Digital Commons Network^™

Understanding Hepatitis C Risk And Harm Reduction Needs Among People Who Smoke Drugs: A Client-Centered Qualitative Inquiry, Maxwell Gustin

Anthropology

The spread of Hepatitis C virus (HCV) via non-injectable equipment is plausible, making people who smoke drugs (PWSD) at-risk for possible infection and transmission. While much research has been conducted into injection drug use (IDU), likely due to the rising opioid epidemic, limited studies focus on the risks PWSD face. Currently, state-funded syringe service programs (SSPs) provide harm reduction education and materials to combat these risks. Safer smoking initiatives have been created and are widely used by PWSD, and have access to SSPs. To gain better insight into the HCV and non-HCV-related risks and burdens PWSD face, a qualitative study …

Implications Of The Attenuated Allee Effect On Population Dynamics, Dana Strong

All Graduate Theses and Dissertations, Fall 2023 to Present

The Allee effect is an ecological phenomenon characterized by a per capita growth rate that increases as the population size increases in the context of low population density. The Allee effect can lead to rapid extinction events. Consequently, ecologists can attempt to control the strength of the Allee effect to help increase the population (in the case of endangered species) or decrease the population (in the case of parasites or pests).

This research aimed to study not the strength of the Allee effect, but the intensity of the Allee effect, or how rapidly cooperation between individuals causes the per capita …

Identifying Barriers For Community Pharmacies As Vaccines For Children (Vfc) Providers In Rural Alabama: Opportunities For Solutions, Myra Bajwa

Honors Theses

Significant Human papillomavirus (HPV) vaccination disparities exist between rural and urban areas in the US. A primary contributor is low access to preventive care in rural areas. Among the most promising strategies to overcome this is increasing access through offering HPV vaccination in non-traditional, convenient health settings such as pharmacies. In rural areas, community pharmacies are trusted, convenient pillars of the community. In Alabama, community pharmacies are eligible for enrollment in the Vaccines for Children (VFC) Program, a federally-funded program that provides free vaccines to children and adolescents under 18 years old who are uninsured, underinsured, American Indian, or Alaska …

The Genetic And Environmental Determinants Of Stress Resilience Across Model Systems, Carson Len Stacy

Graduate Theses and Dissertations

Survival in fluctuating environments demands that organisms effectively anticipate and respond to future challenges. This capacity is shaped by both genetic background and environmental context. In this dissertation, I apply a population aware lens to explore how genetic diversity and environmental conditions intersect to shape stress survival. Integrating functional genomics and transcriptomics in Saccharomyces cerevisiae (brewer’s yeast) and a vertebrate (common canary) system, I dissect gene-by-environment (GE) interactions that underpin resilience. First, I move beyond a single reference genome by using a pan-genomic CRISPR knockout screen to assess osmotic stress survival across diverse S. cerevisiae isolates. This analysis reveals a …

Impact Of Intravenous Drug Use On Neck Abscess Outcomes: 30-Day Readmission & 5-Year Survival Rates, Elliott Sina, Bryce Hambach, Eric Mastrolonardo, Sruti Tekumalla, Meghan Crippen, Richard A. Goldman

Department of Otolaryngology - Head and Neck Surgery Faculty Papers

OBJECTIVES: Injection drug use (IDU) is a known risk factor for neck abscesses, often requiring urgent surgical intervention by acute-care Otolaryngologists. However, data on the prevalence and long-term outcomes of IDU-related neck abscesses are limited. This study investigates differences in 30-day readmission rates and 5-year all-cause mortality between patients with and without a history of IDU hospitalized for neck abscesses.

METHODS: This is a retrospective cohort study utilizing the TriNetX national clinical database. Patients hospitalized for neck abscesses (ICD-10: L02.11) were categorized into two cohorts: IDU (current/previous) and non-IDU. Demographics, 30-day readmission rates, and 5-year survival were analyzed. 1:1 Propensity …

Combating Antimicrobial Resistance In Asia: A Comprehensive Review Of Strategic Action Plans, Policies, And The Role Of The Who, Saud Almawash

Saudi Medical Journal

ABSTRACT Over the past 70 years, antimicrobial resistance (AMR) has emerged as a critical public health concern in Asia. Regional challenges such as dense population, scarce resources, and diverse healthcare systems further complicate the containment efforts. To address this, Asian countries have adopted several strategies and policies. A comprehensive review of published literature was conducted to identify key policies and interventions. Findings revealed diverse approaches to AMR containment, including surveillance and monitoring systems, antibiotic stewardship programs, infection control measures, vaccination strategies, and public health awareness campaigns. However, implementation of these strategies is hindered by resource, political, and regulatory barriers. The …

Asymptomatic Cryptococcal Antigenemia: A Multi-Clinic Cross-Sectional Study On The Prevalence, Associated Factors And Predictors Of Three-Month Outcomes Among Antiretroviralnaïve And Antiretroviral-Experienced Hiv Patients In Dar Es Salaam, Tanzania, Mandela Makakala, Mukasa Mohammed, Mabula Mabelele, Kamran Hameed, Philip Adebayo

Internal Medicine, East Africa

Background: Cryptococcal meningitis remains a leading cause of HIV/AIDS-related mortality, predominantly in Sub-Saharan Africa. Current screening and prevention efforts primarily target antiretroviral therapy (ART)-naïve patients, whereas strategies for ART-experienced individuals are less well defined.

Objectives: This study primarily aimed at determining the prevalence of asymptomatic cryptococcal antigenemia (ACA) among ART-naïve and ART-experienced patients, along with associated factors and predictors of three-month outcomes among HIV patients in three HIV clinics in Dar es Salaam, Tanzania. Secondarily, factors associated with serum cryptococcal antigen positivity in the overall study population were also assessed.

Methods: This cross-sectional clinic-based study recruited 273 HIV-positive participants (ART-naïve …

(R2135) System Dynamical Analysis For Ann-Based Numerical Solutions Of A Compartmental Model: A Bio-Mathematical Model Of Drug Diffusion Through The Compartments Of Blood And Tissue, Rakesh Kumar, Sudarshan Dhua

Applications and Applied Mathematics: An International Journal (AAM)

This paper provides a considerably efficient numerical approach to acquire the solutions of a biomathematical model administrating oral and intravenous distribution of pharmaceuticals in the human body. The proposed numerical approach based on an artificial neural network is employed to extract numerical solutions for a detailed set of ordinary differential equations and analyze the change in concentration of drug diffusion via the compartments of blood and tissue medium. We primarily focus on analyzing three different models established on the diffusion process, exercising laws of mass action and Fick’s principle. In this work, the existing model is reformulated as an optimization …

(R2107) Analysis Of A Bivalent Vaccine Model With Peer Influence Effect On Testing, Manoj Kumar Singh, Anjali .

Applications and Applied Mathematics: An International Journal (AAM)

The coronavirus caused havoc around the world. There was a terrible situation in villages and cities, and no one knew how to deal with it. Although the governments of each country tried their best to save the common people, vaccination programs and testing centers were built everywhere. However, people were not utilizing it due to fear. Because of this, the infection spread rapidly. The qualitative study of the mathematical model here is in context with the situation when bivalent vaccination and testing are available for an epidemic. The mathematical model combines the exposed period and influenza model with vaccination included …

Tricounty Vaccine Improvement Program (Tc-Vip): Enhancing Vaccine Confidence And Uptake In Rural Utah, Aaron Hunt, Yvette Rea, Annalyz Castro

Outcomes and Impact Quarterly

The Utah State University Extension TriCounty Vaccine Improvement Program addressed low rural vaccination rates across a three-county area through bilingual social media campaigns, health fairs, training in motivational interviewing, and neuromarketing. Evaluation results showed improved skills, broad community reach, and positive participant feedback, demonstrating a replicable model to reduce vaccine hesitancy and strengthen rural health systems.

Evaluation And Optimization Of Outpatient Parenteral Antimicrobial Therapy Laboratory Monitoring For Beta-Lactam Antibiotics., Stephanie Subart Pharmd, Trent Towne Pharmd, Bcps, Sarah Pehlke Pharmd, Bcps, Robert D. Beckett Pharmd, Bcps

Pharmacy Residency

Presented at the ASHP Midyear Clinical Meeting. New Orleans, LA

This evaluation found that among patients who experienced eosinophilia, only one exhibited signs of hypersensitivity, while seven required a change in therapy. This indicates that while eosinophilia is a concern, its direct clinical impact may be limited for the majority of patients. In the cohort experiencing elevated LFTs including AST, ALT, or alkaline phosphatase levels, fewer than 2% necessitated a change in therapy. This low rate suggests that routine LFT monitoring may not always correlate with significant clinical decisions, raising questions about the necessity of frequent lab draws.

Determinants Of Utilization Of Skilled Birth Attendant Among Women Of Reproductive Age In Habeswein Ward, Wajir County, Kenya, Suada Hassan

MSc in Advanced Practice Midwifery

Background: Maternal care provided by a skilled birth attendant (SBA) during pregnancy, at delivery, childbirth, and the postpartum period is vital for reducing maternal and neonatal mortality. In sub-Saharan Africa, the overall prevalence of usage of SBA in a 2021 study was 63%. Tanzania recorded the lowest rate at 13.8%, while Kenya registered 89.3% in 2023. However, disparities exist within Kenyan counties, for instance, in Wajir County only 57% of births were assisted by skilled health providers, a disparity that could be due to socio-cultural differences.

Aim: This study aimed to determine the factors influencing the utilization of skilled …

Perceived Stress And Coping Mechanisms Among Nurses Working In Oncology Inpatient Units At Kenyatta National Hospital, Bole Ado

MSc in Advanced Practice Nursing

Introduction: Cancer is the second leading cause of death globally and the third leading cause of death in Kenya. Nurses in oncology units often experience stress because of the emotionally demanding nature of providing care for patients diagnosed with cancer. Global studies show that nurses in the oncology unit reported experiencing moderate to extreme work-related stress, with a prevalence of work stress globally varying between 9.2% to 68% globally. Many nurses experience stress, and because of ineffective coping mechanisms, this affects their psychological well-being and negatively impacts the quality of their care as well as patients’ outcomes.

Objective of the …

Avaren-Fc's Effects On Lymphoma Cells., Jacob Hahn

Electronic Theses and Dissertations

This thesis investigates the therapeutic potential of Avaren-Fc (AvFc), a novel lectin fusion protein that integrates the Fc region of human IgG1 with the engineered lectin Avaren, specifically targeting lymphoma. The study delineates the in vitro binding capabilities of Avaren-Fc with a human B-cell lymphoma cell line, a canine B-cell lymphoma cell line, healthy canine peripheral blood mononuclear cells (PBMCs), and healthy human PBMCs. AvFc was shown to exhibit significant binding to human lymphoma cells. Furthermore, the direct cytotoxicity of Avaren-Fc against canine lymphoma cells, canine lymphoma cells and healthy canine PBMCs was assessed. It was found that there is …

Enzymatic Depletion Of Adenosine To Potentiate Cancer Immunotherapy., Omar Sadi Sarkar

Electronic Theses and Dissertations

Immune checkpoint blockade (ICB) therapies have revolutionized cancer treatment, but many patients still do not respond well. To improve therapeutic outcomes, chemotherapy is often combined with immunotherapy, as chemotherapy is known to promote immunogenicity. However, many patients develop resistance to this combination therapy, and the reasons behind it are not fully understood. In this study, we explored how platinum-based chemotherapy, specifically cisplatin, affects tumor signaling to create an immunosuppressive tumor microenvironment (TME). We found cisplatin triggers ataxia telangiectasia mutated (ATM)-mediated DNA damage signaling and induces higher expression of prostaglandin E₂ (PGE₂) via a cyclooxygenase-2 (COX-2) mediated pathway. We speculate DNA …

Attention - Volume 10

be Still

No abstract provided.

More Than Medicine: The Quiet Power Of Attention, Eleni Geletu

be Still

This short reflection is based on my experience as a Patient Advocacy Representative. It tells the story of a phone call with a patient in distress and shows how simply paying attention and showing care can make a real difference. The piece reminds us that healing often begins with compassion, not just medicine. It highlights the importance of listening, empathy, and human connection in healthcare.

Keywords: compassion, patient care, attention, empathy, narrative medicine, advocacy, healing

Host-Intrinsic Factors Determine Anti-Tumor Efficacy Of Exercise In Pancreatic Ductal Adenocarcinoma, Sumedha Pareek

Dissertations and Theses (Open Access)

Pancreatic Ductal Adenocarcinoma (PDAC) is the third leading cause of cancer-related deaths with a low 5-year relative survival rate of approximately 13.3% for all stages combined. We have previously shown that exercise can improve quality of life and enhance functional capacity among patients with PDAC. Exercise induces a variety of changes in the tumor microenvironment with beneficial effects in several tumor types. However, our understanding of the clinical effects of exercise and the mechanisms that mediate anti-tumor effects are limited in pancreatic cancer.

In this project, using C57BL/6 mice from Taconic Biosciences (Tac) and Jackson Laboratories (Jax), we established a …

A Randomized Controlled Trial Combining House Screening And Insecticide-Treated Nets Reduces Malaria Transmission In Northwestern Ethiopia, Aklilu K. Belay, Abebe Asale, Catherine L. Sole, Abdullahi A. Yusuf, Baldwyn Torto, Zewdu Abro, Menale Kassie, Clifford M. Mutero, David P. Tchouassi

All Peer-Reviewed Publications

House screening (HS) of doors, eaves, and windows using wire-mesh has demonstrated potential in the integrated vector management of malaria. However, limited epidemiological data are available to guide its implementation across different ecological settings. In a 16-month randomized controlled trial (follow-up period) conducted across three agroecological areas (dry mountain, plateau highland, and semi-arid) in Jabi Tehnan district, northwestern Ethiopia, treatment houses were equipped with HS combined with insecticide-treated nets (ITNs), while control houses received ITNs only. The intervention led to a significant 2.3-fold reduction in indoor malaria vector density, the primary entomologic outcome, largely influenced by An. gambiae s.l. mosquitoes. …

The Role Of Attitude Ambivalence In Extending The Theory Of Planned Behavior: A Mixed-Methods Study Of Factors Predicting Influenza Vaccine Uptake Intentions Among Active-Duty Military Parents For Themselves And Their Children, Walter Eugene Carroll

Theses and Dissertations

This dissertation is a mixed-methods study examining how U.S. military parents form intentions to vaccinate themselves and their children against influenza. The study applies the Theory of Planned Behavior (TPB) and the construct of ambivalence tounderstand how attitudes, social norms, and perceived behavioral control influence vaccination decisions within the unique institutional and cultural environment of military life. Quantitative data were collected from 341 military parents through an online survey distributed across more than 50 military-affiliated Facebook groups. Regression models tested TPB constructs, flu knowledge, and social media use as predictors of vaccination intention and ambivalence. Results showed that flu shot …

Prevalence Of Shiga Toxin Producing Escherichia Coli In Illinois Bison Herds, Adam M. Baldocchi

Honors Capstones

Shiga toxin-producing Escherichia coli (STEC) represents an important group of zoonotic pathogens that pose ongoing risks to public health through foodborne outbreaks and environmental transmission. This project evaluated the prevalence and genetic distribution of stx1 and stx2 toxin genes in fecal samples collected from Illinois bison Bison bison) managed under either commercial or preservation conditions. A total of 320 fecal samples were screened for STEC presence by performing enrichment culturing and confirmed by Polymerase Chain Reaction (PCR) for stx1, stx2, and uidA, which confirmed E. coli identity. Of all tested samples, 28.4% were STEC-positive, with stx2 (21.3%) …

Recovery And Characterization Of Moraxella Species From Bovine Specimens, Laura G. Leger

School of Veterinary and Biomedical Sciences: Dissertations, Theses, and Student Research

The family Moraxellaceae is made up of a diverse group of 24 named species that fall into three phylogenetic groups. While most Moraxella spp. act as commensal respiratory and/or ocular flora of mammals, some are associated with disease. One of these diseases, infectious bovine keratoconjunctivitis (IBK), has significant welfare and economic impacts to both cattle and cattle producers. Moraxella bovis is the only experimentally determined cause of IBK, however, an association of Moraxella bovoculi with disease has been proposed. Currently, available vaccines do not have high levels of efficacy in the field. Culture based methods are the gold standard for …

Advanced Practice Provider (App) Midline Training Initiative, Al-Zada Aguilar, Sarah D. Maute

Biennial Convention (CONV)

Temporary, non-tunneled central venous catheters (CVCs) are commonly used for vascular access in patients with vesicant infusion needs or difficult intravenous access (DIVA). However, CVCs are associated with primary bloodstream infections (BSIs), contributing to significant morbidity, mortality, and financial burdens. At our institution, central line-associated bloodstream infection (CLABSI) rates and central utilization ratios have steadily increased since 2023, rising from 0.43 to 0.75 and 0.17 to 0.21, respectively, despite system-wide infection prevention initiatives. Recognizing the limitations of current approaches, particularly for DIVA patients, midlines emerged as an alternative to both CVCs and ultrasound-guided peripheral IVs (USG-PIVs).

In response, a multimodal …

A Prevalence Study Of Iron Deficiency Anemia Among Children In Elbasan, Albania: Directions For Health Care Policy, Artilda Lala

All Dissertations

Iron deficiency anemia (IDA) is one of the most prevalent disorders worldwide, especially in children from low-income and underdeveloped countries. In Albania, anemia is a major public health concern with many unstudied regions (prefectures and rural municipalities). Childhood IDA can impair cognitive development, immunity and overall well-being, so early diagnosis and prevention of anemia is critical. This study examined the prevalence of IDA in children aged 0-10 years in the district of Elbasan, Albania. The data were additionally analyzed for relationships with demographic (age, gender, education, parental education and child academic performance) and nutrition variables.

A cross-sectional study design was …

Infectious Disease Crisis Communication After The Covid-19 Pandemic, Macy Lloyd

Capstone Experience: Master of Public Health

Since the COVID-19 pandemic, the United States has experienced a proliferation of mis- and disinformation, an increasing politicization of health and science, and growing distrust in government, science, and institutions. While these trends present challenges for normal public health communications, during a public health emergency, such as an infectious disease outbreak, these challenges are even more acute. To address challenges at the local level, health departments need plans, products, and tools that adapt health crisis communications to the current media environment and meet community members where they are across the trust continuum. To develop an infectious disease incident communication plan, …

Applicability Of Cementochronology To Estimate Season-Of-Death In Humans: Insights From Modern Documented Collections, Olga Ibarra-Sanchez

Theses and Dissertations

Dental cementum is characterized by lifelong deposition of alternating opaque annuli in fall/winter and translucent bands in spring/summer. This study aims to test the applicability of cementochronology to estimate season-of-death, by observing the properties of the last layer, with direct implications for forensic anthropology and bioarchaeology. The sample includes canine teeth from 146 adults (84 males, 62 females), age-at-death ranging from 20-97 years (mean=61.7 years, SD=18.6 years), from two contemporary skeletal collections. Of these individuals, 78 (53.4%) died in spring/summer and 68 (46.6%) died in fall/winter. Overall accuracy was low at 64.4% (94/146). Accuracy was higher for spring/summer deaths 100.0% …

Reproduction And Larval Development Of The Invasive Asian Longhorned Beetle In South Carolina, Lindsey A. Stone

All Theses

The Asian longhorned beetle (Anoplophora glabripennis Motschulsky; ALB) is a major threat to forest health due to the damage done by larval feeding in host trees. In 2020, ALB was discovered in Charleston County, South Carolina, which presents a novel climate for this invasive pest in North America. I investigated the reproductive biology and larval development of ALB to support detection and management efforts. By exposing 19 host trees to mated pairs of adults, I was able to determine rates of oviposition success (55%), egg viability (55%), and early larval survival (56%). On average, females chewed nearly 1 egg …

Investigating The Impacts Of Azole Antifungals On Growth Of Cryptococcus Neoformans, Gnanambika Sindhe

All Theses

Cryptococcus neoformans, an opportunistic fungal pathogen is responsible for cryptococcosis, leading to approximately 181,000 deaths annually, predominantly in regions such as Sub-Saharan Africa. Fluconazole, a widely used fungistatic azole, is often administered due to its relative affordability and lower toxicity. However, resistance to fluconazole in C. neoformans can arise through aneuploidy, complicating treatment efforts. This study aims to deepen our understanding of resistance mechanisms to azole drugs by comparing fluconazole with other azoles, including both clinical and agricultural azole antifungals. Disk diffusion assays were performed to evaluate the ability of C. neoformans to develop resistance to these compounds, focusing …

Discharge Against Medical Advice Among Pediatric Patients: A Retrospective Study From A Saudi Tertiary Emergency Department, Elaf A. Alshammari, Atheer M. Aljeraibah, Haya M. Aldabas, Saad M. Alqahtani, Raseel S. Alghamdi, Abdulrahman M. Alsharif, Yahya K. Alyahya, Abdullah I. Almojali

Saudi Medical Journal

ABSTRACT Objectives: To investigate the incidence, parental reasons, and predictors of emergency room (ER) revisits following discharge against medical advice (DAMA) in a pediatric center in Saudi Arabia. Methods: This retrospective cohort study was conducted between January 2020 and December 2024 at a tertiary care hospital. Pediatric patients aged 0-14 years who signed the DAMA during ER visits were included. Medical records of patients with DAMA were reviewed to collect demographic data, diagnoses, reasons for DAMA, and outcomes. Results: Among 446,251 ER visits, 2,336 (0.52%, 95% CI: 0.50%–0.55%) involved caregiver-signed DAMA. These rates ranged from 0.45% (2020) to 0.69% (2023). …

A Study On The Influence Of Entity Internet Hospital Platforms And Health Literacy Facilitation On Postoperative Patients’ Platform Usage, Hong Ye

Dissertations and Theses Collection (Open Access)

Entity Internet Hospital (EIH) is emerging online medical service platforms in China. Currently, while EIHs in China are developing rapidly, their usage rates remain low. However, postoperative patients have substantial follow-up consultation needs. Consequently, incentivizing postoperative patients to use EIH from the demand side is a highly challenging proposition in the current era. Grounded in Technology Acceptance Model and Health Belief Model, this study examined the impacts of platform and health literacy facilitation on platform usage (including intention and frequency) among 631 postoperative patients with cardiovascular disease from four medical institutions in Wuhan, and explored the moderating role of literacy …