Digital Commons Network^™

Effects Of A Major Disruption On Mental Health Of Pregnant Women In South Carolina, Lizmarie Maldonado

MUSC Theses and Dissertations

Mental health conditions are a leading cause of death among pregnant and postpartum women, and untreated mental health conditions are associated with adverse maternal and birth outcomes. Major disruptions, such as pandemics, hurricanes, or wildfires, create unprecedented challenges and may impose additional stressors during an already vulnerable time. Community or medical care disruptions during such events may lead to adverse health outcomes. This dissertation seeks to characterize the impact of a recent major disruption on mental health outcomes among pregnant women using administrative claims data for all births in South Carolina in 2019 and 2020. By leveraging unique data sources, …

Suena Como Nosotros: A Spanish-English Storybook For Growing Voices, Stephanie Czajka

Undergraduate Theses

The purpose of this project is to address the lack of speech therapy resources available to bilingual Spanish-English-speaking children between the ages of four to six. It will target common speech and language difficulties observed in children during the critical language development period, between the ages of four and six. This book will provide an accessible, culturally relevant speech therapy resource that can be used in the comfort of the home. Through the creation of this book, equity in healthcare access will be promoted, and bilingual pride and identity will be supported. The objectives of this project include designing and …

Supporting Positive Interactions With Individuals With Disabilities: A Law Enforcement Guide, Brittany James Jefferson, Mary Jan Greer

Spring 2026 OTD Capstone Symposium

This capstone project developed an educational guide to support law enforcement officers in creating safe and effective interactions with individuals with disabilities. A needs assessment informed the guide’s development, which was grounded in occupational therapy principles and the Person Environment Occupation Performance (PEOP) model. The guide was implemented within a law enforcement setting and evaluated through officer feedback. Findings indicated strong baseline experience among officers, with added value in providing structured strategies to support communication, interpretation, and de-escalation. This project highlights the role of occupational therapy in promoting inclusive, community-based practice.

Translating Self-Regulation Concepts Into Practice: A Pediatric Outpatient Occupational Therapy Activity Toolkit, Catherine Spaulding

Entry-Level Occupational Therapy Doctorate - Doctoral Capstone Symposium

Translating Self-Regulation Concepts into Practice: A Pediatric Outpatient Occupational Therapy Activity Toolkit 

Self-regulation is a foundational skill that enables individuals to manage emotions, behaviors, attention, and physiological responses to engage meaningfully in daily life. In childhood, the development of self-regulation predicts academic success, social relationships, mental health, and lifelong wellbeing (Philpott-Robinson et al., 2023; Robson et al., 2020). When children experience self-regulation difficulties, early identification and intervention by pediatric occupational therapists (OTs) can help prevent future mental health and wellbeing challenges (Philpott-Robinson et al., 2023). Pediatric OTs support self-regulation through sensory-based strategies, mindfulness practices, environmental modifications, caregiver education, and collaboration …

Enhancing Occupation-Based Engagement For Adults With Idd, Miranda Brown, Mary Jan Greer

Spring 2026 OTD Capstone Symposium

This study aimed to explore the importance of occupation-based engagement for adults with intellectual and developmental disabilities (IDD) through the lens of occupational therapy (OT). Literature review and needs assessments informed the development of client-centered interventions and program modules. Project outcomes highlighted the benefit of increased opportunity and appropriate grading of occupation-based engagement for adults with IDD, as well as education for community-based site staff and caregivers.

Play For All: Promoting Inclusivity And Providing Modifications For Kids With Disabilities Within An Indoor Play Space, Yasmeen Ikbal, Mary Jan Greer

Spring 2026 OTD Capstone Symposium

Children’s environments need to be enhanced to match their developmental levels (Winter & Dempsey, 1994). There is a lack of tools, play equipment, and structures specifically targeted to children with disabilities (Therrien et al., 2022). Lack of opportunities for these children can hinder their development (Mullick, 2013). This capstone intends to educate staff and parents on how to promote inclusivity by increasing their understanding of disabilities, creating accessible environments, adapting activities, and building confidence in supporting children with disabilities to participate in their occupations.

Medication Nonadherence And Social Participation For African American Adults With Low Vision, Shakeda Mcghee, Mary Jan Greer Phd, Otr, Jaimee Fielder

Spring 2026 OTD Capstone Symposium

The concept of this capstone is to analyze how quality of life (social participation, health management) is affected in adults ages 18-55 with low vision/blindness with conditions to include diabetic retinopathy, glaucoma, and cataracts.

Correspondence: Dean Elizabeth Martin And Frenesi Wilson Concerning Employment, Dr. Elizabeth Martin, Frenesi Wilson

Correspondence

Correspondence between Dr. Elizabeth Martin, dean of the School of Nursing at the University of North Alabama and Frenesi Wilson, PhD candidate at the University of Texas-Austin, concerning employment. Within in this November and December 1975 correspondence, Frenesi Wilson decline's Dean Martin's offer of a faculty position as an assistant professor due to the commitment of her PhD program. However, Dr. Wilson eventually joins the program as dean on July 19, 1976.

Pamela Charlene Kennamer: Nursing Student Correspondence, License & Pin, Pamela Charlene Kennamer

Correspondence

Correspondence pertaining to nursing student Pamela Charlene Kennamer Corble's admittance to Florence State University as a transfer student in May of 1973. Kennamer was a member of one of UNA's, formerly Florence State University, first graduating classes in nursing. Documents in the final pages of the pdf, include her registration for the state nursing exams in 1976 and official license and nursing pin.

Conceptual Framework With Annotations, College Of Nursing, Florence State University

Documents

The document includes the conceptual framework for the School of Nursing at Florence State University dated April 27, 1976. It also features several handwritten annotations that amend and reword portions of it dated July 21, 1996. Overall, the framework argues the impact of the nursing school's interactions with broader society in helping its students reach self-actualization through its pedagogical practices.

Poems By Nursing Students, Anonymous, A. Jann Davis, L M. A, Larry Atkins

Documents

A series of four poems presumed to be authored by nursing students in approximately the 1980s on themes related to mortality and grief.

The first poem "Thoughts of a Dying Person" is written by an anonymous author whose speaker questions the things in life they would do differently if they had more time. Its form is more prose like than the others in the document and could be considered flash fiction or prose poetry but seems to fit the poetic category more through the usage of a triangular shaping of the poem.

The second poem, an untitled piece by A. …

Information Sheet For High School Day, School Of Nursing, University Of North Alabama

Documents

Information sheet prepared by the University of North Alabama Student Nurses' Association for High School Day held on November 17, 1976. The document explains the School of Nursing's founding in 1973 and the admission process for those seeking a Bachelor of Science in Nursing (BSN).

Integrating Zotero With Your Writing: From Research To Publication – Hslic Workshop Apr 2026, Evelyn Wang

HSLIC Faculty and Staff Instructional Resources

This HSLIC workshop presentation provides a practical, step‑by‑step guide to integrating Zotero into the research and writing workflow. Topics include installing and configuring Zotero and the Zotero Connector, collecting references from databases and web pages, organizing items with collections, subcollections, tags, and PDF attachments, inserting citations and generating bibliographies in Microsoft Word and Google Docs, managing and annotating PDFs, handling title case versus sentence case, detecting and merging duplicate records, and using advanced features such as Zotero sync, group libraries, collaboration tools, custom citation styles, and ZoteroBib.

Occupational Therapy And Periodontics Collaboration To Improve Hand Health And Fine Motor Skills In Dental Student, Zainab Alsuwaiyan

Master's Theses (2009 -)

Background: A study conducted in 2023 by the Occupational Therapy (OT) Department and Marquette University school of dentistry (MUsoD) demonstrated that many student participants scored below average on hand function testing, indicating a need for occupational therapy intervention. Objective: The purpose of this study was to evaluate the effectiveness of occupational therapy–led training for periodontics and registered dental hygienist faculty on the performance of dental students in the Introduction to Clinical Practice course (DEIN 7114). Methods: Faculty teaching in DEIN 7114 were recruited for this study. They participated in educational sessions led by occupational therapy faculty focusing on musculoskeletal disorders …

Exploring The Role Of Cine-Virtual Reality In Empathy And Awareness Of Social Determinants Of Health Among Occupational Therapy Students, Leah M. Stade, Madison Mckeever, Emma Gardner, Jana L. Wardian Phd

Innovations in Health Sciences Education Journal

Understanding social determinants of health (SDOH) is crucial for Occupational Therapy students to develop empathy and deliver optimal healthcare. This study explores using web-based 360° cinematic virtual reality (cine-VR) simulations in Level I fieldwork to address SDOH education and occupational engagement before community-based exposure.

This mixed methods study involved surveys and thematic analysis of written reflections from fifty students in a distance-based program at a Midwest university. Students viewed 12 web-based immersive cine-VR modules about a client experiencing multiple SDOH impacts. Surveys were conducted at baseline, post-intervention, and 6-weeks post-intervention, measuring empathy using the Jefferson Empathy Scale and attitudes toward …

Contributing Factors Of Contralateral Breast Cancer In Patients With Brca Mutation (On-Brca Ii Study, Korea-Bsg 11), Seon-Hi Shin, Sung Gwe Ahn, Jai Min Ryu, Sae Byul Lee, Hyung Seok Park, Eun-Shin Lee, Janghee Lee, Byeongju Kang, Sanghwa Kim, Eun Young Kim, Young-Joon Kang, Sun Young Min, Moohyun Lee, Se-Kang Kim, Hong-Kyu Kim, Chihwan David Cha

Faculty, Staff and Students Publications

Background: The cumulative risk of contralateral breast cancer (CBC) in BRCA1/2 carriers is remarkably higher than in non-carriers. This study aimed to investigate the clinicopathological predictors associated with the risk of metachronous CBC among breast cancer patients with BRCA1/2 mutations using correspondence analysis.

Methods: This retrospective study included patients who underwent BRCA testing between January 2008 and December 2018. The inclusion criterion was patients being between 20 and 80-years-old with invasive breast cancer (pT1-3, N0-3). We performed univariate and multivariate survival analyses to assess the risks associated with BRCA mutations, and conducted correspondence analysis to identify contributing factors for CBC …

Identifying Major Sources Of Leptospira Interrogans In San Juan Bay And Río Grande De Loíza Estuaries Of Puerto Rico, Logan Mccullers, Dave Bachoon

Biology Theses

This study evaluated the presence of pathogenic Leptospira interrogans, potential carriers, and environmental factors influencing their occurrence in the San Juan Bay Estuary (SJBE) and Río Grande de Loíza (RGDL) watersheds of Puerto Rico from 2024–2025. Detection of this pathogen from water samples was performed using the lipL32 PCR assay. The likely hosts of L. interrogans were determined using fecal source tracking (FST) assays for human (HF-183), canine (BacCan-UCD), equine (HoF597), and rat mitochondrial DNA NADH dehydrogenase subunit 2 gene (RatMt) markers. In 2024, 91 samples were collected (March: 50; June: 41), and in 2025, 124 samples were collected …

Epigenome-Wide Association Study Of Blood Proteome In The Atherosclerosis Risk In Communities Study, Yang Li, Aditya Surapaneni, Zulema Rodriguez-Hernandez, Pascal Schlosser, Eugene P Rhee, Eric Boerwinkle, Bing Yu, Megan L Grove, Kelly V Ruggles, Josef Coresh, Morgan Grams

Faculty, Staff and Student Publications

Characterizing the relationship between DNA methylation and circulating proteins is critical to understanding the epigenetic regulation of the human plasma proteome. Here, we performed an epigenome-wide association study of 5,032 circulating proteins in 1,449 White and 315 Black participants from the Atherosclerosis Risk in Communities cohort. We identified 12,500 significant protein quantitative trait methylation (pQTM)-protein associations involving 1,647 proteins. Among 7,796 unique pQTMs, 14.7% were classified as cis-pQTMs, which were enriched for fundamental cellular processes, whereas trans-pQTMs were predominantly linked to immune-related functions. Trans-pQTMs also exhibited stronger associations with demographic, lifestyle, and clinical traits as compared with cis-pQTMs. We identified …

Exploring Healthcare Career Pathways: Survey Findings From The Unmc High School Alliance Program, Jana L. Wardian Phd, Rachael Jaixen, Jaynie Bird, Heidi Kaschke

Innovations in Health Sciences Education Journal

The ongoing demand for a well-prepared and adequately staffed healthcare workforce in the United States highlights the value of effective educational pipeline programs. The University of Nebraska Medical Center (UNMC) High School Alliance (HSA) was created as an immersive, academic enrichment initiative to expose motivated high school students from a range of educational and socioeconomic backgrounds to health professions, with the long-term aim of strengthening the healthcare workforce in Nebraska. This article evaluates the design, curriculum, and measurable impact of the UNMC HSA over its 16-year history. Students participate daily throughout the school year, engaging in courses such as patient …

Choice-Aya: Adapting An Evidence-Based Contraceptive Counseling Intervention For Adolescents And Young Adults Experiencing Homelessness., Mariah E. Brewe, Anna Burns, Nikolaus Schuetz, Taylor Stephens, Emma Francis, Haylie Yost, Stephani L. Stancil

Manuscripts, Articles, Book Chapters and Other Papers

INTRODUCTION: Adolescents and young adults (AYA) experiencing homelessness face an increased risk of reproductive violence, unintended pregnancy, and barriers accessing healthcare. While interventions focused on efficacy-first contraceptive counseling are successful at increasing rates of long-acting reversible contraceptive (LARC) use, little is known about how an efficacy-first approach is received by AYA experiencing homelessness given unique factors associated with their reproductive health care. We aimed to adapt the evidence-based CHOICE contraceptive counseling approach for AYA experiencing homelessness.

METHODS: Focus groups discussion with AYA experiencing homelessness were conducted to understand prior reproductive health care experiences and contraception counseling preferences, comparing efficacy first …

The Use Of Radiofrequency In The Treatment Of Erectile Dysfunction, Sarah Ponce, Nikola Rakic, Beatriz Hernandez, Mohit Khera

Faculty, Staff and Students Publications

No abstract provided.

Development And Application Of A Multiplex Bead-Based Platform For Quantifying Host-Pathogen Protein-Protein Interactions, Larah Gorayeb

Electronic Theses and Dissertations 2020 - Present

Host-pathogen protein-protein interactions are the key drivers of infectious diseases, where events such as pathogen adhesion and signaling are directly associated with disease severity. One example of this is Malaria, in which the Plasmodium falciparum infected erythrocytes adhere to endothelial receptors to avoid splenic clearance. This study investigated interactions between PfEMP1 CIDR1 field domains and host receptor CD36 using a multiplex platform to quantitatively determine binding affinities. Variants RP18 and RP27 exhibited strong affinity, suggesting a role in cytoadherence and disease severity. To evaluate broader applicability, the platform was expanded to the interaction between host protein SIVA1 and Helicobacter pylori …

Co-Occurrence Of Transcriptionally Distinct Persister Cell States Underpins Neoadjuvant Therapy Resistance In Triple-Negative Breast Cancer, Yu Zhang, Fatemeh Ahmadi Moughari, Ioanna Mavrommati, Nora J Doleschall, Kate Moore, Gareth Muirhead, Ram Rajaram Srinivasan, Ping Gong, Jonathan T Lei, Amy Fleming, Hwei Minn Khoo, Naomi Guppy, Gabrielle Elshtein, Mohammed Inayatullah, Vijay K Tiwari, Lacey E Dobrolecki, Michael T Lewis, Syed Haider, Rachael Natrajan

Faculty, Staff and Students Publications

Background

Although the addition of neoadjuvant immune checkpoint blockade to chemotherapy has improved patient outcome in early triple‑negative breast cancer (TNBC), some patients continue to have poor disease outcomes.

Methods

To characterise neoadjuvant chemotherapy (NAC) resistant cell populations that persist post-NAC, we created a high-resolution single-cell atlas of 129,433 cells from fourteen TNBC patient-derived xenograft (PDX) models with residual disease post-NAC. We identified transcriptionally distinct cancer subpopulations or cell states using unsupervised clustering and characterised‑ their regulatory network as well as clinical associations with treatment response, metastatic progression and survival. Findings were validated using multiple independent TNBC cohorts.

Results

Four …

Tracking Hiv Through Wastewater: Ethical Considerations In Public Health Surveillance, Faith E Fletcher, Olive R Pertuit, Catherine Troisi, Jelani Kerr, Dakotah Kinsella, Grace Elizabeth White, Steven Vargas, Anthony Maresso, Thomas P Giordano

Faculty, Staff and Students Publications

Ending the HIV epidemic requires timely identification of new HIV infections and promptly linking patients to high-quality care. Innovative methods are needed to capture real-time HIV incidence data to more effectively identify persons in need of HIV care access. Emerging advancements in wastewater surveillance (WWS) offer the potential to identify geographic areas with elevated prevalence of detectable viral loads among people who are undiagnosed or no longer receiving care, enabling more targeted interventions to reduce HIV transmission. The introduction of new public health technologies requires balancing potential risks with the significant clinical and population-level benefits of decreasing the number of …

Evapecognition: An 18-Year Dataset Of Great Ape Cognition, Alejandro Sánchez-Amaro, Sonja J Ebel Van Wijk, Carin Molenaar, Akzira Abuova, Lizbeth Mujica-Manrique, Sarah M Leisterer-Peoples, Bret Beheim, Luke Maurits, Anna Albiach-Serrano, Matthias Allritz, Nazli Altınok, Federica Amici, Alice Mi Auersperg, Filippo Aureli, Elisa Bandini, Jochen Barth, Leïla Benziad, Bettina E Bläsing, Manuel Bohn, Marie Bourjade, Juliane Bräuer, Marie-Hélène Broihanne, Sarah F Brosnan, Nereida Bueno-Guerra, Thomas Bugnyar, David Buttelmann, Frances Buttelmann, Trix Cacchione, Malinda Carpenter, Fernando Colmenares, Catherine Crockford, Katherine A Cronin, África De Las Heras, Arianna De Marco, Sarah E Detroy, Valérie Dufour, Shona Duguid, Robin I M Dunbar, Johanna Eckert, Jan M Engelmann, Joel Fagot, Julia Fischer, Sofia Ingrid Fredrika Forss, Martina Funk, György Gergely, Julia R Greenberg, Johannes Großmann, Sebastian Grüneisen, Marta Halina, Daniel Hanus, Sarah R Heilbronner, Christophe Heintz, Robert Hepach, Esther Herrmann, Satoshi Hirata, Alenka Hribar, Gabriele Janzen, Juliane Kaminski, Patricia Kanngiesser, Fumihiro Kano, Katharina C Kirchhofer, Hagen Knofe, Kathrin S Kopp, Christopher Krupenye, Isabelle Barbara Laumer, Stephen C Levinson, Ulf Liszkowski, Héctor M Manrique, Gema Martin-Ordas, Emma Suvi Mcewen, Richard T Moore, Enric Munar, Marcos Nadal, Christian Nawroth, Suska Nolte, Marie Pelé, Patrizia Potì, Hannes Rakoczy, Julia Riedel, Amélie Romain, Federico Rossano, Yvan I Russell, Gloria Sabbatini, Marie Schäfer, Marina Scheumann, Martin Schmelz, Benjamin Schmid, Vanesa Schmitt, Carla Sebastián-Enesco, Amanda Madeleine Seed, Chikako Suda-King, Tibor Tauzin, Sebastian Tempelmann, Claudio Tennie, Valentina Truppa, Jana Uher, Amrisha Vaish, Edwin J C Van Leeuwen, Elisabetta M Visalberghi, Christoph J Völter, Victoria Vonau, Claudia A F Wascher, Roman M Wittig, Wouter Wolf, Michael Tomasello, Katja Liebal, Josep Call, Daniel B M Haun

Faculty, Staff and Students Publications

The study of great ape cognition offers insights into the evolutionary origins of human intelligence, but is hindered by small sample sizes and restricted access to data. To address this, we present the EVApeCognition Dataset, a publicly available resource comprising 262 experimental datasets from 150 scientific publications from the Wolfgang Köhler Primate Research Center (2004-2021) in Leipzig, Germany. Eighty-one apes participated in 150 studies, with a majority (N = 78) participating in more than one study. Publication of the dataset aims to make these unique datasets accessible for future meta-analyses and correlational analyses, helping us better understand how our great …

Cerebellar Oligodendrocytic Α-Synuclein Pathology And Dentate Nucleus Neuronal Hypertrophy In Parkinson’S Disease, Diego Iacono, Hui Peng, John Paul Bouffard, Roger Kurlan

Department of Neurology Faculty Papers

Idiopathic Parkinson's disease (iPD) research has historically prioritized basal ganglia dysfunction and neuronal Lewy body pathology, often overlooking cerebellar and non-neuronal cells contributions. This study investigates cerebellar neuropathology in iPD, specifically focusing on neuronal and non-neuronal cells of the dentate nucleus (DN) and its adjacent white matter (DN-WM). We systematically assessed autopsy-confirmed iPD brains vs. age-matched controls using immunohistochemistry and stereology-based morphometry methods. The study evaluated α-synuclein pathology, other common age-related co-occurring pathologies (β-amyloid, Tau, neuroinflammation), myelin integrity (Luxol-Fast-Blue), and neuronal volumetric changes in the DN of the cerebellum. In iPD brains, we identified intracytoplasmic α-synuclein inclusions within oligodendrocytes across …

Evaluating The Utility Of Rnaseq In Prenatal Diagnostics: Expression Profiles Of Cultured Chorionic Villus And Amniotic Fluid Samples, Maria C Vladoiu, Sen Zhao, Roni Zemet, Christian M Parobek, Jefferson Cruz Sinson, Stacy Tankersley, Ignatia B Van Den Veyver, Pengfei Liu

Duncan NRI Faculty and Staff Publications

Objective: While RNAseq has enhanced variant interpretation in postnatal cases, its potential in the prenatal setting remains underexplored. This study investigates the utility of RNAseq in prenatal diagnostics by analyzing the expression profiles of cultured chorionic villus samples (cCVS) and amniotic fluid (cAF) samples.

Methods: We performed RNAseq on 25 prenatal samples (10 cCVS and 15 cAF) and compared their expression profiles with those of postnatal tissues-blood and skin fibroblasts.

Results: To evaluate the clinical relevance of gene expression in these samples, we curated a list of genes associated with fetal-onset genetic disorders (n = 375). Using this curated list …

Bi-Allelic Variants In Ap5z1 And Ap5b1 Lead To Retinal Degeneration, Hafiz Muhammad Jafar Hussain, Meng Wang, Paul Yang, Behnoosh Tasharrofi, Yumei Li, Rebecca Lynn Clark, Emma Fale-Olsen, Grace Waldow, Mohammad Keramatipour, Mostafa Asadollahi, Mark E Pennesi, Rui Chen

Faculty, Staff and Students Publications

Inherited retinal diseases (IRDs) comprise a diverse group of disorders that frequently lead to progressive vision impairment and blindness. Despite advances in genetic testing, a significant number of IRD cases remain genetically unsolved, often due to unidentified disease-associated genes or variants. This study reports additional cases for the newly discovered IRD genes of the AP-5 complex. A comprehensive ophthalmological evaluation was performed for all patients, including retinal imaging (multimodal imaging), visual field testing, and electroretinogram (ERG) testing. Whole-genome and -exome sequencing (WGS and WES) were performed for clinically unsolved IRD patients, and data were analyzed to identify underlying causal variants. …

Trajectories Of Plasma And Csf Mtbr-Tau243 And Phosphorylated-Tau Species Across The Alzheimer's Disease Continuum, Lyduine E Collij, Gemma Salvadó, Kanta Horie, Nicolas R Barthélemy, Tobey J Betthauser, Olof Strandberg, Ruben Smith, Sebastian Palmqvist, Suzanne E Schindler, Rik Ossenkoppele, Shorena Janelidze, Niklas Mattsson-Carlgren, Randall J Bateman, Oskar Hansson

2020-Current year OA Pubs

To efficiently implement plasma and cerebrospinal fluid (CSF) biomarkers for staging and prognosis of Alzheimer disease (AD), we must understand their dynamics across disease progression. We analyzed participants from the Swedish BioFINDER-2 study with mass spectrometry measurements of plasma and CSF tau species, including eMTBR-tau243/MTBR-tau243 and phosphorylation occupancies (%p-tau). Disease duration was estimated using Aβ-PET and tau-PET with the SILA algorithm. Bootstrapped LOESS models showed that %p-tau217 changes earliest, increasing just before Aβ-PET positivity. Other p-tau species changed later, with smaller dynamic ranges and earlier ceiling effects. %p-tau205 and MTBR-tau243 changes aligned with tau-PET positivity onset, while MTBR-tau243-especially plasma eMTBR-tau243-tracked …

Harnessing The Gut-Diet Axis To Enhance Chemotherapy And Immunotherapy, Jill Carline

Bryant REDay (Research and Engagement Day)

The human microbiome, a complex ecosystem of trillions of microorganisms including bacteria, fungi, and viruses, represents a critical "gut-diet axis" that significantly influences cancer progression and therapeutic efficacy. While a state of homeostasis supports systemic immunity, dysbiosis is linked to chronic inflammation and can actively promote resistance to standard cytotoxic chemotherapies and modern immune checkpoint inhibitors. Specifically, research indicates that Bacteroides fragilis (ETBF) promotes resistance to 5-Fluorouracil and Oxaliplatin in colorectal cancer by activating Notch1 receptors to inhibit apoptosis and push cancer cells into a resilient, stem-cell-like state. Conversely, the introduction of fiber-rich and fermented foods can cultivate beneficial bacteria …