Digital Commons Network^™

Multicenter, Observational Cohort Study Evaluating Third-Generation Cephalosporin Therapy For Bloodstream Infections Secondary To Enterobacter, Serratia, And Citrobacter Species, Caroline Derrick, P. Brandon Bookstaver, Zhiqiang K. Lu, Christopher M. Bland, S. Travis King, Kayla R. Stover, Kathey Rumley, Shawn H. Macvane, Jenna Swindler, Scott Kincaid, Trisha Branan, David Cluck, Benjamin Britt, Kelly E. Pillinger, Bruce M. Jones, Virginia Fleming, V. Paul Dimondi, Sandy Estrada, Brad Crane, Brian Odle, Majdi N. Al-Hasan, Julie Ann Justo

Faculty Publications

Objectives: There is debate on whether the use of third-generation cephalosporins (3GC) increases the risk of clinical failure in bloodstream infections (BSIs) caused by chromosomally-mediated AmpC-producing Enterobacterales (CAE). This study evaluates the impact of definitive 3GC therapy versus other antibiotics on clinical outcomes in BSIs due to Enterobacter, Serratia, or Citrobacter species. Methods: This multicenter, retrospective cohort study evaluated adult hospitalized patients with BSIs secondary to Enterobacter, Serratia, or Citrobacter species from 1 January 2006 to 1 September 2014. Definitive 3GC therapy was compared to definitive therapy with other non-3GC antibiotics. Multivariable Cox proportional hazards regression evaluated the impact of …

Pharmacist-Driven Culture And Sexually Transmitted Infection Testing Follow-Up Program In The Emergency Department, Stephanie C. Shealy, Christine Alexander, Tina Grof Hardison, Joseph Magagnoli, Julie Ann Justo, Caroline Derrick, Joseph Kohn, Hana Rac Winders, Troy Privette, Majdi N. Al-Hasan, P. Brandon Bookstaver

Faculty Publications

Expanding pharmacist-driven antimicrobial stewardship efforts in the emergency department (ED) can improve antibiotic management for both admitted and discharged patients. We piloted a pharmacist-driven culture and rapid diagnostic technology (RDT) follow-up program in patients discharged from the ED. This was a single-center, pre- and post-implementation, cohort study examining the impact of a pharmacist-driven culture/RDT follow-up program in the ED. Adult patients discharged from the ED with subsequent positive cultures and/or RDT during the pre- (21 August 2018–18 November 2018) and post-implementation (19 November 2018–15 February 2019) periods were screened for inclusion. The primary endpoints were time from ED discharge to …

Impact Of Reappraisal Of Fluoroquinolone Minimum Inhibitory Concentration Susceptibility Breakpoints In Gram-Negative Bloodstream Isolates, Stephanie C. Shealy, Matthew M. Brigmon, Julie Ann Justo, P Brandon Bookstaver, Joseph Kohn, Majdi N. Al-Hasan

Faculty Publications

The Clinical Laboratory Standards Institute lowered the fluoroquinolone minimum inhibitory concentration (MIC) susceptibility breakpoints for and glucose non-fermenting Gram-negative bacilli in January 2019. This retrospective cohort study describes the impact of this reappraisal on ciprofloxacin susceptibility overall and in patients with risk factors for antimicrobial resistance. Gram-negative bloodstream isolates collected from hospitalized adults at Prisma Health-Midlands hospitals in South Carolina, USA, from January 2010 to December 2014 were included. Matched pairs mean difference (MD) with 95% confidence intervals (CI) were calculated to examine the change in ciprofloxacin susceptibility after MIC breakpoint reappraisal. Susceptibility of to ciprofloxacin declined by 5.2% (95% …

Associations Between Food Insecurity And Psychotropic Medication Use Among Women Living With Hiv In The United States, Henry J. Whittle, William R. Wolfe, Lila A. Sheira, Edward A. Frongillo Jr., Kartika Palar, Daniel Merenstein, Tracey E. Wilson, Adebola Adedimeji, Mardge H. Cohen, Eryka L. Wentz, Phyllis C. Tien, Sheri D. Weiser

Faculty Publications

AIMS: Psychotropic prescription rates continue to increase in the United States (USA). Few studies have investigated whether social-structural factors may play a role in psychotropic medication use independent of mental illness. Food insecurity is prevalent among people living with HIV in the USA and has been associated with poor mental health. We investigated whether food insecurity was associated with psychotropic medication use independent of the symptoms of depression and anxiety among women living with HIV in the USA. METHODS: We used cross-sectional data from the Women's Interagency HIV Study (WIHS), a nationwide cohort study. Food security (FS) was the primary …

A Broadly Distributed, Novel Class Of Diiron Enzymes Involved In Para-Aminobenzoate Synthesis, Joseph M. Zambelas

Senior Theses

The overall structure and ligand arrangement of diiron enzymes influence their function and catalytic potential, allowing for them to catalyze an expansive breadth of high energy transformations. The diiron enzyme CADD from Chlamydia trachomatis is involved in a novel biosynthetic pathway for p-aminobenzoic acid (pABA), a precursor for tetrahydrofolate. The unique ligand structure and reactivity of CADD and homolog NE1434 provide an intriguing means to contrast structure function relationships with other known diiron enzymes that activate dioxygen. In this work, studies of CADD and NE1434 orthologs and comparison to other diiron enzymes reveal several sequence motifs that are likely critical …

A Scenario-Based Analysis On The Impact Of Covid-19 On The Public Sector, Private Sector, And International Business, Charles Nastopoulos

Senior Theses

Drawing on four years of academic education received from the #1 International Business Program at the Darla Moore School of Business at the University of South Carolina Honors College, this is a comprehensive and forward-thinking strategic thought piece addressing the international business world and its potential post-pandemic reality. This thesis will answer the overarching question: What are the short- and long-term impacts of the coronavirus pandemic on international business?

Vaccine Confidence, Coverage, And Hesitancy Worldwide: A Literature Analysis Of Vaccine Hesitancy And Potential Causes Worldwide, Jordan Hammond

Senior Theses

Vaccines are one of the world’s most impactful medical therapies. They are cost-effective, successfully proven, and one of the quickest treatment options available today (Clark et al., 2016). They save millions of lives every year and have eliminated certain diseases on a national and international level. However, millions of people worldwide still remain unvaccinated. In developed nations, mainly The United States (U.S.) and the European countries, many of the unvaccinated are a result of rising vaccine hesitancy of parents in conjunction with the anti-vaccination movement. Vaccine hesitancy is defined as “a delay in acceptance or refusal of vaccines despite availability” …

Case Studies In Medical Ethics In The 20th & 21st Centuries As Told Through The Perspective Of A Human Life, Madelynn Wildes

Senior Theses

This paper is an analysis of different case studies in medical ethics in the 20th and 21st century. The case studies are divided into three different categories of a human life: beginning of life, middle of life, and the end of life. Each of these chapters includes a little excerpt about a person named Jane as she goes through each stage of her life. This merely serves to humanize the topics covered a little more. The beginning of life covers topics such as abortion and eugenics and discusses court cases and ethical dilemmas surrounding them. The middle of life covers …

Influenza Vaccination Coverage In Pediatric Patients With Inflammatory Bowel Disease, Kelly Brown

Senior Theses

Background: Children with chronic health conditions, including inflammatory bowel disease (IBD), are at especially high risk for influenza infection and complications. The Crohn’s & Colitis Foundation and American College of Gastroenterology recommend that IBD patients should receive annual influenza vaccination. The aims of this study were to evaluate influenza vaccination coverage over time and identify predictors of flu vaccination in pediatric IBD and non-IBD patients.

Methods: We utilized longitudinal data (2000 to 2016) from South Carolina Medicaid to conduct a matched cohort study. The primary exposure of interest was IBD diagnosis based upon ICD-9/10 diagnosis codes. Children with IBD were …

The Usefulness Of The Left Atrial Dilation Rate In Determining Severity Of Heart Failure, Laura B. Snyder

Senior Theses

Hypertension and vascular stiffness are two physiological conditions that strain the left ventricle (LV) and cause it to gain muscle mass. Eventually, the LV is unable to fill correctly and the patient develops Heart Failure with a preserved Ejection Fraction (HFpEF). Clinically, a patient’s left atrium (LA) area is measured as a diagnostic parameter of HFpEF severity. However, this doesn’t offer a prognosis or threshold of LA size necessitating hospitalization because of variation in patient demographics, genetics, and lifestyle which affect rates of HFpEF progression.

Since there are no medications or effective treatment options for HFpEF patients, there is a …

Consumer-Directed Healthcare And The Physician-Patient Relationship, Chase Floyd

Senior Theses

The physician-patient relationship is the most fundamental unit of medicine itself - and yet currently faces great peril, increasingly encroached upon by a number of different threats. Consumer-directed healthcare, an innovative new form of healthcare financing, empowers indi- viduals to make their own decisions regarding their healthcare, holds providers accountable to their patients, and theoretically establishes a robust working relationship that benefits both par- ties. Could this be what is needed to save and strengthen the physician-patient relationship? This paper studies this question, namely the effect of consumer-directed healthcare on the physi- cian-patient relationship, in-depth through a synthesis of existing …

First Aid And Emergency Preparedness: Improving Health Outcomes Among Aging Adults, Anna J. Kulangara

Senior Theses

As the United States population demographic shifts and the baby boomer population enters seniority, the health sector must adjust and prepare to provide efficient and adequate healthcare to the people. The Silver Tsunami, a metaphor for the expected wave of aging adults, will inevitably strain healthcare professionals and can be partly relieved by promoting risk-minimizing behavior in baby boomers before severe conditions develop. Through this effort, a health education course, titled First Aid and Emergency Preparedness, was developed and taught twice at a local senior center to target senior citizens and promote proactivity and healthy behaviors. Course development founded largely …

The Impact Of Perceptions About Influenza And The Yearly Influenza Vaccine On Vaccine Behaviors Among Undergraduate Students At The University Of South Carolina, Julia G. Fuller

Senior Theses

Background: Undergraduate students are at an increased risk for developing respiratory infections as a result of the proximity in which they live, study, and eat. Despite being a target population for the Centers for Disease Control and Prevention’s yearly flu vaccine, several studies of undergraduate populations have found vaccine uptake to be much lower than other at-risk populations. This study aims to understand how perceptions about influenza and the influenza vaccine affect University of South Carolina undergraduate students’ vaccine behavior. Methods: A cross-sectional study was completed using survey data from 165 undergraduate students at the University of South Carolina. The …

Checkmate: Exploring Father-Son Communication Regarding Reproduction And Sexual Health In Males With Cystic Fibrosis, Dianna C. Sanderson

Theses and Dissertations

Cystic fibrosis (CF) is a heritable monogenic condition with allelic heterogeneity. A variety of sequence alterations in the cystic fibrosis transmembrane conductance regulator (CFTR) gene results clinically in multisystem disease including a reduced reproductive capacity in affected males. Knowledge of reproductive capacity is often disclosed to parents by medical providers and to affected male children by medical providers and their parents. Despite advanced technology and therapeutics yielding the benefits of increased life expectancy and quality of life, males affected with CF largely remain uninformed in broader areas of sexual health and particularly in how their concept of masculine …

Development Of Natural Product-Derived Cationic Polymers For Biomaterial Applications, Moumita Sharmin Jui

Theses and Dissertations

In this thesis, multicyclic natural products and metallocene-containing polymers were synthesized for biomedical applications.

Chapter 1 describes the overall background, the recent development of natural product-based antimicrobial biomaterial and metallocene containing polymer for biomedical application. Afterward, the primary research objectives of my research are illustrated.

In chapter 2, a multicyclic natural product derived guanidine-based facially amphiphilic homopolymers and copolymers were synthesized. Cholic acid is one of the bile acid derivatives used to prepare facially amphiphilic moieties. A neutral polyethylene glycol (PEG) component was used to prepare copolymers with cholic acid. Reversible-addition fragmentation chain transfer (RAFT) polymerization technique was used to …

Structural, Functional And Immunological Studies Of Group 1 And 2 House Dust Mite And Profilin Allergens For The Development Of Allergen Specific Diagnostics And Immunotherapy, Anyway B. Kapingidza

Theses and Dissertations

Group 1 and 2 house dust mites (HDM) allergens elicit IgE response in more than 80% of sensitized individuals. These allergens affect 10-30% of the world’s population. Prolonged inhalation of low doses of allergens (microgram amounts inhaled over months or years) by genetically predisposed individuals leads to the induction of a Th2-type immune response induced by allergen-specific immunoglobulin E (IgE) produced by plasma cells resulting in allergic diseases like asthma, atopic dermatitis, and rhinitis. Group 1 and 2 HDM allergens, in particular, are associated with the development of the aforementioned allergic diseases. The goal of this research was to characterize …

The Impact Of Psychosocial, Clinical, And Neighborhood Factors On Inflammatory Outcomes Among African American Women, Malcolm Seth Bevel

Theses and Dissertations

Inflammatory-related chronic diseases are disparagingly prevalent among African Americans in the United States, particularly in the Southeastern region. Access to community gardens shows promise in mitigating chronic disease outcomes, despite multiple barriers to physical activity and diet among underserved populations. We seek to determine if psychosocial or clinical factors mediate the association between the treatment effect of a healthy lifestyle intervention and inflammatory biomarker levels among African American women, respectively. We also seek to analyze the relationship between residing in a food desert/swamp and inflammatory biomarker levels, while gaining a qualitative perspective about community garden access among African American women. …

Experiences Of College Students In Addiction Recovery: A Critical Case Study, Dory E. Hoffman

Theses and Dissertations

The purpose of this study is to investigate the lived experiences of college students in addiction recovery. Critical ethnographic case study was used to challenge existing paradigms and educational practices regarding students in recovery. The lived experiences of this population are described to share their stories and work towards better policy solutions to the U.S. college drug epidemic.

Development, Validation, And Application Of A Novel Method To Separate And Quantify Silver Intracellular Uptake In Pseudomonas Aeruginosa, Mohammed A. Othman

Theses and Dissertations

Silver nanoparticles (AgNPs) have attracted tremendous attention as a potential broadspectrum antimicrobial agent to overcome multidrug resistant (MDR) infections. However, a comprehensive understanding to AgNPs bactericidal mechanism of action and the relative role of particulate versus ionic Ag in AgNPs antibacterial activity is lacking but essential for their optimization for potential medical applications. Therefore, a novel method to separate and quantify Ag internalization in P. aeruginosa was developed and validated through multimethod approach. The methods used were optical density at 600 nm (OD600), LIVE/DEAD staining, transmission electron microscopy (TEM), and sorbed Ag liberation assays. After optimizing the method, it was …

Surveying Tuberculosis Screening Practices Of South Carolina Hospital Employees, Tamara T. Carree

Theses and Dissertations

BACKGROUND: Every year tuberculosis (TB) causes over 10 millions of people globally and in recent years has caused over 9,000 cases annually in the United States. TB can be transmitted in hospital settings, and South Carolina hospitals, like hospitals elsewhere in the country maintain a responsibility to test their employees for this disease. Nosocomial infections of active TB among patients and healthcare workers can be burdensome on hospital resources. Testing healthcare workers and implementing prevention strategies are examples of administrative controls provided in the 2005 guidelines by the Centers for Disease Control and Prevention (CDC). Implementation of administrative controls are …

The Effects Of Racialization On Skeletal Manifestations Of Disease Among Migrants In Historic St. Louis, Missouri, Kristina M. Zarenko

Theses and Dissertations

This research investigates the biological effects of racialization on migrants in late nineteenth and early twentieth century St. Louis, Missouri. Racialization is a form of structural violence in which real or perceived physical differences contribute to the creation of hierarchical racial categories along a continuum of whiteness. German and Irish immigrants and African American migrants from the South came to St. Louis in search of economic prosperity and in an attempt to escape poverty, famine, or conflict in their places of origin. However, racialization affected each migrant group’s access to housing and employment as well as their exposure to violence. …

Gestational Infections And Obesity: Implications For Intellectual Disability Risk, Maggie S. J. Mccarter

Theses and Dissertations

Maternal body weight, measured as Body Mass Index (BMI) and infection during pregnancy are established risk factors of multiple adverse birth outcomes that are also associated with intellectual disability (ID) in children, but little is known of the interaction of these two factors. This retrospective cohort study sought to explore whether BMI is an effect modifier in the association between maternal infection during pregnancy and ID of the child, and to make comparisons between categories of gestational infection. The study sample (n= 124,047 after exclusion) was derived from Medicaid administrative data. After preliminary analysis of interaction, stratified logistic regression analysis …

Of American Fragility: Public Rituals, Human Rights, And The End Of Invisible Man, Etienne C. Toussaint

Faculty Publications

The COVID-19 pandemic has exposed the fragility of American democracy in at least two important ways. First, the coronavirus has ravaged Black communities across the United States, unmasking decades of inequitable laws and public policies that have rendered Black lives socially and economically isolated from adequate health care services, educational resources, housing stability, environmental security, stable and living wage jobs, generational wealth, and other institutional structures necessary for resilience. Second, government-mandated social distancing in response to the coronavirus has failed to dampen America’s racially biased, violent, and supervisory policing culture, reigniting demands from the Movement for Black Lives for police …

Evaluating Appropriateness And Diagnostic Stewardship Opportunities Of Multiplex Polymerase Chain Reaction Gastrointestinal Testing Within A Hospital System, Melissa O'Neal, Hanna Murray, Sangita Dash, Majdi N. Al-Hasan, Julie Ann Justo, P Brandon Bookstaver

Faculty Publications

Objective: This single-center, retrospective, observational cohort study evaluates the appropriateness of the BioFire® FilmArray® Gastrointestinal (GI) multiplex PCR panel testing at a community-teaching hospital. Methods: All adult, hospitalized patients at Prisma Health Richland Hospital with a documented GI multiplex PCR panel from 1 April 2015 through 28 February 2018 were included in the analysis. Inappropriate use of the GI panel was defined as a test obtained without documented diarrhea, greater than 2 days of hospitalization, redundant use with other diagnostic tests (e.g. PCR), or laxative use in the preceding 48 h. Antibiotic use and host variables were compared between groups …

Online Availability Of Fish Antibiotics And Documented Intent For Self-Medication, Weiwei Zhang, Austin Williams, Nicole Griffith, Jessica Gaskins, P Brandon Bookstaver

Faculty Publications

Self-medication and antibiotic utilization without healthcare oversight may lead to delayed appropriate treatment, transmission of communicable infections, untoward adverse events, and contribute to antimicrobial resistance. Previous data suggest people obtain over-the-counter (OTC) animal antibiotics for their personal use. This study examined the availability of OTC fish antibiotics online and the documented intent for self-medication. The authors conducted a web-based cross-sectional study using Google search engine to identify vendor websites selling fish antibiotics in the United States. Vendor websites were included if product information, consumer reviews, and comments were publicly available. Nine fish antibiotics were chosen due to their possibility of …

Lessons From Disaster: Assessing The Covid19 Response In Youth Jails & Prisons, Madalyn K. Wasilczuk

Faculty Publications

No abstract provided.

Portraiture And The Convergence Of Social Classes In Bleak House, Heather Twele

The Oswald Review: An International Journal of Undergraduate Research and Criticism in the Discipline of English

No abstract provided.

Testing Predictability Of Disease Outbreaks With A Simple Model Of Pathogen Biogeography, Tad Dallas, Colin J. Carlson, Timothée Poisot

Faculty Publications

Predicting disease emergence and outbreak events is a critical task for public health professionals and epidemiologists. Advances in global disease surveillance are increasingly generating datasets that are worth more than their component parts for prediction-oriented work. Here, we use a trait-free approach which leverages information on the global community of human infectious diseases to predict the biogeography of pathogens through time. Our approach takes pairwise dissimilarities between countries’ pathogen communities and pathogens’ geographical distributions and uses these to predict country–pathogen associations. We compare the success rates of our model for predicting pathogen outbreak, emergence and re-emergence potential as a function …

A Baker's Dozen Of Top Antimicrobial Stewardship Intervention Publications In 2018, Elias B. Chahine, Spencer H. Durham, Krutika N. Mediwala, Daniel B. Chastain, Timothy P. Gauthier, Brandon K. Hill, Bruce M. Jones, Jamie J. Kisgen, Ashley H. Marx, Kayla R. Stover, Marylee V. Worley, Christopher M. Bland, P Brandon Bookstaver

Faculty Publications

With an increasing number of antimicrobial stewardship-related articles published each year, attempting to stay current is challenging. The Southeastern Research Group Endeavor (SERGE-45) identified antimicrobial stewardship-related peer-reviewed literature that detailed an actionable intervention for 2018. The top 13 publications were selected using a modified Delphi technique. These manuscripts were reviewed to highlight the actionable intervention used by antimicrobial stewardship programs to provide key stewardship literature for teaching and training as well as to identify potential intervention opportunities within one's institution.

The Association Between Dietary Inflammatory Index (Dii) And Cancer Risk In Korea: A Prospective Cohort Study Within The Koges-Hexa Study, Injeong Ryu, Minji Kwon, Cheongmin Sohn, Nitin Shivappa, James R. Hébert, Woori Na, Mi Kyung Kim

Faculty Publications

Several epidemiological studies have shown that there are consistently positive associations between dietary inflammatory index (DII (R)) scores and cancer incidence in Western populations. However, few DII-cancer studies have been conducted in East Asian populations. In a large cohort representative of the general Korean population, we investigated whether the DII is associated with overall cancer risk. A total of 163,660 participants (56,781 males and 106,879 females) had evaluable data for analyses. This follow-up study was carried out over the course of 7.9 years. DII scores were calculated based on Semi-Quantitative Food-Frequency Questionnaire (SQ-FFQ) data for 106 food items. Cancers were …