Digital Commons Network^™

Utilization Of Intensive Care Interventions In Critically Ill Patients With Candidemia Versus Bacteremia: A Multicenter Retrospective Cohort Study, Mary North Jones, Masayuki Nigo, Stefano Casarin, James Kurian, Aarjav Sanghvi, Enshuo Hsu, Stephen L Jones, Ashton Connor, David B Corry, Cesar A Arias, Max W Adelman

Faculty, Staff and Students Publications

Objectives: Candida species are one of the most common causes of ICU-onset bloodstream infection (BSI). Yet, there is no robust guidance on when to initiate empiric antifungals for ICU patients suspected of BSI. We compared patients with ICU-onset candidemia vs. ICU-onset bacteremia to determine which patients may benefit from empiric antifungals.

Design: We compared characteristics between patients with bacteremia vs. candidemia at time of culture. We determined risk factors for death and constructed a multivariable regression to determine if candidemia is an independent risk factor for death.

Setting/patients: We included ICU patients from a hospital system in Houston, Texas (n …

Divergent Humoral Immune Signatures In Response To Klebsiella Pneumoniae Bacteremia, Paeton L Wantuch, Nadia Wattad, David A Rosen

2020-Current year OA Pubs

OBJECTIVES: Klebsiella pneumoniae is an increasingly threatening global pathogen with high rates of antibiotic resistance and no licensed vaccines available. Despite its worldwide importance, little is known about the human adaptive immune response to K. pneumoniae infection.

METHODS: Herein we observed the longitudinal antibody responses of three immunocompetent patients hospitalized with K. pneumoniae bacteremia. We analyzed the human serum for antibody titers and in vitro functionality. Further, serum function was evaluated via an in vivo mouse model.

RESULTS: We found that in each case, anti-K. pneumoniae antibodies against the infecting strain were still detectable a year after the initial infection. …

Phenofit: A Framework For Determining Computable Phenotyping Algorithm Fitness For Purpose And Reuse, Laura K Wiley, Luke V Rasmussen, Rebecca T Levinson, Jennnifer Malinowski, Sheila M Manemann, Melissa P Wilson, Martin Chapman, Jennifer A Pacheco, Theresa L Walunas, Justin B Starren, Suzette J Bielinski, Rachel L Richesson

2020-Current year OA Pubs

BACKGROUND: Computational phenotyping from electronic health records (EHRs) is essential for clinical research, decision support, and quality/population health assessment, but the proliferation of algorithms for the same conditions makes it difficult to identify which algorithm is most appropriate for reuse.

OBJECTIVE: To develop a framework for assessing phenotyping algorithm fitness for purpose and reuse.

FITNESS FOR PURPOSE: Phenotyping algorithms are fit for purpose when they identify the intended population with performance characteristics appropriate for the intended application.

FITNESS FOR REUSE: Phenotyping algorithms are fit for reuse when the algorithm is implementable and generalizable-that is, it identifies the same intended population …

Clinical Presentation, Risk Factors And Outcome Of Non-Tuberculous Mycobacteria Infection In Hematopoietic Stem-Cell Transplantation: A Multinational Case-Control Study, Mario Fernández-Ruiz, Sasinuch Rutjanawech, Carlos Mejía-Chew, Et Al.

2020-Current year OA Pubs

BACKGROUND: The clinical and microbiological features of infection due to non-tuberculous mycobacteria (NTM) after hematopoietic stem-cell transplantation (HSCT) remain poorly understood.

METHODS: We performed a retrospective, multinational case-control study that included HSCT recipients (≥12 years) diagnosed with NTM disease between January 2008 and December 2018. Controls were HSCT recipients with no evidence of NTM disease, matched (1:2 ratio) by participating center and post-transplant survival. Logistic regression on matched pairs was used to investigate risk factors for NTM disease.

RESULTS: We included 25 cases of NTM disease. The most common HSCT type was allogeneic from unrelated donor (72.0%) after myeloablative conditioning …

Association Of Sleep Disturbance With Survival After Colorectal Cancer Diagnosis: Results From The Colocare Study, Anita R Peoples, Adetunji T Toriola, Et Al.

2020-Current year OA Pubs

INTRODUCTION: Sleep problems are common among cancer patients. The relationship between sleep disruption and clinical outcomes after colorectal cancer (CRC) diagnosis remains poorly understood. We investigated associations of sleep disruption with survival and recurrence in patients with CRC.

METHODS: CRC patients with stages I-IV (N = 895) were included in this study. Self-reported sleep disturbance was assessed presurgery using the sleep item from the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core-30 and classified into "no/mild" or "moderate/severe" sleep disturbance. Cox-proportional hazard models were computed (HRs and 95% confidence intervals) to investigate associations of sleep disturbance …

A Systemic Selective Modified Mrna Delivery Platform For Preventing Chemotherapy-Induced Cardiotoxicity, Jimeen Yoo, Mengcheng Shen, Et Al.

2020-Current year OA Pubs

Doxorubicin (Dox) is a widely employed chemotherapeutic agent, but its use is clinically limited by dose-accumulative cardiotoxicity. More specifically, Dox induces oxidative stress and causes pro-apoptotic ceramide accumulation in cardiomyocytes (CMs). Acid ceramidase (AC) modified mRNA (modRNA) has been shown to reduce ceramide levels and protect the heart following ischemic injury; however, therapeutic modRNA applications have been hindered by the need for invasive delivery. Here, we present a platform for minimally intrusive transmission of modRNA to the heart. This CM-selective modRNA translational system (cmSMRTs) is encapsulated in lipid nanoparticles for intravenous (IV) delivery to enable systemic administration with high cardiac …

Plasma Ceramides Levels In Severe Covid-19 Disease: Correlations With Survival, Tri Pham, Andrea M Heredia Castillo, Andrew Atkinson, Linda R Peterson, M Cristina Vazquez Guillamet

2020-Current year OA Pubs

BACKGROUND: Dysregulated inflammatory processes have been associated with severe COVID-19 disease. Ceramides, bioactive lipids involved in inflammatory signaling, have been utilized to predict outcomes in chronic cardiometabolic diseases and pancreatic cancer, but their role in COVID-19 remains unknown.

METHODS: This observational study prospectively enrolled patients with COVID-19 disease who required intubation and mechanical ventilation at a Midwestern academic hospital between August 2020 and March 2021. Plasma ceramides 16:0 (C16), 22:0 (C22), and 24:0 (C24) and inflammatory markers (CRP, ESR, D-Dimer, and ferritin) were collected and organized weekly from symptom onset for up to 6 weeks. Patients were grouped by in-hospital …

Elevated Serum Lipopolysaccharides And Intrinsic Factor Autoantibodies Correlate With Macrocytic Anemia Among People With Hiv, Daniel Amakye, Samuel Hammond, Osbourne Quaye, Upal Roy, Peter Puplampu, Vincent Ganu, Emmanuel Ayitey Tagoe

Health & Biomedical Sciences Faculty Publications

Introduction: Human immunodeficiency virus (HIV) infection is associated with various comorbidities, including macrocytic anemia, though the role of the infection is unclear. HIV has been implicated in microbial translocation and altered immune responses. This study aimed to establish the relationship between gut microbial translocation and immune response, and macrocytic anemia among people with HIV (PWH).

Materials and methods: Fifty-five PWH on combination antiretroviral therapy (cART) were age-matched with 55 HIV-negative individuals. Demographic data and blood samples were collected from February to July 2023. Hematological indices, including red blood cell (RBC) count, hemoglobin concentration, and mean corpuscular volume (MCV), were measured. …

Dual Tyk2/Jak1 Inhibition By Brepocitinib Reprograms Synoviocyte Pathobiology: Mechanistic Insights Into Targeted Therapy For Rheumatoid Arthritis, Umar Saeed, Zahra Zahid Piracha, Andromeda M. Nauli, Surya M. Nauli

Pharmacy Faculty Articles and Research

Background:

Rheumatoid arthritis (RA) is a chronic autoimmune disorder characterized by synovial hyperplasia, persistent inflammation, and joint destruction. Targeted inhibition of intracellular signaling pathways, such as JAK-STAT, has improved RA treatment outcomes, though safety and selectivity remain as concerns. Brepocitinib, a dual TYK2/JAK1 inhibitor, has shown clinical efficacy in the management of autoimmune diseases, yet its mechanistic impact on synoviocytes remains underexplored.

Objectives:

To investigate the molecular and functional effects of brepocitinib on MH7A and RA-FLS synoviocytes, a key effector cell type in RA pathogenesis.

Methods:

MH7A and RA-FLS cells were treated with brepocitinib (0.5 µM, 1 µM, and 5 …

Private Sector Healthcare Investment In Indonesia: Leveraging Australia-Indonesia Partnerships For Health System Transformation, Susan Josephine Neuhaus

Journal of Indonesian Health Policy and Administration

Australia and Indonesia are strategic partners with expanding bilateral trade valued at AUD 26.7 billion (2022-23). Health care partnerships between the two countries offer significant opportunities for private sector engagement. Indonesia’s large population, rapidly growing middle class, and implementation of Universal Health Coverage (UHC) through the Jaminan Kesehatan Nasional (JKN) present partnership opportunities to strengthen health system capacity, address infrastructure gaps and workforce shortages, and contribute to shared economic and prosperity goals. This study explores how Australian private healthcare investment can complement government initiatives in supporting Indonesia’s UHC while advancing Australia’s regional engagement. A descriptive qualitative analysis was conducted using …

Analysis Of Coverage Of Tuberculosis Prevention Therapy (Tpt): Literature Review, Septia Rahmalina, Ede Surya Darmawan

Journal of Indonesian Health Policy and Administration

Tuberculosis Preventive Therapy (TPT) is a crucial intervention for tuberculosis (TB) control, particularly among high-risk groups such as household contacts of TB patients and people living with Human Immunodeficiency Virus (HIV). Despite being recommended by the World Health Organization (WHO), TPT implementation still faces challenges at the primary care level. This study employed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) method to review 11 articles published between 2021 and 2025 that were relevant to TPT implementation in various high-TB burden countries, including Indonesia. The main barriers identified were input (logistics, training), process (tracing, education, monitoring), and output …

Prophylactic Antibiotic Analysis In Obs-Gyn, Orthopedics, Gastrointestinal Surgery At A South Tangerang Hospital, January-March 2024, Evelina Endang Nurjaman, Helen Andriani

Journal of Indonesian Health Policy and Administration

Inappropriate use of prophylactic antibiotics (PAs) remains a primary driver of antimicrobial resistance (AMR); however, global adherence to established prescribing guidelines remains suboptimal. This study aimed to analyze the compliance and rationality of PA prescription and to evaluate the underlying causes of physician non-adherence in obstetrics, orthopedic, and gastrointestinal surgeries at a hospital in South Tangerang City, Indonesia. Adopting a mixed-methods approach, this investigation combined a quantitative assessment of 208 surgical patient records (January–March 2024) with qualitative exploratory interviews conducted with three specialist peer group heads. This design allowed the triangulation of prescribing data with underlying clinical perspectives. PA rationality …

Salivary Protein Quantity, Ionic Value, And Protein Movement In Stunted And Non-Stunted Children In Indonesia, Munifah Abdat, Sri Rezeki, Putri N. Zulkifli, Mela R. Adinda, Ardiansyah S. Pawinru, Eka Setyawardana

Journal of Dentomaxillofacial Science

Objective: This study aimed to analyze total salivary protein quantity, ionic activity, and protein molecular movement in children with and without stunting.

Material and Method: Saliva samples were collected from 30 children aged 4-6years (15stunted and15 non-stunted). Proteins were extracted using 0.1 M HCI. The total protein quantity was determined using the Bradford assay and Fourier Transform Infrared (FTIR) spectroscopy. Salivary ionic activity (dissolved oxygen, conductivity, and total dissolved solids) and salivary viscosity were measured using an ionic meter and an Ostwald viscometer, respectively. Statistical analyses included independent t-tests, Kruskal-Wallis tests, and Spearman correlation analyses (a=0.05).

Results: Stunted children had …

Novel R Shiny Tool For Survival Analysis With Time-Varying Covariate In Oncology Studies: Overcoming Biases And Enhancing Collaboration, Yimei Li, Yang Qiao, Fei Gao, Jordan Gauthier, Qiang Ed Zhang, Jenna Voutsinas, Wendy Leisenring, Ted Gooley, Corinne Summers, Alexandre Hirayama, Cameron Turtle, Rebecca Gardner, Jarcy Zee, Qian Vicky Wu

Wills Eye Hospital Papers

PURPOSE: Our study is motivated by evaluating the role of hematopoietic cell transplantation (HCT) after chimeric antigen receptor T-cell (CAR-T) therapy for ALL, a debated topic. Because patients may receive HCT at different times after CAR-T infusion or never, HCT post-CAR-T should be considered as a time-varying covariate (TVC).

METHODS: Standard Cox models and Kaplan-Meier (KM) curves (naïve method) assume that TVC status is known and fixed at baseline, which can yield biased estimates. Landmark analysis is a popular alternative but depends on a chosen landmark time. Time-dependent (TD) Cox model is better suited for TVC although visualizing survival curves …

Partial Versus Full Revision In Cementless Single-Stage Exchange For Hip Periprosthetic Joint Infection: A Multicenter Comparative Study With 10-Year Survivorship Analysis, Wenbo Mu, Atthakorn Jarusriwanna, Boyong Xu, Scot A. Brown, Xiaogang Zhang, Alexander Dawes, Javad Parvizi Md, Li Cao

Rothman Institute Papers

BACKGROUND: Periprosthetic joint infection (PJI) is one of the most challenging complications following total hip arthroplasty (THA). Traditional management typically involves full revision to ensure comprehensive infection eradication. However, for patients with well-fixed implants, partial revision in a single-stage cementless approach may provide a viable alternative, potentially preserving bone stock and reducing operative time. The relative efficacy of this approach compared with full revision remains to be fully explored. This multicenter study aims to determine whether partial revision in cementless single-stage exchange surgery offers comparable infection control outcomes to full revision for select patients with well-fixed implants.

METHODS: We conducted …

Shingles: A Case Report, Michele White Dds, Ryan Vahdani Dds, Mha, Gary Frey Dds, Ben Warner Ms, Dds, Md

The Journal of the Michigan Dental Association

This case report details a 58-year-old male who presented at a dental urgent care clinic with oral pain and a facial rash. The report identifies the condition as shingles (herpes zoster), caused by the reactivation of the varicella-zoster virus. It explores the clinical presentation, differential diagnosis—distinguishing it from Ramsay Hunt Syndrome and Bell’s palsy—and emphasizes the importance of early antiviral treatment. Furthermore, the source highlights the role of dental practitioners in identifying infectious diseases and promoting vaccination. It serves as an educational tool for medical and dental clinicians to enhance collaborative care and expedite treatment through better recognition of shingles …

Mast Cells Promote Pathology And Susceptibility In Tuberculosis, Ananya Gupta, Vibha Taneja, Javier Rangel-Moreno, Nilofer Naqvi, Abhimanyu, Yun Tao, Mushtaq Ahmed, Kuldeep Singh Chauhan, Daniela Trejo-Ponce De Leon, Gustavo Ramírez-Martínez, Luis Jiménez-Alvarez, Cesar Luna-Rivero, Joaquin Zuniga, Deepak Kaushal, Shabaana A Khader

2020-Current year OA Pubs

Tuberculosis (TB), caused by the bacterium

Staff Education To Increase Knowledge And Awareness Of Cultural Sensitivity Among Providers, Stephanie Chiamaka Anyanwu

Walden Dissertations and Doctoral Studies

This Doctor of Nursing Practice (DNP) project aimed to enhance cultural sensitivity among healthcare providers through an educational intervention in a local organization. With the U.S. foreign-born population exceeding 47 million, the need for culturally competent care has become paramount. The study involved nine participants who underwent a pretest and posttest assessment to evaluate their knowledge and awareness of cultural sensitivity. Results indicated a significant increase in knowledge, with pretest and posttest scores improving from a mean of 4.33 to 8.56 (p < 0.01). Awareness in key areas such as patient-provider relationships, cultural beliefs, and language barriers also showed marked improvement. These findings further support the necessity of ongoing cultural sensitivity training to enhance patient care and outcomes, highlighting the potential for broader application across healthcare institutions.

Cysteine Protease Activity In Allergen Recognition And Initiation Of Th2 Allergic Responses, Audrey Rae Meloun

ETDs from 2020-2029

Allergens are non-infectious environmental proteins that can trigger T helper 2 (Th2) cell-mediated inflammation in atopic individuals. Allergens are structurally diverse and typically lack pathogen-associated molecules patterns (PAMPs), which are recognized by pathogen recognition receptors (PRRs). PRRs are the canonical sensors of the innate immune system that typically detect PAMPs in microbes, initiating signaling pathways that drive pathogen clearance. Because allergens generally do not activate PRRs in the same way as infectious agents, alternative detection mechanisms are likely responsible for their recognition and the subsequent initiation of Th2 cell-mediated inflammation. House Dust Mite (HDM), a major indoor allergen, and other …

Beyond The Rash: Cutaneous Peripheral T-Cell Lymphoma As A Diagnostic Pitfall In Primary Care, Jared Hensley, Aura Calderon, Blake Martin, Cristina Kochi, Andres Suarez Parraga

School of Medicine Publications

Cutaneous manifestations of T-cell lymphomas may resemble common dermatologic or infectious conditions, increasing the risk of delayed recognition. We report a 78-year-old woman with known peripheral T-cell lymphoma (PTCL) who presented with a rapidly progressive, diffuse erythematous rash accompanied by cervical lymphadenopathy. Initial evaluation prioritized more common etiologies; however, inpatient medicine broadened the differential diagnosis, prompting early hematology and oncology consultation. Contrast-enhanced CT of the neck demonstrated multiple enlarged, partially necrotic left cervical lymph nodes consistent with disease progression. After multidisciplinary discussions and consideration of prognosis, the patient elected palliative-focused management with oncology follow-up. This case underscores the importance of …

Anorectal Complications In Acute Leukaemia: A Retrospective Analysis Of Clinical Characteristics, Management And Outcomes In A Tertiary Care Setting In Oman, Najwa Al Himali, Murtadha Al Khabori, Mohamed Al Huneini

Sultan Qaboos University Medical Journal

Objectives: Anorectal complications are common and serious issues among patients with haematological malignancies, leading to significant morbidity and mortality. Limited data are available on their incidence, microbiology screening and management. This study aimed to improve the understanding of these complications in patients diagnosed with acute leukaemia in Oman. Methods: This retrospective study was conducted at Sultan Qaboos University Hospital, Muscat, Oman and included patients diagnosed with acute leukaemia who developed anorectal complications over the past decade (2015–2024). Results: A total of 100 patients were included in this study; 50% had acute myeloid leukaemia (AML), 35% had acute lymphoblastic leukaemia (ALL) …

Hepatitis C Virus Treatment Outcomes Using A Family Medicine Interdisciplinary Team., Megan Hull

Ambulatory and Primary Care Articles

No abstract provided.

Routine Admission Urinalysis Has Low Clinical Utility In Psychiatric Hospitalizations, Tri Pham, Devanshi Patel, Ana Berce, Alice Bewley, Sena Sayood

2020-Current year OA Pubs

We examined the diagnostic utility of urinalyses (UAs) in psychiatric admissions. Admission UAs led to diagnosis of clinical urinary tract infections in 1.7% of cases. Among those treated with antibiotics, inappropriate prescriptions occurred in 71.3% of cases, with increased odds in older age, female sex, positive cultures, and certain psychiatric diagnoses.

The Consequences Of Attempted Human Perfection: Genetic Enhancement And Why It Is Immoral, Kiran S. Sajnani

Mako: NSU Undergraduate Student Journal

In the field of biomedical ethics, genetic enhancement—the alteration of human DNA to increase characteristics beyond normal function—is a highly contested topic. Genetic enhancement presents serious ethical issues, especially when gene therapy seeks to treat or prevent disease. This paper makes the consequentialist case that genetic enhancement, whether somatic or germline, is intrinsically unethical because of its ethical, societal, and systemic ramifications. The autonomy of future persons is violated by germline enhancement, which also runs the risk of deepening socioeconomic gaps and escalating intergenerational inequity. Even though it only affects the individual, somatic augmentation undermines human diversity and agency by …

Community And Individual Risk Factors Associated With Tuberculosis Treatment Outcomes: Ca, Md, And Oh, [2017-2021]., Kadiatu Banjoko

Walden Dissertations and Doctoral Studies

There are unsuccessful treatment outcomes with Tuberculosis (TB) disease, although effective therapies exist. This study aimed to identify predictors of unsuccessful treatment using the socioecological model. A quantitative cross-sectional study and multinomial logistic regression analysis were used to measure the associations between long-term care (LTC), homelessness, correctional facility, Human Immunodeficiency Virus (HIV), diabetes, excess alcohol, illicit drug use, and TB treatment outcomes of death, lost to follow-up, and treatment refusal. The sample consisted of 7,589 individuals aged 15 and older with pulmonary TB between 2017 and 2021, residing in California, Ohio, and Maryland. Findings indicated a correlation between community factors …

Creative Arts To Enhance Cervical Cancer Awareness Using Art-Based Messages From A Nigerian Crowdsourcing Open Call: Qualitative Thematic Analysis, Abdulhammed O Babatunde, Olufunto A Olusanya, Peter Kalulu, Temitope Ojo, Onyekachukwu Anikamadu, Juliet Iwelunmor, Et Al.

2020-Current year OA Pubs

BACKGROUND: Cervical cancer is a leading cause of cancer deaths among women in Nigeria, yet awareness is low. Historically, art has served as a medium for processing emotions and sharing experiences, which can be effective in promoting health and behavior change.

OBJECTIVE: This study aimed to examine art submissions and social media engagement from a Nigerian crowdsourcing open call to inform co-designed strategies for cervical cancer prevention among women.

METHODS: This study reported following the SRQR (Standard Reporting for Qualitative Research) guideline. From October to November 2023, we launched an open call for art on social media, inviting adult women …

Phase 1b/2 Study Of Bms-813160, A Ccr2/5 Dual Antagonist, In Combination With Chemotherapy Or Nivolumab In Patients With Advanced Pancreatic Or Colorectal Cancer, Dung T. Le, Gunnar Folprecht, Anna M. Varghese, Martin Gutierrez, Marcus Noel, Nikolaos A. Trikalinos, Eric Chen, Farshid Dayyani, S. Lindsey Davis, Wen Wee Ma, Atrayee Basu Mallick, Ignacio Garrido-Laguna, Mayu Osawa, Shaun O'Brien, Ruslan D. Novosiadly, Ke Xu, Danielle M. Greenawalt, Santanu Dutta, Christina Twyman Saint Victor, Heinz-Josef Lenz

Department of Medical Oncology Faculty Papers

BACKGROUND: Cysteine-cysteine chemokine receptors 2 (CCR2) and 5 (CCR5) contribute to immune suppression in tumor microenvironments. CCR2 and CCR5 antagonists have demonstrated antitumor activity in pancreatic ductal adenocarcinoma (PDAC) and colorectal cancer (CRC), respectively. This phase 1b/2, open-label study evaluated BMS-813160, a CCR2/5 dual antagonist, in combination with chemotherapy±nivolumab in advanced PDAC or metastatic CRC.

METHODS: Part 1 included patients with metastatic untreated (first-line (1L)) PDAC, 1L CRC, or previously treated (second or third line (2/3L)) microsatellite stable (MSS) CRC. Patients received 2 weeks of BMS-813160 monotherapy (300 mg two times a day, 600 mg once daily, 300 mg once …

Obesity And Long Covid: Intersecting Epidemics?, Michael Gottlieb, Huihui Yu, Ji Chen, Erica S. Spatz, Nicole L. Gentile, Rachel E. Geyer, Michelle Santangelo, Caitlin Malicki, Kristyn Gatling, Kelli N. O'Laughlin, Kari A. Stephens, Joann G. Elmore, Lauren E. Wisk, Michelle L'Hommedieu, Robert M. Rodriguez, Juan Carlos C. Montoy, Ralph C. Wang, Kristin L. Rising, Efrat Kean, Jonathan W. Dyal, Mandy J. Hill, Arjun K. Venkatesh, Robert A. Weinstein, Inspire Group

Jefferson Center for Connected Care Faculty Papers

BACKGROUND: Obesity affects over 10% of the world population and has significant public health implications. With rising recognition of the long-term effects of Long COVID (LC) coupled with new agents to facilitate weight loss, it is critical to understand the influence of obesity on LC. This study assessed the association of obesity with rates of LC and degree of LC-related mental and physical health outcomes among participants up to three years after initial infection.

METHODS: This was a cross-sectional, multisite study of participants with SARS-CoV-2 infection from 12/11/2020–8/29/2022, with data collected through 4/2/2024. Surveys included validated tools for physical and …

Early-Life Exposure To Pfas Affects Adolescent Neuroimmune Activity, Gia Marie Valdez

Theses and Dissertations from DePaul University

Per-/polyfluoroalkyl substances (PFAS) are persistent organic pollutants commonly used in non-stick, oil-resistant, and water-proof food packaging as well as textiles; they are detected in more than 99% of human serum. Perfluorooctane sulfonic acid (PFOS), one of the most ubiquitous PFAS, is associated with altered lipid metabolism, immunotoxicity, and neurodevelopmental disorders. These outcomes all implicate microglia, resident macrophages in the brain critical for development and sensitive to lipid signaling, as key mediators of toxicity. However, developmental effects of PFOS on microglia are not well-characterized, nor is it clear how PFOS alters microglial inflammatory responses. We hypothesized that early-life PFOS exposure alters …

Postdischarge Pediatric Mortality In Nigeria For Children Under 5 Years Of Age, Philomina Nwaugo Chukwudike

Walden Dissertations and Doctoral Studies

Child mortality has remained a public health issue that is prevalent among families living in Nigeria and low- and middle-income countries. Factors associated with post-discharge pediatric mortality among children under 5 have not been explored. The study involved examining associations between timely individual follow-up visits, availability of healthcare facilities for follow-up care, and likelihood of post-discharge mortality among children under 5 while adjusting for household income, geographical location, mothers’ age, and mothers’ education. The theoretical framework was the social ecological model. Data were generated from the 2018 Demographic and Health Survey. A sample size of N=21,671 was used to determine …