Digital Commons Network^™

Impact Of Efavirenz On Hormone-Positive Breast Cancer Survival In Women Living With Hiv, Arthur T Johnson, Taolo Ntloedibe, Jose Euberto Mendez Reyes, Mogomotsi S Matshaba, Scott L Dryden-Peterson, Elizabeth Y Chiao

Center for Medical Ethics and Health Policy Staff Publications

Women living with HIV and breast cancer have poorer survival than HIV-negative women. Efavirenz-estrogen interactions are documented; however, the survival impact is unknown. Survival between women with estrogen-receptor positive breast cancer taking efavirenz (n = 38) and nonefavirenz regimens (n = 51) were compared. The 5-year overall-survival was 48.9% [95% confidence interval (CI) 33.0-72.2 and 51.1% (95% CI 34.0-76.8)] in the efavirenz and nonefavirenz groups, respectively suggesting efavirenz is unlikely driving poorer survival in women living with HIV and estrogen-receptor positive breast cancer.

Improving Home Designs For Disease Prevention In Gated Communities And Satisfying Living Space Needs In Egypt: A Post-Pandemic Living Assessment, A. Moustafa Kamel Neveen Youssef Azmy, Shahira Sharaf Eldin

Journal of Engineering Research

Abstract Pandemics such as SARS and COVID-19 have highlighted the importance of preventing and controlling diseases. Virus transmission in residential buildings, especially multi-unit apartment complexes, has prompted calls for innovative housing designs. While Western countries prioritize physical and mental health in residential building design, China focuses on comfort, aesthetics, appearance, and lifestyle.

Left Behind In Lockdown: Covid-19 And The Denver Unhoused Community, Lucy Briggs

The Geographical Bulletin

The population experiencing homelessness in Denver, Colorado, increased by nearly 15% from 2018 to 2019. This trend, combined with the SARS-CoV-2 (COVID-19) pandemic of 2020, led to a distinct crisis for unhoused communities. This research attempted to answer the question, “How has COVID-19 impacted the locational strategies and spatial patterns of the Denver unhoused population in relation to public spaces and resources in the city core?” More specifically, this research has three objectives: (1) To explore the impact of COVID-19 on the shelter availability in Denver, (2) to develop an understanding of COVID-19’s impact upon public restrooms in Denver, and …

Dental Hygiene Burnout In Clinical Practice From Covid-19; A Pilot Study Using Self-Reported Questionaire, Yvette Valladares

Dental Hygiene ETDs

The purpose of this study was to determine if the Covid-19 pandemic had increased feelings of burnout in registered dental hygienists who were employed in clinical practice before and during 2020. A survey of registered dental hygienists in California was employed. Participants completed a modified Maslach Burnout Inventory, to evaluate emotional exhaustion (EE), depersonalization (DP), and personal accomplishment (PA). One open-ended question explored specific aspects of Covid-19 contributing to burnout. 162 surveys were completed and 139 met the inclusion criteria. Data analysis revealed that 40.29% reported high Emotional Exhaustion, 43.17% experienced low Depersonalization, and 85.61% reported high Personal Achievement. Lastly, …

Experiences Of Black Males With Generalized Anxiety Disorder During The Covid-19 Pandemic, Cynthia Lynn Williams

Walden Dissertations and Doctoral Studies

This qualitative research dissertation involved exploring the intersection of race, gender, and mental health via lived experiences of Black males who were diagnosed with generalized anxiety disorder during the COVID-19 pandemic to provide a comprehensive understanding of how the unique sociocultural context of the pandemic influenced their experiences with anxiety. Using a qualitative Interpretive Phenomenological Analysis research design and semi-structured interviews with a diverse sample of seven Black males living in various regions of the United States the interviews involved their personal experiences, coping mechanisms, and perceptions of societal and systemic factors that affected their mental health during the pandemic. …

Looking To The Past And Abroad To Enhance U.S. Presidential Debates, Jacob W. Justice, Talya P. Slaw, John Koch

Studies in Debate and Oratory

Presidential debates are a valuable, but flawed, method of educating voters about policy issues and candidates. Growing dissatisfaction with presidential debates, and polling evidence suggesting they are failing to inform audiences, creates exigence to reconsider the format of future debates. In this essay, we propose modifications to the format of United States presidential debates, in the interest of facilitating greater clash and audience education. To improve U.S. presidential debates, we draw upon two sources of inspiration: the history of U.S. presidential debates and international experiences with political debates. We recommend exploration of new debate formats that include (1) a narrow …

An International Multidisciplinary Consensus On Pediatric Metabolic Dysfunction-Associated Fatty Liver Disease, Le Zhang, Mortada El-Shabrawi, Louise A. Baur, Christopher D. Byrne, Giovanni Targher, Mohit Kehar, Gilda Porta, Way Seah Lee, Sander Lefere, Serap Turan, Anna Alisi, Ram Weiss, Maria Felicia Faienza, Ambika Ashraf, Shikha S. Sundaram, Anshu Srivastava, Ruth De Bruyne, Yunkoo Kang, Flora Bacopoulou, Yong Hai Zhou, Andy Darma, Monica Lupsor-Platon, Masahide Hamaguchi, Anoop Misra, Nahum Méndez-Sánchez, Nicholas Beng Hui Ng, Claude Marcus, Amanda E. Staiano, Nadia Waheed, Saleh A. Alqahtani, Cosimo Giannini, Ponsiano Ocama, Mindie H. Nguyen, Maria Teresa Arias-Loste

Population and Public Health Science Faculty Publications

Background: Non-alcoholic fatty liver disease (NAFLD) is highly prevalent in children and adolescents, particularly those with obesity. NAFLD is considered a hepatic manifestation of the metabolic syndrome due to its close associations with abdominal obesity, insulin resistance, and atherogenic dyslipidemia. Experts have proposed an alternative terminology, metabolic dysfunction-associated fatty liver disease (MAFLD), to better reflect its pathophysiology. This study aimed to develop consensus statements and recommendations for pediatric MAFLD through collaboration among international experts. Methods: A group of 65 experts from 35 countries and six continents, including pediatricians, hepatologists, and endocrinologists, participated in a consensus development process. The process encompassed …

Real-World Evidence Study On The Early Use Of Cemiplimab In The Uk: React-Cemi (Real World Evidence Of Advanced Cscc Treatment With Cemiplimab), Amarnath Challapalli, Grant Stewart, Heather Shaw, Peter John Davies, Juan Carlos Lopez-Baez, Edward C Ottley, Stephen Kelly

Faculty, Staff and Student Publications

BACKGROUND: Cemiplimab was licensed in the United Kingdom (UK) in 2019 for the treatment of patients with locally advanced and metastatic CSCC not suitable for curative surgery or radiotherapy (advanced CSCC [aCSCC]). No UK multi-center studies have investigated the real-world experience of cemiplimab post marketing authorization in aCSCC.

METHODS: This non-interventional retrospective study (10 UK centers) involved data collection from medical records of patients with aCSCC who initiated cemiplimab treatment between 2 July 2019 and 30 November 2020. The study period was a minimum of 12 and a maximum of 36 months post cemiplimab initiation. The primary objective was to …

The Experiences Of Icu Nurses Caring For Covid-19 Patients In Zambia, Mable Kasonde Mwila

Walden Dissertations and Doctoral Studies

The purpose of this research was to explore the experiences of ICU nurses caring for COVID-19 patients in Zambia. The problem was lack of knowledge on what intensive care unit nurses experienced while caring for COVID patients then to investigate the experiences of ICU nurses taking care of COVID patients in Lusaka, Zambia. Using Sister Callista Roy’s nursing adaptation model as a conceptual framework, the qualitative interpretative phenomenology approach was used to interview 14 participants in two hospitals in Zambia. MAXQDA software was used to organize data to develop codes and derive six themes, which were education, emotional and psychological …

East African Refugee Women Seeking Health Care After Government Assistance Ends, Sylivia Chelimo

Walden Dissertations and Doctoral Studies

East African refugee women arrive as a vulnerable population in their host country. Before coming to the United States, refugee women may have experienced varying levels of trauma due to civil wars, genocide, sexual assault, deaths of loved ones, terrorist attacks, being taken hostage, and torture in their home country. The purpose of this generic qualitative study was to explore the experiences of refugee women from East African countries seeking health care in the Central United States when government assistance ends. The framework of the behavioral model of health was the guide for examining the experiences of the participant refugee …

Giardiasis: A Review Study In Iraq, Sarah Kamal Naser

Al-Ameed Journal for Medical Research and Health Sciences

Background: Giardia lamblia is the parasite that causes giardiasis, small intestine infection can result in severe issues and persistent symptoms, especially in children, giardiasis is a common diarrheal disease that can affect anyone everywhere in the world. It may not show any signs at all or it may result in symptoms like intermittent flatulence or persistent malabsorption, Giardia antigen  test,  molecular test for the presence of parasite DNA in feces, and identification of the organism in fresh stool or duodenal contents are all methods of diagnosis.

Aims: Finding the prevalence of giardiasis among cities is the purpose of this review …

Implementation Of Chlorhexidine Gluconate Dressings And The Effect On Bloodstream Infections In Extracorporeal Membrane Oxygenation Patients At A Pediatric Hospital, Kaitlin Vernier

Dissertations

Extracorporeal membrane oxygenation (ECMO) is an advanced lifesaving therapy used for patients with significant cardiorespiratory failure not responding to conventional therapies. The most common and life-threatening complications associated with ECMO are blood stream infections (BSIs). In addition to increased mortality, BSI's increase patient length of stay and cost. Chlorhexidine Gluconate (CHG) is known to be a significant factor in BSI reduction. The purpose of this quality improvement project is to assess the utilization of CHG-impregnated dressings on the incidence of BSI rates in pediatric ECMO patients. The setting was a 40-bed pediatric intensive care unit (PICU) and a 30-bed cardiac …

Wiping Out Central Line Associated-Bloodstream Infections: Cleaning High Touch Surfaces In The Picu, Emily Heth

Dissertations

Problem: Central line-associated bloodstream infections (CLABSIs) are a significant, preventable healthcare-related complication of hospital admission and medical management of critically ill and medically complex patients. CLABSIs result in significant adverse outcomes such as increased morbidity and mortality, prolonged length of stay (LOS) in the intensive care unit (ICU) and in the hospital, increased cost of treatment, and increased rates of readmission. Direct and indirect contact within the patient’s hospital environment are potential means of transmission for microorganisms, increasing the inherent risk of acquiring a CLABSI.

Method: For this quality improvement (QI) project, a pre-post design was utilized to evaluate the …

Development Of A Simple And Accurate Polymerase Chain Reaction Screen For Human Papillomavirus In College Students, Emily Bishop, Owen Smith, Paul E. Richardson

Journal of the South Carolina Academy of Science

Human Papillomavirus (HPV) is, according to the CDC, the most common sexually transmitted infection (STI) with many infections developing in a person's late teens or early 20’s. HPV is a nonenveloped, relatively small, icosahedral DNA virus that infects squamous epithelial cells. This infection can happen in genital, anal, and oral cavities. 90% of these infections will self-clear in two years according to the CDC. Of the 10% of infections that do not clear in two years, they could develop into carcinomas later in life. The goal of this developmental research is to create a polymerase chain reaction (PCR) that can …

Emergent Emm4 Group A Streptococcus Evidences A Survival Strategy During Interaction With Immune Effector Cells, Chioma M Odo, Luis A Vega, Piyali Mukherjee, Sruti Debroy, Anthony R Flores, Samuel A Shelburne

Faculty, Staff and Student Publications

The major gram-positive pathogen group A Streptococcus (GAS) is a model organism for studying microbial epidemics as it causes waves of infections. Since 1980, several GAS epidemics have been ascribed to the emergence of clones producing increased amounts of key virulence factors such as streptolysin O (SLO). Herein, we sought to identify mechanisms underlying our recently identified temporal clonal emergence among emm4 GAS, given that emergent strains did not produce augmented levels of virulence factors relative to historic isolates. By creating and analyzing isoallelic strains, we determined that a conserved mutation in a previously undescribed gene encoding a putative carbonic …

The Impact Of Clinical Genome Sequencing In A Global Population With Suspected Rare Genetic Disease, Arturo Serize, Jorge Perez

All Publications

There is mounting evidence of the value of clinical genome sequencing (cGS) in individuals with suspected rare genetic disease (RGD), but cGS performance and impact on clinical care in a diverse population drawn from both high-income countries (HICs) and low- and middle-income countries (LMICs) has not been investigated. The iHope program, a philanthropic cGS initiative, established a network of 24 clinical sites in eight countries through which it provided cGS to individuals with signs or symptoms of an RGD and constrained access to molecular testing. A total of 1,004 individuals (median age, 6.5 years; 53.5% male) with diverse ancestral backgrounds …

Clonal Hematopoiesis Driven By Mutated Dnmt3a Promotes Inflammatory Bone Loss, Hui Wang, Kimon Divaris, Bohu Pan, Xiaofei Li, Jong-Hyung Lim, Gundappa Saha, Marko Barovic, Danai Giannakou, Jonathan M Korostoff, Yu Bing, Souvik Sen, Kevin Moss, Di Wu, James D Beck, Christie M Ballantyne, Pradeep Natarajan, Kari E North, Mihai G Netea, Triantafyllos Chavakis, George Hajishengallis

Faculty, Staff and Student Publications

Clonal hematopoiesis of indeterminate potential (CHIP) arises from aging-associated acquired mutations in hematopoietic progenitors, which display clonal expansion and produce phenotypically altered leukocytes. We associated CHIP-DNMT3A mutations with a higher prevalence of periodontitis and gingival inflammation among 4,946 community-dwelling adults. To model DNMT3A-driven CHIP, we used mice with the heterozygous loss-of-function mutation R878H, equivalent to the human hotspot mutation R882H. Partial transplantation with Dnmt3a

The Impact Of Clinical Genome Sequencing In A Global Population With Suspected Rare Genetic Disease, Erin Thorpe, Taylor Williams, Chad Shaw, Evgenii Chekalin, Julia Ortega, Keisha Robinson, Jason Button, Marilyn C Jones, Miguel Del Campo, Donald Basel, Julie Mccarrier, Laura Davis Keppen, Erin Royer, Romina Foster-Bonds, Milagros M Duenas-Roque, Nora Urraca, Kerri Bosfield, Chester W Brown, Holly Lydigsen, Henry J Mroczkowski, Jewell Ward, Fabio Sirchia, Elisa Giorgio, Keith Vaux, Hildegard Peña Salguero, Aimé Lumaka, Gerrye Mubungu, Prince Makay, Mamy Ngole, Prosper Tshilobo Lukusa, Adeline Vanderver, Kayla Muirhead, Omar Sherbini, Melissa D Lah, Katelynn Anderson, Jeny Bazalar-Montoya, Richard S Rodriguez, Mario Cornejo-Olivas, Karina Milla-Neyra, Marwan Shinawi, Pilar Magoulas, Duncan Henry, Kate Gibson, Samuel Wiafe, Parul Jayakar, Daria Salyakina, Diane Masser-Frye, Arturo Serize, Jorge E Perez, Alan Taylor, Shruti Shenbagam, Ahmad Abou Tayoun, Alka Malhotra, Maren Bennett, Vani Rajan, James Avecilla, Andrew Warren, Max Arseneault, Tasha Kalista, Ali Crawford, Subramanian S Ajay, Denise L Perry, John Belmont, Ryan J Taft

Center for Medical Ethics and Health Policy Staff Publications

There is mounting evidence of the value of clinical genome sequencing (cGS) in individuals with suspected rare genetic disease (RGD), but cGS performance and impact on clinical care in a diverse population drawn from both high-income countries (HICs) and low- and middle-income countries (LMICs) has not been investigated. The iHope program, a philanthropic cGS initiative, established a network of 24 clinical sites in eight countries through which it provided cGS to individuals with signs or symptoms of an RGD and constrained access to molecular testing. A total of 1,004 individuals (median age, 6.5 years; 53.5% male) with diverse ancestral backgrounds …

Leadership Lessons From Past Global Challenges: Managing The Climate Change Challenge Threatening Sustainable Development, Mostafa Sayyadi Ghasabeh, Michael J. Provitera

The Journal of Values-Based Leadership

On June 5, 2024, Antonio Guterres, Secretary-General of the United Nations, stated in open forum quite unequivocally: "We are playing Russian roulette with our planet. We need an exit ramp off the highway to climate hell. Indeed, climate change is a global challenge to sustainable development.” And an applied solution to this global challenge is a common interest point for all. This viewpoint article presents the key leadership lessons from past global challenges in order to better combat the climate change crisis, alleviate the suffering of those immediately affected, and build a more stable future for all.

Summer/Fall 2024

The Journal of Values-Based Leadership

No abstract provided.

Combating Disparities In A Pandemic: Increasing Dissemination Of Coronavirus Disease 2019 Resources In Spanish., Romina Barral, Nicholas Clark, Fernando Zapata, Lines Vargas Collado, July Jean Cuevas, Cristina Fernandez Md

Manuscripts, Articles, Book Chapters and Other Papers

INTRODUCTION: Disparities exist in access to coronavirus disease 2019 (COVID-19)-related health information. We aimed to close a gap in online traffic between English and Spanish COVID-19-related health information on our institution's publicly-facing website by 50% within ten months.

METHODS: We used A3 improvement methodology. Outcome measures were the mean monthly difference between English and Spanish COVID-19 online traffic vis-a-vis (1) total webpage views and (2) unique webpage visits. Process measures were stratification of outcome measures by language. Plan-Do-Study-Act cycles included: Recurring advertisements on a local Spanish television station disseminating up-to-date COVID-19 information, including our institution's Spanish COVID-19 online resources, incorporation …

Identification Of Blood Meals In Field Collected Culex Pipiens, Anopheles Sacharovi And Culex Tritaeniorhynchus (Diptera: Culicidae) Using The Elisa Method, Fatma Bursali, Gi̇zem Anti̇ka, Sare İlknur Yavaşoğlu, Fati̇h Mehmet Şi̇mşek

Turkish Journal of Zoology

Information obtained about the blood feeding behavior of mosquito populations in nature is important for understanding their vectorial capacity and evaluating their potential role in the transmission of vector-borne diseases. This study investigated the feeding patterns of Culex pipiens, Anopheles sacharovi and Culex tritaeniorhynchus by using ELISA method. A total of 435 blood-fed females were collected from the Aegean and Mediterranean regions of Türkiye between May 2021-September 2023. The types and numbers of potential domestic animal hosts were recorded in each village. Of the 372 blood meals tested, 348 gave a single host positive result mainly on bovine and human, …

Costs And Impact Of Disease In Adults With Sickle Cell Disease: A Pilot Study, Sophie Lanzkron, Nicole Crook, Joanne Wu, Sarah Hussain, Randall G. Curtis, Derek Robertson, Judith R. Baker, Diane Nugent, Amit Soni, Jonathan C. Roberts, Megan M. Ullman, Julie Kanter, Michael B. Nichol

Cardeza Foundation for Hematologic Research

We assessed the feasibility to estimate illness burden in adults with SCD, investigated factors associated with health-related quality of life (HRQoL), and estimated societal burden. We recruited 32 participants and collected data on fatigue, HRQoL, and work productivity and activity impairment via patient survey. Health care utilization was abstracted for the 12 months before enrollment using medical chart review. Mean age was 36.7 years; 84.4% of participants had hemoglobin SS or Sβthal0 disease, and 81.3% reported chronic pain (experiencing pain on ≥3 days per week in the past 6 months). Mean EQ-5D-3L visual analogue scale score was 63.4 and the …

Sexual And Reproductive Health Education: A Case Study At Pembina Pekanbaru Special School, Arif Prawira, Imas Diana Aprilia

Journal of ICSAR

The easy access to inappropriate content through digital media presents a particular challenge in education, particularly in special education. This research aims to get a better understanding of sexual and reproductive health education at the Pembina Pekanbaru Special School, Indonesia. The method of this research uses a qualitative method, and the data is collected through interviews with 4 teachers and 2 parents of students. The results indicate that sexual and reproductive health education at the school is still limited to aspects of the content of human anatomy and physiology. However, other aspects such as sexual and reproductive health are not …

The Multifaceted Role Of Neutrophils In Nsclc In The Era Of Immune Checkpoint Inhibitors, Shucheng Miao, Bertha Leticia Rodriguez, Don L Gibbons

Faculty, Staff and Student Publications

Lung cancer is the most common cause of cancer-related death in both males and females in the U.S. and non-small-cell lung cancer (NSCLC) accounts for 85%. Although the use of first- or second-line immune checkpoint inhibitors (ICIs) exhibits remarkable clinical benefits, resistance to ICIs develops over time and dampens the efficacy of ICIs in patients. Tumor-associated neutrophils (TANs) have an important role in modulating the tumor microenvironment (TME) and tumor immune response. The major challenge in the field is to characterize the TANs in NSCLC TME and understand the link between TAN-related immunosuppression with ICI treatment response. In this review, …

Implementation Of Intentional Hourly Rounding At Pediatric Hospital, Margaret Bernard

Dissertations

Problem: Intentional hourly rounding improves patient safety and can impact patient fall rates. At a pediatric hospital in suburban Missouri, the fall rate is 25%. This quality improvement project worked to implement a standardized intentional hourly rounding process at a pediatric hospital to bolster their fall prevention program.

Methods: This quality improvement project was conducted using a descriptive, observational design utilizing patient chart review and hospital quality department records. The setting was a 60-bed pediatric hospital in the Midwest with 2 inpatient units that specializes in chronic, complex care. The sample was a convenience sample of 92 male and female …

Morgs3 Functions In Intracellular Reactive Oxygen Species Perception-Integrated Camp Signaling To Promote Appressorium Formation In Magnaporthe Oryzae, Ruiming Zhang, Xinyu Liu, Jiayun Xu, Chen Chen, Zhaoxuan Tang, Chengtong Wu, Xinyue Li, Lei Su, Muxing Liu, Leiyun Yang, Gang Li, Haifeng Zhang, Ping Wang, Zhengguang Zhang

School of Graduate Studies Faculty Publications

Regulator of G-protein signaling (RGS) proteins exhibit GTPase-accelerating protein activities to govern G-protein function. In the rice blast fungus Magnaporthe oryzae, there is a family of at least eight RGS and RGS-like proteins (MoRgs1 to MoRgs8), each exhibiting distinct or shared functions in the growth, appressorium formation, and pathogenicity. MoRgs3 recently emerged as one of the crucial regulators that senses intracellular oxidation during appressorium formation. To explore this unique regulatory mechanism of MoRgs3, we identified the nucleoside diphosphate kinase MoNdk1 that interacts with MoRgs3. MoNdk1 phosphorylates MoRgs3 under induced intracellular reactive oxygen species levels, and MoRgs3 phosphorylation is required for …

Cyclical Interest In Entrepreneurship And The Virginia Economy, Daniel Farhat

Journal of Business & Entrepreneurship

This study uses keyword search data from Google to construct an index representing broad interest in entrepreneurship in Virginia. Dynamic correlations are evaluated to identify how short-term movements in the index relate to employment and earnings, leading economic indicators, home prices and business applications. Results support opportunity-driven mindsets in the labor market but not in the real estate market. The index is shown to have some economic prediction power, and is capable of producing new insights compared to data from actual business activity. This study highlights the role entrepreneurial interest may play in policy and lays the groundwork for further …

Deep Sequence-Coupled Biopanning And Vaccine Development, Julianne Peabody

Biomedical Sciences ETDs

Virus-like particles (VLPs) are nanoparticles comprised of viral structural proteins. They physically resemble the virus from which they are derived but lack genomic material. They are non-infectious, non-replicating, and have a favorable safety profile. VLPs are highly immunogenic with a dense, repetitive structure that is strongly activating for B cells. VLPs can be utilized to develop vaccines and can be used either as direct immunogens or platforms for the display of heterologous antigens. The display of foreign peptides on VLPs can be used to elicit high-titer antibodies against the displayed peptide. A virus-like particle based on the RNA bacteriophage MS2 …

Influence Of Social Capital On Community-Based Health Care Programs In Rural Paupa New Guinea: An Ethnographic Study, Carol J. Bett

Dissertations

This descriptive, ethnographic study explored the influence of cultural health beliefs and social capital on the adoption of community-based health care interventions by rural villages in Papua New Guinea. The development of local level resources that lead to improved health indices requires an awareness of both the cultural context and the relational components of social capital that link people within the community. Social capital has been defined as resources that are an inherent part of a social group and the elements of social organization such as trust, networks, and norms of reciprocity that facilitate mutual cooperation (Billings, 2000; Carpiano, 2006). …