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Learning From Real Life: Alaska Edition, Christina Tuomi, Eugene Wiseman, Nathan Wormington, Travis Cruse, Lindsey Sprinkle

Conferences

No abstract provided.

Fifty-Ninth Commencement (Graduate), Sacred Heart University

Commencement Programs

Program for graduate ceremonies, May 6 & 7,  2025.

How Do African American Women In Halfway Housing Perceive Their Experiences With Mental And Emotional Rehabilitation, Eiyana Middleton

Walden Dissertations and Doctoral Studies

After reviewing the literature, Black women living in halfway housing needed more culturally accommodative and responsive access to mental health care. Despite recent efforts to improve the access and quality of mental health services for Black Americans, some of the most common barriers that continued to exist include and were not limited to the following: stigma associated with mental illness and distrust of the health care system. The purpose of this hermeneutic phenomenological study was to understand Black women’s perceptions of their mental and emotional rehabilitation while living in halfway housing. The hermeneutic phenomenology theory was most appropriate as it …

Progressive Multifocal Leukoencephalopathy In Chimeric Antigen Receptor T-Cell Therapy Recipients: A Case Study, Michelly Abreu, Chirag B Patel, Krina Patel, Fareed Khawaja, Sudhakar Tummala

Faculty, Staff and Student Publications

Chimeric antigen receptor (CAR) T-cell therapy is a novel immunotherapy modality that has shown remarkable response rates in refractory hematologic malignancies, including multiple myeloma (MM). Cytokine release syndrome (CRS) and neurotoxicity are well-described side effects of this therapy. CAR T-cell therapy recipients are also at increased risk for infections due to immune dysfunction, history of multiple lines of therapy, history of lymphodepleting chemotherapy prior to cell infusion, and prolonged B-cell aplasia. Progressive multifocal leukoencephalopathy (PML) is an opportunistic disease of the central nervous system caused by the reactivation of JC virus (JCV) in the setting of immunosuppression, which leads to …

Afflicted Epistemology: Knowledge, Illness, And New Media After “Truth”, Annika Nilsson

Arts & Sciences Graduate Student Theses and Dissertations

This study examines how people living with complex, medically underdetermined chronic illnesses make sense of their experiences through self-experimentation mediated by online forums and self-help groups in a cultural context characterized by significant controversy surrounding the status of science, expertise, and conventionally authoritative knowledge-producing institutions. Using virtual and conventional ethnography and critical media studies methods, it finds that the fragmentary and decentralized nature of the U.S. healthcare system intensified the interpretive challenges associated with complex chronic illnesses: information was extremely abundant, but deciphering its accuracy, reliability, and relevance proved difficult. In this context, participants relied on experiential knowledge to filter, …

Drug-Induced Hypersensitivity Syndrome Resulting In Hepatotoxicity And Epstein-Barr Virus Reactivation Following Initiation Of Levetiracetam, Zechariah Jung, Xavier Zonna, Samuel J. Wlasowicz, Conor Banta, Lawrence Canale, Joseph Bielecki

Advances in Clinical Medical Research and Healthcare Delivery

A 28-year-old male with a past medical history of alcohol abuse had new-onset seizures suspected to be caused by alcohol use. Twelve days after starting levetiracetam for seizure prophylaxis, he began to develop a pruritic rash, darkening of his urine, periods of jaundice, and hot flashes that correlated with the timing of his levetiracetam dosing. He was subsequently found to have lymphocyte-predominant leukocytosis, elevated aminotransferases, and alkaline phosphatase. Following discontinuation of his levetiracetam, he was found to have positive Epstein-Barr virus (EBV) serology suggestive of reactivation. This case demonstrates levetiracetam as a rare cause of drug-induced hypersensitivity syndrome (DIHS) along …

Intractable Hiccups As The Presenting Symptom Of Relapsed Salmonella Bacteremia Complicated By Salmonella Endocarditis, Sahej Arora, Tripti Jain, Hafsa Jawaid, Nada Hafez, Binita Neupane

Advances in Clinical Medical Research and Healthcare Delivery

Salmonella infections are generally acute diarrheal illnesses that uncommonly spread to deeper or endovascular tissues, with key symptoms being nausea, vomiting, diarrhea, abdominal pain and fever. We present a case of a 76-year male who presented chiefly with recurrent intractable hiccups after finishing two weeks of oral ciprofloxacin for a previous episode of Salmonella bacteremia. He was ultimately found to have an aortic root vegetation on transesophageal echocardiogram and focal adenomyomatosis on gallbladder ultrasound. He underwent cholecystectomy, aortic valve replacement and six weeks of antibiotic therapy with resolution of his hiccups. Our case demonstrates an atypical symptom of intractable hiccups …

Arcanobacterium Haemolyticum Chronic Osteomyelitis And Bacteremia Complicated By Intraosseous Abscess: A Case Report., Edward Lovering, Michelle Bahrain

Journal of Community Hospital Internal Medicine Perspectives

Arcanobacterium haemolyticum is an anaerobic, gram-positive bacillus most commonly associated with non-streptococcal pharyngitis. However, it is a rare cause of systemic infection and bacteremia. In this report, we present the case of a 39-year-old man diagnosed with A. haemolyticum bacteremia secondary to chronic osteomyelitis and an intraosseous abscess.

Rapidly Developing Bilateral Loculated Streptococcus Pyogenes Empyema In An Immunocompetent Adult: A Case Report, Anish K Shrestha, Matthew Dwumah-Agyen, Boniface Mensah, Yvette Yeboah-Kordieh, Marcos A Wolff, Jennifer A Evans

Journal of Community Hospital Internal Medicine Perspectives

Streptococcus pyogenes is a rare cause of empyema, especially in immunocompetent individuals. The organism expresses various virulence factors leading to rapid progression of the disease. We report a case of rapidly progressing bilateral loculated empyema caused by streptococcus pyogenes in an immunocompetent host without additional risk factors.

A Budding Pancreatic Mass: A Review Of Disseminated Blastomycosis, Tina C. L. Phan, Chloe N. Hundman, Neena Thomas-Gosain, Christopher D. Jackson

Journal of Community Hospital Internal Medicine Perspectives

A 67-year-old male patient presented with anorexia, weight loss, skin masses, and flank pain over the past three months. Imaging revealed a lung mass and a cystic lesion in the pancreatic head. After initial diagnostic work-up and clinical deterioration, broad based budding, seen on pathology, led to a diagnosis of disseminated blastomycosis. After receiving a 14-day course of liposomal amphotericin B followed by itraconazole, the patient showed significant clinical improvement. We reviewed all disseminated blastomycosis cases in the medical literature involving gastrointestinal organs. Although pancreatic involvement is rare, we suggest that it should be suspected in those with a rapidly …

A ‘Fluke’ Diagnosis: Suspecting Fascioliasis As A Rare Cause Of Hepatic Abscess, Tharun Shyam, Rosa Lora, Sharanya Kaushik, Jessica Chung, Monica Ghitan, Christina Coyle

Journal of Community Hospital Internal Medicine Perspectives

Hepatic abscess is a rare complication of fascioliasis, with fewer than 50 reported cases worldwide. The diagnosis requires a high degree of suspicion and is often identified after extensive investigation leading to delays in treatment. With this case report, we aim to highlight the need for a higher index of suspicion in non endemic regions like the USA, especially in cities with large immigrant populations. Given the ease and success rates of treatment with oral triclabendazole, the morbidity from unnecessary invasive testing and disease burden is preventable with a thorough evaluation and targeted clinical assessment.

Diverticular Abscess And Percutaneous Drainage Outcomes: A Review Of Clinical Practice For The Primary Team, Omer Usman, Abdullah , Imtiaz, Muhammad Abdul Basit, Maham , Tariq, Rehaab , Mujahid, Muhammad Waqas Khan, Vishakh Prakash, Obaid Ur Rehman

Journal of Community Hospital Internal Medicine Perspectives

The inflammation of the diverticular pouch is called acute diverticulitis which can result in abscess formations sometimes. Percutaneous drainage is routinely considered for the management of diverticular abscesses. Being a minimally invasive procedure employed for the removal of large collections of infected fluid from the abscesses, percutaneous drainage emerged as an appealing option. Historically, surgical removal of the abscesses has resulted in multiple hospitalizations and an increased burden on healthcare resources. With the advancement in radiological techniques, CT-guided percutaneous drainage of diverticular abscesses ensured enhanced patient satisfaction and reduced healthcare costs. The choice between surgery or percutaneous drainage of diverticular …

Hollywood And Healthcare: Navigating The Dual Impact Of Movies On Public Health, Fremita Chelsea Fredrick, Anish Kumar Reddy Meda, Mini Virmani, Guntash Kaur, Baltej Singh, Rohit Jain

Journal of Community Hospital Internal Medicine Perspectives

Introduction Synonymous with the American film industry, Hollywood wields considerable influence on public health through its vast global reach and engaging media. This paper explores Hollywood's role and its impacts on public health, primarily driven by its portrayal of healthcare services, illnesses, and related beliefs and provides recommendations to improve “education entertainment” for the future. Methods PubMed was searched using keywords such as hollywood, healthcare, medical dramas, health education, smoking, suicide, and many more. Relevant literature up to June 2024 has been examined and summarized, which consisted of 37 articles with data from various clinical trials, meta-analyses, and literature reviews. …

A.C.T.S.: Accessing Care For Trafficking Survivors, Stephanie Johnson, Kaitlynn Leffler

Criminology and Criminal Justice Theses and Dissertations

Human trafficking has been a persistent societal problem with significant costs for states, the nation, and across the world. Victims struggle to recognize that they have endured having been trafficked and society lacks the awareness and understanding that is necessary to help. While many organizations have implemented programs aimed at helping victims escape and recover, victims often remain unaware of what resources are available.

Advancements in technology may allow victims a bridge to connecting with services and could offer assistance to law enforcement and prosecutors who are working to hold trafficking offenders accountable. Many younger victims today feel comfortable using …

Gut Dysbiosis Patterns In Cvid Patients With Noninfectious Complications Observed In A Germ-Free Mouse Model Through Fecal Microbiota Transplantation., Joud Hajjar, Anita Y Voigt, Margaret E Conner, Alton G Swennes, Stephanie Fowler, Chadi Calarge, Danielle D Mendonca, Dominique Armstrong, Chen-Yen Chang, Jolan E Walter, Manish J Butte, Tor Savidge, Julia Oh, Farrah Kheradmand, Joseph F Petrosino

Faculty Research 2025

Patients with common variable immunodeficiency (CVID) who develop noninfectious complications (NIC) have worse clinical outcomes than those with infections only (INF). While gut microbiome aberrations have been linked to NIC, reductionist animal models that accurately recapitulate CVID are lacking. Our aim in this study was to uncover potential microbiome roles in the development of NIC in CVID. We performed whole-genome shotgun sequencing on fecal samples from CVID patients with NIC, INF, and their household controls. We also performed fecal microbiota transplants from CVID patients to germ-free mice. We found potentially pathogenic microbes

The Effects Of Healthcare Professionals Wearing Nail Enhancements, Sydney Johnson

Honors Capstones

Healthcare-associated infections (HAIs) continue to be a major concern in hospital settings, with one in thirty-one patients affected daily in the United States (CDC, 2020). While hand hygiene is widely promoted, the impact of nail enhancements worn by healthcare workers is often overlooked. Acrylics, gels, and other artificial nails can harbor bacteria even after handwashing and glove use, increasing the risk of infection transmission.

The purpose of this study was to explore whether hospitals with stricter nail enhancement policies have better staff hygiene practices and potentially lower rates of HAIs. This research used an original survey distributed to registered nurses …

Examing The Role Of Complement Signaling In Viral Neuroinflammatory Responses, Marlene Kanmogne

Arts & Sciences Graduate Student Theses and Dissertations

The complement system is an ancient pathway that serves dual roles as a key regulator of neuroinflammation and a critical regulator of neural networks. Few studies have addressed how these two pathways may interact during infection of the central nervous system. While some components of complement are expressed in the healthy developing brain, complement component 3a receptor (C3aR) is a G protein coupled receptor that is expressed by astrocytes, microglia and infiltrating immune cells during inflammatory states. We previously found that C3aR is required for engulfment of synaptic material by activated microglia during neuroinvasive viral infection. Here, we used a …

Genome Announcement Of Four Parechovirus A3 Isolates From The United States Of America., Debarpan Dhar, Terry Fei Fan Ng, Christopher J. Harrison, Eric Rhoden, Bernardo A Mainou, Anjana Sasidharan, Katelyn E. Vandonge, Varun Chandra Boinpelly, Rangaraj Selvarangan

Manuscripts, Articles, Book Chapters and Other Papers

We report the complete genome sequences of four parechovirus-A3 (PeV-A3) isolates from Children's Mercy Kansas City (CMKC), United States of America (USA): PeV-A3-MO-12-CMKC/CSF/MO/USA/2012 (isolated in 2012 from cerebrospinal fluid), PeV-A3-8C-CMKC/CSF/MO/USA/2022/ (isolated in 2022 from cerebrospinal fluid), PeV-A3-9C-CMKC/CSF/MO/USA/2022 (isolated in 2022 from cerebrospinal fluid), and PeV-A3-11B-CMKC/Blood/MO/USA/2022 (isolated in 2022 from blood). Sequence analysis revealed multiple mutations throughout the genome of the PeV-A3 isolates in comparison to the prototypic PeV-A3 A308/99 reference sequence (AB084913). Several unique amino acid changes were observed in the PeV-A3 isolates from 2022 that were absent in the PeV-A3 isolate from 2012. Phylogenetic analysis comparison determined that the …

Identifying Genetic Errors Of Immunity Due To Mosaicism, Elizabeth G Schmitz, Malachi Griffith, Obi L Griffith, Megan A Cooper

2020-Current year OA Pubs

Inborn errors of immunity are monogenic disorders of the immune system that lead to immune deficiency and/or dysregulation in patients. Identification of precise genetic causes of disease aids diagnosis and advances our understanding of the human immune system; however, a significant portion of patients lack a molecular diagnosis. Somatic mosaicism, genetic changes in a subset of cells, is emerging as an important mechanism of immune disease in both young and older patients. Here, we review the current landscape of somatic genetic errors of immunity and methods for the detection and validation of somatic variants.

Enhancing Nurse Competency: Proper Application Of Chlorhexidine Gluconate Dressings To Prevent Central Line Associated Bloodstream Infections, Joseph Earich

Doctor of Nursing Practice Scholarly Projects

Central line-associated bloodstream infections (CLABSIs) pose a significant risk to patient safety and healthcare outcomes. The proposed Doctor of Nursing Practice (DNP) project addresses the knowledge gap among nurses regarding the correct procedures for changing chlorhexidine gluconate (CHG) dressings on central lines. The goal is to enhance nurse education and adherence to best practices, thereby reducing the incidence of CLABSIs. The project employs a quasi-experimental design with a pre-test and post-test methodology. Nurses will complete a pre-test to assess their baseline knowledge of CHG dressing changes. The nurse will participate in a hands-on educational session to improve their understanding and …

Early Detection Of Sepsis, Precious Aina

Honors Capstones

Sepsis is a life-threatening condition that occurs because of an infection. Sepsis can lead to shock, SIRS, organ failure, and other emergent conditions. This literature review paper is aimed at determining the early detection of sepsis in patients as well as examining early symptoms of sepsis, the significance of early diagnosis, and the implications for patient safety and treatment. In several studies, they used the early warning scores (EWS) and Machine learning with patients' information, vital signs, prehospital patient data, and physician assessments embedded in it to identify patients at risk for sepsis. One of the studies incorporated a device …

Development Of A Clinical Pathway For Acute Pain Management As An Element Of The Prevention Of Delirium In Older Adult Trauma Surgery Patients, Stacey Mermigos

Doctoral Scholarly Projects & Capstones

For hospitalized patients, delirium is prevalent and associated with poor outcomes including increased mortality, morbidity, hospital length of stay, and healthcare costs. Although past studies have identified effective interventions to both prevent and manage delirium in critically ill patients, the most widely used evidence is not easily generalized to non-critically ill patients, specifically trauma patients who experience acute pain, serial surgical procedures, and other notable precipitating and predisposing factors. Clinical pathways are structured plans that are useful for encouraging consistent, evidence-based interventions for various medical conditions and situations. At this time, there is no clinical pathway for the prevention of …

A Four-Year Longitudinal Study Of Effectiveness Of Evidence-Based Bundle Practices For Preventing Catheter-Associated Urinary Tract Infections In An Academic Health Care Center, May Mei-Sheng Riley

Doctoral Projects

Catheter-associated urinary tract infections (CAUTIs) significantly contribute to morbidity, prolonged hospitalization, and elevated healthcare costs, underscoring the crucial need for prevention to ensure patient safety. Despite ongoing mitigation efforts, CAUTI prevalence remained a concern in our facility at the time of this study. Catheter insertion and maintenance bundles, a recognized framework utilizing teamwork, collaboration, and focused interventions, were implemented to reduce CAUTIs and improve patient safety. This study evaluated the effectiveness of these bundles in reducing CAUTIs and catheter utilization to identify best practices for enhanced catheter management and care quality.

Malaria In Mexico, C. Johnson

The Geographical Bulletin

The traditional picture of Mexico, at least to the average tourist, is never complete without a peon, in sombrero and serape, sleeping in the noonday sun, or putting off to manana whatever physical exertion is required. Actually, when seriously considered, this picture is found to be a myth, no more representative of the Mexican than the traditional cowboy or gangster image is of the American. What is interesting in the image of the peon, however, is that he is an excellent example of a population debilitated by malaria. To most North Americans, the existence of endemic malaria in an industrialized, …

Prognostic Value Of Serum And Bronchoalveolar Lavage Fluid Galactomannan Levels In Invasive Aspergillosis: An 8-Year Experience At A Tertiary Cancer Center, Saliba Wehbe, Anne-Marie Chaftari, Ray Hachem, Hiba Dagher, Andrea Haddad, Ann Philip, Ying Jiang, Ramia Zakhour, Peter Bakht, Jishna Shrestha, Peter Lamie, Robin Sherchan, Jennifer Makhoul, Patrick Chaftari, Issam I Raad

Faculty, Staff and Student Publications

Background: Invasive aspergillosis (IA) is a life-threatening fungal infection that primarily affects immunocompromised individuals and has high morbidity and mortality rates, necessitating timely diagnosis and treatment. This study aimed to evaluate the prognostic utility of serum and bronchoalveolar lavage (BAL) fluid galactomannan levels, as well as galactomannan kinetics, in patients with IA.

Methods: We retrospectively reviewed the medical records of patients who were diagnosed with proven or probable IA from March 2016 to April 2024 at a tertiary cancer center. The collected data included patient characteristics, baseline and peak galactomannan levels in serum and BAL fluid, galactomannan trends, and …

Antibiotic De-Escalation In The Intensive Care Unit: Rationale And Potential Strategies, Sarah Singer Matuszak, Lauren Kolodziej, Scott Micek, Marin Kollef

2020-Current year OA Pubs

Antibiotic de-escalation (ADE) is important to help optimize antibiotic use and balance the positive and negative effects of antimicrobial therapy. ADE should be performed promptly, and infections should be treated with the shortest course of antimicrobials as clinically feasible to avoid unnecessary use of broad-spectrum antimicrobials. Several tools have been developed to increase efficient ADE, including rapid diagnostic tests (ex. multiplex PCR), MRSA nasal PCR/culture, and biomarkers. Multiplex PCR and MRSA nasal PCR/culture have been associated with reductions in inappropriate antibiotic use. Procalcitonin, a biomarker, has been associated with shorter antimicrobial durations in some studies; however, widespread use may be …

Evaluating The Impact Of A Renal Dosing Refreshable Sidebar Report On Appropriateness Of Antimicrobial Dosing At A Large Acute Care Cancer Hospital, Emily Fox, Jovan Borjan, Nancy Vuong, Hannah Aune, Claire Marten, Joshua Hendrickson

Advances in Cancer Education and Quality Improvement

Background: Appropriate antimicrobial dosing is vital in the treatment of patients with infectious diseases, though adherence to guideline recommended doses is often suboptimal.

Outcomes: This study was conducted to evaluate the impact of a renal dosing refreshable sidebar report, which displayed recommendations from a previously developed institutional antimicrobial dosing guide at the time of antimicrobial order entry. The primary outcome was adherence to daptomycin dosing guideline recommendations before and after implementation.

Methods: This was a pre- and post-quasi-experimental study at a 600-bed acute care cancer hospital. Adult patients (≥18 years old) that received daptomycin from February-April 2021 (pre-intervention phase) and …

Displacement And Refugeeism In Liberia And Guinea: Reality And Policy Choices, Veronica Nmoma

Journal of African Policy Studies

No abstract provided.

Key Issues Affecting Health Care Delivery Systems In Selected Sub-Saharan African Countries, Alemu Mammo

Journal of African Policy Studies

No abstract provided.

Water-Associated Bacterial Infection Without Aquatic Exposure, Meghan Glaser, Ashley Armstrong, Justin Skrzynski

Conference Presentation Abstracts

Introduction: Shewanella algae is a gram-negative, facultatively anaerobic bacterium most commonly found in marine environments. It is an emerging human pathogen, most often associated with hepatobiliary and skin and soft tissue infections (SSTI) following water exposure. Known risk factors for infection include those participating in recreational water activities, flood victims, and those with underlying liver disease, immunosuppression, or IV drug use. This case involves a 70-year-old male who was involved in a motor vehicle accident in 2008 leading to multiple orthopedic surgeries complicated by recurrent prosthesis infections who presented with concern for sepsis. Case Description: Patient is a 70-year-old male …