Digital Commons Network^™

Diagnostic Stewardship Of Respiratory Cultures Using Clinical Decision Support In The Picu, Anna C Sick-Samuels, John C Lin, Rebecca G Same, Et Al.

2020-Current year OA Pubs

IMPORTANCE: Endotracheal aspirate culture (EAC) practices for evaluation of ventilator-associated infections (VAI) vary widely across pediatric hospitals, and overuse can contribute to overdiagnosis and overtreatment for VAI. Diagnostic stewardship strategies to optimize EAC testing practices may reduce overtesting and unnecessary antibiotic treatment.

OBJECTIVE: To evaluate the association of diagnostic stewardship of EACs using clinical decision support with culture rates, antibiotic use, and patient outcomes across a multicenter collaborative of pediatric intensive care units (PICUs).

DESIGN, SETTING, AND PARTICIPANTS: This was a multicenter cohort study with a pre-post study design among the BrighT STAR (Testing Stewardship for Antibiotic Reduction) Quality Improvement …

Understanding How Fire Impacts Soil Carbon And Nutrient Cycling: Toward Standardized Reporting Of Fire Metrics For The Integrated Plant-Soil System, Julia B. Gaudinski, Kate Wilkin, Jasquelin Peña, Mary E. Miller, Margaret S. Torn

Michigan Tech Publications

Fire events impact soil carbon (C) and nutrient stocks immediately due to combustion of biomass and organic matter and set up additional post-fire changes to ecosystem inputs and losses. The literature on this topic is expanding rapidly as large and intense wildfires are increasingly affecting communities globally. However, many of these studies do not describe initial post-fire soil conditions adequately or consistently, nor do they link the impacts of fire on C and nutrient cycling to key soil properties and soil inputs, stocks and fluxes. Here we conduct a systematic analysis of 56 review- papers published in 2010 or later …

Blinded, Bias-Controlled Multi-Rater Evaluation Of Human-Versus-Ai Brain Metastasis Segmentation Using A Hybrid Foundation-Model Framework, Yiding Han, Enze Zhu, Mhd Hasan Ai Mekdash, Omar Awad, Piyush Pathak, Shixiao Liang, Daniel Allan Hamstra, Xizhe Zhang, Zaid Ali Siddiqui, Baozhou Sun

Faculty, Staff and Students Publications

Background: Accurate segmentation of brain metastases (BM) is essential for diagnosis, stereotactic radiosurgery planning, and longitudinal assessment. However, manual contouring is time-intensive, limiting clinical scalability, and exhibits substantial inter-observer variability. This variability complicates objective assessment of automated segmentation methods and challenges interpretation of model performance.

Purpose: To address these limitations, we developed TUM-SAM, a hybrid foundation-model framework for fully automated BM segmentation, and introduced a bias-controlled, blinded multi-rater evaluation paradigm to determine whether AI-based BM segmentation has reached expert-level performance and whether AI-generated contours are preferred by human experts under unbiased assessment.

Methods: TUM-SAM integrates nnU-Net-based lesion detection with a …

Nuclear-Specific Reductive Carboxylation Of Alpha-Ketoglutarate Fuels Histone Acetylation To Induce Chromatin Accessibility And Gene Activation, Abhisha Sawant Dessai, Nadya A Elhalawany, Tao Dai, Justine J Jacobi, Christian Prechtl, Alphonse N Dimeck, Sierra R Morton, Mark D Long, Prashant K Singh, Nagireddy Putluri, Mariana Lopes, Song Liu, Dominic J Smiraglia, Katerina V Gurova, Peder J Lund, Leah A Gates, Sung Yun Jung, Subhamoy Dasgupta

Faculty, Staff and Students Publications

Mitochondria remain at the core of cell metabolism, whereas the nucleus integrates cellular and environmental signals to activate genes. However, the mechanisms that directly link cellular metabolism to gene regulation are not well understood. Here we show, a metabolic pathway in the nucleus controls acetylation of histones by nuclear localization of mitochondrial enzymes aconitase (ACO2) and isocitrate dehydrogenase (IDH2). Metabolic tracing studies show that IDH2 and ACO2 catalyze reductive carboxylation of α-ketoglutarate to rapidly synthesize citrate to increase nuclear acetyl-CoA pool. Genetic and proteomic analyses reveal nuclear IDH2 and ACO2 form a complex with KAT2A/GCN5 for acetylation of histones to …

Mapping The Conformational Landscape Of Dna Minicircles Through Atomic Force Microscopy And Shape Space Analysis, Laura Wiggins, Tobias A Firth, Max C Gamill, Thomas E Catley, Agnes Noy, Jonathan M Fogg, Lynn Zechiedrich, Alice L B Pyne

Faculty, Staff and Students Publications

The structural dynamics of DNA underpin essential biological processes, yet conventional structural biology methods often obscure conformational heterogeneity through ensemble averaging. Atomic force microscopy (AFM) provides single-molecule topographical maps capable of capturing both local and global variation, but extracting quantitative insight from these images remains challenging. Here, we introduce an automated framework that reduces AFM data to spline representations of the DNA backbone and applies cyclic Procrustes analysis to quantify shape similarity across ensembles. Using purified topoisomers of 339 bp DNA minicircles ranging from relaxed to highly negatively supercoiled, we resolved and measured the relative abundance of conformational states across …

High-Throughput Quantitation Of Pathogen-Induced Calcium Signals Captured Through Live-Cell Fluorescence Microscopy, J Thomas Gebert, Ethan M Huleatt, Francesca J Scribano, Michael R Eledge, Lauren E Dorn, Sammy K Hasmi, Joseph M Hyser

Faculty, Staff and Students Publications

Many intracellular pathogens manipulate host cell calcium to facilitate their survival and replication. Live-cell microscopy using fluorescent calcium indicators has become an indispensable tool for characterizing the mechanisms underlying both homeostatic and pathogen-induced cellular calcium dynamics, but such imaging must be coupled with robust quantitative analysis. Further, calcium imaging is most powerful when paired with reductive studies targeting calcium-modulating proteins. The lack of specific inhibitors or agonists to directly target most pathogen-induced calcium signals precludes many of the approaches that have allowed for robust characterization of major eukaryotic cell calcium signaling mechanisms, such as ER Ca2+ release by inositol triphosphate …

Improving Body Protocoling To Reduce Patient Dose And Optimize Patient Care, Rafael Herrera

Graduate Medical Education Research Journal

NA

From Visual Field To Visual Field: 10-2 Visual Field Map Prediction From 24-2 Visual Field Using Machine Learning And Detection Of Central Visual Field Progression, Golnoush Mahmoudinezhad

Graduate Medical Education Research Journal

NA

Primary Tracheal Small Cell Carcinoma: A Systematized Review, Tony Satroplus

Graduate Medical Education Research Journal

NA

Associations Of Insurance Status, Frailty, And American Society Of Anesthesiologists On Endoscopic Transnasal Transsphenoidal Surgery, Steven Goicoechea

Graduate Medical Education Research Journal

NA

A Rare Case Of Haemophilus Influenzae Shoulder Septic Arthritis In An Elderly Patient, Annemarie Leonard

Graduate Medical Education Research Journal

NA

Detection And Diagnostic Screening Of Breast Cancer: A Systematic Review And Future Frontiers, Lama Yassine, Amira J. Zaylaa

BAU Journal - Science and Technology

A comprehensive evaluation of current and novel diagnostic techniques is necessary since the diagnosis of breast cancer is essential for improving treatment efficacy and raising long-term survival. Evidence from conventional imaging methods including mammography, ultrasonography, and magnetic resonance imaging is combined in this systematic review with advancements in liquid biopsies and current AI-based diagnostic tools. Using specific keywords related to breast cancer, early detection, imaging, biomarkers, and artificial intelligence, a thorough search was conducted in PubMed, Scopus, Web of Science, and IEEE Xplore. Reviews, case reports, and studies unrelated to breast cancer were excluded; only clinical, experimental, and computational research …

Analisis Pengelolaan Persediaan Obat Menggunakan Integrasi Abc–Fsn Dan Economic Order Quantity (Eoq) Di Rsud Haji Provinsi Jawa Timur, Rina Kartika Sari, Irwan Syahrir, Musa Gufron

Jurnal Ekonomi Kesehatan Indonesia

This study aims to analyze the performance of pharmaceutical inventory at RSUD Haji, East Java Province using an integrated ABC–FSN and Economic Order Quantity (EOQ) approach. A quantitative descriptive method was employed using secondary data from 560 drug items during January–December 2025. ABC analysis was used to identify the concentration of investment value, while FSN analysis was applied to evaluate drug movement patterns. Furthermore, EOQ was utilized to determine the optimal order quantity to minimize total inventory costs. The results show that the majority of inventory value is concentrated in category A (70.08%) and is dominated by fast-moving items (89.15%). …

Cleft Lip And Palate: From Genetic Foundations To Psychological Impact – A Multidisciplinary Review, Farah Abdulwahab Al-Saadi, Teeba Fares Hadi, Sura Saleem Albermani

Al-Esraa University College Journal for Medical Sciences

Cleft lip and/or cleft palate consider one of the most known and common congenital disorders of the head causing clear disruption of the normal face structure. Despite being the most seen birth defects, the clefts genetic basis is still not fully comprehended. Clefts have sporadic genetic nature, it can occur duo to rare mutations as part of syndromic disease or it can be isolated, non-syndromic cleft. The contemporary advances in genomic technology have enabled a deeper comprehension of the complex architecture of cleft lip/palate, of these technologies are genome-wide association studies, whole genome sequencing, transcriptome-wide association studies and others. Furthermore, …

Global Trends And Research Landscape Of Metformin And Artificial Intelligence: Bibliometric Analysis, Raya Doraid Mohammed, Alaa Qasim Hayder, Hamza A. Saadallah, Ali Q Saeed, Alice Louis Yousif, Safa M Salim, Noor Mahmood Sultan, Mohammed Ahb. Al-Krdoshi

Al-Esraa University College Journal for Medical Sciences

This bibliometric study examines global research trends and key thematic areas in Artificial Intelligence (AI) applications related to Metformin, especially in diabetes treatment. A total of 227 articles were retrieved from the Science Citation Index Expanded (Web of Science Core Collection) from 2020 to 2024. VOSviewer and CiteSpace were used to analyze publications by year, country, institution, journal, citation impact, and keyword co-occurrence. The United States, Canada, and South Korea contributed over 85% of the output, with leading institutions including the University of California, Los Angeles. Keyword mapping identified ``machine learning,'' ``Metformin,'' and ``Type 2 Diabetes'' as the most influential …

The Role Of Nanotechnology In Improving The Physical And Mechanical Properties Of Denture Base Material, Rasha Mehdi, Intisar J. Ismail, Ahmed Ali Mohammed

Al-Esraa University College Journal for Medical Sciences

Background: Polymethyl methacrylate (PMMA) is still the most common material used for denture bases but its mechanical and physical properties. The aim of this systematic review was to assess the application of nanotechnology for enhancing physical and mechanical properties of denture base materials. Methods: A systematic search of PubMed/MEDLINE, Scopus, and Web of Science was performed to identify in vitro experimental studies from 2020 through 2025. The review was conducted according to the PRISMA 2020 statement. Included studies that characterised the mechanical or physical properties of nanoparticle-reinforced denture base materials. Results: Fourteen in vitro experimental studies were eligible for the …

The Association Between Osteoporosis In Females Following Menopause And Vitamin D Deficiency, Hadel Kareem Al-Rubaiawi, Noor Adel Hussein, Dunia Abdul Jabbar Star, Amer Hasan Abdullah, Salma Abdul-Ridha Abbas, Hawazin Aziz Hamim

Al-Esraa University College Journal for Medical Sciences

The intricate relationship among osteoporosis, vitamin D deficiency, and hormonal changes. Growth hormone, cortisol, parathyroid hormone, estrogen, testosterone, thyroid hormones, and thyroid hormones are a few of the hormones that affect bone turnover and density. Alterations in their concentrations, whether brought on by healthy aging or illnesses, can interfere with bone remodelling and increase the risk of osteoporosis. Moreover, inadequate levels of vitamin D increase the risk by decreasing the absorption of calcium and the mineralization of bone. Estrogen and vitamin D deficits increase bone loss, especially in postmenopausal women. Proactive treatment techniques, including hormone replacement therapy, vitamin D supplements, …

Reinforcement Of Maxillofacial Silicone, Taqwa Majid Abdulhussein, Thekra Ismael Hamad

Al-Esraa University College Journal for Medical Sciences

Maxillofacial prostheses are very important for helping people with head and neck defects (caused by congenital disabilities, accidents, or cancer treatments) get better. Their goal is to restore oral function, comfort, appearance, and mental health. Since the 1960s, silicone elastomers, especially polydimethylsiloxane, have been considered the best materials because they are highly resistant to tearing and stretching, biocompatible, and naturally colour-stable, but silicone has a very short clinical lifespan because it breaks down when exposed to UV radiation, moisture, biological fluids, and mechanical stress. The main goal of reinforcement is to add fillers to silicone elastomers to strengthen and improve …

Organic Coumarin Derivatives As Laser-Active Materials: A Review Of Synthesis, Optical Behaviour, And Applications, Aya H. Mohammed, Mohammed Hasan Al-Dahlaki

Al-Esraa University College Journal for Medical Sciences

Coumarin derivatives have settled into a position of unusual prominence among organic laser-active materials. Few other chromophore families combine such favourable photophysics with synthetic chemistry that is at once long-established and still actively evolving. The aim of this review is to draw together what is now known about coumarin-based laser dyes — their preparation, their optical behaviour, the laser performance that has been achieved with them, and the broader applications that have followed — with particular attention to work published between 2019 and 2026. Considerable space is given to the structural origin of the strong intramolecular charge transfer (ICT) character …

A Mathematical Model For Managing Diphtheria Outbreaks In Nigeria Via Vaccination, Enhanced Surveillance, Effective Quarantine, And Social Distancing Measures, Hycienth Ortser Orapine, Nyiutya Cephas Ine, Dekera Jacob Washachi, Ali Audu Baidu, Lubem Matthew Kwaghkor

Mathematical Modelling and Numerical Simulation with Applications

Diphtheria is a highly infectious respiratory and skin disease that poses a significant threat to global public health. In Nigeria, children and adults with low immunity remain at high risk due to recurring annual outbreaks in the last decade, with a death rate of as high as 68.8\%. This paper presents a deterministic compartmental model to evaluate the effectiveness of interventions implemented by the Nigerian government. The model's mathematical and epidemiological validity is established through proofs of non-negativity and boundedness. The basic reproduction number ($R_0$) is derived, and stability analysis confirms that the diphtheria-free equilibrium is locally and globally asymptotically …

Objective Biomarker Development For Parameter Optimization In Neuromodulation Using High-Density Emg Temporal And Spatial Features, Shirin Madarshahian, Nikoo Javadpour, Michael Trakhtorchuck, Tatiana Guerrero-David, Kristin Gustafson, James Harrop, Caio Matias, M. J. Mulcahey, Alessandro Naopli, Alex R. Vaccaro, Mijail Serruya

Farber Institute for Neuroscience Faculty Papers

Transcutaneous spinal cord stimulation (tSCS) is a promising neuromodulation approach for motor recovery after spinal cord injury (SCI), yet clinical programming remains largely dependent on subjective parameter selection. This study evaluated high-density surface EMG (HD-sEMG)–derived spatial and temporal features as objective biomarkers for tSCS optimization in three adults with chronic cervical SCI. A 64-channel electrode array recorded stimulation-evoked responses across five cervical stimulation levels, four pulse widths, and graded amplitudes. Features describing activation magnitude, spatial distribution, cluster morphology, and temporal dynamics were extracted from epoch-based activation maps. Of the three enrolled participants, two demonstrated measurable stimulation-evoked responses and contributed to …

Clinical Epidemiology Of Stroke In The Productive Age Population In Indonesia: A Scoping Review, Satria Akbar Putra Asmara, Ulil Albab Habibah

Jurnal Epidemiologi Kesehatan Indonesia

Data from the 2018 Indonesian Basic Health Research (Riskesdas) demonstrates a marked increase in stroke prevalence, rising from 7% in 2013 to 10% in 2018. This upward trend is accompanied by a notable epidemiological shift, with stroke no longer predominantly affecting older adults ≥65 years, but increasingly occurring among the productive-age population (15–64 years). This scoping review was conducted in February 2026 in accordance with the JBI methodological guidelines and PRISMA-ScR. Searches were conducted in Google Scholar, PubMed, Garuda, and ScienceDirect. Inclusion criteria include articles published within the last 10 years (2016–2026), articles discussing the characteristics of stroke patients in …

Waste Analysis Of Outpatient Waiting Time In The Obstetrics And Gynecology Polyclinic (Ob-Gyn) On Lean Healthcare Approach At X General Hospital Jember, Widian Almas Zatin, Dwi Prijatmoko, Firman Firman

Preventia: The Indonesian Journal of Public Health

In outpatient services, waiting time is one indicator of the quality of hospital services and can influence patient satisfaction. The research aims to analyze the waste of outpatient waiting time at the OB-GYN polyclinic of X General Hospital, Jember, using a lean healthcare approach. The case study for this research used a mixed-methods exploratory sequential design. Data were collected through observation, structured interviews, reviewing the standard operating procedures and the service flow, and distributing questionnaires to identify critical waste. The sequence of services was analyzed using Value Stream Mapping to identify value-added, non-value-added, and waste. Process Cycle Efficiency (PCE) was …

Kmt2d As An Epigenetic Target In Cervical Cancer: A Literature Review On Polyclonal Antibody Therapeutics And Translational Prospects, Farsya Hidayah Septiananda, Taurisma Aulia Nanda Wibisono, Rajendra Aulya Gilardino, Andreas Budi Wijaya

Preventia: The Indonesian Journal of Public Health

Cervical cancer remains a significant global health burden, particularly in regions with limited access to advanced therapeutics. Beyond viral oncogenesis, accumulating evidence highlights the crucial role of epigenetic dysregulation, particularly KMT2D, in tumor initiation and progression. This literature review aimed to critically synthesize current evidence regarding the biological role of KMT2D in cervical cancer and to explore the opportunities and limitations of antibody-based approaches for future epigenetic intervention. A structured narrative literature review was conducted using PubMed, Scopus, and Web of Science to identify relevant studies published between January 2020 and May 2025. Literature selection was guided by a modified …

Extracellular Vesicles In Adult Acute Myeloid Leukemia, Haniatul Qomariya, Fitrotin Azizah, Yetti Hernaningsih

Folia Medica Indonesiana

Acute Myeloid Leukemia (AML) is an aggressive hematologic malignancy marked by uncontrolled expansion of immature myeloid cells and disruption of normal hematopoiesis. Beyond genetic abnormalities, accumulating evidence demonstrates that leukemic progression is strongly shaped by intercellular communication within the bone marrow niche. Extracellular vesicles (EVs), including exosomes and microvesicles, have emerged as key mediators of this communication, transporting bioactive molecules that influence leukemic cell behavior, immune responses, and treatment sensitivity. This systematic review synthesizes current findings on EVs in adult AML, focusing on their biogenesis, molecular cargo, roles in disease pathogenesis, diagnostic and prognostic relevance, and therapeutic potential. Following PRISMA …

Nanotechnology In Wound Healing And The Rising Role Of Bionanocomposites, Humaira Yasmeen, Saher Mahmood, Iqra Munir, Hubza Ruatt Khan, Iram Asim, Abeera Abid, Kashaf Junaid, Asif Raheem, Sara Janiad

Journal of Bioresource Management

Nanotechnology holds considerable promise in the field of biomedical research, particularly in the creation of innovative materials. Its influence extends significantly to medication formulation, drug delivery systems, and the realm of nanomedicine. These materials are being increasingly investigated for a range of applications; nevertheless, it is essential to conduct thorough assessments of their safety and environmental implications. Globally, millions of people suffer from slow wound healing, which leads to heightened mortality rates and escalated healthcare expenses. The primary factors contributing to impaired wound healing include microbial infection, unstable inflammation, and persistent inflammation. Regrettably, these critical issues have not been adequately …

Evaluation Of Air Quality And Respiratory Health Among Wastewater Treatment Workers Across Different Exposure Levels: A Cross-Sectional Study In Al-Diwaniyah City, Zahraa R. Mizher, Luma H. Alazawii, Israa J Mohammad

Al-Nisour Journal for Medical Sciences

Wastewater treatment facilities are important sources of occupational exposure to dangerous air pollutants, such as particulate matter and toxic gases, which can have a detrimental effect on employees' respiratory health. Lung function may be compromised by prolonged exposure, especially in uncontrolled settings. However, there isn't much information about these dangers in Iraq. The purpose of this study was to evaluate the quality of the air and compare lung function-based diagnoses and related risk factors across workers who were heavily and slightly exposed. A cross-sectional analytical study was conducted on 108 employees of Al-Diwaniyah's sewer networks and wastewater treatment facilities participated. …

Importance Of 8-Ohdg And Mda In Assessing The Oxidative Stress Capacity In Iraqi Brain Tumor Patients, Riyam Hussein Mohammed, Ali Abdul Hussein Mahdi, Maha Diekan Abbas

Al-Nisour Journal for Medical Sciences

Brain cancer is a significant health problem, with a notable change in the oxidative stress and antioxidant levels. Malondialdehyde (MDA) may change the structure of the cell membrane and later may lead to alterations in DNA at the cellular level. The 8-OHdG levels are increased in multiple cancer tissues and may be considered an indicator of the prognosis of most solid tumors. This study aimed to find out the possible relation between the MDA and 8-OHdG, along with exploring the role of blood sugar and HbA1c in the progression of brain tumors. This case- control study includes 60 brain tumor …

Ai-Driven Arabic Linguistics For Autism Spectrum Disorder: A Systematic Review And Conceptual Framework, Jamal K. Abbas, Israa Abed Jawad, Qamar Ali Abdulridha, Haytham Falih Hassan, Dena Qusay Alrawi, Ula Kamal Abdulkadir, Amal Hassan J. Al-Bazzaz, Riyam Zaid Alameri

Al-Nisour Journal for Medical Sciences

ASD is a complicated neurodevelopmental condition where diagnosis and intervention still depend on subjective behavioral observation. These challenges, however, are greater in Arabic-speaking contexts with scant, standardized diagnostic tools, limited linguistic resources, and a broad application of AI solutions developed primarily for English language data. This paper implements a systematic review of a conceptual framework that uses computational linguistics, NLP, and AI to support ASD early screening and speech-language intervention within the Arabic-speaking population. Rather than reporting empirical findings, the paper synthesizes recent peer-reviewed literature to identify linguistically-anchored ASD-related markers suitable for computational analysis, encompassing echolalia, atypical pronoun usage, pragmatic …

Formulation And Evaluation Of Transdermal Delivery Of Naproxen Gel, Ferial Majed Mahdi, Hiba Ezzat Hamed, Aws Saffar, Salah Hassan, Safa Hashim Waheb

Al-Nisour Journal for Medical Sciences

This study aimed to formulate and evaluate transdermal gels containing the nonsteroidal anti-inflammatory drug naproxen, using different polymers including Carbopol 934P, HPMC K4M and sodium CMC as gelling agents. Twelve formulations (F1 to F12) were prepared and subjected to physicochemical evaluation; FTIR results confirmed complete chemical compatibility between the drug and excipients and the pH of all samples (in the range of 5.80 to 6.55) was found to be favorable for skin safety. Increasing the polymer concentration increased the viscosity of the gels and directly controlled the drug release rate in in vitro tests. Formulation F4 (Carbopol 2.0%) was selected …