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2025

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Investigating The E74-Mediated Regulation Of A Gata Factor In Aedes Aegypti Mosquitoes, Jacklyn Marie Estrada Aug 2025

Investigating The E74-Mediated Regulation Of A Gata Factor In Aedes Aegypti Mosquitoes, Jacklyn Marie Estrada

Open Access Theses & Dissertations

The mosquito species Aedes aegypti has a significant impact on public health as a vector for multiple pathogens. Its ability to transmit deadly diseases, including Yellow Fever, Dengue Fever, and Zika, emphasizes the urgency of understanding its reproductive biology. In female mosquitoes, reproductive success hinges on obtaining a vertebrate blood meal, which triggers vitellogenesis - the synthesis of yolk protein precursors (YPPs) necessary for egg development. Without a blood meal, female Ae. aegypti remain in a state of previtellogenic arrest, where the YPP gene vitellogenin (Vg) is repressed by a type of transcriptional factor, GATAr (AaGATAr) (Attardo et al., 2003). …


A Multicomponent Microneedle Patch For The Delivery Of Meloxicam For Veterinary Applications, Katherine Alejandra Miranda Munoz Aug 2025

A Multicomponent Microneedle Patch For The Delivery Of Meloxicam For Veterinary Applications, Katherine Alejandra Miranda Munoz

Graduate Theses and Dissertations

Veterinary medicine requires innovative drug delivery strategies to enhance therapeutic efficacy while minimizing stress and handling. This dissertation explores the development and application of biodegradable microneedle patches for the transdermal delivery of meloxicam in livestock, offering a minimally invasive alternative to traditional administration methods. The research investigates the fabrication and characterization of microneedles using polyvinyl alcohol, collagen, and chitosan blends, demonstrating their mechanical strength, biocompatibility, and ability to facilitate sustained drug release. In vitro and in vivo evaluations confirm effective skin penetration, dissolution, and localized drug delivery. Pharmacokinetic studies highlight anatomical site-dependent variations in drug absorption, emphasizing the need for …


Bridging The Capacity Building Gap For Antimicrobial Stewardship Implementation: Evidence From Virtual Communities Of Practice In Kenya, Ghana, And Malawi, Ana De Lima, Kwame Buabeng, Mavis Sakyi, Hope Chadwala, Nicole Devereaux, Collins Mitambo, Christine Mugo-Sitati, Jennifer Njuhigu, Gunturu Revathi, Emmanuel Tanui Aug 2025

Bridging The Capacity Building Gap For Antimicrobial Stewardship Implementation: Evidence From Virtual Communities Of Practice In Kenya, Ghana, And Malawi, Ana De Lima, Kwame Buabeng, Mavis Sakyi, Hope Chadwala, Nicole Devereaux, Collins Mitambo, Christine Mugo-Sitati, Jennifer Njuhigu, Gunturu Revathi, Emmanuel Tanui

Pathology, East Africa

Background/Objectives: Strengthening antimicrobial stewardship (AMS) programs is an invaluable intervention in the ongoing efforts to contain the threat of antimicrobial resistance (AMR), particularly in low-resource settings. This study evaluates the impact of the Telementoring, Education, and Advocacy Collaboration initiative for Health through Antimicrobial Stewardship (TEACH AMS), which uses the virtual Extension for Community Healthcare Outcomes (ECHO) learning model to enhance AMS capacity in Kenya, Ghana, and Malawi. Methods: A mixed-methods approach was used, which included attendance data collection, facility-level assessments, post-session and follow-up surveys, as well as focus group discussions. Results: Between September 2023 and February 2025, 77 virtual learning …


Celebrating The Fifth Edition Of The International Symposium On Fungal Stress – Isfus, A Decade After Its 2014 Debut, Alene Alder-Rangel, Amanda E A Rangel, Arturo Casadevall, Asiya Gusa, Chaoyang Xue, Charles M Boone, Chris Todd Hittinger, Claudio A Masuda, Consuelo Olivares-Yañez, Deborah Bell-Pedersen, Erica J Washington, Gerhard Braus, Guilhem Janbon, István Pócsi, Jason E Stajich, Jay C Dunlap, Joan W Bennett, Joseph Heitman, Ling Lu, Lucia Landi, Mari L Shinohara, Maurizio Del Poeta, Mavis A Acheampong, Mia R Maltz, Michael C Lorenz, Minou Nowrousian, N Louise Glass, Nichole A Broderick, Nicolás Pedrini, Nir Osherov, R Blake Billmyre, Sabrina Sarrocco, Salomé Leibundgut-Landmann, Vânia Aparecida Vicente, Xiaorong Lin, Xin-Qing Zhao, Yong-Sun Bahn, Zachary A Lewis, Drauzio E N Rangel Aug 2025

Celebrating The Fifth Edition Of The International Symposium On Fungal Stress – Isfus, A Decade After Its 2014 Debut, Alene Alder-Rangel, Amanda E A Rangel, Arturo Casadevall, Asiya Gusa, Chaoyang Xue, Charles M Boone, Chris Todd Hittinger, Claudio A Masuda, Consuelo Olivares-Yañez, Deborah Bell-Pedersen, Erica J Washington, Gerhard Braus, Guilhem Janbon, István Pócsi, Jason E Stajich, Jay C Dunlap, Joan W Bennett, Joseph Heitman, Ling Lu, Lucia Landi, Mari L Shinohara, Maurizio Del Poeta, Mavis A Acheampong, Mia R Maltz, Michael C Lorenz, Minou Nowrousian, N Louise Glass, Nichole A Broderick, Nicolás Pedrini, Nir Osherov, R Blake Billmyre, Sabrina Sarrocco, Salomé Leibundgut-Landmann, Vânia Aparecida Vicente, Xiaorong Lin, Xin-Qing Zhao, Yong-Sun Bahn, Zachary A Lewis, Drauzio E N Rangel

Faculty, Staff and Student Publications

The Fifth International Symposium on Fungal Stress (ISFUS) brought together in Brazil many of the leaders in the field of fungal stress responses, from fourteen countries, for four days of outstanding science ranging from basic research to studies with agricultural, medical, industrial, and environmental significance. In addition to the excellent oral and poster presentations, the Symposium organisers ensured that all participants had ample opportunity to engage, socialise, and network to exchange ideas and share research. The conference was enhanced by the world-class venue near Iguazu Falls, probably the greatest natural phenomenon in South America.


Ppp2r1a Mutations Portend Improved Survival After Cancer Immunotherapy, Yibo Dai, Anne Knisely, Mitsutake Yano, Minghao Dang, Emily M Hinchcliff, Sanghoon Lee, Annalyn Welp, Manoj Chelvanambi, Matthew Lastrapes, Heng Liu, Zhe Yuan, Chen Wang, Hao Nie, Stephanie Jean, Luis J Montaner, Jiakai Hou, Ami Patel, Shrina Patel, Bryan Fellman, Ying Yuan, Baohua Sun, Renganayaki Krishna Pandurengan, Edwin Roger Parra Cuentas, Joseph Celestino, Yan Liu, Jinsong Liu, R Tyler Hillman, Shannon N Westin, Anil K Sood, Pamela T Soliman, Aaron Shafer, Larissa A Meyer, David M Gershenson, David Vining, Dhakshinamoorthy Ganeshan, Karen Lu, Jennifer A Wargo, Weiyi Peng, Rugang Zhang, Linghua Wang, Amir A Jazaeri Aug 2025

Ppp2r1a Mutations Portend Improved Survival After Cancer Immunotherapy, Yibo Dai, Anne Knisely, Mitsutake Yano, Minghao Dang, Emily M Hinchcliff, Sanghoon Lee, Annalyn Welp, Manoj Chelvanambi, Matthew Lastrapes, Heng Liu, Zhe Yuan, Chen Wang, Hao Nie, Stephanie Jean, Luis J Montaner, Jiakai Hou, Ami Patel, Shrina Patel, Bryan Fellman, Ying Yuan, Baohua Sun, Renganayaki Krishna Pandurengan, Edwin Roger Parra Cuentas, Joseph Celestino, Yan Liu, Jinsong Liu, R Tyler Hillman, Shannon N Westin, Anil K Sood, Pamela T Soliman, Aaron Shafer, Larissa A Meyer, David M Gershenson, David Vining, Dhakshinamoorthy Ganeshan, Karen Lu, Jennifer A Wargo, Weiyi Peng, Rugang Zhang, Linghua Wang, Amir A Jazaeri

Faculty, Staff and Student Publications

Immune checkpoint blockade (ICB) therapy is effective against many cancers, although resistance remains a major issue and new strategies are needed to improve clinical outcomes1-5. Here we studied ICB response in a cohort of patients with ovarian clear cell carcinoma-a cancer type that poses considerable clinical challenges and lacks effective therapies6-8. We observed significantly prolonged overall survival and progression-free survival in patients with tumours with PPP2R1A mutations. Importantly, our findings were validated in additional ICB-treated patient cohorts across multiple cancer types. Translational analyses from tumour biopsies demonstrated enhanced IFNγ signalling, and the presence of tertiary lymphoid structures at the baseline, …


Improving Health Outcome Through Mobile Clinics, Spatial Access, And Overdose Management: A Data-Driven Study Of People Who Inject Drugs, Individuals With Opioid Use Disorder, And College Students, Abass A. Babatunde Aug 2025

Improving Health Outcome Through Mobile Clinics, Spatial Access, And Overdose Management: A Data-Driven Study Of People Who Inject Drugs, Individuals With Opioid Use Disorder, And College Students, Abass A. Babatunde

All Dissertations

ABSTRACT

Background

The opioid crisis remains a critical public health challenge in the United States. Mobile Health Clinics (MHCs) have emerged as a promising solution to bridge healthcare access gaps for these vulnerable populations, particularly for PWID and individuals with OUD in underserved and rural communities. Despite their potential, geographic disparities in MHC access and knowledge gaps in opioid overdose management and related diseases, including Hepatitis C Virus (HCV), remain significant barriers to care. This dissertation addresses three key dimensions of healthcare delivery for PWID, OUD populations, and college students: (1) barriers to MHC utilization for HCV screening and treatment …


Essays On Healthcare Regulation And Industrial Regulation, Vitor C. Melo Aug 2025

Essays On Healthcare Regulation And Industrial Regulation, Vitor C. Melo

All Dissertations

The first chapter explores differences in incentives and consequent behavior between for-profit and not-for-profit firms. I investigate a terrible choice nursing homes faced during the pandemic: isolating residents prevents deaths from COVID-19, but increases non-COVID deaths by aggravating mental illnesses such as dementia. I explore how ownership structure led to differences in isolation measures taken and in resultant health outcomes. I model decisions regarding isolation measures as a trade-off between profits and satisfying staff's demands, with not-for-profit managers more constrained in how they consume profits. The model predicts that not-for-profit facilities will have more restrictive isolation measures and, consequently, lower …


Understanding The Experiences And Perceptions Of Faculty Supporting Undergraduate Students With Mental Health Challenges, Jenna Ranee Parbati Jamieson Aug 2025

Understanding The Experiences And Perceptions Of Faculty Supporting Undergraduate Students With Mental Health Challenges, Jenna Ranee Parbati Jamieson

Dissertations

College is a big adjustment for students, and it doesn't come without its challenges, including being in a new place with new responsibilities. This is a stressful time that presents new obstacles and frustrations that can lead to increased stress, anxiety, depression, and mental health challenges that may cause faculty to engage and support undergraduate students with mental health challenges. As students adjust and transition to college, it is vital for university faculty to feel confident and comfortable supporting students from diverse backgrounds with varying levels of distress. By interviewing faculty, a better understanding of their lived experiences and perceptions …


Adiponectin-Regulated Macrophage Responses In Aspergillus Fumigatus Infection: Mechanisms Of Uptake And Killing, Sri Harshini Goli Aug 2025

Adiponectin-Regulated Macrophage Responses In Aspergillus Fumigatus Infection: Mechanisms Of Uptake And Killing, Sri Harshini Goli

All-Inclusive List of Electronic Theses and Dissertations

Invasive aspergillosis (IA), caused by Aspergillus fumigatus, is a life-threatening infection in immunocompromised individuals, necessitating novel host-directed therapies. Macrophages are pivotal in antifungal defense, yet their function can be dysregulated; the influence of the adipokine adiponectin (APN) on this process is not fully understood. This thesis investigated the role of APN signaling in alveolar macrophage (AM) and bone marrow-derived macrophage (BMDM) responses to A. fumigatus and assessed the therapeutic potential of the APN receptor agonist, AdipoRon. Initial studies revealed that genetic deficiency in APN or its receptors renders AMs intrinsically pro-inflammatory and significantly impaired fungicidal activity against A. fumigatus. Subsequent …


Society For Healthcare Epidemiology Of America (Shea) Infectious Diseases Fellow Infection Prevention And Control And Healthcare Epidemiology Curriculum, Elise M Martin, Catherine Cichon, Rebecca Choudhury, Shandra R Day, Yasaman Fatemi, Vera P Luther, Terri Stillwell, Abby Sung Aug 2025

Society For Healthcare Epidemiology Of America (Shea) Infectious Diseases Fellow Infection Prevention And Control And Healthcare Epidemiology Curriculum, Elise M Martin, Catherine Cichon, Rebecca Choudhury, Shandra R Day, Yasaman Fatemi, Vera P Luther, Terri Stillwell, Abby Sung

2020-Current year OA Pubs

With the rapid expansion of the Infection Prevention Control/Healthcare Epidemiology (IPC/HE) fields over recent decades, the pivotal roles of IPC/HE in hospital regulation, quality improvement, patient safety, and healthcare finances have become increasingly apparent. Consequently, the demand for effective IPC/HE leaders has surged.


Implementation Outcomes Of A Patient Decision-Aid In A Diverse Population With Systemic Lupus Erythematosus In 15 Us Rheumatology Clinics, Jasvinder A Singh, Seth Eisen, Alfred Kim, Et Al. Aug 2025

Implementation Outcomes Of A Patient Decision-Aid In A Diverse Population With Systemic Lupus Erythematosus In 15 Us Rheumatology Clinics, Jasvinder A Singh, Seth Eisen, Alfred Kim, Et Al.

2020-Current year OA Pubs

OBJECTIVE: The objective of this study was to examine the clinical outcomes during the implementation of a self-administered patient decision-aid (PtDA) for lupus.

METHODS: We provided an effective computerized lupus PtDA in 15 rheumatology outpatient clinics 2019-2024 (including the COVID pandemic). We undertook Organizational Readiness to Implement Change Surveys (ORICs) and Team Learning and Psychological Safety Surveys (TLPSSs) at baseline. The primary study outcome objective measure, percent penetration/reach, was defined as the number of patients who viewed the lupus PtDA at the end of the study, divided by the total number of eligible patients (times 100). We used validated clinical …


Benefit Of Early Oseltamivir Therapy For Adults Hospitalized With Influenza A: An Observational Study, Nathaniel M Lewis, Jennie H Kwon, Et Al. Aug 2025

Benefit Of Early Oseltamivir Therapy For Adults Hospitalized With Influenza A: An Observational Study, Nathaniel M Lewis, Jennie H Kwon, Et Al.

2020-Current year OA Pubs

BACKGROUND: Clinical guidelines recommend initiation of antiviral therapy as soon as possible for patients hospitalized with confirmed or suspected influenza.

METHODS: A multicenter US observational sentinel surveillance network prospectively enrolled adults (aged ≥18 years) hospitalized with laboratory-confirmed influenza at 24 hospitals during 1 October 2022-21 July 2023. A multivariable proportional odds model was used to compare peak pulmonary disease severity (no oxygen support, standard supplemental oxygen, high-flow oxygen/non-invasive ventilation, invasive mechanical ventilation, or death) after the day of hospital admission among patients starting oseltamivir treatment on the day of admission (early) versus those who did not (late or not treated), …


Dissemination And Implementation Of A Telehealth-Enabled Program For Providing Infectious Disease Expertise In Rural Settings, Robin L P Jump, Jason P Burnham, Et Al. Aug 2025

Dissemination And Implementation Of A Telehealth-Enabled Program For Providing Infectious Disease Expertise In Rural Settings, Robin L P Jump, Jason P Burnham, Et Al.

2020-Current year OA Pubs

BACKGROUND: Telehealth can facilitate improving antibiotic use and related antimicrobial stewardship activities in facilities underserved by infectious diseases (IDs) expertise. We describe implementation of the Department of Veterans Affairs (VA) videoconference antimicrobial stewardship team (VAST) to connect multidisciplinary teams from rural VA medical centers (VAMCs) with geographically distant ID experts.

METHODS: We implemented VASTs at 10 rural VAMCs from September 2021 to February 2024. VASTs consisted of regular meetings between rural VAMCs and an off-site ID expert who met by videoconference to discuss clinical cases, emphasizing recommendations for antibiotic prescribing. The VA Corporate Data Warehouse was used to collect information …


Clostridioides (Clostridium) Difficile In Children And Adolescents In The Community In Cambodia, Lengsea Eng, Paul Turner, Kefyalew Addis Alene, Deirdre A. Collins, Su Chen Lim, Pisey Tan, Sona Soeng, Dylorng Hun, Sotera Yohn, Sarim Vong, Archie C.A. Clements, Thomas V. Riley Aug 2025

Clostridioides (Clostridium) Difficile In Children And Adolescents In The Community In Cambodia, Lengsea Eng, Paul Turner, Kefyalew Addis Alene, Deirdre A. Collins, Su Chen Lim, Pisey Tan, Sona Soeng, Dylorng Hun, Sotera Yohn, Sarim Vong, Archie C.A. Clements, Thomas V. Riley

Research outputs 2022 to 2026

Background: Clostridioides (Clostridium) difficile transmission between community and healthcare settings has been increasingly reported. We aimed to identify the prevalence and molecular epidemiology of C. difficile colonising adolescents and non-hospitalised children in Cambodia. Methods: Stool samples were collected from 266 students at the University of Health Sciences (UHS) in Phnom Penh, between July and August 2022, and 246 children ≥1 year old visiting the outpatient department (OPD) at Angkor Hospital for Children in Siem Reap, between January and August 2022. C. difficile culture, toxin gene detection and PCR ribotyping were performed. Results: Overall, C. difficile was recovered from 07/266 specimens …


Anaphylaxis Definition, Overview, And Clinical Support Tool: 2024 Consensus Report-A Ga2len Project, Timothy E Dribin, Antonella Muraro, Carlos A Camargo, Paul J Turner, Julie Wang, Graham Roberts, Aikaterini Anagnostou, Susanne Halken, Jay Liebermann, Margitta Worm, Torsten Zuberbier, Hugh A Sampson, Ga(2)Len Anaphylaxis Study Team Aug 2025

Anaphylaxis Definition, Overview, And Clinical Support Tool: 2024 Consensus Report-A Ga2len Project, Timothy E Dribin, Antonella Muraro, Carlos A Camargo, Paul J Turner, Julie Wang, Graham Roberts, Aikaterini Anagnostou, Susanne Halken, Jay Liebermann, Margitta Worm, Torsten Zuberbier, Hugh A Sampson, Ga(2)Len Anaphylaxis Study Team

Faculty, Staff and Students Publications

Background: The 2006 National Institute of Allergy and Infectious Disease/Food Allergy and Anaphylaxis Network anaphylaxis criteria are widely used in clinical care and research. In 2020, the World Allergy Organization published modified criteria that have not been uniformly adopted. Different criteria contribute to inconsistent care and research outcomes.

Objective: We sought to develop a consensus anaphylaxis definition, overview, and clinical support tool.

Methods: A 12-member writing group developed draft outputs modified with input from a 46-member international expert panel, 31 medical stakeholder organizations, and 15 patient advocacy organizations. The expert panel participated in a modified Delphi process to seek consensus …


Relapse Patterns Among Children And Adolescents With Kaposi Sarcoma In Malawi, Toni Chanroo, Allison Silverstein, Casey L Mcatee, William Kamiyango, Jimmy Villiera, Parth S Mehta, Erin Peckham-Gregory, Mark Zobeck, Michael E Scheurer, Carl E Allen, Rizine Mzikamanda, Nmazuo W Ozuah, Nader Kim El-Mallawany Aug 2025

Relapse Patterns Among Children And Adolescents With Kaposi Sarcoma In Malawi, Toni Chanroo, Allison Silverstein, Casey L Mcatee, William Kamiyango, Jimmy Villiera, Parth S Mehta, Erin Peckham-Gregory, Mark Zobeck, Michael E Scheurer, Carl E Allen, Rizine Mzikamanda, Nmazuo W Ozuah, Nader Kim El-Mallawany

Faculty, Staff and Students Publications

Kaposi Sarcoma (KS) is a common childhood cancer in Malawi, but few studies have exploredclinical characteristicsofrelapsed disease. We aimed to characterize clinical patterns of relapse to improve treatment and, ultimately, long-term survival in patients with pediatric KS.A retrospective cohort study was conducted among patients ages < 19 years of age at time of KS diagnosis in Lilongwe, Malawi between August 1, 2010 and March 15, 2020. Specifically, emphasis was placed on patients who had relapsed disease and excluded patients with refractory disease or those who died whilst receiving front-line treatment. Salvage therapy typically involved an intensified chemotherapy regimen compared to front-line therapy—namely nonliposomaldoxorubicin plus bleomycin/vincristine or paclitaxel monotherapy.One-hundred and ninety patients with pediatric KS were included in this analysis, 50 of whom experienced relapse (26%).Older median age was associated with occurrence of relapse (10 vs 6.7 years, p-value = 0.004). Median time from diagnosis to first relapse was 10.6 months (range 2.3–49 months). Three-year post-relapse overall survival (OS) for the entire cohort was 60% with a median follow-up time of 4.7 years after relapse.Survival was significantly higher for patients who relapsed with the woody edema clinical phenotype of pediatric KS versus those with visceral/disseminated disease—3-year OS 79% (95% CI 62–100) versus 29% (14–61).These data demonstrate potential for continued survival after KS relapse in the pediatric population and identify subsets of high-risk patients. The higher mortality observed in patients with visceral/disseminated KS highlights the need for improved therapeutic strategies.


Measuring The Impact Of A Delay In Care On Pediatric Otolaryngologic Surgery Completion, Geethanjeli N Mahendran, Ching Siong Tey, Mary Frances Musso, Grace Shebha Anand, Jeffrey Larson, Mitesh Mehta, Lara Reichert, Kara Prickett, Nikhila Pinnapureddy Raol Aug 2025

Measuring The Impact Of A Delay In Care On Pediatric Otolaryngologic Surgery Completion, Geethanjeli N Mahendran, Ching Siong Tey, Mary Frances Musso, Grace Shebha Anand, Jeffrey Larson, Mitesh Mehta, Lara Reichert, Kara Prickett, Nikhila Pinnapureddy Raol

Faculty, Staff and Students Publications

Objective: To determine if postponement of elective pediatric otorhinolaryngology surgeries results in a change in overall healthcare utilization and if there is any commensurate impact on disease progression.

Methods: We identified patients ≤18 years of age whose surgeries were postponed at the onset of the COVID-19 pandemic-related shutdown. We then tracked patients' rate of and patterns of rescheduling surgery. Surveys were also sent to caregivers to better characterize his/her decision regarding moving forward with his/her child's surgery during COVID-19.

Results: A total of 1915 pediatric patients had elective surgeries canceled, of which 992 (51.8%) were rescheduled within 4 months. No …


Orchestrated Architecture Dismantling: Borrelia Burgdorferi’S Coordinated Destruction Of Adaptive Immune Responses, Craig A. Land Aug 2025

Orchestrated Architecture Dismantling: Borrelia Burgdorferi’S Coordinated Destruction Of Adaptive Immune Responses, Craig A. Land

Electronic Theses and Dissertations

Borrelia burgdorferi represents the most prevalent vector-borne bacteria in North America, affecting ~476,000 Americans annually yet persisting despite robust immune responses. This project reveals spirochetes target adaptive immunity through coordinated lymphatic colonization and precision immune dysregulation.

Using comparative host models (C57BL/6 vs. reservoir Peromyscus leucopus), we demonstrate lymph node colonization within 48-hours, with spirochetes exploiting LYVE-1-positive lymphatic structures as dissemination highways while avoiding the interior of follicular regions. Critically, we identify targeted CD4+ T-cell elimination in germinal center border zones at 21-DPI, precisely when these cells should be coordinating protective immunity. Concurrent upregulation of inhibitory receptor CD32b creates molecular …


Reentry For Formerly Incarcerated Individuals: A Focus On Workforce Reentry And Recidivism In Appalachia, Margaret E. Francisco Aug 2025

Reentry For Formerly Incarcerated Individuals: A Focus On Workforce Reentry And Recidivism In Appalachia, Margaret E. Francisco

Electronic Theses and Dissertations

Formerly incarcerated individuals face challenges to successful reentry, a critical component of reducing recidivism and improving public health outcomes. These challenges are particularly acute in rural Appalachia, where structural disadvantages such as limited economic opportunities, healthcare access, and public transportation intersect with stigma and systemic barriers related to prior incarceration. This dissertation addresses these gaps through a mixed-methods examination of reentry and recidivism, grounded in public health frameworks and focused on the unique context of rural Appalachia.

This work includes three studies. First, a PRISMA-guided systematic review synthesized qualitative research on barriers and facilitators to employment following incarceration. Findings highlighted …


Nephrostomy (Pcn) Versus Nephroureteral Stent (Double Jj); An Ongoing Battle, Mohammad Ghasemi-Rad, Kelly Trinh, David Wynne, Mohadese Ahmadzade, Muhammad Hamza Shamim, Omar Guerrero, Ashley Bancroft, Shreya Ranganath, David Leon Aug 2025

Nephrostomy (Pcn) Versus Nephroureteral Stent (Double Jj); An Ongoing Battle, Mohammad Ghasemi-Rad, Kelly Trinh, David Wynne, Mohadese Ahmadzade, Muhammad Hamza Shamim, Omar Guerrero, Ashley Bancroft, Shreya Ranganath, David Leon

Faculty, Staff and Students Publications

In the realm of medical procedures for urinary obstructions, a distinct division of roles is evident: the vast majority of percutaneous nephrostomies (PCNs) are the domain of Interventional Radiology (IR), while the placement of double J stents (JJ stents) falls squarely under Urology. This division, however, is not without its complexities. When confronted with a patient suffering from a urinary obstruction, the decision-making process can become intricate. The underlying cause often fuels the debate: should IR intervene with a PCN, or should Urology place a JJ stent? Such decisions have profound implications for the individual patient.In this comprehensive review, we …


Stool-Based Molecular Tuberculosis Treatment Monitoring: A Faster Means For Detecting Persistent Mycobacteria Compared To Phenotypic Culture, Clement Gascua Adu Gyamfi, Abigail Seeger, Durbbin Mulengwa, Anca Vasiliu, Lucia Carratala-Castro, Bariki Mtafya, Nontobeko Maphalala, Shilzia Munguambe, Belen Saavedra, Tara Ness, Gugu Maphalala, Sozinho Acacio, Edson Mambuque, Joanna Ehrlich, Rojelio Mejia, Mangaliso Ziyane, H Lester Kirchner, Christoph Lange, Alexander Kay, Alberto L Garcia-Basteiro, Anna Mandalakas, Andrew R Dinardo Aug 2025

Stool-Based Molecular Tuberculosis Treatment Monitoring: A Faster Means For Detecting Persistent Mycobacteria Compared To Phenotypic Culture, Clement Gascua Adu Gyamfi, Abigail Seeger, Durbbin Mulengwa, Anca Vasiliu, Lucia Carratala-Castro, Bariki Mtafya, Nontobeko Maphalala, Shilzia Munguambe, Belen Saavedra, Tara Ness, Gugu Maphalala, Sozinho Acacio, Edson Mambuque, Joanna Ehrlich, Rojelio Mejia, Mangaliso Ziyane, H Lester Kirchner, Christoph Lange, Alexander Kay, Alberto L Garcia-Basteiro, Anna Mandalakas, Andrew R Dinardo

Faculty, Staff and Students Publications

Background: Tuberculosis (TB) treatment monitoring is hindered by the lack of a rapidly measured biomarker that accurately predicts clinically relevant outcomes. Symptom screening poorly correlates with bacillary burden. Although culture is a direct measure of viable bacillary burden, the long turnaround time makes it clinically irrelevant.

Methods: The TB treatment monitoring potential of stool-based, quantitative polymerase chain reaction (qPCR) was prospectively assessed among 231 participants of all ages from Eswatini, Tanzania, and Mozambique with microbiologically confirmed TB. Stool qPCR results were compared to sputum culture, persistent symptoms, drug resistance, and World Health Organization TB outcomes.

Results: Quantitative bacillary burden measured …


Implementation Outcomes Of A Patient Decision-Aid In A Diverse Population With Systemic Lupus Erythematosus In 15 Us Rheumatology Clinics, Jasvinder A Singh, Larry R Hearld, Seth Eisen, W Winn Chatham, Sonali Narain, Narender Annapureddy, Diane L Kamen, Kimberly Trotter, Vikas Majithia, Cathy Lee Ching, Zineb Aouhab, Swamy Venuturupalli, Daniel J Wallace, Rosalind Ramsey-Goldman, Alfred Kim, Maureen Mcmahon, S Sam Lim, Kalpana Bhairavarasu, Alexa Meara, Kenneth Kalunian, T Mark Beasley Aug 2025

Implementation Outcomes Of A Patient Decision-Aid In A Diverse Population With Systemic Lupus Erythematosus In 15 Us Rheumatology Clinics, Jasvinder A Singh, Larry R Hearld, Seth Eisen, W Winn Chatham, Sonali Narain, Narender Annapureddy, Diane L Kamen, Kimberly Trotter, Vikas Majithia, Cathy Lee Ching, Zineb Aouhab, Swamy Venuturupalli, Daniel J Wallace, Rosalind Ramsey-Goldman, Alfred Kim, Maureen Mcmahon, S Sam Lim, Kalpana Bhairavarasu, Alexa Meara, Kenneth Kalunian, T Mark Beasley

Faculty, Staff and Students Publications

Objective: The objective of this study was to examine the clinical outcomes during the implementation of a self-administered patient decision-aid (PtDA) for lupus.

Methods: We provided an effective computerized lupus PtDA in 15 rheumatology outpatient clinics 2019-2024 (including the COVID pandemic). We undertook Organizational Readiness to Implement Change Surveys (ORICs) and Team Learning and Psychological Safety Surveys (TLPSSs) at baseline. The primary study outcome objective measure, percent penetration/reach, was defined as the number of patients who viewed the lupus PtDA at the end of the study, divided by the total number of eligible patients (times 100). We used validated clinical …


Trust In Healthcare Ai Can’T Just Be Designed – It Must Be Felt By Clinicians And Patients, Adriana Banozic-Tang, Heng Wang Aug 2025

Trust In Healthcare Ai Can’T Just Be Designed – It Must Be Felt By Clinicians And Patients, Adriana Banozic-Tang, Heng Wang

Research Collection Yong Pung How School Of Law

Trust in healthcare AI currently over-relies on system design, not lived medical realities.Continuous feedback loops are necessary to embed trust in healthcare AI that is responsive to clinician and patient needs.Initiatives in South-East Asia show how trust in technology can be extended from policy to practice.


Work Impairment And Financial Outcomes Among Adults With Vs Without Long Covid, Michael Gottlieb, Ji Chen, Huihui Yu, Michelle Santangelo, Erica S. Spatz, Nicole L. Gentile, Rachel E. Geyer, Caitlin Malicki, Kristyn Gatling, Kelli N. O'Laughlin, Kari A. Stephens, Joann G. Elmore, Lauren E. Wisk, Michelle L'Hommedieu, Robert Rodriguez, Juan Carlos C. Montoy, Ralph C. Wang, Kristin L. Rising, Efrat Kean, Jonathan W. Dyal, Mandy J. Hill, Arjun K. Venkatesh, Robert A. Weinstein Aug 2025

Work Impairment And Financial Outcomes Among Adults With Vs Without Long Covid, Michael Gottlieb, Ji Chen, Huihui Yu, Michelle Santangelo, Erica S. Spatz, Nicole L. Gentile, Rachel E. Geyer, Caitlin Malicki, Kristyn Gatling, Kelli N. O'Laughlin, Kari A. Stephens, Joann G. Elmore, Lauren E. Wisk, Michelle L'Hommedieu, Robert Rodriguez, Juan Carlos C. Montoy, Ralph C. Wang, Kristin L. Rising, Efrat Kean, Jonathan W. Dyal, Mandy J. Hill, Arjun K. Venkatesh, Robert A. Weinstein

Department of Emergency Medicine Faculty Papers

IMPORTANCE: While much of the focus on long COVID (LC; defined as developing new, persistent symptoms lasting 3 months or longer after SARS-CoV-2 infection) has been on health status and quality of life, the impact on individual work productivity and financial distress are less well established.

OBJECTIVES: To assess differences in work and financial outcomes among individuals with current, resolved, and no LC up to 3 years after initial infection.

DESIGN, SETTING, AND PARTICIPANTS: This prospective, multisite, longitudinal cohort study enrolled adult participants (age ≥18 years) with at least 1 reported SARS-CoV-2 infection from December 7, 2020, to August 29, …


Institutional Betrayal And Military Vaccine Mandates: An Inquiry Into Loss Of Health Autonomy Concerning Unlimited Liability Contractual Employment In The Covid-19 Era, Aaron G. Dehaven Aug 2025

Institutional Betrayal And Military Vaccine Mandates: An Inquiry Into Loss Of Health Autonomy Concerning Unlimited Liability Contractual Employment In The Covid-19 Era, Aaron G. Dehaven

Electronic Theses and Dissertations

The balance between government control and personal liberty is a growing concern in the modern world. Nowhere is this more evident than in discussions surrounding government policy in public health and individual health autonomy. The Covid-19 pandemic forced many institutions to change their standard operating procedures by adapting to rapidly changing health guidance instituted to protect public health. These changes highlighted the role of health autonomy and individuals’ rights to refuse medical treatments. The Department of Defense changed many aspects of how it operated during the pandemic, including the mandate of the Covid-19 vaccine for all service members. For various …


Indoor Air Quality Conditions And Respiratory Virus Detections In Elementary Schools—Kansas City, Missouri, February–March 2023, Olivia M. Almendares, Jasmine D. Ruffin, Luke Gard, Rangaraj Selvarangan, Anjana Sasidharan, Dithi Banerjee, Nibha Sagar, Amanda Hayes, Sydnie Petty, Brian R. Lee, Chris T. Young, Janelle Potter, Shannon Tilsworth, Jennifer Goldman, Jennifer E. Schuster, Hannah L. Kirking Aug 2025

Indoor Air Quality Conditions And Respiratory Virus Detections In Elementary Schools—Kansas City, Missouri, February–March 2023, Olivia M. Almendares, Jasmine D. Ruffin, Luke Gard, Rangaraj Selvarangan, Anjana Sasidharan, Dithi Banerjee, Nibha Sagar, Amanda Hayes, Sydnie Petty, Brian R. Lee, Chris T. Young, Janelle Potter, Shannon Tilsworth, Jennifer Goldman, Jennifer E. Schuster, Hannah L. Kirking

Manuscripts, Articles, Book Chapters and Other Papers

Background/Objectives: Respiratory viruses circulate year-round and can spread indoors via inhalation of airborne particles. Effective ventilation and filtration may reduce transmission, particularly in school settings where children and staff spend significant time. This study examines the impact of indoor air quality (IAQ) and ventilation in schools on respiratory virus detection.

Methods: During February 27 to March 30, 2023, we assessed the relationship between IAQ and respiratory viruses in two Kansas City, Missouri, elementary schools by collecting bioaerosol samples, student and staff nasal swabs, and monitoring IAQ across 10 rooms (six classrooms, two common spaces, and two nurses’ offices). We calculated …


Gastrointestinal Infection Before Immune Checkpoint Inhibition Hinders Treatment Efficacy And Increases The Risk Of Colitis, Malek Shatila, Kian Abdul-Baki, Andres Urias Rivera, Kei Takigawa, Irene Jeong-Ah Lee, Andrew Sullivan, Tanvi Gupta, Linfeng Lu, Raakhi Menon, Ayesha Khan, Hamza Salim, Elliot Baerman, Carolina Colli Cruz, Cristina Natha, Varun Vemulapalli, Garrett Coleman, Krishnavathana Varatharajalu, Christopher Fan, Pablo Okhuysen, Anthony J Olszanski, Yan Zhou, Hao Chi Zhang, Mehnaz Shafi, Yinghong Wang Aug 2025

Gastrointestinal Infection Before Immune Checkpoint Inhibition Hinders Treatment Efficacy And Increases The Risk Of Colitis, Malek Shatila, Kian Abdul-Baki, Andres Urias Rivera, Kei Takigawa, Irene Jeong-Ah Lee, Andrew Sullivan, Tanvi Gupta, Linfeng Lu, Raakhi Menon, Ayesha Khan, Hamza Salim, Elliot Baerman, Carolina Colli Cruz, Cristina Natha, Varun Vemulapalli, Garrett Coleman, Krishnavathana Varatharajalu, Christopher Fan, Pablo Okhuysen, Anthony J Olszanski, Yan Zhou, Hao Chi Zhang, Mehnaz Shafi, Yinghong Wang

Faculty, Staff and Students Publications

Background: Gastrointestinal (GI) infections, which often result in or stem from intestinal dysbiosis, can affect the efficacy of immune checkpoint inhibitors (ICIs) and increase the risk of adverse effects, such as colitis. In this study, we explored the impact of GI infections before initiation of ICI therapy on the incidence and severity of immune-mediated colitis (IMC) and survival.

Methods: A single-center, retrospective review including all patients who received ICIs from January 2010 to February 2024 and subsequently developed IMC. Patients were screened for IMC and prior GI infections based on symptoms and stool tests. Patients' demographic, IMC, and GI infection-related …


Advanced Analytical Biosensing For Cancer Detection And Neural Diagnostics Using Tapered Optical Fiber (Tof), Protonic, And High Throughput Microplate –Based Technologie, Bayan Hassan Alharbi Aug 2025

Advanced Analytical Biosensing For Cancer Detection And Neural Diagnostics Using Tapered Optical Fiber (Tof), Protonic, And High Throughput Microplate –Based Technologie, Bayan Hassan Alharbi

Chemistry & Biochemistry Theses & Dissertations

This dissertation investigates the development and application of advanced biosensing technologies to enhance early disease detection, neurological diagnostics, and bioactive compound evaluation. The research spans four key areas. First, it introduces tapered optical fiber (TOF)-based plasmonic biosensors for the non-invasive detection of prostate cancer, demonstrating high sensitivity and specificity compared to conventional diagnostic methods.

Second, it explores the use of fluorescent biosensors to test the Transmembrane Electrostatically Localized Proton (TELP) theory, shedding light on the role of localized protons in neuronal signaling and energy transfer. Third, the work presents a high-throughput, microplate-based biosensing platform for analyzing mitochondrial function under nanosecond …


Use Of Granulocyte-Colony Stimulating Factor For Beta-Lactam Induced Neutropenia In Children With Bacterial Meningitis, Cheng Yu Yen, Sheldon L Kaplan, Debra L Palazzi, Grant Stimes Aug 2025

Use Of Granulocyte-Colony Stimulating Factor For Beta-Lactam Induced Neutropenia In Children With Bacterial Meningitis, Cheng Yu Yen, Sheldon L Kaplan, Debra L Palazzi, Grant Stimes

Faculty, Staff and Students Publications

Drug induced neutropenia is an uncommon but potentially serious side effect in children receiving prolonged β-lactam antibiotic therapy. Management of β-lactam induced neutropenia in children remains challenging and often requires antibiotic therapy interruption or modification. There are limited data in pediatric patients about use of granulocyte-colony stimulating factor (G-CSF) for the treatment of drug induced neutropenia. We report the use of G-CSF for β-lactam induced neutropenia in four pediatric patients between the ages of 3 months and 18 years with bacterial meningitis in this case series.


Visceral, Neural, And Immunotoxicity Of Per- And Polyfluoroalkyl Substances: A Mini Review, Pietro Martano, Samira Mahdi, Tong Zhou, Yasmin Barazandegan, Rebecca Iha, Hannah Do, Joel Burken, Paul Ki-Souk Nam, Qingbo Yang, Ruipu Mu Aug 2025

Visceral, Neural, And Immunotoxicity Of Per- And Polyfluoroalkyl Substances: A Mini Review, Pietro Martano, Samira Mahdi, Tong Zhou, Yasmin Barazandegan, Rebecca Iha, Hannah Do, Joel Burken, Paul Ki-Souk Nam, Qingbo Yang, Ruipu Mu

Chemistry Faculty Research & Creative Works

Per- and polyfluoroalkyl substances (PFASs) have gained significant attention due to their widespread distribution in the environment and potential adverse health effects. While ingestion, especially through contaminated drinking water, is considered the primary route of human exposure, recent research suggests that other pathways, such as inhalation and dermal absorption, also play a significant role. This review provides a concise overview of the toxicological impacts of both legacy and emerging PFASs, such as GenX and perfluoro butane sulfonic acid (PFBS), with a particular focus on their effects on the liver, kidneys, and immune and nervous systems, based on findings from recent …