Medical Specialties Commons^™

Diet Quality As Assessed By The Healthy Eating Index-2020 Among Individuals Diagnosed With And Without Type 2 Diabetes, Minghao Zhou, Hairui Yu, Renee Underwood, Hongning Cai, Tung Sung Tseng, Susu Luo

School of Public Health Faculty Publications

Background: Dietary management is key to preventing and controlling type 2 diabetes mellitus (T2DM). However, few studies have examined differences in Healthy Eating Index (HEI-2020) scores and components among individuals with and without diagnosed T2DM. This study aimed to assess gender differences in HEI-2020 scores and its 13 components by T2DM status. Methods: Using National Health and Nutrition Examination Survey (NHANES) data from 2011 to 2018, this cross-sectional study analyzed 19,464 adults. Diagnosed T2DM was identified via self-report or diabetes medication use. Diet quality was assessed using the HEI-2020, scored from 0 to 100, with a higher HEI score indicates …

Limosilactobacillus Reuteri Promotes Melatonin Release From Human Intestinal Organoids Via 5′Ectonucleotidase Activity, Heather A Danhof, Ludwig Ermann Lundberg, Stefan Roos, Robert A Britton

Faculty, Staff and Students Publications

Strains of Limosilactobacillus reuteri have been used to prevent or treat various conditions; however, the mechanisms by which they exert beneficial effects are not completely understood. Infant colic is one example in which L. reuteri DSM 17938 reduces clinical symptoms. While the etiology of colic is unknown, abnormal melatonin levels in infants have been suggested as a possible contributor. L. reuteri DSM 17938 has been shown to produce adenosine from AMP via production of the extracellular enzyme 5′ectonucleotidase (5′NT). Adenosine is a potent signaling molecule that impacts several important aspects of host physiology, including the release of melatonin from the …

Mucin-Derived Sugars Act As Metabolic Brakes Controlling Growth Initiation In Akkermansia Muciniphila, Bryan D Lakey, Katherine J Wozniak, Robert A Britton, Jeffrey J Tabor

Faculty, Staff and Students Publications

Akkermansia muciniphila is a key member of the gut microbiota and plays important roles in host metabolism and health. In the colon, A. muciniphila extracts nutrients from oligosaccharide-rich mucin glycans that comprise the mucosa. However, this environment is complex and shaped by dietary inputs, microbiome metabolism, and mucin glycan composition varying across hosts, gastrointestinal regions, and physiological states. How strains of A. muciniphila integrate these nutrient signals into growth initiation and niche colonization remains unclear. Here, we compare physiological responses of a human- and mouse-derived strain of A. muciniphila, finding that dietary sugars differentially affect these isolates, suggesting host-associated …

Gut-Derived Bacterial Extracellular Vesicles: The Microbial Dark Matter Contributing To Host Inflammation And Cardiometabolic Disease, Blayne Oliver, Michael Sun, Young Seo Lee, Ssanggoo Cho, Tianyi Zhu, David Durgan, Gary Sweeney

Faculty, Staff and Students Publications

Cardiometabolic diseases (CMDs) represent a growing global health burden, with chronic inflammation and gut microbiota dysbiosis emerging as central contributors to their pathogenesis. Among the diverse microbial products influencing host physiology, bacterial extracellular vesicles (BEVs) have gained attention as potent mediators of interkingdom communication. These nanoscale vesicles, secreted by both gram-positive and gram-negative bacteria, carry a complex cargo of proteins, lipids, nucleic acids, and pathogen-associated molecular patterns (PAMPs) that interact with host pattern recognition receptors (PRRs) to modulate immune and metabolic responses. BEVs can traverse intestinal barriers, disseminate systemically, and accumulate in cardiometabolic tissues, where they influence inflammation, insulin sensitivity, …

When Probiotics Guidelines Differ: A Practical Guide For Clinicians And Researchers, Howard Bauchner, Daniel J Merenstein

Faculty, Staff and Students Publications

Many professional organizations publish clinical practice guidelines for the use of probiotics in gastrointestinal disorders. Generally, no two guidelines align perfectly, and some differ markedly. These discrepancies occur because clinical practice guidelines are not purely mechanical outputs of data synthesis. They are shaped by structured interpretation, value judgments, and predefined thresholds for uncertainty. These elements become particularly visible when effect sizes are small, heterogeneity is high, and outcomes vary in clinical relevance-as is the case with probiotic research. This article examines why discordance among probiotic guidelines is predictable and provides practical guidance for clinicians who must decide among conflicting recommendations …

Steroid Receptor Coactivator 3-Deficient Regulatory T Cells Eradicate Multiple Solid Tumors In Syngeneic Mouse Models, Yuri Park, Adam M Dean, Yan Xia, Jianming Xu, Clifford C Dacso, David M Lonard, Sang Jun Han

Faculty, Staff and Students Publications

Steroid receptor coactivator 3 (SRC-3) is highly expressed in regulatory T cells (Tregs) and is important for their immunosuppressive activity. Recently, we demonstrated that disrupting SRC-3 expression in Tregs eliminates triple-negative breast cancer (TNBC) and prostate cancer in syngeneic animal models by generating an anti-tumor immune microenvironment without inducing immune-related adverse events (irAEs). Further analysis of these mice revealed that SRC-3 knockout (KO) Tregs infiltrated breast tumors and facilitated the infiltration of CD8

Is Your Cyst Really A Ganglion Cyst? A Case Report Of Angioleiomyoma Mimicking A Plantar Fascia Cystic Lesion, Christopher Anjorin Ms Dpmc, Joseph Bender Dpm

School of Podiatric Medicine - Student Research

Ganglion cysts are among the most common benign soft tissue masses encountered in podiatric clinical practice, and their diagnosis is often presumed based on location, clinical observation, and transillumination. However, this case highlights a diagnostic idiosyncrasy: a lesion clinically presumed to be a ganglion cyst within the plantar fascia was ultimately identified as an angioleiomyoma following surgical excision and histopathological evaluation. This finding underscores the importance of maintaining a broad differential diagnosis when assessing cystic lesions, particularly those that transilluminate, as benign vascular tumors may closely mimic more common entities in both clinical presentation and imaging. More importantly, what if …

Deep Brain Stimulation In Early-Stage Alzheimer's Disease: A Systematic Review Of Neuropsychological Outcomes, Nora Huey

Doctoral Dissertations

Alzheimer’s disease (AD) is a progressive neurodegenerative disorder characterized by cognitive decline, memory impairment, and disruption of neural networks involved in cognitive functioning. Although existing treatments may provide symptomatic benefit, there remains a need for interventions capable of slowing or stabilizing disease progression. Deep brain stimulation (DBS) has emerged as a potential neuromodulatory intervention for early-stage AD through stimulation of memory- and cognition-related neural circuitry. This dissertation employed a systematic review research methodology to examine teh neuropsychological and neurobiological outcomes associated with DBS targeting the fornix (DBS-f) and nucleus basalis of Meynert (DBS-NBM) in individuals with early-stage AD over 12–24 …

Adolescent And Young Adult Cancer Survivorship: Supportive Care Needs, Resources, And Barriers, Allison Bryn Koplos

Master's Projects and Capstones

Background: Adolescent and young adult (AYA) cancer survivors experience unique physical, psychosocial, developmental, and healthcare-related challenges that often persist beyond treatment completion. Although survivorship resources have expanded, gaps in supportive care needs persist. This scoping review examined the supportive care needs, survivorship resources, and barriers to accessing supportive care among AYA cancer survivors.

Methods: A scoping review was conducted following the Arksey and O'Malley framework and reported in accordance with the PRISMA-ScR guidelines. Peer-reviewed literature published between 2000 and 2026 was identified through searches in PubMed and Google Scholar. Studies examining supportive care needs, survivorship resources, or supportive care services …

Multiomic And Single-Cell Analysis Of Tumors And Their Immune Microenvironment For Personalized Cancer Therapy, Kartik Singhal

WUSM Theses and Dissertations – All Programs

Precision oncology aims to match cancer treatment to the biology of an individual patient’s tumor. However, tumors that share a diagnosis can differ in their molecular features, cellular composition, clinical course, and response to therapy, making it difficult to determine which treatment will benefit an individual patient. This dissertation integrates genomic, transcriptomic, and single-cell multiomic computational analysis to characterize tumors across their somatic alterations, transcriptional cell states, microenvironment, and the immune response they elicit.

The first study describes a rare case of donor-derived follicular lymphoma following kidney transplantation. Genomic profiling showed that the donor and recipient tumors shared 31 somatic …

Phytochemical And In-Vitro Cytotoxic Analyses Of Flavonoid Species Isolated From Chromolaena Leivensis, Luke A. Bryant

Electronic Theses and Dissertations

As a leading cause of death worldwide, cancer and its treatments remain a primary source of interest among researchers. Modern studies are looking into bioselective cytotoxicity to create new chemotherapies that do not have the same harsh side effects as those we use today. Natural product research has a promising future for the development of such treatments. Specifically, polar flavonoids may be the key to a bioselective treatment. Such flavonoid species are native to plants, often within flower petals or within the body. A natural antioxidant, they are designed not to harm healthy cells. This study focuses on the plant …

Characterizing Children With Chronic Kidney Disease And Severe Proteinuria In The United States: A Retrospective Analysis Using Electronic Health Records., Bradley A. Warady, Simone Heeg, Alfredo E. Farjat, Rachel Knapp, Siir Su Saydam, Alexander Vowinkel, Alain Gay, James Potts, Andrea Scalise, Gordana Atanackovic, Sascha Van Boemmel-Wegmann

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: In recent years, real-world data have been increasingly used to enrich data from interventional studies on treatment effectiveness. To explore the viability of hybrid study designs in pediatric chronic kidney disease (CKD), we assessed the feasibility of identifying a real-world cohort of children with CKD and severely increased proteinuria who satisfied adapted eligibility criteria from the FIONA trial.

METHODS: We used data from the Optum® de-identified Electronic Health Record dataset (Optum® EHR) to identify and characterize children with CKD and severely increased proteinuria in records from January 2013 to December 2022. Patients were identified based on two sets of …

Medication Management And Caregiving Stress Or Benefit In Children With Medical Complexity., Casey O'Hare, Nicole Werner, Makenzie Morgen, Sophie Kooiman, James Feinstein, Michelle A. Chui, Gemma Warner, Anna Jolliff, Brittany Storhoff, Kristan Sondegren, Danielle Gerber, Jens Eickhoff, Ryan J. Coller

Manuscripts, Articles, Book Chapters and Other Papers

This study quantified medication management experiences for children with medical complexity and associations with caregiver stress or benefit. Using data from the MedS@HOME trial, involvement of professional caregivers was associated with increased caregiver benefit, and greater network collective efficacy was associated with increased caregiver benefit and decreased caregiver stress.

TRIAL REGISTRATION: ClinicalTrials.gov, ID NCT05816590.

Touch Contamination And Associated Peritonitis In Children Undergoing Maintenance Peritoneal Dialysis., Rebecca G. Same, Natalie K. Grills, Sreejata Dutta, Alicia M. Neu, Bradley A. Warady, Brandy Begin

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Infections are a leading cause of hospitalization and death in children receiving maintenance peritoneal dialysis (PD). Touch contamination is an established risk factor for development of peritonitis, but data regarding optimal management of touch contamination are limited.

METHODS: We conducted a retrospective cohort study using data submitted to the Standardizing Care to Improve Outcomes in Pediatric End Stage Kidney Disease (SCOPE) collaborative between 10/1/2011 and 7/31/2025 to evaluate touch contamination in children. Reported touch contamination events and their management, including administration of prophylactic antibiotics and transfer set changes, were evaluated. Univariate and multivariable generalized linear mixed modeling were used …

Ambulatory Arterial Stiffness Index Among Children And Adolescents With Chronic Kidney Disease: A Report From The Chronic Kidney Disease In Children Study., Susan M. Halbach, Jennifer Roem, Michael F. Schneider, Joshua Samuels, Susan L. Furth, Bradley A. Warady, Joseph T. Flynn, Ckid Study Investigators

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: To quantify the association between ambulatory arterial stiffness index (AASI) and hypertensive status, and to identify additional predictors of AASI, including body mass index (BMI), proteinuria, and mineral metabolism, in children and adolescents with chronic kidney disease (CKD).

METHODS: We analyzed data collected from 654 participants during 1283 study visits in the Chronic Kidney Disease in Children (CKiD) prospective cohort study. AASI was calculated from ambulatory blood pressure monitoring (ABPM) data as 1 minus the slope coefficient from a least squares linear regression of diastolic blood pressure (BP) on systolic BP. Hypertensive status was determined by clinic BP and …

Methylated Cfdna May Distinguish Between High- And Intermediate-Risk Uveal Melanoma: A Pilot Study, Mike Wu, Daniël P. De Bruyn, Ruben G. Boers, Aaron B. Beasley, Daan M. Hazelaar, Stavros Makrodimitris, Joachim B. Boers, Jolanda Vaarwater, Ronald O.B. De Keizer, Robert M. Verdijk, Nicole C. Naus, Dion Paridaens, Saskia M. Wilting, Elin S. Gray, Wilfred F.J. Van Ijcken, Joost Gribnau, Annelies De Klein, Erwin Brosens, Emine Kiliç

Research outputs 2022 to 2026

Background: Uveal melanoma (UM) is a highly aggressive malignancy with a metastatic risk that depends on the molecular subclass. This subclass can be determined through molecular characterization of tumor-derived tissue. With eye-sparing treatments, tumor tissue is rarely available for molecular testing. We hypothesized that minimal invasive biomarkers such as methylated cell-free DNA (cfDNA) or circulating tumor DNA (ctDNA) can be used for prognosis and monitoring of patients. Methods: Plasma cfDNA was isolated from healthy blood donors (HBDs, N = 19) and UM patients (N = 22). Plasma was collected at baseline (localized disease, N = 13) and during follow-up (metastatic …

In-Hospital Mortality Patterns And Readmissions In Patients With Chronic Obstructive Pulmonary Disease: An Analysis Of The Role Of Pulmonary Hypertension, Saad Afzal Khan, Trishna Parikh, Adishwar Rao, Akriti Agrawal, Aarohi Parikh, Sarah Shin, Maulin Patel, Kha Dinh, Bela Patel, Bindu Akkanti

Faculty, Staff and Student Publications

Chronic obstructive pulmonary disease (COPD) may be complicated by pulmonary hypertension (PH). We aimed to understand the impact of PH on in-hospital mortality and quantify the 30-day readmission rate among patients with COPD. For this cross-sectional study, we used the Nationwide Readmissions Database from 2017-2020 to identify adults ≥18 years with COPD. Patients were stratified according to PH diagnosis. Baseline characteristics between groups were compared using the Pearson chi-square test and two-sample t-test. Predictors of in-hospital mortality were determined using multivariate logistic regression analysis adjusted for demographics and confounders. The 30-day readmission rate and prevalence of PH subgroups by baseline …

Cardiovascular Disease And Fracture Risk In People With Type 2 Diabetes: A Nationwide Matched Case–Control Study, Aksayan Arunanthy Mahalingasivam, Annika Vestergaard Kvist, Joop P. Van Den Bergh, Cassandra Smith, Joshua R. Lewis, Peter Vestergaard, Nicklas Højgaard Hessellund Rasmussen

Research outputs 2022 to 2026

To examine, among people with type 2 diabetes (T2D), whether cardiovascular disease (CVD) phenotypes and cardiovascular medications are associated with any fracture as the primary outcome and major osteoporotic fracture (MOF) as a secondary outcome. Nationwide registry-based matched case–control study in Denmark (2013–2021) among people with T2D. Cases were individuals with T2D who sustained an incident fracture (n = 12,390), and controls were fracture-free individuals with T2D matched 1:3 by age, sex, T2D onset date, and weighted Charlson Comorbidity Index (n = 37,170). The exposures were overall CVD, prespecified clinical CVD phenotypes (acute myocardial infarction (AMI), stroke, heart failure, atrial …

Families' Neighborhood Resources Predict Treatment Response For Regulating Together, A Group Therapy For Emotion Dysregulation In Autistic Youth., Walker S. Mckinney Ph.D., Lauren M. Schmitt, Jennifer R. Ruberg, Marika Coffman, Debra Reisinger, Rebecca C. Shaffer

Manuscripts, Articles, Book Chapters and Other Papers

INTRODUCTION: Autistic youth often face difficulties with emotion dysregulation (ED) and associated challenging behaviors. The Regulating Together (RT) group therapy was developed to treat ED in autistic youth ages 8-18 years and has been shown to be feasible, acceptable, and efficacious at reducing ED. Results from other clinical trials suggest the efficacy of behavioral therapies may vary based on family- or neighborhood-level social determinants of health (SDOH: "the conditions in the environments where people are born, live, learn, work, play, worship, and age that affect a wide range of health, functioning, and quality-of-life outcomes and risks"; U.S. Department of Health …

Mtorc2-Nav1.2 Signaling Drives Early Hyperexcitability In Alzheimer’S Disease Mouse Model

Faculty, Staff and Students Publications

Hyperexcitability is a biomarker of early-stage Alzheimer’s Disease (AD) and hastens cognitive decline later in its course. Mechanistic target of rapamycin (mTOR) signaling contributes to the slope of this trajectory, as evidenced by early increased brain expression and the rescue of hyperexcitability by genetic deletion of mTOR complex 2 (mTORC2); however, a molecular mechanism directly linking mTOR signaling to membrane hyperexcitability in early-stage AD remains elusive. Here, we show that hyperactive mTOR signaling stimulates the voltage-gated Na+ channel 1.2 (Nav1.2), a previously identified downstream phosphorylation target of mTORC2 and a key regulator of membrane electrogenesis. Augmented Nav1.2 channel function induced …

Application Of Artificial Intelligence (Ai) In Cancer Symptom Management For Adult Cancer Survivors: A Scoping Review, Tao Wang, Haiying Wang, Mengyuan Li, Daniel Bressington, Daniel Terry, Guanjin Wang, Wai Hang Kwok, Jing Yu (Benjamin) Tan

Research outputs 2022 to 2026

Background and aim: Artificial Intelligence (AI) has been increasingly used in cancer survivorship to support symptom management. This scoping review aimed to map existing evidence on AI applications in cancer symptom management for adult cancer survivors, including AI model development, AI-enabled intervention delivery and adoption, symptom targets, key features of the AI approaches used, reported outcomes, influencing factors, and research gaps to inform future priorities.

Method: This scoping review was conducted in accordance with the Joanna Briggs Institute methodology for scoping reviews. Eight electronic databases were comprehensively searched in November 2025 and updated in March 2026. Empirical studies published in …

When Defense Turns Destructive: Unraveling The Global Rise Of Autoimmune Disease And Sex-Based Disparities, Avery R. Hammersmith

Caroliniana Undergraduate Research Journal

This article examines the evolution of autoimmunity from its early rejection under the theory of "horror autotoxicus" to its current status as a pressing global epidemic. While early 20th-century scientists believed the body possessed inherent safeguards against self-attack, mid-century discoveries of autoantibodies established that the immune system can indeed target healthy tissues, leading to chronic conditions such as systemic lupus erythematosus (SLE) and Hashimoto's thyroiditis. Current data reflect a significant surge in these disorders, with a reported 19.1% increase in incidence and a 12.5% increase in prevalence between 1985 and 2015. Within the United States, the prevalence of antinuclear antibodies, …

Improving Early Recognition Of Patient Deterioration Through Mews Implementation On General Surgery, Colleen Siongco

St. Joseph Hospital, Orange, CA. Evidence Based Practice Conference

No abstract provided.

Implementing Bedside Handoff In The Cvpacu In The Cardiovascular Short Stay Unit, Alyssa Ruud

St. Joseph Hospital, Orange, CA. Evidence Based Practice Conference

No abstract provided.

Reducing Hospital-Acquired Clostridioides Difficile Infections In The Intensive Care Unit, Renae Sybesma

St. Joseph Hospital, Orange, CA. Evidence Based Practice Conference

No abstract provided.

Impact Of Hypertensive Disorders Of Pregnancy Discharge Checklist Education On Nurse Knowledge And Confidence, Angela Maietta, Mph, Bsn, Bs, Rn, Phn, Mches, Ibclc

St. Joseph Hospital, Orange, CA. Evidence Based Practice Conference

No abstract provided.

Enhancing Skin Integrity In Medical Intensive Care Unit Patients, Chelsea Lannoo

St. Joseph Hospital, Orange, CA. Evidence Based Practice Conference

No abstract provided.

Improving Nursing Documentation Compliance For Acute Heart Failure Patients, Amy Nunez, Kassidi Wedemeyer

St. Joseph Hospital, Orange, CA. Evidence Based Practice Conference

No abstract provided.

Improving Outcomes Through Standardized Nurse-Led Diabetes Education For Post-Transplant Diabetes Mellitus In Kidney Transplant Patients, Audrey Federis

St. Joseph Hospital, Orange, CA. Evidence Based Practice Conference

No abstract provided.

Reducing Foley Catheter Reinsertion Through Implementation Of An Evidence Based Postpartum Urinary Retention Algorithm, Nicole Evaro

St. Joseph Hospital, Orange, CA. Evidence Based Practice Conference

No abstract provided.