Digital Commons Network^™

Disparities In The Inpatient Management Of Anemia: A Multicenter Retrospective Analysis, Eunice Adebayo, Michael Lee Phillips, Ritij Sarvaiya, Harsh Desai, Nayda Parisio Poldiak, Julie Worthington, Taylor Templeton-Jager, Kelsey Zealy

South Atlantic Division GME Research Days 2026

No abstract provided.

Evaluation Of Insulin Dosing In A Hyperkalemia Protocol, Kayla Hedgspeth, Rohan Johnson, Eric Shaw, Stephanie Lesslie

South Atlantic Division GME Research Days 2026

No abstract provided.

The Qualitative Investigation Of The Role Of Nicu-Based Slps, Netanya Tsang

Selected Full-Text Master Theses Collection 2018-

In 2004 that the American Speech Language Hearing Association (ASHA) released a position statement pertaining the roles of SLPs in swallowing and feeding disorders, specifically in the Neonatal Intensive Care Unit (NICU). In the NICU, one of the last criteria for discharge of the neonate is to demonstrate consistent and stable feeding. For NICU-based speech-language pathologists (SLP)s, a primary responsibility is treating the neonate’s ability to feed and swallow. Within this specialized setting over time, the role of the SLP has changed, but there is significant variation across locations and setting; with little formally documented regarding updated responsibilities. Therefore, this …

Perspective: Radiotherapy And Body Composition: Unmet Needs In Low- And Middle-Income Countries, Alexia J Murphy-Alford, Aaron J Grossberg, Vickie E Baracos, Maha Barbar, Judy Bauer, Jonathan P Bennett, Elena Fidarova, Clifton D Fuller, Anastassia Löser, Amy C Moreno, Anurima Patra, Deepa Puttaswamy, David I Rosenthal, Judy Schoeman, Yavuz Anacak

Faculty, Staff and Student Publications

Radiotherapy plays a vital role in cancer treatment, yet its effects on patients' nutritional status can precipitate muscle loss, with significant implications for treatment tolerance and outcomes. Evidence from high-income countries increasingly links radiation-induced muscle loss to adverse clinical outcomes. In contrast, low- and middle-income countries face a stark evidence gap, despite the heightened vulnerability of cancer patients in these settings due to delayed diagnosis, limited access to care, and high rates of co-morbidities. This paper highlights the critical gaps in nutritional care for radiotherapy patients in low- and middle-income countries.

Digital Communication Strategies For Culinary Medicine In Cancer Prevention And Survivorship: Information-Seeking Habits And Content Preferences Of Online Cooking Media Among Adults Participating In Four Cancer Prevention And Control Cohort Studies, Margaret Raber, Sara Fares, Maria Vazquez, Larkin Strong, Carrie Daniel-Macdougall, Lorna Mcneill, Karen Basen-Engquist

Faculty, Staff and Student Publications

Introduction

Poor diet and excess weight have been linked to increased risk for at least 13 types of cancer. Culinary medicine utilizes experiential cooking skill development to improve individuals’ capacity for healthy eating. Digital communication strategies offer pathways for scalable culinary medicine interventions, but little research has explored how online cooking tools could be leveraged for cancer prevention messaging. We conducted a cross-sectional survey study exploring online cooking information-seeking habits and content preferences among participants in four cancer prevention and control cohorts to inform future digital culinary medicine interventions.

Methods

A cross-sectional survey study was conducted with a convenience sample …

Thriving Through Occupation: Enhancing Occupational Participation For Cancer Survivors, Leslie B. Martinez

OT Doctoral Capstones

Cancer survivors often experience decreased participation in meaningful occupations, along with physical, mental, emotional, and financial challenges (Newman et al., 2024). This capstone project developed an educational series to promote engagement in meaningful occupations and provide strategies to combat the negative physical and mental effects of cancer and treatment. Four classes covering various health topics, including cancer-related fatigue, cognitive impairment, mental health, and nutrition, were implemented for cancer survivors at the Rio Grande Cancer Foundation. The classes included an educational portion in which participants were introduced to each topic, followed by interactive learning activities designed to promote the application and …

Trial Interviews To Explore Glycogen Storage Disease Type Ia Patient Experiences Following Gene Therapy, Diane M Turner-Bowker, Jessica Butler, Shayna Egan, David A Weinstein, David F Rodriguez-Buritica, Ayesha Ahmad, María-Luz Couce, Rebecca Riba-Wolman, John J Mitchell, Christina Theodore-Oklota

Faculty, Staff and Student Publications

Background: Glycogen storage disease type Ia (GSDIa) is a rare, inherited, autosomal recessive deficiency of glucose-6-phosphatase (G6Pase), an enzyme necessary in glycogenolysis and gluconeogenesis. To maintain normal blood glucose levels and ensure survival, individuals living with GSDIa must frequently consume complex carbohydrates (eg, uncooked cornstarch). Dietary management can result in chronic complications and significant patient burden. DTX401 (pariglasgene brecaparvovec) is an investigational adeno-associated virus serotype 8 vector (AAV8)-based gene therapy designed to restore endogenous glucose production.

Objectives: Patient experience interviews were conducted as part of an open-label, phase 1/2 dose-escalation trial (NCT03517085) evaluating the safety and efficacy of …

Case Report: Management Of A Challenging Case Presenting With Dysphagia After Thyroidectomy Requiring Administration Of Liquid 131i Via Mic-Key Low-Profile Tube—A Multidisciplinary Approach, Ahmed Ebada Salem, Sandra Ramirez, Brian R Weston, Akram Hussein, Simone Krebs

Faculty, Staff and Student Publications

Radioactive iodine (RAI) therapy with 131-iodine (131I) remains a cornerstone in the postoperative management of differentiated thyroid carcinoma (DTC). The standard route of administration is oral, typically in capsule form and less commonly as a liquid. However, in patients with severe dysphagia and compromised airway, traditional oral 131I delivery may be contraindicated due to the risk of aspiration and radioactivity contamination. These scenarios present unique clinical challenges that necessitate deviation from conventional protocols. While liquid 131I may be administered through the mouth or via nasogastric or percutaneous gastrostomy tubes, there is currently no standardized approach, and potential risks, such as …

Prickle4 Drives Microenvironmental Remodeling And Resistance To Parp Inhibition In Idh-Mutant Glioma, Ju Yang, Hua Yang, Yifan Yuan, Chenyang Zhang, Ziwei Fu, Yanyan Chen, Yinghong Xiong, Shuyu Chen, Kexin Ling, Ying Liu, Jason T Huse, Bo Chen, Timothy A Chan, Zengxin Qi, Zhao Zhang, Xiuping Liu, Yuxiang Wang

Faculty, Staff and Student Publications

Mutations in isocitrate dehydrogenase (IDH) genes sensitize gliomas to PARP inhibition (PARPi) by inducing epigenetic reprogramming of DNA damage repair circuits. However, tumors treated with PARPi eventually relapse despite initial responsiveness. In this study, it is demonstrated that the anti-angiogenic agent lenvatinib synergizes effectively with PARPi, resulting in substantial tumor regression and significantly extended survival. Genomic analysis of tumors reveals that PARPi induces widespread transcriptomic changes that are predominantly pro-inflammatory, thereby promoting tumor angiogenesis. Prickle4, a planar cell polarity protein, is identified as a critical mediator of PARPi-induced neovascularization. Targeting Prickle4 effectively overcomes PARPi resistance in these tumors. Collectively, these …

Clinical Challenges Associated With Enhancing Hypertension Among The Underserved African American Population, Ashley Richardson

Doctor of Nursing Practice (DNP) Scholarly Projects

Background 

African Americans face a significantly higher prevalence of hypertension, tend to develop complications at younger ages, and have disproportionately higher mortality rates. Key social determinants of health (SDoH)—including food deserts, unequal access to healthcare, and geographic disparities in healthcare resources—contribute to these ongoing inequities. Addressing both systemic and individual barriers is crucial for effective hypertension management.

Objective

This study aims to assess the effectiveness of a culturally relevant, community-based intervention designed to reduce both systolic and diastolic blood pressure among Black adults with uncontrolled hypertension.

Methods 

Quality improvement (QI) initiatives typically employ multicomponent, equity-focused models. The primary components of …

Place Matters: Investigating The Social And Environmental Drivers Of Hypertension In Nashville, Marquinta Harvey, Michael D. Oliver, Tatum Brown, Deya Rassul, Thomas Strickler, Jarod Parrish, Catherine Bass

Funded Scholarship

Hypertension disparities persist across communities, driven by interactions between social determinants of health (SDOH) and behavioral factors. This study examines geographic and demographic patterns of hypertension in Nashville, Tennessee, to assess how socioeconomic, environmental, and behavioral factors contribute to inequities in prevalence, treatment, and control. Granular ZIP code-level analyses highlight community-specific drivers and the need for policy reforms to advance health equity.

Coalition Building And Citizen Science For Radon Risk Reduction, Stacy Stanifer, Kathy Rademacher, Whitney Sedio, Naomi Cheek, David Gross, Caitlyn Curtis, Amanda Thaxton-Wiggins, Mary Kay Rayens, Ellen J. Hahn

Nursing Faculty Publications

We evaluated the implementation of local coalitions led in partnership with citizen scientists, community-based organizations, and public libraries in four rural communities to lower exposure to radon in the home. The objectives were to (1) describe the Reach-Effectiveness-Adoption-Implementation-Maintenance (RE-AIM) of four radon coalitions, and (2) compare RE-AIM factors among citizen scientists who participated in the coalitions and those who did not. A larger community-engaged research project embedded coalition building using a citizen science approach. Three of the four coalitions focused on health and wellness more broadly (18–34 members); one focused solely on radon (10 members). Coalition membership and activities varied …

Nemolizumab As An Alternative Therapeutic Option For Indolent Systemic Mastocytosis, Sezim Minbaeva, Stephen K Tyring

Faculty, Staff and Student Publications

Indolent systemic mastocytosis (ISM) is a clonal mast cell disorder characterized by recurrent symptoms that can persist despite treatment with antihistamines, leukotriene antagonists, and mast cell stabilizers. Treatment options are limited when symptoms remain refractory, and avapritinib is contraindicated or declined. We describe the case of a 62-year-old female with an 11-year history of ISM who developed worsening pruritus and urticaria despite extensive conservative and biologic therapies, including topical corticosteroids, hydroxyzine, montelukast, omalizumab, and dupilumab. Given her history of stroke, she declined avapritinib. Nemolizumab was initiated with a 60 mg loading dose followed by 30 mg every four weeks. After …

Preventing G/J Tube Dislodgement: A Device And Communication Innovation, Sarah Clark

2026

The Problem
G/J tube dislodgement is a frequent complication in pediatric patients
Leads to:

• Emergency department visits
• Hospital admissions
• Delays in nutrition/medication

Impact on Patients & Families:

• IV placement (traumatic)
• Radiation exposure
• Overnight hospital stays

Impact on Nurses & System:

• Increased workload (admissions, coordination)
• Occupied inpatient beds for stable patients
• Inefficient care processes

Aims/Objectives
Aim: Reduce unplanned G/J tube dislodgements and related hospital utilization.
Objectives: Develop a breakaway connector prototype

Implementation and Evaluation
Setting: Pediatric inpatient & outpatient system
Participants: Nurses (bedside, GI, IR), caregiver, innovation team
Process:
Roundtable discussions → identified workflow gaps
Communication/workflow audit
Developed device …

Clinical Microbiology & Infectious Diseases: A Concise Guide On The Fundamentals Of Infectious Disease In Podiatric Medical Education, Paramita Basu

Open Touro Created

2026

This Open Educational Resource (OER), Clinical Microbiology & Infectious Diseases, is a student-centered textbook designed to support pre-clinical podiatric medical students enrolled in PCLP 610 Infectious Diseases at the New York College of Podiatric Medicine. The book is structured as a collection of concise “chapter briefs” or high‑yield notes that align closely with the course syllabus, lecture objectives, and student learning outcomes, while also reflecting the Microbiology learning objectives outlined in the AACPM Council of Faculties Curricular Guide.

The content covers core principles of medical microbiology and infectious diseases, including bacteria, viruses, fungi, parasites, host–pathogen interactions, antimicrobial therapy, resistance …

Dietitian-Led Nutrition Care Across The Cellular Therapy Continuum Supports Weight And Strength Recovery, Ashley Pagano Ms, Rdn, Ldn, Samantha Okerson Rdn, Erin Levine Rd, Cso, Ldn, Deanna Yerg Ms, Rdn, Ldn

Clinical Nutrition Service

No abstract provided.

High-Osmolality Medication Exposure And Length Of Stay In Icu Patients With Rectal Tubes, Kimberly Cephas Ms, Rdn, Ldn, Rachel Geosits Ms, Rdn, Cnsc, Ldn, Matthew Fair Pharmd, Hope Kincaid Mph, Cph, Alison Sutter Mph

Clinical Nutrition Service

No abstract provided.

Fumigant Toxicity Of Essential Oils From Chemotypes Of Curry Tree (Murraya Koenigii) Against Adult African Malaria Mosquito (Anopheles Gambiae Sensu Stricto), Clarence M. Mang’Era, Fathiya M. Khamis, Ahmed Hassanali, Paul O. Mireji

All Peer-Reviewed Publications

The toxicity of fumigant formulations of essential oils (EOs) from curry tree (Murraya koenigii (L.) Spreng (Rutaceae)) against African malaria adult mosquito (Anopheles gambiae sensu stricto (Giles, 1902) (Diptera: Culicidae: Culicini)) was evaluated to identify most effective chemotype of the curry tree against the mosquitoes. Ninety-two compounds (91.78%–96.47% coverage) in the EO profiles were identified, among which EO isolated from curry tree chemotype from Kibwezi was most toxic. This chemotype had a median lethal dose (LD50) of 3.6 × 10⁻³ mg/cm³ (95% CI: 2.70–4.58) and a lethal time (Ti50) of 1.91 ± 0.086 h (p < 0.001). The equivalent LD50 of EOs of chemotypes from Mombasa, Makindu, and Malindi in Kenya was 4.9 × 10⁻³, 6.6 …

January 2026, Swosu Bulldog Wellness Committee

SWOSU BULLDOG WELLNESS

• Tired of Failing New Year's Resolutions? Try "Health Esteem" instead.
• January Health Tips
• Route 66 Walking Challenge

Thyroid Storm At Sea: A Case Report Of Algae-Induced Thyrotoxicosis, Alynna Knaub, Amanda Cecchini, John Janousek, Laura Strojny, Jairo Noreña, Zachary Pawlikowski

Department of Medicine Faculty Publications

Iodine-induced thyrotoxicosis (IIT), also known as the Jod-Basedow phenomenon, is a rare yet recognized cause of hyperthyroidism. While iodinated contrast is the most frequent trigger, iodine-rich supplements such as seaweed products or supplements can also precipitate thyrotoxicosis, particularly in individuals with prior chronic iodine deficiency or preexisting thyroid nodular disease. We present a case of thyroid storm following short-term ingestion of Irish sea moss as part of a “crash diet.” A 37-year-old woman with type 1 diabetes mellitus, well controlled on subcutaneous insulin therapy, presented with nausea and vomiting after 6 days of following a restrictive diet consisting solely of …

Metabolic Dysfunction-Associated Steatotic Liver Disease And Circadian Rhythm: Current Understanding And Implications For Future Therapeutic Interventions, William K. Slover, Ashley V. Huang, Steve M. D'Souza, Edward C. Oldfield, David A. Johnson

Department of Medicine Faculty Publications

Metabolic dysfunction-associated steatotic liver disease (MASLD), defined by the American Association for the Study of Liver Diseases as hepatic steatosis with at least one cardiometabolic risk factor, affects approximately 30-40% of adults worldwide. This condition may progress to fibrosis, cirrhosis, and hepatocellular carcinoma. The rising prevalence, alongside obesity and type 2 diabetes, underscores the need for early risk stratification and integrated therapeutic strategies. Circadian homeostasis, orchestrated by the suprachiasmatic nucleus and core clock gene feedback loops, synchronizes hepatic metabolic pathways with environmental light-dark cycles. The objective of this review is to evaluate the role of circadian disruption and metabolic dysfunction …

Isolated Immune-Mediated Enteritis In Patients Treated With Immune Checkpoint Inhibitor Therapy, Sharada Wali, Rohan Srinivas Patel, Maria Julia Moura Nascimento Santos, Anirudha Chatterjee, Sophia Chenyu Fan, Sean Ngo, Tanvi Gupta, Kian Abdul Baki, Lucie Heinzerling, Bryan J Schneider, Kathryn Bollin, Jessica Philpott, Anusha Thomas, Yinghong Wang

Faculty, Staff and Student Publications

Background: Immune checkpoint inhibitors (ICIs) commonly cause colitis, but isolated immune-mediated enteritis (IMEN) is poorly characterized. This study describes the clinical features, diagnostic findings, and outcomes of IMEN.

Method: We retrospectively identified adults with cancer who developed IMEN within one year of ICI initiation, confirmed as duodenitis, ileitis, or both.

Results: Among 20,991 ICI-treated patients, 30 (0.143%) developed isolated IMEN. Median age was 69.5 years; 73.3% were male, and 80% white. The most common malignancies were gastrointestinal/hepatobiliary (26.7%) and melanoma (23.3%). Presenting symptoms included nausea (66.7%), diarrhea (53.3%), and vomiting (46.7%); 62.5% of patients with diarrhea had grade ≥2 severity. …

Barriers And Facilitators To Recruiting Older Adult Care Homeresidents Into Clinical Trials Of Medicines And Vaccines: A Scoping Review, Selvarani Subbarayan, Imogen A. Smith-Dodd, Gabriel Nicolson, Jennifer K. Burton, Janet T. Scott, Seshadri S. Vasan, Susan D. Shenkin, Roy L. Soiza, The Watch Consortium

Research outputs 2022 to 2026

Introduction: Excluding Care Home (CH) residents from clinical trials of medicines and vaccines has led to an evidence gap. Findings from younger adults may not be generalisable to CH residents with frailty and dementia. Therefore, it is essential to evaluate pharmacological treatments directly in CH residents to assess their safety and efficacy.

Methods: As part of the Widening Access to Trials in Care Homes project, we conducted a scoping review using Joanna Briggs Institute methodology to identify barriers and facilitators to recruiting CH residents into clinical trials of medicinal products. We searched EMBASE, MEDLINE, PsycINFO, CINAHL, and the Cochrane Library …

Diet, Gut Microbiota, And Intestinal Permeability: Emerging Mechanisms In Hypertension Pathogenesis, Esha Vashisht, Helen Nguyen, Francine Z. Marques, Matthew Snelson

Research outputs 2022 to 2026

Hypertension is a leading contributor to global morbidity and mortality, arising from the interplay of genetic and environmental risk factors together with the dysregulation of multiple physiological systems involved in blood pressure control. Recent advances have established the gut as a central regulator, implicating the intestinal microbiota and barrier integrity in the modulation of blood pressure. Alterations in the gut microbial consortium, along with changes in levels of metabolites produced by the microbiota, have been associated with blood pressure regulation in animal models and human studies. Key microbial metabolites, including short-chain fatty acids, trimethylamine-N-oxide, and bile acids influence endothelial function, …

Patient-Reported Measures In Children And Adolescents With Chronic Kidney Disease And Their Validation: A Scoping Review, Angela Rejuso, Asif, Martin Howell, Chandana Guha, Siah Kim, Allison Jaure, Anastasia Hughes, Kristy Nicholl, Kylie Ann Mallit, Farzaneh Bouroumad, Jonathan Craig, Armando Teixeira-Pinto, Anna Francis, Nicholas Larkins, Anita Van Zwieten, Germaine Wong

Research outputs 2022 to 2026

Context: Children with chronic kidney disease (CKD) experience complex challenges affecting their physical, emotional and quality of life outcomes. Patient-reported outcome measures (PROMs) and experience measures (PREMs), collectively known as patient-reported measures (PRMs) are essential to capture these impacts, but their validation and suitability in pediatric CKD research remain underexplored. Objective: To identify and evaluate the psychometric properties of PRMs used in research in children with CKD. Data sources: Medline, Embase, CINAHL and PSYCinfo searched from inception to March 2025. Study selection: Studies that reported the results of at least one PRM completed by patients or proxies in children aged …

The Best Practice Guide For Early Childhood Education And Care Food Environment: Module 4: Staff And Family Engagement (Version 1.0), Ros Sambell, Audrey Elford, Connie N. Ihlein, Lochie Clark, Amanda Devine, Helen Helen Alexiou, Lennie Barblett, Fiona Champion, Penelope Clark, Kathy Cologon, Wendy Cook, Katie Dix, Kirsty Elliott, Leanne Elliston, Amanda Ferguson, Yuna Ribeiro Ferreira Alves, Ricky Gelman, Jodie Gray, Natalie Gulberti, Lena Harle, Jill Whelan, Karen Krist, Ashton Leach, Deana Leahy, Stacey Mckenzie, Lauren Moore, Merryn Netting, Ciara O’Flaherty, Asha Rojahn, Blake Stewart, Aimee Sullivan, Suzanne Tamone, Henry Tan, Courtney Trezona, Sandra Vale, Kathy Cologon

Research outputs 2022 to 2026

Engaging with families is a core responsibility of ECEC services and staff. By building positive, personal relationships with families, ECEC staff are able to share concerns or queries about the children in their care in a sensitive way.

One of the more sensitive topics that can come up is food – what they are eating, how much they are eating, their eating behaviours and skills, and everything in between. Through quick conversations at drop-off or via formal communication platforms, services can share a range of information about a child’s eating patterns and behaviours, and also gather information from families to …

Pharmacist-Led Educational Intervention To Improve Knowledge, Medication Adherence, And Asthma Control Among Asthma Patients At Ayder Comprehensive Specialized Hospital: A Protocol For Randomized Controlled Trial, Mekuriaw Dereje Tekele, Goitom Belay Kassa, Yainu Welegerima Welekidane, Derbew Fikadu Berhe, Abadi Kahsu Gebre, Afewerki Gebremeskel Tsadik

Research outputs 2022 to 2026

Objective: To evaluate the effect of a pharmacist-led educational intervention on medication knowledge, adherence, and asthma control among adult asthma patients at Ayder Comprehensive Specialized Hospital, Ethiopia.

Methods: A single-blind, parallel-group randomized controlled trial will be conducted. All eligible adult asthma patients on active follow-up at the chest clinic of Ayder Comprehensive Specialized Hospital will be included. Participants will be randomly assigned via a computer-generated sequence to an intervention group (structured pharmacist-led education using teach-back, illustrated pamphlets, a follow-up phone call and SMS) or a control group (routine care). Outcome assessors will be blinded to group allocation. Outcomes will be …

Trends And Indications For Cesarean Section In The Origins Birth Cohort, Kristjana Einarsdottir, Lisa Gibson, Sarah Whalan, Jacqueline Davis, Laurence Amy Payette, Ravisha Srinivasjois, Desiree T. Silva

Research outputs 2022 to 2026

Objective: Cesarean section (CS) rates have increased substantially in Australia, with particularly high use observed in private maternity care and for pre-labor CS. The aim of the present study was to describe the CS rates and the clinical indications for pre-labor CS in the ORIGINS birth cohort.

Methods: This study analyzed data from the ORIGINS birth cohort, a large birth cohort in Western Australia, including 9473 births occurring at Joondalup Health Campus between 2016 and 2024. Rates of CS and pre-labor CS were compared across study periods (2016–2020 and 2021–2024) and by facility type (public vs. private). Indications for pre-labor …

Tea And Coffee Intakes, Copd, Adult Asthma, And Lung Function In The Uk Biobank, Nicola P. Bondonno, Pratik Pokharel, Benjamin H. Parmenter, Alysha S. Thompson, Amy Jennings, Kevin Murray, Howraman Meteran, Jonathan Hodgson, Tilman Kühn, Aedín Cassidy

Research outputs 2022 to 2026

Introduction: Previous studies suggest non-linear associations between tea and coffee intake and respiratory health, with lower risks at low-to-moderate intakes but higher, unexplored risks at high intakes. This study aims to investigate associations between tea and coffee intake and the risk of chronic obstructive pulmonary disease (COPD) and adult-onset asthma. Methods: Among 366 869 participants of the UK Biobank, intakes of tea and coffee were derived from both a food frequency questionnaire and from repeated 24 hour diet assessments. Cross-sectional associations with measures of lung function [forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), and FEV1/FVC] and …

Effect Of Caffeine Ingestion On Cycling Performance: A Systematic Review And Meta-Analysis, Jinyan Wu, Kai Xu, Mingyue Yin, Xianming Ding, Tong Wang, Qiubo Zhang, Xiaowei Wu, Ningkun Xiao

Research outputs 2022 to 2026

This study aimed to determine the effects of acute caffeine ingestion on cycling performance through a systematic review and meta-analysis, while also exploring the moderating roles of caffeine dosage, training status, and athlete age. A comprehensive search was conducted across five databases, yielding 20 eligible studies with a total of 226 participants. A three-level mixed-effects model was applied to pool main effects on cycling time trial performance, mean power output, mean heart rate, and ratings of perceived exertion (RPE). Subgroup analyses and meta-regression were performed to examine potential moderators. Caffeine intake significantly reduced cycling completion time (SMD = −0.36, 95% …