Open Access. Powered by Scholars. Published by Universities.®

Digital Commons Network™

Open Access. Powered by Scholars. Published by Universities.®

2023

Discipline
Institution
Keyword
Publication
Publication Type
File Type

Articles 3061 - 3090 of 47768

Full-Text Articles in Entire DC Network

The Mayfly Newsletter, Donna Giberson Dec 2023

The Mayfly Newsletter, Donna Giberson

The Mayfly Newsletter

The Mayfly Newsletter is the official newsletter of the Permanent Committee of the International Conferences on Ephemeroptera.


Self-Care Practices For Common Acute Conditions In The Philippines: A Scoping Review, Arianna Maever Loreche, Veincent Christian F. Pepito, Manuel M. Dayrit Dec 2023

Self-Care Practices For Common Acute Conditions In The Philippines: A Scoping Review, Arianna Maever Loreche, Veincent Christian F. Pepito, Manuel M. Dayrit

Ateneo School of Medicine and Public Health Publications

Purpose

This review aimed to identify and map published studies on self-care practices to manage common acute health conditions in the Philippines.

Design/methodology/approach

The authors conducted a scoping review in PubMed, Scopus, Cumulative Index of Nursing and Allied Health Literature (CINAHL), ProQuest Central, Journal Storage (JSTOR) and the Philippine Council for Health Research and Development – Health Research and Development Information Network (HERDIN). The authors included all studies on self-care practices to manage common acute conditions, namely low back pain, allergic rhinitis, general acute pain, cough, cold, diarrhea, constipation and stress, published up to 2021 in the Philippines. Information on …


Survey Of Transfer Learning Approaches In The Machine Learning Of Digital Health Sensing Data, Lina Chato, Emma Regentova Dec 2023

Survey Of Transfer Learning Approaches In The Machine Learning Of Digital Health Sensing Data, Lina Chato, Emma Regentova

Electrical & Computer Engineering Faculty Research

Machine learning and digital health sensing data have led to numerous research achievements aimed at improving digital health technology. However, using machine learning in digital health poses challenges related to data availability, such as incomplete, unstructured, and fragmented data, as well as issues related to data privacy, security, and data format standardization. Furthermore, there is a risk of bias and discrimination in machine learning models. Thus, developing an accurate prediction model from scratch can be an expensive and complicated task that often requires extensive experiments and complex computations. Transfer learning methods have emerged as a feasible solution to address these …


Fall 2023 Commencement Program, University Of Alabama In Huntsville Dec 2023

Fall 2023 Commencement Program, University Of Alabama In Huntsville

Commencement Programs

No abstract provided.


The Diamond, December 12, 2023, Dordt University Dec 2023

The Diamond, December 12, 2023, Dordt University

Dordt Diamond

  • Front Page: Dordt Begins Construction on Townhome Style Housing; Dordt Alumni Elected as Mayor of Sioux Center; Morality and Policy Collide at Feenstra's Faith and Family Event
  • News: Voters Prepare for Iowa's January Caucus; Finals Shift Away from Traditional Exams; MOSAIC Club, Students Without Borders Hosts Christmas Around the World; Iowa Corn Includes College Agriculture Students
  • Feature: Student-Led Short Films Showcase Talents; Zamboni Breaks the Ice at Dordt Hockey; Escaping War and Finding a Home in Sioux County; Dordt Dads Lend a Hand by Washing Dishes; Developing Your Career at Dordt
  • Arts & Entertainment: Student-Directed One …


Status Survey Of Eight Rare Aquatic Macroinvertebrates In East Texas, Alexandra Randall Dec 2023

Status Survey Of Eight Rare Aquatic Macroinvertebrates In East Texas, Alexandra Randall

Biology Theses

Freshwater is essential to human existence. The health of each freshwater source is connected to the survival of pollution intolerant species of aquatic macroinvertebrates in the orders Ephemeroptera, Plecoptera, and Trichoptera (EPT taxa). A higher presence of EPT taxa equates to better water quality because their water bound larvae assist in maintaining clean freshwater environments and will not survive in highly polluted water. Human disruption to natural environments is causing increases in polluted freshwater, leading to decreases in the presence of EPT taxa. Texas Parks and Wildlife Department documentation shows major concern for the populations of eight EPT species of …


The Intersection Of Foreign Influence And Democratization: A Case Study Of Eurasian Powers Influence On Belarus’ Democratic Movement Since 2020, Dalton Xavier Maggs Dec 2023

The Intersection Of Foreign Influence And Democratization: A Case Study Of Eurasian Powers Influence On Belarus’ Democratic Movement Since 2020, Dalton Xavier Maggs

Undergraduate Honors Theses

In 2020, the world took notice of Belarus’ dictator, Alexander Lukashenko’s brutal repression of the Belarusian people, demonstrating their wish to topple his hybrid authoritarian regime to make way for a liberated and democratic Belarus. While that wish has yet to be achieved, the question of “How do the regional powers of Eurasia influence the internal democratization struggle of Belarus?” has been vital to understanding geopolitics over the past three years. Through analysis of government reports, statements, and interviews with experts in the Eurasian region, I showcase the foreign policies of the U.S., EU, Russia, and China relating to Belarus. …


Bridging The Gap: Reducing Disparities In Reproductive Healthcare For Black And White Women, Emma Weiden Dec 2023

Bridging The Gap: Reducing Disparities In Reproductive Healthcare For Black And White Women, Emma Weiden

Population Health Research Brief Series

A woman’s reproductive healthcare experience in the United States can vary dramatically depending on her race. In 2020, the pregnancy-related mortality rate in the U.S. was 40.8 deaths per 100,000 live births for Black women, which is more than three times the rate among White women (12.7 per 100,000). This brief summarizes disparities in reproductive healthcare outcomes for Black women compared to White women in the U.S., advocates for policy changes, and provides recommendations for addressing racial disparities to create more equitable reproductive healthcare.


Systems And Methods For Generating Tactile 3d Maps, Howard David Kaplan, Spenser Fox Mason Dec 2023

Systems And Methods For Generating Tactile 3d Maps, Howard David Kaplan, Spenser Fox Mason

USF Patents

A method for generating three dimensional indicators for the visually impaired. The method includes selecting one or more pre-designed symbols from a plurality of pre-designed symbols. The pre-designed symbols represent standard building layout features and are sized to be readable via a physical touch. The method further includes inserting the one or more selected symbols into a two dimensional digital layout, and generating one or more of an orientation object and a legend object into the two dimensional digital layout. The method further includes converting the two dimensional digital layout into a three dimensional digital model, and generating an output …


Cover And Contents Dec 2023

Cover And Contents

Turkish Journal of Medical Sciences

No abstract provided.


Void Formation And Mortality During Liquid Composite Molding, Jared Michael Turner Dec 2023

Void Formation And Mortality During Liquid Composite Molding, Jared Michael Turner

Theses and Dissertations

Within the high-performance composite manufacturing industry, there exists a need to improve the reliability of LCM (Liquid Composite Molding) manufacturing processes in producing composite parts that better approach the quality and consistency of pre-impregnated composite tapes that are cured in autoclaves with cost being a driving factor of this need. One obstacle to that end is the phenomenon of void formation during the LCM infusion processes. The formation of these voids through different mechanisms leads to composite parts with lower mechanical properties and consistency than their pre-impregnated autoclave cure counterparts. The objective of this research is to investigate the different …


Characterizing Quirky Signals, Joshua D. Forsyth Dec 2023

Characterizing Quirky Signals, Joshua D. Forsyth

Theses and Dissertations

Large collider facilities such as the Large Hadron Collider (LHC) employ a variety of search methods in hopes of finding new particles. It may be that new physics beyond the SM is waiting to be discovered at energies accessible to the LHC. Quirks are particles charged under a new confining gauge group with masses much larger than their confinement scale. This project details the dynamics of quirks, as well as the production and decay of electrically charged bound states of scalar quirks. The cross section for these states is compared to existing Wγ resonance searches at the LHC. Such a …


In Vitro Observation Of Optical Changes In Whole Blood Due To Injection Of Glucose Solution, James Gordon Harkness Dec 2023

In Vitro Observation Of Optical Changes In Whole Blood Due To Injection Of Glucose Solution, James Gordon Harkness

Theses and Dissertations

Significance: While the optical properties of blood have been extensively studied, the influence of glucose concentration on blood optics remains unquantified. This is information which could be used to develop a noninvasive blood glucose monitor. Aim: This in vitro study investigated the optics of blood. Time-dependent effects and various methods of introducing glucose into blood samples were examined. The study aimed to quantify how alterations in glucose levels impacted blood optics across 14 distinct NIR wavelengths. Approach: Blood in a cuvette was exposed to light, and the reflected and transmitted light was captured in integrating spheres. 14 distinct wavelengths from …


The State Of Active Blended Learning In Construction Education: Reviewing Research And Current Perspectives, Shandon Miles Gubler Dec 2023

The State Of Active Blended Learning In Construction Education: Reviewing Research And Current Perspectives, Shandon Miles Gubler

Theses and Dissertations

STEM educators have shown a particular interest in active blended learning. Construction management education, a discipline within STEM education, has naturally considered blended instruction to engage students in the learning process. Documented efforts of construction management educators implementing blended instruction have mostly been recorded in conference proceedings. These recorded efforts often take the form of anecdotal case studies—a current review of how construction management faculty are implementing blended instruction and active learning in their blended courses was not found. In this study, we reviewed the literature for active blended instruction in construction management education. We surveyed construction management faculty about …


Linking Individual Behavior With Physiology To Understand Complex Life Histories, Doreen Cabrera Dec 2023

Linking Individual Behavior With Physiology To Understand Complex Life Histories, Doreen Cabrera

Theses and Dissertations

Life history strategies encompass a suite of co-evolved traits crucial for ensuring an individual's fitness, often evolving from trade-offs between traits competing for the same resources. Adult male crayfish in the Cambaridae family undergo seasonal morphological changes linked to reproductive status, a process called cyclic dimorphism. In this dissertation, we attempt to understand how cyclic dimorphism evolved in non-native northern crayfish (Faxonius virilis). First, in Chapter 1, we review empirical studies that have assessed animal personality across developmental periods. The results show that personality traits tend to be stable within life stages but not across developmental events. In Chapter 2, …


Robotic Arm Controlling Strategy For Fiber-Optic Assessment Of Myofascial Pain, Yuyao Li Dec 2023

Robotic Arm Controlling Strategy For Fiber-Optic Assessment Of Myofascial Pain, Yuyao Li

Electrical and Systems Engineering Undergraduate Student Research

Myofascial pain is a prevalent condition characterized by chronic musculoskeletal discomfort, often requiring precise diagnostic tools for effective assessment. This project focuses on developing an advanced robotic arm control system to facilitate fiber-optic evaluation of myofascial pain. By leveraging Python-based programming, the robotic arm’s functionality was significantly enhanced, transitioning from single-joint control via a proprietary app to parallel joint control through keyboard commands. This advancement streamlines operation, reducing assessment time and improving workflow efficiency.

Key contributions include establishing a robust communication protocol between the robotic arm and external hardware, optimizing system performance through collaboration with Dobot Factory technical support, and …


First Order Approximation On The Basilica Julia Set, Xintan Xia, Taryn Flock Dec 2023

First Order Approximation On The Basilica Julia Set, Xintan Xia, Taryn Flock

Mathematics, Statistics, and Computer Science Honors Projects

We consider the basilica Julia set of the quadratic polynomial P (z) = z^2 - 1, with its successive graph approximations defined in terms of the external ray parametrization of the set. Following the model of Kigami and later Strichartz, we exploit these graph approximations to define derivatives of functions defined on the fractal, an endeavor complicated by asymmetric neighborhood behaviors at approximated vertex points across levels, and by the topology of these vertices. We hence differentiate even and odd levels of approximations of the Julia set and construct, accordingly, normal derivatives corresponding to each level category at the vertices, …


Evaluating The Efficacy Of A Thermoresponsive Hydrogel For Delivering Anti-Collagen Antibodies To Reduce Posttraumatic Scarring In Orthopedic Tissues., Andrzej Steplewski, Jolanta Fertala, Lan Cheng, Mark Wang, Michael Rivlin, Pedro K Beredjiklian, Andrzej Fertala Dec 2023

Evaluating The Efficacy Of A Thermoresponsive Hydrogel For Delivering Anti-Collagen Antibodies To Reduce Posttraumatic Scarring In Orthopedic Tissues., Andrzej Steplewski, Jolanta Fertala, Lan Cheng, Mark Wang, Michael Rivlin, Pedro K Beredjiklian, Andrzej Fertala

Department of Orthopaedic Surgery Faculty Papers

Excessive posttraumatic scarring in orthopedic tissues, such as joint capsules, ligaments, tendons, muscles, and peripheral nerves, presents a significant medical problem, resulting in pain, restricted joint mobility, and impaired musculoskeletal function. Current treatments for excessive scarring are often ineffective and require the surgical removal of fibrotic tissue, which can aggravate the problem. The primary component of orthopedic scars is collagen I-rich fibrils. Our research team has developed a monoclonal anti-collagen antibody (ACA) that alleviates posttraumatic scarring by inhibiting collagen fibril formation. We previously established the safety and efficacy of ACA in a rabbit-based arthrofibrosis model. In this study, we evaluate …


The Experience Of Teaching Disengaged Students In Stem: Examined Through The Lens Of The Abc Engagement Framework, William Randall Hjorth Dec 2023

The Experience Of Teaching Disengaged Students In Stem: Examined Through The Lens Of The Abc Engagement Framework, William Randall Hjorth

Theses and Dissertations

Young people today are increasingly disengaged from their education. Studies indicate that of all school subjects, American students struggle to engage in STEM subjects more than others. For decades, we have known that student engagement/disengagement impacts teachers. Researchers have also claimed that engagement/disengagement can be described as a construct made up of affective, behavioral, and cognitive dimensions (ABC). However, we do not understand how teachers experience student disengagement in these three areas. At a crucial time in education, investigation into the experiences of teachers with disengaged students is needed to uncover insights which may help us understand how teachers interpret …


Newsletter, December 2023, Cedar Oaks Guild Dec 2023

Newsletter, December 2023, Cedar Oaks Guild

Cedar Oaks Guild Newsletter

No abstract provided.


In-Depth Geochemical Analysis Of Turbidite-Associated Shales Of The Pindos Basin, Greece, Jonathon Michael Sevy Dec 2023

In-Depth Geochemical Analysis Of Turbidite-Associated Shales Of The Pindos Basin, Greece, Jonathon Michael Sevy

Theses and Dissertations

Detailed geochemical analysis of the turbidite-associated shales of the Cretaceous Katafito Formation, Greece, reveals important details regarding the paleoenvironment, paleoproductivity, and regional tectonics of the Pindos Basin. The Katafito Formation was deposited along an active margin at the early onset of closure of the Tethys Sea in the Pindos sub-basin. While careful studies of the coarse clastic component of turbidites are common, this study consisted of a detailed geochemical characterization of the fine-grained portions, which helped reveal paleoenvironmental information about the basin. This study combined organic and inorganic geochemistry utilizing elemental, mineralogical, and organic chemical signatures from fine-grained turbidite-associated sediments …


Analisis Hubungan Stres Kerja Dengan Kecelakaan Kerja Pada Pekerja Konstruksi Proyek Pembangunan Jalan Tol Yogyakarta – Bawen Paket 1 (Seksi 1) Tahun 2023, Shafira Agustina Rachmat, Doni Hikmat Hikmat Ramdhan Dec 2023

Analisis Hubungan Stres Kerja Dengan Kecelakaan Kerja Pada Pekerja Konstruksi Proyek Pembangunan Jalan Tol Yogyakarta – Bawen Paket 1 (Seksi 1) Tahun 2023, Shafira Agustina Rachmat, Doni Hikmat Hikmat Ramdhan

National Journal of Occupational Health and Safety

Construction workers are a job with high level of risk. There are many cases of construction workers experiencing stress due to their work, even until accident occurs. Factors that contribute to the occurrence of work stress include physical hazards and psychosocial factors, but it does not rule out the possibility of influence from individual characteristics. This study aims to analyze the correlation between occupational stress and workplace accidents in construction workers at Yogyakarta – Bawen Toll Road Construction Project Package 1 (Section 1) in 2023. This research is a quantitative study with a cross-sectional study design. The factors studied included …


Development And Validation Of A Multiplex Real-Time Pcr Assay For Detection And Quantification Of Streptococcus Pneumoniae In Pediatric Respiratory Samples, Elaine Dowell, Samuel R Dominguez, Linda Lamberth, Kristina G Hultén, Sarah A Jung Dec 2023

Development And Validation Of A Multiplex Real-Time Pcr Assay For Detection And Quantification Of Streptococcus Pneumoniae In Pediatric Respiratory Samples, Elaine Dowell, Samuel R Dominguez, Linda Lamberth, Kristina G Hultén, Sarah A Jung

Faculty, Staff and Students Publications

Streptococcus pneumoniae (Spn) is a bacterial pathogen that causes a range of disease manifestations in children, from acute otitis media to pneumonia, septicemia, and meningitis. Primary Spn laboratory diagnostic identification methods include culture, antigen testing, single-plex real-time PCR, and syndromic PCR panels. However, each method lacks sensitivity, specificity, and/or cost efficiency. We developed and validated a quantitative, multiplex PCR assay using three Spn genomic targets (lytA, piaB, and SP2020) for improved sensitivity and specificity to detect Spn in pleural fluid (PF), bronchoalveolar lavage (BAL), tracheal aspirate (TA), and upper respiratory (UR, research only) samples. Validation testing …


Inclisiran: Where Are We On Safety, Efficacy, And Clinical Effectiveness Of Sirna Therapies For Prevention? Dec 2023

Inclisiran: Where Are We On Safety, Efficacy, And Clinical Effectiveness Of Sirna Therapies For Prevention?

Faculty, Staff and Students Publications

No abstract provided.


Apixaban For Prevention Of Thromboembolism In Pediatric Heart Disease, Christoph Male, Andrea Donti, Leonardo R Brandão, Gunter Balling, Christina J Vanderpluym, Frances Bu'lock, Lazaros K Kochilas, Brigitte Stiller, James F Cnota, Otto Rahkonen, Asra Khan, Rachele Adorisio, Serban Stoica, Lindsay May, Jane C Burns, Jose Francisco K Saraiva, Kimberly E Mchugh, John S Kim, Agustin Rubio, Nadia G Chía-Vazquez, Marcie R Meador, Joshua L Dyme, Alison M Reedy, Toni Ajavon-Hartmann, Praneeth Jarugula, Lauren E Carlson-Taneja, Donna Mills, Olivia Wheaton, Paul Monagle Dec 2023

Apixaban For Prevention Of Thromboembolism In Pediatric Heart Disease, Christoph Male, Andrea Donti, Leonardo R Brandão, Gunter Balling, Christina J Vanderpluym, Frances Bu'lock, Lazaros K Kochilas, Brigitte Stiller, James F Cnota, Otto Rahkonen, Asra Khan, Rachele Adorisio, Serban Stoica, Lindsay May, Jane C Burns, Jose Francisco K Saraiva, Kimberly E Mchugh, John S Kim, Agustin Rubio, Nadia G Chía-Vazquez, Marcie R Meador, Joshua L Dyme, Alison M Reedy, Toni Ajavon-Hartmann, Praneeth Jarugula, Lauren E Carlson-Taneja, Donna Mills, Olivia Wheaton, Paul Monagle

Faculty, Staff and Students Publications

Background: Children with heart disease frequently require anticoagulation for thromboprophylaxis. Current standard of care (SOC), vitamin K antagonists or low-molecular-weight heparin, has significant disadvantages.

Objectives: The authors sought to describe safety, pharmacokinetics (PK), pharmacodynamics, and efficacy of apixaban, an oral, direct factor Xa inhibitor, for prevention of thromboembolism in children with congenital or acquired heart disease.

Methods: Phase 2, open-label trial in children (ages, 28 days to < 18 years) with heart disease requiring thromboprophylaxis. Randomization 2:1 apixaban or SOC for 1 year with intention-to-treat analysis.

Primary endpoint: a composite of adjudicated major or clinically relevant nonmajor bleeding. Secondary endpoints: PK, pharmacodynamics, quality of life, and exploration of efficacy.

Results: From 2017 to 2021, 192 participants were randomized, 129 …


Nitric Oxide Is Required For Lung Alveolarization Revealed By Deficiency Of Argininosuccinate Lyase Dec 2023

Nitric Oxide Is Required For Lung Alveolarization Revealed By Deficiency Of Argininosuccinate Lyase

Faculty, Staff and Students Publications

Inhaled nitric oxide (NO) therapy has been reported to improve lung growth in premature newborns. However, the underlying mechanisms by which NO regulates lung development remain largely unclear. NO is enzymatically produced by three isoforms of nitric oxide synthase (NOS) enzymes. NOS knockout mice are useful tools to investigate NO function in the lung. Each single NOS knockout mouse does not show obvious lung alveolar phenotype, likely due to compensatory mechanisms. While mice lacking all three NOS isoforms display impaired lung alveolarization, implicating NO plays a pivotal role in lung alveolarization. Argininosuccinate lyase (ASL) is the only mammalian enzyme capable …


Circulating Senescent Myeloid Cells Infiltrate The Brain And Cause Neurodegeneration In Histiocytic Disorders, Jessica Le Berichel, Matthew D Park, Camille Bigenwald, George R Heaton, Pauline Hamon, Leanna Troncoso, Brooks P Scull, Diana Dangoor, Aymeric Silvin, Ryan Fleischmann, Meriem Belabed, Howard Lin, Elias Merad Taouli, Steffen Boettcher, Long Li, Antonio Aubry, Markus G Manz, Julia K Kofler, Zhenyu Yue, Sergio A Lira, Florent Ginhoux, John F Crary, Kenneth L Mcclain, Jennifer L Picarsic, Scott J Russo, Carl E Allen, Miriam Merad Dec 2023

Circulating Senescent Myeloid Cells Infiltrate The Brain And Cause Neurodegeneration In Histiocytic Disorders, Jessica Le Berichel, Matthew D Park, Camille Bigenwald, George R Heaton, Pauline Hamon, Leanna Troncoso, Brooks P Scull, Diana Dangoor, Aymeric Silvin, Ryan Fleischmann, Meriem Belabed, Howard Lin, Elias Merad Taouli, Steffen Boettcher, Long Li, Antonio Aubry, Markus G Manz, Julia K Kofler, Zhenyu Yue, Sergio A Lira, Florent Ginhoux, John F Crary, Kenneth L Mcclain, Jennifer L Picarsic, Scott J Russo, Carl E Allen, Miriam Merad

Faculty, Staff and Students Publications

Neurodegenerative diseases (ND) are characterized by progressive loss of neuronal function. Mechanisms of ND pathogenesis are incompletely understood, hampering the development of effective therapies. Langerhans cell histiocytosis (LCH) is an inflammatory neoplastic disorder caused by hematopoietic progenitors expressing mitogen-activated protein kinase (MAPK)-activating mutations that differentiate into senescent myeloid cells that drive lesion formation. Some individuals with LCH subsequently develop progressive and incurable neurodegeneration (LCH-ND). Here, we showed that LCH-ND was caused by myeloid cells that were clonal with peripheral LCH cells. Circulating BRAFV600E


Patterns And Predictors Of Racial/Ethnic Disparities In Hiv Care Continuum In The Southern Usa: Protocol For A Population-Based Cohort Study, Xueying Yang Ph.D., Jiajia Zhang Ph.D., Bankole Olatosi Ph.D., Zhenlong Li, Sharon Weissman, Xiaoming Li Ph.D. Dec 2023

Patterns And Predictors Of Racial/Ethnic Disparities In Hiv Care Continuum In The Southern Usa: Protocol For A Population-Based Cohort Study, Xueying Yang Ph.D., Jiajia Zhang Ph.D., Bankole Olatosi Ph.D., Zhenlong Li, Sharon Weissman, Xiaoming Li Ph.D.

Faculty Publications

Introduction Health disparities exist at every step of the HIV care continuum (HCC) among racial/ethnic minority population. Such racial/ethnic disparities may have significantly delayed the progress in HCC in the Southern US states that are strongly represented among geographic focus areas in the 2019 federal initiative titled 'Ending the HIV Epidemic: A Plan for America'. However, limited efforts have been made to quantify the long-term spatiotemporal variations of HCC disparities and their contributing factors over time, particularly in the context of COVID-19 pandemic. This project aims to identify the spatiotemporal patterns of racial disparities of each HCC outcome and then …


Oral Lactoferrin Administration Does Not Impact The Diversity Or Composition Of The Infant Gut Microbiota In A Peruvian Cohort, Pedro E Romero Dec 2023

Oral Lactoferrin Administration Does Not Impact The Diversity Or Composition Of The Infant Gut Microbiota In A Peruvian Cohort, Pedro E Romero

Faculty, Staff and Student Publications

Previous studies have suggested that oral lactoferrin enhances diversity in the gut microbiota in infants while inhibiting the growth of opportunistic pathogens. However, the effect of lactoferrin on infant gut microbiota over time has yet to be thoroughly studied. Our study suggests that lactoferrin oral treatment in infants aged 12-18 months does not affect gut microbiome diversity and composition over time. to our knowledge, this is the first study to report the effect of lactoferrin on infant gut microbiome composition over time and helps elucidate its impact on infant health and its therapeutic potential.


A Multilevel Mhealth Intervention Boosts Adherence To Hydroxyurea In Individuals With Sickle Cell Disease, Robert Gibson, Cathy Melvin, Victor R Gordeuk, Lewis L Hsu, Chinonyelum Nwosu, Jerlym S Porter, Nicole M Alberts, Sherif M Badawy, Jena Simon, Jeffrey A Glassberg, Richard Lottenberg, Lisa Dimartino, Sara Jacobs, Maria E Fernandez, Hayden B Bosworth, Lisa M Klesges, Nirmish Shah Dec 2023

A Multilevel Mhealth Intervention Boosts Adherence To Hydroxyurea In Individuals With Sickle Cell Disease, Robert Gibson, Cathy Melvin, Victor R Gordeuk, Lewis L Hsu, Chinonyelum Nwosu, Jerlym S Porter, Nicole M Alberts, Sherif M Badawy, Jena Simon, Jeffrey A Glassberg, Richard Lottenberg, Lisa Dimartino, Sara Jacobs, Maria E Fernandez, Hayden B Bosworth, Lisa M Klesges, Nirmish Shah

Faculty, Staff and Student Publications

Hydroxyurea reduces sickle cell disease (SCD) complications, but medication adherence is low. We tested 2 mobile health (mHealth) interventions targeting determinants of low adherence among patients (InCharge Health) and low prescribing among providers (HU toolbox) in a multi-center, non-randomized trial of individuals with SCD ages 15-45. We compared the percentage of days covered (PDC), labs, healthcare utilization, and self-reported pain over 24 weeks of intervention and 12 weeks post-study with a 24-week preintervention interval. We enrolled 293 patients (51% male; median age 27.5 years, 86.8% HbSS/HbSβ0-thalassemia). The mean change in PDC among 235 evaluable subjects increased (39.7% to 56.0%; P < 0.001) and sustained (39.7% to 51.4%, P < 0.001). Mean HbF increased (10.95% to 12.78%; P = 0.03). Self-reported pain frequency reduced (3.54 to 3.35 events/year; P = 0.041). InCharge Health was used ≥1 day by 199 of 235 participants (84.7% implementation; median usage: 17% study days; IQR: 4.8-45.8%). For individuals with ≥1 baseline admission for pain, admissions per 24 weeks declined from baseline through 24 weeks (1.97 to 1.48 events/patient, P = 0.0045) and weeks 25-36 (1.25 events/patient, P = 0.0015). PDC increased with app use (P < 0.001), with the greatest effect in those with private insurance (P = 0.0078), older subjects (P = 0.033), and those with lower pain interference (P = 0.0012). Of the 89 providers (49 hematologists, 36 advanced care providers, 4 unreported), only 11.2% used HU toolbox ≥1/month on average. This use did not affect change in PDC. Tailoring mHealth solutions to address barriers to hydroxyurea adherence can potentially improve adherence and provide clinical benefits. A definitive randomized study is warranted. This trial was registered at www.clinicaltrials.gov as #NCT04080167.