Digital Commons Network^™

Association Of Non-Communicable Diseases With Severe Covid-19 Among People Living With And Without Diagnosed Hiv/Aids In New York State, Ravi Kumar Balu

Electronic Theses & Dissertations (2024 - present)

Background: People living with diagnosed HIV (PLWDH) have a higher chance of co-infections and co-morbidities than the general population. When SARS-CoV-2 was first reported in China in December 2019 and later declared a pandemic, it was speculated that PLWDH might be more prone to SARS-CoV-2 infection and severe disease outcomes given their increased vulnerability to other respiratory infections like influenza, pneumococcal pneumonia and tuberculosis. However, several facets of COVID-19 disease in PLWDH are incompletely understood, including whether non-communicable diseases (NCDs) are strong risk factors for severe disease outcomes and death as they are in the general population.

Methods: The data …

Risk And Prognosis Of Hepatocellular Carcinoma In Mexican Americans With Type 2 Diabetes Mellitus, Rikita I Hatia, Lu-Yu Hwang, Ruosha Li, Catherine Troisi, Prasun K Jalal, Christopher I Amos, Henry F Gomez, Yun Shin Chun, Asif Rashid, Ahmed O Kaseb, Paul A Scheet, Manal M Hassan

Faculty, Staff and Student Publications

INTRODUCTION: Hepatocellular carcinoma (HCC) disproportionately affects Hispanic persons with higher age-specific incidence and increased mortality rates compared to non-Hispanic Whites. These high rates of incidence and mortality may be explained by the variation in risk factors. Given the high prevalence of type 2 diabetes mellitus (DM) among the Hispanic population, we aimed to assess the risk and prognosis of HCC in Mexican Americans with type 2 DM with consideration of treatment for DM.

METHODS: A case-control study of 241 Mexican American HCC patients and 500 healthy controls in Texas was conducted. Multivariable logistic regression analysis was performed to determine the …

Fabrication Of Palladium Decorated Zinc Oxide Nanostructures For Non-Enzymatic Glucose Sensing, Reagan Aviha, Anju Joshi, Gymama Slaughter

Center for Bioelectronics Publications

The growing global burden of diabetes necessitates the development of glucose sensors that are not only reliable and sensitive but also cost-effective and amenable to point-of-care use. In this work, we report a non-enzymatic electrochemical glucose sensor based on laser-induced graphene (LIG), functionalized with zinc oxide (ZnO) and palladium (Pd) nanostructures. The ZnO nanostructures were systematically optimized on the LIG surface by varying electrochemical deposition parameters, including applied potential, temperature, and deposition time, to enhance the electrocatalytic oxidation of glucose in alkaline medium. Subsequent modification with Pd nanostructures further improved the electrocatalytic activity and sensitivity of the sensor. The performance …

Skin Carotenoid Levels And Dermatologic Diseases, Taylor Schwarz, Sidney Smith, Eric Shaw, Adam Ginensky, Nikki Dixon, Patricia Mercado

South Atlantic Division GME Research Day 2025

No abstract provided.

Milk-Alkali Syndrome In Pregnancy: The Hidden Risk Of Over-The-Counter Calcium Supplementation, Lilly Mcincrow, Anna Bryce Tucker, Samantha Perez, Nanette Woodward, Anthony B. Royek

South Atlantic Division GME Research Day 2025

No abstract provided.

Daily Weights, Better Outcomes: The Positive Impact Of Daily Weight Tracking In Hospitalized Patients On The Telemetry Floor, Sophia Zia, David Ortega, Lailany Agront-Davo, Merid Moqattash, William Lopez, Sirin Khajaviyan, Yagmur Beaman, Michael Craig

South Atlantic Division GME Research Day 2025

No abstract provided.

Cerebral Or Renal? Cerebral Salt Wasting In The Absence Of Cerebral Disease, Arthika Sakthevel, Nathan Shekey, Ramalakshmi Santhanam, Mohamed Faris

South Atlantic Division GME Research Day 2025

No abstract provided.

Metformin-Associated Lactic Acidosis: A Case Report, Evelyn Ogbomoh, Karissa Charles, Devi Mahadeo, Sarah Puim

South Atlantic Division GME Research Day 2025

No abstract provided.

A Common Presentation For An Uncommon Diagnosis: Case Report Of Rare Hyperinsulinemia Hypoglycemia, Minh Nguyen, Reggie Skains, Peter Montesano

South Atlantic Division GME Research Day 2025

No abstract provided.

Nutritional Management Of Low Birth Weight And Preterm Infants In Low- And Low Middle-Income Countries, Maha Azhar, Rahima Yasin, Sawera Hanif, Sharib Afzal Bughio, Jai K. Das, Zulfiqar Ahmed Bhutta

Institute for Global Health and Development

Introduction: Preterm and low birth weight (LBW) infants are at an increased risk of morbidity and mortality compared with their term counterparts, with more than 20 million LBW infants born each year, the majority in lower middle-income countries (LMICs). Given the increased vulnerability and higher nutritional needs of these infants, optimizing feeding strategies may play a crucial role in improving their health outcomes.
Methods: We updated evidence of Every Newborn Series published in The Lancet 2014 by identifying relevant systematic reviews, extracting low-income country (LIC) and LMIC data, and conducting revised meta-analysis for these contexts.
Results: We found 15 reviews; …

Body Composition In Patients With Obesity-Related Heart Failure With Preserved Ejection Fraction: A Comparison Study, Hannah Salmons, Syed Imran Ahmed, Hayley E. Billingsley, Alex Reavey-Cantwell, Roshanak Markley, Michele Golino, Marco Giuseppe Del Buono, Juan Ignacio Damonte, Sebastian Pinel, R. Lee Franco, Antonio Abbate, Carrie P. Earthman, Salvatore Carbone

EVMS School of Health Professions Faculty Publications

Background

Appendicular lean mass index is a major determinant of cardiorespiratory fitness in patients with obesity-related heart failure with preserved ejection fraction (HFpEF). Moreover, appendicular lean mass index can be used to diagnose sarcopenia and sarcopenic obesity in this population. We aimed to validate the ability of segmental single-frequency bioelectrical impedance analysis (SF-BIA) to assess body composition compared with dual-energy x-ray absorptiometry (DXA) in patients with HFpEF and obesity, with a focus on appendicular lean mass index for its critical role in diagnosing sarcopenia and sarcopenic obesity.

Methods

We analyzed 62 euvolemic patients from a heart failure outpatient clinic with …

Association Between Neighborhood-Level Social Vulnerability And Hypertension Outcomes, John E. Brush Jr., Chungsoo Kim, Yuntian Liu, Xin Xin, Chenxi Huang, Iris J. Lundy, Jordan R. Asher, Mitsuaki Sawano, Patrick Young, Jacob Mcpadden, Mark Anderson, John S. Burrows, Harlan M. Krumholz, Yuan Lu

Department of Medicine Faculty Publications

Background

Neighborhood-level social vulnerability is associated with hypertension prevalence and severity and with cardiovascular complications in conditions other than hypertension, but its association with cardiovascular complications in patients with hypertension is understudied.

Objectives

The aim of the study was to examine how the neighborhood-level social vulnerability index (SVI) influences cardiovascular outcomes in a large, diverse cohort of patients with hypertension.

Methods

We used electronic health data to examine the association between census tract-level rankings for the SVI with a composite endpoint of incident myocardial infarction, congestive heart failure, or stroke.

Results

In a longitudinal cohort of 330,972 patients with hypertension …

Therapeutic Roles For Alkaline Phosphatases To Target Intestinal Dysfunction In Mouse Models Of Experimental Sepsis And Ischemic Stroke, Rhiannon V. Macom

Graduate Theses, Dissertations, and Problem Reports (ETD)

Abstract

Therapeutic Roles for Alkaline Phosphatases to Target Intestinal Dysfunction in Mouse Models of Experimental Sepsis and Ischemic Stroke

Rhiannon V. Macom

Stroke is a disease that primarily affects the brain; however, ongoing research continues to show that stroke has far reaching systemic effects that can affect both short- and long-term recovery. The gastrointestinal tract has been shown to be affected post-stroke, and these effects are likely due to the bidirectional communication between the gut and the brain via the gut-brain-axis. Alkaline phosphatases (APs) are common membrane bound enzymes that are known to have a role in mitigating inflammation. The …

Investigating The Production Challenges Of The P100.1 Phage Endolysin, Jonah O. Frago

EWU Masters Thesis Collection

Acne vulgaris is one of the most common skin diseases globally. One key aspect of acne pathogenesis is the disturbance of healthy strain diversity of the skin bacterium Cutibacterium acnes. Many acne treatments are antimicrobial; however, these treatments are generally nonspecific and carry a variety of side effects in addition to contributing to rising antibiotic resistance. Lytic bacteriophages (or phages) are viruses that infect and kill bacteria. Their lytic lifestyle is facilitated by enzymes called endolysins. Phages have been studied as an alternative to traditional antimicrobials in acne treatment and have shown reduced C. acnes load in acne lesions and …

Effectiveness Of Fu's Subcutaneous Needling In Pain Management And Rehabilitation: A Narrative Review, Po-En Chiu, Chun-Chang Wu, De-Jian Lu, Zhonghua Fu, Li-Wei Chou

Rehabilitation Practice and Science

Fu’s Subcutaneous Needling (FSN) is a modern needling technique distinct from traditional acupuncture, primarily used for musculoskeletal pain, neuropathic conditions, and emerging applications in rehabilitation. FSN is also designated as a kind of dry needling focusing on deactivating myofascial trigger points. This review categorizes FSN-related studies into case reports, clinical trials, and animal studies, evaluating its therapeutic efficacy, safety, and mechanisms. Case reports suggest that FSN provides rapid pain relief and functional improvement, while clinical trials, including randomized controlled trials (RCTs), support its role in reducing pain and enhancing neuromuscular function despite limitations in sample size and protocol consistency. Animal …

Translating Cardiovascular Clinical Practice Guidelines On Nutrition Therapy: Validation Of The Portfolio Diet Toolkit For Healthcare Providers, Gabrielle Viscardi, Sahba Eskandari, Alyssa Chen, Nicholas Chiang, Meaghan E. Kavanagh, Songhee Back, Micheal Vallis, Mary J. Scourboutakos, Vasanti S. Malik, Cyril W.C. Kendall, David J.A. Jenkins, John L. Sievenpiper, Laura Chiavaroli

Department of Family and Community Medicine Faculty Publications

Background

Cardiovascular disease (CVD) remains a leading cause of death in Canada. Although the Portfolio Diet, a dietary pattern of cholesterol-lowering foods, is supported by CVD clinical practice guidelines, its uptake in clinical practice remains limited. This study assessed the content and face validity of a healthcare provider (HCP)-facing toolkit (infographic and video), designed to support implementation of the Portfolio Diet.

Methods

HCPs were recruited for a 2-round evaluation. They assessed the toolkit using a questionnaire. Content validity of the infographic was assessed using a 4-point Likert scale (1 = irrelevant to 4 = extremely relevant) and face validity of …

Type 2 Diabetes Education And Knowledge In The Adult Hmong Community, Sheng Yang

Doctor of Nursing Practice Projects

Type 2 Diabetes is a chronic health condition that affects many individuals, but specifically has been found to significantly affect minority population groups. There has been very limited research regarding understanding the etiology of the disease in the Hmong community that migrated to the United States from Southeast Asia. The purpose of this project was to design and implement an evidence-based, culturally appropriate educational intervention in the Hmong language to increase knowledge of Type 2 Diabetes among the adult Hmong community in Burke County and Catawba County, NC areas. The intervention was delivered to a total of 30 participants who …

Gout Flare Burden In The United States: A Multiyear Cross-Sectional Survey Study, Jasvinder A Singh, Amy Morlock, Robert Morlock

Faculty, Staff and Students Publications

OBJECTIVE: The objective of this study was to assess the burden of gout flares and examine associated patient characteristics and outcomes in a sample of US adults.

METHODS: Data were collected via an online survey of US adults ≥18 years using a random stratified sampling framework. Participants with gout completed questions about treatments, serum urate (SU) levels, severity, satisfaction with control, and gout flares. All participants completed the Veterans RAND 12-Item Health Survey, the Generalized Anxiety Disorder 7-Item Scale, and the Patient Health Questionnaire 9-Item Scale. Data were summarized using descriptive statistics. Multivariable-adjusted logistic regression analyses examined factors predictive of …

Cultural Influences, Experiences And Interventions Targeting Self-Management Behaviours For Prediabetes Or Type 2 Diabetes In First-Generation Immigrants: A Scoping Review, Min Zhang, Kirsten Coppell, Johnny Lo, Lisa Whitehead

Research outputs 2022 to 2026

Aim: To map the existing evidence and identify research gaps regarding the self-management of prediabetes or type 2 diabetes among first-generation immigrants ≥ 18 years. Design: A scoping review followed the JBI guidelines and was in accordance with the PRISMA extension for Scoping Reviews. Methods: A systematic search of CINAHL, Cochrane, EMBASE, MEDLINE, PsycINFO, ProQuest, SCOPUS and the Web of Science was conducted. Grey literature and reference lists of included studies were searched for additional citations. Articles published in English from the database inception to February 2023 were included. Results: We included 96 studies, of which 28.1% were published within …

Infant Diet Recommendations Reduce Ige-Mediated Egg, Peanut, And Cow's Milk Allergies, Summer V.M. Walker, Nina D'Vaz, Rachelle A. Pretorius, Johnny Lo, Claus Christophersen, Susan L. Prescott, Debra J. Palmer

Research outputs 2022 to 2026

Background: Meta-analyses of randomized controlled trials have found that introducing eggs and peanuts earlier during infancy reduced egg and peanut allergy risk. Hence, infant feeding advice has dramatically changed from previous recommendations of avoidance to current recommendations of inclusion of common food allergens in infant diets. Objective: To compare the prevalence of IgE-mediated food allergies at 1 year of age between 2 cohorts, before and after infant feeding and allergy prevention guidelines changed. Methods: In cohort 1 (506 infants born 2006-2014), no infant feeding advice was provided to participants. In cohort 2 (566 infants born 2016-2022), when the infants were …

Exploring The Association Between Sarcopenic Obesity And Cardiovascular Risk: A Summary Of Findings From Longitudinal Studies And Potential Mechanisms, Zhongyang Guan, Blossom C.M. Stephan, Lorenzo Maria Donini, Carla M. Prado, Marc Sim, Mario Siervo

Research outputs 2022 to 2026

It is estimated that more than one-tenth of adults aged ≥60 years are now classified as having sarcopenic obesity (SO), a clinical condition characterized by the concurrent presence of sarcopenia (low muscle mass and weakness) and obesity (excessive fat mass). Independently, sarcopenia and obesity are associated with a high risk of numerous adverse health outcomes including cardiovascular diseases (CVDs) and neurological conditions (e.g. dementia), but SO may confer a greater risk, exceeding either condition alone. This imposes a substantial burden on individuals, healthcare systems and society. In recent years, an increasing number of observational studies have explored the association between …

Impact Of Volume-Based Procurement Policy On Coronary Stent Use In Tianjin: Interrupted Time Series Analysis, Zhao Yang, Liangyu Ni, Wei Zhao, Yuxi Li, Yongyi Wu, Qiyun Zhu, Linlin Da, Weijia Liu, Qi Zhang, Jianping Li, Bin Jiang

Health Behavior, Policy & Management Faculty Publications

Objectives

This study aimed to analyze the impact of China’s centralized volume-based procurement policy on the procurement and utilization of coronary stents in Tianjin from 2019 to 2021.

Methods

An interrupted time-series design was used to assess monthly procurement data of coronary stents and balloons in Tianjin from January 2019 to December 2021.

Results

The volume-based procurement policy significantly reduced coronary stents prices, with an average price reduction of 92.67% for ten selected stents, and the lowest price dropped to 469 CNY. Following policy implementation, annual procurement in Tianjin increased by 59.55%, and tertiary hospitals demonstrated a significant monthly level …

Diagnosis And Management Of Cardiometabolic Disease After Spinal Cord Injury: Identifying Gaps In Physician Training And Practices, Chinenye Christa Nnoromele, Du Pham, Felicia Skelton, Ryan Solinsky

Faculty, Staff and Students Publications

CONTEXT: Cardiometabolic disease (CMD) frequently occurs in individuals with spinal cord injury (SCI), with growing awareness surrounding the expansive scope of this problem. As CMD has significant morbidity and mortality, early guidelines-based screening and management have been established. However, the extent to which these guidelines have been adopted are unclear.

OBJECTIVE: Describe physicians' screening and management pattern for CMD in patients with SCI, as compared to SCI-specific CMD screening guidelines, and elucidate variables linked to screening and management patterns.

METHODS: SCI medicine-boarded physicians were surveyed on screening timing for CMD following acute SCI, along with their practice pattern and comfort …

Healthcare Utilization Unchanged In The Control Arm Of A Randomized Clinical Trial, Pratik Gongloor, Saad Nadeem, Xiaoying Yu, Mukaila Raji, Kristina D Mena, Elizabeth M Vaughan

Faculty, Staff and Students Publications

including among control groups. Increased access to care and heightened health awareness during trial enrollment could lead to altered behaviors, a phenomenon known as the Hawthorne effect, which may obscure true intervention impacts; however, this effect remains poorly studied in low-income environments.

Aim: To conduct a secondary exploratory analysis of healthcare utilization among control participants of a randomized clinical trial (RCT).

Methods: We retrospectively analyzed electronic medical records from the control arm (n = 26) of an RCT involving low-income Hispanic adults with type 2 diabetes receiving care at a community clinic. Before randomization to a 12-month diabetes education intervention …

From Trials To Practice: Implementing A Clinical Intervention In Community Settings, Elizabeth M Vaughan, Xiaoying Yu, Victor J Cardenas, Craig A Johnston, Salim S Virani, Ashok Balasubramanyam, Christie M Ballantyne, Aanand D Naik

Faculty, Staff and Students Publications

Introduction/objectives: Diabetes increases the risk of complications, especially for vulnerable populations. Our previous randomized clinical trial (RCT), TIME (Telehealth-supported, Integrated Community Health Workers (CHWs), Medication access, group visit Education), showed the efficacy of CHW-led diabetes care. This study aimed to gather data on transitioning TIME from clinical trials to practical implementation.

Methods: We conducted a 12-month RCT at a nonprofit community clinic using the Consolidated Framework for Implementation Research (CFIR). Participants, Hispanic adults without insurance and with type 2 diabetes (N = 58; 29/arm), were randomized to TIME (intervention) or usual care (control). The intervention included monthly group visits and …

Microbial Remodeling Of Gut Tryptophan Metabolism And Indole-3-Lactate Production Regulate Epithelial Barrier Repair And Viral Suppression In Human And Simian Immunodeficiency Virus Infections, Clarissa Santos Rocha, Katie L. Alexander, Carolina Herrera, Mariana G. Weber, Irina Grishina, Lauren A. Hirao, Dylan J. Kramer, Juan Arredondo, Abigail Mende, Katti R. Crakes, Anne N. Fenton, Maria L. Marco, David A. Mills, John C. Kappes, Lesley E. Smythies, Paul Ziprin, Sumathi Sankaran-Walters, Phillip D. Smith, Satya Dandekar

Department of Obstetrics & Gynecology Faculty Publications

Gut inflammatory diseases cause microbial dysbiosis. Human immunodeficiency virus-1 (HIV) infection disrupts intestinal integrity, subverts repair/renewal pathways, impairs mucosal immunity and propels microbial dysbiosis. However, microbial metabolic mechanisms driving repair mechanisms in virally inflamed gut are not well understood. We investigated the capability and mechanisms of gut microbes to restore epithelial barriers and mucosal immunity in virally inflamed gut by using a multipronged approach: an in vivo simian immunodeficiency virus (SIV)-infected nonhuman primate model of HIV/AIDS, ex vivo HIV-exposed human colorectal explants and primary human intestinal epithelial cells. SIV infection reprogrammed tryptophan (TRP) metabolism, increasing kynurenine catabolite levels that are …

Racial Disparities In Maternal Mortality Before, During, And After The Covid-19 Pandemic In The United States: A Difference-In-Difference Analysis, Kyosuke Kamijo, Misa Hayasaka, Tetsuya Kawakita

Department of Obstetrics & Gynecology Faculty Publications

Background

This study aimed to examine changes in racial disparities in pregnancy-related and maternal mortality before, during, and after the COVID-19 pandemic in the United States.

Methodology

This was a cross-sectional study using the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) data from January 2018 to June 2024. We focused on pregnancy-related and maternal mortality among Black and White individuals to examine racial disparities. The study periods were defined as pre-pandemic (January 2018-March 2020), pandemic (April 2020-March 2022), and post-pandemic (April 2022-June 2024). We applied interrupted time series analysis and difference-in-difference (DID) models …

American Society For Gastrointestinal Endoscopy Guideline On Gastrostomy Feeding Tubes: Methodology And Review Of Evidence, Divyanshoo Rai Kohli, Natalie Cosgrove, Wasif M Abidi, Jorge D Machicado, Madhav Desai, Nauzer Forbes, Neil B Marya, Nikhil R Thiruvengadam, Nirav C Thosani, Omeed Alipour, Saowanee Ngamruengphong, Sherif E Elhanafi, Sunil G Sheth, Wenly Ruan, John C Fang, Stephen A Mcclave, Rodrick C Zvavanjanja, Dhruvil K Radadiya, Amir Y Kamel, Bashar J Qumseya

Faculty, Staff and Student Publications

This article from the American Society for Gastrointestinal Endoscopy (ASGE) provides a full description of the methodology used to inform the final guidance outlined in the accompanying summary and recommendations article for strategies to manage endoscopically placed gastrostomy tubes. This article was developed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework and specifically addresses the utility of PEG versus interventional radiology-guided gastrostomy (IR-G), the need for withholding antiplatelet and anticoagulant medications, appropriate timing to initiate tube feedings, and appropriate selection of the gastrostomy technique in patients with malignant dysphagia. In patients needing enteral access, the ASGE suggests …

Changes In Cardiovascular Risk Factors And Health Care Expenditures Among Patients Prescribed Semaglutide, Yuan Lu, Yuntian Lu, Tedi Totojani, Chungsoo Kim, Rohan Khera, Hua Xu, John E. Brush Jr., Harlan M. Krumholtz, Jason Abaluck

Department of Medicine Faculty Publications

Importance Semaglutide, a glucagon-like peptide-1 receptor agonist, has demonstrated substantial weight reduction and cardiovascular benefits in clinical trials. However, its association with clinical outcomes and health care expenditures remains underexplored.

Objective To evaluate changes in cardiovascular risk factors and health care expenditures among patients prescribed semaglutide across multicenter cohorts.

Design, Setting, and Participants This retrospective cohort study included 23 522 adults (≥18 years) who received an initial semaglutide prescription between January 1, 2018, and January 1, 2025, at Sentara Healthcare and between January 1, 2018, and May 1, 2025, at Yale New Haven Health System.

Exposure The first prescription of …

Exploring The Role Of 5-Hydroxymethyl-2-Furfural And Sumiki's Acid In Beta-Cell Metabolism, Daiwik Munjwani, Demitrius Hill, David Regan, David Lee, Mike Muehlbauer, Hans-Ewald Hohmeier, Mette Jensen, Neolle E. Younge, James Bain

Department of Medicine Faculty Publications

Type 1 diabetes (T1D), a leading cause of mortality in the United States, is associated with heart disease, nephropathy, neuropathy, retinopathy, and stroke. While management of T1D with medications and healthy lifestyle choices is critical, recent research highlights the contributory role of environmental diabetogens in the pathogenesis of T1D. Here, we propose that the furan compound, 5-hydroxymethyl-2-furfural (HMF), which forms when hexoses such as glucose or fructose lose three water molecules during thermal food processing, might be an unrecognized dietary diabetogen. HMF is a suspected mutagen and carcinogen. In a previous experiment in the rat 832/13 beta-cell line, when cultures …