Public Health Commons^™

Prospects For Rnai Therapy Of Covid-19, Hasan Uludağ, Kylie Parent, Hamidreza Montazeri Aliabadi, Azita Haddadi

Pharmacy Faculty Articles and Research

COVID-19 caused by the SARS-CoV-2 virus is a fast emerging disease with deadly consequences. The pulmonary system and lungs in particular are most prone to damage caused by the SARS-CoV-2 infection, which leaves a destructive footprint in the lung tissue, making it incapable of conducting its respiratory functions and resulting in severe acute respiratory disease and loss of life. There were no drug treatments or vaccines approved for SARS-CoV-2 at the onset of pandemic, necessitating an urgent need to develop effective therapeutics. To this end, the innate RNA interference (RNAi) mechanism can be employed to develop front line therapies against …

Severe Covid-19, Arpan H. Chawala, Shivam Gulati, Bettina Sinanova, Jose Bordon

The University of Louisville Journal of Respiratory Infections

Introduction: There is substantial variation in the clinical characteristics and outcomes of severe coronavirus disease (COVID-19), making it difficult to do an optimal assessment of this condition. We reviewed the current English literature to identify the findings concerning the baseline characteristics and health outcomes of patients with severe COVID-19, primarily those with acute respiratory distress syndrome (ARDS).

Methods: We examined only studies that assessed patients with confirmed COVID-19 by reverse transcription-polymerase chain reaction (RT-PCR) for severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) with at least one of the following severity criteria: treated in the intensive care unit (ICU), ARDS, and/or invasive …

Is Sars-Cov-2 A Neurotropic Virus And A Potential Facilitator Of Cns Infection For Other Pathogens?, Jose Bordon

The University of Louisville Journal of Respiratory Infections

No abstract provided.

Sars-Cov-2 Viral And Serological Testing When College Campuses Reopen: Some Practical Considerations, Isaac Chun-Hai Fung, Chi-Ngai Cheung, Andreas Handel

Biostatistics, Epidemiology & Environmental Health Sciences: Faculty Publications

The coronavirus disease 2019 (COVID-19) pandemic prompted universities across the United States to close campuses in Spring 2020. Universities are deliberating whether, when, and how they should resume in-person instruction in Fall 2020. In this essay, we discuss some practical considerations for the use of 2 potentially useful control strategies based on testing: (1) severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) reverse transcriptase-polymerase chain reaction (RT-PCR) testing followed by case-patient isolation and quarantine of close contacts, and (2) serological testing followed by an “immune shield” approach, that is, low social distancing requirements for seropositive persons. The isolation of case-patients and …

Face Mask Effects Of Co2, Heart Rate, Respiration Rate, And Oxygen Saturation On Instructor Pilots, Andrew R. Dattel, Nicola M. O'Toole, Guillermina Lopez, Kenneth P. Byrnes

Publications

The COVID-19 pandemic has required people to take new measures to mitigate the spread of the communicable virus. Guidelines from health organizations, government offices, and universities have been disseminated. Adherence to these guidelines cannot be more critical for flight training. This study explored the effects face masks had on CO2, heart rate, respiration rate, and oxygen saturation while wearing a face mask at an oxygen level simulated to 5,000 feet. Thirty-two instructor pilots (IP) volunteered to participate in the study. IPs spent 90 minutes in a normobaric chamber while wearing a cloth face mask or a paper face mask. Participants …

The Importance Of Cycle Threshold Values In The Evaluation Of Patients With Persistent Positive Pcr For Sars-Cov-2: Case Study And Brief Review, Jose Bordon, Donghoon Chung, Priya Krishnan, Ruth Carrico, Julio A. Ramirez

The University of Louisville Journal of Respiratory Infections

Some patients recover from COVID-19, but their reverse transcription-polymerase chain reaction (RT-PCR) for SARS-CoV-2 remains persistently positive. In the evaluation of these patients, it is important to define the cycle threshold (Ct) value of the RT-PCR test. This article will present a case study, address relevant findings and interpretation of the RT-PCR test, and explain the use of Ct values in defining when a healthcare worker may return to work. Our current approach is to allow health care workers with persistently positive RT-PCR to return to work if the Ct value is greater than 35.

Covid-19 Surveillance Testing Of Healthcare Personnel Drives Universal Masking Practice, Paul S. Schulz, Ashley M. Wilde, Steve T. Hester, Jim Frazier, Julio A. Ramirez

The University of Louisville Journal of Respiratory Infections

Health care professionals (HCP) are at increased risk of COVID-19 infection due to the unpredictable clinical presentation of COVID-19 disease, limited SARS-CoV-2 testing, personal protective equipment (PPE) shortages, and the inherent inability to distance from patients. Infected HCP may infect others, including coworkers, leading to a simultaneous increase in the number of infections and decrease in the availability of HCP in a community. Due to PPE shortages, many healthcare systems have faced difficult decisions regarding utilization of PPE to protect HCP, patients, and the communities they serve. We describe Norton Healthcare’s success utilizing surveillance COVID-19 testing of HCP to inform …

Why Every Hospital Needs A Covid-19 Clinical Case Review Team, Ashley M. Wilde, Paul Schulz, Brian C. Bohn, Sarah E. Moore, Matthew Song, Clayton J. Patross, Bryan Denham, Jim Frazier, Steve T. Hester, Julio A. Ramirez

The University of Louisville Journal of Respiratory Infections

A hospital’s response to a global pandemic requires a coordinated effort to provide consistent guidance as information rapidly changes. In the early months of the COVID-19 pandemic, diagnosis and subsequent containment was challenging due to unfamiliarity with disease presentation, unknown reverse transcription-polymerase chain reaction sensitivity, and inconsistent access to testing supplies. A centralized COVID-19 clinical case review team can provide guidance on test interpretation, isolation, resource coordination and more.

The Nurse Practitioner In The Time Of Covid, Julie Marfell, Lynn Kelso

The University of Louisville Journal of Respiratory Infections

No abstract provided.

An Overview Of Current Clinical Trials Of Agents For The Treatment And Prevention Of Covid-19 In The United States, Kenneth Schot Hannan, William P. Mckinney

The University of Louisville Journal of Respiratory Infections

Introduction: Given the rapid worldwide spread of SARS-CoV-2 and the attendant risks for severe complications and mortality, numerous clinical trials for its treatment and prevention have been generated in a short period. This report focuses on the categories of the wide spectrum of agents being studied in the United States and the intensity of effort involved with each so that clinicians may consider whether suggesting enrollment may be appropriate for their patients.

Methods: A search was completed of the ClinicalTrials.gov database on May 28, 2020, for all such trials underway as of that date in the US. A total 190 …

Rna-Gps Predicts Sars-Cov-2 Rna Residency To Host Mitochondria And Nucleolus, Kevin E Wu, Furqan M Fazal, Kevin R Parker, James Zou, Howard Y Chang

Faculty, Staff and Students Publications

SARS-CoV-2 genomic and subgenomic RNA (sgRNA) transcripts hijack the host cell's machinery. Subcellular localization of its viral RNA could, thus, play important roles in viral replication and host antiviral immune response. We perform computational modeling of SARS-CoV-2 viral RNA subcellular residency across eight subcellular neighborhoods. We compare hundreds of SARS-CoV-2 genomes with the human transcriptome and other coronaviruses. We predict the SARS-CoV-2 RNA genome and sgRNAs to be enriched toward the host mitochondrial matrix and nucleolus, and that the 5' and 3' viral untranslated regions contain the strongest, most distinct localization signals. We interpret the mitochondrial residency signal as an …

Vaccine-Preventable Diseases In The Time Of Covid, Thaddeus Zajdowicz, Margan Zajdowicz

The University of Louisville Journal of Respiratory Infections

No abstract provided.

Covid-19 Spread In Europe: The Soccer Connection, Bibodh J. Karki, Raghava S. Ambadapoodi, Zahid Imran, Julio A. Ramirez

The University of Louisville Journal of Respiratory Infections

Introduction: Mass gatherings, such as sports events, are potential causes of the rapid spread of COVID-19 infection. Millions of soccer fans travel across Europe every week. With the world’s most popular leagues continuing play until the second week of March 2020, we hypothesize that a correlation exists between the number of people attending the soccer league games in Spain, Italy, France, Germany, and the UK and the increasing number of cases of COVID-19 in these countries during the ongoing epidemic.

Methods: We calculated the total number of attendees in the five major soccer leagues from the popular sports websites and …

Comparative Whole-Genome And Phenotype Analyses Of Virulence Factors And Lethality In Nematode Challenge Assay Among Aeromonas Isolates, Pyeongsug Kim

Master of Science in Integrative Biology Theses

Aeromonads are bacteria found globally in fresh and brackish waters, with some species causing water-borne diseases vertebrate hosts such as diarrhea and wound-infections in humans and motile Aeromonas septicemia in fish. Although many virulence factors have been described, determining which factors are most important in pathogenesis is ongoing. To examine this further, the genomes of five Aeromonas strains isolated from various animals were sequenced and annotated in this study. Each isolate was further characterized using comparative genomic analyses and testing for production of selected virulence factors. Although previously identified as Aeromonas hydrophila, modern genotypic approaches including multilocus sequence typing …

From R0 To The Herd: A Review Of The Rules Of Contagion, By Adam Kucharski, Nathan D. Grawe

Numeracy

Adam Kucharski. 2020. The Rules of Contagion: Why Things Spread--and Why They Stop; (London: Profile Books, Ltd.). Hardback ISBN 978-17-88-16019-3. E-book ISBN 978-17-82-83430-4.

Kucharski's well-timed Rules of Contagion provides an introduction to the mathematical and epidemiological principles behind contagious phenomenon. While the author's primary expertise stems from work on biological epidemics, the book points to examples from a wide range of fields including finance, psychology, computer science, and criminology. As such, selections of the book could be used by faculty in a wide range of classes to show how our recent experience with a viral epidemic might add to …

Proximity To Comprehensive Emergency Obstetric Care And The Utilization Of Facility-Based Delivery Services Across Six Low-And-Middle Income Countries, Chioma T. Amadi

Dissertations and Theses

Background: More than 90% of maternal deaths occur in low-and-middle-income countries (LMICs) and are largely attributed to preventable pregnancy-related causes. Comprehensive emergency obstetric care (EmOC), also known as signal functions, is the most effective life-saving intervention for managing obstetric and newborn emergencies. Health facilities offering delivery services are generally classified as having either comprehensive, basic or less than basic EmOC capacity based on their obstetric resources. Multiple EmOC methods are regularly utilized in characterizing facility obstetric capacity and this introduces inconsistencies that pose significant public health and policy implications for access to delivery care among women within a service environment. …

Insufficient Sun Exposure Has Become A Real Public Health Problem, Lars Alfredsson, Bruce K Armstrong, D. Allan Butterfield, Rajiv Chowdhury, Frank R. De Gruijl, Martin Feelisch, Cedric F. Garland, Prue H. Hart, David G. Hoel, Ramune Jacobsen, Pelle G. Lindqvist, David J. Llewellyn, Henning Tiemeier, Richard B. Weller, Antony R. Young

Chemistry Faculty Publications

This article aims to alert the medical community and public health authorities to accumulating evidence on health benefits from sun exposure, which suggests that insufficient sun exposure is a significant public health problem. Studies in the past decade indicate that insufficient sun exposure may be responsible for 340,000 deaths in the United States and 480,000 deaths in Europe per year, and an increased incidence of breast cancer, colorectal cancer, hypertension, cardiovascular disease, metabolic syndrome, multiple sclerosis, Alzheimer's disease, autism, asthma, type 1 diabetes and myopia. Vitamin D has long been considered the principal mediator of beneficial effects of sun exposure. …

Correction To: Temporal Trend Of Research Related To Gun Violence From 1981 To 2018 In The United States: A Bibliometric Analysis, Lung-Chang Chien, Maxim Gakh, Courtney Coughenour, Ro-Ting Lin

School of Public Health Faculty Research

No abstract provided.

A Study Of Covid-19 Mortality Under Varying Patient Frailty, Alison N. Sifuentes

Theses and Dissertations

Modeled the spread and mortality of COVID-19 throughout the city of Chicago. By incorporating group frailty into a classic SEIR infectious disease model, we were able to differentiate the population of Chicago by their response to COVID-19. Three age groups with different COVID-19-induced death rates were examined, and the model sought to showcase the multiplicative deviation of each age group death rate from the average disease-induced death rate. This adjustment for different death rates among age groups accounted for heterogeneity within the population, and sought to introduce a more accurate manner for modeling the spread of infectious diseases.

Epidemiology Of Cancers In Men Who Have Sex With Men (Msm): A Protocol For Umbrella Review Of Systematic Reviews, Manoj Kumar Honaryar, Yelena Tarasenko, Maribel Almonte, Vitaly Smelov

Biostatistics, Epidemiology & Environmental Health Sciences: Faculty Publications

While earlier studies on men having sex with men (MSM) tended to examine infection-related cancers, an increasing number of studies have been focusing on effects of sexual orientation on other cancers and social and cultural causes for cancer disparities. As a type of tertiary research, this umbrella review (UR) aims to synthesize findings from existing review studies on the effects of sexual orientation on cancer. Relevant peer-reviewed systematic reviews (SRs) will be identified without date or language restrictions using MEDLINE, Cochrane Database of Systematic Reviews, and the International Prospective Register for Systematic Reviews, among others. The research team members will …

The Strengths, Weaknesses, Opportunities And Threats (Swot) Analysis Of The Severe Acute Respiratory Syndrome Coronavirus 2 Of Covid-19, Michael Oluyemi Babalola Ph.D

The University of Louisville Journal of Respiratory Infections

Introduction: SARS-CoV-2 is the etiologic agent of Coronavirus Disease 2019 (COVID-19), a highly contagious, emergent, acute, viral pneumonia that emanated sporadically in Wuhan, China, in December 2019. COVID-19 became a pandemic in February 2020, leading to 4,942,687 confirmed cases and over 321,987 deaths and grounding several economies around the world as of May 2020. Although global researchers, epidemiologists, virologists, and medical professionals rose steadily to contain the disease, in-depth knowledge of the virus and concerted efforts to combat it are still evolving. This research sought to elucidate the biological Strengths, Weaknesses, Opportunities, and Threats to SARS-CoV-2, with a view to …

Projecting The Covid-19 Weekly Deaths And Hospitalizations For Jefferson County, Kentucky, Seyed Karimi, Natalie Dupre, W. Paul Mckinney, Bert B. Little, Naiya Patel, Sarah Moyer

The University of Louisville Journal of Respiratory Infections

Introduction: The trends in the numbers of active hospitalizations and fatalities caused by the COVID-19 in Jefferson County, Kentucky, were projected over the period May 7 to August 20, 2020.

Methods: The projections provided in this report are from a susceptible-exposed-infectious-recovered (SEIR) model. The model was calibrated using the COVID-19 transmission dynamics parameters from relevant literature and clinical dynamics parameters from the county’s data. The model was used to measure the impact of public health policy interventions designed to contain the infection. The policy was modeled by its intervention day and impact on the transmission of the virus such that …

Cardiac Surgery During The Coronavirus Disease 2019 Pandemic: Perioperative Considerations And Triage Recommendations, Vivek Patel, Ernesto Jimenez, Lorraine Cornwell, Trung Tran, David Paniagua, Ali E Denktas, Andrew Chou, Samuel J Hankins, Biykem Bozkurt, Todd K Rosengart, Hani Jneid

Faculty, Staff and Students Publications

The coronavirus disease 2019 pandemic, caused by severe acute respiratory syndrome coronavirus-2, represents the third human affliction attributed to the highly pathogenic coronavirus in the current century. Because of its highly contagious nature and unprecedented global spread, its aggressive clinical presentation, and the lack of effective treatment, severe acute respiratory syndrome coronavirus-2 infection is causing the loss of thousands of lives and imparting unparalleled strain on healthcare systems around the world. In the current report, we discuss perioperative considerations for patients undergoing cardiac surgery and provide clinicians with recommendations to effectively triage and plan these procedures during the coronavirus disease …

False-Negative Sars-Cov-2 Reverse Transcriptase Polymerase Chain Reaction (Rt-Pcr) Is An Important Consideration For Patient Management And Infection Prevention: A Case Report From The Louisville Covid-19 Epidemiology Study, Matthew Song Pharmd, Bcidp, Ashley M. Wilde, Sarah E. Moore Pharmd, Brian C. Bohn Pharmd, Clayton J. Patross, Bryan Denham, Paul Schulz, Julio A. Ramirez

The University of Louisville Journal of Respiratory Infections

We report a case of false-negative SARS-CoV-2 reverse transcriptase-polymerase chain reaction (RT-PCR) on a nasopharyngeal swab. Treating clinicians and infection preventionists should maintain a high suspicion for COVID-19 in the appropriate clinical setting despite negative test results. Utilization of chest computed tomography (CT) should be strongly considered in the diagnostic work-up for suspected COVID-19, particularly in areas with limited RT-PCR availability.

Concomitant Invasive Pneumococcal Disease In A Patient With Covid-19 – A Case Report From The Louisville Epidemiology Study, Clayton J. Patross, Brian C. Bohn Pharmd, Sarah E. Moore Pharmd, Paul Schulz, Matthew Song Pharmd, Bcidp, Ashley M. Wilde, Julio A. Ramirez

The University of Louisville Journal of Respiratory Infections

A 60-year-old male presented to the emergency department (ED) with a 1–2 day history of confusion, headache, and subjective fever. Because he had met with a contact two days prior to admission who had recently traveled from the Bahamas, a COVID-19 nasopharyngeal (NP) and oropharyngeal (OP) polymerase chain reaction (PCR) test was ordered. He was diagnosed with bacterial meningitis based on presenting neurologic symptoms and the identification of Streptococcus pneumoniae from blood cultures. The COVID-19 NP and OP test returned positive, although he never developed shortness of breath, cough, other respiratory symptoms, diarrhea, abdominal pain, nausea, vomiting, or any change …

Foundational Research And Nih Funding Enabling Emergency Use Authorization Of Remdesivir For Covid-19, Ekaterina Galkina Cleary, Matthew J. Jackson, Zoë Folchman-Wagner, Fred D. Ledley

Natural & Applied Sciences Faculty Publications

Emergency Use Authorization for remdesivir months after discovery of COVID-19 is unprecedented. Typically, decades of research and public-sector funding are required to establish the mature body of foundational research requisite for efficient, targeted drug discovery and development. This work quantifies the body of research related to remdesivir’s biological target, RNA-dependent RNA polymerase (RdRp), or parent chemical structure, nucleoside analogs (NcAn), through 2019, as well as NIH funding for this research 2000–2019. There were 6,567 RdRp-related publications in PubMed, including 1,263 with NIH support, and 11,073 NcAn-related publications, including 2,319 with NIH support. NIH support for RdRp research comprised 2,203 Project …

Evaluation Of Geographic Disparities In Cervical Cancer Survival Across Maine, Kaylee Underkofler, Jason Lachance

Journal of Maine Medical Center

Introduction. National data exists suggesting the existence of geographic disparities in oncology care within the United States. It is unknown whether geographic disparities present a problem for women with gynecologic malignancies locally in Maine.

Methods. Data for each cervical cancer case diagnosed or treated under the MaineHealth system between 2007 and 2011 were acquired from the MaineHealth Network Registry. Average annual incidence and 5-year survival were calculated for each county in Maine and were mapped using geographic information systems (GIS) software. Next, cases were divided into 2 groups: those residing less than or equal to 60 miles from the sole …

Whims (Washing Hands, Immunity Boost, Masking & Social Distancing), Srinivasan Ragothaman

Creative Work

This is a shot poem about preventing the spread of Covid-19. It pleads general public to wear masks, wash hands, social distance, and boost immunity. It is set to a popular tune in Hindi - Dil Ke Jharoke Mein.

A Comparison Efficacy Study Of Commercial Nasopharyngeal Swabs Versus A Novel 3d Printed Swab For The Detection Of Sars-Cov-2, Forest W. Arnold, Gerald Grant, Phillip F. Bressoud, Stephen P. Furmanek, Donghoon Chung, Nadine Sbaih, Dipan Karmali, Meredith Cahill, George Pantalos

The University of Louisville Journal of Respiratory Infections

Introduction: The large volume of diagnostic tests required by the response to the COVID-19 pandemic resulted in a shortage of commercial nasopharyngeal swabs. In an effort to alleviate the shortage, swabs created by 3D printing may be a solution.

Methods: We designed and produced 3D printed swabs and sought to compare their ability to detect SARS-CoV-2 in patients admitted for COVID-19 or who were suspected of having COVID-19.

Results: A total of 30 patients were swabbed with a commercial and a 3D printed swab. Results matched in 27 of 30 patients (90%). Two patients were discordant with a positive commercial …

A Rare Case Of Leprosy In West Florida, Adrian Lugo, Taylor Studsrud, Nemer Dabage, James Demaio

West Florida Division GME Research Day 2020

• Leprosy is caused by acid-fast bacilli of the M. leprae complex, which includes M. leprae and M. lepromatosis.
• Transmission in the U.S. is rare, but has been documented in hunters who handle wild ninebanded armadillo.
• The origins of M. leprae infection among armadillos, the geographic range of the infected animals, and the potential risks infected armadillos present to people have been topics of concern.
• The infection originated amongst armadillos decades before they were ever used in leprosy research, and numerous surveys have confirmed that armadillos in the southern United States are a large natural reservoir for M. leprae; its prevalence …