Digital Commons Network^™

Patient-Centered, Theory-Based, Online Intervention To Promote A Physically Active Lifestyle For People With Multiple Sclerosis: Protocol For A Randomized Controlled Trial, Chungyi Chiu, Vaishnavi Sridharan, Mojtaba Khaliji, Md Refat Uz Zaman Sajib, Xiaotian Gao, Kathleen Zackowski

Children’s Nutrition Research Center Staff Publications

Background: People with multiple sclerosis (MS) experience life challenges due to the nature of disease progression. Although an active lifestyle has been shown effective for symptom and relapse management, most people with MS lead a sedentary lifestyle and do not reach the recommended physical activity (PA) guidelines.

Objective: This study aims to test the preliminary efficacy of a codeveloped, online self-management intervention based on the health action process approach (HAPA) adapted for people with MS to cultivate a physically active lifestyle.

Methods: The 8-week intervention program was developed using community-based participatory research based on the HAPA. The program includes increasing …

Diverse Diagnostic And Management Approaches For Acute Rheumatic Fever In Australia And New Zealand: Findings Of A Prospective Clinical Study, Ruwani Peiris, Rachel Webb, Julie Bennett, Jennifer Yan, Joshua Reginald Francis, Bo Remenyi, Florina Chan Mow, Rachel Burgess, Nigel J. Wilson, Alicia Stanley, Laura Francis, Rhonda Holloway, Roxanne Westbury, Shirley Lawrence, Yolanda Hernandez-Gomez, David Broadhurst, Nicole J. Moreland, Reuben Mcgregor, Caroline Motteram, Glenn Pearson, Mark Mayo, Anna P. Ralph, Jonathan R. Carapetis

Research outputs 2022 to 2026

Objectives To describe diagnostic and management characteristics of acute rheumatic fever (ARF) among participants in the € Searching for a Technology-Driven Acute Rheumatic Fever Test' study, in order to answer clinical questions and determine epidemiological and practice differences in different settings. Design Multisite, prospective cohort study. Setting One hospital in northern Australia and two hospitals in New Zealand, 2018-2021. Participants 143 episodes of definite, probable or possible ARF among 141 participants (median age 10 years, range 5-23; 98% Indigenous). Primary and secondary outcome measures Participant characteristics, clinical, biochemical and echocardiographic data were explored using descriptive data. Associations with length of …

The Perception Of Ai Impact Of Academic Processes: A Study Of Student Perspectives, Nora Murphy, Lana Perkovic, Andzelika Wyka

International Undergraduate Journal of Health Sciences

Artificial Intelligence (AI) has emerged as a transformative technology with the potential to revolutionise education. This research aimed to comprehensively explore students’ perspectives on the integration of AI in educational settings, focusing on understanding its role, advantages, challenges, and expectations. The study analysed responses from a sixteen-question survey created through Google Forms administered online to 196 students from diverse academic backgrounds and educational levels enrolled across two Cork third-level institutions.

The demographic distribution of the respondents showed 44.4% aged 18-20 years old, 43.9% aged 21-23 years old, and 11.7% aged 24 and above, with 67.9% female respondents and 32.1% males. …

Implementing A Standardized Protocol To Screen For Depression In A Gastroenterology Outpatient Clinic, Catherine M. Karle

Dissertations

Problem: There is a lack of mental health screenings for depression taking place in outpatient gastrointestinal (GI) clinics. Outpatient gastrointestinal (GI) offices are not consistently screening patients for depression despite a rise in depression rates and the known adverse impact depression can have on the GI tract.

Methods: This Quality Improvement (QI) study used a descriptive research design guided by the Johns Hopkins Nursing Evidence-Based Practice (JHNEBP) Model. Its purpose was to implement a 10-week PHQ-2/PHQ-8 depression screening protocol at a large midwestern health center's gastroenterology outpatient clinic. The study used purposive sampling, including all GI outpatients aged 18+ with …

Implementation Of A Nurse-Driven Process To Decrease Npo Times In A Geriatric Emergency Department, Luke D. Little

Dissertations

Prolonged nil per os (NPO) status for geriatric patients in the emergency department is a critical safety issue, leading to increased rates of delirium, hypoglycemia, and perioperative complications. A quality improvement project was designed to address this problem through a targeted, nurse-driven intervention. In geriatric patients (age ≥70) in a geriatric emergency department, this project aimed to determine if implementing an electronic health record (EHR)-prompted nursing workflow to obtain a diet order would reduce the length of time patients were kept NPO compared with standard practice. An EHR documentation tool was designed and implemented along with targeted nursing education sessions …

Bowel Regimen Protocol Implementation For Pediatric Patients Following Cardiac Surgery, Eryn Watson

Dissertations

Problem: Pediatric patients with congenital heart disease (CHD) are at an increased risk of constipation following cardiac surgery, which contributes to complications and delays in recovery. Standardized protocols are effective tools for prophylactic management of constipation. However, there is no current standardized protocol in place for postoperative bowel management in a pediatric cardiac intensive care unit (CICU).

Method: This quality improvement project (QI) used a descriptive design with pre- and post-implementation data collection to evaluate the effects of a postoperative bowel regimen protocol on constipation rates and compliance with ordering prophylactic bowel regimens. Convenience sampling was used to identify patients …

Maternal Hyperleptinemia Alters Placental Transcriptome And Progesterone Regulation Without Affecting Early Equine Fetal Growth, Lucinda L. Thorburn

LSU Master's Theses

While consequences of equine obesity are well defined, the extent to which persistent hyperleptinemia and accompanying leptin (Lep) resistance affect the fetal-maternal environment warrants further exploration. This study compared endocrine, fetal, placental, and uterine parameters during early pregnancy (through day 70) in mares with elevated leptin versus normal leptin (NL) concentrations. Fourteen mares were classified as either NL (n = 6; Lep 0.9 ± 0.3 ng/mL), moderate leptin (ML; n = 4; Lep 3.0 ± 0.3 ng/mL), or high leptin (HL; n = 4; Lep 5.8 ± 0.7 ng/mL) based on annual plasma leptin. Mares were artificially inseminated and induced …

Human Development, Inequality, And Their Associations With Brain Structure Across 29 Countries, Vicente Medel, Luz M. Alliende, Richard Bethlehem, Jakob Seidlitz, Grace Ringlein, Celso Arango, Aurina Arnatkevičiūtė, Laila Asmal, Mark Bellgrove, Anderson M. Winkler

Human Genetics Publications

Background: The macro-social and environmental conditions in which people live, such as the level of a country’s development or inequality, are associated with brain-related disorders. However, the relationship between these systemic environmental factors and the brain remains unclear. We here aimed to determine the association between the level of development and inequality of a country and the brain structure of healthy adults.

Methods: We conducted a cross-sectional study pooling brain imaging (T1-based) data from 145 magnetic resonance imaging (MRI) studies in 7,962 healthy adults (4,110 women) in 29 different countries. We used a meta-regression approach to relate the brain structure …

Assessing The Lgbtq+ Beliefs, Behaviors, And Competency Of Nutrition Professionals: A Mixed-Methods Study, Anthony Dissen, Christina Riccardo, Liam Oliver Lair

Journal of Dietetic Education

Lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ+) individuals often experience disproportionate levels of physical and mental health issues including nutrition-specific issues such as eating disorders, body dysmorphia, and food insecurity related to psychological distress from discrimination and stigmatization. This study sought to understand nutrition professionals’ LGBTQ+ competence, beliefs, and behaviors. Researchers distributed 2 data collection tools to registered dietitian nutritionists (RDNs): the Gay Affirmative Practice Scale (GAP-Scale) and the LGBT Competency Assessment Tool (LGBT-CAT). Data from the GAP-Scale were numerically scored using a 5-point Likert scale, and data from LGBT-CAT were scored on a scale of 0 to 3 points. …

Examining Weight Bias Attitude Changes After Exposure To A Brief Photovoice Assignment, Gretchen L. George, Hillary L. Roberts, Kristin Rose, Madison Clemens, Kate G. Burt

Journal of Dietetic Education

Weight bias is present among pre-health professional students (e.g., nutrition, dietetics, nursing, physical therapy, medicine). Educators need support and guidelines about how to enhance learning through engaging assignments while also meeting accreditation requirements. This pilot study examined the impact of an innovative weight bias assignment using photovoice and reflection within existing nutrition education courses, measured through pre-post assessments from the Fat Attitudes Assessment Toolkit. While not all subscales showed significant change, improvements in the Fat Acceptance and Attribution Complexity Composites suggest these methods may be effective in shifting attitudes about fatness. Further research is needed to assess the long-term impact …

Development Of Dietetics Students’ Skills And Self-Efficacy In The Nutrition Care Process, Kristen Heitman, Marcia Nahikian-Nelms, Holly Estes-Doetsch, Kristen M. Roberts, Jennifer A. Garner, Julie Kennel, Christopher A. Taylor

Journal of Dietetic Education

The Nutrition Care Process (NCP) is a systematic framework for providing nutrition care and a cornerstone of dietetics practice. Dietetics education relies on development of skills to achieve competence and demonstrate readiness for practice. The relationship between development of fundamental skills and self-efficacy among dietetics students preparing for clinical practice remains unclear. The purpose of this study was to examine the development of dietetics students’ skills in NCP documentation and their self-efficacy in performing the skills over one academic year. Student nutrition notes (n = 120 notes, n = 30 students) from standardized patient encounters were evaluated for quality using …

Integrated Advanced Education Supports Future Registered Dietitian Nutritionists’ Breastfeeding Self-Efficacy In Practice, Crystal C. Douglas, Simone Camel

Journal of Dietetic Education

Objective: Evaluate the effectiveness of graduate-level breastfeeding and lactation management education that includes didactive and active learning components on future RDNs’ knowledge, attitudes, and self-efficacy. Design: A pre-and post-test design, utilizing a 41-item pre-intervention survey, learning modules, and a 35-item post-intervention survey. Setting: Three U.S. public universities located in Texas, Louisiana, and Arkansas. Participants: Graduate-level dietetic internship students. Intervention: Four advanced education modules (2 didactive; 2 active learning) developed by Registered Dietitian Nutritionists. Main outcome measures: Gains in breastfeeding knowledge, attitudes, and self-efficacy to assist with breastfeeding education and problem-solving using validated and newly developed survey items. Analysis: Descriptive statistics, …

Sense Of Belonging In The Profession And Program Of Study Among Nutrition And Dietetics Students, Jessica Torro, Melissa Masters, Rachel C. Sinley, Jesse Lunsford, Heidi Masching, Miranda Chen Musgrove

Journal of Dietetic Education

Sense of belonging may positively impact student performance, especially in marginalized groups. This study aimed to examine sense of belonging among a diverse group of nutrition and dietetics students. An online survey investigated students’ feelings of belonging, isolation, and connection to the field of nutrition and dietetics and department of study. The survey was distributed through email to the nutrition and dietetics student body in the Department of Nutrition at Metropolitan State University of Denver. Quantitative data were analyzed as count and percentage. Overall sense of belonging scores were calculated as an average on a 5-point scale (1-strongly disagree to …

Cover, Table Of Contents, About The Journal, Diana Cuy Castellanos, M Elizabeth (Beth) Miller

Journal of Dietetic Education

No abstract provided.

Editors' Message, Diana Cuy Castellanos, M Elizabeth (Beth) Miller

Journal of Dietetic Education

No abstract provided.

Environmental Advocacy As An Occupation: Perceived Self-Efficacy And Occupational Justice In Community Programming, Emma Sims, Laura H. Vanpuymbrouck

The Open Journal of Occupational Therapy

Background: Current occupational therapy literature demonstrates a gap in knowledge of environmental advocacy as an occupation, which directly impacts occupational justice in those experiencing environmental racism or discrimination. This study’s purpose was to provide foundational information on the importance of advocacy work in the sphere of environmental and occupational justice through the lived experiences of those directly involved in community environmental advocacy.

Method: Qualitative data was collected via three focus groups using semi-structured interviews focused on perceptions of participant experiences in environmental advocacy occupations. Thematic analysis was used to identify themes relating to research questions.

Results: When …

Breastfeeding Interventions For Dyads With Medical Complexity: A Mixed Methods Study, Jairrah L. Godsil, Julia R. Farrell, Julia Shin, Cary C. Moore, Yongyue Qi, Vanessa D. Jewell

The Open Journal of Occupational Therapy

Background: Breastfeeding dyads with medical complexity have lower success with direct breastfeeding. Evidence to support occupational therapists working with this population is limited. This study explored occupational therapists' experiences, training, and interventions for breastfeeding dyads with medical complexity.

Method: Occupational therapists providing clinical breastfeeding services for parents and or children with medically complex conditions participated in this study. The study employed an explanatory, sequential mixed-methods design, consisting of an online survey (N = 102) followed by two 75-min semi-structured focus groups (N = 7).

Results: Occupational therapists with more clinical breastfeeding experience (p = .003) and …

Implementing Behavioral Management And Social Skills Training For Pediatric Patients With Adhd And Their Caregivers, Meagan A. Conwell

Dissertations

Problem: Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder that affects 11.4% of children in the United States. Patients diagnosed with ADHD struggle with focus, hyperactivity, and impulsivity, resulting in executive and emotional dysfunction, poor social skills and quality of relationships, and poor school performance.

The American Academy of Pediatrics guidelines recommend that school-age children diagnosed with ADHD should receive both medication management and behavioral management training (BMT) for the best treatment outcomes. Research over the last decade has found that combining social skills training (SST) with BMT results in even better outcomes for these patients. Less than half of pediatric …

Implementing A Turn Team Process To Reduce Hospital-Acquired Pressure Injuries On A Telemetry Unit At A Hospital In The Midwest, Sally Wang

Dissertations

Problem: Pressure injuries (PI) are localized wounds to the skin and soft tissues that typically result from sustained pressure on specific areas of the body (Zaidi & Sharma, 2024). Hospital-acquired pressure injury (HAPI) refers to pressure injuries that develop while a patient is in the hospital (Rondinelli et al., 2018). PI can cause patients to experience pain, decreased feelings of dignity, increased feelings of depression and anxiety, reduced levels of social activity, difficulty sleeping, and impaired cognitive function (Roussou et al., 2023). The Advanced Cardiac Care Unit (ACCU) at Missouri Baptist Medical Center experienced an increase in HAPI cases: …

Priority Ir: Protocol For Implementation Research On Single-Dose Postpartum Iv Iron To Treat Iron-Deficiency Anemia Among Women In India And Pakistan, Valerie L. Flax, Narjis Rizvi, Umesh Charantimath, Saleem Jessani, Avinash Kavi, Sarah Saleem, Manjunath Somannavar, Shivaprasad S. Goudar, Anika Hannan, Elizabeth M. Mcclure, Simal Thind, Rosemary Frasso, Richard Derman

Global Health Articles

BACKGROUND: Anemia among women of reproductive age has remained highly prevalent globally. Intravenous (IV) iron is well tolerated and proven effective for treating postpartum iron deficiency anemia in high-income countries, but evidence from LMICs, where oral iron is standard treatment, is limited. The PRIORITY trial will test the effectiveness of IV iron compared to oral iron for postpartum women with moderate anemia in eight LMIC sites. An implementation research (IR) study will be conducted alongside the PRIORITY trial in India and Pakistan to gather information on the intervention characteristics and the implementation process, and to assess feasibility, acceptability, fidelity, and …

Lichen Planopilaris With Pili Torti And Ectodermal Dysplasia: A Hair Curling Case Report, Collins Langley, Elena Plakotaris, Nicole E. Rogers

School of Medicine Faculty Publications

Introduction: Lichen planopilaris (LPP) is a well-known cicatricial alopecia with a frontal fibrosing variant. LPP has a prevalence rate of 13.4 per 100,000 persons. It is understood that LPP favors the female populations. What is not commonly known is that LPP can be preceded by other signs and symptoms such as pili torti. Case Report: We present a case report of a 70-year-old female whose initial flare of LPP was preceded by a flare of pili torti. This patient's case is also complicated by her history of ectodermal dysplasia. She experienced progressive itching, shedding, and mid-scalp hair loss along with …

Patients Journey To Hemodialysis Centers: Multi-Center Study, Ali Al Saedi, Dalia Ali, Anas Aljboori, Anas Mansour, Zahraa Mahdi

Iraqi National Journal of Medicine

Background: Hemodialysis is used to restore electrolyte balance (sodium levels, potassium in the body, bicarbonate, chloride, as well as magnesium, calcium, and phosphate) and filters the waste products and excess fluid. Unfortunately, developing nations continue to have a severe shortage of resources, which makes it difficult to provide highly technical and costly care like dialysis. Aim: The study's objective is to reveal and trace the journey of patients with end stage kidney disease who are on regular hemodialysis program and how they reach to dialysis centers. Methods: the study was to be conducted in many dialysis centers in different regions …

Effect Of Vitamin  C As An Iron-Supporting Supplement In Adolescents With Suspected Iron Deficiency Anemia: Is It Effective For Increasing Hemoglobin Levels?, Ryan Pramana Putra, Nany Hairunisa, Refia Putri Restiana, Husnun Amalia, Emad Yousif

Iraqi National Journal of Medicine

Background: Anemia is a global health problem that affects adolescents, adults, and children in both developed and developing countries. Anemia in adolescent girls (10–19 years of age) is defined as a hemoglobin level in the blood of <12 g/dL. In Indonesia, the prevalence of iron deficiency anemia in adolescent girls reaches 48.9%. Iron supplementation can be enhanced with vitamin C as a companion supplement. Vitamin C increases iron absorption in the body by reducing Fe3+ to Fe2+, which requires an acidic environment for optimal dissolution and absorption. Aim: This study aims to assess the comparative effectiveness of iron supplementation with or without vitamin C in increasing hemoglobin levels. Methodology: An experimental design with consecutive sampling was conducted in September 2023 at Junior High School 1 Prambon, Nganjuk, East Java. The total sample consisted of 52 girls aged 12–13 years with anemia. The first group received iron and vitamin C, while the second group received iron only. Hemoglobin levels were  by the fingerstick method. Results: There were 32 samples (53.33%) aged 13 years. The average change in hemoglobin levels before and after intervention in group 1 was 2.238 g/dL with < 0.05, while in group 2 it was 0.661 g/dL with <0.05. The average difference in changes in hemoglobin levels between groups 1 and 2 after intervention was 1.303 g/dL with <0.05. Conclusion: Iron supplementation with vitamin C results in more significant increases in hemoglobin levels.

Knowledge And Practice Of Undergraduate Medical Students Regarding Self-Medication: A Cross-Sectional Survey In Baghdad, Iraq, Samer Shukur Mohammed, Wael Waleed Mustafa

Iraqi National Journal of Medicine

Background: The global trend of self-medication is rising, making it a priority to investigate associated risks that could lead to life-threatening complications. Aim: To assess self-medication practices among undergraduate medical students and evaluate their knowledge and the factors influencing their use of self-medication Methods: A cross-sectional questionnaire-based study was conducted among 234 medical students from various medical colleges in Baghdad between November 2023 and March 2024. Participants were selected randomly. Data were collected and analyzed using SPSS version 23. The chi-square significance test was performed, and P-values ≤ 0.05 were considered statistically significant. Results: The study found that 72% of …

Barriers To Diet And Exercise Among Patients With Type 2 Diabetes Mellitus In Basrah Hospitals, Jhood Abdul Samad Molan, Fatima K. Hassan, Miaad K. Khaddam, Zainab A.R. Antesh, Hudaa S. Karim

Iraqi National Journal of Medicine

Background: Type 2 diabetes mellitus (T2DM) is growing health concern globally, particularly in the Middle East. To encourage individuals to adopt a healthy lifestyle essential for managing diabetes, it is imperative to thoroughly understand the barriers, especially those that can be modified, encountered by patients following nutritional and exercise medical advice. Aim: The primary objective of this study was to investigate the barriers related to nutrition and exercise among patients with T2DM in hospitals located in Basrah. Methods: This cross-sectional study included 194 adults with history of T2DM who were visiting the outpatient departments of internal medicine in four selected …

Alternate Day Oral Iron Replacement Versus Daily Intake In Women With Iron-Deficiency Anemia In Basrah, Muntadar Jafar Mawla, Mohammed A. Al-Anssari, Qutaiba M. Dawood, Murtadha A. Jeber, Asaad A. Khalaf

Iraqi National Journal of Medicine

Background: Iron-deficiency anemia (IDA) remains a major global health concern, disproportionately affecting women of reproductive age. Conventional daily iron supplementation, though effective, is often associated with poor adherence due to gastrointestinal side effects. Emerging evidence suggests that alternate-day dosing may enhance iron absorption and tolerability, but comparative efficacy data in clinical settings remain limited. Aim: This study aimed to compare the hematological and iron store responses of women with IDA in Basrah, Iraq, between alternate-day and daily oral iron supplementation regimens. Methods: A total of 97 women with confirmed IDA (hemoglobin [Hb] < 12 g/dL, serum ferritin < 15 ng/mL) were enrolled in a prospective follow-up cohort study. The participants were divided into two groups: Group B (n = 48) received 100 mg of elemental iron daily, while Group A (n = 49) received the same dose every other day. Serum ferritin and hematological parameters (Hb, red blood cell [RBC] count, hematocrit) were assessed at baseline, three weeks, six weeks, and three months. ANOVA and paired t-tests were used for statistical analysis, with a significance level of P < 0.05. Results: Compared to the daily group, the alternate-day group exhibited a significantly higher mean increase in serum ferritin (28.6 ± 4.2 ng/mL vs. 22.3 ± 3.8 ng/mL, P = 0.001) and hemoglobin (2.8 ± 0.5 g/dL vs. 2.1 ± 0.4 g/dL, P = 0.001) at three months. The alternate-day group demonstrated earlier and more sustained improvements in iron reserves (P < 0.01 at all follow-ups), but both regimens increased RBC counts. Conclusion: In women with IDA, alternate-day iron supplementation is more effective in restoring hemoglobin and iron stores than daily dosing, possibly due to improved absorption and reduced hepcidin inhibition. These findings suggest potential benefits for patient adherence and clinical outcomes, supporting the use of alternate-day regimens as a superior therapeutic approach. To validate these results, further randomized controlled trials are necessary.

Serum Metabolomic Profiling Of Incident Type 2 Diabetes Mellitus In The Multi-Ethnic Study Of Atherosclerosis And Rotterdam Study, Xuanwei Jiang, Fang Zhu, Gonçalo Graça, Xihao Du, Jinjun Ran, Fariba Ahmadizar, Alexis C Wood, Yanqiu Zhou, Denise M Scholtens, Ali Farzaneh, M Arfan Ikram, Alan Kuang, Carel W Le Roux, Meghana D Gadgil, Marilyn C Cornelis, Kent D Taylor, Xiuqing Guo, Mohsen Ghanbari, Laura J Rasmussen-Torvik, Russell P Tracy, Alain G Bertoni, Jerome I Rotter, David M Herrington, Philip Greenland, Maryam Kavousi, Victor W Zhong

Children’s Nutrition Research Center Staff Publications

Objective: This study aimed to investigate serum metabolomic biomarkers associated with incident type 2 diabetes mellitus (T2DM) and evaluate their performance in improving T2DM risk prediction.

Methods: Untargeted proton nuclear magnetic resonance (1H NMR) spectroscopy-based metabolomics analyses were conducted in the Multi-Ethnic Study of Atherosclerosis (MESA; n = 3460; discovery cohort) and The Rotterdam Study (RS; n = 1556; replication cohort). Multivariable cause-specific hazards models were used to analyze the associations between 23 571 serum metabolomic spectral variables and incident T2DM. Replicated metabolites required an false discovery rate-adjusted P < .01 in MESA, P < .05 in RS, and consistent direction of association. Pathway and network analyses were conducted to elucidate biological mechanisms underlying T2DM development. The utility of the replicated metabolites in improving T2DM risk prediction was assessed based on the Framingham Diabetes Risk Score. A 2-sample Mendelian randomization was conducted to assess causal associations.

Results: Nineteen metabolites were significantly associated with incident T2DM. Pathway analyses …

Role Of Lipoprotein(A) In Atherosclerotic Cardiovascular Disease In South Asian Individuals, Darshan Patel, Marlys L Koschinsky, Anandita Agarwala, Pradeep Natarajan, Harpreet S Bhatia, Anurag Mehta, Jaideep Patel, Matthew Peters, Shreya Pandya, Usman Sagheer, Raman Puri, Salim S Virani, Dinesh K Kalra

Faculty, Staff and Students Publications

South Asian individuals (SA), representing approximately one quarter of the global population, experience a disproportionately high burden of cardiovascular disease. Some of this increased susceptibility is accounted for by traditional risk factors such as diabetes, hypertension, carbohydrate-rich diets, and rising rates of obesity and metabolic syndrome. However, other previously underappreciated risk factors may also play a crucial role. These include environmental pollution, genetic factors, and Lp(a) (lipoprotein(a)). Various epidemiological and genetic studies support the role of Lp(a) as a causal and independent risk factor for atherosclerotic cardiovascular disease. SA have a higher prevalence of elevated Lp(a) levels (25% have levels …

The Overlooked Impact Of Background Diet And Adherence In Nutrition Trials, Javier I Ottaviani, Hagen Schroeter, Dennis M Bier, John W Erdman, Howard D Sesso, Joann E Manson, Gunter G C Kuhnle

Children’s Nutrition Research Center Staff Publications

Randomised controlled trials in nutrition (RCTN) face unique challenges, including the considerable influence of the background diet and the challenge of assuring intervention adherence by participants. The impact of these factors on the outcome of RCTNs has been difficult to quantify, but nutritional biomarkers represent a valuable tool to address these challenges. Using flavanols as a model dietary intervention and a set of recently validated flavanol biomarkers, we here investigated the impact of background diet and adherence on the outcomes of a subcohort of the COcoa Supplement and Multivitamin Outcomes Study (COSMOS, NCT 02422745). We found that 20% of participants …

Exogenous Arginine Differentially Regulates Inflammatory Cytokine And Inducible Nitric Oxide Synthase Expression In Macrophages, Kelsey Stayer, Saliha Pathan, Aalekhya Biswas, Huiqiao Li, Yi Zhu, Fong Wilson Lam, Juan Marini, Sundararajah Thevananther

Faculty, Staff and Students Publications

Immune dysfunction and late mortality from multiorgan failure are hallmarks of severe sepsis. Arginine, a semi-essential amino acid important for protein synthesis, immune response, and circulatory regulation, is deficient in sepsis. However, arginine supplementation in sepsis remains controversial due to the potential to upregulate inducible nitric oxide synthase (iNOS)-mediated excessive nitric oxide (NO) generation in macrophages, leading to vasodilation and hemodynamic catastrophe. Citrulline supplementation has been considered an alternative to replenishing arginine via de novo synthesis, orchestrated by argininosuccinate synthase 1 (ASS1) and argininosuccinate lyase (ASL). However, the functional relevance of the ASS1-ASL pathway in macrophages after endotoxin stimulation is …