Digital Commons Network^™

Aggressive, Adaptive, And Underestimated: From Allergy To Arboviruses, The Rise Of The Lone Star Tick, Emily Ellen Owens Pickle

Theses and Dissertations

Once considered a nuisance with little medical importance, the lone star tick (Amblyomma americanum, Acari:Ixodidae) has emerged as a formidable vector driving a new era of public health threats across the United States of America. This dissertation traces the rise of the lone star tick from obscurity to infamy, exploring its expanding geographic range, unique immunologic impacts on humans, and role in the transmission of emerging tickborne viruses. Through a series of integrated studies, this work characterizes the epidemiology, immunology, and ecological context of tick-borne diseases in the southeastern U.S., with a particular focus on α-Gal syndrome (AGS), …

The Impact Of Adverse Childhood Experiences And Living With Hiv On Cardiovascular Health And Cardiometabolic Disorders In An African Population: An Analysis Of The Indepth Community In Rural South Africa, Samuel Gavi

Theses and Dissertations

Background: Adverse Childhood Experiences (ACEs) have been shown to be associated with cardiometabolic disorders (CMDs) and poor CVH; however, in Africa, this has not been well studied. Cardiovascular health (CVH) is an important measure of risk for cardiovascular diseases (CVD) developed by the American Heart Association (AHA). With the increasing prevalence of CVD in Africa, CVH is a potential upstream prevention approach. Africa also has the highest prevalence of HIV, and an increasing prevalence of comorbidities associated with it. Various mechanisms have been investigated to explain the relationship between CVD and chronic HIV infection. This study explores the potential relationship …

The 29th Scientific Conference Of The Society On Neuroimmune Pharmacology In Omaha, Ne, June 8–12, 2025, Allison M. Andrews, Linda Chang, Rosemarie M. Booze, Sabita Roy, Santhi Gorantla, Iiker K. Sariyer, Jerel Fields, Eliseo Eugenin, Howard E. Gendelman

Faculty Publications

The 29th Scientific Conference of the Society on Neuroimmune Pharmacology (SNIP) in Omaha, NE, will occur from June 8th to 11th, 2025. This four-day conference showcases world-renowned biomedical research, providing insights into the latest advancements in the intersecting fields of neuroscience, immunology, pharmacology, and virology. Presentation abstracts are organized into sections that include early career development investigators, mouse models, neurodegenerative diseases, therapeutics, substance use disorders, counseling, drug targeting, disease pathobiology, Blood-Brain Barrier integrity, educational opportunities, young investigator talks, and translational medicine. SNIP remains the sole global meeting dedicated to neuroimmune pharmacology. The focus of research centers on how the neuroimmune …

Telehealth And In-Person Hiv Care During The Covid-19 Pandemic At A Large Academic Medical Center In North Carolina, Valerie Yelverton, Jan Ostermann Ph.D., Michael E. Yarrington, Andrew K. Weinhold, Nabil Natafgi, Bankole Olatosi, Sharon Weissman, Nathan M. Thielman

Faculty Publications

Background

To maintain HIV care during the COVID-19 pandemic, many HIV clinics across the United States adopted telehealth. However, not everyone participated in telehealth equally. This study assessed the use and disparities in telehealth and in-person HIV care at a large academic medical center in North Carolina (NC) relative to the COVID-19 pandemic.

Methods

Data from the Duke University Infectious Disease clinic in NC were extracted from electronic health records (EHR), aggregated across persons with HIV (PWH) by calendar month, visit type (in-person vs. telehealth HIV care), and by key sociodemographic and clinical characteristics. Variation in HIV care over time …

Perceived Adherence-Related Barriers For Youth Living With Hiv In The Southern United States, Kate Weaver, Sarah J. Miller, Sayward Harrison

Faculty Publications

Objective: Youth are at high risk for HIV, accounting for 19% of new diagnoses in the United States (US) in 2021. Highly effective HIV treatment is available in the form of antiretroviral therapy (ART), which enables individuals with HIV to achieve viral suppression. However, youth living with HIV (YLHIV) have poorer ART adherence and lower rates of viral suppression than adults. This study aimed to explore the perspectives of YLHIV and their HIV care providers on barriers and facilitators to ART adherence for YLHIV in the southern US. Methods: Semi-structured qualitative interviews were conducted with YLHIV (n = 16) …

Frenemies? Fascists And Conservatives In Interwar Britain, Dylan R. Cameron

Senior Theses

This thesis examines the attitudes, beliefs, and arguments of British Conservatives (Tories) in discussions about British fascism through the lens of two mainstream Conservative newspapers, The Daily Telegraph and the Daily Mail, focused primarily on the buildup and aftermath of the infamous Olympia rally in June 1934. This thesis identifies two key factions within the conservative movement which arose in reaction to the rise of Oswald Mosley’s British Union of Fascists (BUF): (1) the staunchly anti-fascist “mainline Tories” who detested the BUF’s “foreign” character, propensity for violence, and antithesis to traditional liberal democratic principles, and (2) the fascist-sympathizing “reactionary Tories” …

Exploring The Impact Of Pharmacy Education On Pharmacy Residents' Confidence & Knowledge Of Gender-Affirming Hormone Therapy, Grace Thompson, Jordan Ballou, Chao Cai

Senior Theses

This thesis will examine the relationship between pharmacy school education about gender-affirming hormone therapy and the confidence and knowledge of PGY1 and PGY2 pharmacy residents at ASHP-accredited or candidate pharmacy residency programs across the United States. This cross-sectional study was completed through an analysis of de-identified survey data, including demographics, confidence-based questions, and knowledge-based questions. The study survey and thesis were compiled by reviewing the current literature regarding the perceptions of pharmacists, pharmacy residents, and student pharmacists on transgender and gender diverse topics. The survey was sent to pharmacy residents through residency program directors (RPDs) and program contacts. After considering …

Revitalizing Passenger Rail: A Sustainable Solution To Environmental And Public Health Challenges In South Carolina, Benjamin Cochran

Theses and Dissertations

South Carolina, a historic leader in passenger rail, has become a heavily vehicle-dependent state. As the population rapidly grows, so does the number of vehicles, vehicle miles traveled, and vehicle emissions, including the greenhouse gas pollutants carbon dioxide (CO2), nitrous oxide (N2O), and particulate matter (PM2.5), significantly contributing to air pollution and deteriorating health and environmental outcomes. Despite this, mass transit is nonexistent for the three largest cities in South Carolina, Charleston, Columbia, and Greenville, forcing residents and travelers to drive. This study evaluates the feasibility and the environmental, public health, environmental justice, and economic implications of a passenger rail …

An Exploratory Study Of Disclosure Of X-Linked Conditions Between Mothers And Daughters, Madge Isabella Stuhlreyer

Theses and Dissertations

Carriers of X-linked conditions, both asymptomatic and symptomatic, face unique challenges regarding their experiences navigating the healthcare system and understanding implications of their carrier status. Studies show that mothers are known to be the main communicators of genetic information within their families, but in families affected with X-linked conditions, communication between mothers and daughters are hindered by factors such as lack of knowledge about the condition and reproductive implications, lack of emotional support, anxiety, and uncertainty about how to initiate these conversations. The purpose of this study was to explore the motivations behind mothers' decisions to initiate conversations with their …

The Effect Of Grape Seed Extract Against The Formation Of S.Aureus Biofilms In A Clinical Setting, Srestha Samaddar

Senior Theses

The rise of antibiotic-resistant bacterial infections, particularly those caused by Staphylococcus aureus, poses a serious threat to public health and clinical care. A major contributor to the persistence of these infections is the formation of bacterial biofilms, structured communities that protect S. aureus from antibiotics and immune responses, especially on surgical sites and medical devices. As conventional treatments become less effective, interest in alternative, natural antimicrobial agents has increased, due to public dissatisfaction with conventional medicine and a growing trust in complementary and alternative medicine. Grape seed extract (GSE), a polyphenol-rich byproduct of winemaking, has emerged as a promising candidate …

Inclusive Leadership Ideology In Crisis Management: A Case Study Analysis On Serving The Homeless During Covid-19, Hee Soun Jang, Yu Shi, Lisa Dicke, Laura Keyes

Journal of Ideology

A core value and ethical tenet of public administration is to ensure the protection and care of the most vulnerable in the community. This research shows that inclusive leadership ideology among public managers can actively engage them in using responsive strategies that respect marginalized groups' diverse cultures, languages, identities, and special needs. Using interviews of homeless-serving nonprofit leaders during the early part of the COVID-19 pandemic, our research demonstrates how leaders navigated critical decision-making in response to the unique service needs of those who were unsheltered and experiencing homelessness. The D-A-I-C model (Shi et al., 2020) serves as a framework …

Niaid Workshop Report: Systematic Approaches For Eskape Bacteria Antigen Discovery, Inka Sastalla, Keehwan Kwon, Clayton Huntley, Kimberly A. Taylor Dnp, Rn, Nea-Bc, Cnor, Clssbb, Liliana Brown, Tamika Samuel, Lanling Zou

Publications

On 14-15 November 2023, the National Institute of Allergy and Infectious Diseases (NIAID) organized a workshop entitled "Systematic Approaches for ESKAPE Bacteria Antigen Discovery". The goal of the workshop was to engage scientists from diverse relevant backgrounds to explore novel technologies that can be harnessed to identify and address current roadblocks impeding advances in antigen and vaccine discoveries for the ESKAPE pathogens (Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter species). The workshop consisted of four sessions that addressed ESKAPE infections, antigen discovery and vaccine efforts, and new technologies including systems immunology and vaccinology approaches. Each …

Temporal Network Analysis Of Comorbidities Among People With Hiv In South Carolina, Yunqing Ma, Matthew Lohman Ph.D., Monique J. Brown Ph.D., Mph, Yichen Li, Xiaoming Li Ph.D., Bankole Olatosi Ph.D., Jiajia Zhang Ph.D.

Faculty Publications

Introduction: People with HIV experience a high rate of comorbidities that can complicate their health outcomes. Understanding the prevalence, interrelationships and temporal development of these comorbidities is crucial for improving health management and quality of life for people with HIV. Methods: We used a population-based cohort extracted from statewide electronic health record (EHR) data in South Carolina (SC), including 18 649 people with HIV who survived at least 1 year after HIV diagnosis between January 1, 2005, and December 31, 2020. Comorbidities and organ systems were classified using ICD-10 codes. Network analysis was performed to assess the closeness centrality among …

“I Feel Like It Gets Worse As I Get Older”: Perspectives Of Peri-Postmenopausal Women With Pcos, Pamela J. Wright Phd, Ms, Med, Rn, Cen, Cynthia F. Corbett Phd, Rn, Faan, Robin M. Dawson Phd, Rn, Cpnp-Pc, Charlotte Burts

Publications

Introduction: Polycystic ovary syndrome (PCOS) is a chronic endocrinopathy that transcends the reproductive years. Peri-postmenopausal women with PCOS remain at cardiometabolic risk or subsist with established comorbidity while continuing to contend with persistent PCOS signs and symptoms such as hirsutism. Evidence based information for peri-postmenopausal women with PCOS is scant. The purpose of this qualitative study was to explore the physical, psychosocial, and healthcare perspectives of peri-postmenopausal women with PCOS.

Methods: Peri-postmenopausal women with PCOS aged ≥43 years (n = 29) were recruited using ResearchMatch to participate in a virtual interview. Interviews were conducted using a semi-structured guide. The interviews …

Complex Role Of Digital Health Literacy In Awareness And Use Of Digital Sexually Transmitted And Blood-Borne Infections Testing: A Structural Equation Modelling Analysis Of The 2022 Getcheckedonline Survey, Ihoghosa Iyamu, Pierce Gorun, Sofia Bartlett, Geoffrey Mckee, Lorie Donelle Phd, Rn, Fcan, Hsiu Ju Chang, Rodrigo Sierra-Rosales, Devon Haag, Heather Nicole Pedersen, Nathan John Lachowsky, Catherine Worthington, Troy Grennan, Daniel Grace, Mark Gilbert

Publications

Background Although digital health literacy (DHL) is recognised as a determinant of access to digital sexually transmitted and blood-borne infection (STBBI) testing, empirical evidence about its contribution to access disparities remains limited. We applied multidimensional DHL measures to examine inequities in awareness and use of GetCheckedOnline, British Columbia’s (BC) publicly funded digital STBBI testing service. Methods We analysed data from GetCheckedOnline’s 2022 community survey of English-speaking BC residents aged ≥16 years who were sexually active in the past year. Outcomes were awareness and use of GetCheckedOnline (yes/no). DHL was measured using latent factors from the eHealth Literacy Scale: Information Navigation, …

Development And Validation Of A Revised Multidimensional Digital Health Literacy Scale: Secondary Analysis Using Cross-Sectional Data From The 2022 Getcheckedonline Community Survey In British Columbia, Canada, Ihoghosa Iyamu, Pierce Gorun, Hsiu Ju Chang, Rodrigo Sierra-Rosales, Devon Haag, Heather Pedersen, Sofia Bartlett, Nathan Lachowsky, Geoffrey Mckee, Catherine Worthington, Troy Grennan, Lorie Donelle Phd, Rn, Fcan, Daniel Grace, Mark Gilbert

Publications

Background: Digital technologies are reshaping health care, making digital health literacy (DHL) a critical competency for navigating online health information. Although widely conceived and measured as a unidimensional measure of DHL, the literature increasingly supports a multidimensional framing of the eHealth Literacy Scale (eHEALS). Studies propose alternative factor structures that can better inform population-level interventions, but these studies have not accounted for the ordinal nature of eHEALS response data. Objective: This study aimed to identify and validate an alternate multidimensional structure of eHEALS accounting for its ordinal response scale. Methods: Data were drawn from the 2022 GetCheckedOnline community survey of …

Longitudinal Viral Load Clustering For People With Hiv Using Functional Principal Component Analysis, Yunqing Ma, Xueying Yang Ph.D., Jiayang Xiao, Xiaoming Li Ph.D., Bankole Olatosi Ph.D., Jiajia Zhang Ph.D.

Faculty Publications

Background: Longitudinal measures of viral load (VL) are critical in monitoring the HIV status. While multiple lab indicators exist for monitoring measures of VL, research on clustering historical/longitudinal VL measures is limited. Analyzing longitudinal VL patterns rather than aggregated measures offers deeper insights into HIV status. This study uses functional data clustering to classify longitudinal VL patterns and characterize each cluster by demographics, comorbidities, social behaviors, and CD4 count.

Methods: Adult PWH diagnosed from 2005 to 2015 in South Carolina with a 5-year minimum follow-up were included. We compared functional principal component analysis (FPCA), K-means, hierarchical clustering, and Gaussian mixture …

Harnessing Big Heterogeneous Data To Evaluate The Potential Impact Of Hiv Responses Among Key Populations In Sub-Saharan Africa: Protocol For The Boloka Data Repository Initiative, Refilwe Nancy Phaswana Mafuya, Edith Phalane, Amrita Rao, Kalai Willis, Katherine Rucinski, K. Alida Voet, Amal Abdulrahman, Claris Siyamayambo, Betty Sebati, Mohlago Seloka, Musa Jaiteh, Lerato Lucia Olifant, Katharine Journeay, Haley Sisel, Xiaoming Li Ph.D., Bankole Olatosi Ph.D., Neset Hikmet, Prashant Duhoon, Francois Wolmarans, Yegnanew A. Shiferaw, Lifutso Motsieloa, Mashudu Rampilo, Stefan Baral

Faculty Publications

Background: In South Africa, there is no centralized HIV surveillance system where key populations (KPs) data, including gay men and other men who have sex with men, female sex workers, transgender persons, people who use drugs, and incarcerated persons, are stored in South Africa despite being on higher risk of HIV acquisition and transmission than the general population. Data on KPs are being collected on a smaller scale by numerous stakeholders and managed in silos. There exists an opportunity to harness a variety of data, such as empirical, contextual, observational, and programmatic data, for evaluating the potential impact of HIV …

Longitudinal Assessments Of Viral Rebound Among People With Hiv In South Carolina: A Population-Based Cohort Study, Jiayang Xiao, Xueying Yang Ph.D., Yunqing Ma, Bankole Olatosi Ph.D., Sharon Weissman, Xiaoming Li Ph.D., Jiajia Zhang Ph.D.

Faculty Publications

Routinely monitoring viral rebound (VR) is important in the life course of people with HIV (PWH). This study examined risk factors for time to the first VR, the number of VRs and their association with VR history in men who have sex with men (MSM). It includes 8176 adult PWH diagnosed from January 2005 to December 2018, followed until July 2021. We used the Cox model for time to the first VR, the Poisson model for a number of VRs, and logistic regression for VR history in MSM. Younger individuals (50–59 years vs 18–29 years, aHR: 0.43, 95% CI: [0.34, …

Healthcare Providers’ Perspective On Hiv Testing And Hypothetical Mhealth-Connected Linkage To Care Among Men Who Have Sex With Men (Msm) In South Carolina, Tony Brown, Prince Nii Ossah Addo, Monique J. Brown Ph.D., Mph, Xiaoming Li, Oluwafemi Adeagbo

Faculty Publications

Background: HIV continues to be an important public health concern in South Carolina (SC). However, an examination of providers’ willingness to use mHealth technologies to address ongoing barriers to HIV care and prevention strategies, particularly among men who have sex with men (MSM) is currently lacking in SC. We therefore explored HIV care providers’ perceptions of HIV testing and treatment uptake among MSM, and providers’ willingness to use mHealth technology to address barriers to HIV testing and treatment in SC. Methods: Between August and December 2021, we conducted semistructured virtual interviews with 10 HIV care providers recruited purposively based on …

Sars-Cov-2 Detection And Persistence In A Remote Amazonian Settlement, Glauco M. Silva, Roberto C. Ilacqua, Franciely G. Gonçalves, Carla M. Santana, Felipe T. Jordão, Paula R. Prist, Melissa S. Nolan Ph.D., Mph, Andreia F. Brilhante, Marcia A. Sperança, Gabriel Z. Laporta

Faculty Publications

Background: COVID-19 continues to pose a major global health challenge. Despite its geographic distance from Brazil’s major urban centers, Acre state has experienced notable outbreaks. This study assessed the detection and persistence of SARS-CoV-2 in the rural settlement of Santa Luzia, located in the remote municipality of Cruzeiro do Sul, Acre state, Brazil. Methods: In July 2022, a cross-sectional survey was conducted at 40 sites from an ongoing environmental study, selected by deforestation patterns and proximity to health posts. Saliva samples were collected from residents aged 5–90 years, followed by nucleic acid extraction and multiplex RT-qPCR for SARS-CoV-2 detection. Results: …

Effect Of Improving Food Security On Parenting Practices And Caregiver–Adolescent Relationships: Qualitative Findings Of An Income-Generating Agricultural Intervention In Rural Kenya, Maricianah A. Onono, Lila Sheira, Edward A. Frongillo Jr., Gladys Odhiambo, Pauline Wekesa, Amy Conroy, Elizabeth A. Bukusi, Craig R. Cohen, Sheri D. Weiser

Faculty Publications

Background

Despite the recognised links between food insecurity and parenting, few studies have evaluated the perceived impacts of livelihood or food security interventions on parental practices, intra-household functioning, adolescent behaviour and psychosocial outcomes in HIV-affected households in sub-Saharan Africa.

Aims

The study aimed to understand the perceived effects of food security on parenting practices and how this was experienced by both adolescent girls (aged 13–19 years) and their caregivers in rural Kenya.

Method

We conducted semi-structured, individual interviews with 62 caregiver–adolescent dyads who were participants in the adolescent Shamba Maisha (NCT03741634), a sub-study of adolescent girls and caregivers with a …

Appropriateness Of Ambulatory Antibiotic Prescribing In South Carolina, 2012–2017, Pamela Bailey, Majdi N. Al-Hasan, Julie Royer, Max Habicht, Julie Ann Justo, P. Brandon Bookstaver Pharm.D., Sharon Weissman, Hana R. Winders

Faculty Publications

This population-based cohort study examines the appropriateness of antibiotic prescribing in South Carolina via aggregated pharmacy claims data matched with diagnosis codes from medical claims. Inappropriate antibiotic prescribing decreased from 30.2% in 2012 to 22.6% in 2017 (P < 0.001) and was more common in adults >40 years old.

Integrated Child Nutrition, Parenting, And Health Intervention In Rural Liberia: A Mixed-Methods Feasibility Study, Sejla Isanovic, Musa Sanoe, Shelbie Wooten, Edward A. Frongillo Ph.D., Aisha K. Yousafzai, Christine E. Blake Ph.D., Rd, Mufaro Kanyangarara Ph.D., Melanie Swan, Nicole Rodger, Miriam Murray, Leila M. Larson Ph.D., Mph

Faculty Publications

In Liberia, children are exposed to multiple forms of adversity which can negatively impact their health and development. Research is needed to examine the feasibility and benefits of integrated interventions that can be incorporated into existing health delivery programs to simultaneously address low responsive stimulation, undernutrition, and infection. This study assessed the feasibility of an integrated intervention promoting psychosocial stimulation and improved child feeding by the provision of eggs and fish. The integrated intervention was incorporated into an existing government health program. Thirty female caregiver-child dyads were randomly selected from two rural communities in Liberia. Participants received fortnightly group parenting …

Sexual Orientation, Gender Identity And Virologic Failure Among People With Hiv: A Cohort Study In All Of Us Research Program, Fanghui Shi, Ruilie Cai, Buwei He, Xiaoming Li Ph.D., Xueying Yang Ph.D., Sharon Weissman, Bankole Olatosi Ph.D., Jiajia Zhang Ph.D.

Faculty Publications

Background: Sexual and gender minorities (SGMs) are at higher risk of HIV incidence compared to their heterosexual cisgender counterparts. Despite the high HIV disease burden among SGMs, there was limited data on whether they are at higher risk of virologic failure, which may lead to potential disease progression and increased transmission risk. The All of Us (AoU) Research Program, a national community-engaged program aiming to improve health and facilitate health equity in the United States by partnering with one million participants, provides a promising resource for identifying a diverse and large volunteer TGD cohort. Leveraging various data sources available through …

The Daily Gamecock: November 2024, University Of South Carolina, Office Of Student Media

November

No abstract provided.

Development Of Prediction Models Of Covid-19 Vaccine Uptake Among Lebanese And Syrians In A District Of Beirut, Lebanon: A Population-Based Study, Marie-Elizabeth Ragi, Hala Ghattas Ph.D., Hazar Shamas, Jocelyn Dejong, Nada M. Melhem, Stephen J. Mccall, The Caep Study Group

Faculty Publications

Introduction Vaccines are essential to prevent infection and reduce the morbidity of infectious diseases. Previous evidence has shown that migrants and refugees are particularly vulnerable to exclusion and discrimination, and low COVID-19 vaccine intention and uptake were observed among refugees globally. This study aimed to develop and internally validate prediction models of COVID-19 vaccine uptake by nationality.

Methods This is a nested prognostic population-based cross-sectional analysis. Data were collected between June and October 2022 in Sin-El-Fil, a district of Beirut, Lebanon. The study population included a random sample of Lebanese adults and all Syrian adults residing in areas of low …

A Historical Analysis Of Infant Mortality In South Carolina From 1920-1970, Allison Ritchie

Senior Theses

This study uses Geographic Information Systems (GIS) to investigate racial and spatial inequalities in South Carolina infant mortality rates (IMR’s) between 1920-1970. In the 20th century, IMR’s declined throughout the United States, primarily due to economic growth, increased sanitation, and improved medical knowledge. Factors such as systemic racism and lack of healthcare access resulted in higher IMR’s for Black infants and infants living in rural areas. In 1920, South Carolina’s Black IMR was 1.5 times higher than the white IMR; by 1970 the difference expanded to 1.9, reflecting a 27% rise. The disparity between Black and white IMR’s increased in …

Trade Secrets In The Artificial Intelligence Era, John G. Sprankling

South Carolina Law Review

No abstract provided.

Bayesian Nonparametric Models For Pooled Data, Yizeng Li

Theses and Dissertations

This work examines two applications of pooling: group testing and pooled biomonitoring. Group testing, introduced by Dorfman in the early 1940s, was initially developed to screen for syphilis among U.S. inductees during World War II. Since then, the approach has demonstrated cost-saving benefits in diverse fields, including drug discovery, genetics, and infectious disease testing. While various regression methods—parametric, nonparametric, and semiparametric—have been proposed to analyze group testing data, they fall short in addressing age-related disparities in disease presence if such variations exist. In Chapter 2, we address this gap by expanding varying coefficient regression within a Bayesian framework to accommodate …