Digital Commons Network^™

Simulation Training In Radiation Oncology, Michael C. Schell, Andrew W. Beavis, Derek W. Brown, Michael Milano, Michael O'Neill, Yan Yu, Daniel C. Pavord, Peter Dunscombe

Department of Radiation Oncology Faculty Papers

Simulation training can be used in the design of new processes or, more commonly, to train and re-train healthcare personnel in standard processes. Simulation training is one avenue to making radiation oncology a high reliability health care intervention. In this paper, we explore the relevance of simulation training to the provision of high-quality and safe radiation oncology practice against the background of simulation training conducted in high reliability industries. The use of simulation training in healthcare, as well as specific examples in radiation oncology, is reviewed. An outline of the steps for developing a simulation training program is provided. Simulation …

Parental Psychological Distress And Perceived Child Externalizing Behaviors: Examining Mediators And Bidirectional Effects, Abigail J. Anderson, Christina M. Rodriguez, James M. Henson

Psychology Faculty Publications

Parental psychological distress is a commonly examined risk factor for the emergence of child problem behaviors, but the factors that contribute to that relationship—such as limited parental resources like greater social support and coping skills—have not been adequately explored, particularly with attention to potential bidirectional relations that incorporate child evocative effects. The current longitudinal study examined maternal and paternal psychological distress in relation to perceived child externalizing behaviors, considering parental resources as mediators within a bidirectional model. The sample included a racially and socioeconomically diverse group of 201 primiparous mothers and 151 fathers. Mothers and fathers reported their current psychological …

Natural Resource Rents And Energy Poverty Nexus In Next Eleven Economies, Muhammad Salah Uddin, Ayub Ali, Zobayer Ahmed, Md Nasir Uddin Sikdar, Ahsan Habib, Abdullah Elah Al-Mahde

Finance Faculty Publications

Energy poverty (EP) remains a persistent global challenge with important implications for economic development, public health, and social welfare. While natural resources, particularly oil and gas, are often viewed as key sources of energy access, their effectiveness in mitigating EP remains underexplored in emerging economies. This study examines the relationship between natural resource rents (NRR), specifically oil rents (OR) and natural gas rents (NGR), and energy poverty (EP) in the Next Eleven (N-11) countries from 2000 to 2020. The primary objective is to assess how NRR influences EP at various levels of poverty using the Method of Moments Quantile Regression …

Impact Of An Educational Video Intervention On Word Recognition And Vocabulary Knowledge Of Paediatric Dental Terms Among Low-Income Caregivers Of Youth Children, Melissa L. Sullivan, Denise C. Mckinney, Abdullah Al-Taiar, Deanne Shuman

Dental Hygiene Faculty Publications

Objective

To evaluate the impact of an educational intervention on paediatric dental term recognition and vocabulary knowledge among low-income caregivers of young children.

Methods

A randomized two-group pretest-posttest trial was used to analyze the impact of an educational intervention on caregivers' word recognition and vocabulary knowledge of paediatric dental terms. The study included 60 pregnant women and caregivers with children enrolled in a Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) in the Southeastern United States. Both groups received an educational pamphlet on children's oral health. The experimental group also received an educational video with common paediatric dental …

Osmotic Dilators Vs. Foley Balloons: Bayesian Secondary Analyses Of The Dilafol Trial, Antonio F. Saad, Elenir B. C. Avritscher, Claudia Pedroza, Xiao Han, George R. Saade

Department of Obstetrics & Gynecology Faculty Publications

Background: Dilapan-S, a synthetic osmotic dilator used for pre-induction cervical ripening, has proven to be as effective as the Foley balloon in terms of vaginal versus cesarean delivery and has been associated with increased patient satisfaction. Nevertheless, its ability to lower cesarean rates and its cost-effectiveness remain poorly studied.

Objectives: To estimate the likelihood that synthetic osmotic dilators reduce cesarean deliveries and to evaluate their health system costs (2026 US$) and incremental cost-effectiveness compared to the Foley balloon during cervical ripening.

Study Design: Secondary Bayesian analyses were conducted using data from the single-center DILAFOL randomized controlled trial, which enrolled 419 …

Adjunctive Technologies To Electronic Fetal Monitoring: Promise, Pitfalls, And Lessons Learned, Rebecca Horgan, George Saade

Department of Obstetrics & Gynecology Faculty Publications

Despite widespread use, electronic fetal monitoring (EFM) has not demonstrably reduced perinatal morbidity or mortality, and likely contributed to the rise in cesarean delivery. To improve its utility, a number of adjunctive approaches have been introduced over the past three decades, including fetal pulse oximetry, ST segment analysis (STAN), and maternal oxygen supplementation. Each intervention was supported by strong physiologic rationale, yet none achieved widespread clinical adoption due to inconsistent evidence of benefit and, in some cases, potential harm. This review critically evaluates landmark studies on EFM adjuncts, highlights the limitations that have impeded progress, and outlines emerging innovations, including …

Leading The Way In Pediatric Oral Health Promotion, Denise C. Mckinney

Dental Hygiene Faculty Publications

[Introduction] Dental hygienists promote oral health and provide preventive services to patients throughout their lifespan. The Commission on Dental Accreditation, Dental Hygiene Standards emphasize that graduates must be competent in providing dental hygiene care for all patient populations, including children.¹ In fact, promoting pediatric oral health begins prior to birth with the expectant mother and/or caregiver. Oral health care to include education is essential during pregnancy; specifically, around the prevention and treatment of dental caries for the mother and the unborn child.² In the U.S., from 2013-2016, roughly 30% of women aged 20-44 years had untreated dental caries.³ Expectant mothers …

How Dentists Can Remain Advisors Of Merit To Their Patients, Daniel L. Orr Ii, Dds, Ms (Anesth), Phd, Jd, Md, Facd (Nevada Section Chair)

Journal of the American College of Dentists

This article examines how members of the dental profession can sustain their longstanding reputation as trusted advisors amid declining public confidence in major institutions. Grounded in ethical principles, informed consent, and professional self-regulation, dentistry has historically ranked among the most trusted professions. The discussion explores challenges to credibility, including media scrutiny, concerns about anesthesia safety, controversial treatment hesitancy, and debates over community water fluoridation. Emphasizing the concept of the “advisor of merit,” the author argues that continued trust depends on truthful communication, transparency about risks, respect for patient autonomy, and freedom from conflicts of interest in clinical and public health …

Empathy And Human-Centered Leadership In Community Health Center Dental Clinics, Pamela S. Alston Dds, Mpp, Facd

Journal of the American College of Dentists

A person-centered approach, with empathy toward patients, can improve satisfaction among both patients and dental health professionals. A dental director with a human-centered leadership style can improve the well-being of oral health team members. This article describes the role that empathy, a core value of humanism and professionalism, plays in accomplishing these improvements in community health center dental clinics. This article also describes the risks of empathy, as experienced by the author in her role as a dental director and practitioner, as well as documented in the literature. It further focuses on dental directors’ human-centered approaches to supporting oral health …

The Epidemiology Of Catastrophic Head And Neck Injuries In High School And College Non-Football Sports: A 4-Decade Review, Courtney M. Meyer, Kristen L. Kucera, Samantha E. Scarneo-Miller, Zachary K. Winkelmann, Susan W. Yeargin

Rehabilitation Sciences Faculty Publications

Background:

Catastrophic head and neck injuries (CHNIs) in sport are rare but can have disabling or fatal outcomes. Prior studies have focused on football, equipment-laden sports, or different injury severities, not CHNI in nonfootball sports.

Purpose:

To describe the epidemiology of CHNI across levels (high school vs collegiate) in nonfootball sports and evaluate differences in injury rates (IRs) by sport, sex, and decade.

Study Design

Descriptive epidemiological study.

Methods:

This study utilized 40 academic years (1982-1983 to 2021-2022) of surveillance data from the National Center for Catastrophic Sports Injury Research. Descriptive statistics summarized athlete, event, and injury characteristics. IRs were …

Rare Manifestation Of Scapular Cutaneous Larva Migrans Infection Among Sand Porters In Warm Climate: A Case Report, Prio Hangudi Sampurno, Tri Wisesa Soetisna

Occupational and Environmental Medicine Journal of Indonesia

Background Cutaneous larva migrans is a serpiginous helminthic infection common among certain occupations dealing with contaminated soil especially in warm climate. Most common predilections include the feet, legs, and buttocks with only a fraction of cases found on the trunk and upper extremities.

Case Presentation A rare scapular cutaneous larva migrans manifestation on a thirty-six years old sand porter with high occupational exposure was described. Physical examination revealed progressive pruritic and warm rash in a serpiginous pattern on the left shoulder.

Results Diagnosis was established based on characteristic serpiginous rash physical findings supported by history of contact. This case needed …

Incident Of Sensorineural Hearing Disorder In Toll Road Workers Exposed To Noise And Lead, Fitria Rimadhanty Setyaningtyas, Muhammad Ilyas, Dewi Yunia Fitriani, Suryo Wibowo

Occupational and Environmental Medicine Journal of Indonesia

Background Toll road workers are exposed to traffic noise and lead, both of which may increase the risk of sensorineural hearing loss (SNHL). This study aimed to examine the association between noise and lead exposure and the occurrence of SNHL among toll road workers.

Methods A cross-sectional study was conducted using secondary data derived from medical check-up records of 1,445 toll road workers in 2022. Study variables included age, sex, length of employment, past medical history, smoking status, job position, blood lead levels and SNHL incidence. Descriptive analyses were performed, followed by bivariate analysis using the chi square test and …

Fatigue Assessment And Workplace Decision-Making: A Scoping Review, Tamio Papilika, Rony Catur Wibowo, Famelia Famelia

Occupational and Environmental Medicine Journal of Indonesia

Background Fatigue is a recognized contributor to impaired performance and increased occupational risk in safety-critical industries. Although various assessment tools are available, their real-world implementation and role in operational decision-making remain unclear.

Methods This scoping review mapped fatigue assessment methods in workplace settings and evaluated their application in operational contexts. A systematic search of PubMed and Google Scholar identified 693 records, of which 21 studies met the inclusion criteria for real-world occupational settings.

Results All included studies utilized combined subjective and objective fatigue assessment approaches; however, this finding should be interpreted in light of the search strategy. Administrative applications were …

Comparison Of Mental Illness Comorbidity Pre-Pandemic Vs. Pandemic-Era And Associations With Clinical And Demographic Characteristics For Virginia Public Hospital Inpatient Discharges With A Substance Use Disorder, Marilyn Bartholmae, Tharidu Gunawardena

Department of Medicine Faculty Publications

The rise in mental illnesses after the COVID-19 pandemic is well documented. However, it is not known whether the rates of mental illness comorbidity increased. The objectives of this study were to compare mental illness comorbidity rates before and after the pandemic among inpatients with SUD and to test associations between mental illness comorbidity, physical illness, and demographics. We used a retrospective cross-sectional design in a sample of inpatient discharges (N = 233,017) at Virginia public hospitals from January 2018 to December 2022. We used Z tests to compare rates of mental illness comorbidity pre- and post-pandemic and Chi-square tests …

Directional Association Between Irritable Bowel Syndrome And Dermatological Disease: A Large-Scale Retrospective Study, Alex Y. Liu, Naomi T. Matsuno, Houston Nelson, David Johnson, David Pariser

Department of Medicine Faculty Publications

Background/Objectives: Microbial dysbiosis is implicated with a pathogenic role in both irritable bowel syndrome (IBS) and several dermatological conditions. Yet, few studies have assessed a potential overlapping epidemiologic association. We aimed to assess the 1-year prevalence of common dermatologic conditions following an initial IBS diagnosis and to evaluate the reverse association using reciprocal analyses. Methods: We conducted a retrospective study using TriNetX. Patients aged 18–50 with no history of inflammatory bowel disease, celiac disease, or infectious intestinal disease were matched 1:1 to healthy controls by demographics and comorbidities. The primary outcome was the prevalence of acne vulgaris, psoriasis, …

Trends In Hypertension Prevalance And Control In The United States Over 25 Years, Omar Saleh, Neda Rehan, Saleh Mostafa, Rehan Qayyum

Department of Medicine Faculty Publications

Despite sustained public health efforts, hypertension remains highly prevalent in the United States, with persistent disparities across demographic and socioeconomic groups. We examined 25-year trends in hypertension prevalence, undiagnosed hypertension, and on-treatment uncontrolled hypertension in the United States using nationally representative National Health and Nutrition Examination Survey (NHANES) data from adults aged ≥18 years. Hypertension was defined as systolic BP ≥130 mmHg, diastolic BP ≥80 mmHg, or current antihypertensive use. Undiagnosed hypertension was defined as elevated BP without prior diagnosis or treatment, while on-treatment uncontrolled hypertension was defined as diagnosed hypertension with BP ≥130/80 mmHg despite treatment. Survey-weighted generalized linear …

A Fishy Situation: Hand Infection Due To Mycobacterium Marinum Mistaken For Giant Cell Tumor, Alynna Knaub, Dylan Baker, Jennifer Hanrahan

Department of Medicine Faculty Publications

Mycobacterium marinum is an acid-fast bacterium (AFB) associated with exposure to water and aquatic species. When inoculated, infection can result in nodular cutaneous lesions. In the absence of detailed history or culture data, these nodular skin lesions can be mistaken for noninfectious orthopedic conditions. We present a case of M. marinum mistaken for a giant cell tumor. This case illustrates the overlap in these conditions, as well as the utility of QuantiFERON Gold testing to provide supportive evidence for the diagnosis of Mycobacterium marinum.

Visit Complexity Differs Between Scarring And Nonscarring Alopecia: A 5-Year Dataderm Analysis, Ian Noel Encarnacion, Noelle Desir, Nicholas Schell, Apoorva Mehta, Temitayo Ogunleye, Susan Taylor

Department of Medicine Faculty Publications

[Introduction] Accurate coding is a critical component of dermatologic practice, influencing reimbursement and documentation of clinical complexity. Although alopecia has significant psychosocial and financial burdens, Current Procedural Terminology (CPT) coding patterns in alopecia management remain largely understudied. Our population-level study using the American Academy of Dermatology's DataDerm clinical registry¹ evaluates alopecia CPT coding trends, pre-2021 and post-2021 evaluation and management (E/M) CPT coding updates,² aiming to inform coding practices and visit complexity, which have significant reimbursement implications.

Ultra-Processed Foods And The Cardiovascular-Kidney-Metabolic Continuum: Integrating Epidemiological, Multi-Omics, And Translational Evidence, Saiful Singar, Amirhossein Ataei Kachouei, Leandro Lantigua-Somoano, David Manley, Anthony Cardinale, Muhammad Zulfiqah Sadikan, Saurabh Kadyan, Donya Shahamati, Lorena Dias, Amber Wood, Cinthia Chavarria, Sara K. Rosenkranz, Neda S. Akhavan

Department of Medicine Faculty Publications

Cardiovascular-kidney-metabolic (CKM) syndrome integrates excess adiposity, metabolic dysfunction, kidney impairment, subclinical cardiovascular diseases, and clinical events along a staged continuum that invites unified prevention and treatment. Ultra-processed foods (UPFs) are a complex, high-prevalence exposure that may influence risk across CKM stages through nutrient profiles, additives, processing-induced compounds, and packaging-related contaminants. This review synthesizes epidemiologic, mechanistic, and translational evidence with attention to exposure definition and analytic rigor. We summarize NOVA-based UPF operationalization across dietary assessment tools, highlighting misclassification of mixed dishes, brand heterogeneity, and energy under-reporting, and we propose further examination of energy-adjusted models, calibration, and harmonized metrics. Observational studies consistently …

Micro- And Nanoplastics: A Paradigm Shift In The Pathogenesis Of Inflammatory Bowel Disease, Michael Saadeh, Priyata Dutta, Gordon Hong, Edward Oldfield, David A. Johnson

Department of Medicine Faculty Publications

Micro- and nanoplastics (MNPs) are pervasive environmental contaminants with growing recognition as potential contributors to human disease. Widespread human exposure occurs primarily through ingestion of contaminated food and water, and MNPs have been detected in multiple human tissues, including the gastrointestinal tract. Experimental evidence provides a plausible biological basis for disease associations, including impairment of intestinal barrier integrity, activation of mucosal immune pathways, and alteration of gut microbial communities caused by MNP exposure. Although human data remain limited, early studies demonstrate MNP detection in stool and suggest potential correlations with inflammatory biomarkers such as fecal calprotectin. These findings, together with …

Selenium And Liver Steatosis And Fibrosis: Opposing Direct And Steatosis-Mediated Associations In A Large Cohort, Neda Rehan, Jubilee Benedict, Rehan Qayyum

Department of Medicine Faculty Publications

Background and Aims

Epidemiologic studies have reported conflicting associations between selenium exposure and liver disease. Whether selenium exerts opposing direct and steatosis-mediated effects on liver fibrosis is unknown. To evaluate the associations of blood selenium with elastography-defined hepatic steatosis and fibrosis and to determine whether hepatic steatosis mediates the relationship between selenium and fibrosis.

Methods

We conducted a cross-sectional analysis of adults aged >= 18 years in NHANES 2017-2023. Hepatic steatosis was assessed using the controlled attenuation parameter (CAP) and fibrosis using liver stiffness measurement (LSM). Blood selenium was categorized into quartiles. Survey-weighted multivariable linear regression and structural equation modeling …

Seasonal And Geographic Patterns Of Gastroschisis In Canada: Protective Effect Of Periconceptional Sunlight Exposure, Shiliang Liu, Shin Jie Yong, Dunjin Chen, Gavin C. Hughes, Claude L. Hughes

Department of Medicine Faculty Publications

Background: Gastroschisis is a right-sided, full-thickness defect with extra-amnionic herniation of abdominal contents directly into the amniotic cavity. The causes of gastroschisis remain obscure. We hypothesized that limited periconceptional sunlight exposure might lead to insufficient vitamin D during fetal development and play a role in gastroschisis etiology.

Methods: We conducted a population-based cohort study of infants conceived in Canada between April 2006 and March 2020. We used winter months (i.e., November and December) and northern geographic latitudes as indicators of insufficient sunlight exposure, while summer months (July and August) and southern geographic latitudes were considered as reference. We examined the …

Glucagon-Like Peptide Receptor Agonists (Glp-1ras) As Cardiovascular Risk Modifiers In Obstructive Sleep Apnea And Obesity: A Real-World Study, Jaeun Ahn, Junmin Song, Kyle Admire, Yu Chang, Kuan-Yu Chi, Nathaniel T. Gordon, Joshua M. Sill

Department of Medicine Faculty Publications

Introduction

Obstructive sleep apnea (OSA) is a well-established risk factor for cardiovascular disease. Glucagon-like peptide-1 receptor agonists (GLP-1RAs) have demonstrated potential in reducing cardiovascular risk and improving OSA severity. However, a significant knowledge gap remains regarding the impact of GLP-1RAs on cardiovascular events in OSA patients.

Methods

We examined patients with a BMI over 30 diagnosed with OSA between January 2010 and November 2021 without a previous diagnosis of heart failure, pulmonary hypertension, or myocardial infarction. Two cohorts were created: those prescribed GLP-1RAs within 1 year of their OSA diagnosis and patients who were never prescribed GLP-1RAs. Propensity score matching …

An Analysis Of Heart Failure Among Cancer Patients In The United States Between 1999 And 2020, Abes A. Bautista Neughebauer, Deepak Talreja, Apostolos Gaitanidis

Department of Medicine Faculty Publications

Background: Cancer and heart failure (HF) are highly prevalent in the population and can co-exist, due to shared risk factors and an aging population. The HF-related mortality burden in cancer patients across in the United States (US) remains poorly understood. The goal of this study is to evaluate the patterns of HF-related deaths among cancer patients in the United States.

Methods: A retrospective analysis was performed using the Centers for Disease Control and Prevention (CDC) WONDER Multiple Cause of Death database between years 1999 and 2020. HF-related deaths were defined as death certificates listing HF as a contributing cause of …

Ensuring Rich Rigor Of Qualitative Methodologies In Behavior Analytic Research, Daria K. Lorio-Barsten, Selena J. Layden

Human Movement Studies & Special Education Faculty Publications

Quantitative methods remain the hallmark of research in applied behavior analysis. Yet, such methods frequently fail to capture the nuances of context where behavior analysis is practiced. Therefore, qualitative methods can provide complementary means to gain deeper insight into changes in socially significant behavior. We believe that researchers within the field of behavior analysis have much to gain from embracing qualitative methodologies. We propose that more researchers can and should consider conducting rigorous qualitative research to elevate the voices of the participants and relate the depth and complexities of their nuanced experiences. This article discusses Tracy’s “big tent” quality criteria …

The Effects Of Physical Activity Timing And Adherence To Physical Activity Guidelines On Sleep In Children With Adhd, Xiao Liang, Mengping Zhao, Li Su, Justin A. Haegele, Richard H. Xu, Jingjing Li, Andy Choi-Yeung Tse, Shirley X. Li

Human Movement Studies & Special Education Faculty Publications

Regular physical activity (PA) has been shown to benefit sleep. However, the effects of PA timing and adherence to the WHO's recommended 60-min moderate-to-vigorous physical activity (MVPA) guideline on sleep are unclear, especially for children with ADHD who often experience sleep problems. This study examined whether timing of MVPA influenced objectively measured sleep, including sleep latency (SL), sleep efficiency (SE), total sleep time (TST), and wake after sleep onset (WASO), among children with ADHD. This cross-sectional study involved 253 children with ADHD (Mage = 8.60 ± 1.31 years, 81% boys). MVPA timing was categorized as more than 8 h before …

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 …

Predicting Dementia Risk: Progress, Pitfalls, And Priorities, Patricia Nistor, Osvaldo Espin-Garcia, Zul Merali, Shehzad Ali

Brain and Mind Institute

As populations age, identifying individuals at high risk for dementia has become a cornerstone of prevention-oriented public health policy. Accurate and scalable risk stratification could enable early intervention and resource targeting. However, existing models face methodological limitations, including constraints in available data and follow-up duration, challenges in dementia ascertainment, heterogeneity in modelling approaches, and limited external validation. This commentary discusses these challenges and identifies methodological priorities for developing dementia risk algorithms that are robust and suitable for real-world implementation.

Intratracheal Interleukin-10 Administration Reduces Acute Lung Injury Induced By Sulfur Dioxide Exposure In Mice, Amy J. Nelson, Todd A. Wyatt, Bradley W. Richmond, Belinda Diaz, Angela Gleason, Michael J. Duryee, Geoffrey M. Thiele, Ted R. Mikuls, Jill A. Poole

Journal Articles: Environmental, Agricultural & Occupational Health

Therapies capable of reducing acute high-consequence airborne chemical exposure-induced lung disease are lacking. This study seeks to determine the therapeutic potential of interleukin (IL)-10 administered following acute sulfur dioxide (SO₂) exposure in mice. C57BL/6 male and female mice were exposed to SO₂ gas at 125 ppm for 4 h and subsequently treated 2-3 h later with IL-10 (1 μg) or vehicle control by intratracheal instillation for a total of 3 doses over 2 days with comparisons to sham-treated mice (N = 20 mice/group). IL-10 treatment reduced SO₂-induced weight loss with corresponding reductions in SO_{2 …}

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

CONRAD Publications

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