26419 research outputs found
Sort by
The Treatment of Obesity in the Context of the Obesity Paradox in Patients with Heart Failure: A Narrative Review
No full textPurpose of review
While excess adiposity is a known risk factor for incident heart failure ( HF), once the condition is established, observational data suggest that increased body mass index (BMI) may confer a survival advantage. This paradox has emphasized the underlying roles of cardiorespiratory fitness (CRF), and body composition, particularly lean mass (LM), in influencing clinical outcomes.
Recent findings
In this review, we explore the multifaceted nature of the obesity paradox in HF, with a focus on emerging anti-obesity incretin-mimetic therapies, such as glucagon-like peptide-1 receptor agonists (GLP-1 RAs) and dual GLP-1/glucose-dependent insulinotropic polypeptide (GIP) receptor agonists. These agents have demonstrated remarkable efficacy in weight reduction and favorable cardiovascular profiles in patients with HF with preserved ejection fraction (EF), yet their use in other HF populations, such as HF with reduced EF, raises important clinical questions and the urgent need for future research. Concerns include the potential for LM loss, implications for sarcopenic obesity, and the uncertain impact of weight loss on outcomes in patients who may not benefit from weight loss. We also highlight the need to assess therapeutic outcomes beyond BMI, incorporating measures of CRF, such as peak oxygen consumption (VO₂ peak), quality of life, and functional capacity, using tools such as the 6-minute walk test. Barriers to implementation, including cost, provider hesitation, insurance restrictions, and patient level challenges are also reviewed.
Summary
Finally, we call for future research using contemporary cohorts and advanced phenotyping to reevaluate the obesity paradox in the context of modern pharmacologic interventions. As obesity treatment continues to evolve, a patient-centered, individualized approach that integrates body composition, functional status, and comorbid conditions will be essential in optimizing care for individuals with HF
2026 Jonathan D. Siegel \u2798 Medical Student Research Symposium Agenda and Flyer
No full textInformation and agenda for the 2nd Annual Jonathan D. Siegel \u2798 Medical School Student Research Symposium
Chris Brydge
No full textPublicity photo submitted by author/presenter for ODU\u27s Annual Literary Festival 2025.https://digitalcommons.odu.edu/litfest_images/1016/thumbnail.jp
Stability of Salivary MicroRNA Measures Across an NCAA Division I Football Season: Implications for MicroRNA as a Biomarker of Concussion
No full textBackground
Clinicians often face challenges in concussion care due to a heavy reliance on subjective patient input. Recently, research has sought objective biomarkers, like salivary microRNAs, to improve concussion management. However, significant limitations hinder the use of microRNAs as a diagnostic tool, including the cumulative effects of a contact sport season. A better understanding of the response to a contact sport season would help researchers and clinicians interpret expression changes at the time of injury in the context of seasonal variation. in Therefore, this study investigated the reliability of previously identified salivary microRNA targets across one contact sport season.
Methods
This longitudinal study involved 50 male NCAA Division I football players (21 ± 1.6 years; 187.5 ± 6.9 cm; 103.1 ± 19.8 kg). Saliva was collected before the season\u27s first contact practice and within 72 hours of the season\u27s final game. Quantitative polymerase chain reaction (qPCR) experiments were conducted using pre-selected microRNA targets. Non-parametric tests compared expressions between time points (α ≤ 0.05).
Results
No significant differences were found between pre- and post-season miRNA (p = .07-.46). However, intraclass correlation coefficients revealed low to moderate reliability across the season (ICC = -.04-.65).
Conclusions
Our study found no significant differences in time points for target microRNA, but ICC statistics indicated low reliability across the season. These findings suggest that microRNA expression may be variable throughout the season regardless of concussive trauma, and clinicians should be aware that changes in microRNA expression should not be directly attributed to concussive forces. Researchers and clinicians should not rely on the presented set of microRNA to make clinical decisions for potential concussive injuries
Optimizing Maintenance Routes for Highway Infrastructure Using Leader-Follower Autonomous Vehicles
No full textThe Autonomous Truck Mounted Attenuator (ATMA), a leader–follower style connected and automated vehicle system, enhances safety during transportation infrastructure maintenance in work zones. However, the significantly lower speed of ATMA, compared to regular vehicles, causes moving bottlenecks that reduce roadway capacity and prolong queuing, leading to further delays. Different ATMA routes lead to varying patterns of time-dependent capacity drop, affecting the user equilibrium traffic assignment and resulting in differing system costs. This study aims to optimize ATMA routing within a network to minimize the system cost associated with its slow-moving operation. To this end, a queuing-based traffic assignment approach is proposed to quantify the system cost incurred by ATMA on a given route. A queuing-based time-dependent (QBTD) travel time function is introduced to incorporate capacity drop into the static user equilibrium traffic assignment problem (TAP), thereby introducing dynamic characteristics. A modified path-based algorithm is developed to solve the resulting queuing-based TAP. The method is validated on both small and large networks and compared against two benchmark models to assess the benefits of capacity drop modeling and the QBTD travel time function. It is further applied to evaluate the impact of different routes on the network and to identify an optimal ATMA route during maintenance operations. Finally, the sensitivity analysis explores the effects of varying traffic demand and capacity reduction
Health Literacy/Numeracy-Related Factors Affecting Interpretation in Medical Laboratory Values
No full textBackground
Health literacy and numeracy are broad terms that relate to a patient’s understanding of their health information. While there is a substantial amount of research on this topic in a general sense as well as in relation to how deficiencies in these skills impact patients’ understanding of laboratory results, little is known regarding the extent to which underlying factors, which are impacted by health literacy/numeracy, affect how patients interpret their results. This literature review attempts to shed light on the current literature on this more focused and narrow issue, including recommendations to address these barriers.
Content
To perform this review, the key terms “health literacy AND numeracy,” “health literacy AND laboratory results,” and “patient understanding of laboratory test results” were searched in the PubMed Central, Health Source: Nursing/Academic Edition, and Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases. After reviewing articles for inclusion and exclusion criteria, a total of 16 articles were included. Major themes from the articles utilized were (a) the impact of the laboratory, (b) factors that affect health literacy and numeracy of laboratory data, and (c) recommendations to improve patient understanding and comprehension of their test results.
Summary
Many factors affect patients’ comprehension of laboratory data, such as access to this information, data presentation, and holistic influences. Recommendations for improving patient health numeracy of laboratory information are to improve how data is presented to patients and to increase access to supplemental resources via patient portals
Endothelin-1 in the Failing Fontan: Pathobiology, Precision Therapeutics, and Future Trial Design
No full textThe Fontan circulation, devised as definitive palliation for single-ventricle congenital heart disease, imposes systemic venous hypertension, loss of pulmonary arterial pulsatility, and restricted preload reserve. These hemodynamic trade-offs progressively injure the pulmonary vasculature, liver, and lymphatic system, producing late morbidities including elevated pulmonary vascular resistance, Fontan-associated liver disease (FALD), protein-losing enteropathy, and arrhythmias. Endothelin-1 (ET-1), a potent vasoconstrictor and profibrotic mediator, plausibly unifies these complications. Mechanistic studies demonstrate ET-1 upregulation in failed Fontan lungs, activating PLC–Ca²⁺, RhoA/ROCK, and MAPK/ERK cascades to drive vasoconstriction and remodeling. In cirrhotic livers, ET-1 localizes to stellate cells, promoting contraction and fibrogenesis, mechanisms biologically relevant to congestive FALD. Clinical cohorts consistently show elevated ET-1 correlating with hospitalization, exercise intolerance, and arrhythmias. Trials of endothelin-receptor antagonists (bosentan, ambrisentan, macitentan) demonstrate reassuring safety and suggest benefit when outcomes emphasize ventilatory efficiency or hepatic endpoints rather than peak oxygen consumption, which is physiologically constrained in Fontan physiology. Given the mixed results of existing trials, a framework is outlined that stratifies Fontan patients into pulmonary-inefficiency, congestive-hepatic, lymphatic, and arrhythmia-dominant phenotypes, using co-primary endpoints such as VE/VCO₂ slope, elastography, and biomarker panels. By linking ET-1 biology to pragmatic trial design, this approach emphasizes targeted strategies that may stabilize the circulation, extend transplant candidacy, and improve long-term outcomes
