Digital Commons Network^™

Development And Applications Of Fluorescence Microscopy Protocol To Investigate Borrelia Burgdorferi Immune Interactions In The Skin, Rebecca V. Landry

Electronic Theses & Dissertations (2024 - present)

The skin is an immunological organ that acts as the hosts’ first line of defense against infectious agents. Infectious disease vectors like ticks breach this barrier by feeding on hosts, transmitting pathogens like Borrelia burgdorferi in the process. Uncleared infection with B. burgdorferi causes Lyme disease, the most prevalent vector-borne disease in the United States. Previous research has explained many elements of Lyme disease pathogenesis and immunity including the dissemination of the spirochete, innate immune cells performing phagocytosis, the production of antibodies by the humoral response, and the impact of prophylactic treatment with monoclonal antibodies. A remaining gap in the …

Hepatitis C Among Persons Who Inject Drugs In New York State: Progress Towards Elimination, Meredith A. Barranco

Electronic Theses & Dissertations (2024 - present)

Background: Hepatitis C virus (HCV) infection is one of the leading causes of liver disease in the United States (US) and worldwide. In the United States today, HCV is transmitted primarily through injection drug use (IDU) and therefore disproportionately impacts persons who inject drugs (PWID), a population with a range of complex social and health needs. HCV is not vaccine-preventable but can be cured in over 90% of cases with an 8–12-week course of daily direct-acting antiviral (DAA) medication. Since approval of curative medications in 2014, various jurisdictions have developed plans to eliminate HCV. In 2021, the New York State …

Population Genomics And Evolution Of Pseudomonas Aeruginosa, Samara T. Choudhury

Electronic Theses & Dissertations (2024 - present)

Pseudomonas aeruginosa is a Gram-negative bacterium ubiquitous in diverse environments and an opportunistic pathogen in humans. It is a leading cause of chronic lung infections in cystic fibrosis patients and of hospital-acquired pneumonia and sepsis. With a large flexible genome and abundant mobile genetic elements, P. aeruginosa exhibits high levels of antimicrobial resistance (AMR), making it a significant public health threat. Evolutionary processes such as homologous recombination, and horizontal gene transfer generate extensive genomic diversity in this species and facilitate the spread of resistance genes. In this dissertation, I investigate the genetic and evolutionary factors shaping P. aeruginosa population structure …

After The Aid Boom: Government Responses To The Global Health Agenda And Political Commitment In Low- And Middle-Income Countries, Sana Abdelkarim

Electronic Theses & Dissertations (2024 - present)

How do governments respond to the global health agenda? Does external health assistance translate to sustained domestic political commitment in low- and middle-income countries? Over the past three decades, development assistance for health has expanded, accompanied by international agreements emphasizing country ownership, alignment, and domestic resource mobilization. Yet domestic fiscal commitment to health remains uneven across countries. These questions have become more pressing as the global aid landscape enters a period of contraction, with a significant decline in development assistance, including health financing, raising concerns about the sustainability of health systems that have become reliant on external support.  This raises …

Time Series Decomposition And Forecasting Of Alzheimer’S Disease Mortality Using A Kolmogorov-Zurbenko Filter, Jack D. Farrell

Electronic Theses & Dissertations (2024 - present)

Alzheimer’s disease mortality has substantially risen in recent history, placing a significant burden on public health infrastructure and highlighting the need for improved analytical methods to better understand mortality data patterns and offer reliable predictions. Time series methods often struggle to balance both accuracy and interpretability, which hinders the ability to gather meaningful insights from time series data. To address these limitations, this study applies the Kolmogorov-Zurbenko (KZ) filter to monthly U.S. Alzheimer’s mortality data spanning from 1999 to 2023 and decomposes the series into long-term trend, seasonal, and noise components on a logarithmic scale. Long-term trend accounts for 86.49% …

Imagining Genomics And Population Health In 2050: Anticipating Future Research, Policy, And Governance Needs, Bartha Maria Knoppers, Yann Joly, Ma Apos N H Zawati, Habiba Alsafar, Jeffrey C Barrett, Laura Blackburn, Brian Hon-Yin Chung, Martina C Cornel, Edward S Dove, David Glazer, Calvin Wai-Loon Ho, Muin J Khoury, Anna C F Lewis, Anneke Lucassen, Peter F R Mills, Colin Mitchell, Nicola Mulder, Ainsley J Newson, Anthony Ng, Paul D P Pharoah, Vasiliki Rahimzadeh, Megan C Roberts, Saskia C Sanderson, Jeffrey M Skopek, Ron Zimmern, Eric M Meslin

Center for Medical Ethics and Health Policy Staff Publications

No abstract provided.

Social Science Contributions To The Global Action Plan On Antimicrobial Resistance Management, Mathieu Poirier, Jaskeerat Singh, Isaac Weldon, Clare I. R. Chandler, Daniela Corno, Laura Valtere, Pedro Henrique D Batista, Daniel Carelli, Geneviève Boily-Larouche, Sonia Lewycka, Fiona Emdin, Kathleen Liddell, Timo Minssen, Ilaria Natali, Susan Nayiga, Iruka N. Okeke, Emmanuel Olamijuwon, Kevin Outterson, Julianne Piper, Kayla Strong, Jarnail Singh Thakur, Kednapa Thavorn, Maarten Van Der Heijden, A. M. Viens, Mary Wiktorowicz, Steven J. Hoffman

Faculty Scholarship

Social science research on antimicrobial resistance has gained traction in the last decade, employing a diverse set of theoretical perspectives to better understand topics ranging from antimicrobial stewardship to political coordination.4 As the action plan commitments will be updated in 2026, an opportunity exists to employ a broader social science scope to accelerate national antimicrobial resistance interventions.

In January 2025, the Global strategy lab convened leading antimicrobial resistance social scientists from a variety of disciplines to determine which new ways of understanding antimicrobial resistance could catalyse and incentivize action. Three conceptions stood out as important to revisions of the action …

Putting The L In Elsi: Legal Methods For Bioethics Research, Anya E R Prince, Benjamin Berkman, Donald Ford, Dov Fox, Christi Guerrini, Amy Koopmann, Natalie Ram, Jessica L Roberts, Kayte Spector-Bagdady, Sonia Suter

Center for Medical Ethics and Health Policy Staff Publications

Lawyers and law professors are increasingly involved in interdisciplinary scientific teams and grant research to answer ethical, legal and policy questions related to biomedical topics. Yet, the methods that lawyers use to conduct legal research and analysis are not always familiar to scientists and social scientists conducting peer review of a proposed project with legal aims or a publication reporting a legal study. To better facilitate interdisciplinary ethical, legal, and social implications collaboration, there is a need to better explain how legal research methodologies can provide robust tools to address a range of nuanced biomedical questions. This paper explores …

Functional Analysis Of Genes Enriched In Male Reproductive Organs: Validation Via Fertility Assessment Of 14 Knockout Mouse Lines, Kazumasa Takemoto, Katarzyna Kent, Kaori Nozawa, Shingo Tonai, Ahn H Pham, Terumi Fujimoto, Thomas X Garcia, Martin M Matzuk, Masahito Ikawa, Keizo Tokuhiro

Faculty, Staff and Students Publications

Tissue-restricted gene expression serves as a key indicator of functional importance within specific organs. Despite advances in high-throughput sequencing and genome editing over the past decade, this principle remains the gold standard for identifying candidate genes for functional studies. In reproductive biology, testis-restricted expression is anticipated to indicate genes crucial for gametogenesis, given the conserved features shared between spermatogenesis and oogenesis. Concurrently, rapid evolution of spermatogenesis-related genes is well documented and thought to arise through duplication and subsequent mutation of ubiquitously expressed genes. In this study, we established 14 knockout (KO) mouse lines for male reproductive organ-enriched genes, all of …

Pd-L1-Centric Whole Blood-Based Immune Signature Profiles Of Tuberculosis Patients During Therapy, Johanna Eggeling, Martina Sester, Christoph Lange, Jan Heyckendorf, Barbara Kalsdorf, Anna M Mandalakas, Andrew R Dinardo, David Lewinsohn, Dagmar Schaub, Tina Schmidt, Eva Tolosa, Maja Reimann, Patricia M Sánchez Carballo

Faculty, Staff and Students Publications

This prospective study investigated whole blood-based immune cell biomarkers for pulmonary tuberculosis (TB) immunoprofiling. Blood samples from 34 healthy controls and 51 tuberculosis patients were analyzed at three timepoints: Prior to therapy (T0), after 14 days of therapy (T1), and at the end of treatment (Te). Using multiparameter flow cytometry, 386 immune cell populations were analyzed. Predictive models were developed using two machine learning algorithms. A TB5LF change score, which was based on five cell populations, effectively distinguished tuberculosis patients from controls (AUC = 0.89) and tuberculosis patients before and at the end of treatment (AUC = 0.92). Similarly, the …

Long Covid And Cardiovascular Diseases Among U.S. Adults: Results From The U.S. Medical Expenditure Panel Survey, Geoffrey Y Zhang, John C Lin, Dang Nguyen, Sameed Ahmed M Khatana, Thomas P Giordano

Faculty, Staff and Students Publications

Objective: Long COVID is associated with persistent symptoms including cardiovascular complications; however, the epidemiology and directionality of this association remain unclear.

Methods: Utilizing a retrospective cohort study design with cross-sectional analyses, 8,332 respondents aged 18 and older from the 2022 Medical Expenditure Panel Survey (MEPS) who had a prior COVID-19 infection, were analyzed to determine the temporal association between long COVID and cardiovascular disease (CVD), modeling each as both outcome and exposure in separate analyses.

Results: Long COVID was associated with any CVD diagnosis (OR 1.37; 95% CI: 1.05-1.80), specifically angina (OR 1.81; 95% CI: 1.18-2.77) and myocardial infarction (OR …

Non-Congenital Hsv-1 Keratitis In An Immunocompetent 9-Month-Old Infant, Caleb A Casanova, Stephanie Trejo Corona, Stephen F Pflugfelder

Faculty, Staff and Students Publications

Isolated, non-congenital herpes simplex virus type 1 (HSV-1) keratitis in immunocompetent infants is exceedingly rare and may be easily misdiagnosed, leading to delays in appropriate antiviral therapy. This case is unique in that it describes HSV-1 keratitis in a healthy 9-month-old infant presenting without systemic illness, initially treated as bacterial conjunctivitis. The patient presented with unilateral eye pain, redness, and corneal opacification. Subsequent evaluation revealed HSV-1 keratitis, and the patient was treated with intravenous acyclovir in combination with topical moxifloxacin and topical ganciclovir, resulting in complete resolution of symptoms within one week. This case adds to the limited literature on …

Updates In Mycobacterial Keratitis Diagnosis And Treatment, Uma L Balakrishnan, Ryan T Wallace, Patricia Chévez-Barrios, Alejandro Arboleda, Masih U Ahmed

Faculty, Staff and Students Publications

Mycobacterial keratitis is an uncommon but challenging form of infectious keratitis, often associated with postsurgical eyes. Clinical presentation is variable and may be difficult to recognize, resulting in delays in diagnosis and challenges in management. Traditional diagnostic techniques from corneal scrapings are limited by slow organism growth and may yield negative results. Treatment is challenging due to antimicrobial resistance and typically requires prolonged multidrug therapy. Advances in diagnostic modalities, antimicrobial therapies, surgical approaches, and adjunctive treatments such as corneal crosslinking have improved clinicians' ability to mitigate or avoid severe visual consequences. Despite these developments, optimal management strategies remain incompletely defined, …

Professionalism In Practice: A Novel Approach To Integrating Small Doses Of Case-Based Professionalism Education Into Monthly Grand Rounds., Allison H Taylor, Andrew Caruso, Kelley Arredondo, Ellen M Friedman, Stacey R Rose

Faculty, Staff and Students Publications

Introduction: Professionalism is a critical construct across the health professions, though learners and faculty report feeling underprepared to navigate difficult situations; education in professionalism is challenged by the absence of a universal definition, time constraints due to overcrowded curricula, and the lack of consistent messaging to learners and faculty.

Methods: Professionalism in Practice (PiP) was developed to provide small doses (∼5 minutes) of case-based professionalism education as part of an existing educational forum (Grand Rounds) to optimize attendance of both learners and faculty. Each vignette highlighted a common professionalism challenge and was aligned with an AAMC professional competency. Sessions were …

Clinical Factors And Diagnoses Associated With Inappropriate Urine Culture Ordering In Primary Care, Marissa Valentine-King, Barbara W Trautner, Michael A Hansen, Roger Zoorob, Lisa C K Danek, Kenneth Muldrew, Forrest Hudson, Robert L Atmar, Larissa Grigoryan

Faculty, Staff and Students Publications

Objective: Evaluate the prevalence and risk factors for inappropriately ordered urine cultures in primary care.

Design: Cross-sectional study using chart reviews.

Setting: Two primary care, safety-net clinics in Houston, Texas.

Patients: Non-pregnant adults without a urinary catheter who had a urine culture and a primary care visit between 11/2018 and 3/2020.

Methods: We classified patients lacking physician documentation of the following symptoms as having an inappropriately ordered urine culture: dysuria, frequency, urgency, hematuria, fever, chills, costovertebral angle tenderness, nephrolithiasis, and pain (suprapubic, pelvic, or flank). We extracted patient demographics, visit-related diagnostic codes, past medical history, and urine culture results. Diagnostic …

Retrenchment, Segregation, And Public Education: A Five-Year Analysis Of State Exclusionary School Discipline Legislation, Thalia Gonzalez, Will Martel

Faculty Scholarship

Notwithstanding the decision in Brown v. Board of Education formally ending educational segregation and more than two decades of state reform, the legislative landscape protecting minoritized children from the structural violence of exclusionary school discipline has dramatically shifted in less than five years. From the passage of state “Teacher’s Bills of Rights” to mandatory expulsions, rescissions of prior protections, and new categories of removal, a retrenchment of anti-inclusion legislation—and its corollary, educational carcerality— has occurred. While studies of other forms of legislative retrenchment in K–12 public schools, such as anti-Critical Race Theory and Don’t Say Gay laws, literacy bans, and …

Use Of A Medication Management Algorithm In Depressed Youth Living With Hiv: Secondary Analysis Of A Multisite Randomized Controlled Trial, Graham J Emslie, Beth D Kennard, Kristin Baltrusaitis, Sophia M Jones, Jessica M Jones, Jaime G Deville, Kathleen Pitts, David E Shapiro, Allison Eliscu, Larry K Brown

Faculty, Staff and Students Publications

Objectives: Depression is a prevalent co-occurring condition in youth living with HIV. This report is a secondary analysis of a multisite cluster randomized trial evaluating the efficacy of a health and wellness cognitive behavioral therapy (CBT) combined with a medication management algorithm utilizing measure-based care (COMB-R) compared with enhanced standard of care (ESC). We describe and compare antidepressant prescribing strategies (i.e., antidepressant treatment, type of antidepressant) for youth living with HIV at COMB-R sites to those at ESC sites over the 24-week intervention. We also describe self-reported adherence to antidepressants.

Methods: Participants (12-24 years) were youth living with HIV diagnosed …

Hybrid Sars-Cov-2 Immunity Among Frontline Workers In A High-Tourism Setting: A Community-Based Serosurvey In Ambergris Caye, Belize, June 2022, Oluwadara Okeremi, Ella Hawes, Anh N Ly, Russell Manzanero, Sarah M Gunter, Shannon E Ronca, Allison Lino, Allyson Hidalgo, Meghan Si, Allison Stewart-Ruano, Adriana Maliga, Eric J Nilles, Gerhaldine Morazan, Kristy O Murray

Faculty, Staff and Students Publications

Tourism is central to Belize's economy, yet the influx of international travelers may contribute to infectious disease introduction and transmission among local workers, including SARS-CoV-2. In June 2022, we conducted a cross-sectional seroepidemiologic study among tourism and government workers in the tropical island tourism center of Ambergris Caye, Belize. The goal of this study was to determine SARS-CoV-2 antibody prevalence for both vaccination (anti-spike protein) and natural infection (anti-nucleocapsid protein), vaccine uptake, history of COVID-like symptoms, and risks for infection two years into the pandemic. Workers from 30 hotels and government agencies were enrolled. Participants completed questionnaires to capture demographics, …

From Local Burden To Global Threat: Neglected Tropical Diseases In An Era Of Climate Change And Human Mobility, Francisco Javier Membrillo, Juan-Carlos Navarro, Diana Marcela Pava-Garzón, Jill Weatherhead, José A Suárez, Alfonso J Rodriguez-Morales

Faculty, Staff and Students Publications

No abstract provided.

A Year In Review On Tuberculosis And Non-Tuberculous Mycobacteria Disease: A 2026 Update For Clinicians And Scientists, Simone Tunesi, Graham Bothamley, Gunar Günther, Yousra Kherabi, Liga Kuksa, Berit Lange, Christoph Lange, Natalie Lorent, Francesca Saluzzo, Martina Sester, Xenia Emilie Sinding Iversen, Marc Tebruegge, Conor Tweed, Anca Vasiliu, Lorenzo Guglielmetti, Tuberculosis Network European Trials Group (Tbnet)

Faculty, Staff and Students Publications

Background: Tuberculosis (TB) remains a major cause of morbidity and mortality worldwide, while infections from non-tuberculous mycobacteria (NTM) represent a growing public health threat. In its 20th year of activity, the Tuberculosis Network European Trials group (TBnet; www.tbnet.eu) is one of the leading research networks in Europe. In this review, we summarize the main advances in TB and NTM that occurred in 2025.

Methods: We conducted a non-systematic review of articles published in 2025, with a strong emphasis on research with current or potential impact on clinical practice. We also selected the most impactful papers regarding the management of adult …

Can You Hear Me Now?, Daniel Gonzalez, Amanda Moore

Faculty Publications

No abstract provided.

School-Level Gaps In Mmr Coverage As The Fuel For Measles Outbreaks, Meagan C Fitzpatrick, Chad R Wells, Abhishek Pandey, Lamia Ayaz, Peter J Hotez, Seyed M Moghadas, Alison P Galvani

Faculty, Staff and Students Publications

No abstract provided.

Priced Out Of Treatment: The Exorbitant Cost Of Antiparasitic Drugs In The United States, Cora Alperin, Nhi Nguyen, Megan Duffey, Eva H Clark

Faculty, Staff and Students Publications

Parasitic infections are often perceived as diseases of low-resource countries, yet they impose a significant and overlooked burden in the United States—especially among immigrants, low-income individuals, and other marginalized populations. This perspectives article examines the case of Mr. X, a landscaper in Houston diagnosed with neurocysticercosis, who faced unaffordable drug costs despite the availability of effective, off-patent treatments. Through his story, we explore the broader issue of pricing for commonly and not-so-commonly prescribed antiparasitic medications, highlighting the role of systemic market failures, regulatory hurdles, and restrictive assistance programs in limiting access to care. The consequences of incomplete treatment include long-term …

Duration Of Antimicrobial Therapy In Cardiovascular Implantable Electronic Device Associated Systemic Infections: A Retrospective Analysis, Emily Y Xiao, Patrick T Lynch, Sarwat Khalil, Derrick A Draeger, Alexandra M Lewis, Faiz M Baqai, Mihail G Chelu, M Rizwan Sohail

Faculty, Staff and Students Publications

Background: While the need for complete device removal is well-established for cardiovascular implantable electronic device (CIED) infections, there is insufficient evidence on the optimal duration of antimicrobial therapy.

Objectives: To examine how antimicrobial duration affects clinical outcomes of patients presenting with CIED-associated bacteremia and lead endocarditis.

Design: This is a retrospective cohort study conducted at a quaternary care hospital in Houston, TX, USA.

Methods: Patients who underwent device removal for a primary indication of bacteremia or lead endocarditis over a 10-year period were stratified by prescribed duration of antibiotics as ⩽2 weeks or >2 weeks post-extraction. Measured outcomes included all-cause …

Sewers To Solutions: A Guide To Wastewater Pathogen Monitoring, Justin R Clark, Anthony W Maresso

Faculty, Staff and Students Publications

Wastewater-based epidemiology (WBE) is the analysis of wastewater to detect pathogen levels or activity for public health awareness or action. Pioneered in the 1940s, WBE underwent a resurgence during the COVID-19 pandemic, providing important information about number of cases, outbreaks, and seasonal impact. With advancements in detection technologies and growing interest in environmental surveillance, WBE is poised to become a standard practice in public health monitoring. Here, we provide an overview of the current state of the art of pathogen WBE, including methods of molecular detection, analysis of wastewater data, real-world applications and programs, public health interventions, and benefits and …

Molecular Heterogeneity Of Hpv-Associated Cancers And Strategies To Overcome Treatment Resistance, Sara Rasouli, Weiyi Gong, Raegan Wood, Danyal Daneshdoust, Anam Khan, Rani Mahyoob, Chongwen Cao, Zihao Yu, Nagireddy Putluri, Gennady Shvets, Haichang Li, Bo Zhao, Xuefeng Liu, Jenny Li

Faculty, Staff and Students Publications

Human papillomavirus (HPV) is a major driver of global cancer incidence, responsible for nearly all cervical cancers and a significant proportion of oropharyngeal, anal, and other anogenital cancers. Despite the availability of effective vaccines, HPV-associated cancers persist due to persistent infection, immune evasion, and the virus's ability to integrate into the host genome, contributing to molecular heterogeneity and therapeutic resistance. Here, we summarize molecular heterogeneity and the emerging combined therapeutic strategies. High-risk HPV types, notably HPV16 and HPV18, initiate carcinogenesis through persistent infection of epithelial basal cells and through the actions of the E6 and E7 oncoproteins, which disrupt the …

Review Of Outcomes: Quality Improvement Of Upper-Extremity Necrotizing Soft Tissue Infections, Cailey A. England Bs, Ryan A. Reinhart Bs, Tien Do Do, Maame A. Effirim Bs, Dylan Bezzini Md

Summer Research Program Abstracts

No abstract provided.

Endocranial Lesions: A Paleopathological Study Of Late Medieval Skeletal Remains From Żelewo Poland, Francesca Aleen Meyer

Cal Poly Humboldt theses and projects

The site of Żelewo is located in a rural area of northwestern Poland, a region historically known as Pomerania. Skeletal remains from the cemetery associated with the archaeological site Żelewo 1-3, dating mostly to the 13th-15th centuries, are likely associated with a nearby Cistercian monastery. Numerous individuals from this site show evidence of endocranial lesions. To evaluate potential factors associated with the lesions, a differential diagnosis was performed based on macroscopic observations of endocranial lesion morphology and distribution. This study takes into account estimated age at death, biological sex, and other signs of pathology in the body. Potential confounding factors, …

From Reactionary To Anticipatory Integrated Action: Novel Environmental Health Surveillance For Mass Gatherings, Benjamin J. Ryan, Michael Donahoo, Danielle Esler, Paul Barach, Benjamin Coghlan, Shelby Garner, Laura M. Langan, John Piispanen, Bryan W. Brooks

College of Population Health Faculty Papers

Advances in AI-driven analytics, human-in-the loop techniques, and wastewater monitoring provide the foundation needed to shift from reactive to anticipatory actions for mass gatherings. Traditional surveillance systems focus on clinical and laboratory-based notification pathways, which often result in tardy actions being implemented. Thus, traditional surveillance is becoming outdated. Mass gatherings pose heightened public health risks and hazards, including trauma; injury and substance misuse; deliberate poisoning; and infectious diseases such as food and waterborne illnesses, sexually transmitted infections, and respiratory diseases. There is also a heightened concern due to reduced vaccination coverage. As a result, future international events such as the …

Preparing For Long-Acting Technologies: A Multistate Analysis Of Prep Persistence And Hiv And Sti Lab Coverage Among Oral Prep Initiators In St. Louis, Missouri (2014-2021), Lindsey M Filiatreau, Rupa Patel, Kate Curoe, Ashley Underwood, Joseph Cherabie, Elvin H Geng, Aditi Ramakrishnan, Rachel Presti, Aaloke Mody

2020-Current year OA Pubs

BACKGROUND: Engagement in pre-exposure prophylaxis (PrEP) care and routine screening for HIV and sexually transmitted infections (STIs) is critical to realizing the full benefits of this HIV prevention strategy.

METHODS: We enrolled a cohort of individuals seeking PrEP services in two clinics in Missouri, an Ending the HIV Epidemic priority state, from June 2014 to November 2021. We used electronic health record and survey data to explore outcomes in the 2 years following linkage to care using multistate methods. We assessed transitions between eight mutually exclusive care states differentiated by receipt of a prescription, lab coverage status, and retention. We …