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Impacts Of Utilizing Reverse Osmosis Concentrate On Mashing, Fermentation, And Water Use In Bourbon Whiskey Production, Ryan C. Sarhan

Theses and Dissertations--Biosystems and Agricultural Engineering

This thesis addresses the feasibility of reusing reverse osmosis concentrate (ROC) in the bourbon whiskey fermentation processes. Initial work compared laboratory-scale mashing and fermentation methods, demonstrating that simultaneous saccharification and fermentation reliably reflects industrial-scale processes, with lower complexity and process time. Building upon this, laboratory and distillery-scale experiments demonstrated that reusing ROC in the mashing and fermentation steps does not negatively impact ethanol yields. ROC produced by systems with a water softener was found to significantly increase mash rheology, suggesting a need for potential process adjustments. Softened ROC also altered the production of flavor-influencing volatile congeners. Under worst case conditions, …

Quantifying Sedimentation Dynamics Of Regulated River Backwater Confluences With Low-Order Tributaries, Abby Kathryne Berry

Theses and Dissertations--Biosystems and Agricultural Engineering

Sediment dynamics in backwater confluences of regulated rivers have received limited study, despite being recognized as hotspots for sedimentation and nutrient attenuation. Development of management and restoration strategies in these landscapes require improved understanding of fluvial geomorphology and sediment transport dynamics due to the alterations in hydraulic regimes and sediment inputs associated with riverine backwaters. The objective of this study was to couple remote sensing, high frequency sensing, and numerical modeling to quantify drivers of erosion and deposition dynamics within regulated river backwater tributary confluences. To meet the objective of this study, data was collected and analyzed from the Fourpole …

Development Of A Cultivation System For Producing Pure Mycelium Materials From Distillers' Spent Grains, Keya Rani Roy

Theses and Dissertations--Biosystems and Agricultural Engineering

Stillage is a byproduct of distilleries which is rich in organic matter, minerals, and acidic components. It is commonly used as animal feed and has high potential for use as an alternative substrate for microorganisms. Filamentous fungi are saprophytes that can utilize stillage solids to grow as threadlike mycelium. The structure and composition of the filamentous mycelium has shown promise to produce pure mycelium materials (PMM), which might have many potential applications, for instance as a leather-like material or alternative protein food ingredient. Basidiomycota fungi (including true mushrooms) species are presently used in industry to produce PMM due to the …

Development Of Non-Destructive Methods For The Detection And Quantification Of Gluten Sources In Foods, Adewale Abiola Oloyede

Theses and Dissertations--Biosystems and Agricultural Engineering

Cross-contamination of food with gluten-rich grains such as wheat, barley, and rye remains a significant challenge in gluten-free food production, posing health risks to individuals with gluten-related disorders. Traditional detection methods are often time-consuming and labor-intensive, highlighting the need for rapid and reliable alternatives. This study investigates the use of hyperspectral imaging (HSI) combined with machine learning (ML) and deep learning (DL) techniques for the detection and quantification of gluten contamination in grain-based foods through three main approaches: (i) classification of gluten source contaminants in gluten-free flour, (ii) quantification of gluten content from wheat, rye, and barley flours, and …

Utilitzing A Nurse Triage Model To Decrease The Administrative Burden Of Emr Messaging, Pamela B. Schneider

DNP Projects

Abstract

Background: The volume of Electronic Medical Records (EMR) messages from patients to providers continues to rise, yet clinic workflows have not been adequately restructured to accommodate. Increased EMR, especially the inbasket, is associated with provider burnout and decreased job satisfaction, contributing to provider turnover.

Purpose: To improve the triage and distribution of the EMR messaging workload

Method: A Nurse Triage Flowchart was implemented in the Gastroenterology Clinic at the University of Kentucky to help RNs/MAs triage patient messages for improved workflow. Surveys were completed by RNs/MAs and providers before and three months post-implementation. Data from EPIC over six …

“What We Say Matters”: Reducing Drug Use Stigmatization By Healthcare Professionals Through A Narrative-Based Awareness Campaign, Adam M. Traugott

DNP Projects

Background: Stigma towards substance use has been identified as a contributor to poor care and health outcomes amongst people who use drugs (PWUD), a vulnerable population. Healthcare worker stigma negatively affects the outcomes of individual patients and may have greater public health implications. Methods of addressing drug-use stigma have previously been implemented in a variety of clinical settings. Presenting the lived experience of PWUD to healthcare workers via emotionally compelling narratives has been found to be an effective means of stigma reduction.

Purpose: This study utilized two psychometrically validated tools to measure (1) the baseline prevalence of drug use stigma …

Impact Of Obesity On The Gut Microbiome And Inflammatory Markers During Siv Infection And Antiretroviral Therapy, Casey M. Mcguire, Isaac R. Cinco, Diana Takahashi, Kristin A. Sauter, Melissa Kirigiti, Ilhem Messaoudi, Jonah B. Sacha, Charles T. Roberts, Paul Kievit

Microbiology, Immunology, and Molecular Genetics Faculty Publications

Dysbiosis and impaired gut barrier integrity contribute to chronic immune activation associated with both obesity and HIV infection. Given the increased incidence of obesity in people living with HIV, we explored the impact of obesity on the gut microbiome and microbial translocation (MT) biomarkers during HIV infection and antiretroviral therapy (ART). Lean and obese rhesus macaques were infected with simian immunodeficiency virus (SIV) and subsequently treated with ART. Obese animals exhibited higher initial MT and inflammation biomarkers that remained constant throughout the study, while lean animals exhibited significant increases in these biomarkers that approached levels observed in obese animals. Lean …

Evaluating A Public Health Program Using The Cdc Framework: A Case Study Approach, Brooke A. Poe

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

In Bourbon County, Kentucky, where rural health challenges and chronic disease burdens persist, a coalition of public health partners set out to improve population-level physical activity through an innovative, community-centered initiative. The Bourbon County Physical Activity Program emerged through collaboration between the Bourbon County Health Department, the University of Kentucky College of Public Health, and UK HealthCare. Together, these partners designed a six-month intervention that combined discounted YMCA memberships, partnerships with employers, a physical activity tracking app with behavioral incentives, and community-wide events to promote accessible and sustained engagement.

Guided by the CDC’s framework for program evaluation in public health, …

Impact Of Bourbon Continuous Column Operations On Ethyl Carbamate Levels, Brad J. Berron, Jon Brown, Jason Gambrell, Travis Cantrell, Meghan Mcintosh, Sarah A. Wilson, Jarrad Gollihue, Harmonie M. Bettenhausen

James B. Beam Institute for Kentucky Spirits Faculty Publications

European and Canadian regulators enforce strict limits on the ethyl carbamate content of alcoholic beverages. North American distillers’ malt have high glycosidic nitrile levels which amplify the ethyl carbamate level of whiskey. Guidelines are required to produce low ethyl carbamate whiskey from North American distillers’ malts. This work challenges several strategies for reducing ethyl carbamate levels in bourbon and American whiskey products. New make spirit was produced using a bourbon mash bill on a continuous beer still with doubler. The low wines alcohol content and beer feed tray were systematically varied while the caustic cleaning schedules were monitored to generate …

Influence Of Perceived Health Provider Communication, Diabetes Duration And Age At Diagnosis With Confidence In Diabetes Self-Care, Courtney L. Ortz, Meredith S. Duncan, Oluwatosin Leshi, William B. Burrows, Brittany L. Smalls

Family and Community Medicine Faculty Publications

Introduction: Several factors influence individuals’ confidence to perform diabetes-related self-care activities, including perceived patient-provider communication, diabetes duration and age at diagnosis. It has been well-documented that patient-provider communication is essential when managing chronic diseases such as diabetes; however, the impact of this communication with diabetes duration and age at diabetes diagnosis on confidence in performing self-care behaviors is obscure.

Research design and methods: We utilized data from the 2021 Household Component of the Medical Expenditure Survey among participants 18 years or older who had completed the Diabetes Care Survey. Ordinal logistic regression models were utilized to assess the association between …

Alterations In Whole Muscle Quality And Physiological Cross-Sectional Area Measured With Quantitative Mri Following Acl Injury, Meredith K. Owen, Lauren Richardson, Darren L. Johnson, Moriel H. Vandsburger, Thorsten Feiweier, Katherine L. Thompson, Christopher S. Fry, Peter A. Hardy, Brian W. Noehren

Physical Therapy Faculty Publications

Background: Emerging evidence suggests that there are morphological and physiological changes to the vastus lateralis after an anterior cruciate ligament (ACL) tear. However, it is unclear whether these alterations are limited to just the vastus lateralis or are more representative of widespread changes across the thigh musculature and/or if these changes precede reconstruction. The purpose of this study was to determine T1ρ relaxation time, a measure of extracellular matrix organization in muscle, and physiological cross-sectional area (PCSA) for muscles of the quadriceps and hamstrings of the ACL-deficient and contralateral limbs soon after ACL injury.

Methods: T1ρ and diffusion …

Effects Of An Active Ankle Exoskeleton On The Walking Biomechanics Of Healthy Men, Sridevi Nagaraja, Jose E. Rubio, Junfei Tong, Aravind Sundaramurthy, Anup Pant, Meredith K. Owen, Michael A. Samaan, Brian W. Noehren, Jaques Reifman

Physical Therapy Faculty Publications

Active lower-body exoskeleton devices can decrease the energy requirement of the human body by providing mechanical assistance to lower-body muscles. However, they also alter gait kinematics and kinetics, and it is not well understood whether such alterations are detrimental or beneficial to the human body. In this pilot study, we investigated the impact of walking with an ankle exoskeleton device on the biomechanics of men while carrying a heavy load. We collected computed tomography images and motion-capture data for five young, healthy men who walked 5 km (∼60 min) with a 22.7-kg load, with and without an active ankle exoskeleton …

Patterns Of Inpatient Antibiotic Utilization By Race And Ethnicity At Us Children’S Hospitals, Bethany A. Wattles, Jeffrey I. Campbell, Theresa Kluthe, Yana B. Feygin, Kahir Jawad, Michelle D. Stevenson, Deborah Winders Davis, Jennifer Porter, V. Faye Jones, Matt Hall, Michael J. Smith

Biostatistics Faculty Publications

Background and Objectives: Racial and ethnic variations in antibiotic utilization are well-reported in outpatient settings but little is known about inpatient settings. Our objective was to describe national inpatient antibiotic utilization among children by race and ethnicity. Methods: This study included hospital visit data from the Pediatric Health Information System between 01/01/2022 and 12/31/2022 for patients <20 years. Primary outcomes were the percentage of hospitalization encounters that received an antibiotic and antibiotic days of therapy (DOT) per 1000 patient days. Mixed-effect regression models were used to determine the association of race-ethnicity with outcomes, adjusting for covariates. Results: There were 846,530 hospitalizations. 45.2% of children were Non-Hispanic (NH) White, 27.1% were Hispanic, 19.2% were NH Black, 4.5% were NH Other, 3.5% were NH Asian, 0.3% were NH Native Hawaiian/Other Pacific Islander (NHPI) and 0.2% were NH American Indian. Adjusting for covariates, NH Black children had lower odds of receiving antibiotics compared to NH White children (aOR 0.96, 95%CI 0.94–0.97), while NH NHPI had higher odds of receiving antibiotics (aOR 1.16, 95%CI 1.05–1.29). Children who were Hispanic, NH Asian, NH American Indian, and children who were NH Other received antibiotic DOT compared to NH White children, while NH NHPI children received more antibiotic DOT. Conclusions: Antibiotic utilization in children’s hospitals differs by race and ethnicity. Hospitals should assess policies and practices that may contribute to disparities in treatment; antibiotic stewardship programs may play an important role in promoting inpatient pharmacoequity. Additional research is needed to examine individual diagnoses, clinical outcomes, and drivers of variation.

A Demographic Description Of Children And Adolescents With Concomitant Autism And Anxiety Along With A Comparison Of Receipt Of Psychological Services, Elizabeth Salt, Amanda T. Wiggins, David N. Toupin, Emma Parks, Chizimuzo Okoli, Mary Kay Rayens

Biostatistics Faculty Publications

Objective:(1) Evaluate differences in demographic distributions between those with autism alone and those with autism concomitant with anxiety and (2) assess demographic factors associated with receipt of psychological therapy in patients with autism.Methods:Using deidentified health care claims data, we extracted all encounters among children with the International Classification of Diseases-10-CM for Autism Spectrum Disorder (F84) and flagged those with concomitant anxiety (F41.9). Extracted data included age, sex, race, ethnicity, insurance status, and Rural-Urban Continuum Codes. Current procedural terminology codes for psychological services were extracted. Data were analyzed using Mann-Whitney U tests, χ² tests of association, and logistic regression.Results:Demographic differences …

Leveraging Machine Learning Models To Explore Disparities In Prostate Cancer Diagnosis, Treatment, And Survival, Reuben Adatorwovor, Rasaq Oladapo, Parisa Ghasemi, Gaurav Kumar, Daniel J. Morton, Motolani E. Ogunsanya, Olufunmilola Abraham

Biostatistics Faculty Publications

Introduction: Prostate cancer (CaP) is the second most common cancer in men globally and a leading cause of cancer-related mortality, particularly among older men. In the United States, disparities in incidence, stage at diagnosis, and outcomes persist across racial, socioeconomic, and geographic lines. Men in medically underserved regions like Appalachia experience higher mortality due to limited access to timely screening and treatment. Given the complex interplay of clinical, behavioral, and sociodemographic factors, machine learning (ML) offers promise in identifying survival predictors that traditional models may overlook. This study applies ML models to assess the impact of age at diagnosis, treatment …

Outcomes Of A Pilot Randomized Clinical Trial Testing Brief Interventions To Increase Hiv Pre-Exposure Prophylaxis Uptake Among Rural People Who Inject Drugs Attending Syringe Services Programs, Hilary L. Surratt, Sarah Brown, Abby L. Burton, Will Cranford, Laura C. Fanucchi, Christie Green, Stephanie M. Mersch, Rebecca Rains, Philip M. Westgate

Biostatistics Faculty Publications

Background: Kentucky is one of seven states with high, sustained rural HIV transmission tied to injection drug use. Expanding access to pre-exposure prophylaxis (PrEP) has been endorsed as a key HIV prevention strategy; however, uptake among people who inject drugs (PWID) has been negligible in rural areas. Syringe services programs (SSPs) have been implemented throughout Kentucky’s Appalachian region, providing an important opportunity to integrate PrEP services. Objectives: The primary objective was to examine preliminary efficacy and effect sizes of the study interventions on PrEP initiation among HIV-negative PWID. Design: Parallel group randomized controlled trial. Methods: Eighty participants were enrolled from …

Clinical Criteria For Limbic-Predominant Age-Related Tdp-43 Encephalopathy, David A. Wolk, Peter T. Nelson, Liana Apostolova, Konstantinos Arfanakis, Patricia A. Boyle, Cynthia M. Carlsson, Nick Corriveau-Lecavalier, Penny Dacks, Bradford C. Dickerson, Kimiko Domoto-Reilly, Brittany N. Dugger, Rebecca Edelmayer, David W. Fardo, Michel J. Grothe, Timothy J. Hohman, David J. Irwin, Gregory A. Jicha, David T. Jones, Claudia H. Kawas, Edward B. Lee, Karen Lincoln, Gladys E. Maestre, Elizabeth C. Mormino, Chiadi U. Onyike, Ronald C. Petersen, Gil D. Rabinovici, Rosa Rademakers, Rema Raman

Biostatistics Faculty Publications

Limbic predominant age-related TDP-43 encephalopathy neuropathologic change (LATE-NC) is highly prevalent in late life and a common co-pathology with Alzheimer's disease neuropathologic change (ADNC). LATE-NC is a slowly progressive, amnestic clinical syndrome. Alternatively, when present with ADNC, LATE-NC is associated with a more rapid course. With the emergence of anti-amyloid therapeutics, discrimination of LATE-NC from ADNC is critical and will lead to greater clinical recognition of amnestic patients without ADNC. Furthermore, co-pathology with LATE-NC may influence outcomes of these therapeutics. Thus there is a need to identify patients during life with likely LATE-NC. We propose criteria for clinical diagnosis of …

Code Status Discussions, Hunter Bechtold, Reagan T. Smith, Peter Wallenhorst, Kaylee Gouge, Sarah Schaefer, Kelsey Karnik, Kristen Mcquerry, Kristen E. Fletcher

Biostatistics Faculty Publications

Introduction: Residents frequently conduct code status discussions (CSDs) with patients, but many report not receiving formal training in this skill. While institutions have attempted to address this, there remains a need for a curriculum that uses standardized patients (SPs), is generalizable to students interested in different medical specialties, and has been tested on a large sample of students. Methods: We trained 192 fourth-year medical students across four different campuses in how to conduct CSDs during one 2-hour workshop as part of their Transition to Residency course in April 2024. Students worked with SPs as part of this workshop. Students at …

How Patient, Infection, And Cysticercus Characteristics Impact The Evolution Of Taenia Solium Larva In The Human Brain, Hongbin Zhang, Meghana G. Shamsunder, Pryanka Bawa, Arturo Carpio, W. Allen Hauser, Karina Quinde-Herrera, Alex Jaramillo, Elizabeth A. Kelvin

Biostatistics Faculty Publications

Neurocysticercosis is a poorly understood infection of the central nervous system with Taenia solium larva and treatment often fails to kill all the parasitic larva. Most research on this infection has used patient-level data, looking at summaries of the encysted parasitic cysticercus burden. Cyst-level analysis is needed to identify factors that impact individual cyst trajectories and how that may vary based on characteristics of the patient, infection, and cyst being followed. We disaggregated data on 221 cysts from 117 patients who participated in a trial evaluating the impact of albendazole treatment to identify factors that impact cyst evolution over time …

A Myostatin Inhibitory Antibody Combined With Insulin, Partially Rescues The Musculoskeletal Phenotype Of Female Insulin-Deficient Diabetic Mice, R. Clay Bunn, Reuben Adatorwovor, Philip D. Ray, Alexander R. Keeble, Christopher S. Fry, Sasidhar Uppuganti, Jeffry S. Nyman, John L. Fowlkes, Evangelia Kalaitzoglou

Biostatistics Faculty Publications

Introduction: Type 1 diabetes is associated with deficits in both skeletal muscle and bone. Inhibition of myostatin, a negative regulator of muscle mass, was explored as a druggable target to improve the musculoskeletal phenotype associated with insulin-deficient diabetes in female mice. Methods: We investigated whether administration of an inhibitory myostatin antibody (MyoAb) in streptozotocin-induced diabetes in female mice is protective for skeletal muscle and bone. DBA/2J female mice were injected with low-dose streptozotocin or with citrate buffer (vehicle). Subsequently, mice were implanted with insulin-containing or vehicle pellets, with groups being randomized to myostatin or control antibody for 8 weeks. At …

Diagnosing Statistical Education Needs Of Health Science Learners, Amy S. Nowacki, Ann M. Brearley, Robert A. Oster, Emily Slade, Katrina L. Devick, Matthew J. Hayat, Sally W. Thurston

Biostatistics Faculty Publications

Many types of health science learners, including clinical and translational scientists, students, researchers, and clinicians, seek to increase their knowledge of biostatistics. These learners are heterogeneous in their field, career stage and career focus. Based on the collective experience of an expert panel with over 115 years teaching statistics to health science learners, we propose a framework for considering the needs of health science learners motivated by their career goals. This framework defines four types of health science learners seeking statistical training: (a) consumers, (b) “milestone makers”, (c) biomedical researchers with statistical support, and (d) biomedical researchers without statistical support. …

Quantitative Magnetic Resonance Imaging Responses In Head And Neck Cancer Patients Treated With Magnetic Resonance-Guided Hypofractionated Radiation Therapy, Ryan Bonate, Musaddiq J. Awan, Heather A. Himburg, Stuart Wong, Monica Shukla, Sergey Tarima, Joseph Zenga, Eric S. Paulson

Biostatistics Faculty Publications

Background and purpose: Quantitative MRI (qMRI) has been explored for detecting tumor changes during radiation therapy (RT) in head and neck squamous cell cancer (HNSCC). Clinical trials show prolonged survival with PD-1 targeted immune checkpoint inhibition. Hypofractionated radiation regimens are being studied to counteract radioresistant clonogen formation. This study aims to use daily qMRI monitoring in these therapies. The objective of this exploratory study was to investigate if qMRI can detect tumor microenvironment changes during hypofractionated RT in a phase I trial of Dose-Escalated Hypofractionated Adaptive Radiotherapy (DEHART). Materials and methods: Seventeen subjects with advanced HNSCC underwent MR-guided RT with …

Pecto-Intercostal Fascial Plane Block With Or Without Rectus Sheath Block In Cardiac Surgery, Anne L. Castro, Hemanckur Makker, Laura S. Gonzalez, Audrey Jensen, Sergey S. Tarima, Adam Pagryzinski, Rozalin Thapa, Ali Qureshi, Christopher Fadumiye, Krystal Weierstahl, Paul Pearson, Julie K. Freed

Biostatistics Faculty Publications

Background Median sternotomy and chest tube sites drive pain following cardiac surgery. Prior research has demonstrated that pecto-intercostal fascial plane blocks (PIFBs) reduce median sternotomy pain after cardiac surgery. Prior studies examining the addition of a rectus sheath block (RSB) to localize the insertion site of subxiphoid chest tubes have had mixed results. Methods In this single-center, randomized, double-blind, placebo-controlled trial, 62 patients undergoing cardiac surgery with median sternotomy and subxiphoid chest tubes were randomized to receive PIFB and RSB with local anesthetic versus PIFB with local anesthetic and RSB with saline placebo. The primary outcome was pain at rest …

The Association Between Four Neighborhood Disadvantage Indices And Child Chronic Health Classifications, Kahir Jawad, Yana B. Feygin, Michelle Stevenson, Bethany A. Wattles, Jennifer Porter, V. Faye Jones, Deborah Winders Davis

Biostatistics Faculty Publications

Background: Neighborhood advantage/disadvantage is a social determinant of health. We aimed to examine the distribution and associations between child chronic health conditions and four commonly used indices. Methods: Children with outpatient visits and valid addresses (n = 115,738) were included and outcomes were categorized as having no chronic disease (N-CD), non-complex chronic disease (NC-CD), and complex chronic disease (C-CD). Four measures of neighborhood characteristics (Child Opportunity Index, Area Deprivation Index, Neighborhood Disadvantage Index, Social Vulnerability Index were calculated from census data. Separate multinomial logistic regression models were used. Results: The indices’ scores were correlated (r = 0.80–0.92). Children in low …

Utilization And Outcomes Of Single-Troponin Discharge From The Emergency Department In A Low-Risk Population, Zhengqiu Zhou, Kory Heier, Jeffrey F. Spindel, Austin Harris, Emily Slade, Weston Mccowan, Dealla Samadi, Joshua Kim, James D. Moore, Seth T. Stearley, Vedant Gupta

Biostatistics Faculty Publications

Objectives: There is emerging data supporting rapid triage of low-risk chest pain patients to help facilitate Emergency Department (ED) throughput. We assessed an algorithm for accelerated rule-out of acute coronary syndrome in low-risk patients with an undetectable initial high sensitivity cardiac troponin (hs-cTn assays; Roche Diagnostics) in a real-world clinical setting. Methods: All adults presenting with chief complaint of non-traumatic chest pain to our tertiary care ED with HEART score ≤3 with at least one hs-cTn and EKG obtained were included in our study. Data and outcomes were compared three months before and after implementation of our updated Acute Chest …

Cloning, Expression, And Characterization Of Collagen Galactosyltransferases From Human, Sponge, And Sea Walnut, Jeong Seon Kim, Tingfei Chen, Botao Zhang, Tristin M. Miller, Marisa E. Gilliam, Houfu Guo

Molecular and Cellular Biochemistry Faculty Publications

Collagen is an extracellular matrix protein conserved across animals and viruses, with its function regulated by post-translational modifications of lysine residues. Specifically, certain lysine residues in collagen are hydroxylated to form hydroxylysine, which serves as an attachment site for hydroxylysine-linked glycosylation. This glycosylation process is initiated by collagen galactosyltransferases from the GT25 family, also known as GLT25D or COLGALT proteins. Despite their biological importance, efficient methods for expressing and isolating GLT25Ds have yet to be fully developed, and the biochemical mechanisms underlying their function still need to be better understood. To address this, we performed sequence alignment and phylogenetic analyses …

All-Cause And Exacerbation-Related Readmissions In Thrombotic Microangiopathy Requiring Plasmapheresis: A Population-Based Cohort Study, Alexander R. Thebert, Toru Yoshino, Sae X. Morita, Misa Ito, Ayman Qasrawi, Hirotaka Kato

Internal Medicine Faculty Publications

Objective: Thrombotic microangiopathy (TMA) is a serious condition characterized by microangiopathic hemolytic anemia and thrombocytopenia, with high exacerbation rates. This study examined all-cause and exacerbation-related readmission risks among patients hospitalized with TMA requiring plasmapheresis.

Materials and Methods: Secondary analysis of the 2020 Nationwide Readmission Database was conducted, including discharge data from non-federal hospitals in 31 U.S. states. Patients aged 18 years or older admitted non-electively with a primary or secondary diagnosis of TMA requiring plasmapheresis were included. Exacerbation-related readmission was defined as subsequent admission requiring plasmapheresis within 7 or 30 days after the original discharge. Multivariable logistic regression and Cox …

Clonal Hematopoiesis Of Indeterminate Potential And The Risk Of Cognitive Impairment In The Women’S Health Initiative Memory Study, Yasminka A. Jakubek, Aaron P. Smith, Xiaoyan I. Leng, Megan E. Hall, Daniel Ezzat, Yash Pershad, Jason M. Collins, Md Mesbah Uddin, David W. Fardo, Pradeep Natarajan, Alexander G. Bick, Jacob O. Kitzman, Michael C. Honigberg, Kathleen M. Hayden, Joann E. Manson, Siddhartha Jaiswal, Eric A. Whitsel, Alexander P. Reiner

Internal Medicine Faculty Publications

INTRODUCTION

Clonal hematopoiesis of indeterminate potential (CHIP) confers an increased risk of several chronic aging-related diseases. Paradoxically, CHIP was associated with lower risk of dementia in recent studies.

METHODS

We examined associations between baseline CHIP and incident mild cognitive impairment (MCI) and/or probable dementia in the Women's Health Initiative Memory Study. CHIP was detected using blood-based targeted sequencing. Cox proportional hazards models examined time to onset of cognitive impairment, adjusting for traditional risk factors.

RESULTS

Using a conventional variant allele fraction (VAF) threshold of 2%, CHIP was not associated with incident cognitive impairment. The presence of larger CHIP clone (VAF …

Dual Biologic Therapy Induces Remission In Refractory Crohn’S Disease With Vedolizumab And Ustekinumab, Syed Adeel Hassan, Courtney Perry, Patrick Carey, Durham Colohan, Mohamed Gebril Eltaher, Nabila Dawoud, Mahmoud Elkammar, Waqas Rasheed, Casie Mayne, Amy Stuffelbeam, Deborah R. Auer Flomenhoft, Terrence A. Barrett

Internal Medicine Faculty Publications

Background

Despite advancements in the therapeutic armamentarium for Crohn’s disease (CD), biologic and small molecule monotherapies are associated with sub-optimal response and remission rates. Utilizing dual biologic therapy (DBT) holds the potential to increase efficacy in the treatment of refractory or partially responsive CD. Evidence pertaining to this strategy remains limited. Methods

We retrospectively examined refractory CD patients treated with a combination of ustekinumab and vedolizumab. Outcomes to DBT at week (wk) 52 were compared to monotherapy. The primary outcome constituted corticosteroid-free remission. Secondary outcomes included adverse events, infections, hospitalizations, surgeries, treatment persistence, and disease clearance. Results

Sixteen of 21 …

Characterization Of Municipal Solid Waste Using Machine Learning Based Imaging And Chemical Analysis, Enyonam Ahadzi

Theses and Dissertations--Biosystems and Agricultural Engineering

According to the U.S. Department of Energy’s 2023-billion-ton report, the United States generates nearly 300 million tons of municipal solid waste every year. More than 50% of that waste is underutilized and ends up in landfills. This poses serious public health and environmental risks. But beyond the environmental and health implications, this is also a wasted opportunity. The U.S. Energy Information Administration estimates that, for every 100 lbs of waste we throw away, about 85% can be used as fuel or for electricity generation. However, its complex and heterogeneous nature poses challenges for efficient sorting and valorization in waste to …