Medical Specialties Commons^™

Polyfluoroalkyl Substances And Altered Glucose Homeostasis In Adolescents Following Bariatric Surgery, Elizabeth Costello, Brittney O Baumert, Zhenjiang Li, Vishal Midya, Shudi Pan, Justin R Ryder, Thomas H Inge, Todd M Jenkins, Stephanie Sisley, Stavra A Xanthakos, Anita Courcoulas, Douglas I Walker, Nikos Stratakis, Damaskini Valvi, Scott M Bartell, Angela L Slitt, Rohit Kohli, Sarah Rock, Michele A La Merrill, Sandrah P Eckel, Max T Aung, Rob Mcconnell, David V Conti, Lida Chatzi

Children’s Nutrition Research Center Staff Publications

Objectives: Bariatric surgery is an effective treatment for severe obesity and associated metabolic comorbidities. Exposure to polyfluoroalkyl substance (PFAS) before bariatric surgery may attenuate improvements in glucose metabolism and explain some of the heterogeneity in post-surgery outcomes.

Design: This is an observational cohort study.

Methods: Adolescents (n = 186) enrolled in the Teen-Longitudinal Assessment of Bariatric Surgery study were included. Eight-PFAS congeners were measured in plasma before surgery. Linear and logistic regressions were used to examine cross-sectional associations between log2-transformed PFAS (ng/mL) and fasting glucose, insulin, hemoglobin A1c (HbA1c), and homeostatic model assessment for insulin resistance (HOMA-IR). Linear mixed …

Examining Widely Held Propositions On Human Dietary Protein Needs And Benefits: A Critical Review Of The Science That Shapes Both The Data And Our Understanding Of An Essential Macronutrient, Mitchell M Kanter, Sally Aaron, Steven N Austad, Andrew W Brown, Nicholas A Burd, Wayne W Campbell, Mark Cope, Teresa A Davis, John W Erdman, Miguel Freitas, Kristen Hicks-Roof, Samuel Klein, Wantanee Kriengsinyos, Dudley W Lamming, Donald K Layman, Heather J Leidy, Kevin C Maki, Richard D Mattes, Shalene Mcneill, Daniel R Moore, Stefan M Pasiakos, Stuart M Phillips, David Raubenheimer, Wendy Reinhardt, Nancy R Rodriguez, Stephen Simpson, Hans H Stein, Luc J C Van Loon, Connie M Weaver, David B Allison

Children’s Nutrition Research Center Staff Publications

The essentiality of protein in the human diet is unequivocal. Yet researchers, clinicians, and lay people often believe numerous propositions about dietary protein despite insufficient supporting or refuting data in some instances. To address this disconnect, and to "pressure-test" current beliefs about dietary protein, the Indiana University School of Public Health-Bloomington convened a workshop in February 2025 titled "Human Dietary Protein Needs and Benefits: A Critical Assessment of Postulated Propositions." More than 20 international experts discussed (1) methodologic issues affecting data acquisition and interpretation; (2) "optimal" dietary protein intakes and effects on muscle protein synthesis rates, muscle protein accretion, …

Limosilactobacillus Reuteri Alleviates Proinflammatory T-Cell-Mediated Liver Injury And Transcriptomic Changes In Immunocompromised Mice, Ana Fadhel Alvarez, Zheng Yin, Beanna Okeugo, Alexander Banerjee, Meng Luo, Christopher M Taylor, Salomea Giorgberidze, Vaishali Harne, Rambabu Majji, Melissa N Munroe, Ji Ho Suh, Stephen T C Wong, Kang Ho Kim, Hari Krishna Yalamanchili, Suhair Al Salihi, Jon Marc Rhoads, Yuying Liu

Children’s Nutrition Research Center Staff Publications

Background: A deficiency of immunosuppressive regulatory T cells, as seen in scurfy (SF) mice or in IPEX syndrome in humans, can lead to multiorgan inflammation. Oral administration of the probiotic Limosilactobacillus reuteri Deutsche Sammlung von Mikroorganismen und Zellkulturen GmbH (DSM) 17938 prolongs survival and reduces Th1- and Th2-associated inflammation in SF mice. It remains unclear how DSM 17938-educated SF-CD4+ T cells modulate T-cell-liver communication.

Methods: To characterize CD4+ T cells from SF mice orally administered DSM 17938 (Prob-SF-CD4+ T cells) and to compare them with CD4+ T cells from SF mice (SF-CD4+ T cells), cells isolated from SF spleens were …

Insulinemic And Inflammatory Dietary Patterns And Colorectal Cancer Risk: A Dietary Data Harmonization Study Of One Million Participants In The Consortium Of Metabolomics Studies (Comets), Ni Shi, Rachel Hoobler, Rhea Harewood, Amanda E Toland, Demetrius Albanes, Emmanouil Bouras, Marc J Gunter, Linda M Liao, Steven C Moore, Fulvio Ricceri, Jerome I Rotter, Rashmi Sinha, Rachael Stolzenberg-Solomon, Anne Tjønneland, Alexis C Wood, Danxia Yu, Mary C Playdon, Fred K Tabung

Children’s Nutrition Research Center Staff Publications

Background: Inflammatory and insulinemic dietary patterns have been associated with colorectal cancer (CRC) risk, but generalizability across diverse populations with heterogeneous food supplies and dietary behaviors has not been established.

Objectives: We harmonized disparate dietary and covariate data on a large scale to compute the reverse Empirical Dietary Index for Hyperinsulinemia (rEDIH), reverse Empirical Dietary Inflammatory Pattern (rEDIP), and Healthy Eating Index (HEI)-2015 scores, and tested their associations with CRC risk.

Methods: We leveraged data among 501,892 women and 407,390 men from 6 cohorts across the United States (NIH-AARP, Multi-Ethnic Study of Atherosclerosis, Prostate, Lung, Colorectal, and Ovarian, SCCS) and …

Cross-Sectional And Longitudinal Relationships Between Abdominal Fat Depots And Cardiometabolic Risk In A Sample Of Mexican Adolescents, Luis Ortíz-Hernández, Erica G Soltero, Miguel Camejo, Jesús Valdes

Children’s Nutrition Research Center Staff Publications

Background: The relationship between abdominal fat depots and cardiometabolic risk among youth is inconclusive due to the cross-sectional nature of existing studies and limitations in assessment methods. In this study, we examined cross-sectional and longitudinal associations of subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT) with cardiometabolic risk indicators among Mexican adolescents.

Methods: Participants (n = 169 at baseline and 134 at follow-up) were assessed for diastolic or systolic blood pressure (DBP or SBP), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), triglycerides, glucose, and insulin. VAT and SAT were measured using magnetic resonance imaging. Measures …

A Pragmatic Guide To Data Integration For Pediatric Researchers: The Nuts And Bolts Of Mixed Methods Analysis, Kathleen A Knafl, Janet A Deatrick, Veronica M Swallow, Yelena P Wu, Debbe Thompson

Children’s Nutrition Research Center Staff Publications

Objective: To provide pragmatic guidance on data analysis, integration, and reporting guidance for investigators new to mixed methods research.

Methods: Three core mixed methods designs (convergent, explanatory sequential, and exploratory sequential) are described. Key decision points related to data integration-specifying intent, data selection, data preparation, integration strategies, use of analysis software, reporting-are explained, including comparison of decision points across the different mixed methods designs.

Results: Recommendations for addressing key decisions during analysis are provided and supported with published examples from mixed methods studies focused on pediatric populations.

Conclusions: Integration of qualitative and quantitative data is the defining characteristic of mixed …

Sustainable Community-Wide Model To Enhance Cancer Data Usage And Utility, Emily S Boja, Mousumi Ghosh, Ying Huang, Tung-Shing Mamie Lih, Rawan Shraim, Gregory Wheeler, Diana Thomas, Rakesh Khanna, Stephanie Sandor, Jinghui Zhang, Sapna Oberoi, Nicolas J Llosa, Aditya Suru, Fernanda Silva Michels, Eric Durbin, Anna Fernandez, Lucy Han, James Galbraith, Yin Lu, Brian Furner, James H Tanis, Michael Watkins, David Higgins, Gavriel Matt, Xin Zhou, Yang Li, Marcin Cieslik, Jamie Estill, Michael Sierk, Yanling Sun, Weiping Ma, Joseph Flores-Toro, Freddie Pruitt, Subhashini Jagu, Elmer A Fernández, Daniela Orschanski, Stephanie J Spielman, Jaclyn Taroni, Trinh Nguyen, Brian Capaldo, Erin Beck, Tanja Davidsen, Johanna Goderre Jones, Minghong Ward, Anne Sturcke, Jennifer M Torres Del Valle, Sean Hanlon, Danielle Daee, Brandon Wright, Nathaniel Boyd, Heather Basehore, Liang Liu, Ying Hu, Daoud Meerzaman, Huiqing Li, Ying Wu, Gregory H Reaman, Erin Rudzinski, Jack F Shern, Brigitte Widemann, Warren Kibbe, Jaime Guidry Auvil

Children’s Nutrition Research Center Staff Publications

Despite vast investments in data collection, generation, and sharing from childhood cancer studies, for example, Gabriella Miller Kids First Research Program, Childhood Cancer Data Initiative, and other efforts, secondary use of data remains a challenge especially for rare diseases. The National Cancer Institute (NCI) Office of Data Sharing (ODS) aimed to promote FAIR (Findable, Accessible, Interoperable, Reusable) data sharing practices to enhance data utility, accelerate discovery, and foster interdisciplinary collaboration. NCI ODS launched its inaugural Data Jamboree focusing on childhood cancer alongside its third Annual Symposium in September 2025. Over 120 participants with diverse backgrounds coalesced into 23 multidisciplinary teams …

Evaluating The Impact Of Telemedicine-Based Medication Education On Glycemic Control In Adult Male Veterans With Type 2 Diabetes Mellitus, Megan N. Calter

West Chester University Graduate Theses, Dissertations, and Final Projects

Veterans experience disproportionately high rates of type 2 diabetes mellitus (20.5% vs 11.6% nationally), driven by military-related factors such as PTSD, deployment-related obesity, and service-connected disabilities. At a large urban primary care clinic, 28% (40/141) of veterans with type 2 diabetes mellitus had persistently elevated HbA1c levels of ≥8%, indicating a high risk for diabetes-related complications. This quality improvement project aimed to reduce the proportion of veterans with HbA1c of ≥8% by implementing tailored telemedicine-based medication education, leveraging underutilized virtual care infrastructure to address access barriers and improve diabetes self-management. Participants received two 30-minute telemedicine medication and disease management education …

Pt/Zno-Decorated Laser-Induced Graphene For Nonenzymatic Glucose Monitoring Under Physiological Conditions, Reagan Aviha, Gymama Slaughter

Center for Bioelectronics Publications

Diabetes continues to impose significant global health and economic burdens, driving the demand for robust, enzyme-free glucose sensors capable of reliable operation under physiological conditions. Here, we report the development of a high-performance nonenzymatic glucose sensor based on laser-induced graphene (LIG) modified with zinc oxide (ZnO) and platinum (Pt) nanostructures. ZnO was electrodeposited onto LIG with modulation potential and deposition duration systematically optimized. The ZnO/LIG electrodes were characterized electrochemically using potassium ferricyanide and evaluated for glucose oxidation in phosphate-buffered solution. Subsequent electrodeposition of Pt under analogous optimized conditions yielded a ternary Pt/ZnO/LIG architecture with enhanced electrocatalytic activity. Sensor performance was …

Enlarging Fingertip Nodule Mimicking A Pyogenic Granuloma In A Man In His 60'S, Avery H. Seward, Jocelyn H. Larocque, Stephen M. Hughes

Department of Medicine Faculty Publications

[Case presentation] A man in his 60's with a history of hypertension, hyperlipidemia, and resected colon cancer in remission presented with a 4-month history of an enlarging nodule on the right fourth fingertip. The patient recalled having a splinter removed from the same site a few weeks prior to the development of the lesion. The lesion was initially diagnosed by an orthopaedist as a pyogenic granuloma (Figure 1a), and the patient was advised to apply table salt to the area several times daily. However, the lesion continued to enlarge over 3 months with occasional bleeding and mild tenderness. Physical examination …

Integrating Self-Determination Theory And Continuous Glucose Monitoring: Promoting Youth Development Among Campers With Type 1 Diabetes, Eddie Hill, Bethany Arrington, Taylor Harvey, Alexis Barmoh, Rowan Williams, Laura Hill

Human Movement Studies & Special Education Faculty Publications

The purpose of this cohort study was to evaluate participants’ general self-management and experiences of autonomy while attending diabetes camp using quantitative and qualitative data collection. Through a partnership, an outdoor diabetes camp was designed to assist youth with type 1 diabetes (T1D) in their management. The REACH Teen program conducted a week-long summer camp for youth with T1D. The study was designed through Outcome-Focused Programming grounded in Self-Determination Theory (SDT) to meet campers’ needs of autonomy, competence, and relatedness. Campers participated in outdoor activities and diabetes education designed to increase healthy behaviors. Twenty-three campers completed a 24-item pre- and …

Triglyceride Glucose Index As A Predictor Of Insulin Resistance In Patients With Hypothyroidism, Nadeen El-Nakeeb, Mohammed A. Helaly, Ahmad S. Hasan, Rania Bahriz

Mansoura Medical Journal

Background: Thyroid hormones play a key role in glucose metabolism, and hypothyroidism is frequently associated with impaired insulin secretion, altered glucose disposal, and insulin resistance (IR).

Aim: This study aimed to assess insulin resistance in patients with hypothyroidism using the triglyceride–glucose (TyG) index in comparison with the homeostasis model assessment of insulin resistance (HOMA-IR).

Methods: This case-control study was conducted on 100 participants (50 hypothyroid patients and 50 euthyroid controls), aged 18–60 years. All subjects underwent detailed clinical evaluation, anthropometric measurements, and fasting laboratory investigations including glucose, lipid profile, insulin, TSH, and free T4. Insulin resistance was assessed using TyG …

Differential Impact Of Admission Type And Clinical Complexity On Diabetes Hospitalization Costs Among African American And Hispanic Patients In Southeastern Virginia, Ismail El Moudden, Asra Amidi, Reem Sharaf-Alddin, Michael C. Bittner, Qi Zhang

Department of Obstetrics & Gynecology Faculty Publications

Background

Diabetes mellitus (DM) imposes substantial healthcare costs with documented disparities among African Americans and Hispanic patients. To inform care delivery and resource allocation, this study identified hospitalization cost predictors among African American and Hispanic patients with diabetes in Southeastern Virginia.

Methods

We analyzed 6,011 hospital discharges from the Virginia Health Information database (2016-2020) for adults aged 18-85 with diabetes. Discharges were classified by Medicare Severity Diagnosis-Related Groups: DM with complications/comorbidities (DCC, n = 3,328), DM with major complications/comorbidities (DMCC, n = 1,518), and DM without major complications/comorbidities (DWO, n = 1,165). Because cost distributions were right-skewed (skewness 3.5-8.24), we …

Contribution Of Comorbidities And Pregnancy Complications To Severe Maternal Morbidity In The United States, Tetsuya Kawakita, Sora A. Jones, Natsume Furukawa, George Saade

Department of Obstetrics & Gynecology Faculty Publications

Objective: To quantify the extent to which rising rates of severe maternal morbidity (SMM) in the United States from 2016 to 2022 are attributable to increasing prevalence of maternal risk factors, including advanced maternal age, obesity, pregestational diabetes mellitus, gestational diabetes, chronic hypertension, and hypertensive disorders of pregnancy (HDP).

Methods: We conducted a retrospective cohort study using the Nationwide Readmissions Database from 2016 to 2022, representing more than 25 million weighted delivery hospitalizations. The primary outcome of SMM was identified with the Centers for Disease Control and Prevention's 21-condition algorithm; a secondary outcome excluded transfusion to improve specificity. Temporal trends …

Stones, Bones, And Hormones: A Multisystem Presentation Of Primary Hyperparathyroidism Due To Parathyroid Adenoma, Gadgesh B, Varsha Tandure, Nandini K, Chandana Srinath

Digital Journal of Clinical Medicine

Primary hyperparathyroidism is an endocrine disorder characterized by excessive secretion of parathyroid hormone, most commonly due to a solitary parathyroid adenoma, resulting in hypercalcemia and multisystem involvement [1]. Although many patients are diagnosed incidentally, delayed recognition may lead to severe renal, skeletal, gastrointestinal, and cardiovascular complications.

We report the case of a 44-year-old male who presented with sepsis and acute kidney injury, later found to have hypercalcemia with nephrocalcinosis, chronic calcific pancreatitis, skeletal deformities, and markedly elevated parathyroid hormone levels. Imaging localized a parathyroid adenoma, and the patient underwent successful parathyroidectomy with significant biochemical and clinical improvement.

This case emphasizes …

Cardiovascular–Kidney–Metabolic Syndrome Through The Lens Of Gut‑Derived Uremic Toxins, Chudan Xu, Matthew Snelson, Francine Z. Marques

Research outputs 2022 to 2026

Cardiovascular–Kidney–Metabolic (CKM) syndrome represents a complex, interconnected cluster of cardiovascular disease, chronic kidney disease, and metabolic disorders such as obesity and type 2 diabetes. These conditions share overlapping metabolic, inflammatory, and vascular pathways, with the gut microbiome increasingly recognised as a key contributor and common underlying risk factor. Uremic toxins, traditionally considered waste products of host and microbial metabolism, are now recognised as active mediators of tissue damage across the CKM spectrum, particularly in the context of impaired renal function. Their production and accumulation are amplified by disrupted intestinal barrier integrity, chronic inflammation, and reduced renal clearance, collectively driving systemic …

Assessing Access To Orthopaedic Care For Patients With Osteogenesis Imperfecta, Annemarie K. Leonard, Kara Ayers, Lauren Faokunla, Kaeli Samson, Erika Carter, Tracy Hart, Maegen Wallace

Graduate Medical Education Research Journal

Background. Osteogenesis Imperfecta (OI) is a rare disorder caused by variations in collagen. Clinical manifestations include multiple fractures, short stature, scoliosis, blue sclera, hearing loss, and opalescent teeth. Patients often need many different medical providers frequently, which may place financial burdens on families. This study sought to identify and understand barriers to care for children with OI.

Methods. We utilized an Institutional Review Board (IRB)-approved survey for primary caregivers of children with OI. Questions included demographic data, type of health insurance, history of and reasons for insurance denials, access to multidisciplinary OI care, and travel to receive OI care. The …

Korelasi Kadar Serum Vegf-A Dengan Rasio Albumin-Kreatinin Urin Pada Pasien Penyakit Ginjal Diabetik, Hannie Q. Syaiful, Drajad Priyono, Harnavi Harun, Arina W. Murni, Akmal M. Hanif, Eifel Faheri, Arnelis Arnelis, Vesri Yoga

Jurnal Penyakit Dalam Indonesia

Introduction. Diabetic kidney disease (DKD) is a major microvascular complication of diabetes mellitus, characterized by persistent albuminuria and a progressive decline in glomerular filtration rate (GFR), making it a leading cause of chronic kidney disease (CKD) and end-stage renal disease. Vascular endothelial growth factor-A (VEGF-A) is implicated in the pathogenesis of DKD, being overexpressed in the kidneys and contributing to increased vascular permeability, inflammation, and fibrosis. Albuminuria, an early indicator of renal damage in DKD, is a strong predictor of CKD progression and cardiovascular events. The urine albumin-to-creatinine ratio (UACR) is the recommended test for detecting and monitoring albuminuria. …

Effect Of Implementing Safety Nursing Measures For Maintaining Fluid And Electrolyte Balance Among Critically Ill Patients With Acute Pancreatitis, Marwa Abdo

Nursing

Acute pancreatitis is a severe inflammatory condition that affects the pancreas and causes multiple organ failure. High rates of morbidity and mortality are caused by acute pancreatitis. Early fluid resuscitation, within the first 48 hrs., remains the hallmark for acute pancreatitis management. It lowers the incidence of pancreatic necrosis. Therefore, the foundation of treating acute pancreatitis in its early stages is safe fluid resuscitation. Aim: This study aims to evaluate the effect of implementing safety nursing measures for maintaining fluid and electrolyte balance among patients. Study design: A quasi-experimental research design was utilized in this study. Setting: This study was …

Spinach (Spinacia Oleracea L) Flavonoids Are Hydrolyzed During Digestion And Their Bioaccessibility Is Under Stronger Genetic Control Than Raw Material Content, Michael P Dzakovich, Alvin L Tak, Elaine A Le, Rachel P Dang, Benjamin W Redan, Geoffrey A Dubrow

Children’s Nutrition Research Center Staff Publications

Spinach (

Cognitive Frailty And Cardiometabolic Risk In Middle-Aged And Older Adults: Evidence From The Uk And China, Haiyang Yan, Jingjing Lang, Chengfeng Li, Samaneh Eftekhariranjbar, Guoyan Jiang, Jing Lei, Lixin Sun, Carlos J. Toro-Huamanchumo, Zhongyang Guan

Research outputs 2022 to 2026

Background: Cognitive frailty, a novel construct integrating cognitive and physical deficits, is increasingly recognized in aging research. Aims: This study aimed to examine the associations between cognitive frailty and cardiometabolic risk in two nationally representative cohorts from China and the United Kingdom. Methods: We analyzed data from 7,628 participants in the China Health and Retirement Longitudinal Study (CHARLS) and 4,703 participants from the English Longitudinal Study of Ageing (ELSA), all aged ≥ 50 years. Frailty was assessed using the frailty index (FI) in the main analysis. Cox proportional hazards models were applied to estimate hazard ratios (HRs) for incident cardiometabolic …

Hypophosphatemia Across The Lifespan, Madhuni Herath, Richard Prince, Craig F. Munns, Albert Kim

Research outputs 2022 to 2026

No abstract provided.

The Effect Of Prednisolone Ingestion And Acute Exercise On Lipocalin-2 And Its Variants In Young Men: A Pilot Randomised Crossover Study, Carlie Bauer, Rhiannon K. Patten, Qiyang Sun, Haoyun Li, Daniels Konja, Mary Woessner, Xuzhu Lin, Andrew Garnham, David L. Hare, Peter R. Ebeling, Marc Sim, Joshua R. Lewis, Yu Wang, Lewan Parker, Itamar Levinger

Research outputs 2022 to 2026

Lipocalin-2 (LCN2) has three main variants; polyaminated (hLCN2) and non-polyaminated (C87A and R81E). The polyaminated form is proposed to positively influence energy control, whereas the non-polyaminated forms negatively impact energy control in mice. Glucocorticoids negatively affect glucose regulation and exercise has a positive effect. We hypothesise that glucocorticoids will suppress, while exercise will increase hLCN2, and decrease C87A and R81E, which will be associated with improved insulin sensitivity. In a randomised crossover design, nine young healthy men (aged 27.8 ± 4.9 years; BMI 24.4 ± 2.4 kg/m2) completed 30 min of high-intensity aerobic exercise (90–95% heart rate reserve) after glucocorticoid …

Transcriptional Coregulator Zmiz1 Modulates Estrogen Responses That Are Essential For Healthy Endometrial Function, Sylvia C Hewitt, Frank Orellana, Ryan M Marquardt, Myeongjin Yi, Cynthia J Willson, Mark Y Chiang, Yong Song, Goutham Venkata Naga Davuluri, Christopher Day, Ramakrishna Kommagani, Joseph Rodriguez, Asgerally T Fazleabas, John P Lydon, Francesco J Demayo

Faculty, Staff and Students Publications

Estrogen is a critical regulator of endometrial health. Aberrant estrogen stimulation can result in infertility, endometrial cancer, and endometriosis. Here, we identified Zinc Finger MIZ-Type Containing 1 (Zmiz1) as a coregulator of uterine estrogen signaling. ZMIZ1 is colocalized with an estrogen receptor α–binding (ESR1-binding) super enhancer. ZMIZ1 mutations are found in endometrial cancer and its RNA levels trend toward reduction in endometrium of patients with endometriosis. ZMIZ1 is dynamically expressed in human endometrial tissues during the menstrual cycle. Disrupting ZMIZ1 in cultured human endometrial stromal cells resulted in impaired cell proliferation and decidual differentiation. Ablation of Zmiz1 using …

Sleep-Disordered Breathing Subtypes And Future Diet Quality In The Multi-Ethnic Study Of Atherosclerosis, Kaitlin S Potts, Cecilia Castro-Diehl, Tianyi Huang, Alexis C Wood, Jerome I Rotter, Stephen S Rich, Tamar Sofer, Susan Redline, Heming Wang

Children’s Nutrition Research Center Staff Publications

Objectives: Sleep-disordered breathing (SDB) and diet quality impact cardiometabolic disease, but few studies have examined if SDB influences diet quality. This study estimated the association between SDB subtypes (with and without sleepiness) and future diet quality in the Multi-Ethnic Study of Atherosclerosis.

Methods: Probable SDB was characterized by self-reported physician-diagnosed sleep apnea (PDSA) or habitual snoring and subtyped by presence or absence of sleepiness. A food frequency questionnaire measured diet 1.6 years before, and 7.8 years after SDB assessment. Diet quality was measured with the Alternate Healthy Eating Index-2010 (AHEI). Mean differences in AHEI at follow-up by SDB subtypes were …

Predicting Five-Year Comorbid Bipolar Disorder After Attention-Deficit/Hyperactivity Disorder Diagnosis: A Population-Based Machine Learning Approach, Yen-Shan Yang, Chih-Wei Hsu, Liang-Jen Wang, Kuo-Chuan Hung, Yang-Chieh Brian Chen, Chih-Sung Liang, Mu-Hong Chen

Children’s Nutrition Research Center Staff Publications

Background

Early detection and accurate prediction of bipolar disorders (BDs) comorbidity in individuals with attention-deficit/hyperactivity disorder (ADHD) are clinically critical. This study used machine-learning methods to identify features predictive of subsequent BD among patients initially diagnosed with ADHD.

Methods

We analyzed claims from the Taiwan National Health Insurance Research Database (2000–2013) and included patients aged ≥ 12 years with at least two diagnoses of ADHD. Predictor features included demographics (sex, age at ADHD onset), healthcare utilization (psychiatric outpatient visit counts), comorbidities (International Classification of Diseases–coded diagnoses), psychiatric medications (Anatomical Therapeutic Chemical–coded prescriptions), and family psychiatric history. All features were extracted …

A Class Of Benzofuranoindoline-Bearing Heptacyclic Fungal Ripps With Anticancer Activities, Qiuyue Nie, Fanglong Zhao, Xuerong Yu, Mithun C Madhusudhanan, Caleb Chang, Siting Li, Sandipan Roy Chowdhury, Bryce Kille, Andy Xu, Rory Sharkey, Chunxiao Sun, Hongzhi Zeng, Shuai Liu, Dishu Zhou, Xin Yu, Kevin Yang, Sandra A C Figueiredo, Maria Zotova, Zichen Hu, Alan Y Du, Dongyin Guan, Rui Tang, Todd Treangen, Jin Wang, Pedro N Leão, Yang Gao, Junjie Chen, Peng Liu, Hans Renata, Xue Gao

Children’s Nutrition Research Center Staff Publications

Ribosomally synthesized and post-translationally modified peptides (RiPPs) are a promising source of new pharmaceuticals, yet the therapeutic potential of fungal RiPPs remains largely underexplored. Here, we report asperigimycins as a distinct class of fungal RiPPs, featuring a unique heptacyclic scaffold consisting of a benzofuranoindoline core and three additional macrocycles, primarily assembled by six distinct fungi-specific DUF3328 oxidases. Inspired by the enhancement of anticancer activity through the N-terminal pyroglutamate in naturally occurring asperigimycins C and D, we chemically modify the inactive asperigimycin B with a series of lipid substitutions at its N-terminus. A derivative with a C-11 linear fatty …

Cumulative Triglyceride-Glucose Index And Hypertension Risk: A Longitudinal Cohort Study, Zhaogui Wu, Dan Wu, Sichi Xu, Yan Borné, Yulong Lan, Shuohua Chen

Research outputs 2022 to 2026

Background: Prior research has established a positive association between the single-measured triglyceride-glucose (TyG) index and hypertension. Nevertheless, longitudinal studies addressing the enduring impact of TyG index on incident hypertension are lacking. This study sought to explore the association between cumulative TyG index (cum-TyG) and incident hypertension, especially obesity-related hypertension (ORHT). Methods: A total of 21,017 individuals [mean (SD) age: 48.5 ± 11.7 years, male (%): 14,544 (69.2)] without hypertension were recruited from the Kailuan Study. The cum-TyG was determined by multiplying the mean TyG index by the time intervals between successive visits. Multivariable Cox regression models were used to investigate …

Hypercalcemia Of Down Syndrome., Seth Lmb, Melissa Litao, Nasreen Talib, Jacob M. Redel

Manuscripts, Articles, Book Chapters and Other Papers

We present a case of hypercalcemia in a 12-month-old female with Down syndrome. The patient presented with significant weight loss (810 g since her 6-month visit) and severe growth failure (weight 5.8 kg, -4.5 SDs). Laboratory evaluation revealed severe hypercalcemia with appropriately suppressed PTH and 1,25-hydroxyvitamin D levels. Renal ultrasound confirmed medullary nephrocalcinosis. After excluding common etiologies, the patient was diagnosed with hypercalcemia of Down syndrome, also termed Abnormal Calcium, Calcinosis, Creatinine in Down syndrome. Treatment with intravenous fluids, calcitonin, and transition to a low-calcium formula (Calcilo XD) normalized serum calcium levels. The patient maintained normal calcium levels on restricted …

Barriers And Facilitators To Lifestyle Behavior Change And Goal Setting In Adolescents With Polycystic Ovary Syndrome., Manasa Gadiraju, Joy Y. Kim, Erin M. Green, Alexandra Macmillan Uribe, Honghui Chang, Tania S. Burgert, Melissa D. Olfert, Heidi Vanden Brink

Manuscripts, Articles, Book Chapters and Other Papers

PURPOSE: To identify barriers and facilitators to lifestyle modifications and goal setting and characterize goal setting for adolescents with polycystic ovary syndrome (PCOS).

METHODS: Retrospective chart review of registered dietitian nutritionist (RDN) nutrition notes from 118 adolescents with PCOS 11-21 years evaluated at a multi-specialty PCOS clinic. Goals, barriers, and facilitators were coded using open coding and a priori objectives and characterized for emerging themes using qualitative content analysis.

RESULTS: Five major themes of barriers and facilitators to behavior change emerged: interest and motivation, family involvement, resources and food environment, taste preferences, and self-efficacy. RDNs set ≥3 goals with 52%, …