Medical Specialties Commons^™

Yx0798 Is A Highly Potent, Selective, And Orally Effective Cdk9 Inhibitor For Treating Aggressive Lymphoma, Vivian Jiang, Yu Xue, Hong Kim, Qingsong Cai, Tianci Zhang, Lei Nie, Joseph Mcintosh, Yang Liu, Haiying Chen, Jia Zhou, Michael Wang

Faculty, Staff and Student Publications

Nongenetic transcription evolution has been increasingly explored and recognized to drive tumor cell progression and therapeutic resistance. As the regulation hub of transcription machinery, cyclin-dependent kinase 9 (CDK9) is the gatekeeper of RNA polymerase II transcription, and CDK9 dysfunction results in transcriptomic reprogramming and tumor cell progression. We recently reported that the heat shock protein 90 (HSP90)-MYC-CDK9 network drives therapeutic resistance in mantle cell lymphoma (MCL) through transcriptomic reprogramming. We also showed that targeting CDK9 by AZD4573 and enitociclib is a safe and effective treatment in preclinical Mantle Cell Lymphoma (MCL) models, supporting CDK9 as a valid therapeutic target for …

Drug-Eluting Resorbable Scaffold Versus Balloon Angioplasty For Below-The-Knee Peripheral Artery Disease: 2-Year Results From The Life-Btk Trial., Brian G Derubertis, Ramon L Varcoe, Prakash Krishnan, Marc P Bonaca, David J O'Connor, Richard Pin, David C Metzger, Andrew Holden, Jen-Kuang Lee, Osamu Iida, Ehrin J Armstrong, Steven W C Kum, Raghu Kolluri, Danielle R Bajakian, Lawrence A Garcia, Mehdi H Shishehbor, Shawn Yu, Karine Ruster, Brad J Martinsen, Zsuzsanna Igyarto, Sahil A Parikh

Heart and Vascular Articles

BACKGROUND: Limited treatment options exist for infrapopliteal disease in patients with chronic limb-threatening ischemia (CLTI), a condition associated with a high risk of limb loss. Interventional management of diseased infrapopliteal vessels with percutaneous transluminal angioplasty (PTA) is associated with high rates of restenosis and reintervention. In the LIFE-BTK randomized controlled trial (Pivotal Investigation of Safety and Efficacy of BRS Treatment-Below the Knee), the drug-eluting resorbable scaffold (DRS) demonstrated superior 12-month efficacy compared with PTA in a selected CLTI population with predominantly noncomplex, mildly to moderately calcified lesions. This report presents the 2-year safety and efficacy outcomes of the Esprit BTK …

Generative Modeling For Interpretable Anomaly Detection In Medical Imaging: Applications In Failure Detection And Data Curation, Mckell E Woodland, Mais Altaie, Caleb S O'Connor, Austin H Castelo, Olubunmi C Lebimoyo, Aashish C Gupta, Joshua P Yung, Paul E Kinahan, Clifton D Fuller, Eugene J Koay, Bruno C Odisio, Ankit B Patel, Kristy K Brock

Faculty, Staff and Students Publications

This work aims to leverage generative modeling-based anomaly detection to enhance interpretability in AI failure detection systems and to aid data curation for large repositories. For failure detection interpretability, this retrospective study utilized 3339 CT scans (525 patients), divided patient-wise into training, baseline test, and anomaly (having failure-causing attributes—e.g., needles, ascites) test datasets. For data curation, 112,120 ChestX-ray14 radiographs were used for training and 2036 radiographs from the Medical Imaging and Data Resource Center for testing, categorized as baseline or anomalous based on attribute alignment with ChestX-ray14. StyleGAN2 networks modeled the training distributions. Test images were reconstructed with backpropagation and …

The Clingen Severe Combined Immunodeficiency Disease Variant Curation Expert Panel: Specifications For Classification Of Variants In Ada, Dclre1c, Il2rg, Il7r, Jak3, Rag1, And Rag2, Vanessa C Jacovas, Michelle Zelnick, Shannon Mcnulty, Justyne E Ross, Namrata Khurana, Xueyang Pan, Alejandro Nieto, Shiloh Martin, Benjamin Mclean, Marwa A Elnagheeb, Morton J Cowan, Jennifer M Puck, Mike S Hershfield, James Verbsky, Jolan Walter, Eric J Allenspach, Alice Y Chan, Nicolai S C Van Oers, Rajarshi Ghosh, Megan Piazza, Bo Yuan, Luigi D Notarangelo, Britt A Johnson, Ivan K Chinn, Severe Combined Immunodeficiency Variant Curation Expert Panel

Faculty, Staff and Students Publications

Purpose: This collaborative study, led by the Clinical Genome Resource Severe Combined Immunodeficiency Disease Variant Curation Expert Panel (ClinGen SCID-VCEP), implemented and adapted the American College of Medical Genetics and Genomics/Association for Molecular Pathology (ACMG/AMP) guidelines for interpreting germline variants in genes with established relationships to SCID. The effort focused on the 7 most common SCID-related genes identified by SCID newborn screening in North America: ADA, DCLRE1C, IL2RG, IL7R, JAK3, RAG1, and RAG2.

Methods: The SCID-VCEP conducted a rigorous review of variants that involved database analyses, literature review, and expert feedback to derive gene-specific modifications to the ACMG/AMP guidelines. These …

Utility Of True Cut Biopsy Tcb In Triple Diagnosis Of Breast Cancer, Ahmed Abdallah Esawy

Journal of Medicine in Scientific Research

objective : The aim of this study is to evaluate the role of breast true cut biopsy (TCB) in the diagnosis of breast Cancer and benign mimics of malignant lesions. True cut biopsy improves the classification of BI-RADS System (upgrade or downgrade, BI-RADS score).TCB decreases follow-up examinations. TCB allows definite rapid breast cancer diagnosis and management. Methods: An observational retrograde study was performed of all TCB reports of a suspicious mass or lesion observed in patients admitted between January 2022 and December 2022, at Al-Sahel Teaching Hospital Conclusion : True cut biopsy is accurate, fast method in diagnosis of breast …

Cervical Premalignant Lesions Treatment: A Randomized Controlled Trial Of Cryotherapy Versus Loop Excision, Fatma A. Dawood, Tarek M. Elhawari, Rafik I. Barakat, Naglaa A. Hussien

Journal of Medicine in Scientific Research

It was discovered that cryotherapy was just as effective as the loop electrosurgical excision process (LEEP) for removing the cervical intraepithelial neoplasia (CIN2+) lesion. In the majority of high-income nations, LEEP is now the accepted course of therapy. This study's objective was to examine the two methods for treating cervical premalignant lesions: cryotherapy versus loop electrosurgical excision as regard safety, efficacy and cost of the two approaches and assess their application. 90 female patients with cervical premalignant lesions, ages 30 to 55, participated in this prospective comparative randomized controlled research. Two equal groups of patients were created: group I received …

Calcium Sensitizers Improve Short Term Outcome After Surgical Repair Of Pediatric Cardiac Patients With Severely Impaired Left Ventricle, Rania Aboshokka, Hanan Mohammed Hassan, Khaled S. Ahmed, Rasha Hosny, Ahmed Algebaly

Journal of Medicine in Scientific Research

Introduction: Delayed diagnosis and management of congenital cardiac defects with high LV afterload and infants with impaired coronary perfusion can lead to severe impairment of LV function. The surgical repair of these patients carries a high perioperative risk. Introduction of Inodilators in the medical management of these cases has greatly improved postoperative outcome. Aim of the work: To evaluate the effect of calcium sensitizers on short-term outcome of surgical repair of cardiac defects in pediatric cardiac patients with severely impaired left ventricle. Methods and results A retrospective study was conducted at our institute in 2024 to evaluate the effect of …

Evaluation Of The Serum Levels Of Il6 And Magnesium In Chronic Kidney Disease Patients (Ckd), And Ckd Patients With Different Comorbidities, Naglaa F. Al-Mihy, Nesreen M. Zakaria, Dina A. Ibrahim

Journal of Medicine in Scientific Research

Background Chronic kidney disease (CKD) is a global health concern that causes a substantial increase in morbidity and mortality rates among adults. CKD is accompanied with several complications including cardiovascular disease (CVD) and death. We aimed to study the relation of level of interleukin-6 (IL-6) in the serum and magnesium (Mg) in CKD and CKD patients with various comorbidities. Methods This cross-sectional study involved 100 CKD adult pre-dialysis patients, they were subdivided into 4 groups; the 1st group included 21 patients with CKD only, the 2nd group included 29 patients with CKD and diabetes mellitus (CKD+DM), the 3rd group included …

Mid-Term Results Of Tricuspid Valve Repair For Functional Tricuspid Regurgitation: Ring And Modified Band Annuloplasty, Ismail R Barrada, Ahmed S Ali, Mahmoud M Abdou

Journal of Medicine in Scientific Research

Background: The concurrent repair of functional tricuspid regurgitation (TR) is typically recommended during left-sided heart valve surgery. Several surgical techniques are available, each targeting long-term effectiveness and clinical success. Objective: This study sought to assess the mid-term outcomes of two widely used tricuspid valve repair (TVr) methods: flexible band annuloplasty (FA) and rigid ring annuloplasty (RA). Methods: This retrospective study involved 85 patients who underwent TVr along with left-sided valve surgery. Of these, 53 patients were assigned to the FA group (Group A), and 32 patients to the RA group (Group B). Transthoracic echocardiography was performed at hospital discharge and …

Efficacy And Safety Of Different Treatment Strategies In Pediatric Fecal Incontinence: A Systematic Review, Seham M. Abd El-Moghny, Wessam A. Al-Kholy, Mohamed I. Elsepaee, Ahmed M. Elgamal, Rabab S. Mohamed

Journal of Medicine in Scientific Research

Background Fecal incontinence (FI) in children is a challenging condition with significant impacts on quality of life (QoL). Multiple therapeutic approaches, including neuromodulation techniques such as sacral nerve stimulation (SNS), biofeedback therapy, botulinum toxin (Botox) injections, and transcutaneous functional electrical stimulation (TFES), have been explored. This systematic review evaluates the efficacy and safety of these interventions in pediatric patients. Methods A thorough investigation was performed in PubMed, Scopus, Web of Science, and the Cochrane Library databases up to February 2025. Studies assessing the effectiveness and safety of SNS, biofeedback, Botox injections, and other interventions in pediatric FI were included. Risk …

Early Outcomes Of Y-Incision Vs. Conventional Techniques For Aortic Root Dilatation, Ahmed Shafeek Ali, Mahmoud Maher Abdou Ibrahim, Haitham Alshahat Ramadan

Journal of Medicine in Scientific Research

Background The y-incision method for expanding the aortic annulus has proven its effectiveness and safety in the short term. We aim to compare the early results of this method with those of the conventional annular dilatation techniques. Methods From March 2022 to April 2024, Eighty consecutive patients at the National Heart Institute in Cairo, Egypt, received aortic valve replacement (AVR) combined with aortic root dilatation (ARD) Utilizing either conventional annular dilatation techniques (group 1, n=40), including Manouguian [12.5% (10/80)], Nicks [35% (28/80)], and others [2.5% (2/80)], or method of Y-incision (group 2, n=40) [ 50% (40/80)]. Preoperative, intraoperative, and early …

Early Outcomes Of Coronary Artery Bypass Grafting Versus Percutaneous Coronary Intervention For Patients With Intermediate Syntax Ii Score, Ahmed A Faragalla, Ahmed M Elshiemy, Ahmed K. Hassan, Sherif M. Elboghdady, Wael S. Nekhila

Journal of Medicine in Scientific Research

Background Navigating the treatment landscape for those whose SYNTAX II scores reside in the transitional band of 23 to 32 (the intermediate score zone) continues to present a formidable clinical dilemma, with the therapeutic arsenal offering divergent paths: the surgical undertaking of coronary artery bypass grafting (CABG), the catheter-based strategy of percutaneous coronary intervention (PCI), or the non-interventional realm of medical therapy. Aim To evaluate the frequency of major adverse cardiac or cerebrovascular events (MACCE) during the in-hospital period following re-vascularization procedures in participants graded as intermediate SYNTAX II scores. Methods A retrospective study was conducted at the National Heart …

Acute Kidney Injury After Open Heart Surgery: The Diagnostic And Predictive Value Of The New Biomarkers, Ahmed A Faragalla, Ahmed M Elshiemy, Sherif A. Elhendawy

Journal of Medicine in Scientific Research

Background Post-operative acute kidney injury (AKI) following cardiac surgery represents a significant clinical challenge, associated with heightened mortality and an increased propensity for chronic kidney disease. Ischemia-reperfusion injury, a primary pathophysiological mechanism, induces renal tubular damage, releasing biomarkers such as Neutrophil gelatinase-associated lipocalin (NGAL) and hemojuvelin (HJV) into the urine. The quantification of these urinary biomarkers offers a means for early AKI detection and risk stratification, with the potential to improve patient prognosis. Aim This investigation tested new urinary biomarkers to detect AKI within the first 24 hours, to enable prompt intervention and enhance patient care. Patients and Method Sixty-three …

Intraoperative Endoscopic Finding Of The Paranasal Sinus Mucoceles, Anwar Moawad Elbatawy, Essam Fathy Mohamed, Mohammad Mostafa Gaballah

Journal of Medicine in Scientific Research

Background Mucocele of the nose and paranasal sinuses are a slowly benign expansion that may cause compression of the surrounding important structures such as the orbit or the brain in 44.9% of cases. Mucopyocele is a rare presentation (especially maxillary mucopyocele) resulting from a secondary bacterial infection. CT scan of the paranasal sinus is efficient in identifying and localizing the affected sinus and its bony extension also helps to plan the endonasal endoscopic surgery. Material and methods This is a retrospective study, we have documented 9 cases with a history of mucocele, or mucopyocele. 2 cases are excluded. One of …

Temperamental Traits For Infants And Toddlers With Rickets, Rabab Salah Eldin Mohamed

Journal of Medicine in Scientific Research

Background Rickets is a deficiency in the mineralization of developing bone. Infant temperament comprises a collection of qualities that define individual behavior. The objective of this work was to determine if there were variations in temperamental qualities between ricketic and normal babies and toddlers, and whether such differences varied by sex. Methods This cross-sectional work had been conducted on 100 children aged from 6 to 24 months both sexes, with rickets (Group 1), and 100 normal sex- and age-matched children as a control group (Group 2). All patients underwent evaluation of temperamental traits. The assessment of psychological aspects for both …

Combined Effect Of Letrozole And Dydrogesterone Versus Dydrogesterone Alone For Relieving Pain In Patients With Endometriosis, Mohamed M.H. Elwakeel, Mohamed A.T. Elsharawy, Abdelghaffar S. Dawod, Dina G. Elkhouly

Journal of Medicine in Scientific Research

Background Endometriosis is a medical condition in women caused by the growth of active endometrial tissue outside the uterine cavity. It predominantly affects women of reproductive age and typically manifests as dysmenorrhea, dyspareunia, chronic pelvic pain, and infertility. It negatively impacts psychological well-being and health-related quality of life. Aim This study aims to compare the effect of the combination of letrozole and dydrogesterone versus the effect of dydrogesterone alone in pain-associated endometriosis Patients & Methods This randomized controlled study was conducted on 88 women with endometriosisassociated pain in the gynecologic outpatient clinic at Tanta University Hospitals, from October 2023 to …

Study Of Awareness, Knowledge, Attitude And Practice Of Pediatric Healthcare Practitioners Towards Wilson Disease., Hanaa Ahmed Elaraby, Magdy Anwar Saber, Sally Waheed Elkhadry, Salwa Gamal Attia, Gihan Ahmed Sobhy

Journal of Medicine in Scientific Research

Background; Wilson disease (WD) is a rare genetic disease that occurs secondary to an excess of copper building up in our body, especially in the liver and brain. Diagnosis of WD is challenging. Since it is a curable illness, raising awareness about it among medical professionals is essential. Aim of the work; to assess the awareness, knowledge, attitude and practice of pediatric practitioners towards WD providing useful alerts about this disease and augmenting their knowledge. Participants and Methods ; Five hundred and one (501) pediatric practitioners with varying academic degrees from several Egyptian governmental hospitals participated in this cross-sectional study …

A Recent Insight On Prevalence Of Atopic Diseases In Children With Type 1 Diabetes, Randa Mohamed Darwish, Ayat Ibrahim Ghanem

Journal of Medicine in Scientific Research

Background Type 1 diabetes mellitus (T1DM) and atopic diseases are both prevalent immunemediated conditions in children. Although traditionally viewed as immunologically opposing disorders—T1DM being Th1-mediated and atopy Th2-mediated—recent studies suggest possible overlap in genetic susceptibility and environmental triggers. This study aimed to evaluate the prevalence and association of various atopic conditions in pediatric T1DM patients. Aim of the study To investigate the prevalence of atopic diseases—including atopic dermatitis, allergic rhinitis, allergic conjunctivitis, bronchial asthma, food allergy, and anaphylaxis—among children with T1DM compared to healthy age- and sex-matched controls, and to analyze contributing risk factors. Methods A retrospective cohort study was …

Imaging Characterization Of Central Nervous System Affection In Hematological Malignancies Patients, Eman Nasr Said, Samia Yehia Abdelrazek Heikal, Ayda A. Youssef, Marwa Romeih, Mary Rabea Mahrous

Journal of Medicine in Scientific Research

Background Central nervous system (CNS) complications in patients with hematological malignancies pose significant diagnostic and therapeutic challenges. Magnetic resonance imaging (MRI), with its various sequences, plays a pivotal role in early diagnosis, characterization, and differentiation of these conditions to guide management and improve outcomes. Objective This research aimed to assess the diagnostic performance and utility of different MRI sequences (conventional, diffusion-weighted imaging (DWI), and apparent diffusion coefficient (ADC) mapping) in detecting and differentiating CNS complications in patients with hematological malignancies presenting with neurological manifestations. Methods A retrospective cohort of 130 patients (age range 2–81 years; 60% male and 40% female) …

The Cardioprotective Effects Of Adiponectin In Diabetes., Tara Kazemi, Yuanjie Mao, Tina Zhang

Ambulatory and Primary Care Articles

PURPOSE OF REVIEW: Adiponectin, a hormone secreted by adipocytes, plays a crucial role in maintaining metabolic balance and supporting cardiovascular health. Although it is known for its protective effects, such as improving insulin sensitivity, reducing inflammation, and maintaining endothelial function, there are paradoxical associations between high adiponectin levels and increased cardiovascular mortality-referred to as the "adiponectin paradox"-which complicates its clinical interpretation. This review explores the cardioprotective effects of adiponectin in both type 1 and type 2 diabetes, focusing on its potential to regulate glucose metabolism and prevent cardiovascular complications.

RECENT FINDINGS: By reviewing key studies, the article evaluates adiponectin's diverse …

Understanding The Nutrition Ecology And Related Distal And Proximal Research Gaps Impacting School-Aged Children's And Adolescents' Functioning-A Report From The "Biomarkers Of Nutrition For Development: Knowledge Indicating Dietary Sufficiency (Bond-Kids)" Project Working Group 2., Maureen M Black, Meg M Bruening, Amy Carroll-Scott, Jayna M Dave, Kristie L Ebi, Lora L Iannotti, Susan L Johnson, Lorrene D Ritchie, Elizabeth Y Jimenez, Alison L Steiber, Daniel J Raiten

Children’s Nutrition Research Center Staff Publications

Nutrition is critical to the health, development, and well-being of children and adolescents, operating through nutrients and the social and physical influences of dietary behaviors. Child and adolescent growth and development depend on complex biological systems interacting with the nutrition ecology. In this review, we focus on bidirectional interactions with the multilevel nutrition ecology, including distal systems (climate, geopolitical, and food systems) and proximal systems (community food options; health, social, and food services; and school policies and programs), all mediated by the family. Thus, the impact of nutrition on children's and adolescents' functional outcomes is dependent on understanding the multilevel …

Advancements In Prenatal Genetic Screening And Testing: Emerging Technologies And Evolving Applications, Mona M Makhamreh, Mei Ling Chong, Ignatia B Van Den Veyver

Duncan NRI Faculty and Staff Publications

Advancements in genomic technologies have transformed prenatal genetic testing, offering more accurate, comprehensive, and noninvasive approaches to reproductive care. This review provides an in-depth overview of current methodologies and emerging innovations, including expanded carrier screening (ECS), cell-free DNA (cfDNA) testing, chromosomal microarray analysis (CMA), and sequencing-based diagnostics. We highlight how next-generation sequencing (NGS) technologies have revolutionized carrier screening and fetal genome analysis, enabling detection of a broad spectrum of genetic conditions. The clinical implementation of cfDNA has expanded from common aneuploidies to include copy number variants (CNVs), and single-gene disorders. Diagnostic testing has similarly evolved, with genome sequencing outperforming traditional …

Characterization Of Suspicious Prostate Lesions At Multiparametric Mri With Dynamic 68 Ga-Gozetotide Pet/Ct, Daniel Parrott, Qing Yuan, Daniella Pinho, Yin Xi, Daniel N Costa, Alberto Diaz De Leon, Marianna Dakanali, Xiankai Sun, Orhan K Oz, Spencer Bowen, Neil M Rofsky, Dana Mathews, Ivan Pedrosa

Faculty, Staff and Student Publications

Background: Prostate cancer (PCa) will affect approximately 12% of US men in their lifetime and remains the 2nd most common cause of cancer-specific death. However, there is a broad spectrum of severity of PCa; some require aggressive treatment and others can "watch-and-wait". Distinction of clinically significant prostate cancer (csPCa) from indolent PCA with current imaging methods remains challenging.

Objective: This study aims to evaluate dynamic prostate specific membrane antigen (PSMA) positron emission tomography (PET/CT) in the characterization of suspicious prostate lesions identified on multiparametric MRI (mpMRI).

Methods: Prospective study of biopsy-naïve patients with at least one Prostate Imaging and Reporting …

Inhibition Of Osteosarcoma Lung Metastases By Β-Glucan And Cd40 Agonist Is Mediated By Activation Of Macrophages And Nk Cells, Pradeep Shrestha, Rejeena Shrestha, Eugenie S Kleinerman

Faculty, Staff and Student Publications

Background: Osteosarcoma (OS) lung metastases remain a significant therapeutic challenge. Innate immune activation is a promising therapeutic approach. Innate immune agonists can modulate the tumor immune microenvironment and improve therapeutic response.

Methods: Using an experimental syngeneic OS lung metastasis BALB/c mouse model with K7M3-luc OS cells, we evaluated the antitumor effects of yeast-derived particulate β-glucan in prevention and therapeutic settings. We then assessed whether the CD40 agonist (CD40a) in combination with β-glucan increased therapeutic response in two different immune-competent mouse models of OS lung tumor burden.

Results: In the pretreatment settings, mice treated with β-glucan prior to OS cell infusion …

Intracranial Neural Biomarkers Of Psychiatric Symptoms And Their Utility For Guiding Neuromodulation Therapy: A Systematic Review, Katherine E Kabotyanski, Nicole R Provenza, Sameer A Sheth

Faculty, Staff and Students Publications

The quest to develop and improve neuromodulatory therapies for treatment-resistant psychiatric disorders has been fueled by the discovery of intracranial neural biomarkers of symptom dimensions. These neural correlates shed light on the underlying neurophysiology of the disorder and may even be useful in guiding therapy delivery. This systematic review summarizes recent efforts in this field relating neural activity to behavior and symptomatology. For years, the majority of these neurobehavioral relationships had been studied in the hospital or clinic environment. Recent technological advances in implanted neuromodulation devices that permit not only stimulation, but also intracranial neural recording have enabled this research …

Risk Factors And Clinical Significance Of Urologic Injury In Cesarean Hysterectomy For Placenta Accreta Spectrum, J Connor Mulhall, Kayla E Ireland, John J Byrne, Patrick S Ramsey, Georgia A Mccann, Jessian L Munoz

Faculty, Staff and Students Publications

Background/Objectives: Placenta accreta spectrum (PAS) is an obstetric condition with placental adherence to the underling myometrium characterized by significant surgical morbidity at time of delivery. PAS delivery is most commonly performed by cesarean hysterectomy. The most common morbidities associated with PAS cesarean hysterectomy are blood transfusion, intensive care unit admission and urinary tract injuries. This requires interdisciplinary team management including obstetricians and urologists. Our objective was to identify pre- and intra-operative risk factors for urologic injury in this high-risk condition.

Methods: A retrospective cohort study was performed at a single tertiary center with the Center for the Management …

A Safety-Ii Approach To Learn From Practice Variation In The Diagnostic Process In The Emergency Department: An Action Research Study, Rick Roos, Laura Zwaan, Myrthe Maranus, Iwan A Meynaar, Vanessa J Valk, Cees Van Nieuwkoop, Gert-Jan Kamps, Hardeep Singh, Maarten O Van Aken

Faculty, Staff and Students Publications

Objectives: The focus on improving patient safety has mainly been by learning from errors and near misses (Safety-I). We applied a novel Safety-II approach to identify and learn from practice variations in the diagnostic process in the emergency department (ED), and subsequently design and implement practice changes.

Methods: In this single-center study, we used action research (cycles of micro-experiments to study and improve processes with active stakeholder involvement) in the diagnostic process. We used three subsequent observation cycles of the following six steps: observations, gathering of follow-up data, analyses, a co-creation session with involved stakeholders, sharing of best practices, and …

Establishing Priority Pediatric Antimicrobial Stewardship Interventions In The Us: Findings From A Delphi Consensus Study., Harry Obeng, Emmanuel Tetteh, Sara Malone, Lauren Walsh, Tyler Walsh, Fernando J. Bula-Rudas, Ritu Banerjee, Adam W. Brothers, Joshua C. Herigon, Katie Namtu, Scott Weissman, Daniel Riggsbee, Jared Olson, Debra Lynn Palazzi, Ann L. Wirtz, Matthew Sattler, Jessica Tansmore, Brittany A. Rodriguez, Monica Abdelnour, Joshua R. Watson, Alison C. Tribble, Jessica Gillon, Mari Nakamura, Sarah Jones, Jason G. Newland, Virginia R. Mckay

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND/OBJECTIVES: Antimicrobial resistance (AMR) is a major global health threat, with children at higher risk due to developmental differences in drug metabolism, limited treatment options and inappropriate antibiotic use. Pediatric antimicrobial stewardship programs (ASPs) face implementation challenges, often relying on adult-based guidelines and limited pediatric-specific evidence. This study aimed to identify and prioritize the most critical areas for pediatric ASP intervention development through a structured, multi-round Delphi consensus process with experts in antimicrobial stewardship and infectious diseases.

METHOD: A four-round modified Delphi process was conducted to identify and prioritize key pediatric ASP interventions. Experts in antimicrobial stewardship and infectious diseases …

Genetic Engineering Of Esophageal Organoids: Crispr-Based Knock-In For Cell Lineage Tracing, Kyung-Pil Ko, Jae-Il Park

Faculty, Staff and Student Publications

Esophageal organoids serve as powerful systems to study epithelial lineage hierarchies and cancer biology. Gene manipulation in these organoids has traditionally involved overexpression or knockout strategies. However, CRISPR-/Cas9-based knock-in (KI) approaches now enable precise cell lineage tracing and live imaging. Here, we describe protocols to generate fluorescent KI organoids from murine esophageal epithelium by tagging Krt13 (BFP) and Sox2 (mNeon). These dual-reporter organoids allow direct monitoring of growth dynamics and differentiation trajectories. We outline CRISPR/Cas9 design, donor construction using homology-independent approaches (CRISPaint), delivery into organoid cells, enrichment and single-clone isolation, and validation by fluorescence. For organoids, homology-directed repair (HDR) can …

Establishing Priority Pediatric Antimicrobial Stewardship Interventions In The Us: Findings From A Delphi Consensus Study, Harry Obeng, Emmanuel Tetteh, Sara Malone, Lauren Walsh, Tyler Walsh, Fernando J Bula-Rudas, Ritu Banerjee, Adam W Brothers, Joshua C Herigon, Katie Namtu, Scott Weissman, Daniel Riggsbee, Jared Olson, Debra Lynn Palazzi, Ann Wirtz, Matthew Sattler, Jessica Tansmore, Brittany A Rodriguez, Monica Abdelnour, Joshua R Watson, Alison C Tribble, Jessica Gillon, Mari Nakamura, Sarah Jones, Jason G Newland, Virginia R Mckay

Faculty, Staff and Students Publications

Background/objectives: Antimicrobial resistance (AMR) is a major global health threat, with children at higher risk due to developmental differences in drug metabolism, limited treatment options and inappropriate antibiotic use. Pediatric antimicrobial stewardship programs (ASPs) face implementation challenges, often relying on adult-based guidelines and limited pediatric-specific evidence. This study aimed to identify and prioritize the most critical areas for pediatric ASP intervention development through a structured, multi-round Delphi consensus process with experts in antimicrobial stewardship and infectious diseases.

Method: A four-round modified Delphi process was conducted to identify and prioritize key pediatric ASP interventions. Experts in antimicrobial stewardship and infectious diseases …