Medicine and Health Sciences Commons^™

Examining How Non-Antifungal Medications Impact Host-Fungal Interactions, Parker Ryan Reitler

Theses and Dissertations (ETD)

Invasive fungal infections (IFIs) are estimated to kill 1.5 million people each year with mortality rates remaining high (around 30-70%), despite the availability of three major classes of antifungal drugs. Furthermore, millions more suffer debilitating infections of the mucosal membranes or destructive subcutaneous mycoses. One of the most common IFIs is invasive candidiasis, mostly commonly caused by Candida albicans infections, with mortality rates of approximately 30%. In addition, the population of susceptible individuals and the incidences of both mucosal and systemic mycoses continue to rise due to the widespread use of broad-spectrum antibacterial agents, cancer chemotherapies, and the immune suppressive …

The Validity And Reliability Of Ultrasound As A Tool For Assessing Skeletal Muscle Characteristics In The Pediatric Population, Elizabeth Seewer

Theses and Dissertations (ETD)

Annually, around 5 million people in the U.S. are admitted to Intensive Care Units (ICU) due to critical conditions, with pediatric patients comprising 21% of these admissions. Approximately 40% of pediatric ICU (PICU) patients require mechanical ventilation and extended stays, and about 6% result in death. Survivors often face long-term disabilities, including loss of skeletal muscle mass (SMM), a risk factor for morbidity and mortality. Abdominal computed tomography (CT) scans, often performed during PICU admissions, can assess muscle mass but pose risks of increased cost and radiation exposure. While CT and Magnetic Resonance Imaging (MRI) are gold standards for muscle …

Molecular Determinants Of Trp Channel Gating, Briar J. Bell

Theses and Dissertations (ETD)

Transient Receptor Potential (TRP) ion channels are a family of proteins that contribute to a myriad of physiological functions. They have been extensively studied since their discovery 35 years ago; however, there are still many questions regarding the mechanisms by which they function. This family of proteins is characterized by a generally shared structure: an intracellular N terminus featuring ankyrin repeats, six transmembrane helices including the pore domain, a re-entrant loop and TRP helix, and an intracellular C terminus with varying structure. Each of these regions has been implicated in the regular function of TRPs, while mutations that alter trafficking …

Anatomical And Physiological Characterization Of Striatal Activation Of The Cerebral Cortex, Yuhan Wang

Theses and Dissertations (ETD)

Purpose. The striatum receives excitatory glutamatergic input from nearly all parts of the cerebral cortex, and its output is delivered by direct pathway medium spiny neurons (dMSNs) expressing D1 type dopamine (DA) receptors (D1Rs) and indirect pathway MSNs (iMSNs) expressing D2 DA receptors (D2Rs). Loss of DA results in the imbalance between the activities of dMSNs and iMSNs in Parkinson’s disease (PD), leading to ab-normal interactions between the cerebral cortex and striatum. Thus, understanding the inter-actions between the cortex and striatum is important. The monosynaptic corticostriatal cir-cuit has been extensively studied. In contrast, due to the poly-synaptic nature of the …

Characterizing The Cellular Response To Astrovirus Infection In The Central Nervous System, Amy E. Davis

Theses and Dissertations (ETD)

Central nervous system (CNS) diseases caused by infectious agents pose significant health challenges, often leading to severe neurological dysfunction with high morbidity and mortality rates. Astroviruses (AstVs), traditionally known for causing gastroenteritis, have recently been identified as neuroinvasive pathogens capable of inducing neurological diseases. This study explores the cellular and molecular mechanisms by which AstV, specifically non-classical VA1 and classical HAstV1 genotypes, induce CNS pathology in human neurons and astrocytes. Utilizing primary human neurons and astrocytes from various brain regions, this research investigates the cytotoxic effects, apoptotic pathways, and inflammatory responses triggered by these viruses. This study reveals that VA1 …

Improving Health Outcomes In Children And Adolescents With Asthma, Elizabeth Kate Coffey Moore

Theses and Dissertations (ETD)

Asthma is among the most prevalent chronic illnesses found in the United States, affecting millions of people under the age of 18 each year. The disease burden for affected children, adolescents, their families, and the healthcare system is immense. Finding ways to mitigate its impact is critical to improving the lives of affected children, adolescents, and their families. The three chapters included in this dissertation aimed to document the asthma triggers that children and adolescents are exposed to and strategies for reducing them and to demonstrate using Imogene King’s conceptual framework to guide nursing practice to care for and nursing …

Pan-Cancer Genomic Characterization Of Human Papillomavirus Associated Tumors, Jeremiah Ray Holt

Theses and Dissertations (ETD)

Infection with high-risk human papillomavirus (HPV) accounts for nearly all cervical cancers (CESC), a subset of other anogenital squamous cancers, and increasing rates of head and neck squamous cell carcinomas (HNSC), with each cancer type having heterogenous outcomes due to a general lack of personalized care. Large scale genomic analyses have catalogued the somatic alterations occurring frequently among squamous tumor types including HNSC and CESC, but few studies have incorporated a thorough analysis of HPV genomics. High-risk HPVs are double-stranded DNA (dsDNA) viruses capable of integrating their genomes into host chromosomes, a phenomenon known to promote HPV-associated cancer formation. HPV …

Ftsk Regulates The Assembly Of The Division Machinery In The Ftsz-Less Chlamydia Trachomatis, Mckenna Katherine Harpring

Theses and Dissertations (ETD)

In evolving to obligate intracellular dependence, Chlamydia trachomatis serovar L2 (Ct), has eliminated several gene products essential for cell division in most other bacteria, including FtsZ, the central coordinator of divisome assembly. In the absence of FtsZ, we show that divisome assembly in Ct is initiated by FtsK, a chromosomal translocase. Chlamydial FtsK forms discrete foci at the septum and at the base of the progenitor mother cell, and our data indicate that FtsK foci at the base of the mother cell mark the location of nascent divisome complexes that form at the site where a daughter cell will emerge …

Wavelet-Based Harmonization Of Local And Global Model Shifts In Federated Learning For Histopathological Images, W. Farzana, A. Temtam, K. M. Iftekharuddin

Electrical & Computer Engineering Faculty Publications

Federated Learning (FL) is a promising machine learning approach for development of data-driven global model using collaborative local models across multiple local institutions. However, the heterogeneity of medical imaging data is one of the challenges within FL. This heterogeneity is caused by the variation in imaging scanner protocols across institutions, which may result in weight shift among local models leading to deterioration in predictive accuracy of global model. The prevailing approaches involve applying different FL averaging techniques to enhance the performance of the global model, ignoring the distinct imaging features of the local domain. In this work, we address both …

Advancing Chronic Kidney Disease Prediction Through Machine Learning And Deep Learning With Feature Analysis, Shiddarth Dey Tusar, S. M. Ahad Ali Chowdhury, Md. Jalal Uddin Chowdhury, Rana M. Pir, H. M. Nur A. Alam, Muhammad Rezaur Rahman, Md. Nural Absar Siddiky, Muhammad Enayetur Rahman

Electrical & Computer Engineering Faculty Publications

Chronic Kidney Diesease (CKD) is a significant health issue, ranking as the fourth leading cause of mortality worldwide. The traditional diagnosis and treatment process, reliant on medical experts, is time-consuming. Therefore, thereis an urgent need for more efficient diagnostic methods to improve patient outcomes and reduce mortality rates. In this study, we employ Machine Learning (ML) and Deep Learning (DL) techniques to predict CKD based on important features. Feature analysis was performed using a correlation matrix and the LASSO algo-rithm to identify the most relevant features for model training. We evaluated several ML and DL classifiers, including Logistic Regression (LR), …

Search Strategies For "Community Engagement Definition And Evaluation For Cancer Center: Scoping Review", Heidi Keeler, Brooke Fitzpatrick, Nicole Carritt, Emma Hymel, Josiane Kabayundo, Jordan Mccullough, Krishtee Napit, Regina Idoate, Shinobu Watanabe-Galloway

Search Strategies: Leon S. McGoogan Health Sciences Library

No abstract provided.

Search Strategies For "Characterizing Metastatic Anogenital Squamous Cell Carcinoma In Immunosuppressed Patients: A Systematic Review", Sierra Thomas, Molly Antonson, Megan Wackel, Cynthia M. Schmidt, Ashley Wysong

Search Strategies: Leon S. McGoogan Health Sciences Library

No abstract provided.

International Consensus On Sleep Problems In Pediatric Palliative Care: Paving The Way, Anna Mercante, Judith Owens, Oliviero Bruni, Magda L. Nunes, Paul Gringras, Shirley Xin Li, Simonetta Papa, Ulrika Kreicbergs, Joanne Wolfe, Boris Zernikow, Ana Lacerda, Franca Benini, Pediatric Sleep And Palliative Care Group

Journal Articles: Munroe-Meyer Institute

OBJECTIVE: Sleep problems constitute a common and heterogeneous complaint in pediatric palliative care (PPC), where they often contribute to disease morbidity and cause additional distress to children and adolescents and their families already facing the burden of life-threatening and life-limiting conditions. Despite the significant impact of sleep problems, clinical evidence is lacking. The application of general pediatric sleep recommendations appears insufficient to address the unique challenges of the PPC dimension in terms of disease variability, duration, comorbidities, complexity of needs, and particular features of sleep problems related to hospice care. Therefore, we initiated an international project aimed at establishing a …

Exploratory Analysis Of The Spatial Distribution Of Adult Glioma Age-Adjusted County Incidence Rates, Nebraska Medicine, 2009-2019, Kendra Ratnapradipa, Amulya Yellala, Nicole Shonka

Journal Articles: Epidemiology

BACKGROUND: Central nervous system (CNS) cancers including gliomas have low incidence but high mortality. The age-adjusted incidence rate for CNS cancers is higher in Nebraska than nationally. This exploratory study was motivated by glioma patient inquiries about possible clustering of cases within the state to see if more in-depth investigation was warranted.

METHODS: Using electronic health records from Nebraska Medicine, we identified Nebraska adult (age ≥19) glioma patients diagnosed between January 1, 2009 and November 1, 2019. Patient residential addresses were geocoded, mapped, and combined with annual US Census data to compute age-adjusted incidence rates (AAIR) at the county level. …

Assessing De Novo Parasite Genomes Assembled Using Only Oxford Nanopore Technologies Minion Data, Kaylee Herzog, Rachel Wu, John M. Hawdon, Peter Nejsum, Joseph R. Fauver

Journal Articles: Epidemiology

In this study, we assessed the quality of de novo genome assemblies for three species of parasitic nematodes (Brugia malayi, Trichuris trichiura, and Ancylostoma caninum) generated using only Oxford Nanopore Technologies MinION data. Assemblies were compared to current reference genomes and against additional assemblies that were supplemented with short-read Illumina data through polishing or hybrid assembly approaches. For each species, assemblies generated using only MinION data had similar or superior measures of contiguity, completeness, and gene content. In terms of gene composition, depending on the species, between 88.9 and 97.6% of complete coding sequences predicted in MinION data only assemblies …

Knowledge And Practices Of Parents Of School Age Children Towards Helminthiasis And Malaria In Northwestern Ethiopia, Abebe Animut, Berhanu Erko, Yohannes Negash, Abraham Degarege

Journal Articles: Epidemiology

BACKGROUND: Helminthiasis and malaria prevail in developing countries including Ethiopia, where they claim lives, retard physical and mental growth, reduce productivity and contain economic growth. Implementing helminthiasis and malaria control strategies require adequate knowledge and practices of the affected communities. Knowledge and practices of parents of school age children was assessed in relation to risk of child infection with Helminthiasis and malaria.

METHODS: A total of 398 parents of school age children attending Maksegnit Number Two Elementary School from September 2020 to June 2021 were interviewed regarding their sociodemography, knowledge and practice towards Helminthiasis and malaria. The risk of child …

Improving Awareness And Identifying Risks For Emergence Delirium In Military Veterans, Hannah E. Pino

Graduate Theses, Dissertations, and Problem Reports (ETD)

Background: Emergence delirium (ED) is an acute state of confusion during the recovery phase from anesthesia that may be life-threatening, especially in the veteran population. Military veteran status may be explored by the Have You Ever Served questionnaire that was developed by the American Academy of Nursing to identify veterans upon admission to the hospital and thus be able to better care for them during their stay. This campaign has been in effect at the hospital site of this project for nearly 10 years. The questionnaire identifies military history risk factors such as combat history or a diagnosis of post-traumatic …

Gambian Mothers Lack Obstetric Danger Sign Knowledge, But Educational Intervention Shows Promise, Kara Shannon, Jocelyn Burridge, Brodus Franklin, Sheena Bhushan, Susan Hilsenbeck, Elena V Petrova, James N'Dow, Ibezimako Iwuh, Sharmila Anandasabapathy, Jeffrey P Wilkinson

Faculty, Staff and Students Publications

BACKGROUND: The Gambia has the 12th highest maternal mortality rate in the world, with 80% of deaths resulting from avoidable causes. Unawareness of pregnancy danger signs (DS) has been shown to be a barrier to seeking obstetric care, while app-based education intervention has shown promise.

OBJECTIVE: We aim to assess patient awareness of DS, identify barriers to awareness, and evaluate potential for implementing smartphone-based technologies for education.

METHODS: A cross-sectional semi-structured survey was administered to Gambian women (n = 100) across five hospitals/health centers. Data and informed consent were collected via an online survey portal. Analysis included bivariate analysis and …

The Physiological And Performance Consequences Of The Australian Special Forces Selection Course, Angela Uphill

Theses: Doctorates and Masters

Special Forces (SF) soldiers are the most elite element of military forces, who have undergone rigorous training in order to prepare them for a wide array of specialised missions. In Australia, entry into the SF is determined through the highly competitive SF Selection Course (SF-SC), which is a gruelling program involving extreme physical demands, psychological stress, and restricted access to sleep and nutrition. The stressors involved in arduous military training events such as the SF-SC can result in significant losses of fat mass and lean mass, disruption to hormonal homeostasis, and significant decreases in neuromuscular capacity, which can potentially increase …

The Impact Of Reported Antibiotic Allergy In Paediatric Care And Antimicrobial Stewardship, Annabelle Arnold

Theses: Doctorates and Masters

Antimicrobial resistance is rising while new drug development declines, making antimicrobial stewardship crucial for optimizing use, preventing resistance, and improving patient outcomes. Antibiotics are vital for bacterial infections, but overuse and inappropriate prescribing have contributed to resistance. Although 5-35% of the global population reports β-lactam allergies, over 90% of reports are inaccurate. Adults have the highest prevalence; however, these labels are often acquired in childhood, with a notable increase among children recently. Unverified allergy labels hinder antimicrobial stewardship, leading to longer hospital stays, alternative prescribing, and a higher risk of adverse events.

This thesis sought to evaluate current evidence regarding …

From Pollution To Resource: Advancing Swine Waste Treatment In The Usa, Viney P. Aneja, Ryke Longest, Matias B. Vanotti, Ariel A. Szogi, Gudigopuram B. Reddy

Faculty Scholarship

Concentrated animal feeding operations (CAFOs) have led to environmental challenges, specifically waste management. Swine CAFOs generate large amounts of waste, requiring proper treatment to avoid air and water pollution. Conventional waste management technologies, such as lagoon and spray field systems, do not prevent air and water pollution impacts. Research for the past few decades led to recommendations for waste treatment technologies superior to lagoons and spray fields. Private environmental sustainability initiatives focused on reducing greenhouse gas emissions in the food supply chain have implemented biogas digester projects for capturing methane in covered swine lagoons to reduce greenhouse gas emissions. However, …

Case-Based Ebm Instruction For Osteopathic Medical Students: A Case Report., Laura Lipke

Library Scholarship

Background: Evidence-based medicine (EBM) is an important part of graduate medical education and a learning outcome necessary for preparing students to become effective residents. However, many medical educators and librarians struggle to offer EBM instruction that is contextualized, relevant, and engaging. Case-based learning (CBL) can establish the relevance of EBM instruction sessions by using clinical scenarios that link theory to practice. Experience: This case report describes how a college of osteopathic medicine (COM) liaison librarian redesigned a large cohort, lecture-based learning approach to EBM instruction into interactive, relevant, and contextualized CBL labs. CBL labs with smaller student groups were designed …

Proton Pump Inhibitors: Rational Use And Use-Reduction - The Windsor Workshop, Peter Kahrilas, Foteini Anastasiou, Albert J Bredenoord, Hashem B El Serag, Joachim Labenz, Juan Mendive, Edoardo V Savarino, Daniel Sifrim, Mihaela Udrescu, Rena Yadlapati, A Pali Hungin

Faculty, Staff and Students Publications

BACKGROUND: Despite deprescribing initiatives to curb overutilization of proton pump inhibitors (PPIs), achieving meaningful reductions in PPI use is proving a challenge.

SUMMARY: An international group of primary care doctors and gastroenterologists examined the literature surrounding PPI use and use-reduction to clarify: (i) what constitutes rational PPI prescribing; (ii) when and in whom PPI use-reduction should be attempted; and (iii) what strategies to use when attempting PPI use-reduction.

KEY MESSAGES: Before starting a PPI for reflux-like symptoms, patients should be educated on potential causes and alternative approaches including dietary and lifestyle modification, weight loss, and relaxation strategies. When commencing a …

Differences In Prediagnostic Serum Metabolomic And Lipidomic Profiles Between Cirrhosis Patients With And Without Incident Hepatocellular Carcinoma, Hannah Powell, Cristian Coarfa, Elisa Ruiz-Echartea, Sandra L Grimm, Omar Najjar, Bing Yu, Luis Olivares, Michael E Scheurer, Christie Ballantyne, Abeer Alsarraj, Emad Mohamed Salem, Aaron P Thrift, Hashem B El Serag, Salma Kaochar

Faculty, Staff and Students Publications

BACKGROUND: Early detection of hepatocellular carcinoma (HCC) is crucial for improving patient outcomes, but we lack robust clinical biomarkers. This study aimed to identify a metabolite and/or lipid panel for early HCC detection.

METHODS: We developed a high-resolution liquid chromatography mass spectrometry (LC-MS)-based profiling platform and evaluated differences in the global metabolome and lipidome between 28 pre-diagnostic serum samples from patients with cirrhosis who subsequently developed HCC (cases) and 30 samples from patients with cirrhosis and no HCC (controls). We linked differentially expressed metabolites and lipids to their associated genes, proteins, and transcriptomic signatures in publicly available datasets. We used …

Concurrent Hbsag And Anti-Hbs Induced By A Pres Deletion Mutant In A Chronic Hepatitis B Patient, Wen Wu, Yingjian Chen, F Blaine Hollinger, Xiangyan Huang

Faculty, Staff and Students Publications

This study analyzed the origins of concurrent hepatitis B surface antigen (HBsAg) and HBsAg antibodies (anti-HBs) in a patient with chronic hepatitis B virus (HBV) infection. The levels of serological markers of HBV infection were determined by enzyme-linked immunosorbent assay (ELISA). The preS/S gene was analyzed by gene amplification and sequencing. The tests revealed that HBsAg and anti-HBs coexisted in this patient with mixed infections of the full-length preS/S virus strain and preS1 183 bp deletion mutant, and both the mutant and the anti-HBs were no longer present after one year, which means that the mutant strain was cleared by …

Trends In Cardiovascular Disease-Related Mortality In Texas, Muhammad Shariq Usman, Adeena Jamil, Zainali Chunawala, Mahboob Alam, Vijay Nambi, Layla A Abushamat, Arunima Misra, Salim S Virani, Christie M Ballantyne, George E Taffet, Khurram Nasir, Sachin Goel, Sadeer Al-Kindi, Javed Butler, Abdul Mannan Khan Minhas

Faculty, Staff and Students Publications

BACKGROUND: Cardiovascular disease (CVD) is associated with high mortality in the United States, but the burden of CVD mortality is unevenly distributed between demographic and geographic subgroups, with poor characterization of state-specific trends. In this study, the disparities in CVD-related mortality trends in Texas and the United States from 1999 to 2019 were assessed.

METHODS: Trends in CVD-related mortality were evaluated through analysis of the Multiple Causes of Death Files from the National Center for Health Statistics. Crude and age-adjusted mortality rates (AAMRs) per 100,000 population with associated annual percentage changes were determined. Joinpoint regression was used to assess trends …

Clinical Utility Of Plasma Microbial Cell-Free Dna Sequencing In Determining Microbiologic Etiology Of Infectious Syndromes In Solid Organ Transplant Recipients, Jesal R Shah, Muhammad Rizwan Sohail, Todd Lasco, John A Goss, Mayar Al Mohajer, Sarwat Khalil

Faculty, Staff and Students Publications

BACKGROUND: Metagenomic next-generation sequencing (mNGS) is increasingly being used for microbial detection in various infectious syndromes. However, data regarding the use of mNGS in solid organ transplant recipients (SOTR) are lacking.

OBJECTIVES: To describe and analyze real-world clinical impact of mNGS using plasma microbial cell-free DNA (mcfDNA) in SOTR.Design: Retrospectively reviewed all adult SOTR who underwent mNGS testing using plasma mcfDNA at Baylor St Luke's Medical Center from March 2017 to February 2023.

METHODS: Clinical impact (positive, neutral, and negative) was assessed using standardized objective criteria. Three Infectious Diseases physicians independently performed clinical adjudication to determine the correlation of mcfDNA …

Clinical Utility Of Metagenomic Next-Generation Sequencing In Fever Of Undetermined Origin, Marilyne Daher, Roumen Iordanov, Mayar Al Mohajer, M Rizwan Sohail, Kristen Andrews Staggers, Ahmed Mufeed Hamdi

Faculty, Staff and Students Publications

BACKGROUND: Metagenomic next-generation sequencing (mNGS) is a novel diagnostic tool increasingly used in the field of infectious diseases. Little guidance is available regarding its appropriate use in different patient populations and clinical syndromes. We aimed to review the clinical utility of mNGS in patients with a specific clinical syndrome and identify factors that may increase its utility.

METHODS: We retrospectively reviewed charts of 72 non-immunocompromised adults hospitalized with the clinical syndrome of 'fever of undetermined origin' and underwent mNGS testing. Standardized criteria from a previously published study were used to determine the clinical impact of mNGS testing. We applied logistic …

The Impact Of The Filmarray Meningitis/Encephalitis Panel On Empiric Antibiotic Prescriptions In Patients With Suspected Community-Acquired Meningitis, Aaron Pathak, Caitlynn Pham, Sabra Shay, Todd Lasco, Mayar Al Mohajer

Faculty, Staff and Students Publications

The BioFire® FilmArray® meningitis/encephalitis (FA/ME) panel provides rapid testing for common cerebrospinal fluid pathogens. We compared empiric antibiotic utilization between patients with suspected community-acquired meningitis with and without an FA/ME panel ordered. No significant differences in antibiotic use were found.

Comparing The Effects Of Two Initial Specimen Diversion Techniques On Blood Culture Contamination Rates And Clinical Outcomes-A Multicenter Study, Anthony Febres-Aldana, Patrycja Ashley, Eva Amenta, Megan Duffey, Theresa Sepulveda, Corina Lopez, Sabra Shay, Miriam Barrett, Todd Lasco, Takei Pipkins, Margaret Reed, Bradley Lembcke, Mayar Al Mohajer

Faculty, Staff and Students Publications

Although the initial specimen diversion device (ISDD) has been shown to reduce blood culture contamination (BCC) rates, its impact on clinical outcomes remains unclear. This multicenter study showed that ISDD significantly decreased BCC. However, there was no reduction in length of stay, days of therapy, or central line-associated bloodstream infections.