Digital Commons Network^™

Fostering A High-Functioning Team In Cancer Care Using The 4r Oncology Model: Assessment In A Large Health System And A Blueprint For Other Institutions, Raymond Liu, Christine B Weldon, Elizabeth Linehan, Nancy Gordon, Thea Abbe, Marti Hennings, Henie James, Jed Katzel, Chun Ng, Megumi Tomita, Jeffrey B Velotta, Stephanie Ossowski, Lori C Sakoda, Sharon Likely Sprague, Anna Dowling, Kimberly Beringer, Arliene Ravelo, Elaine Yu, Julia R Trosman

Faculty, Staff and Student Publications

PURPOSE: Delivering cancer care by high-functioning multidisciplinary teams promises to address care fragmentation, which threatens care quality, affects patient outcomes, and strains the oncology workforce. We assessed whether the 4R Oncology model for team-based interdependent care delivery and patient self-management affected team functioning in a large community-based health system.

METHODS: 4R was deployed at four locations in breast and lung cancers and assessed along four characteristics of high-functioning teams: recognition as a team internally and externally; commitment to an explicit shared goal; enablement of interdependent work to achieve the goal; and engagement in regular reflection to adapt objectives and processes. …

A Case Of Successful Treatment Of Recurrent Urinary Tract Infection By Extended-Spectrum Β-Lactamase Producing Klebsiella Pneumoniae Using Oral Lyophilized Fecal Microbiota Transplant, Naomi Bier, Blake Hanson, Zhi-Dong Jiang, Herbert L Dupont, Cesar A Arias, William R Miller

Faculty, Staff and Student Publications

Recurrent urinary tract infections (UTIs) are a challenging clinical entity that can be frustrating for patient and physician alike. Repeated rounds of antibiotics can select for multidrug-resistant organisms, further complicating care. We describe the successful use of fecal microbiota transplantation (FMT) for the treatment of recurrent extended-spectrum β-lactamase (ESBL)-producing Klebsiella pneumoniae UTIs in a patient with an ileal conduit and urostomy. In the 18 months after FMT, the patient had not experienced new infections with ESBL-producing organisms. The urine and stool microbiomes of the patient were tracked before and post-FMT using 16s RNA sequencing with measurement of α-diversity. Sequencing of …

Development And Validation Of Early Death Risk Score Model For Emergency Status Prediction In Very Severe Aplastic Anemia, Xu Liu, Wenrui Yang, Li Zhang, Liping Jing, Lei Ye, Kang Zhou, Yuan Li, Jianping Li, Huihui Fan, Yang Yang, Youzhen Xiong, Xin Zhao, Fengkui Zhang

Faculty, Staff and Student Publications

This study developed and validated the Early Death Risk Score Model for early identification of emergency patients with very severe aplastic anemia (VSAA). All 377 patients with VSAA receiving first-line immunosuppressive therapy (IST) were categorized into training (n=252) and validation (n=125) cohorts. In the training cohort, age >24 years, absolute neutrophil count ≤0.015×109/L, serum ferritin >900ng/mL and times of fever before IST >1 time were significantly associated with early death. Covariates were assigned scores and categorized as: low (score 0-4), medium (score 5-7) and high (score ≥8) risk. Early death rate was significantly different between risk groups and the validation …

Super-Resolution And Segmentation Deep Learning For Breast Cancer Histopathology Image Analysis, Aniwat Juhong, Bo Li, Cheng-You Yao, Chia-Wei Yang, Dalen W Agnew, Yu Leo Lei, Xuefei Huang, Wibool Piyawattanametha, Zhen Qiu

Faculty, Staff and Student Publications

Traditionally, a high-performance microscope with a large numerical aperture is required to acquire high-resolution images. However, the images' size is typically tremendous. Therefore, they are not conveniently managed and transferred across a computer network or stored in a limited computer storage system. As a result, image compression is commonly used to reduce image size resulting in poor image resolution. Here, we demonstrate custom convolution neural networks (CNNs) for both super-resolution image enhancement from low-resolution images and characterization of both cells and nuclei from hematoxylin and eosin (H&E) stained breast cancer histopathological images by using a combination of generator and discriminator …

Risk Factors Associated With Severe Clostridioides Difficile Infection In Patients With Cancer, Denise Marie A Francisco, Liangliang Zhang, Ying Jiang, Adilene Olvera, Javier Adachi, Eduardo Yepez Guevara, Samuel L Aitken, Kevin W Garey, Christine B Peterson, Kim-Anh Do, Ryan Dillon, Engels N Obi, Robert Jenq, Pablo C Okhuysen

Faculty, Staff and Student Publications

INTRODUCTION: Antibiotic use is a risk factor for Clostridioides difficile infection (CDI). Few studies have correlated use of prior antibiotic classes with CDI, microbiome composition, and disease severity in patients with cancer. We hypothesized that previous antibiotic exposure and fecal microbiome composition at time of presentation are risk factors for severe CDI in patients with cancer.

METHODS: This non-interventional, prospective, cohort study examined 200 patients with cancer who had their first episode or first recurrence of CDI. C. difficile was identified using nucleic acid amplification testing. Univariate analysis was used to determine significant risk factors for severe CDI. Fecal microbiome …

The Interplay Between Neoantigens And Immune Cells In Sarcomas Treated With Checkpoint Inhibition, Irantzu Anzar, Brandon Malone, Pubudu Samarakoon, Ioannis Vardaxis, Boris Simovski, Hugues Fontenelle, Leonardo A Meza-Zepeda, Richard Stratford, Emily Z Keung, Melissa Burgess, Hussein A Tawbi, Ola Myklebost, Trevor Clancy

Faculty, Staff and Student Publications

INTRODUCTION: Sarcomas are comprised of diverse bone and connective tissue tumors with few effective therapeutic options for locally advanced unresectable and/or metastatic disease. Recent advances in immunotherapy, in particular immune checkpoint inhibition (ICI), have shown promising outcomes in several cancer indications. Unfortunately, ICI therapy has provided only modest clinical responses and seems moderately effective in a subset of the diverse subtypes.

METHODS: To explore the immune parameters governing ICI therapy resistance or immune escape, we performed whole exome sequencing (WES) on tumors and their matched normal blood, in addition to RNA-seq from tumors of 31 sarcoma patients treated with pembrolizumab. …

Small Molecule Inhibitor Of Tau Self-Association In A Mouse Model Of Tauopathy: A Preventive Study In P301l Tau Jnpl3 Mice, Eliot J Davidowitz, Patricia Lopez, Heidy Jimenez, Leslie Adrien, Peter Davies, James G Moe

Faculty, Staff and Student Publications

Advances in tau biology and the difficulties of amyloid-directed immunotherapeutics have heightened interest in tau as a target for small molecule drug discovery for neurodegenerative diseases. Here, we evaluated OLX-07010, a small molecule inhibitor of tau self-association, for the prevention of tau aggregation. The primary endpoint of the study was statistically significant reduction of insoluble tau aggregates in treated JNPL3 mice compared with Vehicle-control mice. Secondary endpoints were dose-dependent reduction of insoluble tau aggregates, reduction of phosphorylated tau, and reduction of soluble tau. This study was performed in JNPL3 mice, which are representative of inherited forms of 4-repeat tauopathies with …

Pediatric Diarrhea Patients Living In Urban Areas Have A Higher Incidence Of Clostridioides Difficile Infection, Ayodele T Adesoji, Osaro Mgbere, Charles Darkoh

Faculty, Staff and Student Publications

Clostridioides difficile infection (CDI) is a major cause of antibiotic-associated diarrhea and an unappreciated contributor to child mortality in low- and middle-income countries where the diagnosis may be difficult. There is little information about the prevalence of CDI among infants, children, and adolescents in Africa. Using a cross-sectional design, seventy-six samples were collected from pediatric patients presenting with diarrhea, including infants (≤ 2 years old), children (2-12 years), and adolescents (13 ≤17 years) from three hospitals between January and December 2019. Demographic data, medical history, and prior antibiotic use were recorded. Toxigenic culture and PCR were used to detect and …

Population-Based Assessment Of The Burden Of Covid-19 Infection In African Countries: A First-Year Report Card And Public Health Implications, Osaro Mgbere, Ogbonna Collins Nwabuko, Olajumoke A Olateju, Omolola E Adepoju, Winston Liaw, Charles Darkoh, Ekere James Essien

Faculty, Staff and Student Publications

BACKGROUND: The COVID-19 pandemic constitutes a global health threat and poses a major burden on the African continent. We assessed the real-world burden of COVID-19 infection in African Union (AU) member states to determine the distributional patterns of epidemiological measures during the first 1 year of the pandemic.

METHODS: This retrospective cross-sectional study utilized COVID-19 data from publicly available data repositories of the African Center for Disease Control and Prevention and

RESULTS: A total of 3.21 million cases were reported during the 1-year period, with 2.6 million recoveries, 536,784 cases remaining active, and 77,486 deaths. Most countries (49.1%,

CONCLUSION: Understanding …

Evolutionary Aspects Of Infections: Inflammation And Sickness Behaviors, Robert Dantzer

Faculty, Staff and Student Publications

Sickness behavior was conceptualized initially as the behavioral counterpart of the fever response to infectious pathogens. It helps to raise body temperature to its higher setpoint and to maintain it at this new level and it has the additional benefit of enabling a weakened organism to protect itself from other dangers. The discovery of the behavioral effects of proinflammatory cytokines produced by activated immune cells provided a cellular and molecular basis to this phenomenon. The administration of cytokines or cytokine inducers like lipopolysaccharide to healthy rodents allowed to reveal the similarities and differences between inflammation-induced sickness behavior and the fever …

Examining The Role Of Autonomy Support, Goal Setting, And Care Coordination Quality On Hiv Prep Adherence In Black Men Who Have Sex With Men: Hptn 073, Donte T Boyd, Laron E Nelson, Mandy J Hill, Darren Whitfield, S Raquel Ramos, Samuel Akyirem, Lynda Emel, Leo Wilton, Lisa Hightow-Weidman, Steve Shoptaw, Manya Magnus, Kenneth H Mayer, Estelle Piwowar-Manning, Stephaun E Wallace, Sheldon D Fields, Darrell P Wheeler

Faculty, Staff and Student Publications

Autonomy support is a concept that is derived from self-determination theory. Autonomy refers to the freedom to act as one chooses. The current study aimed to examine if autonomy support was associated with dried blood spot validated pre-exposure prophylaxis (PrEP) adherence, and whether the association was mediated by PrEP adherence goal setting and progress toward PrEP adherence goals. Our sample was drawn from Black men who have sex with men (MSM) from across three cities (Chapel Hill, NC; Los Angeles, CA; and Washington, DC) in the United States between February 2013 and September 2014. We used logistic regression to evaluate …

Are Trauma Surgeons Prepared? A Survey Of Trauma Surgeons’ Disaster Preparedness Before And During The Covid-19 Pandemic, Jay Doucet, David V Shatz, Lewis J Kaplan, Eileen M Bulger, Jeannette Capella, Deborah A Kuhls, Mary Fallat, Kyle N Remick, Christopher Newton, Adam Fox, Randeep Jawa, John A Harvin, David P Blake, Marko Bukur, Jonathan Gates, James Ficke, Mark L Gestring, The American Association For Surgery Of Trauma Disaster Committee

Faculty, Staff and Student Publications

OBJECTIVE: US trauma centers (TCs) must remain prepared for mass casualty incidents (MCIs). However, trauma surgeons may lack formal MCI training. The recent COVID-19 pandemic drove multiple patient surges, overloaded Emergency Medical Services (EMS) agencies, and stressed TCs. This survey assessed trauma surgeons' MCI training, experience, and system and personal preparedness before the pandemic compared with the pandemic's third year.

METHODS: Survey invitations were emailed to all 1544 members of the American Association for the Surgery of Trauma in 2019, and then resent in 2022 to 1575 members with additional questions regarding the pandemic. Questions assessed practice type, TC characteristics, …

Bacterial Meningitis In Africa, Tatiana Barichello, Carlos Henrique Rocha Catalão, Ursula K Rohlwink, Martijn Van Der Kuip, Dan Zaharie, Regan S Solomons, Ronald Van Toorn, Marceline Tutu Van Furth, Rodrigo Hasbun, Federico Iovino, Vivian Ssonko Namale

Faculty, Staff and Student Publications

Bacterial meningitis differs globally, and the incidence and case fatality rates vary by region, country, pathogen, and age group; being a life-threatening disease with a high case fatality rate and long-term complications in low-income countries. Africa has the most significant prevalence of bacterial meningitis illness, and the outbreaks typically vary with the season and the geographic location, with a high incidence in the meningitis belt of the sub-Saharan area from Senegal to Ethiopia. Streptococcus pneumoniae (pneumococcus) and Neisseria meningitidis (meningococcus) are the main etiological agents of bacterial meningitis in adults and children above the age of one. Streptococcus agalactiae (group …

Within Subject Cross-Tissue Analyzes Of Epigenetic Clocks In Substance Use Disorder Postmortem Brain And Blood, Brenda Cabrera-Mendoza, Laura Stertz, Katherine Najera, Sudhakar Selvaraj, Antonio L Teixeira, Thomas D Meyer, Gabriel R Fries, Consuelo Walss-Bass

Faculty, Staff and Student Publications

There is a possible accelerated biological aging in patients with substance use disorders (SUD). The evaluation of epigenetic clocks, which are accurate estimators of biological aging based on DNA methylation changes, has been limited to blood tissue in patients with SUD. Consequently, the impact of biological aging in the brain of individuals with SUD remains unknown. In this study, we evaluated multiple epigenetic clocks (DNAmAge, DNAmAgeHannum, DNAmAgeSkinBlood, DNAmPhenoAge, DNAmGrimAge, and DNAmTL) in individuals with SUD (n = 42), including alcohol (n = 10), opioid (n = 19), and stimulant use disorder (n = 13), and controls (n = 10) in …

Imaging Peripheral Lymphatic Dysfunction In Chronic Conditions, Eva M Sevick-Muraca, Caroline E Fife, John C Rasmussen

Faculty, Staff and Student Publications

The lymphatics play important roles in chronic diseases/conditions that comprise the bulk of healthcare worldwide. Yet the ability to routinely image and diagnose lymphatic dysfunction, using commonly available clinical imaging modalities, has been lacking and as a result, the development of effective treatment strategies suffers. Nearly two decades ago, investigational near-infrared fluorescence lymphatic imaging and ICG lymphography were developed as routine diagnostic for clinically evaluating, quantifying, and treating lymphatic dysfunction in cancer-related and primary lymphedema, chronic venous disease, and more recently, autoimmune and neurodegenerative disorders. In this review, we provide an overview of what these non-invasive technologies have taught us …

Intraventricular Endoscopy And Intraventricular Antibiotics In The Treatment Of Multiloculated Hydrocephalus With Ventriculitis In A Neonate And An Infant: Two Case Reports, Doriam Alejandrino Perera Valdivia, Luis Roberto Zapata Vega, Edgar Abraham Herrera Pérez

Faculty, Staff and Student Publications

BACKGROUND: We present two pediatric cases, a neonate and an infant, who presented with treatment-refractory ventriculitis and multiloculated hydrocephalus treated with simultaneous intraventricular endoscopy and antibiotics. This is the first report of this combined therapy in children.

CASE DESCRIPTION: Using intraventricular endoscopic surgery and antibiotics, hydrocephalus was treated with a minimum number of ventricular shunt systems. In addition, treatment-refractory ventriculitis was treated in both patients using intraventricular antibiotics.

CONCLUSION: Endoscopic surgery and intraventricular antibiotic administration are useful strategies for treating multiloculated hydrocephalus and ventriculitis in children.

An Updated Examination Of The Perception Of Barriers For Pharmacogenomics Implementation And The Usefulness Of Drug/Gene Pairs In Latin America And The Caribbean, Aimeé Salas-Hernández, Macarena Galleguillos, Matías Carrasco, Andrés López-Cortés, María Ana Redal, Dora Fonseca-Mendoza, Patricia Esperón, Farith González-Martínez, Ismael Lares-Asseff, Alberto Lazarowski, Verónica Loera-Castañeda, Diadelis Remírez, Matías F Martínez, Rodrigo Vargas, Fabricio Rios-Santos, Antonio Macho, Juan P Cayún, Germán R Perez, Carolina Gutierrez, Leslie C Cerpa, Tamara Leiva, Susan Calfunao, Lesly Xajil, Christopher Sandoval, Marcelo Suárez, Ariana Gonzalez, Gabriela Echeverría-Garcés, Luis Sullón-Dextre, Eugenia Cordero-García, Alexis R Morales, Andrea Avendaño, Enrique Sánchez, Laura C Bastone, Cesar Lara, Patricia Zuluaga-Arias, Ana María Soler, Julio Da Luz, Gabriela Burgueño-Rodríguez, Marcelo Vital, Elizabeth Reyes-Reyes, Alexander Huaccha, Yeimy V Ariza, Naomi Tzul, Ana L Rendón, Roberto Serrano, Larissa Acosta, Angelo Motta-Pardo, Leonardo Beltrán-Angarita, Erika Brand, Miguel A Jiménez, Gladys Maribel Hidalgo-Lozada, Marina M J Romero-Prado, Karla Escobar-Castro, Mariel Umaña-Rivas, Juan D Vivas, Paola Lagos, Yineth Ballén Martínez, Sharleth Quesada, Camila Calfio, Maria L Arias, María A Lavanderos, Dante D Cáceres, Alberto Salazar-Granara, Nelson M Varela, Luis A Quiñones

Faculty, Staff and Student Publications

Pharmacogenomics (PGx) is considered an emergent field in developing countries. Research on PGx in the Latin American and the Caribbean (LAC) region remains scarce, with limited information in some populations. Thus, extrapolations are complicated, especially in mixed populations. In this paper, we reviewed and analyzed pharmacogenomic knowledge among the LAC scientific and clinical community and examined barriers to clinical application. We performed a search for publications and clinical trials in the field worldwide and evaluated the contribution of LAC. Next, we conducted a regional structured survey that evaluated a list of 14 potential barriers to the clinical implementation of biomarkers …

Head And Neck Cancer Online Support Groups: Disparities In Participation And Impact On Patients, Benjamin Tam, Matthew Lin, Carlos Castellanos, Ruben Ulloa, Niels Kokot, Kevin Hur

Faculty, Staff and Student Publications

OBJECTIVE: To characterize the users of the head and neck cancer (HNC) online support group (OSG) and describe the perceived benefits of membership.

STUDY DESIGN: Cross-sectional.

SETTING: Online.

METHODS: An administered survey with questions asking about demographics, cancer history, treatment choices, and feelings about OSGs was posted on the 5 largest HNC OSGs on Facebook.

RESULTS: A total of 97 participants completed the survey. Mean age was 57.8 years old (standard deviation = 10.7 years). Most participants were female (50.5%) and Caucasian (92.8%). This cohort was well educated with 65.5% holding at least a college degree. Annual income was high …

Aβ Plaques Do Not Protect Against Hsv-1 Infection In A Mouse Model Of Familial Alzheimer’S Disease, And Hsv-1 Does Not Induce Aβ Pathology In A Model Of Late Onset Alzheimer’S Disease, Olga V Bocharova, Aidan Fisher, Narayan P Pandit, Kara Molesworth, Olga Mychko, Alison J Scott, Natallia Makarava, Rodney Ritzel, Ilia V Baskakov

Faculty, Staff and Student Publications

The possibility that the etiology of late onset Alzheimer's disease is linked to viral infections of the CNS has been actively debated in recent years. According to the antiviral protection hypothesis, viral pathogens trigger aggregation of Aβ peptides that are produced as a defense mechanism in response to infection to entrap and neutralize pathogens. To test the causative relationship between viral infection and Aβ aggregation, the current study examined whether Aβ plaques protect the mouse brain against Herpes Simplex Virus 1 (HSV-1) infection introduced via a physiological route and whether HSV-1 infection triggers formation of Aβ plaques in a mouse …

The Impact Of The Progresses Of Knowledge And Technologies In Pediatrics, Kristofer Harris, Yaobin Ling, Avram S Bukhbinder, Luyao Chen, Kamal N Phelps, Gabriela Cruz, Jenna Thomas, Yejin Kim, Xiaoqian Jiang, Paul E Schulz

Faculty, Staff and Student Publications

Background:

Accumulating evidence suggests that adult vaccinations can reduce the risk of developing Alzheimer’s disease (AD) and Alzheimer’s disease related dementias.

Objective:

To compare the risk for developing AD between adults with and without prior vaccination against tetanus and diphtheria, with or without pertussis (Tdap/Td); herpes zoster (HZ); or pneumococcus.

Methods:

A retrospective cohort study was performed using Optum’s de-identified Clinformatics® Data Mart Database. Included patients were free of dementia during a 2-year look-back period and were≥65 years old by the start of the 8-year follow-up period. We compared two similar cohorts identified using propensity score matching (PSM), one vaccinated …

Clonal Isolates Of Treponema Pallidum Subsp Pallidum Nichols Provide Evidence For The Occurrence Of Microevolution During Experimental Rabbit Infection And In Vitro Culture, Diane G Edmondson, Bridget D De Lay, Blake M Hanson, Lindsay E Kowis, Steven J Norris

Faculty, Staff and Student Publications

The recent development of a system for long-term in vitro culture of the syphilis spirochete, Treponema pallidum subsp. pallidum, has introduced the possibility of detailed genetic analysis of this bacterium. In this study, the in vitro culture system was used to isolate and characterize clonal populations of T. pallidum subsp. pallidum Nichols, the most widely studied strain. In limiting dilutions experiments, it was possible to establish cultures with inocula as low as 0.5 T. pallidum per well despite the long generation time (~35 to 40 hours) of this organism. Six Nichols strain clones isolated by limiting dilution were characterized in …

A Large Screen Identifies Beta-Lactam Antibiotics Which Can Be Repurposed To Target The Syphilis Agent, Kathryn A Hayes, Jules M Dressler, Steven J Norris, Diane G Edmondson, Brandon L Jutras

Faculty, Staff and Student Publications

Syphilis, caused by the spirochete Treponema pallidum subsp. pallidum (hereafter called T. pallidum), is re-emerging as a worldwide sexually transmitted infection. A single intramuscular dose of benzathine penicillin G is the preferred syphilis treatment option. Both supply shortage concerns and the potential for acquired antibiotic resistance further the need to broaden the repertoire of syphilis therapeutics. We reasoned that other β-lactams may be equally or more effective at targeting the disease-causing agent, Treponema pallidum, but have yet to be discovered due to a previous lack of a continuous in vitro culture system. Recent technical advances with respect to …

Editorial: Modulation Of Microglia Reactivity And Plasticity In Cns Injury, Zhenyan He, Hailiang Tang, Jiping Tang, Xuying He, Ningbo Xu, Devin W Mcbride

Faculty, Staff and Student Publications

No abstract provided.

Dna Release From Plant Tissue Using Focused Ultrasound Extraction (Fuse), Alexia Stettinius, Hal Holmes, Qian Zhang, Isabelle Mehochko, Misa Winters, Ruby Hutchison, Adam Maxwell, Jason Holliday, Eli Vlaisavljevich

Faculty, Staff and Student Publications

PREMISE: Sample preparation in genomics is a critical step that is often overlooked in molecular workflows and impacts the success of downstream genetic applications. This study explores the use of a recently developed focused ultrasound extraction (FUSE) technique to enable the rapid release of DNA from plant tissues for genetic analysis.

METHODS: FUSE generates a dense acoustic cavitation bubble cloud that pulverizes targeted tissue into acellular debris. This technique was applied to leaf samples of American chestnut (

RESULTS: We observed that FUSE can extract high quantities of DNA in 9-15 min, compared to the 30 min required for control …

Clinical Manifestations And Outcome Of Patients With Primary Amoebic Meningoencephalitis In Pakistan. A Single-Center Experience, Shakeel Ur Rehman, Salman Farooq, Muhammad Bilal Tariq, Nosheen Nasir, Mohammad Wasay, Sobia Masood, Musa Karim

Faculty, Staff and Student Publications

Primary amoebic meningoencephalitis (PAM) is a rapidly progressing central nervous system (CNS) infection caused by Naegleria fowleri, a free-living amoeba found in warm freshwater. The disease progression is very rapid, and the outcome is nearly always fatal. We aim to describe the disease course in patients admitted with PAM in a tertiary care center in Karachi, Pakistan between the periods of 2010 to 2021. A total of 39 patients were included in the study, 33 males (84.6%). The median age of the patients was 34 years. The most frequent presenting complaint was fever, which was found in 37 patients (94.9%) …

Sex And Race Disparities In Mortality And Years Of Potential Life Lost Among People With Hiv: A 21-Year Observational Cohort Study, Rachael A Pellegrino, Peter F Rebeiro, Megan Turner, Amber Davidson, Noelle Best, Chandler Shaffernocker, Asghar Kheshti, Sean Kelly, Stephen Raffanti, Timothy R Sterling, Jessica L Castilho

Faculty, Staff and Student Publications

BACKGROUND: Since the availability of antiretroviral therapy, mortality rates among people with HIV (PWH) have decreased; however, this does not quantify premature deaths among PWH, and disparities persist.

METHODS: We examined all-cause and premature mortality among PWH receiving care at the Vanderbilt Comprehensive Care Clinic from January 1998 to December 2018. Mortality rates were compared by demographic and clinical factors, and adjusted incidence rate ratios (aIRRs) were calculated using multivariable Poisson regression. For individuals who died, age-adjusted years of potential life lost (aYPLL) per total person-years living with HIV were calculated from US sex-specific life tables, and sex and race …

Population-Based Linked Longitudinal Surveillance Of Pregnant People And Their Infants: A Critical Resource For Emerging, Re-Emerging, And Persistent Threats, Van T Tong, Kate R Woodworth, Erin Blau, Neha Shinde, Amanda Akosa, Suzanne M Gilboa, Dana Meaney-Delman

Faculty, Staff and Student Publications

Public health emergencies, from Zika to COVID-19, have underscored the importance of addressing the needs of pregnant people and their infants. Recent events have underlined the critical role of mother-infant-linked longitudinal surveillance to characterize and assess the impacts of emerging, re-emerging, and persistent threats, including infectious diseases, on these populations. In partnership with state, local, and territorial health departments, CDC's National Center on Birth Defects and Developmental Disabilities activated the Surveillance for Emerging Threats to Mothers and Babies Network (SET-NET) to capture information about pregnant people with laboratory-confirmed infection with SARS-CoV-2 (the virus that causes COVID-19) and their infants. SET-NET …

Feasibility Of Clinical Evaluation Of Individuals With Increased Risk For Hpv-Associated Oropharynx Cancer, Nicholas Scott-Wittenborn, Gypsyamber D'Souza, Nafi Aygun, Sakshi R Tewari, Javad Azadi, Peter Vosler, Zhen Gooi, Vikas Mehta, Wojciech Mydlarz, Melonie Nance, Stefan Mlot, Mihir R Patel, Marietta Tan, Brett A Miles, Tanya Troy, Carole Fakhry

Faculty, Staff and Student Publications

BACKGROUND: Human papillomavirus-associated oropharynx squamous cell carcinoma (HPV-OPSCC) has no known pre-malignant lesion. While vaccination offers future primary prevention, there is current interest in secondary prevention. The feasibility of clinical evaluation of individuals at increased risk for HPV-OPSCC is unclear.

METHODS: Individuals with risk factors for HPV-OPSCC were enrolled in a prospective study (MOUTH). Participants positive for biomarkers associated with HPV-OPSCC were eligible for a clinical evaluation which comprised a head and neck examination and imaging with ultrasound and/or magnetic resonance imaging (MRI). This study was designed to evaluate feasibility of clinical evaluation in a screening study.

RESULTS: Three hundred …

A Longitudinal Seroepidemiology Study To Evaluate Antibody Response To Sars-Cov-2 Virus Infection And Vaccination In Children In Calgary, Canada From July 2020 To April 2022: Alberta Covid-19 Childhood Cohort (Ab3c) Study, Emily J Doucette, Joslyn Gray, Kevin Fonseca, Carmen Charlton, Jamil N Kanji, Graham Tipples, Susan Kuhn, Jessica Dunn, Payton Sayers, Nicola Symonds, Guosong Wu, Stephen B Freedman, James D Kellner

Faculty, Staff and Student Publications

BACKGROUND: Measurement of SARS-CoV-2 antibody seropositivity is important to accurately understand exposure to infection and/or vaccination in specific populations. This study aimed to estimate the serologic response to SARS-CoV-2 virus infection and vaccination in children in Calgary, Alberta over a two-year period.

METHODS: Children with or without prior SARS-CoV-2 infections, were enrolled in Calgary, Canada in 2020. Venous blood was sampled 4 times from July 2020 to April 2022 for SARS-CoV-2 nucleocapsid and spike antibodies. Demographic and clinical information was obtained including SARS-CoV-2 testing results and vaccination records.

RESULTS: 1035 children were enrolled and 88.9% completed all 4 visits; median …

Ethnic And Racial Differences In Self-Reported Symptoms, Health Status, Activity Level, And Missed Work At 3 And 6 Months Following Sars-Cov-2 Infection, Kelli N O'Laughlin, Robin E Klabbers, Imtiaz Ebna Mannan, Nicole L Gentile, Rachel E Geyer, Zihan Zheng, Huihui Yu, Shu-Xia Li, Kwun C G Chan, Erica S Spatz, Ralph C Wang, Michelle L'Hommedieu, Robert A Weinstein, Ian D Plumb, Michael Gottlieb, Ryan M Huebinger, Melissa Hagen, Joann G Elmore, Mandy J Hill, Morgan Kelly, Samuel Mcdonald, Kristin L Rising, Robert M Rodriguez, Arjun Venkatesh, Ahamed H Idris, Michelle Santangelo, Katherine Koo, Sharon Saydah, Graham Nichol, Kari A Stephens

Faculty, Staff and Student Publications

INTRODUCTION: Data on ethnic and racial differences in symptoms and health-related impacts following SARS-CoV-2 infection are limited. We aimed to estimate the ethnic and racial differences in symptoms and health-related impacts 3 and 6 months after the first SARS-CoV-2 infection.

METHODS: Participants included adults with SARS-CoV-2 infection enrolled in a prospective multicenter US study between 12/11/2020 and 7/4/2022 as the primary cohort of interest, as well as a SARS-CoV-2-negative cohort to account for non-SARS-CoV-2-infection impacts, who completed enrollment and 3-month surveys (

RESULTS: Following SARS-CoV-2 infection, the majority of symptoms were similar over time between ethnic and racial groups. At …