Health Services Research Commons^™

High Prevalence Of Strongyloides Stercoralis In People Living With Hiv: A Critical Health Challenge In The Peruvian Amazon Basin, Silvia Otero-Rodriguez, Martin Casapia-Morales, Viviana Pinedo-Cancino, Seyer Mego-Campos, Victoria-Ysabel Villacorta-Pezo, Jorge Parráguez-De-La-Cruz, Eva H Clark, Esperanza Merino, Jose-Manuel Ramos-Rincon

Faculty, Staff and Students Publications

Introduction: Strongyloidiasis is an important but underdiagnosed soil-transmitted helminthiasis, particularly in tropical areas and some vulnerable groups.

Objectives: To assess the parasitological prevalence, seroprevalence and sociodemographic factors of Strongyloides stercoralis infection in patients living with human immunodeficiency virus (PLWH) in an endemic area.

Materials and methods: We performed a cross-sectional study of strongyloidiasis in 537 PLWH in two hospitals in Iquitos, Peru, from 20 Oct 2023 to 20 May 2024. We tested patient sera using Strongyloides IgG enzyme-linked immunosorbent assay (ELISA) and stool via the modified Baermann technique and/or charcoal fecal culture as highly sensitive parasitological techniques. We used multivariable …

Performance Of Stool Xpert Mtb/Rif Ultra For Detection Of Mycobacterium Tuberculosis Among Adults Living With Hiv: A Multicentre, Prospective Diagnostic Study, George W Kasule, Sabine Hermans, Sozinho Acacio, Alexander Kay, Joachim Kikoyo Nsubuga, Carlos Fernández-Escobar, Nosisa Shiba, Lucia Carratalá-Castro, Derrick Semugenze, Patricia Mwachan, Shilzia Munguambe, Joanna Ehrlich, Elisa Lopez-Varela, Andrew R Dinardo, Frank Cobelens, Christoph Lange, Moses Joloba, Anna M Mandalakas, Willy Ssengooba, Alberto L García-Basteiro

Faculty, Staff and Students Publications

Background: When people living with HIV develop pulmonary tuberculosis, it often manifests without detectable acid-fast bacilli on sputum microscopy. We aimed to assess the diagnostic accuracy of stool Xpert MTB/RIF Ultra (hereafter, Ultra) for Mycobacterium tuberculosis detection among adults with HIV.

Methods: This multicentre, prospective diagnostic accuracy study was done in outpatient and inpatient health centres in Eswatini, Mozambique, and Uganda. We enrolled adults aged 15 years and older with HIV with presumptive tuberculosis. We evaluated the diagnostic accuracy of stool Ultra using the simple one-step processing method against a composite microbiological reference standard (CMRS) including three WHO-recommended tuberculosis diagnostic …

Complete Genomic Characterization Of Global Pathogens Respiratory Syntical Virus And Human Norovirus Using Probe Based Capture Enrichment, Sravya V Bhamidipati, Anil Surathu, Hsu Chao, Daniel P Agustinho, Qin Xiang, Kavya Kottapalli, Abirami Santhanam, Zeineen Momin, Kimberly Walker, Vipin K Menon, George Weissenberger, Nathanael Emerick, Faria Mahjabeen, Qingchang Meng, Jianhong Hu, Richard Sucgang, David Henke, Fritz J Sedlazeck, Ziad M Khan, Ginger A Metcalf, Vasanthi Avadhanula, Pedro A Piedra, Sasirekha Ramani, Robert L Atmar, Mary K Estes, Joseph F Petrosino, Richard A Gibbs, Donna M Muzny, Sara Cregeen Javornik, Harsha Doddapaneni

Faculty, Staff and Students Publications

Respiratory syncytial virus (RSV) is the leading cause of lower respiratory tract infections in children worldwide, while human noroviruses (HuNoV) are a leading cause of epidemic and sporadic acute gastroenteritis. Generating full-length genome sequences for these viruses is crucial for understanding viral diversity and tracking emerging variants. However, obtaining high-quality sequencing data is often challenging due to viral strain variability, quality, and low titers. Here, we present a set of comprehensive oligonucleotide probe sets designed from 1,570 RSV and 1,376 HuNoV isolate sequences in GenBank. Using these probe sets and a capture enrichment sequencing workflow, 85 RSV positive nasal swab …

Military Inhalational Exposures Outside The Theater Of Conflict And Chronic Respiratory Symptoms, Reza Hosseini, Eric Garshick, Martin D Slade, Andrew Timmons, Anna M Korpak, Nicholas L Smith, Karen S Nakayama, Coleen P Baird, Paul Ciminera, Farrah Kheradmand, Vincent S Fan, Jaime E Hart, Petros Koutrakis, Ware Glenn Kuschner, Octavian C Ioachimescu, Michael Jerrett, Philippe R Montgrain, Susan P Proctor, Christine H Wendt, Cherry Wongtrakool, Emily S Wan, Paul D Blanc, Carrie A Redlich

Faculty, Staff and Students Publications

Importance: Deployment to Afghanistan and Southwest Asia has been associated with adverse respiratory health outcomes. However, the impact of inhalational exposures (eg, vapor, dust, gas, fumes), which are known correlates of reduced lung function and future chronic lung disease, during military service time outside this deployment period has not been assessed.

Objective: To assess military inhalational exposures during nonwartime routine activities and their associations with chronic respiratory symptoms.

Design, setting, and participants: This cross-sectional study used data from the US Department of Veterans Affairs Service and Health Among Deployed Veterans study. US veterans who served between October 7, 2001, and …

Unfolding The Mystery Of Autoimmunity: The Environmental Determinants Of Diabetes In The Young (Teddy) Study, Marian Rewers, Daniel Agardh, Suzanne Bennett Johnson, Ezio Bonifacio, Helena Elding Larsson, Patricia Gesualdo, William Hagopian, Michael J Haller, Heikki Hyöty, Randi Johnson, Richard Mcindoe, Eoin Mckinney, Jessica Melin, Åke Lernmark, Richard E Lloyd, Kristian F Lynch, Jill M Norris, Stephen S Rich, Roswith Roth, Desmond Schatz, Jorma Toppari, Eric Triplett, Kendra Vehik, Suvi M Virtanen, Anette-G Ziegler, Beena Akolkar, Jeffrey P Krischer, Teddy Study Group

Faculty, Staff and Students Publications

In 2025, the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) at the National Institutes of Health celebrates 75 years of leadership in diabetes research. The NIDDK serves people of the U.S. affected by or at risk for many chronic diseases, including diabetes and other endocrine, metabolic, and digestive disorders, by funding innovative research to develop better treatment and prevention and a cure for these conditions. Autoimmunity that leads to type 1 diabetes or celiac disease or thyroid autoimmunity affects 1 in 20 children and adolescents in the U.S. While treatments are available, prevention of these common autoimmune …

Inadequate Healthcare For Women In The United States, Grace Loveless

Journal of Nonprofit Innovation

Barriers to adequate healthcare for women stem from a lack of research on their specific health needs, gender-based biases in healthcare, and harmful societal norms. One key aspect highlighting these disparities is the menstrual cycle—a topic unique to women. Menstrual health, defined as a state of complete physical, mental, and social well-being, illustrates the urgent need for greater focus on reproductive health. Despite its significance, the dialogue and knowledge about reproductive health remain limited; an issue which is exacerbated by societal attitudes of secrecy and shame. These attitudes create barriers that hinder many women in the United States from accessing …

Do Minorities Attend Culturally Competent Hospitals? The Case Of Minority-Serving And Safety-Net Hospitals, Rumel Mahmood

Journal of Social, Behavioral, and Health Sciences

Minorities disproportionately attend minority-serving hospitals (MSHs) and safety-net hospitals (SNHs). This study examines whether MSHs or SNHs are more culturally competent than their counterparts. No research to date has examined the cultural competency of MSHs and SNHs with hospitals outside of these categories. The literature on the determinants of hospital-level cultural competence is sparse, with limited measures used nationally and a robust measure used in a single U.S. state. I calculated a 100-point score of hospital cultural competence from a nationally representative survey of hospitals (N = 849 respondents). Using multilevel regression models, I found that MSHs are culturally …

Self-Powered Rapid Antigen-Specific T-Cell Response Assay For Mycobacterium Tuberculosis Infections, Bo Ning, Sutapa Chandra, Yongchun Pan, Riti Sharan, Ngan Ha, Sanjay Singh, Alexandra Portillo Varela, Lin Li, Qingli Wu, Alexander Kay, Gugu P Maphalala, Clement Adu-Gyamfi, Santiago Carrero Longlax, Anna M Mandalakas, Smriti Mehra, Christopher J Lyon, Edward A Graviss, Andrew R Dinardo, Tony Hu

Faculty, Staff and Students Publications

Interferon-gamma release assays (IGRAs) that evaluate an individual’s T-cell activation response to Mycobacterium tuberculosis (M.tb)-specific peptides serve an important role in diagnosing tuberculosis (TB). However, there are substantial challenges to the use of IGRAs in resource-limited settings. Further, IGRA diagnostic performance can also be compromised in anergic individuals. Here we describe a microfluidic chip-based antigen-specific T-cell response assay (ASTRA) that automates the detection of M.tb-specific T-cell activation responses to facilitate screening for latent M.tb infection and TB. We observe that ASTRA demonstrates high specificity for M.tb infection in independent patient cohorts. Compared with IGRA, ASTRA shows greater …

Retrospective Study Of Elective Intracranial Tumor Surgery Waiting Time At A National Referral Hospital In Indonesia, Sayyid Abdil Hakam Perkasa, Habibah Nurul Rahmah, Abrar Arham

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

Elective surgery waiting times are a key measure of healthcare system performance and service quality. Long wait times can lower patients’ quality of life, worsen symptoms, reduce treatment effectiveness, and increase financial stress. We aimed to provide a descriptive analysis of elective surgery waiting time for Intracranial Tumors at Mahar Mardjono National Brain Center Hospital in 2023. This study is a descriptive retrospective cross-sectional study using data from Electronic Health Records (EHR). The study sample included all elective intracranial tumor surgeries performed in 2023. A total of 371 elective intracranial tumor surgeries were analyzed. The median age of patients was …

Do Female Patients Experience Worse Outcomes Than Male Patients After Inguinal Hernia Repair? An Analysis Of The Abdominal Core Health Quality Collaborative Database, Amrita Iyer, Sunjay Kumar, Martina Rama, Sourav Podder, Li-Ching Huang, Sami Tannouri, Talar Tatarian, Francesco Palazzo

Department of Surgery Faculty Papers

BACKGROUND: Inguinal hernia repair is one of the most common general surgery operations. Some evidence suggests that female patients are at greater risk of chronic postoperative pain and hernia recurrence. We investigated rates of chronic inguinal pain and recurrence after inguinal hernia repair in both male and female patients using the Abdominal Core Health Quality Collaborative database.

METHODS: The Abdominal Core Health Quality Collaborative database was queried for patients undergoing elective, unilateral inguinal hernia repair who completed 30-day clinical follow-up and baseline and 1-year European Registry for Abdominal Wall Hernias Survey surveys. Both open and minimally invasive cases were included. …

Healthy Moms/Healthy Babies Of Mississippi Initial Provider Engagement And Student Feedback Loop Project, Corban Jackson Mph, Jillian Harper-Peavy Lmsw, Imh-E, Starica Harper, Vernesia Wilson Phd, Mph

Journal of Public Health in the Deep South

Background Between 2017 and 2022, 83% of maternal deaths in Mississippi were preventable. Unfortunately, there is a persistent shortage of OB-GYNs in Mississippi, feeding the rise of maternal care deserts and the lapse in collaboration between providers and state maternal health organizations. Purpose Healthy Moms/Healthy Babies of Mississippi, a care management program for high-risk mothers and infants, has partnered with the Mississippi Alliance for Innovation on Maternal Health initiative (AIM) to improve maternal health outcomes through building healthcare networks with existing providers. Methods 33 medical students from the University of Mississippi Medical Center School of Medicine and William Carey University …

The Case For Compulsory Dna Testing At Birth To Confirm Paternity: Ethical, Legal, And Social Considerations, Michael Mncedisi Willie

Journal of Indonesian Health Policy and Administration

Compulsory paternity testing at birth has sparked significant legal, ethical, and social debate due to its potential impact on family dynamics, child well-being, and parental responsibility. This review explores the ethical, legal, and societal implications of such testing, using Bioecological Systems Theory and Rawls' Theory of Justice to frame the discussion. This review evaluates the benefits and challenges of mandatory DNA testing at birth, particularly in reducing paternity fraud, ensuring fairness in child support allocation, and enhancing socio-economic outcomes, especially in low-income households. This qualitative review draws on multidisciplinary literature from family law, genetic counseling, social policy, and fathers' rights …

Btp2 Restricts Tulane Virus And Human Norovirus Replication Independent Of Store-Operated Calcium Entry, Francesca J Scribano, J Thomas Gebert, Kristen A Engevik, Nicole M Hayes, Jorge Villanueva, Son Pham, Soni Kaundal, Janam J Dave, B V Venkataram Prasad, Mary K Estes, Sasirekha Ramani, Joseph M Hyser

Faculty, Staff and Students Publications

Human norovirus is the leading cause of viral gastroenteritis across all age groups. While there is a need for human norovirus antivirals, therapeutic development has been hindered by a lack of cell culture systems and animal models of infection. Surrogate viruses, such as Tulane virus (TV), have provided tractable systems to screen potential antiviral compounds. Our previous work demonstrated that TV encodes a viral ion channel, which dysregulates cytosolic calcium signaling. We set out to investigate whether host pathways triggered by viral ion channel activity, including store-operated calcium entry (SOCE), play a role in virus replication. Using pharmacologic inhibitors and …

How Do Montessori-Based Activities Affect Behaviors For Older People With Dementia: A Literature Review, Isabel Quigley

University Honors Theses

Objectives: This literature review is meant to analyze the development on the research on Montessori-based activities for adults with dementia.

Introduction: Baby Boomers are the largest generation to enter senior age (65+) in history due to the advancement in medicine to increase life expectancy. Dementia is a neurocognitive disease that affects parts of the brain related to memory and signs typically surface around 65 years old. Dementia is not considered healthy aging. Montessori-based activities have been recently developed as an intervention to encourage a feeling of accomplishment and success for adults with dementia.

Methods: Two electronic databases …

Community Perspectives On Cancer And Cancer Research: Findings From Listening Sessions With Diverse Groups In Philadelphia, Karen Glanz, Emma A. Soliva, Krista Scheffey, Yawei Song, Charnita Zeigler-Johnson, Evelyn T. González, Thierry Fortune, Nilsa Graciani, Amy E. Leader

Kimmel Cancer Center Faculty Papers

BACKGROUND: Listening sessions are useful for understanding community perspectives on cancer disparities. The Philadelphia Communities Conquering Cancer (PC3) coalition conducted listening sessions to identify community priorities for cancer prevention and control research among diverse communities in Philadelphia.

METHODS: Guided by a Stakeholder Advisory Committee, PC3 partnered with community-based organizations to conduct 8 listening sessions with diverse communities (including Black, Hispanic, Asian, Russian, LGBTQ + , and veterans) to learn about perceptions of cancer, research priorities, and training and communication preferences. Sessions were facilitated by community members or PC3 members in the primary language of participants. Sessions were audio recorded, transcribed, …

Regulation Of Myogenesis By Mechanomir-200c/Foxo3 Axis, Junaith S Mohamed, Aladin M Boriek

Faculty, Staff and Students Publications

Cyclic mechanical stretch has been shown to inhibit myoblast differentiation while promoting proliferation. However, the underlying molecular mechanisms are not well understood. Here, we report that mechanical stretch inhibits the differentiation of mouse primary myoblasts by promoting the cell cycle program and by inhibiting the expression of the myogenic regulator MyoD. Stretch alters the miRNA expression profile as evidenced by miRNA microarray analysis. We identified miR-200c as one of the highly downregulated mechanosensitive miRNAs (mechanomiRs) whose expression level was increased during differentiation. This suggests that mechanomiRs-200c is a myogenic miRNA. Overexpression of mechanomiR-200c revoked the effect of stretch on myoblast …

Development Of Recommendations For The Future Of Telehealth Use Among Sexual And Gender Minorities (Sgm), Jeffrey A. Wilhite

Dissertations and Theses

It is now well-documented that sexual and gender minoritized individuals (SGMs) face consistent stigmatization from not just the health care system, but also from overarching community, federal, and societal entities. Subsections of the SGM community, like gay men for example, face higher rates of eating disorders, certain cancers, alcoholism, mental illness and even obesity, when compared to heterosexual counterparts. Many of these challenges could be exacerbated by current political administration efforts to silence the community. Ensuring access to clinical care is one way of preserving the health and livelihood of the community. Telehealth, or synchronous, remote based clinical care, can …

Career Impact Of The National Interprofessional Fellowship In Patient Safety: An Alumni Evaluation, Bradley V Watts, Kathleen Carluzzo, Blake F Webb, Kelley Arredondo

Faculty, Staff and Students Publications

Background: There has been a proliferation of health professions training programmes focused on quality and patient safety, but little information regarding the outcomes of these programmes. The purpose of this study was to examine the impact of an interprofessional quality and patient safety curriculum on career outcomes of interprofessional healthcare learners for the Veterans Affairs Patient Safety Fellowship.

Method: We conducted a survey-based assessment of 117 alumni of the Interprofessional Fellowship in Patient Safety assessing their satisfaction with the training program and career impacts.

Results: 84 of 117 alumni were located and participated in the assessment. Fellows entered the training …

Impact Of Sociodemographic Determinants On Enrollment Into Contemporary Lymphoma Clinical Trials: A Systematic Review, Jun Yang Jiang, Ang Li, Alexis Romero, Christopher R Flowers, Chijioke Nze

Faculty, Staff and Students Publications

While the incidence and survival associated with lymphoma have improved in recent years, outcome disparities related to sociodemographic factors such as age, sex, race, ethnicity, socioeconomic status (SES), and other social determinants of health (SDOH) remain prevalent in the modern era. Clinical trials are crucial for further improving outcomes, yet not all sociodemographic groups are equally represented in contemporary lymphoma trials. We conducted a systematic review of the literature evaluating the impact of SDOH on enrollment into clinical trials in the United States and identified 21 relevant studies. We confirmed that Black and Hispanic individuals are underrepresented in lymphoma clinical …

Phage-Induced Protection Against Lethal Bacterial Reinfection, Yikun Xing, Haroldo J Hernandez Santos, Ling Qiu, Samantha R Ritter, Jacob J Zulk, Rachel Lahowetz, Kathryn A Patras, Austen L Terwilliger, Anthony W Maresso

Faculty, Staff and Students Publications

Bacteriophages, or phages, are viruses that target and infect bacteria. Due to a worldwide rise in antimicrobial resistance (AMR), phages have been proposed as a promising alternative to antibiotics for the treatment of resistant bacterial infections. Up to this point in history, phage use in preclinical animal studies, clinical trials, and emergency-use compassionate care cases has centered around the original observation from 1915 showing phage as lytic agent, and thus a treatment that kills bacteria. Here, we describe an activity associated with phage therapy that extends beyond lytic activity that results in long-term protection against reinfection. This activity is potent, …