Digital Commons Network^™

Human Papillomavirus Vaccination And Human Papillomavirus-Related Cancer Rates, Victor Adekanmbi, Itunu Sokale, Fangjian Guo, Jessica Ngo, Thao N Hoang, Christine D Hsu, Abiodun Oluyomi, Abbey B Berenson

Faculty, Staff and Students Publications

IMPORTANCE: To inform the design and implementation of targeted interventions to reduce the future burden of human papillomavirus (HPV)-related cancers in Texas, it is necessary to examine the county and health service region (HSR) levels of (1) the proportion of children and teenagers aged 9 to 17 years who initiated and were up to date for HPV vaccination series and (2) HPV-related cancer incidence rates (IRs).

OBJECTIVE: To evaluate temporal trends and geospatial patterns of HPV vaccination initiation and up-to-date status as well as HPV-related cancer rates at county and HSR levels in Texas.

DESIGN, SETTING, AND PARTICIPANTS: This population-based …

The Il-6 Hypothesis In Covid-19: A Phase 2, Randomised, Double-Blind, Placebo-Controlled Study To Evaluate The Efficacy And Safety Of Free Il-6 Sequestration By The Monoclonal Antibody Sirukumab In Severe And Critical Covid-19, Robert L. Gottlieb, Meredith Clement, Paul Cook, Audra Deveikis, Kap Sum Foong, Philip Robinson, Jihad Slim, Cedric W. Spak, Annemie Buelens, Katleen Callewaert, Sandra De Meyer, Wai Ling Mo, Inge Verbrugge, Liesbeth Van Wesenbeeck, Yanli Zhuang, Jason W. Chien, Magda Opsomer, Erika Van Landuyt

School of Medicine Faculty Publications

Background: Upregulation of IL-6 has been associated with worse prognosis in COVID-19 patients. Impact on IL-6 signalling has mostly been limited to clinical outcomes in IL-6 receptor antagonist trials. Methods: We performed a phase 2, randomised, double-blind, placebo-controlled trial (NCT04380961) of US-based hospitalised adults (< 85 years) with laboratory-confirmed SARS-CoV-2 infection and severe (low levels of supplemental oxygen) or critical disease (high levels of oxygen supplementation). Patients received sirukumab 5 mg/kg or placebo single dose IV on Day 1 plus standard of care. The primary endpoint was time to sustained clinical improvement up to Day 28 based on an ordinal scale. Secondary endpoints included clinical improvement, all-cause mortality, and safety. Following an interim analysis, the protocol was amended to only recruit patients with critical COVID-19. Findings: From May 2020 to March 2021, 209 patients were randomised; 112 had critical disease (72 sirukumab, 40 placebo) at baseline. Median time to sustained clinical improvement in critical patients was 17 and 23 days in the sirukumab and placebo groups (HR, 1∙1; 95% CI, 0∙66–1∙88; p > 0∙05). At Day 28, 59∙4% versus 55∙0% of patients achieved clinical improvement with sirukumab versus placebo and rates of all-cause mortality were 24∙6% versus 30∙0%, respectively. Rates of grade ≥ 3 adverse events were comparable between the sirukumab and placebo groups (25∙9% vs 32∙9%; all patients). Interpretation: In critical COVID-19 patients who received sirukumab, there …

Emerging Special Pathogen C4i: Readiness Is Achieved Through Commitment, Collaboration, Coordination, Cooperation, And Innovation, Darrell Ruby, Christa Arguinchona, Lindsey Bandow, David Brett-Major, Barb Dunham, Heather M. Flavell, Jake Lacore, James Lawler, Patti Lord, Brian Rogge, Mark Vazquez, Jana Broadhurst

Conferences

High Consequence Infectious Disease preparedness in Alaska, a partnership. This presentation will detail how civilian and military stakeholders worked together to enhance readiness for management of an emerged special pathogen. Providence, as the Region 10 Emerging Special Pathogen Treatment Center (RESPTC), leveraged regional relationships and partnered with the University of Nebraska Medical Center (UNMC) to integrate frontline special pathogen preparedness training in Alaska with an operational exercise to test interoperability of local high consequence infection prevention and control and case management workflows with the Isolation System for Treatment and Agile Response for High-Risk Infections (ISTARI). Providence led detailed frontline training …

Lab Resources, Providence - Special Pathogens Program

Additional Resources

No abstract provided.

Waste Management, Providence - Special Pathogens Program

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No abstract provided.

Isolate, Providence - Special Pathogens Program

Additional Resources

No abstract provided.

Neurological Symptoms And Cause Of Death Among Young Children In Low- And Middle-Income Countries, Sara Ajanovic, Zachary Madewell, Shams El Arifeen, Emily Gurley, Mohammad Zahid Hossain, Kazi Munisul Islam, Afruna Rahman, Nega Assefa, Lola Madrid, R Gunturu

Pathology, East Africa

Importance: The emergence of acute neurological symptoms in children necessitates immediate intervention. Although low- and middle-income countries (LMICs) bear the highest burden of neurological diseases, there is a scarcity of diagnostic and therapeutic resources. Therefore, current understanding of the etiology of neurological emergencies in LMICs relies mainly on clinical diagnoses and verbal autopsies.

Objective: To characterize the association of premortem neurological symptoms and their management with postmortem-confirmed cause of death among children aged younger than 5 years in LMICs and to identify current gaps and improve strategies to enhance child survival.

Design, Setting, and Participants: This cross-sectional …

Characterization Of High-Risk-Other Human Papillomavirus Genotypes In Papanicolaou Tests, High-Grade Squamous Intraepithelial Lesions, And Cervical Cancer, Caitlin E. Witt, Elizabeth F. Sutton, Ashley M. Stansbury, Ashley N. Winters, Luke C. Konur, Meng Luo, Jennifer E. Cameron, Beverly Ogden

School of Medicine Faculty Publications

Background: The objective of this study was to determine the human papillomavirus (HPV) genotypes of high-risk-other HPV Papanicolaou (Pap) tests and of biopsy tissues from patients with high-grade squamous intraepithelial lesion (HGSIL) or cervical cancer. High-risk-other HPV status was determined with the cobas HPV Test (Roche Diagnostics, North America) that identifies 12 high-risk, non-16/18 HPV genotypes. We hypothesized that we would find genotypes of HPV in our population that are not covered by the 9-valent HPV vaccine. Methods: For this retrospective cohort study, we randomly selected 50 high-risk-other HPV Pap test samples from 2018 from our pathology department registries for …

Understanding Your Sepsis Diagnosis (Español), Providence Mmhm

Posters with QR Codes

Please see additional files:

1. Patient Education Graphic: Understand Your Sepsis Diagnosis
2. Patient Education Flyer: SEPTICEMIA Todo lo que necesita saber / SEPSIS What You Need to Know (Spanish)

Understanding Your Sepsis Diagnosis (English), Providence Mmhm

Posters with QR Codes

Please see additional files:

1. Patient Education Graphic: Understand Your Sepsis Diagnosis
2. Patient Education Flyer: Sepsis What You Need to Know

Treatment And Care, Providence - Special Pathogens Program

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No abstract provided.

Transportation, Providence - Special Pathogens Program

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No abstract provided.

Ppe, Providence - Special Pathogens Program

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No abstract provided.

Inform, Providence - Special Pathogens Program

Additional Resources

No abstract provided.

Identify, Providence - Special Pathogens Program

Additional Resources

No abstract provided.

Getting Started, Providence - Special Pathogens Program

Additional Resources

No abstract provided.

Complete Genome Sequence Of An Indian Outbreak Strain Of Chikungunya Virus, Eshna Laha, Deepak Jena, Viplov K. Biswas, Sharad Singh, Sunil K. Raghav, Asit K. Pattnaik, Soma Chattopadhyay

Nebraska Center for Virology: Faculty Publications

Here, we report the complete genome sequence of an Indian strain of chikungunya virus isolated from an infected patient from Hyderabad, Andhra Pradesh, India, during a massive outbreak in 2005–2006. The genome length spans 11,811 nucleotides and has a poly(A) tail of 29 residues at the 3′ end.

The Internist's Post V.1 N.7, The University Of Texas Rio Grande Valley. School Of Medicine, Diana Othon Martinez, Edgar Dorsey Trevino, Barbara Malaga-Espinoza, Ramon Elizondo Romo, Carlos Alejos Aguero, Roque Mifuji Lira, Martha Solis, Cesar Gutierrez

School of Medicine Publications

No abstract provided.

Panel Stacking Is A Threat To Consensus Statement Validity, Kasper P Kepp, Preben Aavitsland, Marcel Ballin, Francois Balloux, Stefan Baral, Kevin Bardosh, Howard Bauchner, Eran Bendavid, Raj Bhopal, Daniel T Blumstein, Paolo Boffetta, Florence Bourgeois, Adam Brufsky, Peter J Collignon, Sally Cripps, Ioana A Cristea, Nigel Curtis, Benjamin Djulbegovic, Oliver Faude, Maria Elena Flacco, Gordon H Guyatt, George Hajishengallis, Lars G Hemkens, Tammy Hoffmann, Ari R Joffe, Terry P Klassen, Despina Koletsi, Dimitrios P Kontoyiannis, Ellen Kuhl, Carlo La Vecchia, Tea Lallukka, John Lambris, Michael Levitt, Spyros Makridakis, Helena C Maltezou, Lamberto Manzoli, Ana Marusic, Clio Mavragani, David Moher, Ben W Mol, Taulant Muka, Florian Naudet, Paul W Noble, Anna Nordström, Peter Nordström, Nikolaos Pandis, Stefania Papatheodorou, Chirag J Patel, Irene Petersen, Stefan Pilz, Nikolaus Plesnila, Anne-Louise Ponsonby, Manuel A Rivas, Andrea Saltelli, Manuel Schabus, Michaéla C Schippers, Holger Schünemann, Marco Solmi, Andreas Stang, Hendrik Streeck, Joachim P Sturmberg, Lehana Thabane, Brett D Thombs, Athanasios Tsakris, Simon N Wood, John P A Ioannidis

Faculty, Staff and Student Publications

Consensus statements can be very influential in medicine and public health. Some of these statements use systematic evidence synthesis but others fail on this front. Many consensus statements use panels of experts to deduce perceived consensus through Delphi processes. We argue that stacking of panel members toward one particular position or narrative is a major threat, especially in absence of systematic evidence review. Stacking may involve financial conflicts of interest, but nonfinancial conflicts of strong advocacy can also cause major bias. Given their emerging importance, we describe here how such consensus statements may be misleading, by analyzing in depth a …

Strategies For The Development Of Metalloimmunotherapies, Xiaoqi Sun, Xingwu Zhou, Xiaoyue Shi, Omar A Abed, Xinran An, Yu Leo Lei, James J Moon

Faculty, Staff and Student Publications

Metal ions play crucial roles in the regulation of immune pathways. In fact, metallodrugs have a long record of accomplishment as effective treatments for a wide range of diseases. Here we argue that the modulation of interactions of metal ions with molecules and cells involved in the immune system forms the basis of a new class of immunotherapies. By examining how metal ions modulate the innate and adaptive immune systems, as well as host-microbiota interactions, we discuss strategies for the development of such metalloimmunotherapies for the treatment of cancer and other immune-related diseases.

Determinant Of 30-Day Mortality Of Pulmonary Legionellosis: Do Coinfections Matter?, Takahiro Matsuo, Sebastian Wurster, Ying Jiang, Jeffrey Tarrand, Scott E Evans, Dimitrios P Kontoyiannis

Faculty, Staff and Student Publications

We retrospectively reviewed 64 cases of cancer with pulmonary legionellosis (Legionella pneumophila in 73%). Nearly all patients received Legionella-active antibiotics, yet 30-day mortality was 23%. Independent predictors of 30-day mortality were hyponatremia, bilateral lung involvement, and Sequential Organ Failure Assessment score ≥5. Lung coinfections were common (31%) but did not significantly increase mortality.

Beneficial Effects Of Lactobacillus Plantarum On Growth Performance, Immune Status, Antioxidant Function And Intestinal Microbiota In Broilers, Xiao Xiao, Tiantian Cui, Songke Qin, Tao Wang, Jinsong Liu, Lihan Sa, Yanping Wu, Yifan Zhong, Caimei Yang

Faculty, Staff and Student Publications

Lactobacillus plantarum (L. plantarum) has been globally regarded as antibiotic alternative in animal farming in the past few years. However, the potential function of L. plantarum in broilers has not been systemically explored. In this study, a total of 560 one-day-old yellow-feathered broilers were randomly divided into 3 groups, fed with basal diet and drank with L. plantarum HJZW08 (LP) at the concentration of 0 (CON), 1000 × 10^5 (LP1000), and 2000 × 10^5 CFU/L (LP2000) for 70 d. Results showed that the body weight (BW), average daily …

Lessons Learnt From Broad-Spectrum Coronavirus Antiviral Drug Discovery, Andrew A Bolinger, Jun Li, Xuping Xie, Hongmin Li, Jia Zhou

Faculty, Staff and Student Publications

Introduction: Highly pathogenic coronaviruses (CoVs), such as severe acute respiratory syndrome CoV (SARS-CoV), Middle East respiratory syndrome CoV (MERS-CoV), and the most recent SARS-CoV-2 responsible for the COVID-19 pandemic, pose significant threats to human populations over the past two decades. These CoVs have caused a broad spectrum of clinical manifestations ranging from asymptomatic to severe distress syndromes (ARDS), resulting in high morbidity and mortality.

Areas covered: The accelerated advancements in antiviral drug discovery, spurred by the COVID-19 pandemic, have shed new light on the imperative to develop treatments effective against a broad spectrum of CoVs. This perspective discusses strategies and …

Determinant Of 30-Day Mortality Of Pulmonary Legionellosis: Do Coinfections Matter?, Takahiro Matsuo, Sebastian Wurster, Ying Jiang, Jeffrey Tarrand, Scott E Evans, Dimitrios P Kontoyiannis

Faculty, Staff and Student Publications

We retrospectively reviewed 64 cases of cancer with pulmonary legionellosis (Legionella pneumophila in 73%). Nearly all patients received Legionella-active antibiotics, yet 30-day mortality was 23%. Independent predictors of 30-day mortality were hyponatremia, bilateral lung involvement, and Sequential Organ Failure Assessment score ≥5. Lung coinfections were common (31%) but did not significantly increase mortality.

A Curious Case Of Medium-Vessel Vasculitis, Nisa N Ilsin, Haleigh D Stafford, Anna Catinis, Theodore Rosen

Faculty, Staff and Students Publications

Vasculitis, or the inflammation of vessels due to primary or secondary causes, may arise from numerous etiologies, often leading to diagnostic uncertainty. Delayed treatment due to diagnostic or etiologic uncertainty presents a significant clinical risk, with consequences including organ failure and mortality. We describe a case of a 58-year-old male with a history including ankylosing spondylitis who presented with painful ulcers involving the bilateral lower extremities following a trip to the southern Texas border. Histopathology revealed medium-vessel vasculitis; however, the search for a likely etiology in the setting of a unique combination of potential vasculitis precipitants, including glochid inoculation, a …

Tuberculosis Prevention: Current Strategies And Future Directions, Anca Vasiliu, Leonardo Martinez, Rishi K Gupta, Yohhei Hamada, Tara Ness, Alexander Kay, Maryline Bonnet, Martina Sester, Stefan H E Kaufmann, Christoph Lange, Anna M Mandalakas

Faculty, Staff and Students Publications

BACKGROUND: An estimated one fourth of the world's population is infected with Mycobacterium tuberculosis, and 5-10% of those infected develop tuberculosis in their lifetime. Preventing tuberculosis is one of the most underutilized but essential components of curtailing the tuberculosis epidemic. Moreover, current evidence illustrates that tuberculosis manifestations occur along a dynamic spectrum from infection to disease rather than a binary state as historically conceptualized. Elucidating determinants of transition between these states is crucial to decreasing the tuberculosis burden and reaching the END-TB Strategy goals as defined by the WHO. Vaccination, detection of infection, and provision of preventive treatment are key …

A Prospective Cohort Study Of Pregnancy Outcomes Following Antepartum Infection With Sars-Cov-2, James D Doss, Emily Diveley, Fan Zhang, Amy Scheffer, Ruizhi Huang, Daniel Jackson, Nandini Raghuraman, Ebony B Carter, Indira U Mysorekar, Jeannie C Kelly

Faculty, Staff and Students Publications

Objectives: Our study aimed to explore the impact of COVID-19 infection on pregnancy outcomes, accounting for the progression of variants, vaccines, and treatment modalities.

Study design: We performed a prospective longitudinal cohort study at two urban tertiary centers enrolling patients with a confirmed intrauterine singleton pregnancy from December 23, 2020 to July 18, 2022. Patients were evaluated for SARS-CoV-2 infection at enrollment and every trimester using serum antibody testing. The primary outcome was preterm birth. Symptom and treatment data were collected from pregnant patients with COVID-19 infections. Variant strain infection status was determined from local wastewater analysis.

Results: 448 patients …

Potentially Functional Variants Of Chmp4a And Panx1 In The Pyroptosis-Related Pathway Predict Survival Of Patients With Non-Oropharyngeal Head And Neck Squamous Cell Carcinoma, Xiaozhun Tang, Huiling Wang, Hongliang Liu, Guojun Li, Erich M Sturgis, Sanjay Shete, Qingyi Wei

Faculty, Staff and Students Publications

Background: Pyroptosis has been implicated in the advancement of various cancers. Triggering pyroptosis within tumors amplifies the immune response, thereby fostering an antitumor immune environment. Nonetheless, few published studies have evaluated associations between functional variants in the pyroptosis-related genes and clinical outcomes of patients with non-oropharyngeal head and neck squamous cell carcinoma (NON-ORO HNSCC).

Methods: We conducted an association study of 985 NON-ORO HNSCC patients who were randomly divided into two groups: the discovery group of 492 patients and the replication group of 493 patients. We used Cox proportional hazards regression analysis to examine associations between genetic variants of the …

Clinical Features Of Chagas Disease Progression And Severity, Maria Carmo P Nunes, Caryn Bern, Eva H Clark, Antonio L Teixeira, Israel Molina

Faculty, Staff and Students Publications

Chagas disease, the most common form of nonischaemic cardiomyopathy globally, is one of the leading causes of morbidity and mortality in Latin America. Chagas cardiomyopathy has a wide clinical spectrum and prognosis, which is primarily determined by the severity of left ventricular dysfunction. Chagas disease also affects the brain, particularly manifesting as cardioembolic strokes and cognitive impairments. Disease progression is influenced by various factors such as anti-parasite treatments, host-parasite interactions, and other determinants. This review explores Chagas disease, covering clinical presentations, the range of severity of Chagas cardiomyopathy, and neurological manifestations. We investigate factors that influence the progression of cardiomyopathy, …

A Case Of Persistent Intra-Abdominal Stenotrophomonas Maltophilia Infection Despite Bacteriophage Therapy, Grace D Cullen, Keiko Christine Salazar, Austen Lee Terwilliger, Saima Aslam, Justin R Clark, Anthony W Maresso, Paul L Bollyky, Jenny R Aronson

Faculty, Staff and Students Publications

Multidrug resistant infections are a challenge in the health care setting and a cause of patient morbidity and mortality. Bacteriophages (phages) are viruses that target and kill bacteria and have been used in patients to treat bacterial infections. We present a case of disseminated Stenotrophomonas maltophilia infection, with pulmonary, intra-abdominal and bloodstream involvement. The patient was treated with a combination of antibiotics and personalized phage therapy, administered daily for 12 days both intravenously as well as via intra-abdominal drains. Phage therapy was well-tolerated, the patient cleared S. maltophilia from their bloodstream and their intra-abdominal abscesses were stable or decreased in …