Medicine and Health Sciences Commons^™

Corticosteroids Increase The Risk Of Invasive Fungal Infections More Than Tumor Necrosis Factor-Alpha Inhibitors In Patients With Inflammatory Bowel Disease, Martin H Gregory, Andrej Spec, Dustin Stwalley, Anas Gremida, Carlos Mejia-Chew, Katelin B Nickel, Matthew A Ciorba, Richard P Rood, Margaret A Olsen, Parakkal Deepak

2020-Current year OA Pubs

BACKGROUND: Invasive fungal infections are a devastating complication of inflammatory bowel disease (IBD) treatment. We aimed to determine the incidence of fungal infections in IBD patients and examine the risk with tumor necrosis factor-alpha inhibitors (anti-TNF) compared with corticosteroids.

METHODS: In a retrospective cohort study using the IBM MarketScan Commercial Database we identified US patients with IBD and at least 6 months enrollment from 2006 to 2018. The primary outcome was a composite of invasive fungal infections, identified by ICD-9/10-CM codes plus antifungal treatment. Tuberculosis (TB) infections were a secondary outcome, with infections presented as cases/100 000 person-years (PY). A …

Failure Of Early Mycological Clearance In Hiv-Negative Cryptococcal Meningitis, Zhihui Su, Chongliang Luo, Kai Dai, Dasen Yuan, Bang-E Qin, Meifeng Gu, Junyu Liu, Yong Chen, Fuhua Peng, Ying Jiang

2020-Current year OA Pubs

BACKGROUND: Negative cerebrospinal fluid (CSF) cultures at 2 weeks after antifungal treatment (early mycological clearance [EMC]) should be a treatment goal of cryptococcal meningitis (CM). However, EMC in human immunodeficiency virus (HIV)-negative patients with CM is poorly understood.

METHODS: We conducted a retrospective review of medical records and 1-year follow-up of 141 HIV-negative patients with CM with an initial positive CSF culture for

RESULTS: Of 141 patients, 28 (19.9%) had EMC failure. The 1-year mortality rate was 5.7% (8/141). Multivariate analysis showed that non-amphotericin B (AmB)-based regimens, baseline log

CONCLUSIONS: EMC failure in HIV-negative CM is attributed to non-AmB-based therapy …

Outcome Prediction By The 2022 European Leukemianet Genetic-Risk Classification For Adults With Acute Myeloid Leukemia: An Alliance Study, Krzysztof Mrózek, Geoffrey L Uy, Et Al.

2020-Current year OA Pubs

Recently, the European LeukemiaNet (ELN) revised its genetic-risk classification of acute myeloid leukemia (AML). We categorized 1637 adults with AML treated with cytarabine/anthracycline regimens according to the 2022 and 2017 ELN classifications. Compared with the 2017 ELN classification, 2022 favorable group decreased from 40% to 35% and adverse group increased from 37% to 41% of patients. The 2022 genetic-risk groups seemed to accurately reflect treatment outcomes in all patients and patients aged <60 years, but in patients aged ≥60 years, relapse rates, disease-free (DFS) and overall (OS) survival were not significantly different between intermediate and adverse groups. In younger African-American patients, DFS and OS did not differ between intermediate-risk and adverse-risk patients nor did DFS between favorable and intermediate groups. In Hispanic patients, DFS and OS did not differ between favorable and intermediate groups. Outcome prediction abilities of 2022 and 2017 ELN classifications were similar. Among favorable-risk patients, myelodysplasia-related mutations did not affect patients with CEBPA

Social Disadvantage During Pregnancy: Effects On Gestational Age And Birthweight, Joan L Luby, Sarah K England, Deanna M Barch, Barbara B Warner, Cynthia Rogers, Christopher D Smyser, Regina Triplett, Jyoti Arora, Tara A Smyser, George M Slavich, Peinan Zhao, Molly Stout, Erik Herzog, J Philip Miller

2020-Current year OA Pubs

OBJECTIVE: Whether psychosocial adversity during pregnancy impacts fetal health outcomes at birth remains underexplored. This is a critical issue given significant social disadvantage and psychosocial stress faced by pregnant women worldwide.

STUDY DESIGN: Measures of social disadvantage and psychological factors, and medical/reproductive and nutritional health status in pregnant women were obtained at each trimester. Using Structural Equation Modeling (SEM), we investigated the relationship of forms of adversity to each other and to infant gestational age, and birthweight.

RESULTS: Among 399 singletons, Social Disadvantage significantly predicted gestational age (p = 0.003), and residual birthweight (p = 0.006). There was a 0.4 …

Understanding Misimplementation In U.S. State Health Departments: An Agent-Based Model, Matt Kasman, Ross A Hammond, Rob Purcell, Louise Farah Saliba, Stephanie Mazzucca-Ragan, Margaret Padek, Peg Allen, Douglas A Luke, Sarah Moreland-Russell, Paul C Erwin, Ross C Brownson

2020-Current year OA Pubs

INTRODUCTION: The research goal of this study is to explore why misimplementation occurs in public health agencies and how it can be reduced. Misimplementation is ending effective activities prematurely or continuing ineffective ones, which contributes to wasted resources and suboptimal health outcomes.

METHODS: The study team created an agent-based model that represents how information flow, filtered through organizational structure, capacity, culture, and leadership priorities, shapes continuation decisions. This agent-based model used survey data and interviews with state health department personnel across the U.S. between 2014 and 2020; model design and analyses were conducted with substantial input from stakeholders between 2019 …

The Who Aware (Access, Watch, Reserve) Antibiotic Book And Prevention Of Antimicrobial Resistance, Veronica Zanichelli, Michael Sharland, Bernadette Cappello, Lorenzo Moja, Haileyesus Getahun, Carmem Pessoa-Silva, Hatim Sati, Catharina Van Weezenbeek, Hanan Balkhy, Mariângela Simão, Sumanth Gandra, Benedikt Huttner

2020-Current year OA Pubs

Guidance on the appropriate use of antibiotics for common infections is lacking in many settings. The World Health Organization (WHO) has recently released

Air Pollution And Acute Kidney Injury In The U.S. Medicare Population: A Longitudinal Cohort Study, Whanhee Lee, Ziyad Al-Aly, Et Al.

2020-Current year OA Pubs

BACKGROUND: Recent studies have reported the association between air pollution exposure and reduced kidney function. However, it is unclear whether air pollution is associated with an increased risk of acute kidney injury (AKI).

OBJECTIVES: To address this gap in knowledge, we investigated the effect estimates of long-term exposures to fine particulate matter [PM

METHODS: This nationwide population-based longitudinal cohort study included 61,300,754 beneficiaries enrolled in Medicare Part A fee-for-service (FFS) who were

RESULTS: Exposure to

DISCUSSION: This study found an association between exposures to air pollution and the risk of the first hospital admission with AKI, and this association persisted …

Axatilimab For Chronic Graft-Versus-Host Disease After Failure Of At Least Two Prior Systemic Therapies: Results Of A Phase I/Ii Study, Carrie L Kitko, Iskra Pusic, Et Al.

2020-Current year OA Pubs

PURPOSE: Chronic graft-versus-host disease (cGVHD) remains the major cause of late morbidity after allogeneic hematopoietic cell transplantation. Colony-stimulating factor 1 receptor (CSF-1R)-dependent macrophages promote cGVHD fibrosis, and their elimination in preclinical studies ameliorated cGVHD. Axatilimab is a humanized monoclonal antibody that inhibits CSF-1R signaling and restrains macrophage development.

PATIENTS AND METHODS: This phase I (phI)/phase II (phII) open-label study (ClinicalTrials.gov identifier: NCT03604692) evaluated safety, tolerability, and efficacy of axatilimab in patients age ≥ 6 years with active cGVHD after ≥ 2 prior systemic therapy lines. Primary objectives in phI were to identify the optimal biologic and recommended phII dose and …

Myeloid Autophagy Genes Protect Mice Against Fatal Tnf- And Lps-Induced Cytokine Storm Syndromes, Ya-Ting Wang, Amy Sansone, Asya Smirnov, Christina L Stallings, Anthony Orvedahl

2020-Current year OA Pubs

ATG5: autophagy related 5; ATG7: autophagy related 7; ATG14: autophagy related 14; ATG16L1: autophagy related 16-like 1 (S. cerevisiae); BECN1: beclin 1, autophagy related; CASP1: caspase 1; CASP4/CASP11: caspase 4, apoptosis-related cysteine peptidase; CIM: conditionally immortalized macrophage; CLP: cecal ligation and puncture; CSS: cytokine storm syndrome; DC: dendritic cell; IFNG/IFNγ: interferon gamma; IFNGR1: interferon gamma receptor 1; ip: intraperitoneal; iv: intravenous; IL12/p70: interleukin 12, p70 heterodimer; IL18: Interleukin 18; ITGAX/CD11c: integrin alpha X; LAP: LC3-associated phagocytosis; LPS: lipopolysaccharide; LYZ2/LYSM: lysozyme 2; MAP1LC3A/LC3: microtubule-associated protein 1 light chain 3 alpha; RB1CC1/FIP200: RB1-inducible coiled-coil 1; S100A8/MRP8: S100 calcium binding protein A8 (calgranulin …

Persistent Molecular Disease In Adult Patients With Aml Evaluated With Whole-Exome And Targeted Error-Corrected Dna Sequencing, Michael J Slade, Reza Ghasemi, Michelle O'Laughlin, Tasha Burton, Robert S Fulton, Haley J Abel, Eric J Duncavage, Timothy J Ley, Meagan A Jacoby, David H Spencer

2020-Current year OA Pubs

PURPOSE: Persistent molecular disease (PMD) after induction chemotherapy predicts relapse in AML. In this study, we used whole-exome sequencing (WES) and targeted error-corrected sequencing to assess the frequency and mutational patterns of PMD in 30 patients with AML.

MATERIALS AND METHODS: The study cohort included 30 patients with adult AML younger than 65 years who were uniformly treated with standard induction chemotherapy. Tumor/normal WES was performed for all patients at presentation. PMD analysis was evaluated in bone marrow samples obtained during clinicopathologic remission using repeat WES and analysis of patient-specific mutations and error-corrected sequencing of 40 recurrently mutated AML genes …

Complete Remission Of Widely Metastatic Human Epidermal Growth Factor Receptor 2-Amplified Pancreatic Adenocarcinoma After Precision Immune And Targeted Therapy With Description Of Sequencing And Organoid Correlates, Daniel A King, S Peter Goedegebuure, Xiuli Zhang, Jasreet Hundal, Malachi Griffith, William E Gillanders, Haeseong Park, Et Al.

2020-Current year OA Pubs

No abstract provided.

Delayed Ipsilateral Intestinal Perforation After Endoscopic Gastrojejunostomy: A Perspective On Underlying Mechanisms, Juan Reyes Genere, Zoilo K Suarez, Vladimir Kushnir

2020-Current year OA Pubs

The endoscopic management for malignant gastric outlet obstruction has expanded with the advent of endoscopic ultrasound-guided gastrojejunostomy. Delayed perforation after endoscopic ultrasound-guided gastrojejunostomy is an important yet rarely reported adverse event, and it is unclear why some patients may suffer this complication. We present a case of intestinal perforation occurring one month after endoscopic ultrasound-guided gastrojejunostomy and discuss potential mechanisms which may contribute to this outcome.

Impact Of The Covid-19 Pandemic On Chronic Disease Management And Patient Reported Outcomes In Patients With Pulmonary Hypertension: The Pulmonary Hypertension Association Registry, Megan Mayer, Murali M Chakinala, Et Al.

2020-Current year OA Pubs

To better understand the impact of the COVID-19 pandemic on the care of patients with pulmonary hypertension, we conducted a retrospective cohort study evaluating health insurance status, healthcare access, disease severity, and patient reported outcomes in this population. Using the Pulmonary Hypertension Association Registry (PHAR), we defined and extracted a longitudinal cohort of pulmonary arterial hypertension (PAH) patients from the PHAR's inception in 2015 until March 2022. We used generalized estimating equations to model the impact of the COVID-19 pandemic on patient outcomes, adjusting for demographic confounders. We assessed whether insurance status modified these effects via covariate interactions. PAH patients …

Regulation Of Astrocyte Lipid Metabolism And Apoe Secretion By The Microglial Oxysterol, 25-Hydroxycholesterol, Anil G Cashikar, Danira Toral-Rios, David Timm, Johnathan Romero, Michael Strickland, Justin M Long, Xianlin Han, David M Holtzman, Steven M Paul

2020-Current year OA Pubs

Neuroinflammation, a major hallmark of Alzheimer's disease and several other neurological and psychiatric disorders, is often associated with dysregulated cholesterol metabolism. Relative to homeostatic microglia, activated microglia express higher levels of Ch25h, an enzyme that hydroxylates cholesterol to produce 25-hydroxycholesterol (25HC). 25HC is an oxysterol with interesting immune roles stemming from its ability to regulate cholesterol metabolism. Since astrocytes synthesize cholesterol in the brain and transport it to other cells via ApoE-containing lipoproteins, we hypothesized that secreted 25HC from microglia may influence lipid metabolism as well as extracellular ApoE derived from astrocytes. Here, we show that astrocytes take up externally …

Expanding The Muscle Imaging Spectrum In Dysferlinopathy: Description Of An Outlier Population From The Classical Mri Pattern, Laura Llansó, Alan Pestronk, Et Al.

2020-Current year OA Pubs

Dysferlinopathy is a muscle disease characterized by a variable clinical presentation and is caused by mutations in the DYSF gene. The Jain Clinical Outcome Study for Dysferlinopathy (COS) followed the largest cohort of patients (n=187) with genetically confirmed dysferlinopathy throughout a three-year natural history study, in which the patients underwent muscle function tests and muscle magnetic resonance imaging (MRI). We previously described the pattern of muscle pathology in this population and established a series of imaging criteria for diagnosis. In this paper, we describe the muscle imaging and clinical features of a subgroup of COS participants whose muscle imaging results …

Exploring Modern Trends And Prevention Strategies For Childhood Obesity: A Comprehensive Literature Review, Anya E. Bogen

Honors Program: Senior Projects (Public)

This literature review seeks to provide an overview of the current research on childhood obesity. The study examines the prevalence and causes of childhood obesity, including genetic, environmental, and behavioral factors. The review also discusses the health consequences associated with childhood obesity, such as the increased risk for chronic diseases and psychological and social problems. Additionally, the review explores the effectiveness of interventions designed to prevent childhood obesity, including individual lifestyle modifications, education from health practitioners and school programs, and global, national, and state programs to promote wellness. The literature review concludes that childhood obesity is a complex and multifactorial …

The Effects Of Exercise On The Lipid Profile Of Extracellular Vesicles, Tesha Kerr

Department of Nutrition and Health Sciences: Dissertations, Theses, and Student Research

We sought to ascertain the effect of different types of exercise (aerobic training and resistance training) on the lipid profile of extracellular vesicles. Thus, we had participants perform bouts of AT and RT and rest (control) and collected blood samples from them immediately after (timepoint 0) and 30 minutes after (timepoint 30) exercise. Small extracellular vesicles (sEVs) were isolated from plasma of participants using cushioned-density gradient ultracentrifugation (C-DGUC). Small EV size, morphology, and protein markers were determined using nanoparticle tracking analysis, transmission electron microscopy, and western blot, respectively. Additionally, we performed untargeted lipidomics on the sEV isolate. We found that …

Kangaroo Care Education For Low Socioeconomic Status Families In The Neonatal Care Unit, Joara Peterson

Nursing | Student Research Posters

The early contact between mother and baby is known as skin-to-skin, also referred to as “kangaroo care” (KC). It involves placing the baby on the mother’s chest as soon as it is appropriate (Thompson, 1979). This interaction was primarily for bonding but many researchers have discovered additional benefits. There is significant correlation between kangaroo care and weight gain (especially for low birth weight infants), as well as body temperature and heart rate regulation, which reduces the risk of medical complications. It also decreases levels of stress in mothers and babies by lowering the release of cortisol hormone (Mohammadi et al. …

Migrants Sans Papiers: The Impact Of Cantonal Program And Policy Discrepancies On Undocumented Migrant Healthcare Utilization In Switzerland, Denise Peng

Independent Study Project (ISP) Collection

While Switzerland houses what is generally considered one of the best healthcare systems globally, regional policy discrepancies leave undocumented migrants (UDM) in precarious conditions that threaten the nation’s claim to universal health coverage. Critical analyses of existing UDM-catering structures in different cantons, the Swiss Confederation member states, reveal that local discrepancies in healthcare utilization are functional gradients of cantonal support and public endorsement. Relationships with these authorities are instrumental in steering health outcomes not only with program funding and outreach but also management of studies to better understand UDM health determinants and inform future preventative measures.

UDM services and initiatives …

The Revolutionary Genome Editor: Crispr-Cas9 Systems, Grace Spade

Senior Honors Theses

Genetic engineering is the modification of an organism's genetic material to alter its traits through adding, deleting, or changing specific genes. CRISPR-Cas9 systems are groundbreaking tools for genetic engineering, in short utilizing a molecule called RNA to guide a protein called Cas9 to a specific location in DNA to add, delete, or replace genes. The history of how the CRISPR-Cas9 systems came into existence, how it was adapted from a natural defense system in bacteria, and its mechanism of action in both are explained. Its applications, both present and future, competing genetic modifiers, advantages and disadvantages, and the ethical dilemmas …

In Vitro Gametogenesis: A Research Timeline And Implications For The Future Of Assisted Reproductive Technology, Nicole Buckley

Senior Honors Theses

The novel reproductive technology, In Vitro Gametogenesis (IVG), includes the process of obtaining mature viable germ cells from pluripotent stem cells. To do so, embryonic stem cells and induced pluripotent stem cells are specified to primordial germ cells and differentiated to form gametes that undergo further maturation, which subsequently may undergo in vitro fertilization to form an embryo. With this capability, IVG holds the power to provide a novel treatment option for human infertility. As of now, research has been conducted on mice successfully, and with limited success in humans. Future research will likely focus on discovering the species-specific differences …

Mir125a As Molecular Target Of Vitamin D Mediated Inhibition Of Cd4+ T Cell Differentiation Into Th17 Cells In Mrl/Lpr Lupus-Prone Mice, Miranda Hilt

Undergraduate Distinction Papers

The dynamic function of vitamin D in an array of immunomodulatory and anti-inflammatory mechanisms and its implication in the pathogenesis of autoimmune diseases has been the topic of much recent scholarship. Here I attempt to elucidate the molecular mechanism of vitamin D-mediated inhibition of the differentiation of CD4+ T cells into pro-inflammatory Th17 cells in MRL/lpr lupus prone mice by investigating how miR-125a expression is affected by dietary modulation of cholecalciferol (vitamin D₃). MRL/MpJ and MRL/lpr mice were split into three experimental groups and fed specially formulated diets that varied in their concentrations of vitamin D. …

Serotonin Reuptake Inhibitor Increases Pseudarthrosis Rates In Anterior Cervical Discectomy And Fusions, Mark J. Lambrechts, Nicholas D. D'Antonio, Gregory R R. Toci, Brian A. Karamian, Josuhu Pezzulo, Dominic Farronato, Jose Canseco, Ian David Kaye, Barrett Woods, Jeffrey A. Rihn, Mark Kurd, Joseph K. Lee, Md, Alan S. Hilibrand, Christopher K. Kepler, Alexander R. Vaccaro, Gregory D. Schroeder

Rothman Institute Papers

STUDY DESIGN: Retrospective cohort.

PURPOSE: To determine (1) the effects of serotonin reuptake inhibitors in pseudarthrosis rates after anterior cervical decompression and fusion (ACDF) and (2) to identify patient-reported outcome measures in patients taking serotonin reuptake inhibitors.

OVERVIEW OF LITERATURE: Recent literature suggests that selective serotonin reuptake inhibitors (SSRIs) may inhibit fracture healing via downregulation of osteoblast differentiation. Spinal fusion supplementation with osteoblast-rich substances enhances spinal fusion, thus SSRIs may be detrimental.

METHODS: Patients with 1-year postoperative dynamic cervical spine radiographs following ACDF were grouped into serotonin reuptake inhibitor prescriptions (SSRI, serotonin-norepinephrine reuptake inhibitor [SNRI], or tricyclic antidepressant [TCA]) and …

Integration Of Chinese Herbal Medicine Into Routine Care Was Related To Lower Risk Of Chronic Kidney Disease In Patients With Rheumatoid Arthritis: A Population-Based Nested Case–Control Study In Taiwan, Hou-Hsun Liao, Hsiao-Tien Chen, Hanoch Livneh, Ming-Chi Lu, Ning-Sheng Lai, Chia-Chou Yeh, Multiple Additional Authors

Counselor Education Faculty Publications and Presentations

Objective

Non-steroidal anti-inflammatory drugs (NSAIDs) are frequently used as the first-line agents for the symptomatic relief of rheumatoid arthritis (RA), but it may insidiously provoke the onset of renal diseases, especially chronic kidney disease (CKD). While Chinese herbal medicine (CHM) has become an increasingly popular adjunctive therapy among RA groups, there are currently no available data on the effect of CHM use towards risk of CKD. This study aimed to explore on a population-level whether CHM use decreases sequent CKD risk among them.

Methods

In this nested case–control study retrieved from the nationwide insurance database of Taiwan from 2000 to …

Primary Care In Southern Illinois And Western Kentucky, Matthew J. Crabtree

Honors College Theses

There is a major physician shortage occurring across the United States as of 2023 and it is expected to get worse over the next five to ten years. A significant portion of the shortage is predicted to consist of primary care physicians in rural areas. Data on factors that affect primary care visits like rurality, household income, health insurance coverage, non-communicable disease, and primary care physician prevalence were analyzed from the regions of Southern Illinois and Western Kentucky. Health coverage was found to be average to above average in the two regions. However, almost all counties included in the study …

Impacts Of Stigma On Female Service Members, Alisha Weatherly-Kershaw

Doctor of Psychology (PsyD)

There are a variety of factors that prevent people from seeking mental health treatment. The stigma associated with mental health disorders or seeking treatment is a primary deterrent. This stigma is particularly impactful within the armed forces when they are assessed for fitness for duty. Because most research examines stigma’s impact on male military members, this study aims to identify the type of stigma that creates the most significant barrier to female service members seeking mental health treatment. Results indicate that stigmatizing perceptions of service members significantly impact female service members holding negative views towards seeking treatment.

Assessing And Characterizing Marijuana Use Disorders (Dsm-5) — National Survey On Drug Use And Health, United States, 2020, Alejandro Azofeifa-Ujueta

Dissertations

Despite that marijuana (cannabis) is still considered, under federal law, an illegal Schedule I drug, marijuana is the most commonly used illicit substance in the United States. National trend data has shown that the prevalence of marijuana use has increased over time, particularly among those aged 18 years and older. Some individuals can use marijuana without harm; however, long-term and heavy marijuana users may experience health consequences, including marijuana use disorders (addiction). For the last 20 years, existing national and statelevel epidemiological, surveillance, and research data have analyzed marijuana use disorders (MUD) using previous diagnostic criteria (DSM-IV). There is limited …

Implementation Of Team-Based Learning In The Pre-Clerkship Medical Curriculum: Investigating Essential Elements, Jade Woodcock

Dissertations

Team-based learning (TBL) has been used in undergraduate medical education over the past 20 years. Available evidence suggests that there is a problem with how the core design elements are implemented. It is also unclear the extent to which faculty and students believe TBL supports the goals of undergraduate medical education (UME). The purpose of this research is to identify the essential elements of TBL, how those elements have been used by medical educators over the past 10 years, and identify if faculty and student believe TBL supports the goals of undergraduate medical education at a single medical school where …

Addressing The Surgical Workplace: An Opportunity To Create A Culture Of Belonging, Carla M. Pugh, Orlando C. Kirton, J. E. Betsy Tuttle, Ronald V. Maier, Yue-Yung Hu, John H. Stewart, Julie Ann Freischlag, Julie Ann Sosa, Selwyn M Vickers, Mary T. Hawn, Timothy J. Eberlein, Diana L. Farmer, Robert S. Higgins, Carlos A. Pellegrini, Sanziana A. Roman, Marie L. Crandall, Christian M. De Virgilio, Allan Tsung, L. D. Britt

Abington Jefferson Health Papers

No abstract provided.

Examining Perceptions Of Screening For Hiv, Prep, & Covid Vaccinations For Racial, Ethnic, Sex, And Gender Minorities In Clinical Settings, Nikhil Kalita, Maranda C. Ward, Abigail W. Konopasky

GW Research Showcase 2021-2026

No abstract provided.