Medicine and Health Sciences Commons^™

The Diseased Extracellular Matrix In Chronic Obstructive Pulmonary Disease Modeling, Leigh-Ann M. Antczak

Theses and Dissertations

Chronic obstructive pulmonary disease (COPD) is currently the fourth leading cause of death in the world, with an increasing prevalence as the world’s population ages. In the distal regions of the lungs, COPD is characterized by progressive emphysema due to an imbalance of proteases that continuously degrade essential extracellular matrix (ECM) proteins within the alveolar walls, causing fatal tissue impairment. This dissertation examines the unique properties of this diseased lung ECM in two parts: (1) As a key constituent in inflammatory signaling that leads to increased inflammation and progression of COPD, and (2) as a tool in three-dimensional (3D) in …

Risk Analysis Of Radiosurgery For Vestibular Schwannoma: Systematic Review And Comparative Study Of 10-Year Outcomes, Kevin M. Guy, April A. Pace, Derek S. Tsang, Peter G. Volsky

Department of Otolaryngology (ENT) Faculty Publications

Background: Determine the benefit of stereotactic radiosurgery (SRS) compared to no treatment for sporadic vestibular schwannoma (VS) by calculating epidemiologic risk using 10-year data; apply the analysis to VS that have demonstrated linear growth.

Methods: PubMed, Google Scholar, Web of Science, and Cochrane Library are systematically reviewed for VS tumor control 10 years after SRS and compared to an historical cohort of untreated VS (primary risk analysis). Subgroups of VS limited by size and observed growth are compared to the untreated cohort (secondary analysis).

Results: Twenty-four studies of 4,079 SRS-treated VS exhibited tumor control in 90.93% (87.0%-100%; SD 4.1%), while …

Acute Exacerbations Of Chronic Rhinosinusitis, Robert M. Frederick, Kent Lam, Joseph K. Han

Department of Otolaryngology (ENT) Faculty Publications

Purpose of Review

We aim to highlight recent advancements on the evolving chronic rhinosinusitis (CRS) phenotype: acute exacerbations of chronic rhinosinusitis (AECRS). We focused on studies that expanded the current understanding of its pathophysiology, patient characteristics, and disease burden.

Recent findings

Defining AECRS has been a topic of discussion for many years. A recent regulatory definition of AECRS in the literature incorporates a > 3 day requirement of worsened symptoms and an escalation of treatment. It is important not to rely on patient-reported rescue medication frequency as it was recently demonstrated these are only obtained for 1/3 of reported AECRS episodes. …

A Systematic Review Of Dietary Trends, Influencing Factors, And Their Impacts On Cardiovascular Health In Turkish Populations, Pelin L. Özoğlu

Honors Undergraduate Theses

Cardiovascular disease (CVD) is the leading cause of death globally, including in Türkiye. One key factor influencing CVD prevention is dietary patterns, which directly impacts cardiovascular health. Türkiye traditionally follows the Mediterranean diet (MedDiet), which is acclaimed for its cardiovascular benefits. Despite this, Türkiye continues to experience high rates of CVD, with projections indicating that CVD mortality will double for both men and women by 2030. It is crucial to address diet-related factors, including potential nutritional deficiencies, to reduce cardiovascular health risks.

This research aims to analyze the Turkish community's adherence to the Mediterranean diet to understand why CVD prevalence …

High-Throughput Drug Screening For Disease-Modifying Arthritis Therapy, Janapriya Vijayakumar

Honors Undergraduate Theses

Current therapy for arthritis predominantly focuses on the symptoms rather than the underlying causes of disease progression. Thus, it is necessary to identify novel drugs which target the underlying molecular basis of such diseases. Using high-throughput cell-based drug screening, we screened 458 different compounds, narrowed down from 811 starting compounds from the NIH Mechanistic Set. We selected drugs from the Mechanistic Set following Lipinski's Rule of 5 to ensure optimal pharmacokinetic properties. The study used modified primary human chondrocytes (IIAM-PRG4Luc), which secrete a lubricin promoter-driven luciferase reporter. We use this luciferase expression as a proxy to measure lubricin, a compound …

Investigation Of Lubricin-Stimulating Fda-Approved Compounds For A Disease-Modifying Osteoarthritic Drug, Swathi S. Menon

Honors Undergraduate Theses

Osteoarthritis (OA) is a degenerative disease that affects many people worldwide. Current methods of treatment are palliative, and no treatment exists to fully reverse or cure OA once it begins to progress. The discovery of a disease-modifying osteoarthritic drug (DMOAD) would increase the quality of life for millions and reduce the need for invasive procedures. Screening FDA-approved drugs ensures more promise due to their known safety profile and potential for faster translation to the clinic. The goal of this project was to conduct dose-response assays with FDA-approved drugs that have been shown to stimulate lubricin production in cells that mimic …

Development Of A Proposed Selective Medium For The Isolation And Differentiation Of P. Sordellii, Dimyana Bottros

Honors Undergraduate Theses

Clostridium, a genus of anaerobic, spore-forming bacteria, includes clinically and ecologically significant species like Clostridium difficile and Paeniclostridium sordellii. C. difficile causes antibiotic-associated colitis, while P. sordellii is linked to fatal infections and spontaneous abortions. Recent studies found both species in marine sediments, suggesting their role in environmental and wildlife health disturbances, including the 2013 mass mortality of over 300 manatees in the Indian River Lagoon. However, isolating and differentiating P. sordellii is challenging due to the lack of selective media optimized for its growth. This thesis proposes a novel selective medium tailored to P. sordellii’s physiological …

Biomechanics Of The Atherosclerotic Lipidome: (Un)Expected Statin Interactions And Membrane Remodelling, Ethan M. Fong

Pomona Senior Theses

Statins interact with lipid membranes in ways that shape their pharmacokinetics, off-target effects, and pleiotropic actions, yet these interactions' mechanical and biophysical consequences remain poorly understood. This thesis employs a combination of surface plasmon resonance (SPR), quartz crystal microbalance with dissipation monitoring (QCM-D), and rheological modelling to characterize how representative statins intercalate within biomimetic supported lipid bilayers (SLBs) of healthy and diseased composition. SPR reveals that lipophilic statins exhibit higher apparent affinities and slower dissociation kinetics, especially in cholesterol- and anionic lipid-rich membranes. QCM-D analyses demonstrate that statins alter membrane mass, dissipation, and interfacial stiffness in a statin- and membrane-dependent …

Study Of Maternal And Fetal Outcomes In Pregnancy Complicated By Thyroid Disorders, Sindhu Kumari, Poornima M

Digital Journal of Clinical Medicine

Background:

Thyroid disorders, particularly hypothyroidism, are common during pregnancy and can significantly impact both maternal and fetal outcomes. Despite advancements in screening and treatment, thyroid dysfunction in pregnancy often remains underdiagnosed, especially in low-resource settings. This study aimed to evaluate the prevalence, outcomes and effective management strategies of thyroid dysfunction during pregnancy.

Objectives: To evaluate the prevalence and outcomes of thyroid dysfunction, including both hypothyroidism and hyperthyroidism, during pregnancy, and their associated maternal and fetal complications.

Methods: This prospective observational study included 281 pregnant women with thyroid disorders attending antenatal care at JSS Hospital, Mysuru, from August 2022 …

Semaglutide And The Evolving Landscape Of Metabolic Dysfunction–Associated Steatotic Liver Disease, Rohan Karkra

Digital Journal of Clinical Medicine

The FDA approved Semaglutide (Wegovy™) on August 15, 2025, for adults with MASLD and moderate to advanced fibrosis (F2–F3), making it the second approved therapy after Resmetirom. MASLD affects up to 38% of adults and is now the leading cause of liver disease. In the phase 3 ESSENCE trial, Semaglutide achieved resolution of steatohepatitis without worsening fibrosis in 62.9% versus 34.3% with placebo, with additional benefits in weight loss and glycemic control. While long-term data remain pending and access barriers exist, this approval marks a significant advance in MASLD therapy with meaningful histologic and metabolic improvements.

Inpatient Dermatology Vignettes: Seborrheic Dermatitis, Garrett Furth, Henry Lim, Marshall Hall, Christian Scheufele, Michael Carletti, Stephen Weis

North Texas Research Forum 2025

Seborrheic dermatitis is a common inflammatory disorder characterized by greasy scale, itching, and erythema. It commonly affects areas of the skin that have high sebum production or are sebaceous gland-rich, including the scalp, face, sternum, axilla, groin, and other skin folds. Seborrheic dermatitis can present in infants, adolescents, and adults, and is more common in men. The etiology is not fully understood, but contributing factors include presence of the yeast genus Malassezia, androgen levels, immunosuppression, family history, and stress or lack of sleep. Interestingly, those with neurological and psychiatric conditions, including Parkinsons Disease, spinal cord injury, epilepsy, and tardive dyskinesia, …

Perceived Risk Of Skin Cancer: Influence Of Family History, Age, Ethnicity, And Fitzpatrick Type, Henry Lim, Reem Ayoub, Rafael Do Valle, Kristina Kafle, Dana Olsen, Ysabelle Martinez, Christina Guo, Marshall Hall, Christian Scheufele, Michael Carletti, Stephen Weis

North Texas Research Forum 2025

Background: Skin cancer in the United States accounts for approximately 50% of new early cancer diagnoses. Despite this, many individuals underestimate their personal risk, leading to lower engagement in preventative behaviors. Several factors may influence an individual’s perceived risk, including family history, age, race, ethnicity, skin type, and gender. While some individuals recognize their increased susceptibility based on personal, familial, and cultural experiences, others may have a lower perceived risk due to misconceptions or limited awareness. This study examines how these demographic factors influence individuals' perceived risk of skin cancer. Methods: This study analyzed data from 333 individuals aged 19 …

Follicular Occlusion Syndrome: Diagnosis, Management, And Emerging Insights, Henry Lim, Reem Ayoub, Rafael Do Valle, Marshall Hall, Michael Carletti, Stephen Weis

North Texas Research Forum 2025

Follicular Occlusion Syndromes (FOS) are rare chronic relapsing skin disorders characterized by abnormal follicular hyperkeratinization, plugging, and inflammation. FOS are more commonly discussed as a ‘triad’ or ‘tetrad’ based on the patient’s clinical presentation. The triad includes hidradenitis suppurativa, acne conglobata, and dissecting cellulitis of the scalp. The tetrad in addition to the triad includes a history of pilonidal cysts. These disorders have a considerably negative effect on quality of life due to chronic pain, psychological distress, and body image concerns. Delayed or misdiagnosis can exacerbate patient outcomes, heightening the importance of timely identification and multidisciplinary treatment. We present two …

Body Dysmorphic Disorder Presenting As Alopecia Anxiety: A Case Report, Henry Lim, Paige Loux, Arianne Felicitas, Marshall Hall, Christian Scheufele, Garrett Furth, Michael Carletti, Stephen Weis

North Texas Research Forum 2025

Background: Body dysmorphic disorder (BDD) involves a preoccupation with a nonexistent or insignificant physical defect that causes clinically significant distress and impacts a patient's daily functioning. We present a case of a patient with body dysmorphia that manifested as anxiety about hair loss. Case Information: A 48-year-old otherwise healthy female presented to the dermatology clinic with the chief complaint of 8 months of hair loss. She had been seen previously by 2 other dermatologists. She brought 28 pages of paperwork to her first appointment detailing previous work-up, including four separate skin punch biopsies consistent with androgenetic, non-cicatricial (non-scarring) alopecia. Other …

Skin Color Cannot Be Confined To Six Categories: Comparing The Fitzpatrick Scale And Colorimetric Measures, Henry Lim, Kristina Kafle, Reem Ayoub, Dana Olsen, Ysabelle Martinez, Rafael Do Valle, Christina Guo, Marshall Hall, Christian Scheufele, Michael Carletti, Stephen E. Weis

North Texas Research Forum 2025

Purpose The Fitzpatrick Scale (FS), originally developed to dose photochemotherapy in Caucasian skin, has become widely adopted for skin color categorization. It originally included types I-IV, with types V-VI added later for darker skin. The FS was designed for UV radiation reactivity assessment. However, it is increasingly used as a proxy for objective skin color classification, despite being based on a subjective questionnaire. Individual Typology Angle (ITA), a validated colorimetric measurement, presents a potential alternative. Previous studies examining these classification systems have been limited by small sample sizes and uneven distribution across skin tones with subjects predominantly having lighter skin …

An Unusual Case Of Indolent Systemic Mastocytosis: Diagnostic Insights In The Absence Of Classic Systemic Symptoms, Henry Lim, Jonah Gutierrez, Rafael Do Valle, Reem Ayoub, Marshall Hall, Christian Scheufele, Garrett Furth, Michael Carletti, Stephen Weis

North Texas Research Forum 2025

Introduction: Mastocytosis is a disorder characterized by an abnormal clonal accumulation and subsequent activation of mast cells within one or more organs. It is generally classified as either cutaneous, with or without systemic involvement, or systemic without cutaneous disease based on major and minor criterion. Indolent systemic mastocytosis (ISM) is a subclass of systemic mastocytosis with generally good prognosis. While the etiology of ISM is not completely understood, those who are affected typically have the KIT D816V mast cell receptor mutation. Given that ISM is mast cell mediated, patients predominantly present with a wide range of symptoms related to mast …

A Case Of Neutrophilic Dermatosis Of The Dorsal Hands With Post-Traumatic Onset, Marshall Hall, Kristina Kafle, Henry Lim, Christian Scheufele, Garrett Furth, Michael Carletti, Stephen Weis

North Texas Research Forum 2025

Background Sweet Syndrome is an acute, febrile neutrophilic dermatosis that is characterized by painful red lesions, fever, and neutrophilia with histological findings of dermal neutrophilic infiltrate. Neutrophilic Dermatosis of the Dorsal Hands is a localized variant of Sweet Syndrome. Neutrophilic Dermatosis of the Dorsal Hands presents with focused lesions on the dorsal hands, most commonly between the index finger and thumb, typically with fewer systemic manifestations. This condition presents significant diagnostic challenges as it can mimic infectious processes, potentially leading to delayed appropriate treatment. Case Information A 64-year-old male presented to the emergency department with wounds on the bilateral hands. …

Investigating The Relationship Between Skin Color, Ethnicity, And The Fitzpatrick Skin Scale, Henry Lim, Dana Olsen, Reem Ayoub, Maria Francesca Ysabelle Martinez, Rafael Do Valle, Kristina Kafle, Christina Guo, Marshall Hall, Christian Scheufele, Michael Carletti, Stephen Weis

North Texas Research Forum 2025

Introduction: The Fitzpatrick skin scale has long been used as a proxy for skin tone categorization. However, its initial creation was to classify reactivity of white skin to ultraviolet A radiation. A reported one-third of dermatologists conflate the Fitzpatrick skin scale for race and ethnicity. Approximately half of the dermatologists also reported utilizing the Fitzpatrick scale to describe skin color. The goal of this study was to compare the Fitzpatrick scale to skin color and ethnicity in a larger, cohort including the full spectrum of skin tones. Methods: Subjects completed a standardized questionnaire. The questionnaire encompassed subjective classification methods: self-reported …

A Case Of Biopsy-Proven Atopic Dermatitis Perpetuated By Psychosomatic Factors, Henry Lim, Jamie Y. Choe, Marshall Hall, Arianne Felicitas, Christian Scheufele, Garrett Furth, Michael Carletti, Stephen Weis

North Texas Research Forum 2025

Introduction: Psychodermatology is an interdisciplinary branch of psychosomatic medicine that addresses interactions between the psyche and skin. Stress is often a key exacerbating factor and highlights the bidirectional relationship between psychological factors and skin disorders. Atopic dermatitis (AD) is a chronic skin condition affecting pediatric and adult populations with an estimated global prevalence of approximately 2.6%, or approximately 204 million people. AD classically presents with a red, scaly, pruritic rash. Here, we present a case of biopsy-proven AD induced by stress-associated behaviors related to patient-identified obsessive-compulsive habits. Case Presentation: A 61-year-old female presented for persistent itching and white discoloration in …

Molluscum Dermatitis In A Pediatric Patient, Garrett Furth, Olivia Mayer, Marshall Hall, Henry Lim, Christian Scheufele, Michael Carletti, Stephen Weis

North Texas Research Forum 2025

Atopic dermatitis (AD) is a chronic relapsing condition characterized by irritation, redness, inflammation, and itching of the skin. The cause of AD is theorized to be multifactorial, including genetic components, such as mutations in filaggrin, environmental exposures, and immune predisposition. AD often presents in childhood and adolescence, but can appear at any age. AD eruptions arise through various triggers, which commonly include soaps, detergents, fabrics, and cold or hot weather. Importantly, viral infections can also serve as a trigger, causing systemic inflammation via host defense mechanisms. Molluscum contagiosum (MC) is a double-stranded DNA virus that classically manifests as small, dome-shaped, …

Clinical Evaluation And Management Of Terra Firma-Forme Dermatosis: Insights From Two Diverse Cases, Henry Lim, Rafael Do Valle, Reem Ayoub, Marshall Hall, Michael Carletti, Stephen Weis

North Texas Research Forum 2025

Terra Firma-Forme Dermatosis (TFFD), also known as Duncan’s dirty dermatosis is a benign, asymptomatic dermatologic condition characterized by well-demarcated brown patches to hyperkeratotic papules or plaques. It most commonly affects the neck, trunk, and face but can appear on other body regions. A key diagnostic feature is that these lesions persist despite routine washing with soap and water but can be removed by forcibly wiping the affected area with 70% isopropyl alcohol, revealing normal underlying skin. The exact etiology of TFFD remains unknown, though it is thought to involve abnormal keratinization or delayed desquamation. This condition is often underdiagnosed or …

Development And Validation Of An Accurate And Precise Skin Color Scale, Henry Lim, Christina Guo, Reem Ayoub, Rafael Do Valle, Kristina Kafle, Ysabelle Martinez, Dana Olsen, Marshall Hall, Christian Scheufele, Michael Carletti, Stephen Weis

North Texas Research Forum 2025

Introduction: Utilization of the Fitzpatrick scale to describe skin color does not adequately account for variations in pigmentation that are reflective of skin color characteristics of persons from diverse racial and ethnic backgrounds. This study aims to create a better way to describe skin color. Methods: We developed an 11-point color scale. This Skin Color Scale (SCS) was reproduced onto a physical card that could be placed onto a research participant’s inner arms for independent scale interpretation. Participants and two investigators selected the best matching scale interpretation value for each arm. Self-acquired and investigator assessed Fitzpatrick scores were taken. These …

Utilizing Probiotics To Reduce Diet Induced Dysbiosis And Inflammation In Myelodysplastic Syndromes Susceptible Mice, Tejaswee Bolloju

Theses, Dissertations and Capstones

Human gut microbiota is helpful in digestion by helping in breaking complex carbohydrates, proteins, fats and fibers and many other physiological functions. The Western diet which is high in fat and carbo hydrate percentage alters gut microbiota and leads to growth of pathogenic bacteria and altered gut flora referred to as dysbiosis, which in turn cause gut inflammation and increased permeability of gut and it causes translocation of Lipopolysaccharides (LPS) which causes low grade systemic inflammation. Disturbance in gut microbiota correlated with metabolic conditions like obesity and leads to progression of hematologic diseases like Myelodysplastic Syndromes (MDS). Myelodysplastic syndromes are …

Investigating The Impact Of Phthalate Exposures From Personal Care Products On Uterine Fibroid Incidence And Prevalence In Us-Born Black Women, Ella Brissett

CMC Senior Theses

Uterine fibroids are benign tumors composed of smooth muscle cells and connective tissue that develop within or on the walls of the uterus. Despite being non-cancerous, they can severely affect quality of life by causing heavy bleeding, chronic pain, and reproductive complications. Fibroids are typically found in women of reproductive age, but they disproportionately affect Black women, who experience higher incidence and severity. The underlying causes of this disparity is poorly understood; however, an emerging body of research is highlighting the role of phthalates, endocrine-disrupting chemicals found in many personal care products, in exacerbating fibroid development. Through a critical analysis …

Comparative Analysis Of Lipid Accumulation And Antioxidant Responses In Masld And Control Ipsc-Heps, Anna Werts

CMC Senior Theses

Metabolic dysfunction-associated steatotic liver disease (MASLD) is a prevalent liver condition characterized by lipid accumulation and associated inflammation, driven by genetic, environmental, and metabolic factors. Much is still unknown about the mechanisms of the disease, and research on this is important for advancing effective treatments. This study investigated lipid accumulation and oxidative stress responses to varying concentrations of oleic acid (OA) and palmitic acid (PA) in induced pluripotent stem cell-derived hepatocytes (iPSC-Heps) from MASLD and healthy donors. BODIPY staining revealed that MASLD iPSC-Heps exhibit significantly higher lipid accumulation than controls, especially under prolonged OA and PA exposure. Additionally, PLIN2 expression …

Regulation Of Neuronal Autophagy By Amyotrophic Lateral Sclerosis (Als) - Associated Kinase Tbk1: Evaluating The Role Of Ncoa7, Vikram Chatterjee

CMC Senior Theses

Amyotrophic lateral sclerosis (ALS) is a fatal, neurodegenerative disease characterized by motor neuron loss and the pathological accumulation of misfolded proteins. Autophagy, a lysosome-mediated clearance mechanism, plays a vital role in maintaining cellular homeostasis by removing damaged organelles and protein aggregates. Impairments in autophagy have been increasingly linked to ALS, underscoring its importance in neuronal health. TANK-binding kinase 1 (TBK1) is a key regulator of selective autophagy, facilitating the recognition and sequestration of specific cargo through phosphorylation of autophagy receptors. Notably, mutations in the TBK1 gene have been identified in ALS patients, directly implicating TBK1 dysfunction in disease pathogenesis. Through …

Hiv Protein Tat Dysregulates Multiple Pathways In Human Ipscs- Derived Microglia, Liam Liyang Guo, Robert Jiang, Yan Cheng, Brooke Russell, Yan Y. Sanders, Ming-Lei Guo

Department of Biomedical and Translational Sciences Faculty Publications

In the era of combined antiretroviral therapy, around 50% of chronic HIV (+) individuals show varying degrees of memory and cognitive deficiency (NeuroHIV), a phenomenon of accelerated brain aging. HIV protein transactivator of transcription (TAT) has been well-accepted as a risk factor contributing to NeuroHIV through dysregulating microglia (Mg) functions. Previous studies have demonstrated that HIV-TAT can affect lipid metabolism, immune responses, autophagy, and senescence in rodent Mg. However, due to the significant species differences between rodent and human Mg (hMg), it is essential to take caution when interpreting the results obtained from rodent models into human conditions. For the …

Cellular And Molecular Mechanisms Of Lung Regeneration, Repair, And Fibrosis, Volume Ii, Yong Qiu, Xiao Xiao Tang, Shigeyuki Shichino, Prem Prakash Kushwaha, Yan Y. Sanders, Remo Castro Russo, Chunheng Mo

Department of Biomedical and Translational Sciences Faculty Publications

[Introduction] Organ fibrosis represents a substantial a major contributor to global disease burden, implicated in over 30% of cases leading to disability-associated and fatal conditions. Among these conditions, idiopathic pulmonary fibrosis (IPF) stands as a progressive and frequently fatal interstitial lung disease characterized by aberrant extracellular matrix deposition and parenchymal scarring. The prognosis for IPF patients is poor, with a median survival time of just 3–5 years (Bhattacharya and Ramachandran, 2023; Lederer and Martinez, 2018, Ma et al., 2024, Wei et al., 2024). Current FDA-approved therapeutics, Pirfenidone and Nintedanib, demonstrate capacity to attenuate functional decline in pulmonary fibrosis but remain …

Post-Traumatic Stress Disorder Among Critical Care Nurses Caring For Covid-19 Patients, Marwa Abdo

Nursing

Coronavirus disease 2019 (COVID-19) pandemic has significantly impacted global health, with a substantial number of severe cases requiring admission to isolated intensive care units (ICUs). This unprecedented situation exposed critical care nurses (CCNs) to a highly stressful traumatic environment, placing them at increased risk for developing post-traumatic stress disorder (PTSD). Early identification and intervention for PTSD are crucial to mitigate the negative consequences for nurses' well-being, job performance, and overall quality of life. Aim: This study aimed to assess post-traumatic stress disorder among CCNs caring for COVID-19 patients. Method: A descriptive cross-sectional design with a convenience sample of 109 CCNs …

Anemia In Pregnant Women: Findings From Kuwait Birth Cohort Study, Abdullah Al-Taiar, Ali H. Ziyab, Majeda S. Hammoud, Reem Al-Sabah, Saeed Akhtar

Epidemiology, Biostatistics, & Environmental Health Faculty Publications

Background Anemia is the most common hematologic disorder in pregnancy, affecting over one-third of pregnant women globally. This study aimed to assess the prevalence of anemia in pregnant women and its associated factors in the Kuwait Birth Cohort study.

Methods The Kuwait birth cohort (n = 1,108) was a prospective study in which pregnant women were recruited during their second or third trimester. Data were collected through personal interviews during antenatal care visits, including data on sociodemographic and lifestyle factors. Blood samples were analyzed under strict quality control to measure various laboratory indicators. Anemia was defined as hemoglobin (Hb) < 110 g/L. Predictors of anemia were categorized as underlying or direct factors, and logistic regression models were used to investigate their association with anemia.

Results …