Digital Commons Network^™

Rural-Urban Differences In Antibiotic Prescribing For Uncomplicated Urinary Tract Infection, Abbye W Clark, Michael J Durkin, Margaret A Olsen, Matthew Keller, Yinjiao Ma, Caroline A O'Neil, Anne M Butler

Open Access Publications

OBJECTIVE: To examine rural-urban differences in temporal trends and risk of inappropriate antibiotic use by agent and duration among women with uncomplicated urinary tract infection (UTI).

DESIGN: Observational cohort study.

METHODS: Using the IBM MarketScan Commercial Database (2010-2015), we identified US commercially insured women aged 18-44 years coded for uncomplicated UTI and prescribed an oral antibiotic agent. We classified antibiotic agents and durations as appropriate versus inappropriate based on clinical guidelines. Rural-urban status was defined by residence in a metropolitan statistical area. We used modified Poisson regression to determine the association between rural-urban status and inappropriate antibiotic receipt, accounting for …

Noninvasive Immuno-Pet Imaging Of Cd8 + T Cell Behavior In Influenza A Virus-Infected Mice, Paul W Rothlauf, Zeyang Li, Novalia Pishesha, Yushu Joy Xie, Andrew W Woodham, Djenet Bousbaine, Stephen C Kolifrath, Vincent L Verschoor, Hidde L Ploegh

Open Access Publications

Immuno-positron emission tomography (immuno-PET) is a noninvasive imaging method that enables tracking of immune cells in living animals. We used a nanobody that recognizes mouse CD8α and labeled it with

Bladder Exposure To Gardnerella Activates Host Pathways Necessary For Escherichia Coli Recurrent Uti, Valerie P O'Brien, Amanda L Lewis, Nicole M Gilbert

Open Access Publications

Recurrent urinary tract infections (rUTI) are a costly clinical problem affecting millions of women worldwide each year. The majority of rUTI cases are caused by uropathogenic

Helminth-Virus Interactions: Determinants Of Coinfection Outcomes, Pritesh Desai, Michael S Diamond, Larissa B Thackray

Open Access Publications

Viral infections are often studied in model mammalian organisms under specific pathogen-free conditions. However, in nature, coinfections are common, and infection with one organism can alter host susceptibility to infection with another. Helminth parasites share a long coevolutionary history with mammalian hosts and have shaped host physiology, metabolism, immunity, and the composition of the microbiome. Published studies suggest that helminth infection can either be beneficial or detrimental during viral infection. Here, we discuss coinfection studies in mouse models and use them to define key determinants that impact outcomes, including the type of antiviral immunity, the tissue tropism of both the …

Cost Burden Of Post-Transplant Lymphoproliferative Disease Following Kidney Transplants In Medicare-Eligible Patients By Survival Status, Allyson Hart, Yoon Son Ahn, Crystal Watson, Melissa Skeans, Arie Barlev, Bryn Thompson, Vikas R Dharnidharka

Open Access Publications

AIMS AND OBJECTIVES: Patients diagnosed with post-transplant lymphoproliferative disease (PTLD) experience high mortality within the first 2 years of diagnosis; however, few data exist on the economic burden of PTLD in these patients. We determined the healthcare resource utilization (HRU) and cost burden of post-kidney transplant PTLD and evaluated how these differ by survival status.

MATERIALS AND METHODS: Utilizing data from the United States Renal Data System and the Scientific Registry of Transplant Recipients, we identified 83,818 Medicare-covered kidney transplant recipients between 2007 and 2016, of which 347 had at least one Medicare claim during the first year after diagnosis …

Antibiotic-Driven Intestinal Dysbiosis In Pediatric Short Bowel Syndrome Is Associated With Persistently Altered Microbiome Functions And Gut-Derived Bloodstream Infections, Robert Thänert, Anna Thänert, Jocelyn Ou, Adam Bajinting, Carey-Ann D Burnham, Holly J Engelstad, Maria E Tecos, I Malick Ndao, Carla Hall-Moore, Colleen Rouggly-Nickless, Mike A Carl, Deborah C Rubin, Nicholas O Davidson, Phillip I Tarr, Barbara B Warner, Gautam Dantas, Brad W Warner

Open Access Publications

Surgical removal of the intestine, lifesaving in catastrophic gastrointestinal disorders of infancy, can result in a form of intestinal failure known as short bowel syndrome (SBS). Bloodstream infections (BSIs) are a major challenge in pediatric SBS management. BSIs require frequent antibiotic therapy, with ill-defined consequences for the gut microbiome and childhood health. Here, we combine serial stool collection, shotgun metagenomic sequencing, multivariate statistics and genome-resolved strain-tracking in a cohort of 19 patients with surgically-induced SBS to show that antibiotic-driven intestinal dysbiosis in SBS enriches for persistent intestinal colonization with BSI causative pathogens in SBS. Comparing the gut microbiome composition of …

Factors Influencing Implementation Of Blood Transfusion Recommendations In Pediatric Critical Care Units, Katherine M Steffen, Philip C Spinella, Laura M Holdsworth, Mackenzie A Ford, Grace M Lee, Steven M Asch, Enola K Proctor, Allan Doctor

Open Access Publications

No abstract provided.

Global Parity: Study Design For A Multi-Centered, International Point Prevalence Study To Estimate The Burden Of Pediatric Acute Critical Illness In Resource-Limited Settings, Qalab Abbas, Kenneth E Remy, Et Al

Open Access Publications

Background: The burden of pediatric critical illness and resource utilization by children with critical illness in resource limited settings (RLS) are largely unknown. Without specific data that captures key aspects of critical illness, disease presentation, and resource utilization for pediatric populations in RLS, development of a contextual framework for appropriate, evidence-based interventions to guide allocation of limited but available resources is challenging. We present this methods paper which describes our efforts to determine the prevalence, etiology, hospital outcomes, and resource utilization associated with pediatric acute, critical illness in RLS globally.

Methods: We will conduct a prospective, observational, multicenter, multinational point …

Development And Testing Of A Spray-Dried Tuberculosis Vaccine Candidate In A Mouse Model, Mellissa Gomez, Mushtaq Ahmed, Shibali Das, Leah Mellett, Rosemary Swanson, Ananya Gupta, Shabaana A Khader, Et Al

Open Access Publications

Converting a vaccine into a thermostable dry powder is advantageous as it reduces the resource burden linked with the cold chain and provides flexibility in dosage and administration through different routes. Such a dry powder presentation may be especially useful in the development of a vaccine towards the respiratory infectious disease tuberculosis (TB). This study assesses the immunogenicity and protective efficacy of spray-dried ID93+GLA-SE, a promising TB vaccine candidate, against

Understanding Drivers Of Coronavirus Disease 2019 (Covid-19) Racial Disparities: A Population-Level Analysis Of Covid-19 Testing Among Black And White Populations, Aaloke Mody, Kristin Pfeifauf, Cory Bradley, Branson Fox, Matifadza G. Hlatshwayo, Will Ross, Vetta Sanders-Thompson, Karen Joynt Maddox, Mat Reidhead, Mario Schootman, William G. Powderly, Elvin H. Geng

Open Access Publications

BACKGROUND: Disparities in coronavirus disease 2019 (COVID-19) testing-the pandemic's most critical but limited resource-may be an important but modifiable driver of COVID-19 inequities.

METHODS: We analyzed data from the Missouri State Department of Health and Senior Services on all COVID-19 tests conducted in the St Louis and Kansas City regions. We adapted a well-established tool for measuring inequity-the Lorenz curve-to compare COVID-19 testing rates per diagnosed case among Black and White populations.

RESULTS: Between 14/3/2020 and 15/9/2020, 606 725 and 328 204 COVID-19 tests were conducted in the St Louis and Kansas City regions, respectively. Over time, Black individuals consistently …

Entomological Risk Assessment For Dengue Virus Transmission During 2016-2020 In Kamphaeng Phet, Thailand, Thanyalak Fansiri, Darunee Buddhari, Nattaphol Pathawong, Arissara Pongsiri, Chonticha Klungthong, Sopon Iamsirithaworn, Anthony R. Jones, Stefan Fernandez, Anon Srikiatkhachorn, Alan L. Rothman, Kathryn B. Anderson, Stephen J. Thomas, Timothy P. Endy, Alongkot Ponlawat

Institute for Immunology and Informatics Faculty Publications

Individual houses with high risks of dengue virus (DENV) transmission might be a source of virus transmission within the neighborhood. We conducted an entomological risk assessment for DENV transmission at the household level, comprising family cohort members residing in the same location, to assess the risk for dengue virus transmitted by mosquito vectors. The studies were conducted in Kamphaeng Phet Province, Thailand, during 2016–2020. Entomological investigations were performed in 35 cohort families on day 1 and day 14 after receiving dengue case reports. DENV was found in 22 Aedes samples (4.9%) out of 451 tested samples. A significantly higher DENV …

Divergent Attitudes Regarding The Benefits Of Face Masks In Aviation Colleges And Universities, Andrew R. Dattel, Peiheng Gao, Hanzi Xie, Maxine E. Lubner

Publications

Opinions and practices regarding face masks (FM) to attenuate COVID-19’s spread remains polarized across the United States. We examined whether these attitudes extend to the aviation collegiate community. A 14-question survey was sent to 90 aviation colleges and universities throughout the country. Responses were solicited from students, faculty, and staff. Of the 598 respondents, 77% were students, 13% were faculty, and 10% were staff. Pilots comprised 66% of the respondents. A Principal Component Analysis reduced the questions to two scales: Benefits and Inconvenience. Females, non-pilots, and older respondents reported greater benefits to wearing a FMand fewer inconveniences. A multiple regression …

Epigenetic Mechanisms Underlying Hiv-Infection Induced Susceptibility Of Cd4+ T Cells To Enhanced Activation-Induced Fasl Expression And Cell Death., Smita Ghare, Paula M. Chilton, Aakarsha V. Rao, Swati Joshi-Barve, Paula Peyrani, Andrea Reyes-Vega, Craig J. Mcclain, Kendall Bryant, Robert L. Cook, Mathew Freiberg, Shirish Barve

Faculty and Staff Scholarship

Background:

Chronic immune activation and CD4⁺ T cell depletion are significant pathogenic features of HIV infection. Expression of Fas ligand (FasL), a key mediator of activation-induced cell death in T cells, is elevated in people living with HIV-1 infection (PLWH). However, the epigenetic mechanisms underlying the enhanced induction of FasL expression in CD4⁺ T lymphocytes in PLWH are not completely elucidated. Hence, the current work examined the effect of HIV infection on FasL promoter-associated histone modifications and transcriptional regulation in CD4⁺ T lymphocytes in PLWH.

Method:

Flow cytometric analysis was performed to examine the Fas-FasL expression on …

Inequality, Covid-19, And International Human Rights: Whose Lives Matter?, Barbara J. Stark

Hofstra Law Faculty Scholarship

Part 1 of the article shows that the poor, everywhere, are more likely to get sick and more likely to die when they do. In many countries, they are also more likely to starve.

Part II explains why this is a matter of human rights. The ongoing deprivation of basic rights to healthcare and an adequate standard of living are major factors. As this Part demonstrates, however, the extreme vulnerability of the poor is grounded in earlier violations of human rights, including state-sanctioned segregation in the American south in the 1950s and what one author has called “the darker side …

Embodied Fat Stigma And Health Beliefs About Exercise And Diet, Brie Scrivner

All ETDs from UAB

The purpose of this dissertation is to examine how individuals navigate the cultural mandate for thinness, which pressured individuals to pursue weight loss through exercise and restrictive diets. While sustainable weight loss is not probable for the majority of people, there are still significant physical and mental health benefits to be had from engaging in regular, enjoyable movement. For many, physical activity is an important component of a healthy lifestyle. It can improve quality of life for individuals regardless of weight, body size, chronic illness, or disability. However, many fitness facilities focus on weight loss as the most essential goal …

Phytochemistry And Dna˗Based Authentication Of Medicinal Lasianthus Stipularis Blume (Rubiaceae) Species Against Human Pathogenic Bacteria, Tiwtawat Napiroon, Sutee Duangjai, Srunya Vajrodaya, Markus Bacher, Henrik Balslev, Wichai Santimaleeworagun

The Thai Journal of Pharmaceutical Sciences

Lasianthus stipularis Blume is a medicinal plant found in the tropical rainforests of peninsular Thailand and Malaysia. Its leaves are used in traditional medicine to treat a condition called “noise in the head” (i.e., ear infections). As such infections are often caused by Gram-negative bacteria; this species of Lasianthus may have antibacterial effects. In this study, we examined the non-polar fractions from the leaves and stem bark of L. stipularis using thin-layer chromatography and high-performance liquid chromatography (HPLC). The non-polar fractions exhibited a high coumarin content, while stem bark extracts showed a high concentration of 7-hydroxy-6-methoxycoumarin when isolated by column …

Neonatal Murine Cytomegalovirus Infection Disrupts Synapse Remodeling During Development, Jerome Moulden

All ETDs from UAB

Human cytomegalovirus (HCMV) is a complex double stranded DNA betaherpesvirus. Its linear DNA in enclosed in an icosahedral capsid, and has a genome size of about 230kb and encodes about 170 genes. Primary infection with HCMV lead to a lifelong persistent infection. HCMV can also be transmitted across the placenta and infect the developing fetus leading to infection of the newborn infant, an infection which is commonly described as congenital HCMV infection. In the United States, the prevalence of congenital HCMV infection is between 0.2-1.2%. Approximately 5-15% of these newborn infants will develop long-term neurological damage resulting, motor disorder, cognition …

Multidrug-Resistance, Antibiotic-Associated Acute Kidney Injury, And Poor Disease Prognosis In Community-Acquired Bacterial Pneumonia, Adeniyi J. Idigo

All ETDs from UAB

In this dissertation research, I examined the challenges of treating patients with bacterial community-acquired pneumonia (CAP) with the purpose of identifying risk factors linked with multidrug-resistant (MDR) Pseudomonas, treatment toxicity, and poor disease prognosis. I used a retrospective cohort study design to explore a clinical cohort of patients admitted to the University of Alabama at Birmingham hospital network who had bacterial pneumonia diagnosis assessed to be from community transmission between January 2013-December 2019. Electronic medical records were accessed for socio-demographic and clinical information. First, I examined the local prevalence/incidence of Pseudomonas CAP and MDR Pseudomonas CAP, and the relationship between …

Structural Changes To Desmosomal Architecture During Assembly And Maturation, Reena R. Beggs

All ETDs from UAB

Desmosomes are macromolecular junctions important in adhesion and resisting mechanical stress in epithelial and cardiac tissue. Desmosomes have a complex architecture with transmembrane cadherins, desmogleins and desmocollins, constituting the adhesive interface and plaque proteins, including plakoglobin and desmoplakin, binding the cadherin tails and integrating with intermediate filaments. Dysregulation of desmosomes occurs in many disease states, such as cardiomyopathies, skin diseases, and various cancers. While mature desmosomes' structure is generally understood, less is known about desmosome architecture during assembly and recycling. Desmosomes are dynamic, biochemically intractable, and diffraction-limited, making them challenging to study. To overcome these obstacles, I applied the super-resolution …

The Role Of Visa Status And Acculturation In The Health Of Us Immigrants, Serra Sevde Hatipoglu

All ETDs from UAB

Using data from the 2003 New Immigrant Survey, I examined the association between visa status and acculturation with physical, mental, and self-rated health among immigrants residing in the United States. The primary predictor variable in the study is immigrant visa status. The outcome variables of interest include physical health as any morbidity (chronic diseases), mental health as depressed (as defined by the DSM-IV) and self-rated health (poor self-rated health). Using logistic regressions, I found those with unfavorable visa statuses have worse mental, physical, self-rated health compared to the favorable visa holders. I used inverse odds ratio weighted (IORW) mediation method …

Undergraduate Students’ Perspectives On Mental Health Services, Resources, And Supports During Covid-19: A Qualitative Dissertation, Amy Hutson Chatham

All ETDs from UAB

During the COVID-19 pandemic, increased isolation from supportive relationships, uncertainty about the future, fear of illness, and lack of traditional life-events took a toll on university student mental health. It is important to understand undergraduate students’ mental health needs during the COVID-19 pandemic and their desires for support from their institutions of higher education. Existing studies have documented increased rates of depression, stress, and anxiety among university undergraduates; however, these studies rarely illuminate students’ perspectives on mental health services, resources, and supports that they need during and because of the COVID-19 pandemic. This phenomenological study explored the perspectives of undergraduate …

Review: Formation And Metabolic Function Of Coral Rubble Biofilms In The Reef Ecosystem, Andres Sanchez-Quinto, Luisa I. Falcon

Gulf and Caribbean Research

When coral dies, their calcareous skeletons constitute coral rubble in conjunction with the cementing activity of coralline algae and bacteria, creating a secondary reef structure which takes from years to decades to form. Healthy coral reefs differ from coral—rubble dominated reefs in microbial taxonomic composition and metabolic functional roles. The metabolisms of healthy reefs are dominated by autotrophic pathways, where carbon and nitrogen fixation dominate, while the metabolism of rubble—dominated reefs predominate in degradation of organic matter. Nitrogen fixation is 3 orders of magnitude lower in rubble—dominated reefs than in healthy reefs. Coral—rubble harbors a vast diversity of microbes that …

Understanding Metrics Of Stress In The Context Of Invasion History: The Case Of The Brown Treesnake (Boiga Irregularis), Natalie Claunch, Ignacio Moore, Heather L. Waye, Laura Schoenle, Samantha J. Oakey, Robert N. Reed, Christina Romagosa

Biology Publications

Invasive species can exert rapid depletion of resources after introduction and, in turn, affect their own population density. Additionally, management actions can have direct and indirect effects on demography. Physiological variables can predict demographic change but are often restricted to snapshots-in-time and delayed confirmation of changes in population density reduces their utility. To evaluate the relationships between physiology and demography, we assessed metrics of individual and demographic stress (baseline and 1-h corticosterone (CORT), body condition and bacterial killing ability) in the invasive snake Boiga irregularis on Guam collected in intervals of 10–15 years. We also assessed potential discrepancies between different …

Prevalence And Transmission Of Selected Infectious Disease-Causing Enzootic And Zoonotic Pathogens By Haematophagous Camel Keds, Hippobosca Camelina, In Laisamis, Marsabit County Of Northern Kenya, Kevin Kidambasi

All Master’s Theses

Hippobosca camelina, also known as camel keds or camel louse flies, are the most common blood-sucking ectoparasites infesting camels in, Laisamis Ward, northern Kenya. The ability of these obligate haematophagous biting flies to transmit infectious agents is less understood. The aims of this study were to; I) screen for protozoan, bacterial and viral pathogens in camels and their biting keds, H. camelina, sampled from Laisamis Ward, Marsabit county II) assess the potential utility of camel keds in xenosurveillance of camel haemopathogens, and III) study the capacity of camel keds to transmit haemopathogens to experimental mice. Blood samples (n …

Visual Infrastructures Of Covid-19 Messaging, Julia Ross, Claudine Jaenichen

Art Faculty Articles and Research

Infecting more than two hundred and nineteen million people internationally as of September 2021, SARS-Cov2 (COVID-19) remains a major health crisis despite the availability of vaccines in many countries and publicized guidance on effective preventative measures (WHO, 2021). To combat the spread of the virus, governments worldwide have found themselves relying on their ability to exert control over health behaviors in public and private spaces. Visual communication, which includes both graphics and text, is an integral component of how these behavioral advisories are communicated to the public. Authorities translate scientific information into digestible designs for the public to achieve effective …

Reproductive Health Factors And Maternal Mortality Of Internally Displaced Women In Nigeria, Fatima Mahmood Jibirilla

Walden Dissertations and Doctoral Studies

Approximately 529,000 women die from pregnancy-related causes every year, with 99% of these maternal deaths occurring in developing countries. Each year, about 59,000 maternal deaths occur in Nigeria, with a mortality rate of 576 deaths per 100,000 births. Women constitute about half of the 33.2 million internally displaced persons (IDPs) worldwide. The purpose of this retrospective cross-sectional study was to explore the association between the reproductive health factors and maternal mortality of internally displaced women in Borno state, Nigeria. McCarthy and Maine’s model for determinants of maternal mortality informed this study. A secondary dataset of 400 women (age 14-49 years) …

The Causes And Control Measures Of Extended Spectrum Beta-Lactamase Producing Enterobacteriaceae In Long-Term Care Facilities, Ismaila Olatunji Sule

Walden Dissertations and Doctoral Studies

Due to extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-PE), infections among residents are increasing in long-term care facilities (LTCFs), resulting in high rate of morbidity and healthcare costs. ESBL-PE resists empirical antibiotics and reduces treatment options, and a designated infection control team is unavailable to prevent the prevalence of the disease. Ecological theory guided this study. A systematic review and meta-analysis were conducted to characterize the causes of ESBL-PE and evaluate the infection control strategies within LTCFs. Multiple regression analysis (MRA) was included as supplementary statistical analysis to identify relationships between LTCFs, geographical locations, infection control measures (ICMs), and ESBL-PE. A systematic search …

Employee Wellness Program Participation: Exploring Participation Of Registered Nurses In East Tennessee, Jacquelyn Turner

Doctoral Dissertations and Projects

Many organizations are faced with the challenge of managing employee retention and absenteeism. While retention strategies are focal to organizational leaders across the board, the growing shortage of nurses nationwide creates a critical concern for healthcare leaders. The purpose of this qualitative case study was to delve into the existing body of research pertaining to the impact of employee wellness programs on employee retention and absenteeism and further explore the reasons why employees choose to/ not to participate in wellness programs offered by employers. The intent of this study was to add to the existing body of knowledge on employee …

An Integrative Review: Best Practices In Advanced Practice Registered Nurse (Aprn) Telehealth Services To Improve Outcomes For Children With Chronic Health Conditions, Tamara Sue Moyer

Doctoral Dissertations and Projects

Telehealth is a rapidly growing field that affords individuals the opportunity to receive access to specialty providers, reduce expenses and travel, break down geographic barriers, deliver equality of care, and improve patient outcomes. Equality of healthcare for pediatric patients with chronic health conditions in rural areas face geographic barriers to delivery of care, resulting in poor patient outcomes, and increased costs. An integrative review was completed to identify and describe research findings in an attempt to answer the clinical questions proposed and identify areas in research that can lead to improved patient outcomes. The need to receive access to specialty …

One Child Town: The Health Care Exceptionalism Case Against Agglomeration Economies, Elizabeth Weeks

Scholarly Works

This Article offers an extended rebuttal to the suggestion to move residents away from dying communities to places with greater economic promise. Rural America, arguably, is one of those dying places. A host of strategies aim to shore up those communities and make them more economically viable. But one might ask, “Why bother?” In similar vein, David Schleicher’s provocative 2017 Yale Law Journal article, Stuck! The Law and Economics of Residential Stagnation urged dismantling a host of state and local government laws operating as barriers to migration by Americans from failing economies to robust agglomeration economies. But Schleicher said little …