Digital Commons Network^™

Gastrointestinal Ebv In Immunosuppressed Hosts: A Case Of Ptld After Kidney Transplant, Mary Moussa, Baylen Shoemaker, Vikas Sethi, Alvin Boyd Newman-Caro, Rakhee Shah, Patricia Chun, Michael Schulman

West Florida Division GME Research Day 2026

No abstract provided.

Using Maximum Entropy (Maxent) Tool In Arcgis Pro For Species Distribution Modelling Of Pseudoscorpions In The Pacific Northwest, Elliot Toshihiro Cochran

Masters in GIS Practicum Reports

The use of Geographic Information Systems (GIS) to create Species Distribution Models (SDMs) is rising among many scientific disciplines. Many professionals who were not originally focused on GIS are increasingly becoming more invested in this technology. SDMs are widely used to estimate species’ potential geographic distributions and to evaluate the environmental factors that constrain their ranges. The presence-only maximum entropy (MaxEnt) algorithm implemented in the MaxEnt tool in ArcGIS Pro was used in this project to model habitat suitability for two species of pseudoscorpions, M. pacificus and an undescribed species, in Oregon and Washington. Presence points (of specimen sample locations) …

Tick Lipocalin Triggers Mammalian Igfbp-3-Mediated Apoptosis In Macrophages And Keratinocytes, Krittika Nandy, P. P. Mahesh, Lichao Liu, Daniel E. Sonenshine, Hameeda Sultana, Girish Neelakanta

Biological Sciences Faculty Publications

Ticks secrete several molecules, including lipocalins, in their saliva during blood feeding on a vertebrate host. In this study, we provide novel evidence on the role of Ornithodoros turicata americanus tick lipocalin (Otlip) in modulating cytokine expression and in triggering apoptosis in mammalian macrophages and keratinocytes. The cytokine array analysis revealed significantly increased secretion of insulin-like growth factor-binding protein 3 (IGFBP3) from murine macrophage cell line upon treatment with recombinant Otlip protein (rGST-Otlip) when compared to the secretion noted from cells treated with a control protein (rGST). Similar observation with cytokine protein array analysis was noted when murine macrophages were …

Altered Natural Killer Cell Function In Children With Severe Malaria, Grace Turyasingura, Kagan A. Mellencamp, Ruth Namazzi, Robert Opoka, Chandy C. John, Geoffrey T. Hart

Paediatrics and Child Health, East Africa

Memory-like natural killer (NK) cells with enhanced antibody-dependent cellular cytotoxicity (ADCC) have correlated with protection from uncomplicated malaria in prior studies. However, the role of NK cells in severe malaria (SM) has not been characterized. In Ugandan sites with moderate and low malaria transmission, we evaluated NK cell (CD56bright, CD56dim, CD56neg) phenotype and ADCC function by flow cytometry in children < 5 years of age with SM (n = 21) and control community children (CC, n = 19). Children with SM had similar total NK cell counts to CC. Children with SM had a higher proportion of LILRB1+ NK cells than CC. The level of malaria transmission …

The Placenta & Covid-19: Histological Changes & Clinical Implications, Melissa F. Paul, Allyson J. Zadlo Sensor

All Electronic Theses and Dissertations

Introduction: The COVID-19 pandemic presented the medical community with complex and novel challenges, not the least of which is how to optimize prenatal and postnatal care for pregnant individuals who have been infected. At present, seven years have elapsed, and despite definitive research demonstrating adverse outcomes associated with placental changes, no professional consensus has been reached.
Methods: This integrative review includes studies involving pregnant individuals with confirmed SARS-CoV-2 infection, who recovered during the same pregnancy, and their infants. An examination of the data available reveals a triad of placental pathologies (chronic histiocytic intervillositis, perivillous fibrin deposition, and trophoblast necrosis) that …

Clinical And Demographic Characteristics Of Participants In A Hepatitis C Treatment Trial In Rural Kentucky: How Policies Around Treatment Access May Impact Elimination Efforts In The United States, Jennifer R. Havens, Brittney D. Williams, Takako Schaninger, Virginia A. Shepherd-Tackett, Michelle R. Lofwall, Michele Staton, Sharon L. Walsh, Hannah K. Knudsen

Behavioral Science Faculty Publications

Introduction: The advent of curative direct acting antiviral (DAA) drugs to treat those actively infected with the hepatitis C virus (HCV) has allowed for discussion around HCV elimination. Restrictive state-by-state policies for the coverage of DAAs for Medicaid recipients may hamper elimination efforts in the United States by limiting access to these curative treatments. Methods: The purpose of the current analysis was to examine the sociodemographic, drug use and clinical characteristics of participants in the Kentucky Viral Hepatitis C Treatment (KeY Treat) study in the context of Medicaid policies in the United States. The goal of KeY Treat was to …

Acceptability And Appropriateness Of Harm Reduction Vending Machines Compared To Syringe Service Programs In Appalachian Kentucky, Hannah K. Knudsen, Jennifer R. Havens, April M. Young

Behavioral Science Faculty Publications

Objective:

Many rural people who inject drugs do not use syringe service programs (SSPs). In addition, people who use drugs but do not inject may perceive that SSPs are not intended for their use. Harm reduction vending machines (HRVMs) may be preferred by some individuals. This study examines attitudes and preferences regarding HRVMs to consider possibilities for enhancing the reach of harm reduction services. Method:

Structured surveys were conducted with 712 people who use drugs in two rural Appalachian counties in Kentucky. Participants rated the acceptability/appropriateness of SSPs and HRVMs; HRVM preference was the difference between the two scales. Linear …

Frequent Police Contact And Nonfatal Overdose Among People Who Use Drugs In Rural Appalachia, Javier A. Cepeda, Talia Loeb, Zach R. Salazar, Brittney D. Williams, Brooke Hiltz, Brandon Del Pozo, Eileen V. Pitpitan, Leo Beletsky, April M. Young, Jennifer R. Havens

Behavioral Science Faculty Publications

Introduction: Police contact shapes subsequent health practices and outcomes among people who use drugs (PWUD). However, the relationship between police encounters with overdose remains under-researched. We evaluated how police stop-and-search was associated with nonfatal overdose and identified correlates of frequent police contact among PWUD in rural Kentucky.

Methods: From May 2023– April 2024, 774 PWUD were enrolled in the Social Networks of Appalachian People and KyOSK studies. The exposure of interest was self-reported police stop-and-search in the past 6 months (0, 1–3, ≥4 times). The primary outcome was self-reported nonfatal overdose in the past 6 months. We evaluated the association …

Exploring The Link Between Soil Microbes, And Land Use Through A One Health Lens, Yaw A. Antwi

Master's Theses or Doctor of Nursing Practice

The diversity of microbes within the soil plays an essential role in soil ecosystem

functioning. However, these microbes may also serve as environmental reservoirs for antibiotic resistance genes. The study examined the diversity of bacteria that are found in soil across Rural/Agricultural and Rural/Nonagricultural landscapes within some selected counties in Kansas and its associated antibiotic resistance genes taxa. A total of twenty-four soil samples was collected and analyzed using 16S rRNA gene amplicon sequencing which targeted the V3-V4 regions. Statistical analysis revealed that the alpha diversity metrics (Chao1 richness and Shannon evenness) showed no significant difference in microbial structure (p=0.693, …

The Role Of Tumor Microenvironment In Glioblastoma Multiforme(Gbm) Therapeutic Resistance, Kwesi E. Taylor

Master's Theses or Doctor of Nursing Practice

Despite significant advances in cancer research and treatment, Glioblastoma multiforme (GBM) remains one of the most difficult cancers to treat effectively, with minimal improvement in long-term survival rates over the past few decades. This is largely attributed to tumor heterogeneity and the ability of tumor cells to develop adaptive resistance mechanisms supported by the tumor microenvironment (TME). Although the TME is recognized as a key contributor to tumor progression and therapeutic resistance, the underlying molecular pathways and regulatory genes remain incompletely understood. This study investigated the role of the tumor microenvironment in GBM therapeutic resistance using a bioinformatics approach. Single-cell …

Implementation Of A Reminder/Recall Messaging Program In Kentucky, Laura Schwarz

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Childhood vaccination remains a critical public health priority, yet measles, mumps, and rubella (MMR) vaccination rates in several rural Kentucky counties fall below the 95% threshold required for herd immunity. Recent declines in coverage, compounded by socioeconomic disparities and barriers to healthcare access, place children at increased risk for vaccine-preventable diseases and outbreaks. This capstone project proposes the implementation of an evidence-based reminder/recall (R/R) text messaging intervention utilizing the Kentucky Immunization Registry (KYIR) to improve timely MMR vaccination among children aged 4–6 years before kindergarten entry.

The proposed program targets thirteen Kentucky counties with vaccination rates below 70% and documented …

Bayesian Multivariate Modelling Of Lone Star (Amblyomma Americanum) Tick Life Stage Abundance And Temporal Trends To Inform Public Health Risk In Virginia, Thabo Lephoto, Henry Mwambi, Oliver Bodhlyera, Holly Gaff

Biological Sciences Faculty Publications

The increasing abundance of ticks poses a growing public health concern due to heightened human exposure to tick bites. The lone star tick (Amblyomma americanum: Ixodida: Ixodidae), a common human-biting species in the United States, has expanded its range in recent years. However, how its different life stages vary across time, habitats, and locations remains insufficiently understood. We analyzed tick abundance data collected in southeastern Virginia between 2009 and 2018, focusing on larval, nymphal, and adult life stages. A Bayesian multivariate modelling framework was used to examine seasonal patterns, habitat effects, spatial variation, and biological links between life stages. Two …

Evolutionary Genetics Of Wolbachia Density Variation And Effects On Host Fitness, John Paul Statz

Graduate Student Theses, Dissertations, & Professional Papers

Symbiotic interactions are widespread across the tree of life, and many insects associate with vertically transmitted intracellular bacteria whose fitness is tied to host reproduction. Because these endosymbionts transmit through the maternal line, selection often favors traits that increase the production and success of transmitting females. Over time, endosymbionts can evolve functions such as nutrient provisioning, defense against predators and pathogens, and contributions to environmental stress tolerance, thereby shaping host ecology and evolution. Yet these effects depend critically on the abundance and localization of endosymbionts within host tissues. This dissertation examines these processes in Wolbachia, the most common known animal …

Fusion, 2026, George Washington University, William H. Beaumont Medical Research Honor Society

Fusion

No abstract provided.

Characteristics Of Pulmonary Vs. Extrapulmonary Tuberculosis Cases In Kentucky From 2020 To 2024, Mariam M. Alkhairat

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Objective: Tuberculosis (TB) remains an important public health concern in the United States, especially among people experiencing social and clinical vulnerabilities. Extrapulmonary TB, which occurs outside of the lungs, can be harder to detect and diagnose than pulmonary TB. This study aimed to describe the demographic and clinical characteristics of people with active TB in Kentucky and to identify factors associated with extrapulmonary TB.

Methods: Secondary surveillance data were obtained from the Kentucky Department for Public Health (KDPH) using the National Tuberculosis Surveillance System (NTSS). The study sample included 301 confirmed active TB cases reported in Kentucky. Descriptive statistics were …

Overbreadth In Medical Practice Acts: A Threat To Preventive Speech, Barbara Zabawa

Faculty Works

Many Americans consult unlicensed wellness coaches for scientifically-valid advice on diet, exercise, and lifestyle interventions. Yet state medical practice acts and ambiguous government line drawing between wellness and medical care chill the speech of these coaches as it relates to disease prevention, even though conventional medicine systematically fails to deliver the speech-heavy preventive care consumers need and want. This Article argues that medical practice acts, particularly the sixteen state statutes that include "prevention" in their definition of medical practice, are constitutionally overbroad restrictions on protected speech. Despite judicial and scholarly assumptions to the contrary, not all those working in wellness …

Variable Infections But No Evidence Of Immune Priming In Bumble Bee Hosts Against Novel Exposure To A Honey Bee Virus, Austin C. Calhoun, Ben M. Sadd

Faculty Publications – Biological Sciences

Ongoing global change presents novel challenges to species persistence, including heightened emerging infectious disease (EID) exposure. While invertebrates lack vertebrate acquired immunity, many species exhibit “immune priming” with enhanced protection to repeated pathogen exposures. This phenomenon could be critical for species of conservation concern, such as for wild bumble bees, where EID risk is amplified through contact with managed bee pollinators. We investigate the potential for immune priming against the honey bee-derived Israeli Acute Paralysis Virus (IAPV) in Bombus impatiens bumble bees. We test the hypothesis that prior pathogen-associated exposure affords greater resistance and tolerance upon secondary pathogen exposure, due …

Granulomatous Cellular Signatures In Nontuberculous And Tuberculous Mycobacterial Infections, Brianna M. Doratt, Ethan G. Napier, Mahdi Eskandarian Boroujeni, Sarah Douglas, Michael H. Davies, Luiz Bermudez, Eliot Spindel, Erin F. Mccaffrey, Ilhem Messaoudi

Microbiology, Immunology, and Molecular Genetics Faculty Publications

Mycobacterium tuberculosis (Mtb) and nontuberculous mycobacteria (NTM) are acid-fast bacilli that trigger granuloma formation, a hallmark immune response aimed at containing infection. While the biology of Mtb granulomas has been widely investigated, far less is known about granulomas caused by NTM infection, despite the increasing prevalence and clinical challenge of NTM cases worldwide. Because granulomas influence infection control, pathology, and treatment response, understanding their cellular organization and signaling is critical to improving therapeutic strategies. Therefore, we characterized granulomas formed following infection of rhesus macaques with Mycobacterium avium subsp. hominissuis (MAH) and compared them to granulomas from cynomolgus macaques infected with …

Glycoprotein-Specific Transcriptional Response Contributes To Differential Vaccine Protection Against Lethal Ebola Virus Infection, Sheridan B. Wagner, Delphine C. Malherbe, Ethan G. Napier, Andrea Marzi, Ilhem Messaoudi

Microbiology, Immunology, and Molecular Genetics Faculty Publications

Since the West African Ebola virus (EBOV) epidemic in 2014-2016, recurrent outbreaks of the EBOV-Makona variant have been driven by recrudescence and human-to-human transmission emphasizing the need for effective vaccination strategies. A live-attenuated recombinant vesicular stomatitis virus (VSV)-based vaccine expressing the EBOV-Kikwit variant glycoprotein (VSV-Kik) received FDA approval in December 2019 and provides complete, rapid protection against EBOV-Makona as early as 7 days post-vaccination (DPV). During the 2018-2020 Ebola outbreak, the VSV-Kik vaccine, known as ERVEBO, was administered to lower-risk individuals at a 5-fold dose reduction of the standard 2 × 10 ⁷ PFU to provide broader population protection. Identification …

Community Place Attachment As A Significant Correlate Of Motivation To Change Substance Use Behavior Among Adults Who Inject Drugs In Rural U.S., Janet K. Otachi, Shawndaya S. Thrasher, Keith J. Watts, Juma S. Mwenda, Hilary L. Surratt

Social Work Faculty Publications

Introduction: While motivation is critical for substance use disorder (SUD) recovery, many individuals fail to engage in treatment. The need to belong is a fundamental human motivation, yet the role of community place attachment (CPA) as a social asset in fostering motivation to change substance use behaviors (MCSUB) among people who inject drugs (PWID) is understudied. This paper examines the effect of CPA on PWIDs’ MCSUB.

Methodology: Cross-sectional data were collected from 350 PWID recruited from syringe service programs in rural Appalachian Kentucky (2018–2021). We used hierarchical multivariable linear regression to assess the association between CPA and MCSUB, controlling for …

Hepatitis C Virus Transmission Among People Who Inject Drugs In Rural United States: Mathematical Modeling Study Using Stochastic Agent-Based Network Simulation, Lin Zhu, Jennifer R. Havens, Abby E. Rudolph, April M. Young, Golnaz Eftekhari Yazdi, William W. Thompson, Liesl M. Hagan, Liisa M. Randall, Jianing Wang, Rebecca Earnest, Shayla Nolen, Benjamin P. Linas, Joshua A. Salomon

Center on Drug and Alcohol Research Faculty Publications

People who inject drugs (PWID) account for the majority of hepatitis C virus (HCV) infections in the United States. The injection-equipment-sharing network likely plays an important role in shaping the dynamics of HCV transmission. Recognizing the emerging HCV epidemic in rural communities, we developed an agent-based network simulation model of HCV transmission via injection equipment sharing and used data on rural PWID networks to inform model parameterization and calibration. We then simulated an array of networks that varied key network properties to understand their impact on the magnitude and distribution of HCV incidence. The results show substantial heterogeneity in HCV …

Methylenetetrahydrofolate Reductase (Mthfr) Polymorphisms And Neural Tube Defects In African Populations: A Global Meta-Analysis And Population Genetic Characterization In Uganda, Nana Ekua Entsiwa Adenu-Mensah

Yale Medicine Thesis Digital Library

Background: Neural tube defects (NTDs) affect 1.9 per 1,000 births globally, with the highest burden occurring in African populations that remain underrepresented in genetic epidemiology. The methylenetetrahydrofolate reductase (MTHFR) C677T and A1298C polymorphisms reduce enzyme activity and have been associated with increased NTD risk in several populations, though their relevance across African regions remains unclear.

Methods: We conducted: (1) an updated systematic review and meta-analysis of MTHFR C677T and A1298C polymorphisms and NTD risk (66 studies, ~22,000 participants); (2) population-level genotype characterization of 978 Ugandan children using whole-genome sequencing; and (3), a comparative analysis of MTHFR C677T allele frequencies across …

Starting Strong: Improving Mmr Vaccination Rates In Kindergartners, Regina Bryan

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Abstract

Introduction

During the 2023–2024 academic year, measles, mumps, and rubella (MMR) vaccination coverage among kindergarten students in this school district did not meet the Healthy People 2030 target, thereby elevating the risk of disease outbreaks. This quality improvement project aimed to improve MMR vaccination initiation and completion through coordinated, school-based interventions.

Methods

Guided by the Plan-Do-Study-Act framework, an eight-week immunization bundle was implemented across 14 elementary schools in South Texas. Interventions included reminder calls, multilingual education, districtwide communication, and a partnership with a nonprofit clinic that provides free or reduced-cost vaccines through on-site and community clinics. Pre- and post-intervention …

A Questionnaire Assessing Attitudes And Readiness For Hiv Pre-Exposure Prophylaxis Therapy For Community Members At-Risk For Hiv Acquisition In Liberia, Yishak Bedaso

Yale Medicine Thesis Digital Library

AbstractA Questionnaire Assessing Attitudes And Readiness For HIV Pre-Exposure Prophylaxis Therapy For Community Members At-Risk For HIV Acquisition In Liberia Yishak Bedaso;1 Jessica Tuan, MD, MS;2 Yassah M. Barclay-Korboi;3 Onyema Ogbuagu MBBCh, FACP, FIDSA4 Affiliation: 1. Yale School of Medicine, New Haven, CT, USA 2. Columbia University Vagelos College of Physicians and Surgeons, Department of Infectious Diseases, New York, NY, USA 3. JFK Memorial Hospital, Monrovia, Liberia. 4.Yale Antivirals & Vaccines Research Program, Section of Infectious Diseases, Yale School of Medicine, New Haven, CT, USA; Despite how effective Pre-exposure prophylaxis (PrEP) is in preventing HIV, uptake among women in sub-Saharan …

A Machine Learning Tool For Predicting End-Stage Renal Disease Within One-Year Of Heart Transplantation, Cole Tetsuo Cassady

Yale Medicine Thesis Digital Library

End-stage renal disease (ESRD) after heart transplantation is a common complicationwhich increases risk of mortality. Simultaneous heart-kidney transplantation (SHKT) lowers this risk. Eligibility for SHKT relies on pre-transplant estimated glomerular filtration rate (eGFR) with ongoing discussion regarding optimal eligibility guidelines. We present an eXtreme Gradient Boosting Decision Tree (XGBoost) machine learning model for predicting ESRD within one year of heart transplant procedure in candidates ineligible for kidney-alone transplantation. The model was trained using readily available elements from pre-transplant evaluation and performed with an area under the receiver operating characteristic curve (AUROC) of 0.71. The model discrimination was statistically significantly better …

Prevalence Of K13 Mutant Malaria Parasites In Busia, Uganda, Ahmed Elzamzami

Yale Medicine Thesis Digital Library

Artemisinin derivatives form the backbone of all antimalarial combination therapies usedworld-wide. Resistance to this critical drug class is a growing problem in the highest malaria transmission regions of the world. First detected in southeast Asia, independent mutations conferring partial resistance to artemisinin’s have now emerged in East Africa.27, 32 Retrospectively, these mutations have been detected as early as 2016 in Uganda.36 Previous work by the Parikh lab highlights the efficacy of 3-day vs 5-day artemether-lumefantrine treatment regimen for uncomplicated malarial episodes in Busia, Uganda in 2019.41 Infections were followed and classified as recrudescent, a reinfection, SBP1 slow clearing, or an …

Tone Matters: Advancing Equity Through A Pilot Intervention To Increase Exposure Of Clinical Findings In Skin Of Color, Lamley Amanuah Lawson

Yale Medicine Thesis Digital Library

Background: The ability to accurately recognize cutaneous manifestations of disease is a foundational clinical skill. However, current undergraduate medical education heavily relies on lighter skin tone prototypes, leaving trainees underprepared to diagnose conditions in patients with melanin-rich skin.Research Aims: This study aimed to evaluate the efficacy of a brief, targeted, visually comparative digital intervention by measuring its impact on medical students' immediate diagnostic accuracy and self-reported clinical confidence in identifying dermatologic conditions across a diverse range of skin tones. Hypothesis: We hypothesized that a brief, targeted digital educational intervention featuring side-by-side visual comparisons of dermatologic conditions across a range of …

The Rhesus Macaque Model Of Mycobacterium Avium Infection Reveals That Age-Related Disease Is Due In Part To Chronic Inflammation And Lung Microbial Dysbiosis, Ethan G. Napier

Theses and Dissertations--Microbiology, Immunology, and Molecular Genetics

Aging is associated with dysregulated immunity and increased susceptibility to infection, a phenomenon dubbed as immunosenescence and characterized by reduced naïve T and B cell pools, altered innate immune function, and chronic low-grade inflammation. Nontuberculous mycobacterial (NTM) pulmonary disease (NTMPD) is an increasingly relevant chronic lung infection that disproportionately affects older adults (65+ years) and immunocompromised individuals. However, the host factors underlying increased disease severity in aged patients remain poorly defined. Literature suggests that effective control of NTM relies on coordinated innate and adaptive immune responses, particularly macrophage activation and Th1 cytokine signaling. Using a rhesus macaque model that closely …

A Framework For Characterizing The Peripheral Immune Isonome Using Long-Read Single-Cell Rna Sequencing And Its Relevance To Neurological Disease, Patricia Hayes Doyle

Theses and Dissertations--Neuroscience

Long-read single-cell RNA sequencing provides an opportunity to understand human health and disease at isoform resolution, revealing cellular diversity and disease mechanisms difficult to resolve with bulk or short-read methodologies.

Using a modified PIPseq workflow and computational pipeline adapted for Oxford Nanopore (ONT) sequencing, we profiled isoform usage across immune cells, integrating marker expression and isoform discovery, generating the largest long-read single-cell dataset of human immune cells from a single individual to date. We identified non-canonical protein-coding variants of GZMB and CD3G enriched in unexpected cell types. We also discovered novel transcripts from CMC1 and LYAR with cell-type-specific signatures that …

Environmental Predictors Of Human Lyme Disease Incidence Across Appalachian Counties In Kentucky, Virginia, And West Virginia, 2000-2019, Karlie D. Rennison

Theses and Dissertations--Epidemiology and Biostatistics

This ecological study examined county-level environmental, landscape, and host-related predictors of Lyme disease incidence across Kentucky, Virginia, and West Virginia from 2000-2019. Lyme disease is an emerging public health concern in the Appalachian region, where geographic expansion and shifting ecological conditions may influence disease risk.

Lyme disease case rates (per 10,000 population) were analyzed in relation to climate variables, land cover metrics, host density measures, and rurality using publicly available data sources. Descriptive and regression analyses were conducted to evaluate associations between candidate predictors and disease incidence.

Substantial geographic variation in Lyme disease incidence was observed, with higher case rates …