Medicine and Health Sciences Commons^™

Comparison Of Microbial Respiratory Cultures Versus Mrsa Nasal Screen To Guide Vancomycin De-Escalation In Patients Hospitalized For Bacterial Pneumonia, Victoria E. Grusauskas, Anthony Wasielewski, Kristin Boyar

Nursing & Health Sciences Research Journal

Background: Methicillin-resistant Staphylococcus aureus (MRSA) nasal screen identifies the presence of MRSA nasal colonization, which can be used as a valuable antimicrobial stewardship tool to de-escalate empiric vancomycin therapy in patients with pneumonia. Current practices at a Florida hospital include using respiratory culture and MRSA nasal screening results to assist in treating MRSA pneumonia infections. This study aimed to evaluate the total duration of vancomycin therapy in patients with suspected MRSA respiratory tract infections. Methods: This was a single-center, retrospective chart review conducted at a tertiary medical center. Adult patients were assigned to either the respiratory culture-directed group or the …

Polypharmacy And Medication Fill Nonadherence In A Population-Based Sample Of Adolescent And Young Adult Cancer Survivors, 2008–2017, Andrea C Betts, Caitlin C Murphy, L Aubree Shay, Bijal A Balasubramanian, Christine Markham, Michael E Roth, Marlyn Allicock

Faculty, Staff and Student Publications

PURPOSE: We examined the association between polypharmacy-an established risk factor for nonadherence in the elderly-and medication fill nonadherence in a large national sample of adolescent and young adult cancer survivors (AYAs) in the USA.

METHODS: We pooled data (2008-2017) from the Medical Expenditure Panel Survey. We defined polypharmacy as ≥ 3 unique medications prescribed, based on self-report and pharmacy data, and medication fill nonadherence as self-reported delay or inability to obtain a necessary medication. We estimated prevalence of medication fill nonadherence among AYAs (age 18-39 years with a cancer history). We used logistic regression to estimate the association between (1) …

Pneumatosis Intestinalis In Cancer Patients Who Received Immune Checkpoint Inhibitors, Gabriel Sperling, Malek Shatila, Krishnavathan Varatharajalu, Yang Lu, Mehmet Altan, Yan Zhou, Dan Zhao, Enrico N De Toni, Helga-Paula Török, Bryan J Schneider, Anam Khan, Anusha S Thomas, Hao Chi Zhang, Mehnaz A Shafi, Yinghong Wang

Faculty, Staff and Student Publications

Purpose: Immune checkpoint inhibitor (ICI) therapy may give rise to immune-related adverse events (irAEs). Pneumatosis intestinalis (PI), or gas within the bowel wall, has very rarely been observed following ICI therapy, and its clinical significance is unclear. We described the clinical characteristics and outcomes of PI as a possible irAE in cancer patients.

Methods: We retrospectively identified 12 adult cancer patients with radiologic evidence of PI within 1 year after ICI exposure during January 2010-January 2023. Clinical characteristics, treatment, and outcomes were evaluated.

Results: The median age of our sample was 64 years. The most common cancer types were thoracic/head …

Re: Incidence Of Sars-Cov-2 Breakthrough Infections After Vaccination In Adults: A Population-Based Survey Through 1 March 2023, Stacia M Desantis, Ashraf Yaseen, Tianyao Hao, Luis León-Novelo, Yashar Talebi, Melissa A Valerio-Shewmaker, Cesar L Pinzon Gomez, Sarah E Messiah, Harold W Kohl, Steven H Kelder, Jessica A Ross, Lindsay N Padilla, Mark Silberman, Samantha Wylie, David Lakey, Jennifer A Shuford, Stephen J Pont, Eric Boerwinkle, Michael D Swartz

Faculty, Staff and Student Publications

No abstract provided.

Atypical Meningiomas With Multiple Extracranial Metastases: A Case Description, Yipei Song, Mengyao Hu, Xiwen Wang, Qiming Fang, Xuan Xiao, Lianggeng Gong

Faculty, Staff and Student Publications

No abstract provided.

Economic Analysis Of Population-Based Next Generation Sequencing For Breast Cancer, Sapphire Curelaru

University Honors Theses

Breast cancer develops due to accumulated DNA replication insults which causes cancer to uncontrollably proliferate. An individual's predisposition to developing cancer, as well as the composition of a tumor, can be sequenced using genetic tests. Myriad's BRACAnalysis CDx^® seems to be the most utilized genetic test. However, Next Generation Sequencing (NGS) seems to be a better genetic test for breast cancer when compared to Myriad's BRACAnalysisCDx^® in terms of return-time, accuracy, efficiency, and healthcare cost. By using Next Generation Sequencing tests, stakeholders can save money on genetic testing which can be invested in more genetic tests. Payers can …

The Association Between Inflammatory Bowel Disease And All-Cause And Cause-Specific Mortality In The Uk Biobank, Fangyu Li, Yesenia Ramirez, Yukiko Yano, Carrie R Daniel, Shreela V Sharma, Eric L Brown, Ruosha Li, Baharak Moshiree, Erikka Loftfield, Qing Lan, Rashmi Sinha, Maki Inoue-Choi, Emily Vogtmann

Faculty, Staff and Student Publications

PURPOSE: Inflammatory bowel disease (IBD) has a rising global prevalence. However, the understanding of its impact on mortality remains inconsistent so we explored the association between IBD and all-cause and cause-specific mortality.

METHODS: This study included 502,369 participants from the UK Biobank, a large, population-based, prospective cohort study with mortality data through 2022. IBD was defined by baseline self-report or from primary care or hospital admission data. We estimated hazard ratios (HRs) and 95% confidence intervals (CIs) for all-cause and cause-specific mortality in multivariable Cox proportional hazards regression models.

RESULTS: A total of 5799 (1.2%) participants had a history of …

Development Of A Remote Dosimetric Audit Framework For Carbon Therapy, Paige Taylor

Dissertations and Theses (Open Access)

Carbon ion therapy is available at over a dozen institutions around the world and is being employed for treatment of cancer. The increased biological effect of carbon compared to conventional photon-based radiotherapy holds promise for the therapeutic benefit in historically radioresistant tumors. While ion chamber dosimetry has been used for day-to-day clinical measurements of absorbed dose, there are few options for remote dosimetry. The availability of such tools would support the development of a robust remote audit program for carbon ion therapy.

The Imaging and Radiation Oncology Core (IROC) conducts remote audits of photon and proton therapy. These audits are …

Downregulation Of Mir-10a-5p As A Potential Therapeutic Target To Improve The Detrimental Effects Of Post-Stroke Social Isolation, Patrick Mooz

Dissertations and Theses (Open Access)

Introduction

Social isolation is detrimental to health. Isolation and loneliness are linked to all-cause mortality and accelerated disease progression in patients with cancer, dementia, and vascular disease. The number of individuals that live alone is increasing in our society, especially in the elderly, and loneliness and isolation represent a profound growing public health challenge. Previous studies have found that the detrimental effects of social isolation can be recapitulated in animal models. Mice that are socially isolated (SI) prior to an experimental stroke have larger infarcts and significantly worse outcomes. Importantly, animals that remain pair housed (PH) when an experimental stroke …

A Novel Ngs Assay To Detect Any Kmt2a Fusion Transcript At Low Levels, Ghayas Issa

Dissertations and Theses (Open Access)

Measurable residual disease (MRD) detection is associated with cancer relapse. Leukemias with rearrangement of the lysine methyltransferase 2 A gene (KMT2Ar) have an adverse prognosis with more than 80 possible fusion partner genes (FPG) identified. With the advent of effective targeted therapies for KMT2Ar leukemia such as menin inhibitors, there is an unmet need for sensitive assays to detect these various fusions. Standard next-generation sequencing (NGS) methods cannot accurately detect genetic alterations at low frequencies because of inherent technical errors and the need for high sequencing depth. Blocker Displacement Amplification (BDA) technology enables selective detection of such rare …

Single Cell Proteogenomics Analysis Of Aml Samples Treated With Decitabine And Venetoclax Reveals Divergent Treatment Escape Mechanisms, Yi June Kim

Dissertations and Theses (Open Access)

Venetoclax is a small molecule inhibitor targeting BCL-2. Since its approval, the combination therapy of hypomethylating agents and Venetoclax (HMA+Ven) has become a standard of care for acute myeloid leukemia (AML) patients unfit for intensive chemotherapy. Nonetheless, clinical challenges persist as patients either do not respond or eventually relapse, and the underlying mechanisms of these outcomes are not yet fully understood. Prior studies have identified genetic factors (TP53 and RTK/RAS pathway mutations) and phenotypic factors (monocytic differentiation) to be associated with resistance. In this light, we hypothesized that integrative assessment of genetic and phenotypic factors could further elucidate the unknown …

Impact Of Post-Incarceration Care Engagement Interventions On Hiv Transmission Among Young Black Men Who Have Sex With Men And Their Sexual Partners: An Agent-Based Network Modeling Study, Anna L Hotton, Francis Lee, Daniel Sheeler, Jonathan Ozik, Nicholson Collier, Mert Edali, Babak Mahdavi Ardestani, Russell Brewer, Katrina M Schrode, Kayo Fujimoto, Nina T Harawa, John A Schneider, Aditya S Khanna

Faculty, Staff and Student Publications

BACKGROUND: Understanding the impact of incarceration on HIV transmission among Black men who have sex with men is important given their disproportionate representation among people experiencing incarceration and the potential impact of incarceration on social and sexual networks, employment, housing, and medical care. We developed an agent-based network model (ABNM) of 10,000 agents representing young Black men who have sex with men in the city of Chicago to examine the impact of varying degrees of post-incarceration care disruption and care engagement interventions following release from jail on HIV incidence.

METHODS: Exponential random graph models were used to model network formation …

Mortality And Morbidity Among Individuals With Hypertension Receiving A Diuretic, Ace Inhibitor, Or Calcium Channel Blocker: A Secondary Analysis Of A Randomized Clinical Trial, Jose-Miguel Yamal, Journey Martinez, Mikala C Osani, Xianglin L Du, Lara M Simpson, Barry R Davis

Faculty, Staff and Student Publications

IMPORTANCE: The long-term relative risk of antihypertensive treatments with regard to mortality and morbidity is not well understood.

OBJECTIVE: to determine the long-term posttrial risk of primary and secondary outcomes among trial participants who were randomized to either a thiazide-type diuretic, calcium channel blocker (CCB), or angiotensin-converting enzyme (ACE) inhibitor with up to 23 years of follow-up.

DESIGN, SETTING, AND PARTICIPANTS: This prespecified secondary analysis of the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT), a multicenter randomized, double-blind, active-controlled clinical trial, followed up with participants aged 55 years or older with a diagnosis of hypertension and at …

Opening The Black Box Of Family-Based Treatments: An Artificial Intelligence Framework To Examine Therapeutic Alliance And Therapist Empathy, Phillippe B Cunningham, Jordon Gilmore, Sylvie Naar, Stephanie D Preston, Catherine F Eubanks, Nina Christina Hubig, Jerome Mcclendon, Samiran Ghosh, Stacy Ryan-Pettes

Faculty, Staff and Student Publications

The evidence-based treatment (EBT) movement has primarily focused on core intervention content or treatment fidelity and has largely ignored practitioner skills to manage interpersonal process issues that emerge during treatment, especially with difficult-to-treat adolescents (delinquent, substance-using, medical non-adherence) and those of color. A chief complaint of "real world" practitioners about manualized treatments is the lack of correspondence between following a manual and managing microsocial interpersonal processes (e.g. negative affect) that arise in treating "real world clients." Although family-based EBTs share core similarities (e.g. focus on family interactions, emphasis on practitioner engagement, family involvement), most of these treatments do not have …

A Double-Robust Test For High-Dimensional Gene Coexpression Networks Conditioning On Clinical Information, Maomao Ding, Ruosha Li, Jin Qin, Jing Ning

Faculty, Staff and Student Publications

It has been increasingly appealing to evaluate whether expression levels of two genes in a gene coexpression network are still dependent given samples' clinical information, in which the conditional independence test plays an essential role. For enhanced robustness regarding model assumptions, we propose a class of double-robust tests for evaluating the dependence of bivariate outcomes after controlling for known clinical information. Although the proposed test relies on the marginal density functions of bivariate outcomes given clinical information, the test remains valid as long as one of the density functions is correctly specified. Because of the closed-form variance formula, the proposed …

Addressing Cervical Cancer Disparities In Texas: Expansion Of A Community-Based Prevention Initiative For Medically Underserved Populations, Samantha H Batman, Melissa L Varon, Maria Daheri, Tony Ogburn, Saul D Rivas, Laura Guerra, Paul A Toscano, Monica Gasca, Lori Campos, Savanah Foster, Melissa Martin, Marian Yvette Williams-Brown, Yvette Poindexter, Belinda Reininger, Mila P Salcedo, Andrea Milbourne, Bryan Fellman, Maria E Fernandez, Ellen Baker, Rose Gowen, Susan Fisher-Hoch, Ana M Rodriguez, Jessica Milan, Monica Pippin, Ernest Hawk, Kathleen M Schmeler

Faculty, Staff and Student Publications

Although cervical cancer is preventable, significant disparities exist in access to screening and prevention services. In medically underserved areas (MUAs) of Texas, these rates are 55% higher compared to the remainder of the US. In 2019, we expanded a multicomponent, comprehensive program to improve cervical cancer prevention in partnership with 13 clinics and mobile vans in MUAs of Texas. Our multicomponent intervention program consists of community education and patient navigation coupled with a training/mentoring program for local medical providers to perform diagnostic procedures and treatment for patients with abnormal screening results. Hands-on training courses to learn these skills are coupled …

A Practical Method For Integrating Community Priorities In Planning And Implementing Cancer Control Programs, Emily Bilenduke, Andrea J Dwyer, Elsa S Staples, Kristin Kilbourn, Patricia A Valverde, Maria E Fernández, Betsy C Risendal

Faculty, Staff and Student Publications

PURPOSE: Community engagement is essential in effective public health programs. This paper illustrates the methods used to engage community in the development of a multi-level implementation intervention to address cancer disparities related to hereditary cancer syndromes.

METHODS: Implementation Mapping (IM), was used to guide the co-creation of an intervention. Key partners were recruited to a 13-member statewide community advisory board (CAB) representing healthcare and community-based organizations. As part of a needs assessment, a 3-round modified Delphi method with the CAB was used to identify implementation outcomes to use in later steps of IM. An anonymous online survey of a validated …

Shaping Policy And Practice: Analyzing The Reach Of Highly Cited And High Altmetrics Publications For Broader Impact On Physical Activity, Andrea Ramírez Varela, Natalicio Serrano, Juliana Mejía Grueso, Anita Nguyen, Deborah Salvo, Ross C Brownson, Adrian Bauman, Rodrigo Reis, Pedro Hallal, Michael Pratt

Faculty, Staff and Student Publications

BACKGROUND: A significant gap remains between the availability of physical activity (PA) evidence-based interventions and their application in real-world settings in policy and practice areas. This study aims to describe highly cited and high altmetrics publications in PA research and explore their impact on PA policy and practice.

METHODS: Mixed-methods sequential explanatory study including the identification and description of the top highly cited and high altmetrics PA publications from the last 10 years (including study design, population, type of PA study, number of citations, and altmetrics score), and interviews with key informants regarding research dissemination and implications on PA policy …

Addressing The Analytical And Computational Challenges Using Machine Learning In Biomedical Research, Yizhuo Wang

Dissertations and Theses (Open Access)

In the contemporary healthcare field, professionals are confronted with an ever-growing volume of clinical data stored in electronic health records, alongside the genomic data stemming from laboratory experiments. As a response to this deluge of data, the application of machine learning (ML) techniques is gaining popularity since ML techniques have demonstrated an exceptional proficiency in processing big data and deciphering complex nonlinear patterns that are intrinsic to biomedical research.

My research leverages ML's capabilities to address the computational challenges spanning diverse areas, including adaptive clinical trial designs, survival analysis, and high-dimensional genetic data analysis. Specifically, Chapter 2 focused on the …

The Effects Of Mindfulness And Exercise On Symptoms Of Parkinson’S Disease: A Systematic Review, Collin Tyler Garner

Dissertations

Parkinson’s Disease (PD) is the second most common neurodegenerative disease affecting which affects motor control, emotional regulation, cognition, and sleep through degradation of dopaminergic neurons. As of 2019, PD affects approximately 8.5 million individuals worldwide, with prevalence estimated to increase to between 8.7 and 9.3 million by 2030. The primary therapeutic approach to PD management is pharmaceutical, relying on dopamine replacement therapy. However, recent research has identified promising complementary therapies such as exercise and mindfulness training.

This review was conducted to compile and present evidence related to the efficacy of exercise, mindfulness, and combined exercise and mindfulness protocols as complementary …

Influence Of Access To Public Parks On Mortality Among Older Adults In The United States, Jiaying Dong

All Dissertations

Research shows the health benefits of green spaces are universal, but there's a noticeable disparity in their distribution in the U.S., especially between urban and rural areas. Marginalized groups, particularly those of lower economic status or racial minorities, often have limited access to these spaces. This inequity could be more impactful on the elderly, who are more vulnerable to health issues. However, specific health benefits of green spaces for seniors are not well defined. This study examines the correlation between park access, mortality in those over 65, and income disparities across all U.S. counties.

The study employed a quantitative approach …

Interpretable Mechanistic And Machine Learning Models For Pre-Dicting Cardiac Remodeling From Biochemical And Biomechanical Features, Anamul Haque

All Dissertations

Biochemical and biomechanical signals drive cardiac remodeling, resulting in altered heart physiology and the precursor for several cardiac diseases, the leading cause of death for most racial groups in the USA. Reversing cardiac remodeling requires medication and device-assisted treatment such as Cardiac Resynchronization Therapy (CRT), but current interventions produce highly variable responses from patient to patient. Mechanistic modeling and Machine learning (ML) approaches have the functionality to aid diagnosis and therapy selection using various input features. Moreover, 'Interpretable' machine learning methods have helped make machine learning models fairer and more suited for clinical application. The overarching objective of this doctoral …

Social Media And Mental Health: The Public Health Impact And Future Policy Directives, Renae A. Merrill

Graduate Theses and Dissertations

The relationship between social media use among young people and the increasing concerns of mental health problems in the U.S. and globally is on systemic agendas. Furthermore, research on social media use and mental health indicate reasons to suspect a causal relationship, but more work needs to be done. Therefore, this three-article dissertation seeks to explore (1) associations between social media use, personality, and depression; (2) associations between social media emotional support, anxiety, and personality; and (3) the relationship between social media use and mental health using Deborah Stone’s causal stories framework. Findings from this study provide an improved understanding …

The Developmental Process For Adenoviral Vectored Canine Influenza Vaccines, Nicholas Jeanjaquet

School of Biological Sciences: Dissertations, Theses, and Student Research

Canine Influenza Virus (CIV) is a recently emerged branch of Influenza A virus that is highly infectious in dogs. The first strain was isolated in 2003, and it has quickly become endemic in areas with dense dog populations, most notably in Asia. The proximity of dogs to humans, along with their potential to serve as mixing vessels for reassortment, raises concern for possible zoonotic transmission and a potential human pandemic. Available vaccines are not frequently updated and struggle to prevent the spread of currently circulating strains. This highlights the need for a new and more effective vaccine. We outline the …

Sars-Cov-2 Seroprevalence In Pregnant Women In Kilifi, Kenya From March 2020 To March 2022, Angela Koech, Geoffrey Omuse, Alex Mugo, Isaac Mwaniki, Joseph Mutunga, Moses Mukhanya, Onesmus Wanje, Grace Mwashigadi, Geoffrey Katana, Marleen Temmerman

Centre of Excellence in Women and Child Health

Background: Seroprevalence studies are an alternative approach to estimating the extent of transmission of SARS-CoV-2 and the evolution of the pandemic in different geographical settings. We aimed to determine the SARS-CoV-2 seroprevalence from March 2020 to March 2022 in a rural and urban setting in Kilifi County, Kenya.

Methods: We obtained representative random samples of stored serum from a pregnancy cohort study for the period March 2020 to March 2022 and tested for antibodies against the spike protein using a qualitative SARS-CoV-2 ELISA kit (Wantai, total antibodies). All positive samples were retested for anti-SARS-CoV-2 anti-nucleocapsid antibodies (Euroimmun, ELISA kits, NCP, …

Women, Power, And Cancer: A Lancet Commission, Ophira Ginsburg, Verna Vanderpuye, Ann Marie Beddoe, Nirmala Bhoo-Pathy, Freddie Bray, Carlo Caduf, Narjust Florez, Ibtihal Fadhil, Nazik Hammad, Miriam Mutebi

General Surgery, East Africa

Women interact with cancer in complex ways, as healthy individuals participating in cancer prevention and screening activities, as individuals living with and beyond a cancer diagnosis, as caregivers for family members and friends, as patient advocates, as health workers and healthcare professionals, and as cancer researchers and policy makers. The topic of women and cancer spans broad terrain, beyond women’s cancers and the biomedical aspects of any type of cancer that women in all their diversities might experience. It is inclusive of the ways in which sex and gender influence exposures to cancer risk factors, interactions with the cancer health …

Advanced Breast Cancer Care: The Current Situation And Global Disparities, Aruni Ghose, Susannah Stanway, Bhawna Sirohi, Miriam Mutebi, Sarah Adomah

General Surgery, East Africa

Objectives: Advanced breast cancer (ABC) is an incurable disease. The number of people living with ABC has increased globally. Disparities in ABC care exist at both individual and system levels. ABC cases in most low- and middle-income countries (LMICs) are underreported due to a lack of national cancer registries. Harmonized guidelines for resource stratification and capacity building in LMICs are under way.

Data sources: MEDLINE, Cochrane, and Google Scholar databases were used.

Conclusion: To improve ABC outcomes and resolve disparities, more robust health systems or pathways need to be developed across the cancer continuum in addition to social education.

Implications …

Investigating White Matter Hyperintensities In A Multicenter Covid-19 Study Using 7t Mri, Tales Santini, Oluwatobi F. Adeyemi, Valentina R. Garbarino, Mohamad Habes, Christof Karmonik, Joseph C. Masdeu, Vibhuti N. Patel, Howard J. Aizenstein, Richard Bowtell, Gustavo C. Roman

School of Medicine Publications

Background: Emerging evidence indicates that COVID-19 can negatively impact patient’s brain health (Douaud et al., 2022) (Cecchetti et al., 2022). Common clinical symptoms include brain fog, headaches, difficulty concentrating, and loss of sense of smell or taste. Some studies suggest that SARS-CoV-2 infection can damage the blood brain barrier either directly or through immune-inflammatory mechanisms (Zhang, et al. 2021). White matter hyperintensities (WMH) are imaging biomarkers of brain vascular or inflammatory injury. We investigated the association between severity of COVID-19 infection and burden of white matter hyperintensity volumes within a diverse multi-nation, multi-racial cohort using 7 Tesla (7T) MRI …

Identification Of Genetic Regions Associated With Alzheimer ‘S Disease Blood-Based Biomarkers In Mexican American Families, Marcio A. Almeida

School of Medicine Publications

Background: Dementias are heterogeneous age-associated neurodegenerative disorders generally included in the broad term, Alzheimer’s disease (AD) and related dementias (ADRD). ADRD affects individuals of all ethnicities, but Hispanic individuals show a 1.5-fold higher risk when compared to non-Hispanic whites. Many AD risk biomarkers have been proposed but not much is known about how genetic elements control their expression. We used 2000 genome sequenced Mexican Americans from extended pedigrees to identify genetic regions associated with AD blood-based biomarkers.

Method: A total of 70 Mexican American subjects were diagnosed as ADRD cases (h²= 0.75, p = 2.6×10^-5). We …

Preparation Of Zein-Based Nanoparticles : Nanoprecipitation Versus Microfluidic-Assisted Manufacture, Effects Of Pegylation On Nanoparticle Characteristics And Cellular Uptake By Melanoma Cells, Jitkasem Meewan, Sukrut Somani, Jamal Almowalad, Partha Laskar, Margaret Mullin, Graeme Mackenzie, Swapnil Khadke, Yvonne Perrie, Christine Dufès

School of Medicine Publications

Background: The manufacture of nanoparticles using manual methods is hampered by its challenging scaleup and poor reproducibility. To overcome this issue, the production of zein nanoparticles entrapping a lipophilic drug model, coumarin-6, by using a microfluidic system was assessed in this study. The influence of PEG density and chain length on zein nanoparticle characteristics, as well as their uptake efficacy in melanoma cancer cells, was also evaluated.

Methods: Zein nanoparticles were prepared by both manual and microfluidic approaches to allow comparison between the two processes. PEGylated zein nanoparticles with various PEG densities and chain lengths were produced by …