Raphael E. Cuomo

University of California · School of Medicine

Public trust in medical institutions is essential for ensuring compliance with medical directives. However, the politicization of public health issues and the polarized nature of major news outlets suggest that partisanship and news consumption habits can influence medical trust. This study employed a survey with 858 participants and used regressio...

Introduction: The debate over the legal status of many cannabis- and hemp-derived products, including delta-8 tetrahydrocannabinol (THC), is in question. Although low concentrations of delta-8 THC are legal at the Federal level, many states have implemented their own regulations to both allow and restrict its use and sale. Of concern, sellers with...

Introduction: The state of California has enacted progressive anti-tobacco policies, including Proposition 56 in 2016. In response, the alternative and emerging tobacco product (ATP) industry has increased its political activity. This study explores the association between the proportion of people voting against Proposition 56 and tobacco/ATP reta...

Background The opioid epidemic has had a devastating impact on youth from American Indian and Alaska Native (AI/AN) Tribes and Villages, which also experience disparate suicide rates. The use of publicly available social media data originating from AI/AN communities may enhance public health response time to substance use disorder (SUD)-related ove...

Background Access to tobacco products, including vape products, from local brick-and-mortar stores influences the exposure, uptake, and use of these products in local communities. Methods Licensed tobacco retailers in California were classified as specialized tobacco/vape stores or non-specialized stores by obtaining categories published on Yelp....

Introduction: Tobacco retailer density may be associated with greater youth initiation and reduced success during quit attempts; however, the extent to which tobacco retailer density has changed overtime across multiple categories of retailers has not been reported. Methods: Data on licensed tobacco retailers within California from 2015-2019 wer...

Introduction: Previous studies have identified numerous adverse events experienced with use of electronic nicotine delivery systems (ENDS), or e-cigarettes. Much remains unknown, however, about adverse event frequency, duration, and response experienced by users. The purpose of this study was to inductively characterize ENDS-attributed adverse even...

A case-control study was conducted between 12/01/2021–01/31/2022 to identify factors which increase risk for COVID-19 among athletes in the National Basketball Association (NBA). Behavioral factors and stadium attendance significantly decreased time to COVID-19 infection, but local COVID-19 rates were not associated in a multivariable model.

Social media has been documented as widely used for initiating online sales of illicit drugs such as opioids. However, not much is known about how affordances of social networking sites (SNS) influence how dealers advertise their supplies. To explore this topic, social media posts across 5 online platforms (Google Groups, Instagram, Twitter, Reddit...

Background: There was an estimated 100,306 drug overdose deaths between April 2020 and April 2021, a three-quarters increase from the prior 12-month period. There is an approximate six-month reporting lag for provisional counts of drug overdose deaths from the National Vital Statistics System, and the highest level of geospatial resolution is at t...

Introduction: The urgent need to acquire medical supplies amidst the COVID-19 pandemic has led to bypassing of controls that govern the global pharmaceutical supply chain, increasing the risk of corruption. Hence, promoting anti-corruption, transparency, and accountability (ACTA) in supply chain and procurement has never been more important. The a...

Background TikTok is a microvideo social media platform currently experiencing rapid growth and with 60% of its monthly users between the ages of 16 and 24 years. Increased exposure to e-cigarette content on social media may influence patterns of use, including the risk of overconsumption and possible nicotine poisoning, when users engage in trendi...

Introduction Exposure to pro-tobacco and electronic nicotine delivery system (ENDS) social media content can lead to overconsumption, increasing the likelihood of nicotine poisoning. This study aims to examine trends and characteristics of nicotine sickness content on Twitter between 2018–2020. Methods Tweets were collected retrospectively from th...

BACKGROUND Synthetic cannabinoids are a significant public health concern, especially among incarcerated populations due to increased reports of abuse. Recent news reports have highlighted the severe consequence of K2/Spice, a synthetic cannabinoid, on the prison population in the United States. Despite regulations against cell phone use, inmates u...

Background Synthetic cannabinoids are a significant public health concern, especially among incarcerated populations due to increased reports of abuse. Recent news reports have highlighted the severe consequences of K2/Spice, a synthetic cannabinoid, among the prison population in the United States. Despite regulations against cell phone use, inmat...

Background Health advice in the wake of the COVID-19 pandemic has called upon the public to re-evaluate risk associated with recently routine behavior. However, differences in demographics, situational circumstances, and psychological dispositions create inequities in how people are able to respond to risks presented by the virus. Method Within a...

Objective: We sought to determine school and community characteristics associated with proximity to tobacco and ENDS storefronts within a 0.5-kilometer radius in California. Methods: A list of licensed tobacco retailers was obtained from the California Department of Tax and Fee Administration; retailer names and addresses were used to scrape Yelp i...

Background Increased public health and regulatory scrutiny concerning the youth vaping epidemic has led to greater attention to promotion and sales of vaping products on social media platforms. Objectives We used unsupervised machine learning to identify and characterise sale offers of electronic nicotine delivery systems (ENDS) and associated pro...

PURPOSE Colorectal cancer (CRC) is a leading cause of international morbidity and is the second highest cause of cancer-related mortality in the world. The purpose of this study was to investigate the relationship between international health care spending on CRC mortality over time. METHODS This is a retrospective study using a publicly available...

BACKGROUND TikTok is a microvideo social media platform currently experiencing rapid growth and with 60% of its monthly users between the ages of 16 and 24 years. Increased exposure to e-cigarette content on social media may influence patterns of use, including the risk of overconsumption and possible nicotine poisoning, when users engage in trendi...

Background: The number of colleges and universities with smoke- or tobacco-free campus policies has been increasing. The effects of campus smoking policies on overall sentiment, particularly among young adult populations, are more difficult to assess owing to the changing tobacco and e-cigarette product landscape and differential attitudes toward...

BACKGROUND The number of colleges and universities with smoke- or tobacco-free campus policies has been increasing. The effects of campus smoking policies on overall sentiment, particularly among young adult populations, are more difficult to assess owing to the changing tobacco and e-cigarette product landscape and differential attitudes toward po...

Background Vitamin D has been identified as a potential protective factor in the development of colorectal cancer (CRC). We expect to see a stronger association of ultraviolet B (UVB) exposure and CRC crude rates with increasing age since chronic vitamin D deficiency leads to sustained molecular changes that increase cancer risk. The DINOMIT (disju...

The Open Payments database reports payments made to physicians by industry. Given the potential for financial conflicts of interest relating to patient outcomes, further scrutiny of these data is valuable. Therefore, the objective of this study was to analyze physician-industry relationships by specialty type, payment type, geospatial trend, and lo...

Due to corruption and limited oversight, philanthropy in China has come under increasing scrutiny by both the Chinese government and public. In particular, corruption has impacted charities, resulting in operational funding declines that have also impacted legitimate charities serving the vulnerable. Hence, an increase in the number of Chinese char...

Introduction: Concomitant with the popularization of vaping, vape shops have dramatically proliferated over the past years. This study assesses whether vape storefronts in California are significantly associated with density of different age groups, and whether this differs between tobacco storefronts or non-specific tobacco retailers. Methods:...

Introduction Early reports of COVID-19 cases and deaths may not accurately convey community-level concern about the pandemic during early stages, particularly in the United States where testing capacity was initially limited. Social media interaction may elucidate public reaction and communication dynamics about COVID-19 in this critical period, du...

Introduction: College-aged youth are active on social media yet smoking-related social media engagement in these populations has not been thoroughly investigated. We sought to conduct an exploratory infoveillance study focused on geolocated data to characterize smoking-related tweets originating from California 4-year colleges on Twitter. Methods:...

Background In 2016, the “Act on Support for Overseas Expansion of Healthcare System and Attraction of International Patients” was enacted by the South Korean government in an attempt to accelerate growth of its medical tourism industry. However, only a few years after its implementation, the benefits are not well understood, nor have the positive o...

Introduction The potential of regenerative medicine to improve human health has led to the rapid expansion of stem cell clinics throughout the world with varying levels of regulation and oversight. This has led to a market ripe for stem cell tourism, with Tijuana, Mexico, as a major destination. In this study, we characterize the online marketing,...

A Correction to this paper has been published: https://doi.org/10.1007/s00384-020-03808-3

Introduction: Recent reports of lung injury associated with Electronic Nicotine Delivery System (ENDS) products precipitated by increasing vaping prevalence and interest in flavors among adolescents has led to policies that restrict the sale, distribution, and accessibility of ENDS products. This study assessed compliance of online ENDS vendors to...

Background The COVID-19 pandemic has reached 40 million confirmed cases worldwide. Given its rapid progression, it is important to examine its origins to better understand how people’s knowledge, attitudes, and reactions have evolved over time. One method is to use data mining of social media conversations related to information exposure and self-r...

Background: Vitamin D has been identified as a potential protective factor the development of colorectal cancer (CRC). We expect to see a stronger association of ultraviolet B (UVB) exposure and CRC crude rates with increasing age since chronic vitamin D deficiency leads to sustained molecular changes that increase cancer risk. The DINOMIT (disjunc...

Introduction: Local rates of COVID-19 cases and deaths may not accurately convey the variability in community-level concern about COVID-19 during the early outbreak period in the United States. Social media interaction may elucidate communication about COVID-19 in this critical period, during which communities may have formulated initial conception...

Objectives According to current reporting, the number of active coronavirus disease 2019 (COVID-19) infections is not evenly distributed, both spatially and temporally. Reported COVID-19 infections may not have properly conveyed the full extent of attention to the pandemic. Furthermore, infection metrics are unlikely to illustrate the full scope of...

Introduction Since the first case of COVID-19 was recorded in California, the geospatial distribution of disease cases has fluctuated over time. Given documented racial disparities in other parts of the country, longitudinal convergence of COVID-19 rates around race groups warrants assessment. Methods County-level cases for COVID-19 were collected...

PurposeRestorative proctocolectomy (RPC) is performed for patients with refractory ulcerative colitis (UC). This operation is performed in 2 or 3 stages and involves forming a diverting loop ileostomy thought to protect patients from complications related to anastomotic leak. However, some advocate for a modified 2-stage approach, consisting of sub...

Increasingly, social scientists are recognizing the limitations of traditional measures (e.g., geographic, demographic, economic) when trying to explain differing regional prosperity outcomes. This research seeks to understand how regions’ differing personalities can help describe economic variance. We test this by employing least squares linear re...

BACKGROUND The global impact of the COVID-19 pandemic is staggering as it now has eclipsed 24 million confirmed cases globally. Given its rapid progression, it is important to examine its origins to better understand how people’s knowledge, attitudes and reactions have evolved over time. One method is to use data mining of social media conversation...

Introduction From late 2014 through 2015, Scott County, Indiana faced an HIV outbreak triggered by opioid abuse and transition to injection drug use. Investigating the origins, risk factors, and responses related to this outbreak is critical to inform future surveillance, interventions, and policymaking. In response, this retrospective infoveillanc...

The purpose of this study was to explore the factors underlying variability in compliance with CDC guidelines in response to the novel coronavirus, or COVID-19. To do this, we examined the frequency of once ordinary, but newly risky behavior (as deemed by CDC guidelines) in a sample of 482 MTurkers. We ran analyses probing the situational and dispo...

Introduction and Aims Infoveillance approaches (i.e. surveillance methods using online content) that leverage big data can provide new insights about infectious disease outbreaks and substance use disorder topics. We assessed social media messages about HIV, opioid use and injection drug use in order to understand how unstructured data can prepare...

BACKGROUND The coronavirus (COVID-19) pandemic is a globally, rapidly spreading event with close to 2.5 million cases as of mid-April, representing an outbreak of historical scope and one with an accelerating trajectory. However, there are ongoing concerns about the accuracy of COVID-19 case counts due to issues such as lack of access to testing an...

Background The coronavirus disease (COVID-19) pandemic is a global health emergency with over 6 million cases worldwide as of the beginning of June 2020. The pandemic is historic in scope and precedent given its emergence in an increasingly digital era. Importantly, there have been concerns about the accuracy of COVID-19 case counts due to issues s...

Background The coronavirus disease (COVID-19) pandemic, which began in Wuhan, China in December 2019, is rapidly spreading worldwide with over 1.9 million cases as of mid-April 2020. Infoveillance approaches using social media can help characterize disease distribution and public knowledge, attitudes, and behaviors critical to the early stages of a...

BACKGROUND The coronavirus disease (COVID-19) pandemic, which began in Wuhan, China in December 2019, is rapidly spreading worldwide with over 1.9 million cases as of mid-April 2020. Infoveillance approaches using social media can help characterize disease distribution and public knowledge, attitudes, and behaviors critical to the early stages of a...

Literature shows that religiosity can provide individual resilience to life shocks as well as regional resilience to disasters caused by natural hazards. Related work has examined the complicated links between religion and economic growth. Yet few, if any, studies examine the role of regional levels of religiosity on a region's resilience to recess...

Background: Pharmaceutical corruption is a serious challenge in global health. Digital technologies that can detect and prevent fraud and corruption are particularly important to address barriers to access to medicines, such as medicines availability and affordability, stockouts, shortages, diversion, and infiltration of substandard and falsified m...

Background Vitamin D has been identified as a potential protective factor the development of colorectal cancer (CRC). We expect to see a stronger association of ultraviolet B (UVB) exposure and CRC crude rates with increasing age since chronic vitamin D deficiency leads to sustained molecular changes that increase cancer risk. The DINOMIT (disjunct...

Background: Vitamin D has been identified as a potential protective factor the development of colorectal cancer (CRC). We expect to see a stronger association of ultraviolet B (UVB) exposure and CRC crude rates with increasing age since chronic vitamin D deficiency leads to sustained molecular changes that increase cancer risk. The DINOMIT (disjunc...

Background: Vitamin D has been identified as a potential protective factor the development of colorectal cancer (CRC). We expect to see a stronger association of ultraviolet B (UVB) exposure and CRC crude rates with increasing age since chronic vitamin D deficiency leads to sustained molecular changes that increase cancer risk. The DINOMIT (disjunc...

Objectives: Prior research has not adequately examined the relationship between international migration and colorectal cancer (CRC) by cultural regions in the US. The purpose of this exploratory study was to determine how annual CRC incidence varied with US annual international migrant inflow in ten different regions, corresponding to dominant ance...

Background Accessibility to essential cancer medications in low- and middle-income countries is threatened by insufficient availability and affordability. The objective of this study is to characterize variation in transactional prices for essential cancer medications across geographies, medication type, and time. Methods Drug purchase prices for...

Background: Youth and adolescent non-medical use of prescription medications (NUPM) has become a national epidemic. However, little is known about the association between promotion of NUPM behavior and access via the popular social media microblogging site, Twitter, which is currently used by a third of all teens. Objective: In order to better asse...

There are 52,380 cases of leukemia and 24,090 deaths from it in the US annually. Its causes are unknown and no preventive strategies have been implemented. We hypothesized that leukemia is due mainly to vitamin D deficiency, which is due mainly to low solar ultraviolet B (UVB) irradiance. To test this hypothesis, we estimated age-standardized cloud...

Rates of age-standardized leukemia incidence (cases per 100,000) in both sexes according to cloud cover-adjusted UVB irradiance (W/m2) with countries weighted according to total population, 172 countries, 2012. (TIF)

Country-level data used in creating graphs and regression models. (XLS)

World map of leukemia incidence in both sexes (per 100,000 people), represented by graduated symbols, overlaid upon cloud cover-adjusted UVB irradiance (Watts/m2), represented by a choropleth gradient, 172 countries, 2012. (TIF)

Background: Previous studies have examined marketing characteristics of e-cigarettes sold online and others have examined e-cigarettes pricing in retail (non-Internet) settings. This study expands on these findings by examining pricing and marketing characteristics of interest among e-cigarette online vendors. Methods: Structured web searches we...