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Emanuela Taioli
Institute for Translational Epidemiology and Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, USA

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Research article
Published: 24 July 2021 in BMC Public Health
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Background New York City (NYC) was the epicenter of the COVID-19 pandemic, and is home to underserved populations with higher prevalence of chronic conditions that put them in danger of more serious infection. Little is known about how the presence of chronic risk factors correlates with mortality at the population level. Here we determine the relationship between these factors and COVD-19 mortality in NYC. Methods A cross-sectional study of mortality data obtained from the NYC Coronavirus data repository (03/02/2020–07/06/2020) and the prevalence of neighborhood-level risk factors for COVID-19 severity was performed. A risk index was created based on the CDC criteria for risk of severe illness and complications from COVID-19, and stepwise linear regression was implemented to predict the COVID-19 mortality rate across NYC zip code tabulation areas (ZCTAs) utilizing the risk index, median age, socioeconomic status index, and the racial and Hispanic composition at the ZCTA-level as predictors. Results The COVID-19 death rate per 100,000 persons significantly decreased with the increasing proportion of white residents (βadj = − 0.91, SE = 0.31, p = 0.0037), while the increasing proportion of Hispanic residents (βadj = 0.90, SE = 0.38, p = 0.0200), median age (βadj = 3.45, SE = 1.74, p = 0.0489), and COVID-19 severity risk index (βadj = 5.84, SE = 0.82, p < 0.001) were statistically significantly positively associated with death rates. Conclusions Disparities in COVID-19 mortality exist across NYC and these vulnerable areas require increased attention, including repeated and widespread testing, to minimize the threat of serious illness and mortality.

ACS Style

Wil Lieberman-Cribbin; Naomi Alpert; Raja Flores; Emanuela Taioli. A risk index for COVID-19 severity is associated with COVID-19 mortality in New York City. BMC Public Health 2021, 21, 1 -8.

AMA Style

Wil Lieberman-Cribbin, Naomi Alpert, Raja Flores, Emanuela Taioli. A risk index for COVID-19 severity is associated with COVID-19 mortality in New York City. BMC Public Health. 2021; 21 (1):1-8.

Chicago/Turabian Style

Wil Lieberman-Cribbin; Naomi Alpert; Raja Flores; Emanuela Taioli. 2021. "A risk index for COVID-19 severity is associated with COVID-19 mortality in New York City." BMC Public Health 21, no. 1: 1-8.

Journal article
Published: 28 June 2021 in BMC Medical Education
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Background Although the value of DACA medical students has been hypothesized, no data are available on their contribution to US healthcare. While the exact number of DACA recipients in medical school is unknown, DACA medical students are projected to represent an increasing proportion of physicians in the future. The current literature on DACA students has not analyzed the experiences of these students. Methods A mixed-methods study on the career intentions and experiences of DACA medical students was performed utilizing survey data and in-depth interviews. The academic performance of a convenience sample of DACA medical students was compared to that of matriculated medical students from corresponding medical schools, national averages, and first-year residents according to specialty. Results Thirty-three DACA medical students completed the survey and five participated in a qualitative interview. The average undergraduate GPA (SD) of the DACA medical student sample was 3.7 (0.3), the same as the national GPA of 2017–2018 matriculated medical students. The most common intended residency programs were Internal Medicine (27.2%), Emergency Medicine (15.2%), and Family Medicine (9.1%). In interviews, DACA students discussed their motivation for pursuing medicine, barriers and facilitators that they faced in attending medical school, their experiences as medical students, and their future plans. Conclusions The intent of this sample to pursue medical specialties in which there is a growing need further exemplifies the unique value of these students. It is vital to protect the status of DACA recipients and realize the contributions that DACA physicians provide to US healthcare.

ACS Style

Christina Gillezeau; Wil Lieberman-Cribbin; Kristin Bevilacqua; Julio Ramos; Naomi Alpert; Raja Flores; Rebecca M. Schwartz; Emanuela Taioli. Deferred Action for Childhood Arrivals (DACA) medical students – an examination of their journey and experiences as medical students in limbo. BMC Medical Education 2021, 21, 1 -10.

AMA Style

Christina Gillezeau, Wil Lieberman-Cribbin, Kristin Bevilacqua, Julio Ramos, Naomi Alpert, Raja Flores, Rebecca M. Schwartz, Emanuela Taioli. Deferred Action for Childhood Arrivals (DACA) medical students – an examination of their journey and experiences as medical students in limbo. BMC Medical Education. 2021; 21 (1):1-10.

Chicago/Turabian Style

Christina Gillezeau; Wil Lieberman-Cribbin; Kristin Bevilacqua; Julio Ramos; Naomi Alpert; Raja Flores; Rebecca M. Schwartz; Emanuela Taioli. 2021. "Deferred Action for Childhood Arrivals (DACA) medical students – an examination of their journey and experiences as medical students in limbo." BMC Medical Education 21, no. 1: 1-10.

Original paper
Published: 26 May 2021 in Journal of Community Health
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This study aimed to assess the coronavirus disease (COVID-19) school-related information New York City residents sought through the 311 Call Center. July to November inquiries were downloaded from the NYC Open Data website for 2018–2020. Calls were categorized as related to “Schools”, “Access”, “Food”, “Hospitals”, “Transportation”, and “Unemployment”. Overall call types, and among school-related calls, detailed call types, were compared over the years, using chi-squared tests. School-related inquiries increased by 71% from 2018 to 2020. During 2020, the most common (49%, n = 22,471) call description was “Coronavirus and Schools”, encompassing calls about learning options, safety, and resources. Spikes in these calls corresponded to official announcements, including those about Fall reopening plans (August 31: n = 678; September 1: n = 624) and schedules and staffing (September 16th: n = 1043; September 17th: n = 713), and after the start of in-person learning (September 21: n = 680). This study demonstrates that as government officials updated NYC schooling plans for Fall 2020, there were increased concerns among NYC residents. Future COVID-19 schooling changes need to be conveyed clearly and disseminated effectively in order to avoid confusion about NYC’s pandemic learning strategy and to address health and safety concerns.

ACS Style

Adriana Eugene; Naomi Alpert; Wil Lieberman-Cribbin; Emanuela Taioli. Trends in COVID-19 School Related Inquiries Using 311 New York City Open Data. Journal of Community Health 2021, 1 -6.

AMA Style

Adriana Eugene, Naomi Alpert, Wil Lieberman-Cribbin, Emanuela Taioli. Trends in COVID-19 School Related Inquiries Using 311 New York City Open Data. Journal of Community Health. 2021; ():1-6.

Chicago/Turabian Style

Adriana Eugene; Naomi Alpert; Wil Lieberman-Cribbin; Emanuela Taioli. 2021. "Trends in COVID-19 School Related Inquiries Using 311 New York City Open Data." Journal of Community Health , no. : 1-6.

Original research
Published: 21 May 2021 in Disaster Medicine and Public Health Preparedness
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Objectives: Hurricane Sandy made landfall across New York City (NYC) in October 2012, but the long-term consequences of the storm are still not fully understood. We analyzed NYC data to quantify the extent of Hurricane Sandy-related concerns over time. Methods: Data on NYC 311 Call Center inquiries were downloaded from the NYC Open Data website (October 29, 2012 to May 26, 2020) to provide information about Sandy-related calls using the keywords “Hurricane” and “Sandy”. Results: In the first 2 wk after Hurricane Sandy, 15.6% of 311 calls were related to the storm. From 2012 to 2020, the volume of inquiries decreased from 87,209 to 25. The majority of calls in 2012 (49,181; 56%) was requesting general Hurricane Sandy information, and in 2020 assistance with property restoration (20; 79%) Conclusions: The long-term consequences of Hurricane Sandy in NYC persist into 2020, almost 8 y after the initial event. The needs of Hurricane Sandy victims have changed over time from requiring general information regarding closures, property destruction and immediate disaster relief to aid with legal, financial, and mental health consequences. Disaster response policy-makers must understand the changing needs of NYC residents to provide resources and prepare for future disasters.

ACS Style

Adriana Eugene; Naomi Alpert; Wil Lieberman-Cribbin; Emanuela Taioli. Using NYC 311 Call Center Data to Assess Short- and Long-Term Needs Following Hurricane Sandy. Disaster Medicine and Public Health Preparedness 2021, 1 -5.

AMA Style

Adriana Eugene, Naomi Alpert, Wil Lieberman-Cribbin, Emanuela Taioli. Using NYC 311 Call Center Data to Assess Short- and Long-Term Needs Following Hurricane Sandy. Disaster Medicine and Public Health Preparedness. 2021; ():1-5.

Chicago/Turabian Style

Adriana Eugene; Naomi Alpert; Wil Lieberman-Cribbin; Emanuela Taioli. 2021. "Using NYC 311 Call Center Data to Assess Short- and Long-Term Needs Following Hurricane Sandy." Disaster Medicine and Public Health Preparedness , no. : 1-5.

Original article
Published: 19 May 2021 in American Journal of Clinical Oncology
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Introduction: The role of specific immune cell types within the tumor immune microenvironment in non−small cell lung cancer survival is unclear. The potential of these immune cells to become predictive biomarkers of prognosis, and to define subpopulations who will benefit of additional treatment is urgently needed. Methods: Stage I to IIIA non−small cell lung cancer patients who underwent surgical resection were queried from the Cancer Genome Atlas; RNAseq data as well as clinical information was extracted. Sample-specific scores for different immune cells were computed via xCell. The association between each cell type and survival was assessed with Cox regression, both unadjusted and adjusted for sex, stage, smoking status, and tumor purity. Models were stratified by lung adenocarcinoma and lung squamous cell carcinoma. Results: There were 383 lung adenocarcinoma and 328 lung squamous cell carcinoma samples, and 161 (42%) and 124 (38%) deaths respectively. There was no association between any immune cell infiltrations and survival in the combined unadjusted Cox regression model. After adjustment, the presence of CD8+ cytotoxic T cells (adjusted hazard ratio [HRajd]: 0.84; 95% confidence interval [CI]: 0.71-0.99; P=0.03), CD4+ helper T cells (HRajd: 0.79; 95% CI: 0.66-0.95; P=0.01) and CD20+ B cells (HRajd: 0.80; 95% CI: 0.66-0.97; P=0.02) were significant predictors of decreased risk of death. Conclusions: This study shows that the adjustment for clinical characteristics is key when evaluating tumor immune infiltration and its association with cancer outcomes. Adjustment for confounding factors modified the prognostic significance of specific immune cell populations in early-stage surgically resected NSCLC cases; clinical attributes may have high relevance on immune infiltration composition.

ACS Style

Stephanie Tuminello; Francesca Petralia; Rajwanth Veluswamy; Pei Wang; Raja Flores; Emanuela Taioli. Prognostic Value of the Tumor Immune Microenvironment for Early-stage, Non−Small Cell Lung Cancer. American Journal of Clinical Oncology 2021, 44, 350 -355.

AMA Style

Stephanie Tuminello, Francesca Petralia, Rajwanth Veluswamy, Pei Wang, Raja Flores, Emanuela Taioli. Prognostic Value of the Tumor Immune Microenvironment for Early-stage, Non−Small Cell Lung Cancer. American Journal of Clinical Oncology. 2021; 44 (7):350-355.

Chicago/Turabian Style

Stephanie Tuminello; Francesca Petralia; Rajwanth Veluswamy; Pei Wang; Raja Flores; Emanuela Taioli. 2021. "Prognostic Value of the Tumor Immune Microenvironment for Early-stage, Non−Small Cell Lung Cancer." American Journal of Clinical Oncology 44, no. 7: 350-355.

Research article
Published: 06 May 2021 in eJHaem
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The coronavirus disease 2019 (COVID‐19) caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS‐CoV‐2) has led to an unprecedented international health crisis. COVID‐19 clinical presentations cover a wide range from asymptomatic to severe illness and death. Given the limited therapeutic resources and unexpected clinical features of the disease, readily accessible predictive biomarkers are urgently needed to improve patient care and management. We asked the degree to which anemia may influence the outcome of patients with COVID‐19. To this end, we identified 3777 patients who were positively diagnosed with COVID‐19 between March 1 and April 1 2020 in New York City. We evaluated 2,562 patients with available red blood cell, hemoglobin, and related laboratory values. Multivariable cox proportional hazards regression showed that anemia was a significant independent predictor of mortality (hazard ratio (HR): 1.26, 95% Confidence Interval [CI]: 1.06‐1.51), independent of age, sex, and comorbidities. There was a direct correlation between the degree of anemia and the risk of mortality when hemoglobin was treated as a continuous variable (HRadj 1.05; [CI]: 1.01‐1.09). The hemoglobin level that was maximally predictive of mortality, was 11.5 g/dL in males and 11.8 g/dL in females. These findings identify a routinely measured biomarker that is predictive of disease outcomes and will aid in refining clinical care algorithms and optimize resource allocation. Mechanisms of impacts of anemia on COVID‐19 outcome are likely to be multiple in nature and require further investigation.

ACS Style

Douglas Tremblay; Joseph L. Rapp; Naomi Alpert; Wil Lieberman‐Cribbin; John Mascarenhas; Emanuela Taioli; Saghi Ghaffari. Mild anemia as a single independent predictor of mortality in patients with COVID‐19. eJHaem 2021, 1 .

AMA Style

Douglas Tremblay, Joseph L. Rapp, Naomi Alpert, Wil Lieberman‐Cribbin, John Mascarenhas, Emanuela Taioli, Saghi Ghaffari. Mild anemia as a single independent predictor of mortality in patients with COVID‐19. eJHaem. 2021; ():1.

Chicago/Turabian Style

Douglas Tremblay; Joseph L. Rapp; Naomi Alpert; Wil Lieberman‐Cribbin; John Mascarenhas; Emanuela Taioli; Saghi Ghaffari. 2021. "Mild anemia as a single independent predictor of mortality in patients with COVID‐19." eJHaem , no. : 1.

Journal article
Published: 01 May 2021 in American Journal of Preventive Medicine
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This multiyear, cross-sectional study explores the changes over time in how U.S. middle- and high-school students perceive the harm and addiction risk of E-cigarettes. This study analyzed 83,779 participants in the National Youth Tobacco Survey from 2015 to 2019. Associations of survey year with perceived harm and addiction risk of E-cigarettes were assessed using multivariable multinomial logistic regression models, adjusted for sociodemographic characteristics. Smoking decreased over the 5 years (-1.85 percentage points, p=0.07); vaping increased (9.03 percentage points, p<0.01). Perceived harm of both combustible cigarettes and E-cigarettes increased with time. Male, older, and non-White students perceived less harm from smoking or vaping. Perceptions of the addictiveness of E-cigarettes increased over time: 26.31% of students considered E-cigarettes to be more addictive than combustible cigarettes in 2019, compared with 7.26% in 2016. Female and non-White students were more likely to think that E-cigarettes were at least as addictive as combustible cigarettes but also reported less knowledge about them. The perceptions of both harm and addictiveness of E-cigarettes have increased over time, independent of current use. Perceptions vary on the basis of age, sex, race/ethnicity, and current use. Efforts should be made to further educate adolescents about E-cigarettes and to regulate their sale and advertisement. Efforts to reduce the uptake of combustible cigarettes among adolescents have been successful and should be duplicated for E-cigarettes.

ACS Style

Joseph L. Rapp; Naomi Alpert; Karen M. Wilson; Raja M. Flores; Emanuela Taioli. Changes in E-Cigarette Perceptions Over Time: A National Youth Tobacco Survey Analysis. American Journal of Preventive Medicine 2021, 1 .

AMA Style

Joseph L. Rapp, Naomi Alpert, Karen M. Wilson, Raja M. Flores, Emanuela Taioli. Changes in E-Cigarette Perceptions Over Time: A National Youth Tobacco Survey Analysis. American Journal of Preventive Medicine. 2021; ():1.

Chicago/Turabian Style

Joseph L. Rapp; Naomi Alpert; Karen M. Wilson; Raja M. Flores; Emanuela Taioli. 2021. "Changes in E-Cigarette Perceptions Over Time: A National Youth Tobacco Survey Analysis." American Journal of Preventive Medicine , no. : 1.

Letter to the editor
Published: 29 April 2021 in Journal of Medical Virology
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Christina Gillezeau; Naomi Alpert; Marcantonio Caltabiano; Raja Flores; Emanuela Taioli. Informing the global COVID‐19 response by estimating excess deaths in Italy during the COVID‐19 and 1918 influenza pandemics. Journal of Medical Virology 2021, 1 .

AMA Style

Christina Gillezeau, Naomi Alpert, Marcantonio Caltabiano, Raja Flores, Emanuela Taioli. Informing the global COVID‐19 response by estimating excess deaths in Italy during the COVID‐19 and 1918 influenza pandemics. Journal of Medical Virology. 2021; ():1.

Chicago/Turabian Style

Christina Gillezeau; Naomi Alpert; Marcantonio Caltabiano; Raja Flores; Emanuela Taioli. 2021. "Informing the global COVID‐19 response by estimating excess deaths in Italy during the COVID‐19 and 1918 influenza pandemics." Journal of Medical Virology , no. : 1.

Journal article
Published: 19 April 2021 in Journal of Exposure Science & Environmental Epidemiology
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Hurricane Harvey facilitated exposure to various toxic substances and floodwater throughout the greater Houston metropolitan area. Although disparities exist in this exposure and vulnerable populations can bear a disproportionate impact, no research has integrated disparities in exposure to toxic incidents following Hurricane Harvey. The objective of this study was to analyze the relationship between flooding, socioeconomic status (SES), and toxic site incidents. Data on toxic site locations, reported releases, and flood water depths during Hurricane Harvey in the greater Houston area were compiled from multiple sources. A multivariable logistic regression was performed to predict the odds of a toxic site release by flooding at the site, SES and racial composition of the census tract. 83 out of 1403 toxic sites (5.9%) had reported releases during Hurricane Harvey. The proportion of toxic sites with reported incidents across increasing SES index quintiles were 8.35, 7.67, 5.14, 4.55, and 0.51, respectively. The odds of an incident were lower in the highest SES quintile areas (ORadj = 0.06, 95% CI: 0.01–0.42) compared to the lowest SES quintile. Flooding was similar at toxic sites with and without incidents, and was distributed similarly and highest at toxic sites located in lower SES quintiles. Despite similar flooding across toxic sites during Hurricane Harvey, areas with lower SES were more likely to have a toxic release during the storm, after accounting for number of toxic sites. Improving quality of maintenance, safety protocols, number of storm-resilient facilities may minimize this disproportionate exposure and its subsequent adverse outcomes among socioeconomically vulnerable populations.

ACS Style

Wil Lieberman-Cribbin; Bian Liu; Perry Sheffield; Rebecca Schwartz; Emanuela Taioli. Socioeconomic disparities in incidents at toxic sites during Hurricane Harvey. Journal of Exposure Science & Environmental Epidemiology 2021, 31, 454 -460.

AMA Style

Wil Lieberman-Cribbin, Bian Liu, Perry Sheffield, Rebecca Schwartz, Emanuela Taioli. Socioeconomic disparities in incidents at toxic sites during Hurricane Harvey. Journal of Exposure Science & Environmental Epidemiology. 2021; 31 (3):454-460.

Chicago/Turabian Style

Wil Lieberman-Cribbin; Bian Liu; Perry Sheffield; Rebecca Schwartz; Emanuela Taioli. 2021. "Socioeconomic disparities in incidents at toxic sites during Hurricane Harvey." Journal of Exposure Science & Environmental Epidemiology 31, no. 3: 454-460.

Letter to the editor
Published: 10 April 2021 in Journal of Medical Virology
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Introduction We have read with great interest the meta‐analysis that examined the impact of increased red cell distribution width (RDW) and COVID‐19 outcomes, conducted by Lee and colleagues, and recently published in the Journal of Medical Virology. The authors concluded that elevations in RDW were associated with adverse COVID‐19 outcomes. However, the impact of elevation of RDW independent of anemia in COVID‐19 remains to be clarified. Methods Patients ≥18 years who were diagnosed with COVID‐19 at the Mount Sinai Health System between March 1 and April 1, 2020 and had a complete blood count (CBC) at presentation (n=2562) were selected to assess the association between RDW and mortality. Multivariable Cox proportional hazards regression models, stratified by presence of anemia, were performed to assess the independent association of RDW with mechanical ventilation and mortality. Results At univariate analysis, elevated RDW was statistically significantly associated with mechanical ventilation (p = 0.0109) and mortality (p < 0.0001). We found that elevated RDW was statistically associated with higher risk of both being placed on a ventilator (HRadj: 1.66, 95% CI: 1.19‐2.32) and mortality (HRadj: 1.60, 95% CI: 1.18‐2.15) in non‐anemic patients, but there was no association in anemic patients. These associations were independent of the effects of age, sex, race, and CCI. Discussion In this study, we show that the elevated RDW association with mortality and mechanical ventilation is present exclusively in non‐anemic patients. Therefore, we propose that RDW be considered by clinicians, especially in non‐anemic patients, when risk‐stratifying COVID‐19 patients.

ACS Style

Joseph L. Rapp; Douglas Tremblay; Naomi Alpert; Wil Lieberman‐Cribbin; John Mascarenhas; Emanuela Taioli; Saghi Ghaffari. Red cell distribution width is associated with mortality in non‐anemic patients with COVID‐19. Journal of Medical Virology 2021, 93, 4130 -4132.

AMA Style

Joseph L. Rapp, Douglas Tremblay, Naomi Alpert, Wil Lieberman‐Cribbin, John Mascarenhas, Emanuela Taioli, Saghi Ghaffari. Red cell distribution width is associated with mortality in non‐anemic patients with COVID‐19. Journal of Medical Virology. 2021; 93 (7):4130-4132.

Chicago/Turabian Style

Joseph L. Rapp; Douglas Tremblay; Naomi Alpert; Wil Lieberman‐Cribbin; John Mascarenhas; Emanuela Taioli; Saghi Ghaffari. 2021. "Red cell distribution width is associated with mortality in non‐anemic patients with COVID‐19." Journal of Medical Virology 93, no. 7: 4130-4132.

Review
Published: 03 March 2021 in JNCI: Journal of the National Cancer Institute
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Naomi Alpert; Emanuela Taioli. Re: Clinical Characteristics and Outcomes of COVID-19–Infected Cancer Patients: A Systematic Review and Meta-Analysis. JNCI: Journal of the National Cancer Institute 2021, 113, 501 -502.

AMA Style

Naomi Alpert, Emanuela Taioli. Re: Clinical Characteristics and Outcomes of COVID-19–Infected Cancer Patients: A Systematic Review and Meta-Analysis. JNCI: Journal of the National Cancer Institute. 2021; 113 (4):501-502.

Chicago/Turabian Style

Naomi Alpert; Emanuela Taioli. 2021. "Re: Clinical Characteristics and Outcomes of COVID-19–Infected Cancer Patients: A Systematic Review and Meta-Analysis." JNCI: Journal of the National Cancer Institute 113, no. 4: 501-502.

Journal article
Published: 03 March 2021 in Cancers
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Surgery is a mainstay of treatment allowing for debulking of tumor and expansion of the lung for improvement in median survival and quality of life for patients with malignant pleural mesothelioma (MPM). Although optimal surgical technique remains open for debate—extrapleural pneumonectomy (EPP) vs. pleurectomy/decortication (P/D)—minimally invasive surgery (VATS-P/D) remains underutilized in the management of MPM. We examined whether VATS-P/D is a feasible alternative to EPP and P/D. We evaluated the New York Statewide Planning and Research Cooperative System (SPARCS) from 2007–2017 to assess the short-term complications of EPP vs. P/D, including a subanalysis of open P/D vs. VATS-P/D. There were 331 patients with open surgery; 269 with P/D and 62 with EPP. There were 384 patients with P/D; 269 were open and 115 VATS. Rates of any complication were similar between EPP and P/D patients, but EPP had significantly higher rates of cardiovascular complications. After adjusting for confounders, those with a VATS approach were less likely to have any complication, compared to an open approach and significantly less likely to have a pulmonary complication. VATS-P/D remains a viable alternative to radical surgery in MPM patients allowing for improved short-term outcomes.

ACS Style

Dong-Seok Lee; Andrea Carollo; Naomi Alpert; Emanuela Taioli; Raja Flores. VATS Pleurectomy Decortication Is a Reasonable Alternative for Higher Risk Patients in the Management of Malignant Pleural Mesothelioma: An Analysis of Short-Term Outcomes. Cancers 2021, 13, 1068 .

AMA Style

Dong-Seok Lee, Andrea Carollo, Naomi Alpert, Emanuela Taioli, Raja Flores. VATS Pleurectomy Decortication Is a Reasonable Alternative for Higher Risk Patients in the Management of Malignant Pleural Mesothelioma: An Analysis of Short-Term Outcomes. Cancers. 2021; 13 (5):1068.

Chicago/Turabian Style

Dong-Seok Lee; Andrea Carollo; Naomi Alpert; Emanuela Taioli; Raja Flores. 2021. "VATS Pleurectomy Decortication Is a Reasonable Alternative for Higher Risk Patients in the Management of Malignant Pleural Mesothelioma: An Analysis of Short-Term Outcomes." Cancers 13, no. 5: 1068.

Journal article
Published: 09 December 2020 in Toxics
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Perfluoroalkyl acids (PFAS) are known endocrine disrupting chemicals, potentially affecting thyroid function. Smoking has been associated with PFAS levels as well as with thyroid function. The impact of smoking on the association between PFAS and thyroid function remains to be elucidated, so the objective was to assess the effect of PFAS exposure on thyroid function in the general population, stratified by smoking status, using the National Health and Nutrition Examination Survey (NHANES). NHANES adult participants who were part of the 2011–2012 laboratory subsample and had PFAS and thyroid function measured were included (n = 1325). Adjusted linear regression models and stratified analyses were performed. There was a significant positive association between perfluorooctanesulfonic acid (PFOS) (p = 0.003), perfluorononanoic acid (PFNA) (p = 0.014), total PFAS (p = 0.004) concentrations and free T4 (FT4). No significant associations were found between perfluorooctanoic acid (PFOA), PFOS, perfluorohexane sulfonate (PFHxS), PFNA, total PFAS and total T4 (TT4) or thyroid stimulating hormone (TSH). In non-smokers, a significant positive association was found between PFOS (p = 0.003), PFHxS (p = 0.034), PFNA (p = 0.012), total PFAS (p = 0.003) and FT4 while no significant associations were found in smokers. The present study showed that increased PFAS exposure was associated with increased FT4 in non-smokers, while no association was found in smokers. These results confirm that smoking modifies the association between PFAS exposure and thyroid function.

ACS Style

Maaike Van Gerwen; Naomi Alpert; Mathilda Alsen; Kimia Ziadkhanpour; Emanuela Taioli; Eric Genden. The Impact of Smoking on the Association between Perfluoroalkyl Acids (PFAS) and Thyroid Hormones: A National Health and Nutrition Examination Survey Analysis. Toxics 2020, 8, 116 .

AMA Style

Maaike Van Gerwen, Naomi Alpert, Mathilda Alsen, Kimia Ziadkhanpour, Emanuela Taioli, Eric Genden. The Impact of Smoking on the Association between Perfluoroalkyl Acids (PFAS) and Thyroid Hormones: A National Health and Nutrition Examination Survey Analysis. Toxics. 2020; 8 (4):116.

Chicago/Turabian Style

Maaike Van Gerwen; Naomi Alpert; Mathilda Alsen; Kimia Ziadkhanpour; Emanuela Taioli; Eric Genden. 2020. "The Impact of Smoking on the Association between Perfluoroalkyl Acids (PFAS) and Thyroid Hormones: A National Health and Nutrition Examination Survey Analysis." Toxics 8, no. 4: 116.

Oncology
Published: 20 November 2020 in Frontiers in Oncology
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BackgroundCytopenia, a reduced count of blood cells manifesting as anemia, neutropenia, and/or thrombocytopenia is frequently associated with other medical conditions. However, a cytopenia may not be accompanied by a known determinant and in some of these cases, may be a precursor to pre-malignancies or hematologic cancers. Little is known about the prevalence of these unexplained cytopenias and their distribution in the population.Materials and MethodsThe National Health and Nutrition Examination Survey (NHANES) from 1999 to 2002 was used to identify those with a cytopenia in the general population. Those without an identifiable determinant in the NHANES were classified as having unexplained cytopenia. Weighted frequencies were examined to assess the prevalence of unexplained cytopenia in the population. Distribution of blood counts comparing those with unexplained cytopenia to the general population was examined. Multivariable logistic regression was conducted to assess the association between unexplained cytopenia and demographic factors.ResultsOf the 7,962 people in the sample, 236 (2.0%) had any cytopenia and 86 (0.9%) had an unexplained cytopenia. Approximately 43% of all cytopenias were not accompanied by a clinical determinant. Unexplained cytopenia was more common in men (1.1%) than in women (0.7%) and in Non-Hispanic Black participants (3.4%). Among those with an unexplained cytopenia, the majority (74.8%) manifested as neutropenia. Compared to those with no cytopenia, those with unexplained cytopenia were significantly less likely to be female, have body mass index ≥30 kg/m2, and work in the service industry, and were significantly more likely to be non-Hispanic Black.ConclusionsThis is the first study to examine the prevalence of unexplained cytopenia in a nationally representative sample and may serve as a baseline for comparison with other populations. Future research to identify risk factors for development of malignant hematological disorders among those with unexplained cytopenia is warranted.

ACS Style

Naomi Alpert; Joseph L. Rapp; John Mascarenhas; Eileen Scigliano; Douglas Tremblay; Bridget K. Marcellino; Emanuela Taioli. Prevalence of Cytopenia in the General Population—A National Health and Nutrition Examination Survey Analysis. Frontiers in Oncology 2020, 10, 1 .

AMA Style

Naomi Alpert, Joseph L. Rapp, John Mascarenhas, Eileen Scigliano, Douglas Tremblay, Bridget K. Marcellino, Emanuela Taioli. Prevalence of Cytopenia in the General Population—A National Health and Nutrition Examination Survey Analysis. Frontiers in Oncology. 2020; 10 ():1.

Chicago/Turabian Style

Naomi Alpert; Joseph L. Rapp; John Mascarenhas; Eileen Scigliano; Douglas Tremblay; Bridget K. Marcellino; Emanuela Taioli. 2020. "Prevalence of Cytopenia in the General Population—A National Health and Nutrition Examination Survey Analysis." Frontiers in Oncology 10, no. : 1.

Review
Published: 12 November 2020 in Environmental Health
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Background Glyphosate, a commonly used pesticide, has been the topic of much debate. The effects of exposure to glyphosate remains a contentious topic. This paper provides an update to the existing literature regarding levels of glyphosate exposure in occupationally exposed individuals and focuses or reviewing all the available published literature regarding glyphosate exposure levels in children. Methods A literature review was conducted and any articles reporting quantifiable exposure levels in humans published since January 2019 (the last published review on glyphosate exposure) were reviewed and data extracted and standardized. Results A total of five new studies reporting exposure levels in humans were found including 578 subjects. Two of these studies focused on occupationally exposed individuals while three of them focused on glyphosate exposure levels in children. Given the sparse nature of the new data, previously identified studies on exposure to glyphosate in children were included in our analysis of children’s exposure. The lowest average level of glyphosate exposure reported was 0.28 μg/L and the highest average exposure levels reported was 4.04 μg/L. Conclusion The literature on glyphosate exposure levels, especially in children, remains limited. Without more data collected in a standardized way, parsing out the potential relationship between glyphosate exposure and disease will not be possible.

ACS Style

Christina Gillezeau; Wil Lieberman-Cribbin; Emanuela Taioli. Update on human exposure to glyphosate, with a complete review of exposure in children. Environmental Health 2020, 19, 1 -8.

AMA Style

Christina Gillezeau, Wil Lieberman-Cribbin, Emanuela Taioli. Update on human exposure to glyphosate, with a complete review of exposure in children. Environmental Health. 2020; 19 (1):1-8.

Chicago/Turabian Style

Christina Gillezeau; Wil Lieberman-Cribbin; Emanuela Taioli. 2020. "Update on human exposure to glyphosate, with a complete review of exposure in children." Environmental Health 19, no. 1: 1-8.

Journal article
Published: 02 November 2020 in JNCI Cancer Spectrum
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Background Complications in cancer patients with coronavirus disease 2019 (COVID-19) have not been examined. This analysis aimed to compare characteristics of COVID-19 patients with and without cancer and assess whether cancer is associated with COVID-19 morbidity or mortality. Methods COVID-19–positive patients with an inpatient or emergency encounter at the Mount Sinai Health System between March 1, 2020, and May 27, 2020, were included and compared across cancer status on demographics and clinical characteristics. Multivariable logistic regressions were used to model the associations of cancer with sepsis, venous thromboembolism, acute kidney injury, intensive care unit admission, and all-cause mortality. Results There were 5556 COVID-19–positive patients included, 421 (7.6%) with cancer (325 solid, 96 nonsolid). Those with cancer were statistically significantly older, more likely to be non-Hispanic Black and to be admitted to the hospital during their encounter, and had more comorbidities than noncancer COVID-19 patients. Cancer patients were statistically significantly more likely to develop sepsis (adjusted odds ratio [ORadj] = 1.31, 95% confidence interval [CI] = 1.06 to 1.61) and venous thromboembolism (ORadj = 1.77, 95% CI = 1.01 to 3.09); there was no statistically significant difference in acute kidney injury (ORadj = 1.10, 95% CI = 0.87 to 1.39), intensive care unit admissions (ORadj = 1.04, 95% CI = 0.80 to 1.34), or mortality (ORadj = 1.02, 95% CI = 0.81 to 1.29). Conclusions COVID-19 patients with cancer may have a higher risk for adverse outcomes. Although there was no statistically significant difference in mortality, COVID-19 patients with cancer have statistically significantly higher risk of thromboembolism and sepsis. Further research is warranted into the potential effects of cancer treatments on inflammatory and immune responses to COVID-19 and on the efficacy of anticoagulant therapy in these patients.

ACS Style

Naomi Alpert; Joseph L Rapp; Bridget Marcellino; Wil Lieberman-Cribbin; Raja Flores; Emanuela Taioli. Clinical Course of Cancer Patients With COVID-19: A Retrospective Cohort Study. JNCI Cancer Spectrum 2020, 5, pkaa085 .

AMA Style

Naomi Alpert, Joseph L Rapp, Bridget Marcellino, Wil Lieberman-Cribbin, Raja Flores, Emanuela Taioli. Clinical Course of Cancer Patients With COVID-19: A Retrospective Cohort Study. JNCI Cancer Spectrum. 2020; 5 (1):pkaa085.

Chicago/Turabian Style

Naomi Alpert; Joseph L Rapp; Bridget Marcellino; Wil Lieberman-Cribbin; Raja Flores; Emanuela Taioli. 2020. "Clinical Course of Cancer Patients With COVID-19: A Retrospective Cohort Study." JNCI Cancer Spectrum 5, no. 1: pkaa085.

Other
Published: 03 September 2020
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Importance Clinical biomarkers that accurately predict mortality are needed for the effective management of patients with severe COVID-19 illness. Objective To determine whether D-dimer levels after anticoagulation treatment is predictive of in-hospital mortality. Design Retrospective study using electronic health record data. Setting A large New York City hospital network serving a diverse, urban patient population. Participants Adult patients hospitalized for severe COVID-19 infection who received therapeutic anticoagulation for thromboprophylaxis between February 25, 2020 and May 31, 2020. Exposures Mean and trend of D-dimer levels in the 3 days following the first therapeutic dose of anticoagulation. Main Outcomes In-hospital mortality versus discharge. Results 1835 adult patients (median age, 67 years [interquartile range, 57-78]; 58% male) with PCR-confirmed COVID-19 who received therapeutic anticoagulation during hospitalization were included. 74% (1365) of patients were discharged and 26% (430) died in hospital. The study cohort was divided into four groups based on the mean D-dimer levels and its trend following anticoagulation initiation, with significantly different in-hospital mortality rates (p<0.001): 49% for the high mean-increase trend (HI) group; 27% for the high-decrease (HD) group; 21% for the low-increase (LI) group; and 9% for the low-decrease (LD) group. Using penalized logistic regression models to simultaneously analyze 67 variables (baseline demographics, comorbidities, vital signs, laboratory values, D-dimer levels), post-anticoagulant D-dimer groups had the highest adjusted odds ratios (ORadj) for predicting in-hospital mortality. The ORadj of in-hospital death among patients from the HI group was 6.58 folds (95% CI 3.81-11.16) higher compared to the LD group. The LI (ORadj: 4.06, 95% CI 2.23-7.38) and HD (ORadj: 2.37; 95% CI 1.37-4.09) groups were also associated with higher mortality compared to the LD group. Conclusions and Relevance D-dimer levels and its trend following the initiation of anticoagulation have high and independent predictive value for in-hospital mortality. This novel prognostic biomarker should be incorporated into management protocols to guide resource allocation and prospective studies for emerging treatments in hospitalized COVID-19 patients. Key Points Question Are D-dimer levels following therapeutic anticoagulation predictive of mortality in hospitalized COVID-19 patients? Finding In a retrospective study of 1835 adult COVID-19 patients who received therapeutic anticoagulation for thromboprophylaxis during hospitalization, 1365 (74%) patients were discharged and 470 (26%) died. Post-anticoagulant D-dimer levels and trends were significantly and independently predictive of mortality. Meaning Active monitoring of post-anticoagulant D-dimer levels in hospitalized COVID-19 patients is a novel strategy for stratifying individual risk of in-hospital mortality that can help guide resource allocation and prospective studies for emerging treatments for severe COVID-19 illness.

ACS Style

Xiaoyu Song; Jiayi Ji; Boris Reva; Himanshu Joshi; Anna Pamela Calinawan; Madhu Mazumdar; Emanuela Taioli; Pei Wang; Rajwanth Veluswamy. Post-Anticoagulant D-dimer as a Highly Prognostic Biomarker of COVID-19 Mortality. 2020, 1 .

AMA Style

Xiaoyu Song, Jiayi Ji, Boris Reva, Himanshu Joshi, Anna Pamela Calinawan, Madhu Mazumdar, Emanuela Taioli, Pei Wang, Rajwanth Veluswamy. Post-Anticoagulant D-dimer as a Highly Prognostic Biomarker of COVID-19 Mortality. . 2020; ():1.

Chicago/Turabian Style

Xiaoyu Song; Jiayi Ji; Boris Reva; Himanshu Joshi; Anna Pamela Calinawan; Madhu Mazumdar; Emanuela Taioli; Pei Wang; Rajwanth Veluswamy. 2020. "Post-Anticoagulant D-dimer as a Highly Prognostic Biomarker of COVID-19 Mortality." , no. : 1.

Journal article
Published: 28 August 2020 in Chest
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The pathophysiology of the acute respiratory syndrome in the setting of coronavirus disease 2019 (COVID-19) is not yet fully understood.1Tay M.Z. Poh C.M. Rénia L. MacAry P.A. Ng L.F.P. The trinity of COVID-19: immunity, inflammation and intervention.Nature Rev Immunol. 2020; ([Published online ahead of print April 28, 2020])https://doi.org/10.1038/s41577-020-0311-8Crossref PubMed Scopus (360) Google Scholar Differences in severity and fatality outcomes according to patient’s sex have been noted across multiple early pandemic outbreak areas, such as China2Guan W.J. Ni Z.Y. Hu Y. et al.Clinical characteristics of coronavirus disease 2019 in China.N Engl J Med. 2020; 382: 1708-1720Crossref PubMed Scopus (5177) Google Scholar and Italy.3Grasselli G. Zangrillo A. Zanella A. et al.Baseline characteristics and outcomes of 1591 patients infected with SARS-CoV-2 admitted to ICUs of the Lombardy Region, Italy.JAMA. 2020; ([Published online April 06, 2020])https://doi.org/10.1001/jama.2020.5394Crossref Scopus (801) Google Scholar Studies performed in the United States have examined predictors of mortality and severity; however, they included a few hundred patients4Palaiodimos L. Kokkinidis D.G. Li W. et al.Severe obesity, increasing age and male sex are independently associated with worse in-hospital outcomes, and higher in-hospital mortality, in a cohort of patients with COVID-19 in the Bronx, New York.Metabolism. 2020; ([Published online ahead of print May 16, 2020])https://doi.org/10.1016/j.metabol.2020.154262Abstract Full Text Full Text PDF PubMed Scopus (50) Google Scholar or were focused on time periods early in the COVID-19 outbreak, and confounders were not properly addressed with multivariate analyses.5Richardson S. Hirsch J.S. Narasimhan M. et al.Presenting characteristics, comorbidities, and outcomes among 5700 patients hospitalized with COVID-19 in the New York City area.JAMA. 2020; 323: 2052-2059Crossref PubMed Scopus (1018) Google Scholar,6Goyal P. Choi J.J. Pinheiro L.C. et al.Clinical characteristics of Covid-19 in New York city.N Engl J Med. 2020; 382: 2372-2374Crossref PubMed Scopus (317) Google Scholar Here we assess differences in COVID-19 severity between male and female patients while accounting for a large number of demographic and clinical covariates in New York City by investigating both initial presentation and mortality among hospitalized patients with COVID-19.

ACS Style

Joseph L. Rapp; Wil Lieberman-Cribbin; Stephanie Tuminello; Emanuela Taioli. Male Sex, Severe Obesity, Older Age, and Chronic Kidney Disease Are Associated With COVID-19 Severity and Mortality in New York City. Chest 2020, 159, 112 -115.

AMA Style

Joseph L. Rapp, Wil Lieberman-Cribbin, Stephanie Tuminello, Emanuela Taioli. Male Sex, Severe Obesity, Older Age, and Chronic Kidney Disease Are Associated With COVID-19 Severity and Mortality in New York City. Chest. 2020; 159 (1):112-115.

Chicago/Turabian Style

Joseph L. Rapp; Wil Lieberman-Cribbin; Stephanie Tuminello; Emanuela Taioli. 2020. "Male Sex, Severe Obesity, Older Age, and Chronic Kidney Disease Are Associated With COVID-19 Severity and Mortality in New York City." Chest 159, no. 1: 112-115.

Original articles
Published: 18 August 2020 in American Journal of Clinical Oncology
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Background: Mesothelioma is a rare and deadly form of cancer, linked to asbestos exposure. Although the United Kingdom has banned asbestos, the incidence rate remains high. Previous research has indicated that female individuals have better survival than male individuals, but this has never been examined in the United Kingdom. Materials and Methods: Pleural mesothelioma cases from 2005 to 2014 were extracted from the United Kingdom Lung Cancer Dataset. Multivariable logistic regression was used to assess the clinical and demographic factors associated with gender. A multivariable Cox proportional hazards model and propensity matching methods were used to assess gender differences in overall survival while accounting for potential confounders. Results: There were 8479 (87.8%) male and 1765 (17.2%) female individuals included in the analysis. Female individuals were significantly younger, with more epithelial histology than male individuals. Female individuals had significantly better overall survival (adjusted hazard ratio, 0.85, 95% confidence interval, 0.81-0.90). Results remained similar when stratifying by age and performance status, and when limiting to patients with epithelial histology. Conclusions: The study increases knowledge about gender differences in mesothelioma survival and is the first to directly examine this in the United Kingdom. It further disentangles the effects of age, histology, and health status. Increased estrogen may improve survival and could provide a potential target for future therapies.

ACS Style

Naomi Alpert; Maaike van Gerwen; Raja Flores; Emanuela Taioli. Gender Differences in Outcomes of Patients With Mesothelioma. American Journal of Clinical Oncology 2020, 43, 792 -797.

AMA Style

Naomi Alpert, Maaike van Gerwen, Raja Flores, Emanuela Taioli. Gender Differences in Outcomes of Patients With Mesothelioma. American Journal of Clinical Oncology. 2020; 43 (11):792-797.

Chicago/Turabian Style

Naomi Alpert; Maaike van Gerwen; Raja Flores; Emanuela Taioli. 2020. "Gender Differences in Outcomes of Patients With Mesothelioma." American Journal of Clinical Oncology 43, no. 11: 792-797.

Review
Published: 01 August 2020 in Translational Lung Cancer Research
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PD-L1 as a prognostic biomarker in surgically resectable non- small cell lung cancer: a meta-analysis

ACS Style

Stephanie Tuminello; Daniel Sikavi; Rajwanth Veluswamy; Cesar Gamarra; Wil Lieberman-Cribbin; Raja Flores; Emanuela Taioli. PD-L1 as a prognostic biomarker in surgically resectable non- small cell lung cancer: a meta-analysis. Translational Lung Cancer Research 2020, 9, 1343 -1360.

AMA Style

Stephanie Tuminello, Daniel Sikavi, Rajwanth Veluswamy, Cesar Gamarra, Wil Lieberman-Cribbin, Raja Flores, Emanuela Taioli. PD-L1 as a prognostic biomarker in surgically resectable non- small cell lung cancer: a meta-analysis. Translational Lung Cancer Research. 2020; 9 (4):1343-1360.

Chicago/Turabian Style

Stephanie Tuminello; Daniel Sikavi; Rajwanth Veluswamy; Cesar Gamarra; Wil Lieberman-Cribbin; Raja Flores; Emanuela Taioli. 2020. "PD-L1 as a prognostic biomarker in surgically resectable non- small cell lung cancer: a meta-analysis." Translational Lung Cancer Research 9, no. 4: 1343-1360.