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Recent EPI Publications

Pathways to optimize a pediatric telemedicine and medication delivery service: a multi-level qualitative study in Haiti

While telemedicine has become an established component of healthcare delivery globally, challenges to scaling emerging initiatives persist across multiple levels. Over the last 5 years, our team has developed a pediatric telemedicine and medication delivery service (TMDS) in Haiti that integrates clinical guidance with rapid access to medications. Building on successful proof-of-concept studies, we are now well positioned to characterize both general challenges to telemedicine scale-up and those unique to the TMDS model.

Current and emerging therapies for fungal biofilms and systemic infections

Fungal pathogens pose a global public health risk, driven by the alarming rise of antifungal resistance. The current antifungal pipeline remains limited to three main classes (azoles, polyene, and echinocandins). Additionally, fungal biofilms, with its extracellular matrix, further complicates the antifungal therapeutics.

Randomized Trial of Targeted Indoor Spraying to Prevent Aedes-Borne Diseases

Targeted indoor residual spraying focuses insecticide applications on common resting surfaces of Aedes aegypti mosquitoes (an arboviral disease vector) in houses, such as exposed lower sections of walls and under furniture. We conducted a two-group, parallel, unblinded, cluster-randomized trial in Merida, Mexico, to quantify the efficacy of targeted indoor residual spraying for preventing aedes-borne diseases (chikungunya, dengue, or Zika).

Quantifying the mortality and morbidity impact of medicaid work requirements: a modeling study

Federal Medicaid work requirements, recently enacted under national legislation, are expected to cause substantial disenrollment among low-income adults. However, the public health consequences of these policies remain poorly quantified. Medicaid work requirements are projected to increase mortality and chronic disease burden across the United States. These findings highlight the role of state administrative capacity and underscore the public health cost of restricting insurance access.

Galleria mellonella possesses the essential nutritional needs to host the fastidious Huanglongbing bacterial pathogen ‘Candidatus Liberibacter asiaticus’

Citrus greening disease, caused by ‘Candidatus Liberibacter asiaticus’, severely impacts citrus production worldwide. The development of sustainable control strategies for this disease is restricted by the unavailability of the bacterium in pure culture. Herein, the metabolic profile of the waxworm larvae, Galleria mellonella, was compared to that of Diaphorina citri, the vector of ‘Ca. L. asiaticus’.

Contrasting Ecological Patterns of Venezuelan Equine Encephalitis and Madariaga Viruses in Small Mammal and Mosquito Populations from Two Enzootic Regions of Panama

Understanding enzootic cycles is key to arbovirus control. Rodents are primary reservoirs of Venezuelan equine encephalitis virus (VEEV), whereas the vertebrate host of Madariaga virus (MADV) remains unknown. Culex (Melanoconion) mosquitoes are considered primary vectors. We studied small mammals and mosquito ecology in the Darién province and Panamá Oeste province, two enzootic regions of Panama. Additional alphavirus seroprevalence was assessed in small mammals.

Hypoxia increases susceptibility of human intestinal epithelial cells to rotavirus infection through repression of interferon induction

Intestinal epithelial cells (IECs) serve as both a physical barrier and a source of robust antiviral interferon (IFN) response. As such, they constitute the primary barrier that enteric viruses, such as rotavirus, need to overcome to initiate infection. The gut is characterized by very low oxygen levels (hypoxia) within the lumen, resulting in a unique hypoxic physiological environment in which rotavirus infection occurs.

Expert Knowledge Elicitation: Accessing the Big Data in Experts’ Brains

A vast amount of expert knowledge currently remains inaccessible to digital information systems. Expert knowledge elicitation is a systematic approach to accessing and synthesizing the insights of subject matter experts, especially when available objective data are incomplete. In plant pathology, expert knowledge elicitation is valuable for addressing urgent, uncertain, and/or future challenges, such as emerging disease threats, complex epidemiological systems, knowledge gaps when resources are limited, and future scenarios.

Innovative engineering approaches to model host-microbiome interactions in vitro

The human microbiome plays a critical role in health and disease. Disruptions in microbiota composition or function have been implicated not only as markers but also as drivers of diverse pathologies, creating opportunities for targeted microbiome interventions. Advancing these therapies requires experimental models that can unravel the complex, bidirectional interactions between human tissue and microbial communities.