Digital Commons Network^™

Delays To Antibiotics In The Emergency Department And Risk Of Mortality In Children With Sepsis, Roni D Lane, Troy Richardson, Halden F Scott, Raina M Paul, Fran Balamuth, Matthew A Eisenberg, Ruth Riggs, W Charles Huskins, Christopher M Horvat, Grant E Keeney, Leslie A Hueschen, Justin M Lockwood, Vishal Gunnala, Bryan P Mckee, Nikhil Patankar, Venessa Lynn Pinto, Amanda M Sebring, Matthew P Sharron, Jennifer Treseler, Jennifer J Wilkes, Jennifer K Workman

Faculty, Staff and Students Publications

IMPORTANCE: Pediatric consensus guidelines recommend antibiotic administration within 1 hour for septic shock and within 3 hours for sepsis without shock. Limited studies exist identifying a specific time past which delays in antibiotic administration are associated with worse outcomes.

OBJECTIVE: To determine a time point for antibiotic administration that is associated with increased risk of mortality among pediatric patients with sepsis.

DESIGN, SETTING, AND PARTICIPANTS: This retrospective cohort study used data from 51 US children's hospitals in the Improving Pediatric Sepsis Outcomes collaborative. Participants included patients aged 29 days to less than 18 years with sepsis recognized within 1 hour …

Individuals With Jak1 Variants Are Affected By Syndromic Features Encompassing Autoimmunity, Atopy, Colitis, And Dermatitis, Michael E Horesh, Marta Martin-Fernandez, Conor Gruber, Sofija Buta, Tom Le Voyer, Eve Puzenat, Harry Lesmana, Yiming Wu, Ashley Richardson, David Stein, Stephanie Hodeib, Mariam Youssef, Jacob A Kurowski, Elizabeth Feuille, Luis A Pedroza, Ramsay L Fuleihan, Alexandria Haseley, Alain Hovnanian, Pierre Quartier, Jérémie Rosain, Georgina Davis, Daniel Mullan, O'Jay Stewart, Roosheel Patel, Angelica E Lee, Rebecca Rubinstein, Leyla Ewald, Nikhil Maheshwari, Virginia Rahming, Ivan K Chinn, James R Lupski, Jordan S Orange, Vanessa Sancho-Shimizu, Jean-Laurent Casanova, Noura S Abul-Husn, Yuval Itan, Joshua D Milner, Jacinta Bustamante, Dusan Bogunovic

Faculty, Staff and Students Publications

Inborn errors of immunity lead to autoimmunity, inflammation, allergy, infection, and/or malignancy. Disease-causing JAK1 gain-of-function (GoF) mutations are considered exceedingly rare and have been identified in only four families. Here, we use forward and reverse genetics to identify 59 individuals harboring one of four heterozygous JAK1 variants. In vitro and ex vivo analysis of these variants revealed hyperactive baseline and cytokine-induced STAT phosphorylation and interferon-stimulated gene (ISG) levels compared with wild-type JAK1. A systematic review of electronic health records from the BioME Biobank revealed increased likelihood of clinical presentation with autoimmunity, atopy, colitis, and/or dermatitis in JAK1 variant-positive individuals. Finally, …

Delays To Antibiotics In The Emergency Department And Risk Of Mortality In Children With Sepsis., Roni D. Lane, Troy Richardson, Halden F. Scott, Raina M. Paul, Fran Balamuth, Matthew A. Eisenberg, Ruth Riggs, W Charles Huskins, Christopher M. Horvat, Grant E. Keeney, Leslie Hueschen, Justin M. Lockwood, Vishal Gunnala, Bryan P. Mckee, Nikhil Patankar, Venessa Lynn Pinto, Amanda M. Sebring, Matthew P. Sharron, Jennifer Treseler, Jennifer J. Wilkes, Jennifer K. Workman

Manuscripts, Articles, Book Chapters and Other Papers

IMPORTANCE: Pediatric consensus guidelines recommend antibiotic administration within 1 hour for septic shock and within 3 hours for sepsis without shock. Limited studies exist identifying a specific time past which delays in antibiotic administration are associated with worse outcomes.

OBJECTIVE: To determine a time point for antibiotic administration that is associated with increased risk of mortality among pediatric patients with sepsis.

DESIGN, SETTING, AND PARTICIPANTS: This retrospective cohort study used data from 51 US children's hospitals in the Improving Pediatric Sepsis Outcomes collaborative. Participants included patients aged 29 days to less than 18 years with sepsis recognized within 1 hour …

Twenty-Five Years Of The Detroit River (Michigan-Ontario) Christmas Bird Count, Julie A. Craves, James A. Fowler Jr.

Ontario Birds

No abstract provided.

House Finch Population Trends In Ontario, Ron Tozer

Ontario Birds

No abstract provided.

Nymc Synapse Issue 43, School Of Medicine Student Senate, New York Medical College

The Synapse

No abstract provided.

(R2068) A Study To Assess The Stress On Students Of Higher Education During Covid-19 Using Fuzzy Logic System, Monika Rathore, Uday Raj Singh, Sanjeev Kumar

Applications and Applied Mathematics: An International Journal (AAM)

The COVID-19 pandemic significantly disrupted various sectors, with higher education being one of the most severely affected. Students in higher education faced numerous challenges transitioning to online learning, leading to a surge in mental health issues. The abrupt shift in the mode of education and the inability of many students to adapt exacerbated their mental health struggles. This, in turn, contributed to a notable rise in student suicide rates in India during the pandemic-induced isolation period. Addressing this critical socio-psychological issue requires effective strategies for stress detection and management. The proposed study employed the Online Education Stress Scale (Online ESS) …

School Nutrition Stakeholders Find Utility In Mealsim: An Agent-Based Model, Melissa Pflugh Prescott

Faculty Scholarship

Objective: To obtain feedback from school nutrition stakeholders on an agent-based model simulating school lunch to inform model refinement and future applications. Design: Qualitative study using online discussion groups. Setting: School nutrition professional stakeholders across the US. Participants: Twenty-eight school nutrition stakeholders. Phenomenon of Interest: Perceptions and applicability of MealSim for school nutrition stakeholders to help reduce food waste. Analysis: Deductive approach followed by inductive analysis of discussion group transcripts. Results: Stakeholders appreciated the customizability of the cafeteria characteristics and suggested adding additional characteristics to best represent the school meal system, such as factors relating to school staff supervision of …

Creating Advanced Processes Through Utilizing Renewable Eutectics For Gas Capture And Separation, Ahmad Mohammad Rasheed Al-Bodour

Dissertations

Global efforts to reduce emissions of environmentally harmful gases have intensified, with carbon dioxide (CO2) being identified as the most significant greenhouse gas and a key target for reduction strategies. Carbon dioxide (CO2) has the highest potential of threatening the environment. It is recognized as one of the greenhouse gases which has the potential of negative effects on the human being, atmosphere, and the environment. Even though CO2 gas has negative effects but at the same time it has high potential to be exploited in beneficial ways. For instance, CO2 is used in the energy field to produce the so-called …

Systems Genetics Uncover New Loci Containing Functional Gene Candidates In Mycobacterium Tuberculosis-Infected Diversity Outbred Mice., Daniel Mario Gatti, Anna L. Tyler, J Matthew Mahoney, Gary Churchill, Bulent Yener, Deniz Koyuncu, Metin N Gurcan, Mk Khalid Niazi, Thomas Tavolara, Adam Gower, Denise Dayao, Emily Mcglone, Melanie L Ginese, Aubrey Specht, Anas Alsharaydeh, Philipe A Tessier, Sherry L Kurtz, Karen L Elkins, Igor Kramnik, Gillian Beamer

Faculty Research 2024

Mycobacterium tuberculosis infects two billion people across the globe, and results in 8-9 million new tuberculosis (TB) cases and 1-1.5 million deaths each year. Most patients have no known genetic basis that predisposes them to disease. Here, we investigate the complex genetic basis of pulmonary TB by modelling human genetic diversity with the Diversity Outbred mouse population. When infected with M. tuberculosis, one-third develop early onset, rapidly progressive, necrotizing granulomas and succumb within 60 days. The remaining develop non-necrotizing granulomas and survive longer than 60 days. Genetic mapping using immune and inflammatory mediators; and clinical, microbiological, and granuloma correlates of …

Capture Rates Of Eptesicus Fuscus Increase Following White-Nose Syndrome Across The Eastern Us, Molly C. Simonis, Lynn K. Hartzler, Gregory G. Turner, Michael R. Scafini, Joseph S. Johnson, Megan A. Rúa

Biological Sciences Faculty Publications

Emerging infectious diseases threaten wildlife globally. While the effects of infectious diseases on hosts with severe infections and high mortality rates often receive considerable attention, effects on hosts that persist despite infection are less frequently studied. To understand how persisting host populations change in the face of disease, we quantified changes to the capture rates of Eptesicus fuscus (big brown bats), a persisting species susceptible to infection by the invasive fungal pathogen Pseudogymnoascus destructans (Pd; causative agent for white-nose syndrome), across the eastern US using a 30-year dataset. Capture rates of male and female E. fuscus increased from preinvasion to …

One Health In The Philippines: A Review And Situational Analysis, Lystra Zyrill A. Dayapera, Jenica Clarisse Y. Sy, Sary Valenzuela, Samantha Julia L. Eala, Ciara Maria Ines P. Del Rosario, Karen Nicole C. Buensuceso, Adrian S. Dy, Danielle A. Morales, Anna Giselle Gibson, Geminn Louis C. Apostol

Ateneo School of Medicine and Public Health Publications

The Philippines faces a complex and interconnected web of human, animal, and environmental health issues, including zoonotic and reverse zoonotic diseases, antimicrobial resistance, food insecurity and contamination, and threats from environmental degradation. This paper examines these issues, existing interventions, and their implementation challenges. The overall framework used to analyze the level of operationalization of the One Health approach is the Multi-sectoral One Health Coordination Framework developed by the World Health Organization, Food and Agriculture Organization, and the World Organization for Animal Health. A two-step process was conducted: literature review, followed by consultations with government and non-government stakeholders across national, subnational, …

Feasibility Of Wastewater-Based Public Health Monitoring Systems In Texas’ Small Rural Communities, Itza Mendoza-Sanchez, Davida S. Smyth, Monica O. Mendez, Trish Pearl, Hanadi Rifai, Nathan Howell, Erick Butler

Journal of Contemporary Water Research and Education

In recent years, there has been much focus on the use of wastewater-based epidemiology (WBE) in urban centers, particularly for SARS-CoV-2 monitoring. However, less is known about the application of WBE in rural settings or in areas of limited resources. Most WBE programs in low-resource communities have occurred outside the United States. To reap the benefits, WBE would need to be tailored to better reflect the socioeconomic challenges, technical barriers, communication limitations, and variable wastewater infrastructures associated with rural communities. The objective of this review is to evaluate the potential opportunities and challenges of deploying the current SARS-CoV-2 monitoring methodologies …

Accuracy Of Phq-9 Against Psychiatric Diagnosis For Depression Among People Living With Hiv: A Multicounty Cross-Sectional Study, Marcel Yotebieng, Natalia Zotova, Charlotte Bernard, Suzanne Goodrich, Rogers Awoh, Dana Watnick, Dominique Nsonde, Elodie Moungang, Julie Noumedem, Lukoye Atwoli

Internal Medicine, East Africa

Objective: The aim of this study was to assess the performance of the 9-item Patient Health questionnaire (PHQ-9) against psychiatrist diagnosis in PLWH.

Design: Cross-sectional analysis of data collected between January 2018 and July 2022 across five sites in Cameroon, Cote d’Ivoire, Kenya, Senegal, and the Republic of Congo. Participants were ≥18 years and receiving HIV care at the participating site. PHQ-9 was administered by study staff followed by a psychiatrist’s evaluation within 3 days.

Results: Overall, 778 participants with complete data were included: 297 (38.2%) in Cameroon, 132 (17.0%) in Congo, 148 (19.0%) in Cote d’Ivoire, …

Adaptive Phase I–Ii Clinical Trial Designs Identifying Optimal Biological Doses For Targeted Agents And Immunotherapies, Yong Zang, Beibei Guo, Yingjie Qiu, Hao Liu, Mateusz Opyrchal, Xiongbin Lu

Faculty Publications

Targeted agents and immunotherapies have revolutionized cancer treatment, offering promising options for various cancer types. Unlike traditional therapies the principle of “more is better” is not always applicable to these new therapies due to their unique biomedical mechanisms. As a result, various phase I–II clinical trial designs have been proposed to identify the optimal biological dose that maximizes the therapeutic effect of targeted therapies and immunotherapies by jointly monitoring both efficacy and toxicity outcomes. This review article examines several innovative phase I–II clinical trial designs that utilize accumulated efficacy and toxicity outcomes to adaptively determine doses for subsequent patients and …

Fisheries Occasional Publication No.147 - Aquaculture Development Zones – Policy Position Relating To Permitted Alternative Species, Department Of Primary Industries And Regional Development, Western Australia

Fisheries Occasional Publications

The purpose of this policy is to set out considerations relevant to the assessment of aquaculture proposals within Aquaculture Development Zones (ADZ) for species distinct from the group of species for which the ADZ was initially established (Alternative Species).

Associations Between Disordered Eating Behaviour And Sexual Behaviour Amongst Emerging Adults Attending A Tertiary Education Institution In Coastal Kenya, Stevenson Chea, Adama Kazienga, Eunice Oyugi, Isaac Menza, Carophine Nasambu, Fauz Ibrahim, Osman Abdullahi, Amin Hassan, Amina Abubakar, Kristien Michielsen

Institute for Human Development, East Africa

Background Sexual behavior (SB) is a well-documented pathway to HIV acquisition in emerging adults and remains common amongst African emerging adults. Previous research in high-income countries indicates a correlation between disordered eating behavior (DEB) and engaging in sexual behaviors. We aimed to describe the relationship between DEB and SB amongst emerging adults attending a tertiary educational institution at the Kenyan Coast.

Methods We applied a cross-sectional design nested in a young adults’ cohort study. Eligibility included sexually active emerging adults aged 18–24 years. Three DEBs (emotional, restrained and external eating) were assessed using the Dutch Eating Behavior Questionnaire and analysed …

Introduction To Application Of Predictive Modeling In Healthcare, Motahareh (Moti) Tavakoli Msc

Quality Improvement & Patient Safety Hot Topics

No abstract provided.

The Inhibition Of Sars-Cov-2 Papain-Like Protease By Tanshinones, Alex Beringer

PCOM Biomedical Studies Student Scholarship

The emergence of SARS-CoV-2, the virus responsible for the COVID-19 pandemic, has highlighted the critical need for effective antiviral treatments. Three significant coronaviruses—SARS-CoV-1, MERS-CoV, and SARS-CoV-2—have posed serious global health threats in the past two decades. Among them, SARS-CoV-2 has demonstrated the highest transmission and mortality rates, underscoring the urgency for innovative therapeutic strategies. This study delves into the potential of tanshinones, natural compounds derived from Salvia miltiorrhiza, as inhibitors of the SARS-CoV-2 PLpro enzyme. PLpro is a pivotal enzyme in the viral replication and an attractive target for antiviral drug development. By inhibiting PLpro, tanshinones may hinder viral replication …

Comprehensive Examination Of The Effect Of A Randomized Controlled Brief Mindfulness-Based Intervention On Autonomic Nervous System Functioning, Li Shen Chong

Legacy Theses & Dissertations (2009 - 2024)

Brief mindfulness-based interventions are comparable to traditional mindfulness-based interventions in alleviating stress and improving well-being. To explore the underlying biological mechanisms of these practices, researchers have been exploring the effects of mindfulness-based interventions through the autonomic nervous system (ANS), a major bodily stress response system. Nevertheless, most of these studies relied on one stress response system or a specific biomarker. This study aims to comprehensively examine the effectiveness of two sessions of brief mindfulness-based interventions on ANS functioning. Participants were assigned to the brief mindfulness intervention condition (n = 44) or control condition (n = 47). Participants’ physiological data, including …

Negotiating Pluralism: Dilemmas Of Decentralization In The Middle East, Asli Ü. Bâli, Omar M. Dajani

UC Law Journal

This Article explores the potential of decentralized governance and territorial arrangements to address the overlapping governance crises and identity conflicts in the Middle East and North Africa (the “MENA”). Despite an extensive literature on decentralization and federalism in comparative law and politics, few studies have considered such initiatives in this region. By undertaking a qualitative comparison of decentralizing initiatives in four MENA countries—Tunisia, Iran, Syria, and Yemen—this Article provides the first sustained examination of these understudied cases and in the process suggests a variety of region-wide implications.

The cases are generative both in addressing ongoing debates about the merits of …

Application Of Methods To Population-Based Surveys To Reduce Bias In Estimates Of Sars-Cov-2 Infection Burden In The Population, Saba Qasmieh

Dissertations and Theses

BACKGROUND: Population-based surveys designed to randomly sample the population can be a critical and complementary tool to traditional surveillance approaches. Probability-based surveys enable the measurement of SARS-CoV-2 testing and outcomes that avoid issues around self-selection into testing, making them an effective approach to address ascertainment bias in passive surveillance. For surveys to be a useful and reliable surveillance tool for understanding the burden and distribution of SARS-CoV-2 infection, they need to capture prevalence estimates that are both valid and reliable to be optimally informative for public health measures. The dissertation was undertaken to address three main gaps that have implications …

Rare Presentation Of Central Nervous System Tuberculosis With Bilateral Anterior Cerebral Artery Aneurysm: A Case Report, Maryam Khalil, Mansoor Iqbal, Samer Naik, Ayma Khan Khan, Zakir Jan, Mazhar Badshah

Pakistan Journal of Neurological Sciences (PJNS)

Central Nervous System tuberculosis (CNS TB) with intracranial aneurysms is rare and needs prompt diagnosis and early management. The presence of un-ruptured or ruptured aneurysms in the presence of CNS infection is difficult to treat in both acute settings and long-term management because of possible complications prevention. A female of 70 years of age presented with a history of fever, headache, vomiting, and altered sensorium for one week with GCS of 13/15, later developing paraparesis. She was diagnosed to have CNS tuberculosis with complicating bilateral anterior communicating artery (ACA) aneurysms. She was managed conservatively in our hospital and was referred …

Best Practice Of Peritoneal Dialysis-Associated Gram-Negative Peritonitis In Children: Insights From The International Pediatric Peritoneal Dialysis Network Registry., Dagmara Borzych-Dużałka, Rebeca Same, Alicia Neu, Hui Kim Yap, Enrico Verrina, Sevcan A Bakkaloglu, Francisco Cano, Hiren Patel, Maria Szczepańska, Łukasz Obrycki, Ana Paula Spizzirri, Lisa Sartz, Karel Vondrak, Anabella Rebori, Gordana Milosevski-Lomic, Eugene Yu-Hin Chan, Biswanath Basu, Andrea Lazcano Pezo, Ariane Zaloszyc, Vimal Chadha, Franz Schaefer, Bradley A. Warady

Manuscripts, Articles, Book Chapters and Other Papers

INTRODUCTION: Gram-negative peritonitis (GNP) is associated with significant morbidity in children receiving long-term peritoneal dialysis (PD) and current treatment recommendations are based on limited data.

METHODS: Analysis of 379 GNP episodes in 308 children (median age 6.9 years, interquartile range [IQR]: 3.0-13.6) from 45 centers in 28 countries reported to the International Pediatric Peritoneal Dialysis Network registry between 2011 and 2023.

RESULTS: Overall, 74% of episodes responded well to empiric therapy and full functional recovery (FFR) was achieved in 82% of cases. In vitro bacterial susceptibility to empiric antibiotics and lack of severe abdominal pain at onset were associated with …

Optimizing Central Venous Access Simulation Training To Surgical Education Trends: A Hybrid Approach Of 3d Anatomy Technology And Flipped Classroom, Ung-Kai Ting, Ming-Hsien Chiang, Yung-Chih Wang, Chin-Sheng Lin, Jiunn-Tay Lee, Yuan-Ming Tsai

Journal of Medical Education

Purpose: Central venous catheterization is a critical skill in perioperative and critical care medicine. During their postgraduate-year training (PGY), postgraduate trainees are expected to perform central venous catheter (CVC) insertion. Despite learning anatomy in medical school, the demanding nature of the hospital environment requires continuous reinforcement of their knowledge. This pilot study examines the efficacy of three-dimensional (3D) anatomy technology in teaching vascular anatomy for CVC insertion through a flipped classroom approach. Methods: An educational 3D anatomy platform "Complete Anatomy" was utilized to create central-line vascular models to teach vascular anatomy. Trainees completed an online course and a self-assessment before …

Strengthening U.S. Jail Systems’ Response To Infectious Diseases: An Evaluation Of The Covid-19 Pandemic, Erinn Bacchus

Dissertations and Theses

Jails across the United States were struck with increased infections and deaths during the COVID-19 pandemic. Studies have shown the structural make up of jails, lack of preparedness plans, and overcrowding contributed to health risks and poor health outcomes both inside jails and local communities. Yet little research has been dedicated to strengthening jail responses to infectious disease outbreaks spanning prevention measures, data collection, and reentry planning. Gaps include information on the (1) myriad infectious disease mitigation strategies used in jails and adherence to CDC prevention guidelines, (2) development of a standardized epidemiologic surveillance system, and (3) experiences working at …

Association Of Circulating Markers Of Microbial Translocation And Hepatic Inflammation With Liver Injury In Patients With Type 2 Diabetes, Leila Gobejishvili, Vatsalya Vatsalya, Diana V. Avila, Yana B. Feygin, Craig J. Mcclain, Sriprakash Mokshagundam, Shirish Barve

Biostatistics Faculty Publications

Background: Virtually the entire spectrum of liver disease is observed in association with type 2 diabetes mellitus (T2DM); indeed, T2DM is now the most common cause of liver disease in the U.S. We conducted a pilot study to investigate the relevance of increased microbial translocation and systemic inflammation in the development of liver injury in patients with T2DM. Methods: Patients with T2DM (n = 17) and non-diabetic controls (NDC; n = 11) aged 25–80 yrs. participated in this study. Serum levels of endotoxin, calprotectin, soluble CD14 and CD163, and several inflammatory cytokines were measured. In addition to standard liver injury …

Associations Between Longer Leukocyte Telomere Length And Increased Lung Cancer Risk Among Never Smokers In Urban China, Jason Y Y Wong, Xiao-Ou Shu, Wei Hu, Batel Blechter, Jianxin Shi, Kevin Wang, Richard Cawthon, Qiuyin Cai, Gong Yang, Mohammad L Rahman, Bu-Tian Ji, Yutang Gao, Wei Zheng, Nathaniel Rothman, Qing Lan

Faculty, Staff and Student Publications

BACKGROUND: The complex relationship between measured leukocyte telomere length (LTL), genetically predicted LTL (gTL), and carcinogenesis is exemplified by lung cancer. We previously reported associations between longer pre-diagnostic LTL, gTL, and increased lung cancer risk among European and East Asian populations. However, we had limited statistical power to examine the associations among never smokers by gender and histology.

METHODS: To investigate further, we conducted nested case-control analyses on an expanded sample of never smokers from the prospective Shanghai Women's Health Studies (798 cases and 792 controls) and Shanghai Men's Health Studies (161 cases and 162 controls). We broke the case-control …

Internet Drug Prohibition And The Opioid Overdose Crisis, Benjamin A. Barsky

Washington Law Review

The Ryan Haight Online Pharmacy Consumer Protection Act (Ryan Haight Act) prohibits controlled substance tele-prescribing when it occurs without a preliminary in-person medical evaluation. This Article details the Ryan Haight Act’s consequences for the practice of telemedicine in general and opioid addiction treatment in particular. In doing so, it builds on literature exploring the tension between the federal criminal regulation of controlled substance prescribing and the management of large-scale public health crises, particularly the opioid overdose crisis.

By restricting the tele-prescription of certain controlled substances used for opioid addiction treatment, the Ryan Haight Act limits access to care for a …

Aita O Paul Gauguin I Ite I Te Parau I Te Reo Tahiti: The Colonial Implications Of Paul Gauguin’S Incorrect Tahitian, Elise Hatch

Pacific Studies

No abstract provided.