Medicine and Health Sciences Commons^™

Monkeypox Virus Hosts And Transmission Routes: A Systematic Review Of A Zoonotic Pathogen, Mary Walker

Biological Sciences Undergraduate Honors Theses

Monkeypox virus (MPXV) is an etiological agent of Monkeypox with origins believed to be of Central/West Africa. As a member of the orthopoxvirus family and due to its increasing emergence, it has become a pathogen in need of research. This paper works to find common trends of transmission routes and reservoir hosts in previous publications through a systematic review. Articles found on Web of Science containing the search term “Monkeypox” were sorted based on relevance to the review topics of potential reservoir hosts and transmission routes of Monkeypox virus. Through Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), 1,036 …

Transmission Risk Of Malaria Via Gas Flares In Africa, Elle Blake

Health, Human Performance and Recreation Undergraduate Honors Theses

Gas flaring occurs at oil drilling sites around the world. It is a method to get rid of the extra gas, as well as to release pressure in emergency situations. The pollutants that are contributed to the air through routine gas flaring can be extremely harmful. Chemicals such as sulfur dioxide and methane are burned into the air we breathe (Baker Hughes, 2019). Not only does this have a direct impact on our health, but also on greenhouse gas emissions. The effects on greenhouse gas emissions impact diseases such as Malaria by increasing the temperature of our planet. The purpose …

Equitable Vaccine Access Within An Age-Based Framework, Alan B. Cobo-Lewis

Developmental Disabilities Network Journal

Objectives: When vaccine supply was limited, several states adopted age-based prioritization for Covid-19 vaccine eligibility because it is simple (especially when age is quantized by decade) and age is strongly associated with Covid-19 mortality. But this approach raises equity concerns based in law and ethics. I propose data-driven solutions for equitable policy within an age-based framework. Methods: Using CDC and Census Bureau data, I analyzed 538,627 U.S. Covid-19 deaths by age and race-ethnicity through February 2021 and compared the risk ratios to published data on risk ratios for other conditions. Results: Covid-19 mortality rose 2.56-fold per decade of life. Down …

Covid-19 Case Complicated With Organizing Pneumonia And Pneumothorax: A Case Report, Tammy E. Phillips, Hammad A. Bhatti, Minh Q. Ho

The University of Louisville Journal of Respiratory Infections

Organizing pneumonia can be idiopathic or caused by multiple etiologies, including viral or bacterial pneumonia, drugs, and autoimmune disorders. It can rarely lead to cyst formation and pneumothorax with the exact mechanism remaining unclear. This case presents a previously healthy 50-year-old male who contracted COVID-19 with subsequent development of organizing pneumonia and pneumothorax. Patients presenting with hypoxic respiratory failure due to COVID-19 should be screened for organizing pneumonia upon discharge. This case also illustrates the importance of following such patients radiologically to monitor interstitial lung disease and consider pneumothorax for patients re-presenting with acute symptoms.

Dnp Final Report: Sane Finder: A Web-Based Mobile Solution To Identify The Location Of Currently Available Sexual Assault Nurse Examiners (Sane) For First Responders, Brenda D. Herrmann

DNP Final Reports

Society views sexual assault as one of the most horrific crimes committed by one human being against another, but the “rescue” has the potential to make the experience even more difficult for the victim, in essence re-traumatizing them (Nugent-Borakove et al., 2006). In the United States in 2018, almost 140,000 victims reported being sexually assaulted (U.S. Department of Justice - Federal Bureau of Investigation, 2019). In Texas, over 6 million individuals have been sexually assaulted in their lifetime (Busch-Armendariz et al., 2015). Getting victims to a specially trained sexual assault nurse examiner (SANE) as quickly as possible improves outcomes. SANEs …

Impact Of Mass Distribution Of Insecticide-Treated Nets In Mozambique, 2012 To 2025: Estimates Of Child Lives Saved Using The Lives Saved Tool, Erica Wetzler, Chulwoo Park, Jorge A. H. Arroz, Marta Chande, Figueiredo Mussambala, Baltazar Candrinho

Faculty Research, Scholarly, and Creative Activity

Malaria was the leading cause of post-neonatal deaths in Mozambique in 2017. The use of insecticide treated nets (ITNs) is recognized as one of the most effective ways to reduce malaria mortality in children. No previous analyses have estimated changes in mortality attributable to the scale-up of ITNs, accounting for provincial differences in mortality rates and coverage of health interventions. Based upon annual provincial ownership coverage of ITNs, the Lives Saved Tool (LiST), a multi-cause mathematical model, estimated under-5 lives saved attributable to increased household ITN coverage in 10 provinces of Mozambique between 2012 and 2018, and projected lives saved …

Are Antipyretic Medications Compatible With Sars-Cov-2 Vaccines?, Sharanya S E Santhi, Niguma Rayamajhi, Steven B Lippmann

The University of Louisville Journal of Respiratory Infections

No abstract provided.

Sotrovimab: Neutralizing Antibody To Combat Covid-19, Aya Allam, Steven Lippmann

The University of Louisville Journal of Respiratory Infections

No abstract provided.

Mental Disorder Symptoms During The Covid-19 Pandemic In Latin America – A Systematic Review And Meta-Analysis, Stephen X. Zhang, Kavita Batra, Wen Xu, Tao Liu, Rebecca Kechen Dong, Allen Yin, Andrew Yilong Delios, Bryan Z. Chen, Richard Z. Chen, Saylor Miller, Xue Wan, Wenping Ye, Jiyao Chen

School of Medicine Faculty Publications

Aims There is a lack of evidence related to the prevalence of mental health symptoms as well as their heterogeneities during the coronavirus disease 2019 (COVID-19) pandemic in Latin America, a large area spanning the equator. The current study aims to provide meta-analytical evidence on mental health symptoms during COVID-19 among frontline healthcare workers, general healthcare workers, the general population and university students in Latin America. Methods Bibliographical databases, such as PubMed, Embase, Web of Science, PsycINFO and medRxiv, were systematically searched to identify pertinent studies up to August 13, 2021. Two coders performed the screening using predefined eligibility criteria. …

Leptospirosis Presenting As Diffuse Alveolar Hemorrhage, Alejandra González, Paola Alvarez, Mariano Fielli, Analia Santos, Neil Gomez Querales, Elkin Rodriguez Arzuaga

The University of Louisville Journal of Respiratory Infections

Diffuse alveolar hemorrhage (DAH) syndrome has a mortality rate of 30 to 60%. A 15-year-old male patient presented with a seven-day abdominal pain, vomiting, non-dysenteric diarrhea, conjunctival injection, and fever. Chest radiography revealed bilateral interstitial infiltrates predominating in the lower left lobe. The patient’s condition worsened within hours, with the development of massive hemoptysis, acute respiratory distress syndrome (ARDS), arterial hypotension, and hematocrit decline requiring mechanical ventilation. A chest computed tomography (CT) showed ground-glass opacities with consolidation areas in lower lobes, diffuse tree-in-bud opacities, and centrilobular nodules. A bronchoscopy was conducted without endoluminal lesions and bronchoalveolar lavage (BAL) consistent with …

Mucormycosis: Covid-19 And Corticosteroids, Mittal Savaliya, Nivedita Jha, Steven B Lippmann

The University of Louisville Journal of Respiratory Infections

No abstract provided.

The Impact Of Afghan Opium Cultivation On The U.S. Opioid Epidemic, Zachary Wahab Cheek

UNL Student Research Days Posters, Undergraduate

I argue here that increases in Afghan opium cultivation, the most prolific in the world, has depressed American prescription opioid and heroin prices, thereby increasing abuse risk in U.S. addict populations and increasing death rates. Utilizing a two-stage regression model with a sparse dataset from several national and international sources, I find evidence that a one percent increase in Afghan opium production is associated with a 0.122 percent increase in prescription opioid overdose deaths, and a 0.367 percent increase in heroin overdose deaths. Assessing the 2001-2002 Taliban opium ban with an identification strategy, I find that in this timeframe prescription …

Reducing Immigration-Related Stress In An Immigrant Population, Stephanie Avdagic

Graduate Theses, Dissertations, and Capstones

Immigrants are a growing population in the United States and face stressors specific to immigration. Stress is associated with increased mental and physical health issues, so increased stress puts this population at risk for many health concerns. A review of literature showed that implementing community resource classes for immigrants may help decrease immigration-related stress. The purpose of this evidence-based project was to assess if implementation of community resource classes at a local day center for immigrants could help decrease immigration-related stress. The classes addressed issues such as limited English proficiency and lack of legal immigration status. The Stress of Immigration …

The Intersection Between Climate Change And Human Inequality: A Narrative Review, Julia Serwaa

College of Health Sciences Posters

Introduction: Although developed countries are the largest contributors to climate change, its impacts continue to adversely affect low-income countries at a disproportionate rate. The purpose of this analysis is to address the environmental and health impacts of climate change in low-income countries as opposed to developed countries.

Methods:

A narrative literature review was conducted using a web-based search from scientific databases. The databases utilized were: United National Library of Medicine, JSTOR, and SpringerLink. The reviewer assessed the following inclusion criteria: peer-reviewed publications from 2012 – 2022, the availability of the publication in English, and the categorization as original research, reviews, …

“Pandemias Políticas: The Effects Of Political And Social Instability On Infectious Disease Epidemiology In Latin America"”, Sarah H. Noonan

Senior Theses

This paper seeks to analyze the relationship between political and social unrest and conflict and infectious disease epidemiology in Latin America. An analysis of published literature regarding epidemiological, biomedical, political, and historical content was conducted to highlight potential connections between infectious disease epidemics and sociopolitical conflict in the region. Specific analyses of Smallpox, Venezuelan Equine Encephalitis, Chagas disease, Cholera, Dengue, and COVID-19 were conducted, in an effort to uncover potential causations and context of epidemics of these conditions. Results of this analysis depict a necessity for further research into public health and disease control mechanisms during times of conflict and …

A Comparative Analysis Of Migrant Health Policies And Practices In The Us And Switzerland, Rebecca Mak

Independent Study Project (ISP) Collection

Migrants compose a large proportion of the population in both the US and Switzerland. The social vulnerability of migrants has been well-established in literature, but few studies have attempted to compare healthcare policies and approaches that most effectively support migrant health using multiple measures.

To fill this gap in the literature, this study will comparatively analyze of the efficacy of US and Switzerland migrant health policies and services by assessing access to and quality of care for migrants in each country. Four main features of healthcare systems were analyzed: insurance policy, healthcare utilization, NCD outcomes, and patient perceptions of care. …

The Correlation Between Vaccine Hesitancy And Privilege: Exploring The Degree To Which Education And Income Foster Resistance To Vaccination Efforts, Sophie Goldenberg

Independent Study Project (ISP) Collection

Vaccine hesitancy is a public health issue of growing concern. Extensive pre-existing literature offers several explanations and conflicting viewpoints regarding reluctance toward vaccinations. However, minimal research has been done exploring the upstream social determinants driving vaccine hesitancy. Utilizing academic and gray literature and interviews with experts in the field, this study addresses this gap in knowledge with the research question: To what extent does privilege impact vaccine hesitancy and resistance? Vaccine hesitancy appears globally and is particularly concerning given the re-emergence of vaccine-preventable diseases (VPDs). Additionally, due to inconsistent causes, vaccine hesitancy is difficult to combat. In referencing the history …

Facilitators To Becoming And Remaining Open Defecation Free In Uganda: Implications For Community-Led Total Sanitation Programming, Danette Lee Cagnet

Electronic Theses and Dissertations

Poor sanitation behaviors, including open defecation, present risks for diarrhea, which is credited with 600,000 deaths a year in children under age five. Although CLTS is a solution to ending open defecation, more than half of the investment in producing open defecation free (ODF) communities is lost during the maintenance phase. The purpose of this qualitative, case study was to understand stakeholder perceptions of the facilitators and hindrances to becoming ODF certified and maintaining ODF status and sanitary behaviors in a small village community located in Uganda, East Africa. The researcher held individual interviews and in-person focus group discussions to …

In-Silico Determination Of Phytochemicals Against Spike Protein Of Covid-19, Muhammad Irfan, Muhammad Adil, Areej Fatima, Arooj Fatima, Ammara Khalid, Muhammad Bilal

Journal of Bioresource Management

Spike protein is present on the exterior of SARS-CoV-2 that mediates the binding of virus with human ACE2 receptor. S-protein has the ability to mutate in a short span of time. Using S-protein as a therapeutic target, Covid-19 infection can be prevented. Many plant-derived phytochemicals are found effective to treat viral infections. In this study, we selected top 10 phytochemicals following the Lipinski’s rule of five from total 82 candidate phytochemicals. The binding energies were determined through molecular docking of the phytochemical ligands. Top three compounds having maximal interactions and lowest binding energies were visualized. We suggested Dictamnine, Deoxypodophyllotoxin and …

Knowledge Or Awareness Of Non-Communicable Diseases And Their Associated Risk Factors Among University Students In Fiji: A Cross-Sectional Study, Awadhesh Kumar Shirotriya, Kavita Batra

School of Medicine Faculty Publications

Introduction: Chronic diseases (aka Non-communicable diseases, NCDs) contribute to the global burden of morbidity and mortality, with a significant share of premature deaths among low-and middle-income countries (LMICs), including Fiji. The early exposure to the risk factors of NCDs affects the entire life course; knowledge or awareness of adolescents towards NCDs and associated risk factors is critical for health promotion. This study aims to investigate the knowledge or awareness level of chronic conditions and their risk factors among Fijian students. Methods: In this cross-sectional study, a sample of 338 university students was recruited using the paper as well as web-based …

Intersecting Disadvantages For Married Adolescents: Life After Marriage Pre- And Post-Covid-19 In Contexts Of Displacement., Sarah Baird, Maureen Murphy, Jennifer Seager, Nicola Jones, Anju Malhotra, Sarah Alheiwidi, Guday Emirie, Sabina Rashid, Maheen Sultan

Global Health Faculty Publications

PURPOSE: Although there is a growing evidence base on the drivers of child marriage, comparatively little is known about the experiences of married girls in refugee settings and how their development trajectories diverge from those of their nonmarried peers, particularly in the context of the COVID-19 pandemic. Drawing on cross-national panel data from Bangladesh and Jordan, this article explores diversity in child marriage experiences in contexts affected by forced displacement, highlighting how married girls' well-being differs from that of their unmarried peers, and how COVID-19 has reinforced these differences.

METHODS: We analyzed longitudinal survey data-collected pre- and post-COVID-19-from the Gender …

Sleep And Economic Status Are Linked To Daily Life Stress In African-Born Blacks Living In America., Zoe C. Waldman, Blayne R. Schenk, Marie Grace Duhuze Karera, Arielle C. Patterson, Thomas Hormenu, Lilian S. Mabundo, Christopher W. Dubose, Ram Jagannathan, Peter L. Whitesell, Annemarie Wentzel, Margrethe F. Horlyck-Romanovsky, Anne E. Sumner

Publications and Research

To identify determinants of daily life stress in Africans in America, 156 African-born Blacks (Age: 40 ± 10 years (mean ± SD), range 22-65 years) who came to the United States as adults (age ≥ 18 years) were asked about stress, sleep, behavior and socioeconomic status. Daily life stress and sleep quality were assessed with the Perceived Stress Scale (PSS) and Pittsburgh Sleep Quality Index (PSQI), respectively. High-stress was defined by the threshold of the upper quartile of population distribution of PSS (≥16) and low-stress as PSS < 16. Poor sleep quality required PSQI > 5. Low income was defined as groups, PSS were: 21 ± 4 versus …

Pulmonary Post-Acute Sequelae Of Covid-19, Usman Akbar, Shivam Gulati, Johnny Zakhour Md, Alex Glynn, Jose Bordon

The University of Louisville Journal of Respiratory Infections

Introduction: Persistent symptoms have been observed in a substantial proportion of survivors of COVID-19 since relatively early in the pandemic. Among these post-acute sequelae of COVID-19 (PASC), respiratory symptoms appear to be the most prevalent.

Methods: We conducted a literature review of peer-reviewed publications in English on the clinical and epidemiological features of respiratory PASC in cohorts of 100 or more patients with a follow-up of four weeks or more after acute infection. Included studies reported the prevalence of persistent respiratory symptoms and/or the results of follow-up pulmonary function tests.

Results: On our review included 14 studies across eight countries …

Compliance With Guidelines For Treatment Of Staphylococcus Aureus Bacteremia Is Associated With Decreased Mortality In Patients Hospitalized For Community-Acquired Pneumonia With Staphylococcus Aureus Bacteremia, Leslie Beavin, Vidyulata Salunkhe, Shashvin Singh, Ahmed Gana, Balaji Sekaran, Mahder A. Tella, Stephen P. Furmanek, Forest W. Arnold

The University of Louisville Journal of Respiratory Infections

Introduction: Staphylococcus aureus bacteremia has a minimum treatment duration of two weeks, while S. aureus community-acquired pneumonia (CAP) treatment is at least five days. Treatment failure, persistent bacteremia, and recurrence are common among patients with community-acquired S. aureus bacteremia. There is conflicting information in the current Infectious Diseases Society of America (IDSA) guidelines for the treatment of S.aureus bacteremia patients with CAP. Therefore, the appropriate treatment duration and modality for S. aureus CAP with bacteremia is unclear. The objective of this study was to compare outcomes among patients with S. aureus CAP and bacteremia treated in compliance versus non-compliance with …

Clinical Outcomes For Patients With Community-Acquired Pneumonia Are Worse In Those With A History Of Stroke, Pradeepthi Badugu, Dilip Kc, Bibodh Jung Karki, Mahder A. Tella, Vidyulata Salunkhe

The University of Louisville Journal of Respiratory Infections

Background: Stroke is one of the most prevalent neurological diseases in the United States. Community-acquired pneumonia (CAP) is the leading cause of infections in survivors of stroke. There is limited research evaluating the clinical outcomes of CAP in patients with stroke. The objective of this study was to evaluate the clinical characteristics and outcomes of hospitalized patients with CAP and a history of stroke.

Methods: This was a secondary analysis of the University of Louisville Pneumonia Study database. Patients were divided into two groups based on the presence or absence of a history of stroke. Clinical outcomes were length of …

Implementation Of A Drive-Through Covid-19 Mass Vaccination Site: Experiences From Louvax–Broadbent In Louisville, Kentucky, Ruth Carrico, Sarah Beth Hartlage, Valenchia Brown Msn, Aprn, Fnp-C, Sarah M. Bishop, Luanne Didelot, William Hayden, Beverly Williams Coleman, Sarah Tan, Delanor Manson, Kellie Kane, Dawn Balcom, Paul Kern

The University of Louisville Journal of Respiratory Infections

Background: Response to the COVID-19 pandemic has required innovative approaches to vaccination, including methods to rapidly and safely immunize communities. A major challenge to such a response involved access to untapped healthcare worker resources. The Louisville, Kentucky, response involved the use of a large volunteer workforce to supplement local public health employees in planning and implementing a large-scale drive-through vaccination event. The objective of this manuscript was to outline processes involved in training a mass immunization workforce and implementating a large-scale COVID-19 community vaccination.

Approach: Competency-based and standardized training was provided for every volunteer before working their shift. Volunteers worked …

Dissecting Fc Signatures Of Protection In Neonates Following Maternal Influenza Vaccination In A Placebo-Controlled Trial., Carolyn M Boudreau, John S Burke, Kiel D Shuey, Caitlin Wolf, Joanne Katz, James Tielsch, Subarna Khatry, Steven C Leclerq, Janet A Englund, Helen Y Chu, Galit Alter

Global Health Faculty Publications

Influenza is an important cause of illness and morbidity for infants. Seasonal influenza vaccination during pregnancy aims to provide protection to mothers, but it can also provide immunity to infants. The precise influence of maternal vaccination on immunity in infants and how vaccine-elicited antibodies provide protection in some but not all infants is incompletely understood. We comprehensively profiled the transfer of functional antibodies and defined humoral factors contributing to immunity against influenza in a clinical trial of maternal influenza vaccination. Influenza-specific antibody subclass levels, Fc ɣ receptor (FCGR) binding levels, and antibody-dependent innate immune functions were all profiled in the …

Nevirapine Hair And Plasma Concentrations And Hiv-1 Viral Suppression Among Hiv Infected Ante-Partum And Post-Partum Women Attended In A Mother And Child Prevention Program In Maputo City, Mozambique, Rosa Marlene Cuco, Osvaldo Loquiha, Adelino Juga, Aleny Couto, Bindiya Meggi, Adolfo Vubil, Esperança Sevene, Nafissa Osman, Marleen Temmerman, Olivier Degomme

Obstetrics and Gynaecology, East Africa

Introduction: Prevention of mother to child transmission of HIV (PMTCT) is frequently challenged by irregular access to more effective anti-retroviral therapy. Nevirapine single dose (sdNVP), sdNVP+AZT+3TC for MTCT prophylaxis and NVP+ AZT+3TC for treatment and PMTCT were withdrawn due to low genetic resistance barrier and low efficacy. However current PMTCT lines in Mozambique include DTG+3TC+TDF, TDF+3TC+EFV, DTG +ABC+3TC, and AZT + NVP syrup prophylaxis for exposed babies. We assessed NVP hair and plasma concentrations and association with HIV-1RNA suppression among HIV+ ante-partum and post-partum women under PMTCT in Maputo, Mozambique.

Methods: From December 2013 to November 2014, prospectively …

Learning From South Korea’S Covid-19 Response: Why Centralizing The United States Public Health System Is Essential For Future Pandemic Responses, Meghan Ricci

Seattle Journal of Technology, Environmental & Innovation Law

The COVID-19 pandemic revealed stark differences in governmental preparedness across the globe. The United States, once thought of as a global leader in public health, had the theoretical skill and efficiency to handle the pandemic but failed to utilize those skills and resources during an actual health crisis. In the spring of 2020, everyone watched the U.S.’s reaction to the unfolding of the COVID-19 pandemic due to its historic placeholder as a global leader and innovator. However, the performance of the U.S. in response to the global pandemic disappointed both global commentators and U.S. citizens. This paper will compare the …

Impact Of Pooling Samples On Analytic Sensitivity Of A Real-Time Reverse Transcriptase Pcr Assay For Sars Cov-2, Subathra Marimuthu, Stephen P. Furmanek, Holly Aliesky, Leslie A. Wolf

The University of Louisville Journal of Respiratory Infections

During the COVID-19 pandemic, laboratories experienced periods of shortages for certain critical materials required to meet the high demand for SARS-CoV-2 testing. The U.S. Food & Drug Administration provided a template for molecular diagnostic testing, including guidance for a specimen pooling process in order to evaluate performance of the SARS-CoV-2 nucleic acid amplification assay. This study aimed to evaluate the testing of pooled specimens consisting of four nasopharyngeal swab specimens using the Luminex ARIES^® nucleic acid amplification platform. Results indicated that there was a loss of analytic sensitivity with pooled nasopharyngeal swab samples, demonstrating that this approach should be …