Digital Commons Network^™

Synergistic Cefiderocol-Containing Antibiotic Combinations Active Against Highly Drug-Resistant Acinetobacter Baumannii Patient Isolates With Diverse Resistance Mechanisms, Justin Halim, Andrew P. Keane, Jeannete Bouzo, Tope Aderibigbe, Jessica A. Chicola, Katie T. Nolan, Keertana Jonnalagadda, Jason X. Tran, Valerie J. Carabetta

Rowan-Virtua School of Osteopathic Medicine Departmental Research

BACKGROUND: Acinetobacter baumannii is a nosocomial pathogen known for rapidly developing resistance to nearly all antibiotics, including last-line agents. Cefiderocol, a novel siderophore cephalosporin, has shown in vitro activity against A. baumannii and is now used clinically, but resistance is emerging. Data on cefiderocol-based antibiotic combinations are limited.

OBJECTIVES: To evaluate the in vitro activity of cefiderocol alone and in combination with other antibiotics against XDR and PDR A. baumannii clinical isolates, and to explore resistance mechanisms underlying cefiderocol synergy.

METHODS: We tested 21 XDR/PDR clinical isolates and one NDM-1-producing strain using broth microdilution and checkerboard assays with cefiderocol and …

Fatal Facial Necrotizing Fasciitis: A Case Report Highlighting Diagnostic And Therapeutic Challenges, Muhammad Sheraz Hameed, Syed Rafay Hussain Zaidi, Ali Iqbal, Muhammad Ahsan, Austin Mitchell, Azka Asad Mirza, Joshiah Gordon, Rahmat Gul Omarzai

Department of Medicine Faculty Papers

BACKGROUND: Facial Necrotizing Fasciitis (FNF) is a rare but aggressive, life-threatening infection involving the face's subcutaneous tissues and underlying musculature. It can rapidly progress to septic shock and multi-organ failure if not promptly recognized and treated. The clinical course, including severe pain, disproportionate tenderness, and systemic signs, is often the most crucial factor in diagnosis. While computed tomography (CT) can aid in identifying early signs such as soft tissue swelling and gas formation, clinical suspicion remains paramount and should not be delayed by reliance on imaging alone. Without early intervention, FNF may lead to devastating outcomes, including disfigurement, blindness, or …

Parents’ Perceptions Of The Influence Of Interpersonal Trauma On Children’S Academic Achievement In Low Socioeconomic Families During The Covid-19 Pandemic, Brandi Walker

Walden Dissertations and Doctoral Studies

The COVID-19 pandemic intensified the challenges faced by families from low socioeconomic (SES) backgrounds regarding their children’s academic development. Students during this time experienced disruptions in their academic development, further hindering their educational progress. The purpose of this qualitative phenomenological study was to explore parents’ perceptions of how interpersonal trauma and SES challenges impacted their elementary-age children’s academic achievement during the pandemic. Bronfenbrenner’s ecological systems theory served as the theoretical foundation, offering a framework to understand how environmental factors shaped children’s experiences and academic development. Data were gathered through semistructured interviews with eight parents from low-SES backgrounds. Content analysis of …

An Investigation Of Parental Involvement In The Safe Passage Initiative (An Anti-Violence Program), Danielle King

Electronic Theses and Dissertations

This dissertation investigates the issue of parental involvement in Safe Passage, an anti-violence initiative operating within seven Pittsburgh Public Schools. Recognizing the involvement of parents is critical for successful violence prevention, this study explores the barriers hindering meaningful participation and identifies strategies to enhance parent-school-community collaboration.

Utilizing qualitative research methods, the study captures insights from parents, educators, and community stakeholders through a reflective Journey Line activity and focus group discussion. Data collected revealed several significant barriers such as inconsistent communication, limited parental availability due to demanding work schedules, mental and emotional exhaustion, cultural disconnects, and a lack of clarity regarding …

Immunogenicity And Safety Of A Rabies-Based Highly Pathogenic Influenza A Virus H5 Vaccine In Cattle, Nir Paran, Christoph Wirblich, Catherine Olal, Alessandro Tarquinio, Kimberly H. Lohmeyer, Drishya Kurup, Stacey Schultz-Cherry, Ismaila Shittu, Gregory C. Gray, Dennis A. Bente, Pia U. Olafson, Matthias J. Schnell

Department of Microbiology and Immunology Faculty Papers

The circulation of highly pathogenic H5 influenza A viruses in cattle, other mammals, and wildlife threatens animal and human health. To address this, we vaccinated heifer-calves with a deactivated rabies-virus-based H5 vaccine, which was well-tolerated and elicited neutralizing antibodies against both clade-1 and clade-2.3.4.4b H5N1 viruses, comparable to naturally H5-infected and convalescing cows. The immune responses to the vaccine platform were durable for at least 200 days and unaffected by preexisting RABV immunity.

Improving The Timing To Antibiotic Administration In Patients That Present To The Emergency Department With Sepsis, Adriana Lott, Christina Vejnovich

Group: Nebraska Methodist College

Problem: Early identification and timely management of sepsis in the emergency department (ED) is critical to reducing morbidity and mortality. Delays in sepsis recognition and antibiotic administration can worsen outcomes. This project aimed to address these challenges. Intervention: A triage sepsis screening (TSS) tool was implemented over 30-days to improve sepsis identification at triage. Staff education related to knowledge and confidence of sepsis was also provided. Measures: The impact of a TSS tool was evaluated using pre- and post-intervention data on antibiotic timing. Staff knowledge was measured with a 4-item multiple-choice quiz, and confidence with a 5-item Likert scale, adapted …

Causes Of Symptoms And Symptom Persistence In Long Covid And Myalgic Encephalomyelitis/Chronic Fatigue Syndrome, Anthony L Komaroff, Robert Dantzer

Faculty, Staff and Student Publications

Debilitating symptoms for many years can follow acute COVID-19 ("long COVID"), myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), and various post-acute infection syndromes (PAISs). Together, long COVID and ME/CFS affect 60-400 million individuals, globally. Many similar underlying biological abnormalities have been identified in both conditions including autoantibodies against neural targets, endothelial dysfunction, acquired mitochondrial dysfunction, and a pro-inflammatory gut microbiome. Each of these abnormalities may directly cause some of the symptoms. In addition, the symptoms also may be caused by ancient, evolutionarily conserved symptomatic and metabolic responses to vital threats-sickness behavior and torpor-responses mediated by specific, recently discovered neural circuits. These neural …

Screening And Variable Selection For Analyzing Binary Outcome With Rare Events And High-Dimensional Predictors, Mohammad Nahian Ferdous Abrar

Electronic Theses and Dissertations Archive

Binary outcomes with rare events (event rate less than 5%) present significant analytical challenges, particularly in high-dimensional settings such as epigenome-wide association studies (EWAS) involving DNA methylation data. Traditional logistic regressions are often inadequate under these conditions, suffering from bias, high variance, and diminished power when the event rate is low and the number of predictors exceeds the sample size (p >> n). To address these limitations, we developed a series of novel methods that enhance sensitivity and accuracy in identifying biologically meaningful biomarkers while accounting for both event rarity and high dimensionality. We first introduce two innovative screening approaches. The …

Nurse-Initiated Improvement For Documentation Of Penicillin Adverse Drug Reactions In Pediatric Urgent Care Clinics., Elizabeth Monsees, Diane Petrie, Rana El Feghaly, Sarah Suppes, Brian R. Lee, Megan Whitt, Amanda Nedved

Manuscripts, Articles, Book Chapters and Other Papers

Background/Objective: Penicillin allergy labels (PALs) contribute to broad-spectrum antibiotic use. Thorough documentation can help prescribers identify and remove unnecessary PALs. We aimed to improve documentation of PALs in three pediatric urgent care (PUC) clinics, using a nurse-initiated quality improvement (QI) approach. Methods: QI interventions included a survey to assess prescriber and nurse confidence, an online educational module, and an algorithm to aid in clarifying PALs. We measured the percentage of PALs with a clarified reaction severity as our primary outcome using annotated control charts. Descriptive and inferential statistics evaluated survey responses between nurses and prescribers. Results: Clarified PAL reaction severity …

Changes In Self-Reported Excessive Daytime Sleepiness Are Associated With 5-Year All-Cause Mortality Risk Among Veterans, Katherine G Bay, Arash Maghsoudi, Amin Ramezani, Drew A Helmer, Amir Sharafkhaneh, Javad Razjouyan

Faculty, Staff and Students Publications

Excessive daytime sleepiness (EDS) is linked to adverse clinical outcomes. This study evaluated changes in a validated tool to assess EDS, the Epworth Sleepiness Scale (ESS) and mortality risk. This retrospective cohort study included Veterans receiving sleep-related services in the Department of Veterans Affairs (VA) from October 4, 1999 to August 18, 2018, with two qualifying ESS measures. ESS values were extracted from patient notes using a validated natural language processing (NLP) pipeline (96% accuracy). ESS scores were categorised as Normal (0-10) or Abnormal (11-24). Patients were grouped based on ESS changes: Normal-Normal, Normal-Abnormal, Abnormal-Abnormal and Abnormal-Normal. Cox proportional hazards …

The Shorthorn: October 15, 1976

The Shorthorn Newspaper Collection: 1970s

No abstract provided.

Predicting Utilization Of Mental Health Services Among Undergraduate Nursing Students On College Campuses In The Mississippi Delta, Deidra Michelle Byas

Walden Dissertations and Doctoral Studies

Over recent years, concerns about the mental health of nursing students in the Mississippi Delta have increased. However, research indicated that many nursing students do not utilize mental health services. This population has received little research attention, creating a gap in the literature and leaving counselor educators and supervisors ill-equipped to prepare counselors to meet the needs of nursing students. This quantitative study examined whether attitudes toward mental health services, social and cultural stigmas, and demographic characteristics explained the variance in nursing students’ willingness to seek help. Guided by the Theory of Planned Behavior, the study focused on three areas: …

Reconciling Harm Reduction Philosophy And Approaches Among Abstinence-Only Substance Abuse Treatment Professionals, Amy Rose Ashton-Williams

Walden Dissertations and Doctoral Studies

Historically, substance use disorder (SUD) treatment in the United States has been firmly grounded in abstinence-only treatment approaches. Harm reduction as a treatment model has gained additional traction. With increased rates of opioid use, overdoses, and advancements in medications for SUDs, harm reduction treatment approaches are becoming more important to improve lives of people who use drugs. Little is known about how counselors who have been educated, trained, and deliver abstinence-based SUD treatment reconcile use of harm reduction into their practice. To address this gap in literature, a generic qualitative study was conducted using the social constructivism theory. A purposive …

Spatial Patterns In Electronic Health Record Data-Based Predictive Modeling: A Case Study Of Prenatal Care And Preeclampsia, Abigail Lewis

McKelvey School of Engineering Graduate Student Theses & Dissertations

The electronic health record (EHR) documents interactions between patients and healthcare systems and is widely used for secondary research on health outcomes due to broad adoption. While EHR data support efficient clinical informatics research, they are subject to biases stemming from healthcare seeking behavior, health system attributes, and individual or environmental characteristics. Place-based characteristics, in particular, strongly influence when and how patients access care and shape health outcomes. These biases in EHR data can affect predictive modeling pipelines which leverage them, contributing to variation in model performance across groups. In healthcare, where predictive models are increasingly used to guide care, …

Faster, Higher, Stronger: Modern Methodologies For The Calibration, Exploration, And Utilization Of Agent-Based Models, David O'Gara

McKelvey School of Engineering Graduate Student Theses & Dissertations

Increases in computing power and availability have led to the widespread use and adoption of agent-based models (ABMs) in the physical, biological, and social sciences. At their core, ABMs represent a novel paradigm for scientific inquiry: their micro-level specification allows for the simulation of the individual components of a system which yields a deeper understanding of dynamic processes such as contagion and adaptive decision-making when used appropriately. However, several hurdles exist when attempting to use ABMs to their full potential. In this thesis, we will explore and address several challenges in designing and utilizing ABMs, with a focus on applying …

Molecular Survey Of Leptospira Spp. And Bartonella Spp. In Alaskan Voles, Tabitha Page

Biological Sciences

Leptospira spp. and Bartonella spp. are two Gram-negative bacterial genera responsible for important zoonotic diseases worldwide, yet they remain poorly studied in northern ecosystems. Out objective was to assess Bartonella and Leptospira prevalence in vole populations in Interior Alaska and examine potential associations between prevalence and human activities (landscape and resource modification from sled dog kennels and reindeer farms). I surveyed for Bartonella and Leptospira in three vole species, Clethrionomys rutilis, Microtus pennsylvanicus, and Alexandronomys oeconomus, collected from three different areas in Interior Alaska in the summer of 2024. Using conventional PCR, I targeted the 16S rRNA gene for Leptospira …

Computational Studies On The Major Antioxidant Enzymes Of Wuchereria Bancrofti Towards The Development Of Anti Filarial Leads, Sureshan M

Theses and Dissertations

Lymphatic filariasis (LF), or elephantiasis, is a mosquito-borne parasitic disease affecting the lymphatic system, primarily in tropical and subtropical regions. It is the second leading cause of long-term disability and a neglected tropical disease. According to WHO, LF threatens 882 million people in 44 countries, with over 9 billion treatments administered. The disease is caused by three nematodes: Wuchereria bancrofti (90% of cases worldwide, including India), Brugia malayi (10% in Southeast and Eastern Asia), and Brugia timori (found in Timor and nearby islands). Lymphatic filariasis (LF) is an ancient disease that continues to challenge scientists and physicians. Current treatments include …

Fabrication Of Protein-Based Nanomicelle Against Inflamed Synoviocytes In Rheumatoid Arthritis, Madhumithra Thangadurai

Theses and Dissertations

Rheumatoid arthritis (RA) is a chronic autoimmune disease marked by persistent synovial inflammation, progressive cartilage and bone destruction, and systemic complications. 1% of the global population are affected by RA, when their immune system targets synovial tissues, leading to joint pain, swelling, and functional disability. Standard treatments, such as disease-modifying antirheumatic drugs (DMARDs) like methotrexate (MTX), are limited by systemic toxicity and inconsistent patient responses, highlighting the need for improved therapies. This research work explores protein-glycosaminoglycan nanomicelles engineered using Zein with Chondroitin or carboxymethylated Dextran Sulfate as targeted drug delivery vehicles for RA.

MTX was encapsulated within these nanomicelles to …

Bridging Scales In Epidemic Modeling From Individuals To Networks And Ecosystems, Saiprasasd Vr

Theses and Dissertations

Epidemics have shaped the trajectory of human history, repeatedly exposing vulnerabilities in healthcare systems and influencing socio-economic dynamics on a global scale. The COVID-19 pandemic, in particular, underscored the pressing need for flexible and responsive modeling framework capable of adapting to dynamic and evolving epidemic scenarios. Motivated by these challenges, this thesis explores the development of innovative epidemic models that integrate classical mathematical modeling techniques, network-based frameworks, and modern data-driven approaches. Each chapter addresses a distinct dimension of epidemic spread, from vaccination dynamics and community coupling to ecological complexity and adaptive human behavior, culminating in a model-free paradigm suitable for …

Genomic Surveillance Of Indian Klebsiella Pneumoniae And Exploration Of Resistance Inhibitors, Abhirami Ks Ms

Theses and Dissertations

Klebsiella pneumoniae is an important ESKAPE pathogen that causes life threatening infections. The strains exhibiting multidrug-resistance (MDR) and hypervirulence are the priority pathogens for which immediate treatment and dissemination prevention strategies are required. To address this, genome profiling was performed to understand the AMR patterns, role of episomes, phages, virulence determinants and its association with sequence types.

The study includes 267 publicly available Indian K. pneumoniae genomes over a period of ten years and four sequenced isolates. Whole genome analysis revealed the widespread presence of diverse β-lactamase genes, with β-lactam resistance being predominant. Genes such as blaCTX-M-15, blaTEM-1B and blaOXA-232 …

Pneumonia And Hypokalemia Outcomes Investigated In A Rural, Midwestern Population, Mason P. Penske, Claire E. Reagen, Amanda M. Sonnenburg, Megan A. Unrath, Scott A. Andelin, Nova Beyersdorfer, Kerry D. Johnson, John D. Paulson

Student Publications

Background

Pneumonia is a broad term encompassing lung infections with varying causes, presentations, and prognoses. The objective of this study was to determine if the presence of hypokalemia in subjects admitted to the hospital for pneumonia was associated with an increased mortality rate compared to subjects admitted with pneumonia without hypokalemia. Finding comorbidities associated with worse outcomes in subjects with pneumonia could improve treatment and subsequently improve morbidity and mortality rates.

Methods

This retrospective study used data from the Freeman Health System (FHS) electronic medical record in Joplin and Neosho, MO, from January 1, 2019, to December 31, 2021. Hospital …

Differential Interferon Synthesis And Signaling Between Parainfluenza Virus Acute And Persistently Infected Cells, Vonisha Kaigler

Graduate Thesis and Dissertation post-2024

RNA virus infections can transition from an initial acute infection to a prolonged or persistent infection, in which infected cells survive and continue to produce progeny virus. This presents a major clinical problem as persistently infected (PI) cells extend viral shedding, maintain inflammation, and provide potential sources for new viral variants. The RNA virus, Parainfluenza virus 5 (PIV5), with mutations in the P/V gene region (P/V mutant) is a strong inducer of antiviral responses. Interestingly, over time, there is an emergence of cells that survive as P/V mutant PI cells. Given that changes in innate immune signaling pathways can occur …

Management Of Critically Ill Patients Following Earthquake Disasters, Esat Kivanç Kaya, Burçi̇n Halaçli, Mehmet Yildirim, Arzu Topeli̇

Turkish Journal of Medical Sciences

The devastating earthquakes that struck southeastern Turkiye on February 6, 2023, emphasized the profound societal and healthcare challenges posed by natural disasters. These events highlighted the essential need for healthcare professionals to be well-prepared and equipped with the expertise to manage such crises effectively. Earthquake-induced trauma presents a wide array of medical and surgical complications, frequently requiring urgent hospitalization and specialized management for critically ill patients. However, the limited availability of comprehensive data and evidence-based guidelines complicates optimal care delivery in these scenarios. This review outlines current recommendations for the multidisciplinary management of critically ill patients with earthquake-related trauma. It …

Detection And Quantification Of Microplastics In Cerumen, Bengi̇ Arslan, Yüce İslamoğlu, Ali̇ Sami̇ Berçi̇n, Selen Akbulut, Mehmet Meli̇koğlu

Turkish Journal of Medical Sciences

Background/aim: Microplastics (MPs) are a growing concern due to their pervasive environmental presence and potential environmental and human exposure impacts. Given evidence of systemic MP presence in human tissues and fluids, and the ear canal's environmental exposure, this novel study aimed to identify these particles in human cerumen. Cerumen was collected from the proximal ear canal to minimize potential airborne contamination.

Materials and methods: Cerumen samples were prospectively collected from 12 adult patients (23 patient-derived specimens) and 3 control water samples, following ethical approval and consent. Samples were extracted using sterile instruments, stored in glass, diluted, and filtered through 0.22 …

Metabolic And Genotypic Characterization Of Meropenem Susceptible And Resistant Serratia Marcescens Isolates, Şeyma Ni̇gi̇z, Gülşen Hazirolan, Gülşen Altinkanat Gelmez, Ceren Özkul Koçak, Engi̇n Koçak, Sevi̇lay Erdoğan Kablan, Emi̇rhan Nemutlu, Aycan Gündoğdu, Fatma Bayrakdar, Ufuk Hasdemi̇r, Deni̇z Gür

Turkish Journal of Medical Sciences

Background/aim: Serratia marcescens which is a nosocomial pathogen, is naturally resistant to a wide spectrum of antibiotics, which makes the management of infections difficult. The aim of this study was to determine the in vitro susceptibilities of S. marcescens to ceftriaxone, ceftazidime, meropenem, amikacin, gentamicin, ciprofloxacin, and to compare the metabolic profiles of meropenemresistant isolates under basal conditions and after exposure to sublethal concentrations of meropenem.

Materials and methods: A total of 84 S. marcescens isolates were included from various samples. Genes for meropenem resistance were determined by polymerase chain reaction (PCR). Genetic similarities among isolates of S. marcescens were …

The Association Of Adult Medicaid Beneficiaries’ Characteristics And Their Experience During The Covid-19 Pandemic, Frank R. Tortorella

Dissertations and Theses (Open Access)

Background: The COVID-19 pandemic disrupted the United States’ safety net program, Medicaid, for low-income individuals affecting access to care, increasing enrollment, and requiring new approaches to care delivery. The literature shows that beneficiaries’ personal characteristics influence their healthcare experience. This study investigated the association between Medicaid beneficiary characteristics and experience with their Medicaid health plan, examined if COVID-19 negatively impacted experience, and tested if COVID-19 moderated the relationship between beneficiary characteristics and experience.

Methods: The research sample was 76,976 adult Medicaid beneficiaries who voluntarily completed the annual Consumer Assessment of Healthcare Providers and Systems (CAHPS) health plan surveys in 2018 …

The Association Between The Social Determinants Of Health And Shared Decision Making: An Investigation Of The National Survey Of Children's Health, Vernon T. Headley

Graduate Thesis and Dissertation post-2024

Objective: Shared decision-making (SDM) is defined as a clinical approach that allows both physicians and patients to communicate on the best treatment options that will improve the patient's overall health outcomes. Shared decision-making plays a vital role in how parents engage with their physicians regarding the healthcare needs of their children. This dissertation assessed the association between the social determinants of health and shared decision-making regarding children’s health-related issues.

Methods: The data for the current research were the National Survey of Children’s Health (NSCH), combined 2017-2020. The dependent variable was shared decision-making and included discussing treatment options, raising concerns regarding …

Hot Spring Associated Infectious Diseases In The Great Basin And Southwest, Matthew Bentz

UNLV Theses, Dissertations, Professional Papers, and Capstones

Like all bodies of freshwater, natural hot springs can harbor pathogenic microorganisms that carry the threat of infectious disease. The unique chemistry, increased temperature, and popularity for bathing may alter the risk profile of hot springs compared to other natural bodies of water. Despite this risk, the role of hot springs as a reservoir for infectious diseases remains understudied, particularly within the context of regional public health. Nevada and the Great Basin/Southwest have increasingly promoted hot springs for the purposes of tourism, and they share a strong link to the cultural heritage of the region. The unknown risk profile and …

Role Of Stabilin-1 Expressing Macrophages In Colorectal Liver Metastasis, Jampa L. Gurung

Theses & Dissertations

Colorectal cancer (CRC) is the 2nd most common cause of cancer-related mortality, primarily due to its spread to distant organs. Colorectal liver metastasis (CRLM) is the foremost form of CRC spread due to the anatomical link between the liver and intestine. Despite advancements in diagnostic tools and adjuvant therapies, the survival rate of CRLM remains low, indicating the significant need to identify targetable mechanisms. Stabilin-1 (STAB1), a scavenger receptor expressed on tumor-associated macrophages, has been linked to tumorigenesis and poor outcomes in various cancers. However, the role of STAB1 in CRLM is not known. Here, we investigated the role of …

Challenges And Opportunities In Medical Tourism, Nizar Zein

Visions in Leisure and Business

Medical tourism is a rapidly expanding industry, with an increasing number of patients traveling abroad for medical treatments and procedures. This trend is expected to continue as the industry evolves to meet shifting patient demands and preferences. People are motivated to seek healthcare outside their home countries for various reasons, such as access to advanced technology, faster treatment, higher quality care, or more affordable options available in the destination country. Patients today are more informed and selective about their healthcare choices. They seek not only cost-effective treatments but also high-quality care and an exceptional patient experience. The future of medical …