Digital Commons Network^™

Outpatient Parenteral Antimicrobial Therapy Practices Among Adult Infectious Disease Physicians, Michael A. Lane, Jonas Marschall, Susan E. Beekman, Philip M. Polgreen, Ritu Banerjee, Adam L. Hersh, Hilary M. Babcock

Open Access Publications

No abstract provided.

Eata, An Immunogenic Protective Antigen Of Enterotoxigenic Escherichia Coli, Degrades Intestinal Mucin, Pardeep Kumar, Qingwei Luo, Tim J. Vickers, Alaullah Sheikh, James M. Fleckenstein

Open Access Publications

No abstract provided.

Health Professionals’ Attitude Towards Substance Abusers : A Part Of The Health Professionals’ Value And Belief System Which Prevails In Society, Ana Gotay

Master in Public Administration Theses

No abstract provided.

Democratic Deliberation And The Ethical Review Of Human Subjects Research, Govind Persad

Sturm College of Law: Faculty Scholarship

In the United States, the Presidential Commission for the Study of Bioethical Issues has proposed deliberative democracy as an approach for dealing with ethical issues surrounding synthetic biology. Deliberative democracy might similarly help us as we update the regulation of human subjects research. This paper considers how the values that deliberative democratic engagement aims to realize can be realized in a human subjects research context. Deliberative democracy is characterized by an ongoing exchange of ideas between participants, and an effort to justify decisions that bind participants by appeal to reasons that the participants can understand and share. Even when unanimous …

2014 Viewbook, Office Of Admissions

Viewbook

Established by the State of Illinois to develop talent and leadership in science, technology, engineering and mathematics, the Illinois Mathematics and Science Academy has become an internationally recognized, world-class powerhouse for inspiring, challenging and nurturing talented students who use their exceptional abilities to improve people's lives. IMSA's advanced residential college preparatory program enables academically talented Illinois students in grades 10 through 12 to reach extraordinary levels of achievement.

Vol. 26 August (2014)

In Principio - 2010s

No abstract provided.

Cancer Incidence In Hiv-Infected Versus Uninfected Veterans: Comparison Of Cancer Registry And Icd-9 Code Diagnoses, Lesley S. Park, Janet P. Tate, Maria Rodriguez-Barradas, David Rimland, Matthew B. Goetz, Cynthia L. Gibert, Sheldon T. Brown, Michael J. Kelley, Amy C. Justice, Robert Dubrow

Medicine Faculty Publications

Background: Given the growing interest in the cancer burden in persons living with HIV/AIDS, we examined the validity of data sources for cancer diagnoses (cancer registry versus International Classification of Diseases, Ninth Revision [ICD-9 codes]) and compared the association between HIV status and cancer risk using each data source in the Veterans Aging Cohort Study (VACS), a prospective cohort of HIV-infected and uninfected veterans from 1996 to 2008.

Methods: We reviewed charts to confirm potential incident cancers at four VACS sites. In the entire cohort, we calculated cancer-type-specific age-, sex-, race/ethnicity-, and calendar-period-standardized incidence rates and incidence rate ratios (IRR) …

Cd8+ T-Cells Count In Acute Myocardial Infarction In Hiv Diseases In A Predominantly Male Cohort, Oluwatosin A. Badejo, Chung-Chou Chang, Kaku A. So-Armah, Russell P. Tracy, Jason V. Baker, Cynthia L. Gibert, +15 Additional Authors

Medicine Faculty Publications

Human Immunodeficiency Virus- (HIV-) infected persons have a higher risk for acute myocardial infarction (AMI) than HIV-uninfected persons. Earlier studies suggest that HIV viral load, CD4+ T-cell count, and antiretroviral therapy are associated with cardiovascular disease (CVD) risk. Whether CD8+ T-cell count is associated with CVD risk is not clear. We investigated the association between CD8+ T-cell count and incident AMI in a cohort of 73,398 people (of which 97.3% were men) enrolled in the U.S. Veterans Aging Cohort Study-Virtual Cohort (VACS-VC). Compared to uninfected people, HIV-infected people with high baseline CD8+ T-cell counts (>1065 cells/mm3) had increased AMI …

Development And Validation Of An Algorithm To Identify Patients Newly Diagnosed With Hiv Infection From Electronic Health Records, Matthew B. Goetz, Tuyen Hoang, Virginia Kan, David Rimland, Maria Rodriguez-Barradas

Medicine Faculty Publications

An algorithm was developed that identifies patients with new diagnoses of HIV infection by the use of electronic health records. It was based on the sequence of HIV diagnostic tests, entry of ICD-9-CM diagnostic codes, and measurement of HIV-1 plasma RNA levels in persons undergoing HIV testing from 2006 to 2012 at four large urban Veterans Health Administration (VHA) facilities. Source data were obtained from the VHA National Corporate Data Warehouse. Chart review was done by a single trained abstractor to validate site-level data regarding new diagnoses. We identified 1,153 patients as having a positive HIV diagnostic test within the …

Pathoscope 2.0: A Complete Computational Framework For Strain Identification In Environmental Or Clinical Sequencing Samples., Changjin Hong, Solaiappan Manimaran, Ying Shen, Joseph F Perez-Rogers, Allyson L Byrd, Eduardo Castro-Nallar, Keith A Crandall, William Evan Johnson

Computational Biology Institute

BACKGROUND: Recent innovations in sequencing technologies have provided researchers with the ability to rapidly characterize the microbial content of an environmental or clinical sample with unprecedented resolution. These approaches are producing a wealth of information that is providing novel insights into the microbial ecology of the environment and human health. However, these sequencing-based approaches produce large and complex datasets that require efficient and sensitive computational analysis workflows. Many recent tools for analyzing metagenomic-sequencing data have emerged, however, these approaches often suffer from issues of specificity, efficiency, and typically do not include a complete metagenomic analysis framework.

RESULTS: We present PathoScope …

Characterization Of Cytomegalovirus Lung Infection In Non-Hiv Infected Children, Sonia M. Restrepo-Gualteros, Lina E. Jaramillo-Barberi, Monica Gonzalez-Santos, Carlos E. Rodriguez-Martinez, Geovanny F. Perez, Maria J. Gutierrez, Gustavo Nino

Pediatrics Faculty Publications

Cytomegalovirus (CMV) is a prevalent pathogen in the immunocompromised host and invasive pneumonia is a feared complication of the virus in this population. In this pediatric case series we characterized CMV lung infection in 15 non-HIV infected children (median age 3 years; IQR 0.2–4.9 years), using current molecular and imaging diagnostic modalities, in combination with respiratory signs and symptoms. The most prominent clinical and laboratory findings included cough (100%), hypoxemia (100%), diffuse adventitious breath sounds (100%) and increased respiratory effort (93%). All patients had abnormal lung images characterized by ground glass opacity/consolidation in 80% of cases. CMV was detected in …

Engagement With Care, Substance Use, And Adherence To Therapy In Hiv/Aids, Patrice K. Nicholas, Suzanne Willard, Clinton J. Thompson, Carol Dawson-Rose, Inge B. Corless, +20 Additional Authors

GW Biostatistics Center

Engagement with care for those living with HIV is aimed at establishing a strong relationship between patients and their health care provider and is often associated with greater adherence to therapy and treatment (Flickinger, Saha, Moore, and Beach, 2013). Substance use behaviors are linked with lower rates of engagement with care and medication adherence (Horvath, Carrico, Simoni, Boyer, Amico, and Petroli, 2013). This study is a secondary data analysis using a cross-sectional design from a larger randomized controlled trial (n = 775) that investigated the efficacy of a self-care symptom management manual for participants living with HIV. Participants were …

Synthesis And Biological Evaluation Of 5′-O-Dicarboxylic Fatty Acyl Monoester Derivatives Of Anti-Hiv Nucleoside Reverse Transcriptase Inhibitors, Bhanu Pemmaraju, Hitesh K. Agarwal, Donghoon Oh, Karen W. Buckheit, Robert W. Buckheit Jr., Rakesh Tiwari, Keykavous Parang

Biomedical and Pharmaceutical Sciences Faculty Publications

A number of 5′-O-dicarboxylic fatty acyl monoester derivatives of 3′-azido-3′-deoxythymidine (zidovudine, AZT), 2′,3′-didehydro-2′,3′-dideoxythymidine (stavudine, d4T), and 3′-fluoro-3′-deoxythymidine (alovudine, FLT) were synthesized to improve the lipophilicity and potentially the cellular delivery of parent polar 2′,3′-dideoxynucleoside (ddN) analogs. The compounds were evaluated for their anti-HIV activity. Three different fatty acids with varying chain length of suberic acid (octanedioic acid), sebacic acid (decanedioic acid), and dodecanedioic acid were used for the conjugation with the nucleosides. The compounds were evaluated for anti-HIV activity and cytotoxicity. All dicarboxylic ester conjugates of nucleosides exhibited significantly higher anti-HIV activity than that of the corresponding parent …

In Vitro Antibiofilm Efficacies Of Different Antibiotic Combinations With Zinc Sulfate Against Pseudomonas Aeruginosa Recovered From Hospitalized Patients With Urinary Tract Infection, Walid Elkhatib, Ayman Noreddin

Pharmacy Faculty Articles and Research

Urinary tract infections (UTIs) are a serious healthcare dilemma influencing millions of patients every year and represent the second most frequent type of body infection. Pseudomonas aeruginosa is a multidrug-resistant pathogen causing numerous chronic biofilm-associated infections including urinary tract, nosocomial, and medical devices-related infections. In the present study, the biofilm of P. aeruginosa CCIN34519, recovered from inpatients with UTIs, was established on polystyrene substratum and scanning electron microscopy (SEM) and was utilized for visualization of the biofilm. A previously described in vitro system for real-time monitoring of biofilm growth/inhibition was utilized to assess the antimicrobial effects of ciprofloxacin, levofloxacin, moxifloxacin, …

Hemorrhagic Stroke In An Adolescent Female With Hiv-Associated Thrombotic Thrombocytopenic Purpura, Natella Rakhmanina, Edward C.C. Wong, Jeremiah C. Davis, Patricio E. Ray

Pediatrics Faculty Publications

HIV-1 infection can trigger acute episodes of Idiopathic Thrombocytoponic Purpura (ITP), and Thrombotic Thrombocytopenic Purpura (TTP), particularly in populations with advanced disease and poor adherence to antiretroviral therapy (ART). These diseases should be distinguished because they respond to different treatments. Previous studies done in adults with HIV-TTP have recommended the prompt initiation or re-initiation of ART in parallel with plasma exchange therapy to improve the clinical outcome of these patients. Here, we describe a case of HIVTTP resulting in an acute hemorrhagic stroke in a 16 year old female with perinatally acquired HIV infection and non-adherence to ART, who presented …

Hiv Testing Implementation In Two Urban Cities: Practice, Policy, And Perceived Barriers., Camden J Hallmark, Jennifer Skillicorn, Thomas P Giordano, Jessica A Davila, Marlene Mcneese, Nestor Rocha, Avemaria Smith, Stacey Cooper, Amanda D. Castel

Epidemiology Faculty Publications

BACKGROUND: Although funding has supported the scale up of routine, opt-out HIV testing in the US, variance in implementation mechanisms and barriers in high-burden jurisdictions remains unknown.

METHODS: We conducted a survey of health care organizations in Washington, DC and Houston/Harris County to determine number of HIV tests completed in 2011, policy and practices associated with HIV testing, funding mechanisms, and reported barriers to testing in each jurisdiction and to compare results between jurisdictions.

RESULTS: In 2012, 43 Houston and 35 DC HIV-testing organizations participated in the survey. Participants represented 85% of Department of Health-supported testers in DC and 90% …

Using A Theory Of Change Approach To Analyze Global Health Diplomacy Practice In Myanmar, Sangeeta Mookherji, Holly Greb, Rebecca Katz

Global Health Faculty Publications

The current picture of global health diplomacy (GHD) is one of increasing complexity, with multiple actors striving for multiple objectives, using a multitude of strategies and activities. Analysis and documentation of GHD practice is urgently needed to help identify the opportunities GHD provides for jointly improving global health and international relations, as well as possible unintended consequences. Systematic analysis of GHD practice is challenging without a conceptual framework. We identified a Theory of Change approach as one way to conceptualize GHD practice and potential impacts that could also depict its complexity and identify relationships and pathways for measuring success. We …

Eyes, Ears And Guesswork: Creating Orthographic And Phonological Measures Of Vocabulary Breadth For Beginning And Advanced Spanish And Mandarin Chinese Second-Language Learners, Robert Matthew Klinkel

Theses & ETDs

Spanish is the most studied language in the U.S., and the study of Mandarin Chinese is increasing the most rapidly. Efficient measures of vocabulary acquisition, although available in other languages, are not readily available in Spanish and Chinese. Vocabulary measures are important because they help to assess learners’ receptive vocabulary breadth, or size, as well as to predict overall language ability. The X_Lex and A_Lex are standard measures of vocabulary breadth that assess two dimensions of vocabulary knowledge: the X_Lex measures orthographic, or reading knowledge, while the A_Lex measures phonological, or listening knowledge. Thus, the X_Lex better predicts reading and …

Medical Tourism: Comparing Coronary Bypass Surgery In The U.S. And Abroad, William K. Willis, Alberto Coustasse

Management Faculty Research

Rising health care costs have employers searching for remedies to the increasing rates they pay for employee health insurance. The development of U.S. health insurance policies, with the option of utilizing medical tourism as a low cost care provider for treatment of cardiac coronary bypass surgery provides a method for receiving treatment. The medical tourism approach to providing treatment for bypass surgery has prompted hospitals in India, Thailand, and Singapore to seek U.S. patients. A comparison of costs for bypass treatment between the U.S. and these countries illustrates some of the issues and concerns that arise when making such comparisons. …

Caring Minds, University Of Texas Health Science Center At Houston School Of Nursing

Caring Minds

No abstract provided.

Severe Morbidity And Mortality Risk From Malaria In The United States, 1985–2011, Jimee Hwang, Karen A. Cullen, S. Patrick Kachur, Paul M. Arguin, J. Kevin Baird

United States Public Health Resources

Background. Recent reports of Plasmodium vivax associated with severe syndromes and mortality from malaria endemic areas questions the “benign” course of non-falciparum malarias.

Methods. We retrospectively analyzed data from patients reported to the US Centers for Disease Control and Prevention with a diagnosis of malaria parasite single-species infection between 1985 and 2011. Patients classified as having severe illness were further classified according to outcome (survival versus death) and clinical syndrome.

Results. Among all cases, .9% of Plasmodium falciparum cases resulted in death and 9.3% were classified as severe, whereas .09% of P. vivax cases resulted in death and 1.3% were …

Caregiver Behavior Change For Child Survival And Development In Low- And Middle-Income Countries: An Examination Of The Evidence, John P. Elder, Willo Pequegnat, Saifuddin Ahmed, Gretchen Bachman, Merry Bullock, Waldemar A. Carlo, Venkatrama Chandra- Mouli, Nathan A. Fox, Sara Harkness, Gillian Huebner, Joan Lombardi, Velma Mcbride Murry, Allisyn Moran, Maureen Norton, Jennifer Mulik, Will Parks, Helen Raikes, Joseph Smyser, Caroline Sugg, Michael Sweat

United States Public Health Resources

In June of 2012, representatives from more than 80 countries promulgated a Child Survival Call to Action, which called for reducing child mortality to 20 or fewer child deaths per 1,000 live births in every country by 2035. To address the problem of ending preventable child deaths, the U.S. Agency for International Development and the United Nations Children’s Fund convened, on June 3–4, 2013, an Evidence Summit on Enhancing Child Survival and Development in Lower- and Middle-Income Countries by Achieving Population-Level Behavior Change. Six evidence review teams were established on different topics related to child survival and healthy development to …

Impaired Hcv Clearance In Hiv/Hcv Coinfected Subjects Treated With Pegifn And Rbv Due To Interference Of Ifn Signaling By Ifnαr2a, Yu Jin Lee, Xiaozhen Zhang, Estefania Vazquez, Gayathri Shivasabesan, Howard A. Young, Alison Murphy, Honghui Wang, Anthony F. Suffredini, Ulrich Siebenlist, Shyam Kottilil

United States Public Health Resources

Enhanced endogenous interferon (IFN) stimulated gene (ISG) signature has been associated with nonresponsiveness to hepatitis C treatment using pegylated-IFNα (pegIFNα) and ribavirin (RBV) in human immunodeficiency virus/hepatitis C virus (HIV/HCV) coinfected patients. Using a proteomic approach, we identified high levels of IFNα receptor 2a (IFNαR2a) in the serum of null responders to pegIFNα/RBV. IFNαR2a inhibited antiviral activity of all formulations of IFNα in JFH/Huh7.5 cells. Furthermore, serum from null responders, but not from those who achieved sustained virologic response, suppressed IFN-signaling and ISG expression in IFNα-stimulated PBMCs of healthy donors in an IFNαR2a specific fashion. An IFNαR2a transgenic mice model …

Detection Of Five Shiga Toxin-Producing Escherichia Coli Genes With Multiplex Pcr, Insook Son, Rachel Binet, Anna Maounounen-Laasri, Andrew Lin, Thomas S. Hammack, Julie A. Kase

United States Public Health Resources

Escherichia coli serogroup O157 is the pathogen most commonly associated with foodborne disease outbreaks, but epidemiological studies suggest that non-O157 Shiga toxin-producing E. coli (STEC) is a major player as well. The ten most clinically relevant STECs belong to serogroups O26, O103, O111, O145, O157, O91, O113, O128, O45, and O121; but emerging strains, such as O104:H4 that was identified with the 2011 German outbreak, could become more prevalent in the future. A 75-min conventional multiplex PCR assay, IS-5P, targeting the four virulence factors stx1, stx2, eae, and ehxA plus the O157:H7- specific +93 uidA single nucleotide …

Type I Interferon Responses In Rhesus Macaques Prevent Siv Infection And Slow Disease Progression, Netanya G. Sandler, Steven E. Bosinger, Jacob D. Estes, Richard T. R. Zhu, Gregory K. Tharp, Eli Boritz, Doron Levin, Sathi Wijeyesinghe, Krystelle Nganou Makamdop, Gregory D. Del Prete, Brenna J. Hill, J. Katherina Timmer, Emma Reiss, Ganit Yarden, Samuel Darko, Eduardo Contijoch, John Paul Todd, Guido Silvestri, Martha Nason, Robert B. Norgren Jr., Brandon F. Keele, Srinivas Rao, Jerome A. Langer, Jeffrey D. Lifson, Gideon Schreiber, Daniel C. Douek

United States Public Health Resources

Inflammation in HIV infection is predictive of non-AIDSmorbidity and death¹, higher set point plasma virus load² and virus acquisition³; thus, therapeutic agents are in development to reduce its causes and consequences. However, inflammation may simultaneously confer both detrimental and beneficial effects. This dichotomy is particularly applicable to type I interferons (IFN-I) which, while contributing to innate control of infection^4–10, also provide target cells for the virus during acute infection, impairCD4T-cell recovery, and are associated with disease progression^6,7,11–19.Herewe manipulated IFN-I signalling in rhesus macaques (Macaca mulatta) during simian immunodeficiency virus …

Antifibrotic Therapy In Simian Immunodeficiency Virus Infection Preserves Cd4+ T-Cell Populations And Improves Immune Reconstitution With Antiretroviral Therapy, Jacob D. Estes, Cavan Reilly, Charles M. Trubey, Courtney V. Fletcher, Theodore J. Cory, Michael Piatak Jr., Samuel Russ, Jodi Anderson, Thomas G. Reimann, Robert Star, Anthony Smith, Russell P. Tracy, Anna Berglund, Thomas Schmidt, Vicky Coalter, Elena Chertova, Jeremy Smedley, Ashley T. Haase, Jeffrey D. Lifson, Timothy W. Schacker

United States Public Health Resources

Even with prolonged antiretroviral therapy (ART), many human immunodeficiency virus-infected individuals have CD4⁺ T cells/μL, and CD4⁺ T cells in lymphoid tissues remain severely depleted, due in part to fibrosis of the paracortical T-cell zone (TZ) that impairs homeostatic mechanisms required for T-cell survival.We therefore used antifibrotic therapy in simian immunodeficiency virus-infected rhesus macaques to determine whether decreased TZ fibrosis would improve reconstitution of peripheral and lymphoid CD4⁺ T cells. Treatment with the antifibrotic drug pirfenidone preserved TZ architecture and was associated with significantly larger populations of CD4⁺ T cells in peripheral blood and lymphoid tissues. …

Molecular Epidemiology Of Infant Botulism In California And Elsewhere, 1976–2010, Haydee A. Dabritz, Karen K. Hill, Jason R. Barash, Lawrence O. Ticknor, Charles H. Helma, Nir Dover, Jessica R. Payne, Stephen S. Arnon

United States Public Health Resources

Background. Infant botulism (IB), first identified in California in 1976, results from Clostridium botulinum spores that germinate, multiply, and produce botulinum neurotoxin (BoNT) in the immature intestine. From 1976 to 2010 we created an archive of 1090 BoNT-producing isolates consisting of 1012 IB patient (10 outpatient, 985 hospitalized, 17 sudden death), 25 food, 18 dust/soils, and 35 other strains. Methods. The mouse neutralization assay determined isolate toxin type (56% BoNT/A, 32% BoNT/B). Amplified fragment-length polymorphism (AFLP) analysis of the isolates was combined with epidemiologic information. Results. The AFLP dendrogram, the largest to date, contained 154 clades; 52% of isolates …

Influenza-Like Illness, The Time To Seek Healthcare, And Influenza Antiviral Receipt During The 2010–2011 Influenza Season— United States, Matthew Biggerstaff, Michael A. Jhung, Carrie Reed, Alicia M. Fry, Lina Balluz, Lyn Finelli

United States Public Health Resources

Background. Few data exist describing healthcare-seeking behaviors among persons with influenza-like illness (ILI) or adherence to influenza antiviral treatment recommendations. Methods. We analyzed adult responses to the Behavioral Risk Factor Surveillance System in 31 states and the District of Columbia (DC) and pediatric responses in 25 states and DC for January–April 2011 by demographics and underlying health conditions. Results. Among 75 088 adult and 15 649 child respondents, 8.9% and 33.9%, respectively, reported ILI. ILI was more frequent among adults with asthma (16%), chronic obstruction pulmonary disease (COPD; 26%), diabetes (12%), heart disease (19%), kidney disease (16%), or obesity (11%). …

Internet And Telephonic Ivr Mixed-Mode Survey For Longitudinal Studies: Choice, Retention, And Data Equivalency, Santosh K. Verma, Theodore K. Courtney, David A. Lombardi, Wen-Ruey Chang, Yueng-Hsiang Huang, Melanye J. Brennan, Melissa J. Perry

Environmental and Occupational Health Faculty Publications

Purpose

This study examined data equivalency and loss to follow-up rates from Internet and interactive voice response (IVR) system surveys in a prospective-cohort study.

Methods

475 limited-service restaurant workers participating in the 12-week study were given a choice to report their weekly slipping experience by either IVR or Internet. Demographic differences, loss to follow-up, self-reported rates of slipping, and selection of first and last choices were compared.

Results

Loss to follow-up rates were slightly higher for those choosing the IVR mode. Rates of slipping and selection of first and last choices were not significantly different between survey modes. Propensity to …

Synthesizing Data And Models For The Spread Of Mers-Cov, 2013: Key Role Of Index Cases And Hospital Transmission, Gerardo Chowell, Seth Blumberg, Lone Simonsen, Mark A. Miller, Cecile Viboud

Global Health Faculty Publications

The outbreak of Middle East respiratory syndrome coronavirus (MERS-CoV) has caused 209 deaths and 699 laboratory-confirmed cases in the Arabian Peninsula as of June 11, 2014. Preparedness efforts are hampered by considerable uncertainty about the nature and intensity of human-to-human transmission, with previous reproduction number estimates ranging from 0.4 to 1.5. Here we synthesize epidemiological data and transmission models for the MERS-CoV outbreak during April–October 2013 to resolve uncertainties in epidemic risk, while considering the impact of observation bias. We match the progression of MERS-CoV cases in 2013 to a dynamic transmission model that incorporates community and hospital compartments, and …