CE Project Presentations
Esther Kim: Comparative Analysis of Cervical Cancer and HPV Knowledge among Women Living with HIV and the General U.S. Female Population
Background: Cervical cancer is largely preventable through HPV vaccination and regular cervical screening; however, significant disparities persist, especially among women living with HIV (WLWHIV). Due to immunodeficiency, WLWHIV experience greater susceptibility to cervical cancer and face additional barriers, including socioeconomic challenges, risky health behaviors, and limited knowledge about HPV and screening recommendations. Existing research highlights low adherence to cervical cancer screening and limited HPV awareness among WLWHIV compared to the general population, underscoring the urgent need for targeted educational interventions. This study aims to address gaps in cervical cancer and HPV knowledge between WLWHIV and the general female U.S. population, identify key predictors associated with high knowledge levels, and explore the role of demographic factors in shaping these differences.
Methods: This cross-sectional comparative analysis used two datasets: MySHARE2, comprising 49 WLWHIV from Washington, DC, and the nationally representative Health Information National Trends Survey (HINTS) 2007 dataset, which included 3,490 women. HPV and cervical cancer knowledge were assessed using composite scores derived from survey responses on HPV awareness, transmission, vaccination, and screening guidelines. Knowledge scores were dichotomized into high and low based on the dataset-specific mean. Sociodemographic predictors examined included age, race/ethnicity (Black vs. Non-Black), and educational attainment (college degree vs. less than college). Descriptive statistics, logistic regression analyses, and graphical visualizations were conducted using R software to identify predictors associated with high HPV knowledge and to assess differences between WLWHIV and the general population.
Significance: The findings will highlight disparities in cervical cancer and HPV knowledge between WLWHIV and the general female population, emphasizing key demographic predictors that influence knowledge levels. Understanding these disparities and their underlying factors can directly inform the development of culturally tailored education and outreach programs targeting high-risk groups. Immediate implications include guiding healthcare providers to integrate targeted HPV education into routine care for WLWHIV. Long-term, this research has potential to shape public health strategies, reduce cervical cancer disparities, and improve health outcomes by addressing identified knowledge gaps through evidence-based interventions.
Naman Gupta: Divergent Airborne Pollutants in Cryptogenic vs. Non-Cryptogenic Hepatocellular Carcinoma: A State-Level Cross-Sectional Study
We conducted a state-level cross-sectional study linking EPA AirToxScreen 2020 emissions with 815 hepatocellular carcinoma (HCC) cases from the NIH All of Us Research Program (2020–2022). Cryptogenic HCC was enriched in states with high benzene exposure, largely from wildfire and waste-related sources, whereas non-cryptogenic HCC clustered in states with elevated vinyl chloride emissions from large stationary industrial facilities. Total emissions did not correlate with overall HCC burden, but subtype-specific patterns were clear. These findings support targeted surveillance and regulatory strategies addressing pollutant-specific risks in HCC subtypes.
Augustine Ogwoh
Mini-Abstract
This cross-sectional study examined the associations between environmental vinyl chloride exposure and liver-related comorbidities among 524 patients with hepatocellular carcinoma from the NIH-sponsored All of Us Research Program (2020–2023), finding a high prevalence of comorbidities but no significant correlations with state-level exposure metrics.
Structured Abstract
Objective: To investigate associations between environmental vinyl chloride exposure and prevalence of hepatic fibrosis and diabetes mellitus among hepatocellular carcinoma (HCC) patients
Summary Background Data: Vinyl chloride is a Group 1 carcinogen with established links to hepatocellular carcinoma. While occupational studies demonstrate hepatotoxic effects, including fibrosis and metabolic dysfunction, the relationship between environmental exposure levels and liver-related comorbidities in HCC populations remains unclear. Understanding these associations is important for identifying high-risk populations and informing environmental health policies.
Methods: We conducted a cross-sectional analysis of 524 HCC cases from the NIH All of Us Research Program (2020–2023) linked with EPA AirToxScreen 2020 vinyl chloride exposure data. Hepatic fibrosis and diabetes mellitus were identified using SNOMED-CT codes from electronic health records. State-level vinyl chloride exposure metrics were calculated from census tract-level ambient air concentration data. Pearson correlation analyses examined associations between exposure metrics and comorbidity prevalence across 12 states. A sensitivity analysis excluding Massachusetts was performed due to its notably high vinyl chloride concentration (0.00239 µg/m³) and lower cancer risk estimates (10 per million). Additionally, individual-level multinomial logistic regression was performed among 436 patients to evaluate associations between standardized vinyl chloride exposure metrics and comorbidity patterns ("hepatic fibrosis only" [reference], "diabetes only," "both conditions"), adjusting for age, sex, ethnicity, state, and year of diagnosis.
Results: Among 524 HCC cases, 434 (82.8%) had hepatic fibrosis, 288 (55.0%) had diabetes, and 198 (37.8%) had both conditions. The mean age was 69.4 ± 9.3 years; 312 (59.5%) were male, and 507 (96.8%) were Hispanic/Latino. State-level vinyl chloride concentrations ranged from 0.000141 to 0.00239 µg/m³ across 12 states. Primary correlation analyses, including all 12 states, revealed no significant associations between exposure metrics and comorbidity prevalence (all p > 0.05). The sensitivity analysis excluding Massachusetts showed similarly weak, non-significant correlations (r = 0.070, p = 0.838 for hepatic fibrosis; r = -0.070, p = 0.838 for diabetes). In multinomial regression among 436 patients from 12 states, vinyl chloride concentration was not significantly associated with odds of diabetes only (OR = 0.80, 95% CI: 0.00–3.74e+13, p = 0.99) or both conditions (OR = 0.94, 95% CI: 0.70–1.26, p = 0.68) compared to hepatic fibrosis only.
Conclusions: Liver-related comorbidities are highly prevalent among HCC patients, but neither ecological correlations nor individual-level multinomial regression demonstrated statistically significant associations with environmental vinyl chloride exposure at current ambient levels. These findings support prioritizing established risk factor modification and comprehensive comorbidity management in HCC care.
Rinella Casseus: Effects of a Mindfulness Curriculum on Student Well-being and Academic Success among Middle School Students in New Orleans, Louisiana: A Single Arm Pre-Post Intervention Study
ABSTRACT
Background: Adolescent mental health disorders affect approximately 20% of youth, with Louisiana ranking 49th nationally in child well-being. Mindfulness-based interventions have demonstrated efficacy in reducing anxiety and depression while improving emotional regulation in educational settings. However, limited evidence exists regarding their effectiveness in high- risk middle school populations. This study evaluated a 16-week school-based mindfulness curriculum's impact on student well-being.
Methods: We conducted secondary data analysis using a single-arm pre-post design of survey data from 183 middle school students (grades 7-8) participating in the Align US mindfulness curriculum in New Orleans, Louisiana. Since subject identifiers linking pre and post outcome measures were missing, two-sample t-tests evaluated differences in group means between pre- and post-intervention measurements for psychological well-being, self-confidence, purpose/meaning, social support, and physical well-being. Subgroup analyses examined grade and sex differences using linear models.
Results: Significant deterioration occurred in psychological well-being (stress/worry increase: d = -0.295, p = 0.046), with composite scores decreasing from 2.89 to 2.78 following proper reverse coding. No significant changes were observed in other domains overall. Stratified analyses revealed pronounced sex differences: females experienced large psychological well- being decline (d = -0.521) and significant social support decline (d = -0.519). Grade differences showed 8th graders responding more favorably than 7th graders, particularly in physical well-being.
Conclusions: The mindfulness curriculum demonstrated concerning negative effects on psychological well-being among Louisiana middle schoolers. Significant demographic differences—particularly severe deterioration among females—emphasize the need for immediate program pause and comprehensive modifications. Results suggest caution regarding school-based mindfulness implementation pending thorough evaluation of delivery methods and potential adverse effects.