Digital Commons Network^™

Effects Of Aging On Urinary Tract Epithelial Homeostasis And Immunity, Marianne M Ligon, Chetanchandra S Joshi, Bisiayo E Fashemi, Arnold M Salazar, Indira U Mysorekar

Faculty, Staff and Students Publications

A global increase in older individuals creates an increasing demand to understand numerous healthcare challenges related to aging. This population is subject to changes in tissue physiology and the immune response network. Older individuals are particularly susceptible to infectious diseases, with one of the most common being urinary tract infections (UTIs). Postmenopausal and older women have the highest risk of recurrent UTIs (rUTIs); however, why rUTIs become more frequent after menopause and during old age is incompletely understood. This increased susceptibility and severity among older individuals may involve functional changes to the immune system with age. Aging also has substantial …

Engaging Patients In Antimicrobial Stewardship: Co-Designed Educational Tool To Improve Periprocedural Care Through De-Implementation Of Guideline-Discordant Antimicrobial Use, Hawra Al Lawati, Marlena Shin, Rebecca Lamkin, Tyler Thompson, Isabella Epshtein, Hillary Mull, Dipandita Basnet Thapa, Dimitri Drekonja, Maria C Rodriguez-Barradas, Teena Huan Xu, Howard Gold, A Rani Elwy, Judy Strymish, Westyn Branch-Elliman

Faculty, Staff and Students Publications

Effective de-implementation models often include replacement of an ineffective practice with an alternative. We co-developed patient education materials as a replacement strategy for inappropriate post-procedural antibiotics in cardiac device procedures. Lessons learned and developed materials may be used to promote infection prevention in other periprocedural settings.

Clinical Approach To Evaluation Of Underlying Cardiac Device Infection In Patients Hospitalized With Bacteremia, Dierdre B Axell-House, Sarwat Khalil, M Rizwan Sohail

Faculty, Staff and Students Publications

More than 400,000 cardiac implantable electronic devices (CIEDs), including permanent pacemakers, implantable cardioverter-defibrillators, and cardiac resynchronization therapy devices, are implanted every year in the United States (US). Infection is a serious complication of CIED therapy and is associated with high morbidity and mortality. While CIED pocket infection can be diagnosed based on clinical exam findings, positive blood culture may be the only manifestation of CIED lead infection. Thus, management of bacteremia in patients living with CIEDs requires special consideration. This review summarizes contemporary data in the context of the recently updated 2023 Duke-International Society for Cardiovascular Infectious Diseases Criteria for …

Combining Charlson Comorbidity And Vacs Indices Improves Prognostic Accuracy For All-Cause Mortality For Patients With And Without Hiv In The Veterans Health Administration, Kathleen A Mcginnis, Amy C Justice, Vincent C Marconi, Maria C Rodriguez-Barradas, Ronald G Hauser, Krisann K Oursler, Sheldon T Brown, Kendall J Bryant, Janet P Tate, Veterans Aging Cohort Study Affiliations

Faculty, Staff and Students Publications

INTRODUCTION: As people age with HIV (PWH), many comorbid diseases are more common than among age matched comparators without HIV (PWoH). While the Veterans Aging Cohort (VACS) Index 2.0 accurately predicts mortality in PWH using age and clinical biomarkers, the only included comorbidity is hepatitis C. We asked whether adding comorbid disease groupings from the Charlson Comorbidity Index (CCI) improves the accuracy of VACS Index.

METHODS: To maximize our ability to model mortality among older age groups, we began with PWoH in Veterans Health Administration (VA) from 2007-2017, divided into development and validation samples. Baseline predictors included age, and components …

Implications Of The Paradigm Shift In Management Of Helicobacter Pylori Infections, David Y Graham

Faculty, Staff and Students Publications

The recent availability of susceptibility testing for Helicobacter pylori infections in the United Sates has resulted in paradigm shifts in the diagnosis, therapy, and follow-up of H. pylori infections. Here, we reviewed the English literature concerning changes in H. pylori diagnosis and therapy with an emphasis on the last 3 years. We focus on the new methods that offer rapid and convenient susceptibility testing using either invasive (endoscopic) or noninvasive (stool) methods of obtaining test material. We also discuss the implications of this availability on therapy and follow-up after therapy. The approach to therapy was categorized into four groups: (1) …

How Widespread And Convenient H Pylori Susceptibility Testing Will Result In Pharmacological Opportunities, Theodore Rokkas, David Y Graham

Faculty, Staff and Students Publications

Introduction:

Until recently antimicrobial therapy for Helicobacter pylori infections was almost universally empirical and based on a combination of expert opinion and local effectiveness. However, the average cure rates rarely achieved more than 80%. The new requirement that all therapeutic regimens reliably achieve high cure rates, the introduction of potassium competitive acid blockers and the availability of susceptibility testing many pharmacological opportunities particularly since all current therapies will require optimization. The ability to rapidly and inexpensively obtain H. pylori susceptibility data using stool samples makes obtaining susceptibility data practical and allows using susceptibility-based therapy routinely for both treatment naïve patient …

Warrantying Health Equity, Heather Payne, Jennifer Oliva

Articles by Maurer Faculty

The United States is experiencing a significant rise in the prevalence of asthma and other debilitating respiratory and cardiovascular ailments that disproportionately burden low income and marginalized Americans. This is due in large measure to climate change, which is responsible for increasingly devastating air quality events—including wildfires and drought—that trigger these serious health conditions. As a result, it is imperative that we begin to explore potential legal and policy reforms that rein in sources of health-impairing air pollution.

The common law of property has long implied in residential leasing arrangements a warranty guaranteed by landlords to tenants that the premises …

Impact Of Gastrointestinal Polymerase Chain Reaction Panels On Antibiotic Utilization In Hospitalized Adult Patients, Gillean A Kelly, Roumen Iordanov, Alex Franklin, Amna Ahmed, Krithika Srinivasan, Jesica Hayon, Todd Lasco, Rosie Amini, Sabra Shay, Prathit A Kulkarni, Mayar Al Mohajer

Faculty, Staff and Students Publications

Multiplex stool polymerase chain reaction (PCR) panels offer rapid comprehensive testing for patients with infectious diarrhea. We compared antibiotic utilization among hospitalized patients with suspected infectious diarrhea who underwent diagnostic testing with either a stool culture or stool PCR panel. No significant differences in antibiotic utilization were identified.

Vaxi-Dl: An Artificial Intelligence-Enabled Platform For Vaccine Development, P Preeti, Swarsat Kaushik Nath, Nevidita Arambam, Trapti Sharma, Priyanka Ray Choudhury, Alakto Choudhury, Vrinda Khanna, Ulrich Strych, Peter J Hotez, Maria Elena Bottazzi, Kamal Rawal

Faculty, Staff and Students Publications

Vaccine development is a complex and long process. It involves several steps, including computational studies, experimental analyses, animal model system studies, and clinical trials. This process can be accelerated by using in silico antigen screening to identify potential vaccine candidates. In this chapter, we describe a deep learning-based technique which utilizes 18 biological and 9154 physicochemical properties of proteins for finding potential vaccine candidates. Using this technique, a new web-based system, named Vaxi-DL, was developed which helped in finding new vaccine candidates from bacteria, protozoa, viruses, and fungi. Vaxi-DL is available at: https://vac.kamalrawal.in/vaxidl/ .

Nourishing The Brain On Deep Space Missions: Nutritional Psychiatry In Promoting Resilience, Nihar N Pathare, Flavia Fayet-Moore, Jennifer A Fogarty, Felice N Jacka, Philip Strandwitz, Gary E Strangman, Dorit B Donoviel

Faculty, Staff and Students Publications

The grueling psychological demands of a journey into deep space coupled with ever-increasing distances away from home pose a unique problem: how can we best take advantage of the benefits of fresh foods in a place that has none? Here, we consider the biggest challenges associated with our current spaceflight food system, highlight the importance of supporting optimal brain health on missions into deep space, and discuss evidence about food components that impact brain health. We propose a future food system that leverages the gut microbiota that can be individually tailored to best support the brain and mental health of …

Quantifying The Implementation And Cost Of A Multisite Antibiotic Stewardship Intervention For Asymptomatic Bacteriuria, Eva Amenta, Larissa Grigoryan, Suja S Rajan, David Ramsey, Jennifer R Kramer, Annette Walder, Andrew Chou, John N Van, Sarah L Krein, Sylvia Hysong, Aanand D Naik, Barbara W Trautner

Faculty, Staff and Student Publications

OBJECTIVE: The intensity of an antibiotic stewardship intervention to achieve clinical impact is not known. We conducted a multisite dissemination project of an intervention to reduce treatment of asymptomatic bacteriuria (ASB) and studied: (1) the association between implementation metrics and clinical outcomes and (2) the cost of implementation.

DESIGN/SETTING/PARTICIPANTS: A central site facilitated a multimodality intervention to decrease unnecessary urine cultures and antibiotic treatment in patients with ASB at 4 Veterans Affairs medical centers.

METHODS: The intervention consisted of a decision support aid algorithm and interactive teaching cases that provided in the moment audit and feedback on how to manage …

Absolute Lymphocyte Count Recovery Following Initial Acute Myelogenous Leukemia Therapy: Implications For Adoptive Cell Therapy, John C Molina, Yimei Li, William R Otto, Tamara P Miller, Kelly D Getz, Carly Mccoubrey, Mark Ramos, Edward Krause, Lusha Cao, M Monica Gramatges, Karen Rabin, Michael Scheurer, Caitlin W Elgarten, Regina M Myers, Alix E Seif, Brian T Fisher, Nirali N Shah, Richard Aplenc

Faculty, Staff and Students Publications

Background: An adequate absolute lymphocyte count (ALC) is an essential first step in autologous chimeric antigen receptor (CAR) T-cell manufacturing. For patients with acute myelogenous leukemia (AML), the intensity of chemotherapy received may affect adequate ALC recovery required for CAR T-cell production. We sought to analyze ALC following each course of upfront therapy as one metric for CAR T-cell manufacturing feasibility in children and young adults with AML.

Procedure: ALC data were collected from an observational study of patients with newly diagnosed AML between the ages of 1 month and 21 years who received treatment between the years of 2006 …

Protocol Of Detection Of West Nile Virus In Clinical Samples, Hephzibah Nwanosike, Freedom M Green, Kristy O Murray, Jill E Weatherhead, Shannon E Ronca

Faculty, Staff and Students Publications

West Nile virus (WNV) is one of the leading causes of arboviral encephalitis in the United States but is often underdiagnosed. Despite the wide breadth of WNV-induced clinical disease syndromes, many of the symptoms associated with WNV are nonspecific at the time of presentation; thus, choosing the right diagnostic tool is essential to not only understand the true burden of disease but also provide pathogen-directed interventions for WNV-infected patients. In this chapter, we briefly discuss the three most common types of diagnostic methods for WNV in human clinical samples: nucleic acid detection, enzyme-linked immunoassay (ELISA), and plaque reduction neutralization test …

Safety Procedures To Work With West Nile Virus In Biosafety Level 3 Facilities, Freedom M Green, Shannon E Ronca

Faculty, Staff and Students Publications

West Nile virus (WNV) can cause severe and sometimes fatal disease, but we do not have treatments or therapeutics to manage these outcomes. Since its introduction to the USA in 1999, WNV has been handled in a biosafety level 3 laboratory to decrease risk to researchers, requiring strict safety protocols and important considerations with planning experiments. Recent changes in US guidelines suggest that WNV can be handled at a lower biosafety level due to its endemicity in the USA and generally minor symptoms, but some research still requires the use of the agent at biosafety level 3. This chapter will …

Problems With Etiologic Diagnosis Of Community-Acquired Pneumonia Using Plasma Microbial Cell-Free Dna Sequencing, Daniel M Musher

Faculty, Staff and Students Publications

No abstract provided.

Peptidases Are Potential Targets Of Copper(Ii)-1,10-Phenanthroline-5,6-Dione Complex, A Promising And Potent New Drug Against Trichomonas Vaginalis, Graziela Vargas Rigo, Fernando Gomes Cardoso, Matheus Menonca Pereira, Michael Devereux, Malachy Mccann, Andre L.S. Santos, Tiana Tasca

Articles

Trichomonas vaginalis is responsible for 156 million new cases per year worldwide. When present asymptomatically, the parasite can lead to serious complications, such as development of cervical and prostate cancer. As infection increases the acquisition and transmission of HIV, the control of trichomoniasis represents an important niche for the discovery and development of new antiparasitic molecules. This urogenital parasite synthesizes several molecules that allow the establishment and pathogenesis of infection. Among them, peptidases occupy key roles as virulence factors, and the inhibition of these enzymes has become an important mechanism for modulating pathogenesis. Based on these premises, our group recently …

Effect Of Pre-Analytical Variables On Raman And Ftir Spectral Content Of Lymphocytes, Jade F. Monaghan, Daniel Cullen, Claire Wynne, Fiona Lyng, Aidan Meade

Articles

The use of Fourier transform infrared (FTIR) and Raman spectroscopy (RS) for the analysis of lymphocytes in clinical applications is increasing in the field of biomedicine. The pre-analytical phase, which is the most vulnerable stage of the testing process, is where most errors and sample variance occur; however, it is unclear how pre-analytical variables affect the FTIR and Raman spectra of lymphocytes. In this study, we evaluated how pre-analytical procedures undertaken before spectroscopic analysis influence the spectral integrity of lymphocytes purified from the peripheral blood of male volunteers (n = 3). Pre-analytical variables investigated were associated with (i) sample preparation, …

Assessing The Impact Of Contact Tracing With An Agent-Based Model For Simulating The Spread Of Covid-19: The Irish Experience, Elizabeth Hunter, Sudipta Saha, Jwenish Kumawat, Ciara Carroll, John Kelleher, Claire Buckley, Conor Mcaloon, Patricia Kearney, Michelle Gilbert, Greg Martin

Articles

Contact tracing is an important tool in managing infectious disease outbreaks and Ireland used a comprehensive contact tracing program to slow the spread of COVID-19. Although the benefits of contact tracing seem obvious, it is difficult to estimate the actual impact contact tracing has on an outbreak because it is hard to separate the effects of contact tracing from other behavioural changes or interventions. To understand the impact contact tracing had in Ireland, we used an agent-based model that is designed to simulate the spread of COVID-19 through Ireland. The model uses real contact tracing data from the first year …

A Picture Worth A Thousand Words: Factors Influencing Disability Accommodations, Alicia E. Martin

Cal Poly Humboldt theses and projects

Because not all disabilities look the same it is difficult to label a person with disabilities just by looking at them. Given that our knowledge, attitudes, and perceptions impact how we interpret our world and our willingness to act, people, including professors, may be biased toward providing accommodations for those with easily recognizable disabilities and biased against those with non-recognizable disabilities, and this may impact the disabled person’s ability to learn. This thesis aims to address whether professors’ disability-related attitudes, perceptions of accommodation reasonableness, and willingness to provide accommodations differ when the disability is recognizable (student is pictured in a …

Uncertainty, Parenting Attitudes, Risk Perceptions, And Covid-19 Vaccination Intentions, Zoë Royer

Cal Poly Humboldt theses and projects

The COVID-19 pandemic has had a significant impact on the lives of millions of people, particularly parents. Drawing on uncertainty-identity theory and research on intensive parenting attitudes, two studies sought to understand the effects of self-uncertainty, parenting beliefs, and perceived illness and vaccine side effect severity, on parental intentions to vaccinate children against COVID-19. We hypothesized that parents with intensive parenting attitudes would rely on their parenting identity to reduce uncertainty and make decisions about vaccinating their children. The results revealed that parents who perceived illness severity in unvaccinated children as high were more likely to vaccinate their children, while …

Characterization Of Cerebrospinal Fluid (Csf) Microbiota At The Time Of Initial Surgical Intervention For Children With Hydrocephalus, Shailly Pandey, Kathryn B. Whitlock, Matthew R. Test, Paul Hodor, Christopher E. Pope, David D. Limbrick, Patrick J. Mcdonald, Jason S. Hauptman, Lucas R. Hoffman, Tamara D. Simon, Cerebrospinal Fluid Microbiota In Shunts (Climb) Study Group

2020-Current year OA Pubs

OBJECTIVE: To characterize the microbiota of the cerebrospinal fluid (CSF) from children with hydrocephalus at the time of initial surgical intervention.

STUDY DESIGN: CSF was obtained at initial surgical intervention. One aliquot was stored in skim milk-tryptone-glucose-glycerol (STGG) medium and the second was unprocessed; both were then stored at -70°C. Bacterial growth for CSF samples stored in STGG were subsequently characterized using aerobic and anaerobic culture on blood agar and MALDI-TOF sequencing. All unprocessed CSF samples underwent 16S quantitative polymerase chain reaction (qPCR) sequencing, and a subset underwent standard clinical microbiological culture. CSF with culture growth (either after storage in …

Structural And Biophysical Characterization Of The Secreted, Β-Helical Adhesin Etpa Of Enterotoxigenic Escherichia Coli, Clifford Manyo Ntui, James M. Fleckenstein, Wolf-Dieter Schubert

2020-Current year OA Pubs

Enterotoxigenic Escherichia coli (ETEC) is a diarrhoeal pathogen associated with high morbidity and mortality especially among young children in developing countries. At present, there is no vaccine for ETEC. One candidate vaccine antigen, EtpA, is a conserved secreted adhesin that binds to the tips of flagellae to bridge ETEC to host intestinal glycans. EtpA is exported through a Gram-negative, two-partner secretion system (TPSS, type Vb) comprised of the secreted EtpA passenger (TpsA) protein and EtpB (TpsB) transporter that is integrated into the outer bacterial membrane. TpsA proteins share a conserved, N-terminal TPS domain followed by an extensive C-terminal domain with …

Prevalence Of Diarrheagenic Escherichia Coli And Impact On Child Health In Cap-Haitien, Haiti, Jenna N. Diaz, Lora L. Iannotti, Sherlie Jean Louis Dulience, Sydney Vie, Xuntian Jiang, Vadim Grigura, Jacques Boncy, Francesca J. Marhone Pierre, F. Matthew Kuhlmann

2020-Current year OA Pubs

BACKGROUND: Diarrheagenic Escherichia coli (DEC) are common pathogens infecting children during their growth and development. Determining the epidemiology and the impact of DEC on child anthropometric measures informs prioritization of prevention efforts. These relationships were evaluated in a novel setting, Cap-Haitien, Haiti.

METHODS: We performed pre-specified secondary analysis of a case-control study of community-dwelling children, 6-36 months of age, enrolled 96 cases with diarrhea and 99 asymptomatic controls. Assessments were performed at enrollment and one month later at follow-up. Established endpoint PCR methodologies targeted DEC gDNA isolated from fecal swabs. The association between DEC and anthropometric z-scores at enrollment was …

Association Of Hospital Centrality In Inter-Hospital Patient-Sharing Networks With Patient Mortality And Length Of Stay, Regan W. Bergmark, Ginger Jin, Robert S. Semco, Marc Santolini, Margaret A. Olsen, Amar Dhand

2020-Current year OA Pubs

OBJECTIVE: The interdependence of hospitals is underappreciated in patient outcomes studies. We used a network science approach to foreground this interdependence. Specifically, within two large state-based interhospital networks, we examined the relationship of a hospital's network position with in-hospital mortality and length of stay.

METHODS: We constructed interhospital network graphs using data from the Healthcare Cost and Utilization Project and the American Hospital Association Annual Survey for Florida (2014) and California (2011). The exposure of interest was hospital centrality, defined as weighted degree (sum of all ties to a given hospital from other hospitals). The outcomes were in-hospital mortality and …

Bacterial Species And Antimicrobial Resistance Differ Between Catheter And Non-Catheter-Associated Urinary Tract Infections: Data From A National Surveillance Network, Stéphanie D'Incau, Andrew Atkinson, Lorenz Leitner, Andreas Kronenberg, Thomas M Kessler, Jonas Marschall

2020-Current year OA Pubs

OBJECTIVE: To investigate clinically relevant microbiological characteristics of uropathogens and to compare patients with catheter-associated urinary tract infections (CAUTIs) to those with non-CAUTIs.

METHODS: All urine cultures from the calendar year 2019 of the Swiss Centre for Antibiotic Resistance database were analyzed. Group differences in the proportions of bacterial species and antibiotic-resistant isolates from CAUTI and non-CAUTI samples were investigated.

RESULTS: Data from 27,158 urine cultures met the inclusion criteria.

CONCLUSION: CAUTI pathogens were more often resistant to recommended empirical antibiotics than non-CAUTI pathogens. This finding emphasizes the need for urine sampling for culturing before initiating therapy for CAUTI and …

Barriers To And Solutions For Representative Inclusion Across The Lifespan And In Life Course Research: The Need For Structural Competency Highlighted By The Covid-19 Pandemic, Madison N Lecroy, Ebony B Carter, Sarah S Farabi, Dominic N Reeds, Et Al.

2020-Current year OA Pubs

Exclusion of special populations (older adults; pregnant women, children, and adolescents; individuals of lower socioeconomic status and/or who live in rural communities; people from racial and ethnic minority groups; individuals from sexual or gender minority groups; and individuals with disabilities) in research is a pervasive problem, despite efforts and policy changes by the National Institutes of Health and other organizations. These populations are adversely impacted by social determinants of health (SDOH) that reduce access and ability to participate in biomedical research. In March 2020, the Northwestern University Clinical and Translational Sciences Institute hosted the "Lifespan and Life Course Research: integrating …

Training In Eight Low-And Middle-Income Countries: Lessons Learned From A Pilot Study Using The Who-Tdr Dissemination And Implementation Massive Open Online Course, Ashlin Rakhra, Victor Davila-Roman, Ana A Baumann, Et Al.

2020-Current year OA Pubs

INTRODUCTION: Non-communicable diseases (NCDs) are a leading cause of morbidity and mortality in low-and middle- income countries (LMICs). Despite this, a lack of funding, training and mentorship for NCD investigators in LMICs exists. In an effort to gain knowledge and skills to address these gaps, participants from the Global Research on Implementation and Translation Science (GRIT), a consortium of studies in eight LMICs and their networks, attended the dissemination and implementation (D&I) massive open online course (MOOC) developed by the Special Programme for Research and Training in Tropical Diseases at the World Health Organization to strengthen D&I capacity building. Here, …

Understanding Tailoring To Support The Implementation Of Evidence-Based Interventions In Healthcare: The Customise Research Programme Protocol, Sheena M Mchugh, Fiona Riordan, Claire Kerins, Geoff Curran, Cara C Lewis, Justin Presseau, Luke Wolfenden, Byron J Powell

2020-Current year OA Pubs

Although there are effective evidence-based interventions (EBIs) to prevent, treat and coordinate care for chronic conditions they may not be adopted widely and when adopted, implementation challenges can limit their impact. Implementation strategies are "methods or techniques used to enhance the adoption, implementation, and sustainment of a clinical program or practice". There is some evidence to suggest that to be more effective, strategies should be

Changes In Distribution Of Severe Neurologic Involvement In Us Pediatric Inpatients With Covid-19 Or Multisystem Inflammatory Syndrome In Children In 2021 Vs 2020, Kerri L Larovere, Amanda R Kolmar, Et Al.

2020-Current year OA Pubs

IMPORTANCE: In 2020 during the COVID-19 pandemic, neurologic involvement was common in children and adolescents hospitalized in the United States for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-related complications.

OBJECTIVE: To provide an update on the spectrum of SARS-CoV-2-related neurologic involvement among children and adolescents in 2021.

DESIGN, SETTING, AND PARTICIPANTS: Case series investigation of patients reported to public health surveillance hospitalized with SARS-CoV-2-related illness between December 15, 2020, and December 31, 2021, in 55 US hospitals in 31 states with follow-up at hospital discharge. A total of 2253 patients were enrolled during the investigation period. Patients suspected of having …

Abundance Of Acvr1b Transcript Is Elevated During Septic Conditions: Perspectives Obtained From A Hands-On Reductionist Investigation, Anucha Preechanukul, Thatcha Yimthin, Sarunporn Tandhavanant, Tobias Brummaier, Chalita Chomkatekaew, Sukanta Das, Basirudeen Syed Ahamed Kabeer, Mohammed Toufiq, Darawan Rinchai, T Eoin West, Damien Chaussabel, Narisara Chantratita, Mathieu Garand

2020-Current year OA Pubs

Sepsis is a complex heterogeneous condition, and the current lack of effective risk and outcome predictors hinders the improvement of its management. Using a reductionist approach leveraging publicly available transcriptomic data, we describe a knowledge gap for the role of ACVR1B (activin A receptor type 1B) in sepsis. ACVR1B, a member of the transforming growth factor-beta (TGF-beta) superfamily, was selected based on the following: 1) induction upon