Medicine and Health Sciences Commons^™

Association Between Race/Ethnicity And Covid-19 Disease Outcomes In The United States: A Qualitative Systematic Review Of The Literature, Jacob Smith

MEDI 9331 Scholarly Activities Clinical Years

Background/Objective: As studies have shown disparities in coronavirus disease-19 prevalence and severity, we sought to evaluate differences in outcomes of acute SARS-CoV-2 infection by race/ethnicity.

Design: Systematic review

Data Source: Studies from PubMed were included.

Review methods: Articles published in English language from January 1, 2019 through March 22, 2020. Studies included were observational studies that examined racial or ethnic disparities in SARS-CoV-2 infection outcomes in the United States. One reviewer performed data extraction.

Results: Out of a possible 1,944 articles, 99 observational studies (82 individual-level and 17 population-level) were included. Differential rates of hospitalization or otherwise severe illness …

Developing An Enhanced 7-Color Multiplex Ihc Protocol To Dissect Immune Infiltration In Human Cancers., Zhaoyu Sun, Richard Nyberg, Yaping Wu, Brady Bernard, William L. Redmond

Articles, Abstracts, and Reports

The TSA Opal multiplex immunohistochemistry (mIHC) protocol (PerkinElmer) has been used to characterize immune infiltration in human cancers. This technique allows multiple biomarkers to be simultaneously stained in a single tissue section, which helps to elucidate the spatial relationship among individual cell types. We developed and optimized two improved mIHC protocols for a 7-color panel containing 6 biomarkers (CD3, CD8, CD163, PD-L1, FoxP3, and cytokeratin (CK)) and DAPI. The only difference between these two protocols was the staining sequence of those 6 biomarkers as the first sequence is PD-L1/CD163/CD8/CK/CD3/FoxP3/DAPI and the second sequence is FoxP3/CD163/CD8/CK/CD3/PD-L1/DAPI. By comparing PD-L1/FoxP3 staining in …

2020 Kentucky Dental Workforce Update, Sydney P. Thompson, Melissa Slone, Frances J. Feltner

Center of Excellence in Rural Health Infographics

No abstract provided.

Investigations Into The Genetics Of Mixed Pathologies In Dementia, Adam Dugan

Theses and Dissertations--Epidemiology and Biostatistics

Alzheimer’s disease (AD) is an irreversible, progressive brain disorder that leads to a loss of memory and thinking skills. While tremendous progress has been made in our understanding of the genetics underlying AD, currently known genetic variants explain only approximately 30% of the heritable risk of developing AD. One hurdle to AD research is that it can only be definitively diagnosed at autopsy, making cruder, clinic-based diagnoses more common. In recent years, several brain pathologies that mimic AD’s clinical presentation have been identified including brain arteriolosclerosis, hippocampal sclerosis (HS), and, most recently, limbic-predominant age-related TDP-43 encephalopathy (LATE). It has become …

An Assessment Of Kentucky Birth Records, Focusing On Early-Onset Hypertensive Disorders Of Pregnancy, Environmental Metal Exposures, And Geocoding Precision, 2008-2017, Courtney J. Walker

Theses and Dissertations--Epidemiology and Biostatistics

Using live and stillbirth records from Kentucky (2008-2017), this dissertation assessed the county-level prevalence and geospatial patterns of early-onset hypertensive disorders of pregnancy (eHDP); examined the geocoding precision of addresses recorded on birth records, and evaluated the association between individual risk factors and environmental metal exposures on eHDP prevalence. After adjusting for maternal demographic factors and pre-existing health conditions, we observed that eHDP prevalence was 38% higher (aPR=1.38, 95%CI:1.16, 1.64) in counties with the highest prevalence of married women (> 53.8%) compared to lower prevalence areas (31.6%) had a 20% higher prevalence of eHDP(aPR=1.20, 95%CI:1.00, 1.44) compared to counties with …

A Baseline Review Of The Ability Of Hospitals In Kenya To Provide Emergency And Critical Care Services For Covid-19 Patients, Benjamin Wachira, Margarita Mwai

Emergency Medicine, East Africa

Introduction: As the Coronavirus Disease 2019 (COVID-19) cases in Kenya begin to rise, the number of severe and critical COVID-19 patients has the potential to quickly overload the local healthcare system beyond its capacity to treat people.

Objective: The purpose of this study was to gather information about the ability of hospitals in Kenya to provide emergency and critical care services and to identify priority actions for use by policymakers and other stakeholders as a roadmap toward strengthening the COVID-19 response in the country.

Methods: This was a comprehensive review of the published and grey literature on emergency and critical …

Exploring Nurse Beliefs And Perceived Readiness For System-Wide Integration Of Evidence-Based Practice In A Large Pediatric Health Care System, Lindsey Patton, Mayra Garcia, Virginia Young, Jerithea Tidwell

2021

Background: Implementation of evidence-based practice within healthcare leads to improved patient outcomes, high quality care, job satisfaction, reduced nursing turnover, professional autonomy, and validates nursing practice. Although there is a plethora of research focusing on implementation of EBP, little attention has been given to assess organizational readiness for integration.

Aims/ Methods: The primary aims were to explore nursing beliefs and attitudes about EBP using the Evidence Based Practice Beliefs Scale (EBPB) and the culture and readiness among pediatric nurses for system wide integration of EBP using the Organizational Culture and Readiness for System-Wide Integration of Evidence-Based Practice (OCRSIEP).

Results: Overall …

How A Crew Of Experts Can Pave The Road To Quality Improvement Inpreventing Central Line-Associated Bloodstream Infections, Ginny Leinweber, Angie Morris, Kendra Shotts-Fraser

2021

Purpose

To improve outcomes for PICU patients with central lines by reducing central line-associated bloodstream infections (CLABSIs) and meeting a 2021 goal rate of < 1.3 infections per 1000 central line days.

Background

PICU CLABSI rates increased from 2.2 in 2019 to 2.6 in 2020. Despite this increase, Quality and Safety data showed high compliance to CLABSI prevention bundles and no evident trends to inform improvement efforts.

Methodology

PICU leadership and CNS met to discuss quality improvement solutions to supplement routine safety cards and decrease CLABSI rates. This team developed a plan for a group composed of designated bedside staff and unit leaders who would focus on reducing …

Squashing Superbugs: Using Procalcitonin Levels Toidentify Bacterial Infections To Direct Antibiotic Therapy, Janna Berg, Tera Holland, Krista Westbrook

2021

The current standard in diagnosing and treating pediatric infections is obtaining cultures, interpreting complete blood count results, and following the trends of erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP). Infection triggers an inflammatory response; if untreated or mistreated, this microbe invasion can lead to sepsis. The purpose of this submission is to address the promising use of procalcitonin levels (PCT) as a superior marker in the early detection of bacterial infection via a scholarly literature review. 

Studies involving PCT are more readily found in the evaluation of the neonatal population and in adults with respiratory illnesses. Pediatric studies are …

Exploring Child Anxiety And Family Satisfaction In Thepre Anesthesia Clinic, Ann Johnson, Bonita Conley, Brenda Fields

2021

Studies show that families experience anxiety in the perioperative period. From the child’s perspective, coping with stressful experiences varies according to their appraisal of the situation, their experience and cognitive stage. Child stress or anxiety is best ascertained by self-report, and there is lack of evidence about the child's perspective during the pre-anesthesia period, as well as factors that relate to child anxiety. Purpose: The purpose of this project was to explore child report of anxiety during the pre-anesthesia clinic visit prior to a scheduled procedure with general anesthesia in a sample of patients ages 7 to 17 years. We …

Picu Team Member Innovative Support Planintentional Caring Practices To Mitigate Moral Distress, Secondary Trauma, Andburnout In The Intensive Care Unit., Ginny Leinweber, Kendel Richards, Jessica Roumillat

2021

Situation:

PICU staff frequently verbalize feelings of moral distress, anxiety, and exhaustion related to repeated exposure to complicated, ethically challenging situations and the intense nature of work in the PICU. Stressors associated with complex long term patient cases, deaths, medical errors, and adverse events are compounded by factors like the pandemic, high patient acuity, and instability of staffing. Collectively, these situations increase the risk of burnout and decreased job satisfaction.

Background:

Research shows that cultivating resiliency practices can improve overall well-being of the individual and lessen burnout and turnover. Though the hospital offers a program (RISE) that promotes resilience, integrated …

The Critical Need For A Culturally Sensitive Suicide Risk Assessment Instrument For American Indian And Alaska Native Youth, Courtney E. Shaw

All Graduate Theses, Dissertations, and Other Capstone Projects

Objective: This systematic literature review was conducted to better understand why there has been a significant increase in America Indian/Alaska Native (AI/AN) youth suicides in tribes across the United States today. The intent of this review is to understand key issues surrounding the increasing numbers of AI/AN youth with suicide ideation, plans, and attempt in order to be able to answer the following clinical question: Is there a valid and reliable culturally sensitive assessment tool designed to recognize at-risk AI/AN youth presenting for primary care? If not, what are key aspects to consider for developing an instrument that could …

Younger Hmong People’S Willingness To Communicate About Depression, Wa Yang

All Graduate Theses, Dissertations, and Other Capstone Projects

This research examines the underlying issues about mental illness, particularly depression within the Hmong community. Previous scholars have focused on the Hmong culture’s origins, mental health status of Hmong refugees arriving in the United States, martial roles and mental health on Hmong females, and comparisons of Hmong traditional healing and Westernized medicine. These studies intersect in fields including psychology, medicine and public health, Hmong history, and social work. However, one missing component to this body of scholarship has been communication. Thus, my study focused on younger Hmong people’s willingness to communicate about depression within their families. Specifically, I conducted semi-structured …

Integrated Systems Analysis Of Mixed Neuroglial Cultures Proteome Post Oxycodone Exposure, Rahul Guda, Katherine E. Odegaard, Chengxi Tan, Victoria L. Schaal, Sowmya V. Yelamanchili, Gurudutt Pendyala

Journal Articles: Anesthesiology

Opioid abuse has become a major public health crisis that affects millions of individuals across the globe. This widespread abuse of prescription opioids and dramatic increase in the availability of illicit opioids have created what is known as the opioid epidemic. Pregnant women are a particularly vulnerable group since they are prescribed for opioids such as morphine, buprenorphine, and methadone, all of which have been shown to cross the placenta and potentially impact the developing fetus. Limited information exists regarding the effect of oxycodone (oxy) on synaptic alterations. To fill this knowledge gap, we employed an integrated system approach to …

Hemingway Drunk: A Study Of Prohibition, Medico-Legal Rhetoric, And The Autonomy Of Masculinity, Graham P. Studdard

Honors Undergraduate Theses

This thesis uses a combination of medical humanities, queer public theory, and literary analysis to showcase the uniquely American connections between alcoholism and masculinity in the literature of Ernest Hemingway. By situating both Hemingway and his characters within the medico-legal rhetoric of modernism’s famous Parisian Jazz-age, which occurred at the same time as American prohibition, I reveal changes in white American men’s relationships with gender, bodily autonomy, and the patriarchy that are often overlooked due to Hemingway’s publicly constructed masculine persona. My work provides new queer interpretations of The Sun Also Rises (1926) and the posthumous Garden of Eden (1986) …

Cognitive Abilities In Hearing Loss: Perceived And Performance Abilities Of Adults Related To Attention, Memory, And Social Cognition, Karah Gottschalk

Theses and Dissertations--Gerontology

Hearing loss is the most common sensory deficit noted in aging adults. It is commonly known to reduce an individual’s ability to detect, identify, and localize sounds and speech and to cause issues in communication. However, there are other less commonly discussed impacts that hearing loss has beyond the auditory system. Literature suggests a correlation between hearing loss and cognition in aging adults. Similar to hearing loss, the domains of cognition experience performance and functional changes across the life span. In an aging adult, changes related to cognition are also suggested to be associated with hearing loss. This study aimed …

A Systematic Review Of Center Of Mass As A Measure Of Dynamic Postural Control Following Concussion, Sarah Patejak, Joshua Forrest, Emily Harting, Mable Sisk, Eric Schussler

Rehabilitation Sciences Faculty Publications

BACKGROUND: The incidence of sports-related concussion in the US is between 1.6-3.8 million annually. Identification of ongoing impairment post-concussion continues to be challenging, as research indicates many patients are cleared for return to activity while still suffering subclinical impairment of function. Purpose: To identify and review the current literature on the use of center of mass (COM) during gait as a potential indicator variable after concussive injury. Study Design: Systematic Review.

METHODS: A Pubmed search was undertaken utilizing search terms involving gait performance and concussion. Study inclusion criteria included: (1) COM used as a variable in data analysis, (2) study …

Alcohol-Induced Lysosomal Damage And Suppression Of Lysosome Biogenesis Contribute To Hepatotoxicity In Hiv-Exposed Liver Cells, Moses New-Aaron, Paul G. Thomes, Murali Ganesan, Raghubendra Singh Dagur, Terrence Donohue, Kusum K. Kharbanda, Larisa Y. Poluektova, Natalia A. Osna

Journal Articles: Internal Medicine

Although the causes of hepatotoxicity among alcohol-abusing HIV patients are multifactorial, alcohol remains the least explored “second hit” for HIV-related hepatotoxicity. Here, we investigated whether metabolically derived acetaldehyde impairs lysosomes to enhance HIV-induced hepatotoxicity. We exposed Cytochrome P450 2E1 (CYP2E1)-expressing Huh 7.5 (also known as RLW) cells to an acetaldehyde-generating system (AGS) for 24 h. We then infected (or not) the cells with HIV-1_ADA then exposed them again to AGS for another 48 h. Lysosome damage was assessed by galectin 3/LAMP1 co-localization and cathepsin leakage. Expression of lysosome biogenesis–transcription factor, TFEB, was measured by its protein levels and by …

Understanding Structural Malleability Of The Sars-Cov-2 Proteins And Their Relation To The Comorbidities, Sagnik Sen, Ashmita Dey, Sanghamitra Bandyopadhyay, Ujjwal Maulik, Vladimir Uversky

Molecular Medicine Faculty Publications

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a causative agent of the coronavirus disease (CoVID-19), is a part of the β-coronaviridae family. In comparison with two other members of this family of coronaviruses infecting humans (SARS-CoV and Middle East Respiratory Syndrome (MERS) CoV), SARS-CoV-2 showed the most severe effects on the entire Earth population causing world-wide CoVID-19 pandemic. SARS-CoV-2 contains five major protein classes, such as four structural proteins (Nucleocapsid (N), Membrane (M), Envelop (E), and Spike Glycoprotein (S)) and Replicase polyproteins (R), which are synthesized as two polyproteins (ORF1a and ORF1ab) that are subsequently processed into 12 nonstructural proteins …

Natural Resources To Control Covid-19: Could Lactoferrin Amend Sars-Cov-2 Infectivity?, Ehab H. Mattar, Fatma Elrashdy, Hussein A. Almehdar, Vladimir N. Uversky, Elrashdy M. Redwan

Molecular Medicine Faculty Publications

The world population is still facing the second wave of the COVID-19 pandemic. Such a challenge requires complicated tools to control, namely vaccines, effective cures, and complementary agents. Here we present one candidate for the role of an effective cure and/or complementary agent: lactoferrin. It is the cross-talking mediator between many organs/cellular systems in the body. It serves as a physiological, immunological, and anti-microbial barrier, and acts as a regulator molecule. Furthermore, lactoferrin has receptors on most tissues cells, and is a rich source for bioactive peptides, particularly in the digestive system. In the past months, in vitro and in …

Networks Of Networks: An Essay On Multi-Level Biological Organization, Vladimir N. Uversky, Alessandro Giuliani

Molecular Medicine Faculty Publications

The multi-level organization of nature is self-evident: proteins do interact among them to give rise to an organized metabolism, while in the same time each protein (a single node of such interaction network) is itself a network of interacting amino-acid residues allowing coordinated motion of the macromolecule and systemic effect as allosteric behavior. Similar pictures can be drawn for structure and function of cells, organs, tissues, and ecological systems. The majority of biologists are used to think that causally relevant events originate from the lower level (the molecular one) in the form of perturbations, that “climb up” the hierarchy reaching …

On The Prevalence And Potential Functionality Of An Intrinsic Disorder In The Mers-Cov Proteome, Manal A. Alshehri, Manee M. Manee, Fahad H. Alqahtani, Badr M. Al-Shomrani, Vladimir N. Uversky

Molecular Medicine Faculty Publications

Middle East respiratory syndrome is a severe respiratory illness caused by an infectious coronavirus. This virus is associated with a high mortality rate, but there is as of yet no effective vaccine or antibody available for human immunity/treatment. Drug design relies on understanding the 3D structures of viral proteins; however, arriving at such understanding is difficult for intrinsically disordered proteins, whose disorder-dependent functions are key to the virus’s biology. Disorder is suggested to provide viral proteins with highly flexible structures and diverse functions that are utilized when invading host organisms and adjusting to new habitats. To date, the functional roles …

Tudor Staphylococcal Nuclease Is A Docking Platform For Stress Granule Components And Is Essential For Snrk1 Activation In Arabidopsis, Emilio Gutierrez-Beltran, Pernilla H. Elander, Kerstin Dalman, Guy W. Dayhoff, Panagiotis N. Moschou, Vladimir N. Uversky, Jose L. Crespo, Peter V. Bozhkov

Molecular Medicine Faculty Publications

Tudor staphylococcal nuclease (TSN; also known as Tudor-SN, p100, or SND1) is a multifunctional, evolutionarily conserved regulator of gene expression, exhibiting cytoprotective activity in animals and plants and oncogenic activity in mammals. During stress, TSN stably associates with stress granules (SGs), in a poorly understood process. Here, we show that in the model plant Arabidopsis thaliana, TSN is an intrinsically disordered protein (IDP) acting as a scaffold for a large pool of other IDPs, enriched for conserved stress granule components as well as novel or plant-specific SG-localized proteins. While approximately 30% of TSN interactors are recruited to stress granules …

Baicalein Inhibits Heparin-Induced Tau Aggregation By Initializing Non-Toxic Tau Oligomer Formation, Shweta Kishor Sonawane, Vladimir N. Uversky, Subashchandrabose Chinnathambi

Molecular Medicine Faculty Publications

Background: Amyloid aggregate deposition is the key feature of Alzheimer’s disease. The proteinaceous aggregates found in the afflicted brain are the intra-neuronal neurofibrillary tangles formed by the microtubule-associated protein Tau and extracellular deposits, senile plaques, of amyloid beta (Aβ) peptide proteolytically derived from the amyloid precursor protein. Accumulation of these aggregates has manifestations in the later stages of the disease, such as memory loss and cognitive inabilities originating from the neuronal dysfunction, neurodegeneration, and brain atrophy. Treatment of this disease at the late stages is difficult, and many clinical trials have failed. Hence, the goal is to find means capable …

Biomolecules From Different Angles, Vladimir N. Uversky

Molecular Medicine Faculty Publications

No abstract provided.

Questions Concerning The Proximal Origin Of Sars-Cov-2, Murat Seyran, Damiano Pizzol, Parise Adadi, Tarek M. El-Aziz, Sk. Sarif Hassan, Antonio Soares, Ramesh Kandimalla, Kenneth Lundstrom, Murtaza Tambuwala, Alaa A. Aljabali, Amos Lal, Gajendra K. Azad, Pabitra P. Choudhury, Vladimir N. Uversky, Samendra P. Sherchan, Bruce D. Uhal, Nima Rezaei, Adam M. Brufsky

Molecular Medicine Faculty Publications

No abstract provided.

Targeting Autophagy In Ischemic Stroke: From Molecular Mechanisms To Clinical Therapeutics, Amir Ajoolabady, Shuyi Wang, Guido Kroemer, Josef M. Penninger, Vladimir N. Uversky, Domenico Pratico, Nils Henninger, Russel J. Reiter, Askiel Bruno, Kaumudi Joshipura, Hamid Aslkhodapasandhokmabad, Daniel J. Klionsky, Jun Ren

Molecular Medicine Faculty Publications

Stroke constitutes the second leading cause of death and a major cause of disability worldwide. Stroke is normally classified as either ischemic or hemorrhagic stroke (HS) although 87% of cases belong to ischemic nature. Approximately 700,000 individuals suffer an ischemic stroke (IS) in the US each year. Recent evidence has denoted a rather pivotal role for defective macroautophagy/autophagy in the pathogenesis of IS. Cellular response to stroke includes autophagy as an adaptive mechanism that alleviates cellular stresses by removing long-lived or damaged organelles, protein aggregates, and surplus cellular components via the autophagosome-lysosomal degradation process. In this context, autophagy functions as …

Simple And Efficient Protocol For Immunoglobulin Y Purification From Chicken Egg Yolk, Elrashdy M. Redwan, Abdullah A. Aljadawi, Vladimir N. Uversky

Molecular Medicine Faculty Publications

Besides being a common food component broadly consumed worldwide, egg yolk immunoglobulin Y (IgY) has essential therapeutic potentials. In fact, in a time of ever-increasing risk of antibiotic resistance, it is crucial to find new ways to battle infection, and oral administration of preformed specific antibodies represents one of the most attractive approaches against infection. Infectious diseases of bacterial and viral origin in humans and animals can be controlled and passively cured by orally applied IgYs isolated from chicken egg yolks. Despite multiple obvious advantages of oral administration of IgY, harvesting IgY from egg yolk in a pure form is …

Structural Modeling Of The Treponema Pallidum Outer Membrane Protein Repertoire: A Road Map For Deconvolution Of Syphilis Pathogenesis And Development Of A Syphilis Vaccine, Kelly L. Hawley, Jairo M. Montezuma-Rusca, Kristina N. Delgado, Navreeta Singh, Vladimir N. Uversky, Melissa J. Caimano, Justin D. Radolf, Amit Luthra

Molecular Medicine Faculty Publications

Treponema pallidum, an obligate human pathogen, has an outer membrane (OM) whose physical properties, ultrastructure, and composition differ markedly from those of phylogenetically distant Gram-negative bacteria. We developed structural models for the outer membrane protein (OMP) repertoire (OMPeome) of T. pallidum Nichols using solved Gram-negative structures, computational tools, and small-angle X-ray scattering (SAXS) of selected recombinant periplasmic domains. The T. pallidum “OMPeome” harbors two “stand-alone” proteins (BamA and LptD) involved in OM biogenesis and four paralogous families involved in the influx/efflux of small molecules: 8-stranded β-barrels, long-chain-fatty-acid transporters (FadLs), OM factors (OMFs) for efflux pumps, and T. pallidum repeat proteins …

Serotonin Promotes Serum Albumin Interaction With The Monomeric Amyloid Β Peptide, Ekaterina A. Litus, Alexei S. Kazakov, Eugenia I. Deryusheva, Ekaterina L. Nemashkalova, Marina P. Shevelyova, Aliya A. Nazipova, Maria E. Permyakova, Elena V. Raznikova, Vladimir N. Uversky, Sergei E. Permyakov

Molecular Medicine Faculty Publications

Prevention of amyloid β peptide (Aβ) deposition via facilitation of Aβ binding to its natural depot, human serum albumin (HSA), is a promising approach to preclude Alzheimer’s disease (AD) onset and progression. Previously, we demonstrated the ability of natural HSA ligands, fatty acids, to improve the affinity of this protein to monomeric Aβ by a factor of 3 (BBRC, 510(2), 248–253). Using plasmon resonance spectroscopy, we show here that another HSA ligand related to AD pathogenesis, serotonin (SRO), increases the affinity of the Aβ monomer to HSA by a factor of 7/17 for Aβ40/Aβ42, respectively. Meanwhile, the structurally homologous SRO …