Digital Commons Network^™

Acute Pediatric Chagas Disease In Antioquia, Colombia: A Geographic Location Of Suspected Oral Transmission, Lídia Gual-Gonzalez, Catalina Aango-Ferreira, Laura Camila Lopera-Restrepo, Omar Cantillo-Barraza, Daniela Velásquez Marín, Natalia Restrepo Bustamante, Omar Triana-Chavez, Melissa Nolan Ph.D., Mph

Faculty Publications

Chagas disease, Trypanosoma cruzi infection, is an insidious cause of heart failure in Latin America. Early diagnosis and treatment are critical to prevent irreversible myocardial damage that progressively accumulates over decades. Several structural barriers account for the less than 1% of cases in Colombia being treated, including poor physician knowledge, especially considering that some regions are considered non-endemic. The two cases reported here represent an emerging epidemiologic scenario associated with pediatric Chagas disease. Both cases are suspected oral transmitted parasitic infection in a geographic region of Colombia (Andean region of Antioquia) where no previous oral transmission of Chagas disease had …

Consultation/Liaison Psychiatry During Covid-19, Robert Frierson, Steven B Lippmann

The University of Louisville Journal of Respiratory Infections

Consultation/liaison psychiatrists care for people with co-existing medical and psychologic difficulties. The coronavirus pandemic is stressful for patients and their psychiatric caregivers. Patients have lost support systems and harbor fears about exposing family to the virus. COVID-19 sometimes exacerbates previous psychiatric conditions, while diminishing intimacy with physicians. Everyone is oversaturated with COVID-19-related news focusing on rising concerns about the illness and about jobs, school, and housing insecurities.

The psychiatrist maintains a hospital presence despite fear of contracting the disease. Challenges include addressing staff morale, evidencing empathy despite telecommunication devices, and treating anxiety, depression, sleep phobias, post intubation flashbacks, COVID-19-induced cognitive …

Genomic Epidemiology Of Clostridium Difficile Colonization And Transmission In An Intensive Care Unit Cohort, Brianne Ciferri

Dissertations and Theses

Abstract

Genomic epidemiology of Clostridium difficile colonization and transmission in an intensive care unit cohort

by Brianne Ciferri, MPH

Advisor: C. Mary Schooling, PhD

Introduction: Clostridiodes difficile (C. difficile) is a leading cause of healthcare associated infections (HAI) in the United States and responsible for an estimated incidence of 223,900 cases and 12,800 deaths per year^1,2. C. difficile can cause gastrointestinal illness with symptoms ranging from mild diarrheal illness to a life-threatening condition. C. difficile is an opportunistic pathogen in which spores can live in an undisturbed dormant state within the intestinal tract and become …

"These Jests Of God": Arrowsmith And Tropical Medicine’S Racial Ecology, James Fitz Gerald

English and Media Studies Faculty Publications

This essay examines Sinclair Lewis's Arrowsmith (1925) through the ethical and ecological contingencies of U.S. tropical medicine in the early twentieth century. With an eye kept on the novel's well-known "St. Hubert " chapters, the essay elaborates the dangerous compromises that even the most well-intentioned medical professionals make in the name of scientific progress. The novel, I argue, summons and yet moves beyond the traditional outbreak narrative to unravel the various political, economic, and cultural strands of U.S. imperial medicine. The novel's platform for applied sanitary science helps me revisit famed public health campaigns, particularly those from Cuba and Panama, …

Examining An Intersection Of Environmental Justice And Covid-19 Risk Assessment: A Review, Ashley Ellis

Honors Theses

This study views the risks associated with the novel coronavirus (COVID-19) as an environmental injustice issue due to the connection between existing environmental disparities and the disproportional negative impacts brought upon by the virus. The social and health determinants attributed to those environmental disparities have traditionally been evaluated as individual risk factors, an approach that fails to gauge the complexity of an environmental injustice issue. This study employs the emerging theory of intersectionality, a belief that phenomena cannot be linked to one principal cause but instead an interconnected web of influences, in order to synthesize the multitude of factors believed …

The Association Between Depression And Anxiety With Covid-19 Outcomes., Erica Miller

Electronic Theses and Dissertations

Previous studies have shown that mental disorders affect COVID-19 mortality. This study investigated the effect of depression and/or anxiety on COVID-19 outcomes. Depression/anxiety was defined by actively taking medication and/or diagnosis. The outcomes were ICU admission; ventilation; mortality; and time to mortality. Of 698 hospitalized patients, there were 204 (29%) defined to have either depression or anxiety. There were 109 deaths, and of those, 52 (48%) were diagnosed with depression/anxiety. Multivariable logistic regression and Cox proportional hazards models were used to examine associations. ICU admission and ventilation were not significantly associated with depression/anxiety. Depression/anxiety was associated with mortality (OR: 1.84, …

(R1412) Stability And Bifurcation Of A Cholera Epidemic Model With Saturated Recovery Rate, Huda Abdul-Satar, Raid K. Naji

Applications and Applied Mathematics: An International Journal (AAM)

In this paper, a Cholera epidemic model is proposed and studied analytically as well as numerically. It is assumed that the disease is transmitted by contact with Vibrio cholerae and infected person according to dose-response function. However, the saturated treatment function is used to describe the recovery process. Moreover, the vaccine against the disease is assumed to be utterly ineffective. The existence, uniqueness and boundedness of the solution of the proposed model are discussed. All possible equilibrium points and the basic reproduction number are determined. The local stability and persistence conditions are established. Lyapunov method and the second additive compound …

Examination Of The Association Between C - Reactive Protein(Crp) And Covid-19 Infection Severity And Length Of Hospitalization, Abdulahi Aremu Ayanwale

Open Access Theses & Dissertations

Chronic stress can lead to many systemic complications and low-grade systemic inflammation including increased levels of inflammatory cytokines, such as C-reactive protein (CRP). CRP is a marker of systemic inflammation and is associated with depression and perceived stress. Elevations can result in ineffective immune responses, thereby increasing the risk of complications and mortality from infections. Recent evidence suggests that uncontrolled inflammatory responses associated with COVID 19 are a major determinant of disease severity.  The COVID 19 is transmitted from one person to another through droplets from coughing, sneezing, talking, touching droplets on surfaces and contamination by hand-to-mouth routes. The mechanism …

The Indonesian Strategy To Achieve Universal Health Coverage Through National Health Insurance System: Challenges In Human Resources, Atikah Adyas

Kesmas

Many countries are currently trying to achieve universal health insurance coverage in order to provide health protection for their population. Indonesia has received a strong political commitment to implement national health insurance including government support to finance the poor. The implementation of comprehensive national health insurance requires human resources, each of which has a role in fighting for noble goals for the welfare of all people. This paper is taken from the experience of Indonesia and several other countries as well as guidelines that can be used in exploring the role of human resources for the success of the implementation …

Integrated Model Of A Family Approach And Local Support In Tuberculosis Case Finding Efforts In People With Hiv/Aids, Erni Astutik, Chatarina Umbul Wahyuni, Imelda F E Manurung, Geofrey Ssekalembe

Kesmas

The human immunodeficiency virus (HIV) remains a major global public health problem. People with HIV/acquired immune deficiency syndrome (AIDS) are more susceptible to opportunistic infections such as tuberculosis (TB). Therefore, families and community leaders need to help monitor people living with HIV/AIDS (PLWHA). This study aimed to analyze an integrated family approach and local support model to detect TB cases in PLWHA. This study used a case-control study in Kupang City, East Nusa Tenggara Province, in July 2020. The sample comprised 100 people (50 PLWHA with TB case and 50 controls) using total sampling and random sampling, respectively. The variables …

How Risky People Of Getting Covid-19 Based On Their Daily Activities?, Fajar Ariyanti, Mustakim Mustakim, Moch T A Al Ayubi, Desty Pratiwi Marlisman

Kesmas

In Indonesia at the end of 2020, COVID-19 cases were increasing and predicted to continue, as it had not yet passed the peak of the pandemic curve. The government had implemented mobility restrictions to reduce exposure to COVID-19. This study aimed to identify the risk of people getting COVID-19 based on their daily activities. Using a cross-sectional design, this study took 315 respondents under non-probability sampling from September to October 2020. Thedata were analyzed using the Chi-square test with α 0.05. This study showed that the risk percentage of people infected with COVID-19 based on their daily activities was 15.56% …

The Covid-19 Pandemic: Role Of Coping Humor And Internal Health Locus Of Control On Social Dysfunction And Anxiety & Depression, Muhammad Arief Sumantri, Zahrani Zahrani, Hilda Rosa Ainiyah, Azmul Fuady Idham

Kesmas

The concerns about the impact of social distancing on mental health have been widely discussed. This study aimed to know the predictive effect of coping humor and Internal Health Locus of Control (Internal HLoC) on social dysfunction and anxiety & depression during the implementation of the COVID-19 social distancing agenda. This study was also intended to assess the effect of humor content on coping humor. A quantitative approach was used as the method ofthe study with 243 online-recruited participants, and a PLS-SEM analysis was applied to find out the predictive effect in this study. The results and conclusions showed that …

Predictors Of The Covid-19 Social Distancing Practice Among Undergraduate Health Students In Samarinda City, Indonesia: A Cross-Sectional Study, Siti Hadijah Aspan, Pramon Viwattanakulvanid

Kesmas

Social distancing is a health protocol recommended by the World Health Organization (WHO) for reducing the spread of COVID-19. Undergraduate health students play an important role in the dissemination of accurate information. This study identified predictors that influenced the COVID-19 social distancing practice and examined the sources of social distancing information among undergraduate health students in Samarinda City, Indonesia. This cross-sectionalonline survey study (March-April 2021) involved 422 undergraduate students from medicine, public health, and pharmacy faculties at Mulawarman University. Binary logistic regression was conducted to identify factors associated with the COVID-19 social distancing practice. The results showed that age (AOR …

The Seroprevalence Of Toxoplasma Gondii In Cats At The House Of Maternal Women With Toxoplasmosis In Badung, Indonesia, Made Subrata, Nyoman Mantik Astawa, Nyoman Tigeh Suryadi, Sang Gede Purnama, Kadek Karang Agustina, Ngakan Putu Anom Harjana, Made Damriyasa

Kesmas

Toxoplasmosis is a zoonotic disease caused by infection with the parasite called Toxoplasma gondii (T. gondii). The health and social impacts of the infectionare enormous, including miscarriage, hydrocephalus, blindness, and mental retardation. The occurrence of toxoplasmosis in maternal women cannot be se parated from cats around their houses. This study aimed to determine the seroprevalence of the parasite in cats found in the human carriers residences and identify the risk factors of toxoplasmosis in maternal women in Badung District, Bali Province, Indonesia. A total of 80 cat serum samples were obtained from two residential groups, 40 from the housing where …

The Effectiveness And Safety Of Favipiravir In Covid-19 Hospitalized Patients At Tertiary Referral Hospital, Bali, Indonesia, Herni Damayanti, I Gede K Sajinadiyasa, Hindun Wilda Risni, Rani Sauriasari

Kesmas

COVID-19 is a major public health problem, with still questionable specific cure. Favipiravir is a COVID-19 antiviral that is potentially a therapy for COVID-19. This study aimed to analyze its effectivity and safety in moderate to critical hospitalized patients. This study was a retrospective cohort in a tertiary referral hospital in Denpasar City, Bali Province, Indonesia, from August 2020 to January 2021. There was a total of 192 patients; 96 in the favipiravir group and 96in the non-favipiravir group (remdesivir/oseltamivir). Effectivity was measured by assessing the clinical condition at the end of the isolation period of 14 days. The favipiravir …

A Community-Based Management Of Covid-19 In A Mobile Container Unit, Elena Petrova, Timothy Farinholt, Tejas P Joshi, Hannah Moreno, Mayar Al Mohajer, Shital M Patel, Joseph Petrosino, Sharmila Anandasabapathy

Faculty, Staff and Students Publications

Vaccine uptake is a multifactor measure of successful immunization outcomes that includes access to healthcare and vaccine hesitancy for both healthcare workers and communities. The present coronavirus disease (COVID-19) pandemic has highlighted the need for novel strategies to expand vaccine coverage in underserved regions. Mobile clinics hold the promise of ameliorating such inequities, although there is a paucity of studies that validate environmental infection in such facilities. Here, we describe community-based management of COVID-19 through a Smart Pod mobile clinic deployed in an underserved community area in the United States (Aldine, Harris County, TX, USA). In particular, we validate infection …

Posttranslational Modifications In Pd-L1 Turnover And Function: From Cradle To Grave, Xinfang Yu, Wei Li, Ken H Young, Yong Li

Faculty, Staff and Students Publications

Programmed death-ligand 1 (PD-L1) is one of the most classic immune checkpoint molecules. Cancer cells express PD-L1 to inhibit the activity of effector T cells' cytotoxicity through programmed death 1 (PD-1) engagement in exposure to inflammatory cytokines. PD-L1 expression levels on cancer cells might affect the clinical response to anti-PD-1/PD-L1 therapies. Hence, understanding molecular mechanisms for regulating PD-L1 expression is essential for improving the clinical response rate and efficacy of PD-1/PD-L1 blockade. Posttranslational modifications (PTMs), including phosphorylation, glycosylation, ubiquitination, and acetylation, regulate PD-L1 stability, cellular translocation, and interaction with its receptor. A coordinated positive and negative regulation via PTMs is …

Estimation Analysis For The Seir Model With Stochastic Perturbation For The Covid-19 Outbreak In Bogotá, Viswanathan Arunachalam, Andres Rios-Gutierrez

Annual Symposium on Biomathematics and Ecology Education and Research

No abstract provided.

Efficacy Of The Mrna-1273 Sars-Cov-2 Vaccine At Completion Of Blinded Phase, Hana M El Sahly, Lindsey R Baden, Brandon Essink, Susanne Doblecki-Lewis, Judith M Martin, Evan J Anderson, Thomas B Campbell, Jesse Clark, Lisa A Jackson, Carl J Fichtenbaum, Marcus Zervos, Bruce Rankin, Frank Eder, Gregory Feldman, Christina Kennelly, Laurie Han-Conrad, Michael Levin, Kathleen M Neuzil, Lawrence Corey, Peter Gilbert, Holly Janes, Dean Follmann, Mary Marovich, Laura Polakowski, John R Mascola, Julie E Ledgerwood, Barney S Graham, Allison August, Heather Clouting, Weiping Deng, Shu Han, Brett Leav, Deb Manzo, Rolando Pajon, Florian Schödel, Joanne E Tomassini, Honghong Zhou, Jacqueline Miller

Faculty, Staff and Students Publications

BACKGROUND: At interim analysis in a phase 3, observer-blinded, placebo-controlled clinical trial, the mRNA-1273 vaccine showed 94.1% efficacy in preventing coronavirus disease 2019 (Covid-19). After emergency use of the vaccine was authorized, the protocol was amended to include an open-label phase. Final analyses of efficacy and safety data from the blinded phase of the trial are reported.

METHODS: We enrolled volunteers who were at high risk for Covid-19 or its complications; participants were randomly assigned in a 1:1 ratio to receive two intramuscular injections of mRNA-1273 (100 μg) or placebo, 28 days apart, at 99 centers across the United States. …

Responding To The Pandemic: A Multicountry Study On Social-Political Factors And Health Outcomes Of Covid-19, Lan Yao

Theses and Dissertations (ETD)

Introduction. Coronavirus Disease 2019 (COVID-19) poses a major global threat to human beings, which has caused devastating consequences of population health, political, and economic crises in many countries. This dissertation was composed of three research activities to study the following aims: (1) review the existing literature focusing on political factors and health outcomes of COVID-19; (2) assess the relationship between democracy and case fatality rate of COVID-19 by controlling for the effect of age, comorbidity, health expenditure, healthcare workforce, and population density; and (3) identify the trajectory pattern cases peak days, deaths peak days, and peak periods.

Methods. We accessed …

Effects Of Sesame Consumption On Inflammatory Biomarkers In Humans: A Systematic Review And Meta-Analysis Of Randomized Controlled Trials, Shabnam Rafiee, Roghaye Faryabi, Mohammad Ali Zareian, Jessie Hawkins, Nitin Shivappa Mbbs, Mph, Ph.D., Laila Shirbeigi

Faculty Publications

Objectives. Existing evidence produces conflicting findings regarding the effect of sesame intake on inflammatory biomarkers; thisknowledge gap has yet to be met through systematic review and meta-analysis. )is meta-analysis of randomized, controlledclinical trials (RCTs) was conducted to evaluate the effects of sesame consumption on markers of inflammation in humans. Methods. PubMed, Scopus, and the Cochrane Database of Systematic Reviews were searched through August 2020 to identify relevant papers for inclusion. Using the random-effects model, data were evaluated as weighted mean differences (WMD) with 95% confidence intervals (CI). Cochrane’s Q and I-squared (I2) tests were used to …

Hubungan Kepadatan Nyamuk Aedes Aegypti Di Rumah Dengan Kejadian Demam Berdarah Dengue (Dbd) Di Kelurahan Tegal Alur Kecamatan Kalideres, Jakarta Barat, Tahun 2019, Alifia Daariy, R Budi Haryanto

Jurnal Nasional Kesehatan Lingkungan Global

Background. Dengue Hemorrhagic Fever (DHF) is one of the main public health concerns in Indonesia. Aedes aegypti mosquito abundance is a risk factor for DHF. This condition is also influenced by individual characteristics and worsened by environmental factors, eradication of mosquito nests and prevention of mosquito bites practice. Metode. This quantitative study with a cross-sectional design aims to analyze the correlation of adult Ae. aegypti density in houses with DHF in Tegal Alur, Kalideres, 2019. The data were obtained from interviewing 152 study subjects and collecting adult mosquitoes in 55 selected houses in 4 high incidence RW. Adult Ae. aegypti …

Analisis Spasial Kejadian Demam Berdarah Dengue Di Kabupaten Cirebon Tahun 2014-2018, Irwin Umi Latifah, Laila Fitria

Jurnal Nasional Kesehatan Lingkungan Global

Background. Dengue hemorrhagic fever is a arbovirus disease transmitted by Aedes sp. throughout the world including Indonesia. This disease is endemic in several regions such as West Java, one of regions is Cirebon regency whose cases are always in the region. This study aims to spatially analyze the incidence of dengue fever in Cirebon regency in 2014-2018. This study uses an ecological study design, which analyzes the population between climate variables (air temperature, relative humidity, rainfall and wind speed), population density, and larval free numbers using secondary data. Methods. This study uses graphical relationship analysis, statistical analysis that is statistical …

A Research Framework For Evaluating Next Generation Sequencing In Community-Acquired Pneumonia, Ashley M. Wilde, Elena Swingler, Sarah E. Moore Pharmd, Brian C. Bohn Pharmd, Matthew Song Pharmd, Bcidp, Ruth Carrico, Julio A. Ramirez

The University of Louisville Journal of Respiratory Infections

No abstract provided.

Racial And Ethnic Data Reported For Peanut Allergy Epidemiology Do Little To Advance Its Cause, Treatment, Or Prevention, Nigel Mark Thomas

Publications and Research

No abstract provided.

South To North Migration Patterns Of Tuberculosis Patients Diagnosed In The Mexican Border With Texas, Jennifer S. Curry, Bassent Abdelbary, Moncerrato García-Viveros, Juan Ignacio Garcia, Marcel Yotebieng, Adrian Rendon, Jordi B. Torrelles, Blanca I. Restrepo

School of Medicine Publications

The Mexican state of Tamaulipas serves as a migration waypoint into the US. Here, we determined the contribution of immigrants to TB burden in Tamaulipas. TB surveillance data from Tamaulipas (2006–2013) was used to conduct a cross-sectional characterization of TB immigrants (born outside Tamaulipas) and identify their association with TB treatment outcomes. Immigrants comprised 30.8% of TB patients, with > 99% originating from internal Mexican migration. Most migration was from South to North, with cities adjacent to the US border as destinations. Immigrants had higher odds of risk factors for TB [older age (≥ 65 year old, OR 2.4, 95% CI …

Covid-19-Associated Pulmonary Aspergillosis: A Case Report From The Covid-19 Surveillance Program., Mohamad Belal Aldaas, Dylan Goldsmith, Forest W. Arnold

The University of Louisville Journal of Respiratory Infections

A 72-year-old male was brought to the hospital following a motorcycle crash and was admitted for multiple trauma management. His initial course of hospitalization was complicated by mild hypoxemia and altered mental status. Respiratory workup and imaging were consistent with SARS-CoV-2 pneumonia. He completed a five-day course of remdesivir and a ten-day course of dexamethasone. Twenty days later, he developed a low-grade fever. His chest computerized tomography (CT) showed gas and fluid containing parenchymal collection in the anteromedial right middle lobe measuring up to 4.8 cm, most consistent with a pulmonary abscess. Antimicrobial treatment was started.

The patient became hypoxic …

Mitigating The Externality Of Diseases Of Poverty Through Health Aid, Kamal Jnawali, Michael G. Tyshenko, Tamer Oraby

School of Mathematical & Statistical Sciences Faculty Publications

Externality exists in healthcare when an individual benefits from others being healthy as it reduces the probability of getting sick from illness. Healthy workers are considered to be the more productive labourers leading to a country’s positive economic growth over time. Several research studies have modelled disease transmission and its economic impact on a single country in isolation. We developed a two-country diseaseeconomy model that explores disease transmission and crossborder infection of disease for its impacts. The model includes aspects of a worsening and rapid transmission of disease juxtaposed by positive impacts to the economy from tourism. We found that …

University Of Louisville International Travel Clinic: Pivoting During The Covid-19 Pandemic, Dawn Balcom, Subathra Marimuthu, Leslie A Wolf, Luanne Didelot, Sarah Tan, Daniel Hall, Ruth Carrico

The University of Louisville Journal of Respiratory Infections

No abstract provided.

Association Of Lung Cancer With Pneumonia And Chlamydia Pneumoniae Infection, Johnny Zakhour Md, Daniel Muller, Alex Glynn, Jose Bordon

The University of Louisville Journal of Respiratory Infections

Introduction: The degree of association and type of causal versus non-causal relationship between pneumonia and lung cancer (LC) are evolving discussions. We reviewed English publications on the degree of association between pneumonia and subsequent LC.

Methods: We searched the PubMed database using key words for pneumonia, LC, and chlamydia infection. We selected peer-reviewed studies of patients with pneumonia and LC. Case reports and other literature reviews were excluded from this review.

Results: Five studies examined the incidence and/or risk of LC for a total of 415,750 patients, and four studies examined cases with Chlamydia pneumoniae chronic infection at the time …