Digital Commons Network^™

Optimisation Of Sampling For A New Skin Microbiome Assay Pilot Study, Anita Smith

Theses

Recent interest in the diverse ecosystem of bacteria, fungi and viruses that make up the skin microbiome has led to numerous studies investigating the microbiome in healthy skin and in dermatological diseases. An imbalance of the normal skin microbial flora can cause some skin diseases, and current culture techniques are often unable to detect a microorganism to further our understanding of the clinical–microbiological correlates of disease and dysbiosis. Atopic dermatitis and rosacea are presentations that General practitioners (GPs) often manage that may have an infective or microbiological component and can be challenging to treat. Further research using culture-independent techniques is …

When Therapy Becomes The Trigger: An Antibiotic With A Twist, Hinal Rathi, Roshini Raghu, Parekha Yedla

UAB Huntsville Research Day - All Presentations

2026 clinical vignette poster

Evaluating The Alt-70 Model For Cellulitis Management In The Emergency Department, Marshall Hall, Paige Loux, Henry Lim, Jeffrey Durbin, Garrett Furth, Olivia Gruver, Christina Guo, Dustin Wilkes, Michael Carletti, Stephen E. Weis

North Texas GME Research Forum 2026

Background: Cellulitis is a common skin infection that classically presents with unilateral lower extremity erythema, swelling, and pain. The diagnosis is made clinically. Many conditions may mimic cellulitis that are collectively referred to as “pseudocellulitis.” These include stasis dermatitis, deep vein thrombosis, atopic dermatitis, psoriasis, and gout. The Alt-70 model is a validated clinical prediction tool for differentiating cellulitis from pseudocellulitis. It is unclear if it is utilized or if it has changed clinical practice in the emergency department setting.

Methods: This was a retrospective chart review study utilizing the HCA Healthcare Data Warehouse. The Alt-70 model was applied using …

The Impact Of A Social Wellness Intervention On The Perception Of Social Support Among Working Adults, Jannysse Gray

DNP Research Projects

Abstract 

Objective: Social isolation and loneliness have detrimental effects on physical and mental health. For working adults, these experiences may impact work attendance, performance, satisfaction, and retention, leading to burnout, fatigue, grief, and disengagement. Barriers to developing and nurturing healthy relationships, such as competing work and family responsibilities, or a lack of resources or energy, can contribute to this problem; therefore, this group was chosen for the intervention. This project aimed to raise awareness of the importance of social connections and to analyze whether an online educational intervention was associated with improved perceptions of social support among working adults. Methods: …

Implementing Hepatitis C Screening And Treatment In Primary Care, Michele Castellano Wetmore

Yale School of Nursing Digital Theses

AbstractHepatitis C (HCV) is a curable hepatic disease. With direct-acting antivirals, it can be treated in 95% of cases. When left untreated, it can cause severe liver disease, including hepatocellular carcinoma and even death. The World Health Organization’s (WHO) goal is to eliminate HCV by 2030. This Quality Improvement (QI) project, conducted at a Federally Qualified Health Center (FQHC) from 8/4/2025 to 11/4/2025, will address the barriers to elimination and show that providing local services closes gaps. Screening and treating HCV within primary care has become a strategic approach to enhance access to treatment. This involves developing and utilizing a …

Nanoparticle Carriers Enhance The Prophylactic Antiviral Effects Of Dsrna In Vitro And Ex Vivo, Shayne Oberhoffner, Stephanie Dewitte-Orr, Starla Richardson, Leah Haile, Dominique Daniels, Erin Cooper, Aizah Ijaz, Janet Velasquez Perez, Mathilde Peruzzi, Bertrand Collet, Paul Craig, Kristof Jenik

Theses and Dissertations (Comprehensive)

Aquaculture now outpaces traditional capture fisheries as the world population and demand for sustainable protein sources increases. Wild and farmed species are increasingly susceptible to pathogen spread as global temperatures rise and stocking densities increase. Despite the devastating losses experienced by aquaculture due to viral infections, there remain few effective prophylactic antiviral therapeutics. Long double-stranded (ds)RNA is a uniquely viral molecule produced by nearly all viruses during their replication cycle, and its detection by salmonids like rainbow trout (Oncorhynchus mykiss) and chinook salmon (Oncorhynchus tshawytsha) leads to the establishment of a defensive antiviral state. Previous in vitro studies demonstrated a …

Envisioning The Role Of Community-Owned Stores & Aligning Federal Food Policies: A Participatory Approach To Food Security And Food Sovereignty In Sambaa K’E, Denendeh (Northwest Territories, Canada), Narayan Subramoniam

Theses and Dissertations (Comprehensive)

Northern Indigenous communities have relied on traditional food systems for meaningful, nutritious diets since time immemorial. But many Indigenous communities in remote northern regions of Canada still face disproportionately elevated levels of food insecurity due to climate change radically altering the availability for traditional foods, colonial food policies imposing Western diets, and the high costs of transporting store-bought foods. Extreme weather events such as wildfires further isolate fly-in remote communities increasing both the costs of transporting store-bought foods and the difficulties of harvesting traditional foods. There are many examples of community-based initiatives for supporting traditional and locally grown foods, however, …

Investigating The Immunostimulatory Potential Of Dsrna-Silk Nanoparticle Complexes In Melanoma, Samuel J. Peters

Theses and Dissertations (Comprehensive)

The rate of resistance to immune checkpoint inhibitor treatment in metastatic melanoma is quite high, with an overall rate of 70%. Melanoma achieves these high rates of resistance by suppressing the immune response in the tumour microenvironment (TME), making them immunologically “cold”. The type 1 interferon response could be leveraged to initiate immune responses in melanoma, making their “cold” TMEs “warm” again. Double-stranded ribonucleic acids (dsRNAs) are potent activators of an innate immune response; however, they are susceptible to degradation by nucleases present in the body and need a carrier. Silk nanoparticles (SNPs) are an ideal drug-delivery platform as they …

Searching For Cause Of Unexplained Protein Interaction With Multiple Assembly Methods, Gavin Anderson

Master's Projects

Research into colistin adjuvants has identified interactions between a host of proteins and proteins found within certain strains of bacteria. BLAST, a widely adopted local sequence alignment tool, was used to create a database containing the genomes of relevant bacterial strains, which would then be used to query against the previously identified proteins. Many of these strains do not have publicly available assemblies, which makes database construction difficult. CATwalk, a new naïve fragment extender, is first described in this paper and used to extend fragments of interest. BLAST results first identified short fragments with sufficient similarity, which can then be …

Ovarian Cancer Immunology And Immunotherapy: Editorial Note, Chris D. Platsoucas

Biological Sciences Faculty Publications

[Introduction] As the guest editor of the Special Issue on Ovarian Cancer Immunology Immunotherapy, I would like to include certain brief comments on the current state of the field and to introduce the Special Issue. Ovarian carcinoma and malignant melanoma are the first human tumors where immune responses, primarily restricted to autologous tumor cells, were first demonstrated. T-cell lines and clones developed in recombinant interleukin-2 (rIL-2) from tumor-infiltrating lymphocytes (TIL) from these tumors exhibited cytotoxicity and/or cytokine production, primarily restricted to autologous tumor cells. The T-cell receptor (TCR) and the CD3 differentiation antigen on effector T cells and HLA on …

Impact Of Sepsis Order Set Optimization On Sep-1 Compliance And Clinical Outcomes: A Retrospective Data Analysis, Janelle Harding

West Chester University Graduate Theses, Dissertations, and Final Projects

Sepsis remains a leading cause of mortality, morbidity, and healthcare expenditure in the United States, with national SEP-1 compliance rates persistently near 60%. This quality improvement project evaluated whether optimizing sepsis order sets within a large, urban, Magnet-designated hospital improved adherence to the CMS SEP-1 quality measure and associated patient outcomes. Guided by the Donabedian Model, a multidisciplinary sepsis workgroup redesigned emergency department and inpatient sepsis order sets to streamline evidence-based care, enhance workflow alignment, and reduce variation in treatment. A retrospective analysis of 158 adult SEP-1 cases, with 67 cases in the preintervention group and 91 cases in the …

Molecular Detection Of Campylobacter Spp. In Filth Flies Associated With Broiler Breeder Facilities In Oklahoma And Arkansas, Allen Szalanski

Entomology and Plant Pathology Faculty Publications and Presentations

Adult filth flies (Diptera: Muscidae) (non-biting flies that develop in decaying organic matter) are abundant in poultry facilities and may contribute to the dissemination of pathogenic Campylobacter spp. among flocks. We sampled adult house flies, Musca domestica L., and black dump flies, Hydrotaea aenescens (Wiedemann), at five broiler-breeder farms in Oklahoma and Arkansas to determine the prevalence of Campylobacter spp. vectored by filth flies and the effects of farm, fly species, and location (inside vs outside houses) on the rates of Campylobacter spp. occurrence. A total of 1,076 house flies and 1,008 black dump flies were collected inside and outside …

Evaluating The Implementation And Use Of A Standardized Screening Process To Increase Flu Vaccine Uptake In A Rural Health Primary Care Clinic, Mackenzie L. Pierce

DNP Projects

Background: Research has shown that an annual influenza vaccine is the most effective way to both prevent and reduce the risk of hospitalization and severe health complications of the flu. A yearly influenza vaccination is recommended for everyone age 6 moths and older.

Local Problem: Rural communities have lower rates of influenza vaccination which can be due in part to a lack of screening and education on vaccines and their importance. No process for influenza vaccine status screening existed at the project site prior to this project.

Methods: A quality-improvement project was conducted to evaluate the implementation of a standardized …

Improving Compliance With Preoperative Antibiotic Protocols For Cardiac Implanted Electronic Devices: A Quality Improvement Project, James Kaup

DNP Projects

Abstract

Background

Cardiac implantable electronic device infections remain a serious complication of permanent pacemaker implantation despite evidence-based infection prevention guidelines.

Local Problem

An academic electrophysiology laboratory identified inconsistent guideline-concordant antibiotic selection despite consistently high compliance with recommended antibiotic timing.

Methods

A nurse-led, quasi-experimental pre-post quality improvement project evaluated implementation of a standardized preoperative antibiotic prophylaxis protocol. Data from 36 permanent pacemaker implantations (16 pre-intervention, 20 postintervention) were analyzed.

Interventions

The intervention included a standardized antibiotic protocol, multidisciplinary staff education, and performance feedback.

Results

Guideline-concordant antibiotic selection improved from 37.5% to 95.0% (χ² = 11.27, P = .001). Antibiotic timing remained …

Going Green: Can We Save Teeth And The Planet?, Stuart Segelnick Dds, Ms

The New York State Dental Journal

You might not think you have a role to play in combatting climate change, but dentists can make a difference by reducing plastics in their offices.

Development Of An Adhesive Emulsion Hydrogel For Soft Tissue Reconstruction, David J. Alpert

Dissertations and Theses

Soft tissue filling materials are most commonly associated with various aesthetic, cosmetic procedures, primarily using lightly cross-linked hyaluronic acid to fill wrinkles and give facial features a more youthful appearance. These natural materials are biocompatible but degrade over time while more persistent synthetic fillers may provoke a chronic inflammatory response. Migration from the injection site is also a key factor as this may not only render the implant non- functional but necessitate further procedures for removal of the foreign material. Such concerns are more pronounced for soft tissue reconstruction procedures (e.g., to treat congenital defects or traumatic injuries), which require …

Predicting Healthcare-Seeking For Childhood Diarrhea Across Low- And Middle-Income Countries, Madi Baltagulov

Public Health Theses

Healthcare-seeking behavior (HSB) for childhood diarrhea is a central but persistently uncertain input for rotavirus burden models and vaccine cost-effectiveness analyses. Demographic and Health Surveys (DHS) provide the only nationally representative measurements, yet they are expensive and absent from the majority of low- and middle-income countries (LMICs). This thesis asks whether publicly available country-level indicators can substitute for DHS data when survey estimates are unavailable.Using the most recent DHS conducted between 2011 and 2024 in 51 LMICs (78,008 children under five with diarrhea), I fit a multilevel modified Poisson regression and a two-stage random-effects meta-regression with four World Bank moderators: …

Stigma, Coping & Resilience Among Hiv+ Pwid In St. Petersburg, Rf, Gabrielle Bogut

Public Health Theses

Russia and the other countries that comprised the Soviet Union constitute the one region in which the HIV epidemic continues to expand. Unlike most other regions, more than a quarter of HIV cases in Russia resulted from unsafe injection among people who inject drugs (PWID), and St. Petersburg is among the cities with the highest rates and case counts of HIV. Our study sought to identify actionable psychosocial characteristics influencing receipt of antiretroviral therapy (ART) in PWID. This study assessed survey results from 225 HIV-positive individuals recruited from a Russian NGO that provides PWID with harm reduction services. Individuals were …

Scaling Up Long-Acting Hiv Prep: Perspectives From Health Practitioners On Implementation Of Twice Yearly Lenacapavir, Taylor Braunstein

Public Health Theses

BackgroundLenacapavir (LEN), a twice-yearly subcutaneous injectable Pre-Exposure Prophylaxis (PrEP) medication for HIV, was approved by the Food and Drug Administration (FDA) in 2025. LEN represents a significant advancement in HIV prevention, demonstrating 99.96-100% efficacy in the PURPOSE 1 and 2 clinical trials12,21. Despite its promise in HIV prevention, high list prices, complex loading regimens, and implementation uncertainties pose barriers to widespread uptake. This study examines provider perspectives on the acceptability, feasibility, and appropriateness of LEN as PrEP, as well as perceived implementation barriers and facilitators. Methods This mixed-methods, cross-sectional study recruited licensed US practitioners (RNs, NPs, PAs, MDs, DOs, and …

Clostridioides Difficile Infection Trends And Treatment Concordance With Idsa/Shea Guidelines In The Connecticut Emerging Infections Program Catchment Area, 2011-2024, Rachael Hopkins

Public Health Theses

Background: Clostridioides difficile infection (CDI) is a gastrointestinal infection causing colon inflammation, diarrhea, and potential life-threatening complications. In 2021, treatment guidelines for CDI were updated by the Infectious Diseases Society of America (IDSA) and the Society for Healthcare Epidemiology of America (SHEA). This study analyzed Connecticut Emerging Infections Program (EIP) data to assess CDI incidence trends (2011-2024) and evaluate physician concordance with 2021 guidelines for incident cases (2022-2024). Methods: The Connecticut EIP conducted CDI surveillance in New Haven County (2011-2023) and South Central and Naugatuck planning regions (2024). Incidence rates were calculated using census data. Concordance was defined as treatment …

Cost-Effectiveness Analysis Of Twice-Yearly Injectable Lenacapavir Versus Daily Oral Prep For Hiv Prevention Among Men Who Have Sex With Men In China, Xueqing Guo

Public Health Theses

Men who have sex with men (MSM) remain a key at-risk population in China’s HIV epidemic while the real-world effectiveness of daily oral pre-exposure prophylaxis (PrEP) among MSM has been limited by low uptake and suboptimal drug adherence. Lenacapavir, a first-in-class capsid inhibitor administered twice yearly, emerged as a highly efficacious, long-acting prevention strategy with the potential to reduce drug burdens associated with current PrEP strategy. However, its high price ($28,000 per patient per year) raises major affordability concerns, and its economic value in China remains understudied. This study aimed to evaluate the cost-effectiveness of lenacapavir compared with daily oral …

Using The Behavior Change Wheel To Understand The Role Of Antimicrobial Stewardship Programs, Siqi Jiang

Public Health Theses

Objectives: This review aimed to summarize recent antimicrobial stewardship programs (ASPs) implemented in pediatric outpatient settings and analyze how these interventions influence appropriate antibiotic use.Methods: PubMed and Scopus were searched for studies published between 2016 and 2026 globally. Studies were included if they evaluated an antimicrobial stewardship intervention in a pediatric outpatient setting. Only English studies are included. Studies that describe the results of implementations and policies related to ASP are included, including randomized controlled trials, quasi-experiments, natural experiments, quality improvement studies and observational studies, and longitudinal studies. Interventions in selected articles were analyzed using the COM-B (Capability, Opportunity, Motivation-Behavior) …

Kinetics Of Antibody Responses To Hookworm Excretory/Secretory Products In A Hamster Model Of Infection And Cure, Jacquelyn Kauffman

Public Health Theses

Hookworms are a major global health burden in resource-limited settings despite ongoing control programs. This makes understanding host immune responses to infection and treatment critical to improve diagnostics and interventions. This study investigates the long-term kinetics of antibody responses following infection with Ancylostoma ceylanicum in a hamster model. Over a one-year study, groups of six hamsters were assigned to uninfected, infected, or infected then treated groups, with antibody responses measured using ELISAs. All infected animals had elevated IgG, IgM, and IgA responses by day 21 post infection. Mebendazole-treated hamsters had significantly reduced, but not eliminated, antibody levels, with IgM responses …

Nowcasting Dengue Cases In Poor Surveillance Nations Using Meteorology And Climate-Similar Countries, Hanna Kim

Public Health Theses

Dengue fever poses a growing public health burden across the Caribbean, yet surveillance infrastructure remains inconsistent and timely outbreak detection in data-poor nations becomes limited. This study investigates whether shared meteorological patterns between Caribbean countries can be leveraged to nowcast dengue activity in low-surveillance settings using climate-matched, well-surveilled nations as epidemiological proxies. Weekly and monthly dengue case data for six countries, the Dominican Republic, Jamaica, Puerto Rico, Trinidad and Tobago, Cuba, and Haiti, were extracted from the OpenDengue database for 2005–2024, and satellite-derived climate data were obtained from the NASA POWER API. Pairwise climate correlations revealed strong temperature synchrony across …

Pediatric Rheumatic Heart Disease Screening For Secondary Antibiotic Prophylaxis: An Explainable Shannon Energy Approach Using Heart Phonocardiogram In Northeast Brazil, Zhuohui Lin

Public Health Theses

Rheumatic Heart Disease (RHD), caused by Group A Streptococcus (GAS), remains a significant global health burden, particularly among children in low- and middle-income countries. Untreated GAS infection can lead to acute rheumatic fever and subsequent chronic valvular damage of RHD, such as mitral valve (MV) regurgitation. Hence, early detection is critical for the administration of Secondary Antibiotic Prophylaxis to prevent disease progression. Although deep learning models demonstrate high diagnostic accuracy, limited explainability restricts clinical adoption, especially in resource-limited settings. In this proof-of-concept study, we evaluated Shannon energy (SE) transformation as a proxy to differentiate holosystolic murmurs associated with RHD-related mitral …

Climate, Land Use, And Lyme Disease Risk In The United States, Mohan Li

Public Health Theses

Lyme disease is the most common vector-borne bacterial infection in the United States. It remains an important public health concern due to its high disease burden, expanding geographic distribution, and complex transmission cycle. Climate change is frequently regarded as a driver of Lyme disease emergence, as many previous studies suggested. However, ongoing debate about the magnitude and mechanisms of climate effects complicates the interpretation of this relationship. This review synthesizes evidence on how climate influences Lyme disease through both direct and indirect pathways, with a focus on studies relevant to the United States and North America.Climate directly affects Lyme disease …

Characterization Of Tick Exoproteins Interacting With Anaplasma Phagocytophilum, Yilei Qin

Public Health Theses

Anaplasma phagocytophilum (Ap) is an Ixodes-transmitted obligate intracellular bacterium thatinfects neutrophils and causes human granulocytic anaplasmosis. Ap alternates between an infectious dense-cored (DC) form and a replicative reticulate cell (RC) form, and successful transmission depends on coordinated interactions at the vector–pathogen interface. Tick extracellular and secreted proteins (the tick exoproteome) likely contribute to Ap survival and transmission, yet many proposed tick factors remain computationally annotated with limited experimental validation. In this thesis, I prioritize candidate tick exoproteins, identified from yeast- display screens using whole Ap organisms, and evaluate them using a two-step validation strategy. First, I quantify tissue-specific expression of …

Invasive Pneumococcal Disease: Outcomes And Vaccine Effectiveness By Risk Profiles Among A Pediatric Cohort From 2002 – 2025, Keyner Rojas

Public Health Theses

AbstractBackground: Invasive pneumococcal disease (IPD) remains a significant cause of morbidity and mortality among children globally, despite the widespread use of protein conjugate vaccines (PCVs). While the introduction and implementation of these vaccines have drastically reduced the incidence of vaccine-type invasive disease, shifts in circulating serotypes raise concerns of serotype replacement. Methods: This study is a retrospective observational study of pediatric IPD cases in Massachusetts from 2002 – 2025. Over the course of these 23 years, the Massachusetts Department of Public Health has operated an enhanced population-based, statewide surveillance system for IPD. Isolates of Streptococcus pneumoniae from normally sterile sites …

Vibriosis In Connecticut: Case Trends And Seasonality, 1997–2024, Lisa Michelle Stutzman

Public Health Theses

Vibrio bacteria species, including V. vulnificus and V. parahaemolyticus, cause vibriosis, which can present as gastrointestinal illnesses, wound infections, or septicemia. In the United States the geographical range of these infections is growing, with the northward expansion of Vibrio along the Atlantic coast highlights the importance of understanding trends in vibriosis in Connecticut. This analysis is based on surveillance data from the Connecticut Emerging Infections Program from January 1, 1997–December 31, 2024. Analyses were restricted to culture-confirmed cases to ensure consistent case definitions and conducted on data aggregated to the state level. Descriptive statistics were used to characterize trends in …

Effectiveness Of The Release Of Wmel Wolbachia-Infected Aedes Aegypti Mosquitoes On The Incidence Of Chikungunya In Campo Grande, Brazil, Vivienne Zhong Ying Su

Public Health Theses

Chikungunya is a mosquito-borne arboviral disease primarily transmitted by Aedes aegypti and Aedes albopictus that is rapidly emerging in new geographical settings because of climate change, viral adaptation, and globalization. Brazil has experienced the significant expansion of chikungunya over the past decade and has adopted novel vector control interventions, including Wolbachia-based population replacement, as part of its public health response. While the effectiveness of wMel Wolbachia on dengue incidence has been demonstrated across multiple settings, evidence on its effect on chikungunya risk remains limited. Large-scale releases of wMel-infected Aedes aegypti mosquitoes were implemented in the city of Campo Grande, Brazil …