Digital Commons Network^™

In Pursuit Of The Optimal Antimicrobial Stewardship Practice Model: A Multihospital Analysis Of Direct Patient Care Interventions To Characterize The Role Of Infectious Diseases Pharmacists, Jefferson Cua, Alice Landayan, Lourdes Menendez Alvarado, Lee Amaya, Timothy Gauthier

All Publications

This retrospective analysis across 3 hospitals evaluates antimicrobial stewardship interventions by clinical pharmacists, specialist pharmacists, and infectious diseases specialist pharmacists. Findings highlight differences in intervention types, urgency, and complexity, underscoring the value of infectious diseases specialist pharmacists in optimizing patient care and antimicrobial use within a multitiered pharmacy practice model.

Animal-Centered Service Design For Stray Animals In India, Faiza Khan, Shamit Shrivastav

ServDes Conference Series

According to the State of Pet Homelessness Index data of 2021, India has a high prevalence of stray animals, with around 80 million homeless cats and dogs. The living conditions of these animals are harsh and unsafe. Services for stray animals are managed by the animal welfare departments, non-profit organizations, and caretakers. The objective of this study is to investigate the efficacy of existing stray animal welfare services and understand the role of the stakeholders towards creating a safe and healthy environment for these animals. Semi-structured interviews of eighteen stakeholders and site immersions at five Mumbai-based NGOs were conducted. The …

Infective Endocarditis And Meningitis In A Healthy Newborn Without Underlying Heart Disease, Due To Streptococcus Agalactiae - A Case Report., Dalal Siddig Idris, Muath Mohammed Al Ghamdi, Maria Laura Bellovalls, Mohammed Fararjeh

Journal of the Saudi Heart Association

Streptococcus Agalactiae endocarditis is a rare clinical entity in newborns with a normal structured heart. It is generally characterized by acute onset, the presence of large vegetations, rapid valvular destruction and frequent complications, particularly embolization. Mortality is high with medical therapy alone. We are reporting a rare case of infective endocarditis (IE) with mitral valve vegetation in a 9-day old healthy newborn following Streptococcus Agalactiae sepsis, complicated by meningitis and micro-abscesses. Mitral valve (MV) vegetation was removed surgically; the patient received intravenous antibiotics for six weeks. Transthoracic echocardiography after surgery showed severe MV regurgitation and severe pulmonary hypertension which was …

Practicing With Intent: How To Teach An Old Dogma New Tricks, Matthew C Phillips, Kusha Davar, Sarah Freling, Steven Y C Tong, Todd C Lee, Emily G Mcdonald, Travis B Nielsen, Noah Wald-Dickler, Alfredo J Mena Lora, Rachael A Lee, Fergus Hamilton, Daniel M Musher, Rodrigo P L Costa, Bassam Ghanem, Rachel Baden, Brad Spellberg

Faculty, Staff and Students Publications

Clinicians are constantly bombarded with an onslaught of newly published data, yet they must make clinical decisions despite a dearth of clinical data. Sometimes, they may fall back on clinical practices entrenched by experience, unaware that they are upheld by dogmatic tradition rather than robust evidence. Ideally, the totality of evidence must be assessed and utilized for clinical decision-making, irrespective of entrenched orthodoxy. Here, we explore the questions, how much evidence is needed to revise established clinical practices and, more fundamentally, can data alone truly catalyze such shifts.

Correlation Of Immunological Biomarkers And Severity Of Pneumonia In Pediatric Patients, Dhifaf Abdulrhaman, Mohammed B Hassan

Al-Nisour Journal for Medical Sciences

Among children under five, pneumonia stands as a major contributor to both illness and death, creating a significant challenge for global health efforts. This study aimed to evaluate the correlation between radiological severity, clinical parameters (such as fever and oxygen saturation), and laboratory markers (including CRP levels, white blood cell count, and the neutrophil-to-lymphocyte ratio) in pediatric patients with pneumonia. A retrospective analysis was conducted on 51 hospitalized children with severe pneumonia admitted to Al Mansour Pediatric Hospital in Baghdad from July 2024 to February 2025. The results revealed a strong association between radiologic severity and clinical indicators, with higher …

The Importance Of Pus/ Epithelial Cells Counts In Diagnosis Of Urinary Tract Infection And Asymptomatic Bacteriuria., Saja Hadi Abdul . Hamza, Suhad Hadi Mohammed

Al-Ameed Journal for Medical Research and Health Sciences

Background: Asymptomatic bacteriuria (ABU) is often diagnosed incidentally, and detection of bacteria in urine can lead to unnecessary antibiotic use, may aggravate antimicrobial resistance. To our knowledge, no prior study has focused on the dual presence of pus and epithelial cells (PEDP) and its diagnostic value.

Objective: To evaluate the importance of Pus/ Epithelial Cells Counts in diagnosis of ABU and UTI.

Methods: A case-control study was conducted on (140) females, divided into two groups: 70 with UTI and 70 apparently healthy controls, 28 had ABU and 42 had sterile urine cultures, with age ranging from (18 to over 58) …

Functional Foods For Older Adults: Comparing The Bioactive Properties Of Cheese To Identify Products That Promote Healthy Ageing, Aimee Plante

Theses

Functional foods for the elderly: comparing the bioactive properties of cheese to identify products that promote healthy ageing.

People are living longer, and a healthy ageing population is a key goal of our National Positive Ageing Strategy. One approach to support this initiative is to promote and develop functional foods that can support healthy ageing by reducing age-related conditions, including cardiovascular disease, diabetes, obesity and cancer. Cheese particularly aged and fermented varieties like cheddar show great potential as a functional food with inherent and established health properties. It naturally contains bioactive peptides, vitamins, minerals, protein and possible cultures that confer …

Detection Of Serotypes And Knockdown-Resistance Mutations In Dengue And Other Flavivirus Samples Collected From Mengare Island, Indonesia, Tasya Amalia Dwiyanti, Teguh Hari Sucipto, Khoirunnisa Suhandarini, Azizia Kanya Fathiarachman, Helena Putri Nastiti, Anika Rahma Putri, Shifa Fauziyah, Prihartini Widiyanti, Hariyono Hariyono, Saifur Rehman

Folia Medica Indonesiana

Dengue fever, caused by the dengue virus (DENV), poses a significant public health challenge, particularly in tropical regions. This study aimed to detect flavivirus presence, DENV serotypes, and knockdown-resistance (kdr) mutations in mosquito samples collected from Mengare Island, Gresik, Indonesia. A cross-sectional experimental design was employed, utilizing reverse transcription polymerase chain reaction (RT-PCR) for flavivirus detection and serotyping, as well as for identifying kdr mutations. Ribonucleic acid (RNA) extraction was performed using the Quick-RNA\texttrademark Miniprep Plus Kit (Zymo Research, Irvine, CA, USA), followed by RT-PCR with specific primers for DENV serotypes 1–4 and kdr mutations (V1016G and F1534C). …

Assessing Spatial Variability In Observed Infectious Disease Spread In A Prospective Time-Space Series, Chih-Chieh Wu, Chien-Hsiun Chen, Shann-Rong Wang, Sanjay Shete

Faculty, Staff and Student Publications

Most of the growing prospective analytic methods in space-time disease surveillance and intended functions of disease surveillance systems focus on earlier detection of disease outbreaks, disease clusters, or increased incidence. The spread of the virus such as SARS-CoV-2 has not been spatially and temporally uniform in an outbreak. With the identification of an infectious disease outbreak, recognizing and evaluating anomalies (excess and decline) of disease incidence spread at the time of occurrence during the course of an outbreak is a logical next step. We propose and formulate a hypergeometric probability model that investigates anomalies of infectious disease incidence spread at …

Vaccine Value Profile For Schistosomiasis, Gavin Yamey, Kaci Kennedy Mcdade, Roy M Anderson, Sarah M Bartsch, Maria Elena Bottazzi, David Diemert, Peter J Hotez, Bruce Y Lee, Donald Mcmanus, Adebayo J Molehin, Meta Roestenberg, David Rollinson, Afzal A Siddiqui, Miriam Tendler, Joanne P Webster, Hong You, Raphaël M Zellweger, Caroline Marshall

Faculty, Staff and Students Publications

Schistosomiasis is caused by parasitic flatworms (Schistosoma). The disease in humans can be caused by seven different species of Schistosoma: S. mansoni, S. japonicum, S. haematobium, S. malayensis, S. mekongi, S. guineensis and S. intercalatum, as well as by hybrids between species, including livestock schistosome species. People are infected when exposed to infested water and the parasite larvae penetrate the skin. Poor and rural communities are typically the most affected, and the general population who lives in affected areas and is exposed to contaminated water is at risk. Areas with poor access to safe water and adequate sanitation are also …

Analisis Implementasi Rekam Medis Elektronik Terhadap Kelengkapan Dokumentasi Rekam Medis, Novita Purnamasari, Adang Bachtiar

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

Completeness of medical records is one of the important factors in improving the quality of health services. Despite its importance, incomplete documentation remains a prevalent issue, and the adoption of Electronic Medical Records (EMRs) is anticipated to address this challenge. This study is a narrative review and utilized the PRISMA 2020 flow diagram for literature selection. Articles were sourced from the ProQuest and Scopus databases for articles published in 2019-2024. From an initial selection of 431 articles, eight articles met the inclusion criteria for this study. The analysis of these studies shows that the implementation of electronic medical records positively …

Oncopacket: Integration Of Cancer Research Data Using Ga4gh Phenopackets., Michael Sierk, Daniel Danis, Sujay Patil, Nobal Kishor, Rajdeep Mondal, Abhishek Jha, Qingrong Chen, Chunhua Yan, Monica Munoz-Torres, Daoud Meerzaman, Peter N Robinson, Justin T Reese

Faculty Research 2025

SUMMARY: Lack of data integration remains a significant impediment to cancer research, and many analyses still require customized software to transform and prepare cancer data. We describe a software package to harmonize genetic and clinical cancer data into the GA4GH Phenopacket schema, an ISO standard for representing clinical case data. We integrated demographic, mutation, morphology, diagnosis, intervention, and survival data using case data from the National Cancer Institute for 12 cancer types. The Phenopacket standard provides a foundation for downstream use, including sophisticated statistical and AI/ML analyses. We demonstrate fitness for purpose by using the integrated data to recapitulate a …

Automating Candidate Gene Prioritization With Large Language Models: From Naive Scoring To Literature-Grounded Validation., Taushif Khan, Mohammed Toufiq, Marina Yurieva, Nitaya Indrawattana, Akanitt Jittmittraphap, Nathamon Kosoltanapiwat, Pornpan Pumirat, Passanesh Sukphopetch, Muthita Vanaporn, Karolina Palucka, Basirudeen Syed Ahamed Kabeer, Darawan Rinchai, Damien Chaussabel

Faculty Research 2025

MOTIVATION: Identifying promising therapeutic targets from thousands of genes in transcriptomic studies remains a major bottleneck in biomedical research. While large language models (LLMs) show potential for gene prioritization, they suffer from hallucination and lack systematic validation against expert knowledge.

RESULTS: The framework identified 609 sepsis-relevant genes with >94% filtering efficiency, demonstrating strong enrichment for inflammatory pathways including TNF-α signaling, complement activation, and interferon responses. Literature validation yielded 30 ultra-high confidence therapeutic candidates, including both established sepsis genes (IL10, TREM1, S100A9, NLRP3) and novel targets warranting investigation. Benchmark validation against expert-curated databases achieved 71.2% recall, with systematic correlation between computational …

Advancing Peptide-Based Vaccines Against Candida: A Comparative Perspective On Liposomal And Synthetic Formulations, Hong Xin

School of Graduate Studies Faculty Publications

The growing threat of multidrug-resistant fungal pathogens, especially Candida auris, has underscored the need for effective antifungal vaccines. This commentary highlights recent advances in peptide-based vaccination using the SNAP (Spontaneous Nanoliposome Antigen Presentation) platform, focusing on the FM-SNAP vaccine, a bivalent liposomal formulation targeting the surface-expressed peptides fructose bisphosphate aldolase (Fba) and methionine synthase (Met6). Compared to earlier constructs such as MP12, FM-SNAP achieves superior immunogenicity and long-lasting protection at lower antigen doses. It elicits balanced Th1/Th2 cytokine responses and demonstrates durable efficacy in both immunocompetent and complement-deficient mouse models. The platform's compatibility with clinically approved adjuvants (MPLA and QS-21), …

Editorial: Decoding Vascular Aging: Unraveling The Enigma Of Pathological Conditions And Pre-Mature Vascular Aging, Mitra Esfandiarei, Roshanak Rahimian

Pacific Faculty Work

No abstract provided.

Leading With A Doctorate: The Impact Of Advanced Scholarship On Leadership Effectiveness, James R. Kilgore

Lynchburg Journal of Medical Science

ABSTRACT

In an era marked by rapid change and complex challenges, the demand for effective leadership has never been more critical. This manuscript explores the transformative impact of doctoral-level education on leadership effectiveness across various sectors, including healthcare and education. Through a comprehensive review of recent literature, this study examines how advanced scholarship fosters critical thinking, ethical reasoning, and strategic insight, which are essential traits for successful leadership. The methodology involves a systematic review of peer-reviewed articles, books, and other scholarly resources published within the past decade, utilizing databases such as PubMed, Cochrane Database of Systematic Reviews, and Google Scholar. …

Exploring The Experience Of Nursing Students During Their Community Health Nursing Clinical Placement At Schools, Lina Ghosn Nouwayhed

Dissertations

Community health nursing is an exciting, challenging, and evolving field that creatively integrates various areas of nursing practice with public health knowledge (Stanhope & Lancaster, 2016). Learning in practical settings is invaluable for student nurses; that is why clinical placements account for 50% of nursing curriculum requirements (Henderson, 2011). At Makassed University of Beirut, the community nursing practicum takes place in schools, with school nurses serving as mentors during these placements.

This research study aims to:

• Explore the experiences of student nurses during community clinical practice.
• Develop guidelines to enhance learning during community clinical practice.

The study sample consisted of …

Annual Campus Safety And Fire Report 2025, University Of Nebraska Police And Public Safety Department

Public Safety Reports

This 2025 Annual Safety and Fire Report was compiled for enrolled or prospective students and employed or prospective faculty and staff. Its purpose is to communicate the safety of the University of Nebraska Omaha campus.

Identifying And Addressing Barriers To Long Term Follow Up Care Of Patients With Hepatitis C In A Rural Southern Appalachian Clinic, Sarah M. Brown

Doctoral Projects

This project addressed the issue of loss to follow-up (LTFU) among patients infected with hepatitis C virus (HCV), a significant barrier to achieving sustained virologic response (SVR) and improving outcomes. LTFU is particularly critical among marginalized and rural populations who face socioeconomic barriers, stigma, and other social determinants of health (SDOH) that affect treatment adherence. Grounded in the Social Ecological Model (SEM), this project examined systemic, community, interpersonal, and individual factors influencing LTFU (Ahmed et al., 2022; Al-Khazraji et al., 2019; Kilanowski, 2017).

This Doctor of Nursing Practice (DNP) quality improvement initiative sought to improve patient retention in HCV care …

Access In Context: A Comparative Study Of Refugee And Asylum-Seeking Child Immunization In Uganda’S National System And Chad’S Humanitarian System, Maya Lunt

Switzerland: Global Health and Development Policy

Vaccinations and child immunizations are widely recognized as a safe and effective public health tool to stop preventable deaths of children and eliminate disease. Refugees and asylum-seeking children are often more vulnerable and have a greater risk of having incomplete immunization. This is due to a wide variety of barriers that refugees can face, which can be unique to different health system designs or country policies. Chad and Uganda are two lower-middle-income countries that have different refugee health system designs. Chad has a health system design where a parallel system is run for refugees, which heavily involves humanitarian aid from …

Beyond The Needle: Microarray Patches And The Pursuit Of Measles Vaccination Equity In Sub-Saharan Africa, Paige Littlefield

Switzerland: Global Health and Development Policy

Persistent inequities in measles vaccination systems across Sub-Saharan Africa leave millions unreached by both routine services and outbreak campaigns. Microarray patches for measles-rubella vaccination (MR-MAPs) are widely promoted as a solution to logistical and workforce barriers, yet little empirical work examines how their benefits align with real operational constraints. This study analyzes the potential role of MR-MAPs in advancing immunization equity through expert interviews and targeted document analysis. Findings reveal a tension between the technological promise of MR-MAPs and the structural limitations of current health systems. While thermostability, simplified application, and task-shifting opportunities could expand reach among zero-dose, mobile, and …

The Rise Of E-Patients In Tanzania: Reflections On The Unregulated Growth Of Digital Health Consultations, Kahabi Isangula

School of Nursing & Midwifery, East Africa

Background: Digital technologies have significantly transformed healthcare delivery globally, enabling patients to access healthcare services through electronic and mobile platforms. In Tanzania, this transformation has manifested in the rise of “e-patients” — individuals who actively seek health advice, consultation, or treatment through unregulated digital platforms. This paper examines the drivers, patterns, and implications of this trend in Tanzania.

Methods: A descriptive approach was employed, synthesising peer-reviewed and grey literature from global and sub-Saharan African sources, with a particular focus on Tanzania. Insights were also drawn from expert discussions, public digital platforms, and the author’s experiential reflections to contextualize …

A Comprehensive Nutrition Education Program Promotes Behavior Change And Perception Of Food Access Across The Older Adult Age Span, Sarah Misyak, Camille Mcguire, Victor Olayemi, Maria Denunzio, Paige Harrigan, Elena Serrano

Journal of Human Sciences and Extension

Strategies to promote healthy behaviors among older adults are needed to mitigate vulnerabilities to negative health outcomes, especially for those with low income. Healthy Eating and Staying Active as We Age (HESA), a nine-lesson educational series for Supplemental Nutrition Assistance Program-eligible older adults, was created to promote health among aging audiences. The purpose of this study was to evaluate the behavior change of older adults following participation in HESA, which covers food resource management, nutrition, food safety, and physical activity behaviors, as well as perceived food affordability and accessibility, and to determine if HESA is appropriate across the age span …

Methicillin-Resistant Staphylococcus Aureus (Mrsa) Infection Prevention, Kayla Andrees, Kaitlyn Angell, Ana Biondo, Susana Duran, Brianne Greco, Victoria Noerr

NURSI 2330 Role of the Nurse II

Hospital-onset Methicillin-resistant Staphylococcus aureus(MRSA) remains a major concern in healthcare settings. These preventable infections are linked to longer hospital stays, higher costs, and increased patient risk. In the U.S., over 10,000 hospital-onset MRSA bloodstream infections occur annually, costing billions. This literature review explores evidence-based strategies to prevent MRSA, using research from peer-reviewed journals and clinical guidelines. Key methods include hand hygiene, contact precautions, environmental cleaning, patient screening, and decolonization. Findings show that combining these approaches, particularly when led by nursing teams, can significantly reduce infection rates. Ongoing staff education, strong leadership, and consistent infection control are essential for success.

Mhc Gene Analysis And Immune Variation In Lepidodactylus Lugubris (The Mourning Gecko), Helen T. Vu

2025 Fall Honors Capstones Projects - Archive

The major histocompatibility complex (MHC) plays a central role in vertebrate immune defense by enabling pathogen recognition and initiating adaptive immune responses. While MHC diversity has been extensively studied in sexually reproducing species, comparatively little is known about its evolution in asexual lineages. The parthenogenetic gecko Lepidodactylus lugubris provides a unique opportunity to investigate how clonality and hybrid origins influence immune gene diversity. By leveraging whole-genome data, this study overcomes the limitations of previous transcriptome-based analyses and provides a more comprehensive view of MHC diversity in a clonal vertebrate. As the first step towards understanding MHC evolution in parthenogenetic lizards, …

Understanding Strategies To Translate Knowledge On Hookah Smoking: A Mixed Methods Study, Rabia Mir

Doctor of Philosophy in Translational Health Sciences Dissertations

Background: One tobacco trend of the 21 st century is smoking hookah or waterpipes. Hookah smoking is thriving on a false widespread belief that it is a safe alternate to smoking cigarettes when in fact it has adverse effects on health and is not safer. Hookah use has especially become popular for young adults and college students.

Study Objectives: The purpose of this study is to generate knowledge to inform university administration (health education personnel and campus policy makers) on what the psychosocial profile of a hookah smoker is, including risk factors, and how they can use messaging to reduce …

Monitoring The Laboratory Frequency For Musculoskeletal Infections At A Tertiary Care Children's Hospital: A Diagnostic Stewardship Qi Project, Kedar Tilak, Douglas Swanson, Christine Symes, Alaina N. Burns, Ann L. Wirtz, Rana El Feghaly

Posters

Patients with musculoskeletal infections (MSKI) undergo several laboratory tests. To promote laboratory stewardship, our Infectious diseases (ID) division recommended the following frequencies for labs: 1) C-reactive protein (CRP) every 2-3 days until >50% reduction while >3mg/dL, otherwise weekly until normal, 2) Sedimentation rate (ESR) at the start of therapy and end if > 20mm/hr initially, 3) Complete blood cell count (CBC) at the start of therapy and when transitioning to oral therapy if WBC is initially elevated. Baseline data showed that of 42 children evaluated between July 2023-May 2024, only 15 (35.7%) had a CBC and 13 (30.95%) had a CRP …

District Vulnerability Index For Pakistan (Dvip): Harnessing Multisectoral Data To Inform Equitable Policy And Climate Action, Population Council

Climate and Environmental Changes

Pakistan’s highly heterogeneous population faces significant development challenges, including unequal resource distribution and disparities in access to services, which create varying levels of vulnerability across communities. While existing studies have primarily examined vulnerability through climate, economic, or other disaster lenses, they often overlook underlying structural and systemic factors. This study aims to address that gap by developing an index that incorporates domains of vulnerability typically underrepresented in analyses of Pakistan.

Issue 15: Pulmonary & Critical Care Insider, Bharat Bajantri Md, Sarah Ellsworth-Hoffman Mls, Kristin Lytal Pharmd, Mspgx, Stephanie Subart Pharmd

Critical Care & Pulmonary

Pulmonary & Critical Care Insider Issue 15

Compiled by Bharat Bajantri, MD, and librarian Sarah Ellsworth, MLS for the clinicians of the Pulmonary and Critical Care team of Parkview.

The Pulmonary & Critical Care Insider newsletter was created by Dr. Bharat Bajantri, MD and Sarah Ellsworth, MLS in 2023 as a form of current awareness for current practice at our hospital, Parkview Health.

Topics:

2025 Guidelines for ANCA Vasculitis

Airway Scaffolds for Emphysema: Six-Month BREATHE TRIAL Results

Tackling Emphysema-Related Hyperinflation: Scaffolds, Valves, or Vapor? How They Work?

Bactericidal vs. Bacteriostatic Antibiotics in Critically Ill Patients

Modified Cuff Leak Test (CLT) …

Quality & Patient Safety Gazette : Volume 4, Issue 3 - 2025, Quality & Patient Safety Department And Infection Prevention & Hospital Epidemiology

Quality and Patient Safety Archives

• Advancing Healthcare Excellence: Structured Journey to JCI Clinical Care Program Certification (CCPC)
• Sindh Healthcare Commission Monitoring Visit at AKUH Clifton Medical Services
• SafeCare Recertification Assessment of Four Off-Campus Hospitals, Pakistan
• Comprehensive Unit Based Safety Program (CUSP) Grand Round
• AKDN-HS Quality KPI Training Program Strengthens Alignment Across AKDN Health System
• JCI Patient Safety Pathways Grand Round-Pediatric Patient Safety I International Webinar
• International Webinar - Protecting our littlest Patients: Unmasking Pediatric Pain as a Safety Issue - Health Standards Organization
• Wed-Webinar Series 2025 JCI 8th Edition I Introductory Session
• Wed-Webinar | International Patient Safety Goals (IPSG)
• Wed-Webinar | Patient Centered Care (PCC) …