Digital Commons Network^™

Barriers And Facilitators To Implementing A Task-Sharing Mental Health Intervention For Sickle Cell Disease Populations In Low- And Middle-Income Countries: A Qualitative Analysis Using The Consolidated Framework For Implementation Research (Cfir), John Patena, Leah Elster, Tania Hameed, Sumedha Kulkarni, Alden Yuanhong Lai, Annika C Sweetland, Joyce Gyamfi, Temitope Ojo, Angela Odoms-Young, Charmaine Royal, Emmanuel Peprah

2020-Current year OA Pubs

BACKGROUND: People living with Sickle Cell Disease (SCD) experience higher rates of common mental disorders (CMD). There is an alarming treatment gap in the provision of adequate mental health services for CMDs in low- and middle-income countries (LMIC). One solution is the implementation of task-sharing interventions such as the Friendship Bench which utilizes concepts of problem-solving therapy (PST). This investigation uses a qualitative study design to evaluate the acceptability and feasibility of implementing a PST-based task-sharing mental health intervention for SCD populations in LMICs using the Consolidated Framework for Implementation Research (CFIR).

METHODS: Purposive, convenience, and snowball sampling strategies were …

Sauna Use As A Novel Management Approach For Cardiovascular Health And Peripheral Arterial Disease, Sergio Sastriques-Dunlop, Santiago Elizondo-Benedetto, Mohamed A Zayed

2020-Current year OA Pubs

INTRODUCTION: Heat therapy (HT), particularly in the form of whole-body sauna bathing, has emerged as a promising intervention for the management of cardiovascular disease (CVD). Passive HT can induce both local and systemic physiological responses, primarily through repeated thermal stress consisting of short-term passive exposure to high temperatures. Such responses closely parallel the physiological adaptations observed during aerobic exercise. Peripheral arterial disease (PAD) poses significant health challenges, impacting millions of individuals worldwide. Supervised exercise is considered a cornerstone therapy for PAD, yet many patients face significant health-related barriers that complicate its broad implementation.

METHODS: We conducted a comprehensive review of …

The Genomic Landscape Of Hermetia Illucens: Exploring The Potential Of The Black Soldier Fly Through Molecular Insights, Peter Muchina, Johnson Kinyua, Fathiya Khamis, Chrysantus M. Tanga, Grum Gebreyesus, Zexi Cai, Goutam Sahana

All Peer-Reviewed Publications

Abstract The black soldier fly (BSF), Hermetia illucens, has garnered significant attention recently due to its potential applications in waste management, animal feed production, frass fertilizer production, and biotechnology. Despite its numerous advantages, genomic resources for BSF remain limited, underscoring the necessity for continued genomic exploration. This review provides a comprehensive overview of the genomic landscape of BSF, emphasizing the critical role of genomics in understanding its biology and optimizing its applications. We highlighted recent advancements in BSF genome sequencing, transcriptomic and proteomic studies, and the characterization of the gut microbiome, revealing its implications for BSF health and production efficiency. …

From Myriad To Moderna: The Modern (Bio)Pharmaceutical Company, Ana Santos Rutschman

Faculty Publications

This Article examines the emergence of two modern pharmaceutical companies: Myriad and Moderna. After providing a brief background on each company, this Article contrasts them across the following areas: the technologies they have brought to market; their location; their start-up stages and the role that venture capital played in catalyzing their evolution from start-ups to large corporate structures; their relationships with other entities in the private sector, in academia and in the public sector; and their intellectual property and licensing strategies.

Predictors Of Viral Suppression Among People Living With Hiv (Plhiv) On Antiretroviral Treatment In Almaty, Kazakhstan, Ainur Kussainova

Electronic Theses & Dissertations (2024 - present)

ABSTRACT

Introduction

The Eastern Europe and Central Asia (EECA) region is experiencing the world’s fastest-growing HIV epidemic, with Kazakhstan among the countries most affected. Despite progress in HIV testing and treatment, Kazakhstan continues to face significant challenges in achieving optimal viral suppression among PLHIV. While 82% of PLHIV in Kazakhstan know their HIV status, only 73% are on ART, and just 67% of those on treatment achieve viral suppression. Adherence to ART remains a critical barrier, influenced by a complex interplay of individual, social, and structural factors, including mental health disorders such as depression, substance use, stigma and discrimination. Understanding …

Kafka In The Plague Years: Reinterpreting Absurdity In The 2020s, Chris Lownie

Electronic Theses & Dissertations (2024 - present)

No word better encapsulates the confusion and inequality proliferating in the post-2020 global world than “absurd.” Absurdity consumes the way we interact with one another, going about life-as-usual in pocket worlds in which the individual is alienated from both oneself and others. Life is defined by a series of problems that regularly go ignored by both institution and general populace alike, but not by the human body: the effects of sustained illness and reinfection by recurrent viruses in a world that no longer acknowledges their severity nor their pervasiveness nor steps we may take towards personal safety. Daily life has …

Ribosome Hibernation In Mycobacterium Abscessus And Its Effect On Antibiotic Resistance, Ryan Treen

Electronic Theses & Dissertations (2024 - present)

Non-tuberculosis mycobacteria (NTM) represent a diverse repertoire of species, most of which are ubiquitous in the environment. Some NTM species, such as Mycobacterium abscessus, can cause life-threatening infections in people with underlying medical conditions. The clinical incidence of such infections is on the rise, posing an emerging threat to public health. M. abscessus is characterized by intrinsic and acquired antibiotic resistance, complicating treatment strategies. Most chemotherapeutic approaches for M. abscessus infection target the bacterial ribosome, necessitating a better understanding of the physiological processes which confer this resistance. Multiple mycobacterial species respond to zinc-limiting conditions by inducing remodeling and hibernation …

Polygenic Risk Scores Of Grip Strength In Men And Women With Or At Risk For Hiv, Sreevidya Sadananda Sadasiva Rao

Electronic Theses & Dissertations (2024 - present)

Background: Adequate hand function among older adults is necessary for the successful completion of activities of daily living and can affect whether an older adult is able to live independently. Current research highlights grip strength, the strength people have in their hands, as a robust predictor of morbidity and mortality, and explores the decline in grip strength over time. A person’s family history and genes (DNA) affect how much grip strength they have. Previous studies have identified genes that affect grip strength, mainly in European ancestry populations. In this study, we examined whether these genetic elements predict grip strength in …

Association Of Non-Communicable Diseases With Severe Covid-19 Among People Living With And Without Diagnosed Hiv/Aids In New York State, Ravi Kumar Balu

Electronic Theses & Dissertations (2024 - present)

Background: People living with diagnosed HIV (PLWDH) have a higher chance of co-infections and co-morbidities than the general population. When SARS-CoV-2 was first reported in China in December 2019 and later declared a pandemic, it was speculated that PLWDH might be more prone to SARS-CoV-2 infection and severe disease outcomes given their increased vulnerability to other respiratory infections like influenza, pneumococcal pneumonia and tuberculosis. However, several facets of COVID-19 disease in PLWDH are incompletely understood, including whether non-communicable diseases (NCDs) are strong risk factors for severe disease outcomes and death as they are in the general population.

Methods: The data …

How Do Young Adults With Drug Use Disorder (Dud) Utilize Treatment? Exploring And Examining Lived Experiences Towards Treatment Completion In Indonesia, Dewi Kartikawatiningsih

Electronic Theses & Dissertations (2024 - present)

In Indonesia which has the highest rate of drug addiction in Southeast Asia, there is currently little knowledge about how young adults perceive the barriers faced when completing treatment or how treatment providers' perspectives influence their treatment completion. Understanding and identifying barriers to treatment completion is essential to making drug treatment more effective. The purpose of this study is to explore the perspectives and live experiences of young adults with DUD and their addiction counselors to develop a deeper understanding of treatment needs. This study interviewed 33 clients and 15 counselors from the rehabilitation center of the Badan Nasional Narkotika …

Theoretical Foundations And Applied Performance Of Periodicity-Aware Imputation: Variable Bandpass Block Bootstrap Methods For Incomplete Time Series, Asmaa Ahmad

Electronic Theses & Dissertations (2024 - present)

Time series data are prevalent across a wide range of disciplines, including health surveillance, public policy, and environmental monitoring. In the presence of underlying cyclical patterns, the integrity of time series analysis depends critically on the ability to detect, model, and impute structured missing data without compromising the temporal structure. This dissertation introduces and validates a novel imputation framework that integrates the Variable Bandpass Periodic Block Bootstrap (VBPBB) into multiple imputation procedures, improving the accuracy, robustness, and interpretability of time series models under high rates of missingness and noise. The overarching goal of this dissertation was to develop and evaluate …

Integration Of Theoretical Frameworks For Problematic Exercise: Toward A Comprehensive Model Of Maladaptive And Adaptive Exercise, Christina M. Sanzari

Electronic Theses & Dissertations (2024 - present)

Exercise can promote health and well-being, and yet a proportion of individuals who exercise develop a maladaptive relationship with physical activity. Problematic exercise is often associated with significant impairment and psychological distress, yet a consensus has not been reached regarding how problematic exercise should be conceptualized. The literature distinguishes between primary exercise dependence, or excessive exercise driven by its intrinsic reinforcement, and secondary exercise dependence, or excessive exercise driven by compensatory motivations related to weight and shape concerns. However, to date, little is known about the prevalence and nature of exercise dependence in the absence of eating pathology. This incongruity …

Molecular Epidemiologic Studies Of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (Me/Cfs), Anil Kumar

Electronic Theses & Dissertations (2024 - present)

Background: Myalgic encephalomyelitis (ME)/chronic fatigue syndrome (CFS) is a disabling multisystem complex disorder with no known etiology or approved treatment. Our studies aimed to assess the link between ME/CFS and autoimmune disease (AID) and cancer, and to identify potential biomarkers and biological mechanisms to further explore pathophysiology of this diseases.

Methods: All analyses were done using data from a case-control study of ME/CFS conducted by Dr. Roxana Moslehi and her collaborators. In our first study we estimated the cumulative incidences of AID and cancer among first degree relatives of 60 cases and 61 controls and compared cumulative …

Diversity Within Species: Mechanisms, Evolution And Implications In Bacterial Disease, Kathryn R. Piper

Electronic Theses & Dissertations (2024 - present)

The Gram-positive bacterium Staphylococcus aureus and the Gram-negative bacterium Escherichia coli are ubiquitous commensal and opportunistic pathogens. In humans, S. aureus is commonly found on the skin and mucus membranes, and is known to cause infections in the skin, bloodstream and brain. E. coli is a normal part of the gut microbiota in humans and can cause intestinal and extraintestinal infections alike. S. aureus and E. coli pose global threats to public health, due to the high morbidity and mortality of invasive strains. The wide range of infections they cause in humans and other animals are exacerbated by the presence …

Robot-Assisted Surgical Treatment Of Caseoma, Nancy Wang, Abdussalam Elsenousi, Kenneth K Liao

The Texas Heart Institute Journal

This report reviews 5 cases of mitral annular caseoma. Four patients presented with fatigue, stroke, or mitral stenosis. Robot-assisted resection of caseoma with or without mitral valve replacement was successfully performed in all patients with good outcomes. These cases demonstrate the safety and efficacy of robotic surgery in treating caseoma.

Different Responses Involving Tfh Cells Delay Parasite-Specific Antibody Production In Trypanosoma Cruzi Acute Experimental Models, Ana Carolina Leão, Maria Jose Villar, Rakesh Adhikari, Cristina Poveda, Leroy Versteeg, Gregório Almeida, Peter J Hotez, Maria Elena Bottazzi, Kathryn M Jones

Center for Medical Ethics and Health Policy Staff Publications

Introduction: Chagas disease (CD), caused by the parasite Trypanosoma cruzi, affects millions globally. Despite treatment options in the acute phase, most infections progress to a chronic indeterminate form or develop severe cardiac/gastrointestinal complications. Understanding the immune response is crucial for the development of vaccines and more efficient drugs for the disease control.

Methods: This work investigates the immune response to T. cruzi H1 K68 strain infection in female BALB/c and C57BL/6 mice to characterize differences in Tfh and B cell responses that may be involved in the poor parasite-specific antibody production during acute infection. For this, mice were euthanized …

Comparison Of Dynamic Mode Decomposition With Other Data-Driven Models For Lung Cancer Incidence Rate Prediction, L. Raymond Guo, Jifu Tan, M. Courtney Hughes

Faculty Articles, Papers, and Other Scholarship

Introduction: Public health data analysis is critical to understanding disease trends. Existing analysis methods struggle with the complexity of public health data, which includes both location and time factors. Machine learning offers powerful tools but can be computationally expensive and require specialized knowledge. Dynamic mode decomposition (DMD) is an alternative that offers efficient analysis with fewer resources. This study explores applying DMD in public health using lung cancer data and compares it with other machine learning models.

Methods: We analyzed lung cancer incidence data (2000–2021) from 1,013 US counties. Machine learning models (random forest, gradient boosting machine, support vector machine) …

Nanobody Screening And Machine Learning Guided Identification Of Cross-Variant Anti-Sars-Cov-2 Neutralizing Heavy-Chain Only Antibodies, Peter R. Mcilroy, Zhuoming Liu, Sean Whelan, Et Al.

2020-Current year OA Pubs

Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) continues to persist, demonstrating the risks posed by emerging infectious diseases to national security, public health, and the economy. Development of new vaccines and antibodies for emerging viral threats requires substantial resources and time, and traditional development platforms for vaccines and antibodies are often too slow to combat continuously evolving immunological escape variants, reducing their efficacy over time. Previously, we designed a next-generation synthetic humanized nanobody (Nb) phage display library and demonstrated that this library could be used to rapidly identify highly specific and potent neutralizing heavy chain-only antibodies (HCAbs) with prophylactic and …

Association Of Helicobacter Pylori Infection With Pediatric Asthma In Palestine, Alaa Hrizat, Amal A Shahin, Banan M Mafarjeh, Mohammad A Atawneh, Kamel Gharaibeh, Nisreen Rumman, Mutaz Sultan

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

Purpose: Significant debate exists on the association between Helicobacter pylori infection and childhood asthma. We aimed to explore this association in a cohort of children in Palestine while estimating the prevalence of H. pylori in this population. Methods: We conducted a prospective case-control study among children aged 6–15 years in Palestine, including 44 asthma cases diagnosed by pediatric pulmonologists and 99 age-matched healthy controls recruited through cluster sampling from schools. H. pylori status was determined using a stool antigen test. Asthma severity was assessed using the International Study of Asthma and Allergies in Childhood questionnaire. Data on recent antibiotic use, …

Differences In Long Covid Severity By Duration Of Illness, Symptom Evolution, And Vaccination: A Longitudinal Cohort Study From The Inspire Group, Michael Gottlieb, Huihui Yu, Ji Chen, Erica S. Spatz, Nicole L. Gentile, Rachel E. Geyer, Michelle Santangelo, Caitlin Malicki, Kristyn Gatling, Sharon Saydah, Kelli N. O'Laughlin, Kari A. Stephens, Joann G. Elmore, Lauren E. Wisk, Michelle L'Hommedieu, Robert M. Rodriguez, Juan Carlos C. Montoy, Ralph C. Wang, Kristin L. Rising, Efrat Kean, Jonathan W. Dyal, Mandy J. Hill, Arjun K. Venkatesh, Robert A. Weinstein

Department of Emergency Medicine Faculty Papers

Background: Although short-term outcomes of Long COVID have been described, longer-term physical and mental health outcomes of Long COVID are less well-established. This study sought to assess differences in long-term physical and mental health outcomes extending up to three years among those with current, resolved, and no Long COVID, as well as duration of Long COVID and vaccination status. Methods: This was a prospective, multisite, study of participants with SARS-CoV-2 infection from 12/7/2020-8/29/2022, with data collected through 4/2/2024. Surveys included validated tools for physical and mental health. Data were analyzed by Long COVID status (never-had, resolved, current), Long COVID duration …

From Misinformation To Policy Solutions: Teaching Herd Immunity And Vaccine Hesitancy Through Real-World Case Studies Of Measles Outbreaks, Laurieann Klockow

Biomedical Sciences Faculty Research and Publications

Vaccine hesitancy threatens herd immunity, contributing to the resurgence of measles outbreaks. This lesson engages upper-level biomedical science students in analyzing the complex interplay between vaccination rates, herd immunity and vaccine exemption policies through examination of the 2019 New York measles outbreak that threatened the United States’ measles elimination status. Students critically evaluate anti-vaccine misinformation, analyze epidemiological data and develop evidence-based policy recommendations to increase vaccination rates. The lesson combines team-based learning with authentic assessment through vaccine policy development, moving beyond knowledge acquisition and content to building scientific literacy and evidence-based reasoning skills essential for scientifically literate citizens and future …

Neonatal Immune System Development, Miriam Solomson

The Science Journal of the Lander College of Arts and Sciences

The immune system is essential for the body’s function and survival, consisting of two main components, the innate and adaptive immune systems. This paper will explore the various components of the neonatal immune system, such as the innate and adaptive or acquired systems, the initial colonization of microbes, and the crucial role of maternal antibodies. Additionally, this paper will delve into the significance of breastfeeding, the influence of different birth methods on gut microbiota, and the success of vaccines on neonates. This research paper’s goal is to provide insight into neonatal immune system development, the various factors that have an …

Risk Factors Of Covid-19 Mortality, Ellie Wolff

The Science Journal of the Lander College of Arts and Sciences

This paper investigates the relationship between key health demographics and COVID-19 mortality while focusing on identifying both physiological and genetic factors that contribute to variations in mortality rates. Specifically, it examines how pre-existing conditions—such as sex, autoimmune disorders, cardiovascular diseases, and obesity—interact with COVID-19 pathophysiology to influence patient outcomes. While previous research has highlighted demographic disparities in hospital mortality rates, this study aims to establish a causal, mechanistic link between these health factors and COVID-19 severity. Methods to extract and analyze data included literature review using existing studies such as peer-reviewed articles and reports from PubMed, CDC, etc. By analyzing …

Multidisciplinary Approach To Treating Complex Immune Dysregulation Disorders: An Adaptive Model For Institutional Implementation, Lauren A Henderson, Megan A Cooper, Anthony French, Et Al.

2020-Current year OA Pubs

Patients with immune dysregulation may present with varying combinations of autoimmunity, autoinflammation, immunodeficiency, atopy, lymphoproliferation, and/or malignancy, often with multisystem involvement. Recognizing specific patterns of immune dysregulation, coordinating and interpreting complex diagnostic testing, and choosing initial (often empiric) treatment can be challenging. Centers are increasingly assembling multidisciplinary teams (MDTs) to standardize evaluation and optimize treatment of patients with complex immune dysregulation (immune dysregulation MDTs [immMDTs]). However, published information on the composition and function of immMDTs is sparse, and there is little guidance for those seeking to establish or optimize an immMDT. To inform this review, we assembled a panel of …

Adapting Data Science Competencies By Role And Purpose: Voice Ai, David A Dorr, Andrea Krussel, Rachel Hauck, Christie Jackson, Abhijeet Dalal, Steven Bedrick, Philip R O Payne, Bridge2ai-Voice Consortium;, William Hersh

2020-Current year OA Pubs

Competencies help define the skills and knowledge needed by learners. Often broad, educators integrate competencies to provide a framework for curricula or professional standards. For data science, the rate of change in the field, role variations, and specificity in key applications can be challenging. Our objective was to adapt general data science competencies for different learner roles in an emerging area: the clinical utility of Voice, Language, and Speech-based Artificial Intelligence/Machine Learning (AI/ML). Using a persona-inductive approach, we adapted competencies to support learners from varying professional and educational backgrounds and implemented these adaptations in a multi-institutional summer school. Results from …

No Evidence Of Mmr Induced Trained Immunity To Prevent Sars Cov2: Results From A Multi-Centre Rct, Sinead Delany-Moretlwe, George Kyei, Erik Dubberke, Linda Yun, Leon Du Toit, Mary Politi, Ben Swan, Anne Deschryver, Sherry Mckinnon, Ananya Gupta, Shabaana Khader, Michael S Avidan, Et Al.

2020-Current year OA Pubs

BACKGROUND: Measles-containing vaccines (MCV), by training innate immune cells, are hypothesized to prevent severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and coronavirus disease 2019 (COVID-19).

METHODS: In this international, double-blind, placebo-controlled trial, we randomly assigned adults, 18 years and older, to receive MCV or saline. The primary outcome was polymerase chain reaction (PCR) confirmed symptomatic COVID-19, up to 60 days after intervention. Secondary outcomes were PCR-confirmed symptomatic COVID-19 and serologically confirmed SARS-CoV-2 infection, up to 150 days after intervention.

RESULTS: Of 3411 randomised participants, the modified intention-to-treat population included 1607 in the MCV and 1545 in the saline group. …

Characterization Of Tlr9 Responsiveness In Cell Subsets Derived From In Vitro Pdc Differentiation Of Hematopoietic Stem And Progenitor Cells, Sabina Sánchez Hernández, Tobias Wang Bjerg, Ian Helstrup Nielsen, Anders Laustsen, Hai Q Tang, Lars Henning Pedersen, Eynav Klechevsky, Martin R Jakobsen, Rasmus O Bak

2020-Current year OA Pubs

Plasmacytoid dendritic cells (pDCs) are multifunctional immune cells with roles in both the innate and adaptive immune system. Their hallmark function is production of large amounts of type I interferons in response to viral infections, but they are also capable of producing a range of other cytokines, antigen presentation, and cytotoxicity. Their potential as an immunotherapy for cancer and infectious disease is being explored, but broad application of these cells is challenged by low frequency in the blood and low viability during

Bcg-Induced Dna Methylation Changes Improve Coronavirus Disease 2019 Vaccine Immunity Without Decreasing The Risk For Severe Acute Respiratory Syndrome Coronavirus 2 Infection, Santiago Carrero Longlax, Kent J Koster, Ashish M Kamat, Marisa Lozano, Seth P Lerner, Rebecca Hannigan, Tomoki Nishiguchi, Abhimanyu, Daanish Sheikh, Malik Ladki, Alexandra Portillo, Amrit Koirala, Tajhal D Patel, Zoe Spieler, Aaron B Benjamin, Maxim Lebedev, Theresa U Ofili, Robert W Hutchison, George Udeani, Lynne A Opperman, Gabriel Neal, Anna M Mandalakas, Mihai G Netea, Moshe Arditi, Pablo Avalos, Sandra L Grimm, Cristian Coarfa, Jeffrey D Cirillo, Andrew R Dinardo

Faculty, Staff and Students Publications

BACKGROUND: The BCG vaccine induces trained immunity, an epigenetic-mediated increase in innate immune responsiveness. Therefore, this clinical trial evaluated if BCG-induced trained immunity could decrease coronavirus disease 2019 (COVID-19)-related frequency or severity.

METHODS: A double-blind, placebo-controlled clinical trial of healthcare workers randomized participants to vaccination with BCG TICE or placebo (saline). Enrollment included 529 healthcare workers randomized to receive BCG or placebo. Primary analysis evaluated COVID-19 disease frequency, while secondary analysis evaluated coronavirus immunity in a subset of participants. Study enrollment ceased early in December 2020 following introduction of COVID-19-specific vaccines.

RESULTS: Study enrollment was halted early, prior to reaching …

Impact Of Methicillin-Resistant Staphylococcus Aureus Surveillance And Decolonization In The Nicu: The Texas Children’S Hospital Experience, Nahid Hiermandi, Catherine Foster, Judith Campbell, Krystal Purnell, Elizabeth Tocco, Tjin Koy, Kenneth Nobleza, Duc Nguyen, Lucila Marquez

Faculty, Staff and Students Publications

OBJECTIVE: To determine the impact of screening and decolonization on methicillin-resistant

STUDY DESIGN: This is a single-center retrospective cohort study comparing patient characteristics among MRSA-colonized and MRSA-infected infants, rates of MRSA infection before and after screening with targeted decolonization, and MRSA infection among those receiving single or combined decolonization agents.

SETTING: Texas Children's Hospital Pavilion for Women is a 42-bed level three neonatal intensive care units (NICU) in Houston, TX.

PATIENTS: Neonates admitted to the NICU from 2012 to 2022 were included in analysis of MRSA colonization and infection. The gestational age ranged from 22 weeks to 42 weeks.

INTERVENTIONS: …

The Infected Diabetic Foot: Risk Factors For Re-Infection After Treatment For Diabetic Foot Osteomyelitis, Lawrence A Lavery, Mario C Reyes, Bijan Najafi, Tyler L Coye, Matthew Sideman, Michael C Siah, Arthur N Tarricone

Center on Aging Staff Publications

Our objective was to evaluate risk factors for re-infection in patients after treatment for diabetic foot osteomyelitis (OM). We used pooled patient level data from two RTCs that evaluated patients with diabetic foot infections. We evaluated 171 patients with OM. OM was confirmed with bone culture or histopathology. Data from the 12-month follow-up were used to determine clinical outcomes. Re-infection occurred in 47 (27.5%) patients. Risk factors for re-infection were Toe Brachial Index < 0.40 (25.7% vs. 9.8%, p = 0.02), skin perfusion pressure < 40 mmHg (6.3% vs. 5.9%, p = 0.04), wound healing (55.3% vs. 75.0%, p = 0.01), time to heal (156.0, 69.5-365 vs. 91.5, 38.8-365, p = 0.001), and history of MI (14.9% vs. 3.2%, p = 0.005). During 12-month follow-up, patients with re-infections were 198.8 times more likely to require a foot related hospitalisation (81.8% vs. 0.0%, p = 0.001), 10.4 times more likely have an all-cause hospitalisation (70.2% vs. 18.5%, p = 0.001) and 9.4 times more likely to need an amputation (36.2% vs. 5.6%, p = 0.001). Patients with re-infection had a significantly longer median length of hospitalisation (20.0, 13.5-34.5 vs. 14.0, 10.0-22.0, p = 0.003) and median length of antibiotic duration (55.0, 35.0-87.0 vs. 46.0, 22.8-68.0, p = 0.03). Patients with re-infection are less likely to heal and have more foot-related hospitalizations and amputations.