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Analysis Of Humoral Immune Responses In Horses With Equine Protozoal Myeloencephalitis, Catherine-Jane Angwin

Theses and Dissertations--Veterinary Science

Equine protozoal myeloencephalitis (EPM), caused by the protozoan parasite Sarcocystis neurona, is one of the most important neurological diseases of horses in the Americas. While seroprevalence of S. neurona in horses is high, clinical manifestation of EPM occurs in less than 1% of infected horses. Factors governing the occurrence and severity of EPM are largely unknown, although horse immunity might play an important role in clinical outcome. We hypothesize that EPM occurs due to an aberrant immune response, which will be discernable in the equine IgG subisotypes a, b, and (T) that recognize S. neurona in infected diseased horses versus …

Lymphocyte-Mediated Inflamm-Aging In The Horse, Melissa Hope Siard

Theses and Dissertations--Veterinary Science

Senior horses (≥20 years) exhibit inflamm-aging, or chronic, low-grade inflammation that occurs systemically with aging, similarly to humans. Inflamm-aging has previously been characterized in the horse in circulation as well as specifically being mediated by lymphocytes and monocytes. In humans, inflamm-aging has been associated with increased morbidity and mortality. However, in the horse, relatively little about inflamm-aging is known regarding clinical effects or factors influencing severity. The contribution of lymphocytes to inflamm-aging of senior horses was examined, specifically through determining the relationships of inflamm-aging with various other health parameters, effects of seasonality, and the extent to which inflamm-aging can be …

Altitude- And Sex-Specific Variation In Roosting Ecology And Thermoregulation Of Myotis Lucifugus In Yellowstone National Park, Alexandra C. Slusher

Theses and Dissertations--Forestry and Natural Resources

Fifty-nine female and six male little brown myotis (Myotis lucifugus) were radio-tagged during the summers of 2012, 2013, 2014, and 2015 in Yellowstone National Park. The grand models for daily maximum skin temperature (F_98,154 = 1.55, P = 0.007), daily minimum skin temperature (F_98,154 = 1.33, P = 0.05), and daily variation in skin temperature (F_98,154 = 1.56, P = 0.006) were significant across roost type and reproductive condition class for adult females. Roosts were classified into Types A (warmest roosts), B (roosts with largest daily temperature variance), and C (stable and cool roosts) depending …

Evolution Of Equine Arteritis Virus During Persistent Infection In The Reproductive Tract Of The Stallion And The Male Donkey, Bora Nam

Theses and Dissertations--Veterinary Science

Equine arteritis virus (EAV) establishes persistent infection in the stallion reproductive tract, and the carrier stallion continues to shed virus in semen for weeks to years or lifelong. The objective of this study was to elucidate the intra-host evolution of EAV during persistent infection in stallions. Seven EAV seronegative stallions were experimentally infected with EAV KY84 strain and followed for 726 days post-infection, and sequential clinical samples including semen were collected for virus isolation and next-generation sequencing (NGS). In addition, archived sequential semen samples from two stallions that were naturally infected with EAV KY84 for a long-period (up to 10 …

Evaluation Of Pyriproxyfen Applied In Barrier Sprays For Mosquito Suppression, Andrea Glenn Skiles

Theses and Dissertations--Entomology

Despite advances in mosquito management, mosquito-borne disease in the United States is still of relevant public health concern and vector control is a top priority in preventing transmission of pathogens. Insecticide barrier sprays have become a common tool for suppression of mosquitoes in single-homeowner backyards. The application of the synthetic pyrethroid, lambda-cyhalothrin to perimeter vegetation with a backpack sprayer has been shown to significantly suppress mosquito levels for around 6 weeks. In an attempt to lengthen the effective duration of treatment, the IGR, pyriproxyfen, was added to a backpack mist blower with lambda-cyhalothrin, as adult mosquitoes exposed to pyriproxyfen have …

Community Based Sexual Education In Hamilton County Ohio, Jennifer Winbigler

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

This project proposes the implementation of a community-based sexual education program in Hamilton County Ohio. The proposed program is Focus on Youth + ImPACT. FOY + ImPACT is an evidenced based intervention focused on providing knowledge and skill based education to both youth (during FOY sessions) and parents (during the ImPACT session). The educational program will be implemented at three sites: the Boys and Girls Club of Greater Cincinnati, Lighthouse Youth Services, and Caracole. Each site was selected for its current infrastructure conducive to youth programming. This included ease of access to youth as well as experience in the provision …

Addressing Barriers To Hepatitis C Treatment Initiation In Kentucky Clinic, Moaz Abdelwadoud

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Introduction. Hepatitis C virus (HCV) is the most prevalent blood borne infection in the United States and its chronic infection has a high burden on the American healthcare system. Since 2014, the all-oral Directly Acting Antiviral (DAA)-based therapy has been established as the standardized curative treatment for HCV with unprecedented high effectiveness and tolerability. Nevertheless, there is a significant gap between the promise from DAAs benefits and the treatment initiation rates in the United States and Kentucky.

Objectives. The goal of this study is to improve the access to the all-oral DAA-based treatment among HCV patients seeking outpatient …

Retention In Continuous Care And Sustained Viral Suppression: Examining The Association Among Individuals Living With Hiv, Timothy N. Crawford, Alice C. Thornton

Internal Medicine Faculty Publications

Objectives: To examine the relationship between retention in continuous care and sustained viral suppression.

Methods: The authors retrospectively followed 653 persons who were virally suppressed and seeking care at an infectious disease clinic in Kentucky for an average of 6 years to determine the rates of retention in medical care (≥2 visits separated by ≥3 months within a 12-month period) and sustained viral suppression (<400 copies/mL). A generalized linear mixed model was used to determine an association between retention and suppression over time.

Results: Approximately 61% of the study population were retained in continuous care and 75% had sustained viral suppression for all patient-years. Persons retained in care were 3 times the odds of sustaining viral suppression over …

Assessment Of The Current Reporting Requirements Of The Kentucky Immunization Registry, Lindsey Lewis

MPA/MPP/MPFM Capstone Projects

Immunizations are essential to societal health and wellbeing. Throughout one’s lifespan, immunizations are to be administered incrementally to decrease the prevalence of preventable diseases. Despite this, there are disparities in the rates of vaccinations across the country. Numerous guidelines and regulations have been published regarding the administration and scheduling of vaccines. Certain vaccinations are mandatory in order to be able to attend school or hold certain occupational positions and normally proof of administration is required.

Immunization registries were created to monitor and record patient-specific data about administered vaccines. These confidential reporting systems were developed to improve population health by allowing …

Implementing A Patient Hand-Hygiene Protocol To Decrease Clostridium Difficile Infections In The Acute Care Setting, Lydia S. Mendez

DNP Projects

PURPOSE: The purpose of this study was to develop and implement a patient hand hygiene protocol (PHHP) to improve patient outcomes, specifically to decrease the rates of clostridium difficile infections (CDI) at Norton Hospital (NH) and Norton Audubon Hospital (NAH) in Louisville, Kentucky.

METHODS: This was a multi-center, quasi-experimental study that implemented a PHHP on three units at two hospitals in the Norton Healthcare system. The sample consisted of 159 patients in the pre-intervention period and 18 patients in the intervention period. A retrospective records review was performed to analyze specific demographic variables.

RESULTS: No differences in age and gender …

The Impact Of Nursing Staff Adherence With Chlorhexidine Gluconate Bathing On Intensive Care Unit Patient Outcomes, Tara M. Jones

DNP Projects

Purpose: The purpose of this study is to evaluate nursing staff adherence to a chlorhexidine gluconate (CHG) bathing protocol in the intensive care unit at Norton Brownsboro Hospital.

Methods: This study utilized a single-site, quasi-experimental, retrospective electronic medical record review format. The sample consisted of 200 patient records post CHG bathing protocol initiation from the Norton Brownsboro Hospital Intensive Care Unit during the period of March, 2015 to May, 2017.

Results: The sample was divided into adherent and non-adherent groups. No significant differences in age, sex, race, ICU length of stay (LOS), BMI, or mortality scores, presence of indwelling medical …

A Gap Analysis On Vaccine Administration For Average And High-Risk Adults, Whitney Pack Metcalfe

DNP Projects

Background: Nationally adult immunization rates continue to fall below the current benchmark goals. It is estimated adult vaccinations range from 20 to 60 percent, depending on the vaccine. There are different vaccine schedules for those of average-risk compared to those with high-risk conditions. Providers are being encouraged to explore their administration of vaccines as preventable, communicable diseases continue to be seen. Objectives: In a primary care clinic, a gap analysis was conducted to: 1.) Determine adult immunization rates, 2.) Compare vaccine administration rates of the Tdap, PCV13, PPSV23, and influenza vaccines between average and high-risk adults, 3.) Determine if specific …

An Evaluation Of Provider Adherence To Adult Sinusitis Quality Measures And Guideline, Caitlin A. Davidson

DNP Projects

Purpose

The purpose of this project is to evaluate adherence to Physician Quality Reporting System (PQRS) Measures #331 (delaying antibiotic treatment until at least seven days of symptoms) and #332 (prescribing amoxicillin or amoxicillin/clavulanate) on adult sinusitis treatment. Data was collected from patient encounters at the University of Kentucky College of Nursing Community Health Center (UKCONCHC) in Wilmore, Kentucky. To adhere to these quality measures would foster antibiotic stewardship. Further statistical analysis was completed to determine if gender or age bias was present in prescribing practices.

Methods

A retrospective chart audit was conducted to determine adherence to the quality measures. …

Adult Acute Sinusitis Antimicrobial Stewardship Program In A Primary Care Setting, Katelyn M. Hellman

DNP Projects

BACKGROUND: Inappropriate antibiotic prescribing is a well-documented global health crisis (Centers for Disease Control, CDC, 2013). Antimicrobial stewardship (AS) is the purposeful selection of the correct drug, dose, route and duration of antimicrobial treatment to decrease microbial resistance, adverse drug effects and cost while improving patient outcomes (Dellit et al., 2007; CDC, 2016). Antimicrobial Stewardship Programs (ASP) are multidisciplinary programs designed to improve AS.

PURPOSE: To describe baseline prescribing patterns and evaluate the effect of an antimicrobial stewardship program (ASP) for adult acute sinusitis on provider knowledge and antibiotic prescribing practice. among primary care providers in an internal medicine clinic …

Center Of Pressure Excursion During A Single Leg Standing Test In Ambulatory Children With Cerebral Palsy, Ryan Thomas Callahan

Theses and Dissertations--Kinesiology and Health Promotion

INTRODUCTION: Cerebral Palsy (CP) is the most common disabling motor disorder found during childhood, occurring in 2.1-3.2 of every 1,000 births. Motor functionality of children with CP is commonly compromised and is classified with a gross motor function classification score (GMFCS) and with the gross motor function measure (GMFM). Balance ability has typically been assessed using single leg stance test (SLST) time but more recently, center of pressure excursion (COPE) has shown to be a more valid measurement in populations with altered motor abilities. However, COPE has not been used to test balance in the CP population, yet. This study …

Molecular Mechanism: The Human Dopamine Transporter Histidine 547 Regulates Basal And Hiv-1 Tat Protein-Inhibited Dopamine Transport, Pamela M. Quizon, Wei-Lun Sun, Yaxia Yuan, Narasimha M. Midde, Chang-Guo Zhan, Jun Zhu

Molecular Modeling and Biopharmaceutical Center Faculty Publications

Abnormal dopaminergic transmission has been implicated as a risk determinant of HIV-1-associated neurocognitive disorders. HIV-1 Tat protein increases synaptic dopamine (DA) levels by directly inhibiting DA transporter (DAT) activity, ultimately leading to dopaminergic neuron damage. Through integrated computational modeling prediction and experimental validation, we identified that histidine547 on human DAT (hDAT) is critical for regulation of basal DA uptake and Tat-induced inhibition of DA transport. Compared to wild type hDAT (WT hDAT), mutation of histidine547 (H547A) displayed a 196% increase in DA uptake. Other substitutions of histidine547 showed that DA uptake was not altered in H547R but decreased by 99% …

2016 Study Of Current Conditions Of Kentucky County Animal Shelters And Degree Of Compliance With Kentucky Animal Shelter Laws, Cynthia L. Gaskill, Rachel Cullman-Clark, Liane Lachiewicz, Matt Lamarre, Brad Rohleder, Kristin Sadler, Rachel Sparling, Craig N. Carter

Veterinary Science Reports

Kentucky’s county animal shelter conditions have not been studied for over 20 years. Major goals of this study were to assess current conditions in Kentucky’s county shelters and determine the degree of compliance with Kentucky shelter laws. Additional information was gathered to determine the major problems and needs identified by shelter personnel and researchers. Data was used to determine if additional state funds or refinements and additions to current laws are warranted to ensure humane care of animals in Kentucky’s county shelters. Researchers consisted of a group of 6 veterinary students who traveled to all Kentucky county animal shelters. Ninety …

Availability Of Buprenorphine Treatment In Kentucky, Elijah T. Myers, Tyrone F. Borders

Institute for Rural Health Policy Reports

Drug overdose and substance use treatment admissions data indicate that opioid use is problematic in Kentucky, but little information exists about the geographic availability of buprenorphine treatment across the state. Furthermore, there is even less information about the characteristics of the physicians prescribing buprenorphine. This report describes the availability of buprenorphine treatment in Kentucky.

Accuracy Of Name And Age Data Provided About Network Members In A Social Network Study Of People Who Use Drugs: Implications For Constructing Sociometric Networks, April M. Young, Abby E. Rudolph, Amanda E. Su, Lee King, Susan Jent, Jennifer R. Havens

Epidemiology and Environmental Health Faculty Publications

Purpose—Network analysis has become increasingly popular in epidemiologic research, but the accuracy of data key to constructing risk networks is largely unknown. Using network data from people who use drugs (PWUD), the study examined how accurately PWUD reported their network members’ (i.e., alters’) names and ages.

Methods—Data were collected from 2008 to 2010 from 503 PWUD residing in rural Appalachia. Network ties (n=897) involved recent (past 6 months) sex, drug co-usage, and/or social support. Participants provided alters’ names, ages, and relationship-level characteristics; these data were cross-referenced to that of other participants to identify participant-participant relationships and to determine …

The Life Cycle Stages Of Pneumocystis Murina Have Opposing Effects On The Immune Response To This Opportunistic Fungal Pathogen, Heather M. Evans, Grady L. Bryant Iii, Beth A. Garvy

Microbiology, Immunology, and Molecular Genetics Faculty Publications

The cell wall β-glucans of Pneumocystis cysts have been shown to stimulate immune responses in lung epithelial cells, dendritic cells, and alveolar macrophages. Little is known about how the trophic life forms, which do not have a fungal cell wall, interact with these innate immune cells. Here we report differences in the responses of both neonatal and adult mice to the trophic and cystic life cycle stages of Pneumocystis murina. The adult and neonatal immune responses to infection with Pneumocystis murina trophic forms were less robust than the responses to infection with a physiologically normal mixture of cysts and …

Building Viral Replication Organelles: Close Encounters Of The Membrane Types, Peter D. Nagy, Jeroen R. P. M. Strating, Frank J. M. Van Kuppeveld

Plant Pathology Faculty Publications

Positive-strand (+)RNA viruses are important and emerging pathogens of humans, animals, and plants. Upon infection, they induce the formation of specialized membranous replication organelles with unique lipid composition to facilitate robust virus replication. In this article, the authors discuss the proviral role of virus-induced membrane contact sites (vMCSs). The emerging picture is that vMCSs channel lipids to viral membranes and tune the lipid composition for optimal generation and functioning of replication organelles.

Mycosins Are Required For The Stabilization Of The Esx-1 And Esx-5 Type Vii Secretion Membrane Complexes, Vincent J. C. Van Winden, Roy Ummels, Sander R. Piersma, Connie R. Jiménez, Konstantin V. Korotkov, Wilbert Bitter, Edith N. G. Houben

Molecular and Cellular Biochemistry Faculty Publications

ABSTRACT Pathogenic mycobacteria contain up to five type VII secretion (T7S) systems, ESX-1 to ESX-5. One of the conserved T7S components is the serine protease mycosin (MycP). Strikingly, whereas MycP is essential for secretion, the protease activity of MycP₁ in Mycobacterium tuberculosis has been shown to be dispensable for secretion. The essential role of MycP therefore remains unclear. Here we show that MycP₁ and MycP₅ of M. marinum have similar phenotypes, confirming that MycP has a second unknown function that is essential for its T7S system. To investigate whether this role is related to proper functioning of …

Sphingosine 1-Phosphate Activation Of Egfr As A Novel Target For Meningitic Escherichia Coli Penetration Of The Blood-Brain Barrier, Xiangru Wang, Ravi Maruvada, Andrew J. Morris, Jun O. Liu, Michael J. Wolfgang, Dong Jae Baek, Robert Bittman, Kwang Sik Kim

Internal Medicine Faculty Publications

Central nervous system (CNS) infection continues to be an important cause of mortality and morbidity, necessitating new approaches for investigating its pathogenesis, prevention and therapy. Escherichia coli is the most common Gram-negative bacillary organism causing meningitis, which develops following penetration of the blood–brain barrier (BBB). By chemical library screening, we identified epidermal growth factor receptor (EGFR) as a contributor to E. coli invasion of the BBB in vitro. Here, we obtained the direct evidence that CNS-infecting E. coli exploited sphingosine 1-phosphate (S1P) for EGFR activation in penetration of the BBB in vitro and in vivo. We …

Using Electronic Health Record Data To Improve Community Health Assessment, Brian E. Dixon, Jian "Frank" Zou, Karen F. Comer, Marc Rosenman, Jennifer L. Craig, P Gibson

Frontiers in Public Health Services and Systems Research

Background: Community health assessments assist health departments in identifying health needs as well as disparities, and they enable linking of needs with available interventions. Electronic health record (EHR) systems possess growing volumes of clinical and administrative data, making them a valuable source of data for ongoing community health assessment.

Purpose: To produce population health indicators using data from EHR systems that could be combined and visually displayed alongside social determinants data, and to provide data sets at geographic levels smaller than a county.

Methods: Data from multiple EHR systems used by major health systems covering >90% of the population in …

Inhibition Of Human Metapneumovirus Binding To Heparan Sulfate Blocks Infection In Human Lung Cells And Airway Tissues, Edita M. Klimyte, Stacy E. Smith, Pasqua Oreste, David Lembo, Rebecca Ellis Dutch

Molecular and Cellular Biochemistry Faculty Publications

Human metapneumovirus (HMPV), a recently discovered paramyxovirus, infects nearly 100% of the world population and causes severe respiratory disease in infants, the elderly, and immunocompromised patients. We previously showed that HMPV binds heparan sulfate proteoglycans (HSPGs) and that HMPV binding requires only the viral fusion (F) protein. To characterize the features of this interaction critical for HMPV binding and the role of this interaction in infection in relevant models, we utilized sulfated polysaccharides, heparan sulfate mimetics, and occluding compounds. Iota-carrageenan demonstrated potent anti-HMPV activity by inhibiting binding to lung cells mediated by the F protein. Furthermore, analysis of a minilibrary …

Human Metapneumovirus Induces Reorganization Of The Actin Cytoskeleton For Direct Cell-To-Cell Spread, Farah El Najjar, Nicolás Cifuentes-Muñoz, Jing Chen, Haining Zhu, Ursula J. Buchholz, Carole L. Moncman, Rebecca Ellis Dutch

Molecular and Cellular Biochemistry Faculty Publications

Paramyxovirus spread generally involves assembly of individual viral particles which then infect target cells. We show that infection of human bronchial airway cells with human metapneumovirus (HMPV), a recently identified paramyxovirus which causes significant respiratory disease, results in formation of intercellular extensions and extensive networks of branched cell-associated filaments. Formation of these structures is dependent on actin, but not microtubule, polymerization. Interestingly, using a co-culture assay we show that conditions which block regular infection by HMPV particles, including addition of neutralizing antibodies or removal of cell surface heparan sulfate, did not prevent viral spread from infected to new target cells. …

Female Adult Aedes Albopictus Suppression By Wolbachia-Infected Male Mosquitoes, James W. Mains, Corey L. Brelsfoard, Robert I. Rose, Stephen L. Dobson

Entomology Faculty Publications

Dengue, chikungunya and zika viruses are pathogens with an increasing global impact. In the absence of an approved vaccine or therapy, their management relies on controlling the mosquito vectors. But traditional controls are inadequate, and the range of invasive species such as Aedes albopictus (Asian Tiger Mosquito) is expanding. Genetically modified mosquitoes are being tested, but their use has encountered regulatory barriers and public opposition in some countries. Wolbachia bacteria can cause a form of conditional sterility, which can provide an alternative to genetic modification or irradiation. It is unknown however, whether openly released, artificially infected male Ae. albopictus can …

Health Care, Employers And Population Health, Glen P. Mays

Health Management and Policy Presentations

Data from the National Longitudinal Survey of Public Health Systems show that hospital and employer contributions to population health activities vary widely across U.S. communities. As peripheral participants in the organizational networks that support population health activities, these stakeholders bring novel information and resources to multi-sector work. This fact may explain the tendency for population health improvement activities to be more effective when hospitals and employers are involved.

Lipophosphoglycans From Leishmania Amazonensis Strains Display Immunomodulatory Properties Via Tlr4 And Do Not Affect Sand Fly Infection, Paula M. Nogueira, Rafael R. Assis, Ana C. Torrecilhas, Elvira M. Saraiva, Natália L. Pessoa, Marco A. Campos, Eric F. Marialva, Cláudia M. Ríos-Velasquez, Felipe A. Pessoa, Nágila F. Secundino, Jerônimo N. Rugani, Elsa Nieves, Salvatore J. Turco, Maria N. Melo, Rodrigo P. Soares

Molecular and Cellular Biochemistry Faculty Publications

The immunomodulatory properties of lipophosphoglycans (LPG) from New World species of Leishmania have been assessed in Leishmania infantum and Leishmania braziliensis, the causative agents of visceral and cutaneous leishmaniasis, respectively. This glycoconjugate is highly polymorphic among species with variation in sugars that branch off the conserved Gal(β1,4)Man(α1)-PO₄ backbone of repeat units. Here, the immunomodulatory activity of LPGs from Leishmania amazonensis, the causative agent of diffuse cutaneous leishmaniasis, was evaluated in two strains from Brazil. One strain (PH8) was originally isolated from the sand fly and the other (Josefa) was isolated from a human case. The ability of …

A Case Of Pituitary Abscess Presenting Without A Source Of Infection Or Prior Pituitary Pathology, Derick Adams, Philip A. Kern

Internal Medicine Faculty Publications

Pituitary abscess is a relatively uncommon cause of pituitary hormone deficiencies and/or a suprasellar mass. Risk factors for pituitary abscess include prior surgery, irradiation and/or pathology of the suprasellar region as well as underlying infections. We present the case of a 22-year-old female presenting with a spontaneous pituitary abscess in the absence of risk factors described previously. Her initial presentation included headache, bitemporal hemianopia, polyuria, polydipsia and amenorrhoea. Magnetic resonance imaging (MRI) of her pituitary showed a suprasellar mass. As the patient did not have any risk factors for pituitary abscess or symptoms of infection, the diagnosis was not suspected …