Publications by authors named "Megan Wallace"

Importance: Strong evidence demonstrates long-term cognitive decline associated with anticholinergics. While prevalent among older populations, medical management of overactive bladder (OAB) is dictated by insurance coverage rather than medical provider and patient preferences.

Objective: The aim of this study was to assess Medicare insurance plan coverage for select OAB medications and evaluate coverage of preferred medications to medications with a greater risk of cognitive dysfunction.

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Maternal asthma is associated with increased rates of neonatal lung disease, and fetuses from asthmatic ewes have fewer surfactant-producing cells and lower surfactant-protein B gene (SFTPB) expression than controls. Antenatal betamethasone increases lung surfactant production in preterm babies, and we therefore tested this therapy in experimental maternal asthma. Ewes were sensitised to house dust mite allergen, and an asthmatic phenotype induced by fortnightly allergen lung challenges; controls received saline.

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  • Regulatory agencies and NITAGs evaluate the balance of vaccine benefits and harms, with DQCs (direct quantitative comparisons) being used to support decision-making during the COVID-19 pandemic.
  • The study reviewed 23 publications where DQCs were utilized, revealing their role in various situations, such as new safety signals and changing vaccine contexts.
  • While DQCs provided timely and transparent communication, their reliance on assumptions made them sensitive to changes and limited their applicability to different contexts, especially in the rapidly evolving COVID-19 situation.
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  • COVID-19 vaccinations, particularly the newly recommended monovalent XBB.1-strain vaccines for all individuals 6 months and older, are vital for protection against severe illness and death from COVID-19, especially as new strains like Omicron JN.1 and KP.2 are spreading in the U.S.! -
  • As vaccine effectiveness decreases over time, the ACIP has advised that everyone 6 months and older should receive the 2024-2025 COVID-19 vaccines, which have been approved or authorized by the FDA, including those from Moderna and Pfizer-BioNTech for ages 12 and up, and under Emergency Use Authorization for younger children!* -
  • The FDA also authorized Novava
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The most prevalent arthropod-borne viruses, including the dengue viruses, are primarily transmitted by infected mosquitoes. However, the dynamics of dengue virus (DENV) infection and dissemination in human skin following probing remain poorly understood. We exposed human skin explants to adult female mosquitoes following their infection with DENV-2 by intrathoracic injection.

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An influenza vaccine approach that overcomes the problem of viral sequence diversity and provides long-lived heterosubtypic protection is urgently needed to protect against pandemic influenza viruses. Here, to determine if lung-resident effector memory T cells induced by cytomegalovirus (CMV)-vectored vaccines expressing conserved internal influenza antigens could protect against lethal influenza challenge, we immunize Mauritian cynomolgus macaques (MCM) with cynomolgus CMV (CyCMV) vaccines expressing H1N1 1918 influenza M1, NP, and PB1 antigens (CyCMV/Flu), and challenge with heterologous, aerosolized avian H5N1 influenza. All six unvaccinated MCM died by seven days post infection with acute respiratory distress, while 54.

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Background: Residents of nursing homes remain an epidemiologically important population for COVID-19 prevention efforts, including vaccination. We aim to understand effectiveness of bivalent vaccination for preventing SARS-CoV-2 infections in this population.

Methods: We used a retrospective cohort of nursing home residents from November 1, 2022, through March 31, 2023, to identify new SARS-CoV-2 infections.

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  • Preterm rabbits were studied to see how changing expiratory resistance (Re) affects lung aeration during positive pressure ventilation right after birth.
  • Increasing Re slowed down lung deflation and increased functional residual capacity (FRC), indicating that higher resistance may improve lung function during mechanical ventilation.
  • The findings suggest that improving the expiratory phase in ventilation devices could enhance outcomes for preterm infants by preserving more FRC, despite breath-related work reduction efforts.
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remains a pre-eminent insect model system for host-virus interaction, but the host range and fitness consequences of the drosophilid virome are poorly understood. Metagenomic studies have reported approximately 200 viruses associated with Drosophilidae, but few isolates are available to characterize the immune response, and most characterization has relied on injection and systemic infection. Here, we use a more natural infection route to characterize the fitness effects of infection and to study a wider range of viruses.

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  • - COVID-19 is still a significant public health concern, especially for individuals aged 65 and older, who accounted for 67% of COVID-19-related hospitalizations from October 2023 to January 2024.
  • - The CDC recommended that everyone aged 6 months and older receive the updated 2023-2024 COVID-19 vaccine to protect against severe illness, as the virus continues to circulate and variants are emerging.
  • - Additionally, on February 28, 2024, it was advised that those aged 65 and older get an extra dose of the updated vaccine to boost their immunity and reduce the risk of severe outcomes, including death.
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Importance: There is strong evidence for long-term cognitive effects with anticholinergic use. Differences in insurance coverage of anticholinergics and beta-3 agonists hinder individualization of overactive bladder (OAB) treatment.

Objectives: The aims of the study were to assess individual and family health insurance plan coverage for select OAB medications and to compare coverage of preferred medications to those with a greater risk of cognitive dysfunction.

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To slow the spread of COVID-19 many mental health providers transitioned to telehealth delivery of trauma-focused treatment for maltreated children. However, these providers faced myriad challenges, including equitable access to equipment and technical demands of telehealth software. Training clinics overseeing pre-doctoral clinical psychology interns experienced the added challenge of providing quality supervision and training via telehealth.

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Background: Manual tactile stimulation is used to counteract apnea in preterm infants, but it is unknown when this intervention should be applied. We compared an anticipatory to a reactive approach using vibrotactile stimulation to prevent hypoxia induced apneas.

Methods: Preterm rabbit kittens were prematurely delivered and randomized to either group.

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  • COVID-19 increases the risk of thromboembolic events like stroke and heart issues, but vaccines seem to reduce this risk.
  • A study found that receiving a bivalent mRNA COVID-19 vaccine after an original monovalent one significantly decreases the likelihood of these events, showing a vaccine effectiveness of 47% for those aged 65 and older, and 51% for younger adults with severe kidney disease.
  • Overall, staying updated with COVID-19 vaccinations is crucial for preventing complications related to the virus, especially thromboembolic events.
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  • - COVID-19 vaccines have been a significant success in reducing hospitalizations and deaths in the U.S., with over 675 million doses given and over 80% of the population receiving at least one dose.
  • - The vaccines are estimated to have prevented more than 18 million hospitalizations and 3 million deaths, despite over one million fatalities from COVID-19 during the pandemic.
  • - The Advisory Committee on Immunization Practices (ACIP) has actively reviewed data and made recommendations on COVID-19 vaccines, emphasizing their safety and effectiveness as key tools in combating serious illness from the virus.
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Background: Infants with a congenital diaphragmatic hernia (DH) have underdeveloped lungs and require mechanical ventilation after birth, but the optimal approach is unknown. We hypothesised that sustained inflation (SI) increases lung aeration in newborn kittens with a DH.

Methods: In pregnant New Zealand white rabbits, a left-sided DH was induced in two fetal kittens per doe at 24-days gestation (term = 32 days); litter mates acted as controls.

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  • COVID-19 vaccines are crucial for preventing severe outcomes, like hospitalization and death, but their effectiveness has been impacted by evolving variants.
  • Since September 2022, bivalent mRNA vaccines were recommended, but they were tailored to variants that are no longer prevalent.
  • As of September and October 2023, the FDA approved updated vaccines from Moderna, Pfizer-BioNTech, and Novavax to enhance immunity against currently circulating variants, with vaccination recommended for everyone aged 6 months and older.
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  • Respiratory syncytial virus (RSV) is a major cause of hospitalization for infants in the U.S., leading to recommended preventative measures like nirsevimab (Bevfortus) for infants and the newly approved RSVpreF vaccine (Abrysvo) for pregnant individuals.
  • The FDA approved the RSVpreF vaccine in August 2023 for administration during weeks 32-36 of pregnancy to help protect infants under 6 months from RSV-related respiratory issues.
  • The CDC's Advisory Committee on Immunization Practices recommends that either the RSVpreF vaccine for mothers or nirsevimab for infants be used to protect against RSV, but not necessarily both for most infants.
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Highly pathogenic avian influenza A H5N1 viruses cause high mortality in humans and have pandemic potential. Effective vaccines and treatments against this threat are urgently needed. Here, we have refined our previously established model of lethal H5N1 infection in cynomolgus macaques.

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  • The COVID-19 Scenario Modeling Hub, starting in December 2020, provided data-driven projections on cases, hospitalizations, and deaths resulting from COVID-19, pulling insights from up to nine different modeling groups.
  • These projections were crucial for understanding the effects of various interventions and informed the public and health authorities, including the CDC, about potential future trends and vaccination strategies.
  • The hub's collaborative approach allowed for rapid sharing of information amid uncertainties, highlighting how these models directly influenced public health communication and decision-making, while also outlining challenges faced during this process.
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To inform Advisory Committee for Immunization Practices (ACIP) COVID-19 vaccine policy decisions, we developed a benefit-risk assessment framework that directly compared the estimated benefits of COVID-19 vaccination to individuals (e.g., prevention of COVID-19-associated hospitalization) with risks associated with COVID-19 vaccines.

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  • * Vaccination with primary COVID-19 mRNA series and boosters has proven effective in reducing COVID-19-related health issues for these residents, with the NHSN updating guidelines in October 2022 to include bivalent vaccines.
  • * Analysis of data from late 2022 showed that being up to date with vaccinations offers a 31.2% effectiveness in preventing SARS-CoV-2 infections among nursing home residents, highlighting the importance of regular vaccination updates.
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  • The CDC has been providing guidelines for COVID-19 vaccine use in the U.S. during the national public health emergency, based on recommendations from the Advisory Committee on Immunization Practices (ACIP).
  • Between August 2022 and April 2023, the FDA approved a bivalent COVID-19 vaccine that targets both the original virus and Omicron BA.4/BA.5 strains for people aged 6 and older, as well as vaccines for younger children and additional doses for high-risk groups.
  • Currently, there are three approved COVID-19 vaccines in the U.S.: the bivalent mRNA Pfizer-BioNTech, the bivalent mRNA Moderna, and the monovalent Novavax, while mon
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Congenital diaphragmatic hernia (CDH) is a major cause of severe lung hypoplasia and pulmonary hypertension in the newborn. While the pulmonary hypertension is thought to result from abnormal vascular development and arterial vasoreactivity, the anatomical changes in vascular development are unclear. We have examined the 3D structure of the pulmonary arterial tree in rabbits with a surgically induced diaphragmatic hernia (DH).

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Background: Molecular epidemiological approaches provide opportunities to characterize HIV transmission dynamics. We analyzed HIV sequences and virus load (VL) results obtained during routine clinical care, and individual’s zip-code location to determine utility of this approach. Methods: HIV-1 pol sequences aligned using ClustalW were subtyped using REGA.

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