Digital Commons Network^™

Scaling Up Biomedical Vision-Language Models: Fine-Tuning, Instruction Tuning, And Multi-Modal Learning, Cheng Peng, Kai Zhang, Mengxian Lyu, Hongfang Liu, Lichao Sun, Yonghui Wu

Faculty, Staff and Student Publications

Objective: To advance biomedical vision language model capabilities through scaling up, fine-tuning, and instruction tuning, develop vision-language models with improved performance in handling long text, explore strategies to efficiently adopt vision language models for diverse multi-modal biomedical tasks, and examine the zero-shot learning performance.

Methods: We developed two biomedical vision language models, BiomedGPT-Large and BiomedGPT-XLarge, based on an encoder-decoder-based transformer architecture. We fine-tuned the two models on 23 benchmark datasets from 6 multi-modal biomedical tasks, including one image-only task (image classification), three language-only tasks (text understanding, text summarization, and question answering), and two vision-language tasks (visual question answering and image …

A Novel Approach For Neutrosophic Complete Graph And Neutrosophic Excellent Domination, Murugan Raji, Ponnaiah Tharaniya, Surapati Pramanik, G. Prabhu

Neutrosophic Sets and Systems

No abstract provided.

Providing Spatial Support During A Major Cholera Outbreak In Port-Au-Prince, Haiti: Creative Mapping Solutions In A Challenging Data Poor Environment, Andrew Curtis, Jayakrishnan Ajayakumar

Faculty Scholarship

In this paper we describe the spatial data challenges faced in terms of providing accurate and timely analysis for a clinic during a cholera epidemic that spread through Port au Prince, Haiti in late 2022. This “triage” spatial epidemiology involved developing a bespoke geocoder that allowed for weekly maps of spread to be created in near real time. Resulting case data were also analyzed using a novel grid heatmapping approach which considers the epidemiological curve for each neighborhood. Adding further complexity during this period to both the data generation, and explaining cholera amplification and spread patterns, was a rising gang …

Laceration, Children's Mercy Kansas City

Clinical Pathways

No abstract provided.

Hiv Pre-Exposure Prophylaxis Does Not Increase Gonorrhea And Chlamydia Incidence In Young Black And Hispanic Men Who Have Sex With Men: An Observational Cohort Study, Octavio C Mesner, Rishabh Jain, Aditi Ramakrishnan, Derrick D Matthews, Jeremy T Goldbach

2020-Current year OA Pubs

BACKGROUND: HIV pre-exposure prophylaxis (PrEP) use has been linked with increases in sexually transmitted infection (STI) incidence. Despite efforts to expand PrEP uptake among young Black and Hispanic men who have sex with men (YBHMSM), little research has been done to understand the impact of PrEP on STI incidence within these communities. We examine the effect of PrEP use on gonorrhea and chlamydia (NG/CT) incidence, condom use, and external STI testing (ie, outside of study visits).

METHODS: In a longitudinal cohort of HIV-negative YBHMSM (ages 16-24 years), we modeled the effect of PrEP use on study-external STI testing and number …

Skin Soft Tissue Infection: Antibiotics For Abscesses, Children's Mercy Kansas City

Clinical Critically Appraised Topics

No abstract provided.

Harnessing Artificial Intelligence To Optimize Antimicrobial Stewardship Programs: A Scoping Review, Philip Tran, Tien Dinh, Ivan Portillo, Emi Minejima, Amy Y. Kang

Pharmacy Faculty Articles and Research

Objectives

Dean's Research Newsletter, November 2025, Neil W. Schluger

SOM Dean's Research Newsletter

No abstract provided.

Single-Nucleus Mrna-Sequencing Reveals Dynamics Of Lipogenic And Thermogenic Adipocyte Populations In Murine Brown Adipose Tissue In Response To Cold Exposure, Janina Behrens, Tongtong Wang, Christoph Kilian, Anna Worthmann, Mark A Herman, Joerg Heeren, Lorenz Adlung, Ludger Scheja

Faculty, Staff and Students Publications

Objective and methods: Brown adipose tissue (BAT) comprises a heterogeneous population of adipocytes and non-adipocyte cell types. To characterize these cellular subpopulations and their adaptation to cold, we performed single-nucleus mRNA-sequencing (snRNA-seq) on interscapular BAT from mice maintained at room temperature or exposed to acute (24h) or chronic (10 days) cold (6 °C). To investigate the role of the de novo lipogenesis (DNL)-regulating transcription factor carbohydrate response element-binding protein (ChREBP), we analyzed control and brown adipocyte-specific ChREBP knockout mice.

Results: We identified different cell populations, including seven brown adipocyte subtypes with distinct metabolic profiles. One of them highly expressed ChREBP …

Intravascular Hemolysis As A Converging Mechanism In Hemolytic Disorders, Justin A Courson, Arun Saini

Faculty, Staff and Students Publications

No abstract provided.

From Pachymeningitis Hemorrhagica To Abusive Head Trauma: A Journey Through The Centuries, Oliver Berthold, Flora Blangis, Christopher Spencer Greeley

Faculty, Staff and Students Publications

The development of medical knowledge follows specific principles. These also apply to abusive head trauma. The seminal literature from the early 20th century is based on earlier research from Europe, which is fundamental to understand the evolution of understanding and nomenclature of abusive head trauma. A review of original medical literature on intracranial injuries in children, published in German, English, and French, was conducted using PubMed and Google Scholar for articles before 1950. The primary search focused on subdural hemorrhages and pachymeningitis in children, followed by a snowball search of references. Full texts of available manuscripts were reviewed. Primary literature …

Two Decades Of Diagnostic Safety Research: Advances, Challenges, And Next Steps, Sundas Khan, Andrea Bradford, Christina L Cifra, Hardeep Singh

Faculty, Staff and Students Publications

Since the National Academies of Sciences, Engineering, and Medicine (NASEM) report Improving Diagnosis in Health Care, various research efforts have accelerated progress to understand and improve diagnostic safety. In this opinion piece, we summarize two decades of progress in methods for identifying and learning from diagnostic errors and provide recommendations for future research. Multiple methods have been used to quantify diagnostic errors in various clinical settings, thereby facilitating a deeper understanding of the nature and magnitude of the problem and enabling studies of contributing factors. However, the use of standardized definitions of a diagnostic error and/or diagnostic safety event, …

Foreword: Addressing Diagnostic Error: The First 10 Years, Mark L Graber, Edward P Hoffer, Hardeep Singh

Faculty, Staff and Students Publications

No abstract provided.

Alterations In Cardiovascular Parameters In 5xfad Murine Model, Andrea G Marshall, Dominique Stephens, Kit Neikirk, Sepiso K Masenga, Bryanna Shao, Amber Crabtree, Zer Vue, Heather K Beasley, Edgar Garza-Lopez, Estevão Scudese, Benjamin I Rodriguez, Han Le, Steven Damo, George E Taffet, Okwute M Ochayi, Ronald Mcmillan, Jeremiah M Afolabi, Vernat Exil, Ashton Oliver, Vineeta Sharma, Pamela Martin, Amadou Gaye, Chanel Harris, Briar Tomeau, Lacara Bell, Markis Hamilton, Taneisha Gillyard, Railyn Webster, Marcus Jackson, Prem Prakash, Shanilah Frierson, Chandravanu Dash, Margaret Mungai, Annet Kirabo, Jennifer A Gaddy, Nelson Wandira, Antentor Hinton, Anilkumar K Reddy

Faculty, Staff and Students Publications

Alzheimer's Disease (AD) is a global health issue, affecting over 6 million people in the United States, with that number expected to increase as the population ages. As a neurodegenerative disorder that affects memory and cognitive functions, it is well established that AD is associated with cardiovascular risk factors beyond only cerebral decline. In this study, we measured hemodynamic parameters related to cardiovascular and cerebrovascular function in 5xFAD mice with AD and their littermates. Specifically, we measured cardiovascular pulse wave velocity parameters, a marker of arterial stiffness and cardiovascular risk, and cerebrovascular pulse wave velocity, a novel technique to measure …

Diagnostic Efficacy And Clinical Impact Of Image-Guided Core Needle Biopsy Of Suspected Adult Nonvertebral Osteomyelitis, Winston L Winkler, Ige A George, Sumanth Gandra, Jonathan C Baker, Anderanik Tomasian, Benjamin Northrup, Theodore L Vander Velde, Travis J Hillen, Chongliang Luo, Resten Imaoka, Gino M Dettorre, Jack W Jennings

2020-Current year OA Pubs

OBJECTIVES: The diagnostic yield and clinical impact of image-guided core needle biopsy (ICNB) of suspected nonvertebral osteomyelitis in adults is heterogenous in published studies because of small sample size, indicating the need for large cohort studies.

METHODS: A retrospective analysis of ICNBs was performed from 2010 to 2021 for patients with suspected nonvertebral osteomyelitis. For each biopsy, a series of factors were analyzed, as well as if histopathology was diagnostic of osteomyelitis and if microbiological cultures were positive. Additionally, it was recorded in what way biopsy influenced clinical management regarding antimicrobial treatment. Multivariate statistical analysis was performed to evaluate the …

Comparison Of Metal Nanoparticles As Antifungal Agents: Efficacy, Mechanisms, And Toxicity Against Candida, Aspergillus, And Cryptococcus, Ahmed Falah Imran, Hayder Hameed Saeed, Khaldoon Jasim Mohammed

AUIQ Complementary Biological System

Candida albicans, Aspergillus fumigatus, and Cryptococcus neoformans are the invasive fungi whose diseases are becoming a growing health issue in the global community, particularly in immunocompromised people. The increasing resistance of the conventional antifungals and the shortage of the existing treatment methods require alternative methods. The present review is an evaluation of the antifungal activity of metal-based nanoparticles, including silver (Ag), copper (Cu), zinc oxide (ZnO), titanium dioxide (TiO₂), and selenium (Se) in relation to the three predominant pathogenic fungi. It also talks about their mode of action, relative efficacy, toxicity and their possible future clinical …

Lyme Disease Presenting As A Dermal Hypersensitivity Reaction, William T. Snider, Ian Depew, Rebecca Hicks, Shane Cook

Marshall Journal of Medicine

Background:

Lyme disease is a well-recognized illness commonly associated with skin manifestations such as erythema migrans. However, atypical presentations can complicate diagnosis, particularly when they deviate from classic clinical and histological findings.

Methods:

We report a potential case of Lyme disease presenting as a dermal hypersensitivity reaction (DHR), with clinical findings resembling urticaria rather than urticarial vasculitis. Skin biopsy findings were reviewed, and Lyme serology testing was performed.

Results:

The biopsy did not demonstrate the characteristic superficial perivascular lymphocytic infiltrate typically seen with erythema migrans. The patient's history included prior tick exposures, but while Lyme IgM was positive, the Lyme …

Mirm In An Adolescent Male: A Diagnostic Challenge And Review Of The Literature, Emily Saurborn, Savannah Carty, Shane Cook, Lauren Tufts

Marshall Journal of Medicine

Mycoplasma-Induced Rash and Mucositis (MIRM) is a subset of Reactive Infectious Mucocutaneous Eruption (RIME), most commonly associated with Mycoplasma pneumoniae. MIRM commonly presents with significant mucositis and mild or absent cutaneous involvement. MIRM exists on a spectrum with Stevens-Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN). Due to the significant clinical overlap, early diagnosis of MIRM can be challenging. We report a case of a 19-year-old male who presented with a two-day history of worsening throat pain and decreased oral intake after initiating Augmentin for treatment of community acquired pneumonia. During hospitalization, he developed progressive ocular, oral and genital …

Upper Respiratory Tract Infection Leading To A New Diagnosis Of Sweet Syndrome And Monoclonal Gammopathy Of Unknown Significance, Nidhi Rawat, Meron Gebrehiwot, Jason Raw, Jeyaprakash Ramachandran

HCA Healthcare Journal of Medicine

Background

We present a rare case of Sweet syndrome with underlying monoclonal gammopathy of unknown significance (MGUS) which initially presented as upper respiratory tract infection.

Case Presentation

A 52-year-old woman presented with a complaint of sore throat for 6 days, productive cough and fever for 5 days, and red, pruritic, circular, tender rashes on face, arms and trunk for 2 days. There was a past history of similar self-limiting rashes presenting intermittently for 1.5 years. She also reported to be taking tablet ibuprofen, as required for the past 1-2 years, for cervical spondylosis. On integumentary examination, widespread, red, tender, annular …

Rectal Fidaxomicin As Salvage Therapy In Fulminant Clostridioides Difficile Infection After Total Colectomy: A Case Report, Akankcha Alok, Mohamed Ismail, Stephanie Pino Fabara, Mohammed Al Said, Vidya Sagar Kollu

HCA Healthcare Journal of Medicine

Introduction

Clostridioides difficile infection (CDI) is a significant cause of antibiotic-associated diarrhea and colitis, ranging from mild to severe and potentially life-threatening conditions, like fulminant colitis with toxic megacolon and bowel perforation. The 2021 guidelines from the Infectious Diseases Society of America (IDSA) and Society for Healthcare Epidemiology of America (SHEA) recommend vancomycin and metronidazole for fulminant CDI (FCDI), with consideration of rectal vancomycin for cases with ileus. Fidaxomicin, though preferred for initial and recurrent CDI treatment, is not the first line for FCDI due to limited evidence. Fidaxomicin has a narrow spectrum of activity only targeting C difficile and …

Perceived Benefits And Side Effect Of High-Fiber, High-Protein Meal Replacements In Weight Loss Programs, Esti Nurwanti, Harry Fl Muhammad, Naufal M. Nurdin

Indonesian Journal of Public Health Nutrition (IJPHN)

Obesity is a major risk factor for chronic diseases and early mortality. Although dietary counseling is essential in managing obesity, maintaining a calorie deficit and preventing weight regain remain difficult. Functional foods like high-protein, high-fiber meal replacements may enhance adherence and support weight loss. This randomized controlled trial evaluated the subjective outcomes of a weight loss program incorporating a protein- and fiber-enriched meal replacement among 73 overweight women aged 20–30 years. Participants were randomized to an intervention group (n=38), receiving dietary counseling plus one daily meal replacement, or a control group (n=35), receiving counseling alone. Both groups followed an 8-week …

The Effectiveness Of Screencast Corrective Feedback On L2 English Academic Writing, Ming Cheng

Electronic Theses and Dissertations Archive

While research indicates that written corrective feedback (WCF) can promote learning of language and writing skills (Ferris, 2004; Bitchener, 2008), both students and teachers report persistent limitations. Students often find written comments difficult to interpret, while teachers consider them time-consuming to provide. Screencast corrective feedback (SCF) offers an alternative by utilizing screen recording technology to deliver audiovisual cues and personalized explanations that can reduce ambiguity and foster rapport (Harper et al., 2012). However, existing studies on SCF have largely emphasized learner perceptions rather than its measurable impact on language development (Cheng & Li, 2020). This dissertation investigates the comparative effectiveness …

Va Dent J July, August And September 2022

Virginia Dental Journal

No abstract provided.

Virginia Dental Showcase 2022, Megan Wyman

Virginia Dental Journal

No abstract provided.

Mentored Structural Biology Of Human Pathogens (Msbio-Path) Summer Program, Harani Athwale

Trick to the Treat of Internships and Research

No abstract provided.

Project #089: The Epic Antibiotic Steward: Electronic Health Record (Ehr) Tools Optimize Antibiotic Selection And Discharge Duration, Merin Babu, Anita Shallal, Tricia Stein, Rachel Kenney

Quality Expo 2025

No abstract provided.

Project #089: The Epic Antibiotic Steward: Electronic Health Record (Ehr) Tools Optimize Antibiotic Selection And Discharge Duration, Merin Babu, Anita Shallal, Tricia Stein, Rachel Kenney

Quality Expo 2025

No abstract provided.

Erratum To <[Transplant Cell Ther 2023 Jul;29(7):438e1-438e16 Epub 2023 Mar 9]>, Melissa R Hines, Tristan E Knight, Kevin O Mcnerney, Mark B Leick, Tania Jain, Sairah Ahmed, Matthew J Frigault, Joshua A Hill, Michael D Jain, William T Johnson, Yi Lin, Kris M Mahadeo, Gabriela M Maron, Rebecca A Marsh, Sattva S Neelapu, Sarah Nikiforow, Amanda K Ombrello, Nirav N Shah, Aimee C Talleur, David Turicek, Anant Vatsayan, Sandy W Wong, Marcela V Maus, Krishna V Komanduri, Nancy Berliner, Jan-Inge Henter, Miguel-Angel Perales, Noelle V Frey, David T Teachey, Matthew J Frank, Nirali N Shah

Faculty, Staff and Student Publications

No abstract provided.

Seroprevalence Of Small Ruminant Lentiviruses (Srlvs) And Peste Des Petits Ruminants Virus (Pprv) In Nonvaccinated Sheep And Goats In Sarawak, Malaysia, Bura Thlama Paul, Ali Saidu, Maria Eva Barudi, Faez Firdaus Abdullah Jesse, Juriah Kamaludeen, Suhaili Mustafa, Masnindah Malahubban, Ali Hanafiah Hakim, Krishnan Nair Balakrishnan, Mohd Azmi Mohd Lila

The Thai Journal of Veterinary Medicine

Small ruminant lentiviruses (SRLVs) and Peste des Petits Ruminants virus (PPRV) are economically important viral diseases that threaten small ruminant production globally. While previous studies have reported their serological status in Peninsular Malaysia, there is limited epidemiological information on their occurrence in East Malaysia. This study aimed to determine the seroprevalence and risk factors of SRLVs and PPRV among nonvaccinated sheep and goats from selected smallholder farms in Sarawak. A total of 245 serum samples collected from sheep (n = 117) and goat (n = 128) were screened using commercial ID Screen^® PPR competition (PPRC ver. 0821) and MVV/CAEV …

Managing Anticoagulation In A Patient With Calciphylaxis And Mechanical Valve: A Therapeutic Dilemma, Qutaiba Qafisheh, Abdalhakim Shubietah, Mohanad Qwaider, Muath A. Baniowda, Abdalrahman Assaassa, Roaa Aljunaidi, Abubakar Nazir

Division of Cardiology Faculty Papers

BACKGROUND: Calciphylaxis is a rare, life-threatening vasculopathic syndrome most commonly seen in end-stage renal disease (ESRD) and associated with high mortality. Vitamin K antagonists complicate management in patients with mechanical valves by potentially exacerbating vascular calcification while remaining essential for thromboprophylaxis.

CASE PRESENTATION: A 50-year-old woman with ESRD on hemodialysis and a mechanical mitral valve on warfarin presented with severe abdominal pain and rapidly progressive necrotic ulcers. Despite broad-spectrum antibiotics and sodium thiosulfate, lesions worsened. Biopsies were nondiagnostic; however, the clinical phenotype was consistent with calciphylaxis. A multidisciplinary team transitioned anticoagulation from warfarin to subcutaneous unfractionated heparin (UFH) (333 U/kg …