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Updates In Mycobacterial Keratitis Diagnosis And Treatment, Uma L Balakrishnan, Ryan T Wallace, Patricia Chévez-Barrios, Alejandro Arboleda, Masih U Ahmed Jan 2026

Updates In Mycobacterial Keratitis Diagnosis And Treatment, Uma L Balakrishnan, Ryan T Wallace, Patricia Chévez-Barrios, Alejandro Arboleda, Masih U Ahmed

Faculty, Staff and Students Publications

Mycobacterial keratitis is an uncommon but challenging form of infectious keratitis, often associated with postsurgical eyes. Clinical presentation is variable and may be difficult to recognize, resulting in delays in diagnosis and challenges in management. Traditional diagnostic techniques from corneal scrapings are limited by slow organism growth and may yield negative results. Treatment is challenging due to antimicrobial resistance and typically requires prolonged multidrug therapy. Advances in diagnostic modalities, antimicrobial therapies, surgical approaches, and adjunctive treatments such as corneal crosslinking have improved clinicians' ability to mitigate or avoid severe visual consequences. Despite these developments, optimal management strategies remain incompletely defined, …


Professionalism In Practice: A Novel Approach To Integrating Small Doses Of Case-Based Professionalism Education Into Monthly Grand Rounds., Allison H Taylor, Andrew Caruso, Kelley Arredondo, Ellen M Friedman, Stacey R Rose Jan 2026

Professionalism In Practice: A Novel Approach To Integrating Small Doses Of Case-Based Professionalism Education Into Monthly Grand Rounds., Allison H Taylor, Andrew Caruso, Kelley Arredondo, Ellen M Friedman, Stacey R Rose

Faculty, Staff and Students Publications

Introduction: Professionalism is a critical construct across the health professions, though learners and faculty report feeling underprepared to navigate difficult situations; education in professionalism is challenged by the absence of a universal definition, time constraints due to overcrowded curricula, and the lack of consistent messaging to learners and faculty.

Methods: Professionalism in Practice (PiP) was developed to provide small doses (∼5 minutes) of case-based professionalism education as part of an existing educational forum (Grand Rounds) to optimize attendance of both learners and faculty. Each vignette highlighted a common professionalism challenge and was aligned with an AAMC professional competency. Sessions were …


Imagining Genomics And Population Health In 2050: Anticipating Future Research, Policy, And Governance Needs, Bartha Maria Knoppers, Yann Joly, Ma Apos N H Zawati, Habiba Alsafar, Jeffrey C Barrett, Laura Blackburn, Brian Hon-Yin Chung, Martina C Cornel, Edward S Dove, David Glazer, Calvin Wai-Loon Ho, Muin J Khoury, Anna C F Lewis, Anneke Lucassen, Peter F R Mills, Colin Mitchell, Nicola Mulder, Ainsley J Newson, Anthony Ng, Paul D P Pharoah, Vasiliki Rahimzadeh, Megan C Roberts, Saskia C Sanderson, Jeffrey M Skopek, Ron Zimmern, Eric M Meslin Jan 2026

Imagining Genomics And Population Health In 2050: Anticipating Future Research, Policy, And Governance Needs, Bartha Maria Knoppers, Yann Joly, Ma Apos N H Zawati, Habiba Alsafar, Jeffrey C Barrett, Laura Blackburn, Brian Hon-Yin Chung, Martina C Cornel, Edward S Dove, David Glazer, Calvin Wai-Loon Ho, Muin J Khoury, Anna C F Lewis, Anneke Lucassen, Peter F R Mills, Colin Mitchell, Nicola Mulder, Ainsley J Newson, Anthony Ng, Paul D P Pharoah, Vasiliki Rahimzadeh, Megan C Roberts, Saskia C Sanderson, Jeffrey M Skopek, Ron Zimmern, Eric M Meslin

Center for Medical Ethics and Health Policy Staff Publications

No abstract provided.


A Position Statement On Endovascular Models And Effectiveness Metrics For Mechanical Thrombectomy Navigation, On Behalf Of The Stakeholder Taskforce For Artificial Intelligence-Assisted Robotic Thrombectomy (Start), Harry Robertshaw, Anna Barnes, Phil Blakelock, Raphael Blanc, Robert Crossley, Rebecca Fahrig, Ameer E. Hassan, Benjamin Jackson, Lennart Karstensen Jan 2026

A Position Statement On Endovascular Models And Effectiveness Metrics For Mechanical Thrombectomy Navigation, On Behalf Of The Stakeholder Taskforce For Artificial Intelligence-Assisted Robotic Thrombectomy (Start), Harry Robertshaw, Anna Barnes, Phil Blakelock, Raphael Blanc, Robert Crossley, Rebecca Fahrig, Ameer E. Hassan, Benjamin Jackson, Lennart Karstensen

School of Medicine Publications

Although we are making progress in overcoming infectious diseases and cancer, one of the major medical challenges of the mid-21st century will be the increasing prevalence of stroke. Occlusions in large vessels are especially debilitating, yet effective treatment—needed within hours to achieve best outcomes—remains limited because of geographic accessibility. One solution for improving timely access to mechanical thrombectomy in geographically diverse populations is the widespread deployment of robotic surgical systems. Artificial intelligence assistance may enable the safe and effective upskilling of operators in this emerging therapeutic delivery approach. Our aim was to establish consensus frameworks for developing and validating artificial …


Studies Towards Chemical Synthesis Of Homogeneous Prion Glycoprotein, Baotong Tian Jan 2026

Studies Towards Chemical Synthesis Of Homogeneous Prion Glycoprotein, Baotong Tian

Electronic Theses & Dissertations (2024 - present)

Prion diseases are fatal neurodegenerative disorders initiated by conformational misfolding of the prion protein (PrP), which generates pathogenic conformers that propagate via templated conversion and accumulate as aggregates. Glycosylation can modulate the PrP folding energy landscape, thereby biasing folding trajectories and the distribution of resulting conformational states. Bank vole PrP contains two N-linked glycosylation sites, and disentangling the contributions of site occupancy versus glycan structure requires homogeneous, site-defined glycoforms. In contrast, biosynthetic expression typically produces heterogeneous glycoform ensembles due to multistep Golgi processing, precluding independent control of glycan identity at each site. Here we report a chemical synthesis strategy of …


A Year In Review On Tuberculosis And Non-Tuberculous Mycobacteria Disease: A 2026 Update For Clinicians And Scientists, Simone Tunesi, Graham Bothamley, Gunar Günther, Yousra Kherabi, Liga Kuksa, Berit Lange, Christoph Lange, Natalie Lorent, Francesca Saluzzo, Martina Sester, Xenia Emilie Sinding Iversen, Marc Tebruegge, Conor Tweed, Anca Vasiliu, Lorenzo Guglielmetti, Tuberculosis Network European Trials Group (Tbnet) Jan 2026

A Year In Review On Tuberculosis And Non-Tuberculous Mycobacteria Disease: A 2026 Update For Clinicians And Scientists, Simone Tunesi, Graham Bothamley, Gunar Günther, Yousra Kherabi, Liga Kuksa, Berit Lange, Christoph Lange, Natalie Lorent, Francesca Saluzzo, Martina Sester, Xenia Emilie Sinding Iversen, Marc Tebruegge, Conor Tweed, Anca Vasiliu, Lorenzo Guglielmetti, Tuberculosis Network European Trials Group (Tbnet)

Faculty, Staff and Students Publications

Background: Tuberculosis (TB) remains a major cause of morbidity and mortality worldwide, while infections from non-tuberculous mycobacteria (NTM) represent a growing public health threat. In its 20th year of activity, the Tuberculosis Network European Trials group (TBnet; www.tbnet.eu) is one of the leading research networks in Europe. In this review, we summarize the main advances in TB and NTM that occurred in 2025.

Methods: We conducted a non-systematic review of articles published in 2025, with a strong emphasis on research with current or potential impact on clinical practice. We also selected the most impactful papers regarding the management of adult …


Preparing For Long-Acting Technologies: A Multistate Analysis Of Prep Persistence And Hiv And Sti Lab Coverage Among Oral Prep Initiators In St. Louis, Missouri (2014-2021), Lindsey M Filiatreau, Rupa Patel, Kate Curoe, Ashley Underwood, Joseph Cherabie, Elvin H Geng, Aditi Ramakrishnan, Rachel Presti, Aaloke Mody Jan 2026

Preparing For Long-Acting Technologies: A Multistate Analysis Of Prep Persistence And Hiv And Sti Lab Coverage Among Oral Prep Initiators In St. Louis, Missouri (2014-2021), Lindsey M Filiatreau, Rupa Patel, Kate Curoe, Ashley Underwood, Joseph Cherabie, Elvin H Geng, Aditi Ramakrishnan, Rachel Presti, Aaloke Mody

2020-Current year OA Pubs

BACKGROUND: Engagement in pre-exposure prophylaxis (PrEP) care and routine screening for HIV and sexually transmitted infections (STIs) is critical to realizing the full benefits of this HIV prevention strategy.

METHODS: We enrolled a cohort of individuals seeking PrEP services in two clinics in Missouri, an Ending the HIV Epidemic priority state, from June 2014 to November 2021. We used electronic health record and survey data to explore outcomes in the 2 years following linkage to care using multistate methods. We assessed transitions between eight mutually exclusive care states differentiated by receipt of a prescription, lab coverage status, and retention. We …


The Effects Of Micro- And Nanoplastics On Human Monocytes, Caitlin G. Valerian Jan 2026

The Effects Of Micro- And Nanoplastics On Human Monocytes, Caitlin G. Valerian

Honors Theses and Capstones

No abstract provided.


Development And Applications Of Fluorescence Microscopy Protocol To Investigate Borrelia Burgdorferi Immune Interactions In The Skin, Rebecca V. Landry Jan 2026

Development And Applications Of Fluorescence Microscopy Protocol To Investigate Borrelia Burgdorferi Immune Interactions In The Skin, Rebecca V. Landry

Electronic Theses & Dissertations (2024 - present)

The skin is an immunological organ that acts as the hosts’ first line of defense against infectious agents. Infectious disease vectors like ticks breach this barrier by feeding on hosts, transmitting pathogens like Borrelia burgdorferi in the process. Uncleared infection with B. burgdorferi causes Lyme disease, the most prevalent vector-borne disease in the United States. Previous research has explained many elements of Lyme disease pathogenesis and immunity including the dissemination of the spirochete, innate immune cells performing phagocytosis, the production of antibodies by the humoral response, and the impact of prophylactic treatment with monoclonal antibodies. A remaining gap in the …


Hepatitis C Among Persons Who Inject Drugs In New York State: Progress Towards Elimination, Meredith A. Barranco Jan 2026

Hepatitis C Among Persons Who Inject Drugs In New York State: Progress Towards Elimination, Meredith A. Barranco

Electronic Theses & Dissertations (2024 - present)

Background: Hepatitis C virus (HCV) infection is one of the leading causes of liver disease in the United States (US) and worldwide. In the United States today, HCV is transmitted primarily through injection drug use (IDU) and therefore disproportionately impacts persons who inject drugs (PWID), a population with a range of complex social and health needs. HCV is not vaccine-preventable but can be cured in over 90% of cases with an 8–12-week course of daily direct-acting antiviral (DAA) medication. Since approval of curative medications in 2014, various jurisdictions have developed plans to eliminate HCV. In 2021, the New York State …


Understanding The Syphilis Resurgence Among Females Of Childbearing Age: Informing Prevention Efforts In New York State, Salvatore Currenti Jan 2026

Understanding The Syphilis Resurgence Among Females Of Childbearing Age: Informing Prevention Efforts In New York State, Salvatore Currenti

Electronic Theses & Dissertations (2024 - present)

Syphilis is caused by Treponema pallidum and transmitted through direct contact with infected mucosal lesions and via vertical transmission during pregnancy (i.e., congenital). Transmission of syphilis to an infant during pregnancy (i.e., congenital syphilis [CS]) can lead to early fetal death, stillbirth, neonatal death, preterm birth, low birthweight, and congenital infection in infants. The United States (U.S.) is experiencing epidemic increases in both females of reproductive age with syphilis and infants with CS. In New York State (NYS), these trends have also occurred, especially after COVID-19 emergence, and increases in reported cases and incidence rates are comparable to national statistics. …


Improving Antibiotic Prescribing For Urinary Tract Infections In Urgent Care Centers, Alexis Alastanos Jan 2026

Improving Antibiotic Prescribing For Urinary Tract Infections In Urgent Care Centers, Alexis Alastanos

Graduate Theses, Dissertations, and Problem Reports (ETD)

Introduction: Urinary tract infections (UTIs) are one of the most common infections that require antibiotic therapy. Providers working in three urgent care clinics located in Eastern West Virginia diagnosis and treat UTIs based on their clinical judgement. Variability in clinical judgement results in inappropriate antibiotic use which has implications on antibiotic resistance and the financial burden of the patients as well as the entire organization.

Evidence Review: A total of 10 articles were evaluated to support the implementation of antibiotic stewardship initiatives that provide guidance in caring for this population. Interventions include electronic health record enhancements, provider education, and tracking …


Implementation Of A Ventilator-Associated Pneumonia Bundle To Reduce The Incidence Of Ventilator-Associated-Pneumonia And Improve Patient Care, Taylor Ryan Rice Jan 2026

Implementation Of A Ventilator-Associated Pneumonia Bundle To Reduce The Incidence Of Ventilator-Associated-Pneumonia And Improve Patient Care, Taylor Ryan Rice

Graduate Theses, Dissertations, and Problem Reports (ETD)

Introduction: Ventilator-associated pneumonia (VAP) is a concerning complication that can

develop from complications when a patient is placed on a mechanical ventilator. Endotracheal

intubation puts patients at risk for micro aspiration, which can lead to VAP.

Evidence Review: Nine articles were selected for review; after critical appraisal, seven were

kept for further review. Evidence in these articles shows that using evidence-based methods in a

VAP bundle can decrease the length of stay, mechanical ventilator days, and the incidence of

VAP.

Purpose: The purpose of this project was to improve oral care for intubated patients and keep

the incidence of VAP …


Infection Control Across Clinical And Laboratory Dental Settings Protocols, Risks, And The Role Of Emerging Technologies, Khrystyna Vyprynyuk, Laura Andreesku Jan 2026

Infection Control Across Clinical And Laboratory Dental Settings Protocols, Risks, And The Role Of Emerging Technologies, Khrystyna Vyprynyuk, Laura Andreesku

Publications and Research

This article explores infection prevention strategies and disease transmission pathways in dental settings, emphasizing the critical connection between clinical practice and dental laboratories. It highlights the risks of cross-contamination, disinfection and sterilization challenges, and the growing role of technology in enhancing infection control.


Perceived Hiv Risk, Barriers, And Preferences For Hiv Testing In Structurally Vulnerable Communities In St. Louis: A Best-Worst Scaling Survey, Emmanuel K Tetteh, Noelle Le Tourneau, Gregory Gross, Mckenzie Swan, Tyrell Manning, Justin Cole, Katie Wolf, Lawrence Hudson-Lewis, Julia D López, Todd Combs, Virginia R Mckay Jan 2026

Perceived Hiv Risk, Barriers, And Preferences For Hiv Testing In Structurally Vulnerable Communities In St. Louis: A Best-Worst Scaling Survey, Emmanuel K Tetteh, Noelle Le Tourneau, Gregory Gross, Mckenzie Swan, Tyrell Manning, Justin Cole, Katie Wolf, Lawrence Hudson-Lewis, Julia D López, Todd Combs, Virginia R Mckay

2020-Current year OA Pubs

BackgroundPersistent gaps in efforts to end the HIV epidemic in the United States highlight the need for community-specific, evidence-based HIV testing strategies. This study investigated barriers and preferences around HIV testing among underserved populations, including Black, queer, and young adults in the St. Louis, Missouri area.MethodsWe conducted a Best-Worst Scaling (BWS) survey with adults (16+ years) recruited at community events, collecting responses electronically and providing a $25 incentive. The survey assessed the relative importance of 13 potential barriers to HIV testing such as stigma, structural barriers, and perceived HIV risk, chosen based on literature review and community input. Mean preference …


Evaluation Of Mycoplasma Genitalium Positivity And Co-Infection With Chlamydia Trachomatis And/Or Neisseria Gonorrhoeae At Various Care Sites Across The United States, Rebecca Lillis, Stacey House, Et Al. Jan 2026

Evaluation Of Mycoplasma Genitalium Positivity And Co-Infection With Chlamydia Trachomatis And/Or Neisseria Gonorrhoeae At Various Care Sites Across The United States, Rebecca Lillis, Stacey House, Et Al.

2020-Current year OA Pubs

OBJECTIVES: We evaluated Mycoplasma genitalium (MG) positivity and co-infection with Chlamydia trachomatis (CT) and/or Neisseria gonorrhoeae (NG), based on results from a trial assessing clinical performance of the Cobas® Liat CT/NG/MG point-of-care test.

METHODS: A prospective, US, multicenter, noninterventional study assessed MG positivity in prospective urine samples (male) and clinician-collected vaginal swabs (female) from symptomatic/asymptomatic patients aged ≥14 years attending various clinical settings. Participants were designated positive or negative for MG, CT, and NG based on combined results from three US Food and Drug Administration-approved assays and one laboratory-developed test. MG co-infection with CT and/or NG was assessed.

RESULTS: Among …


Comparison Of Push-Pull Air Curtain To Overhead Downdraft Systems On Aerosol Containment And Distribution In Controlled Environments, Manal Mutairi Jan 2026

Comparison Of Push-Pull Air Curtain To Overhead Downdraft Systems On Aerosol Containment And Distribution In Controlled Environments, Manal Mutairi

Graduate Theses, Dissertations, and Problem Reports (ETD)

Abstract

Comparison of Push-Pull Air Curtain to Overhead Downdraft Systems on Aerosol Containment and Distribution in Controlled Environments.

This dissertation looks at the ongoing issue of tiny airborne particles created during medical and dental procedures and evaluates ways to reduce the risk of exposure for healthcare workers and patients to these particles. The first study focuses on the size, how long particles stay in the air, and how far they travel from common medical procedures that create aerosols, showing that tiny particles (less than 5 µm) can stay in the air long enough to escape basic droplet controls. As a …


Community Resilience Drives Change, Andrew Thomas Solt Jan 2026

Community Resilience Drives Change, Andrew Thomas Solt

Graduate Theses, Dissertations, and Problem Reports (ETD)

The opioid crisis has impacted many Americans. From 1999 to 2023, approximately 800,000 people have died due to opioid overdose (CDC, 2025). What began as overprescriptions of painkillers has quickly evolved into a complex social health issue that is now further worsened by stronger synthetic drugs like fentanyl. Fentanyl and fentanyl analogs (synthetic opioids that are very similar chemically to fentanyl) are often found in illegal drug supplies and in counterfeit pills (CDC, 2025). Thus, individuals who might have been initially overprescribed painkillers might now be pushed towards illegally produced drugs that are significantly more potent than what they were …


Characteristics And Outcomes Of Patients With Hematologic Malignancies Hospitalized With Respiratory Viral Infections, Zulfiqar A Lokhandwala, Brenna Park-Egan, Ravneet Waraich, Colleen A Mcevoy, Andrew P Michelson, Alice F Bewley, Lynne Strasfeld, Rachel Cook, Brandon Hayes-Lattin, Catherine L Hough, Patrick G Lyons Jan 2026

Characteristics And Outcomes Of Patients With Hematologic Malignancies Hospitalized With Respiratory Viral Infections, Zulfiqar A Lokhandwala, Brenna Park-Egan, Ravneet Waraich, Colleen A Mcevoy, Andrew P Michelson, Alice F Bewley, Lynne Strasfeld, Rachel Cook, Brandon Hayes-Lattin, Catherine L Hough, Patrick G Lyons

2020-Current year OA Pubs

BACKGROUND: Respiratory viral infections in patients with hematologic malignancies or hematopoietic stem cell transplants (HCTs) are associated with increased morbidity and mortality. However, the hospital presentations and courses of these infections remain under-described.

METHODS: We performed a multicenter retrospective cohort study of hospitalized patients with hematologic malignancy or HCT at 2 comprehensive cancer centers between January 2019 and June 2023. We included all patients with acute viral respiratory infection (identified based on a constellation of test results and objective physiology), comparing clinical presentations, care processes, and patient outcomes across pathogens; the primary outcome was the composite of hospital death or …


Maternal Prebiotic Supplementation Modifies Associations Between Intrapartum Antibiotics And Infant Allergy, Summer V.M. Walker, Thomas R. Sullivan, Rachelle A, Pretorius, Nina D'Vaz, Johnny Lo, Johan Garssen, Jeffrey A. Keelan, Desiree Silva, Susan L. Prescott, Claus T. Christophersen, Debra J. Palmer Jan 2026

Maternal Prebiotic Supplementation Modifies Associations Between Intrapartum Antibiotics And Infant Allergy, Summer V.M. Walker, Thomas R. Sullivan, Rachelle A, Pretorius, Nina D'Vaz, Johnny Lo, Johan Garssen, Jeffrey A. Keelan, Desiree Silva, Susan L. Prescott, Claus T. Christophersen, Debra J. Palmer

Research outputs 2022 to 2026

Background: Prebiotics promote growth of beneficial gut bacteria, whereas antibiotics can disrupt the microbial balance, reduce diversity, and potentially cause gut dysbiosis. This investigation aimed to determine whether antibiotic use before, during, or after birth altered the risk of infant allergic disease outcomes within a maternal prebiotic dietary supplementation trial. Methods: Maternal participants were allocated to consume daily prebiotics (galacto-oligosaccharides and fructo-oligosaccharides) or placebo (maltodextrin) powder from 18 to 20 weeks' gestation until 6 months postnatal. All infants had a family history of allergic disease. Maternal and infant antibiotic use was prospectively collected monthly throughout the trial intervention period, and …


The Best Practice Guide For Early Childhood Education And Care Food Environment: Module 6: Quality, Leadership And Governance (Version 1.0), Ros Sambell, Audrey Elford, Connie N. Ihlein, Lochie Clark, Amanda Devine, Helen Alexiou, Peter D’Cress, Kasie Jackson, Karen Hunter, Stacey Mckenzie, Avalon O’Dowd, Asha Rojahn, Blake Stewart, Henry Tan Jan 2026

The Best Practice Guide For Early Childhood Education And Care Food Environment: Module 6: Quality, Leadership And Governance (Version 1.0), Ros Sambell, Audrey Elford, Connie N. Ihlein, Lochie Clark, Amanda Devine, Helen Alexiou, Peter D’Cress, Kasie Jackson, Karen Hunter, Stacey Mckenzie, Avalon O’Dowd, Asha Rojahn, Blake Stewart, Henry Tan

Research outputs 2022 to 2026

Quality, Leadership and Governance are central pillars in the role early learning settings play in children’s growth, development and wellbeing. By meeting regulatory requirements and quality standards through stringent business procedures and continuous improvement practices, services can provide high-quality food environments for all children – shaping their thoughts, feelings, and practices around food and eating.

This Quality, Leadership and Governance (QLG) module aims to:

- Provide critical context for how the Early Childhood Education and Care (ECEC) food environment is intertwined with National Law and Regulations.

- Support services to meet regulatory requirements, through specific resources and guidance.

- Provide …


Multiparametric Flow Cytometry Immune Profiling Of Pulmonary And Extra-Pulmonary Tuberculosis Reveals Distinct Blood-Based Biomarker Signatures, Kalaiarasan Ellappan, Prakash Babu Narasimhan, Harriet N. Garlant, Seshadri Vasan, Komal Jain, Saka Vinod Kumar, Vishnukanth Govindaraj, Vir Singh Negi, Karen E. Kempsell Jan 2026

Multiparametric Flow Cytometry Immune Profiling Of Pulmonary And Extra-Pulmonary Tuberculosis Reveals Distinct Blood-Based Biomarker Signatures, Kalaiarasan Ellappan, Prakash Babu Narasimhan, Harriet N. Garlant, Seshadri Vasan, Komal Jain, Saka Vinod Kumar, Vishnukanth Govindaraj, Vir Singh Negi, Karen E. Kempsell

Research outputs 2022 to 2026

This study investigated immune cell distributions, cell-specific immune markers, and selected biomarker targets in pulmonary tuberculosis (PTB) and extrapulmonary tuberculosis (EPTB) using multiparametric flow cytometry (MFC). Whole blood was collected from 45 individuals, including healthy controls (HC), EPTB, and PTB patients (n = 15/group). Peripheral blood leukocytes were analysed by MFC to characterize CD4+ and CD8+ T cells, natural killer (NK), invariant NKT (iNKT) and NKT cells, classical (CM), intermediate (IM) and non-classical monocytes (NCM), and activated monocytes (AM). Expression of GBP1, CALCOCO2, IFIT3, SNX10, ARG1, PD-1, and PD-L1 was assessed across these immune subsets. Increased frequencies of NK, NKT, …


The Impact Of A Vancomycin Intervention On Vancomycin-Associated Nephrotoxicity In Children: A Quality Improvement Initiative, Megan R. Nettleton, Hwi Eun Mary Shim, Joanne Abbotsford, Zoy Goff, Briony Hazelton, Matthew O'Brien, Tenielle Porter, Thomas Snelling, Daniel K. Yeoh, Asha C. Bowen, Christopher C. Blyth, Anita J. Campbell Jan 2026

The Impact Of A Vancomycin Intervention On Vancomycin-Associated Nephrotoxicity In Children: A Quality Improvement Initiative, Megan R. Nettleton, Hwi Eun Mary Shim, Joanne Abbotsford, Zoy Goff, Briony Hazelton, Matthew O'Brien, Tenielle Porter, Thomas Snelling, Daniel K. Yeoh, Asha C. Bowen, Christopher C. Blyth, Anita J. Campbell

Research outputs 2022 to 2026

Background: Vancomycin is first-line treatment for methicillin-resistant Staphylococcus aureus (MRSA) infections. However, despite guideline recommendations, there is no evidence that targeting vancomycin trough concentrations of ≥15 mg/L in children confers clinical benefit and is associated with vancomycin-associated nephrotoxicity (VAN). Aim: This study aimed to evaluate the impact of a vancomycin safety bundle on VAN and vancomycin utilisation in hospitalised paediatric inpatients. Method: A pre–post-intervention study was conducted in a tertiary paediatric hospital comparing January–December 2018 (pre-intervention) to May 2019–April 2020 (post-intervention). Hospitalised children, aged 30 days to <18 years, that received intravenous vancomycin with at least one trough concentration were included. The intervention bundle comprised: (1) lowered empiric vancomycin trough targets (5–15 mg/L), (2) enhanced creatinine monitoring (concomitant serum creatinine with vancomycin trough), (3) guideline modification (reduced pre-authorised indications for empiric vancomycin use), and (4) prescriber education initiatives. Ethical approval was granted by the WA Child and Adolescent Health Service Research Ethics Committee, Governance Evidence Knowledge Outcomes Program (Reference no: 41830) and the study conforms with the National Health and Medical Research Council's Ethical considerations in quality assistance and evaluation activities. Results: A total of 314 vancomycin prescriptions were analysed (n = 204 pre-intervention; n = 110 post-intervention). Post-intervention, VAN incidence decreased almost twofold from 0.46 to 0.25 episodes per 1000 patient bed days (p ≤ 0.01), and vancomycin prescription days decreased by 19%. Total hospital drug costs for vancomycin decreased by AUD $16 033. Overall, and for paediatric invasive MRSA, no significant difference in clinical outcomes or 30-day mortality was observed between study periods. Conclusion: This study demonstrated the implementation of a vancomycin safety bundle significantly reduced paediatric VAN and vancomycin utilisation without compromising clinical outcomes. These data support antimicrobial stewardship interventions to improve medication safety for children.


Could Peri-Coronary Fat Thickness Predict Severity Of Pulmonary Covid 19 And Post Covid-19 Pulmonary Scarring?, Basma A El-Ged, Dalia Fahmy, Mohamed Hamoda, Mohamed Tohlob, Heba M Abou El-Atta Jan 2026

Could Peri-Coronary Fat Thickness Predict Severity Of Pulmonary Covid 19 And Post Covid-19 Pulmonary Scarring?, Basma A El-Ged, Dalia Fahmy, Mohamed Hamoda, Mohamed Tohlob, Heba M Abou El-Atta

Mansoura Medical Journal

Objective: to study the correlation between peri-coronary fat thickness (PCFT) and clinical disease severity in patients with proved COVID-19, as well as post COVID-19 scarring.

Patients and methods: This retrospective comparative study included 202 patients with pulmonary COVID-19 who were referred for Chest High Resolution Computed Tomography (HRCT). Patients were further classified into Group A who had non-severe covid 19 disease and group B who had severe and critical disease according to WHO criteria. CT severity score (CSS), Total fibrosis score (TFS) and peri coronary fat thickness (PCFT) were evaluated and compared for both groups in the CT scans of …


Hypoalbuminemia As A Predictive Factor For Acute Kidney Injury In Pediatric Patients Running Title: Hypoalbuminemia In Aki Pediatrics, Kareem El-Saeed El-Maasrany, Ayman Hammad, Hosam Zaghloul, Ahmed Elhusseiny Jan 2026

Hypoalbuminemia As A Predictive Factor For Acute Kidney Injury In Pediatric Patients Running Title: Hypoalbuminemia In Aki Pediatrics, Kareem El-Saeed El-Maasrany, Ayman Hammad, Hosam Zaghloul, Ahmed Elhusseiny

Mansoura Medical Journal

Aim: Hypoalbuminemia is a well-known risk factor for illness and death, but its role as a particular predictor of acute kidney injury (AKI) is still not fully understood. This study intended to evaluate the role of hypoalbuminemia as a predictive factor for AKI outcome among pediatric patients, regarding hospital stay, kidney replacement therapy and mortality rate.

Subjects and Methods: This prospective observational cohort was conducted on 70 children with AKI divided into two groups: group I (35 AKI children combined with hypoalbuminemia) and group II (35 AKI children without hypoalbuminemia). All participants were subjected to full history taking, clinical examination …


The Role Of Adult Appendicitis Score In Reducing The Negative Appendectomy Rate, Mohamed Mahmoud Mansour El Ghzzawy, Magdy Basheer, Mohamed Balata, Amir A. Fikry Jan 2026

The Role Of Adult Appendicitis Score In Reducing The Negative Appendectomy Rate, Mohamed Mahmoud Mansour El Ghzzawy, Magdy Basheer, Mohamed Balata, Amir A. Fikry

Mansoura Medical Journal

Aim: Approximately 15 – 30% of all acute appendectomies are performed based only on clinical suspicion. A negative appendectomy has a 10–12% morbidity rate, which could be detrimental to patients. The current study aimed to evaluate the effectiveness of adult appendicitis score (AAS) in accurate identification of cases with acute appendicitis.

Patients and Methods: This prospective observational study was conducted on 150 patients who presented with manifestations of acute appendicitis admitted to Mansoura Emergency Hospital.  The AAS was calculated, the decision on appendectomy was solely based on the surgeon’s clinical judgment after taking into consideration all the findings of clinical, …


Ageing With Hiv: Epidemiological Transition, Biological Mechanisms, And The Impact Of Evolving Antiretroviral Therapy, Jude Eteneneng Enoh, Roland Tiagha Akah Jan 2026

Ageing With Hiv: Epidemiological Transition, Biological Mechanisms, And The Impact Of Evolving Antiretroviral Therapy, Jude Eteneneng Enoh, Roland Tiagha Akah

Mansoura Medical Journal

The scale up of antiretroviral therapy (ART) has led to the evolution of HIV infection into a chronic condition, leading to a rapid growth in the number of older adults with HIV. This trend involves several biological, medical, and psychological challenges that go beyond conventional HIV treatment. The current mini-review provides a summary of recent data (2014 – 2026) regarding the changing epidemiology of HIV, biological aspects of ageing, and comorbidities and health systems associated with ageing.

Ageing is driven by persistent immune activation, inflammation, immune senescence, and microbial translocation, all of which accelerate biological ageing. These biological factors lead …


Closing The Gaps: Improving Opioid Overdose Prevention In African American Communities Through Education And Community Engagement, Tara Clinding Jan 2026

Closing The Gaps: Improving Opioid Overdose Prevention In African American Communities Through Education And Community Engagement, Tara Clinding

Doctor of Nursing Practice Projects

African Americans continue to experience high rates of opioid mortality, emphasizing the need for culturally relevant community education and overdose prevention strategies. The purpose of this Doctor of Nursing Practice (DNP) quality improvement project was to implement and evaluate community-based opioid overdose prevention education designed for individuals with substance use disorder, family and friends, and community members. Guided by Betty Neuman’s Model, the education focuses on recognizing opioid overdoses, administering naloxone when indicated, and identifying community treatment and recovery resources. A pre- and post-test design was used to evaluate changes in participants' knowledge and confidence following a structured educational session. …


Central Line-Associated Bloodstream Infections In Patients Diagnosed With A Hematologic Malignancy, Rebecca D. Jennings Jan 2026

Central Line-Associated Bloodstream Infections In Patients Diagnosed With A Hematologic Malignancy, Rebecca D. Jennings

Doctor of Nursing Practice Projects

Knowledge of nurse-sensitive indicators such as CLABSI and how they impact patient outcomes is an essential aspect of healthcare today. Hospital-acquired infections increase mortality, increase length of stay in the hospital, and increase financial burden to the patient and facility. The aim of this quality project was to provide targeted education on the impact of central line-associated bloodstream infections. Using a pre- and post-survey design, a convenience sample of staff nurses working in the hematology/oncology units of a large academic hospital participated in an education intervention focused on central line-associated bloodstream infection prevention. Knowledge scores were unaffected by the intervention. …


A Systematic Review On Niosomes: Composition, Preparation, And Applications, Sanket Gawade Mr., Sunil Attimarad, Vishakha Desai Ms. Jan 2026

A Systematic Review On Niosomes: Composition, Preparation, And Applications, Sanket Gawade Mr., Sunil Attimarad, Vishakha Desai Ms.

Manipal Journal of Medical Sciences

Conventional drug carrier systems are restricted owing to poor bioavailability, weak stability and non-specific localization, which causes systemic toxicities and reduced therapeutic efficacy. Niosomes, one of the nonionic surfactant vesicular systems, have been suggested that value to overcome these constraints. In this review, we give an account of recent progress in niosome research, highlighting their merits, composition, characterization, and applications.

Niosomes offer several advantages including increased drug bioavailability, targeted delivery and reduced toxicity. Bilayered niosomes can entrap both hydrophilic and lipophilic drugs, therefore allowing simultaneous delivery of actives components. We provide an overview of various techniques for niosome preparation including …