Grantee Research Project Results
2018 Progress Report: Comparing Urban and Rural Effects of Poverty on COPD (CURE COPD)
EPA Grant Number: R836150Center: Comparing Urban and Rural Effects of Poverty on COPD
Center Director: Hansel, Nadia
Title: Comparing Urban and Rural Effects of Poverty on COPD (CURE COPD)
Investigators: Hansel, Nadia , Diette, Gregory B. , Matsui, Elizabeth C. , Peng, Roger D. , Hanson, Corrine K , Rand, Cynthia , Koehler, Kirsten , Maier, Kurt , Paulin, Laura , McCormack, Meredith , Maisonet, Mildred , Putcha, Nirupama , Scheuerman, Phillip , Li, Ying
Current Investigators: Hansel, Nadia , Matsui, Elizabeth C. , McCormack, Meredith , Rand, Cynthia , Koehler, Kirsten
Institution: The Johns Hopkins University , University of Nebraska Medical Center , East Tennessee State University
Current Institution: The Johns Hopkins University
EPA Project Officer: Callan, Richard
Project Period: July 1, 2015 through June 30, 2020 (Extended to June 30, 2022)
Project Period Covered by this Report: July 1, 2017 through June 30,2018
Project Amount: $1,500,000
RFA: NIH/EPA Centers of Excellence on Environmental Health Disparities Research (2015) RFA Text | Recipients Lists
Research Category: Human Health
Objective:
Due to the importance of understanding the role of indoor air pollution in contributing to the COPD health disparities identified in low income settings; we have chosen to focus our studies on the role of indoor air pollution (particulate matter, PM and nitrogen dioxide, NO2) exposures on COPD morbidity in two different low income US communities: an urban community (Baltimore county) and a rural community (Appalachian region). We will also have a specific focus on understanding the role of obesity and poor dietary intake (low anti-oxidant, pro-inflammatory diet) as factors that are common in low income communities and may increase susceptibility to indoor pollution exposure.
Progress Summary:
In the last 12 months of the program award, the Co-Program Directors, Nadia N Hansel, MD MPH and Gregory B. Diette, MD, have assembled a well-trained staff providing essential support to the faculty, students, and researchers with the similar premises to the objectives of the Johns Hopkins University Centers of Excellence on Environmental Health Disparities Research and the Comparing Urban and Rural Effects of Poverty on COPD (CURE COPD). A central point of focus of the Center has been to cultivate the central framework that promotes responsible governance of the Center’s Cores and Projects. During this reporting time, we have applied ongoing quality management activities, promoting the development of data management, safety management and statistical analysis plans, and cooperative agreements and other administrative documents, these dynamic documents, include best practice project guidelines and Standard Operating Procedures (SOPs), Manual of Procedures (MOP) that facilitate the Center’s scientific integrity. These documents are routinely monitored by key team members, making certain that they are reassessed and up-to-date.
To date, Project 1 has enrolled 63 COPD participants and Project 2 has enrolled 39 COPD participants. As presented in individual project and environmental core sections, the enrolled subjects represent low-income individuals with moderate to severe COPD with a high prevalence of obesity. In addition, as anticipated, these subjects reside in homes that tend to have indoor pollutant concentrations that are on average, higher than outdoor air and higher than indoor concentrations seen in many indoor home environments.
Core A: The Administrative Core (CAC)
This year Core A continued to develop the Center’s internal communication plans, ensuring that thorough collaboration between the leaders of the two projects and four cores are occurring, with proficient exchanges of ideas and knowledge. As a result of the communication plans, there have been monthly and weekly teleconferencing with the Center’s collaborators at East Tennessee State University (ETSU) and the University of Nebraska investigators.
To promote scientific interactions, the Administrative Core invited guest speakers from external intuitions to give talks and encourage collaboration.
- In August (08/17/2017) the BREATHE Center welcomed Dr. Sacoby Wilson, (Assistant Professor at the University of Maryland, and Director of the Community Engagement, Environmental Justice, and Health (CEEJH). Dr. Wilson presented research on “Environmental Justice and Air Pollution: Current Research and Gaps.”
- In May (5/18/2017), Dr. Corrine Hanson (University of Nebraska Medical Center Associate Professor, Medical Nutrition Education and M. Patricia and James W. Leuschen Professor) presented “The Gut-Lung Axis in COPD: The Role of the Microbiome and Dietary Fiber Intake.“
- In January (1/25/2018), the Environmental Integrity Project’s Senior Attorneys, Leah Kelly and Kira Burkhart (Senior Research Analyst at EIP) lead a discussion on the newly released EIP report on asthma and air pollution in Baltimore City. (http://www.environmentalintegrity.org/what-we-do/environmental-justice/)
- In February (2/1/2018), Dr. Tak Igusa, Engineering Professor with joint appointments in International Health and Earth & Planetary Sciences, lead a discussion on Simulation Modeling and Systems Science (SMSS) and data autoregressive integrated moving average (ARIMA) model analysis to address health disparities. These tools help to apprehend the magnitude of intended and unintended consequences of specific interventions, providing options to adjust and/or refine simulated intervention designs prior to actual implementation testing in the real world.
Core B: The Environmental Assessments Core (EAC)
As the centralized Environmental Core, the EAC has carried out all exposure assessment activities, data collection and providing specialized expertise and technical expertise involving sampling methodology, supporting Projects 1 and 2.
Project 1: In Baltimore, we have collected measurements of 99 indoor and 59 outdoor PM2.5, 100 indoor and 86 outdoor NO2, and 95 indoor air nicotine. Due to the batched nature of the blanks and duplicate analysis, determining final concentrations is lagged.
Project 2: With the ETSU staff, we have collected and received measurements of indoor and outdoor PM2.5, indoor and outdoor NO2, and indoor air nicotine. We have successfully received shipments of environmental samples from ETSU to JHU and are currently completing the first batch of blanks, which will enable us to calculate final mass concentrations for each of these pollutants.
The development of a constructive framework and the extensive training of the staff and field workers has resulted in confirmation of our hypothesis that indoor pollutants in low income homes tend to be high, then outdoor pollutant levels.
Core C: The Data Management Core (DMC)
The focus of the past period has been on the development of data management, data validation and data cleaning using the interface REDCap. In addition to the quality management the DMC has established a recruitment and retention report that has been distributed and reviewed weekly. This report was developed to keep the PI’s and key staff members focused on the recruitment goals for Project 1 and Project 2. Currently the DMC is working in coordination with the EAC on managing the quality of Environmental data, confirming the data quality management plan (QMP) for the different types of pollutants (PM2.5, P10, NO2, Air Nicotine, and eventually Black Carbon) that will be collected.
Core D: The Community Engagement Core (CEC)
Last year, the CEC established relationships with Community Engagement Programs through the Institute for Clinical and Translational Research (ICTR), the Community Research Advisory Council (C-RAC), during this reporting period we continue to work with the C-RAC, meetings with the C-RAC are held every three months, this allows us time to discuss our current research with community members, as well as our research findings. Further, we participate in the annual C-RAC symposium, allowing scientists and physicians to discuss their ongoing research to a large audience of Baltimore City persons. The ETSU CEC team continues to meet regularly with local county health councils in Tennessee, while actively seeking new opportunities for community outreach and education throughout rural low-income Appalachia. Meetings with the community members substantiates our research, specifically with the participant recruitment, and staying abreast of new culturally sensitive approaches.
Actual or anticipated challenges, difficulties or delays and actions or plans to resolve them: “For project2, recruitment has been a challenge. It is rare for people in Appalachia to allow strangers in their homes even if it is for valid reasons. We learned early on that the leadership of a physician champion was vital to fulfill the study’s enrollment and implementation needs. Last year we started collaborating with a physician who found the study goals and benefits from learning about sources and levels of indoor air pollution of importance for his patients and agreed to support enrollment. His leadership has opened the doors to the homes of many who would not have otherwise participated in the study. We have also started the process of identifying other physician champions to expand the recruitment area to include participants from Southwest Virginia and Southeast Kentucky. We have identified two such physicians. Currently we have reached a third of our enrollment goal, in the last year 40 of the 42 enrolled subjects have been recruited; and we do not anticipate difficulties in continuing with the current pace of recruitment.
Changes of key personnel: Nothing to report.
Expenditures to date: Spending is on track compared to recruitment progress. There is no change from what was proposed.
Quality Assurance: To assure the quality of environmental measurements, data generation and use, the Center has prepared a Quality Management Plan (QMP) document that was submitted for EPA in 2017. The QMP described the organization's quality system in terms of the organizational structure, policy and procedures, functional responsibilities of management and staff, lines of authority, and required interfaces for those planning, implementing, documenting, and assessing all activities conducted across projects 1 and 2, and the Environmental and Data assessment cores.
Research Results: Our preliminary results have been disseminated through national and international meetings and symposiums. In addition, Core D, the Community Engagement Core (CEC) has developed a synergy of actions between a Baltimore City Community Research Advisory Council (C-RAC) and a number of Country Health Council, in Tennessee. Core D has carefully chosen literacy-appropriate lung health educational materials at faith based organizations, neighborhoods, schools lower income and public housing in both urban inner city Baltimore and the targeted Appalachian communities.
Research Misconduct: Nothing to report.
Future Activities:
Planned activities: The aims for the next reporting period, includes:
- To continue to increase participant recruitment, enrollment and follow-up compliance in Project 1 and increased enrollment in Project 2.
- We will continue to have weekly to biweekly calls between the ETSU and JHU teams.
- The Administrative Core, will continue scheduling and organizing the Outside Advisory Board meetings and streamlining specific organizational elements to accomplish the goals of the Center.
- The Environmental Core will continue with the development of the exposure assessment protocols and advancing the interpretation of the exposure assessments for all environmental samples.
- The Data Core will continue to monitor the quality of the environmental exposures and clinic outcomes data that is collected as part of projects 1 and 2 and will work on the expansion of REDCap to include environmental and bio- specimen data from Project 1 and 2.
- The Community Core will continue to build on the established partnerships with the communities stakeholders by participating community engagement programs, i.e., health fairs and other community events that will take place in both urban inner city Baltimore and the targeted Appalachian communities, the CEC will also encourage the communities feedback to ensure that the COPD-CURE projects are informed and strengthened by community input.
Journal Articles: 36 Displayed | Download in RIS Format
Other center views: | All 50 publications | 36 publications in selected types | All 36 journal articles |
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Belli AJ, Bose S, Aggarwal N, DaSilva C, Thapa S, Grammer L, Paulin LM, Hansel NN. Indoor particulate matter exposure is associated with increased black carbon content in airway macrophages of former smokers with COPD. Environmental Research 2016;150:398-402. |
R836150 (2017) R836150 (2019) R836150 (2020) R836152 (2019) R836152 (2020) |
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Galiatsatos P, Kineza C, Hwang S, Pietri J, Brigham E, Putcha N, Rand CS, McCormack M, Hansel NN. Neighbourhood characteristics and health outcomes:evaluating the association between socioeconomic status, tobacco store density and health outcomes in Baltimore City. Tobacco Control 2018;27(e1):e19-e24. |
R836150 (2018) R836150 (2020) R836152 (2018) R836152 (2019) R836152 (2020) |
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Kemper T, Woo H, Belz D, Fawzy A, Lorisio W, Eakin M, Putcha N, McCormack M, Brigham E, Hanson C, Koch A, Hansel N. Higher Plasma Omega-3 Levels are Associated With Improved Exacerbation Risk and Respiratory-Specific Quality of Life in COPD. CHRONIC OBSTRUCTIVE PULMONARY DISEASES-JOURNAL OF THE COPD FOUNDATION 2024;11(9):293-302 |
R836150 (Final) |
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Lambert AA, Putcha N, Drummond MB, Boriek AM, Hanania NA, Kim V, Kinney GL, McDonald MN, Brigham EP, Wise RA, McCormack MC, Hansel NN, COPDGene Investigators. Obesity is associated with increased morbidity in moderate to severe COPD. Chest 2017;151(1):68-77. |
R836150 (2017) R836150 (2019) R836150 (2020) R836152 (2019) R836152 (2020) |
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Lemoine C, Brigham E, Woo H, Koch A, Hanson C, Hoffman E, Putcha N, McCormack M, Hansel N. Relationship between Omega-3 and Omega-6 Fatty Acid Intake and Chronic Obstructive Pulmonary Disease Morbidity. ANNALS OF THE AMERICAN THORACIC SOCIETY 2020;17(3):379-383. |
R836150 (2021) |
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Levy JI, Quiros-Alcala L, Fabian MP, Basra K, Hansel NN. Established and emerging environmental contributors to disparities in asthma and chronic obstructive pulmonary disease. Current Epidemiology Reports 2018;5(2):114-124. |
R836150 (2019) R836150 (2020) R836152 (2018) R836152 (2019) R836152 (2020) R836156 (2018) R836156 (2019) R836156 (2020) |
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McCormack MC, Belli AJ, Waugh D, Matsui EC, Peng RD, Williams DL, Paulin L, Saha A, Aloe CM, Diette GB, Breysse PN, Hansel NN. Respiratory effects of indoor heat and the interaction with air pollution in chronic obstructive pulmonary disease. Annals of the American Thoracic Society 2016;13(12):2125-2131. |
R836150 (2019) R836150 (2020) R836152 (2018) R836152 (2019) R836152 (2020) |
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McCormack MC, Paulin LM, Gummerson CE, Peng RD, Diette GB, Hansel NN. Colder temperature is associated with increased COPD morbidity. European Respiratory Journal 2017;49(6):1601501. |
R836150 (2018) R836150 (2019) R836150 (2020) R836152 (2019) R836152 (2020) |
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McCormack M, Balsubramanian A, Wise R, Keet C, Matsui E, Peng R. Reply by McCormack et al. to Townsend and Cowl, and to Miller et al. AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE 2022;206(6):795-796. |
R836150 (2021) |
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Moughames E, Galiatsatos P, Woo H, Romero-Rivero K, Raju S, Hoffman E, Ortega V, Parekh T, Krishnan J, Drummond M, Buhr R, Comellas A, Couper D, Paine R, Paulin L, Putcha N, Hansel N. Disparities in access to food and chronic obstructive pulmonary disease (COPD)-related outcomes:a cross-sectional analysis. AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE 2021;21(1):139. |
R836150 (2021) |
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Peterson CE, Rauscher GH, Johnson TP, Kirschner CV, Barrett RE, Kim S, Fitzgibbon ML, Joslin CE, Davis FG. The association between neighborhood socioeconomic status and ovarian cancer tumor characteristics. Cancer Causes and Control 2014;25(5):633-637. |
R836150 (2020) NIMHD002 (Final) |
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Tejwani V, Rueda A, Khare P, Zhang C, Le A, Putcha N, D'Alessio F, Alexis N, Hansel N, Fawzy A. Airway and Systemic Prostaglandin E2 Association with COPD Symptoms and Macrophage Phenotype. CHRONIC OBSTRUCTIVE PULMONARY DISEASES - JOURNALF OF THE COPD FOUNDATION 2023;10(2):159-169 |
R836150 (2021) |
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Wu T, Fawzy A, Brigham E, McCormack M, Rosas I, Villareal D, Hanania N. Association of Triglyceride-Glucose Index and Lung Health A Population-Based Study. CHEST 2021;160(3):1026-1034 |
R836150 (2021) R836152 (Final) |
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Younas H, Vieira M, Gu C, Lee R, Shin MK, Berger S, Loube J, Nelson A, Bevans-Fonti S, Zhong Q, D’Alessio FR. Caloric restriction prevents the development of airway hyperresponsiveness in mice on a high fat diet. Scientific reports 2019;9(1):1-9. |
R836150 (2020) R834510 (Final) R836152 (Final) |
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Raju S, Keet CA, Paulin LM, Matsui EC, Peng RD, Hansel NN, McCormack MC. Rural residence and poverty are independent risk factors for chronic obstructive pulmonary disease in the United States. American journal of respiratory and critical care medicine. 2019;199(8):961-969. |
R836150 (2019) R836150 (2020) R836152 (2019) R836152 (2020) |
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Tsou PY, McCormack MC, Matsui EC, Peng RD, Diette GB, Hansel NN, Davis MF. The effect of dog allergen exposure on asthma morbidity among inner‐city children with asthma. Pediatric Allergy and Immunology 2020;31(2):210-3. |
R836150 (2020) R832139 (Final) R834510 (Final) R836152 (Final) |
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Paulin LM, Gassett AJ, Alexis NE, Kirwa K, Kanner RE, Peters S, Krishnan JA, Paine R, Dransfield M, Woodruff PG, Cooper CB. Association of long-term ambient ozone exposure with respiratory morbidity in smokers. JAMA internal medicine 2020;180(1):106-15. |
R836150 (2020) |
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Tarazona-Meza CE, Hanson C, Pollard SL, Rivero KM, Davila RM, Talegawkar S, Rojas C, Rice JL, Checkley W, Hansel NN. Dietary patterns and asthma among Peruvian children and adolescents. BMC pulmonary medicine 2020;20(1):1-9. |
R836150 (2020) |
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Zuidema C, Stebounova LV, Sousan S, Gray A, Stroh O, Thomas G, Peters T, Koehler K. Estimating personal exposures from a multi-hazard sensor network. Journal of exposure science & environmental epidemiology 2020;30(6):1013-22. |
R836150 (2020) |
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Hersh CP, Zacharia S, Chelvan RP, Hayden LP, Mirtar A, Zarei S, Putcha N, COPDGene® Investigators. Immunoglobulin E as a biomarker for the overlap of atopic asthma and chronic obstructive pulmonary disease. Chronic Obstructive Pulmonary Diseases:Journal of the COPD Foundation 2020;7(1):1. |
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Koch AL, Brown RH, Woo H, Brooker AC, Paulin LM, Schneider H, Schwartz AR, Diette GB, Wise RA, Hansel NN, Putcha N. Obstructive Sleep Apnea and Airway Dimensions in Chronic Obstructive Pulmonary Disease. Annals of the American Thoracic Society 2020;17(1):116-8. |
R836150 (2020) |
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Galiatsatos P, Gomez E, Lin CT, Illei PB, Shah P, Neptune E. Secondhand smoke from electronic cigarette resulting in hypersensitivity pneumonitis. BMJ Case Reports CP 2020;13(3):e233381. |
R836150 (2020) |
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Ghosh B, Park B, Bhowmik D, Nishida K, Lauver M, Putcha N, Gao P, Ramanathan Jr M, Hansel N, Biswal S, Sidhaye VK. Strong correlation between air-liquid interface cultures and in vivo transcriptomics of nasal brush biopsy. American Journal of Physiology-Lung Cellular and Molecular Physiology 2020;318(5):L1056-62. |
R836150 (2020) |
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Galiatsatos P, Woo H, Paulin LM, Kind A, Putcha N, Gassett AJ, Cooper CB, Dransfield MT, Parekh TM, Oates GR, Barr RG. The Association Between Neighborhood Socioeconomic Disadvantage and Chronic Obstructive Pulmonary Disease. International Journal of Chronic Obstructive Pulmonary Disease 2020;15:981. |
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Galiatsatos P, Follin A, Alghanim F, Sherry M, Sylvester C, Daniel Y, Chanmugam A, Townsend J, Saria S, Kind AJ, Chen E. The Association Between Neighborhood Socioeconomic Disadvantage and Readmissions for Patients Hospitalized With Sepsis. Critical Care Medicine 2020;48(6):808-14. |
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Raju S, Brigham EP, Paulin LM, Putcha N, Balasubramanian A, Hansel NN, McCormack MC. The Burden of Rural Chronic Obstructive Pulmonary Disease:Analyses from the National Health and Nutrition Examination Survey. American journal of respiratory and critical care medicine 2020;201(4):488-91. |
R836150 (2020) |
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Wu TD, Fawzy A, Kinney GL, Bon J, Neupane M, Tejwani V, Hansel NN, Wise RA, Putcha N, McCormack MC. Metformin use and respiratory outcomes in asthma-COPD overlap. Respiratory research 2021;22(1):1-8. |
R836150 (2021) R836152 (Final) |
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Afshar-Mohajer N, Wu TD, Shade R, Brigham E, Woo H, Wood M, Koehl R, Koehler K, Kirkness J, Hansel NN, Ramchandran G. Obesity, tidal volume, and pulmonary deposition of fine particulate matter in children with asthma. European Respiratory Journal 2022;59(3). |
R836150 (2021) R836152 (Final) |
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Galiatsatos P, Brigham E, Krasnoff R, Rice J, Van Wyck L, Sherry M, Rand CS, Hansel NN, McCormack MC. Association between neighborhood socioeconomic status, tobacco store density and smoking status in pregnant women in an urban area. Preventive Medicine 2020:106107. |
R836150 (2020) |
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Eakin MN, Eckmann T, Dinglas VD, Akinremi AA, Hosey M, Hopkins RO, Needham DM. Association between participant contact attempts and reports of being bothered in a national, longitudinal cohort study of ARDS survivors. Chest 2020 Mar 17. |
R836150 (2020) |
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Sharp M, Brown T, Chen ES, Rand CS, Moller DR, Eakin MN. Association of Medication Adherence and Clinical Outcomes in Sarcoidosis. Chest 2020 Feb 4. |
R836150 (2020) |
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Burkes RM, Ceppe AS, Doerschuk CM, Couper D, Hoffman EA, Comellas AP, Barr RG, Krishnan JA, Cooper C, Labaki WW, Ortega VE. Associations Among 25-Hydroxyvitamin D Levels, Lung Function, and Exacerbation Outcomes in COPD:An Analysis of the SPIROMICS Cohort. Chest 2020 Jan 17. |
R836150 (2020) |
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Balasubramanian A, Kolb TM, Damico RL, Hassoun PM, McCormack MC, Mathai SC. Diffusing Capacity is an Independent Predictor of Outcomes in Pulmonary Hypertension Associated with Chronic Obstructive Pulmonary Disease. Chest 2020 Mar 14. |
R836150 (2020) |
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Tarazona-Meza CE, Nicholson A, Romero KM, Pollard SL, Gálvez-Davila RM, Hansel NN, Checkley W. Household food insecurity is associated with asthma control in Peruvian children living in a resource-poor setting. Journal of Asthma 2019 Aug 26:1-8. |
R836150 (2020) |
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Hanson C, Brigham E. Maternal nutrition and child respiratory outcomes:paradigms of lung health and disease. Eur Respir J |
R836150 (2020) |
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Swarr D, Putcha N, Zacharias W. “PIK” ing Out New Epigenetic Markers in Lung Disease. Am J Respir Crit Care Med . |
R836150 (2020) |
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Relevant Websites:
Progress and Final Reports:
Original Abstract Subprojects under this Center: (EPA does not fund or establish subprojects; EPA awards and manages the overall grant for this center).
R836150C001 Obesity and Adverse Dietary Patterns as Susceptibility Factors to Pollutant Exposure in Urban COPD
R836150C002 Environmental Health Disparities in Rural Appalachia: The impact of air pollution, obesity and diet on COPD morbidity
The perspectives, information and conclusions conveyed in research project abstracts, progress reports, final reports, journal abstracts and journal publications convey the viewpoints of the principal investigator and may not represent the views and policies of ORD and EPA. Conclusions drawn by the principal investigators have not been reviewed by the Agency.
Project Research Results
- Final Report
- 2021 Progress Report
- 2020 Progress Report
- 2019 Progress Report
- 2017 Progress Report
- 2016 Progress Report
- Original Abstract
36 journal articles for this center