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Alexa Sauvagere

Hello, my name is Alexa.

Potential for an Electronic Clinical Decision Support Tool to Support Appropriate Antibiotic Use for Pediatric Diarrhea Among Village Doctors in Bangladesh

Diarrhea is a significant cause of morbidity among children in low- and middle-income countries (LMICs), and is responsible for over 500 000 deaths per year. In many LMICs, informally trained healthcare providers are the first point of care for children with diarrhea. In Bangladesh, “village doctors” practice allopathic medicine with limited formal training and provide healthcare services to approximately two-thirds of Bangladesh’s population.

Hepatitis B virus (HBV) viremia despite tenofovir disoproxil fumarate-containing antiretroviral therapy in persons with HBV/HIV coinfection

HIV/HBV coinfection is common in areas that are endemic for both viruses. In 2015, ∼2.7 million (7.4 %) of 36.7 million people living with HIV worldwide were infected with HBV, with 71 % (1.96 million) living in sub-Saharan Africa. Complications of chronic HBV infection like cirrhosis, hepatocellular carcinoma, and death are associated with HBV replication

Etiology of Severely Dehydrating Diarrheal Illness in Infants and Young Children Residing in Low- and Middle-Income Countries

Severe dehydration due to acute infectious diarrhea remains a leading cause of death among young children worldwide. Diarrhea with severe dehydration is a clinical syndrome with distinct management per the World Health Organization (WHO) Integrated Management of Childhood Illness (IMCI) and the WHO Global Task Force on Cholera Control (GTFCC) guidelines. We sought to characterize the pathogens causing severe dehydration using data from the Global Enteric Multicenter Study.

Interleukin-22 Promotes Cell Proliferation to Combat Virus Infection in Human Intestinal Epithelial Cells

Interferon lambdas (IFN-λs) are crucial to control virus infections at mucosal surfaces. Interleukin-22 (IL-22) was reported to help IFN-λ control rotavirus infection in the intestinal epithelium of mice either by aiding in the induction of interferon-stimulated genes (ISGs) or by increasing cell proliferation thereby clearing virally infected cells. We investigated whether IL-22 and IFN-λs exhibit similar synergistic effects in human intestinal epithelial cells (IECs) models.

Integrated analyses of the transmission history of SARS-CoV-2 and its association with molecular evolution of the virus underlining the pandemic outbreaks in Italy, 2019-2023

Italy was significantly affected by the COVID-19 pandemic, experiencing multiple waves of infection following the sequential emergence of new variants. Understanding the transmission patterns and evolution of SARS-CoV-2 is vital for future preparedness. The changing patterns of viral spread and variant prevalence throughout Italy's pandemic response underscore the continued importance of flexible public health strategies and genomic surveillance, both of which are crucial for tracking the evolution of variants and adapting control measures effectively to ensure preparedness for future outbreaks.

Development and implementation of learning collaboratives for infection prevention and control education in long-term care facilities

Infections in long-term care facilities pose a critical challenge, with 1 to 3 million serious infections annually and up to 380,000 associated deaths. The vulnerability of aging populations and inadequate infection prevention and control programs underscore the need for intervention. This initiative provided tailored continuing education through 8 virtual learning collaboratives serving 541 infection preventionists.

Reasons for not seeking alcohol treatment among a sample of Florida adults with HIV who perceived the need for treatment

A minority of people who need alcohol treatment receive it. Unhealthy alcohol use is common among people with HIV (PWH) and can lead to negative health outcomes. The aims of this multi-methods study are to (1) quantitatively describe the prevalence, psychosocial characteristics, and demographic traits of a sample of PWH currently receiving HIV care in Florida who had a self-reported need for alcohol treatment but did not seek care and (2) qualitatively explore reasons why PWH did not seek treatment.

Trajectories of Adherence to Oral Pre-exposure Prophylaxis and Risks of HIV and Sexually Transmitted Infections

Pre-exposure prophylaxis (PrEP) effectiveness is highly dependent on medication adherence, which is associated with differential HIV risks and possibly sexually transmitted infection (STI). These findings underscore the benefits of continuing and remaining adherent to PrEP and may also inform public health strategies, clinical guidelines, and interventions aimed at maximizing the effectiveness of PrEP in reducing new HIV infections while developing targeted strategies to prevent STIs with PrEP use.

Eliding Consent in the Case of Pandemic Countermeasures Authorized Only for Emergency Use

Four months after the first vaccines against Covid-19 became available to the public, and just as some universities announced plans to require inoculations, the Boston Globe quoted me as (alone) suggesting that mandates would conflict with federal law. When Congress created a special mechanism for the emergency use of still investigational products, it directed providers to reveal, among other things, that individuals remained free to decline such an intervention; only after full FDA approval of a medical countermeasure would this disclosure obligation become inapplicable