Medicine and Health Sciences Commons^™

Characterization Of Age-Associated Gut Microbial Dysbiosis And Plasma Metabolite Alterations In People Living With Hiv (Plwh)., R. Sighal, Smita Ghare, Vaughn Bryant, Sabina Gautam, Chanakya Charan Tirumala, Andrea Reyes-Vega, Craig J. Mcclain, Ronald Cohen, Varand Govind, R L. Cook, Shirish Barve

Faculty Scholarship

Background: HIV-1 infection and aging are independently associated with gut microbial dysbiosis and neurocognitive impairment. However, the interactive effects of HIV-infection and aging on the development of specific pathogenic features of gut microbial dysbiosis and consequent metabolic abnormalities associated with neurocognitive dysfunction remain largely undetermined and were examined in the present study

International Respiratory Infections Society Covid Research Conversations: Podcast 3 With Dr. Antoni Torres, Julio A. Ramirez, Antoni Torres

The University of Louisville Journal of Respiratory Infections

Section(s) Topics

1–4 Introductions

5 “Spanish” influenza

6–9 Dr. Torres’ personal thoughts and experiences

10 COVID-19 hospitalizations in Barcelona

11 A threatening phone call

12–13 Origin of the CIBERESUCICOVID project

14 Baseline characteristics

15 Bloodwork at hospital admission; ICU admission vs. day 3

16 Treatments

17 Complications

18 Outcomes related to interventions

19 Viral RNA load in plasma associated with critical illness and dysregulated response

20 Follow-up with health care workers

21 Medical education

22 Conclusions

23–26 Interleukin 6

27–29 Ventilatory approach

30–33 Post-COVID syndrome

34–38 Impact on health care workers

39–41 Holidays and COVID-19 infection

42–43 New paradigm for …

A New Chapter In The Life Of The Journal, Julio A. Ramirez

The University of Louisville Journal of Respiratory Infections

No abstract provided.

A Transition Of Uljri Leadership, Forest W. Arnold, Jose Bordon

The University of Louisville Journal of Respiratory Infections

No abstract provided.

Facial Mask Use And Covid-19 Protection Measures In Jefferson County, Kentucky: Results From An Observational Survey, November 5−11, 2020, Seyed M. Karimi, Sonali S. Salunkhe, Kelsey B. White, Sahal A. Alzahrani, Bert Little, William P. Mckinney, Natalie Dupre, Riten Mitra, Yuting Chen, Martha M Popescu, Emily R. Adkins, Julia A. Barclay, Emmanuel Ezekekwu, Caleb.He X. He, Dylan M Hurst, Aravindreddy Kothagadi, Shaminul H. Shakib, Devin N. Swinney, David A. Johnson, Rebecca Hollenbach, Sarah Moyer

The University of Louisville Journal of Respiratory Infections

Introduction: The transmission of respiratory infectious diseases such as COVID-19 can significantly decrease by mask-wearing. However, accurate information about the extent and proper use of the facial mask is scarce. This study’s main objective was to observe and analyze mask-wearing behavior and the level of COVID-19 protection measures in indoor public areas (PAs) of Jefferson County, Kentucky.

Methods: For conducting the observational survey study, targets were indoor PAs, and zip codes were defined as surveying clusters. The number of selected PAs in each zip code was proportional to the population and the total number of PAs in that zip code. …

International Respiratory Infections Society Covid Research Conversations: Podcast 2 With Dr. Michael S. Niederman And Dr. Edward J. Schenck, Julio A. Ramirez, Michael S. Niederman, Edward J. Schenck

The University of Louisville Journal of Respiratory Infections

Section(s) Topics

1–4 Introductions

5 COVID-19 in New York City

6–7 Telemedicine, long-term sequelae

8 Development of a multi-disciplinary ICU team

9–10 Treatment of ARDS, COVID-19 pathogenesis

11–12 Prioritizing treatment at research

13 Challenges in tracing the natural history of severe COVID-19

14–15 Experience with mechanically ventilated patients; non-pulmonary organ failure

16–17 Mapping COVID-19 trajectories by SOFA score

18–20 Findings: additive organ dysfunction, improving vs. worsening trajectory

21 ARDS therapeutic approaches

22 Clinical trials involving Cornell

23–25 Lessons learned: patient care, research, education, caring for critical care workers

26–30 2021 predictions: improved therapies and research, endemic COVID-19, vaccines

31–33 Prioritizing …

Defining Early And Late Clinical Outcomes In Patients With Sars-Cov-2 Pneumonia, Julio A. Ramirez, Jose Bordon, Rodrigo Cavallazzi, Stephen P. Furmanek, Jiapeng Huang, Timothy L. Wiemken, Forest W. Arnold

The University of Louisville Journal of Respiratory Infections

No abstract provided.

Gme: Gym In Medical Education-Maintaining Physical And Mental Well Being During The Covid-19 Pandemic, Brian J. Nguyen, Elana A. Meer, Joyce E. Nguyen

Journal of Wellness

No abstract provided.

H1n1 Influenza Virus (Swine Flu): A Comprehensive Insight Into Escalating Catch-22 Scenarios, Muhammad Shahzaib, Ehsan Ul Haq

The University of Louisville Journal of Respiratory Infections

Introduction: Viruses have always been a major cause of various disastrous pandemics in mankind’s history. H1N1 became a threat when its original strain was first discovered back in the swine flu pandemic of 2009. It became highly catastrophic on a large scale because none of the therapeutic interventions and methodologies that were already present at the time were effective against the virus.

Methods: A vast amount of literature and research is available regarding H1N1 influenza from different reputable sources online. The data were gathered with the contrasting and relative situations of 1918 and 2009 pandemics in mind. The overall extracted …

The Complicated Path To Wellness, Jennifer Reese, Martin Huecker

Journal of Wellness

No abstract provided.

International Respiratory Infections Society Covid Research Conversations: Podcast 1 With Dr. Francesco Blasi, Julio A. Ramirez Md, Francesco Blasi Md, Phd

The University of Louisville Journal of Respiratory Infections

Section(s) Topics

1–2 Introductions

3 Foundations of best practice

4 COVID-19 as stimulus for innovation

5 Adapting and evolving therapeutic approach

6 Age and comorbidities as risk factors

7 Over-capacity ICU

8 Adapting the ER for COVID-19

9 Training personnel for COVID-19

10 Psychological support, healthcare heroes, and COVID fatigue

11 Increased oxygen requirement

12–13 Milan’s multi-disciplinary unit

14 Standardizing respiratory support measures

15 Nutrition, sedation, and life support

16 CPAP successes and failures

17 Prone and lateral positioning of patients on CPAP

18 Different COVID-19 phenotypes?

19 Thromboembolism risk score, age, and comorbidities

20 Cardiorespiratory considerations: hypertension, echocardiography

21 …

An Update On The Leading Covid-19 Vaccines, Ahmed A. Eladely, Javaria Anwer Mbbs, Ashwini Gotimukul Mbbs, Manish Kc Mbbs, Jessica Petrey Msls, Alex Glynn Ma, Ruth M. Carrico Phd, Dnp, Julio A. Ramirez Md

The University of Louisville Journal of Respiratory Infections

We reviewed the COVID-19 vaccines that reached phase III of clinical development. For each of the 10 vaccines identified, we described the technology used for vaccine development, the available data from phase III clinical trials, data on vaccine safety, and the role of new SARS-CoV-2 variants on vaccine efficacy.

The Words We Use, The Actions We Take, And The Perceptions We Hold: First-Step Assessments To Inform Wellness Curricula And Burnout Prevention Programming, Karen Horneffer-Ginter, Jeffrey Greene, Lisa Graves, Kristine Gibson, Roger Apple, Julia Tullio, Adrienne Kaufman

Journal of Wellness

Introduction: In response to concerns about burnout, many medical schools have been initiating wellness curricula and programming. A key to the success of these efforts is having engagement from targeted audiences. Gathering input from these groups regarding preferred lexicon, wellness actions, and perceptions of judgement or guilt around such actions can help in developing and promoting such curricular and programmatic offerings. Engagement is especially important when it comes to the predictors of burnout (e.g., self-care, self-compassion, and emotional self-disclosure).

Methods: Utilizing a focus-group methodology as a preliminary step, medical school faculty and students discussed terms regarding burnout predictors. Thematic analysis …

Lack Of Association Of The Abo Blood Group With Covid-19 Risk And Severity In Hospitalized Patients In Louisville, Ky, Rafael Fernandez-Botran, Meredith Cahill, Raghava S. Ambadapoodi, Evelyn Exposito Gonzalez, Stephen P. Furmanek, Ruth Carrico, Jose Bordon, Julio A. Ramirez

The University of Louisville Journal of Respiratory Infections

Background: The potential association of the ABO blood group with the risk of COVID-19 and its severity has attracted a lot of interest since the start of the pandemic. While a number of studies have reported an increased risk associated with blood type A and a reduced risk with type O, other studies have did not found a significant effect. This study aimed to define the prevalence of different ABO blood groups in hospitalized COVID-19 patients in the Louisville, KY area and to investigate whether an association exists between the blood group and disease severity.

Methods: This was a retrospective …

The Relevance Of Modern Stoicism, Maximillian V. Kutch

Journal of Wellness

No abstract provided.

Review Of Chemoselective Reagent Based-Breath Analysis Techniques, Madeline F. Mccloud

Grawemeyer Colloquium Papers

Volatile organic compounds (VOCs) pose a threat due to the negative effects of many compounds on human health. VOCs of interest are specific carbonyl compounds produced exogenously and endogenously, resultant of industrial pollution and diseases such as cancer. High concentrations of these carbonyl compounds are found in exhaled breath are linked to cancer, therefore non-invasive breath tests would prove beneficial for cancer diagnosis. Usage of chemoselective cationic reagents allows for efficient testing of these concentrations. The development of these breath tests is detailed in the report.

Gender Identity And Pronoun Usage In Standardized Patient Encounters, Martha M. Popescu, Emily J. Noonan, Laura A. Weingartner

Grawemeyer Colloquium Papers

One of the most common documentation frameworks clinicians use for patient evaluations are Subjective, Objective, Assessment, and Plan, (SOAP) notes. The clinician will usually record medical, family, social, etc. history as “subjective” information. Temperature, blood pressure, lab work, etc. would be considered “objective” information. An evaluation of the patient’s health and possible medical issues would be considered the “assessment,” and their intentions for current and future treatment would be the “plan” within these notes. Trainees often write SOAP notes after completing a standardized patient (SP) encounter—an educational practice used in medical schools to simulate real-world physician-patient interactions in order to …

A Comparative Analysis Of The Knowledge And Stigmatizing Attitude Of Ghanaians And Nigerians Towards Covid-19 Survivors, Emmanuel Lamptey, Dorcas Serwaa, Maxwell Hubert Antwi, Theckla Ikome Ms, Nkechi Odogwu

Journal of Refugee & Global Health

Introduction: In Africa, COVID-19 associated stigmatization still remains the contextual factor that poses a challenge for the mitigation and suppression of COVID-19 spread, especially among the illiterate populations. This comparative study was therefore conducted to assess the knowledge and willingness of Ghanaians and Nigerians to associate with COVID-19 survivors.

Methods: A cross-sectional study was conducted to collect information from 290 Ghanaian and 220 Nigerian nationals aged 18 years and above between 11th July-30th October 2020. An electronic-based questionnaire was developed to collect information on the public. The data were analyzed with SPSS v 22 and factors influencing knowledge and willingness …

Wellness Review 2020, Part 2, Brian Ferguson, Martin Huecker

Journal of Wellness

Introduction: This article comprises Part 2 of the Journal of Wellness review of 2020 wellness literature (July – December). In this review, JWellness editors continue the goal of offering a cohesive summary of recent publications within the wellness domain. We summarize new science and resilience initiatives published outside of JWellness that seek understanding of either burnout and its prevention or thriving in the medical community.

Methods: From the interval of 01 July – 31 Dec 2020, PubMed was queried for empirical research studies, review articles, and editorials in accordance with the following algorithm: an article was required to …

Physician Trading Cards As A Tool To Improve Resident Joy In Medicine While Improving Patient Satisfaction, Lindsay Weiss, Mary Edmond, Sarah Varghese, Anthony Cooley

Journal of Wellness

Introduction: To combat resident physician burnout, wellness programming should include approaches that foster joy to work as a physician. Photograph trading cards have been used to improve patient satisfaction but have not been explored as a way to improve physician work satisfaction. We aimed to use trading cards to improve resident physician identification by patients’ families, as well as measure their effect on the hospital experience for patients and residents.

Methods: For a one-month period in 2019, trading cards were piloted with the nine residents assigned to the inpatient pediatrics service. Employing five-point Likert scales, surveys were administered to residents …

Epidemiology And Outcomes Of Hospitalized Adults With Sars-Cov-2 Community-Acquired Pneumonia In Louisville, Kentucky, Julio A. Ramirez, T'Shura Ali, Thomas Chandler, Stephen P. Furmanek, Daniya Sheikh, Vidyulata Salunkhe, Steven Gootee, Mohammad Tahboub, William A. Mattingly, Demetra Antimisiaris, Jiapeng Huang, Jose Bordon, Rodrigo Cavallazzi, Paul Schulz, William P. Mckinney, Dawn Balcom, Mark Burns, Ruth Carrico, Forest W. Arnold, Cerid Covid-19 Study Group

The University of Louisville Journal of Respiratory Infections

Background: During the ongoing pandemic of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), SARS-CoV-2 community-acquired pneumonia (CAP) has been the primary cause of hospitalization. The objective of this study was to evaluate the clinical characteristics and outcomes of 1,013 patients hospitalized with SARS-CoV-2 CAP from September 2020 through March 2021 in Louisville, Kentucky.

Methods: This was a retrospective observational study of 1,013 patients hospitalized with SARS-CoV-2 CAP at eight of the adult hospitals in the city of Louisville from September 2020 through March 2021. Patients with 1) a positive reverse transcriptase-polymerase chain reaction (RT-PCR) for SARS-CoV-2, 2) fever, cough, or …

An Investigation Of The Character Strengths And Resilience Of Future Military Leaders, Lobna Chérif, Valerie Wood, Meaghan Wilkin

Journal of Wellness

Introduction: The importance of both character and resilience for critical occupations (military, emergency medicine, first responders, and correctional officers) has been emphasized at the highest levels of military leadership. No studies to date have examined the relationship between character strengths and resilience within military populations. The purpose of this study was to evaluate the perceived importance of character strengths for Canadian military cadet success, the top strengths endorsed by cadets, and, in a subset of cadets, the relationships among core strengths and resilience. In line with previous research on character strengths in military populations, we predicted that bravery, honesty, perseverance, …

Examining Neuroanatomical Effects Of Prenatal Valproic Acid And Postnatal Testosterone In A Mouse Model Of Autism Spectrum Disorder, Bishakha Kumari, Elizabeth Ann Gordon, Cynthia Corbitt

Undergraduate Arts and Research Showcase

Sex differences in Autism Spectrum Disorder (ASD) are well documented; males are diagnosed 4:1 over females. Testosterone (T) is one factor that differs by sex in humans and mice that could increase vulnerability to developing ASD in males. Valproic acid (VPA) is an anticonvulsant that has been found to increase the risk of autism in male offspring of pregnant women who take it to control seizures and is commonly used in mouse models of ASD. After prenatal VPA or vehicle on embryonic day 13, testosterone (T) or vehicle was administered to the mice on postnatal day 2 to investigate whether …

The Inhibition Of Growth Of S. Cerevisiae, U. Maydis, And M. Lychinidis-Dioicae By Apiaecea Plant Extracts, Jackson M Hoffman, Jared Scott, David Schultz Phd

Undergraduate Arts and Research Showcase

The Apiaceae family of plants contains over 3,500 species, many of which are used as food crops: vegetables (carrot, parsnip, celery, etc.), herbs (cilantro, fennel, dill, etc.), and spices (cumin, anise, caraway, etc.). Many spices have been shown to exhibit antimicrobial properties against both bacteria and fungi. We set out to determine if the Apiaceae spice extracts currently used in our lab for anticancer studies exhibit any antimicrobial properties. Ethanolic extracts were made from several Apiaceae seeds: Apium graveolens (celery), Cuminum cyminum (cumin), Anethum graveolens(dill), Foeniculum vulgare (fennel), Coriandrum satvium (coriander), Pimpinella ansium (anise), Trachyspermum ammi (ajwain), Carum carvi …

Comparing Medical Student Nonverbal Behavior With Cisgender And Transgender Standardized Patients, Meghan M. Schneider, Meghan M. Schneider, Emily J. Noonan, Laura A. Weingartner

Undergraduate Arts and Research Showcase

BACKGROUND

It is essential for medical students to effectively communicate with patients of all gender identities. Nonverbal behaviors such as eye contact and nodding are key communication skills. Evaluating nonverbal behavior is one way to assess the quality of patient care, and examining providers’ behaviors while working with cisgender and transgender patients can identify potential biases linked to patient identity.

METHODS

To evaluate nonverbal behavior, we analyzed video-recorded training sessions with medical students interviewing standardized patients who identified as cisgender or transgender women. All students identified as cisgender men or cisgender women. Ten nonverbal behaviors were rated from 1-7 using …

Hpv Vaccine Discussions Between Medical Students And Standardized Patients, Eric S. Brian, Emily Noonan, Laura A. Weingartner

Undergraduate Arts and Research Showcase

The vaccination against human papillomavirus (HPV) protectsindividuals from cancer by preventing HPV infection. This vaccination is recommended for people who are assigned male or female at birth. However, since these groups are often associated with different risks of HPV infection, there may be gaps in how effectively the vaccination is recommended to patients. We gathered data by viewing recordings of medical students taking histories from standardized patients. We recorded if and which vaccinations were discussed as the patients established primary care. We focused on discussions surrounding HPV vaccines and used discussions around influenza vaccines as a comparison. We recorded if …

Genus Applications For Alzheimer's Disease Pathology, Whitney L Carter

Undergraduate Arts and Research Showcase

Estimates vary, but it is thought that 5.5 million Americans age 60 and up may be living with Alzheimer’s diseases (AD). AD is the most common type of dementia and is characterized by a decline in episodic memories, long-term memory, language, attention, and personality changes. The first symptoms can vary, but for most people memory is the first capacity to become impaired. However, symptoms can also be a decline in non-memory aspects of cognition like work-finding, vision/spatial issues, and impaired reasoning or judgement. AD is identified mainly by two histopathological features: extracellular plague of amyloid-beta protein and intracellular neuronal tangles …

Efficacy Of A Social Determinants Of Health Training Intervention, Stacy A. Henley, Emily J. Noonan, Laura A. Weingartner

Undergraduate Arts and Research Showcase

BACKGROUND

Social determinants of health (SDOH) are circumstances, such as living and work conditions, that affect patient health outcomes and contribute to health inequalities. Understanding patients’ SDOH can help physicians recognize barriers to care. Therefore, it is important that medical students learn to gather information on SDOH from patients.

METHODS

Standardized patient (SP) encounters with rising third-year students were analyzed to determine if an educational intervention about SDOH increased the frequency SDOH were discussed with patients. SP encounters were randomly sampled from 2017 (pre-intervention, n₁ = 37) and 2018 (post-intervention, n₂ = 40) video recordings of students eliciting …

Epigenetic Mechanisms Underlying Hiv-Infection Induced Susceptibility Of Cd4+ T Cells To Enhanced Activation-Induced Fasl Expression And Cell Death., Smita Ghare, Paula M. Chilton, Aakarsha V. Rao, Swati Joshi-Barve, Paula Peyrani, Andrea Reyes-Vega, Craig J. Mcclain, Kendall Bryant, Robert L. Cook, Mathew Freiberg, Shirish Barve

Faculty Scholarship

Background:

Chronic immune activation and CD4⁺ T cell depletion are significant pathogenic features of HIV infection. Expression of Fas ligand (FasL), a key mediator of activation-induced cell death in T cells, is elevated in people living with HIV-1 infection (PLWH). However, the epigenetic mechanisms underlying the enhanced induction of FasL expression in CD4⁺ T lymphocytes in PLWH are not completely elucidated. Hence, the current work examined the effect of HIV infection on FasL promoter-associated histone modifications and transcriptional regulation in CD4⁺ T lymphocytes in PLWH.

Method:

Flow cytometric analysis was performed to examine the Fas-FasL expression on …