Medicine and Health Sciences Commons^™

Differential Effects Of Neighborhood Ambient Pm2.5 Exposure And Social Vulnerability On Cancer-Related Systemic Inflammation By Race In A Large Health Care System Population From 2000 To 2020, Benjamin A. Rybicki, Zihan Lin, Amber L. Pearson

Biological, Geological, and Environmental Faculty Publications

BackgroundThe environment can impact cancer risk both directly, such as through the air we breathe, and indirectly, through the neighborhoods we live in. These risk factors often work in concert but can have disparate effects.MethodsTo understand how air pollution, as measured by ambient particulate matter 2.5 (PM2.5) levels and neighborhood disadvantage based on a geographically assigned social vulnerability index (SVI), may act together to impact cancer risk, we used 2000-2020 statewide cohort data from a large health system based in metropolitan Detroit, MI, USA (n = 245,438). Systemic inflammation was used as a surrogate indicator of cancer risk among study …

Pharmacokinetic Profiles Of Sertraline In Pregnancy As A Predictor Of Postpartum Depressive Symptoms, Sílvia M. Illamola, Zachary N. Stowe, Marc L. Kalin, Michael D. Evans, Catherine M.T. Sherwin, Maged M. Costantine, D. Jeffrey Newport, James C. Ritchie, Angela K. Birnbaum

Pediatrics Faculty Publications

Aim: To characterize pharmacokinetic changes of sertraline and its metabolite during pregnancy and postpartum, and their relationship to maternal postpartum depressive symptoms. Methods: This was a prospective observational, longitudinal study of pregnant women with a major depressive disorder treated with sertraline (N = 185 women, 205 pregnancies). Women were enrolled at <16 weeks' gestation and followed at 4-8 week intervals throughout pregnancy and the first postpartum year. Baseline measures included structured clinical interviews and demographic information. Drug and metabolite concentrations and psychometric measures (study outcomes) (ie, Hamilton Rating Scale for depression - 17 item, Beck Depression Inventory, Edinburgh Postnatal Depression Scale [EPDS], Clinical Global Impression [CGI]) were measured at follow-up visits. Serum sertraline and N-desmethylsertraline exposure were reported asstandardized 24-h concentration-to-dose (C/D) and parent to metabolite (P/M) ratios. Linear mixed-effects and latent trajectory models were used to characterize longitudinal patterns in concentration measures across pregnancy and postpartum, and their association with study outcomes. Results: Mean 24-h C/D ratios showed high variability throughout pregnancy and postpartuM.T.hat were characterized by three trajectories for sertraline and five for N-desmethylsertraline and P/M ratio corresponding to different sertraline pharmacokinetic profiles. At postpartum, sertraline drug exposure was inversely associated with higher EPDS score (P < .05), while N-desmethylsertraline exposure was associated with higher scores for all measured depression scales (P < .001). Higher P/M ratios had higher CGI scores (P < .05) postpartum. Conclusion: Sertraline pharmacokinetic profiles varied across pregnant women and were associated with postpartum depressive symptoms. The use of therapeutic monitoring may provide clinical insight that can be useful for identifying patients with a potential toward depressive symptoms.

An Odd Protocol For An Agent-Based Model Of Hepatitis C Virus Transmission In A Homogeneous Syringe-Sharing Network, Seun Ale, Que Thi Nguyet Nguyen Dr., John D. Kelleher Prof., Elizabeth Hunter Dr.

Reports

The model described in this ODD is an agent-based model of hepatitis C virus (HCV) transmission among people who inject drugs (PWID). The model assumes homogeneous mixing among syringe-sharing agents, without any form of heterogeneity in the agents interactions or syringe-sharing attitude. All syringe-sharing PWID are treated as identical in terms of their interaction frequency and syringe-sharing probability. Interactions are generated dynamically using proximity-based sampling at each timestep (one day), allowing agents to form syringe-sharing interactions based on spatial closeness. The number of daily interaction events is fixed at the population level, and each syringe-sharing agent has the same probability …

An Odd Protocol For An Agent-Based Model Of Hepatitis C Virus Transmission With Inter- And Intra-Group Structural And Behavioural Heterogeneous Syringe-Sharing Networks (5), Seun Ale, Que Nguyen Dr., John D. Kelleher Prof., Elizabeth Hunter Dr.

Reports

The model described in this ODD is an agent-based model of hepatitis C virus (HCV) transmission among people who inject drugs (PWID). The model incorporates structural heterogeneity through a three-group interaction framework and behavioural heterogeneity through group-specific syringe-sharing rates with additional intra-group variability. The syringe-sharing population in the model is divided into core, inner, and outer circle groups representing individuals with high, moderate, and low levels of syringe-sharing interaction intensity, respectively. In addition to differences in the number of daily interaction opportunities across groups, agents in each group are assigned syringe-sharing probabilities that vary at the individual level around their …

Issue 17: Pulmonary & Critical Care Insider, Bharat Bajantri Md, Sarah Ellsworth Mls, Stephanie Subart Pharmd

Critical Care & Pulmonary

Pulmonary & Critical Care Insider Issue 17

Compiled by Bharat Bajantri, MD, and librarian Sarah Ellsworth, MLS for the clinicians of the Pulmonary and Critical Care team of Parkview.

The Pulmonary & Critical Care Insider newsletter was created by Dr. Bharat Bajantri, MD and Sarah Ellsworth, MLS in 2023 as a form of current awareness for current practice at our hospital, Parkview Health.

Topics: 

• Management of Uncomplicated Gram-Negative Bacteremia
• Complicated Urinary Tract Infection Guidelines Update
• Ketamine vs Etomidate for RSI
• STORM-PE 
• Lung Ultrasound–Guided Weaning
•  D-Dimer for Pulmonary Embolism
• Extubation Failure
•  A Multimodal, physiology-Driven approach to pleural effusions
• Dexmedetomidine for Hyperactive …

Ten-Year Pathology-Based Cancer Registry At A Tertiary Referral Hospital In Kenya (2015–2024): Distribution Of Cancers And Completeness Of Pathology Reporting, Brian Ayara, Samuel Mukono, Rodney Adam, Shahin Sayed

Pathology, East Africa

Background Population-based cancer registries remain limited in low- and middle-income countries (LMICs). In Kenya, their coverage is below the 20% threshold recommended by the International Agency for Research on Cancer. Pathology-based registries can provide complementary data in such contexts. This study describes the distribution of cancers diagnosed at a tertiary referral hospital in Nairobi over ten years, and evaluates the completeness of pathology reporting for selected cancers using College of American Pathologists (CAP) protocols.

Methods We conducted a retrospective review of all histologically confirmed cancers at the Aga Khan University Hospital, Nairobi, from 2015 to 2024. Data were extracted from …

A Physician Survey On Research And Implementation Priorities For Caffeine Citrate Use In Newborn Care In Sub-Saharan Africa, Olufunke Bolaji, Osayame Ekhaguere, Franck Houndjahoue, Nicholas Embleton, Helen Nabwera

Centre of Excellence in Women and Child Health

Background:Evidence on caffeine citrate (CC) for apnoeaof prematurity (AOP) originate from high-income countries. This study aimed to develop consensus on research design for evidence in sub-Saharan Africa (SSA).

Methods:We surveyed physicians in newborn units across SSA to assess their opinions on CC research and their preferred study designs.

Participants rated four study designs:a) an observational before-and-after study; a randomized controlled trial (RCT) of b) caffeine versus placebo; c) caffeine versus aminophylline; d) a traditional or stepped wedge cluster trial.  They  assessed  each  design  using  a  Likert  scale  for  evidence, feasibility, and ethics considerations.

Results:Ninety-two   newborn   physicians …

Benefits, Challenges, And The Way Forward: Medical Specialists' Perception On Family Physician Integration In Healthcare System In Tanzania, Juvenalius Anselm, Roselyter Riang’A, Neelam Ismail, Davis Rubagumya, Jesca Munishi, Sumayyah Saudin, Lynn Moshi, Willbroad Kyejo, Nancy Matillya

Family Medicine, East Africa

Background Family medicine provides comprehensive care by integrating biomedical, behavioral, and social sciences. While established in some sub-Saharan countries, it remains new and unintegrated in Tanzania’s public health system. Its integration is vital for healthcare reform to enhance patient care and system quality.This study aimed to understand the perceptions of medical specialists regarding the integration of family physicians into the Tanzanian healthcare system.

Methods A descriptive qualitative study was conducted through in-depth interviews with ten medical specialists from Aga Khan Hospital and Muhimbili National Hospital in Dar es Salaam. Thematic analysis was employed in this study.

Results Integration of family …

Designing A Telemedicine-Supported Delirium Triage Pathway For Skilled Nursing Facilities: An Evidence-Based Pilot Framework, Benjamin Antill, Eric W. Bean Do, Tara Fritch Ma, Kate Huck Mba, Nha

USF-LVHN SELECT

No abstract provided.

Breastfeeding Allocation And Comparative Data Across Lvhn, Johnathan V Torikashvili, Autumn Kieber-Emmons Md, Mph

USF-LVHN SELECT

No abstract provided.

Mental Wellbeing Of Family Caregivers Of People Living With Mental Illness In Kenya: Who Cares? A Cross-Sectional Study, Norah Obungu, Fleur Meijer, Stanley Luchters

Family Medicine, East Africa

Background Although about 60% of patients with chronic mental health disorders in sub-Saharan Africa live with their relatives, burden amongst family caregivers has not been studied much. The aim of this study was to evaluate the prevalence and factors associated with caregiver burden among family caregivers of patients with chronic mental illness attending two psychiatric care facilities in Nairobi, Kenya.

Methods A cross-sectional study was conducted among 284 systematically sampled participants who completed a socio-demographic questionnaire and the Zarit Burden Interview. Moderate to severe burden was defined as a ZBI score > 41. Independent associations were examined using bivariable and multivariable …

In Vitro Pharmacological Evaluation Of Novel Cmpi Derivatives As Selective Positive Allosteric Modulators Of The Alpha4 Beta2 Nicotinic Acetylcholine Receptor, Josue Gaona, Nataly Sanchez, Wilder Felix, Nathalia Menegasso, Brisa Cea, Ganesh Thakur, Ayman K. Hamouda

School of Medicine Student Publications and Presentations

Nicotinic acetylcholine receptors (nAChRs) contribute to the pathogenesis of neurodegenerative diseases such as Parkinson’s disease (PD), where degeneration of dopaminergic and cholinergic neurons disrupts neurotransmission. The (α4)₃(β2)₂ nAChR subtype is expressed on affected neuronal populations and represents a promising therapeutic target. Positive allosteric modulators (PAMs) may enhance receptor function while preserving endogenous signaling. We evaluated chemical derivatives of CMPI [3-(2-chlorophenyl)-5-(5-methyl-1-(piperidin-4-yl)-1H-pyrazol-4-yl)isoxazol] as selective PAMs of (α4)₃(β2)₂ nAChRs. Two-electrode voltage-clamp recordings were performed in Xenopus laevis oocytes expressing defined receptor stoichiometries to assess potentiation and generate dose–response curves. Cytotoxicity was assessed in HEK cells using the MTT assay. Substitutions at the pyrazole …

Eeg Features And Rotterdam Head Ct Score Predict Early Favorable Outcome In Pediatric Severe Tbi, Xuexin Lu

Presentations

INTRODUCTION Accurate prognostication after pediatric severe TBI (sTBI) remains challenging. We examined the utility of continuous EEG (cEEG) and Rotterdam head CT score in predicting short-term favorable outcome. METHODS 7-yr (01/2018-12/2024) retrospective study of children aged 1.5-18 yrs admitted to our PICU with sTBI and receiving cEEG monitoring per institutional protocol. Early favorable outcome was defined as Pediatric Cerebral Performance Category scale 1-3 at PICU discharge. cEEG features (background, sleep architecture, reactivity, and seizure) during the 1st 12-hrs of monitoring and initial Rotterdam head CT scores were recorded. Demographics, GCS score, pupillary reactivity, injury severity score (ISS), clinical seizure, cardiac …

Mainstreaming Mistrust: The Shift In Us Vaccine Policy Under The Trump Administration, Sanjin Musa, Amy Estlund, Megan A. Berman

Faculty Scholarship

Department of Health and Human Services led by Robert F. Kennedy Jr., represents a significant departure from long-standing public health norms. This commentary explores how historically marginalized anti-vaccine activism has moved into the mainstream of government oversight. Key actions driving this transition include the wholesale replacement of the Advisory Committee on Immunization Practices, the departure of senior CDC officials, and the public questioning of established childhood immunization schedules. Furthermore, the administration has ceased financial support for global health entities like the World Health Organization and Gavi, the Vaccine Alliance, while canceling funding for innovative mRNA vaccine platforms. 

These domestic policy …

Grwd1 Inhibits Nucleolar Stress And Reduces The Sensitivity Of Hepatocellular Carcinoma To Oxaliplatin., Yuanyuan Li, Yumeng Wu, Shenghuan Zuo, Wenjing Zhao, Jibin Liu, Yilang Wang, Xiubing Zhang, Jian Xu, Feng Sun, Dianzheng Zhang, Shudong Zhu, Aiguo Shen

PCOM Scholarly Works

No abstract available

Can We Refute A Role For Infections In Alzheimer's Disease Pathogenesis?, Zena K Chatila, Michael R Duggan, Esther Silberberg, Juan Fernandez, Lavinia A Auber, Elizabeth M Bradshaw, Nikki M. Schultek

PCOM Scholarly Works

While a growing body of literature suggests a role for infections in Alzheimer's disease (AD), microbial contributions to AD remains a contentious topic, in part due to challenges in reconciling the positive evidence with studies reporting null findings. Here, we examine the evidence that argues against a role for infections in AD, while offering mechanistic hypotheses that may account for both the negative and positive findings, including dysregulated host immunity and gene-environment interactions of AD-associated genes.

Barriers To Implementing Simulation-Based Surgical Training For Improving Quality And Safety In Developing Countries: A Short Communication, Abdullah Saeed Khan, Selina Hasan, Faisal Wasim Ismail, Nadeem Ahmed Siddiqui

Centre for Innovation in Medical Education

Simulation-based surgical training has the potential to significantly improve surgical outcomes in developing countries. However, its implementation faces numerous challenges, including financial constraints, infrastructural limitations, cultural barriers, and a lack of trained personnel. High costs, limited access to technology, and resistance to innovative teaching methods hinder the adoption of simulation-based surgical training. To overcome these obstacles, strategic approaches are needed, such as leveraging low-fidelity simulators, building strong partnerships, and investing in faculty development. By addressing these challenges, developing countries can harness the power of simulation-based surgical training to enhance surgical education and improve patient care.

Measurement Of Mucocutaneous Domain Activity In A Novel Treatment Response Measure For Systemic Lupus Erythematosus Clinical Trials, Kathryn Connelly, Eric Morand, Rachel Koelmeyer, Lavanya Rajagopala, Ambika Wakhlu, Yanjie Hao, Katie Liao, Darshini Ayton, Amita Aggarwal, Angela Migowa

Paediatrics and Child Health, East Africa

Objectives Previous work by an international taskforce delivered consensus to include rash, mucosal ulcers and alopecia in the mucocutaneous domain of a novel multi-domain clinical outcome measure for systemic lupus erythematosus (SLE) clinical trials, the Treatment Response Measure for SLE (TRM-SLE). (1) Here we report results of a consensus process to define a fit for purpose clinical outcome assessment and entry and response thresholds for assessment of mucocutaneous activity.

Methods A multi-step consensus process was completed by a 18-person working group comprising rheumatologists, dermatologists, and patients with lived experience of mucocutaneous SLE. The domain scope for rash, mucosal ulcers and …

An Odd Protocol For An Agent-Based Model Of Hepatitis C Virus Transmission In A Two-Group Structural Heterogeneous Syringe-Sharing Network (M2), Seun Ale, Que Nguyen Dr., John D. Kelleher Prof., Elizabeth Hunter Dr.

Reports

The model described in this ODD is an agent-based model of hepatitis C virus (HCV) transmission among people who inject drugs (PWID). The model extended a baseline homogeneous model by incorporating structural heterogeneity via a two-group interaction framework. The syringe-sharing population in the model is divided into inner and outer circle groups representing individuals with differing levels of syringe-sharing interaction intensity. While all agents share the same syringe-sharing probability and epidemiological processes remain identical across agents, the number of daily interaction opportunities differs between the two groups. Interactions in the model are generated dynamically using proximity-based sampling at each timestep …

An Odd Protocol For An Agent-Based Model Of Hepatitis C Virus Transmission In A Three-Group Structural Heterogeneous Syringe-Sharing Network (M3), Seun Ale, Que Nguyen Dr., John D. Kelleher Prof., Elizabeth Hunter Dr.

Reports

The model described in this ODD is an agent-based model of hepatitis C virus (HCV) transmission among people who inject drugs (PWID). The model incorporates structural heterogeneity through a three-group interaction framework. The syringe-sharing population in the model is divided into core, inner, and outer circle groups representing individuals with high, moderate, and low levels of syringe-sharing interaction intensity, respectively. While the syringe-sharing rate and all epidemiological processes remain identical across agents, the number of daily interaction opportunities differs by agent grouping, capturing variation in structural position within the syringe-sharing network. Interactions are generated dynamically using proximity-based sampling at each …

An Odd Protocol For An Agent-Based Model Of Hepatitis C Virus Transmission With Inter-Group Structural And Behavioural Heterogeneous Syringe-Sharing Networks (M4), Seun Ale, Que Nguyen Dr., John D. Kelleher Prof., Elizabeth Hunter Dr.

Reports

The model described in this ODD is an agent-based model of hepatitis C virus (HCV) transmission among people who inject drugs (PWID). The model incorporates structural heterogeneity through a three-group interaction framework and behavioural heterogeneity through group-specific syringe-sharing rates. The syringe-sharing population in the model is divided into core, inner, and outer circle groups representing individuals with high, moderate, and low levels of syringe-sharing interaction intensity, respectively. In addition to differences in the number of daily interaction opportunities across groups, agents in each group are assigned distinct syringe-sharing probabilities, reflecting variation in risk-taking behaviour across structural groups within the syringe-sharing …

Text Messages To Improve Young Child Diets: Results From A Cluster-Randomized Controlled Trial In Kanchanpur, Nepal, Kenda Cunningham, Sidney Cech, Aman Sen Gupta, Pooja Pandey Rana, Debbie Humphries, Edward A. Frongillo Jr. Ph.D.

Faculty Publications

The objective of this study was to test whether adding a text message campaign about the importance of eating eggs and other nutrition-related behaviours to an on-going package of large-scale, diverse social and behaviour change interventions would improve four types of nutrition-related knowledge and behaviour outcomes: child diets (egg consumption as the primary outcome), maternal diets, maternal nutrition knowledge, and maternal participation in additional interventions. The cluster-randomized controlled trial involved a repeat cross-sectional design, recruiting families with children 12–23 months of age at baseline and endline in one plains district of Nepal. Throughout the 1000-day period, 51 text messages were …

Impact Of Suaahara, An At-Scale Multisectoral Nutrition Programme, On Health Workers’ Maternal And Child Health, And Nutrition Knowledge And Skills In Nepal, Deependra K. Thapa, Edward A. Frongillo Jr. Ph.D., Shalini Suresh, Ramesh P. Adhikari, Bhim Pun, Karuna L. Shakya, Raj Mandal, Subir K. Kole, Kenda Cunningham

Faculty Publications

Suaahara, an at-scale multisectoral nutrition programme in Nepal, aimed to advance knowledge and skills of frontline health workers to improve the quality of nutrition and health services at health facility and community levels. This study assessed the impact of Suaahara interventions on knowledge and skills of health facility workers and Female Community Health Volunteers (FCHVs). The study used a quasi-experimental design in which four Suaahara intervention districts were compared with pair-matched comparison districts. One health facility worker and three FCHVs from each survey cluster were included. Baseline survey consisted of 93 health facility workers (2015) and 118 FCHVs (2012), and …

Consolidation Enfortumab Vedotin And Pembrolizumab After Cisplatin Induction In Metastatic Urothelial Cancer: Outcomes Of Complete Response And Bladder Preservation, Kok Hoe Chan, Putao Cen, Tung Shu, Steven Canfield, Hui Zhao, Anneliese Gonzalez, Julie Rowe, Varaha Tammisetti, Hajar Ayoub, Angel Blanco, Mark Amsbaugh, Nizar Tannir

Faculty, Staff and Student Publications

Bladder preservation remains a highly desirable therapeutic goal in urothelial carcinoma, particularly when durable survival can be achieved. Radical cystectomy is the standard treatment for muscle-invasive disease; however, it results in irreversible bladder loss and significant morbidity. Among patients with locally advanced or metastatic urothelial carcinoma, recurrence rates after standard therapy remain high. Consolidation therapy with enfortumab vedotin and pembrolizumab following cisplatin-based induction chemotherapy has demonstrated promising efficacy, with substantial complete response rates and improved bladder preservation. This single-center retrospective analysis evaluated the efficacy and safety of enfortumab vedotin plus pembrolizumab as consolidation therapy in 11 patients with metastatic urothelial …

Did A.T. Still, Do, Have An Md Degree?, David B. Fuller

PCOM Scholarly Works

A.T. Still, DO (1828–1917), founder of osteopathic medicine, was a licensed physician practicing in late 19th- and early 20th-century America. Although many assume he held an MD degree, the reality is more complex. Examining whether Dr. Still earned an MD degree provides important insight into the origins of osteopathic medicine and the profession that followed.

Soft Skills For Medical Physicists: Evolving A Profession., Tomas Kron, Julie Raffi, Shada Wadi-Ramahi, Abdelkader Toutaoui, Bilal Jalal, Peter A Sandwall, Graciela Velez, Dario Sanz, Godfrey Azangwe

Oncology Articles

PURPOSE: Medical physicists are essential healthcare professionals who bridge the gap between technology and patient care, particularly in radiation oncology and medical imaging. With the profession expanding its clinical and global roles, the need for competencies beyond technical expertise-such as communication, leadership, and cultural awareness-is increasingly evident. These competencies, commonly referred to as soft skills, are critical for patient-centered care but remain insufficiently integrated into formal education and training pathways. The aim of the present work was to identify soft skills relevant to medical physics practice and investigate where in a career they are acquired and used.

METHODS: This paper …

Feasibility And Outcomes Of Perirectal Spacer Implantation In Previously Treated Prostate Cancer Patients Undergoing Salvage Proton Therapy Radiation., Irini Yacoub, Keyur Mehta, Daniel Gorovets, Shaakir Hasan, J Isabelle Choi, Arpit M Chhabra, Stanislav Lazarev, Madhur Garg, Charles B Simone

Oncology Articles

PURPOSE: Treatment of recurrent prostate cancer following prior therapy is challenging due to the risk of toxicities to previously irradiated normal tissues, particularly the rectum. Proton therapy offers a conformal approach that may reduce this risk. Perirectal spacers have been shown to further minimize rectal dose in primary treatment, but the ability to be placed and their value in the retreatment setting have not been thoroughly evaluated to date. The purpose of this study was to evaluate feasibility of rectal spacer placement after prior pelvic radiation or other local treatments for prostate cancer.

METHODS AND MATERIALS: We conducted a retrospective …

Educating To Exhaustion: Intention To Leave Among Us Full-Time Nursing Faculty, Jacqueline Christianson, Kathryn J. Malin, Jessica Leiberg, Lisa M. Grabert, Stephanie E. Moser, Jessica L. Zemlak

College of Nursing Faculty Research and Publications

AIM 

The aim of this study was to examine the relationships between work efforts and rewards with intention to leave and burnout among full-time nurse educators.

BACKGROUND 

The nursing faculty shortage is a contributor to the nursing shortage. Poor balance between work efforts and rewards may contribute to intention to leave.

METHOD 

A cross-sectional survey of US nurse faculty examined work efforts, rewards, burnout, and intention to leave. Structural equation modeling was used to evaluate the relationships among variables.

RESULTS 

Among 588 participants, efforts and rewards both had significant effects on burnout. Burnout and rewards had significant effects on intention …

A Word From The Writing Team (March 2026), Pam Walter, Mfa, Laura Deloretta, Phd

A Word From the Writing Team (Newsletter)

No abstract provided.

Cholecalciferol (Vitamin D3) Is An Agonist Of The Alzheimer's Disease-Associated Immune Receptor Trem2, Hunter B Dean, Ryan A Tuckey, Rory A Greer, Jessica A Greven, Shan-Zhong Yang, Daniel S Elston, Gunnar N Eastep, Yuwei Song, Thomas J Brett, Yuhua Song, Erik D Roberson

2020-Current year OA Pubs

Triggering Receptor Expressed on Myeloid Cells 2 (TREM2) is one of the strongest genetic risk factors for late-onset Alzheimer's disease (AD). Several TREM2 ligands are known, including charged lipids and AD-associated proteins like apolipoprotein E and amyloid-β, but the full range of endogenous ligands for TREM2 remains unknown. Here we combined virtual screening of the Human Metabolome Database with molecular dynamics simulations, binding free energy estimation, and biolayer interferometry to identify novel TREM2 ligands and map their binding sites. Cholecalciferol, the unmodified parent form of vitamin D3, emerged as a top candidate. Structural modeling indicated that cholecalciferol binds TREM2 at …