Digital Commons Network^™

Perspectives On The Use Of Molecular Hiv Data For Public Health, Margaret Watson

College of Graduate Studies: Theses & Dissertations

Background. Effective HIV treatment and pre-exposure prophylaxis can drastically reduce the risk of acquiring HIV and prevent most future transmission, but these advances are not accessible to many who could most benefit from them. Advances in use of molecular sequence data to inform prevention efforts, paired with supportive interventions, have the potential to identify clusters of rapid HIV transmission and focus prevention resources toward areas of highest need. Although molecular cluster detection has been successfully used in other areas of public health, advocates for people with HIV have raised concerns about the application of this approach because of HIV …

Burkholderia Collagen-Like Protein 8, Bucl8, Is An Outer-Membrane Component Of A Novel Efflux Pump And Immunogenic Vaccine Candidate, Megan Elizabeth Grund

Graduate Theses, Dissertations, and Problem Reports (ETD)

Burkholderia spp. are Gram‐negative intrinsically resistant bacteria that are responsible for environmental and nosocomial infections of clinical and biodefense concern. Our laboratory previously identified in silico Burkholderia collagen-like protein 8 (Bucl8) in the BSL-3 pathogens Burkholderia pseudomallei and Burkholderia mallei (Figure 1). The protein sequence of Bucl8 contains tandem outer-membrane efflux protein domains (OEP) typical of efflux systems and a unique collagen-like domain (CL) consisting of a repeating sequence of Glycine-Alanine-Serine (GAS). Because efflux pumps are often a mechanism of pathogenicity and antibiotic resistance, we investigated Bucl8 further. Here, we determined that the locus of bucl8 contains genes …

Precision Medicine Approach To Alzheimer’S Disease: Rationale And Implications, Dale E. Bredesen, Kat Toups, Ann Hathaway, Deborha Gordon, Henrianna Chung, Cyrus Raji, Alan Boyd, Benjamin D. Hill, Sharon Hausman-Cohen, Mouna Attarha, Won Jong Chwa, Alexei Kurakin, Michael Jarrett

University Faculty and Staff Publications

The neurodegenerative disease field has enjoyed extremely limited success in the development of effective therapeutics. One potential reason is the lack of disease models that yield accurate predictions and optimal therapeutic targets. Standard clinical trials have pre-determined a single treatment modality, which may be unrelated to the primary drivers of neurodegeneration. Recent proof-of-concept clinical trials using a precision medicine approach suggest a new model of Alzheimer’s disease (AD) as a chronic innate encephalitis that creates a network insufficiency. Identifying and addressing the multiple potential contributors to cognitive decline for each patient may represent a more effective strategy. Here we review …

Entomophagy: Mealworm Protein In An Inpatient Hospital Setting (Engagement And Education To Rollout Entomophagy For Improved Nutrition), Caryl Showalter

Department of Entomology: Distance Master of Science Projects

The consumption of insects (entomophagy) is a well-practiced phenomenon in many parts of the world. Western societies, including the US, are among the few places that do not participate in this practice. However, entomophagy has the potential to ease nutritional burdens, globally. While many may believe that nutritional deficits are a relic of more economically challenging times or a problem specifically linked to the low economic countries, the truth is that any area can face this problem. This was made clear in the US during the coronavirus lockdown with an estimated doubling in food insecurity associated with a lack of …

Documenting The Presence Of Chagas Disease In Prehistoric North America: Applying The Stockholm Paradigm To Archaeoparasitology, Part Ii, Karl J. Reinhard, Daniel R. Brooks, Aida Romera Barbera, T. Michael Fink

Karl Reinhard Publications

The DAMA protocol (Document, Assess, Monitor, Act) is the applied aspect of the Stockholm Paradigm. Evidence from archaeology and history of medicine has a demonstrated value in documenting infection risk for specific study areas. Bioarchaeological remains and historical documents show vivid examples of pathology related to the Chagas disease life cycle. The science of archaeology defines the lifestyles that created risk of triatomine kissing bug infestations and trypanosome protozoa infections. Paleogenetics, in the form of molecular analyses of Trypanosoma cruzi, elucidate the temporal origins of genetic variants and adaptation to human environments. We illustrate how these fields reveal the risk …

Exploring The Evolution Of Trypanosoma Cruzi And The Emergence Of Chagas Disease In The Context Of Environmental Change: Applying The Stockholm Paradigm To Archaeoparasitology, Part I, Aida Romera Barbera, Daniel R. Brooks, T. Michael Fink, Karl J. Reinhard

Karl Reinhard Publications

The Stockholm Paradigm is an evolutionary synthesis that explains the emergence of novel pathogens in the context of environmental disturbances. Considering the urgent climate change situation, anticipation stands as key to prevent and mitigate the effects that climate change can have in the emergence of pathogens. However, the success of preventive measures is hindered by a limited knowledge of the interplaying dynamics between biology, environment, and culture leading to emerging infectious diseases. For many decades, bioarchaeologists have been gathering data on past human-environment interactions, therefore contributing to the conversation. Archaeoparasitology, at the intersection between pathology, bioarchaeology, and biology, is uniquely …

Cost-Benefit Analysis Of Increased Water Treatment Plant Service Goals On Reducing Water Quality Risk, Briton Polen, Kendra Sanner

Williams Honors College, Honors Research Projects

To treat water to make it safe to drink, disinfection processes are used in water treatment plants. These disinfection processes produce disinfection byproducts (DBPs) through the reaction of organic matter and the disinfectant, such as chlorine. DBPs have been shown to pose a cancer risk to consumers. In this report, the focus is on two types of DBPs, trihalomethanes (THMs) and haloacetic acids (HAAs). The cancer risks associated with DBPs are analyzed through ingestion and inhalation pathways. Ingestion and inhalation consist of common water uses like drinking, cooking, or bathing. In addition to this, DBPs have been shown to increase …

An Explainable Artificial Intelligence Framework For The Predictive Analysis Of Hypo And Hyper Thyroidism Using Machine Learning Algorithms, Md. Bipul Hossain, Anika Shama, Apurba Adhikary, Avi Deb Raha, K. M. Aslam Uddin, Mohammad Amzad Hossain, Imtia Islam, Saydul Akbar Murad, Md. Shirajum Munir, Anupam Kumur Bairagi

Electrical & Computer Engineering Faculty Publications

The thyroid gland is the crucial organ in the human body, secreting two hormones that help to regulate the human body's metabolism. Thyroid disease is a severe medical complaint that could be developed by high Thyroid Stimulating Hormone (TSH) levels or an infection in the thyroid tissues. Hypothyroidism and hyperthyroidism are two critical conditions caused by insufficient thyroid hormone production and excessive thyroid hormone production, respectively. Machine learning models can be used to precisely process the data generated from different medical sectors and to build a model to predict several diseases. In this paper, we use different machine-learning algorithms to …

The Shortfalls Of Vulnerability Indexes For Public Health Decision-Making In The Face Of Emergent Crises: The Case Of Covid-19 Vaccine Uptake In Virginia, Lydia Cleveland Sa, Erika Frydenlund

VMASC Publications

Equitable and effective vaccine uptake is a key issue in addressing COVID-19. To achieve this, we must comprehensively characterize the context-specific socio-behavioral and structural determinants of vaccine uptake. However, to quickly focus public health interventions, state agencies and planners often rely on already existing indexes of "vulnerability." Many such "vulnerability indexes" exist and become benchmarks for targeting interventions in wide ranging scenarios, but they vary considerably in the factors and themes that they cover. Some are even uncritical of the use of the word "vulnerable," which should take on different meanings in different contexts. The objective of this study is …

Livestock Cattle As A Predictor Of Schistosomiasis Transmission In Nigeria, Oyetunde T. Oyeyemi, Oluyemi A. Okunlola, Zhiqiang Fu, Yang Hong, Jun-Hu Chen, Lisa M. Shollenberger

Biological Sciences Faculty Publications

Livestock cattle have been widely linked to schistosomiasis epidemiology, but little is known about its contribution to schistosomiasis transmission in Nigeria. The aim of this study is to examine the association between prevalence of schistosomiasis and livestock cattle index in Nigeria. The study's data came from three sources: the demographic and health survey (DHS), the malaria indicators survey (MIS), and the expanded special project for the eradication of neglected tropical diseases (ESPEN). Analysis of variance, correlation, and logistic regression were used to evaluate the mean difference in schistosomiasis prevalence across geopolitical zones, the relationship between schistosomiasis prevalence and livestock cattle, …

First Bovine Vaccine To Prevent Human Schistosomiasis - A Cluster Randomised Phase 3 Clinical Trial, Allen G. Ross, Donald A. Harn, Delia Chy, Marianette Inobaya, Jerric R. Guevarra, Lisa Shollenberger, Yuesheng Li, Donald P. Mcmanus, Darren J. Gray, Gail M. Williams

Biological Sciences Faculty Publications

Objective

Schistosomiasis is a neglected tropical parasitic disease caused by blood flukes of the genus Schistosoma. Schistosoma japonicum is zoonotic in China, the Philippines, and Indonesia, with bovines acting as major reservoirs of human infection. The primary objective of the trial was to examine the impact of a combination of human mass chemotherapy, snail control through mollusciciding, and SjCTPI bovine vaccination on the rate of human infection.

Methods

A 5-year phase IIIa cluster randomized control trial was conducted among 18 schistosomiasis-endemic villages comprising 18,221 residents in Northern Samar, The Philippines.

Results

Overall, bovine vaccination resulted in a statistically significant decrease …

Investigation Of Lower Extremity Neuromuscular Function In Individuals With And Without Diabetes, Roya Hoveizavi

Theses and Dissertations--Kinesiology and Health Promotion

Background: Diabetes mellitus is associated with notable neuromuscular and motor dysfunctions that could lead to an increased risk of plantar ulcers and amputations. Several contributing factors, including increased muscle-tendon stiffness and abnormal muscle activation pattern may influence the kinematics and kinetics of walking in people with diabetes and promote formation of plantar ulcers. Hyperglycemia and the resultant accelerated rate of glycation have been recognized as the leading cause of muscle and tendon degeneration, yet the precise mechanisms by which diabetes affects the biomechanical properties of the muscle-tendon unit remains unclear. Altered muscle activity during gait is observed in people with …

The Telltale Of Left Atrial Thrombus Formation In Mitral Stenosis: Revisiting The Virchow’S Triad, Bayushi Eka Putra, Rina Ariani, Anwar Santoso, Prima Almazini, Estu Rudiktyo, Amiliana Mardiani Soesanto

Journal of the Hong Kong College of Cardiology

Aims: This study was conducted to assess the relationship of simple hematological parameters with the incidence of left atrial thrombus in rheumatic mitral stenosis in addition to conventional contributing factors. Methods: A cross-sectional analytical study was conducted in patients with significant rheumatic stenosis from 1 January 2018 to 31 July 2021. Thrombus evaluation was confirmed by transthoracic or transesophageal echocardiography. Lab tests were performed within 10 days prior to the echocardiographic evaluation. Subjects with significant mitral regurgitation will be excluded. Logistic regression analysis was done to evaluate the relationship between each variable to the presence of a thrombus. Results: Of …

Development Of Sensors For Bacteria And Wound Environment Monitoring, Pannawich Thirabowonkitphithan

Chulalongkorn University Theses and Dissertations (Chula ETD)

Diabetes mellitus (DM) is a leading cause of death and reduces life expectancy. Complications from diabetes have wreaked havoc not only on patients' quality of life, but also on the global burdens of public health and socioeconomic development. The most frequent complication among patients with diabetes mellitus is diabetic wounds, particularly diabetic foot ulcers because of the damage to sensory nerves and blood vessel issues brought on by elevated blood glucose levels. As a result, chronic wounds eventually develop and are prone to infection. In this study, several novel analytical devices for the detection of wound infections and the wound …

Developing Honey Bee Diagnostics At The New Hampshire Veterinary Diagnostics Lab: Successes And Challenges, Mary Feranda

Honors Theses and Capstones

No abstract provided.

An Xai Approach For Covid-19 Detection Using Transfer Learning With X-Ray Images, Salih Sarp, Ferhat Ozgur Catak, Murat Kuzlu, Umit Cali, Huseyin Kusetogullari, Yanxiao Zhao, Gungor Ates, Ozgur Guler

Engineering Technology Faculty Publications

The coronavirus disease (COVID-19) has continued to cause severe challenges during this unprecedented time, affecting every part of daily life in terms of health, economics, and social development. There is an increasing demand for chest X-ray (CXR) scans, as pneumonia is the primary and vital complication of COVID-19. CXR is widely used as a screening tool for lung-related diseases due to its simple and relatively inexpensive application. However, these scans require expert radiologists to interpret the results for clinical decisions, i.e., diagnosis, treatment, and prognosis. The digitalization of various sectors, including healthcare, has accelerated during the pandemic, with the use …

A Case Of Biventricular Hypertrophic Obstructive Cardiomyopathy: Echocardiographic Diagnosis, Michiyo Yamano, Takeshi Nakamura, Tetsuhiro Yamano, Satoaki Matoba

The Texas Heart Institute Journal

No abstract provided.

The Texas Heart Institute Journal At 50 Years: Upholding Our Vision, Zvonimir Krajcer

The Texas Heart Institute Journal

No abstract provided.

Isolated Cardiac Paraganglioma Encasing Right Coronary Artery With Evidence Of Succinyl Dehydrogenase Gene Mutation: Successful Management Using Multimodality Imaging, Naveen Garg, Shashank Pandey, Shiva Madan, Subhash Yadav, Gurango Majumdar, Neeraj Jain, Manoj Jain

The Texas Heart Institute Journal

This report involves a young woman with isolated cardiac paraganglioma that was diagnosed using 68Gallium-labeled [1,4,7,10-tetraazacyclododecane-1,4,7,10-tetraacetic acid]-1-NaI3-octreotide positron emission tomographic scintigraphy. For the preoperative evaluation, multimodality imaging accurately described the anatomic location of the tumor and its relationship with the surrounding tissues. The patient underwent successful surgical resection of the tumor along with right coronary artery bypass grafting. The 2-month follow-up scintigraphy was normal. Next-generation sequencing evaluation revealed a novel germline mutation for the succinate dehydrogenase subunit B gene.

Validity And Diagnostic Performance Of Computing Fractional Flow Reserve From 2-Dimensional Coronary Angiography Images, Vahid Mohammadi, Massoud Ghasemi, Reza Rahmani, Maryam Mehrpooya, Hamidreza Babakhani, Akbar Shafiee, Mohammad Sadeghian

The Texas Heart Institute Journal

BACKGROUND: Measurement of fractional flow reserve (FFR) is the gold standard for determining the physiologic significance of coronary artery stenosis, but newer software programs can calculate the FFR from 2-dimensional angiography images.

METHODS: A retrospective analysis was conducted using the records of patients with intermediate coronary stenoses who had undergone adenosine FFR (aFFR). To calculate the computed FFR, a software program used simulated coronary blood flow using computational geometry constructed using at least 2 patient-specific angiographic images. Two cardiologists reviewed the angiograms and determined the computational FFR independently. Intraobserver variability was measured using κ analysis and the intraclass correlation coefficient. …

Diabetic Retinopathy And The Role Of Vegf, Aishwarya Gatiganti, Laura Valdez, Andrew Tsin Ph.D.

School of Medicine Publications

Diabetic retinopathy (DR) is the leading cause of blindness in the working-age population. It works by disrupting the neural and vascular components in the retina and leads to loss of neural interaction/function, vascular permeability, and angiogenesis. It can be classified into two general stages: non-proliferative diabetic retinopathy (NPDR) and proliferative diabetic retinopathy (PDR). DR can also lead to vascular leakage and cause diabetic macular edema (DME), the most common cause of vision loss in DR (Duh, Sun et al. 2017). There are currently a wide range of therapies, but they are limited in their efficacy and side effects. None of …

Social Protection And Foundational Cognitive Skills During Adolescence: Evidence From A Large Public Works Program, Sirunya Silapunt

Faculty, Staff and Student Publications

INTRODUCTION: Reddit, a popular social media website, has numerous forums where users may discuss healthcare-related topics and request diagnostic and treatment advice for dermatologic conditions. We sought to analyze and grade user-submitted requests for dermatologic advice and their top responses on Reddit.

METHODS: User-submitted posts requesting diagnostic advice and their respective responses on two popular Reddit forums, SkinCareAddiction (ScA) and DermatologyQuestions (DQ), were reviewed by three board-certified dermatologists using a grading rubric designed for this study.

RESULTS: 300 posts and comments were reviewed. Diagnoses among all graders matched in 52.3% of posts with a mean grader confidence score of 4/5 …

Not Just A Pain: A Medical Simulation Case About Biased Communication And Osteomyelitis In Pediatric Sickle Cell Anemia

Faculty, Staff and Student Publications

Introduction

Biases in communication can be harmful to patient perceptions of care and the medical team's decision-making. Optimal communication must be taught and practiced similarly to the optimal management of the complex medical conditions associated with sickle cell disease (SCD). This simulation is designed to teach about biases, optimizing communication to and about a patient with SCD, and appropriately diagnosing and managing pediatric osteomyelitis as a complication of SCD.

Methods

We designed and implemented a simulation case targeting emergency medicine residents and fellows to raise awareness about biases associated with SCD care and the complication of osteomyelitis in children with …

Good Outcome Associated With Blood-Brain Barrier Disruption And Lower Blood Pressure After Endovascular Therapy, John K Lynch

Faculty, Staff and Student Publications

OBJECTIVES: To evaluate the association between post-endovascular thrombectomy (EVT) blood-brain barrier (BBB) disruption on MRI or CT and average systolic blood pressure (SBP) with favorable 90-day functional outcome. Observational studies have found elevated SBP associated with worse outcomes post-EVT, while recent randomized trials found no difference in targeted BP reduction. There may be a subgroup of patients who benefit from targeted BP reduction post-EVT.

METHODS: This is a single-center study of 1) anterior large vessel occlusion stroke patients treated with EVT from 2015 to 2021, 2) achieved mTICI grade 2b or 3. Hyperintense acute reperfusion marker (HARM), hemorrhagic transformation (HT), …

Evaluation Of The Effect Of New Multimodal Analgesia Regimen For Cardiac Surgery: A Prospective, Randomized Controlled, Single-Center Clinical Study, Yihao Huang, Jiapeng Huang, Kefang Guo

Faculty, Staff and Student Publications

OBJECTIVE: To investigate the feasibility of multimodal regimen by paracetamol, gabapentin, ketamine, lidocaine, dexmedetomidine and sufentanil among cardiac surgery patients, and compare the analgesia efficacy with conventional sufentanil-based regimen.

DESIGN: A single-center, prospective, randomized, controlled clinical trial.

SETTING: One participating center, the cardiovascular center of the major integrated teaching hospital.

PARTICIPANTS: A total of 115 patients were assessed for eligibility: 108 patients were randomized, 7 cases were excluded.

INTERVENTIONS: The control group (group T) received conventional anesthesia management. Interventions in the multimodal group (group M) were as follows in addition to the standard of care: gabapentin and acetaminophen 1 hour …

Regulatory Mechanisms Controlling Store-Operated Calcium Entry

Faculty, Staff and Student Publications

Calcium influx through plasma membrane ion channels is crucial for many events in cellular physiology. Cell surface stimuli lead to the production of inositol 1,4,5-trisphosphate (IP

Open Treatments For Thoracoabdominal Aortic Aneurysm Repair

Faculty, Staff and Student Publications

Thoracoabdominal aortic aneurysms (TAAA) represent a unique pathology that is associated with considerable mortality if untreated. While the advent of endovascular technologies has introduced new modalities for consideration, the mainstay of TAAA treatment remains open surgical repair. However, the optimal conduct of open TAAA repair requires careful consideration of patient risk factors and a collaborative team effort to mitigate the risk of perioperative complications. In this chapter, we briefly outline the history of treating TAAA, preoperative preparation and postoperative care, and our operative techniques for treatment.

Robot-Assisted Resection Of Left Ventricular Papillary Fibroelastoma Arising From The Mitral Chordal Apparatus, Danny Ramzy

Faculty, Staff and Student Publications

The application of robot-assisted thoracoscopy to cardiac surgery affords an opportunity to leverage the exceptional intraoperative exposure, visualization, and dexterity of the robotic platform. Here, we report the case of a 72-year-old woman who presented to our institution for evaluation of a left ventricular mass that was identified following workup for an embolic event. We present an intraoperative video that provides technical details of the robot-assisted resection of the lesion, which was found to be a left ventricular papillary fibroelastoma arising from the mitral chordal apparatus. This case highlights the advantages provided by the robotic platform, which permitted complete, minimally …

Addition Of Aspirin To Venous Thromboembolism Chemoprophylaxis Safely Decreases Venous Thromboembolism Rates In Trauma Patients, Jeffrey Tomasek, Charles C Miller, John B Holcomb

Faculty, Staff and Student Publications

Background: Trauma patients exhibit a multifactorial hypercoagulable state and have increased risk of venous thromboembolism (VTE). Despite early and aggressive chemoprophylaxis (CP) with various heparin compounds ("standard" CP; sCP), VTE rates remain high. In high-quality studies, aspirin has been shown to decrease VTE in postoperative elective surgical and orthopedic trauma patients. We hypothesized that inhibiting platelet function with aspirin as an adjunct to sCP would reduce the risk of VTE in trauma patients.

Methods: We performed a retrospective observational study of prospectively collected data from all adult patients admitted to an American College of Surgeons Level I Trauma center from …

Initial Thoracic Endovascular Aortic Repair Vs Medical Therapy For Acute Uncomplicated Type B Aortic Dissection, Panagiotis Kougias, Eric A Secemsky, Andrew M Vekstein, Sherene Shalhub, Firas F Mussa, Manesh R Patel, Sreekanth Vemulapalli

Faculty, Staff and Student Publications

IMPORTANCE: Thoracic endovascular aortic repair (TEVAR) has increasingly been used for uncomplicated type B aortic dissection (uTBAD) despite limited supporting data.

OBJECTIVE: To assess whether initial TEVAR following uTBAD is associated with reduced mortality or morbidity compared with medical therapy alone.

DESIGN, SETTING, AND PARTICIPANTS: This cohort study included Centers for Medicare & Medicaid Services inpatient claims data for adults aged 65 years or older with index admissions for acute uTBAD from January 1, 2011, to December 31, 2018, with follow-up available through December 31, 2019.

EXPOSURES: Initial TEVAR was defined as TEVAR within 30 days of admission for acute …