About

Aaron Pannone is the Director of the Master of Public Health Program and an Associate Professor of Public Health at the School of Medicine. He is involved in the field of Global Public Health, contributing to the academic and practical understanding of health issues on a global scale. His role includes leadership within the public health program, supporting educational initiatives and advancing the university's engagement in global health topics.

Research topics

• Medicine
• Nursing
• Internal medicine
• Medical emergency
• Microbiology
• Virology
• Emergency medicine
• Intensive care medicine
• Biology
• Engineering
• Psychology
• Operations management
• Pathology

Selected publications

• Free testosterone independently predicts metabolic syndrome severity in U.S. adolescent girls aged 12–19 years

  Journal of the Endocrine Society · 2026-03-06

  articleOpen access

  Abstract Context Hyperandrogenemia is associated with increased risks for metabolic syndrome in asymptomatic women and women with polycystic ovary syndrome. The relationship between hyperandrogenemia and metabolic syndrome in adolescent girls remains poorly defined. Objective The aim of this study was to assess whether free testosterone concentrations predict metabolic syndrome severity (MSS) in adolescent girls. Design/setting Using data from the U.S. National Health and Nutrition Examination Survey (2013-2016), we performed weighted regression analysis to evaluate whether free testosterone predicts MSS z-score after adjusting for body fat percentage, chronological age, and gynecological age. Similar analyses were performed using either total testosterone or sex hormone-binding globulin (SHBG) as the primary predictor variable. Participants 287 girls aged 12–19 years. Main outcome measure MSS z-score. Results In simple regression analyses, free testosterone and percent body fat predicted MSS z-score (R2 = 0.11 and 0.35, respectively; P < .0001 for both), but chronological age and gynecological age did not. In the multivariable regression model (R2 = 0.41), higher free testosterone and percent body fat were independently associated with higher MSS z-score (P = .0081 and < .0001, respectively), with no significant independent associations with chronological age or gynecological age. While SHBG was an independent predictor of MSS z-score (P = .0104) in a multivariable regression model, total testosterone was not (P = .77). Conclusion Higher free testosterone predicts greater MSS in a nationally representative sample of adolescent girls aged 12–19 years. This relationship at least partly reflects the relationship between MSS z-score and SHBG.

  PublisherDOI

• SUPPLEMENTAL MATERIALS for "Free testosterone independently predicts metabolic syndrome severity in U.S. adolescent girls aged 12 to 19 years"

  Libra · 2026-03-18 · 1 citations

  datasetOpen access

  Supplemental analyses for "Free testosterone independently predicts metabolic syndrome severity in U.S. adolescent girls aged 12 to 19 years"

  PublisherDOI

• “Four I” Framework for Telehealth Optimization in Congregate Care Communities

  Telemedicine Journal and e-Health · 2025-02-07 · 1 citations

  article

  Background: Telehealth can provide innovative models of care for people living in congregate care communities (CCC), but lack of consistent workflow is a barrier for administrators and staff. We propose a framework for CCC to implement workflows for age-inclusive telehealth. Methods: As part of an infection control initiative with a focus on telehealth optimization, Virginia Infection Mitigation, Prevention and Control Through Technology developed relationships with administrators and staff of CCC across the Commonwealth of Virginia. Partners in this community of practice completed a statewide survey that we conducted on anticipated and experienced barriers to telehealth implementation. Through survey responses, virtual meetings with organizational leadership, and on-site facility visits, our team assessed the strengths, needs, and goals for telehealth capability. Working with administrative and clinical teams, we developed a consultation report to define short- and long-term implementation steps. Results: We collaborated with a nonprofit organization supporting a community of people with neurodevelopmental disabilities and a rural Program of All-Inclusive Care for the Elderly. We developed a framework for telehealth optimization with four tiers: Initiate, Integrate, Incentivize, and Inspire. Each stage included an overall goal with corresponding interventions to guide program implementation. Discussion: The “Four I” Framework can be used to outline telehealth readiness and implement workflows for CCC. We aim to further develop an iterative process and to collaborate with additional organizations to optimize telehealth programs.

  PublisherDOI

• Response to Letter to the Editor From Li and Luo: Obesity is Associated With Hyperandrogenemia in a Nationally Representative Sample of US Girls Aged 6 to 18 Years

  The Journal of Clinical Endocrinology & Metabolism · 2024-11-22

  letter
  PublisherDOI

• Obesity Is Associated With Hyperandrogenemia in a Nationally Representative Sample of US Girls Aged 6 to 18 Years

  The Journal of Clinical Endocrinology & Metabolism · 2024-09-23 · 9 citations

  articleOpen access

  CONTEXT: Studies have associated obesity with peripubertal hyperandrogenemia. However, these studies were performed in academic centers and could have been influenced by selection bias. OBJECTIVE: To investigate if free testosterone levels are elevated in peripubertal girls with obesity. DESIGN/SETTING: We analyzed data from the National Health and Nutrition Examination Survey 2013-2016 databases. PARTICIPANTS: 1299 girls aged 6-18 years residing in the United States. MAIN OUTCOME MEASURES: Mean free testosterone concentration (calculated from total testosterone and SHBG). RESULTS: Among girls aged 6 to 9 years, mean (95% confidence interval) free testosterone was 0.33 pg/mL (0.28-0.38) in healthy-weight girls vs 0.86 pg/mL (0.67-1.05) in girls with obesity. Among girls aged 10 to 14 years, free testosterone was 2.29 pg/mL (2.05-2.53) in healthy-weight girls vs 4.10 pg/mL (3.60-4.60) in girls with obesity. Among girls aged 15 to 18 years, free testosterone was 3.33 pg/mL (2.96-3.70) in healthy-weight girls and 5.64 pg/mL (4.93-6.36) in girls with obesity. Girls with obesity in all age groups had higher free testosterone levels compared to healthy-weight girls. In each age group, the 95% confidence intervals for free testosterone did not overlap between healthy weight vs obesity subgroups. A multiple regression model accounted for 42% of the variance in free testosterone (R2 = 0.42), and both weight and age categories were independent predictors of free testosterone (P < .0001 for each). CONCLUSION: In a nationally representative sample of US girls, obesity is associated with elevated free testosterone, suggesting an important relationship between obesity and peripubertal hyperandrogenemia.

  PublisherOA PDFDOI

• Long-term Care Resident Quality of Life 1 Year Following Initial COVID-19 Vaccination

  Journal of the American Medical Directors Association · 2023-04-27

  articleOpen access
  PublisherOA PDFDOI

• RF10 | PMON242 Free Testosterone is an Independent Predictor of Metabolic Syndrome Severity in U.S. Adolescent Girls Ages 12-19, National Health and Nutrition Examination Survey (NHANES) 2013-2016

  Journal of the Endocrine Society · 2022-11-01

  articleOpen access

  Abstract Background Metabolic syndrome (MetS) affects ∼10% of U.S. adolescents, especially those with obesity. Adolescent obesity is associated with adolescent hyperandrogenemia (HA), while adult HA is associated with increased risk of MetS in both asymptomatic women and women with polycystic ovary syndrome (Torchen et al, Obesity [Silver Spring] 2020). Yet, the relationship between HA and severity of MetS during adolescence remains unclear. We investigated whether free testosterone (T) concentrations independently predict MetS severity in adolescent girls. Methods We performed a weighted analysis using data from the National Health and Nutrition Examination Survey (NHANES) for 2013–2016, utilizing a cross-sectional study design. In particular, we analyzed data from a nationally-representative sample of 230 girls aged 12-19 years. We performed regression analysis to evaluate whether free T (independent variable) predicted MetS Severity Z-score (outcome). In a multiple regression model, we adjusted for total percent body fat, age (months), and menarche status (premenarcheal vs. postmenarcheal). Free T was calculated (Vermuelen equation) from total T and sex hormone binding globulin (SHBG). MetS severity was determined by a calculator validated for children (Gurka et al, Metabolic Syndrome Severity Calculator, doi: 10.5281/zeondo.2542213; Gurka et al, Cardiovascular Diabetology 2012) using reported fasting labs and anthropometric parameters. As secondary analyses, we (1) repeated the above analysis substituting SHBG for free T in the primary cohort, and (2) repeated the above analysis substituting total T for tree T in an expanded cohort (n=251). Results In the primary cohort, MetS z-score was -0.27 (-0.41 to -0.13) [mean (95% CI)]; free T 4.0 pg/ml (3.7–4.3); total T 28.7 ng/dL (27.1–30.3); SHBG 60.8 nmol/L (54.0–67.6); total percent body fat 34.5% (33.3–35.6). In simple regression analyses, free T (R=0.11) and percent body fat (R=0.57) each predicted MetS z-score (p&amp;lt;0.001 for each), but age (p=0.68) and menarche status (p=0.18) did not. Our adjusted regression model accounted for 60% of the variance in MetS z-score (R2=0.60). Higher free T and percent body fat were independently associated with higher MetS z-score, while younger age was independently associated with higher MetS z-score (p&amp;lt;0.001 for each). When substituting SHBG and total T for free T, model R2 values were 0.61 and 0.59, respectively, with only percent body fat and age being significant independent predictors of MetS z-score in each model (SHBG, p=0.06; total T, p=0.90). Conclusion We conclude that free T is an independent predictor of MetS severity in a nationally-representative sample of adolescent girls aged 12 to 19 years. Total T was not an independent predictor of MetS severity, suggesting that the relationship between free T and MetS z-score may partly reflect obesity-associated reductions in SHBG levels. These data suggest that HA may contribute to MetS severity in adolescent girls. Presentation: Saturday, June 11, 2022 1:06 p.m. - 1:11 p.m., Monday, June 13, 2022 12:30 p.m. - 2:30 p.m.

  PublisherOA PDFDOI

• OR15-1 Obesity is Associated with Adolescent Hyperandrogenemia in Girls Aged 6-18, National Health and Nutrition Examination Survey (NHANES) 2013-2016

  Journal of the Endocrine Society · 2022-11-01 · 3 citations

  articleOpen access

  Abstract Background Peripubertal hyperandrogenemia (HA) often represents a forerunner to adolescent/adult polycystic ovary syndrome (PCOS), but risk factors for peripubertal HA are unclear. Studies have associated obesity with HA throughout puberty (e.g., McCartney, JCEM 2007;92: 430-436, Knudsen, Obesity 2010;18: 2118-2124). However, these studies were performed in academic centers and could have been influenced by recruitment bias. We therefore investigated if there was a difference in calculated free testosterone (T) levels between girls with healthy weight and those with obesity in a nationally-representative U.S. sample. Methods We analyzed data for 1,196 girls aged 6–18 years from the National Health and Nutrition Examination Survey (NHANES) 2013-2016 databases, utilizing a cross-sectional study design. We calculated free T from total T and sex hormone-binding globulin (Vermuelen equation). We divided girls into 3 groups by age, based on presumed pubertal stages: "Pre-/Early" (6–9 years), "Middle" (10–14 years), and "Late" (15–18 years). Each individual was also categorized as healthy-weight (BMI-for-age percentile 5-85) or obese (BMI-for-age percentile ≥95). We analyzed mean free T concentrations by weight status (healthy-weight vs. obese) for each age group by calculating population estimates. We also performed survey-weighted regression analysis to assess the relationships between weight status and age category (independent variables) and free T (outcome). Results Among Pre-/Early girls, free T was 0.33 pg/ml (0.28-0.38) [mean (95% CI)] for healthy-weight vs. 0.86 pg/ml (0.67-1.05) for obese. Among Middle girls, free T was 2.53 pg/ml (2.27-2.78) for healthy-weight vs. 4.35 pg/ml (3.75-4.95) for obese. Among Late girls, free T was 3.33 pg/ml (2.96-3.70) for healthy-weight vs. 5.64 pg/ml (4.93-6.36) for obese. (Notably, in each age group, the 95% CIs for free T did not overlap between healthy-weight vs. obese subgroups). Mean free T increased with advancing age in both healthy-weight and obese groups, especially between Pre-/Early and Middle age ranges (Pre-/Early-to-Middle differences were 2.20 pg/ml for healthy-weight and 3.49 pg/ml for obese). Our regression model accounted for 45% of the variance in free T (R2=0.45). Both weight status (obese vs. healthy-weight) and age group were independent predictors of free T concentrations (p&amp;lt;0.0001 for both). When adding an age-in-months-by-BMI-percentile interaction term, the model R2 value was 0.47, with age category, weight category, and the interaction term all being independent predictors of free T (p&amp;lt;0.001 for all). Conclusion We conclude that obesity is associated with higher free T levels in U.S. girls aged 6–18 years. Age also predicts free T, likely reflecting increases related to pubertal maturation, and free T differences according to weight status are more prominent in older girls. This study in a nationally-representative sample of U.S. girls supports previous analyses of girls studied at academic centers, further suggesting an important relationship between obesity and peripubertal androgen excess. Presentation: Sunday, June 12, 2022 11:00 a.m. - 11:15 a.m.

  PublisherDOI

• Exploring Perceptions of Shift Length: A State-Based Survey of Registered Nurses: Erratum

  JONA The Journal of Nursing Administration · 2021-10-27

  erratum

  The authors would like to correct an error in the article: “Exploring Perceptions of Shift Length: A State-Based Survey of Registered Nurses” [JONA 50 (9), PP 449-455]. Page 451, Heading: Results; Sub-heading: Quantitative; third sentence should read ‘Forty-eight percent reported their primary practice setting as acute care and the emergency department (ED), whereas ..… ‘.

  PublisherDOI

• COVID-19 Collaborative Model for an Academic Hospital and Long-Term Care Facilities

  Journal of the American Medical Directors Association · 2020 · 52 citations

  • Medicine
  • Medical emergency
  • Virology
  PublisherOA PDFDOI

Frequent coauthors

• R Bernheim

  17 shared

• Terry Brandenburg

  Medical College of Wisconsin

  16 shared

• Alan Melnick

  Clark County Public Health

  16 shared

• Matthew Stefanak

  Bial (Portugal)

  16 shared

• Christopher R. McCartney

  University of Virginia

  6 shared

• Derrick W. Crook

  University of Oxford

  5 shared

• Nicole Stoesser

  Oxford University Hospitals NHS Trust

  5 shared

• Mark D. DeBoer

  University of Virginia

  4 shared

Labs

• Public Health SciencesPI