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A Mechanistic Study On The Immunological Effects Of A Novel Anti-Schistosomal Compound, Caleb M. Sandall, Paul H. Davis

Theses/Capstones/Creative Projects

Schistosomiasis is a condition caused by a parasitic worm infection that is one of the primary neglected tropical diseases. It infects approximately 250 million people every year, and it causes the second largest economic impact from any parasitic disease. There exists a treatment for Schistosomiasis; however, it is ineffective against the juvenile stages of the worm. A novel drug has been developed that has been illustrated to have efficacy against all stages of worm infection. However, before this drug can be utilized, its method of action must be determined. Preliminary single cell transcriptomic data from our lab suggests that our …

Dysglycemia In Patients Presenting With Stroke And Acute Coronary Syndrome At Aga Khan University Hospital, Nairobi, Beverly Yongo Owino

Master of Medicine in Internal Medicine

Background: Dysglycemia is often diagnosed late in sub-Saharan Africa with a significant number of patients presenting with complications. Data is needed to expand knowledge on the impact diabetes has on major adverse cardiovascular outcomes. Objective: We aimed to determine the prevalence of dysglycemia in patients with stroke and Acute Coronary Syndrome (ACS) and define characteristics of the patients with dysglycemia. Methods: A prospective cross-sectional study was conducted at Aga Khan University Hospital, Nairobi which is a tertiary facility. Consenting adults above 18 years (n=211) with stroke and acute coronary syndrome were recruited in the study in the period of April …

Association Between Ct Severity Score And Clinical Severity Score Of Covid-19 Pneumonia At Aga Khan University Hospital, Nairobi, Paul Kareithi Nduati

Master of Medicine in Imaging and Diagnostic Radiology

Background: Imaging with chest computed tomography (CT) has demonstrated a role in stratifying COVID-19 patients into different clinical severity groups thus facilitating appropriate care decisions. In a limited number of settings, the wider applicability and reproducibility of these findings is unclear. Objectives: To determine the association between chest CT severity score and clinical severity of illness in RT-PCR confirmed SARS-CoV2 patients. To evaluate the relationship of CT chest severity score with short term clinical outcome of patients. Methods: CT chest of 172 SARS-CoV2 patients who accessed care at Aga Khan University Hospital Nairobi between 14th March and 31st December 2020 …

Radiological Comparison Of Tumour Burden Of Lymphoma In Hiv Positive And Hiv Negative Patients, Poonamjeet Kaur Loyal

Master of Medicine in Imaging and Diagnostic Radiology

Introduction: Patients with Human Immunodeficiency Virus (HIV) are known to exhibit atypical pattern of lymphoma on imaging. There is paucity of literature on differences in tumour volume or burden of disease amongst HIV positive patients compared with HIV negative patients and how this correlates with clinicopathological parameters of aggressiveness and effects on prognosis. Objective: The purpose of this study was to evaluate the tumour burden of non-Hodgkin’s lymphoma in HIV positive patients compared with HIV negative and how this correlates with the clinicopathological parameters of aggressiveness and the overall clinical outcome. Methods: This was a retrospective analytical cross-sectional study. All …

Comparison Of Maldi-Tof Ms And 16s Rrna Sequencing For Identification Of A Collection Of Clinical Isolates Of Nonntuberculous Mycobacteria In Kenya And Describing Their Antimicrobial Susceptibilities, David Enoch Kawalya

Master of Medicine in Clinical Pathology

Study background: non-tuberculous mycobacteria (NTM) are members of the genus Mycobacteria that are ubiquitous in the environment. They are increasingly documented to cause multi-drug resistant human and animal infections in immunocompromised as well as immunocompetent hosts and thus, they are a huge burden on public health resources. Diagnosis and treatment of these infections is particularly challenging due to their variable clinical presentation and the lack of easily accessible identification methods. MALDI-TOF MS is a proteomic method that has gained traction in the identification of microbial organisms in clinical practice due to its fast turn-around time, high resolution, and cost-effectiveness but …

The Executive’S Guide To Getting Ai Wrong, Jerrold Soh

Asian Management Insights

This article explores how we see AI and argues that we mostly get it wrong. In the process, it explains the reasons backed by social science research on why we tend to get AI wrong and illustrates the dangers of doing so from a managerial and law-making perspective. Some readers may also find the article useful as a guide on how and when to manipulate portrayals of AI in your favour.

Strategies To Prevent Central Line-Associated Bloodstream Infections In Acute-Care Hospitals: 2022 Update., Niccolò Buetti, Jonas Marschall, Marci Drees, Mohamad G. Fakih, Lynn Hadaway, Lisa L. Maragakis, Elizabeth Monsees, Shannon Novosad, Naomi P. O'Grady, Mark E. Rupp, Joshua Wolf, Deborah Yokoe, Leonard A. Mermel

Manuscripts, Articles, Book Chapters and Other Papers

No abstract provided.

Fluctuating Parasite Prevalence Is Not Linked To Patterns Of Mhc Class Ii-Ss Diversity In An Island Endemic Reptile, Gina Zwicky

LSU New Orleans Theses and Dissertations

Few studies have explored the evolutionary mechanisms that maintain adaptive immunogenetic diversity in nature. We took advantage of museum samples to test for evidence of parasite-mediated fluctuating selection at MHC Class II-ß loci in an endemic island reptile. The Saban anole Anolis sabanus is commonly infected with three species of malaria (Plasmodium). Proportions of each parasite species detected in anole blood samples fluctuated over space and time, suggesting competitive interactions between parasites or differences in vector ecology. Our analyses of parasite prevalence and MHC Class II-ß allelic variation found that malaria infection was not associated with patterns of …

A Pathogen Outside Its Host: F. Tularensis Survival In Water, Aisling Macaraeg

Senior Honors Projects

Francisella tularensis is a Gram-negative pathogenic bacterium and is the causative agent for tularemia. While our understanding of F. tularensis survival in the environment is limited, it is clear they can persist in freshwater aquatic environments for long periods of time. Currently, there is a gap in knowledge with the understanding of the genes involved with the long-term survival of F. tularensis in an aquatic environment. In the laboratory setting, it has been found that lower temperatures seem to allow longer survival. The aim of this project is to identify laboratory conditions that allow F. tularensis to survive longterm in …

The Role Of Stm1987 And Arti In Arginine Response Of Salmonella Typhimurium, Deeba Mohseni

Undergraduate Honors Theses

Cyclic-di-GMP, a common bacterial second messenger, has been thought to help develop virulence and biofilms in bacteria, most specifically in Salmonella Typhimurium. By being able to dysregulate cyclic-di-GMP production, virulence may be better combatted. STM1987, an L-arginine-responsive diguanylate cyclase with a periplasmic sensory domain, dimerizes and generates the bacterial second messenger cyclic-di-GMP in response to the amino acid L-arginine in a pathway that also requires the periplasmic L-arginine-binding protein ArtI. Their biochemical responses to L-arginine and when they dimerize could help clarify this pathway, so I sought to develop a periplasmic dimerization sensor to better monitor these biochemical interactions. Similar …

Gastrointestinal Alterations In Two Mouse Models Associated With Social Behavior Deficits, Gracie Leamon

Undergraduate Honors Theses

The gastrointestinal (GI) tract is a diverse habitat for multiple microorganisms. Disturbances in the microbiome of the GI tract have been associated with psychiatric disorders including autism spectrum disorder (ASD). Individuals with ASD, when compared to neurotypical individuals, have demonstrated differing gut species. Also, it has been shown that microbial transplant therapies impact ASD symptoms in patients. Animal models of behaviors associated with ASD might offer insight for the actual role these microbial differences may occupy regarding symptoms. Unfortunately, ASD does not have an accepted animal model where the GI alterations have been thoroughly explored. In this study, we sought …

Evaluating The Effectiveness Of Restorative Justice Rehabilitative Services Available In Northeast Tennessee For Mothers Diagnosed With Substance Use Disorder, Claire Roberson

Undergraduate Honors Theses

Substance Use Disorder (SUD) has plagued families of rural Appalachia for many years, perpetuating involvement in the criminal justice system as well as generational trauma for people diagnosed with SUD and their children. This points to the necessity of a trauma-informed, restorative-justice based framework for rehabilitative services to most effectively heal families, address trauma, and re-integrate people diagnosed with SUD into society. A restorative justice-based program would provide health care services for addiction and any comorbid mental health disorders as well as teach parents how to properly provide for themselves and their families, manage finances, obtain employment, and further education. …

Vitamin D And Its In Vitro Therapeutic Action Mediated Through Vdr Rather Than Pdia3, Jaeden Pyburn

Undergraduate Honors Theses

Brain calcification is a common occurrence in the aging process, with >20% of individuals over the age of 65 showing hardened plaques in the basal ganglia. Loss of the vitamin D receptor (VDR) in transgenic mice leads to formation of calcified plaques in the basal ganglia and thalamus within the mice. Vitamin D signals through two known vitamin D responsive proteins, protein disulfide isomerase A3 (PDIA3) and VDR. In vitro, vitamin D has been demonstrated to suppress calcification in osteoblast-like cells. Here, we aim to elucidate which of either PDIA3 or VDR transduce vitamin D mediated suppression of calcification in …

Identification Of Genetic Elements Involved In Alcaligenes Faecalis’ Inhibitory Mechanism Against Polymicrobial Species, Abigail Mathis

Undergraduate Honors Theses

The rise of antibiotic resistance in common human pathogens and the lack of development of novel therapeutic treatments has created a threat to global health. A unique source for potential novel treatments are from microorganisms, particularly within the complex, antagonistic polymicrobial interactions that take place in microbial communities. These unique mechanisms utilized by microorganisms to fight each other could potentially identify novel therapeutic targets for use at a clinical level, however, there is a lack of research in this area to determine its applicability. Alcaligenes faecalis is a Gram-negative bacterium that seldom causes human disease and has been observed in …

Contributing Factors To Drug Abuse In The Appalachian Region, Will Holcombe

Undergraduate Honors Theses

The Appalachian region faces wide scale drug use and opioid addiction that exceeds the national average, and the crisis needs more attention in order to properly address the epidemic. Many previous studies have documented the problems Appalachian residents face regarding opioid addiction and other diseases of despair. However, this study focuses on two specific contributing causes of the opioid crisis: a lack of access to medical care and over-prescription of opioids. Additionally, while the problems of substance abuse, particularly opioid abuse, are well represented in media accounts, there is an under-representation of drug recovery and the positive aspects of the …

Outdated Ventriculoperitoneal Shunts And Their Effects On Quality Of Life: An Interdisciplinary Study, Emma Hilario

Honors Capstone Projects

Though many people in the medical field are aware of patients having a low quality of life from ventriculoperitoneal shunts not having updated material and technology, many choose to look at the problem through only one disciplinary perspective. In light of this issue, the sole purpose of this study was to use an interdisciplinary perspective on how outdated ventriculoperitoneal shunts affect quality of life as well as express technology advancement recommendations through this type of analysis. This study involved extensive interdisciplinary work on the causes and symptoms of intracranial pressure, types and advancements of shunt valves, and surgery outcomes and …

A Prisoner’S Dilemma: Why Covid-19 Must Serve As A Catalyst To Address Compassionate Release Limitations In Federal Prison, Mary M. Haasl

Minnesota Law Review Vols. 106:2 onward (2021-present)

COVID-19 significantly impacted the U.S. prison population. Given concerns surrounding its rapid spread through prisons, many federal inmates petitioned for compassionate release during the pandemic’s initial months. This significant increase in compassionate release petitions has yielded an impactful case study regarding the significant limitations posed by the compassionate release statute as written—particularly related to its exhaustion of administrative remedy requirement. Under the First Step Act of 2018, inmates must exhaust their administrative remedies before petitioning the district court for compassionate release. With concerns surrounding COVID-19 spread, some federal district courts allowed the waiver of the exhaustion requirement, while other did …

An Overview Of Mrna Vaccine Technology, Rachel N. Bruening

Physician Assistant Scholarly Project Papers

This project will serve to analyze the mechanism, efficacy, and adverse effects of mRNA technology in detail while also comparing it with a previous recombinant Influenza vaccine trial. In this systematic literature review, three library data bases were searched including Pub Med, Clinical Key, and Ebsco Megafile. Search criteria included the key terms: mRNA vaccines, vaccines, and COVID-19. Additional phrases used included: mechanism, history, and efficacy. Each key word was entered as it appears in the databases with additional phrases used to narrow down the research. The search was limited to the last five years to ensure up to date …

Antimicrobial Stewardship And Its Effects On Resistant Organisms, John D. Seifert

Physician Assistant Scholarly Project Papers

Antimicrobial stewardship has been found to have an impact on resistant organisms, but it has been unclear the importance of how strong those recommendations should be and if more strict or numerous guidelines equals fewer or less resistant organisms. “Antimicrobial stewardship (AMS), an organizational or system-wide health-care strategy, is designed to promote, improve, monitor, and evaluate the rational use of antimicrobials to preserve their future effectiveness, along with the promotion and protection of public health. (Majumder et al., 2020)” In reviewing recent peer-reviewed research it can be shown that medical facilities that utilize antimicrobial stewardship guidelines when prescribing antibiotics have …

Vitamind D Concentrations And Covid-19 Outcomes, Bennett A. Leitch

Physician Assistant Scholarly Project Papers

In March 2020, the World Health Organization declared COVID-19 a pandemic. Now, with over five million deaths the pandemic continues to cloak the globe. As of November 2021, 49.1% of the world population has received at least one dose of the COVID-19 vaccination according to ourworldindata.org/covid-vaccinations. In the United States, the CDC reported 57.6% of the population is fully vaccinated. With much of the population unvaccinated, potential protective factors are needed to help diminish infection. This literature review aimed to investigate a correlation between low serum vitamin D concentrations and outcomes of COVID-19 infections. A total of 27 research articles …

Long Term Outcomes Of Anti-Retroviral Treatment Vs. Additional Nutritional Supplementation For Hiv Patients, Michael P. Gillispie

Physician Assistant Scholarly Project Papers

The purpose of this systematic literature review is not to determine the best treatment for human immunodeficiency virus HIV but to analyze additional supplementation that can prolong the progression of the disease process. Zinc, vitamin A, D, and E will be evaluated additionally with the antiretroviral treatment ART. The cost of an ART Regimen can be very expensive and challenging for patients to afford. The goal is to find an acceptable option to complement ART with a sensible cost to prolong disease progression and minimize additional costs of health care. With the advances of ART, more and more patients can …

Hepatitis C Treatment For Substance Users In North Dakota, Janae Arnold

Physician Assistant Scholarly Project Papers

In the 1960’s, the hepatitis C virus (HCV) epidemic began mainly through the transmission of blood transfusions. By the time screening was implemented, millions had already become infected worldwide. After a decade of declining infection rates, a second wave started in the midst of the opioid epidemic in 2010. Prior to 2014 and the application of curative direct-acting antivirals, treatment was expensive, had low efficacy, many side effects, and long treatment durations. Advances in medicine have allowed for HCV elimination with shorter treatment durations, less side effects, and higher treatment rates. Unfortunately, treatment is not offered to all HCV patients …

Knowledge, Attitude And Beliefs Towards Polypharmacy Amongst Older People Attending Family Medicine Clinic (Fmc) At The Aga Khan University Hospital, Nairobi, Kenya (Akuhn)., Maureen Wanjiru Kamau

Master of Medicine in Family Medicine

Introduction: Life expectancy has increased over the last century amongst older individuals, and in particular, those 60 years and over. The World Health Organization estimates that the world's population of persons over 60 years will rise to 22 per cent by the year 2050. Ageing is associated with increasing disability, multiple chronic conditions, and an increase in the use of health services. Multiple chronic conditions associated with ageing are managed with different medications (polypharmacy) amongst the older population. Polypharmacy has numerous adverse effects including non-adherence, an increased risk of drug interactions with the various medications, reduced appetite, and risk of …

Adequacy Of Pain Management Among Advanced Cancer Patients With Solid Tumors Attending Palliative Care Centers In Dar Es Salaam, Judith Mwijage

Master of Medicine in Family Medicine

Background: Cancer pain is a universal undesirable symptom among cancer patients that if not addressed causes suffering and impedes quality of life of both the patients and their family. Observational studies available have shown increase in palliative care programs in Tanzania but there is dearth of information regarding the adequacy of pain control among patients with cancer after the initiation of these programs and improvement of the available interventions. Objectives: This study aimed to determine adequacy of pain management among advanced cancer patients with solid tumors as well as factors affecting adequate Cancer Related Pain management. Methods: We conducted a …

Analyzing The Survival Rate Of Clinically Pathogenic Bacteria On Occupational Therapy Devices Used During Full Hip Replacement Rehabilitation, Meredith Rippy

Honors Theses

An increasing concern of the healthcare system has been that of Healthcare-Associated Infections (HAIs). HAIs currently account for approximately 1.7 million infections and 99,000 deaths per year in United States hospitals. HAI’s (formerly called nosocomial infections) are defined as infections that develop in patients who have been in residence in a healthcare facility (i.e., in-patient clinics) for 48 hours or longer and who previously had no evidence of infection prior to admission. Consequences of HAIs include increased length of hospital stay, exposure to high frequency antibiotics, sepsis, and in unfortunate cases, death. In out-patient environments where patients are receiving rehabilitative …

Genomic Tools And Models For Investigating The Role Of Germline Diversity In Mouse Antibody Repertoire Development., Justin T. Kos

Electronic Theses and Dissertations

Given the diversity and complexity within immunoglobulin (IG) loci, effective mouse models first require characterization of intra-strain differences and construction of high-quality reference assemblies for IG loci in several representative strains. To understand light chain germline diversity across biomedically significant mouse strains, we profiled the expressed IGK and IGL repertoires of 18 commonly used laboratory mouse strains using AIRR-seq. Across strains, we observed germline IGKV sequences shared by three different IGK haplotypes and a more conserved IGLV germline repertoire among common laboratory strains. Pacific Biosciences (PacBio) Single-Molecule Real-Time (SMRT) sequencing was used to sequence and assemble bacterial artificial chromosomes (BAC) …

The Use Of Spectral Imaging To Reveal Inorganics And Organics Identity In The Biological Samples, Qamar Alshammari

Pharmaceutical Sciences (PhD) Dissertations

The wavelength is used to identify the exact location and quantify the number of molecules in the spectral imaging system. It aids in identifying materials and studying their quantities by examining how they interact with light. A traditional spectrometer provides spectrum information of chemical compounds, while standard imaging provides the intensity at each pixel of the image. Spectral imaging (SI) combines these two aspects by equipping intensity and spectral data for each pixel. In biomedical research, it is important to assess the inorganics/organics molecules to understand drug activity, cellular toxicity, and distribution. Using the microscopy technique, we found for the …

Atr-Mediated Cd47 And Pd-L1 Upregulation Restricts Radiotherapy-Induced Immune Priming And Abscopal Responses In Colorectal Cancer, Cheng-En Hsieh, Cheng-En Hsieh

Dissertations and Theses (Open Access)

Radiotherapy of colorectal cancer (CRC) can prime adaptive immunity against tumor-associated antigen (TAA)-expressing CRC cells systemically. However, incidences of abscopal tumor remission are extremely rare, and the post-irradiation immune escape mechanisms in CRC remain elusive. We report that CRC cells utilize a common DNA repair signaling pathway — ATR/Chk1/STAT3 — to upregulate both CD47 and PD-L1 in response to radiotherapy, which through engagement of SIRPα and PD-1 suppresses the capacity of antigen-presenting cells to phagocytose them thereby preventing TAA cross-presentation and innate immune activation. This post-irradiation CD47 and PD-L1 upregulation can be observed across various human solid tumor cells. Concordantly, …

Demonstration And Acceptability Of A Safer Conception Intervention For Men With Hiv In South Africa: Pilot Cohort Study, Lynn T. Matthews, Christina Psaros, Mxolisi Mathenjwa, Nzwakie Mosery, Letitia Rambally Greener, Hazar Khidir, Madeline Pratt, David Bangsberg, Multiple Additional Authors

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background: Many men with HIV (MWH) want to have children. HIV viral suppression minimizes sexual HIV transmission risks while allowing for conception and optimization of the health of men, their partners, and their infants.

Objective: This study developed and evaluated the feasibility and acceptability of an intervention to promote serostatus disclosure, antiretroviral therapy (ART) uptake and adherence, and viral suppression among MWH who want to have children in South Africa.

Methods: We developed a safer conception intervention (Sinikithemba Kwabesilisa or We give hope to men) to promote viral suppression via ART uptake and adherence, HIV serostatus disclosure, and other safer …

Characterization Of A Novel Microfilarial Antigen For Diagnosis Of Wuchereria Bancrofti Infections, Sarah E. Greene, Kerstin Fischer, Young-Jun Choi, Kurt C. Curtis, Philip J. Budge, Makedonka Mitreva, Christopher L. King, Peter U. Fischer, Gary J. Weil

Open Access Publications

BACKGROUND: Lymphatic filariasis (LF) is a neglected tropical disease caused by the filarial nematodes Wuchereria bancrofti, Brugia malayi and Brugia timori. The Global Program to Eliminate LF uses mass drug administration (MDA) of anti-filarial drugs that clear microfilariae (Mf) from blood to interrupt transmission by mosquitos. New diagnostic tools are needed to assess the impact of MDA on bancroftian filariasis, because available serologic tests can remain positive after successful treatment.

METHODOLOGY/PRINCIPAL FINDINGS: We identified Wb-bhp-1, which encodes a W. bancrofti homologue of BmR1, the B. malayi protein used in the Brugia Rapid antibody test for brugian filariasis. Wb-bhp-1 has a …