Digital Commons Network^™

Disease And Healing In Ancient Societies: Dental Calculus Residues And Skeletal Pathology Data Indicate Age And Sex-Biased Medicinal Practices Among Native Californians, Mario Zimmermann, Brian F. Byrd, Laurel Engbring, Jelmer W. Eerkens, Monica V. Arellano, Alan M. Leventhal, Dave Grant, Diane Diguiseppe, Elisabeth Mabie, Anna Berim, David Gang, Shannon Tushingham

Human Biology Open Access Pre-Prints

The health of humans is intricately linked to the substances - both food and non-dietary items -we ingest. Adverse health outcomes related to smoking of products like tobacco and other psychoactive substances are clearly established in modern populations but are less well understood for ancient communities. Grasping these dynamics is further complicated by the curative, religious, and medicinal context of many of these substances, which have often been commodified, refined, and altered in recent history. As part of a larger collaboration with the Muwekma Ohlone Tribe dedicated to understanding medicinal plant use among native Californians, we present a summary of …

Icu Nurses’ Adherence To The Cdc’S Central Line Bundle: A Qualitative Study, Cherie Burke, Cherie Burke

Electronic Theses and Dissertations

Background: Central line associated bloodstream infections (CLABSIs) are one of the most common healthcare associated infections and result in prolonged hospital stays, significant morbidity, and increased costs to the healthcare system. Adherence to the CDC central line maintenance bundle has been shown to be effective in decreasing CLABSI yet these infections continue to be a problem. ICU nurses play a vital role in managing central lines and adhering to the maintenance guidelines, however different situations may arise during the care that may impact CLABSIs.

Objectives: 1) To determine nurses’ adherence to the CDC’s maintenance central line

bundle; 2) To determine …

Introducing A Trauma-Informed Care Model To Address Racial Disparities In Perinatal Outcomes Among African American Women, Mariah K. White

Honors College Theses

Racial disparities in maternal and infant health have remained an issue within the United States despite efforts to advance and improve our health system. Most maternal deaths are preventable, especially with early and adequate maternal care. Infant mortality occurs for several reasons, but inadequate care usage increases the risk for adverse outcomes. Prenatal care usage within the United States has been inadequate for numerous years, most commonly among African American women, despite its known benefit. Low prenatal care usage among African American women can be attributed to community barriers, social injustices, trauma, discrimination, and health care mistrust. Trauma is common …

Noninvasive Screening Of Nonalcoholic Fatty Liver Disease Among People Living With Hiv, Essi M. Havor

Dissertations and Theses (Open Access)

Background: Nonalcoholic fatty liver disease (NAFLD) disproportionately affects up to 75% of people living with HIV (PLWH). Given the high HIV prevalence in Houston and Harris County, knowledge of the prevalence of NAFLD in PLWH is needed to inform prevention efforts. In addition, such knowledge is required to raise awareness among at-risk individuals and healthcare professionals.

Specific Aims: This cross-sectional study aimed (1) to examine the demographic, behavioral, clinical, and psychosocial characteristics of PLWH in Houston/Harris County, Texas, and to estimate the prevalence of NAFLD, (2) to determine factors associated with the severity of NAFLD, and (3) to identify specific …

The Dynamics Of Sedimentary Chlorophyll Α At A High-Energy Beach, Sarah (Gray) Abel

Honors Theses

Productive sandy beaches are one of the most crucial areas serving our ecosystem today. While often overlooked in scientific research, productive beaches have many essential functions that lead to the preservation and protection of many different species as well as ecological wellness and stability. A key factor that is linked to this productivity is the presence of chlorophyll in the sediments. Piston cores of the sediments at the low-tide mark at Waties Island, South Carolina, were collected across multiple years and subsequently analyzed for chlorophyll concentrations through fluorometry after acetone extraction and acidification. Each core profile was processed to calculate …

Cbt Technology Implementation With Pediatric And Adolescent Populations, Tracey W. Kreipe, Heath Gage, Sandra Obiebi

Doctor of Nursing Practice Projects

Abstract

Digital therapy is a growing healthcare intervention improving limited access to specialty care for specific populations and geographic areas. Cognitive Behavioral Therapy (CBT) applications focus on treating anxiety and depression and assist pediatric and adolescent patients in learning behavioral techniques as they wait for 3-6 months or longer to see a mental health provider. Such delays are attributed to the national shortage of mental health practitioners and the further scarcity of fewer psychiatric providers in rural areas, causing the potential for adverse patient outcomes. The setting for this 8-week quality improvement project was a pediatric care clinic that sees …

Cefazolin Administration In Penicillin Allergic Patients, Jessica Doerr

Doctor of Nursing Practice Projects

Surgical site infections (SSI) are a type of hospital-acquired infection that are largely preventable. Cefazolin, a first-generation cephalosporin beta-lactam, is the recommended antibiotic for SSI prophylaxis (Bratzler et al., 2013). Approximately 10% of the general population reports a penicillin allergy (Joint Task Force on Practice Parameters et al., 2010). Penicillin is another beta-lactam. Penicillin-allergic patients are commonly prescribed alternative, less effective, antimicrobial agents for SSI prophylaxis, causing suboptimal outcomes. Current literature reports a cross-reactivity potential of less than 2%, with an even lower risk associated with cefazolin (Picard et al., 2019; Sousa-Pinto et al., 2021). This project aimed to review …

Lessons Learned From All For Them: Best Practices For A Cross-Collaboration Approach To Hpv Vaccination In Public Schools, Paula M Cuccaro, Jihye Choi, Efrat K Gabay, J Michael Wilkerson, Diane Santa Maria, Sanghamitra M Misra, Mayra Aguilar Mcbride, Sally W Vernon

Faculty, Staff and Student Publications

The Community Preventive Services Task Force endorses vaccination programs in schools to increase access to vaccinations. However, implementing a school-based approach requires substantial coordination, planning, and resources. All for Them (AFT) is a multilevel, multicomponent approach to increase HPV vaccination among adolescents attending public schools in medically underserved areas in Texas. AFT comprised a social marketing campaign, school-based vaccination clinics, and school nurse continuing education. Process evaluation metrics and key informant interviews to understand experiences with AFT program implementation informed lessons learned. Lessons emerged in six domains: strong champion, school-level support, tailored and cost-effective marketing approaches, mobile provider collaboration, community …

Pooling Patents For Pandemic Progress: Mrna Vaccines And The Broader Context Of Modernatx Inc V. Pfizer Inc., Francis Brefo

DePaul Journal of Art, Technology & Intellectual Property Law

No abstract provided.

Home-Based Tdcs For Apathy In Alzheimer’S Disease: A Protocol For A Randomized Double-Blinded Controlled Pilot Study, Antonio L Teixeira, Laís Bhering Martins, Thiago Macedo E Cordeiro, Lijin Jose, Robert Suchting, Holly M Holmes, Ron Acierno, Hyochol Ahn

Faculty, Staff and Student Publications

BACKGROUND: Apathy is among the most common behavioral symptoms in dementia and is consistently associated with negative outcomes in Alzheimer's disease (AD). Despite its prevalence and clinical relevance, available pharmacological and non-pharmacological strategies to treat apathy in AD have been marked, respectively, by potentially severe side effects and/or limited efficacy. Transcranial direct current stimulation (tDCS) is a relatively novel non-pharmacological method of neuromodulation with promising results. Compared to previous tDCS formats, recent technological advances have increased the portability of tDCS, which creates the potential for caregiver-administered, home use. Our study aims to evaluate the feasibility, safety, and efficacy of home-based …

Saving The Microbiome One Phlegm At A Time: Sputum Collection In The Ed For Patients Admitted With Pneumonia, Joanna Watterson, Jessica Mitchell, Elyse Sheehan, Meghan Brett

Quality Improvement/Patient Safety Symposium

Problem Identification

Patients brought into the Emergency Department (ED) with pneumonia who require admission often receive broad-spectrum antibiotics, due to high acuity and desire to cover an array of possible pathogens. While this is reasonable, broad-spectrum antibiotics come with potential harms to both the individual patient and the community at large, and efforts should be made to narrow coverage as soon as possible, usually informed by culture data and sensitivities. To this end, IDSA guidelines for hospital acquired pneumonia currently recommend antibiotic treatment based on culture data, over empiric treatment[i]. However, culture data takes time. Therefore, antibiotic stewardship …

Medication For Opioid Use Disorder During Pregnancy - Maternal And Infant Network To Understand Outcomes Associated With Use Of Medication For Opioid Use Disorder During Pregnancy (Mat-Link), 2014-2021, Kathryn Miele, Shin Y. Kim, Rachelle Jones, Juneka H. Rembert, Elisha M. Wachman, Hira Shrestha, Michelle L. Henninger, Teresa M. Kimes, Patrick D. Schneider, Vaseekaran Sivaloganathan, Katherine A. Sward, Vikrant G. Deshmukh, Pilar M. Sanjuan, Jessie R. Maxwell, Neil S. Seligman, Sarah Caveglia, Judette M. Louis, Tanner Wright, Carolyne Cody Bennett, Caitlin Green, Nisha George, Lucas Gosdin, Emmy L. Tran, Dana Meaney-Delman, Suzanne M. Gilboa

Pediatrics Research and Scholarship

PROBLEM: Medication for opioid use disorder (MOUD) is recommended for persons with opioid use disorder (OUD) during pregnancy. However, knowledge gaps exist about best practices for management of OUD during pregnancy and these data are needed to guide clinical care.

PERIOD COVERED: 2014-2021.

DESCRIPTION OF THE SYSTEM: Established in 2019, the Maternal and Infant Network to Understand Outcomes Associated with Medication for Opioid Use Disorder During Pregnancy (MAT-LINK) is a surveillance network of seven clinical sites in the United States. Boston Medical Center, Kaiser Permanente Northwest, The Ohio State University, and the University of Utah were the initial clinical sites …

Improved Tracking And Referrals For Vision And Dental Care For Patients With Hiv, Kory Tillery, Michelle Iandiorio

Quality Improvement/Patient Safety Symposium

BACKGROUND

Regular vision and dental care are important components of healthcare for persons with HIV (PWH). HIV infection is associated with a wide array of complications for both ocular and oral health regardless of severity of HIV disease. Ocular disease can range from opportunistic or associated infections (i.e cytomegalovirus retinitis, ocular syphilis); to inflammatory or degenerative disease (i.e retinal vasculopathy, optic neuropathy), or drug effects. Oral disease similarly encompasses infectious and noninfectious etiologies, including opportunistic infections (i.e., candidiasis, oral hairy leukoplakia), comorbid infections (i.e. herpes simplex virus, human papilloma virus, periodontitis/gingivitis), or inflammatory conditions (i.e. salivary gland disease). The Health …

A Thousand Views Of The Cathedral: The Law, Politics, And Statistics Of Pandemic Dashboards, Jeff Lingwall, Tj Bliss

Health Matrix: The Journal of Law-Medicine

This Article explores the law, politics, and statistics of communicating data through the thousands of state, county, school district, and higher-education dashboards created in response to the COVID-19 global pandemic. Using a nationally distributed questionnaire and series of interviews with dashboard managers and stakeholders, we offer a wide-ranging view of data visualization practice in response to COVID-19. We pair this evidence with a survey of almost 3,000 entities responsible for public health communication, which resulted in collection of over 1,100 COVID-19 dashboards from a spectrum of government actors and private parties. We evaluate how legal issues were perceived and acted …

Evidence For Community Face Masking To Limit The Spread Of Sars-Cov-2: A Critical Review, Ian T. Liu, Vinay Prasad, Jonathan D. Darrow

Health Matrix: The Journal of Law-Medicine

The use of facemasks in community settings has become an accepted public policy response to decrease disease transmission during the COVID-19 pandemic. Yet evidence of facemask efficacy is based primarily on observational studies that are subject to confounding and on mechanistic studies that rely on surrogate endpoints (such as droplet dispersion) as proxies for disease transmission. The available clinical evidence of facemask efficacy is of low quality and the best available clinical evidence has mostly failed to show efficacy, with fourteen of sixteen identified randomized controlled trials comparing face masks to no mask controls failing to find statistically significant benefit …

Compassion Fatigue In An Infodemic: A Physician’S Duty To Treat In The Age Of Misinformation, Alessandra Perez

University of Miami International and Comparative Law Review

This Note considers how misinformation has exacerbated the COVID-19 pandemic and the inevitable burden it has placed on the healthcare industry. It explores the intersection between a doctor’s oath of ethics and their right to refuse care by uncovering the obligations that guide their decisions. Justice dictates that physicians provide care to all who seek it, and it is unconstitutional for a physician to refuse to treat patients based on race, ethnicity, gender, religion, or sexual orientation. Even if a patient’s request is antithetical to a physician’s personal beliefs, the unwavering duty to treat generally mandates that physicians treat any …

The Impact Of Covid-19 On Post-Recovery Memory, Chelsea Mcnamara, Alison Mancuso

Rowan-Virtua Research Day

The SARS-CoV-2 virus, responsible for the covid-19 pandemic, has had profound effects on countries worldwide. As the pandemic progressed, clinical and patient data continued to mount. A subset of symptoms named “Long Covid Syndrome” persisted in patients after recovering from infection. One commonly reported but understudied symptom was a deficit in memory function. Although commonly reported, prevalence of ‘brain fog’ has yet to be characterized using patient data. Using Rowan Medicine electronic patient data, we were able to collect information on patients before and after the emergence of the coronavirus. Data was collected on reported memory-related symptoms as well as …

An Unusual Ed Case: Spontaneous Necrotizing Fasciitis Presenting As Hypoxic Pneumonia, Chetna Thawani, Kishan Patel

Rowan-Virtua Research Day

We present a case of necrotizing fasciitis initially presenting as septic hypoxic pneumonia, and discuss imaging modalities and diagnostic evaluation. Necrotizing soft tissue infection (NSTI) is a rapidly progressive surgical emergency with a mortality rate of 30%. In approximately 80% of cases, it is introduced through a break in the skin. It can also occur after any invasive procedure or surgery. It is most commonly associated with skin flora including staph and strep, though polymicrobial infections are most common. It usually presents with signs of systemic infection, including fever, chills, sepsis, altered mental status - and signs of cutaneous involvement …

Whole Body Cryotherapy As A Novel Treatment For Long Covid Syndrome Associated Brain Fog, James Mack, Brandon Goodwin, Paras Patel, Kyra Herman, Daniel Casal, Emily Levenson

Rowan-Virtua Research Day

SARS-CoV-2, which causes coronavirus disease 2019 (COVID-19), was first discovered in December 2019 in Wuhan, China when adults began presenting with severe pneumonia of an unknown cause. SARS-CoV-2 can cause a wide range of clinical manifestations. SARS-CoV-2 can penetrate the olfactory mucosa and may enter the brain through the cribriform plate along the olfactory tract, through vagal or trigeminal pathways, or pass through the blood-brain barrier. Once inside the brain, levels of inflammatory cytokines are increased and can lead to altered learning, memory, neuroplasticity, hallucinations, nightmares, cognitive and attention deficits, new-onset anxiety and depression, and psychosis. A theoretical treatment for …

Factors That Influence The Decision To Get Vaccinated Against Covid-19, Rhea Bhargava, Meghan H. Foos, Brandy M. Gotti, Alexandra L. Mulvenna, Taylor O. Smith, Danielle Cooley, Venkateswar Venkataman

Rowan-Virtua Research Day

Since the start of the COVID-19 pandemic and the launch of the vaccine, healthcare workers have been encouraging people to get vaccinated to prevent the spread of the virus. However, there is a significant number of people who are vaccine hesitant, or uncertain about receiving the COVID-19 vaccine and its booster. Vaccine hesitancy represents a state of opportunity to make positive change; therefore, it is crucial for healthcare workers to identify those who are in this population. When factors contributing to the vaccine hesitancy, including gender, age, ethnicity, education level, and income were studied, it was found that women, those …

Ureterocutaneous Fistula In Setting Of Recurrent Gluteal Abscesses: A Case Report, Catherine Alapatt, Young Son, Benjamin Fink, Brian Thomas, Sean Coulson, Shawon Akanda, Jacob Thatcher, Thomas Mueller

Rowan-Virtua Research Day

Ureteral fistulas are a rare occurrence that can arise from iatrogenic trauma, radiation, malignancy, and inflammation. Treatment options of urinary tract fistulas are handled on a case-by-case basis and can necessitate a surgical approach. We present the case of an 85-year-old patient with a ureterocutaneous fistula where conservative management with PCN is a viable alternative to surgical intervention.

The Influence Of Health & Racial Disparities On The African American Mortality And Mortality From Covid-19, Oluwapelumi Oluwo

Rowan-Virtua Research Day

By now we have all heard of the Coronavirus which the WHO defines as an infectious disease caused by an infection from the SARS-CoV-2 virus6. The aim of this study was to examine the relationship between health & racial disparities and their effects on the morbidity and mortality rates of African Americans who contracted the virus during the pandemic. We found that there was a relationship between race and various outcomes from the coronavirus. We found that there is a significant relationship between various comorbidities and increased infection rates among African Americans. Although we did not find a relationship between …

When Constipation Becomes Lethal: Septic Shock Induced By Stercoral Colitis In A 77-Year-Old Female, Anna Delancy, Nicholas Tomasello, Joan Wiley, James Espinosa, Alan Lucerna

Rowan-Virtua Research Day

Stercoral colitis is a form of colitis caused by fecal impaction distending the colon and causing fecaloma formation. Fecalomas lead to pressure necrosis of the colon and eventual perforation. The increased intraluminal pressure from the distention of the colon causes vascular compromise and ischemia. The most common locations of necrosis are in the sigmoid colon and rectum . When progressed to perforation, the mortality rate is as high as 60%. The most common cases of stercoral colitis occur in nursing home patients, mentally impaired patients, or those with chronic constipation. Here we describe an unusual case of stercoral colitis causing …

Case Report: Cavitary Pneumonia In A 28 Year Old Male, Dan Zaayenga, Katelyn Courtney

Rowan-Virtua Research Day

Cavitary pneumonia can be caused by several different mechanisms. Such causes include suppurative necrosis (pyogenic lung abscess), caseous necrosis (tuberculosis), ischemic necrosis (pulmonary infarction) cystic dilatation of lung structures (ball value obstruction and Pneumocystis pneumonia) as well as malignant processes. Causes are subject to both environmental factors and host susceptibility. The most common cause of infectious process is tuberculosis with its propensity to cause extensive caseous necrosis. The potential for secondary infection after an individual develops a cavitary pneumonia is also great as it provides a shelter for various pathogens the flourish in an environment otherwise usually well-guarded by host …

Case Report: Abrupt Psychosis Or Nmda Receptor Encephalitis?, Alexis Dunn, Neelesh Parikh, James Espinosa, Alan Lucerna

Rowan-Virtua Research Day

We report a case of a 46-year-old female who was initially committed to a psychiatric facility for new onset schizophrenia symptoms. She later had an extensive workup in the hospital due to leukocytosis and was believed to have NMDA Receptor Encephalitis as the cause for her new behavioral symptoms. This case report aims to educate EM (emergency medicine) physicians to keep a broad differential diagnosis on patients who present with new onset, unprovoked psychosis later in life.

Imidazole Propionate As A Potential Modulator Of T-Cell Function, Chinanu Gubor

Electronic Theses and Dissertations Archive

Research has shown the metabolic role and therapeutic potential of the gut microbiome in modulating health and disease states. Microbial metabolites are known to be involved in various metabolic functions throughout the body. The purpose of this study was to determine if the microbial metabolite imidazole propionate, shown to be increased in obesity and type II diabetes, has an effect on key human T-cell functions. Two fasted blood samples were collected from 10 human subjects. PBMCs were isolated, and a subset were stimulated in the presence of ImP. After staining for cell-surface antigens and intracellular cytokines, flow cytometry analysis was …

Sex-Biased Immunological Processes Drive Hidradenitis Suppurativa, Kelly Z. Young, Peter Dimitrion, Li Zhou, Indra Adrianto, Qing-Sheng Mi

Dermatology Articles

Hidradenitis suppurativa (HS) is a chronic inflammatory skin condition that can manifest with abscesses, sinus tracts, and scarring in the intertriginous areas of the body. HS is characterized by immune dysregulation, featuring elevated levels of myeloid cells, T helper (Th) cells, and pro-inflammatory cytokines, particularly those involved in Th1- and Th17-mediated immunity. In most epidemiological studies, HS shows a strong female sex bias, with reported female-to-male ratios estimated at roughly 3:1, suggesting that sex-related factors contribute to HS pathophysiology. In this article, we review the role of intrinsic and extrinsic factors that contribute to immunological differences between the sexes and …

Surface Enhanced Raman Scattering-Based Multiplexing Detection Of Proteins In Solutions, Hallie Feldman

Undergraduate Honors Theses

The Influenza virus infected over 36 million people in 2019, whereas the COVID-19
virus caused a deadly pandemic that has infected over 700 million people to date. Both viruses share a magnitude of similar symptoms, which presents a key challenge for the need of a highly sensitive and selective biosensors that can simultaneously detect the specific biomarkers for each of these viruses. This work focuses on developing a Surface-enhanced Raman scattering (SERS) based biosensor for detecting protein biomarkers related to the two viruses such as H1N1 and S- protein. Gold nanoparticles are used for SERS signal amplification. The objective of …

Telehealth Monitoring For Non-Hospitalized Covid-19 Positive Patients In A Rural Setting, Rebekah Leann French

Doctor of Nursing Practice Scholarly Projects

Purpose

This quality improvement project evaluates the efficacy of an outpatient COVID-19 telehealth monitoring program intended to increase access to care, decrease emergency room/urgent care visits, and hospital admissions among telehealth observed adult patients in a rural area while providing safe home monitoring during acute illness.

Rationale/Background

Prior to COVID-19 pandemic, healthcare systems within the United States encountered several challenges including healthcare inequality and decreased healthcare access, particularly in rural communities. These gaps became more apparent when a novel COVID-19 pandemic emerged straining healthcare systems in the United States and throughout the world. Challenges ranged from overwhelmed emergency room (ER) …

Infection Of Neonatal Mice With The Murine Norovirus Strain Wu23 Is A Robust Model To Study Norovirus Pathogenesis, Amy M Peiper, Emily W Helm, Quyen Nguyen, Matthew Phillips, Caroline G Williams, Dhairya Shah, Sarah Tatum, Neha Iyer, Marco Grodzki, Laura B Eurell, Aqsa Nasir, Megan T Baldridge, Stephanie M Karst

2020-Current year OA Pubs

Noroviruses are the leading cause of severe childhood diarrhea and foodborne disease worldwide. While they are a major cause of disease in all age groups, infections in the very young can be quite severe, with annual estimates of 50,000-200,000 fatalities in children under 5 years old. In spite of the remarkable disease burden associated with norovirus infections, very little is known about the pathogenic mechanisms underlying norovirus diarrhea, principally because of the lack of tractable small animal models. The development of the murine norovirus (MNV) model nearly two decades ago has facilitated progress in understanding host-norovirus interactions and norovirus strain …