Digital Commons Network^™

Improving Satisfaction For Patients With Diabetic Foot Ulcer Using A Diagnosis Specific Written Education Packet, Douglas W. Kozeluh

Doctor of Nursing Practice Scholarly Projects

Diabetes mellitus is a significant health care concern affecting 30.2 million Americans in 2015. One of the most common, costly, and serious sequela of diabetes is diabetic foot ulceration (DFU), which may lead to lower extremity amputation. Up to 50% of DFUs and lower extremity amputations can be prevented through effective patient education (PE). PE provided through written information is one intervention designed to improve patient understanding and self-management practices in order to reduce the risks and complications of DFU. The purpose of this Doctorate in Nursing Practice (DNP) project was to determine if implementation of a DFU specific written …

Clostridium Sporogenes Bacteremia In An Immunocompetent Patient, Waiel Abusnina, Mena Shehata, Emhemmid S. Karem, Zeynep C. Koc, Elie Khalil

Internal Medicine

Of the 200 Clostridium spp. known to exist, approximately 30 have been associated with human disease. Commonly found in soil, marine sediment and mammalian intestinal tracts, these gram-positive bacilli are known to cause infections ranging from cellulitis to septicemia. Isolates that are identified by clinical microbiology laboratories include Clostridium perfrigens species in 20–40% of cases. However, when Clostridium sporogenes is identified, is rarely considered to be pathogenic. We present a case of Clostridium sporogenes bacteremia secondary to lower limb cellulitis and osteomyelitis in an immunocompetent patient.

Ectopic High Endothelial Venules In Pancreatic Ductal Adenocarcinoma: A Unique Site For Targeted Delivery., Baharak Bahmani, Mayuko Uehara, Farideh Ordikhani, Xiaofei Li, Liwei Jiang, Naima Banouni, Takaharu Ichimura, Vivek Kasinath, Siawosh K Eskandari, Nasim Annabi, Jonathan S Bromberg, Leonard D. Shultz, Dale L Greiner, Reza Abdi

Faculty Research 2018

BACKGROUND: Nanomedicine offers an excellent opportunity to tackle treatment-refractory malignancies by enhancing the delivery of therapeutics to the tumor site. High endothelial venules (HEVs) are found primarily in lymph nodes or formed de novo in peripheral tissues during inflammatory responses. They express peripheral node addressin (PNAd), which is recognized by the monoclonal antibody MECA79.

METHODS: Here, we demonstrated that HEVs form de novo in human pancreatic ductal adenocarcinoma (PDAC). We engineered MECA79 coated nanoparticles (MECA79-NPs) that recognize these ectopic HEVs in PDAC.

FINDINGS: The trafficking of MECA79-NPs following intravenous delivery to human PDAC implanted in a humanized mouse model was …

Accumulation Of Lead By Biofilms In Drinking Water Distribution Systems, Kaleb Oren Belcher

Graduate Theses and Dissertations

Recent crises, such as the one in Flint, MI, indicate that lead exposure from drinking water is a major health concern in the United States. Over six million lead service lines are still in use in the United States, and a universal protocol to safely remove these lead service lines from drinking water distribution systems has not yet been established. This paper calls to attention the potential hazard that biofilms pose as a source of lead in distribution systems, even after the removal of lead pipes. This study used a simulated water distribution system containing a lead source pipe and …

The Monadnock Volume 60, December 2018, Clark University Geographical Society

The Monadnock (Clark Geographical Society)

Volume 60 of The Monadnock. The Monadnock was the alumni magazine of the Clark University Geographical Society (1927-1985) (2014-present).

White-Nose Syndrome Detected In Bats Over An Extensive Area Of Russia, Veronika Kovacova, Jan Zukal, Hana Bandouchova, Alexander D. Botvinkin, Markéta Harazim, Natália Martínková, Oleg L. Orlov, Vladimir Piacek, Alexandra P. Shumkina, Mikhail P. Tiunov, Jiri Pikula

KIP Articles

No abstract provided.

Service Learning Education Intervention: Survey Of Knowledge On Parasitic Worms And Hand Hygiene In Northern Belize Adolescents Ages 10-18, Tiffany Kim

2018 Fall Honors Capstone Projects - Archive

The purpose of this project is to assess if there is a knowledge barrier concerning hand hygiene and the contraction of parasitic worms in the northern districts of Belize. In countries around the world, hygiene maintenance is an issue. This issue is complicated by factors such as deficient knowledge, poor implementation of hand hygiene, and minimal access to clean water or soap. This lack of consistent hand hygiene practice often leads to higher infection rates. The most prominent infection observed in communities of Belize is of parasitic worms. Hand hygiene and its effect upon infection rates by parasitic worms requires …

The Role Of Cathelicidin In The Regulation Of Gut Microbiota And Inflammasome Activation In Alcoholic Liver Disease., Fengyuan Li

Electronic Theses and Dissertations

Alcoholic liver disease (ALD) is characterized by gut dysbiosis and hepatic and intestinal inflammation. Gut microbiota is critically maintained by antimicrobial peptides (AMPs) expressed in the epithelial and immune cells. AMPs are also identified as immune-regulators in various diseases. Previous studies demonstrated that deficiency of AMPs REG3 lectins exacerbated alcoholic steatohepatitis. LL-37 is the sole member of human cathelicidin AMP family, named CRAMP in mouse. Despite of the extensive studies in infectious diseases and in gut-microbiota-related inflammatory bowel disease, the role of LL-37/CRAMP in ALD is yet unknown. Our previous studies showed a decreased intestinal CRAMP in a mouse model …

Characterizing The Gut Microbiota During Plasmodium Infection And Antimalarial Treatment., Joshua E. Denny

Electronic Theses and Dissertations

Plasmodium, the parasitic cause of malaria, is a global pathogen, annually causing 216 million infections and 445,000 deaths. As drug resistance continues develop and no effective vaccine is available, it is critical to understand the factors underlying the severity of this disease. Plasmodium is an extra-gastrointestinal tract infection where the parasite infects red blood cells causing clinical malaria. However, recent publications have pointed to interactions between the gut microbiota and malaria. With this in mind, the role of the gut microbiota in malaria infection was studied. C57BL/6 mice from different vendors displayed differential resistance and susceptibility to severe malaria, …

Lead And Crime: An Ecological Study Between Lead Contaminated Topsoil And Violent Crime., Brian Guinn

Electronic Theses and Dissertations

Lead is a known neurotoxicant. Human exposure to lead comes primarily through environmental exposures, including remnant lead paint, lead contaminated topsoil and lead contaminated water. Prenatal and early life lead exposure has been associated with numerous neurocognitive and neuropsychiatric disorders. This dissertation presents findings from an ecological study which evaluated the geospatial association between topsoil lead content and the incidence of FBI designated violent crime in Jefferson County, Kentucky. A total of 412 topsoil samples were collected along roadways (n=300) and from Louisville Metro Parks (n=112). Jefferson County crime data was obtained from the Louisville Metro Police Department – Crime …

Is Macrolide And Beta-Lactam Combination Therapy Associated With Early Clinical Stability Or 30 Day Mortality In Hospitalized Patients With Pneumonia? An Assessment Of Confounding By Indication., Evangeline Pierce

Electronic Theses and Dissertations

Pneumonia and influenza are one of the leading causes of infectious disease-related deaths worldwide. Current guidelines for the treatment of hospitalized patients with community acquired pneumonia (CAP) include empiric antimicrobial therapy with a macrolide and a beta-lactam. There is little consensus among studies as to which antimicrobial regimen is best. The confusing results seen may very well be due to lack of assessment of confounding by indication (CBI). This analysis was a secondary analysis from Hospitalized Adults with Pneumococcal Pneumonia: Incidence Study (HAPPI). The study participants were those in HAPPI who had received either macrolide and beta-lactam combination therapy or …

Screening, Brief Intervention, And Referral To Treatment For Alcohol Misuse In Primary Care, Sai-Han Ackerman Yu

Doctor of Nursing Practice

An annual average of 88,000 deaths in the United States from 2006 to 2010 has been attributed to alcohol misuse, defined as risky or heavy alcohol consumption. Heavy or risky alcohol use for all adults aged 65 and older and for women aged 18 and older is defined as consuming more than 7 drinks per week and/or 3 drinks per day. For men aged 18 to 65 years of age, heavy or risky alcohol use is defined as consuming more than 14 drinks a week and/or 4 drinks a day. Chronic alcohol misuse increases the incidence of heart problems, cognitive …

Implementing Pneumococcal Vaccination Recommendations For Adults Age 19 And Over In A Family Care Clinic, Truc Le

Doctor of Nursing Practice

Pneumococcal vaccines are essential to children and adults. Having pneumococcal vaccines not only prevents pneumococcal infections but can also potentially lessen the severity of the disease. There are many scholarly articles attesting the herd effect in adults who received pneumococcal vaccines. Therefore, the purpose of this quality improvement project was to raise awareness of the pneumococcal vaccine and increase the vaccination rate in a primary care clinic in Texas. The Centers for Disease Control and Prevention’s pneumococcal vaccination schedule was utilized as guide for vaccine administration. The staff and provider were educated on screening, documenting, and administering the pneumococcal vaccine …

Sofosbuvir, Velpatasvir, And Voxilaprevir For Treatment Of Recurrent Hepatitis C Virus Infection After Liver Transplantation., Maria G Cardona-Gonzalez, Jason D Goldman, Lawrence Narayan, Diana M Brainard, Kris V Kowdley

Articles, Abstracts, and Reports

There are limited data on direct-acting antiviral (DAA) treatment options for previously treated patients with recurrent genotype 3 (GT3) hepatitis C virus (HCV) after liver transplantation. Sofosbuvir/velpatasvir/voxilaprevir (SOF/VEL/VOX) is currently approved for treatment of HCV in patients with prior treatment with DAAs. We report the first published experience using SOF/VEL/VOX after liver transplantation for a DAA-experienced patient with severe hepatitis due to early recurrent GT3 HCV. The patient was treated with SOF/VEL/VOX that was extended to a total duration of 16 weeks and was intensified with ribavirin (RBV) starting at week 8 due to persistent viremia during treatment. Sustained virologic …

Identifying Risk Factors Associated With Cardiovascular Disease Risk In Lesbians, Sofia S. Velazquez

Dissertations and Theses (Open Access)

Cardiovascular disease (CVD) is the leading cause of female deaths in the United States (1). While women, in general, are at risk for CVD, current research indicates that sexual minority women (i.e. lesbians and bisexual women [SMW]) may be at greater risk for CVD than heterosexual women. This heightened risk potentially stems from an increased prevalence of traditional CVD risk factors in SMW, creating health disparities between SMW and their heterosexual counterparts (2). Further research into this high-risk population is needed, in order to minimize these disparities.

The purpose of this study was to establish differences in the prevalence of …

Molecular Detection For Japanese Encephalitis And Chikungunya Virus As Etiology Agent For Dengue-Like Fever Symptoms, Rizka Ariani, Tjahjani M. Sudiro, Beti E. Dewi

Makara Journal of Health Research

Background: Acute fever with dengue-like fever symptoms with headache, rash, arthritis, perifer bleeding like ptechie and rinhorrhea are symptoms that often complained by patient and it may be caused by arboviruses infection. Arboviruses are very endemic in Indonesia, especially Dengue Virus (DENV), Japanese Encephalisitis Virus (JEV), and Chikungunya Virus (CHIKV) that causing similar symptoms. Molecular detection is very important to confirm the etiology for adequate management. Methods: This study investigated the etiological agent using one step real time RT reverse transcription polymerase chain reaction (RT PCR) method and SYBR Green I as fluorescent binding dye reporter. The viruses that were …

The Perils Of Philanthrocapitalism, Eric Franklin Amarante

Maryland Law Review

For over a century, philosophers, politicians, and sociologists have bemoaned philanthropy’s inherent antidemocratic, paternalistic, and amateuristic aspects. The antidemocratic nature of philanthropy is self-evident: When a wealthy person determines the best way to address a societal problem without the input of either society at large or the intended beneficiaries of the philanthropy, the result is a deficit of democracy. Philanthropy’s amateurism stems from the illogical belief that wealthy individuals ought to address some of the world’s most complex and intransigent problems simply because they successfully amassed a fortune in the private sector. The paternalism critique focuses on the assumption that …

Role Of The Physical Environment On Team-Based Primary Care In The Military Health System, William B. Lewis

All Dissertations

Primary care in the United States has shifted from a physician-centered care approach to a multidisciplinary, team-based care approach. This shift has resulted in many day-to-day changes in the care delivery process including how clinical staff collaborate; interact with patients; and use space, equipment, and various technologies. Team-based approaches, such as the Patient-Centered Medical Home (PCMH) model, are demonstrating improvements in patient health outcomes. The U.S. Military Health System, one of the largest healthcare organizations in the world, has adopted the PCMH model for primary care clinics. To support this new care model, a team-based clinical module is emerging as …

Natural Selection In Bats With Historical Exposure To White-Nose Syndrome, Markéta Harazim, Ivan Horáček, Lucie Jakešová

KIP Articles

Hibernation allows animals to survive periods of resource scarcity by reducing their energy expenditure through decreased metabolism. However, hibernators become susceptible to psychrophilic pathogens if they cannot mount an efficient immune response to infection. While Nearctic bats infected with white-nose syndrome (WNS) suffer high mortality, related Palearctic taxa are better able to survive the disease than their Nearctic counterparts. We hypothesised that WNS exerted historical selective pressure in Palearctic bats, resulting in genomic changes that promote infection tolerance.We investigated partial sequences of 23 genes related to water metabolism and skin structure function in nine Palearctic and Nearctic hibernating bat species …

Gauging Support For Macroecological Patterns In Helminth Parasites, Tad A. Dallas, A. Alonso Aguirre, Sarah Budischak, Colin Carlson, Vanessa Ezenwa, Barbara Han, Shan Huang, Patrick R. Stephens

Faculty Publications

© 2018 John Wiley & Sons Ltd Aim: To explore spatial patterns of helminth parasite diversity, and to investigate three main macroecological patterns – (a) latitude–diversity relationships, (b) positive scaling between parasite and host diversity, and (c) species–area relationships – using a largely underutilized global database of helminth parasite occurrence records. Location: Global. Methods: We examined the London Natural History Museum’s collection of helminth parasite occurrence records, consisting of over 18,000 unique host species and 27,000 unique helminth parasite species distributed across over 350 distinct terrestrial and aquatic localities. Results: We find support for latitudinal gradients in parasite diversity and …

Towards A Better Understanding Of The Effects Of Praziquantel On The Interaction Between The Helminth Parasite Schistosoma Mansoni And Its Murine Host, Melissa Catherine Sanchez

Biology ETDs

Schistosomiasis is a neglected tropical disease (NTD) that infects 206 million individuals worldwide. This disease is caused by dioecious trematodes of the genus Schistosoma, and its pathology is associated with the large number of eggs that are released by the female. Entrapped eggs lead to host immune and inflammatory responses resulting in disease progression. Chemotherapy provides the main means of control and praziquantel (PZQ) is the only widely available drug that is used in all mass drug administration (MDA) programs. As the number of individuals receiving PZQ continues to grow, the development of PZQ resistance is a concern and …

Vertical Transmission Of Zika Virus In Aedes Aegypti And Aedes Albopictus, Stephanie Cantu

Honors Theses

Arboviruses such as Zika (ZIKV), dengue, chikungunya are responsible causing over 4 million people to live with debilitating conditions and may produce long-term health consequences. Zika virus, a newly emerging arbovirus, has potentially severe neurological complications and a potential to cause severe birth defects. There are no current vaccines for Zika virus, and the primary method for control the spread of this disease is through early detection and vector control. Assessing and quantifying viral transmission patterns is critical for successful control efforts. Zika virus shows some unique (among arboviruses) transmission patterns, notably the ability to be sexually transmitted. One aspect …

Models For Networks With Consumable Resources: Applications To Smart Cities, Hayato Montezuma Ushijima-Mwesigwa

All Dissertations

In this dissertation, we introduce different models for understanding and controlling the spreading dynamics of a network with a consumable resource. In particular, we consider a spreading process where a resource necessary for transit is partially consumed along the way while being refilled at special nodes on the network. Examples include fuel consumption of vehicles together with refueling stations, information loss during dissemination with error correcting nodes, consumption of ammunition of military troops while moving, and migration of wild animals in a network with a limited number of water-holes. We undertake this study from two different perspectives. First, we consider …

On Some Environmental Applications Of Stochastic Processes, Liu Zhu

All Dissertations

This dissertation focuses on the study of some environmental applications of stochastic processes. In the first Chapter, we study an extreme value time series, where the extremes are derived using the block maxima/minima method. In extreme value analyses, the block maxima/minima are typically assumed to be statistically independent from block to block. However, extreme data arising from applications often present significant correlations. The main result of the chapter is to develop a simple and efficient method to estimate extreme model parameters and compute standard errors for them that account for correlation. More precisely, we develop a likelihood for sequences of …

Bloodstream Infection Due To Piperacillin/Tazobactam Non-Susceptible, Cephalosporin Susceptible Escherichia Coli: A Missed Opportunity For De-Escalation Of Therapy, Leah Carlisle, Julie Ann Justo, Majdi N. Al-Hasan

Faculty Publications

An increasing number of reports describing Escherichia coli isolates with piperacillin/tazobactam resistance, despite retained cephalosporin susceptibility, suggest further emergence of this phenotypic resistance pattern. In this report, a patient with metastatic breast cancer presented to medical care after two days of chills, nausea, vomiting, reduced oral intake, and generalized weakness. Blood and urine cultures grew E. coli as identified by rapid diagnostics multiplex PCR and MALDI-TOF, respectively. The patient continued to manifest signs of sepsis with hypotension and tachypnea during the first three days of hospitalization despite empirical antimicrobial therapy with intravenous piperacillin/tazobactam. After in vitro antimicrobial susceptibility testing demonstrated …

On A Stochastic 2d Simplified Liquid Crystal Model Driven By Jump Noise, T. Tachim Medjo

Communications on Stochastic Analysis

No abstract provided.

Pharmacy Newsletter : December 2018, Pharmacy Department

Department of Pharmacy Archives

Content:

• Seizure Prophylaxis in Adult Traumatic Brain Injury
• Tizanidine and Ciprofloxacin – Serious Drug Interaction
• Seasonal Flu and Influenza Vaccine in Healthcare Workers
• Raised Concerns on Quinolones for Hypoglycemia and Psychiatric Adverse Effect
• Rabies Immunization: Recommendations WHO 2018

Implementating A Transitional Care Program To Reduce Hospital Readmissions In Medicare Recipients: A Research Translation Pilot Project, Gail Rattigan

Doctoral Scholarly Projects & Capstones

Patients discharged from hospital to home, especially the chronically ill and older adults, are too frequently readmitted within 30 days. The Centers for Medicare and Medicaid Services (n.d.; 2017) along with other interdisciplinary researchers have proposed, studied, and implemented strategies to decrease this excessive and expensive phenomenon. After the implementation of the Hospital Readmission Reduction Program in 2009, preventable readmissions have decreased but remain at unacceptable levels. Care transitions from hospital to home have been implicated as perilous and fraught with communication breakdown and lack of patient support and follow up. Strategies aimed at both the hospitalization phase and the …

Rape Messaging, Alena Allen

Fordham Law Review

When feminists began advocating for rape reform in the 1970s, the rape message was clear: rape was not a crime to be taken seriously because women lie. After decades of criminal law reform, the legal requirement that a woman vigorously resist a man’s sexual advances to prove that she was raped has largely disappeared from the statute books, and, in theory, rape shield laws make a woman’s prior sexual history irrelevant. Yet, despite what the law dictates, rape law reforms have not had a “trickle-down” effect, where changes in law lead to changes in attitude. Women are still believed to …

Understanding Fear Of Zika: Personal, Interpersonal, And Media Influences, Chun Yang, James Price Dillard, Ruobing Li

Faculty Publications

Fear of infectious disease often motivates people to protect themselves. But, it can also produce negative bio-social-psychological effects whose severity is on par with those of the disease. The WHO declaration of Zika as a world health crisis presented an opportunity to study factors that bring about fear. Beginning nine days after the WHO announcement, data were gathered from women aged 18–35 living in the southern United States (N = 719). Respondents reported experiencing fear of Zika at levels akin to those reported following other significant crises/disasters (e.g., the terrorist attacks of 9/11). Fear increased as a function of (1) …