Digital Commons Network^™

Factors Affecting The Characterization Of Post-Exertional Malaise Derived From Patient Input, Carly S. Holtzman, Claire Fisher, Shaun Bhatia, Leonard A. Jason

Journal of Health Disparities Research and Practice

The National Institutes of Health/Center for Disease Control and Prevention (NIH/CDC) Common Data Elements (CDE) established a post-exertional malaise (PEM) workgroup with the task of describing PEM and recommending a standardized way of assessing it in patients with myalgic encephalomyelitis and chronic fatigue syndrome (ME/CFS). As a stigmatized group, patients with ME/CFS are in need of instruments which can properly describe their symptomatic experiences, which can help reduce the disparity between illness seriousness and appropriate attention from healthcare. The current study explored attitudes and preferences among 115 patients with ME/CFS who participated in the creation of a patient-driven instrument to …

Ua12/2/1 College Heights Herald, Vol. 96, No. 2, Wku Student Affairs

WKU Administration Documents

WKU campus newspaper reporting campus, athletic and Bowling Green, Kentucky news. This issue contains articles:

• Collins, Michael. Rough Start – COVID-19
• Thornton, Maggie. What a WKU Student Learned from Her Experience with COVID-19
• Harkreader, Dylan & Debra Murray. Programs That Rely On Hands-on Learning Adapt to Virtual Courses
• Meyer-Thornton, Zane. Keep It Going
• Hurst, Courtney, Robin Lester & Trenton Peyton. What Is Intercultural Student Engagement Center?
• Sisler, Julie. WKU Grad Student: It’s On the Administration, Not the Students
• Kieser, Nick. Football Takes Precautions to Kick Off Season COVID-Free
• Warner, Casey: Setting Up – Football
• Gaylord, Kaden. Making It Safe to …

Etiology Of Acute Undifferentiated Fever In Patients Presenting To The Emergency Department Of A Tertiary Care Center In Karachi, Pakistan, Noman Ali, Nadeem Ullah Khan, Shahid Shahid, Syed Mustahsan

Department of Emergency Medicine

Objective: Our study aimed at identifying the characteristics and etiology of various causes of acute undifferentiated fever in patients presenting to the emergency department of a tertiary care hospital.
Methods: This was a retrospective study conducted at the department of emergency medicine, Aga Khan University Hospital from January to June 2016. Adult patients presenting to Emergency department with acute undifferentiated fever were enrolled. Descriptive statistics were calculated in terms of mean±SD for continuous variables like age of the patients and duration of fever, whereas frequency and percentage were computed for categorical variables like gender and causes of fever.
Results: A …

Guidance For Contemporary Use Of Biologics In Management Of Chronic Rhinosinusitis With Nasal Polyps: Discussion From A National Institutes Of Health-Sponsored Workshop, Lauren T Roland, Timothy L Smith, Rodney J Schlosser, Zachary M Soler, Anju T Peters, Tanya M Laidlaw, Benjamin S Bleier, Vijay Ramakrishnan, Elina Toskala, David W Kennedy, Amber U Luong

Faculty, Staff and Student Publications

BACKGROUND: Biologic medications are emerging as options for treating chronic rhinosinusitis with nasal polyps (CRSwNP). Several questions remain regarding patient selection, indications, clinical efficacy, and cost effectiveness.

METHODS: In November 2019, a group of physicians and scientists gathered to consider strategies for future studies regarding biologics. During the discussion, gaps in knowledge highlighted a need for a consensus on the present day use of biologics in polyp patients.

RESULTS: The goal of this guideline is to propose recommendations for the current use of biologics in CRSwNP as new evidence continues to emerge and inform practice.

CONCLUSION: We suggest that physicians …

Tuberculosis Of The Flexor Carpi Radialis Muscle - A Case Report, Shah Fahad, Naveed Baloch, Nasir Ud Din

Section of Orthopaedic Surgery

Tuberculosis involving almost any organ of the body is a major problem in developing countries. The most commonly affected site in tuberculosis is the lung. Of the extra pulmonary tuberculosis, musculoskeletal involvement accounts for 1-5% of the cases. Muscular involvement in tuberculosis is a rare manifestation of extra pulmonary tuberculosis. Unusual presentations often go undetected and are associated with a diagnostic and therapeutic delay. This case report presents tuberculosis of the flexor carpi radialis.

Drivers Of Stunting Reduction In Peru: A Country Case Study, Luis Huicho, Elisa Vidal-Cárdenas, Nadia Akseer, Samanpreet Brar, Kaitlin Conway, Muhammad Islam, Elisa Juarez, Aviva Rappaport, Hana Tasic, Tyler Vaivada, Jannah Wigle, Zulfiqar Ahmed Bhutta

Woman and Child Health

Background: Peru reduced its under-5 child stunting prevalence notably from 31.3% in 2000 to 13.1% in 2016.
Objectives: We aimed to study factors and key enablers of child stunting reduction in Peru from 2000-2016.
Methods: Demographic and Health Surveys were used to conduct descriptive analyses [height-for-age z scores (HAZ) means and distributions, equity analysis, predicted child growth curves through polynomial regressions] and advanced regression analyses. An ecological (at department level) multilevel regression analysis was conducted to identify the major predictors of stunting decline from 2000 to 2016, and Oaxaca-Blinder decomposition was conducted to identify the relative contribution of each factor …

Stunting In Childhood: An Overview Of Global Burden, Trends, Determinants, And Drivers Of Decline, Tyler Vaivada, Nadia Akseer, Selai Akseer, Ahalya Somaskandan, Marianne Stefopulos, Zulfiqar Ahmed Bhutta

Woman and Child Health

Background: Progress has been made worldwide in reducing chronic undernutrition and rates of linear growth stunting in children under 5 y of age, although rates still remain high in many regions. Policies, programs, and interventions supporting maternal and child health and nutrition have the potential to improve child growth and development.
Objective: This article synthesizes the available global evidence on the drivers of national declines in stunting prevalence and compares the relative effect of major drivers of stunting decline between countries.
Methods: We conducted a systematic review of published peer-reviewed and gray literature analyzing the relation between changes in key …

Sepsis Knowledge Among Adults Living In Tippecanoe County, Jessica Devine

The Journal of Purdue Undergraduate Research

No abstract provided.

The Kinetics Of Influenza A (A/California/4/2009-H1n1) And B (B/Phuket/3073/2013 (Byam), B/Brisbane/60/2008 (Bvic)) Virus Infection In Ferrets, Demi L. Erickson

Honors Thesis

Influenza is a persistent threat to individual and global health. Seasonal influenza kills nearly 500,000 people globally each year. Influenza viruses have circulated within the human population, causing a significant disease burden. In order to create the most effective antiviral therapies, knowledge concerning all lineages of influenza must be studied accurately and thoroughly. The influenza virus itself is not always responsible for these mortalities, rather, the secondary bacterial infections associated with death. In order to protect the population and examine the secondary infections that arise, the kinetics of influenza must be studied entirely. To understand the kinetics, researchers are turning …

Intensive Animal Farming Conditions Are A Major Threat To Global Health, Cynthia Schuck-Paim

Animal Sentience

Wiebers & Feigin accurately propose that reducing the risks posed by infectious disease outbreaks and other global health challenges will depend critically on transitioning away from intensive animal farming practices. Creating the right incentive structure for this transition to happen is one of the great challenges in the years to come, but a much-needed step to ensure the health and well-being of current and future generations.

Ua12/2/1 College Heights Herald, Vol. 96, No. 1, Wku Student Affairs

WKU Administration Documents

WKU campus newspaper reporting campus, athletic and Bowling Green, Kentucky news. This issue contains articles:

• Rash, Liza. Math Department Head Makes a Shocking Model Regarding Potential Campus COVID-19 Death Rate
• Bertucci, Leo. WKU Introduces COVID-19 Testing to Campus Community
• Marshall, Olivia. How Students Can Navigate Campus Facilities This Semester
• Bunton, Gabrielle. Campus Organizations Prepare to Engage Students Amid COVID Restrictions
• Deppen, Laurel. On-campus Students Who Contract COVID to be Moved to New Location to Quarantine
• Stack, Madalyn. Editorial Cartoon re: Social Distancing
• College of Health & Human Services Should Have Been More Involved in Restart Committee
• Deppen, Laurel. From the …

Impact Of 2012 Spanish Health Care Reform On Hiv-Positive Immigrants: A Mixed Methods Approach, Megi Gogishvili

Dissertations and Theses

Background: The financial crisis of 2008 hit Spain hard. As a consequence, the government took multiple austerity measures, including reforms in the healthcare system in 2012. Specifically, the government reduced the budget for health and social services by 13.7% in 2012.The reduction was further followed with structural changes via the 2012 Royal Decree Law (RDL) and Royal Decree (RD).The 2012 RDL and RD entailed broad areas of action,but most importantly the Spanish National Health System (SNS) no longer covered undocumented immigrants. The 2012 RDL and RD excluded approximately 500,000 undocumented immigrants from SNS.

The number of immigrants in Spain has …

A Policy Change To Reduce Hospital-Acquired Clostridium Difficile Infection Rates: A Quality Improvement Project, Nia Hidalgo

Student Scholarly Projects

Practice Problem: At a small community facility in Los Angeles County, there was a reporting rate of hospital-acquired Clostridium difficile cases that was higher than both state and national benchmarks.

PICOT: The PICOT question that guided this project was: In acute care patients aged 18-90, does not retesting for CDI for at least seven days compared to retesting in less than seven days reduce the incidence of false positive CDI tests during the first seven days of the hospital stay?

Evidence: The evidence demonstrates that if patients are tested initially for Clostridium difficile and then retested seven days after, the …

Adherence To Hiv Antiretroviral Therapy Among Pregnant And Postpartum Women During The Option B+ Era: 12-Month Cohort Study In Urban South Africa And Rural Uganda, Lynn T. Matthews, Catherine Orrell, Mwebesa B. Bwana, Alexander C. Tsai, Christina A. Psaros, Stephen Asiimwe, Gideon Amanyire, Nicholas Musinguzi, Kathleen Bell, David Bangsberg, Jessica E. Haberer

OHSU-PSU School of Public Health Faculty Publications and Presentations

Introduction: We conducted a cohort study to understand patterns of anti-retroviral therapy (ART) adherence during pregnancy, postpartum and non-pregnancy follow-up among women initiating ART in public clinics offering Option B+ in rural Uganda and urban South Africa. Methods: We collected survey data, continuously monitored ART adherence (Wisepill), HIV-RNA and pregnancy tests at zero, six and twelve months from women initiating ART in Uganda and South Africa, 2015 to 2017. The primary predictor of interest was follow-up time categorized as pregnant (pregnancy diagnosis to pregnancy end), postpartum (pregnancy end to study exit) or non-pregnancy-related (neither pregnant nor postpartum). Fractional regression …

Examining The Intersection Of Environmental Justice, Chronic Disease, And Pandemics; How A Mobile Health App Could Improve Health Outcomes And Inform Policy, Jessica Snow

Master's Projects and Capstones

The purpose of this paper is to analyze the intersection of environmental justice, chronic disease and illness, and pandemics. The inequitable distribution of polluting factories, landfills, and hazardous waste sites have been a long-standing concern in the field of environmental justice. Local zoning codes and land use policies have been tools for segregating people and concentrating pollution in low-income communities and communities of color. Many studies have found that pollution varies among racial and minority groups, and the burden of pollution is not one that is evenly shared. Communities of color and low income communities are disproportionately affected by air …

Understanding Covid-19: From Origin To Potential Therapeutics, Muhammad Moazzam, Muhammad Imran Sajid, Hamza Shahid, Jahanzaib Butt, Irfan Bashir, Muhammad Jamshaid, Amir Nasrolahi Shirazi, Rakesh Kumar Tiwari

Pharmacy Faculty Articles and Research

Currently, a global pandemic era of public health concerns is going on with the Coronavirus Disease 2019 (COVID-19), which is caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). The first case of COVID-19 was reported from Wuhan’s Huanan seafood market in China late December 2019. Bats, pangolins, and snakes have been nominated as salient carriers of the virus. Thanks to its high pathogenicity, it can cause severe respiratory infections. Fever, dry cough, sore throat, pneumonia, septic shock, and ground-glass opacities are the foremost clinical manifestations of COVID-19. Immunocompromised patients are at high risk for COVID-19 infection and may lead to …

Previous And Active Tuberculosis Increases Risk Of Death And Prolongs Recovery In Patients With Covid-19, Karla Therese L. Sy, Nel Jason L. Haw, Jhanna Uy

Health Sciences Faculty Publications

Background: There is a growing literature on the association of SARS-CoV-2 and other chronic conditions, such as noncommunicable diseases. However, little is known about the impact of coinfection with tuberculosis. We aimed to compare the risk of death and recovery, as well as time-to-death and time-to-recovery, in COVID-19 patients with and without tuberculosis.

Methods: We created a 4:1 propensity score matched sample of COVID-19 patients without and with tuberculosis, using COVID-19 surveillance data in the Philippines. We conducted a longitudinal cohort analysis of matched COVID-19 patients as of May 17, 2020, following them until June 15, 2020. The …

Heartland Virus In Lone Star Ticks, Alabama, Usa, Brent C. Newman, William B. Sutton, Abelardo C. Moncayo, Holly R. Hughes, Ali Taheri, Thomas C. Moore, Callie J. Schweitzer, Yong Wang

Agricultural and Environmental Sciences Faculty Research

We detected Heartland virus (HRTV) in lone star nymphs collected in 2018 in northern Alabama, USA. Real-time reverse transcription PCR selective for the small segment of the HRTV genome and confirmatory sequencing of positive samples showed high identity with HRTV strains sequenced from Tennessee and Missouri.

Treatment With Hydroxychloroquine, Azithromycin, And Combination In Patients Hospitalized With Covid-19, Samia Arshad, Paul Kilgore, Zohra S. Chaudhry, Gordon Jacobsen, Dee Dee Wang, Kylie Huitsing, Indira Brar, George J. Alangaden, Mayur S. Ramesh, John E. Mckinnon, William O'Neill, Marcus Zervos, Henry Ford Covid-19 Task Force

Department of Pharmacy Practice

Significance: The United States is in an acceleration phase of the COVID-19 pandemic. Currently there is no known effective therapy or vaccine for treatment of SARS-CoV-2, highlighting urgency around identifying effective therapies.

Objective: The purpose of this study was to evaluate the role of hydroxychloroquine therapy alone and in combination with azithromycin in hospitalized patients positive for COVID-19.

Design: Multi-center retrospective observational study.

Setting: The Henry Ford Health System (HFHS) in Southeast Michigan: large six hospital integrated health system; the largest of hospitals is an 802-bed quaternary academic teaching hospital in urban Detroit, Michigan.

Participants: Consecutive patients hospitalized with a …

The Use Of Animal-Assisted Therapeutic Interventions In The Hospital Setting During The Covid-19 Pandemic, Alicia Cesare

Graduate Theses/Dissertations

Handlers of therapy and/or facility dogs working within hospital settings have experienced various barriers and challenges within their practice during the COVID-19 pandemic. Animal-assisted interventions, specifically therapeutic working dogs, are a valued source of support to individuals, communities, hospital settings, and disaster sites during times of community distress. The purpose of this study was to identify barriers and solutions to the continued use of animal-assisted therapeutic interventions in support of patients and families within the hospital setting during the COVID-19 pandemic. This researcher’s position within the research is the knowledge and experience of being a facility dog handler within the …

The Inhibitory Effects Of An Antimicrobial Gel On The Staphylococcus Species, Mara Trinkle

Undergraduate Honors Theses

The prevalence of antibiotic resistant bacteria has made the choices for topical treatments for patients who experience burns wounds extremely limited. The Staphylococcus genus is naturally occurring in and on the human body but can become harmful once it enters the bloodstream. A novel antimicrobial gel has been shown by our laboratory to inhibit both the planktonic growth and biofilm formation of Staphylococcus aureus in previous studies. The antimicrobial gel is made of seven natural compounds including antioxidants (vitamin C and E). We wanted to examine the effects of the antimicrobial gel on numerous other Staphylococcal species because it is …

Combating Covid On College Campuses: The Impact Of Structural Changes On Viral Transmissions, Jared Knofczynski, Aria Killebrew Bruehl, Ben Warner, Ryne Shelton

altREU Projects

One of the most significant issues in the COVID-19 pandemic is the reopening of schools while minimizing the transmission of coronavirus. Opportunities for evaluating the effectiveness of policies that might be utilized at such institutions are limited, as the necessary empirical data has not been gathered yet. Agent-based modeling, where various entities within an environment are simulated as agents, offers an opportunity to examine the effectiveness of various policies in a way that drastically minimizes the health and economic risks involved. Agent-based modeling is common within biology, ecology and other fields; and has seen some use within the coronavirus literature. …

Impact Of The Societal Response To Covid-19 On Access To Healthcare For Non-Covid-19 Health Issues In Slum Communities Of Bangladesh, Kenya, Nigeria And Pakistan: Results Of Pre-Covid And Covid-19 Lockdown Stakeholder Engagements, Syed A K Shifat Ahmed, Motunrayo Ajisola, Kehkashan Azeem, Pauline Bakibinga, Yen-Fu Chen, Narjis Rizvi, Syed Iqbal Azam, Romaina Iqbal, Ahsana Nazish, Komal Tabani

Community Health Sciences

Introduction: With COVID-19, there is urgency for policymakers to understand and respond to the health needs of slum communities. Lockdowns for pandemic control have health, social and economic consequences. We consider access to healthcare before and during COVID-19 with those working and living in slum communities.
Methods: In seven slums in Bangladesh, Kenya, Nigeria and Pakistan, we explored stakeholder perspectives and experiences of healthcare access for non-COVID-19 conditions in two periods: pre-COVID-19 and during COVID-19 lockdowns.
Results: Between March 2018 and May 2020, we engaged with 860 community leaders, residents, health workers and local authority representatives. Perceived common illnesses in …

Development, Expansion And Role Of Myeloid-Derived Suppressor Cells In Post-Sepsis Immune Suppression, Tuqa Alkhateeb

Electronic Theses and Dissertations

Myeloid-derived suppressor cells (MDSCs) numbers increase significantly in sepsis and are associated with high mortality rates. These myeloid cell precursors promote immunosuppression, especially in the late (post sepsis) stage. However, the mechanisms that underlie MDSC expansion and programming are not completely understood. To investigate these mechanisms, we used a cecal-ligation and puncture (CLP) mouse model of polymicrobial sepsis that progresses from an early/acute proinflammatory phase to a late/chronic immunosuppressive phase. Previous studies in our laboratory showed that microRNA (miR)-21 and miR-181b elevate levels of the transcription factor nuclear factor 1 (NFI-A) that promotes MDSC expansion. We report here that miR-21 …

“Tomorrow Never Dies”: Recent Advances In Diagnosis, Treatment, And Prevention Modalities Against Coronavirus (Covid-19) Amid Controversies, Partha Laskar, Murali M. Yallapu, Subhash C. Chauhan

School of Medicine Publications

The outbreak of novel coronavirus disease (2019-nCoV or COVID-19) is responsible for severe health emergency throughout the world. The attack of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is found to be responsible for COVID-19. The World Health Organization has declared the ongoing global public health emergency as a pandemic. The whole world fights against this invincible enemy in various capacities to restore economy, lifestyle, and safe life. Enormous amount of scientific research work(s), administrative strategies, and economic measurements are in place to create a successful step against COVID-19. Furthermore, differences in opinion, facts, and implementation methods laid additional layers …

Intussusception In An Infant As A Manifestation Of Covid-19, Zorays Moazzam, Areej Saleem, Alina Ashraf, Fyezah Jehan, Muhammad Arshad

Medical College Documents

Gastrointestinal manifestations of COVID-19 are rare and have primarily been limited to diarrhea or vomiting. Intussusception is the most common cause of bowel obstruction in infants, with up to 30% of pediatric intussusception cases having a preceding viral illness. We present the rare case of intussusception in a SARS-CoV-2 positive infant. This is the first documented case of survival in a SARS-CoV-2 positive patient presenting with intussusception as the primary manifestation. As our knowledge of this disease evolves, surgeons need to remain suspicious for possible gastrointestinal manifestations of COVID-19.

Plasmodium Impairs Antibacterial Innate Immunity To Systemic Infections In Part Through Hemozoin-Bound Bioactive Molecules., Christopher Lynn Harding

Electronic Theses and Dissertations

Despite efforts to decrease the global health burden of malaria, infections with Plasmodium species continue to cause over 200 million episodes of malaria each year which resulted in 405,000 deaths in 2018 [1]. One complication of malaria is increased susceptibility to invasive bacterial infections. Plasmodium infections impair host immunity to non-Typhoid Salmonella (NTS) through activities of heme oxygenase I (HO-I) )-induced release of immature granulocytes and myeloid cell-derived IL-10. Yet, it is not known if these mechanisms are specific to NTS. We show here, that Plasmodium yoelii 17XNL (Py) infected mice had impaired clearance of systemic Listeria monocytogenes (Lm) during …

Reducing Overtreatment Of Urinalysis In Obstetric Triage Patients, Emelia Winston, Rachel Marteney, Erin Casey, Kevin Conway

Marshall Journal of Medicine

Introduction

Overtreatment of asymptomatic bacteriuria (ASB) is a major issue that has been coming to the forefront in recent decades. Studies have shown that it can lead to adverse side effects, extra costs, and antimicrobial resistance. The purpose of this study was to determine the number of patients presenting to obstetric triage who were overtreated for a urinalysis (UA) and to see if an educational intervention could reduce the incidence of overtreatment for suspected ASB.

Methods

This was a retrospective chart review analyzing UA results and outcomes of OB triage patients that came through labor and delivery before and after …

Prospects For Rnai Therapy Of Covid-19, Hasan Uludağ, Kylie Parent, Hamidreza Montazeri Aliabadi, Azita Haddadi

Pharmacy Faculty Articles and Research

COVID-19 caused by the SARS-CoV-2 virus is a fast emerging disease with deadly consequences. The pulmonary system and lungs in particular are most prone to damage caused by the SARS-CoV-2 infection, which leaves a destructive footprint in the lung tissue, making it incapable of conducting its respiratory functions and resulting in severe acute respiratory disease and loss of life. There were no drug treatments or vaccines approved for SARS-CoV-2 at the onset of pandemic, necessitating an urgent need to develop effective therapeutics. To this end, the innate RNA interference (RNAi) mechanism can be employed to develop front line therapies against …

Environmental Surveillance As A Tool For Identifying High-Risk Settings For Typhoid Transmission, Jason R. Andrews, Alexander T. Yu, Senjuti Saha, Jivan Shakya, Kristen Aiemjoy, Lily Horng, Farah Qamar, Denise Garret, Stephen Baker, Samir Saha, Stephen P. Luby

Department of Paediatrics and Child Health

Enteric fever remains a major cause of morbidity in developing countries with poor sanitation conditions that enable fecal contamination of water distribution systems. Historical evidence has shown that contamination of water systems used for household consumption or agriculture are key transmission routes for Salmonella Typhi and Salmonella Paratyphi A. The World Health Organization now recommends that typhoid conjugate vaccines (TCV) be used in settings with high typhoid incidence; consequently, governments face a challenge regarding how to prioritize typhoid against other emerging diseases. A key issue is the lack of typhoid burden data in many low- and middle-income countries where TCV …