Digital Commons Network^™

Improving A1c Levels Through An Individualized Diabetes Education Among Patients Living With Type 2 Diabetes, David W. Cardona Jr.

Doctor of Nursing Practice Final Manuscripts

Type 2 diabetes mellitus (T2DM) represents an increasing global health, social, and financial burdens. Nutrition, among other diabetes self-management topics, is a foundational aspect in managing T2DM. Significant knowledge gaps persist among patients regarding the impact of mindful eating habits in relation to euglycemia. Individualized diabetes education focused on healthy eating habits offers a promising strategy to address this gap. The quality improvement (QI) project aimed to evaluate the impact of diabetes education, focused on nutritional awareness, and mindful eating habits on hemoglobin (A1c) levels, weight, and diabetes self-management questionnaire scores (DSMQ-R) were assessed among adults living with T2DM. The …

The Impact Of Translated Phq-9 And Gad-7 Scales On Treatment Recommendations In An Adult Vietnamese Population: A 3-Month Primary Care Evaluation, Vivienne Bui

Doctor of Nursing Practice Final Manuscripts

Depression and anxiety are prevalent yet underdiagnosed in limited-English-proficient (LEP) populations due to language barriers, cultural stigma, and provider bias. Vietnamese-speaking patients are particularly vulnerable to under-recognition in primary care. This quality improvement project evaluated whether implementing Vietnamese-translated Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7) tools would improve mental health diagnosis and referral rates. Guided by the Johns Hopkins Evidence-Based Practice Model, a pre–post design was conducted at a San Diego clinic from March 26 to June 26, 2025. Vietnamese-speaking adults (≥18 years) completed translated PHQ-9 and GAD-7 forms during intake. Providers used scores in conjunction with clinical …

Bridging The Vaccine Gap: Multilingual Vaccine Education For Families In Transitional Housing, Isaac Olaes, Alexia Sandoval, Kassandra Solano, Rachael Termure, Sydney Webber, Jordan West, Maya Parman

Nursing Leadership in Community Engagement Projects

As part of a health promotion initiative in the community, our leadership team of seven nursing students is partnering with an agency that supports families experiencing housing instability by providing transitional housing. According to agency staff, some families have limited health literacy regarding vaccinations. Common concerns include illness following a vaccination, perceived risks of autism, and attention deficit hyperactivity disorder. To address these concerns, we have developed a vaccine education binder containing materials in handout form. To accommodate language accessibility, we provided handouts in the four most spoken languages including English, French, Amharic, and Tigrinya. Through this initiative, we aim …

Barriers To Physical Activity Among Community College Students, Erica Keels

Doctoral Dissertations and Projects

The purpose of this qualitative study was to explore the perceived barriers, motivators, and student-identified strategies related to physical activity among students enrolled at a community college located in Northwest Florida. Guided by the Social Ecological Model (SEM), Self-Determination Theory (SDT), Health Belief Model (HBM), and Theory of Planned Behavior (TPB), this study employed a qualitative descriptive design to examine students’ lived experiences and perceptions that influence their physical activity behaviors. Data were collected through an online open-ended survey administered to students aged 18 years and older. A total of 134 students initially accessed the survey, and 126 eligible participants …

Pr Interval Alternans And The Mystery Of Inverse Decremental Conduction, Alyssa Zakala, Mohammed Hussein Kamareddine, Farah Olleik, Ali Keramati, Gan-Xin Yan

Department of Medicine Faculty Papers

CASE SUMMARY: A 73-year-old man with severe aortic stenosis and preexisting right bundle branch block (RBBB) underwent transcatheter aortic valve replacement. Postprocedural day 4 mobile cardiac outpatient telemetry revealed intermittent atrioventricular block. A 12-lead electrocardiogram obtained in the emergency department revealed PR interval alternans with RBBB, with longer PR following longer preceding RP intervals, and shorter PR following shorter RP intervals. He suddenly experienced cardiac arrest due to proximal atrioventricular block, requiring cardiopulmonary resuscitation.

TAKE-HOME MESSAGES: Inverse decremental conduction, known as Yan conduction, demonstrates an inverse relationship between conduction time and frequency of upstream stimulation. Inverse decremental conduction within the …

When Qtc Shrinks After Rhythm Conversion, Mohammed Hussein Kamareddine, Alyssa Zakala, Farid Farkouh, Ibrahim Alameh, Gan-Xin Yan

Department of Medicine Faculty Papers

CASE SUMMARY: An 83-year-old man with a history of atrial fibrillation on amiodarone therapy was admitted for direct-current cardioversion because of recurrent atrial fibrillation with a ventricular rate of approximately 105 beats per minute. Cardioversion successfully restored sinus rhythm. Postcardioversion 12-lead electrocardiography revealed an unexpectedly short QTc of 344 ms despite chronic treatment with a QT-prolonging agent. This finding was attributed to QT hysteresis, reflecting delayed adaptation of ventricular repolarization to the abrupt reduction in heart rate after rhythm conversion.

TAKE-HOME MESSAGE: QT hysteresis can result in transient QTc shortening and has important implications for interpretation of QT intervals during …

Objective Oculomotor, Vestibular, Reaction Time, And Cognitive Signatures Of Vestibular Migraine, Claire E. J. Ceriani, Alexandr Braverman, Alexander Kiderman

Department of Neurology Faculty Papers

OBJECTIVE: To evaluate oculomotor, vestibular, reaction time, and cognitive (OVRT-C) function in patients with vestibular migraine (VM) using objective eye-tracking-based metrics and to identify patterns of dysfunction relative to healthy controls.

BACKGROUND: Vestibular migraine is a common yet underdiagnosed cause of vertigo. Diagnosis remains primarily clinical, because objective neurologic and vestibular findings are often absent or inconsistent. Quantitative methods capable of capturing the multisystem manifestations of VM may improve objective characterization of the disorder.

METHODS: Participants with a clinical diagnosis of vestibular migraine were recruited from a tertiary headache center and assessed using a battery of OVRT-C tests administered with …

Mitochondrial Ca2+ Uniporter (Mcu) Variants Form Plasma-Membrane Channels, Iuliia Polina, Jyotsna Mishra, Michael Cypress, Maria Landherr, Nedyalka Valkov, Isabel Chaput, Bridget Nieto, Brian Rhee, Ameneh Ahrari, Nathan Demichaelis, Kye-Im Jeon, Ulrike Mende, Peng Zhang, Bong Sook Jhun, Jin O-Uchi

Center for Translational Medicine Faculty Papers

MCU, originally known as CCDC109A, is widely recognized as the gene responsible for encoding a pore-forming subunit of a Ca2+-selective channel, mitochondrial Ca2+ uniporter complex (mtCUC). While MCU expression is typically highly mitochondrial-specific, we report here a protein variant derived from the MCU gene, termed MCU-S, which lacks the mitochondria-targeting sequence (MTS) and forms a Ca2+-permeable channel outside of mitochondria. The mRNA of MCU-S was ubiquitously expressed in all cell types/tissues tested, with particularly high expression in human platelets. MCU-S protein formed Ca2+ channels at the plasma membrane, which exhibited similar channel properties to those observed in mtCUC. MCU-S channels …

A Review Of Robotic Vnotes Surgery: Current Applications, Advantages, And Future Directions, Daniel Y Lovell, Qiannan Yang, Xiaoming Guan

Faculty, Staff and Students Publications

Over the past 500 years, the convergence of three distinct paths - vaginal surgery, laparoscopy, and robotic technologies - has enabled the development of robot-assisted vaginal natural orifice transluminal endoscopic surgery (RA-vNOTES). The ongoing evolution of vaginal surgery has led to contemporary procedures such as hysterectomy, myomectomy, sacrocolpopexy, adnexal interventions, and oncologic operations, applicable to a wide range of diagnoses and pathologies. This approach offers patients significant benefits, including superior cosmetic outcomes, less pain, lower infection rates, and faster recovery of baseline quality of life. Surgeons benefit from improved ergonomics, better visualization, the ability to use multiple instruments, and enhanced …

Symmetrical Drug-Related Intertriginous And Flexural Exanthema Associated With Tirzepatide, William Goodman, Karan Pandher, Mahaa Ayub

Department of Dermatology and Cutaneous Biology Faculty Papers

No abstract provided.

Determinants Of Pre-Exposure Prophylaxis Medication Use Among People Aged 18–29 Years Living In Florida, Jeremiah Magraubin Mchaka Wandabwa

Walden Dissertations and Doctoral Studies

No abstract provided.

Movement-Stabilized Three-Dimensional Optical Recordings Of Membrane Potential Changes And Calcium Dynamics In Hippocampal Ca1 Dendrites, Kevin C Gonzalez, Satoshi Terada, Asako Noguchi, George N Zakka, Cliodhna O'Toole, Giuliana Bilbao, Luke Reynolds, Anna Jász, Borbála Kertész, Zoltán Szadai, Alissa Shen, François St-Pierre, Franck Polleux, Attila Losonczy, Balázs Rózsa

Faculty, Staff and Students Publications

Local dendritic computations are thought to critically influence neuronal signaling and plasticity yet remain largely unexplored in vivo due to challenges in stably imaging small structures at ultrafast timescales. We developed a 3D real-time motion correction platform for movement-stabilized, ultrafast two-photon voltage imaging. By co-labeling CA1 pyramidal neurons with voltage and calcium indicators, we simultaneously measured somato-dendritic and electro-calcium coupling at multiple dendritic sites. We characterized isolated dendritic spikes and distance-dependent backpropagation of naturally occurring and photostimulation-evoked bursts and single spikes. We found that bursts backpropagated more reliably than single spikes, validated that somato-dendritic coupling decreases with distance from soma, …

Repurposing Semaglutide As An Adjunctive Treatment For Cocaine Use Disorder: Protocol For A Randomised Controlled Trial, Luba Yammine, Francesco Versace, Charles E Green, Heather E Webber, Jin Ho Yoon, Absalon D Gutierrez, Samuel J Leonard, Michael F Weaver, Joy Schmitz

Faculty, Staff and Student Publications

Introduction: Cocaine use disorder (CUD) is a significant public health concern in the USA, with considerable prevalence and mortality and no Food and Drug Administration (FDA)-approved pharmacotherapies. Recent advances in addiction science emphasise the need for novel, mechanism-based treatments. Glucagon-like peptide-1 receptor agonists, such as semaglutide, have shown promise in modulating reward-related behaviours and may offer therapeutic benefits for CUD. We present a study protocol evaluating semaglutide, as an adjunct to cognitive behavioural therapy (CBT), as a novel approach for treating CUD.

Methods and analysis: This is a randomised, double-blind, placebo-controlled trial enrolling 75 treatment-seeking adults with CUD. Participants will …

Brain-Wide Structural Markers Of Familial And Clinical Risk For Bipolar Disorder In Youth, Danella M Hafeman, Jamie Feldman, John Merranko, Mary L Phillips, Boris Birmaher, Si Gao, Yizhou Ma, Peter Kochunov

Faculty, Staff and Student Publications

Background: Bipolar Disorder (BD) is a severe mental illness, often emerging during adolescence, that is associated with significant psychosocial impairment. BD risk is elevated in offspring of affected parents, particularly those with antecedent symptoms (e.g., mood lability, subthreshold manic symptoms). However, robust, replicable brain-based markers of risk in this population are lacking. We assessed the degree to which the Regional Vulnerability Index for BD (RVI-BD), quantified as an individual's brain-wide similarity to BD patterns derived from meta-analytic studies, is elevated in youth at familial risk and correlates with symptom predictors of BD.

Methods: We recruited n=82 adolescents (10-15 years old), …

Exploring The Impact Of Cultural Beliefs On Death Anxiety: A Qualitative Study To Inform Healthcare Education And Practices, Sharon Sonnilal

Doctoral Dissertations and Projects

A hermeneutic phenomenological approach framed this qualitative study, examining how cultural beliefs, spiritual traditions, and relational contexts shape death anxiety and meaning-making among adults from diverse backgrounds. Terror Management Theory and Culturally Sensitive Grief Treatment guided the conceptualization of death anxiety as a culturally mediated and relational phenomenon rather than an isolated psychological response. A purposive sample of 13 adults aged 18 and older represented diverse cultural, racial, gender, and spiritual identities. Recruitment occurred via Instagram, and participants completed an open-ended demographic and narrative survey. Participants who provided rich survey narratives received invitations to complete semi-structured Zoom interviews to deepen …

Exceptional Response Of Radiotherapy-Naïve Cranial Meningiomas To Dual Immune Checkpoint Blockade In Bap1 Tumor Predisposition Syndrome, Gary Gallia, Christine Hann, Calixto-Hope Lucas, Licia Pacheco Luna, David Kamson, Takami Sato

Department of Medical Oncology Faculty Papers

Meningiomas are the most common primary central nervous system tumors, and while most are benign, atypical and anaplastic variants frequently recur and have limited effective treatment options. Recent trials of PD-1 blockade in unselected meningioma cohorts have demonstrated modest activity, with low objective response rates. These findings highlight the need to identify molecular biomarkers that may predict immunotherapy sensitivity in this disease. BRCA1-associated protein 1 (BAP1) is a tumor suppressor critical for chromatin regulation and DNA repair, and germline pathogenic variants cause BAP1 tumor predisposition syndrome (BAP1-TPDS), a hereditary cancer syndrome characterized by uveal melanoma, mesothelioma, renal cell carcinoma, meningioma, …

Phkg2 Confers Resistance Of Escc To Cisplatin And Enhances Cxcl8-Dependent Immunosuppression To Exacerbate Tumorigenesis, Jiayan Wu, Chengrui Zhong, Haosheng Zheng, Fei Qin, Xianyu Qin, Yuzhen Zheng, Junguo Chen, Gengfeng Wang, Bozhu Jian, Zui Liu, Xingping Yang, Chao Cheng, Guolin Li, Hongying Liao

Faculty, Staff and Students Publications

Cisplatin (DDP)-based chemotherapy serves as a foundational cornerstone in the clinical management of esophageal squamous cell carcinoma (ESCC). However, intrinsic or acquired resistance to DDP persists as a significant clinical challenge, severely undermining therapeutic efficacy and contributing to unfavorable patient prognoses. Through functional screening with a CRISPR/Cas9 knockout library, transcriptomic profiling of cisplatin-resistant cell lines and clinical specimens, and in vitro/in vivo validation assays, we identified PHKG2 as a key mediator of cisplatin resistance in ESCC. Mechanistically, PHKG2-mediated cisplatin resistance is driven by the phosphorylation of IGF2BP3 at residues T225 and T306. This post-translational modification enhances IGF2BP3 phase separation, thereby …

Exploring The Role Of Self-Efficacy In Undergraduate Nursing Students: A Transcendental Phenomenological Study, Dorothy Elaine Rolling

Doctoral Dissertations and Projects

The purpose of this phenomenological study was to explore the role of self-efficacy for nursing students whose primary language was not English and who were enrolled in higher education in the northeastern area of the United States. The theory guiding this study was Bandura’s theory on self-efficacy. The major tenets of the self-efficacy theory aligned with the metaparadigm of nursing (person, health, environment, nursing) and with the study’s focus, which was to explore how English as a second language (ESL) nursing students could successfully complete the registered nursing program at an institution of higher learning. The central research question was: …

Beyond Crisis: Patient Access And Sustainability, Miguel A. Mendoza

Doctoral Dissertations and Projects

Critical systems underwent drastic workflow adaptations during the COVID-19 pandemic. Many of these operational alterations persist today, while others have been reduced or eliminated. This is a qualitative study on the operational, technological, and human-centered challenges experienced by healthcare organizations providing primary care services in Southwest Ohio during and immediately after the pandemic. This flexible research design implements in-depth, semi-structured interviews with healthcare professionals leading primary care operations to capture a longitudinal perspective on pandemic-era service delivery, and the legacy systems still in place today. Thematic analysis revealed seven themes that determine the effectiveness of care delivery models. Social Determinants …

Inadequate Access To Healthcare In Low-Income Hispanic Communities In Brooklyn, Joanna Marie Garcia

Doctoral Dissertations and Projects

The purpose of this qualitative research was to understand healthcare disparities using the Solar and Irwin conceptual framework and to shed light on healthcare disparities as the reason low-income Hispanic patients, male and female, from the ages of 20-90 in Brooklyn, New York, received inadequate access to healthcare. Healthcare disparities represented a critical issue in providing adequate patient care for adult Hispanic patients within the United States healthcare system. Research into healthcare disparities has been conducted; however, detailed information about the causes of the disparities was lacking, especially concerning inadequate access to healthcare in low-income Hispanic communities. This qualitative research …

Temporomandibular Joint Ganglion Cyst Causing Dynamic External Auditory Canal Obstruction And Position-Dependent Hearing Loss: A Case Report And Literature Review, Ali Akbar, Abdulrahman Meerza, Craig Pearl

Faculty, Staff and Student Publications

Purpose: Ganglion cysts of the temporomandibular joint (TMJ) are uncommon periarticular lesions and may be diagnostically challenging because symptoms are often nonspecific. When these lesions arise posterior to the joint, they can produce otologic complaints through dynamic narrowing of the external auditory canal (EAC). Herein, we report on a histologically confirmed TMJ ganglion cyst causing position-dependent hearing loss and review the relevant literature.

Case description: A 72-year-old woman presented with a 3-year history of bilateral preauricular pain, left-sided tinnitus, left aural fullness, and near-complete hearing loss in the left ear when the mandible was closed in occlusion. Clinical examination showed …

Polymorphic Ventricular Tachycardia, Sarcoidosis, And The Ultimate Unmasking Of A Pheochromocytoma, Anusha U. Saga, Elizabeth Clark, Isaac R. Whitman

Department of Medicine Faculty Papers

The pitfall of anchoring bias may contribute to diagnostic conundra. In this case, a patient with a history of systemic sarcoidosis presented to the electrophysiology clinic with palpitations. Rhythm monitoring revealed polymorphic ventricular tachycardia (PMVT). A diagnosis of cardiac sarcoidosis was presumed and pursued even though repeat cardiac imaging was negative. In the interim, the patient developed new hypertension, and the patient’s primary care provider screened the patient for pheochromocytoma. Despite the initial pursuit of a misdiagnosis in a patient with a high pretest probability for the wrong diagnosis, the pheochromocytoma was resected and the PMVT and hypertension was cured.

Cognitive Behavioral Therapy-Based Psychosocial Interventions To Reduce Anxiety After Social Isolation In Adolescent Females, Bailey E. Noble

InnovateHER Meeting 2026

• COVID-19 social isolation linked with higher anxiety risk in adolescents, especially females
• Review examined whether CBT-based psychosocial interventions reduce anxiety after pandemic-related loneliness/social isolation
• Across 6 studies, remote and internet-delivered CBT linked with anxiety improvement 
• Strongest outcomes seen with therapist-assisted CBT
• Common barriers: privacy, motivation, scheduling, and digital access
• Nursing relevance: early screening, referral, and support for treatment participation

Health-Seeking Behaviors Of Ethiopian Women In The United States: A Pilot Qualitative Study, Hanna Belay, Felicia Leammuda, Ahmed Ugbad, Beamlak Kebede

InnovateHER Meeting 2026

This study explores how Ethiopian immigrant women understand health and navigate healthcare in the United States. Using qualitative interviews with two participants, findings show that health is viewed holistically, with strong reliance on traditional remedies. Participants engage with the U.S. healthcare system selectively, often seeking care only when symptoms become severe. Barriers such as system complexity, fear, and time delays influence healthcare decisions.

Advancing Exclusive Breastfeeding Through Prenatal Education, Emr Optimization, And Community Partnership: A Champs National Quality Improvement Initiative, Heather Klein, Hannah Koepp

InnovateHER Meeting 2026

CHAMPS National is a CDC-funded quality improvement initiative focused on improving exclusive breastfeeding rates, strengthening maternity care practices, and reducing racial disparities. This project implemented culturally responsive prenatal education, optimized EMR workflows, and strengthened community partnerships to support informed infant feeding decisions and improve breastfeeding equity.

Headset To Reset: Virtual Reality Therapy In Postoperative Heart And Lung Transplant Patients, Michaela Sanchez

Doctoral Projects

Postoperative heart, lung, and heart-lung transplant recipients are at increased risk for anxiety and depression, both of which have been associated with increased risk of complications and higher mortality rates. The purpose of this quality improvement project was to implement a mindfulness-based virtual reality (VR) therapy intervention for postoperative transplant recipients at a Northern California academic medical center and to evaluate its feasibility, tolerability, and acceptability during the index hospitalization. Over a 15-week period, five participants completed a total of eight VR sessions. Participants selected from immersive mindfulness-based environments, including guided meditation and other relaxation experiences. Anxiety and depression were …

Cultura, Collaborations, And Chisme: The Latinx Caucus’ Oral History Project, Adela Justice, Brandon Kennedy, Jessica Diaz, Manuel Pasos, Saily Marrero, Sandra Desjardins

Library Staff Publications

The MLA Latinx Caucus began an oral history project featuring its members. Using a collaborative, community-based approach, the project brings together medical library professionals to share their experiences and reflect on cultural identity, professional growth, and collective advocacy. This poster describes the development of this significant project.   Background: In Fall 2025 one of the caucus leaders shared that they had a robust oral history project at their library organization, and had learned oral history processes and standards. This began the idea of forming an oral history project at the MLA caucus level. Lessons learned from the MLA AAMLA Caucus showed …

Elongin B Orchestrates Chromatin And Transcriptional Programs In H3k27m-Mutant Diffuse Midline Glioma, Alan L Jiao, Rebecca L Murdaugh, Adam F Kebede, Claudia A Mimoso, Barry M Zee, Rosemary U Richard, Kwanha Yu, Caitlin L Bagnetto, Karen Adelman, Mariella G Filbin, Yang Shi, Jamie N Anastas

Faculty, Staff and Students Publications

Recurrent driver mutations in genes encoding histone H3 (H3.3K27M and H3.1K27M) are observed in ~80% of diffuse midline gliomas (DMG), which lead to aberrant gene regulation, yet the specific RNA polymerase II (Pol2) regulators that induce transcriptional dysregulation in DMG are not fully defined. We identified multiple regulators of Pol2 elongation as DMG genetic dependencies in a chromatin-focused CRISPR screen. Additional studies confirm that knockout (KO) of the Pol2 SIII complex gene elongin B (ELOB) inhibits DMG cell proliferation in tissue culture and tumor growth in xenograft models. Further genomic analyses reveal that ELOB binding sites are enriched in H3K27M …

Deep-Learning Endomicroscope With Large Field-Of-View And Depth-Of-Field For Real-Time In Vivo Imaging Of Epithelial Cancer Hallmarks, Huayu Hou, Jimin Wu, Jinyun Liu, Vivek Boominathan, Argaja Shende, Karthik Goli, Jennifer Carns, Richard A Schwarz, Ann M Gillenwater, Preetha Ramalingam, Mila P Salcedo, Kathleen M Schmeler, Tomasz S Tkaczyk, Jacob T Robinson, Ashok Veeraraghavan, Rebecca R Richards-Kortum

Faculty, Staff and Students Publications

In vivo microscopy (IVM) has shown great promise to improve early detection of epithelial precancer, but it suffers from fundamental trade-offs that limit the resolution, field-of-view (FOV) and depth-of-field (DOF). Here, we present PrecisionView, a compact, deep learning-enabled endomicroscope that breaks these constraints and achieves 20 mm2 FOV and 500 µm DOF with 4 µm resolution, representing approximately 5× increase in FOV and 8× larger DOF compared to conventional IVM with similar resolution. PrecisionView integrates a deep learning-optimized phase mask and real-time reconstruction, enabling rapid in vivo assessment of two key hallmarks of cancer: epithelial cell nuclear morphology and subsurface …

Sex-Biased Intratumoral Microbiome Influences Tumor Molecular And Immune Landscape And Disease Outcomes, Yuting Shan, Yingbo Huang, Adam Lee, Radwa M. Elmorsi, Tuyen Phan, Indrajit Chaudhury, Tom Corbiere, Lindsey B. Collins, Elizabeth B. Hirsch, Benjamin A. Weinberg, Jennifer M. Johnson, Emmanuel S. Antonarakis, Emil Lou, R. Stephanie Huang

Department of Otolaryngology - Head and Neck Surgery Faculty Papers

The intratumoral microbiome is increasingly recognized as a regulator of cancer biology, yet sex-specific patterns and their relevance to cancer disparities remain poorly understood. We perform a multi-kingdom analysis of more than 5,000 tumors from seven datasets to identify sex-differential microbial taxa across aerodigestive and gastrointestinal cancers. We identify and validate 22 taxa with consistent sex-biased abundance, including in real-world cohort. These microbes show cancer-type- and microbe-specific associations with tumor transcriptomes, oncogenic pathways, and immune cell infiltration. Female-enriched microbes are linked to increased estrogen signaling and interferon responses, whereas male-enriched taxa show opposing patterns. In gastric cancer, intratumoral Epstein-Barr virus …