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Peaks Island Star : January 2026, Vol. 46, Issue 1, Service Agencies Of The Island

Peaks Island Star, 2026

The Peaks Island Star is the newsletter of the island's service agencies and other community news.

Empowering Through Structured Boundaries: An Integral Model For Fostering Balanced Eating And Nutritional Well-Being, Citrine Elatrash, Colleen Macke, Jenna Shi, Theresa Wilson, Sarah H Elsea, Stephanie Sisley

Faculty, Staff and Students Publications

Purpose: Treating obesity in complex disorders requires individualized health management plans. Effective obesity management in the Smith-Magenis syndrome (SMS) population has multiple inherent barriers related to their cognitive impairments, anxiety, behavioral disturbances, and sleep disorders. However, to date, no research exists related to strategies caregivers successfully employ to help individuals with SMS manage their food intake and mitigate associated behaviors.

Methods: We performed a qualitative thematic analysis of group interviews from 23 caregivers representing 21 individuals with SMS. Hybrid thematic analysis revealed that successful strategies employed by caregivers in this unique population revolved around a global theme of Empowering Through …

Amino Acids And Lean Mass Accretion In Preterm Neonates, Antonio C Ramos Dos Santos, Marta L Fiorotto, Teresa A Davis

Faculty, Staff and Students Publications

Purpose of review: This review evaluates recent evidence on how total protein and energy intake, amino acid composition, and nutrient delivery modality influence protein synthesis in preterm neonates, with the goal of informing nutritional strategies to support optimal lean mass accretion and growth.

Recent findings: Preterm neonates exhibit anabolic resistance to feeding due to impaired insulin and amino acid signaling in skeletal muscle. Enteral nutrition, especially fortified human milk, supports better lean mass accretion and neurodevelopment than parenteral nutrition. Intermittent bolus feeding and pulsatile leucine supplementation during continuous feeding further enhance mTORC1-dependent translation initiation signaling and protein synthesis efficiency in …

Priced Out Of Treatment: The Exorbitant Cost Of Antiparasitic Drugs In The United States, Cora Alperin, Nhi Nguyen, Megan Duffey, Eva H Clark

Faculty, Staff and Students Publications

Parasitic infections are often perceived as diseases of low-resource countries, yet they impose a significant and overlooked burden in the United States—especially among immigrants, low-income individuals, and other marginalized populations. This perspectives article examines the case of Mr. X, a landscaper in Houston diagnosed with neurocysticercosis, who faced unaffordable drug costs despite the availability of effective, off-patent treatments. Through his story, we explore the broader issue of pricing for commonly and not-so-commonly prescribed antiparasitic medications, highlighting the role of systemic market failures, regulatory hurdles, and restrictive assistance programs in limiting access to care. The consequences of incomplete treatment include long-term …

Decentralized Linear Solvers: Communication Cost And Privacy, Nelson G. Brasil, Vinay A. Vaishampayan

Publications and Research

We consider the problem of multiple parties iteratively solving a system of linear equations in a decentralized manner. Specifically, we solve for $\negr{x} \in \R^n$, the $n \times n$ system of linear equations $M\negr{x} = \negr{b}$ when each party only knows their row of the matrix $M$ and a single component of $\negr{b} \in \R^n$. Our objective is to determine the tradeoff between the accuracy of the solution and the total communication cost measured in bits. A fully connected, reliable mesh network is assumed to connect the different parties. We develop a general formulation that applies to a large class …

Clinical Factors And Diagnoses Associated With Inappropriate Urine Culture Ordering In Primary Care, Marissa Valentine-King, Barbara W Trautner, Michael A Hansen, Roger Zoorob, Lisa C K Danek, Kenneth Muldrew, Forrest Hudson, Robert L Atmar, Larissa Grigoryan

Faculty, Staff and Students Publications

Objective: Evaluate the prevalence and risk factors for inappropriately ordered urine cultures in primary care.

Design: Cross-sectional study using chart reviews.

Setting: Two primary care, safety-net clinics in Houston, Texas.

Patients: Non-pregnant adults without a urinary catheter who had a urine culture and a primary care visit between 11/2018 and 3/2020.

Methods: We classified patients lacking physician documentation of the following symptoms as having an inappropriately ordered urine culture: dysuria, frequency, urgency, hematuria, fever, chills, costovertebral angle tenderness, nephrolithiasis, and pain (suprapubic, pelvic, or flank). We extracted patient demographics, visit-related diagnostic codes, past medical history, and urine culture results. Diagnostic …

Leveraging Cross-Reactivity For Dual Serological Detection Of Closely Related Schistosoma Species, Oyetunde T. Oyeyemi, Lisa M. Shollenberger

Biological Sciences Faculty Publications

Schistosomiasis is a disease of poverty that is highly prevalent in Sub-Saharan African countries. Cross-reacting proteins in Schistosoma mansoni (Sm) and S. haematobium (Sh) have been reported to pose diagnostic challenges. Proteins from these two parasites may help overcome diagnostic limitations caused by cross-reactivity and poor species discrimination in serological assays. The study aims to identify cross-reacting protein markers from S. mansoni and S. haematobium for possible concurrent diagnosis of the two parasites. High-quality protein extracts were prepared from the eggs (soluble egg antigen, SEA) and adult worms (Schistosoma worm antigens preparation, SWAP) of S. haematobium and S. mansoni …

Impact Of Cigarette Smoke On Immune And Stromal Cells, Justin Wong

Master's Projects

Cigarette smoke is a plight on human health, being a major contributor to lung diseases. The aryl hydrocarbon receptor (AHR) directs immune regulation and metabolic adaptation in response to environmental toxins. This study investigates transcriptomic changes between wild-type and AHR knockout mouse lung tissue under smoke and air conditions. Single-cell RNA sequencing data were generated by the Butcher Lab and analyzed in Seurat for differential gene expression (DGE) analysis. A two way ANOVA framework was used with DGE analysis to classify genes as smoke induced or suppressed in an AHR dependent or independent manner, and these gene sets were analyzed …

Searching For Cause Of Unexplained Protein Interaction With Multiple Assembly Methods, Gavin Anderson

Master's Projects

Research into colistin adjuvants has identified interactions between a host of proteins and proteins found within certain strains of bacteria. BLAST, a widely adopted local sequence alignment tool, was used to create a database containing the genomes of relevant bacterial strains, which would then be used to query against the previously identified proteins. Many of these strains do not have publicly available assemblies, which makes database construction difficult. CATwalk, a new naïve fragment extender, is first described in this paper and used to extend fragments of interest. BLAST results first identified short fragments with sufficient similarity, which can then be …

Detection And Characterization Of Cancer Using Cfdna Fragmentomic Analysis, Guneet Bhogal

Master's Projects

Cell-free DNA (cfDNA) fragmentomics has emerged as a promising non-invasive approach for detecting and characterizing cancer by analyzing DNA fragmentation patterns. These fragment patterns are unique and can be used to distinguish between tumor and healthy DNA. This paper uses machine learning models to detect cancer by evaluating Shannon entropy of fragment lengths at the first coding exon 1 regions and correlating them to targeted cancer genes. This approach was applied to two datasets consisting of samples with prostate, breast, and lung cancers. Our results indicated that exon 1 fragmentation entropy captures biologically relevant differences in cancer-specific chromatin organization and …

Combining Crispr And Nanoasv To Uncover The Rare Bacterial Communities Of The Human Oral Microbiome, Gilma Ruth Sevilla Alvarez

Master's Projects

Studying the oral microbiome is vital because its health implications are not contained to the mouth. Cariogenic bacteria cause tooth demineralization and oral microbes that translocate to extra-oral organ systems are linked to conditions like Alzheimer’s disease, heart disease, diabetes, and cancer. Some of these pathogens belong to the most abundant phyla in the oral cavity: Bacillota, Pseudomonadota, Bacteroidota, Actinomycetota, Spirochaetota, and Fusobacteriota, which together comprise 94% of the oral microbiome. This project uses CRISPR-Cas9 to deplete sequences from highly abundant phyla and the Eubacteria domain, enriching the remaining 6% of rarer taxa. Paired with NanoASV for single-nucleotide resolution, this …

Memory Effects In Many-Body Systems, Jeffrey Beckstrand

Master's Projects

This thesis investigates memory effects in many-body systems through the MoriZwanzig Formalism for projected dynamics of a Hamiltonian System which yields the Generalized Langevin Equation (GLE). The GLE is a stochastic differential equation (SDE) that studies the dynamics of observables under the effects of many other observables in the system. Although satisfying, the GLE has a term called the Memory Kernel that encodes the past of the system and introduces a computational challenge by introducing a non-Markovian property to the equation. The kernel is often approximated by introducing a delta function, which simplifies the computation, but at the loss of …

Javatutor: An Integrated Llm Framework For Structured Programming Tutoring And Problem-Solving In Java, Amey Makarand Dhongade

Master's Projects

Large Language Models (LLMs) are being adopted more actively to assist in pro- gramming tasks, but much of the available AI code assistants devices are encouraging the rapid generation of solutions, as opposed to assisting students in developing an understanding. As a result, they can give the students correct code without teaching on how to judge a problem and how to build solutions or how to debug their programs themselves. This study describes JavaTutor, an LLM-based tutoring system that is used to assist learners in the learning process in a three-step process of understand- ing, generating a solution, and refining …

Safe-R2r: A Safety-Aware And Budget-Optimized Retrieval Controller For Rag Systems, Mandar Sunil Gondane

Master's Projects

Retrieval-Augmented Generation (RAG) improves factual grounding in large language models by incorporating external evidence during inference. However, most RAG systems rely on fixed retrieval strategies that ignore query difficulty, computational cost, and prediction uncertainty. This project introduces SAFE-R2R (Safety-Aware and Budget-Optimized Reason-to-Retrieve), a retrieval controller that treats retrieval as a query-dependent decision problem. SAFE-R2R organizes retrieval into a multi-rung ladder ranging from no retrieval to deeper retrieval with reranking. At each rung, the system generates an answer, computes reliability signals, and combines them into a risk score used within a conformal calibration framework to decide whether to accept the answer …

Multimodal Emotion Detection System, Shubhankar Sameer Munshi

Master's Projects

Trying to understand emotion from speech is a problem that is present in human computer interaction. Nevertheless, there are still some shortcomings in current SER methods. Text-based systems may miss vital vocal cues, such as sarcasm, tone changes, and delivery. On the other hand, purely audio-based systems are prone to noise and unstable acoustic features. The combination of linguistic and acoustic features in multimodal approaches partially solves this problem, but many existing approaches use inflexible multimodal fusion techniques that cannot adjust their behaviors according to the quality of input signals. In this work, we propose a multimodal approach based on …

Modeling Sealed Deck Construction In Collectible Card Games Using Learning-To-Rank Approach, Michael Dinh Nguyen

Master's Projects

Artificial intelligence has demonstrated strong performance in complex decision-making domains such as chess and Go, motivating research into its application for games with even richer rules and combinatorial complexity. In collectible card games like Magic: The Gathering, deck construction from a constrained card pool is a critical and challenging task that requires evaluating card strength, synergy, and resource balance. This project explores whether machine learning, specifically learning-to-rank (LTR), can effectively model these human decision processes to construct competitive decks in a sealed format. The results found here can also be applicable to other areas of note, such as sports drafting …

Stepwise Sudoku Reasoning Training Using Transformers, Lok Man Chu

Master's Projects

Sudoku is a constraint satisfaction problem that serves as a testbed for studying reasoning and stepwise deduction. While many solvers can produce correct solutions, they often fail to generate human interpretable sequences of logically consistent steps. This study investigates whether a transformer trained on stepwise deduction traces can learn to solve Sudoku puzzles through sequential, logically deducible moves. Results show that solve accuracy improves significantly with more training data, reaching approximately 78% at 1500k samples. Stepwise analysis indicates that the model effectively learns simple strategies, achieving near-perfect performance. However, performance on more complex strategies remains limited. Overall, while the model …

Multi-Agent Path Planning And Optimization Using Q-Learning, Chirag Rudresh

Master's Projects

Robot navigation in a multi-agent setting requires a balance between safety and efficiency, especially in dense environments. In these two-dimensional spaces, the scope for geometric errors is much less and could lead to collisions or immobility. This project proposes to address the navigation task using a two-phase path planning pipeline that combines reinforcement learning and convex optimization in a scalable and robust manner. The first phase consists of generating diverse collision-free paths using a Q-learning agent that is trained on a visibility graph representation of the environment. The discretization of the environment using waypoint-based graphs allows the agent to train …

Predictors Of Inpatient Rn Turnover In Rural And Urban Vha Hospitals, Katherine G Bay, Chase S Eck, Melissa K Knox, Paras Mehta, Laura A Petersen

Faculty, Staff and Students Publications

Background: The rising demand for health care delivery and an aging workforce is of particular concern in rural areas, where health care access depends upon an adequate nursing workforce. To address this shortage and optimize care, it is essential to measure when registered nurses (RN) leave inpatient direct care positions (ie, inpatient RN turnover) and identify modifiable factors correlated with RN turnover.

Objectives: Apply a novel method for characterizing inpatient RN turnover to understand factors associated with variation in RNs leaving inpatient positions at rural and urban Veterans Health Administration (VHA) hospitals.

Project design: Retrospective cohort study.

Subjects: Direct care …

Relationship Between Number Of Assigned Patients And Rn Time To Administer Medications During The Peak-Time Medication Pass, Chase S Eck, Melissa K Knox, Paras D Mehta, Christine Yang, Laura A Petersen

Faculty, Staff and Students Publications

Background: Inpatient nurse staffing affects patient outcomes. Less is known about the mechanism of this relationship and how lower overall staffing in a unit affects individual RN activities at the bedside.

Objectives: Estimate the relationship between the number of patients assigned to an RN and time spent on medication administration at the peak-time medication pass (PTM), a common nursing task.

Research design: Estimate the association using multivariable linear regression to adjust for patient severity and staff and unit fixed effects.

Subjects: All 9272 RNs administering medications during the PTM on 243 inpatient units in 113 VHA hospitals in 2019.

Measures: …

Using Medication Pass Analysis To Examine Longitudinal Changes In Va Inpatient Nurse Staffing And Workload Before And Through The Covid-19 Pandemic: 2019-2022, Melissa K Knox, Chase S Eck, Lynette Dorsey, Paras D Mehta, Christine Yang, Laura A Petersen

Faculty, Staff and Students Publications

Background: The COVID-19 pandemic resulted in extended disruption to the health care system. National-level data-driven comparisons of inpatient nurse staffing and workload before and during the pandemic have been limited.

Objectives: Assess the extent to which registered nurse (RN) staffing and workload changed from prepandemic levels in a national integrated health care system.

Research design: Longitudinal descriptive analysis. Medication pass analysis using bar code medication administration data for the peak-time medication pass (PTM) assessing year-over-year changes from 2019 to 2022. To assess significance of year-over-year changes in means we used the Welch 2-sample t test.

Subjects: Staff (N=42,999) administering PTM …

Healthcare Transition In Spina Bifida: A National Mixed Method Study, Betsy Hopson, Kathy H Huen, Molly B Richardson, Rhonda G Cady, Jennifer T Queally, Judy Thibadeau, Ellen Fremion

Faculty, Staff and Students Publications

Introduction: Adolescents and young adults (AYA) with spina bifida (SB) face substantial challenges during the transition from pediatric to adult healthcare, including fragmented systems, limited adult provider availability, and gaps in self-management readiness. Despite national guidelines, little is known about how transition practices are implemented across the Spina Bifida Association (SBA) Clinical Care Partner (CCP) network. This study examined clinician perspectives on current practices, barriers, facilitators, and definitions of successful healthcare transition (HCT).

Methods: Using an explanatory sequential mixed methods design, we first conducted a 47-item survey with clinicians from SBA CCP clinics (n = 20/32; 62.5 % response rate). …

Safety And Efficacy Of Vadadustat Versus Darbepoetin Alfa For Chronic Kidney Disease-Related Anemia In Patients Receiving Dialysis By Baseline Erythropoiesis-Stimulating Agent Dose, Alan Jardine, Steven K Burke, Wenli Luo, Todd Minga, Mark J Sarnak, Wolfgang C Winkelmayer, Rajiv Agarwal, Glenn M Chertow, Kai-Uwe Eckardt, Mark J Koury

Faculty, Staff and Students Publications

Introduction: Erythropoiesis-stimulating agents (ESAs) and iron supplementation are standard treatments for chronic kidney disease (CKD)-related anemia. Targeting higher hemoglobin values in CKD increases cardiovascular risk. Whether the increased risk is from higher ESA doses or higher hemoglobin levels is uncertain, but alternative therapies are sought for patients requiring high ESA doses. Phase 3 INNO2VATE trials in patients with dialysis-dependent CKD (DD-CKD) demonstrated vadadustat's noninferiority compared with darbepoetin alfa. To determine vadadustat's potential to treat anemia, including in patients requiring high ESA doses, its safety and efficacy were compared with those of darbepoetin alfa across prespecified baseline ESA dose subgroups in …

Ptpn1 Regulation Via Ybx1-Ptbp1 Interaction Promotes Fibroblast Activation And Fibrotic Remodeling In The Lung, Huibing Liu, Cong Xia, Yingying Zhang, Yulong Gan, Lianhui Cheng, Xuqian Wang, Airu Chang, Wenyu Zhao, Bin Li, Yaxuan Wang, Yajun Li, Ivan Rosas, Juntang Yang, Guoying Yu, Lan Wang

Faculty, Staff and Students Publications

Idiopathic pulmonary fibrosis (IPF) is a chronic, progressive interstitial pneumonia of unknown etiology. Its pathogenesis involves complex multicellular interactions and signaling pathways, with fibroblast-to-myofibroblast transition (FMT) being critical for fibrogenesis. Although the transcription factor Y-box binding protein 1 (YBX1) regulates processes such as cell proliferation, transcription, translation, and DNA repair, its role in IPF remains undefined. Here, we demonstrate that YBX1 overexpression significantly promotes transforming growth factor-β1 (TGF-β1)-induced pulmonary FMT, leading to substantially increased extracellular matrix (ECM) deposition in primary human (PHLFs) and mouse (PMLFs) lung fibroblasts. Conversely, YBX1 inhibition markedly suppresses TGF-β1-driven aberrant fibroblast migration and activation. Mechanistically, YBX1 …

Left Atrial Appendage Closure Devices: A Contemporary Review Of Techniques, Tips And Tricks, Kamran Namjouyan, Hafeez Ul Hassan Virk, Affan Rizwan, Muzamil Khawaja, Mahboob Alam, Markus Strauss, Chayakrit Krittanawong

Faculty, Staff and Students Publications

Atrial fibrillation (AF) affects approximately 3%-5% of adults and is projected to double in prevalence by 2060, significantly increasing the burden of thromboembolic stroke. This risk is largely attributed to thrombus formation within the left atrial appendage (LAA), particularly in nonvalvular AF, where the LAA's trabeculated anatomy, diverse morphologies (e.g., chicken wing, windsock, cactus, cauliflower), and impaired contractility allows for blood stasis and thrombogenesis. As a result, the LAA has become a focus for stroke prevention strategies. This review demonstrates current evidence on LAA closure by discussing patient selection, anatomical feasibility, procedural workflow, imaging guidance (transesophageal echocardiography vs. intracardiac echocardiography), …

A Practical Approach To The Management Of Percutaneous Coronary Intervention Complications, Tanawat Attachaipanich, Hafeez Ul Hassan Virk, Muzamil Khawaja, Mahboob Alam, Ravi S Hira, Jacob A Doll, Chayakrit Krittanawong

Faculty, Staff and Students Publications

Introduction: Despite advances in stent design, pharmacotherapy, and procedural techniques that have improved percutaneous coronary intervention (PCI) outcomes and reduced PCI-related complications, these events still occur and are associated with adverse outcomes. Moreover, complex PCI procedures, which predispose to increased risk of complications, are increasingly performed. Understanding risk factors, underlying mechanisms, evidence-based management, and preventive strategies are essential to optimize procedural outcomes. This review aims to summarize current evidence and highlight gaps in knowledge related to PCI-associated complications.

Methods: This narrative review used a focused PubMed search through October 2025, prioritizing randomized trials, large observational studies, guidelines, and consensus statements. …

Inducible Pou Class 2 Homeobox 3 Expression In Human Intestinal Organoids As A Model Of Human Tuft Cells, Carolyn Bomidi, Luqiong Wang, Hoa Nguyen-Phuc, Mary K Estes, Sarah E Blutt

Faculty, Staff and Students Publications

No abstract provided.

Sewers To Solutions: A Guide To Wastewater Pathogen Monitoring, Justin R Clark, Anthony W Maresso

Faculty, Staff and Students Publications

Wastewater-based epidemiology (WBE) is the analysis of wastewater to detect pathogen levels or activity for public health awareness or action. Pioneered in the 1940s, WBE underwent a resurgence during the COVID-19 pandemic, providing important information about number of cases, outbreaks, and seasonal impact. With advancements in detection technologies and growing interest in environmental surveillance, WBE is poised to become a standard practice in public health monitoring. Here, we provide an overview of the current state of the art of pathogen WBE, including methods of molecular detection, analysis of wastewater data, real-world applications and programs, public health interventions, and benefits and …

Editorial: Advances In Phage Applications: Deciphering Phage Biological And Ecological Mechanisms Through Metagenomics, Tasha M Santiago-Rodriguez, Gary A Toranzos

Faculty, Staff and Students Publications

No abstract provided.

Genomic And Structural Analysis Of Major Antigenic Proteins’ Variability In The Human Relapsing Fever Spirochete Borrelia Persica, Dor Shwartz, Yaarit Nachum-Biala, Reinhard K Straubinger, Ofir Segev, Asaf Levy, Job E Lopez, Gad Baneth

Faculty, Staff and Students Publications

Antigenic variation enables immune evasion of pathogens, yet the mechanisms for the rapid change in their antigens without loss of structural and functional features are not fully known. Tick-borne relapsing fever (TBRF) spirochetes of the genus Borrelia can be used as a model because their variable major proteins (Vmps) drive antigenic variation followed by recurrent waves of bacteremia. In this study we generated the genome of Borrelia persica LMU-C01 and evaluated Vmp structure across relapsing fever Borrelia species. Borrelia persica was found to have a genome of 1.7Mb with one linear chromosome, 12 linear and one circular plasmids. Telomeric hairpin …