Medicine and Health Sciences Commons^™

Development Of A Clinical Prediction Model To Guide The Selective Use Of Spect/Ct In Papillary Thyroid Cancer, Liya Zhu, Junik Son, Lu Wang, Haifeng Hou, Byeong Cheol Ahn

Research outputs 2022 to 2026

Background: Radioiodine whole-body scan (WBS) is routinely performed after radioiodine therapy in papillary thyroid cancer (PTC), but its two-dimensional nature limits anatomical localization. The addition of single-photon emission computed tomography/computed tomography (SPECT/CT) improves diagnostic accuracy; however, routine use exposes patients to additional radiation, longer imaging time, and higher costs. This study aimed to establish a predictive model to identify which patients with PTC are more likely to benefit by adding SPECT/CT imaging after WBS, enabling selective rather than routine use. Methods: This retrospective study included 265 patients with pathologically confirmed PTC who underwent postoperative radioiodine therapy followed by WBS and …

Emerging Blood-Based Biomarkers For The Detection Of Parenchymal Brain Metastasis: Current Progress And Future Perspectives, Désirée Sexauer, Elin S. Gray, Helen Rizos, Pauline Zaenker, Aaron B. Beasley

Research outputs 2022 to 2026

Parenchymal brain metastases of solid malignancies remain a significant clinical challenge, as they are often detected at later symptomatic stages, which are typically associated with worse prognosis. Delayed detection limits treatment options and contributes to poor outcomes, while early detection is critical for improving patient outcomes and quality of life. In this comprehensive review, we investigated the potential use and challenges of blood-based biomarkers, including circulating tumor cells, cell-free DNA, noncoding RNAs, extracellular vesicles, proteins, and other immune-related biomarkers, for the early detection of parenchymal brain metastasis. The use of blood-based liquid biopsies offers a promising avenue for early detection …

Effectiveness, Reach, Uptake, And Feasibility Of Digital Health Interventions For Culturally And Linguistically Diverse Populations Living With Prediabetes Across The Lifespan: Systematic Review And Meta-Analysis, Lisa Whitehead, Min Zhang, Wai Hang Kwok, Diana Arabiat, Amanda Towell Barnard

Research outputs 2022 to 2026

Background: Culturally and linguistically diverse (CaLD) populations are at a higher risk of developing prediabetes; however, the effectiveness and implementation of digital health interventions for prediabetes management in this population are not well understood. Objective: This review aims to evaluate the effectiveness and implementation of digital health interventions (DHIs) versus usual care for glycemic control in CaLD populations living with prediabetes. Methods: This review aimed to include people of any age living with prediabetes who are from a CaLD background. Experimental and quasi-experimental studies that compare digital health interventions to usual care, waitlist, or active control were eligible. The primary …

Navigating Prediabetes In A Foreign Country: A Qualitative Study Of Self-Management Experiences Among Chinese-Speaking Immigrants In Australia, Min Zhang, Kirsten J. Coppell, Johnny Lo, Lisa Whitehead

Research outputs 2022 to 2026

Aim: Chinese-speaking immigrants in Australia have a higher risk of type 2 diabetes and face more barriers to accessing quality healthcare compared to non-culturally and linguistically diverse populations. This study aimed to explore the self-management experiences of Chinese-speaking Australians with self-reported lived experience of prediabetes following immigration. Design: Qualitative study. Methods: Semi-structured interviews were conducted with 10 purposively selected Australian Chinese-speaking immigrants aged over 40 years. Data collection was undertaken in Perth, Western Australia between April and August 2024. Data were analysed using reflexive thematic analysis. Results: Three themes are presented in this paper: (1) An acculturation journey: Reshaping cultural …

Effects Of Resistance Vs High Intensity Interval Training On Myokines And Cancer Cell Suppression In Breast Cancer Survivors: A Randomized Trial, Francesco Bettariga, Dennis R. Taaffe, Cristina Crespo-Garcia, Timothy D. Clay, Mauro De Santi, Giulia Baldelli, Sanjeev Adhikari, Elin S. Gray, Daniel A. Galvão, Robert U. Newton

Research outputs 2022 to 2026

Purpose: Reducing recurrence and mortality is crucial for breast cancer survivors. We investigated the effects of a 12-week resistance training (RT) vs high-intensity interval training (HIIT) program on myokines, cytokines secreted by skeletal muscle cells at rest in response to muscle contraction, and cancer cell inhibition. Methods: Twenty-eight survivors of breast cancer (age 55.5 ± 8.8 yr, body mass index 27.9 ± 5.1 kg/m², time since diagnosis 31 ± 12.3 months) were randomly allocated to a 12-week supervised moderate to high intensity RT (n = 14) or HIIT (n = 14) program 3 days per week. Resting blood …

Review Of Outcomes: Quality Improvement Of Upper-Extremity Necrotizing Soft Tissue Infections, Cailey A. England Bs, Ryan A. Reinhart Bs, Tien Do Do, Maame A. Effirim Bs, Dylan Bezzini Md

Summer Research Program Abstracts

No abstract provided.

Use Of Sonorheometry To Treat Trauma-Induced Coagulopathy, Dawson L. Weiss, Gabrielle E. Hatton, Miranda E. Wood, Oscar I. Estrada Munoz, David H. Kim, John A. Harvin

Summer Research Program Abstracts

No abstract provided.

Multidimensional Sleep Health And Sleep Environment Factors In Individuals With Cancer Undergoing Outpatient Chemotherapy: An Exploratory Cross-Sectional Analysis, Sam Adams, D. Clay, Arman Hasani, Mitchell Turner, Travis Cruickshank

Research outputs 2022 to 2026

Purpose: Sleep problems are common amongst individuals with cancer receiving chemotherapy and are associated with poorer health outcomes. Considerable research to date has investigated specific sleep domains or symptomology, with little attention given to overall sleep health, which is more closely associated with overall health. This exploratory cross-sectional study aimed to characterize multidimensional sleep health in individuals with cancer reporting sleep complaints whilst undergoing chemotherapy, with exploratory examination of environmental associations. Patients and Methods: Twenty-three participants were included in this exploratory cross-sectional analysis. Participants were diagnosed with cancer within the last 6 months, undergoing outpatient chemotherapy at time of study …

Educational Attainment And Symptom Improvement In Treatment-Resistant Depression: A Longitudinal Cohort Analysis Across Treatment Modalities, Marjorie Harrison, Giselli Scaini Msc, Phd, Aspen Viamontes

Summer Research Program Abstracts

No abstract provided.

Reference-Point Indentation Captures Age-Related Material-Quality Changes In Human Infant Rib Cortical Bone, Kush Patel

Summer Research Program Abstracts

No abstract provided.

Neurodevelopmental Outcomes After Posthemorrhagic Hydrocephalus Of Prematurity, Mekal S. Mathew, Rene Leal, Caroline L. Hanan, David J. Sun, Hasan K. Mubarak, Amelie D. Perrier, William E. Johnson, Micolette R. Mardik, Trevor R. Alwell, Christian Amezquita Contreras, Chance E. Hatfield, Peter H. Yang

Summer Research Program Abstracts

No abstract provided.

Training Set Augmentation And Biology-Aware Harmonization Improve Radiomic Models For Lung Cancer Prediction In Indeterminate Nodules, Claire Huchthausen, Menglin Shi, Gabriel De Sousa, James Larner, Einsley Janowski, Jonathan Colen, Krishni Wijesooriya

Data Science Faculty Publications

CT radiomics-based machine learning has potential to predict lung cancer in pulmonary nodules (PNs) earlier than standard-of-care methods. Low malignancy rates in early-development PNs and variable image acquisition hinder development of radiomic models for diagnosing these PNs. To address these challenges, we augmented training using later-development PNs and harmonized for acquisition effects. We examine early-development benign and malignant PNs (n = 106) below the sensitivity of standard-of-care diagnosis. Classifiers predicting malignancy performed near chance when trained on ComBat-harmonized radiomic features from only early-development PNs. We then augmented training with later-development benign and malignant PNs (n = 225). We evaluated whether …

Preoperative Patient Sentiment Is Associated With Postoperative Outcomes In Adult Spinal Deformity Surgery, Ross J. Gore, David Mazur-Hart, Mohan K. Sunkara, Aaqib Ali, Qizar Ali, Christopher J. Lynch, Christopher Ames

Center for Secure and Intelligent Critical Systems (CSICS) Publications

Study Design: Prospective observational pilot study of adult spinal deformity surgery patients.

Objective: To determine whether preoperative patient sentiment, quantified using a 21-class valence scale extending the CARP paradigm implemented through an offline Large Language Model, predicts postoperative outcomes.

Summary of Background Data: Predicting adult spinal deformity surgery outcomes remains challenging with traditional clinical and radiographic parameters alone. Although patient psychological factors and expectations significantly influence postoperative satisfaction and quality of life, systematic approaches to capture these factors are underdeveloped. Offline Large Language Models offer scalable, privacy-preserving psychological risk stratification.

Materials and Methods: We prospectively enrolled 18 patients undergoing adult …

Promoting The Use Of Smoke Evacuation Systems In The Operating Room: A Quality Improvement Initiative, Andrea Leigh Drayer

Graduate Theses, Dissertations, and Problem Reports (ETD)

Background: Surgical smoke produced during procedures poses serious health risks to operating

room (OR) staff and patients, yet many hospitals, including an academic medical center in

northern West Virginia, have underutilized smoke evacuation systems. The imminent

enforcement of West Virginia House Bill 4376, mandating smoke evacuation use, provided both

urgency and opportunity for an intervention.

Purpose: The purpose of this Doctor of Nursing Practice (DNP) quality improvement project

was to increase timely compliance with the use of smoke evacuation systems during all smoke-

producing procedures, ensuring alignment with safety standards and legislative requirements.

Methods: A systematic evidence review of academic …

Increasing Repeat Blood Pressure Compliance Rates At A Primary Care Clinic, Anne Giampietro, Kristin Coulter, Sarah Fincham, Julie Nugent-Carney

Publications 2026-present

No abstract provided.

Professional Quality Of Life Among Medical Surgical And Telemetry Registered Nurses, William Lim, Emy-Lee Marie Anglo Ricafrente, Jenny Carrillo

Publications 2026-present

No abstract provided.

New Therapies, New Challenges: Cystic Lung Disease After Cancer Immunotherapy, Ananya Venkatesh, David Camacho, Ross Summer, Michael Dong

Division of Internal Medicine Faculty Papers & Presentations

Immunotherapies have reduced reliance on cytotoxic strategies with their associated high toxicity levels, revolutionizing cancer care. However, these targeted therapies have also increased prevalence of previously rare sequelae, impacting patients experiencing longer survival. We describe a case of endometrial adenocarcinoma with lung metastases, in which tumor resolution following immunotherapy created cystic airspaces, leading to a pneumothorax complication. A 49-year-old female with advanced stage endometrial adenocarcinoma and lung metastasis developed cystic lung lesions in areas of previous metastatic lesions after treatment with Pembrolizumab and Bevacizumab. She developed a pneumothorax secondary to the rupture of one of the large lung cysts, leading …

Oxytocin Dosing During Trial Of Labor After Cesarean To Minimize The Risk Of Uterine Rupture: A Systematic Review And Meta-Analysis, Pierpaolo Nicolì, Moti Gulersen, Jordan Beacham, Hila Hochler, Alessandra Familiari, Anna Locatelli, Cynthia Abraham, Ettore Cicinelli, Amerigo Vitagliano, Vincenzo Berghella

Department of Obstetrics and Gynecology Faculty Papers

OBJECTIVE: Oxytocin remains the mainstay for induction and for the management of labor arrest during trial of labor after cesarean (TOLAC). Therefore, the clinical question should be not whether to use oxytocin, but how to optimize its administration. This meta-analysis aimed to assess which oxytocin protocol, in terms of initial dose, amount of increase, timing to next increase, and maximum dose, may minimize the risk of uterine rupture (UR) during TOLAC.

DATA SOURCES: PubMed, Embase and Clinicaltrials.gov were searched up to September 21, 2024.

STUDY ELIGIBILITY CRITERIA: Randomized and nonrandomized studies evaluating the association between induction and/or augmentation with oxytocin …

Impact Of Prophylactic Oral Azithromycin During Labor On Azithromycin Resistance (Amr) In Nasal Staphylococcus Aureus And Streptococcus Pneumoniae In Women And Infants In The Multi-Country Azithromycin Prevention In Labor Use Study (A-Plus)., Patricia L. Hibberd, Jean H. Kim, Marissa Trotta, Sixto M. Leal, Anna Aceituno, Doyle V. Ward, Archana Patel, Akila Subramaniam, Waldemar A. Carlo, Imran Ahmed, Sarah Saleem, Sk Masum Billah, Rashidun Haque, Manolo Mazariegos, Fabian Esamai, Manjunath S. Somannavar, Shivaprasad S. Goudar, Elwyn Chomba, Muska Mwenchanya, Adrien Lokangaka, Antoinette Tshefu, Robert L. Goldenberg, Melissa Bauserman, Nancy F. Krebs, Sherri Bucher, Richard J. Derman, William A. Petri, Marion Koso-Thomas, Denise C. Babineau, Elizabeth M. Mcclure, Alan T. N. Tita

Department of Obstetrics and Gynecology Faculty Papers

BACKGROUND: Prophylactic oral azithromycin vs. placebo reduced maternal, but not neonatal, mortality/sepsis in the A-PLUS Randomized Trial. While prophylactic intrapartum azithromycin reduces maternal mortality/sepsis, it may promote antimicrobial resistance (AMR) in commensal bacteria,.

METHODS: Randomly selected women and their infants participating in A-PLUS were enrolled in a longitudinal cross-sectional sub-study to assess the presence of azithromycin resistance in selected bacteria in nasal cultures. Staphylococcus aureus and Streptococcus pneumoniae were cultured on selective agar, then azithromycin-containing agar to select for azithromycin resistant bacteria, identified biochemically. Azithromycin susceptibility was assessed by E-test. Nasal cultures were collected from women and infants between August …

Real-Space Imaging Of The Electron-Pair Density Hole In Molecular Auger-Meitner Decay, Mats Simmermacher, Nathan Goff, Andres Moreno Carrascosa, Elke Fasshauer, Thomas Northey, Lingyu Ma, Haiwang Yong, Brian Stankus, Asami Odate, Xuan Xu, Wenping Du, Kyle Acheson, Joseph C. Cooper, Daniel Ratner, Mengning Liang, Ruaridh Forbes, Michael P. Minitti, Adam Kirrander, Peter M. Weber

Physics Faculty Publications

Electrons in matter can rearrange extremely quickly under external perturbations, underpinning subsequent structural and chemical transformations. Coulomb interactions between neighbouring electrons often shape this response, giving rise to correlated motion and strongly affecting the distribution of electrons in the system. Here we show that non-resonant hard X-ray scattering can directly access changes in the radial electron-pair density during the rapid rearrangement of core and valence electrons. We do this by studying sulfur hexafluoride molecules undergoing Auger–Meitner decay. We exploit a second-order interaction between the X-ray photons and the molecules to trigger and probe the decay dynamics with a single pulse, …

Evaluation Of Mycoplasma Genitalium Positivity And Co-Infection With Chlamydia Trachomatis And/Or Neisseria Gonorrhoeae At Various Care Sites Across The United States, Rebecca Lillis, Rodney Arcenas, Christy M. Boraas, Steven E. Chavoustie, Lashonda Crane, Nicole D'Empaire, Aaron C. Ermel, Glenn Harnett, Federico Hinestrosa, Stacey House, Joseph Miller, Anthony Mills, Ronald Poblete, Stephen Young, Barbara Van Der Pol

School of Medicine Faculty Publications

OBJECTIVES: We evaluated Mycoplasma genitalium (MG) positivity and co-infection with Chlamydia trachomatis (CT) and/or Neisseria gonorrhoeae (NG), based on results from a trial assessing clinical performance of the Cobas® Liat CT/NG/MG point-of-care test. METHODS: A prospective, US, multicenter, noninterventional study assessed MG positivity in prospective urine samples (male) and clinician-collected vaginal swabs (female) from symptomatic/asymptomatic patients aged ≥14 years attending various clinical settings. Participants were designated positive or negative for MG, CT, and NG based on combined results from three US Food and Drug Administration-approved assays and one laboratory-developed test. MG co-infection with CT and/or NG was assessed. RESULTS: Among …

Donor-Derived Cell-Free Dna In Antibody-Mediated Rejection: An Analysis Of The Surveillance Heartcare Outcomes Registry, Paul J. Kim, Amit H. Alam, Jeffrey J. Teuteberg, Kiran K. Khush, Sean P. Pinney, Richard K. Cheng, Amin Yehya, Jeremy Kobulnik, Kevin M. Pinney, Kris A. Oreschak, Christopher R. Ensor Pharmd, Steven Fan, Marcus A. Urey, Palak Shah, Shelley A. Hall

Department of Medicine Faculty Publications

Background

Donor-derived cell-free DNA (dd-cfDNA) has emerged as a biomarker for antibody-mediated rejection (AMR), but its performance characteristics have not been evaluated in a large contemporary heart transplant population.

Objectives

The study aimed to characterize the incidence and timing of biopsy-proven AMR and evaluate the performance characteristics of dd-cfDNA for AMR.

Methods

The authors included 2,240 subjects from the SHORE (Surveillance HeartCare Outcomes Registry) registry transplanted between 2017 and 2022 with verified biopsy, dd-cfDNA, echocardiographic, and donor-specific antibody (DSA) data. They evaluated the performance characteristics of dd-cfDNA for AMR and the incidence of AMR in different clinical contexts.

Results

AMR …

Upadacitinib For Recalcitrant Extraintestinal Crohn Disease, Avery H. Seward, Jeffrey P. Callen

Department of Medicine Faculty Publications

[Introduction] Crohn disease is a chronic inflammatory bowel disease that affects the gastrointestinal tract from the mouth to the anus. Extra-intestinal manifestations of Crohn disease are common, with the skin being the most commonly involved site.¹ Cutaneous manifestations of Crohn include lesions that directly extend from the bowel to the skin, whereas extraintestinal Crohn disease involves sites that do not directly extend from the bowel.¹ Extraintestinal Crohn disease is often resistant to treatments and often does not parallel the activity of the bowel disease.¹ There have only been 3 documented cases of extraintestinal Crohn disease responding to upadacitinib.²,³ We describe …

Cold-Sensitive Acral Hand Lesions, Avery H. Seward, Jocelyn H. Larocque

Department of Medicine Faculty Publications

[Case description] An otherwise healthy woman in her 60s presented with a 2-year history of a persistent, itchy, and tender rash on the dorsal hands. The rash fluctuated in severity with the seasons, worsening during the colder months. The patient denied joint pain and fatigue, or lesions elsewhere.

Examination revealed partially blanchable violaceous plaques on the dorsal hands with partial sparing of the proximal and distal interphalangeal joints (Fig 1). A few punctate, crusted erosions and purpuric macules were present on the dorsal and volar distal phalanges (Figs 2 and 3).

Combined Snare And Buddy-Balloon Strategy For Failed Valve Crossing In Valve-In-Valve Transcatheter Aortic Valve Replacement, Hira Sarfraz, Muhammad U. Javed, Parth K. Parikh, Joshua A. Cohen, Raymond L. Benza, Matthew R. Summers, Deepak R. Talreja

Department of Medicine Faculty Publications

Background

Retrograde valve crossing during valve-in-valve transcatheter aortic valve replacement (ViV TAVR) may fail despite modern delivery systems.

Case Summary

A 67-year-old man with a degenerated 27-mm Magna Ease bioprosthesis and unfavorable aortic geometry (kinked ascending aorta at a prior surgical graft site) underwent ViV TAVR, where retrograde valve crossing failed despite multiple stiff guidewires and snare traction alone. Successful delivery of a 29-mm Evolut FX+ was ultimately achieved by combining gooseneck-snare traction for coaxial realignment with a partially inflated Tyshak buddy balloon acting as a mechanical ramp across the surgical valve frame.

Discussion

This case demonstrates a structured, stepwise …

Failure Rates And Patient-Reported Outcomes Are Similar Across 5 Arthroscopic, Suprapectoral Bicepts Tenodesis Fixation Techniques, Senah E. Stephens, Samantha M. Strohm, Rachael M. Shaughnessy, Katherine S. Worcester, Kevin F. Bonner

Department of Medicine Faculty Publications

Purpose

To compare failure rates and patient‐reported outcome measures (PROMs) across 5 arthroscopic, suprapectoral biceps tenodesis fixation techniques: tenodesis screw, tenodesis anchor, expanding tenodesis anchor, onlay with single all‐suture anchor, and soft tissue tenodesis in the bicipital groove with suture.

Methods

This was a retrospective cohort study approved by the Institutional Review Board, including patients age 18 years or older who underwent arthroscopic, suprapectoral biceps tenodesis between 2014 and 2024 with a minimum of 6 months of clinical follow‐up. Exclusion criteria included cervical pathology, chronic pain syndromes, revisions, and workers' compensation cases. Patients completed PROMs including pain Visual Analog Scale …

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 …

Educational Case: Hidradenitis Suppurativa, Ryan C. Saal, Linnea Lackstrom Westerkam, Cristo A. Carrasco Mendoza, Paul B. George, Christopher J. Sayed

Department of Medicine Faculty Publications

[Introduction] The following fictional case is intended as a learning tool within the Pathology Competencies for Medical Education (PCME), a set of national standards for teaching pathology. These are divided into three basic competencies: Disease Mechanisms and Processes, Organ System Pathology, and Diagnostic Medicine and Therapeutic Pathology. For additional information, and a full list of learning objectives for all three competencies, see https://doi.org/10.1016/j.acpath.2023.100086.1¹

Objective SK1.1: Pathophysiology of changes in the skin. Describe the pathophysiologic basis for changes in the color, surface texture, swelling, temperature, and sensitivity of skin.

Competency 2: Organ system pathology, Topic: Skin (SK); Learning Goal 1: …

Real-Time Electronic Drug Monitoring: Experiences From A Multinational Phase 3 Clinical Trial To Prevent Multidrug-Resistant Tb, T. Jimah, J.E. Haberer, K.R. Amico, J. Tinkamanyire, M.A. Kendall, S. Moonsamy, R.T. Khan, K.B.F. Fetalvero, N. Suryavanshi, A. Gupta, A.C. Hesseling, Susan Swindells, G. Churchyard

Journal Articles: Infectious Diseases

OBJECTIVE: We describe the experience of implementing real-time electronic drug monitoring (EDM) within a clinical trial to prevent multidrug-resistant TB (MDR-TB) among high-risk household contacts.

METHODS: The Protecting Households On Exposure to Newly Diagnosed Index Multidrug-Resistant Tuberculosis Patients (PHOENIx) trial is a phase 3, open-label, cluster-randomised clinical trial conducted in 31 sites in Africa, Asia, and Latin America. Household contacts of adults with MDR-TB were enrolled from June 2019 to January 2025, each receiving an EDM device to monitor adherence to TB preventive therapy. Here, we review selection of the adherence monitoring approach and key procedures implemented to support EDM …

Social Health Programming During Adolescence Is Associated With Increased Serum Levels Of Carotenoids, Vitamin A, And Vitamin E In Young Women: An Observational Cohort Study, Rebecca Drakowski, Matthew Vanormer, Laura Ebers, Katie Mayhan, Anum Akbar, Colman Freel, Taija Hahka, Rebekah Rapoza, Corrine K. Hanson, Keyonna King, Aaryn Mustoe, Melissa K. Thoene, Ann Anderson-Berry

Journal Articles: Pediatrics

Over 85% of young women in the United States do not meet fruit and vegetable intake recommendations, placing them at risk for low antioxidant nutrient intake. Social health programming (SHP) can improve dietary intake of fruits and vegetables, but it is not known how SHP impacts serum levels of specific antioxidant nutrients. This observational cohort study assessed the effect of participation in SHP through Girls Inc., Omaha, on serum carotenoid, retinol, and tocopherol levels for 12–29-year-old women. Serum nutrient levels were measured using high-performance liquid chromatography and nutrient intake from diet was measured using three 24 h dietary recalls (ASA24 …