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Counting Every Death When Every Death Counts: A Mixed-Methods Study Of Hurricane Michael Excess Mortality, Blake L. Scott Jun 2023

Counting Every Death When Every Death Counts: A Mixed-Methods Study Of Hurricane Michael Excess Mortality, Blake L. Scott

USF Tampa Graduate Theses and Dissertations

Vulnerable populations have been shown to be disproportionately impacted by natural disasters, such as hurricanes. Hurricane Michael, a Category 5 storm, in October of 2018 hit the rural and socioeconomically vulnerable area of the Florida Panhandle, causing 50 fatalities in Florida, massive destruction to area including the healthcare infrastructure, and led a prolonged recovery period. The purpose of the research was to examine long-term impacts to health in Florida Panhandle after Hurricane Michael; changes to mortality trends, changes to health of survivors, and changes to their access to health care using a mixed-methods, sequential, explanatory study design.

The initial phase …


Reframing Resistance, Resilience, And Racial Equity In Maternal Health: A Mixed Methods Exploration Of Paternal Involvement And The Racial Disparity In Severe Maternal Morbidity, Marshara G. Fross Jun 2023

Reframing Resistance, Resilience, And Racial Equity In Maternal Health: A Mixed Methods Exploration Of Paternal Involvement And The Racial Disparity In Severe Maternal Morbidity, Marshara G. Fross

USF Tampa Graduate Theses and Dissertations

Background: The preventable, persistent racial inequity observed in maternal and infant death has lasting impacts on African American communities and families. Fathers, partners, and co-parents are important supports during the sensitive and vulnerable perinatal period. Emerging research has begun to demonstrate a concerted effort to move beyond the sphere of medicine and quality improvement, towards exploring and integrating social factors into targeted intervention strategies to address racial inequality in health outcomes. However, sparse literature concentrates on understanding the role of fathers and partners in peripartum care and maternal health outcomes. This study aimed to explore, understand, and describe the role …


Prevalence And Burden Of Gastrointestinal Parasites Among University Students At Dar Es Salaam University College Of Education, Tanzania, Magreth Fulgence, Ummul-Khair Mustafa, Jared S. Bakuza Jun 2023

Prevalence And Burden Of Gastrointestinal Parasites Among University Students At Dar Es Salaam University College Of Education, Tanzania, Magreth Fulgence, Ummul-Khair Mustafa, Jared S. Bakuza

Tanzania Journal of Science

Gastrointestinal parasites cause major health problems in many tropical and sub-tropical countries including Tanzania. However, information on the status of these infections is often scanty, especially among young adults including students in higher learning institutions.  During December 2020 to June 2021, a total of 272 faecal samples from university students at Dar es Salaam University College of Education (DUCE) were examined for parasites using the Kato Katz technique and analysed for infection levels based on standard guidelines. Detected parasites were identified as Schistosoma mansoni (8.1%), hookworms (1.5%), Trichuris trichiura (0.4%) and Hymenolepis diminuta (0.4%), with an overall prevalence of 10.4%. …


Dampak Guncangan Kesehatan Terhadap Konsumsi Rumah Tangga Di Indonesia: Adakah Peran Asuransi Kesehatan Dan Kredit Mikro?, Rodhiah Umaroh, Listiono Listiono Jun 2023

Dampak Guncangan Kesehatan Terhadap Konsumsi Rumah Tangga Di Indonesia: Adakah Peran Asuransi Kesehatan Dan Kredit Mikro?, Rodhiah Umaroh, Listiono Listiono

Jurnal Ekonomi Kesehatan Indonesia

This paper aims to analyze the impact of health shock on household consumption and estimate the role of health insurance and microcredit in tackling the shock impact. The primary variable used in this study as a proxy for health shock is the impairment of activity in daily living (ADL) experienced by household heads. The impact evaluation method of Propensity Score Matching (PSM) was employed to estimate the impact of health shock on Indonesian household consumption using data from Indonesian Family Life Survey (IFLS-5). This study's result reveals that health shock significantly reduces household consumption of both food and non-food consumption. …


Sars-Cov-2 Covid-19 Infection During Pregnancy And Differential Dna Methylation In Human Cord Blood Cells From Term Neonates, Pedro Urday, Suhita Gayen Nee' Betal, Rochelle Sequeira Gomes, Huda B. Al-Kouatly, Kolawole Solarin, Joanna S.Y. Chan, Dongmei Li, Irfan Rahman, Sankar Addya, Rupsa C. Boelig, Zubair H. Aghai Jun 2023

Sars-Cov-2 Covid-19 Infection During Pregnancy And Differential Dna Methylation In Human Cord Blood Cells From Term Neonates, Pedro Urday, Suhita Gayen Nee' Betal, Rochelle Sequeira Gomes, Huda B. Al-Kouatly, Kolawole Solarin, Joanna S.Y. Chan, Dongmei Li, Irfan Rahman, Sankar Addya, Rupsa C. Boelig, Zubair H. Aghai

Department of Obstetrics and Gynecology Faculty Papers

Background:

The global pandemic of coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). About 18.4% of total Covid-19 cases were reported in children. Even though vertical transmission from mother to infant is likely to occur at a low rate, exposure to COVID-19 during fetal life may alter DNA methylation patterns with potential long-term effects.

Objective:

To determine if COVID-19 infection during pregnancy alters the DNA methylation patterns in umbilical cord blood cells from term infants and to identify potential pathways and genes affected by exposure to COVID-19 infection.

Methods:

Umbilical cord blood was collected …


Assessment Of Antimicrobial Competence Of Epiphytes And Endophytes From Osmium Basilicum And Trigonella Foenum Graecum, Iram Asim, Atia Iqbal, Muhammad Ikrama Tanveer Jun 2023

Assessment Of Antimicrobial Competence Of Epiphytes And Endophytes From Osmium Basilicum And Trigonella Foenum Graecum, Iram Asim, Atia Iqbal, Muhammad Ikrama Tanveer

Journal of Bioresource Management

Plant-associated bacteria are an unexplored group of microorganisms that has enormous potential. These bacteria are the source of finding new antimicrobial substances. The present study aimed to isolate and characterize the epiphytes and endophytes from Osmium basilicum and Trigonella foenum graecum plants and to determine their antimicrobial potential against pathogenic bacteria from Nishtar Hospital Multan, Pakistan. The sum of 18 stems and roots along leaf specimens were assembled as of the plant's Osmium basilicum plus Trigonella foenum graecum as of the distinct locales of the Multan city. Overall 73 bacterial strains were isolated and their colony morphology, gram staining, spore …


Understanding Influenza Vaccine Hesitancy And Uptake Among U.S. Hispanic Adults During The Covid-19 Pandemic, Helen J. Arteaga Jun 2023

Understanding Influenza Vaccine Hesitancy And Uptake Among U.S. Hispanic Adults During The Covid-19 Pandemic, Helen J. Arteaga

Dissertations and Theses

The health burden caused by seasonal flu is substantial in the general population and each season targeted efforts are needed to decrease the risk of flu illness, hospitalization, and death. Flu risks and the disease burden are disproportionately higher among Hispanic adults, yet little is known about the factors influencing flu vaccine hesitancy and uptake among this marginalized population. This cross-sectional quantitative study used national survey data from the Understanding America Study (UAS) and logistic regression to address three research aims. Aim 1 was to examine the most significant demographic factors associated with flu vaccine uptake among the Hispanic community. …


Transcriptome- And Proteome-Wide Association Studies Nominate Determinants Of Kidney Function And Damage, Pascal Schlosser, Jingning Zhang, Hongbo Liu, Aditya L Surapaneni, Eugene P Rhee, Dan E Arking, Bing Yu, Eric Boerwinkle, Paul A Welling, Nilanjan Chatterjee, Katalin Susztak, Josef Coresh, Morgan E Grams Jun 2023

Transcriptome- And Proteome-Wide Association Studies Nominate Determinants Of Kidney Function And Damage, Pascal Schlosser, Jingning Zhang, Hongbo Liu, Aditya L Surapaneni, Eugene P Rhee, Dan E Arking, Bing Yu, Eric Boerwinkle, Paul A Welling, Nilanjan Chatterjee, Katalin Susztak, Josef Coresh, Morgan E Grams

Faculty, Staff and Student Publications

BACKGROUND: The pathophysiological causes of kidney disease are not fully understood. Here we show that the integration of genome-wide genetic, transcriptomic, and proteomic association studies can nominate causal determinants of kidney function and damage.

RESULTS: Through transcriptome-wide association studies (TWAS) in kidney cortex, kidney tubule, liver, and whole blood and proteome-wide association studies (PWAS) in plasma, we assess for effects of 12,893 genes and 1342 proteins on kidney filtration (glomerular filtration rate (GFR) estimated by creatinine; GFR estimated by cystatin C; and blood urea nitrogen) and kidney damage (albuminuria). We find 1561 associations distributed among 260 genomic regions that are …


Researching Covid To Enhance Recovery (Recover) Adult Study Protocol: Rationale, Objectives, And Design, Leora I Horwitz, Tanayott Thaweethai, Shari B Brosnahan, Mine S Cicek, Megan L Fitzgerald, Jason D Goldman, Rachel Hess, S L Hodder, Vanessa L Jacoby, Michael R Jordan, Jerry A Krishnan, Adeyinka O Laiyemo, Torri D Metz, Lauren Nichols, Rachel E Patzer, Anisha Sekar, Nora G Singer, Lauren E Stiles, Barbara S Taylor, Shifa Ahmed, Heather A Algren, Khamal Anglin, Lisa Aponte-Soto, Hassan Ashktorab, Ingrid V Bassett, Brahmchetna Bedi, Nahid Bhadelia, Christian Bime, Marie-Abele C Bind, Lora J Black, Andra L Blomkalns, Hassan Brim, Mario Castro, James Chan, Alexander W Charney, Benjamin K Chen, Li Qing Chen, Peter Chen, David Chestek, Lori B Chibnik, Dominic C Chow, Helen Y Chu, Rebecca G Clifton, Shelby Collins, Maged M Costantine, Sushma K Cribbs, Steven G Deeks, John D Dickinson, Sarah E Donohue, Matthew S Durstenfeld, Ivette F Emery, Kristine M Erlandson, Julio C Facelli, Rachael Farah-Abraham, Aloke V Finn, Melinda S Fischer, Valerie J Flaherman, Judes Fleurimont, Vivian Fonseca, Emily J Gallagher, Jennifer C Gander, Maria Laura Gennaro, Kelly S Gibson, Minjoung Go, Steven N Goodman, Joey P Granger, Frank L Greenway, John W Hafner, Jenny E Han, Michelle S Harkins, Kristine S P Hauser, James R Heath, Carla R Hernandez, On Ho, Matthew K Hoffman, Susan E Hoover, Carol R Horowitz, Harvey Hsu, Priscilla Y Hsue, Brenna L Hughes, Prasanna Jagannathan, Judith A James, Janice John, Sarah Jolley, S E Judd, Joy J Juskowich, Diane G Kanjilal, Elizabeth W Karlson, Stuart D Katz, J Daniel Kelly, Sara W Kelly, Arthur Y Kim, John P Kirwan, Kenneth S Knox, Andre Kumar, Michelle F Lamendola-Essel, Margaret Lanca, Joyce K Lee-Lannotti, R Craig Lefebvre, Bruce D Levy, Janet Y Lin, Brian P Logarbo, Jennifer K Logue, Michele T Longo, Carlos A Luciano, Karen Lutrick, Shahdi K Malakooti, Gail Mallett, Gabrielle Maranga, Jai G Marathe, Vincent C Marconi, Gailen D Marshall, Christopher F Martin, Jeffrey N Martin, Heidi T May, Grace A Mccomsey, Dylan Mcdonald, Hector Mendez-Figueroa, Lucio Miele, Murray A Mittleman, Sindhu Mohandas, Christian Mouchati, Janet M Mullington, Girish N Nadkarni, Erica R Nahin, Robert B Neuman, Lisa T Newman, Amber Nguyen, Janko Z Nikolich, Igho Ofotokun, Princess U Ogbogu, Anna Palatnik, Kristy T S Palomares, Tanyalak Parimon, Samuel Parry, Sairam Parthasarathy, Thomas F Patterson, Ann Pearman, Michael J Peluso, Priscilla Pemu, Christian M Pettker, Beth A Plunkett, Kristen Pogreba-Brown, Athena Poppas, J Zachary Porterfield, John G Quigley, Davin K Quinn, Hengameh Raissy, Candida J Rebello, Uma M Reddy, Rebecca Reece, Harrison T Reeder, Franz P Rischard, Johana M Rosas, Clifford J Rosen, Nadine G Rouphael, Dwight J Rouse, Adam M Ruff, Christina Saint Jean, Grecio J Sandoval, Jorge L Santana, Shannon M Schlater, Frank C Sciurba, Caitlin Selvaggi, Sudha Seshadri, Howard D Sesso, Dimpy P Shah, Eyal Shemesh, Zaki A Sherif, Daniel J Shinnick, Hyagriv N Simhan, Upinder Singh, Amber Sowles, Vignesh Subbian, Jun Sun, Mehul S Suthar, Larissa J Teunis, John M Thorp, Amberly Ticotsky, Alan T N Tita, Robin Tragus, Katherine R Tuttle, Alfredo E Urdaneta, P J Utz, Timothy M Vanwagoner, Andrew Vasey, Suzanne D Vernon, Crystal Vidal, Tiffany Walker, Honorine D Ward, David E Warren, Ryan M Weeks, Steven J Weiner, Jordan C Weyer, Jennifer L Wheeler, Sidney W Whiteheart, Zanthia Wiley, Natasha J Williams, Juan P Wisnivesky, John C Wood, Lynn M Yee, Natalie M Young, Sokratis N Zisis, Andrea S Foulkes Jun 2023

Researching Covid To Enhance Recovery (Recover) Adult Study Protocol: Rationale, Objectives, And Design, Leora I Horwitz, Tanayott Thaweethai, Shari B Brosnahan, Mine S Cicek, Megan L Fitzgerald, Jason D Goldman, Rachel Hess, S L Hodder, Vanessa L Jacoby, Michael R Jordan, Jerry A Krishnan, Adeyinka O Laiyemo, Torri D Metz, Lauren Nichols, Rachel E Patzer, Anisha Sekar, Nora G Singer, Lauren E Stiles, Barbara S Taylor, Shifa Ahmed, Heather A Algren, Khamal Anglin, Lisa Aponte-Soto, Hassan Ashktorab, Ingrid V Bassett, Brahmchetna Bedi, Nahid Bhadelia, Christian Bime, Marie-Abele C Bind, Lora J Black, Andra L Blomkalns, Hassan Brim, Mario Castro, James Chan, Alexander W Charney, Benjamin K Chen, Li Qing Chen, Peter Chen, David Chestek, Lori B Chibnik, Dominic C Chow, Helen Y Chu, Rebecca G Clifton, Shelby Collins, Maged M Costantine, Sushma K Cribbs, Steven G Deeks, John D Dickinson, Sarah E Donohue, Matthew S Durstenfeld, Ivette F Emery, Kristine M Erlandson, Julio C Facelli, Rachael Farah-Abraham, Aloke V Finn, Melinda S Fischer, Valerie J Flaherman, Judes Fleurimont, Vivian Fonseca, Emily J Gallagher, Jennifer C Gander, Maria Laura Gennaro, Kelly S Gibson, Minjoung Go, Steven N Goodman, Joey P Granger, Frank L Greenway, John W Hafner, Jenny E Han, Michelle S Harkins, Kristine S P Hauser, James R Heath, Carla R Hernandez, On Ho, Matthew K Hoffman, Susan E Hoover, Carol R Horowitz, Harvey Hsu, Priscilla Y Hsue, Brenna L Hughes, Prasanna Jagannathan, Judith A James, Janice John, Sarah Jolley, S E Judd, Joy J Juskowich, Diane G Kanjilal, Elizabeth W Karlson, Stuart D Katz, J Daniel Kelly, Sara W Kelly, Arthur Y Kim, John P Kirwan, Kenneth S Knox, Andre Kumar, Michelle F Lamendola-Essel, Margaret Lanca, Joyce K Lee-Lannotti, R Craig Lefebvre, Bruce D Levy, Janet Y Lin, Brian P Logarbo, Jennifer K Logue, Michele T Longo, Carlos A Luciano, Karen Lutrick, Shahdi K Malakooti, Gail Mallett, Gabrielle Maranga, Jai G Marathe, Vincent C Marconi, Gailen D Marshall, Christopher F Martin, Jeffrey N Martin, Heidi T May, Grace A Mccomsey, Dylan Mcdonald, Hector Mendez-Figueroa, Lucio Miele, Murray A Mittleman, Sindhu Mohandas, Christian Mouchati, Janet M Mullington, Girish N Nadkarni, Erica R Nahin, Robert B Neuman, Lisa T Newman, Amber Nguyen, Janko Z Nikolich, Igho Ofotokun, Princess U Ogbogu, Anna Palatnik, Kristy T S Palomares, Tanyalak Parimon, Samuel Parry, Sairam Parthasarathy, Thomas F Patterson, Ann Pearman, Michael J Peluso, Priscilla Pemu, Christian M Pettker, Beth A Plunkett, Kristen Pogreba-Brown, Athena Poppas, J Zachary Porterfield, John G Quigley, Davin K Quinn, Hengameh Raissy, Candida J Rebello, Uma M Reddy, Rebecca Reece, Harrison T Reeder, Franz P Rischard, Johana M Rosas, Clifford J Rosen, Nadine G Rouphael, Dwight J Rouse, Adam M Ruff, Christina Saint Jean, Grecio J Sandoval, Jorge L Santana, Shannon M Schlater, Frank C Sciurba, Caitlin Selvaggi, Sudha Seshadri, Howard D Sesso, Dimpy P Shah, Eyal Shemesh, Zaki A Sherif, Daniel J Shinnick, Hyagriv N Simhan, Upinder Singh, Amber Sowles, Vignesh Subbian, Jun Sun, Mehul S Suthar, Larissa J Teunis, John M Thorp, Amberly Ticotsky, Alan T N Tita, Robin Tragus, Katherine R Tuttle, Alfredo E Urdaneta, P J Utz, Timothy M Vanwagoner, Andrew Vasey, Suzanne D Vernon, Crystal Vidal, Tiffany Walker, Honorine D Ward, David E Warren, Ryan M Weeks, Steven J Weiner, Jordan C Weyer, Jennifer L Wheeler, Sidney W Whiteheart, Zanthia Wiley, Natasha J Williams, Juan P Wisnivesky, John C Wood, Lynn M Yee, Natalie M Young, Sokratis N Zisis, Andrea S Foulkes

Faculty, Staff and Student Publications

IMPORTANCE: SARS-CoV-2 infection can result in ongoing, relapsing, or new symptoms or other health effects after the acute phase of infection; termed post-acute sequelae of SARS-CoV-2 infection (PASC), or long COVID. The characteristics, prevalence, trajectory and mechanisms of PASC are ill-defined. The objectives of the Researching COVID to Enhance Recovery (RECOVER) Multi-site Observational Study of PASC in Adults (RECOVER-Adult) are to: (1) characterize PASC prevalence; (2) characterize the symptoms, organ dysfunction, natural history, and distinct phenotypes of PASC; (3) identify demographic, social and clinical risk factors for PASC onset and recovery; and (4) define the biological mechanisms underlying PASC pathogenesis. …


Researching Covid To Enhance Recovery (Recover) Adult Study Protocol: Rationale, Objectives, And Design, Leora I. Horwitz, Tanayott Thaweethai, Shari B. Brosnahan, Mine S. Cicek, Megan L. Fitzgerald, Jason D. Goldman, Rachel Hess, S. L. Hodder, Vanessa L. Jacoby, Michael R. Jordan, Jerry A. Krishnan, Adeyinka O. Laiyemo, Torri D. Metz, Lauren Nichols, Rachel E. Patzer, Anisha Sekar, Nora G. Singer, Lauren E. Stiles, Barbara S. Taylor, Shifa Ahmed, Heather A. Algren, Khamal Anglin, Lisa Aponte-Soto, Hassan Ashktorab, Ingrid V. Bassett, Brahmchetna Bedi, Nahid Bhadelia Jun 2023

Researching Covid To Enhance Recovery (Recover) Adult Study Protocol: Rationale, Objectives, And Design, Leora I. Horwitz, Tanayott Thaweethai, Shari B. Brosnahan, Mine S. Cicek, Megan L. Fitzgerald, Jason D. Goldman, Rachel Hess, S. L. Hodder, Vanessa L. Jacoby, Michael R. Jordan, Jerry A. Krishnan, Adeyinka O. Laiyemo, Torri D. Metz, Lauren Nichols, Rachel E. Patzer, Anisha Sekar, Nora G. Singer, Lauren E. Stiles, Barbara S. Taylor, Shifa Ahmed, Heather A. Algren, Khamal Anglin, Lisa Aponte-Soto, Hassan Ashktorab, Ingrid V. Bassett, Brahmchetna Bedi, Nahid Bhadelia

School of Medicine Faculty Publications

Importance SARS-CoV-2 infection can result in ongoing, relapsing, or new symptoms or other health effects after the acute phase of infection; termed post-acute sequelae of SARS-CoV-2 infection (PASC), or long COVID. The characteristics, prevalence, trajectory and mechanisms of PASC are ill-defined. The objectives of the Researching COVID to Enhance Recovery (RECOVER) Multi-site Observational Study of PASC in Adults (RECOVER-Adult) are to: (1) characterize PASC prevalence; (2) characterize the symptoms, organ dysfunction, natural history, and distinct phenotypes of PASC; (3) identify demographic, social and clinical risk factors for PASC onset and recovery; and (4) define the biological mechanisms underlying PASC pathogenesis. …


Prevalence Of Overweight And Obesity Among Secondary School Students In Gaza Strip- Palestine, Abd Elkareem Abd Raboh El-Majdalawi, Yousef Aljeesh, Bothina Bassyonie Etewa Jun 2023

Prevalence Of Overweight And Obesity Among Secondary School Students In Gaza Strip- Palestine, Abd Elkareem Abd Raboh El-Majdalawi, Yousef Aljeesh, Bothina Bassyonie Etewa

Journal of the Arab American University مجلة الجامعة العربية الامريكية للبحوث

Background

Childhood obesity is one of the most serious public health challenges of the 21st century. The effects of childhood overweight and obesity are devastating to the health and well-being of children now and throughout adulthood. The overweight and obese children are likely to stay obese into adulthood and more likely to develop non-communicable diseases (NCDs) like diabetes, cardiovascular diseases and cancer at a younger age.

Study Aim: The aim of the study is investigating the problem of overweight/obesity among secondary school students in Gaza Strip, Palestine.

Study design: The design of this study was cross-sectional, descriptive, analytical, …


Differential Levels Of Nutrients And Heavy Metals In Tilapia Collected From Drains In Egypt, Emily Burch Jun 2023

Differential Levels Of Nutrients And Heavy Metals In Tilapia Collected From Drains In Egypt, Emily Burch

Theses and Dissertations

Tilapia is one of the most widely cultivated and consumed fish globally. In terms of human health, tilapia is an excellent source of protein, polyunsaturated fatty acids, and micronutrients. Tilapia and other aquatic species have become increasingly susceptible to contamination, as anthropogenic activities have been increasing around the world. Anthropogenetic activities often introduce high levels of contaminants, including heavy metals, into the marine environment. These contaminants often do not biodegrade, and they are absorbed by aquatic species. Contaminants can bioaccumulate and proceed in biomagnification up the fish food chain putting consumers at an increased risk of exposure. Heavy metals can …


Blm Overexpression As A Predictive Biomarker For Chk1 Inhibitor Response In Parp Inhibitor-Resistant Brca-Mutant Ovarian Cancer, Nitasha Gupta, Tzu-Ting Huang, Jayakumar R Nair, Daniel An, Grant Zurcher, Erika J Lampert, Ann Mccoy, Ashley Cimino-Mathews, Elizabeth M Swisher, Marc R Radke, Christina M Lockwood, Jonathan B Reichel, Chih-Yuan Chiang, Kelli M Wilson, Ken Chih-Chien Cheng, Darryl Nousome, Jung-Min Lee Jun 2023

Blm Overexpression As A Predictive Biomarker For Chk1 Inhibitor Response In Parp Inhibitor-Resistant Brca-Mutant Ovarian Cancer, Nitasha Gupta, Tzu-Ting Huang, Jayakumar R Nair, Daniel An, Grant Zurcher, Erika J Lampert, Ann Mccoy, Ashley Cimino-Mathews, Elizabeth M Swisher, Marc R Radke, Christina M Lockwood, Jonathan B Reichel, Chih-Yuan Chiang, Kelli M Wilson, Ken Chih-Chien Cheng, Darryl Nousome, Jung-Min Lee

Faculty, Staff and Student Publications

Poly(ADP-ribose) polymerase inhibitors (PARPis) have changed the treatment paradigm in breast cancer gene (BRCA)–mutant high-grade serous ovarian carcinoma (HGSC). However, most patients eventually develop resistance to PARPis, highlighting an unmet need for improved therapeutic strategies. Using high-throughput drug screens, we identified ataxia telangiectasia and rad3-related protein/checkpoint kinase 1 (CHK1) pathway inhibitors as cytotoxic and further validated the activity of the CHK1 inhibitor (CHK1i) prexasertib in PARPi-sensitive and -resistant BRCA-mutant HGSC cells and xenograft mouse models. CHK1i monotherapy induced DNA damage, apoptosis, and tumor size reduction. We then conducted a phase 2 study (NCT02203513) of prexasertib …


Development Of A Ddpcr Multiplex To Measure The Immune Response To Borrelia Burgdorferi., Kailey Marie Mccain Jun 2023

Development Of A Ddpcr Multiplex To Measure The Immune Response To Borrelia Burgdorferi., Kailey Marie Mccain

USF Tampa Graduate Theses and Dissertations

Zoonotic diseases account for a significant proportion of emerging infectious diseases (EIDs), with their dynamics being heavily influenced by the environment. While the effects of the environment on population-level disease dynamics have been extensively studied, there is limited research investigating the impact of the environment on individual-level disease susceptibility and transmission. This study aims to fill this gap by creating a tool to examine the variation in immune response to Borrelia burgdorferi, the causative agent of Lyme Disease, in two competent host species, Peromyscus leucopus and Peromyscus maniculatus. Two triplex droplet digital polymerase chain reaction (ddPCR) assays were developed to …


Blue-Mindfulness Training: A Story Of Restorative Justice Decolonizing And Re-Indigenizing Communal Relationships With Water, Thaddeus Gamory, Miriam Lynch Ph.D., A. Udaya Thomas, Angela K. Beale-Tawfeeq Ph.D., Mph Jun 2023

Blue-Mindfulness Training: A Story Of Restorative Justice Decolonizing And Re-Indigenizing Communal Relationships With Water, Thaddeus Gamory, Miriam Lynch Ph.D., A. Udaya Thomas, Angela K. Beale-Tawfeeq Ph.D., Mph

International Journal of Aquatic Research and Education

This article aims to introduce and describe the development of the concept of Blue-Mindfulness TrainingTM, which was created and designed by Thaddeus Gamory and supported by research and the experience of other experts in the field. Drawing from the author’s and others' practical experience, the authors present a "Voice from the Field" perspective on creating and developing the Blue-MindfulnessTM . This Instructional Framework, coined by Mr. Thaddeus Gamory Blue-MindfulnessTM, addresses the impacts of historical racial discrimination and trauma in BIPOC communities, specifically on marginalized African American communities while promoting a communal and safe relationship with …


Global Health Governance And Its Role In Health Equity: The Case Of Covid-19, Wafa Abu El Kheir-Mataria Jun 2023

Global Health Governance And Its Role In Health Equity: The Case Of Covid-19, Wafa Abu El Kheir-Mataria

Theses and Dissertations

In the globalized world, we are living in, health became the joint responsibility of individuals, their governments, and the global health governance system. Moreover, based on the right to health, health equity is increasingly in demand, and adopting it to a global level has become an even more complex task to realize. This thesis is focuses on health equity at a global level. The main research questions addressed are: Is health equity present at an intercountry /global level? how is it related to Global Health Governance (GHG)? Is GHG performing well in achieving health equity? what are the reasons behind …


Let Kids Sleep: The Role Of Interdisciplinary Neuroscience Outreach In Stimulating Brains And Developing Research-Informed Approaches To Community Concerns, Marc Chenard Jun 2023

Let Kids Sleep: The Role Of Interdisciplinary Neuroscience Outreach In Stimulating Brains And Developing Research-Informed Approaches To Community Concerns, Marc Chenard

University Honors Theses

Northwest Noggin (NW Noggin), an all-volunteer neuroscience education outreach non-profit, serves its community by bringing students, artists, scientists and other participants together for artistic collaboration and learning. The outreach takes place in K-12 schools and other institutions (such as museums, coffee shops and correctional facilities) all over the Pacific Northwest. Neuroscience education outreach generates discourse surrounding community concerns through illuminating the brain-centric qualities of issues and by drawing on neuroscience research to create solutions. The neuroscience research-informed perspectives on these concerns stimulate awareness, create momentum towards evidence-based reform, and can result in policy interventions. This thesis details how NW Noggin …


The Impact Of Period Poverty On Low-Income Adolescents In The United States, Makayla Olson Jun 2023

The Impact Of Period Poverty On Low-Income Adolescents In The United States, Makayla Olson

University Honors Theses

Period poverty is an issue that impacts menstruators globally. This creates a significant health disparity for menstruators, including difficulties accessing menstrual products, inadequate menstrual and puberty health education, and shame and stigma that come from societal misunderstandings and misinformation regarding menstruation. This paper examines the effects of period poverty on low-income adolescents in the United States. It looks at the current literature that addresses how the financial and accessibility barriers that cause period poverty, as well as how these causes impact school-aged menstruators. It aims to address the role that schools play in creating safe environments for menstruators, including staff …


An Analysis Of State Sex Education Policies To Explore The Inclusiveness Of School Based Sex Education, Amarah Scott Jun 2023

An Analysis Of State Sex Education Policies To Explore The Inclusiveness Of School Based Sex Education, Amarah Scott

USF Tampa Graduate Theses and Dissertations

The purpose of this study was to analyze state policies related to sex education proposed between 2018 and 2022 to determine the extent to which sex education needs of LGBTQ youth were being addressed. Previous research has shown that, on average, both abstinence-only and comprehensive sex education curricula do not include information that is relevant to LGBTQ youth. Much of the information included in sex education curricula such as pregnancy prevention and the benefits and disadvantages of condoms are most relevant to youth who identify as heterosexual. Not receiving relevant and accurate sex education puts LGBTQ youth at risk for …


The Evolution Of Leadership During The Covid-19 Pandemic: An Analysis Of The Research, Luca Patrick Thierry Gregston Jun 2023

The Evolution Of Leadership During The Covid-19 Pandemic: An Analysis Of The Research, Luca Patrick Thierry Gregston

University Honors Theses

This paper's research question, "How has the COVID-19 pandemic changed the concept and practice of leadership? In the end much of the empirical evidence for what COVID-19 did or didn't change in leadership practices is still relatively ambiguous. So it is too early to say that "business as usual" is gone for good. And COVID furthered and deepened long term trends, accelerating the great resignation and a dramatic revaluation of intangible assets like reputation, intellectual property and human capital. In response, there is a clear need for a new leadership mindset for the 21st century after the COVID pandemic.


Predicting Chemotherapy Benefit Across Different Races In Early-Stage Breast Cancer Patients Using The Oncotype Dx Score, Vikram R Shaw, Christopher I Amos, Chao Cheng Jun 2023

Predicting Chemotherapy Benefit Across Different Races In Early-Stage Breast Cancer Patients Using The Oncotype Dx Score, Vikram R Shaw, Christopher I Amos, Chao Cheng

Faculty, Staff and Students Publications

Background: Oncotype DX assay, a multigene molecular test, has been widely used to stratify relapse risk and guide chemotherapy treatment in breast cancer. However, the optimal threshold of the Oncotype DX score in predicting chemotherapy benefit and its racial variation has not been investigated.

Methods: In this study, we apply a random forest survival model to the SEER-Oncotype cohort data (Surveillance, Epidemiology, and End Results with Oncotype DX test information for breast cancer patients) and determine chemotherapy benefit thresholds in early-stage, estrogen-receptor-positive (ER+), and HER2-negative (HER2-) patients of different races.

Results: Our results indicate that early-stage ER+, HER2-, and LN-/LN+ …


Tonb-Dependent Receptor Protein Displayed On Spores Of Bacillus Subtilis Stimulates Protective Immune Responses Against Acinetobacter Baumannii, Nor-Aziyah Matrahim, Kathryn Marie Jones, Brian P Keegan, Ulrich Strych, Bin Zhan, Hai-Yen Lee, Sazaly Abubakar Jun 2023

Tonb-Dependent Receptor Protein Displayed On Spores Of Bacillus Subtilis Stimulates Protective Immune Responses Against Acinetobacter Baumannii, Nor-Aziyah Matrahim, Kathryn Marie Jones, Brian P Keegan, Ulrich Strych, Bin Zhan, Hai-Yen Lee, Sazaly Abubakar

Faculty, Staff and Students Publications

The emergence of antibiotic-resistant Acinetobacter baumannii strains with limited treatment options has become a significant global health concern. Efforts to develop vaccines against the bacteria have centred on several potential protein targets, including the TonB-dependent receptors (TBDRs). In the present study, TBDRs from A. baumannii were displayed on the surface of Bacillus subtilis spores. The immunogenicity of the recombinant spores was evaluated in orally vaccinated mice. None of the immunized mice demonstrated signs of illness and were observed to be healthy throughout the study. Sera and the intestinal secretions from the recombinant spores-treated mice demonstrated mucosal and humoral antibody responses …


Final (Year 2) Report To Oha On Sogi Demographic Standards For Minors, Martin Arrigotti, Nell Carpenter, Kieran Chase, Alysia Cox, Itai Jeffries, Alexis Dinno Jun 2023

Final (Year 2) Report To Oha On Sogi Demographic Standards For Minors, Martin Arrigotti, Nell Carpenter, Kieran Chase, Alysia Cox, Itai Jeffries, Alexis Dinno

OHSU-PSU School of Public Health Faculty Publications and Presentations

Executive Summary

The report synthesizes thoughtful recommendations of the authors to the Oregon Health Authority (OHA) about routine data collection of SOGI† (sex, sexual orientation, and gender) demographic data in minors for clinical and reporting purposes. We see five primary motivations to routinely collect SOGI data, including to:

  1. create an inclusive practice in order to welcome and make space for people from historically excluded genders, sexes, and sexual orientations,
  2. promote health equity between minority and majority SOGI identities,
  3. direct group-specific services towards those who need them,
  4. represent the actual diversity of Oregon, and its communities, and
  5. shift normative expectations about …


Assessing The Correlation Between The Socioeconomic Level And Cognitive Function Among Older Adults In Egypt, Macy Abougabal Jun 2023

Assessing The Correlation Between The Socioeconomic Level And Cognitive Function Among Older Adults In Egypt, Macy Abougabal

Theses and Dissertations

The number of older adults is increasing worldwide at an unprecedented rate. Some countries began to understand the challenges of aging, while others are still at the stage of comprehending the true dimensions of the situation. There is a global focus on aging research to appropriately mitigate the negative impact of aging and cognitive decline. Not only that dementia add economic pressure on governments, it also increase the psychological and physical burden of the caregivers. Scholars have previously studied socioeconomic level in three variables, namely work, education, and income, and their relationship with cognitive function. It was concluded that the …


Colocalization Of Linezolid Resistance (Cfr) And Virulence Factors Cytolysin And Hemolysin (Cln And Hln) On A Plasmid In Enterococcus Faecalis, Nikita V Singh, Kavindra V Singh, An Q Dinh, Cesar A Arias, William C Shropshire, Blake M Hanson, Barbara E Murray Jun 2023

Colocalization Of Linezolid Resistance (Cfr) And Virulence Factors Cytolysin And Hemolysin (Cln And Hln) On A Plasmid In Enterococcus Faecalis, Nikita V Singh, Kavindra V Singh, An Q Dinh, Cesar A Arias, William C Shropshire, Blake M Hanson, Barbara E Murray

Faculty, Staff and Student Publications

No abstract provided.


Variability Of Air Sampling Results Using Air-O-Cell Cassettes, Christina M. Haworth Jun 2023

Variability Of Air Sampling Results Using Air-O-Cell Cassettes, Christina M. Haworth

USF Tampa Graduate Theses and Dissertations

No current federal or state standards for mold exposure exist, partly due to the lack of accurate methods for assessing fungal exposure. Exposure to airborne fungal spores can result in several symptoms such as allergic rhinitis, coughing, and fatigue. Non-industrial occupational settings are common and fungal exposures may occur in these environments. The purpose of this study is to evaluate the meaningfulness of fungal spore trap results from samples collected in both a corporate office and a university classroom. Air-O-Cell cassettes with a Zefon Bio-Pump were used to collect one outdoor and three indoor samples at each location on three …


Understanding Mental Health As Public Health, Christi M. Navarro Jun 2023

Understanding Mental Health As Public Health, Christi M. Navarro

Faculty Proceedings, Presentations, Speeches and Lectures

In this interactive workshop, we will utilize a multi-level public health framework to illustrate factors of risk and prevention that influence mental health and well-being. We will discuss shifting the narrative of mental health as an individual issue to the responsibility of society, culture, and environment. Participants will reflect on their role and level of influence in this model as well as their potential for action and positive impact.


Microbiome Alteration Via Fecal Microbiota Transplantation Is Effective For Refractory Immune Checkpoint Inhibitor-Induced Colitis, Taylor M Halsey, Anusha S Thomas, Tomo Hayase, Weijie Ma, Hamzah Abu-Sbeih, Baohua Sun, Edwin Roger Parra, Zhi-Dong Jiang, Herbert L Dupont, Christopher Sanchez, Rawan El-Himri, Alexandria Brown, Ivonne Flores, Lauren Mcdaniel, Miriam Ortega Turrubiates, Matthew Hensel, Dung Pham, Stephanie S Watowich, Eiko Hayase, Chia-Chi Chang, Robert R Jenq, Yinghong Wang Jun 2023

Microbiome Alteration Via Fecal Microbiota Transplantation Is Effective For Refractory Immune Checkpoint Inhibitor-Induced Colitis, Taylor M Halsey, Anusha S Thomas, Tomo Hayase, Weijie Ma, Hamzah Abu-Sbeih, Baohua Sun, Edwin Roger Parra, Zhi-Dong Jiang, Herbert L Dupont, Christopher Sanchez, Rawan El-Himri, Alexandria Brown, Ivonne Flores, Lauren Mcdaniel, Miriam Ortega Turrubiates, Matthew Hensel, Dung Pham, Stephanie S Watowich, Eiko Hayase, Chia-Chi Chang, Robert R Jenq, Yinghong Wang

Faculty, Staff and Student Publications

Immune checkpoint inhibitors (ICIs) target advanced malignancies with high efficacy but also predispose patients to immune-related adverse events like immune-mediated colitis (IMC). Given the association between gut bacteria with response to ICI therapy and subsequent IMC, fecal microbiota transplantation (FMT) represents a feasible way to manipulate microbial composition in patients, with a potential benefit for IMC. Here, we present a large case series of 12 patients with refractory IMC who underwent FMT from healthy donors as salvage therapy. All 12 patients had grade 3 or 4 ICI-related diarrhea or colitis that failed to respond to standard first-line (corticosteroids) and second-line …


Disparities In Violent Fatal Injury Among Racial And Ethnic Minorities, 2009–2019: A Portfolio Analysis Of United States—National Institutes Of Health, Maria-Isabel Roldós, Tilda Farhat, Marcia M. Gómez Jun 2023

Disparities In Violent Fatal Injury Among Racial And Ethnic Minorities, 2009–2019: A Portfolio Analysis Of United States—National Institutes Of Health, Maria-Isabel Roldós, Tilda Farhat, Marcia M. Gómez

Publications and Research

The excess mortality burden due to violent fatal injuries is an urgent public health issue for adolescents and young adults, especially those from racial and ethnic minority populations. We examined the research portfolio of the United States National Institutes of Health (NIH) related to violent fatal injuries between 2009 and 2019 to focus on adolescents and young adults from NIH-designated populations experiencing health disparities and to identify trends and research gaps. We analyzed funded projects by populations covered, geographic location of the study population, type of research (etiology, intervention, methodology), type of determinants, and publications generated. In 10 years, NIH …


Development Of A Definition Of Postacute Sequelae Of Sars-Cov-2 Infection, Tanayott Thaweethai, Sarah E Jolley, Elizabeth W Karlson, Emily B Levitan, Bruce Levy, Grace A Mccomsey, Lisa Mccorkell, Girish N Nadkarni, Sairam Parthasarathy, Upinder Singh, Tiffany A Walker, Caitlin A Selvaggi, Daniel J Shinnick, Carolin C M Schulte, Rachel Atchley-Challenner, George A Alba, Radica Alicic, Natasha Altman, Khamal Anglin, Urania Argueta, Hassan Ashktorab, Gaston Baslet, Ingrid V Bassett, Lucinda Bateman, Brahmchetna Bedi, Shamik Bhattacharyya, Marie-Abele Bind, Andra L Blomkalns, Hector Bonilla, Hassan Brim, Patricia A Bush, Mario Castro, James Chan, Alexander W Charney, Peter Chen, Lori B Chibnik, Helen Y Chu, Rebecca G Clifton, Maged M Costantine, Sushma K Cribbs, Sylvia I Davila Nieves, Steven G Deeks, Alexandria Duven, Ivette F Emery, Nathan Erdmann, Kristine M Erlandson, Kacey C Ernst, Rachael Farah-Abraham, Cheryl E Farner, Elen M Feuerriegel, Judes Fleurimont, Vivian Fonseca, Nicholas Franko, Vivian Gainer, Jennifer C Gander, Edward M Gardner, Linda N Geng, Kelly S Gibson, Minjoung Go, Jason D Goldman, Halle Grebe, Frank L Greenway, Mounira Habli, John Hafner, Jenny E Han, Keith A Hanson, James Heath, Carla Hernandez, Rachel Hess, Sally L Hodder, Matthew K Hoffman, Susan E Hoover, Beatrice Huang, Brenna L Hughes, Prasanna Jagannathan, Janice John, Michael R Jordan, Stuart D Katz, Elizabeth S Kaufman, John D Kelly, Sara W Kelly, Megan M Kemp, John P Kirwan, Jonathan D Klein, Kenneth S Knox, Jerry A Krishnan, Andre Kumar, Adeyinka O Laiyemo, Allison A Lambert, Margaret Lanca, Joyce K Lee-Iannotti, Brian P Logarbo, Michele T Longo, Carlos A Luciano, Karen Lutrick, Jason H Maley, Gail Mallett, Jai G Marathe, Vincent Marconi, Gailen D Marshall, Christopher F Martin, Yuri Matusov, Alem Mehari, Hector Mendez-Figueroa, Robin Mermelstein, Torri D Metz, Richard Morse, Jarrod Mosier, Christian Mouchati, Janet Mullington, Shawn N Murphy, Robert B Neuman, Janko Z Nikolich, Ighovwerha Ofotokun, Elizabeth Ojemakinde, Anna Palatnik, Kristy Palomares, Tanyalak Parimon, Samuel Parry, Jan E Patterson, Thomas F Patterson, Rachel E Patzer, Michael J Peluso, Priscilla Pemu, Christian M Pettker, Beth A Plunkett, Kristen Pogreba-Brown, Athena Poppas, John G Quigley, Uma Reddy, Rebecca Reece, Harrison Reeder, W B Reeves, Eric M Reiman, Franz Rischard, Jonathan Rosand, Dwight J Rouse, Adam Ruff, George Saade, Grecio J Sandoval, Jorge L Santana, Shannon M Schlater, Frank C Sciurba, Fitzgerald Shepherd, Zaki A Sherif, Hyagriv Simhan, Nora G Singer, Daniel W Skupski, Amber Sowles, Jeffrey A Sparks, Fatima I Sukhera, Barbara S Taylor, Larissa Teunis, Robert J Thomas, John M Thorp, Paul Thuluvath, Amberly Ticotsky, Alan T Tita, Katherine R Tuttle, Alfredo E Urdaneta, Daisy Valdivieso, Timothy M Vanwagoner, Andrew Vasey, Monica Verduzco-Gutierrez, Zachary S Wallace, Honorine D Ward, David E Warren, Steven J Weiner, Shelley Welch, Sidney W Whiteheart, Zanthia Wiley, Juan P Wisnivesky, Lynn M Yee, Sokratis Zisis, Leora I Horwitz, Andrea S Foulkes Jun 2023

Development Of A Definition Of Postacute Sequelae Of Sars-Cov-2 Infection, Tanayott Thaweethai, Sarah E Jolley, Elizabeth W Karlson, Emily B Levitan, Bruce Levy, Grace A Mccomsey, Lisa Mccorkell, Girish N Nadkarni, Sairam Parthasarathy, Upinder Singh, Tiffany A Walker, Caitlin A Selvaggi, Daniel J Shinnick, Carolin C M Schulte, Rachel Atchley-Challenner, George A Alba, Radica Alicic, Natasha Altman, Khamal Anglin, Urania Argueta, Hassan Ashktorab, Gaston Baslet, Ingrid V Bassett, Lucinda Bateman, Brahmchetna Bedi, Shamik Bhattacharyya, Marie-Abele Bind, Andra L Blomkalns, Hector Bonilla, Hassan Brim, Patricia A Bush, Mario Castro, James Chan, Alexander W Charney, Peter Chen, Lori B Chibnik, Helen Y Chu, Rebecca G Clifton, Maged M Costantine, Sushma K Cribbs, Sylvia I Davila Nieves, Steven G Deeks, Alexandria Duven, Ivette F Emery, Nathan Erdmann, Kristine M Erlandson, Kacey C Ernst, Rachael Farah-Abraham, Cheryl E Farner, Elen M Feuerriegel, Judes Fleurimont, Vivian Fonseca, Nicholas Franko, Vivian Gainer, Jennifer C Gander, Edward M Gardner, Linda N Geng, Kelly S Gibson, Minjoung Go, Jason D Goldman, Halle Grebe, Frank L Greenway, Mounira Habli, John Hafner, Jenny E Han, Keith A Hanson, James Heath, Carla Hernandez, Rachel Hess, Sally L Hodder, Matthew K Hoffman, Susan E Hoover, Beatrice Huang, Brenna L Hughes, Prasanna Jagannathan, Janice John, Michael R Jordan, Stuart D Katz, Elizabeth S Kaufman, John D Kelly, Sara W Kelly, Megan M Kemp, John P Kirwan, Jonathan D Klein, Kenneth S Knox, Jerry A Krishnan, Andre Kumar, Adeyinka O Laiyemo, Allison A Lambert, Margaret Lanca, Joyce K Lee-Iannotti, Brian P Logarbo, Michele T Longo, Carlos A Luciano, Karen Lutrick, Jason H Maley, Gail Mallett, Jai G Marathe, Vincent Marconi, Gailen D Marshall, Christopher F Martin, Yuri Matusov, Alem Mehari, Hector Mendez-Figueroa, Robin Mermelstein, Torri D Metz, Richard Morse, Jarrod Mosier, Christian Mouchati, Janet Mullington, Shawn N Murphy, Robert B Neuman, Janko Z Nikolich, Ighovwerha Ofotokun, Elizabeth Ojemakinde, Anna Palatnik, Kristy Palomares, Tanyalak Parimon, Samuel Parry, Jan E Patterson, Thomas F Patterson, Rachel E Patzer, Michael J Peluso, Priscilla Pemu, Christian M Pettker, Beth A Plunkett, Kristen Pogreba-Brown, Athena Poppas, John G Quigley, Uma Reddy, Rebecca Reece, Harrison Reeder, W B Reeves, Eric M Reiman, Franz Rischard, Jonathan Rosand, Dwight J Rouse, Adam Ruff, George Saade, Grecio J Sandoval, Jorge L Santana, Shannon M Schlater, Frank C Sciurba, Fitzgerald Shepherd, Zaki A Sherif, Hyagriv Simhan, Nora G Singer, Daniel W Skupski, Amber Sowles, Jeffrey A Sparks, Fatima I Sukhera, Barbara S Taylor, Larissa Teunis, Robert J Thomas, John M Thorp, Paul Thuluvath, Amberly Ticotsky, Alan T Tita, Katherine R Tuttle, Alfredo E Urdaneta, Daisy Valdivieso, Timothy M Vanwagoner, Andrew Vasey, Monica Verduzco-Gutierrez, Zachary S Wallace, Honorine D Ward, David E Warren, Steven J Weiner, Shelley Welch, Sidney W Whiteheart, Zanthia Wiley, Juan P Wisnivesky, Lynn M Yee, Sokratis Zisis, Leora I Horwitz, Andrea S Foulkes

Faculty, Staff and Student Publications

IMPORTANCE: SARS-CoV-2 infection is associated with persistent, relapsing, or new symptoms or other health effects occurring after acute infection, termed postacute sequelae of SARS-CoV-2 infection (PASC), also known as long COVID. Characterizing PASC requires analysis of prospectively and uniformly collected data from diverse uninfected and infected individuals.

OBJECTIVE: To develop a definition of PASC using self-reported symptoms and describe PASC frequencies across cohorts, vaccination status, and number of infections.

DESIGN, SETTING, AND PARTICIPANTS: Prospective observational cohort study of adults with and without SARS-CoV-2 infection at 85 enrolling sites (hospitals, health centers, community organizations) located in 33 states plus Washington, DC, …