Digital Commons Network^™

Contemporary Trends In Pediatric Extubation Failure And Noninvasive Respiratory Support Use, Jeremy M Loberger, Mitchell Moore, Matthew Scanlon, Robinder G Khemani, Samer Abu-Sultaneh, Colin M Rogerson

Faculty, Staff and Student Publications

Background: Prolonged invasive mechanical ventilation (IMV) is associated with morbidity and mortality in children. Timely extubation is essential and must balance the competing risks of extubation failure (EF) and prolonged use of noninvasive respiratory support after extubation.

Research question: Did EF risk factors, EF rates, noninvasive respiratory support after extubation practices, and patient-centered outcomes changed between 2013 and 2022?

Study design and methods: Retrospective cross-sectional study of patients younger than 19 years receiving IMV for ≥ 24 hours and extubated between 2013 and 2022 from 158 North American sites in the Virtual Pediatric Intensive Care, LLC, quality improvement database.

Results: …

Risk Factors And Outcomes Of Reintubation Following Combined Heart-Lung Transplantation, Ye In Christopher Kwon, Michael Keller, Alan Lai, Brian Bao, Joshua Pei, Matthew Ambrosio, Jay Patel, Motaz Al-Yafi, Zachary Fitch, Josue Chery, Patricia Nicolato, Vigneshwar Kasirajan, Zubair A Hashmi

Faculty, Staff and Student Publications

Background: Unplanned reintubation after combined heart-lung transplantation (HLT) significantly affects morbidity and mortality, yet national data are limited. We evaluated the incidence, predictors, timing, and outcomes associated with reintubation after HLT.

Methods: We retrospectively reviewed adults undergoing primary HLT in the UNOS registry from January 2004 to September 2024. Patients were stratified by reintubation status (defined as re-established mechanical ventilation (MV) after initial extubation). Propensity matching (1:1) balanced recipient and donor characteristics. Multivariable logistic regression models identified independent risk factors.

Results: Among 609 adult HLT recipients, 165 (27.1%) required postoperative reintubation. After 1:1 propensity score matching, 146 patients who were …

Rituximab For The Treatment Of Immune Checkpoint Inhibitor-Induced Glomerulonephritis, Yazen Alasadi, Juan Cintron Garcia, Naszrin Arani, Valda Page, Yimin Geng, Clark R Andersen, Amanda Tchakarov, Abhijat Kitchlu, Omar Mamlouk, Ala Abudayyeh

Faculty, Staff and Student Publications

Background: Among patients receiving immune checkpoint inhibitor (ICI) therapy, the most common renal immune-related adverse event is interstitial nephritis, which is caused by severe T-cell infiltration and is typically responsive to steroids; although rarer, autoimmune induction in the kidney has also been reported. There is a paucity of data regarding ICI-induced autoimmune disease in the kidney and the challenges associated with continuing ICI therapy. Here, we present a single center case series of ICI-induced glomerulonephritis with data on treatment rechallenge.

Methods: We retrospectively reviewed 241 patients who underwent kidney biopsies at our institution between 2015 and 2024 and identified those …

Collision Tumors Involving Metastatic Carcinoma And Plasma Cell Myeloma: Report Of Two Cases, Ahmed A Ahmed, Muhammad Hassaan Khalid, Asad Ur Rehman, Nghia D Nguyen, Xinhai Robert Zhang

Faculty, Staff and Student Publications

Synchronous coexistence of plasma cell neoplasms (PCNs) and metastatic carcinoma is not a common phenomenon and poses a significant diagnostic challenge requiring meticulous histopathological and immunophenotypic analysis for accurate lineage assignment. We report two cases of collision tumors comprising PCN and metastatic lung carcinoma. Case 1 involved a 68-year-old male with metastatic non-small cell lung adenocarcinoma who developed intracranial lesions; resection revealed metastatic adenocarcinoma intermingled with clonal plasma cells. Case 2 was a 73-year-old woman with a lytic iliac crest lesion whose bone marrow and lesion biopsies showed diffuse infiltration by both carcinoma and atypical plasma cells. Comprehensive immunohistochemical profiling, …

“Do Everything” Versus Realistic Surgical Interventions: Navigating The Road To Shared Decision-Making In Trauma Surgery, Victoria E Wagner, Ashna S Karpe, Martin L Blakely, Lillian S Kao, Thaddeus J Puzio

Faculty, Staff and Student Publications

"DO EVERYTHING!!" How many times have you heard that phrase from a distressed family member? We routinely receive this desperate plea, and our knee-jerk reaction is to press on, push harder, be more aggressive. We, as acute care surgeons, have spent our lives learning a craft geared towards "doing everything" to heal patients so this response comes naturally. However, how do we respond to "do everything" when the probability of a meaningful recovery is extremely low or non-existent? These situations create moral tension for surgeons who must reconcile the desire to preserve life with the obligation to avoid harm, respect …

Unraveling The Significance Of Fecal Microrna Profile In Alzheimer’S Disease, Kavisha Katuwawala, Prashant Bharadwaj, Ian Martins, B. G.D.N.K. De Silva, Vincent Ho, Asiri Dissanayake, Ralph N. Martins, W. M.A.D.Binosha Fernando

Research outputs 2022 to 2026

Alzheimer’s disease (AD), a complex neurodegenerative disorder characterised by progressive cognitive decline, affects millions globally. With no current cure, treatment focuses on symptom management and slowing disease progression. Early identification is therefore crucial. Fecal microRNA (miRNA) analysis is emerging as a promising non-invasive diagnostic tool. Evidence suggests that miRNAs present in fecal samples may regulate gene expression linked to AD pathology, impacting cellular functions and disease progression. Dietary factors critically influence gut microbiota composition and diversity, affecting brain health via the gut brain axis. Macronutrients such as carbohydrates, proteins, and fats modulate miRNA expression and gut microbiota, influencing AD risk. …

Prevalence Of Dementia In Selected Middle East And North Africa (Mena) Countries: A Systematic Review And Meta-Analysis, Mohsen Sedighi, Mohammad Hasan Shahabi, Alireza Amanollahi, Khurshid Alam, Soudabeh Shemehsavar, Zahra Shirzadi, Serena Sabatini, Ahmad R. Khatoonabadi, Matthew Prina, Akram A. Hosseini, Claire V. Burley, Jennifer Dunne, Simin Mahinrad, Iman Dajani, Ralph N. Martins, Blossom C.M. Stephan, Ali Chaari, Hamid R. Sohrabi

Research outputs 2022 to 2026

Data on dementia epidemiology in the Middle East and North Africa (MENA) region is limited. This systematic review and meta-analysis examined dementia prevalence across MENA. Databases were searched up to October 2024. Analyses were stratified by country and sex. Pooled prevalence was estimated using a random-effects model with a 95% confidence interval (CI). Fifty-two studies on the selected countries met inclusion criteria, covering 87,219 individuals with dementia from a total population of 1,045,908. The pooled prevalence was 12.16% (95% CI: 9.61–14.96) for the region and the Israel had the highest prevalence (17.00%), followed by Iran (13.20%), Turkey (11.40%), Saudi Arabia …

Pain In People With Dementia Is A Significant Contributor To Increased Professional Caregiver Burden: Results Of An Observation Study, Kreshnik Hoti, Ipsit Vahia, Paola Chivers, Jeffery Hughes

Research outputs 2022 to 2026

Aim: To investigate the association between the presence of neuropsychological symptoms, professional caregiver burden and pain intensity.

Methods: Eleven neuropsychiatric symptoms reportedly associated with caregiver burden which are included within the PainChek® pain assessment tool were identified: aggressiveness, inappropriate behavior, distressed, verbally offensive, confusion, restlessness, pacing and wandering, crying, screaming, altered sleep and resisting care. A caregiver burden score based on binary scoring of the presence of these indicators was calculated (summative score range from 0 to 11). Generalized estimating equations were used to evaluate the relationships between (1) pain score and sum of caregiver indicators present and (2) pain …

Deep Reinforcement Learning–Driven Multi-Omics Integration For Constructing Gtage: A Novel Aging Clock From Igg N-Glycome And Blood Transcriptome, Yao Xia, Syed Mohammed Shamsul Islam, Xingang Li, Abdul Baten, Xuerui Tan, Wei Wang

Research outputs 2022 to 2026

Previous studies have demonstrated that the immunoglobulin G (IgG) N-glycome and transcriptome are potential biochemical signatures of chronological and biological ages, and several aging clocks have been developed. By integrating the IgG N-glycome and transcriptome, we propose a novel aging clock, gtAge. We developed a deep reinforcement learning-based multiomics integration method called AlphaSnake. The results showed that AlphaSnake achieved a predicted coefficient of determination (R²) value of 0.853, outperforming the concatenation-based integration method (R² = 0.820). The gtAge estimated by AlphaSnake explained up to 85.3% of the variance in chronological age, which was higher than that in …

Can Dna Be Glycosylated?, Wei Wang

Research outputs 2022 to 2026

No abstract provided.

The Treatment Of Obesity In The Context Of The Obesity Paradox In Patients With Heart Failure: A Narrative Review, Pamela L. Alebna, Sarah Martey, Anurag Mehta, Carl J. Lavie, Salvatore Carbone

EVMS School of Health Professions Faculty Publications

Purpose of review

While excess adiposity is a known risk factor for incident heart failure ( HF), once the condition is established, observational data suggest that increased body mass index (BMI) may confer a survival advantage. This paradox has emphasized the underlying roles of cardiorespiratory fitness (CRF), and body composition, particularly lean mass (LM), in influencing clinical outcomes.

Recent findings

In this review, we explore the multifaceted nature of the obesity paradox in HF, with a focus on emerging anti-obesity incretin-mimetic therapies, such as glucagon-like peptide-1 receptor agonists (GLP-1 RAs) and dual GLP-1/glucose-dependent insulinotropic polypeptide (GIP) receptor agonists. These agents …

Automation And Autonomy In The Ivf Laboratory: Concepts And Implications For Embryologists, Jacques Cohen, Gerardo Mendizabal-Ruiz, Giles Anthony Palmer, Giuseppe Silvestri, Mina Alikani

EVMS School of Health Professions Faculty Publications

Automation is regarded as the next phase in the evolution of laboratory IVF. Despite technological advances, most laboratory procedures remain operator-dependent, contributing to variability in performance and outcomes. While automation has improved reproducibility and efficiency in many areas of medicine, its adoption in IVF has been slow. This review examines how automation may be integrated into IVF laboratories through a set of conceptual distinctions. Automation refers to the execution of procedural steps by machine-controlled systems, whereas autonomy describes the degree to which such systems can operate without human intervention. This review distinguishes between static automation, which maintains or monitors the …

Yk-4-250, A Synthetic Telmisartan-Tempol Conjugate: Crystal Structure Of A Stabilized Free Radical Containing An Angiotensin At₁ Receptor Inhibitor, Simon Friedrich, Yali Kong, Faik N. Musayev, Milton L. Brown, B. Frank Gupton

Department of Biomedical and Translational Sciences Faculty Publications

We report the first crystal structure of the telmisartan-tempol conjugate 2,2,6,6-tetramethyl-1-(λ'-oxidaneyl)piperidin-4-yl 4'-[(1,7'-dimethyl-2'-propyl-1H,3'H-[2,5'-bibenzo[d]imidazol]-3'-yl)methyl]-[1,1'-biphenyl]-2-carboxylate free radical (YK-4-250, C₄₂H₄₆N₅O₃), a dual-function inhibitor designed to target both the angiotensin II type 1 receptor (AT₁R) and reactive oxygen species (ROS). Structural analysis reveals a unique crystal architecture in which the nitroxide radical is stabilized within a sterically protected environment while preserving the telmisartan pharmacophore essential for high-affinity receptor antagonism. YK-4-250 is a novel small-molecule conjugate of telmisartan and tempol that incorporates a catalytic stabilized nitroxide radical and was rationally designed to mitigate gastrointestinal acute radiation syndrome (GI-ARS).

Ornithine Metabolism In Retinal Pigment Epithelium And Retina And Implications In Gyrate Atrophy, Artjola Puja

Graduate Theses, Dissertations, and Problem Reports (ETD)

Ornithine aminotransferase (OAT) is a mitochondrial enzyme that regulates ornithine metabolism by converting ornithine to pyrroline-5-carboxylate, a precursor for proline and glutamate synthesis. Deficiency of OAT causes systemic ornithine accumulation and leads to gyrate atrophy (GA) of the choroid and retina, a hereditary disorder characterized by progressive chorioretinal degeneration and irreversible vision loss. Chorioretinal atrophy typically starts at the mid-peripheral retina and progresses toward the macula. Although elevated ornithine is considered toxic to the eye, how ornithine is metabolized in ocular tissues and why OAT deficiency causes selective, region-specific vulnerability remain unclear. We combined ex vivo and in vivo stable …

Antiestrogens As Bone Protective Therapeutics For Estrogen Receptor-Positive Breast Cancer In The Presence Of Osteoporosis, Faith E. Parker, Emily K. Zboril, David C. Boyd, Rachel Myrick, J. Chuck Harrell

UROP Posters

Breast cancer (BC) is one of the most significant causes of mortality among women and the second leading cause of cancer death in women. The estrogen receptor (ER) is a key oncogenic driver in the majority of breast cancer. ER+ BC is the most common molecular subtype of BC. Management of ER+ breast cancer varies depending on menopausal status. For premenopausal women, the goal is to suppress estradiol production from the ovaries with surgical oophorectomy and/or aromatase inhibitors. In postmenopausal women, endocrine therapy (ET) serves to suppress estradiol production from sources other than the ovaries. During the menopausal transition, estradiol …

Increasing Documentation Of Endotracheal Tube Cuff Pressures: A Quality Improvement Initiative For Flight Crew Providers, Matthew D. Noss

Graduate Theses, Dissertations, and Problem Reports (ETD)

ABSTRACT

Background: There was a lack of documentation of endotracheal tube (ETT) cuff pressures (CPs) by flight crew providers at Base 1 of HealthNet Aeromedical Services. A three-month pre-intervention data collection showed 1.8% of patients had initial CPs documented. Inadequate documentation and monitoring of ETT CPs can lead to patient complications such as tracheal injury and aspiration making this an important area for quality improvement.

Purpose: To increase documentation of ETT CPs through education and evidence-based interventions.

Intervention: This project implemented an educational in-service on ETT cuff syringe manometry for flight crew providers. The educational intervention consisted of …

Integrating Genetic Modifier Genotype With Serum Proteomics In Duchenne Muscular Dystrophy Clinical Trials Links Ltbp4 Genetic Modifier To Il-23/Cd93 Pathways In Muscle, Utkarsh J. Dang, Yuan Fang, Daniele Sabbatini, Elena Pegoraro, Luca Bello, Paula R. Clemens, Michela Guglieri, John Van Den Anker, Jesse Damsker, Laura Hagerty, Yetrib Hathout, Michael Ziemba, Lauren Morgenroth, Surajit Bhattacharya, Kanneboyina Nagaraju, Jyoti K. Jaiswal, Eric P. Hoffman

Mathematics & Statistics Faculty Publications

Genetic modifiers of Duchenne muscular dystrophy (DMD) that alter disease severity or response to therapy have been reported using natural history or registry data sets of older corticosteroid-treated patients. We tested associations of genetic modifiers on motor function outcomes in young (4 to <  7 years) steroid naïve clinical trial participants. Participants in clinical trials (VBP15-002/003 [n = 48]; VBP15-004 [n = 121]; DNA available for n = 110) were genotyped for eight published genetic modifier loci, and associations of genotypes with baseline motor function defined via an age-adjusted linear model. Corticosteroid drug response was modeled by genotype-stratified placebo vs. steroid treatment at 12- and 24-weeks posttreatment (mixed model for repeated measures). …

Stim1-Dependent Treg Dysfunction Promotes Cardiometabolic Hfpef: Insights From Patients And Animal Studies, Balaji Srinivas, Alluri Kiran, Hongmei Peng, Jiang Xu, Paula Fortuno, Jennifer May, Ismail El Moudden, Nour-Eddine Rhaleb, John M. Herre, Raymond L. Benza, Khalid Matrougui

Department of Biomedical and Translational Sciences Faculty Publications

Background

Heart failure with preserved ejection fraction (HFpEF) arises from chronic cardiometabolic and vascular stress and is increasingly recognized as an inflammatory syndrome with immune dysregulation. Regulatory T cells (Tregs) are critical modulators of cardiovascular inflammation, yet the mechanisms driving Treg dysfunction in HFpEF remain poorly defined. stromal interaction molecule 1 (STIM1)-dependent calcium signaling is a key stress-responsive pathway in immune cells; however, its role in Treg maladaptation during HFpEF remains unknown.

Methods

Circulating Tregs from patients with and without HFpEF were analyzed for abundance, STIM1 expression, and stress-associated signaling pathways. To establish causality, mice with Treg-specific deletion of STIM1 …

Gaze Transition Entropy And Automation Trust In Multitasking Workspace, Yusuke Yamani, Austin Jackson, Tetsuya Sato, Feyishola Ashimi, Michael S. Politowicz, Eric T. Chancey, Makoto Itoh

Psychology Faculty Publications

Safe flight operation requires visual scanning across multiple displays in a cockpit, which collectively represent the state of the aircraft and supporting automation. Trust is a crucial factor that drives human-automation interaction, and recent work has suggested a relationship between an operator's visual attention and automation trust. One index that captures predictability of eye movements between different areas of interest is gaze transition entropy. The current work reanalyzed data from Sato et al., which examined eye movement patterns and trust in automation associated with the system monitoring task of the Multi-Attribute Task Battery. Results showed credible positive correlations between the …

Longitudinal Changes In Plasma Biomarkers Of Immune Activation, Neuronal Inflammation And Injury In Persons With Hiv Initiating Art, Merle Henderson, Peter Dutey-Magni, Carolina Herrera, Wolfgang Stöhr, Alejandro Arenas-Pinto, Owen Swann, Amanda Heslegrave, Henrik Zetterberg, John Tregoning, Sarah Fidler, François Raffi, Andrea Calcagno, Ab Babiker, Alan Winston

CONRAD Publications

Background

Data on changes in biomarkers of brain health, and their associations with cognitive function in adults commencing either dual- or triple-antiretroviral therapy (ART) are sparse.

Methods

Plasma biomarkers (neurofilament light [NfL], glial fibrillary acidic protein [GFAP], sCD14, CXCL10, neopterin and IL-6) were measured at baseline and after 96 weeks on ART in individuals randomized to darunavir/ritonavir and either tenofovir-DF/emtricitabine (triple-ART, n = 119) or raltegravir (dual-ART, n = 119) in NEAT-001/ANRS143. Regression models examined associations of baseline and week-96 biomarker concentrations with HIV clinical parameters, composite cognitive test scores (Standardized neuropsychological test [NPZ], 7-domains) and treatment arm.

Results

In …

Formulation Development Of Topical Inserts Containing Doxycycline And Doxycycline Combined With Tenofovir Alafenamide And Elvitegravir For The Prevention Of Sexually Transmitted Infections, Vivek Agrahari, M. Melissa Peet, Jasmin Monpara, Rijo John, Sriramakamal Jonnalagadda, Pardeep K. Gupta, Meredith R. Clark, Gustavo F. Doncel

CONRAD Publications

Despite advances in oral and injectable HIV prevention options and oral prophylaxis for sexually transmitted infections (STIs) of bacterial origin, there remains a critical need for effective on-demand topical (vaginal and rectal) products for pre- and post-exposure prophylaxis (PrEP and PEP). To fill this gap, we have developed single and first-in-kind multi-active topical inserts for bacterial STIs and HIV/STIs prevention. We have formulated two different inserts, one containing doxycycline (DOX) at 10, 50, and 100 mg doses for bacterial STI prevention, and a multipurpose prevention product (TED insert) that combines DOX (10 mg) with the antiretrovirals tenofovir alafenamide (TAF; 20 …

Micrornas Regulated By Pregnancy Target Antiviral And Cancer Immunity Overlapping With The Hiv Interactome, Paula F. T. Cezar-De-Mello, Jonathan M. Dreyfuss, Pai-Lien Chen, Hidemi Yamamoto, Xiaoming Gao, Hui Pan, Charles Morrison, Gustavo F. Doncel, Robert L. Barbieri, Raina N. Fichorova

CONRAD Publications

Innate immunity predictors of HIV-1 risk and pathogenesis vary with reproductive hormones, pregnancy, and lactation, yet the underlying mechanisms remain unclear. We hypothesized that pregnancy-associated physiological adaptations alter systemic microRNA (miRNA) expression, thereby regulating immunity, pathogenesis and susceptibility to infection. We analyzed 174 serum samples from 88 participants in a longitudinal cohort from Uganda and Zimbabwe across pre-pregnancy (PP), pregnancy (P), and postpartum breastfeeding (BF). Cell-free peripheral blood miRNAs (n = 2083) were profiled using HTG EdgeSeq. Pregnancy-specific miRNAs were identified by intersecting differentially expressed (DE) miRNAs from P vs. PP and P vs. BF comparisons. miRNA targets and pathways …

The Associations Between Sleep Environment Factors And Sleep Health In Individuals Living With Neurological Conditions, Mitchell Turner, Laws, Madeline Griffiths, Travis Cruickshank

Research outputs 2022 to 2026

Objectives: To explore associations between air temperature and light in the sleeping environment and sleep health in individuals with neurological conditions. Methods: The sleep health of 46 individuals with neurological conditions (mean age 51.37 ± 14.24 years; 20 males, 26 females) was measured using the Sleep Health Index (SHI). Air temperature and light data were captured across seven days using a light/temperature data logger positioned next to the participant’s bed. Data recorded during the participants’ sleeping periods (determined using a sleep diary) were analyzed. Linear regression models were used to assess the associations between air temperature and light and sleep …

Beta-Band Modulation Reveals The Cortical Dynamics Of Auditory Statistical Learning In Children, Jarrad A.G Lum, Christine N. Moreau, Li Ann Leow, Welber Marinovic, Sarah J. Lum, Marc F. Joanisse, Laura J. Batterink

Research outputs 2022 to 2026

Children's ability to extract statistical regularities from speech is considered fundamental to lexical, syntactic, and grammatical development. However, the neural oscillatory mechanisms supporting this process in childhood remains poorly understood. While beta-band oscillations have been linked to statistical learning in visual and motor domains, it is unclear whether similar dynamics support auditory statistical learning in children. In this study, we recorded electroencephalography (EEG) from children aged 8–12 years as they listened to a continuous stream of trisyllabic nonwords (e.g., dapiku), where syllable order within each nonword was fixed (high predictability), but transitions between nonwords were variable (low predictability). Beta power …

Exploring The Mechanisms Of Tanshinone Iia In The Treatment Of Intracranial Aneurysm Based On Network Pharmacology And Machine Learning, Wanqi Wang, Lois Balmer, Shaotao Weng

Research outputs 2022 to 2026

Background Intracranial aneurysm (IA) is a cerebrovascular disease with high mortality and limited treatment options. Tanshinone IIA (Tan IIA), a bioactive compound from Salvia miltiorrhiza , has shown vascular protective effects, but its mechanism in the treatment of IA remains unclear. Methods The GSE75436 dataset was used to identify differentially expressed genes (DEGs). Weighted gene co-expression network analysis (WGCNA) was performed to identify disease-related modules. IA targets were obtained from GeneCards and the Comparative Toxicogenomics Database (CTD). Potential targets of Tan IIA were predicted using TCMSP, SwissTargetPrediction, and SymMap. KEGG enrichment analysis was conducted for DEGs, WGCNA modules, disease-related genes, …

Fgf19 As A Colorectal Cancer Serum Biomarker And Fgfr4 As A Mediator Of Anti-Her2 Resistance In Breast Cancer, Jordan Beardsley

Graduate Studies Theses and Dissertations 2026

The fibroblast growth factor 19 (FGF19)-fibroblast growth factor receptor 4 (FGFR4) signaling pathway regulates hepatic metabolism, bile acid (BA) synthesis, and hepatocyte proliferation. This signaling axis also is implicated in promoting tumor progression, therapeutic resistance, and metastasis in certain cancers.

In colorectal cancer (CRC) there is a critical need for non-invasive biomarkers for disease detection and monitoring. We identified FGF19 as a candidate CRC serum marker through meta-transcriptomics and found FGF19 to be expressed and secreted by CRC cell lines. Tumor-derived FGF19 was detectable in mouse serum at levels correlating with tumor volume in a subcutaneous xenograft model. RNA sequencing …

Pioglitazone Uncouples Macrophage Inflammatory Signaling From Epithelial Oxidative Stress During Map Infection Mimicking Crohn’S Disease Treatment, Sabera Akter Bushra

Graduate Studies Theses and Dissertations 2026

Crohn’s disease (CD) is a chronic inflammatory bowel disease characterized by intestinal inflammation, epithelial barrier dysfunction, and abnormal immune signaling. CD pathophysiology is increasingly linked to Mycobacterium avium subspecies paratuberculosis (MAP) infection, which increases chronic macrophage activation and the production of inflammatory mediators that lead to epithelial damage. Among these mediators, CXCL10, TNF-α, and IL-6 contribute in inflammation, while NOX-1 and SERPINE-1 indicate epithelial oxidative stress and damage. Despite the role of macrophage-epithelial interaction in CD, selective pharmaceutical regulation of this axis remains unclear. Pioglitazone, an FDA-approved PPARγ agonist used for type 2 diabetes, is an appealing repurposing candidate, given …

Pilot Study On The Use Of Multimorbidity Index In Patients Receiving Home Parenteral Nutrition, Michael M. Rothkopf, Mohan Pant, Zachary Rothkopf, Rebecca Brown Rdn, Jaime Haselhorst Rdn, Debbie L. Stevenson Rdn, Andrew Depalma Mba, Michael Saracco

Epidemiology, Biostatistics, & Environmental Health Faculty Publications

Background

Home parenteral nutrition (HPN) patients often have multiple comorbidities. A validated multimorbidity index (MMI) could help determine resource needs and risks with HPN. We evaluated MMI scoring to determine if it predicted HPN resource use and outcomes.

Methods

We performed a secondary analysis of 60 HPN patients from a previous study based on Cumulative Illness Rating Scale (CIRS) scoring. We examined three variables: PN formula changes, hospitalizations, and hospital length of stay (LOS). Density plots were produced to select a CIRS score cutoff value. Spearman correlations among the three variables of interest were computed. The data were then subjected …

Vitamin D Status During Pregnancy Modulates The Effect Of Pre-Pregnancy Obesity On Gestational Diabetes Mellitus Risk: A Birth Cohort Study, Ali H. Ziyab, Abdullah Al-Taiar, Reem Al-Sabah, Majeda S. Hammoud, Saeed Akhtar

Epidemiology, Biostatistics, & Environmental Health Faculty Publications

Objective:

To determine whether gestational vitamin D status modulates the effect of pre-pregnancy obesity on gestational diabetes mellitus (GDM) risk while stratifying by maternal age.

Design:

Birth cohort.

Setting:

A major maternity hospital in Kuwait.

Participants:

Pregnant women in their second/third trimester of gestation were enrolled. Pre-pregnancy body mass index (BMI, kg/m²) was categorized as under/normal weight (< 25.0), overweight (25.0 to < 30.0), and obesity (≥30.0). Gestational 25-hydroxyvitamin D concentrations were categorized as deficiency (< 50 nmol/L) or insufficiency/sufficiency (≥50 nmol/L). GDM status was ascertained according to international guidelines. Adjusted odds ratios (aOR) and 95% confidence intervals (CI) were estimated using logistic regression.

Results:

Data from 957 pregnant women were analyzed, with GDM affecting 166 (17.4%) pregnancies. Pre-pregnancy obesity and gestational vitamin D deficiency was ascertained in 275 (28.7%) and 533 (55.7%) pregnant women, respectively. The association between pre-pregnancy obesity and GDM risk differed according …

Deer Antler Tip Cell Culture Supernatant Restores Endothelial Barrier Function And Angiotensin Converting Enzyme 2/Endothelial Nitric Oxide Synthase Nitric Oxide Signaling Impaired By Porphyromonas Gingivalis Lipopolysaccharide, Ming-Shou Hsieh, Ya-Ting Yang, Chin-Sheng Huang, Ting-Yi Renn, Chuen-Kai Wang, Chia-Chen Hsu, Wei Jen Chang, Yu-Sheng Chang

Journal of Dental Sciences

Background/purpose:

Periodontal inflammation contributes to endothelial dysfunction, but effective biologically active strategies for vascular protection remain limited. This study investigated whether deer antler tip cell culture supernatant could rescue Porphyromonas gingivalis lipopolysaccharide (Pg-LPS) induced endothelial injury and restore endothelial homeostasis.

Materials and methods:

Velvet antler tissues from the tip, shaft, and burr regions were examined histologically and used for primary cell isolation. Human umbilical vein endothelial cells were exposed to Pg-LPS or indirectly co-cultured with LPS-stimulated THP-1-derived macrophages. Deer antler tip cell culture supernatant was subsequently applied to these endothelial inflammatory models, and its protective effects were …