Digital Commons Network^™

Comparison Of Early Warning Scores For Sepsis Early Identification And Prediction In The General Ward Setting, Sean C Yu, Nirmala Shivakumar, Kevin Betthauser, Aditi Gupta, Albert M Lai, Marin H Kollef, Philip R O Payne, Andrew P Michelson

2020-Current year OA Pubs

The objective of this study was to directly compare the ability of commonly used early warning scores (EWS) for early identification and prediction of sepsis in the general ward setting. For general ward patients at a large, academic medical center between early-2012 and mid-2018, common EWS and patient acuity scoring systems were calculated from electronic health records (EHR) data for patients that both met and did not meet Sepsis-3 criteria. For identification of sepsis at index time, National Early Warning Score 2 (NEWS 2) had the highest performance (area under the receiver operating characteristic curve: 0.803 [95% confidence interval [CI]: …

The Politics Of Medicine: Power, Actors, And Ideas In The Making Of Health, Claire Wulf Winiarek

Graduate Program in International Studies Theses & Dissertations

The practice of medicine has become the prescribing of medicine. Reflecting a construct of health defined by Rationalism, individualism, and biomedical science, medicines (pharmaceuticals) are politically constructed to be the first – and sometimes only prescribed – line of defense against illness and disease. Pharmaceuticals also represent a highly desirable, ‘recession-proof’ component of many Nation-states’ (states’) export strategies, helping advanced economies, in particular, to maintain favorable trade balances and economic growth amidst the headwinds of deindustrialization.

Higher use and the overreliance on pharmaceuticals promote an outsized role for certain actors and ideas in the making of global health, referring to …

A Workshop On Re-Negotiating Parent-Child Relationships When Living Together, Deena Aguiar

Capstone Projects and Master's Theses

A workshop on re-negotiating parent-child relationships while living together as adults.

Anatomy And Physiology Of The Palatine Tonsils, Adenoids, And Lingual Tonsils., Alexandra Arambula, Jason R. Brown, Laura Neff

Manuscripts, Articles, Book Chapters and Other Papers

Objective: This review aims to discuss the basic anatomy and physiology of the palatine and pharyngeal tonsils, with reference to how this foundational understanding may affect patient management and surgical procedures in these regions of the upper airway.

Methods: A literature search was performed using PubMed and Google Scholar using the MeSH terms tonsils, adenoids, anatomy, physiology, and adenotonsillectomy. Primary sources were excluded if they were abstracts only, non-English language, or non-human studies. Thirty-five sources were included in this review.

Results and conclusions: The pharyngeal and palatine tonsils are compact yet physiologically complex mucosa-associated lymphoid tissues that make up a …

Course Descriptions, Saint Mary's College Of California

Academic Catalog

No abstract provided.

Socio-Economic And Geographical Inequalities In Adolescent Fertility Rate In Ghana, 1993–2014, Bright Opoku Ahinkorah, Eugene Budu, Henry Ofori Duah, Joshua Okyere, Abdul-Aziz Seidu

College of Nursing Faculty Research and Publications

Background

Despite public health interventions to control adolescent fertility, it remains high in sub-Saharan Africa. Ghana is one of the countries in sub-Saharan Africa with the highest adolescent fertility rates. We examined the trends and socio-economic and geographical patterns of disparities in adolescent fertility in Ghana from 1993 to 2014.

Methods

Using the World Health Organization’s (WHO) Health Equity Assessment Toolkit (HEAT) software, data from the 1993–2014 Ghana Demographic and Health surveys were analyzed. First, we disaggregated adolescent fertility rates (AFR) by four equity stratifiers: wealth index, education, residence and region. Second, we measured the inequality through summary measures, namely …

Determination Of Freedom-From-Rabies For Small Indian Mongoose Populations In The United States Virgin Islands, 2019–2020, A. Springer Browne, Hannah M. Cranford, Clint N. Morgan, James A. Ellison, Are Berentsen, Nicholas Wiese, Alexandra Medley, John Rossow, Leanne Jankelunas, Alan S. Mckinley, Claudia D. Lombard, Nicole F. Angeli, Thomas Kelley, Jennifer Valiulus, Bethany Bradford, Valicia J. Burke-France, Cosme J. Harrison, Irene Guendel, Marissa Taylor, Gerard L. Blanchard, Jeffrey B. Doty, David J. Worthington, David Horner, Keith R. Garcia, Joseph Roth, Brett R. Ellis, Kristine M. Bisgard, Ryan Wallace, Esther M. Ellis

United States Department of Agriculture Wildlife Services: Staff Publications

Mongooses, a nonnative species, are a known reservoir of rabies virus in the Caribbean region. A cross-sectional study of mongooses at 41 field sites on the US Virgin Islands of St. Croix, St. John, and St. Thomas captured 312 mongooses (32% capture rate). We determined the absence of rabies virus by antigen testing and rabies virus exposure by antibody testing in mongoose populations on all three islands. USVI is the first Caribbean state to determine freedom-from-rabies for its mongoose populations with a scientifically-led robust cross-sectional study. Ongoing surveillance activities will determine if other domestic and wildlife populations in USVI are …

Landscape Of Stress: Tree Mortality Influences Physiological Stress And Survival In A Native Mesocarnivore, Jennifer R. Kordosky, Eric M. Gese, Craig M. Thompson, Patricia A. Terletzky, Lorin A. Neuman-Lee, Jon D. Schneiderman, Kathryn L. Purcell, Susannah S. French

United States Department of Agriculture Wildlife Services: Staff Publications

Climate change and anthropogenic modifications to the landscape can have both positive and negative effects on an animal. Linking landscape change to physiological stress and fitness of an animal is a fundamental tenet to be examined in applied ecology. Cortisol is a glucocorticoid hormone that can be used to indicate an animal’s physiological stress response. In the Sierra Nevada Mountains of California, fishers (Pekania pennanti) are a threatened mesocarnivore that have been subjected to rapid landscape changes due to anthropogenic modifications and tree mortality related to a 4-year drought. We measured cortisol concentrations in the hair of 64 …

Risks Of Introduction And Economic Consequences Associated With African Swine Fever, Classical Swine Fever And Foot-And-Mouth Disease: A Review Of The Literature, Vienna Brown, Ryan S. Miller, Sophie C. Mckee, Karina H. Ernst, Nicole M. Didero, Rachel M. Maison, Meredith J. Grady, Stephanie A. Shwiff

United States Department of Agriculture Wildlife Services: Staff Publications

African swine fever (ASF), classical swine fever (CSF) and foot-and-mouth disease (FMD) are considered to be three of the most detrimental animal diseases and are currently foreign to the U.S. Emerging and re-emerging pathogens can have tremendous impacts in terms of livestock morbidity and mortality events, production losses, forced trade restrictions, and costs associated with treatment and control. The United States is the world's top producer of beef for domestic and export use and the world's third-largest producer and consumer of pork and pork products; it has also recently been either the world's largest or second largest exporter of pork …

Economic Losses Of Catfish To Avian Predation: A Case Report, Ganesh Kumar, Shraddha Hegde, David Wise, Charles Mischke, Brian Dorr

United States Department of Agriculture Wildlife Services: Staff Publications

Avian predation in catfish aquaculture has been a persistent issue throughout the history of the industry, and as production has expanded predation from piscivorous birds has intensified. Catfish ponds in the Mississippi River delta (in the Mississippi migratory flyway) provide a constant and readily accessible supply of forage for birds. Intensive foraging by fish-eating birds has led to a specific regulatory policy and numerous on-farm and regional management efforts. However, in 2016, legal challenges lead to recision of some federal policies and uncertainty as to allowable management, resulting in limitations on bird depredation. Estimating the extent of fish losses to …

Hspx-Mediated Survival Pathways Of Pathogenic Mycobacteria, Fahad Alhusain

Saudi Medical Journal

Objectives: To optimize an enzyme-linked immunosorbent assay (ELISA) for measuring the HspX protein (α-crystallin) levels and then evaluate its correlation with the accumulation of lipid bodies in Mycobacterium bovis ( M. bovis) during hypoxia and exposure to nitric oxide. Methods: This study was conducted at Prince Sultan Military Medical City, Riyadh, Saudi Arabia between 2016 and 2017. We first optimized ELISA conditions for the detection of HspX. The optimization protocol focused on minimizing concentrations of the capture antibody, detection antibody, and conjugated secondary antibody, and determining the minimum detection limit of the antigen, HspX. Bacteria were grown either in shaking …

The Impact Of The Coronavirus (Covid-19) Pandemic On The Development Of Obsessive-Compulsive Symptoms In Saudi Arabia, Deemah A. Alateeq, Haneen N. Almughera, Tharaa N. Almughera, Raghad F. Alfedeah, Taeef S. Nasser, Khozama A. Alaraj

Saudi Medical Journal

Objectives: To explore the impact of the COVID-19 pandemic on the development of obsessive-compulsive disorder (OCD) symptoms and its correlation with the level of perceived stress among the Saudi population. Methods: In July 2020, a cross-sectional survey of 2909 participants in Saudi Arabia during the outbreak was conducted to collect data related to sociodemographic characteristics and scores on the Brief Obsessive-Compulsive Scale (BOCS) and Perceived Stress Scale (PSS). Results: Most participants were female (73.9%) with a university level of education or higher (81%). The prevalence of new-onset obsessions was 57.8%, compulsions 45.9%, and moderate/high perceived stress 72.4%. New-onset dirt, germs, …

Kawasaki Disease In An Infant After Administration Of Hexavalent Vaccine, Meshal Z. Almeshary, Saud A. Alanazi, Khalid M. Almoosa, Rolan K. Bassrawi

Saudi Medical Journal

Kawasaki disease is a vascular disorder of unknown etiology that affects children. Kawasaki disease mainly involves medium-sized blood vessels and may cause cardiovascular complications, particularly coronary artery aneurysms. Concern has been raised against various types of vaccines becoming potential risk factors for Kawasaki disease. Here, we describe a case of a 4-month-old Saudi infant who presented with incomplete Kawasaki disease a few hours after receiving his hexavalent vaccine and there was a significant dilatation of all coronary arteries. Although a relationship between vaccinations and Kawasaki disease has been suggested, there is no strong evidence of an increased risk or causal …

Cystic Fibrosis Foundation Consensus Statements For The Care Of Cystic Fibrosis Lung Transplant Recipients, Pali Shah, Marina Litvin, Ramsey R Hachem, Et Al.

2020-Current year OA Pubs

Cystic fibrosis (CF) is the indication for transplantation in approximately 15% of recipients worldwide, and Cystic Fibrosis Lung Transplant Recipients (CFLTRs) have excellent long-term outcomes. Yet, CFLTRs have unique comorbidities that require specialized care. The objective of this document is to provide recommendations to CF and lung transplant clinicians for the management of perioperative and underlying comorbidities of CFLTRs and the impact of transplantation on these comorbidities. The Cystic Fibrosis Foundation (CFF) organized a multidisciplinary committee to develop CF Lung Transplant Clinical Care Recommendations. Three workgroups were formed to develop focused questions. Following a literature search, consensus recommendations were developed …

Body Composition Changes In Children During Treatment For Moderate Acute Malnutrition: Findings From A 4-Arm Cluster-Randomized Trial In Sierra Leone, Devika J Suri, Isabel Potani, Akriti Singh, Stacy Griswold, William W Wong, Breanne Langlois, Ye Shen, Kwan Ho Kenneth Chui, Irwin H Rosenberg, Patrick Webb, Beatrice L Rogers

Children’s Nutrition Research Center Staff Publications

Background: Measures that better describe "healthy" and sustainable recovery during nutritional treatment of children with moderate acute malnutrition (MAM) are needed.

Objectives: We compared changes to body composition among children receiving 1 of 4 specialized nutritious food (SNFs) during treatment of MAM and by recovery and relapse outcomes.

Methods: The study was nested within a prospective, cluster-randomized, community-based, cost-effectiveness trial assessing 4 SNFs to treat children aged 6-59 mo with MAM [midupper arm circumference (MUAC) ≥11.5 cm and <12.5 cm without bipedal edema] in Sierra Leone. Biweekly SNF rations (1 of 3 fortified-blended foods or a lipid-based nutrient supplement) were given until children recovered (MUAC ≥12.5 cm), or up to 7 rations (∼12 wk). Deuterium dilution was used to estimate fat-free mass (FFM) and fat mass (FM) at enrollment and after 4 wk of treatment to ensure similar treatment exposure among the participants. Another MUAC measurement was performed among recovered children 4 wk after program exit to determine whether recovery was sustained. ANOVA, paired t tests, and linear regression models were used to determine significant differences in changes from baseline to 4 wk.

Results: Among 312 analyzed participants, mean baseline weight comprised ∼80% FFM; mean weight gained after 4 wk comprised ∼82% FFM. Changes in …

Antecedents And Outcomes Of Health Risk Perceptions In Tourism, Following The Covid-19 Pandemic, Maksim Godovykh, Abraham Pizam, Frida Bahja

Faculty Scholarship and Creative Works

Purpose: The purpose of this paper is to clarify the concept of perceived risks, identify the main antecedents and outcomes of health risk perceptions and propose a conceptual model of health risk perceptions in tourism.

Design/methodology/approach: This paper provides a review of the literature on customer risk perceptions, along with their antecedents and outcomes, and proposes a conceptual model of health risk perceptions in tourism.

Findings: Key findings reveal that the main factors of health risk perceptions can be broadly classified into cognitive, affective, individual and contextual components. The proposed conceptual model of health risk perceptions provides a theoretically integrated …

The Impact Of Nanopulse Treatment On The Tumor Microenvironment In Breast Cancer: Overturning The Treg Immunosuppressive Dominance, Anthony Nanajian

Biomedical Sciences Theses & Dissertations

Nanopulse treatment (NPT) is a high-power electric engineering modality that has been shown to be an effective local tumor treatment approach in multiple cancer models. Our previous studies on the orthotopic 4T1-luc breast cancer model demonstrated that NPT ablated local tumors. The treatment consequently conferred protection against a second live tumor challenge and minimized spontaneous metastasis. This study aims to understand how NPT mounts a potent immune response in a predominantly immunosuppressive tumor.

NPT changed the local and systemic dynamics of immunosuppressive cells by significantly reducing the numbers of regulatory T cells (Tregs), myeloid-derived suppressor cells (MDSCs), and tumor-associated macrophages …

Global Impact Of Covid-19 On Stroke Care, Raul G. Nogueira, Mohamad Abdalkader, Muhammad M. Qureshi, Michael Frankel, Ossama Y. Mansour, Hiroshi Yamagami, Zhongming Qiu, Mehdi Farhoudi, James E. Siegler, Ameer E. Hassan

School of Medicine Publications

Background

Aims

Methods

Results

Impact Of Covid-19 On The Severe Acute Malnutrition Admissions Among Children Under 5 Years Of Age Seeking Nutrition Services In Afghanistan, Sahar Sayedy

Graduate Theses and Dissertations

The purpose of the study was to assess the impact of COVID-19 on the number of admissions of severe acute malnutrition among children under 5 years of age seeking nutrition services in Afghanistan especially in the provinces where the prevalence of COVID-19 was high, for the period of February – September 2020. The study used comparison and analysis of secondary datasets of the Integrated Management of Acute Malnutrition – a national program for detection and management of moderate and severe acute malnutrition in the country.

This study analyzed the association between COVID-19 cases and severe acute malnutrition (SAM) admissions of …

Vulnerability To And Protection Against Covid-19 Fear, Threat, And Worry, Marsha Kim Huh

Graduate Theses and Dissertations

Drawing from a sample of 10,368 adults living in the U.S., the current study examines the role of social and psychological resources in lowering COVID-related fear, threat, and worry, controlling for a number of social vulnerabilities (e.g. gender, race/ethnicity, and presence of children). The impact of social location, particularly in regards to race, and how one accesses and/or utilizes social and psychological resources is also examined through disaggregated regression models. Results demonstrate that some social and psychological resources impact COVID-specific distress (fear/threat/worry), but depending on the resource, relationships vary in direction and significance. The strength of social ties and mastery …

A Portable Point-Of-Care Device Using Joule Heating And Latent Energy Storage For The Temperature Regulation Of Isothermal Nucleic Acid Amplification Tests, Aubrey Lynn Schultz

Graduate Theses and Dissertations

Accurate and early diagnosis of infectious diseases extremely important. Rapid diagnosis allows for effective treatment and increases the chance for recovery without complications. Additionally, the ability to test the populace frequently, swiftly, and affordably significantly aids in containing wide-scale outbreaks. In terms of specificity and sensitivity, nucleic acid amplification tests (NAAT) are one of the best options for diagnosing infectious diseases. Isothermal NAATS present a unique opportunity to create diagnostic tests deployed at a Point-of-Care (POC) level. Specifically, loop-mediated isothermal amplification (LAMP) and recombinase polymerase amplification (RPA) have the potential to deliver reliable POC diagnostics in low-resource settings. When designing …

Optimization Of Vaccine Supply Chains In Low- And Middle-Income Countries Utilizing Drones, Maximilian Kolter

Graduate Theses and Dissertations

Despite tremendous efforts from governments and humanitarian organizations, millions of children in low- and low-middle-income countries (LICs and LMICs) are still excluded from the benefits of immunization. The vaccine distribution in LICs and LMICs is challenging for several reasons, such as limited cold chain capacities, vaccine wastage, uncertain demand, and lack of access to immunization services. A promising avenue to address these issues is the utilization of drones for vaccine delivery. Drones can fly at high speed on direct paths and could enable on-demand deliveries to mitigate limited storage capacities. Further, their independence of road networks could allow them reaching …

Host-Parasite Interactions Within Food Webs, Adam Zvanut Hasik

Graduate Theses and Dissertations

Parasitism is one of the most common life history strategies employed in nature, yet the effects of parasites are often thought to be minimal, and the vast majority of studies fail to consider parasites and their effects on host organisms. This is likely a problem, as the magnitude of parasite-mediated effects on their hosts can be quite large. Additionally, the effects of parasites are known to extend beyond the host to affect other species interactions. I used a series of approaches to gain a more integral understanding of host-parasite interactions by studying (1) the effects of parasites on biotic interactions …

Child-Centered Play Therapy’S Impact On Externalized Behaviors Of Children Who Have Experienced Trauma: A Single-Case Research Design, Timothy "T.J." Schoonover

Graduate Theses and Dissertations

Adverse childhood experiences (ACEs) are defined as exposure to emotional abuse, physical abuse, sexual abuse, emotional neglect, physical neglect, loss of a parent, domestic violence, family member with addiction, family member with depression or mental illness, and family member incarcerated (Felitti et al., 1998). ACEs have been studied for many years and have shown to have long term negative health and social-emotional outcomes and costs the world over $1 trillion a year (Bellis et al., 2019; Felitti et al., 1998; Hughes et al., 2017). Due to the emotional, physical, and dollar amount cost to not addressing the impact of ACEs …

Roles Of Librarians In Combating Misinformation On Corona Virus Disease (Covid-19), Grace D. Pelemo Mrs., Millie Horsfall Phd, Onyinye Alexander Osedo

Library Philosophy and Practice (e-journal)

The outbreak of the Corona Virus Disease (COVID-19) in Wuhan, China and the attendant explosion of “fake news” brings to the fore the need for Librarians and Libraries as well as other information providers to offer access to dependable information resources for the consumption of their patrons and users. Giving access to reliable sources of information and resources with minimal barriers comprises cooperation among Librarians and Libraries. This article surveyed the roles of Librarians and Libraries in response to the problems of fake news and misinformation arising from the outbreak of COVID-19 focusing on how librarians and other information professionals …

Implications Of Helminth Immunomodulation On Covid-19 Co-Infections, Nathalie Chacon, Leonor Chacin-Bonilla, Italo M. Cesar

School of Medicine Publications

Coronavirus disease 2019 (COVID-19) and helminths infections can be in a synergistic epidemic in developing and suburban areas of industrialized countries. The coinfected hosts will derive a parasite-specific Th2 innate and adaptive immune response with CD4+ T cells, eosinophils, interleukin-4, interleukin-5, and interleukin-10. In the early stages of severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) infection, virus-specific Th1 cytotoxic CD8+ T cell, interleukin-6, interferon-γ, and interleukin-27 by lung are keys in controlling viral replication in the lung epithelial cells and limiting the pathology to other organs, like the intestine. CD4+ and CD8+ T cells are associated with protective immunity …

Clinical Characteristics And Laboratory Biomarkers For Patients With Suspected Covid-19 Infection Within Hca Healthcare, Scott Gutovitz, Justin Hanson, Christian Vandever, Dietrich Jehle

HCA Healthcare Journal of Medicine

Background

The coronavirus infection (COVID-19), also known as the Severe Acute Respiratory Syndrome Virus 2 (SARS-CoV-2), caused significant illness and a worldwide pandemic beginning in 2020. Early case reports showed common patient characteristics, clinical variables and laboratory values in these patients. We compared a large population of American COVID-19 patients to see if they had similar findings to these smaller reports. In addition, we examined our population to identify any differences between mild or severe COVID-19 infections.

Methods

We retrospectively accessed a de-identified, multi-hospital database managed by HCA Healthcare to identify all adult emergency department (ED) patients that were tested …

Acute Psychosis With Recurrent Neurocysticercosis: A Case Presentation, Nasir F. Siddique, Kristy A. Fisher, Joshua Chang, Clara L. Alvarez Villalba

HCA Healthcare Journal of Medicine

Neurocysticercosis, a parasitic infection of the central nervous system (CNS) caused by the Taenia solium cestode, presents clinically with a large and diverse spectrum of symptomatology, dependent upon lesion number, locale and ensuing inflammatory response. To this date, there are only two documented cases of psychosis presenting in patients with neurocysticercosis, both of which were published in India. This case presentation depicts the first documented case of Psychotic Disorder Due to Another Medical Condition: Neurocysticercosis in the United States. The authors postulate that the atypical presentation of the neuropsychiatric instability with the aberrant recurrence of neurocysticercosis is predominantly attributable to …

A Case Report: Utilization Of Topical Amphotericin In Postoperative Mucormycosis, Kenny Wang, Jomel Jacinto, Alex Davis, Andrei Hetman, Alok Kumar

HCA Healthcare Journal of Medicine

Mucormycosis is a rare devastating fungal infection with a high mortality rate often associated with diabetic and immunosuppressed individuals. However, infections found in postoperative states and in immunocompetent patients are rare. Systemic liposomal amphotericin is viewed as a first line treatment for mucormycosis in addition to aggressive debridement to prevent the spread of infection. Literature describing the treatment of mucormycosis with both systemic and topical amphotericin B is scarce. We present a case of an immunocompetent male admitted for perforated diverticulitis who received a left hemicolectomy with colostomy creation. During hospitalization, stool from the colostomy bag was reportedly leaking into …

The Conspiracy Theory Defense In Response To Whistleblower Accusations: Turning A Hero Into A Villain, James K. Beggan

Heroism Science

Whistleblowers can be viewed as heroic actors who reveal institutional misdeeds. In contrast, conspiracy theorists are seen as members of a marginalized element perpetuating misinformation. Despite this apparent difference, the present analysis focuses on how similarities between the two constructs can allow a target to discredit a whistleblower accusation by countering that the whistleblower is operating as part of a conspiracy. More generally, this paper considers how the difficulty inherent in disproving conspiracy theory claims facilitates their utility as a defense. The case study of President Donald Trump’s responses to whistleblower accusations are considered to illustrate the arguments.