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The Diagnostic Enigma - A Case Of Tuberculosis Or Malignancy?, Vartika Singh, Chandana Acharya

MELIORA 2023-THE STUDENT MEDICAL CONFERENCE OF KMC MANIPAL

No abstract provided.

Nocardia Farcinica Cerebral Abscess Masquerading As Metastatic Brain Lesions, Omanshi Agarwal, Sneha Khandelwal, Barnini Banerjee, Muralidhar Varma, Raghavendra Nayak

MELIORA 2023-THE STUDENT MEDICAL CONFERENCE OF KMC MANIPAL

No abstract provided.

Transmission Of Yellow Fever Vaccine Virus Through Blood Transfusion And Organ Transplantation In The Usa In 2021: Report Of An Investigation, Carolyn V. Gould, Rebecca J. Free, Julu Bhatnagar, Raymond A. Soto, Tricia L. Royer, Warren R. Maley, Sean Moss, Matthew A. Berk, Rebecca Craig-Shapiro, Rosy Priya L. Kodiyanplakkal, Lars F. Westblade, Thangamani Muthukumar, Yoram A. Puius, Amresh Raina, Azam Hadi, Kymberly A. Gyure, Danielle Trief, Marcus Pereira, Matthew J. Kuehnert, Vennus Ballen, Debra A. Kessler, Kimberly Dailey, Charles Omura, Thuy Doan, Steve Miller, Michael R. Wilson, Jennifer A. Lehman, Jana M. Ritter, Elizabeth Lee, Luciana Silva-Flannery, Sarah Reagan-Steiner, Jason O. Velez, Janeen J. Laven, Kelly A. Fitzpatrick, Amanda Panella, Emily H. Davis, Holly R. Hughes, Aaron C. Brault, Kirsten St George, Amy B. Dean, Joel Ackelsberg, Sridhar V. Basavaraju, Charles Y. Chiu, J. Erin Staples

Department of Medicine Faculty Papers

BACKGROUND: In 2021, four patients who had received solid organ transplants in the USA developed encephalitis beginning 2-6 weeks after transplantation from a common organ donor. We describe an investigation into the cause of encephalitis in these patients.

METHODS: From Nov 7, 2021, to Feb 24, 2022, we conducted a public health investigation involving 15 agencies and medical centres in the USA. We tested various specimens (blood, cerebrospinal fluid, intraocular fluid, serum, and tissues) from the organ donor and recipients by serology, RT-PCR, immunohistochemistry, metagenomic next-generation sequencing, and host gene expression, and conducted a traceback of blood transfusions received by …

Providing Care During The Covid-19 Pandemic As Narrated By Er Nurses In Toronto, Canada, Andrea Marsh, Jane Tyerman

Creating Healthy Work Environments (CHWE)

Through narrative inquiry, this study examines the experience of working as an ER nurse in Toronto, Canada, during the COVID-19 pandemic and aims to: understand the thoughts, feelings, and problems facing ER nurses during the COVID-19 pandemic; develop solutions to problems for future pandemics; and allow for healing through storytelling.

Nurses' Intention To Leave During The Covid-19 Pandemic: The Importance Of Workplace Support, Brian Ayotte, Marni B. Kellogg, Anna Schierberl Scherr

Creating Healthy Work Environments (CHWE)

Nurses caring for COVID-19 patients are frequently stressed and anxious. One-third of nurses (33.6%) consider leaving their jobs, and some are quitting the profession altogether. Nurses who do not feel supported at work are more likely to leave. Administrators must act to ensure adequate support is offered.

Concept Analysis Of Colleague Solidarity Among Nurses Who Cared For Patients With Covid-19, Nah-Mee Shin, Moon Yeon Kong

Creating Healthy Work Environments (CHWE)

This study aimed to define and clarify the concept of colleague solidarity among nurses who cared for infected patients with COVID-19 in South Korea. A hybrid model method was used to investigate the concept from theoretical views and fieldwork views with nine nurses serving at the frontline of the pandemic.

Safety And Efficacy Of Immune Checkpoint Inhibitors In Patients With Cancer And Viral Hepatitis: The Md Anderson Cancer Center Experience, Mirella Nardo, Bulent Yilmaz, Blessie Elizabeth Nelson, Harrys A Torres, Lan Sun Wang, Bruno Palma Granwehr, Juhee Song, Hanna R F Dalla Pria, Van A Trinh, Isabella C Glitza Oliva, Sapna P Patel, Nizar M Tannir, Ahmed Omar Kaseb, Mehmet Altan, Sunyoung S Lee, Ethan Miller, Hao Zhang, Bettzy A Stephen, Aung Naing

Faculty, Staff and Student Publications

Background: Despite the clinical benefit of immune checkpoint inhibitors (ICIs), patients with a viral hepatitis have been excluded from clinical trials because of safety concerns. The purpose of this study was to determine the incidence rate of adverse events (AEs) in patients with viral hepatitis who received ICIs for cancer treatment.

Materials and methods: We conducted a retrospective study in patients with cancer and concurrent hepatitis B or C, who had undergone treatment with ICI at MD Anderson Cancer Center from January 1, 2010 to December 31, 2019.

Results: Of the 1076 patients screened, we identified 33 with concurrent hepatitis. …

An Attenuated Herpesvirus Vectored Vaccine Candidate Induces T-Cell Responses Against Highly Conserved Porcine Reproductive And Respiratory Syndrome Virus M And Nsp5 Proteins That Are Unable To Control Infection, Brito Rcf De, Kerry Holtham, Jessica Roser, Jack E. Saunders, Yvonne Wezel, Summer Henderson, Thekla Mauch, Beatriz Sanz-Bernardo, Jean Pierre Frossard, Matthieu Bernard, Fabian Z.X. Lean, Alejandro Nunez, Simon Gubbins, Nicolás M. Suárez, Andrew J. Davison, Michael J. Francis, Michael Huether, Hafid Benchaoui, Jeremy Salt, Veronica L. Fowler, Michael A. Jarvis, Simon P. Graham

School of Biomedical Sciences

Porcine reproductive and respiratory syndrome virus (PRRSV) remains a leading cause of economic loss in pig farming worldwide. Existing commercial vaccines, all based on modified live or inactivated PRRSV, fail to provide effective immunity against the highly diverse circulating strains of both PRRSV-1 and PRRSV-2. Therefore, there is an urgent need to develop more effective and broadly active PRRSV vaccines. In the absence of neutralizing antibodies, T cells are thought to play a central role in controlling PRRSV infection. Herpesvirus-based vectors are novel vaccine platforms capable of inducing high levels of T cells against encoded heterologous antigens. Therefore, the aim …

Donor-Recipient Specificity And Age-Dependency In Fecal Microbiota Therapy And Probiotic Resolution Of Gastrointestinal Symptoms, Qinglong Wu, Prapaporn Boonma, Shyam Badu, Nazli Yalcinkaya, Sik Yu So, Kevin W Garey, Kent Williams, L Eugene Arnold, Robert J Shulman, Richard Kellermayer, Tor C Savidge

Faculty, Staff and Students Publications

Fecal microbiota transplantation (FMT) has proven to be an effective treatment for recurrent Clostridioides difficile infection (rCDI) in both adult and pediatric patients. However, as microbiome development is a critical factor in children, it remains unclear whether adult fecal donors can provide age-appropriate functional restoration in pediatric patients. To address this issue, we conducted an integrated systems approach and found that concordant donor strain engraftment, along with metabolite restoration, are associated with FMT outcomes in both adult and pediatric rCDI patients. Although functional restoration after FMT is not strain-specific, specialized metabolic functions are retained in pediatric patients when adult fecal …

How Covid-19 Changed Frontline Healthcare Workers’ Experiences: A Narrative Inquiry Into The Impact Of Chronic Burnout On A Surgical Physician Assistant’S Wellness, Lihua Dishman, Rhionna J. Smith

Patient Experience Journal

Burnout is an occupational phenomenon resulting from unmanaged chronic workplace stress. Since COVID-19 started, burnout among healthcare workers has worsened and become a public health crisis. Wellness is about leading a physically, mentally, and spiritually healthy lifestyle to achieve one’s full potential through positive affirmations. Its multiple dimensions include (1) physical, (2) emotional, (3) intellectual, (4) occupational, (5) social, and (6) spiritual. Extant empirical literature lacked regarding surgical physician assistants and how chronic burnout affected their wellness. This longitudinal narrative inquiry thus aimed to explore the perceived impact of a surgical physician assistant’s chronic burnout during the COVID-19 pandemic on …

Sensing The Rhizosphere: Microbial Transcriptome Responses To Root Exudates And Redox-Active Metabolites, Ankita Bhattacharyya

Dissertations

The term “rhizosphere” describes the dynamic interface between plant roots and soil influenced by root exudates. It is a hotspot of microbial activity, plant-microbe, and microbe-microbe interactions. Distinct variations in bacterial diversity are thought to be driven by plant root exudates. However, the molecular details of these processes still remain unclear.

I addressed this gap by focusing on two strains, Pseudomonas synxantha 2-79 and Burkholderia lata 383, representing diverse groups of Gammaproteobacteria comprised of species with environmental, agricultural, and medical significance. In the first part of this project, we used a combination of metabolomics and RNA-seq to characterize transcriptome responses …

Sick From Freedom: The Untold Story Of A Smallpox Epidemic Among Formerly Enslaved People, Jim Downs

Rondel V. Davidson Endowed Lecture Series

Emancipated from slavery, former bondspeople entered into an environment in which more soldiers died from disease than from battle. This talk explores the high rate of illness and mortality that devastated formerly enslaved people during the Civil War and Reconstruction. In particular, it provides the first analysis of the smallpox epidemic that began in Washington, DC in 1862 and then spread to the Lower South in 1863 and Mississippi Valley in 1864-65. By 1865, the epidemic plagued the entire South and began to move west and infected Native Americans on reservations. Due to the unexpected and inordinate mortality, the federal …

The Effects Of Covid-19 On Cognition In The Pediatric Population, Mia Ramirez, Hope Mccarroll, Lisa Griggs-Stapleton

Summer 2023 Virtual OTD Capstone Symposium

Coronavirus disease or COVID-19, is an infectious disease caused by the SARS-CoV-2 virus. COVID-19 can affect adults and children by causing long-term symptoms such as difficulty concentrating, anxiety, depression, long-term breathing problems, and even heart complications. Children represent about 19% of all reported COVID-19 cases since the pandemic first began. Children also can have trouble concentrating, which can impact their ability to attend school and do their daily activities that require concentration, such as dressing, showering, and social participation. Cognitive deficits due to COVID-19 can impact the pediatric population as they may have decreased occupational performance in desired occupations, such …

Certified Occupational Health Nurses: Advocating For The Workforce And Work Environment, Lucille F. Carlson

Creating Healthy Work Environments (CHWE)

Occupational health nursing is the specialty practice that provides health, safety, and wellness programs and services to workers. The practice focuses on promotion of health, prevention of illness/injury, and protection from work-related and environmental hazards. The presentation will focus on benefits of certification in advocacy for workforces and work environments.

The Lived Experience Of Frontline Nurses: Covid-19 In Rural America, Samantha Bartelt, Michelle Gierach, Gwenneth A. Jensen, Coreen Mcclellan, Karen Robinson, Brenda Wolles

Creating Healthy Work Environments (CHWE)

This phenomenological research study relates the meaning of dramatic and intense experiences of hospital nurses during the pandemic in the rural Midwest. Included are experiences of nurses on the frontlines at work, at home, and in their communities.

Using A Team Of Teams Approach To Optimize The Work Environment And Decrease Clabsi Rates, Warren Boudreau, Mona Clark, Sheranda Fesler, Tjin Koy, Tanya Nelson-Hall, Lauren Salinas

Creating Healthy Work Environments (CHWE)

The purpose of this activity is to introduce the Team of Teams approach and discuss its application to the promotion of a healthy work environment through interprofessional communication and collaboration, and the subsequent reduction of catheter line-associated bloodstream infection incidence and rates.

Purification And Detection Of Antibiotic-Resistant Bacteria From Whole Blood With Nano-Sieve, Xinye Chen

Theses

Life-threatening bloodstream infections (BSI), such as sepsis, mainly caused by the body’s syndromic response to pathogen infection, are a major public health concern, leading to ~11 million deaths each year. The identification of sepsis presents significant challenges in the diagnostic process, as the isolation of low concentration pathogens from bodily fluids (e.g., human blood) is extremely demanding, and typically relies on time-consuming and complicated isolation processes. Therefore, this work aims to explore the potential of microfluidics as a powerful tool for rapid purification and concentration of antibiotic-resistant bacteria (ARB) from blood samples, meanwhile developing a molecular diagnostic technology by combining …

Indwelling Catheter Vs Intermittent Catheterization: Is There A Difference In Uti Susceptibility?, Vera Neumeier, Fabian P Stangl, Joëlle Borer, Collene E Anderson, Veronika Birkhäuser, Oksana Chemych, Oliver Gross, Miriam Koschorke, Jonas Marschall, Shawna Mccallin, Ulrich Mehnert, Helen Sadri, Lara Stächele, Thomas M Kessler, Lorenz Leitner

2020-Current year OA Pubs

BACKGROUND: Patients with neurogenic lower urinary tract dysfunction (NLUTD) often rely on some type of catheterization for bladder emptying. Intermittent catheterization (IC) is considered the gold standard and is preferred over continuous catheterization, since it is considered to cause fewer urinary tract infections (UTIs) than indwelling catheterization. The main objective of our study was to describe UTI prevalence (at visit) and incidence (within the last 12 months) and urine culture characteristics between patients using an indwelling catheter versus (vs) those performing IC.

METHODS: In this cross-sectional study, we prospectively evaluated from 02/2020 to 01/2021 patients with NLUTD undergoing urine cultures …

“I Got You”: Centering Identities And Humanness In Collaborations Between Mathematics Educators And Mathematicians, Anne M. Marshall, Sarah Sword, Mollie Applegate, Steven Greenstein, Terrance Pendleton, Kamuela E. Yong, Michael Young, Jennifer A. Wolfe, Theodore Chao, Pamela E. Harris

Journal of Humanistic Mathematics

Existing literature widely reports on the value of collaborations between mathematicians and mathematics educators, and also how complex those collaborations can be. In this paper, we report on four collaborations that sought to address what mathematics is and who gets to do it. Drawing on the literature and from the careful and intentional work of the collaborators, we offer a framework to capture the richness of those collaborations – one that acknowledges the importance of acknowledging and welcoming the extensive personal and professional experience of each person involved in the collaboration – and a look at how collaborations built with …

Evaluation Of Antimicrobial Stewardship For The Treatment Of Urinary Tract Infections After Pharmacist-Led Provider Education At The Center For Family Medicine, Kaylee Ayers, Faith E. Bader, Karly Blaalid, Tominee Sorenson, Sara Smith, Jennifer Ball

Pharmacy and Allied Health Professions Student Research Publications and Projects

Purpose: Urinary tract infections are a common outpatient infection, and proper antibiotic treatment is important for better patient outcomes, reducing healthcare costs, and reducing bacterial resistance. Specifically at the Center for Family Medicine (CFM), resident physicians may lack experience in prescribing proper antibiotic treatments based on patient factors for UTIs. The purpose of this study is to assess the appropriate use of antibiotics before and after a provider education pertaining to guideline recommended therapy for UTIs. The education included classifications of UTIs, first line and second line antibiotic therapy for acute uncomplicated UTIs, and first line therapy based on renal …

Introduction Of A Policy Adherence Plan In An Outpatient Buprenorphine Treatment Clinic., Stacie Switzer Cheney

Doctor of Nursing Practice Papers

Abstract

Background: Medication-Assisted Treatment (MAT) is one of the most effective pharmacological therapies for opioid dependence. Regular urine drug screening to include random urine drug screens at least once a month is a key factor in improving quality care for those receiving treatment in an outpatient MAT clinic.

Problem: A rural outpatient MAT clinic has a current random urine policy that is not being utilized when treating clients with Opioid Use Disorder (OUD). This increases the risk of diversion and misuse of buprenorphine/naloxone (Suboxone), thus increasing the risk of overdose and death for OUD patients.

Environment: This project was implemented …

Effects Of Preoperative Chlorhexidine Gluconate (Chg) Cloths Educational Intervention For Preoperative Staff On Chg Knowledge And Surgical Site Infection Rates: A Quality Improvement Initiative., Deven Leffler

Doctor of Nursing Practice Papers

Abstract

Background: Surgical site infections (SSIs) are the most common cause of a surgical complication and account for 38% of all hospital acquired infections (HAI). The cost of caring for SSIs in the United States can range from $3.5-$10 billion annually.

Purpose: The purpose of this DNP Quality Improvement (QI) initiative was to improve preoperative staff’s knowledge and application of the Food and Drug Administration (FDA) approved 3-minute application scrub time for the 2% CHG cloths and reduce SSIs for an acute care hospital located in Louisville, Kentucky.

Methods: Quality improvement was initiated using the Plan, Do, Study, Act (PDSA) …

The Structural Characterization And Bioactivity Assessment Of Nonspecific Lipid Transfer Protein 1 (Nsltp1) From Caraway (Carum Carvi) Seeds, Taibah Aldakhil

Pharmaceutical Sciences (PhD) Dissertations

Background: Carum carvi (caraway) of the Apiaceae family has been used in many cultures as a cooking spice and part of the traditional medicine. Previous reports primarily focus on the medicinal properties of caraway seed essential oil and the whole seeds extract. However, no effort has been made to study caraway proteins and their potential pharmacological properties, including nonspecific lipid transfer protein (nsLTP), necessitating further research. The current study aimed to characterize nonspecific lipid transfer protein 1 (nsLTP1) from caraway seed, determine its three-dimensional structure, and analyze protein-ligand complex interactions through docking studies. Also, evaluate nsLTP1 in vitro cytotoxic …

Microglial Response To Glucocorticoids During Chronic Sleep Fragmentation, Christian Chelson

Masters Theses & Specialist Projects

Sleep is one of the body’s greatest and most basic needs. Chronic sleep loss (<6 hours a day) is linked to many cardiovascular issues, diabetes, and inflammatory conditions and has been shown to lower life expectancy. Obstructive sleep apnea (OSA) is a complication that causes sleep fragmentation in >8% of adults from developed countries, and many with OSA may be unaware of their condition. Having long-term OSA is linked to neuroinflammation caused by activated microglia in the brain, but the mechanics of this inflammation are not well understood. It is known that glucocorticoids, steroid hormones produced and released from the adrenal glands, have a suppressive effect on microglia. The purpose of this study is to explore the role that glucocorticoids have upon microglia activation induced by chronic sleep fragmentation (SF). C57BL/6J mice were …

Guide And Algorithm Creation For Hepatitis B Vaccination And Tuberculosis Testing Requirements For A Nursing Program., Jumoke Owolabi

Doctor of Nursing Practice Papers

This project developed a guide and algorithm for hepatitis B vaccination and tuberculosis (TB) testing requirements for nursing students at the University of Louisville [UofL] School of Nursing [SON] before clinical placement. Clarifying the requirements for hepatitis B vaccination, testing, and tuberculosis testing was paramount for clinical compliance because the current policy was determined to be ambiguous. The literature review revealed discrepancies with policies for hepatitis B and TB among countries and with individual institutions confirming the need for aligning with evidence-based vaccination guidelines. Based on these findings, an evidence-based guide and algorithm were created. Feedback from the clinical compliance …

Older Women’S Stories Of Covid-19 Loss: Communicated Narrative Sense-Making Through Photography, Anne Walker

Electronic Theses and Dissertations

The diverse array of challenges associated with the COVID-19 pandemic make it difficult to assess the full impact of this global health crisis. More than 300,000 older Americans died, leaving a nation of grieving survivors in their absence. This profound loss of life will undoubtedly inform the field’s understanding of grief and grieving for many years to come. Pre-pandemic, older women in the United States understood grief to be part of their life stage; COVID-19 amplified the grief experience through both cumulative losses and the isolation particular to the novel coronavirus response. However, few qualitative studies explore older women’s grief, …

Biomarkers In Borrelia Burgdorferi Infected Triple-Negative Breast Cancer Cells, Sambuddha Paul

Master's Theses

Triple-negative breast cancer (TNBC) is an aggressive subtype of breast cancer with limited treatment options and a poor prognosis. Although some studies have attempted to identify new biomarkers and therapies, only a few have shown promise in clinical trials. In the context of cancer development, infectious agents rank as the third major risk factor, contributing to approximately 15-20% of cancer cases, according to the American Cancer Society. Hence, the identification of biomarkers associated with infection-originated cancer is crucial for enhancing cancer prevention, early detection, diagnosis, and treatment. Borrelia burgdorferi, the causative agent of Lyme disease, has been linked to TNBC …

Activation Of The Renin–Angiotensin–Aldosterone System Is Attenuated In Hypertensive Compared With Normotensive Pregnancy, Robin C. Shoemaker, Marko Poglitsch, Hong Huang, Katherine Vignes, Aarthi Srinivasan, Cynthia Cockerham-Morris, Aric Schadler, John Anthony Bauer, John O'Brien

UK CARES Faculty Publications

Hypertension during pregnancy increases the risk of adverse maternal and fetal outcomes, but the mechanisms of pregnancy hypertension are not precisely understood. Elevated plasma renin activity and aldosterone concentrations play an important role in the normal physiologic adaptation to pregnancy. These effectors are reduced in patients with pregnancy hypertension, creating an opportunity to define the features of the renin–angiotensin–aldosterone system (RAAS) that are characteristic of this disorder. In the current study, we used a novel LC-MS/MS-based methodology to develop comprehensive profiles of RAAS peptides and effectors over gestation in a cohort of 74 pregnant women followed prospectively for the development …

The Effect Of Symbioses Between Mold Mites (Acaridae: Tyrophagus Putrescentiae) And Aspergillus Flavus On Their Respective Populations In Stored Maize., Paige Pionke Cummins

Graduate Theses and Dissertations

Zea mays is the most commonly grown grain in the world and is used for animal feed, human consumption, and the creation of other products such as ethanol and bioplastics. Contamination of stored maize with stored grain invaders can lead to loss of revenue, reduced food availability, and potential health complications. Two such storage invaders; the mold mite Tyrophagus putrescentiae and the fungus Aspergillus flavus can work as symbionts within the grain storage system. To determine resulting population growth from this symbiosis, maize was inoculated with three treatments: A. flavus with no mites, T. putrescentiae with no fungus, and both …

Long-Term Spring Through Fall Capture Data Of Eptesicus Fuscus In The Eastern Usa Before And After White-Nose Syndrome, Molly Simonis, Lynn K. Hartzler, Joshua Campbell, Timothy C. Carter, Lisa Noelle Cooper, Katelin Cross, Katherine Etchison, Traci, R. Andrew King, Richard J. Reynolds, Yasmeen Samar, Michael Yasmeen, Sarah Stankavich, Gregory G. Turner, Megan A. Rúa

Biological Sciences Faculty Publications

Emerging infectious diseases threaten wildlife populations. Without well monitored wildlife systems, it is challenging to determine accurate population and ecosystem losses following disease emergence. North American temperate bats present a unique opportunity for studying the broad impacts of wildlife disease emergence, as their federal monitoring programs were prioritized in the USA throughout the 20 th century and they are currently threatened by the invasive fungal pathogen, Pseudogymnoascus destructans ( Pd ), which causes white-nose syndrome. Here we provide a long-term dataset for capture records of Eptesicus fuscus (big brown bat) across the eastern USA, spanning 16 years before and 14 …