Digital Commons Network^™

Healthcare Barriers For The Undocumented Immigrant In The United States, Anita Gipson

Integrated Studies

Abstract

We are taught early in our education that the United States of America was founded by immigrants. The United States is a very diverse country that people of other countries see as a land of opportunity. However, not everyone that enters into our beautiful country enter legally. Many residents of other countries are so desperate to provide a better life of opportunities to their families that they will do anything to make that happen. Even if it means breaking, the immigration laws in place by the United States and enter illegally by crossing the border. Many reasons play a …

Reducing The Risks Of Contaminated Flexible Endoscopes And Improving The Margin Of Safety With The Reprocessing Process, Lisa Greenwell

Integrated Studies

Gastrointestinal (GI) endoscopy is a minimally invasive, medical procedure that is an important tool for the identification and treatment of disorders of the gastrointestinal tract. Contaminated flexible endoscopes pose a significant risk to patients. Endoscopy associated infections and outbreaks have been reported with multi-drug resistant microorganisms. Inadequate endoscope reprocessing has been associated with infectious outbreaks, but some outbreaks have occurred despite strict adherence to established guidelines. To lessen the risk associated with endoscopy, it is imperative to identify problem areas within current reprocessing standards and develop, evaluate, and implement evidence-based solutions.

Is There A Correlation Between Epstein - Barr Virus (Mononucleosis) And Hodgkin’S Lymphoma?, Rooth Cohen

The Science Journal of the Lander College of Arts and Sciences

Symptoms of acute Infectious Mononucleosis (IM), which develops after Epstein-Barr virus (EBV) in half the cases, is strikingly like those of Hodgkin’s Lymphoma (HL). This, combined with the findings that many patients with HL had a history of EBV and/or IM, triggered an interest in scientists to learn if the two were biochemically related. Many studies in this field unanimously concluded that the development of IM after EBV infection presented a higher risk of developing HL. However, whether this relationship is coincidental or pathological remains a matter of controversy until this day. In the last decade, there has been a …

In Vivo Gene Essentiality And Metabolism In Bordetella Pertussis, Laura A. Gonyar, Patrick E. Gelbach, Dennis G. Mcduffe, Alexander F. Koeppel, Qing Chen, Gloria Lee, Louise M. Temple, Scott Stibitz, Erik L. Hewlwtt, Jason A. Papin, F. Heath Damron, Joshua C. Eby

Faculty & Staff Scholarship

Bordetella pertussis is the causative agent of whooping cough, a serious respiratory illness affecting children and adults, associated with prolonged cough and potential mortality. Whooping cough has reemerged in recent years, emphasizing a need for increased knowledge of basic mechanisms of B. pertussis growth and pathogenicity. While previous studies have provided insight into in vitro gene essentiality of this organism, very little is known about in vivo gene essentiality, a critical gap in knowledge, since B. pertussis has no previously identified environmental reservoir and is isolated from human respiratory tract samples. We hypothesize that the metabolic capabilities of B. pertussis …

Systemic Inhibition Of Tissue-Nonspecific Alkaline Phosphatase Alters The Brain-Immune Axis In Experimental Sepsis, Allison L. Brichacek, Stanely A. Benkovic, Sreeparna Chakraborty, Divine C. Nwafor, Wei Wang, Sujung Jun, Duaa Dakhlallah, Werner Geldenhuys, Anthony B. Pinkerton, José Luis Millán, Candice M. Brown

Faculty & Staff Scholarship

Tissue-nonspecific alkaline phosphatase (TNAP) is a ubiquitous enzyme present in many cells and tissues, including the central nervous system. Yet its functions at the brain-immune axis remain unclear. The goal of this study was to use a novel small molecular inhibitor of TNAP, SBI-425, to interrogate the function of TNAP in neuroimmune disorders. Following intraperitoneal (IP) administration of SBI-425, mass spectrometry analysis revealed that the SBI-425 does not cross the blood-brain barrier (BBB) in healthy mice. To elucidate the role of TNAP at the brain-immune axis, mice were subjected to experimental sepsis and received either vehicle or SBI-425 (25 mg/kg, …

Enhancement Of Immune Response Against Bordetella Spp. By Disrupting Immunomodulation, Monica C. Gestal, Laura K. Howard, Kalyan Dewan, Hannah M. Johnson, Mariette Barbier, Clare Bryant, Illiassou Hamidou Soumana, Israel Rivera, Bodo Lina, Uriel Blas-Machado, Eric T. Harvill

Faculty & Staff Scholarship

Well-adapted pathogens must evade clearance by the host immune system and the study of how they do this has revealed myriad complex strategies and mechanisms. Classical bordetellae are very closely related subspecies that are known to modulate adaptive immunity in a variety of ways, permitting them to either persist for life or repeatedly infect the same host. Exploring the hypothesis that exposure to immune cells would cause bordetellae to induce expression of important immunomodulatory mechanisms, we identified a putative regulator of an immunomodulatory pathway. The deletion of btrS in B. bronchiseptica did not affect colonization or initial growth in the …

Adaptive Design Of A Clinical Decision Support Tool: What The Impact On Utilization Rates Means For Future Cds Research, D. Mann, R. Hess, T. Mcginn, R. Mishuris, S. Chokshi, L. Mccullagh, P. D. Smith, J. Palmisano, S. Richardson, D. A. Feldstein

Journal Articles

© The Author(s) 2019. OBJECTIVE: We employed an agile, user-centered approach to the design of a clinical decision support tool in our prior integrated clinical prediction rule study, which achieved high adoption rates. To understand if applying this user-centered process to adapt clinical decision support tools is effective in improving the use of clinical prediction rules, we examined utilization rates of a clinical decision support tool adapted from the original integrated clinical prediction rule study tool to determine if applying this user-centered process to design yields enhanced utilization rates similar to the integrated clinical prediction rule study. MATERIALS & METHODS: …

A Rare Case Of Hiv-Induced Inflammatory Demyelinating Polyneuropathy., A. Sajan, S. Zahid, J. Stumph, D. Griepp, S. Saba, N. Ilyas, I. M. Mc Farlane

Journal Articles

Background:Acute inflammatory demyelinating polyneuropathy (AIDP) is an uncommon form of neuropathy in HIV-infected patients that can cause pain, sensory disturbance, and motor weakness. Case presentation:A 23-year-old African American male with past medical history of Guillain-Barre Syndrome (GBS), Lyme disease, and sexually transmitted infections including syphilis and chlamydia presented with acute back pain radiating to bilateral lower extremities with worsening right foot weakness for four days. Cerebrospinal fluid (CSF) studies including meningoencephalitis panel were negative as well as blood tests for Lyme disease and HIV antibody testing. Patient was initially treated with penicillin for positive treponemal serology but without improvement in …

Septic Emboli Of The Lung Due To Fusobacterium Necrophorum, A Case Of Lemierre's Syndrome, S. Habib, K. Rajdev, A. H. Siddiqui, M. Azam, A. Memon, M. Chalhoub

Journal Articles

© 2019 The Authors Fusobacterium necrophorum plays a causal role in a rare and life-threatening condition, Lemierre's syndrome. It is characterized by infection involving the posterior compartment of the lateral pharyngeal space complicated by septic suppurative thrombophlebitis of the internal jugular vein with F. necrophorum bacteremia and metastatic abscesses, primarily to the lung and pulmonary septic emboli. Herein, we present a very rare case of oropharyngeal infection complicated by Lemierre's syndrome with characteristic septic emboli to the lungs presenting as sore throat in a previously healthy patient. A 23-year-old woman presented with sore throat and was found to be in …

Combination Therapy With Trimethoprim-Sulfamethoxazole And Caspofungin In A Case Of Severe Pneumocystis Pneumonia, R. Koshy, T. Chen

Journal Articles

© 2019 The Authors Trimethoprim-sulfamethoxazole (TMP-SMX, co-trimoxazole, or bactrim) has been the standard first-line treatment against Pneumocystis jirovecii pneumonia (PCP) for decades. However, adverse effects and cases of treatment failure have led to a search for alternative agents. We present a case of a 50 year old immune compromised female whose course of PCP did not improve until Caspofungin was added to TMP-SMX.

Live Usability Testing Of Two Complex Clinical Decision Support Tools: Observational Study, S. Richardson, D. Feldstein, T. Mcginn, L. S. Park, S. Khan, R. Hess, P. D. Smith, R. G. Mishuris, L. Mccullagh, D. Mann

Journal Articles

© 2019 Journal of Medical Internet Research. All rights reserved. Background: Potential of the electronic health records (EHR) and clinical decision support (CDS) systems to improve the practice of medicine has been tempered by poor design and the resulting burden they place on providers. CDS is rarely tested in the real clinical environment. As a result, many tools are hard to use, placing strain on providers and resulting in low adoption rates. The existing CDS usability literature relies primarily on expert opinion and provider feedback via survey. This is the first study to evaluate CDS usability and the provider-computer-patient interaction …

Current Aats Guidelines On Surgical Treatment Of Infective Endocarditis, G. B. Pettersson, S. T. Hussain

Journal Articles

© Annals of Cardiothoracic Surgery. The 2016 American Association for Thoracic Surgery (AATS) guidelines for surgical treatment of infective endocarditis (IE) are question based and address questions of specific relevance to cardiac surgeons. Clinical scenarios in IE are often complex, requiring prompt diagnosis, early institution of antibiotics, and decision-making related to complications, including risk of embolism and timing of surgery when indicated. The importance of an early, multispecialty team approach to patients with IE is emphasized. Management issues are divided into groups of questions related to indications for and timing of surgery, pre-surgical work-up, preoperative antibiotic treatment, surgical risk assessment, …

Assessing Cognitive Impairment In Sle: Examining Relationships Between Resting Glucose Metabolism And Anti-Nmdar Antibodies With Navigational Performance., E. Ploran, C. Tang, M. Mackay, E. Anderson, C. Aranow, C. Sartori, P. Watson, B. Volpe, B. Diamond, D. Eidelberg, +4 Additional Authors

Journal Articles

Objective: Resting Fluorine-18 fluorodeoxyglucose positron emission tomography (FDG-PET) brain imaging and neuropsychological testing were used to investigate the usefulness of a spatial navigation task (SNT) as a performance benchmark for cognitive impairment related to anti-N-methyl D-aspartate (anti-NMDA) receptor antibodies (DNRAb) in SLE.

Methods: Neuropsychological assessments, including a desktop 3-D virtual SNT, were performed on 19 SLE participants and 9 healthy control (HC) subjects. SLE participants had stable disease activity and medication doses and no history of neuropsychiatric illness or current use of mind-altering medications. Resting FDG-PET scans were obtained on all SLE participants and compared with a historical set from …

Neurogenesis In Neurodegenerative Diseases: Role Of Mfg-E8, C. Cheyuo, M. Aziz, P. Wang

Journal Articles

No abstract provided.

Analyzing Public View Towards Vaccination Using Twitter, Mahajan Rutuja

Browse all Theses and Dissertations

Educating people about vaccination tends to target vaccine acceptance and reduction of hesitancy. Social media provides a promising platform for studying public perception regarding vaccination. In this study, we harvested tweets over a year related to vaccines from February 2018 to January 2019. We present a two-stage classifier to: (1) classify the tweets as relevant or non-relevant and (2) categorize them in terms of pro-vaccination, anti-vaccination, or neutral outlook. We found that the classifier was able to distinguish clearly between anti-vaccination and pro-vaccination tweets, but also misclassified many of these as neutral. Using Latent Dirichlet Allocation, we found that two …

October 2019, Nova Southeastern University

KPCOM SGA Rounds

No abstract provided.

Tuberculosis: Early Diagnosis And Treatment, Gloria Obeng

Nursing Student Class Projects (Formerly MSN)

Although there are measures in place to control tuberculosis (TB) cases in the U.S., TB is prevalent and has high morbidity and mortality rate. This issue is due to the failure to identify and treat the disease as early as possible, especially in the latent stage. The late diagnosis of the disease causes a delay in treatment which may result in complications or even death. Understanding the pathophysiological process of TB will aid in the control of the disease. Also, TB cases have been recorded among foreign-born and immigrants who are visiting the U.S. but some of these immigrants are …

Genetic Study Of Checkpoint Defects Of The Mus81-1 Mutant In The Fission Yeast Schizosaccharomyces Pombe, Darlington Osei Abrefa

Browse all Theses and Dissertations

In response to various perturbations of DNA replication, the DNA replication checkpoint is activated in eukaryotes to stimulate a cascade of cellular responses that are crucial for maintaining genome stability and cell survival. Defects in the checkpoint pathway result in mutations and genome instability, which is a hallmark for cancers. This study used a genetic approach to identify a mutation in the MMS (methyl methanesulfonate) and UV-sensitive protein Mus81, a DNA repair enzyme that resolves aberrant DNA structures through the homologous recombination pathway. We show that a single missense mutation, identified in fission yeast mus81-1, causes moderate reduction in the …

Preliminary Pcr-Based Screening Indicates A Higher Incidence Of Porcine Endogenous Retrovirus Subtype C (Perv-C) In Feral Versus Domestic Swine, Rashmi Acharya, Zoey K. Wallis, Robert Keener, Eric T. Gillock Ph.D.

Biological Sciences Faculty Publications

Xenotransplantation is considered a potential alternative to allotransplantation to relieve the current shortage of human organs. Due to their similar size and physiology, the organs of pigs are of particular interest for this purpose. Endogenous retroviruses are a result of integration of retroviral genomes into the genome of infected germ cells as DNA proviruses, which are then carried in all cells of the offspring of the organism. Porcine endogenous retroviruses (PERVs) are of special concern because they are found in pig organs and tissues that might otherwise be used for xenotransplantation. PERV proviruses can be induced to replicate and recombine …

Feasibility Of Integrating Microfluidics Into Point-Of-Care Bio-Diagnostics, Swetha Manoharan

Theses

Potassium in the body needs to be maintained in proper levels for the normal functioning of heart and kidneys. The aim of this work is to develop a simple technique to measure the concentration of Potassium present in a bodily fluid sample, which can be used to assess the health condition of extremely sick patients, especially when the patient's condition needs to be diagnosed and results needs to be obtained rapidly under Point-of-Care settings. Microfluidics is one of the platforms used in bio-diagnostics because of several advantages such as low sample volume requirement and integration into high-throughput screening. In this …

Research And Creative Activity, July 1, 2018-June 30, 2019: Major Sponsored Programs And Faculty Awards For Research And Creative Activity, University Of Nebraska-Lincoln, Office Of Research And Economic Development, University Of Nebraska-Lincoln

Office of Research and Economic Development: Publications

Foreword by Bob Wilhelm, Vice Chancellor for Research and Economic Development:

This booklet highlights successes in research, scholarship and creative activity by University of Nebraska–Lincoln faculty during the fiscal year running July 1, 2018, to June 30, 2019.

It lists investigators, project titles and funding sources on major grants and sponsored awards received during the year; fellowships and other recognitions and honors bestowed on our faculty; books published by faculty; performances, exhibitions and other creative activity by our faculty; and patents and licensing agreements issued for products of Nebraska research.

2019 marks the university’s 150th anniversary, an exciting time to …

Perspectives Of Us Women Participating In A Candidate Prep Study: Adherence, Acceptability And Future Use Intentions, K Rivet Amico, Catalina Ramirez, Margaret R. Caplan, Brooke E E Montgomery, Jennifer Stewart, Sally Hodder, Shobha Swaminathan, Jing Wang, Noshima Y. Darden-Tabb, Marybeth Mccauley, Kenneth H. Mayer, Timothy Wilkin, Raphael J. Landovitz, Roy Gulick, Adaora A. Adimora

Faculty & Staff Scholarship

Introduction

Limited data exist on acceptability of candidate pre‐exposure prophylaxis (PrEP) regimens among US women. We evaluated PrEP experiences, attitudes and future use intentions among sexually active women who completed the US‐based HIV Prevention Trials Network 069/AIDS Clinical Trials Group 5305 study.

Methods

Women participated in the study between March 2013 and November 2015. We analysed computer‐assisted self‐interview (CASI) surveys among 130 women and conducted in‐depth interviews among a subset of 26 women from three sites. Interviews were conducted in mid/late‐2015.

Results

Most women (57%) reported very good/excellent PrEP adherence on CASI, although 21% acknowledged over‐reporting adherence at least some …

Chronic Enteroviral Meningoencephalitis In A Patient On Rituximab For The Treatment Of Psoriatic Arthritis: A Case Report And Brief Literature Review, Roberto Tellez, Allison M. Lastinger, Jeffery P. Hogg

Faculty & Staff Scholarship

Enteroviruses are RNA viruses within the Picornaviridae family. Enteroviruses derive their name from the way they are typically transmitted via the intestinal tract. They commonly infect millions of people every year and often do not cause severe disease in immunocompetent patients with few exceptions. Aseptic meningitis is a classic manifestation and is usually self-limited, however, can lead to severe neurological complications in an immunocompromised individual. It has been well-described that patients with hypogammaglobulinemia are predisposed to developing chronic enteroviral meningoencephalitis [1]. This is the first reported case of enteroviral meningoencephalitis in a patient being treated for psoriatic arthritis with rituximab …

Pyometra Due To Pseudomonas Aeruginosa, Nathan Mcleod, Allison Lastinger

Faculty & Staff Scholarship

Pyometra is an unusual presentation of uterine infection, this condition is characterized by purulent fluid within the uterine cavity. In this report we describe pyometra due to Pseudomonas aeruginosa in a 90-year-old woman who presented with abdominal pain, nausea with emesis and diarrhea. She was evaluated at an outside emergency department and computed tomography (CT) revealed a large, complex, cystic mass measuring 9.2 cm (cm) in greatest diameter. Given her age, the diagnosis of malignancy was entertained. She was referred to gynecologic-oncologyservice for evaluation and underwent exploratory laparotomy with total abdominal hysterectomy and lysis of adhesions. Intraoperative findings …

Salmonella Neck Abscess In A Diabetic, Nathan Mcleod, Allison Lastinger, Nicole Bryan, Theodore Kieffer, Trevor Wolfe

Faculty & Staff Scholarship

Salmonella is known to cause invasive illness. However, head and neck abscesses are an unusual presentation of extra-intestinal infection with this organism. We describe a case of Salmonella neck abscess in a diabetic patient. An 18 year old diabetic male was admitted with increasing left sided neck pain and swelling approximately four weeks after gastrointestinal illness. Imaging revealed a left sided neck abscess. Surgical drainage was undertaken. Cultures grew non-typhoid Salmonella species. He was treated with intravenous antibiotics and did well clinically. Salmonella infection should be considered in the differential diagnosis of patients with immunocompromising conditions presenting with neck abscess …

Comparison Of The Panther Fusion And Bd Max Gbs Assays For Detection Of Group B Streptococcus In Prenatal Screening Specimens., G. J. Berry, F. Zhang, R. Manji, S. Juretschko

Journal Articles

Streptococcus agalactiae, or Group B Streptococcus (GBS) is the cause of early and late-onset GBS disease in neonates and can present as septicemia, meningitis, and pneumonia. Our objective was to compare the performance of two FDA-approved nucleic acid amplification tests (NAATs), the Panther Fusion and BD MAX™ systems, for detection of group B Streptococcus (GBS) in vaginal-rectal screening specimens. A total of 510 vaginal-rectal prepartum specimens were tested simultaneously in both NAATs following broth enrichment. Assay agreement was calculated using the kappa statistics. Overall agreement between assays was 99.0% (505/510; 95% CI: 0.951 to 0.997; kappa = 0.974). Discordant results …

Performance Evaluation Of The Luminex Aries® C. Difficile Assay In Comparison To Two Other Molecular Assays Within A Multi-Hospital Health Care Center., S. Juretschko, R. Manji, R. Khare, S. Das, S. Dunbar

Journal Articles

Clostridioides difficile infections (CDI) remain a serious issue in the U.S. Both fast and accurate diagnosis of CDI is paramount to achieve immediate infection control initiation, triaging and isolation, as well as appropriate antibiotic treatment. However, both, over- and under-diagnosis can lead to adverse patient outcomes, such as unnecessary administration of antibiotics or unwanted spread of spores in any hospital setting, respectively. In this prospective study, we evaluated the FDA-cleared ARIES® C. difficile Assay and compared its performance and workflow characteristics to the BD MAX Cdiff and Xpert C.difficile/Epi assays. Out of 302 samples tested, 55 (18.2%) samples were positive, …

Quantitative Human Immunodeficiency Virus (Hiv)-1 Antibodies Correlate With Plasma Hiv-1 Rna And Cell-Associated Dna Levels In Children On Antiretroviral Therapy, M. Mcmanus, J. Henderson, A. Gautam, R. Brody, E. R. Weiss, D. Persaud, E. Mick, K. Luzuriaga, V. Bonagura, I. Febo, +22 Additional Authors

Journal Articles

No abstract provided.

Homozygous Nlrp1 Gain-Of-Function Mutation In Siblings With A Syndromic Form Of Recurrent Respiratory Papillomatosis, S. B. Drutman, F. Haerynck, F. L. Zhong, D. Hum, N. J. Hernandez, S. Belkaya, F. Rapaport, S. J. De Jong, V. R. Bonagura, J. Laurent-Casanova, +13 Additional Authors

Journal Articles

© 2019 National Academy of Sciences. All rights reserved. Juvenile-onset recurrent respiratory papillomatosis (JRRP) is a rare and debilitating childhood disease that presents with recurrent growth of papillomas in the upper airway. Two common human papillomaviruses (HPVs), HPV-6 and -11, are implicated in most cases, but it is still not understood why only a small proportion of children develop JRRP following exposure to these common viruses. We report 2 siblings with a syndromic form of JRRP associated with mild dermatologic abnormalities. Whole-exome sequencing of the patients revealed a private homozygous mutation in NLRP1, encoding Nucleotide-Binding Domain Leucine-Rich Repeat Family Pyrin …

Physician Agreement On The Diagnosis Of Sepsis In The Intensive Care Unit: Estimation Of Concordance And Analysis Of Underlying Factors In A Multicenter Cohort, B. K. Lopansri, R. R. Miller, J. P. Burke, M. Levy, S. Opal, M. Narasimhan, A. Tsegaye, S. Hahn, P. Mayo, R. B. Brandon, +19 Additional Authors

Journal Articles

© 2019 The Author(s). Background: Differentiating sepsis from the systemic inflammatory response syndrome (SIRS) in critical care patients is challenging, especially before serious organ damage is evident, and with variable clinical presentations of patients and variable training and experience of attending physicians. Our objective was to describe and quantify physician agreement in diagnosing SIRS or sepsis in critical care patients as a function of available clinical information, infection site, and hospital setting. Methods: We conducted a post hoc analysis of previously collected data from a prospective, observational trial (N = 249 subjects) in intensive care units at seven US hospitals, …