Medicine and Health Sciences Commons^™

Cardiovascular Outcomes With Icosapent Ethyl By Burden Of Standard Modifiable Cardiovascular Risk Factors In Reduce-It, Rahul Aggarwal, Deepak L Bhatt, Michael Miller, Christie M Ballantyne, Eliot A Brinton, Terry A Jacobson, Steven B Ketchum, Jean-Claude Tardif, Matthew J Budoff, Gemma A Figtree, Ph Gabriel Steg

Faculty, Staff and Students Publications

No abstract provided.

Androgen Activity In The Male Embryonic Hindbrain Drives Lethal Pfa Ependymoma, Jiao Zhang, Winnie Ong, Alexandra Rasnitsyn, Ricardo Daniel Gonzalez, Rodrigo Lopez Gutierrez, Polina Balin, Amr Saadeldin, Xiaochong Wu, Maria C Vladoiu, Vicente Santa-Maria Lopez, Fernando Gonzalez-Salinas, Navneesh Yadav, Dinesh Mohanakrishnan, Kannan Boosi Narayana Rao, Raja Gopal Reddy Mooli, Hinda Najem, Sebastian Pacheco, Kaitlin Kharas, Cory Richman, David Przelicki, Evan Y Wang, Haipeng Su, Rachel Naomi Curry, Runze Yang, Michelle Masayo Kameda-Smith, Bryn Livingston, David Scott, Zaili Luo, Mingyang Xia, Namal Abeysundara, Anders W Erickson, Ncedile Mankahla, Lucas Zhongming Hu, Chu Pan, Raul Suarez, Ning Huang, Yihao Wu, Hao Wang, Tajana Douglas, Jonelle Pallota, Steven Hébert, Karen Ng, Krystin Mantione, Heather Whetstone, Hassaan Maan, Hussein Lakkis, Juyeun Lee, Sadeesh K Ramakrishnan, Yanxin Pei, Yujie Tang, Frank Y Lin, Guillermo Aldave, Marco Gallo, Robert M Friedlander, Faiyaz Notta, Laura K Donovan, Murali Chintagumpala, Bo Wang, Yun Li, Daniel D De Carvalho, Zhaolei Zhang, Ying Mao, Wei Hua, Charles Eberhart, Calixto-Hope G Lucas, Sriram Venneti, Poul H Sorensen, Alberto Delaidelli, Hao Li, Wenhao Zhou, Jason Kirk, Dean G Tang, Tao Jiang, Hailong Liu, Justin D Lathia, Hiromichi Suzuki, Jeremy N Rich, Lincoln D Stein, Nada Jabado, Vijay Ramaswamy, Q Richard Lu, Amy B Heimberger, Craig Daniels, Kulandaimanuvel Antony Michealraj, Claudia L Kleinman, Michael D Taylor

Faculty, Staff and Students Publications

Posterior fossa type A (PFA) ependymoma is an unusual infantile brain tumour with few known somatic mutations, thought to be driven by epigenetic mechanisms1. PFA ependymoma has a markedly higher incidence and worse prognosis in male children than in female children2. The mechanisms that underlie these sex differences are at present unknown. Here we show that the cellular hierarchy of PFA ependymoma is less differentiated in male individuals than it is in female individuals. In the normal developing mouse hindbrain, male gliogenic progenitors are less differentiated than matched female sibling controls. To further parse the effects …

Robotic Single-Incision Laparoscopic Surgery For The Management Of Endometriosis: First Experience Via The Da Vinci Sp Platform, Qiannan Yang, Daniel Y Lovell, Xiaoming Guan

Faculty, Staff and Students Publications

Objective: To demonstrate the feasibility and mid-term outcomes of Robotic single-port single-incision laparoscopic surgery (RSP-SILS) for endometriosis management.

Methods: A retrospective analysis was conducted on 50 adult women with endometriosis who underwent RSP-SILS via the da Vinci SP platform between November 2023 and July 2025.

Results: Median total operative time was 142 min, robot dock time was 3 min, and robot console time was 99 min. Median estimated blood loss was 25 mL. No conversion occurred. Reported mid-term outcomes included 1 case each of pelvic haematoma, Clostridioides difficile colitis, and umbilical surgical site infection, as well as 3 cases of …

Robotic-Assisted Transumbilical Single-Site And Transvaginal Notes Resection Of Abdominal Wall Cesarean Scar Endometriosis: Two Case Reports, Xiaoming Guan, Qiannan Yang, Victoria Zhang, Chunhua Zhang

Faculty, Staff and Students Publications

No abstract provided.

Da Vinci Single-Port Transvaginal Natural Orifice Transluminal Endoscopic Surgery (Vnotes) Sacrocolpopexy: A Case Report And Literature Review, Xiaoming Guan, Chunhua Zhang, Qiannan Yang, Shunjia Hong, Wai Ieng Fong

Faculty, Staff and Students Publications

Pelvic organ prolapse remains a common condition requiring durable surgical correction, with sacrocolpopexy considered the gold standard. Transvaginal natural orifice transluminal endoscopic surgery (vNOTES) has emerged as a scarless minimally invasive approach, while the integration of robotic single-port technology may further enhance surgical precision and ergonomics. However, data on robotic-assisted single-port vNOTES (RSP-vNOTES) sacrocolpopexy remains limited. We report a case of a 58-year-old Asian woman with symptomatic apical pelvic organ prolapse. The pelvic organ prolapse quantification (POP-Q) assessment demonstrated stage II uterine prolapse. She underwent robotic-assisted single-port vNOTES (RSP-vNOTES) sacrocolpopexy using the da Vinci single-port (SP) platform. The procedure was …

A Comprehensive Review Of Tear Fluid Proteome Alterations In Dry Eye Disease: Insights Into Pathophysiology And Biomarker Potential, Saleh Ahmed, Steven Safille, Victoria Clifton, Shruti Sharma, Cintia S De Paiva, Ashok Sharma

Faculty, Staff and Students Publications

Tear fluid is a highly specialized and dynamic biofluid composed of proteins, lipids, mucins, and electrolytes that is essential for maintaining ocular surface integrity, immune defense, and tear film stability. Growing evidence from tear proteomic studieshas revealed extensive alterations in protein composition in dry eye disease (DED), reflecting a complex interplay between local ocular surface pathology and systemic inflammatory influences. This review summarizes proteomic findings from 50 published studies to identify tear proteins that are consistently upregulated or downregulated in DED and to interpret their biological relevance in the context of ocular surface homeostasis. Across studies, proteins upregulated in DED …

Leadless Pacing And The Emerging Era Of Combined Procedures In Adult Congenital Heart Disease, Srikant Das, Brock A Karolcik, Taylor S Howard

Faculty, Staff and Students Publications

No abstract provided.

Confessions In Cases Of Child Physical Abuse-A Capnet Study, Margaret R Russell, Antoinette L Laskey, Henry T Puls, Suzanne P Starling, Joanne N Wood, Daniel M Lindberg, Nancy S Harper, Caitlin R Mcnamara, Angela N Bachim, Farah W Brink, Lori D Frasier, James D Anderst, Porcia Vaughn, Kristine A Campbell

Faculty, Staff and Students Publications

Objective: Prior research on confessions of physical abuse (PA) has explored mechanisms of injury. Little is known about conditions supporting a confession of abuse or how confessions may influence case outcomes.

Methods: This cross-sectional study of suspected PA in children aged < 10 years at 10 centers participating in CAPNET, a multicenter child PA research network, included children with in-person Child Abuse Pediatrics (CAP) consultations between February 2021 and December 2022 and excluded children without injury. Our focus was a confession of inflicted injury known to the CAP during clinical involvement. We compared child and clinical characteristics, out-of-home (OOH) placements, and arrests between cases with and without confessions. Multivariable models using generalized estimating equations (GEE) produced adjusted predicted probabilities (APP) clustering by CAPNET site.

Results: Confessions were known to CAPs in 115/4297 (2.7%) cases, with significant site variability. In a multivariable GEE model, confessions were more likely in cases with injuries with high specificity for abuse (APP 6.0% vs 1.6%, P < .001), near-fatality (APP 5.6% vs 2.3%, P < .001), and older children (APP 4.8% vs 2.5%, P = .025). OOH placements and arrests were more common in cases with confessions. CAP awareness of confessions, OOH placements, and arrests did not follow racial or ethnic patterns seen in the US child welfare system. Lower socioeconomic status was associated with OOH placements and arrests but not with CAP awareness of confessions.

Conclusions: Our findings highlight differences in case characteristics and outcomes where a confession is known to the CAP and raise questions about …

Methodological Progress Note: Logic Models, Molly J Horstman, Kyler M Godwin

Faculty and Staff Publications

Logic models are an accessible tool to organize the planning, management, and evaluation of programs across healthcare disciplines. This methodological progress note describes the five standard components of a logic model (Inputs, Activities, Outputs, Outcomes, and Impact) and provides guidance for developing a logic model. Logic models offer a visual representation of the work and theory of a program and should be created with input from all interested parties. Logic models are living tools that need to be revised as programs evolve and new information becomes available.

Kidney Disease And Heart Failure: Recent Advances And Current Challenges: Conclusions From A Kidney Disease: Improving Global Outcomes (Kdigo) Controversies Conference, Carolyn S P Lam, Biykem Bozkurt, David Z I Cherney, Justin A Ezekowitz, Meg J Jardine, Sadiya S Khan, Magdalena Madero, Mark J Sarnak, Jozine M Ter Maaten, Michael Cheung, Jennifer M King, Morgan E Grams, Michel Jadoul, Nisha Bansal

Faculty, Staff and Students Publications

Heart failure (HF) and chronic kidney disease (CKD) frequently coexist, which elevates the risks of hospitalization, disease progression, and death. Despite advances in treating each condition independently, many challenges remain in diagnosing and managing them in combination. In March 2024, Kidney Disease: Improving Global Outcomes (KDIGO) held the Controversies Conference on Kidney Disease and Heart Failure: Recent Advances and Current Challenges. Discussions highlighted the complex, bidirectional relationship between HF and CKD, including shared risk factors and overlapping pathophysiology as well as nuances in interpreting biomarkers such as natriuretic peptides and serum creatinine. Sodium-glucose cotransporter-2 inhibitors, renin-angiotensin-aldosterone system inhibitors, and emerging …

Advanced Artificial Intelligence Vs Simpler Models For 1-Year Death Prediction Among Patients Receiving Hemodialysis, Karthikeyan K, Jennifer E Flythe, Patrick H Pun, Wolfgang C Winkelmayer, David Carlson

Faculty, Staff and Students Publications

Objectives: We evaluated the data requirement for modern AI tools to outperform simpler models in predicting short-term mortality in over 500 000 patients with hemodialysis-dependent kidney failure.

Materials and methods: We compared logistic regression, boosting, and transformers using increasingly complex feature sets (from last-visit data to full trajectories). Performance was measured using the area under the ROC curve (AUC-ROC) and the Precision-Recall curve (AUC-PR) across training data sizes ranging from 500 to 490 197 samples.

Results: Using features with temporal information is beneficial across all models. On the full dataset, Transformers (AUC-ROC = 0.8568) and boosting (AUC-ROC = 0.8598) perform …

Comprehensive Profiling Of The Human Tear Fluid Mirnome Using Small Rna Sequencing, Garrett Jones, Drew Mayernik, Saleh Ahmed, Eliza Williams, Jeremy Altman, Tae Jin Lee, Amy Estes, Cintia S De Paiva, Pamela Martin, Shruti Sharma, Ashok Sharma

Faculty, Staff and Students Publications

Purpose: To generate a comprehensive profile of microRNAs (miRNAs) present in human tear fluid using next-generation sequencing (NGS), establish a reference miRNome for healthy human tear fluid, and investigate whether miRNA expression varies by sex, race, or age.

Methods: Tear samples were collected from 32 adults using Schirmer strips. RNA was isolated using the miRNeasy Serum/Plasma Kit, and cDNA libraries were prepared using the QIAseq miRNA Library Kit. Barcoded libraries were sequenced on the NovaSeq 6000 platform. Bioinformatic analyses included adapter trimming, alignment to miRBase, normalization with DESeq2, and functional annotation using multiMiR and clusterProfiler. Differential expression analysis was performed …

Rexinoid Net-3ib Promotes Resident Macrophage Gene Expression And Mitigates Desiccation-Induced Ocular Surface Disease, Jehan Alam, Yangluowa Qu, Jianming Shao, Ebru Yaman, Karen Zheng, Hiroki Kakuta, Stephen C Pflugfelder

Faculty, Staff and Students Publications

Purpose: To evaluate the effects of rexinoid NEt-3IB on desiccating stress-induced dry eye, as well as monocyte/macrophage gene expression and cellular trajectory.

Methods: Eyes were topically treated with rexinoid NEt-3IB (5 µM) or vehicle three times a day for 5 days of desiccating stress-induced dry eye. Single-cell RNA sequencing (RNA-seq) profiled gene expression in conjunctival immune cells. RNA-seq was also used to evaluate gene expression in lipopolysaccharide (LPS)-stimulated, dexamethasone-treated (Dex, 1 µM), or NEt-3IB-treated (1-1000 nM) cultured monocytes. Cellular state trajectory and latent time were inferred with scVelo, and latent-time-associated genes were identified using Monocle 3. Permeability to Oregon Green-labeled …

Ethical Controversies In Organ Procurement: A National Survey On Public Perceptions Of Thoracoabdominal Normothermic Regional Perfusion, Trevor M Bibler, Jill Oliver Robinson, Adam Omelianchuk, Tariq Nisar, Savitri Fedson, Ariel N Levchenko, Amy L Mcguire

Center for Medical Ethics and Health Policy Staff Publications

Thoracoabdominal normothermic regional perfusion (TA-NRP) would likely expand the quantity and quality of organs procured after controlled circulatory death donation in the United States, yet its ethical permissibility remains contested. We surveyed a representative sample of US adults (n = 975) with the goal of assessing their perspectives on the ethical permissibility of TA-NRP. After reading a neutral description of TA-NRP, participants judged its permissibility, reviewed 5 critic and 5 supporter arguments (in random order), and chose which argument they found most convincing. Multivariable logistic regression examined predictors of agreeing with critics. Before exposure to the arguments, 51.5% stated that …

Implementation And Costs Of A Food Insecurity Resource Navigation Program For Primary Care Patients With Diabetes And Hypertension In South Carolina, Deeksha Gupta, Darin Thomas, Stella Coker Watson Self Ph.D., Ms, Edward A. Frongillo Jr. Ph.D., Alain H. Litwin, Joseph A. Ewing, Lynnette Ramos-Gonzalez, Lynnette Ramos-Gonzalez

Faculty Publications

Objective

To examine food insecurity resource navigation program costs and how navigation intensity relates to clinical outcomes, healthcare costs, and quality of life (QOL) for diabetes and/or hypertension patients.

Methods

This retrospective study included patients receiving resource navigation (July 12, 2021-December 31, 2022 with twelve-month follow-up) across three primary care practices in South Carolina's largest health system. Participants were 18+ years old (from electronic medical records/Epic), had food insecurity (from Hunger Vital Sign™), and diabetes and/or hypertension (from Epic registries). Matched controls came from food insecurity screening-only practices. Patients in each group (n= 219) had diabetes (9.13%), hypertension …

Improving Documentation Efficiency Through Implementation Of Emr Note Templates In A Multidisciplinary Stroke Clinic, Mirriam Hijazi

Doctor of Nursing Practice Final Project Abstract

Purpose: This quality improvement project aimed to increase documentation efficiency in a multidisciplinary stroke clinic through implementation of standardized neurological note templates within the electronic medical record (EMR) system.

Background: EMR documentation is essential for safe and coordinated patient care, but can be time-consuming for healthcare providers. Neurological documentation requires detailed clinical information, contributing to increased documentation burden. At the multidisciplinary stroke clinic, providers reported spending significant time on documentation, with some notes finalized up to 48 hours after patient encounters.

Methodology: Standardized neurological note templates were developed with provider input. Documentation efficiency metrics included note completion time, proportion of …

Improving Bedside Nurse Central Line Policy Compliance And Combating Clabsis, Keyshawna N. Chambers

Doctor of Nursing Practice Final Project Abstract

Central line-associated bloodstream infections (CLABSIs) are a problem, both globally and locally at this 20-bed pediatric cardiovascular ICU in Houston, TX. Bedside nursing staff had gaps in knowledge of central line policies and were often unaware of when dressings needed to be changed. This posed a significant concern, as this nosocomial infection is among the most life-threatening and costly complications in healthcare. Leadership attempted to correct this issue with weekly multidisciplinary rounds, but with high turnover, this was not a long-term fix. This quality improvement project aimed to increase central line policy compliance among bedside nursing staff to 93%, from …

The Use Of A Safety Screening Tool To Improve Sedation Holiday Compliance And Nurse Confidence, Shelby Marchisio

Doctor of Nursing Practice Final Project Abstract

Purpose

This project sought to evaluate the impact of a safety screening tool on sedation holiday compliance and nurse confidence.

Background

This project was conducted within a 42-bed intensive care unit at a large academic hospital in Houston, Texas. Despite having a nurse-led sedation holiday protocol, compliance averages varied from 50-85%. In alignment with evidence-based practice, it was determined that integrating a safety screening tool into the sedation holiday process may improve compliance.

Methodology

The FADE Model for Quality Improvement guided project development. An anonymous survey was conducted using Likert-scale ratings to assess nursing perceptions and confidence related to sedation …

Reduction Of Waste And Cost In A Cardiac Intensive Care Unit, Jincy C. Skaria

Doctor of Nursing Practice Final Project Abstract

Purpose:
To reduce medical supply waste and associated costs in a Cardiac ICU using a standardized supply cart system.
Background:
Pre-packed post-operative recovery kits were routinely opened for all admissions in the Cardiac ICU, resulting in disposal of unused supplies due to infection control and single-use policies. This practice contributed to avoidable waste, increased costs, and poor resource stewardship.
Methodology:
This quality improvement project was conducted in a 20-bed Cardiac ICU from September 28 to December 6, 2025. The intervention replaced routine opening of full recovery kits with selective retrieval of supplies by nurses from a standardized cart located outside …

Implementing Hypertension Guidelines Into Clinical Practice, Misti Michele Mays

Electronic Theses and Dissertations

Hypertension is a complex chronic disease process, and it is essential to educate the patient on the disease process, as well as on all aspects of self-management. It is essential that providers choose an evidence-based guideline by which they will manage their hypertensive patients. In addition, providers must schedule regular follow-up appointments with their patients, along with a wide variety of other multifactorial components in regard to the management of patients diagnosed with hypertension. In addition, providers have a responsibility to stay informed on new approaches to blood pressure management by reviewing the professional literature on a regular basis. Much …

Identification Of Bioactive Inhibitors In Dragon Fruit (Hylocereus Undatus) Targeting Top2a Protein In Human Breast Cancer, Md Iftehimul, Soharth Hasnat, Md Hasibur Rahman, Md Shohel Hossain, Md Arju Hossain, Abdul Barik, Md Faisal Amin, Dipta Dey, Tofazzal Islam, M. Nazmul Hoque

School of Integrative Biological & Chemical Sciences Faculty Publications

Breast cancer (BC) is the second most common cause of cancer-related mortality worldwide. Topoisomerase II alpha (TOP2A), a key enzyme involved in DNA replication and repair, represents an important biomarker and a promising therapeutic target in BC. This study investigated the therapeutic potential of bioactive compounds from dragon fruit (Hylocereus undatus) as inhibitors of TOP2A using computational biology approaches. A total of 72 phytochemicals were retrieved from the PubChem database and evaluated for binding affinity, toxicity, drug-likeness, and inhibitory potential against TOP2A. Among these, fifteen compounds satisfied Lipinski's rule of five and were predicted to be non-toxic and non-carcinogenic. Further …

From Story Time To Self-Esteem: Using Books To Foster Positive Body Image In Pediatric Athletes, Emma Lieser

Senior Theses

This creative project explores the relationship between sport-specific musculature development and body image among pediatric girls, addressing how differing athletic movements shape both physical form and self-perception. Research indicates that girls often disengage from sports at a young age due in part to negative body image and comparison with peers, despite the physical and psychological benefits of participation. This project examines how common athletic movements—such as running, jumping, throwing, and skating—develop distinct muscle groups, contributing to diverse yet functional body types. In addition, the project investigates the influential role of children’s literature in shaping perceptions of body image and physical …

Feeding The Mind: Dietary Consumption And Neural Aging, Bhavani Tuppale

Senior Theses

Neural aging is the process of physiological decline in the brain and increased vulnerability to neurodegenerative diseases. Neurodegenerative diseases such as Alzheimer’s disease are associated with aging and the interaction of genetics and lifestyle choices. Previous research studies have connected Alzheimer’s disease with dysfunction in the metabolic system. To combat age-associated dysfunctions in the metabolic system, research studies propose using the ketogenic diet, which utilizes ketone bodies as an energy source instead of glucose. The thesis analyzes literature on the effect of neural aging on various model organisms, how a ketogenic diet affects aging model organisms, and how aging and …

Loss Of Sarm1 Affects Myelin Uptake And Clearance In Macrophages, Grace J. Bergeron

Senior Theses

Clearance of myelin debris is an essential step in nerve regeneration after injury in both the central nervous system (CNS) and peripheral nervous system (PNS), a process that is primarily carried out by macrophages. Failure to phagocytose and clear myelin can prolong inflammation and impair recovery. Sterile alpha and TIR motif-containing protein 1 (SARM1) is well researched as a regulator of axonal degeneration, yet its role in macrophages is still unclear. This study investigates how sarm1 deletion and cytokine signaling influence macrophage uptake and clearance of CNS and PNS myelin in vitro. Splenic macrophages isolated from wild-type (WT) and sarm1 …

The Role Of Community Health Workers In Rural South Carolina, Sarah W. Haselden

Senior Theses

This paper aims to explore the role of Community Health Workers (CHWs) in rural South Carolina through a literature review as well as the data supplied from the Community Health Alignment Initiative (CHAI) and Community Health Workers Changing Outcomes in SC (CCOSC). Through reviewing the collection of materials and data, the effectiveness of CHWs can be studied. Community Health Workers (CHWs) provide a unique aspect to primary care within communities through their aid in prevention of health conditions. CCOSC and CHAI collected data throughout South Carolina to determine the needs of communities and how CHWs can work to address those …

Discovering Drug-Like Compounds By Targeting Protein-Protein Interactions Using A Yeast-3-Hybrid System, Chesley C. Blake

Senior Theses

Protein-protein interactions are important targets in cancer biology as they can make historically “undruggable” proteins viable drug targets. However, the current approach to targeting protein-protein interactions relies on the use of small molecule drugs, which have low efficiencies as they must cover a large surface area of the interaction. Further, traditional drug therapies often lead to off-target toxicity, limiting therapeutic specificity. The objective of this project is to develop a selection system in yeast to identify short peptide sequences that can disrupt protein-protein interactions specific to cancer cells. Following proof of principle and development of the AH109 yeast strain having …

Exploring Synthesized Cbd Derivatives: Implications Of Therapeutic Strategies For Neuroinflammation, Josephine Mosser

Senior Theses

Cannabidiol (CBD) is a non-psychoactive phytocannabinoid derived from Cannabis Sativa with well-documented antioxidant and anti-inflammatory properties, yet its clinical utility is limited by moderate receptor selectivity, rapid hepatic metabolism, and broad pharmacological activity on the central nervous system (CNS). This thesis describes the design and partial execution of a multi-step synthetic route aimed at generating CBD/CBD-derived chalcone intermediates for potential therapeutic applications for neuroinflammation. The steps encompass an O-methylation, O-acetylation, and a Fries rearrangement. The first three steps were completed successfully and reproducibly shown through 1H-NMR and 12C-NMR; however, purification of the fourth step was not successful within the available …

Antibiotics And You: A Comprehensive Guide, Brady Haas

Senior Theses

Antibiotic resistance is a rapidly emerging issue within public health. As resistance grows, the effectiveness of traditional antibiotic therapies diminishes while risk of treatment grows. Alongside novel therapies, public knowledge is a strong combatant of the resistance-related risks of antibiotic usage. Through a comprehensive review of current literature, this work serves as an accessible guide to the mechanisms of antibiotics, bacterial resistance, and the challenges related to current antibiotic usage. Additionally, the ability of current policy and emerging novel treatments, such as nanoparticles and bacteriophage therapy, to fight antibiotic resistance is evaluated. This analysis highlights the importance of improving public …

Cell-Free Mitochondrial Dna (Mtdna) Triggers Vascular Dysfunction Via Toll-Like Receptor 9 (Tlr9)-Dependent Activation Of Inflammasomes, Mohin Amin

Senior Theses

Hypertension is the leading global risk factor for mortality and is closely associated with vascular inflammation and dysfunction. Damaged mitochondria release cell-free mitochondrial DNA (cf-mtDNA), which activates toll-like receptor 9 (TLR9). The binding of TLR9 to mtDNA activates the NLRP3 inflammasome pathway, promoting the release of pro-inflammatory cytokines via gasdermin D (GSDMD), therefore worsening inflammation. However, the mechanisms linking mitochondrial injury to inflammation-induced vascular dysfunction remain unclear. We hypothesize that cf-mtDNA triggers TLR9-dependent NLRP3 inflammasome activation contributing to vascular and endothelial dysfunction. To assess that, adult male C57BL/6 were exposed to 28 consecutive days of chronic unpredictable stress (CUS) or …

Global Trends In Bioterrorism And Biosecurity Research Publications (1997–2025): A Scopus Bibliometric Analysis, Festus Mulakoli, Samuel Gesaka, John Mbataru

School of Nursing & Midwifery, East Africa

Introduction: Bioterrorism and biosecurity preparedness are critical pillars of global public health protection and resilience of health systems worldwide. Although this field has grown over the past few decades, there remains limited clarity on how research efforts have evolved and where critical gaps persist, particularly regarding global collaboration and emerging biological threats. To address this, we conducted a bibliometric analysis to map publication trends, influential contributors, and collaboration networks in bioterrorism and biosecurity from 1997 to 2025. This study analyzed global research output, collaboration, and thematic evolution in bioterrorism and biosecurity and identified gaps relevant to preparedness and policy. …