Digital Commons Network^™

Nivolumab Monotherapy Or Combination With Ipilimumab With Or Without Cobimetinib In Previously Treated Patients With Pancreatic Adenocarcinoma (Checkmate 032), Margaret Callahan, Asim Amin, Frederic J Kaye, Michael A Morse, Matthew H Taylor, Katriina J Peltola, Padmanee Sharma, Eileen M O'Reilly, Stephanie Meadows Shropshire, Shaun O'Brien, Marina Tschaika, Dung T Le

Faculty, Staff and Student Publications

BACKGROUND: Pancreatic cancer is one of the deadliest cancer types and represents a major unmet medical need. CheckMate 032 investigated safety and efficacy of nivolumab monotherapy and nivolumab plus ipilimumab with/without cobimetinib in advanced/metastatic solid tumors, including pancreatic cancer.

METHODS: In the original pancreatic cancer cohort, previously treated patients (≥1 prior regimen) with advanced/metastatic pancreatic adenocarcinoma were assigned to nivolumab 3 mg/kg every 2 weeks (monotherapy arm) or nivolumab 1 mg/kg and ipilimumab 1 mg/kg or 3 mg/kg every 3 weeks for four doses, followed by nivolumab 3 mg/kg every 2 weeks (combination arm). A subsequent modified pancreatic cohort (one …

Opportunities For Pharmacogenetic Testing To Guide Dosing Of Medications In Youths With Medicaid., Sonya Tang Girdwood, Matthew Hall, James W. Antoon, Kathryn Kyler, Derek J. Williams, Samir S. Shah, Lucas E. Orth, Jennifer Goldman, James A. Feinstein, Laura B. Ramsey

Manuscripts, Articles, Book Chapters and Other Papers

IMPORTANCE: There are an increasing number of medications with a high level of evidence for pharmacogenetic-guided dosing (PGx drugs). Knowledge of the prevalence of dispensings of PGx drugs and their associated genes may allow hospitals and clinical laboratories to determine which pharmacogenetic tests to implement.

OBJECTIVES: To investigate the prevalence of outpatient dispensings of PGx drugs among Medicaid-insured youths, determine genes most frequently associated with PGx drug dispenses, and describe characteristics of youths who were dispensed at least 1 PGx drug.

DESIGN, SETTING, AND PARTICIPANTS: This serial cross-sectional study includes data from 2011 to 2019 among youths aged 0 to …

Hiv-Associated Gut Microbial Alterations Are Dependent On Host And Geographic Context, Muntsa Rocafort, Guoyan Zhao, Scott A Handley, Et Al.

2020-Current year OA Pubs

HIV-associated changes in intestinal microbiota are believed to be important drivers of disease progression. However, the majority of studies have focused on populations in high-income countries rather than in developing regions where HIV burden is greatest. To better understand the impact of HIV on fecal microbiota globally, we compare the fecal microbial community of individuals in the U.S., Uganda, and Botswana. We identify significant bacterial taxa alterations with both treated and untreated HIV infection with a high degree of uniqueness in each cohort. HIV-associated taxa alterations are also significantly different between populations that report men who have sex with men …

Use Of The Ftir Technique As A Diagnostic And Monitoring Tool For Cancer Patients: A Review Of A Decade (2010–2022), Hiba Ghmeedh Adhab, Shaymaa Awad Kadhim, Mohammed Abduljaleel Hussein

Maaen Journal for Medical Sciences

The use of spectroscopy in the analysis of carcinoid tumors depends on this method's capacity to reveal details about the biochemical composition and the structure of the tissue. Numerous clinical investigations have shown potential benefits of employing spectroscopic techniques. These techniques have a number of advantages, including minimal implementation costs, convenience of use, and the ability to be conducted using small, portable instruments without the need for specialized equipment or professional interpretation. This article discusses several research that used FTIR spectroscopy to extract spectral characteristics from various biological materials in order to diagnose diseases in a concise manner. It was …

Exploring Referral And Service Utilization Patterns Within An Outpatient Interdisciplinary Pediatric Chronic Pain Program, Aimee Hildenbrand, Christina M Amaro, Benjamin Bear, Catherine Soprano, Katherine S Salamon

Department of Medicine Faculty Papers

PURPOSE: We examine referral sources and clinical characteristics for youth presenting to an outpatient interdisciplinary pediatric chronic pain program.

PATIENTS AND METHODS: Referral data were extracted from the electronic health record. PROMIS Pediatric Anxiety and Pain Interference Scales were administered at an initial evaluation visit.

RESULTS: The program received 1488 referrals between 2016 and 2019, representing 1338 patients, with increasing volume of referrals over time. Referrals were primarily from orthopedics (19.6%), physical medicine and rehabilitation (18.8%), neurology (14.4%), and rheumatology (12.6%). Patients referred were primarily female (75.4%), White (80.1%), English-speaking (98.4%) adolescents (median=15.0 years). Of those referred, 732 (54.7%) attended …

Gestational Diabetes Augments Group B Streptococcus Infection By Disrupting Maternal Immunity And The Vaginal Microbiota, Vicki Mercado-Evans, Marlyd E Mejia, Jacob J Zulk, Samantha Ottinger, Zainab A Hameed, Camille Serchejian, Madelynn G Marunde, Clare M Robertson, Mallory B Ballard, Simone H Ruano, Natalia Korotkova, Anthony R Flores, Kathleen A Pennington, Kathryn A Patras

Faculty, Staff and Student Publications

Group B Streptococcus (GBS) is a pervasive perinatal pathogen, yet factors driving GBS dissemination in utero are poorly defined. Gestational diabetes mellitus (GDM), a complication marked by dysregulated immunity and maternal microbial dysbiosis, increases risk for GBS perinatal disease. Using a murine GDM model of GBS colonization and perinatal transmission, we find that GDM mice display greater GBS in utero dissemination and subsequently worse neonatal outcomes. Dual-RNA sequencing reveals differential GBS adaptation to the GDM reproductive tract, including a putative glycosyltransferase (yfhO), and altered host responses. GDM immune disruptions include reduced uterine natural killer cell activation, impaired recruitment to placentae, …

Assessing Pattern Of The Pediatric Multisystem Inflammatory Syndrome (Pmis) In Children During The Covid-19 Pandemic: Experience From The Emergency Department Of Tertiary Care Center Of A Low-Middle-Income Country, Saleem Akhtar, Iqra Anis, Kumar Nirdosh, Muhammad Ihsan Tayyab Ihsan, Ahmed Raheem Buksh, Surraiya Bano

Department of Paediatrics and Child Health

Background: Pediatric Multisystem Inflammatory Syndrome (PMIS) is a hyperinflammatory condition affecting multiple organs in children, often resembling incomplete Kawasaki Disease during later phases of COVID-19 infection. Data on PMIS in low-middle-income countries, particularly in emergency department settings, is limited.
Objectives: This prospective observational study at Aga Khan University Hospital, Karachi, aimed to determine the frequency, clinical presentation patterns, and laboratory parameters of children with PMIS visiting the emergency department during the COVID-19 pandemic. Secondary objectives included assessing factors associated with in-hospital mortality.
Methods: From March 2020 to September 2021, patients meeting World Health Organization PMIS criteria were enrolled. COVID-19 testing …

Efficacy And Safety Of Autologous Tumor-Infiltrating Lymphocytes In Recurrent Or Refractory Ovarian Cancer, Colorectal Cancer, And Pancreatic Ductal Adenocarcinoma, Rodabe Amaria, Anne Knisely, David Vining, Scott Kopetz, Michael J Overman, Milind Javle, Mara B Antonoff, Ching-Wei D Tzeng, Robert A Wolff, Shubham Pant, Kathryn Lito, Kelly Rangel, Bryan Fellman, Ying Yuan, Karen H Lu, Donastas Sakellariou-Thompson, Cara L Haymaker, Marie-Andrée Forget, Patrick Hwu, Chantale Bernatchez, Amir A Jazaeri

Faculty, Staff and Student Publications

BACKGROUND: Tumor-infiltrating lymphocyte (TIL) therapy has shown efficacy in metastatic melanoma, non-small cell lung cancer, and other solid tumors. Our preclinical work demonstrated more robust CD8 predominant TIL production when agonistic anti-4-1BB and CD3 antibodies were used in early ex vivo TIL culture.

METHODS: Patients with treatment-refractory metastatic colorectal (CRC), pancreatic (PDAC) and ovarian (OVCA) cancers were eligible. Lymphodepleting chemotherapy was followed by infusion of ex vivo expanded TIL, manufactured at MD Anderson Cancer Center with IL-2 and agonistic stimulation of CD3 and 4-1BB (urelumab). Patients received up to six doses of high-dose IL-2 after TIL infusion. Primary endpoint was …

Characteristics And Patterns Of Diagnoses For Patients Admitted From And Discharged To Court Or Law Enforcement In The State Of Florida, Christopher Bridgeman

MUSC Theses and Dissertations

OBJECTIVE: The role of prison healthcare is to provide safe, high-quality, and timely healthcare for prisoners. This study examines the characteristics of patients discharged from healthcare in the nation’s third-largest prison system, the state of Florida.

METHODS: This was a study of adults (18-64) admitted from or discharged to law enforcement agencies in Florida in 2018 for healthcare in Florida hospitals. Patients were divided among distinguishable characteristics of gender, zip code, income quartile, rural/urban locality, and insurance type. Data was collected within the Office of Data Collection & Quality Assurance (DCQA) within the Florida Agency for Health Care Administration (Florida …

Association Between Malaria Educational Message Exposure And Malaria Prevalence Among Children In Nigeria, Eberechukwu Jacob Ajiwe

Walden Dissertations and Doctoral Studies

No abstract provided.

Chronic Wasting Disease: State Of The Science, Jason C Bartz, Rebeca Benavente, Byron Caughey, Sonja Christensen, Allen Herbst, Edward A Hoover, Candace K Mathiason, Debbie Mckenzie, Rodrigo Morales, Marc D Schwabenlander, Daniel P Walsh, The Nc North American Interdisciplinary Chronic Wasting Disease Research Consortium Members

Faculty, Staff and Student Publications

Chronic wasting disease (CWD) is a prion disease affecting cervid species, both free-ranging and captive populations. As the geographic range continues to expand and disease prevalence continues to increase, CWD will have an impact on cervid populations, local economies, and ecosystem health. Mitigation of this "wicked" disease will require input from many different stakeholders including hunters, landowners, research biologists, wildlife managers, and others, working together. The NC1209 (North American interdisciplinary chronic wasting disease research consortium) is composed of scientists from different disciplines involved with investigating and managing CWD. Leveraging this broad breadth of expertise, the Consortium has created a state-of-the-science …

Covid-19 Vaccine And Survival Of Diabetes Patient On Dialysis, Luis Guillermo De Jesús Iii Vega

Walden Dissertations and Doctoral Studies

No abstract provided.

The Role Of Educational Status And The Management Of Diabetes Among Mexican Migrants On The Northern Mexican Border, Suvipuli Mayarata Quinn

Walden Dissertations and Doctoral Studies

No abstract provided.

Nursing Advocacy Reduces Surgical Site Infections, Zebina Rodger, Claudia Chanes

All Publications

No abstract provided.

Advancing Virtual At-Home Care For Community Health Center Patients Using Patient Self-Care Tools, Technology, And Education [Letter], Cheryl Modica, Joy H. Lewis, Curtis Bay

SOMA Faculty Publications

Abstract

Introduction

Health centers are community-based, patient directed primary care providers that offer accessible, high-quality primary care within medically underserved communities. Screening for cancer and managing complex chronic conditions such as diabetes, hypertension, obesity, and depression are vital services for the vulnerable populations seen by community health centers. Delivering care for complex chronic conditions and preventive services using virtual models that integrate self-care tools and technology is an important approach to increasing access for hard-to-reach patients served by health centers.

Objective

This study aimed to explore the use of a virtual care model, applied using a systems approach and patient-driven …

Atypical Lyme Disease Rash: A Case Report, Selena Khanna, Lynne J. Goebel

Internal Medicine

Lyme disease (LD), caused in the United States primarily by Borrelia burgdorferi sensu lato, is a tick-borne illness characterized by a spectrum of clinical manifestations depending on the stage of illness. Most clinicians are familiar with the classic bullseye appearance of the erythema migrans (EM) rash that occurs inthe early stage of the disease. However, many providers may not be aware of alternate appearances for the rash. This paper reports the case of a 69-year-old female with LD, exhibiting an atypical rash with purplish discoloration that was devoid of an outer ring or central clearing. In geographic areas with a …

Diversity And Prevalence Of Zoonotic Infections At The Animal-Human Interface Of Primate Trafficking In Peru, A. Patricia Mendoza, Ana Muñoz-Maceda, Bruno M. Ghersi, Micaela De La Puente, Carlos Zariquiey, Nancy Cavero, Yovana Murillo, Miguel Sebastian, Yohani Ibañez, Patricia G. Parker, Alberto Perez, Marcela Uhart, Janine Robinson, Sarah H. Olson, Marieke H. Rosenbaum

Biology Department Faculty Works

Wildlife trafficking creates favorable scenarios for intra- and inter-specific interactions that can lead to parasite spread and disease emergence. Among the fauna affected by this activity, primates are relevant due to their potential to acquire and share zoonoses - infections caused by parasites that can spread between humans and other animals. Though it is known that most primate parasites can affect multiple hosts and that many are zoonotic, comparative studies across different contexts for animal-human interactions are scarce. We conducted a multi-parasite screening targeting the detection of zoonotic infections in wild-caught monkeys in nine Peruvian cities across three contexts: captivity …

Procalcitonin In Sepsis And Bacterial Infection, Children's Mercy Kansas City

Clinical Critically Appraised Topics

No abstract provided.

Community-Acquired Pneumonia, Children's Mercy Kansas City

Clinical Pathways (Formally Known As Clinical Practice Guidelines)

No abstract provided.

Experimental Sars-Cov-2 Infection Of Elk And Mule Deer, Stephanie M. Porter, Airn E. Hartwig, Helle Bielefeldt-Ohmann, Jeffrey M. Marano, J. Jeffrey Root, Angela M. Bosco-Lauth

United States Department of Agriculture Wildlife Services: Staff Publications

To assess the susceptibility of elk (Cervus canadensis) and mule deer (Odocoileus hemionus) to SARS-CoV-2, we performed experimental infections in both species. Elk did not shed infectious virus but mounted low-level serologic responses. Mule deer shed and transmitted virus and mounted pronounced serologic responses and thus could play a role in SARS-CoV-2 epidemiology.

Simple Sars-Cov-2 Concentration Methods For Wastewater Surveillance In Low Resource Settings, Mohammad Dehghan Banadaki, Soroosh Torabi, Alexus Lori Rockward, William Strike, Ann Noble, James W. Keck, Scott M. Berry

UK CARES Faculty Publications

Wastewater-based epidemiology (WBE) measures pathogens in wastewater to monitor infectious disease prevalence in communities. Due to the high dilution of pathogens in sewage, a concentration method is often required to achieve reliable biomarker signals. However, most of the current concentration methods rely on expensive equipment and labor-intensive processes, which limits the application of WBE in low-resource settings. Here, we compared the performance of four inexpensive and simple concentration methods to detect SARS-CoV-2 in wastewater samples: Solid Fraction, Porcine Gastric Mucin-conjugated Magnetic Beads, Calcium Flocculation- Citrate Dissolution (CFCD), and Nanotrap® Magnetic Beads (NMBs). The NMBs and CFCD methods yielded the highest …

Mathematical Model Of Oxygen, Nutrient, And Drug Transport In Tuberculosis Granulomas, Meenal Datta, Mccarthy Kennedy, Saeed Siri, Laura Via, James W. Baish, Lei Xu, Veronique Dartois, Clifton Barry, Rakesh Jain

Faculty Journal Articles

Physiological abnormalities in pulmonary granulomas–pathological hallmarks of tuberculosis (TB)–compromise the transport of oxygen, nutrients, and drugs. In prior studies, we demonstrated mathematically and experimentally that hypoxia and necrosis emerge in the granuloma microenvironment (GME) as a direct result of limited oxygen availability. Building on our initial model of avascular oxygen diffusion, here we explore additional aspects of oxy- gen transport, including the roles of granuloma vasculature, transcapillary transport, plasma dilution, and interstitial convection, followed by cellular metabolism. Approximate analytical solutions are provided for oxygen and glucose concentration, interstitial fluid velocity, interstitial fluid pressure, and the thickness of the convective zone. …

Acceptability And Feasibility Study For The Dapivirine Vaginal Ring In Cambodia: A Qualitative Study On The Dapivirine Vaginal Ring For Use Amongst Cisgender Women At Substantial Hiv Risk In Cambodia, Kingdom Of Cambodia, National Center For Hiv/Aids, Dermatology And Std

Dapivirine Vaginal Ring (PrEP Ring)

No abstract provided.

Association Between Community Social Vulnerability And Preventable Hospitalizations, Rachel Hogg-Graham, Joseph A. Benitez, Mary E. Lacy, Joshua Bush, Juan Lang, Haritomane Nikolaou, Emily R. Clear, J. M. Mccullough, Teresa M. Waters

Public and Population Health Faculty Publications and Presentations

Preventable hospitalizations are common and costly events that burden patients and our health care system. While research suggests that these events are strongly linked to ambulatory care access, emerging evidence suggests they may also be sensitive to a patient’s social, environmental, and economic conditions. This study examines the association between variations in social vulnerability and preventable hospitalization rates. We conducted a cross-sectional analysis of county-level preventable hospitalization rates for 33 states linked with data from the 2020 Social Vulnerability Index (SVI). Preventable hospitalizations were 40% higher in the most vulnerable counties compared with the least vulnerable. Adjusted regression results confirm …

Synthesis Of High-Performance Antibacterial Magnesium Oxide Nanostructures Through Laser Ablation, Sara Abbas, Adawiya Haider, Sharafaldin Al-Musawi, Bakr Taha

Journal of Applied Sciences and Nanotechnology

In this study, we synthesized magnesium oxide (MgO) nano flakes (NFs) through pulsed laser ablation of magnesium ribbons, investigating their potent antibacterial properties for potential biomedical applications. Thorough characterization utilizing advanced analytical techniques verified the phase purity and functionality of the fabricated MgO NFs. Results revealed a distinctive flake-like structure with an average diameter of 100-400 nm and a slender wall thickness of 24 nm. The efficiency of the laser ablation method was validated by EDX imaging, showing high purity in the MgO sample. XRD analysis further confirmed the polycrystalline nature of MgO NFs, with dominant peaks at 2θ values …

Who Has The Authority? Opportunities For Reform In Global Health Governance, Luka VujašKović

North Carolina Journal of International Law

No abstract provided.

The Potential Of Ethiopian Medicinal Plants To Treat Emergent Viral Diseases, Mekbib Fekadu, Ermias Lulekal, Solomon Tesfaye, Morgan Ruelle, Nigist Asfaw, Tesfaye Awas, Kebu Balemie, Kaleab Asres, Sebastian Guenther, Zemede Asfaw, Sebsebe Demissew

Sustainability and Social Justice

Ethiopians have deep-rooted traditions of using plants to treat ailments affecting humans and domesticated animals. Approximately 80% of the population continues to rely on traditional medicine, including for the prevention and treatment of viral diseases. Many antiviral plants are available to and widely used by communities in areas where access to conventional healthcare systems is limited. In some cases, pharmacological studies also confirm the potent antiviral properties of Ethiopian plants. Building on traditional knowledge of medicinal plants and testing their antiviral properties may help to expand options to address the global pandemic of COVID-19 including its recently isolated virulent variants …

Bioassay-Guided Purification And Identification Of Antimicrobial Compound From Corn Silk Extract And Postharvest Application Against Fusarium Verticillioides On Cherry Tomato, Ummara Khan, Rita-Cindy Aye-Ayire Sedjoah, Yuting Shao, Dyaaaldin Abdalmegeed, Zichao Wu, Zhihong Xin

Turkish Journal of Agriculture and Forestry

Corn silk (Stigma maydis), the silky hairs on top of maize, is commonly discarded as waste. Despite its traditional medicinal use in countries like China, the United States, France, and Turkey, its phytochemical and pharmacological attributes have received limited study. In this study, the agar well diffusion method was used to evaluate the antimicrobial activity of free and bound crude extracts from cornsilk obtained using different solvents. Compared to the free crude extract, the bound crude extract exhibited greater efficacy against the tested microorganisms. Consequently, sequential fractionation was performed on the bound crude extract, and it was found that the …

Diagnostic Accuracy Of Intraoperative Frozen Section For Margin Evaluation Of Oral Cavity Squamous Cell Carcinoma, Javaria P. Ali, Bakhtawar Allauddin Mallick, Khushbakht Rashid, Umair Arshad Malik, Atif Ali Hashmi, Shamail Zia, Muhammad Irfan, Amir Khan, Naveen Faridi

Section of Internal Medicine

Objectives: Intraoperative frozen-section evaluation is a valuable technique for detecting positive margins intraoperatively for oral squamous cell carcinoma. We conducted this study to determine the diagnostic accuracy of frozen section in detecting margin status and the effect of tumor grade and stage on diagnostic accuracy.
Results: A total of 251 biopsy-proven cases of oral squamous cell carcinoma were included in this study. The tissue specimen resected during surgery was sent to the laboratory for frozen section evaluation. The frozen section results were then compared with the permanent section results to determine the sensitivity, specificity, positive predictive value, negative predictive value, …

Immune Evasion, Infectivity, And Fusogenicity Of Sars-Cov-2 Ba286 And Flip Variants, Panke Qu, Kai Xu, Julia N Faraone, Negin Goodarzi, Yi-Min Zheng, Claire Carlin, Joseph S Bednash, Jeffrey C Horowitz, Rama K Mallampalli, Linda J Saif, Eugene M Oltz, Daniel Jones, Richard J Gumina, Shan-Lu Liu

Faculty, Staff and Student Publications

Evolution of SARS-CoV-2 requires the reassessment of current vaccine measures. Here, we characterized BA.2.86 and XBB-derived variant FLip by investigating their neutralization alongside D614G, BA.1, BA.2, BA.4/5, XBB.1.5, and EG.5.1 by sera from 3-dose-vaccinated and bivalent-vaccinated healthcare workers, XBB.1.5-wave-infected first responders, and monoclonal antibody (mAb) S309. We assessed the biology of the variant spikes by measuring viral infectivity and membrane fusogenicity. BA.2.86 is less immune evasive compared to FLip and other XBB variants, consistent with antigenic distances. Importantly, distinct from XBB variants, mAb S309 was unable to neutralize BA.2.86, likely due to a D339H mutation based on modeling. BA.2.86 had …