Digital Commons Network^™

Determination Of Reference Intervals For Common Chemistry And Immunoassay Tests For Kenyan Adults Based On An Internationally Harmonized Protocol And Up-To-Date Statistical Methods, Geoffrey Omuse, Kiyoshi Ichihara, Daniel Maina, Mariza Hoffman, Elizabeth Kagotho, Alice Kanyua, Jane Mwangi, Caroline Wambua, Angela Amayo, Peter Ojwang, Zul Premji, Rajiv Erasmus

Pathology, East Africa

Background: Due to a lack of reliable reference intervals (RIs) for Kenya, we set out to determine RIs for 40 common chemistry and immunoassay tests as part of the IFCC global RI project.

Methods: Apparently healthy adults aged 18–65 years were recruited according to a harmonized protocol and samples analyzed using Beckman-Coulter analyzers. Value assigned serum panels were measured to standardize chemistry results. The need for partitioning reference values by sex and age was based on between-subgroup differences expressed as standard deviation ratio (SDR) or bias in lower or upper limits (LLs and ULs) of the RI. RIs …

Resident Ume Updates, Fred Markham, Marisyl Delacruz

Department of Family & Community Medicine Presentations and Grand Rounds

Agenda

1. Guidelines for Students in Clinical Spaces
2. Grading and feedback
3. RIME scheme
4. Telehealth, QI curriculum
5. Phase 3 Updates and JeffDOT
6. Q&A

Lessening The Hazards Of Florida Red Tides: A Common Sense Approach, Porter Hoagland, Barbara Kirkpatrick, Di Jin, Gary Kirkpatrick, Lora E. Fleming, Steven G. Ullmann, Andrew Beet, Gary Hitchcock, Kate K. Harrison, Zongchao C. Li, Bruce Garrison, Roberto E. Diaz, Vince Lovko

Faculty Research, Scholarly, and Creative Activity

In the Gulf of Mexico, especially along the southwest Florida coast, blooms of the dinoflagellate Karenia brevis are a coastal natural hazard. The organism produces a potent class of toxins, known as brevetoxins, which are released following cell lysis into ocean or estuarine waters or, upon aerosolization, into the atmosphere. When exposed to sufficient levels of brevetoxins, humans may suffer from respiratory, gastrointestinal, or neurological illnesses. The hazard has been exacerbated by the geometric growth of human populations, including both residents and tourists, along Florida’s southwest coast. Impacts to marine organisms or ecosystems also may occur, such as fish kills …

The Strengths, Weaknesses, Opportunities And Threats (Swot) Analysis Of The Severe Acute Respiratory Syndrome Coronavirus 2 Of Covid-19, Michael Oluyemi Babalola Ph.D

The University of Louisville Journal of Respiratory Infections

Introduction: SARS-CoV-2 is the etiologic agent of Coronavirus Disease 2019 (COVID-19), a highly contagious, emergent, acute, viral pneumonia that emanated sporadically in Wuhan, China, in December 2019. COVID-19 became a pandemic in February 2020, leading to 4,942,687 confirmed cases and over 321,987 deaths and grounding several economies around the world as of May 2020. Although global researchers, epidemiologists, virologists, and medical professionals rose steadily to contain the disease, in-depth knowledge of the virus and concerted efforts to combat it are still evolving. This research sought to elucidate the biological Strengths, Weaknesses, Opportunities, and Threats to SARS-CoV-2, with a view to …

Increasing Cms Sepsis Core Measure Adherence Rates Through Virtual Consultation, Angela Cann

Dissertations

Problem: According to the Centers of Disease Control and Prevention (CDC, 2016), it is estimated that sepsis affects around 1.5 million individuals in the United States annually, causing the death of 250,000 individuals and being responsible for one out of three hospital deaths. One-fourth of patients who develop severe sepsis will die during their hospital stay. Delays in sepsis treatment contribute significantly to increased morbidity, mortality, and length of stay in the hospital. The Centers for Medicare and Medicaid (CMS) sepsis bundle guideline adherence rate in the Emergency Department of a Level III Trauma Center was stagnant at 55% through …

Optimizing The Effectiveness Of Peripheral Intravenous Catheters, Carrie Kollar

Dissertations

Problem Hospitalized adult patients require more than one short peripheral catheter (SPC) to complete the prescribed intravenous (IV) therapy due to catheter failure and the practice of resiting. The purpose of this quality improvement initiative was to increase the rate of SPCs remaining in situ for the entire duration of the IV therapy for hospitalized adult patients.

Methods Application of an engineered securement device (ESD), an educational program pertaining to modifiable risk factors, and changing the practice to removal upon clinical indication were methods utilized to reduce the number of SPC insertions and catheter failures. This study was conducted at …

2020-07-08_Michiganoverview_Covidsymptoms, Michigan Department Of Health & Human Services

Michigan COVID-19 Syndromic Surveillance System Data

The Syndromic Surveillance System Data report was obtained from Michigan's COVID-19 dashboard, from under the link "​Coronavirus Symptoms": https://www.michigan.gov/coronavirus. Data was compiled by the Michigan Department of Health and Human Services (MDHHS). The information was updated daily.

Syndromic Surveillance System data is obtained from approximately 183 facilities participating in syndromic surveillance (132 Emergency Departments (ED), 51 Urgent Cares) across the State of Michigan. The reporting is based on individuals who present at EDs and may not be representative of the overall population. The coronavirus-like symptoms query searches visit free-text (chief complaint, triage notes, and clinical impression) for fever or …

Pathophysiology Of Hyperkalemia Presenting As Brugada Pattern On Electrocardiogram (Ecg), Benjamin Doty, Elaine Kim, Jeremiah T. Phelps, Peter Akpunonu

Emergency Medicine Faculty Publications

BACKGROUND Brugada phenocopies (BrP) are clinical and electrocardiographic (ECG) entities elicited by reversible medical conditions speculated to have pathogenesis rooted in ion current imbalances or conduction delays within the myocardial wall. During an inciting pathologic condition, it produces ECG patterns identical to those of congenitally-acquired Brugada syndrome and subsequently returns to normal ECG patterns upon resolution of the medical condition. This case report describes a 26-year-old man presenting to the Emergency Department (ED) for suspected heroin overdose with a rare ECG consistent with BrP secondary to acute hyperkalemia.

CASE REPORT A 26-year-old man with a history of substance abuse and …

Acute Effusive Pericarditis: A Late Complication Of Covid-19., Kelli Fox, Jessica A Prokup, Kyle Butson, Kim Jordan

Heart and Vascular Articles

As the COVID-19 pandemic evolves, the medical community continues to discover novel clinical manifestations of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus. Often, extrapulmonary manifestations occur simultaneously with pulmonary disease. However, there is a paucity of literature describing the cardiac manifestations of COVID-19 in the absence of pulmonary findings. We report a rare case of acute pericarditis presenting with pericardial effusion and cardiac tamponade in a 43-year-old man diagnosed with COVID-19. This case emphasizes the importance of continued investigation regarding diagnosis and treatment of COVID-19 and its related symptoms.

An Applied Ecology Of Fear Framework: Linking Theory To Conservation Practice, Kaitlyn M. Gaynor, Michael J. Cherry, Sophie L. Gilbert, Michael T. Kohl, Courtney L. Larson, Thomas M. Newsome, Laura R. Prugh, Justin P. Suraci, Julie K. Young, Justine A. Smith

United States Department of Agriculture Wildlife Services: Staff Publications

Research on the ecology of fear has highlighted the importance of perceived risk from predators and humans in shaping animal behavior and physiology, with potential demographic and ecosystem-wide consequences. Despite recent conceptual advances and potential management implications of the ecology of fear, theory and conservation practices have rarely been linked. Many challenges in animal conservation may be alleviated by actively harnessing or compensating for risk perception and risk avoidance behavior in wild animal populations. Integration of the ecology of fear into conservation and management practice can contribute to the recovery of threatened populations, human–wildlife conflict mitigation, invasive species management, maintenance …

Edwardsiella Ictaluri Is Capable Of Persisting In Channel Catfish By Evading Host T Cell And Cell Death Responses, Elizabeth Watts Griggs

LSU Doctoral Dissertations

Edwardsiella ictaluri is a gram-negative bacterium of the family Enterobacteriaceae that infects and causes enteric septicemia (ESC) of channel catfish (Ictalurus punctatus), a fatal disease costing the catfish industry millions of dollars in losses each year. Edwardsiella. ictaluri is capable of replicating in catfish head-kidney-derived-macrophages (HKDM), and like many other gram-negative bacteria, E. ictaluri encodes a Type III Secretion System (T3SS) that is required for virulence and intracellular replication. In the case of E. ictaluri, the T3SS translocates effectors from the Edwardsiella containing vacuole (ECV) through the bacterial cell wall and the vacuolar membrane directly to the …

Coeliac Disease Pathogenesis: The Uncertainties Of A Well-Known Immune Mediated Disorder, Greg Byrne, Margaret Dunne, Con Feighery, Fernando Chirdo

Articles

Coeliac disease is a common small bowel enteropathy arising in genetically predisposed individuals and caused by ingestion of gluten in the diet. Great advances have been made in understanding the role of the adaptive immune system in response to gluten peptides. Despite detailed knowledge of these adaptive immune mechanisms, the complete series of pathogenic events responsible for development of the tissue lesion remains less certain. This review contributes to the field by discussing additional mechanisms which may also contribute to pathogenesis. These include the production of cytokines such as interleukin-15 by intestinal epithelial cells and local antigen presenting cells as …

2020-07-07_Michiganoverview_Covidsymptoms, Michigan Department Of Health & Human Services

Michigan COVID-19 Syndromic Surveillance System Data

The Syndromic Surveillance System Data report was obtained from Michigan's COVID-19 dashboard, from under the link "​Coronavirus Symptoms": https://www.michigan.gov/coronavirus. Data was compiled by the Michigan Department of Health and Human Services (MDHHS). The information was updated daily.

Syndromic Surveillance System data is obtained from approximately 183 facilities participating in syndromic surveillance (132 Emergency Departments (ED), 51 Urgent Cares) across the State of Michigan. The reporting is based on individuals who present at EDs and may not be representative of the overall population. The coronavirus-like symptoms query searches visit free-text (chief complaint, triage notes, and clinical impression) for fever or …

Key Strategic Issues List (Ksil) 2021-2022, Steve Cunningham

Articles & Editorials

New for Academic Years 2021-2022, the USAWC has published an updated Key Strategic Issues List (KSIL). The KSIL informs students, faculty, and external research associates of strategic topics requiring research and analysis. The USAWC in coordination with Headquarters Department of the Army (HQDA), major commands throughout the Army, and the joint and interagency community has updated the Army's priorities for strategic analysis to address issues in the emerging strategic environment and to align with elements of the current Army Vision and Army Strategy. The USAWC will continue to address select topics as Integrated Research Projects and through other research efforts. …

Need For Professionals Who Speak A Second Language Greater Than Ever, Shannon Thomason

Browse All News

No abstract provided.

Inhibition Of Fatty Acid Oxidation Promotes Macrophage Control Of Mycobacterium Tuberculosis, Pallavi Chandra, Li He, Matthew Zimmerman, Guozhe Yang, Stefan Köster, Mireille Ouimet, Han Wang, Kathyrn J Moore, Véronique Dartois, Joel D Schilling, Jennifer A Philips

Open Access Publications

Macrophage activation involves metabolic reprogramming to support antimicrobial cellular functions. How these metabolic shifts influence the outcome of infection by intracellular pathogens remains incompletely understood.

Pandemic Abandonment, Panoramic Displays And Fascist Propaganda: The Month The Earth Stood Still, Peter Mclaren

Education Faculty Articles and Research

"While governing a country facing a global pandemic, a shattered economy, and widespread civil unrest over the death of George Floyd, Trump has shown little compassion for humanity and has chosen ego gratification over care and concern for his countrymen and in the process put the entire world in greater danger from Covid-19."

Best Clinical Practice Of Disinfection In Intravenous Device Therapy Contaminated With Klebsiella Pneumoniae, Camila Biazus Dalcin, Patrí­Cia Kuerten Rocha, Thaí­S Cristine Marques Sincero, Juliana Coelho Pina, Sabrina Souza, Maria Lurdes Lomba

General Submissions: Presentations (Oral and Poster)

Klebsiella pneumoniae is a Gram-negative bacteria. The treatment of infections from this bacteria in children is more challenging due to limited appropriate antibiotic use in this specific group (Akturk et al., 2016). Evidence-based research is necessary to understand best practice methods for the decontamination of needle-free devices (Kelly et al., 2017) such as network cables intravenous therapy newborn access (Polifix® - B Braun). It is necessary to verify the best method to disinfect needleless connectors, by developing evidence-based research.

Cardiac Surgery During The Coronavirus Disease 2019 Pandemic: Perioperative Considerations And Triage Recommendations, Vivek Patel, Ernesto Jimenez, Lorraine Cornwell, Trung Tran, David Paniagua, Ali E Denktas, Andrew Chou, Samuel J Hankins, Biykem Bozkurt, Todd K Rosengart, Hani Jneid

Faculty, Staff and Students Publications

The coronavirus disease 2019 pandemic, caused by severe acute respiratory syndrome coronavirus-2, represents the third human affliction attributed to the highly pathogenic coronavirus in the current century. Because of its highly contagious nature and unprecedented global spread, its aggressive clinical presentation, and the lack of effective treatment, severe acute respiratory syndrome coronavirus-2 infection is causing the loss of thousands of lives and imparting unparalleled strain on healthcare systems around the world. In the current report, we discuss perioperative considerations for patients undergoing cardiac surgery and provide clinicians with recommendations to effectively triage and plan these procedures during the coronavirus disease …

Key Strategic Issues List (Ksil) 2021–2022, Steve Cunningham

Books, Monographs & Collaborative Studies

New for Academic Years 2021-2022, the USAWC has published an updated Key Strategic Issues List (KSIL). The KSIL informs students, faculty, and external research associates of strategic topics requiring research and analysis. The USAWC in coordination with Headquarters Department of the Army (HQDA), major commands throughout the Army, and the joint and interagency community has updated the Army's priorities for strategic analysis to address issues in the emerging strategic environment and to align with elements of the current Army Vision and Army Strategy. The USAWC will continue to address select topics as Integrated Research Projects and through other research efforts. …

Stop Fighting The Coronavirus, Pranay Sinha

Journal of Wellness

During the COVID-19 pandemic, the refrain of war has echoed across the world. It has tainted the way we speak about the pandemic and shaped the way we think about it. Metaphors can direct thought and action. This essay reflects on the ways in which the metaphor of war is disrupting the way we relate to the pandemic, to our society, and to each other and concludes with an alternative metaphor.

2020-07-06_Michiganoverview_Covidsymptoms, Michigan Department Of Health & Human Services

Michigan COVID-19 Syndromic Surveillance System Data

The Syndromic Surveillance System Data report was obtained from Michigan's COVID-19 dashboard, from under the link "​Coronavirus Symptoms": https://www.michigan.gov/coronavirus. Data was compiled by the Michigan Department of Health and Human Services (MDHHS). The information was updated daily.

Syndromic Surveillance System data is obtained from approximately 183 facilities participating in syndromic surveillance (132 Emergency Departments (ED), 51 Urgent Cares) across the State of Michigan. The reporting is based on individuals who present at EDs and may not be representative of the overall population. The coronavirus-like symptoms query searches visit free-text (chief complaint, triage notes, and clinical impression) for fever or …

False-Negative Sars-Cov-2 Reverse Transcriptase Polymerase Chain Reaction (Rt-Pcr) Is An Important Consideration For Patient Management And Infection Prevention: A Case Report From The Louisville Covid-19 Epidemiology Study, Matthew Song Pharmd, Bcidp, Ashley M. Wilde, Sarah E. Moore Pharmd, Brian C. Bohn Pharmd, Clayton J. Patross, Bryan Denham, Paul Schulz, Julio A. Ramirez

The University of Louisville Journal of Respiratory Infections

We report a case of false-negative SARS-CoV-2 reverse transcriptase-polymerase chain reaction (RT-PCR) on a nasopharyngeal swab. Treating clinicians and infection preventionists should maintain a high suspicion for COVID-19 in the appropriate clinical setting despite negative test results. Utilization of chest computed tomography (CT) should be strongly considered in the diagnostic work-up for suspected COVID-19, particularly in areas with limited RT-PCR availability.

Concomitant Invasive Pneumococcal Disease In A Patient With Covid-19 – A Case Report From The Louisville Epidemiology Study, Clayton J. Patross, Brian C. Bohn Pharmd, Sarah E. Moore Pharmd, Paul Schulz, Matthew Song Pharmd, Bcidp, Ashley M. Wilde, Julio A. Ramirez

The University of Louisville Journal of Respiratory Infections

A 60-year-old male presented to the emergency department (ED) with a 1–2 day history of confusion, headache, and subjective fever. Because he had met with a contact two days prior to admission who had recently traveled from the Bahamas, a COVID-19 nasopharyngeal (NP) and oropharyngeal (OP) polymerase chain reaction (PCR) test was ordered. He was diagnosed with bacterial meningitis based on presenting neurologic symptoms and the identification of Streptococcus pneumoniae from blood cultures. The COVID-19 NP and OP test returned positive, although he never developed shortness of breath, cough, other respiratory symptoms, diarrhea, abdominal pain, nausea, vomiting, or any change …

Foundational Research And Nih Funding Enabling Emergency Use Authorization Of Remdesivir For Covid-19, Ekaterina Galkina Cleary, Matthew J. Jackson, Zoë Folchman-Wagner, Fred D. Ledley

Natural & Applied Sciences Faculty Publications

Emergency Use Authorization for remdesivir months after discovery of COVID-19 is unprecedented. Typically, decades of research and public-sector funding are required to establish the mature body of foundational research requisite for efficient, targeted drug discovery and development. This work quantifies the body of research related to remdesivir’s biological target, RNA-dependent RNA polymerase (RdRp), or parent chemical structure, nucleoside analogs (NcAn), through 2019, as well as NIH funding for this research 2000–2019. There were 6,567 RdRp-related publications in PubMed, including 1,263 with NIH support, and 11,073 NcAn-related publications, including 2,319 with NIH support. NIH support for RdRp research comprised 2,203 Project …

Social Patterns And Pathways Of Hiv Care Among Hiv-Positive Transgender Women, Dana D. Hines

Dissertations

Transgender women have the highest HIV prevalence rates of all gender and sexual minorities, yet are less likely to enter and be retained in HIV care. As a result, they are at high risk for HIV-related morbidity and mortality. This study aimed to describe the illness career of transgender women living with HIV and to describe how interactions with health care providers and important others influenced their illness trajectory.

A Study Of The Efficacy Of Machine Learning For Diagnosing Obstructive Coronary Artery Disease In Non-Diabetic Patients, Demond Larae Handley

Theses and Dissertations

According to the Centers for Disease Control and Prevention, about 18.2 million adults age 20 and older have Coronary Artery Disease in the United States. Early diagnosis is therefore of crucial importance to help prevent debilitating consequences, and principally death for many patients. In this study we use data containing gene expression values from peripheral blood samples in 198 non-diabetic patients, with the goal of developing an age and sex gene expression model for diagnosis of Coronary Artery Disease. We employ machine learning methods to obtain a classification based on genetic information, age and sex. Our implementation uses feed forward …

An Unusual Case Of Campylobacter Jejuni Gastroenteritis Presenting With Acute Reversible Encephalopathy In An Immunocompetent Host, Irma Huayanay, Leonardo Pozo, Salman Bangash, Denisse Ramirez, Luis Rosas, Renzo Arauco Brown

School of Medicine Publications

Campylobacter jejuni gastroenteritis is the most frequent organism associated with acute infectious diarrhea worldwide. (e clinical presentation involves fever, diarrhea, rigors, and myalgias. Other extraintestinal symptoms that have been described involve delirium and other neurological complications, and the most well-known is Guillain-Barr´e, where there is cross-reactivity between the gastrointestinal tract and the brain. Despite previously described multiple neurological complications, there is a lack of clinical data on the association of Campylobacter-related gastroenteritis with acute encephalopathy in immunocompetent patients. (e type of population, immunocompetent stage, and unfamiliarity with the clinical presentation makes this a challenging diagnosis for clinicians. We report a …

Covid Stress Syndrome: Concept, Structure, And Correlates, Steven Taylor, Caeleigh A. Landry, Michelle M. Paluszek, Thomas A. Fergus, Dean Mckay, Gordon J.G. Asmundsone

Covid-19 Digital Research

Research shows that the COVID Stress Scales have a robust multifactorial structure, representing five correlated facets of COVID‐19‐related distress: (a) Fear of the dangerousness of COVID‐19, which includes fear of coming into contact with fomites potentially contaminated with SARSCoV2, (b) worry about socioeconomic costs of COVID‐19 (e.g., worry about personal finances and disruption in the supply chain), (c) xenophobic fears that foreigners are spreading SARSCoV2, (d) traumatic stress symptoms associated with direct or vicarious traumatic exposure to COVID‐19 (nightmares, intrusive thoughts, or images related to COVID‐19), and (e) COVID‐19‐related compulsive checking and reassurance seeking. These factors cohere to form a …

2020-07-05_Michiganoverview_Covidsymptoms, Michigan Department Of Health & Human Services

Michigan COVID-19 Syndromic Surveillance System Data

The Syndromic Surveillance System Data report was obtained from Michigan's COVID-19 dashboard, from under the link "​Coronavirus Symptoms": https://www.michigan.gov/coronavirus. Data was compiled by the Michigan Department of Health and Human Services (MDHHS). The information was updated daily.

Syndromic Surveillance System data is obtained from approximately 183 facilities participating in syndromic surveillance (132 Emergency Departments (ED), 51 Urgent Cares) across the State of Michigan. The reporting is based on individuals who present at EDs and may not be representative of the overall population. The coronavirus-like symptoms query searches visit free-text (chief complaint, triage notes, and clinical impression) for fever or …