.Item COVID-19 Vaccine Hesitancy among Arab Americans(Springer Nature, 2022-04-14) Kheil, Mira H.; Jain, Deepti; Jomaa, Jamil; Askar, Brandon; Alcodray, Yasmeen; Wahbi, Shatha; Brikho, Salar; Kadouh, Ali; Harajli, Deanna; Jawad, Zain N.; Fehmi, Ziad; Elhage, Malaak; Tawil, Tala; Fehmi, Omar; Alzouhayli, Suma J.; Ujayli, Deema; Suleiman, Noor; Kazziha, Omar; Saleh, Rawan; Abada, Evi; Shallal, Anita; Kim, Seongho; Kumar, Vijaya Arun; Zervos, Marcus; Cote, Michele L.; Ali-Fehmi, Rouba; Epidemiology, Richard M. Fairbanks School of Public Health(1) Background: Coronavirus disease-2019 (COVID-19) vaccines have a significant impact on reducing morbidity and mortality from infection. However, vaccine hesitancy remains an obstacle in combating the pandemic. The Arab American (AA) population is understudied; thus, we aimed to explore COVID-19 attitudes within this community. (2) Methods: This was a cross-sectional study. An anonymous online survey was distributed to members of different AA associations and to the community through the snowball method. (3) Results: A total of 1746 participants completed the survey. A total of 92% of respondents reported having received at least one dose of a COVID-19 vaccine. A total of 73% reported willingness to receive a booster, and 72% plan to give their children the vaccine. On multivariate analysis, respondents were more likely to be vaccine-hesitant if they were hesitant about receiving any vaccine in general. They were less likely to be vaccine-hesitant if they were immigrants, over the age of 40, up to date on their general vaccination and if they believed that COVID-19 vaccines are safe and effective in preventing an infection. The belief that all vaccines are effective at preventing diseases was also associated with lower hesitancy. (4) Conclusions: This sample of AAs have higher vaccination rates and are more willing to vaccinate their children against COVID-19 when compared to the rest of the population. However, a reemergence of hesitancy might be arising towards the boosters.Item Evaluation of COVID-19 Vaccine Attitudes among Arab American Healthcare Professionals Living in the United States(MDPI, 2021-08-24) Shallal, Anita; Abada, Evi; Musallam, Rami; Fehmi, Omar; Kaljee, Linda; Fehmi, Ziad; Alzouhayli, Suma; Ujayli, Deema; Dankerlui, Doreen; Kim, Seongho; Cote, Michele L.; Kumar, Vijaya Arun; Zervos, Marcus; Ali-Fehmi, Rouba; Epidemiology, Richard M. Fairbanks School of Public HealthBackground: Vaccine hesitancy is the next great barrier for public health. Arab Americans are a rapidly growing demographic in the United States with limited information on the prevalence of vaccine hesitancy. We therefore sought to study the attitudes towards the coronavirus disease 2019 (COVID-19) vaccine amongst Arab American health professionals living in the United States. Methods: This was a cross sectional study utilizing an anonymous online survey. The survey was distributed via e-mail to National Arab American Medical Association members and Arab-American Center for Economic and Social Services healthcare employees. Respondents were considered vaccine hesitant if they selected responses other than a willingness to receive the COVID-19 vaccine. Results: A total of 4000 surveys were sent via e-mail from 28 December 2020 to 31 January 2021, and 513 responses were received. The highest group of respondents were between the ages of 18-29 years and physicians constituted 48% of the respondents. On multivariable analysis, we found that respondents who had declined an influenza vaccine in the preceding 5 years (p < 0.001) and allied health professionals (medical assistants, hospital administrators, case managers, researchers, scribes, pharmacists, dieticians and social workers) were more likely to be vaccine hesitant (p = 0.025). In addition, respondents earning over $150,000 US dollars annually were less likely to be vaccine hesitant and this finding was significant on multivariable analysis (p = 0.011). Conclusions: Vaccine hesitancy among health care providers could have substantial impact on vaccine attitudes of the general population, and such data may help inform vaccine advocacy efforts.Item Contributions of the Microbiome-Derived Metabolome for Risk Assessment and Prognostication of Pancreatic Cancer(Oxford University Press, 2024) León-Letelier, Ricardo A.; Dou, Rongzhang; Vykoukal, Jody; Yip-Schneider, Michele T.; Maitra, Anirban; Irajizad, Ehsan; Wu, Ranran; Dennison, Jennifer B.; Do, Kim-An; Zhang, Jianjun; Schmidt, C. Max; Hanash, Samir; Fahrmann, Johannes F.; Epidemiology, Richard M. Fairbanks School of Public HealthBackground: Increasing evidence implicates microbiome involvement in the development and progression of pancreatic ductal adenocarcinoma (PDAC). Studies suggest that reflux of gut or oral microbiota can lead to colonization in the pancreas, resulting in dysbiosis that culminates in release of microbial toxins and metabolites that potentiate an inflammatory response and increase susceptibility to PDAC. Moreover, microbe-derived metabolites can exert direct effector functions on precursors and cancer cells, as well as other cell types, to either promote or attenuate tumor development and modulate treatment response. Content: The occurrence of microbial metabolites in biofluids thereby enables risk assessment and prognostication of PDAC, as well as having potential for design of interception strategies. In this review, we first highlight the relevance of the microbiome for progression of precancerous lesions in the pancreas and, using liquid chromatography-mass spectrometry, provide supporting evidence that microbe-derived metabolites manifest in pancreatic cystic fluid and are associated with malignant progression of intraductal papillary mucinous neoplasm(s). We secondly summarize the biomarker potential of microbe-derived metabolite signatures for (a) identifying individuals at high risk of developing or harboring PDAC and (b) predicting response to treatment and disease outcomes. Summary: The microbiome-derived metabolome holds considerable promise for risk assessment and prognostication of PDAC.Item Human–Computer Interaction in Healthcare: A Bibliometric Analysis with CiteSpace(MDPI, 2024-12-06) Zhao, Xiangying; Zhang, Shunan; Nan, Dongyan; Han, Jiali; Kim, Jang Hyun; Epidemiology, Richard M. Fairbanks School of Public HealthBackground/Objectives: Studies on the application and exploration of human–computer interaction (HCI) technologies within the healthcare sector have rapidly expanded, showcasing the immense potential of HCI to enhance medical services, elevate patient experiences, and advance health management. Despite this proliferating interest, there is a notable shortage of comprehensive bibliometric analyses dedicated to the application of HCI in healthcare, which limits a thorough comprehension of the growth trends and future trajectories in this area. Methods: To bridge this gap, we employed bibliometric methods using the CiteSpace tool to systematically review and analyze the current state and trends of HCI research in healthcare. A meticulous topic search of Web of Science yielded 3598 papers published between 2004 and 2023. Results: Through literature analysis, the most productive researchers, institutes, and countries/territories and the collaboration networks among authors and countries within the field were analyzed. Additionally, by conducting a co-citation analysis, journals and literature with high citation rates and influence within the academic community in this field were revealed. Through a cluster analysis based on literature co-citations and keyword burst analyses, we further explored the main research themes and hot topics within the fields of healthcare and HCI. Conclusions: In summary, through a comprehensive and systematic bibliometric analysis, this study provides a solid knowledge foundation for HCI in the healthcare research community, thereby fostering the development of innovative research and the optimization of practical applications in the field.